The film A Streetcar Named Desire from the silent film era through the Essay

The film A Streetcar Named Desire from the silent film era through the 1950s - Essay Example Stella is married to Stanley played by Marlon Brando and they are expecting a child. Stanley and Blanche are the two central characters of this movie. The story gradually becomes interesting as friction begins to develop between Stanley and Blanche. Stanley being an uncouth, randy, sweaty and rough character does not like Stella very much which ultimately leads to immoral and violent depictions in the movie. The movie received a lot of criticism upon its release regarding the vulgarity and decadence depicted in it. Brando’s performance as Stanley is hailed as one the best performances in the history of American cinema. Brando was able to represent the exact nature of Stanley in front of the viewers. Stanley had to be uncouth yet attractive to women and Marlon Brando was just the man for that. This paper will analyze Marlon Brando’s acting skills in this movie. Later on, these skills and tools will be associated with the method acting presented by Uta Hagen in her book R espect for Acting. Stanley wears shirts that reveal his muscles and sweat; he drinks and smokes in a greedy fashion yet he possesses a grace in his personality. He is gentle in his own sense. Brando played this character in very realistic manner. He gave the character true raw emotions. His style in this movie is said to have influenced the Hollywood film industry so much that it inspired many artists such as Sean Penn, Jack Nicholson and James Dean. Before Brando’s performance in this movie, no matter how violent the emotions in acting may be, audience could always spot a hint of modesty in it. Brando left a mark on acting style that was adopted by Hollywood and embraced by the audience immediately. Brando portrayed more than just the violent nature of the character. Every single action of the Brando in this character feels as real as his anger outbursts. Moreover, Brando was able to pull off this role with such delicacy that he left a lot of fragments of Stanley’s pe rsonality for the audience to interpret. There are instances where the audience cannot easily interpret the actions of Stanley because there is no apparent cause for the way he behaves and this makes the audience wonder about the life of the character which ultimately leads to the development of sympathy towards characters. The character shows that it has much more than just his raw violent outbursts and callous behavior (Ebert). Brando sank in this character so well that the audience could not view Stanley and Brando as two different individuals. In fact, Brando himself became the character and was soon associated with Stanley. The charms of his acting can be measured by the fact that the audience started learning to develop sympathy for film characters after this movie. Brando presented Stanley to the audience in a manner that would distress them but this distress is accompanied by enticement. The audience fell in love with a loathsome character. The charm of the character overpow ered them. Brando’s sexual appeal and charms superseded Stanley’s uncouth and rowdy behavior. If we take the audience out of picture, even then it would be hard to separate the two entities as they resolved well together. It seems that Brando did not make any effort playing this character. He was so at ease that it appears Stanley is a part of Brando’s personality. Such realistic acting comes from specific methodologies that involve the resolution of the character and the actor. Unlike the conventional acting of the rest of the cast of the movie, Brando’

Jane Eyre Female Characters Essay Example for Free

Jane Eyre Female Characters Essay â€Å"Though restrained by social convention, the passions of the female characters emerge with great force. † In the light of this comment, discuss Bronte’s presentation of female characters. Bronte presents the female characters in many different ways. One early example we see of this in chapter one is Jane’s passion as you speaks out a John. â€Å"You are like a murderer – you are like a slave-driver – you are like the Roman emperors! † This is the first time we see Jane’s true passion as she is speaking out to John. By doing so, she is breaking the social norms of that time. At the beginning of chapter two we see how Bronte presents Jane as being a lower class and status than her cousin John, which would have been very common at the time, where females were seen as being less important than men. â€Å"Miss Eyre, to strike a young gentleman, your benefactress’s son! Your master. Master! How is he my master? Am I a servant? No; you are less than a servant, you do nothing for your keep† We see here that Jane is seen as being less than a servant, whereas John is known as The Master. We also see in this quote that Jane speaks out to the title given to John â€Å"Master† How is he my master? Am I a servant† Most children would just accept this and day nothing but through Jane saying this we see that Bronte is presenting her to being different, not just form the Reed family but to most children at this time. When Jane is locked in the Red Room we see more of her passion when she says â€Å"Unjust! – Unjust† rather than accepting her punishment. We see this side of Jane a lot in the early stages of the novel. We see how Jane is angry, rebellious and hungry for adventure. Charlotte Bronte saw the novel as lifting the lid on an English that was built on violence on the young and vulnerable. It also relates to the position of women at the time in which the book came out. Even though there was a Queen on the throne at this time, it made no difference to the legal and economic position of other women. They had little more power than children. Women couldn’t vote and there were no laws in favour of them. Legally a woman belonged to her nearest male relative. When married any property she owned is given to her husband as well does any money she had. Even middle class women had little rights. They allowed no economically productive careers and they were not permitted to go to university. A middle class woman was expected to stay at home until she married, then once married they were expected to stay at home and look after her new family. For woman of this time to have so little rights, it truly would have shocked some people to see Jane’s passion, to say such things to her male counterparts was seen as bad coming from a girl but from a child made it even more shocking. We see how this is backed up by the early critical reviews and how the novel was received. Despite it being a bestseller, Victorian critics did not like it Jane Eyre’s strong minded independence and many thought the novel was coarse. The novel was also blamed for the corruption of contemporary tastes and morality. Most critics felt that there was something dangerous in the novel’s underlying message, while Jane Eyre was godless and unrestrained. The Reed family are very much detestable. They treat Jane as a nobody and as we only see them from Jane’s point of view it’s hard to see any good in them! Mrs Reed hates Jane because she has been foisted upon them by a lying wish made by Mr Reed, in which he made Mrs Reed promise to treat Jane as her own, a promise in which Mrs Reed breaks. The Reeds show us how Jane is a social outcast and her response to them demonstrates how she blankly refuses to accept her. The fact that Jane has no money makes the Reeds look down on her, it makes her less important than them as they are a wealthy family. We see a good example of this on page 13 when John speaks: â€Å"You have no business to take our books; you are a dependent, mamma says; you have no money; you family left you none; you ought to beg, and not to live here with gentleman’s children like us, and eat the same meals we do, and wear clothes at our mamma’s expense. † In this cruel speech by John directed a Jane we see how social class in this time and more particular in Jane’s case causes her to be completely separated from being anything like the Reed family. John’s speech is something like a man would say, not a fourteen year old talking to his ten year old cousin. The above quote is the perfect summary of the plight of Jane under the reign of the Reed family at Gateshead.

