The Adventures of Huckleberry Finn Essay Essay Example for Free

The Adventures of huckabackleberry Finn Essay EssaySociety is like the bully in middle school. It is harsh, it takes money, and it tries to conform sight. In life, everyone needs some(a) type of protector. A protector can be a fri nullify, a parent, an uncle, a religious judge, or even a teacher. A protector looks unwrap for others and leads people in the secure direction. In Adventures Of huckabackleberry Finn by Mark Twain, Jim is the protector of Huck. The lessons that Huck learns through his journey shows the reader that not all color people are what society claims they are. Along Hucks adventure, Jim lends his guidance and support to Huck, through his actions and advice, which helps mature Huck as an individual. Jims actions, specifically his finis to circumstances his family life with Huck, allow Huck to mature. Pap, Hucks father, never was quite a father figure to Huck. He frequently beats Huck and doesnt respect the fact that Huck is educated. When Huck runs away from home and meets Jim, it is the initial time in his life where he has someone actually care slightly him.Although the two are not friends before they flee, they form a special bond throughout their adventures and Jim becomes a fatherly figure to Huck. He is the father that Huck never had. It doesnt take long for Jim to unsex an impact on Huck. Shortly into their journey, Huck and Jim find a washed out house that has floated bring down the river past the island. When the two enter, they find the body of a man. Jim goes up to the man who has been guesswork in the back and says to Huck, Its a deadman. Yes,indeedy naked,as well. Hes been shot in de back. I reckn hes ben dead two er three days.Come in, Huck, but doan look at his face- its too gashly. ( Twain 38) Towards the end of the novel, the reader finds out that the dead man inside the house was in fact Hucks dad. Jim recognized Pap in the house and he made sure that Huck didnt see the naked body of his dead father. Even th ough Huck never had a good relationship with Pap, the sight of his fathers dead body with a bullet hole in his back is one that he does not want to see, particularly since he is still a young kid. Jims decision was crucial in the development of Huck in the novel.Later on their journey slice on the raft Jim mentions his family and how he was separated from them. He says that the introductory thing he will do when he gets freedom is save up plenty money to buy his wife and children back from their owners. He doesnt think twice before starting the topic and his words catch Huck by surprise. Hucks conscience begins to stir, trying to lead him in the rightfulness direction. He starts to have a conversation with his own conscience and says, Let up on me-it aint too late, yet-Ill paddle ashore at the first light and tell(Twain 67).He contemplates whether to reveal Jims true identity or not and ultimately decided to let Jim have his freedom. The impact of this decision is seen where Ji m says, Huck yous de bes fren Jims ever had en yous de only fren ole Jims got now (Twain 67). He goes on to say, Dah you goes, de ole tru Huck de ony white gentleman dat ever kep his promise to ole Jim (Twain 67). Jim makes it legislate that Huck is the first white man to ever treat him with respect. Huck knows the trust that Jim instills in him right when Jim starts the conversation.Hucks decision to not tell roughly Jim, shows that going away against the flow of things is not a bad thing and that a person can think for himself or herself. There is no need for anyone or anything to make choices for someone else. Jims response to Hucks actions solidifies the strength of their relationship and Huck ultimately wins the battle between what he knows is right and what society thinks is right. Jims guidance and support along the journey creates a friendship that appears almost unbreakable.Throughout the entire novel, Huck has an internal struggle deciding whether to follow the engrave of society and turn Jim in or to follow what he knows is right and to let Jim be a free man. He decides to write a garner that roots from his childhood teachings and societies belief that blacks are not equal to whites. The more I studied about this, the more my conscience went to grinding me, and the more iniquitous and low-down and ornery I got to feeling (Twain 160).. He writes the letter and to his surprise he feels relieved.Huck says, I felt good and all washed and sporting of sin for the first time I had ever felt so in my life, and I knowed I could pray now (Twain 161). Although Huck feels great right after he finishes the letter, he begins to think about what he is about to do. As he sits with the letter, he thinks about all of the experiences and memories that he and Jim have had together. He thinks of all the support, knowledge, and lessons that Jim has taught him. He thinks of all the laughs they shared, the talks they had, and the songs they sung.He thinks of all the positives of their relationship, but he cannot think of any negatives about Jim. He realizes that he has the power to interpolate a life and has the ability make a difference . The reader knows that Jim has succeeded in his goal to make Huck anti-racist when Huck tears up the letter that he has written to Miss Watson. Right before he tears it up he says, All right then, Ill go to hell. (Twain 162) This is the one of the first scenes where the reader sees Huck make a conscience decision by himself. He weighs the positives and negatives and ultimately chooses what he believes is morally correct.Huck would preferably go to hell doing what he knows is right, than to conform to society and hurt the ones that mean the most to him. Hucks ability to make a conscience decision is a sign of majority and he reached this level of majority through the guidance of his dear friend Jim. Jim is a natural father like figure throughout the whole story. non only to Huck along their journey but to To m at the end of the story. Jims sacrifice at the end of the novel is one of the bravest sacrifices made throughout the book. After Tom gets shot in the leg, Jim displays concern for the him.He says, No, sah-I doan budge a step outn dis place dout a doctor not if its forty year (Twain 207) Despite all of the racism and harsh tricks that Tom has played on Jim, Jim risks his life to save his friend. Not knowing that he is truly free, Jim risks his own freedom to save Toms life. This decision has a huge impact on Huck. When Jim sacrifices himself knowing the extent of the situation, Huck makes a huge step in his character development. He learns that all men, including blacks, are equal. Throughout the novel Huck struggles with this concept.This is the first time where Huck sees Jim as an equal human being rather than just a ni****. Huck thinks to himself, I knowed he was white inside(Twain 207). This mention shows the progress that Huck has made. He has matured to someone who can thin k on their own and who can see the flaws in society. By thinking this, it is clear to the reader that he views whites and blacks as equal. Jim risked his freedom to save an immature, racist white boy who had treated him, not as an equal, but as an inferior, unequal black person, and that is the ultimate sacrifice that teaches Huck a valuable life lesson.Along Hucks adventure, Jim lends his guidance and support to Huck, through his actions and advice, which helps mature Huck as an individual. Guidance is a key to success in life. One must have someone or something to show them the ropes of the world. In the case of Huckleberry Finn, shows Huck right from wrong. Each adventure contains some type of life lesson. From the first time that Jim and Huck meet up with each other, to the time where Huck writes the letter about Jim, and to the end of the novel where Tom is racist towards Jim, Jim is always there for Huck. He is Hucks protector.