Nursing Role in Elderly Person Discharge Planning

Nursing Role in Elderly Person Discharge Planning Title: Critically discuss the role of the nurse in the planning and implementation of safe discharge for the hospitalised elderly person. 1. define your understanding of discharge planning linking it to the ageing process and the reasons why older people are more susceptible to poor discharge planning. The NHS is effectively a rationed service with a finite limit on its resources. Coast points out that one of the major limiting factors which determines the overall ability of the NHS to deliver appropriate healthcare is the number of beds which are available at any given time (Coast et al. 1996) A direct consequence of this statement is the realisation that the availability of beds in the NHS as a whole is a reflection on the bed occupancy and also the efficiency with which potential patients can get into these beds. (Costain et al. 1992). It also directly follows that the efficiency with which patients can be safely discharged back into the community (or to other destinations) has a profound impact on the overall availability of beds for new patients. A patient’s discharge is ultimately dependent on an enormous number of interdependent variables, not the least of which are their physical, mental, emotional and financial state. (Gould et al. 1995). Clearly other factors such as their support networks and the availability of appropriate carers may play a critical role. If we accept that the elderly are more likely to be dependent as a demographic group, then it is clear that all of these issues must be addressed in a timely and positive fashion before a typical elderly patient can be safely discharged from hospital. If we accept that it is not ideal or practical for all of these factors to be assessed by one healthcare professional, then best practice would suggest that it is appropriate to assimilate information that is available from a number of different agencies in order to allow a proper evidence based decision to be made. (Sackett, 1996). Common clinical practice is to invoke the help of a multidisciplinary discharge team. In the context of this essay, we should note that the elderly may face a number of different discharge options and the multidisciplinary discharge team should ideally consider all of them as appropriate. We shall not discuss them all in detail here, but provide an overview of the most commonly utilised options. Victor Nazareth (et al 1994) point to the fact that multidisciplinary discharge planning may be subsumed by expediency in some cases where some immediately attractive schemes such as discharge to a nursing home may be employed as it requires only a modest investment of planning time but effectively shifts the patient sideways out of an acute hospital bed. Such options may appear to be attractive in the short term but the implications for the elderly patient and their family can be profound if they are not explored properly prior to discharge. (Stojcevic N et al. 1996) Some centres utilise the mechanism of nurse-led inpatient rehabilitation care for the elderly who no longer require medical attention, but this does not address the issue of releasing hospital beds. (Steiner 1997) The elderly, as a group, may frequently fall into a category where they are not quite well enough or independent enough to be discharged home but yet are not really ill enough to remain in hospital. (Closs et al. 1995). In these circumstances the multidisciplinary discharge team may consider the option of a Hospital at Home which acts effectively as a transition stage where help at an enhanced level can be provided in the short term which allows the elderly patient to be safely discharged from hospital thereby releasing the bed for another acutely ill patient and the original patient can recuperate in their own home until well. (Fulop et al. 1997) Martin points to the fact that, in order to be effective, a multidisciplinary discharge team needs to ensure that appropriate facilities are put in place in a timely fashion prior to patient discharge. (Martin et al 1994). Failure to do this will render the whole scheme less than optimally effective, as the patients may not get the full range of appropriate facilities, not derive appropriate benefit and this may culminate in premature or unnecessary readmission to hospital, which is effectively a waste of resources. (Pound et al. 1995) Richards (et al 1998) has provided an exemplary tour de force of the issue with a randomised controlled trial of a large cohort of patients. Their main outcome markers were, excess mortality, quality of life, cost and patient acceptability. (Coast et al. 1998) The paper is actually both long and detailed but the main findings were that all of the parameters that were measured (with one exception), showed no adverse effect of an early discharge. The differences were that there was a greater expression of patient satisfaction with the Hospital at Home scheme. (Wilson et al 1997) 2. Anatomy and physiology of the ageing process should be briefly explained. The anatomy and physiology of aging are two subjects which are specialties in themselves and we do not presume to attempt to cover them in any detail in this essay. Russell points out that older adults are not simply a more aged version of a younger adult, they have distinct metabolic and anatomical differences that alter (for example) their nutritional requirements. As humans age their variability in nutritional need becomes greater rather than narrower. (Russell R M 2000). This type of change can be demonstrated in the fact that the older adult generally maintains their ability to absorb macronutrients well into advanced years but they loose the ability to absorb a wide variety of micronutrients. (van Asselt D Z et al. 1998) Other areas where the aging adult is demonstrably different from the young adult is in the state of their DNA which undergoes progressive oxidation from free radicals throughout life. This has repercussions with regard to a number of disease processes such as diabetes mellitus and many types of cancer. (Gilchrest B A et al. 1997) There appears to be a pre-programmed reduction in mitochondria content of tissues as they age. This is manifest in a number of clinical ways. Reduced strength and energy together with muscle wasting are frequent accompaniments of advancing years and may be one of the most significant factors in the rehabilitation of the elderly person. (Navarro A et al. 2007) 3. In this assignment it is important to define and discuss your understanding of ageism and ageist attitudes in relation to appropriate discharge planning. There are many studies which explore the subject of ageism in clinical practice. They reveal a stereotypical belief that older people are â€Å"dull, disagreeable, inactive, and economically burdensome† (Spence D L et al. 1998 These attitudes are still encountered in some healthcare professionals who may categorise lives into discrete stages as a means of charting progress. The expression â€Å"Act your age† suggests that one has to comply with the cultural (rather than biological) expectations of a stage in life. These stages are commonly associated with economic power with the 40s and 50s usually being considered to be the pinnacle of life as such people tend to have good health and are most likely to have robust financial resources. (Schroots J J F 1998) Engendering positive feelings about older people will help to produce a climate of better care for the elderly. (Puckett J M et al. 1999) In terms of the multidisciplinary discharge team, one should clearly be aware of the fact that the elderly have different needs, requirements and abilities. The belief that this equates with a lesser status and a lower level of expectation should be actively challenged. There is no rational reason to expect an 80 yr old to be less entitled to dignity and a good quality of life than a 30 yr old. If we consider the Rudd study (Rudd et al 1997) we can point to a hard evidence base to support the concept that active multidisciplinary discharge planning can actually produce an improvement in the quality of life indicators for the elderly if ageist stereotypes are actively challenged. It is fair to observe that this particular study utilised a particularly wide-ranging and apparently forward thinking multidisciplinary discharge team, but the results achieved are impressive by any analysis. 4. Explore the role of the nurse in relation to multi disciplinary team working in planning safe discharge. By its very nature, the multidisciplinary discharge team is made up of members from a number of clinical disciplines. The role of the nurse is multifactorial. Very often the nurse is the lead organiser in the team. (Lindley et al 1995). In addition to this, the professional role of the nurse often will allow a special insight into the dynamics of the caring and support networks outside of the hospital environment. It is part of the professional nursing requirement that the nurse should also act as the patient advocate (in common with other clinical disciplines) and as such should speak up for the patient if she believes that a clinical or social need is being unfulfilled. (Roper et al. 1983) 5. consider the psychological psychosocial impact that appropriate discharge planning could have on the older person and their family. Because of the increased likelihood of physical frailty, secondary morbidity and financial insecurity in this demographic group, increased dependence is more likely to be found in the elderly. This dependence is almost certain to be increased in the short term in the immediate aftermath of a hospitalisation. This will inevitably have a significant impact on the psychological well-being of both the patient and their carers. Depression is commonly seen (but less commonly recognised) in the elderly as they may struggle to cope with the demands of daily living which are also likely to be more acute after as in-patient spell. (Roper et al. 1983). Anxiety is another commonly experienced entity in both the patient and their carers as, to a degree, if planning has not been adequately carried out or inadequately explained, they may be concerned about how they are going to manage. Intuitively one can suggest that both of these factors can be significantly reduced with appropriate pre-discharge planning and intervention. (Drummond et al. 1995). 6. Appraise strategies in health promotion and rehabilitation with regard to discharge planning that can assist the older person and their family. This is potentially a vast area as there are a great many papers which have looked at the efficacy of the multidisciplinary discharge team in the discharge planning process. As illustrative examples we can consider some of them. The Mahoney paper suggests that the basic minimum input for a multidisciplinary discharge team should be a nurse and an occupational therapist and that these core workers should have the ability and discretion to co-opt additional specialists such as physiotherapists, geriatricians, social workers and psychologists as they feel appropriate. (Mahoney et al 1965) Specific types of patient discharge may require specific modifications of the basic plan. Ball produced a tour de force in his paper on discharge of the elderly from a coronary care unit, (Ball et al. 2003) where patients were allowed to go home earlier than they might normally have been allowed home but with the proviso that specific teams of specialist nurses were available to reassess the patient in their own home and consider direct readmission if required. The team referred to in this study was comparatively unusual insofar as it was comprised six nursing staff but with different skills and experience and they referred the patients to other members of the team only if they felt that more expert input was required. Many papers consider the role of the occupational therapist as a specific and vital entity in the discharge planning process. Gilbertson (et al. 2000) considered the various impacts that each individual professional had on the overall effectiveness of the eventual discharge and came to the conclusion that the impact of the discharge process (as measured by the Barthel quality of life indicator) was influenced by the input of the occupational therapist more than by any other individual category of healthcare professional. In making this statement, we should note that the authors were conducting a study into the discharge of stroke patients and therefore their findings may not be completely generalsable across the entire spectrum of patient discharge. We should also note that these benefits, which were detailed at some length in the analysis section of the trial, were only demonstrable on a comparatively short term basis. Their six month follow up after discharge showed that the patients had returned to the pre-admission status of quality of life. This, in itself, should not be considered as a negative finding as ultimately, it is one of the purposes of hospital admission to try to maintain or improve a patient’s quality of life In passing, we should also note that the Logan study (Logan P A et al. 1997) produced a similar trial structure and concluded that the Social Worker had an equally important part to play in the successful discharge of the patient. 7. your discussions should address inter disciplinary practice, relevant research and government policies (including the national service framework for older people). Discussion There are a great many studies that have been consulted in preparation for this essay. An overview would suggest that it is best practice to carefully assess, consider and then implement an appropriate discharge package for each patient. This has the advantage of minimising physical, psychological and practical trauma for the patient and their carers but also, (as Hensher observes) it can reduce the incidence of readmission in the immediate post-discharge period. (Hensher N et al. 1999) The National Service Framework for the elderly makes a number of good practice recommendations together with targets and goals that have a specific impact on the whole of the discharge process. (Rouse et al. 2001). Arguably one of the most significant recommendations is the implementation of the multidisciplinary discharge team process although there is no specific recommendation as to how the team should be comprised. A number of papers have examined the impact of the various differential structures of the teams and have come to differing conclusions. We have cited some of these already but some, such as the huge STUC trial suggest that, in specific consideration of the elderly, the prime determinant of whether a patient was going to eventually cope at home or not was their ability to transfer â€Å"successfully and reliably† from chair to chair and to a large extent, this was dependent on the availability of physiotherapy input. (STUC 1997) To conclude, we should perhaps detail the structure and facilities of the â€Å"ideal† discharge team as outlined by the STUC authors. A hospital based outpatient clinic, geriatric day hospital, generic domicillary physiotherapy and speech and language therapy, hospital outpatient physiotherapy, and the usual community resources. The maximum level of home care available in the study area to all patients was three one hour visits daily by a home help for personal care, meals on wheels, and community nurse visits for specific tasks. In addition this paper also quotes details of the additional measures that were also available for the patients:- Patients randomised to the community therapy team remained in hospital until the required package of social services care could be organised and any home adaptations undertaken whereas a store of commodes, high chairs, and toilet frames was kept by the team to expedite discharge. The patients were assessed for rehabilitation needs before discharge in conjunction with the hospital based therapists to set initial objectives and to ensure continuity of care. After discharge, patients were given a planned course of domiciliary physiotherapy, occupational therapy, and speech therapy, with visits as frequently as considered appropriate (maximum one daily visit from each therapist). In addition to all this input, the paper comments that each patient was assessed by the team on a weekly basis for up to three months to ensure optimum utilisation of resources The team’s input base was detailed as:- i) Senior physiotherapist grade 1 with neurological training, ii) Senior occupational therapist grade 1, iii) Speech and language therapist, iv) Therapy aide. v) Nurse vi) Consultant physician To conclude, we can consider a very valid point made by Haines (T P et al. 2004) who suggests that if proper multidisciplinary assessments take place in admission units as well as prior to patient discharge, it is quite possible that some cases may not actually need hospital admission in the first instance. References Ball, Kirkby Williams, (20030 Effect of the critical care outreach team on patient survival to discharge from hospital and readmission to critical care: non-randomised population based study. BMJ 2003 ; 327 : 1014 (1 November), Closs S J, Stewart L S P, Brand E, Currie C T. (1995) A scheme of early supported discharge for elderly trauma patients the views of patients, carers and community staff. Br J Occup Ther 1995 ; 58 : 373 376. Coast J, Inglis A, Frankel S. (1996) Alternatives to hospital care: what are they and who should decide. BMJ 1996 ; 312 : 162 166 Costain D, Warner M, eds. (1992) From hospital to home care. London : Kings Fund, 1992. Drummond A E R, Walker M F. (1995) A randomised controlled trial of leisure rehabilitation. Clin Rehab 1995 ; 9 : 283 290. Fulop N J, Hood S, Parsons S. (1997) Does the National Health Service want hospital at home? J R Soc Med 1997 ; 90 : 212 215 Gilbertson, Peter Langhorne, Andrew Walker, Ann Allen, and Gordon D Murray (2000) Domiciliary occupational therapy for patients with stroke discharged from hospital: randomised controlled trial. BMJ, Mar 2000 ; 320 : 603 606 ; Gilchrest B A and VA Bohr (1997) Aging processes, DNA damage, and repair. The FASEB Journal, Vol 11, 322 330, 1997 Gould M M, Iliffe S. (1995) Hospital at home: a case study in service development. Br J Health Care Manage 1995 ; 1 : 809 812. Haines T P, Kim L Bennell, Richard H Osborne, and Keith D Hill (2004) Effectiveness of targeted falls prevention programme in subacute hospital setting: randomised controlled trial. BMJ, Mar 2004 ; 328 : 676 ; Hensher, N. Fulop, J. Coast, and E. Jefferys (1999) The hospital of the future: Better out than in? Alternatives to acute hospital care. BMJ, October 23, 1999 ; 319 (7217) : 1127 1130. Lindley R I, Amayo E O, Marshall J, Sandercock P A G, Dennis M, Warlow C P. (1995) Hospital services for patients with acute stroke in the United Kingdom: the Stroke Association survey of consultant opinion. Age Ageing 1995 ; 24 : 525 32. Logan P A, Gladman J R F, Lincoln N B. (1997) A randomised controlled trial of enhanced social service occupational therapy for stroke patients. Clin Rehab 1997 ; 11 : 107 113 Mahoney F I, Barthel D W. (1965) Functional evaluation: the Barthel index. Maryland State Med J 1965 ; 14 : 61 65. Martin F, Oyewole A, Maloney A. (1994) A randomised controlled trial of a high support hospital discharge team for elderly people. Age Ageing 1994 ; 23 : 228 34. Navarro A. Boveris A (2007) The mitochondrial energy transduction system and the aging process. Am J Physiol Cell Physiol 292 : C670 C686, 2007 Pound P, Bury M, Gompertz P, Ebrahim S. (1995) Stroke patients views on their admission to hospital. BMJ 1995 : 311 : 18 22. Puckett J M, Petty R E, Cacioppo J T, Fischer D L. (1999) The relative impact of age and attractiveness stereotypes on persuasion. J Gerontol. 1999 ; 38 : 340 343. Richards, Joanna Coast, David J Gunnell, Tim J Peters, John Pounsford, and Mary-Anne Darlow (1998) Randomised controlled trial comparing effectiveness and acceptability of an early discharge, hospital at home scheme with acute hospital care. BMJ, Jun 1998 ; 316 : 1796 – 1801 Roper Logan Tierney (1983) Using a model for nursing. Edinburgh : Churchill Livingstone 1983 Rouse, Jolley, and Read (2001) National service frameworks. BMJ, Dec 2001 ; 323 : 1429. Rudd, Charles D A Wolfe, Kate Tilling, and Roger Beech (1997) Randomised controlled trial to evaluate early discharge scheme for patients with stroke. BMJ, Oct 1997 ; 315 : 1039 – 1044 Russell R M (2000) The aging process as a modifier of metabolism. American Journal of Clinical Nutrition, Vol. 72, No. 2, 529S 532s, August 2000 Sackett, (1996). Doing the Right Thing Right: Is Evidence-Based Medicine the Answer? Ann Intern Med, Jul 1996 ; 127 : 91 94. Schroots J J F. (1998) On growing, formative change, and aging. In : Birren J E, Bengston V L, eds. Emergent Theories of Aging. New York, NY : Springer-Verlag; 1998. Spence D L, Feigenbaum E M, Fitzgerald F, Roth J. (1998) Medical student attitudes toward the geriatric patient. J Am Geriatr Soc. 1998 ;16 : 976 983. Steiner A.(1997) Intermediate care: a conceptual framework and review of the literature. London: Kings Fund, 1997. Stojcevic N, Wilkinson P, Wolfe C. (1996) Outcome measurement in stroke patients. In: Wolfe C, Rudd T, Beech R, eds. Stroke services and research. London: The Stroke Association, 1996. STUC (1997) Stroke Unit Trialists Collaboration. Collaborative systematic review of the randomised trials of organised inpatient (stroke unit) care after stroke. BMJ 1997 ; 314 : 1151 8. van Asselt D Z, de Groot L C, van Staveren W A, et al. (1998) Role of cobalamin intake and atrophic gastritis in mild cobalamin deficiency in older Dutch subjects. Am J Clin Nutr 1998 ; 68 : 328 – 34. Victor C, Nazareth B, Hudson M, Fulop N.(1994) The inappropriate use of acute hospital beds in an inner London District Health Authority. Health Trends 1994 ; 25 (3) : 94 97. Wilson A, Parker H, Wynn A, Jones J, Spiers N, Jagger C, et al. (1997) Hospital at home is as safe as hospital, cheaper, and patients like it more: early results from a randomised controlled trial. Society for Social Medicine abstracts. J Epidemiol Community Health 1997 ; 51 : 593.