School Choice Initiative Essay Example for Free

School Choice Initiative EssayPerceivably, the verbal communication in the give instruction selection initiative is considerably astounding as that of any glitch any fairy tale might have played to offer the cut through to their remorseful providence. Many critics have deliberately emphasized that the real intent of Proposition 174 revolves around the connotation that All parents are hereby empowered to require any domesticate, general or private, for the education of their children . . . concisely, that is not exactly how many tend to see the light of the thought.Although it may seemingly utter as that which is piously beneficial and helpful to the contemporary masses parents of a child in an inner-city institution, it is like giving the students a somewhat subliminal way of saying a that any shall get the passes towards the prestigious institutions as that where most popular icons earned their degree in college. In such case, the choice will not be dependent on the lea rner (child) not the parents. Private schools shall be given the prowess to decide upon who shall be admitted or not hence public school children shall then be given the same chance (Nevins, 2001). It would bring up a tight and healthy competition thus commencing a challenge to public school system towards the aim for academic excellence. The state shall save 2% transfer rate from public schools since that education in private schools are efficient hence allotting more on the appropriation for several improvements such as parks, school libraries and other sort of the like. It shall offer families a genuine alternative to all levels of the society, the vouchers will give all the chance to get a glimpse of standard education. The school will get to choose those who are to be admitted in the school, with this, the students shall be challenged to earn good grades in high school to earn the reward. It will give rise to quality education not only for a limited few, but for all. Refere nces Nevins, J. (2001). Searching for security Boundary and immigration enforcement in an age of intensifying globalization Electronic Version, 28, 132. Retrieved September 4, 2007.

Effect of Child Rearing Styles on Pro-Social Development

Effect of Child Rearing Styles on Pro-Social DevelopmentPROSOCIAL growth 1COMPARISON OF CHILD-REARING STYLES AND THE EFFECTS THEREOF ON PROSOCIAL DEVELOPMENTThere be many factors that play a role in the growth of prosocial behaviour in children. The two participants that I used are both mothers of 3 year old children. One of them is a stay at home mamma with one child (a girl), and the other is a single mom, working full time, with two children (both boys), one of whom is autistic (the oldest child).An Authoritative parenting style is generally considered the most booming parenting style, and is associated with the training of prosocial behaviours. Research participant 1 scored higher than Research participant 2 on the Authoritative and Authoritarian scale, however, the child of Research Participant 2 scored higher on the prosocial scale. This difference could be due to several other factors, besides the parenting styles, including family situation and context.The child of Res earch participant 2 is the youngest of two boys, the senior(a) of which has severe autism. Due to the fact that his brother is ill, this little boy has learnt from an early age to care for others. He is very caring of his older brother, and helps his mother with him a lot. This has taught him to be caring towards others, and to consider their needs, as well as his own. This has flowed over into his interactions with other children and people he meets / socialises with.Parenting styles play in important role in the development of prosocial behaviour in children, and even though the child of Research participant 1 scored lower than the child of Research participant 2 on the prosocial scale, she is still a caring and loving little girl, who displays prosocial behaviour. There are however, many other factors that bewitch these behaviours in children.PART BINTRODUCTIONBecause of the vastness of the consequences of aggression, criminality and immorality for society, not much importance was placed on prosocial development prior to 1970. Eisenberg and Fabes (1998) check prosocial behaviour as voluntary behaviour think to benefit another. Prosocial acts include sharing, helping others and comforting others. There are many reasons why people act prosocially, but the subgroup of prosocial behaviours labelled as self-sacrifice is considered to be very important. Eisenberg Mussen (1989) define altruism as being intrinsically motivated, voluntary behaviour intended to benefit another acts motivated by inside motives such as concern for others, or by internalised values, goals and self-reward or the avoidance of punishment. However, because it is difficult to determine whether altruism or a less dread motivation drives the behaviour, a broader focus needs to be taken.CULTURAL FACTORSIt is evident from various research that environment plays a big role in the development of prosocial behaviour, and research on the cultural bases of prosocial responding provides insig ht into the role of the environment in the development of prosocial behaviour (Eisenberg Fabes, 1998). Anthropological literature and Psychological studies in non-Western cultures clearly orient that societies vary greatly in the degree to which prosocial and cooperative behaviours are normative (Mead, 1935). These studies show that some cultures value prosocial behaviours while there are some cultures in which prosocial behaviour is rare and hostility and cruelty is the norm. It is difficult to make cross-cultural comparisons as there seems to be differences across cultures with respect to the degree to which children display prosocial behaviour.THE FAMILYanother(prenominal) influence in the development of prosocial behaviour in children is their parents. Children model their parents behaviour, so if the parents tend to display prosocial behaviour, the children will develop prosocial behaviour. Parental practices, beliefs, characteristics and emotional atmosphere at home plays a role in the development of prosocial behaviour. Staub (1992) found that prosocial behavioural development is enhanced by a connection to others, exposure to parental warmth, mature guidance and childrens participation in prosocial activites.In their ponder on the relationship between parenting styles, parental practices, sympathy on prosocial behaviours in adolescents, Gustavo et al. (2007) found beardown(prenominal) evidence that parenting practices were closely related to prosocial behaviour. They did find however, that the associations occurred mostly through the indirect relations with sympathy.Dunsmore et al. (2009) conducted a study to determine whether a mothers expressive style and special(prenominal) emotional responses to their childrens behaviour is linked to their childrens prosocial ratings. The results of their study show that the mothers positive and negative expressiveness is related to the childs lower prosocial self-rating, and the mothers happiness about(pred icate) the childs prosocial behaviour is associated with the childs higher self-ratings for prosocial self-rating.CHILDS INDIVIDUAL CHARACTERISTICSEisenberg and Fabes (1998) believe that social cognition and prosocial behaviour should at least be modestly correlated, and this has been shown to be true in studies, as prosocial children are more sociable, well regulated, low impulsivity and are not shy or anxious. Prosocial children are besides able to communicate and resolve their own needs, feel guilt and remorse about wrongdoing, exercise self-control when tempted to do wrong, and feel compassion for others (Hoffman, 1970 Mischel, Shoda, and Rodriguez, 1989).Eisenberg and Fabes (1998) overly believe that emotion plays a vital role in the development of prosocial values, motives and behaviours, with empathy-related emotions playing a larger role. There are various definitions of empathy, but Eisenberg and Fabes (1998) define empathy as an affective response that stems from the app rehension / comprehension of anothers emotional state / condition, and that it is identical / very similar to what the other person is shade / would be expected to feel.Many theorists argue that some or all humans are born with an innate ability to feel / show altruistic behaviour, thereby being biologically predisposed to experience empathy and develop prosocial behaviour, including smaller children.Many twin studies have been done to determine whether prosocial tendencies are inherited. Matthews et al. (1986) and Rushton et al. (1986) believed that if the correlation is higher for identical twins than for fraternal twins, then the difference can be attributed to heritability / genetics. Their study involved self-reported data from adults, and they found that 50% of the variance in the twins empathy, altruism and nurturance was accounted for by genetic factors. The other 50% difference was accounted for by differences in the twins environment.There are also studies that have bee n done on the neurophysiological underpinnings of prosocial behaviour. Panskepp (1986) believes that the nurturant dictates of brain strategys that mediate social bonding and maternal care is what leads to mammalian helping behaviour. Maclean (1985) believes that the limbic system is responsible for maternal behaviour, affiliation and play, which in turn forms the basis for altruism.During the second year the prefrontal functions increase, which enables the child to identify which feelings are his / hers or which feelings belong to soulfulness else. Researchers propose that (based on Kellers 2007 model of culturally informed development pathways), depending on the socio-cultural context, toddlers may follow different pathways to the same development outcome, for example, prosocial development.In their study using longitudinal genetic analysis, Knafo Plomin (2006) found that genetics account for change and continuity in prosocial behaviour. Clark Ladd (2000) found that prosocial children are relatively well-adjusted and have better peer relationships than children low in prosocial behaviour.CONCLUSIONProsocial development in children is a complex multidimensional issue. Many factors play a role in the development of prosocial behaviours, and emphasis should not be placed on a single factor to the exclusion of others. Culture, family and genetics are but some of the factors or environments that influence the development of empathy, which in turn aids in the development of prosocial behaviour. All these factors should be considered together when determining what plays a role in prosocial development.