The Day Labor Market in Phoenix, Arizona Essay -- Business Economics U

The Day Labor Market in Phoenix, Arizona Introduction This paper focuses on the Macehualli Day Labor Union located in Phoenix, Arizona in the 85032 area. Throughout the history of the United States, illegal immigrants have come from all over the world to find work and a better way of life. It is estimated that right now there are about seven million illegal aliens living in America. About 69% of these illegal immigrants are Mexican and over 283,000 of them live in Arizona1. In this paper, we presuppose that the illegal aliens we refer to are Mexican. This is because the aliens living in the geographic area around the day labor center we examine are over 99% Mexican (Reza, 2003, personal interview). Many Mexicans risk everything they have, including their lives, in their attempts to cross the border and live the â€Å"American Dream.† Most immigrants are motivated by the lure of lucrative employment across the border. They come to this country with the hope of finding a higher paying job. In most cases, the immigrants are young men who leave their families behind, but intend to earn enough money to eventually bring their loved ones across (Reza, 2003, personal interview). Over the past three decades, the influx of illegal immigrants has become even more noticeable (Immigration and Naturalization Service, 1999). In the year 2000, unauthorized immigrants accounted for about 2.5% of the U.S. population2. These immigrants’ illegal status is a serious obstacle in their search for employment. Almost all employers require some proof of United States citizenship. For citizens and legal immigrants, this is easily established through a driver’s license or state identification card. Illegal workers, on the other hand, obvi... .... 11 Jun. 2003. Day Labor Union Workers. Personal Interview. 25 Oct. 2003 Gonzalez, Daniel. â€Å"Future Will Require Immigrants by Millions for Jobs, Report Says.† The Arizona Republic 31 Aug. 2003 : A6. Reza, Salvador (Director of the Macehualli Day Labor Union). Personal Interview. 25 Oct. 2003. Smart pages. 2 Dec. 2003 U.S. Citizenship and Immigration Services. â€Å"Estimates of the Unauthorized Immigrant Population Residing in the United States: 1999 to 2000† 2 Dec. 2003 . U.S. Department of Labor. 2 Dec. 2003 minimumwage.htm>. Valenzuela, Abel Jr. â€Å"Day Labourers as Entrepreneurs?† Journal of Ethnic and Migration Studies 27.2 (2001) : 335-352 Valenzuela, Abel Jr. â€Å"Day Labor Work† Annual Review of Sociology 29 (2003) : 307-33

Morality Defined Essay

Legendary philosopher, Socrates once said, â€Å"A system of morality which is based on relative emotional values is a mere illusion, a thoroughly vulgar conception which has nothing sound in it and nothing true.† With this statement, Socrates argues that there are few people in this world who possess an absolute morality within themselves whereas most others have a relative morality which they stand by. Absolute morality is the belief that something is always right or always wrong while relative morality is the belief that something is right or wrong depending on the circumstances. The crucial difference between absolute and relative morality lies in the viewpoints of the people who possess each one. However, Socrates’ belief is that relative morality is nothing more than a mere illusion because it really has no guidelines that it stands behind; it is solely based on opinion. In his mind, it should not even be considered a morality. In essence, Socrates is arguing that you must believe in something to its extreme or not at all; there is no in-between. Cormac McCarthy’s novel The Road, tells the riveting story of a father and son’s survival in a post-apocalyptic world full of thieves and cannibals. The man and the boy travel the United States in search of food and shelter, while also attempting to flee from danger and the threat of death. All through the story, they consistently struggle with issues concerning their own morality, character, and conscience. They are forced to make life altering-decisions that ultimately define who they are as people. Throughout the novel The Road, McCarthy uses nature symbolism and apocalyptic imagery to criticize that many people’s ethics dissipate and their immorality consequently rises when they are immersed in an evil world. The desolate world that the boy, man, and others have to live in results in some people going to the extremes to survive. As the boy and man journey on the road, they encounter very few people along the way. However, one day, the man realizes there are people following him and the boy, so they hide out. Three men and a pregnant woman pass them on the road. A few minutes later they are met with a shocking sight, â€Å"Oh Papa, he said. He turned and looked again. What the boy had seen was a charred human infant headless and gutted and blackening on the spit. He bent and picked the boy up and started for the road with him, holding him close. I’m sorry, he whispered. I’m sorry† (McCarthy 198). The author deliberately describes the appearance of the burning baby using words that convey graphic imagery such as, â€Å"charred, human, infant, headless, gutted, and blackening,† eliciting a repulsive feeling and characterizing the ugliness of evil in the world. The sight traumatizes the boy evidenced when he gasps, â€Å"Oh, Papa,† and turns â€Å"and looked again [at the burning baby].† The man feels regretful for letting the boy experience such a horrendous sight and apologizes as he takes the boy back to the road. This gruesome imagery reveals the absolute social breakdown in humanity and society. The morality of the people in this apocalyptic world has completely faded because there are no governing rules or laws to keep them in line. This results in total chaos and turmoil as seen when the weakest and most helpless of human beings – an infant – is preyed upon by a group of insane man-eaters. The cannibals clearly symbolize the end of civilization and this passage represents the extremes of violence, hunger, and cruelty within the apocalyptic world. Every person in the story seems to be judged by the man and boy as either good and moral or evil and immoral. In his view, the man strongly believes he and the boy are moral and good because, as he tells the boy, â€Å"we’re carrying the fire† (McCarthy 83). This â€Å"fire† is symbolic of hope and human perseverance, despite the wicked world they are living in. The man assures the boy that they are the â€Å"good guys† who â€Å"carry the fire† within themselves to never stop trying to survive in the horrible world even amongst â€Å"bad guys† who kill and even cannibalize people in order to survive. As the story unfolds, the boy and the man encounter many potential threats to their existence and make questionable decisions in order to survive which sometimes violate their self-professed â€Å"good guy† virtues. Through his actions, the man subtly begins to show signs that he is heading towards immorality and evil. The man and the boy are awoken by the sound of a diesel truck not too far from them. They flee their camp site and listen quietly until the silence is broken by a guy stumbling through the woods. The guy wrestles the boy into his arms and the man fires his loaded pistol, â€Å"The man fell back instantly and lay with blood bubbling from the hole in his forehead. The boy was lying in his lap with no expression at all†¦covered with gore and mute as a stone† (McCarthy 66). The man’s quick reaction to save his son represents the very rare love bonds that still exist in this apocalyptic world. The author compares the boy to a â€Å"mute stone† after he obviously experiences another life-changing moment. Sickening imagery is also used in this passage, as seen through the words, â€Å"bubbling, hole, and gore.† These words portray the man’s heroic act to save his son; however, it comes at the expense of the brutal murder he committed. The man shoots the guy who threatens his son with the intention of ensuring the boy’s safety, yet it contradicts his own moral virtues. Because he did this out of love, the man can essentially justify the violent killing as being morally correct. Yet, what the man fails to realize, is what makes his choice more praiseworthy than the choices of the people who kill and even cannibalize others in order to survive. This clearly raises a contradiction which creates an ambiguity between immorality and morality. Although the man killed this guy to protect his son, his decision is still problematic because it only takes one bad decision like this to arouse the inner evil within himself and eventually drive him to immorality. After living in such a malicious world for such a long time, it is nearly impossible for the man not to succumb to immorality and evil. The boy and the man enjoy a nice walk on the beach until they come back to find their camp completely raided. Their entire shopping cart full of food and other survival necessities had been stolen and as a result, they set out to find the thief. They follow the tracks of the shopping cart and finally find the thief in front of the cart with a butcher knife. The man is enraged and pulls his pistol out and threatens the crook, â€Å"Take your clothes off. / What? / Take them off. Every goddamned stitch. / Come on. Don’t do this. / I’ll kill you where you stand. / He stripped slowly and piled his vile rags in the road. / Put the clothes in the shopping cart. / He bent and scooped the up the rags in his arms and piled them on top of the shoes. / Don’t do this, man. / You didn’t mind doing it to us. / You tried to kill us. / I’m starving, man. You’d have done the same. / You took everything. / Come on, man. I’ll die. / I’m going to leave you the way you left us† (McCarthy 256-257). The man clearly displays immorality by the way he treated the thief and how he reacted to the situation at hand. It is obvious he is incapable of any empathy for the guy who is trying to survive in the same hellish world he is trying to live in. The fact that he wanted to punish the guy by stripping him suggests he wants to make the crook suffer a horrible death because the world is too cold to live without any sort of clothing. The thief in this passage symbolizes the deterioration of the human race because he embodies the ugliness that has emerged in this new world where formerly common things are now extremely valuable. The man still believes he is a â€Å"good guy,† however, this controversial decision proves otherwise. Because the man is acting so cruelly in this scene, his viciousness can almost be compared to the brutality of the savages that roam the same barren world he lives in. Mark Twain’s novel The Adventures of Huckleberry Finn, set in the Pre-Civil War period, tells the story of young boy named Huckleberry â€Å"Huck† Finn, who ventures throughout the Mississippi River Valley. Huck travels with a run-away slave named Jim, meets many new people, and encounters frequent obstacles along the way. Throughout the novel, Huck constantly struggles with complex circumstances affecting his own conscience and morality, but ends up making a big decision that reflects his true character in the end. Due to the social environment in which Huck grew up, his racist outlook is displayed on occasion throughout the story. In one short exchange with Aunt Sally, Huck indicates that he doesn’t actually view blacks as real people. Huck tells his aunt that his boat ran ashore and she worriedly responds, â€Å"‘Good gracious! Anybody hurt?†Ã¢â‚¬Ëœ Huck replies, ‘†No’m. Killed a nigger,†Ã¢â‚¬Ëœ to which Aunt Sally answers, ‘†Well, it’s lucky; because sometimes people do get hurt’† (Twain 167). Huck’s conversation with his aunt vividly illustrates the deeply embedded racism within society. Not only does this exchange exemplify Huck’s own beliefs about blacks’ inferiority, but also proves his prejudiced outlook is primarily derived from the racist society in which he lives. The conversation suggests that both the aunt and Huck think of blacks only as â€Å"things† or â€Å"objects,† not actually human beings. When Huck informs his aunt that a â€Å"nigger† had died in the crash, she casually dismisses any loss of life. Instead, she responds by pointing out that â€Å"it’s lucky; because sometimes people do get hurt [in boat crashes],† therefore essentially revealing that she believes that blacks are not people. Both Aunt Sally and Huck offer no empathy or show any responsiveness to the death, which most people would do if another human had died. Although Huck views slavery as morally correct, he only believes this because it is customary during this time period. In essence, Huck’s moral nature has been misguided and distorted throughout his childhood, causing him to believe slavery and white superiority is ethically right. Sadly, his morality has been skewed so he believes something not necessarily because he actually believes it in his heart, but possibly because it is just what is socially accepted at the time. Bennett Kravits, author of the critical essay â€Å"Reinventing the world and reinventing the self in Huck Finn† reveals his criticism regarding Twain’s portrayal of whites’ perceptions of blacks. He specifically deals with the phrase that Huck uses to describe Jim, â€Å"white inside† (Twain 345).† He essentially explains that although that seems to be an overtly racist description, it actually has the potential to â€Å"undercut the prejudicial notions that whites held concerning blacks† (Kravits 6). It is clear Huck has a difficult time seeing Jim as an equal member of society, but he instead can view him as white inside. According to Kravits, the significance behind this depiction is that Huck discovers a way to see Jim as a fellow human being, just in an odd way. Huck’s morality has been molded throughout his childhood and he has an ingrained belief that blacks are just inhumane slaves that are property to white people; however, Kravits is actually arguing that Huck realizes black people deserve to be labeled as humans and not property. While journeying down the Mississippi River together, Huck and Jim begin to bond in a unique way. A friendship between them starts to develop and Huck’s compassion for Jim grows despite him being a black slave. Huck is faced with the particularly difficult decision of either turning Jim in or rescuing himself from the Phelps’. He struggles between standing up for Jim and what he believes is right or surrendering to the embedded racism he has grown up around. With Jim’s fate on his hands, Huck decides to save Jim instead of himself and rips up the letter to Miss Watson with the astounding exclamation, â€Å"‘All right, then I’ll go to Hell†Ã¢â‚¬Ëœ (Twain 162). During the moments leading up to this heroic decision, his mind runs wild with the thoughts of the harsh punishments Jim could possibly face. Huck recognizes that he has a power to give Jim something he has desired his entire life: freedom. Huck’s empathy is so strong at this point, that combined with his loyalty and morality, it causes Huck to have a significant epiphany. The epiphany illuminates Huck’s concern for Jim and shows another step in his moral development. The fact that Huck believes he is giving up his soul for Jim’s freedom demonstrates that Huck’s morality has truly developed over the course of the novel. This shows Huck’s incredible loyalty and his ability to put himself in Jim’s shoes in order to sacrifice his owns wants, needs and desires to save Jim. His empathy displayed in this scene supports the belief that although Huck is racist, he still possesses an enormous capacity to see Jim as a fellow human being. Every person acts in accordance with their beliefs, attitudes, and values, which consequently reflects that person’s ultimate identity. Many factors are responsible for determining the principles people value and respect, including familial, societal, and environmental influences. Throughout Mark Twain’s novel The Adventures of Huckleberry Finn, Huck is in the midst of moral development in his subconscious and his deeper feelings arise as the truer expression of his morality. He makes decisions in his adventures which demonstrate that not only does he possess morals, he possesses extraordinary ones. Huck’s moral maturity rings clear after he makes significant controversial decisions. Huck’s character progression shows that good scruples can be developed in anyone and a more empathetic part of people can triumph over heartlessness. . In the novel The Road, Cormac McCarthy describes the struggle between morality and immorality that exists within every person that walks the post-apocalyptic world. He demonstrates that some people give into the evil while others are able to remain good. McCarthy essentially concentrates on the man’s progression from the moral â€Å"good guy† to an immoral â€Å"bad guy.† â€Å"The fire† that the man truly believed he possessed slowly smolders and he begins to succumb to the immoral world he had faced for such a long time. Huck and the man serve as foils to each other by highlighting Huck’s progression towards a better morality as the man regresses and loses the morals he originally possessed. In essence, both Twain and McCarthy conclude that all people are faced with adversity and difficult decisions, but those people have the power to make certain choices which ultimately define who they really are. Works Cited McCarthy, Cormac. The Road. New York: Alfred A. Knopf, 2006. Print. Kravits, Bennett. â€Å"Reinventing the World and Reinventing the Self in Huck Finn.† Literature Resource Center. Gale, Winter 2004. Web. 22 May 2012. . Socrates. â€Å"Morality Quotes.† ThinkExist. Web. 22 May. 2012. . Twain, Mark. The Adventures of Huckleberry Finn. United Sates: Tom Doherty Associates, 1985. Print.