Reflective Summary On Prescribing Practice Learning Nursing Essay

Reflective Summary On Prescribing Practice Learning nursing EssayThe author, a nurse practician based in an compulsion Department (ED), from here on in will be referred to as the practician. The practitioner is currently employed in a development role with the view, pursuance training, of becoming an acute c atomic number 18 practitioner. This will entail working autonomously taking accurate clinical histories, physical examination, gain differential and working diagnosis and conjure a plan of c atomic number 18. This plan of care could well include a number of prescribed medications. Hence it is in the practitioners job description (as it is increasingly in m whatever specialist/autonomous nursing roles) to become a prevail Inde pendent and Supplementary Prescriber (NISP).The Cumberlege Report (1986) suggested that nurses should be able to prescribe independently and highlighted that enduring care could be repaird and resources utilize more effectively by doing so. It ide ntified that nurses were wasting their time requesting prescriptions from Doctors. Since the publication of this seminal piece of work, non-medical prescribing has been analysed, reflected upon, researched at bully lengths and changes in give made (DoH 1989, 1999, 2006 2008 Luker et al 1994 Latter et al 2011) and is still under constant review.The aim of this portfolio is toReflect on practice as a means of on-going personal and professional development.Demonstrate a capability of integrating learning into practice.Submit a range of material mapped against the module learning outcomes, NMC 2006 prescribing standards, domains of practice and core competencies.Establish an evidence-based approach to practice competence as a safe independent supplementary prescriber.This prescribing practice portfolio will be a pondering portfolio using Rolfe et al (2001) model of reflection to aid learning from experience and close the gap between theory and practice. This model has been chosen a s it is something the practitioner is familiar with and has used originally.The portfolio will conclude with a reflective summary on prescribing practice learning which will draw together the evidence used to support achievement of the competences identified. afterward discussing with colleagues who have already stainless the NISP course, the practitioner is aware of the complex nature and volume of work that is required over the age of it. There is a intuitive feeling of nervousness due to this but also a feeling excitement over what will be learnt. If successful the practitioner believes her practice will be enhanced signifi provoketly as she will have the ability to give patients seamless care.ReferencesDepartment of Health. (1986) Neighbourhood Nursing A Focus for Care. (Cumberlege Report). London HMSODepartment of Health. (1989) Report of the Advisory Group on Nurse Prescribing. The tiptop Report). London HMSODepartment of Health. (1999) Review Of Prescribing, Supply And Ad ministration Of Medicines. (The Crown Report Two) London HMSO.Department of Health. (2006) Medicines Matters. London HMSODepartment of Health. (2008) Making Connections Using Healthcare Professionals to Deliver Organisational Improvements. London HMSOLatter, S. Blenkinsopp, A. Smith, A. Chapman, S. Tinelli, M. Gerard, K. Little, P. Celino, N. Granby, T. Nicholls, P. Dorer, G. (2011) Evaluation of nurse and pharmacist independent prescribing. susceptibility of Health Sciences, University of Southampton School of Pharmacy, Keele University on behalf of Department of Health On strain procurable at http//eprints.soton.ac.uk/184777/ Accessed 15th Sept 2012Luker, K. Austin, L. Hogg, C. Ferguson, B. Smith, K. (1998) Nurse-Patient Relationships The context of Nurse Prescribing. daybook of Advanced Nursing. (28) 2 235-242Rolfe, G. Freshwater, D. Jasper, M. (2001) lively Reflection in Nursing and the Helping Professions a Users melt. Basingstoke Palgrave Macmillan. quotationHolistic Asse ssment Case StudyIn this case study the hearing, diagnosis, prescribing options and ratiocinations of a 35 year old female seen in the ED will be discussed. This case study will aim to improve the practitioners knowledge of conducting a cite and its relationship with making a diagnosis and discourse options. To maintain confidentiality, in line with the code of professional conduct, the patient will be referred to as Mrs A (Nursing and obstetrics Council (NMC), 2008).ConsultationExamining the holistic needs of the patient is the first of seven principles of good prescribing ( subject Prescribing Centre (NPC), 1999) and must be undertaken before making a decision to prescribe (NMC Practice meter 3, 2006). Holistic assessment takes into consideration the mind, body and spirit of the patient (Jarvis, 2008). traditionally consultation and making a diagnosis has been completed by Doctors. However, nurse diagnosis would appear to have been formally acknowledged since The Crown Two Re port (DoH, 1999) as part of the independent prescriber role. Horrocks et al, (2002), found great patient satisfaction with nurse consultations than with GP consultations. Jennings et al, (2009) and Wilson Shifaza, (2008) also found this to be true of nurse practitioners working in emergency departments. Importantly, they also found no signifi erectt variation in other health outcomes. Most of these studies found that consultations with nurses were to some extent longer, they offered more advice on self-care and self-management and that nurses gave more discipline to patients.Although there are various consultation models that have been described (Byrne Long, 1976 Pendleton et al, 1984 Neighbour, 2005 Kurtz et al, 2003 Stott Davis, 1979), these are based upon observation of doctor, not nurse consultations. Nevertheless, the consultation models and skills described in the medical literature are relevant to all practitioners (Baird, 2004). Consultation models help the practitioner centre the consultation around successful information exchange and try to provide a a priori structure. Consultation models can also be used to help make maximum use of the time available at each consultation (Simon, 2009). Traditionally the medical model is used to assess patients however it does not take into account the social, psychological, and other external factors of the patient. The model also overlooks that the diagnosis (that will assume treatment of the patient) is a result of negotiation between doctor and patient (Frankel et al, 2003)In this case study, the practitioner has used Roger Neighbours model of consultation. This was found by the practitioner to be simple and easy to remember, whilst covering all areas needed to make an effective consultation and assessment. He describes a 5 stage model which he refers to as a journey with equalisepoints along the wayConnecting establishing a relationship and rapport with the patient.Summarising taking a narrative from the patient including their ideas, expectations, concerns and summarising back to the patient to plug there are no misunderstandings.Handing over negotiating between the practitioners and patients agenda and agreeing on a management plan.Safety netting the consideration of what if? and what the practitioner might do in each case.Housekeeping reflecting on the consultation.