cain and able

cain and able Everybody knows the age-old story of Cain and Abel. I wouldn't say that they were the first rivalry between siblings but they certainly were not the best brothers. Cain and Abel were the sons of Adam and Eve the first people on the Earth. Cain and Abel every year offered what they had at the beginning of the harvest. This was a thing that happened every harvest and was a norm in the lives of Cain of Abel and in their family, but why did God not accept Cain's sacrifice and accepted Abel's?In the Bible it describes only the one harvest and how it affects the lives Cain and Abel. Abel was a person that obviously loved god and gave God credit for his success and was very successful. In the Bible Abel gave the best of his new sheep to God and this was the blood sacrifice.Cain gave a portion of his crops for his sacrifice. God accepted Abel's offering and rejected Cain's because it was not the absolute best or the first portion of the harvest. God had explained to Adam and Eve when they si nned that sin only be washed away by blood. God did not except a crop sacrifice because it simply wasn't blood.God would not accept Cain's sacrifice because of his heart and his attitude. God didn't care more about what Cain brought but his mindset when he brought it. Cain's attitude was a key factor in displeasing God. His heart was not in the right place to make a sacrifice. This is seen when God warned Cain and said" You will be accepted if you do what is right. But if you refuse to do what is right, then watch out! Sin is crouching at the door, eager...

The End of the Cold War and the New Threats to Global Security The WritePass Journal

The End of the Cold War and the New Threats to Global Security 1.Introduction The End of the Cold War and the New Threats to Global Security 1.Introduction Changing perceptions of military force and war2.1 New sources of security threat 2.2 Changing notions of war in a global world Meeting the new security challenges: a revised agenda for peace ConclusionBibliography: Related 1.Introduction The end of the Cold War marked a new beginning for the international security agenda, and the demise of the simple bipolarity brought forward a revised agenda for human rights, international peace and cooperation and stability. The end of the Cold War triggered the rise of new threats and challenges to international security, and the advance of globalization led to the redistribution of power in the international system (Baylis Smith, 2007; Brown, 2005). In the context of globalization, the capacity of the state was undermined and as a result state-to-state relations dramatically changed (Strange, 2002). Classic wars were gradually transformed into â€Å"modern wars† (Kaldor, 1999; Smith, 2006; Shaw, 2005). In this different political environment, the security challenges were no longer existent on a state-to-state level, because of the growing importance of sub-state actors. This essay will focus on the reorganization of the international system after the end of the Cold War, and will discuss the new challenges to global security, posed by the demise of the bipolar regime. The essay will support the view that with the end of the Cold War, the world became a more dangerous place, because of the multiplicity of actors on the international scene and the changed perceptions of military force, war and security. Changing perceptions of military force and war The end of the Cold War brought forward the change of the perceptions of military force in several different aspects. The impact of these changed perceptions upon the international security agenda has been undisputed, and will be discussed in detail. For clarity, the author has chosen to focus only on the most important security-related transformations following the Cold War the new sources of threat such as nuclear weapons and terrorism, and the changing notions of war in the context of globalization. Their features will be discussed in the context of the changed dynamics of the international system. 2.1 New sources of security threat The end of the Cold War led to new security challenges, because of changing notions of military force and the new sources of security threat (Smith, 2006; Shaw, 2005). The first one is related to the rise of nuclear power. With the demise of the USSR, the simple bipolarity of the Cold War world was replaced by a multipolar world, where the centrality of power was no longer clearly defined (Brown, 2005; Jackson Sorensen, 2003). The rise of the Asian economic powers, the advance of nuclear and biological weapons in countries such as Iran, Israel and Iraq challenged the stability of the mutual deterrence principle, comfortably sustained during the Cold War (Hammes, 2005). Another source of security threat after the Cold War was related to terrorism, and the rise of sub-state actors (Smith, 2006). The War on terror, embedded in the Bush doctrine, was a clear demonstration of the changing nature of war, and the elusive image of the new enemy (Shaw, 2005). After 9/11 it became clear that terrorism was not a war against an enemy, but against tactics (Baylis Smith, 2007). Its manifestations and capacity to destroy were as much the result of political construction, as of historically embedded perceptions about the East and the West and their manipulation by mass media and policy-makers. After the end of the Cold War non-state actors such as Al Qaeda and Hamas, became a new source of security threat because of their ability to operate internationally but at the same time to exist inside the state (Shaw, 2005). Also, the controversies, around states labelled as rogue and unable to comply with the international standards for peace and democracy such as Afghan istan, Iraq, North Korea, Libya and Syria necessitated new means for meeting the challenges to threat and security. They will be discussed in section 3. 2.2 Changing notions of war in a global world Here it is important to mention globalization as a factor, which led to re-examination of the capacity of the state to observe human security and human rights (Strange, 2002). In the context of a borderless world, the international human rights agenda is inevitably revisited, and the main carriers of legal standards are no longer represented solely by state actors, but by the global civil society, comprising of International non-governmental organizations (INGOs). Because of these inevitable transformations, the very perception of security, threat and war changed in several important aspects. As Mary Kaldor famously observes, the end of the Cold War saw the rise of the modern wars, which lack time and space, because they are based on non-quantifiable demands often related to ideology, ethnicity, religion and the social construction of history (1999). The old wars were pushed away by new types of threats and conflicts, such as organized crime, and religious and civil wars. The early 1 990s saw the bloody demise of former Yugoslavia, and a series of conflicts in Rwanda, Congo, Sudan and Somalia, triggered by the redefinition of political borders, the struggle over economic resources and ethnic and religious factionalism. In the context of globalization, the modern wars are interstate conflicts, executed by sub-state actors. In this sense, it is important to mention that the growing presence of the sub-state actors has posed new challenges to the classic perceptions of security, because of non-tangible variables such as perceptions, as opposed to old-time military ambitions related to territorial invasion and economic gain. Meeting the new security challenges: a revised agenda for peace In order to meet the new security challenges, identified earlier, the international community had to devise a new agenda in the post-Cold war era. First, humanitarian intervention became important, and triggered as an effect of the revised agenda, where the security of foreign nationals, whose human rights have been violated by their home state became important (Jackson Sorensen, 2003). Despite the ongoing political debate about the legality and legitimacy of humanitarian intervention, a norm of intervention was authorized by the UN Security Council in the 1990s, which was followed by operations in the Democratic Republic of Congo in 1996 and Kosovo in 1999 (Baylis Smith, 2007). Despite the criticisms that humanitarian intervention might stop the immediate killing of civilians but is not a reliable strategy for long-term piece, it reveals a shifted emphasis from military to human security in the years following the end of the Cold War. In this relation, another trend in dealing with conflicts became prominent – the imposition of economic sanctions for the purpose of exerting political, rather than military pressure upo n non-compliant states and communities. The posts of such wars of containment are the conflicts in Iraq and Afghanistan. In addition, the role of the global civil society and the growing influence of INGOs as advocates of peace and human rights deserve a mention. The importance of international non-governmental organizations in global policy-making has been undisputed because of the more complicated security agenda in the post-Cold War era. Also, because of the multiplicity of actors in the international system, and the new security needs, states and intergovernmental organizations are unable to deal with international crises without the development programmes and research, provided by the INGOs. Although their political success remains disputed, their role as independent observers and proponents of policy change is growing. Conclusion This essay has attempted to show the changing nature of the international system after the end of the Cold War. Today the international community faces different security threats based on a new perception of military force. Terrorism and the spread of nuclear power have shunned classic state-to-state conflicts, and as a result a new security agenda for peace and cooperation has been embraced. In the era of globalization, the transition towards collective security as a model of global governance, remains a challenge but also a prerequisite for peace. Bibliography: Baylis, J. Smith, S. (2007) eds, The Globalization of World Politics. Oxford: Oxford University Press Brown, C., (2005) Understanding International Relations, Palgrave: Macmillan, Ch. 6, pp. 106-123 Clausewitz, C. (1977) ‘What is War?’, On War, Princeton: Princeton University Press Hammes, T.X (2005) ‘War evolves into the fourth generation’, Contemporary Security Policy, Vol.26, No.2pp.189–221. Jervis, R. (1991/1992) ‘The Future of World Politics: Will It Resemble the Past?’ International Security 16, no. 3 Jackson, R. Sorensen, G. (2003) Introduction to International Relations, Oxford: Oxford University Press Kaldor, M. (1999) New and Old Wars: Organized Violence in a Global Era. Cambridge: Polity Press Shaw, M. (2005) The New Western Way of War: Risk Transfer war and its Crisis in Iraq Cambridge: Polity Press Smith, R. (2006) The Utility of Force: The Art of War in the Modern World London: Penguin Strange, S. (2002) The Declining Authority of States, in The Global Transformations Reader: an Introduction to the Globalization Debate, 2nd edition, Held and MacGrew (eds) Cambridge: Polity Press, pp.127-134 Van Creveld, M. (1991) The Transformation Of War NY: Free Press