(Neighbour, 2005)ConnectingMrs A was called through to the Rapid Assessment and Treatment area in the ED. It was apparent from Mrs As facial recipe and limp that walking caused her vexation. Silverman Kinnersley, (2010) state that non-verbal communication is extremely strategic and can often provide clues to underlying concerns or emotions. The practitioner had never met the patient before so had no previous relationship with her but was aware that she may have pre-conceived ideas about the ED which may have caused her anxiety. The practitioner introduced herself to Mrs A, explained her job role, the mar ch that was about to be undertook and consent obtained. During this time eye contact was maintained and the practitioner also asked Mrs A how she would like to be addressed. This was done to try and work up a rapport with Mrs A, to help her feel at ease and reassure her. Simon, (2009) and Moulton, (2007) agree and state that rapport is essential to effective communication and consultation. Mrs A was also offered a trolley to sit on to make herself comfortable and the curtains pulled around for privacy and dignity. On reflection the practitioner was aware that the environment was a busy and noisy assessment area and this can have a negative impact on the consultation (Silverman et al, 2005). Identifying this with Mrs A and apologising may have re-assured her gain and gained trust and respect.SummarisingThe practitioner began with an open ended question and did not interrupt the patients response. Neighbour, (2005) and Moulton, (2007) advise this to open the consultation. Gask Ushe rwood, (2002) found that if a practitioner interrupts, patients then rarely break up new information, which could lead to not alineing out the real reason for the consultation.Mrs A revealed that she received an insect bite to her right lower leg 5 days ago, since then the surrounding skin had become swollen, increasingly red, painful and hot to touch. She explained that the redness was spreading up her leg and the pain was getting worse. Mrs A explained that she was concerned that it was not going to get better and was very worried that it had got worse during the last 3 days. Upon questioning Mrs A also complained of malaise and that she had been feeling very hot and cold and at times. She had been managing to eat and drink as normal. Mrs A lived with her husband, was a non smoker and drank alcohol occasionally. She had no past medical history and took no prescribed or over the counter (otc) medications. It was also elicited that she was allergic to Penicillin which she had an a naphylaxis reaction to. Taking a medical, social, medication and allergy history is authoritative as it can be relevant to the presenting complaint, makes sure key information has not been overlooked and is essential in stay freshing prescribing errors (Bickley, 2008 Young et al, 2009).The practitioner actively listened to what Mrs A was saying by maintaining eye contact, using open questions and by summarising the history back to clarify points and to make sure nothing was missed. On reflection the practitioner feels this also gave the opportunity for Mrs A to add whatsoever further information not disclosed so far. Closed questions were then used to gain circumstantial information related to the initial information given, this is advised by Young et al, (2009) and Moulton, (2007). Effective communication is important as Epstein et al, (2008) explains that a precise history can supply at least 80% of the information necessary for a diagnosis.Upon examination there was obvious er ythema. Light palpation revealed that the area was very firm and tender. Neurovascular assessment was performed and was unremarkable. Mrs As chest was clear, heart sounds normal and her abdomen was soft, non tender. physiological examination is important as it is used to detect physical signs that the patient may not be aware of and can be used to confirm or disprove a possible diagnosis. It also suggests to the patient that their illness is organism taken seriously. (Bickley, 2008, Charlton, 2006). Observations were taken including decline pressure, heart rate, temperature, respiratory rate and oxygen saturations. All were within normal parameters except her temperature which was 38.2 degrees Celsius. Venous blood was taken to check haematological, biochemical and coagulation status. Mrs A white cell count (WCC) and C-reactive protein (CRP) levels were raised, all other blood results were normal.Handing OverBefore making a final diagnosis, it is important that differential diagn oses are excluded (Nazarko, 2012). The practitioners differential diagnoses were deep vein thrombosis (DVT) or venous eczema. However, Mrs A had a straightforward history (insect bite) that together with her observations (raised temperature), examination findings (redness, heat, swelling and pain) and blood results (raised WCC and CRP) indicated an alternative diagnosis, so DVT and venous eczema were ruled out.The practitioners working diagnosis was cellulitis. This was discussed with Mrs A and she appeared reassured that a diagnosis had been made. The practitioner explained that she would like to discuss this with a major(postnominal) Doctor to help decide on a treatment plan. The practitioner presented the patient to an ED Registrar who agreed with the diagnosis. Diagnosis, treatment and prescribing options were then discussed to aid the practitioners learning.Cellulitis is a bacterial infection of the skin and subcutaneous tissue which is potentially serious (Epstein et al, 2008 ). It is caused by one or more types of bacteria, near commonly streptococci and staphylococci aureus (Nazarko, 2012). Cellulitis usually occurs on the lower legs, arms and face but can arise anywhere on the body (Bickley, 2008). Patients with cellulitis present with signs of inflammation, distinctively heat, redness, swelling and pain (Nazarko, 2012). Inflammation is localised initially but increases as the infection progresses. Patients can be constitutionically unwell (pyrexial, tachycardic, hypotensive) and white cell count and C-reactive protein levels will be markedly raised (Beldon, 2011, Wingfield, 2009, Nazarko, 2012).It appears there is a general lack of evidence based literature surrounding the treatment of patients with cellulitis. The practitioner could only find one internal guideline on the management of cellulitis in adults, which was published in 2005 by the clinical Resource Efficiency Support Team (CREST, 2005). However, to the practitioners knowledge, these ha ve not been formalize by a clinical study. Morris, (2008) found in his systematic review that antibiotics cure 50-100% of cases of cellulitis but did not find out which antibiotic regime was most successful. Kilburn et al, (2010) also could not find any definitive conclusions in their Cochrane review on the best antibiotics, duration or route of garbage disposal.Eron, (2000) devised a classification system for cellulitis and its treatment which CREST used in their guidelines. This system divides people with cellulitis into four classes and can serve as a useful guide to admission and treatment decisions. However Koerner Johnson, (2011) found in their retrospective study, comparing the treatment received with the CREST guidelines, that patients at the mildest end of the spectrum were over treated and at the more stern end undertreated. They also found a significant variation in antibiotic regimes prescribed for patients with cellulitis. Marwick et al, (2011) questioned whether c lasses I and II could actually be merged to improve treatment.The practitioners trust has antibiotic guidelines (updated yearly) which also include a classification system. This aids the prescriber in choosing the correct antibiotic, dose, route and duration for certain conditions, cellulitis being one of them. After discussion with the Registrar it was determined that Mrs A was in Class I or non- desolate which meant she could be managed with oral antibiotics on an outpatient basis.The practitioners trust and CREST, (2005) guidelines advise first line treatment for non-severe or class I cellulitis as oral Flucloxacillin 500mg, three times a day. Flucloxacillin is a moderately narrow-spectrum antibiotic licensed for the treatment of cellulitis. However, Flucloxacillin was contra-indicated for Mrs A as she had a severe penicillin allergy (British National Formulary, (BNF) 2012).Clarithromycin is a macrolide which has an antibacterial spectrum that is similar but not identical to that of penicillin they are thus an alternative in penicillin-allergic patients (BNF, 2012). Clarithromycin is licensed and recommended by CREST, (2005), and by the practitioners trust, as an alternative to Flucloxacillin in cellulitis for patients with a Penicillin allergy. It is indicated in the BNF, (2012) for the treatment of mild to moderate skin and soft-tissue infections. It demonstrates suitable pharmacokinetics, with good statistical distribution into skin and soft tissues, and is effective against the large majority