Tiempo máximo de estancia permitido en Estados Unidos

Tiempo mximo de estancia permitido en Estados Unidos Para evitar problemas migratorios muy serios es necesario saber y respetar el tiempo mximo de estancia legal permitido en Estados Unidos. En realidad, el monto de la estadà ­a legal depende de varios factores, como por ejemplo, tipo de visa. En este artà ­culo se informa sobre la cantidad de tiempo que un extranjero con visa de no inmigrante puede quedarse legalmente en Estados Unidos, segà ºn los casos –turista, estudiante, intercambio, trabajo o inversià ³n–. Tambià ©n se informa sobre lo que se conoce como periodo de gracia  y cà ³mo afecta a la estadà ­a legal la extensià ³n o los cambios de visa realizados desde dentro de Estados Unidos. Por supuesto, los extranjeros con una tarjeta de residencia pueden permanecer en el paà ­s el tiempo que quieran. Es ms, estn obligados a vivir en el paà ­s y sà ³lo pueden ausentarse para viajar a otro por tiempo limitado. Tiempo que turistas pueden quedarse legalmente en EE.UU. Para el caso de los turistas hay respuestas diferentes segà ºn el documento que se ha utilizado para ingresar al paà ­s. Adems surge la duda sobre si conviene agotar el tiempo permitido o es ms aconsejable salir antes.   Un primer caso es el de los turistas que ingresan a Estados Unidos sin visa. Los ciudadanos de 38 paà ­ses pueden ingresar a los Estados Unidos sin visa, si lo hacen como turistas o para un asunto de negocios. Si llegan por avià ³n o barco necesitan solicitar antes una autorizacià ³n electrà ³nica que se conoce como ESTA. Para las personas que estn en esta situacià ³n el tiempo mximo de estadà ­a es de 90 dà ­as. No hay excepcià ³n. Tampoco es posible pedir una extensià ³n. Asimismo tampoco funciona salirse a un paà ­s fronterizo, como Canad o Mà ©xico, con la idea de ganar otros 90 dà ­as.   Si se sale a uno de esos paà ­ses, se reingresa con el mismo periodo de tiempo que ya se tenà ­a, sin que se inicie otro nuevo y si ya est agotado el oficial del paso migratorio puede denegar la entrada por considerar que se est jugando con los là ­mites legales de estancia. Un segundo caso es el de los turistas que ingresan a Estados Unidos con una visa lser, tambià ©n conocida como tarjeta de cruce. Pueden tenerla los mexicanos o los ciudadanos de otros paà ­ses que residen legalmente junto a la frontera entre Mà ©xico y Estados Unidos. Las lser tienen sus propias reglas para solicitarlas, millas que se puede ingresar en el paà ­s y tiempo de estadà ­a.  Como norma general, con la visa lser sà ³lo se puede permanecer en Estados Unidos un mximo de 30 dà ­as. Si se desea ingresar por ms tiempo solicitar el permiso I-94 en el paso fronterizo. Por à ºltimo, est el caso de los turistas que ingresan a Estados Unidos con visa de turista, tambià ©n conocida en algunos paà ­ses como de placer o de paseo o como B2 o la combinada B1/B2. El tiempo mximo de estadà ­a lo fija el oficial de la CBP en el puesto fronterizo terrestre, puerto o aeropuerto.   Aunque es muy comà ºn que se permita el ingreso por 180 dà ­as, eso no es siempre asà ­ y puede ser por mucho menos. Este dato hay que tenerlo claro. Y si no se sabe, consultar el registro de ingreso y salida en la pgina de la CBP. Asimismo, no se debe confundir jams el tiempo de autorizacià ³n para permanecer legalmente en Estados Unidos con la fecha de expiracià ³n de la visa, ya que son dos cosas muy distintas.   Conveniencia de quedarse en EEUU todo el tiempo autorizado Frecuentemente los turistas se plantean si es buena idea permanecer en Estados Unidos hasta agotar el plazo legal de estancia. Lamentablemente, a esa pregunta no hay una respuesta à ºnica, ya que va a depender del caso de cada uno. Lo importante es que el oficial de inmigracià ³n en el punto de ingreso a los Estados Unidos no tenga ninguna razà ³n para sospechar que la estancia en el paà ­s ha sido o va a ser por motivos distintos al turismo. Hay que evitar dar la impresià ³n de que se estn desarrollando actividades no permitidas con la visa, como por ejemplo estudiar, trabajar o, simplemente, residir. Antes de quedarse ms tiempo del permitido es necesario saber las consecuencias, ya que pueden ser muy serias. Asimismo, conviene saber con quà © frecuencia se puede ingresar al paà ­s para evitar ser parado por las autoridades migratorias y ser regresado al paà ­s de origen. Cunto tiempo se puede permanecer en USA con la visa J-1 Las visas J-1 de intercambio comprenden una gran variedad de programas. La regla general para las personas que tienen estas visas es que se pueden ingresar a Estados Unidos un mximo de 30 dà ­as antes de iniciar el programa y se pueden quedar durante la duracià ³n regular del mismo, que est seà ±alado en el DS 2019.   Una vez que se termina se tienen 30 dà ­as de periodo de gracia para dejar Estados Unidos. Durante ese mes se puede viajar, si asà ­ se desea, pero no se puede seguir participando en ninguna actividad relacionada con el programa.   Estas reglas aplican tambià ©n a los familiares de las personas con visas J-1 y que estn en USA como dependientes. Tiempo de permanencia visas F-1 y M-1 de estudiante Con cualquiera de estas dos visas de estudiante se puede ingresar a Estados Unidos un mximo de 30 dà ­as antes al comienzo del programa. Sin embargo siguen reglas distintas para el periodo de gracia. Los titulares de visas M-1 deben salir del paà ­s en un mximo de 30 dà ­as desde la finalizacià ³n regular del programa mientras que los de la F-1 tienen un mximo de 60 dà ­as desde la fecha de finalizacià ³n regular del programa. Tiempo de permanencia para los titulares de visas H En esta categorà ­a entran las H-1B para profesionales y modelos, las H-2A para agricultura, las H-2B para trabajos temporeros no agrà ­colas, las H-3 para formacià ³n profesional y las H-4 para familiares de los titulares de otras visa H y que estn en Estados Unidos como acompaà ±antes. Todas estas personas pueden ingresar a Estados Unidos un mximo de 10 dà ­as antes de comenzar su trabajo y el periodo de gracia para permanecer en el paà ­s una vez que se acaba el trabajo es de 10 dà ­as. Incrementar el tiempo que se puede permanecer legalmente Si se ha ingresado con una visa no inmigrante es posible solicitar una extensià ³n de la estadà ­a o un cambio a otro tipo de visa no inmigrante, como por ejemplo, un turista pasarse a estudiante.   Si la fecha de la estancia autorizada llega a su fin antes que la aprobacià ³n de la extensià ³n se considera que no hay problema siempre y cuando la peticià ³n se hubiera realizado de buena fe.   Si se ha ingresado con visa, se ha pedido extensià ³n y no es aprobada, entonces con carcter general se conceden 30 dà ­as para salir de Estados Unidos. Los dà ­as se cuentan a partir de la fecha que aparece en la carta en la que se notifica la denegacià ³n. Pero hay que tener en cuenta que cada caso es un mundo, y que en la carta se puede notificar un periodo ms corto, que es el que habrà ­a que respetar. Sin embargo, un caso muy distinto al anterior es el de las personas que ingresaron sin visa como turistas o para hacer negocios por pertenecer a los paà ­ses del Visa Waiver Program. Estos extranjeros no pueden bajo ninguna circunstancia extender la estadà ­a ni solicitar ningà ºn tipo de visa mientras estn presentes en Estados Unidos. Si bien en casos muy concretos podrà ­an quedarse mediante un ajuste de estatus como por ejemplo en los casos de matrimonio con ciudadano y cumpliendo todos los requisitos. Pero son casos muy delicados y es siempre aconsejable asesorarse con un buen abogado de inmigracià ³n.  Finalmente,  en algunos casos muy especà ­ficos es posible pedir una restauracià ³n de estatus que es lo que se conoce por la expresià ³n del latà ­n nunc pro tunc. A tener en cuenta cuando se est en un periodo de gracia Hay que pensarlo dos veces antes de salir de USA y volver a ingresar, ya que puede suceder que no se permita el regreso. Quà © sucede cuando se sobrepasatiempo mximo de estancia Quedarse ms tiempo del permitido tiene importantes consecuencias migratorias que conviene no ignorar, asà ­ sea por sà ³lo un dà ­a el exceso. Lo primero, es que la persona se coloca en situacià ³n de indocumentada y, por lo tanto, puede ser detenida y dependiendo de las circunstancias de cada caso, puede ser expulsada o deportada. En algunos casos puede ser posible arreglar los papeles, pero en otros la situacià ³n de indocumentado cierra esa posibilidad por lo que antes de hacerlo conviene informarse bien con un abogado de migracià ³n reputado. Adems, la visa serà ­a revocada ya que es una de las causas de cancelacià ³n de la visa. En el caso de haber ingresado como turista sin visa por ser de un paà ­s del Programa de Exencià ³n de visados, se pierde ese privilegio. Finalmente, es posible incurrir en el castigo de los 3 y de los 10 aà ±os que podrà ­a complicar enormemente el regreso a Estados Unidos. Puntos clave Los turistas sin visa pueden permanecer 90 dà ­as, sin cambios ni extensià ³nLos turistas con visa B2, generalmente 180 dà ­as, pero verificar con el I-94Los estudiantes con visa F-1 y derivadas: 60 dà ­as desde fin de programaEstudiantes con visa M-1 y derivadas: 30 dà ­as desde fin de programaPrograma de intercambio J-1 y derivadas: 30 dà ­as desde el fin del programaVisas de trabajo H y derivadas: cuanto antes, mximo 10 dà ­as desde fin de trabajo Este es un artà ­culo informativo. No es asesorà ­a para ningà ºn caso concreto.