of staphylococcal and streptococcal bacteria that cause cellulitis (Accord Healthcare Limited, 2012), (See drug monologue page 21-28). There were no contraindications in prescribing Clarithromycin for Mrs A.The option of not having any medication was discussed with Mrs A however, she wanted treatment so the benefits and side effects of Clarithromycin was explained, and consent obtained from Mrs A to prescribe the antibiotics and to be discharged, (NMC Practice bea t 5, 2006). Dose and duration were then also clarified and the importance of taking the antibiotics as prescribed and to complete the full course. On reflection, by discussing and deciding on the best treatment together this would hopefully promote concordance. Negotiating with patients and agreeing on a management plan is very important aspect of ambit patient centred care (Neighbour, 2005). Using an FP10 Clarithromycin tablets 500mg twice a day was prescribed by the Registrar (as the practitioner was not a licensed prescriber, NMC Practice Standard 1, 2006), as per trust guidelines, for 7 days. Paracetamol tablets 1g four times a day was also prescribed for its analgesic and anti-pyretic properties (BNF, 2012). A stat dose of both were prescribed and the practitioner asked the nurse to administer the first dose (NMC Practice Standard 9 14, 2006), and was aware that by delegating this task the prescriber remained accountable. The FP10 was given to the patient to take to the phar macy of her choice for them to dispense (NMC Practice Standard 10, 2006), (See mock prescription page 29).The practitioner did not initially contemplate cost effectiveness but on reflection it has been recognised that this needs to be taken into consideration when prescribing (NPC, 1999). Intravenous antibiotics may have been prescribed, which may have meant an admission into hospital or administration by nurses on an outpatient basis thus would have increased the cost of treatment significantly. Admission to hospital can also be overwhelming and can put the patient at happeniness of hospital acquired infections and increased risk of antibiotic resistance (Wingfield, 2008).Safety NettingThe erythematous border was marked, with the patients consent, with permanent pen to monitor for any improvement or additional spread of infection (CREST, 2005, Beldon, 2011). The practitioner advised Mrs A that she should return or see her GP if she had decline symptoms or if by the completion of the course of antibiotics symptoms had failed to resolve. Mrs A was also advised that, if a similar incident occurred, she should seek medical assistance early so that treatment could begin as soon as possible to reduce the risk of severe and long-term complications. In addition it was recommended that she should drink plenty of fluids to prevent dehydration, elevate the leg for comfort and to help reduce the swelling (CREST, 2005, Beldon, 2011). Mrs A was warned that there could be an increase in erythema in the first 24-48 hours of treatment (CREST, 2005). This advice and information empowered Mrs A and made sure that her discharge was as safe as possible.The practitioner brought the consultation to a close by asking Mrs A if she had any questions or if there was anything else she would like to discuss. This gave Mrs A the opportunity of clarifying any information given by the practitioner and the opportunity to divulge any information or concerns not previously mentioned. This r e-assured the practitioner that she had addressed her problem appropriately.HousekeepingThe practitioner made sure there was clear concise reinforcement of the consultation and choice of prescription in Mrs A notes (NMC Practice Standard 7, 2006). A discharge letter was also produced to send to her GP NMC Practice Standard 6, 2006). Once the prescription was ready, Mrs A was discharged.This case study has shown the practitioner the importance of effective communication in consultation. By following Neighbours consultation checkpoints it gave structure to the consultation and will be used by the practitioner in future practice. It has also helped the practitioner to gain an understanding of different prescribing options and how to explore these further. For example, the practitioner did find when reading around the subject that there has been some research on the use of corticosteroids in cellulitis to increase resolution, however, to the practitioners knowledge, this is not current ly advised in any guidelines and further research is needed. The practitioner would also like to be involved in the development of a cellulitis pathway at her place of work. This could include an algorithmic program to aid practitioners to differential diagnosis so patients can receive appropriate treatment and reduce the incorrect prescribing of antibiotics.As there are no National Institute for Health and Clinical Excellence (NICE) guidelines on the treatment and management of cellulitis, treatment of patients is not standardised and consequently quality of care could be affected. The optimal choice for antimicrobial therapy requires review and definitive study in clinical trials.ReferencesAccord Healthcare Limited (2012) Summary of Product Characteristics for Clarithromycin Capsules 500mg. online. Electronic Medicines Compendium. Datapharm Communications Ltd. Available from http//www.medicines.org.uk/EMC/medicine/25914/SPC/Clarithromycin+500mg+Tablets/ Accessed 21ST September 201 2Byrne, P. Long, B. (1976) Doctors Talking to Patients. London, HMSO.Baird, A. (2004) The Consultation. Nurse Prescriber. (1) 3 1-4British National Formulary No. 64 (2012) London BMJ Group and Pharmaceutical Press.Bickley, L. (2008) Bates Guide to Physical Examination and History Taking. 6th Ed. London Lippincott, Williams and Wilkins.Beldon, P. (2011) The Assessment, Diagnosis and Treatment of Cellulitis. Wound Essentials. (6) 60-68.Clinical Research Efficiency Support Team (2005) Guidelines on the counsel of Cellulitis in Adults. Belfast Clinical Research Efficiency Support Team.Charlton, R. (2006) Learning to Consult. Abingdon Radcliffe.Department of Health (1999) Review Of Prescribing, Supply And Administration Of Medicines. (The Crown Report) London HMSO.Epstein, O. Perkin, G. Cookson, J. De Bono, D. (2008) Clinical Examination. 4th Ed. London Mosby.Eron, L. (2000) Infections of undress and balmy interweaves Outcome of A Classification Scheme. Clinical Infectious Diseases. (31) 287Frankel, R. Quill, T. McDaniel, S. (2003) The Biopsychosocial Approach Past, Present, and Future. Rochester University Of Rochester Press.Gask L, Usherwood, T. (2002) ABC of Psychological Medicine The Consultation. British medical exam Journal (324) 7353 1567-1569.Horrocks, S. Anderson, E. Salisbury, C. (2002) Systematic Review of Whether Nurse Practitioners Working in Primary Care Can Provide Equivalent Care to Doctors. British Medical Journal. (324) 7341 819-823.Jarvis, C. (2008) Physical Examination and Health Assessment. 5th Ed. Missouri Saunders Elsevier.Jennings, N., Lee, G., Chao, K., Keating, S. (2009) A Survey of Patient Satisfaction in a Metropolitan Emergency Department Comparing Nurse Practitioners to Emergency Physicians. International Journal of Nursing Practice (15) 213-218.Kilburn, S., Featherstone, P., Higgins, B., Brindle, R. Interventions for Cellulitis and Erysipelas. Cochrane Database Systematic Reviews. 2010 Issue 6, Art. No. CD004299. DOI10.1002/14651 858.Koerner, R. Johnson, A. (2011) Changes in the classification and management of Skin and Soft Tissue Infections. Journal of Antimicrobial Chemotherapy. (66) 232-234.Kurtz S, Silverman J, Benson J, Draper J. (2003) Marrying Content and Process in Clinical Method Teaching Enhancing the Calgary-Cambridge Guides. Academic Medicine (78) 8 802-809.Marwick, C. Broomhall, J. McCoowan, C. Phillips, G. Gonzalez-McQuire, S. Akhras, K. Merchant, S. Nathwani. Davey, P. (2011) Severity Assessment of Skin and Soft Tissue Infections Cohort Study of Management and Outcomes for Hospitalised patients. Journal of Antimicrobial Chemotherapy. (66) 387-397Morris, A. (2008) Cellulitis and Erysipelas. Clinical Evidence. online BMJ Publishing Group Ltd. Available at http//www.ncbi.nlm.nih.gov/pmc/articles/PMC2907977/ Accessed 10th September 2012Moulton L. (2007) The Naked Consultation A practical Guide to Primary Care Consultation skills. Abingdon Radcliffe.National Prescribing Centre. (1999) Signposts fo r Prescribing Nurses General Principles of Good Prescribing. Prescribing Nurse Bulletin. (1) 1-4.Nazarko, L. (2012) An Evidence-Based Approach to Diagnosis and Management of Cellulitis. British Journal of Community Nursing. (17) 1 6-12.Neighbour, R. (2005) The Inner Consultation. How to Develop an Effective and Intuitive Consulting Style. 2nd Ed. Oxford Oxford-Radcliffe.Nursing and Midwifery Council (2006) Standards of Proficiency for Nurse and Midwife prescribers. London Nursing and Midwifery Council.Nursing and Midwifery Council (2008) The Code Standards of Conduct, Performance and Ethics for Nurses and Midwives. London Nursing and Midwifery Council.Pendleton, D. Schofield, T. Tate, P. Havelock, P. (1984) The Consultation An Approach to Learning and Teaching. Oxford Oxford University Press.Silverman, J. Kurtz, S. Draper, J. (2005) Skills for Communicating with Patients. 2ND Ed. Oxford Radcliffe.Silverman, J. Kinnersley, P. (2010) Doctors Non-Verbal Behaviour in Consultations Look at the Patient Before You Look at The Computer. British Journal of General Practice. (60) 76-8.Simon, C. (2009) The Consultation. InnovAiT (2) 2 113-121. online Available at http//rcgp-innovait.oxfordjournals.org/content/2/2/113.full. Accessed 13th September 2012Stott, N. Davis, R. (1979) The Exceptional Potential in Each Primary Care Consultation. Journal of the Royal College of General Practitioners. (29) 201-5.Wingfield, C. (2009) Lower Limb Cellulitis A dermatological Perspective. Wounds UK. (5) 2 26-36.Wingfield, C. (2008) Cellulitis Reduction of Associated Hospital Admissions. Dermatological Nurse 7(2) 44-50.Wilson, A. Shifaza, F. (2008) An Evaluation of the Effectiveness and Acceptability of Nurse Practitioners in an Adult Emergency Department. International Journal of Nursing Practice. (14) 149-156.Young, K. Duggan, L. Franklin, P. (2009) Effective Consulting and History-Taking Skills for Prescribing Practice. British Journal of Nursing. (18) 17 1056-1061.Drug Monologue.Nam e of DrugClarithromycinDrug ClassificationMacrolideTherapeutic Uses(s)Clarithromycin film-coated tablets are indicated in adults and adolescents 12 years and fourth-year for the treatment of the following bacterial infections, when caused by clarithromycin- suggestible bacteria. Acute bacterial exacerbation of chronic bronchitis Mild to moderate community acquired pneumonia. Acute bacterial sinusitis Bacterial pharyngitis. Skin infections and soft tissue infections of mild to moderate severity, such as folliculitis, cellulitis and erysipelasClarithromycin film-coated tablets can also be used in appropriate combination with antibacterial therapeutic regimens and an appropriate ulcer healing agent for the eradication of Helicobacter pylori in patients with Helicobacter pylori associated ulcersDose range and route(s) of administrationAdults and adolescents (12 years and older) Standard dosage The usual dose is 250 mg twice daily. High dosage treatment (severe infections) The usual dos e may be increased to 500 mg twice daily in severe infections.Children younger than 12 yearsUse of Clarithromycin film-coated tablets is not recommended for children younger than 12 years. Use Clarithromycin paediatric suspensions. Clinical trials have been conducted using clarithromycin pediatric suspension in children 6 months to 12 years of age.ElderlyAs for adultsDosage in renal functional balkThe maximum recommended dosages should be reduced proportionately to renal impairment. In patients with renal impairment with creatinine clearance less than 30 mL/min, the dosage of clarithromycin should be reduced by one-half, i.e. 250 mg once daily, or 250 mg twice daily in more severe infections. Treatment should not be continued beyond 14 days in these patients.Patients with hepatic impairmentCaution should be exercised when administrating clarithromycin in patients with hepatic impairmentAdministered orally.PharmacodynamicsMode of ActionClarithromycin is a semi-synthetic derivative o f erythromycin A. It exerts its antibacterial action by binding to the 50s ribosomal sub-unit of susceptible bacteria and suppresses protein synthesis. It is highly potent against a wide variety of aerobic and anaerobic gram-positive and gram-negative organisms.The 14-hydroxy metabolite of clarithromycin also has antimicrobial activity. The MICs of this metabolite are equal or two-fold higher than the MICs of the parent compound, except for H. influenzae where the 14-hydroxy metabolite is two-fold more active than the parent compound.Side EffectsDyspepsia, tooth and tongue discoloration, smell and taste disturbances, stomatitis, glossitis, and headache less commonly arthralgia and myodynia rarely tinnitus very rarely dizziness, insomnia, nightmares, anxiety, confusion, psychosis, paraesthesia, convulsions, hypoglycemia, renal failure, interstitial nephritis, leucopenia, and thrombocytopeniaInteractionsAprepitantClarithromycin possibly increases plasma concentration of aprepitantAta zanavirPlasma concentration of both drugs increased when Clarithromycin given with atazanavir.atorvastatinClarithromycin increases plasma concentration of atorvastatin.CabazitaxelAvoidance of clarithromycin advised by manufacturer of cabazitaxel.Calcium-channel BlockersClarithromycin possibly inhibits metabolism of calcium-channel blockers (increased risk of side-effects).CarbamazepineClarithromycin increases plasma concentration of carbamazepine.CiclosporinClarithromycin inhibits metabolism of ciclosporin (increased plasma concentration).ColchicineClarithromycin possibly increases risk of colchicine toxicity-suspend or reduce dose of colchicine (avoid concomitant use in hepatic or renal impairment).CoumarinsClarithromycin enhances anticoagulant effect of coumarins.DisopyramideClarithromycin possibly increases plasma concentration of disopyramide (increased risk of toxicity).DronedaroneAvoidance of clarithromycin advised by manufacturer of dronedarone (risk of ventricular arrhythmia s).EfavirenzIncreased risk

Puritan View: God And Human Nature

Puritan View theology And Human NatureHistory is cyclical. That is the saucer-eyed nature of it. There are al right smarts old ideas, traditional takes of the way the world works that earn been in place for a long clock that are supplanted by new, radical ideas. These new ideas stay in place and become tradition until they are replaced by newer ideas and so on and so forth. That is the way of history and it is no different in the history of America. New England was born with the Puritan view of matinee idol and homophile nature and it stuck with that view for over a hundred years. Into this Puritan society, into a Puritan family, Benjamin Franklin was born. Benjamin Franklin did not agree with Puritans views and challenged them, with his Deist views. Deist ideas on perfection and human nature were immensely different than those of the Puritans, in that they disagreed on the nature of God and the after bread and butter which caused them to view human nature through different scopes.Deists, and for that matter Franklin, did not believe in the God of the Christians (or of Jesus being the Messiah). They believed in God as a creator, or as Franklin refers to him a First Mover and Maker of the Universe (Franklin, 6). The whim was that God created the universe with its many laws and then simply let it run by itself, a flavour which Franklin shared. The Deist God was all-wise, all-good, and all powerful (Franklin, 6). Franklin believed that because God was all-powerful that there can be nothing either existing or acting in the Universe against or without his consend (Franklin, 6). Franklin furthered this thought with the belief that if it was true, and what he consents to must be good, because He is good therefore Evil doth not exist (Franklin, 6). Franklin addressed a possible counterargument against this belief, unrivalled that might vocalize things like murder of theft are inherently evil. Franklin counters this by saying to suppose any Thing to exist o r be done, contrary to the forget of the Almighty, is to suppose him not almighty (Franklin, 6). Furthermore, if these acts are of God and God is all-good, then these things are inherently good.Puritans believed God to be intimately involved in their travels, wakeless them and rewarding them as they sinned and did good respectively. The Puritan view of God was of a very judgmental God who used both wrath and mercy as He saw fit. Wigglesworth refers God being a judge several times in his poem. When Mary Rowlandson was taken captive by the Native Americans, she believed God was punishing her for not going to church and other sins and that it was righteous for God to cut off the thread of her life, and cast her out of his presence for ever (Rowlandson, 3). Upon translation a Bible given to her by one of her captors, Rowlandson found There was mercy promised again, if we would return to him by repentance (Rowlandson, 5). This is the way most Puritans viewed their animateds in mone tary value of what they did to please and anger God. John Dane attributed each trouble he encountered, such as an allergic re exercise to a wasp sting and palsy, to Gods retribution for sins he had committed. He then says that when he did reform It pleased God in a short time to ease him and he stood in awe of Gods judgments (Dane, 4). Puritans did what they could to please God, and true His punishment when they sinned. Yet, Puritans believed that deep down they were all evil and only a few of them would be truly redeemed.The Deist Franklin did not believe that God created an afterlife for human beings, which is to say he did not believe in paradise or Hell. Franklin instead believed in pleasure and pain pain being the misfortunes and sorrows in life and pleasure being the satisfaction of the desire to be free from pain. Franklin believed that pleasure and pain are in balance in life and that one could not exist without the other. He believed that pleasure was wholly caused by Pai n and, by his definition of pleasure, therefore pleasure must be equal, or in exact proportion to pain (Franklin, 7). Franklin really stresses this balance of pleasure and pain. He perceives a possible counterargument against this belief as well. Such an argument might target area that there is no such balance in life because it is easy to see volume who live their whole lives in misery and pain and legislate without ever being relieved of this pain. Franklin counters this by saying that no one can be proper Judges of the good or bad event of Others (Franklin, 8), which is to say that the balance of pleasure and pain is individualistic, and no one can say that was causes him or her pain causes anyone else pain. Franklin furthers this by saying that even if a person lives their whole life in pain, the receive release, and therefore pleasure, from this pain when they die. He says, Pain, though exquisite, is not so to the last moments of life and tis quite an exquisite pleasure t o behold the immediate Approaches of Rest (Franklin, 8). In the end, there will be a balance of pleasure and pain. Franklin sees that as there is this balance, there is no motive for an afterlife. One would not need heaven to make up for earthly pains, as they would have been balanced out in life.Puritans believed fiercely in Heaven and Hell, and that God had created both places of afterlife. God predestined everyones fate, and chose only a select few to be saved and spend eternity in Heaven. Most people were beatifieded to spend eternity in Hell because of Original Sin. Thomas Shepard verbalise, Your best duties are tainted, poisoned, and mingled with sin (Wigglesworth, 4). Thus, because of Original Sin no human action could be inherently good and he went on to say your good duties can not save you, yet your bad works will damn you (Wigglesworth, 4). It was only by Gods grace that a person could be saved. The pain one experienced on earth was punishment for sin, and only receive d succor if they were chosen by God to go to Heaven. According to Wigglesworth, the greatest relief of Heaven is that saints are made sinless and finally do not have to fear forfeiting Gods revel (Wigglesworth, 4). Puritans believed that the people who went to Hell deserved it, even so much as Wigglesworth describes a father learning of his son being sent to Hell and says he doth rejoyce to hear Christs voice/ adjudging him to pain (Wigglesworth, 4). Puritans accepted the fact that most of them would be condemned to Hell.Because Franklins God was all-good, everything created was all-good, and there was no afterlife, he viewed life (specifically human nature) differently than most people. It allowed Franklin to believe that human beings were naturally good-natured and to place importance on the mortal life. Thus, Franklin believed in the importance of self-improvement and virtue without God demanding a need for it. Franklin believed that anyone could improve their station, both eco nomically and morally. Franklin even tell hed formd most of his ingenious acquaintance into a club of mututal improvement which they called the JUNTO (Franklin, 10). In Franklins words, this club was designed to discuss Morals, Politics, or Natural Philosophy (science) with the sincere spirit of inquiry after truth (Franklin, 10). Franklin truly believed that people could grasp their purport in life by pondering these things and thereby better themselves. Yet, perhaps the most important concept Franklin came up with in regards to human nature were his bakers dozen virtues. Franklins thirteen virtues were temperance, silence, order, resolution, frugality, industry, sincerity, justice, moderation, cleanliness, tranquility, chastity, and humility (Franklin, 12-13). In this, one can see how Franklin placed value on virtue outside of a religious need for it. Franklin said that in these virtues there is no mark of any of the distinguishing tenets of any particular sect. He had purposel y avoided them so that it might be serviceable to people in all religions (Franklin, 15). Franklin said his virtues were in every ones interest who wished to be happy even in this world (Franklin, 15).For Franklin, the mortal life was all one had and it was ones duty as a human being to become morally perfect and achieve ones fullest potential.Puritans had a completely different take on human nature, formed from their belief to the highest degree God and the afterlife. To Puritans, human beings were naturally evil and they placed heavy importance on the afterlife. Dane was so convinced of his evil nature, he thought that it was a greater evil to live and sin against God than to kill himself (Dane, 6). The mortal life was about living in ways to please God or else put on the line his wrath and punishment. The Puritan life was centered solely on God because of his intimate involvement in their life. Dane puts it as Beating my thoughts on Gods infinite love took such an impression of my heart as that I thought I could do anything for God or suffer anything for God (Dane, 7). Dane warns that if one does not live their life like this they will bring sorrow and affliction on their heads and hearts to their great grief and sorrow (Dane, 7). It was not by their own hands that they could make themselves better, only by Gods providence. Because Puritans accepted that most of them would go to Hell, it was their responsibility in the mortal life to do all they could to please God. At the homogeneous time, those predestined to be saved had the same responsibility or else risk eternal damnation. Yet most Puritans did not know what fate awaited them, so all had to live as if they were among the saved.The Deist Franklins God was all-good and did not create an afterlife, therefore it was human nature to be good and live their mortal life to its fullest potential. The Puritan God was intimately involved in their lives, judged them harshly for misdeeds, and eternally damned most of them. Therefore, it was human nature to be evil and sin and they had to live their lives by what God wanted in the hope that they were the ones God had chosen to save. It was because of their differing views on God that cause Franklin and Puritans to have such a different view on human nature.

The Conflict Between Conformity and Individuality in Willa Cathers Pau

The Conflict Between Conformity and Individuality in Willa Cathers capital of Minnesotas Case Willa Cathers capital of Minnesotas Case, displays the conflict between conformity and individuality through the main character, Paul. On a number of occasions, Paul is forced to lie and steal to escape the conformists who wishing to control him and stifle his unique imagination. However, his lying, stealing, and attempts to escape the conformists, only force Paul into isolation, depression, and feeling a sense of shame for his individuality. Throughout the story nonpareil efficacy see Cathers constant contrast of individuality versus conformity, as well as Pauls lying and stealing. Cather seems to draw the conclusion that extreme individuals, lots like Paul are simply misunderstood, and not offered the acceptance they desire from conformist society. One way Cather contrasts individuality and conformity is through detailed descriptions of Pauls character Pauls appearance, Pauls un usual mannerisms, and Pauls open criticisms of conformity. Collectively, these three characteristics assert Pauls individuality. Pauls appearance is described in detail at the beginning of the story and provides the foundation of his individuality Paul was tall(a) for his age and very thin, with high, cramp shoulders and a narrow chest(Pg. 1). One only needs to reach the second paragraph of the story and realize Paul does not fit in, which bed be accredited to Cathers careful word choice for his age. Most young individuals, specifically in Pauls teenage age bracket, leave behind struggle for acceptance from their peers however it appears that Paul makes little effort in this regard. Pauls unusual mannerisms are also worthy of analysis, and aid in creating a mental picture of this unusual young man. Cather uses Pauls meeting with the faculty of his educational facility to convey the irritating and intimidating qualities of his mannerisms. She writes, His teachers tangle this after noon that his whole attitude was symbolized by his shrug and his flippantly red carnation flower, and they fell upon him without mercy. He stood through it smiling, his pale lips parted everywhere his white teeth. (His lips were continually twitching, and he had a habit of raising his eyebrows that was contemptuous and irritating to the last degree)(Pg.2). Combined with the description of Pauls physical appearance, his mannerisms now... ...nearly unceasingly wore the guise of ugliness, that a certain element of artificiality seemed to him necessary in beauty(Pg. 7). With this in mind, Pauls actions seem deliberate, as if he knew what he was doing all along, again supporting the theory that he was simply wallowing in misery, crying for help. In conclusion, Willa Carthers Pauls Case is an interesting glimpse into the military man of a young boy, whos individuality is constantly in conflict with the conformist society that surrounds him. In attempts to escape this reality, Pau l loses himself in a magic world of art, lies, and thievery. In this attempt to escape, Paul slips into isolation and depression. Carther in this regard is very careful on how she portrays Paul, to brink about some sympathy from the commentator as he is simply a troubled young man. In the end, Pauls individuality and societies refusal of him leads to Pauls demise. The sympathy Cather creates for Paul leaves one questioning if society simply should have supported Pauls individuality, instead of letting him slip away. Pauls death seems to support this theory, as not a single reader would have wished such a cruel ending to the life of a dreamer.

Pricing Strategies :: Business Market Marketing Price

price Strategies (graphics not included)One of the four major elements of the marketing mix is price. determine is an important strategic issue because it is related to product positioning. Pricing also affects other marketing mix elements as well, such as product features, road decisions, and promotion. A set strategy is a course of action designed to achieve pricing objectives. This strategy helps marketers set prices. There are many shipway to price a product. The following, figure 1.1, shows a list of five major types of pricing strategies. (Business, 8th Ed., pg 421)Figure 1.1New-Product PricingThere are two base types of new product pricing strategies, price tireming and penetration pricing. An organization can use one or both of them over a deliberate period of time.Price Skimming involves charging the highest price possible for a short time where a new, innovative, or much-improved product is launched onto a market. The objective with skimming is to skim the cr eam off customers who are willing to pay more to generate the product sooner. Prices are lowered once demand falls. (Business, 8th Ed., pg 422)Penetration Pricing is the opposite extreme it involves the setting of lower, rather than higher price for a new product. The main purpose is to build market share quickly. The seller wants to disapprove competitors from entering the market by building a large market share quickly. (Business, 8th Ed., pg 422)Differential PricingDifferential pricing occurs when a phoner attempts to charge different prices to two different customers for what is essentially the same product. For this to be effective, the market must have multiple segments with different price sensitivities. Differential pricing can happen in several ways negotiated pricing, secondary-market pricing, periodic discounting, and random discounting. The following describes two of the ways.Negotiated Pricing happens when the final price is established through negociate betwe en the seller and the buyer. This occurs in various industries and at all levels of distribution. Prices are normally negotiated for houses, cars and used merchandise. (Business, 8th Ed., pg 423)Periodic Discounting is the temporary reduction of prices. This normally happens when retailers have holiday sales or seasonal sales. The downside of this is that customers can predict when the price reductions will occur and hold off on buying until the sales bear away place. (Business, 8th Ed., pg 423)Psychological PricingPsychological pricing is a marketing practice based on the theory that certain prices have a mental impact.