Supply Chain Essay Example | Topics and Well Written Essays - 750 words - 1

Supply Chain - Essay Example According to management study guide (MSG) (2013), a design framework should take into consideration elements of technology, external environment, market, and product. A supply chain is the critical backbone for distribution and consumption of goods and services (Watson et al. 2012). An efficient design should span across the market and should involve suppliers, wholesalers, retailers and consumers. With changing consumer patterns, firms want to supply their products through different channels (Watson et al. 2012). A supply chain network dictates the manufacturing methodology and assembly points a given good or service should be collected from (MSG 2013). An organization maximizes its profitability by minimizing transportation costs by setting up warehouses closer to the consumers (Watson et al. 2012). The production unit should be situated where transportation costs of raw materials are minimal. A supply chain network defines sales and marketing decisions. MSG (2013) states that a supply chain network extrapolates cost impacts and combines possible combinations to project profitability. Supply design network is a strategic endeavor that includes long term; short term and capacity planning that extend over lengthy time horizons. An integer and linear programming mathematical optimization are the best approaches to deciding on various options and determine the best locations for supply (Watson et al. 2012). A strategic fit concept requires that organizations achieve efficiency in a supply chain in a way that meets the organization’s competitive strategy. The organization has to identify relevant drivers to achieve this efficiency. In any organization, capital productivity in the supply chain context comes when responsiveness and efficiency are improved (Business and Management University, 2011). Inventory, transportation, information and facilities determine the

Consulting Assignment Example | Topics and Well Written Essays - 1000 words

Consulting - Assignment Example There is an expectation for the company to lead to economies of scale in storage, as well as the opening of a bigger market for the soft candies due to the merger. The level of IT of the company is crucial to make estimation on the efficiency it has on the Company. The assets of the merger companies are necessary to estimate the equity of the companies and also the physical conditions of the company so as to capitalize upon each asset jointly (Florzak, 2010). The main objectives for the consulting project are to give the company a sneak recommendation on the procedure to follow. This is in the acquisition of the company because some assets do not fit their uses including the refrigerator. This would help the company to expand on its marketing channels as well as their branding strategy (Maguire, 2007). There should be the development of an understanding of the requirement of customers from a print which is favorable and suppliers who are reprographic. This is in terms of service products as well as the products that the business makes. There is the identification of the major competitors that the company faces. As a result of the of the various strategies, the company will be able to define the range of the products as well as services that are on offer by the company so as to increase the company’s level of competition. It is also able to initiate a campaign that focuses on the gaining of new customers in the sector as well as to maintain the current customers. The approach in use gives an emphasis on the reasons for getting information which is reliable to the IT team, the manufacturing department, and marketing department from the two companies, as well as the distribution department. Use of secondary marketing research is in use for the establishment of an image of the dynamics surrounding the reprographic and printing market as well as the competitive situation. For the investigation of the

Information Technology Essay Example | Topics and Well Written Essays - 2000 words

Information Technology - Essay Example IBM markets and manufactures hardware along with software and involved in delivering other services such as infrastructure development that include nanotechnology and mainframe computers. The company was established in the year 1911 with the merger between three companies namely International Time Recording Company, Tabulating Machine Company and the Computing Scale Company (IBM, 2013). Specially mentioning, integration towards technological aspects is duly considered to be one of the decisive aspects for any business and IBM being one of the most renowned companies widely utilizes this particular concept. In this regard, integration is often viewed as one of the most cost-effective ways through which Information Technology (IT) is able to add commercial value to various enterprises. Over the years, numerous companies have spent end number of dollars for the primary objective of developing solutions in order to solve business problems (Bussler, 2003). In this respect, the essay will develop a problem along with a purpose statement about the evaluation of technology integration in IBM. Additionally, a model representing the efforts that could be made by the company in order to integrate its technologies to improve performance will also be included. For the purpose of determining the most effective integration strategies, the essay will follow up appropriate recommendations for integrating technologies to improve overall organizational performance. ... The organization possesses a special sort of technology named as Integrated Technology Services (ITS) that are backed by IBM processes, proprietary tools along with assets that ensure a dynamic IT infrastructure, catering to the requirements of the organization towards accomplishing its expected business targets. IBM delivers a broad array of infrastructure services such as build, design, maintenance, consulting and management that are intended to assist the organization while providing technological support (Taylor, 2004; IBM, 2013). Information Technology is regarded as one of the most booming industries in today’s business landscape. With the advent of modern technologies, the demands of consumers are rising by a considerable extent. It can be viewed that the consumers nowadays seem to be attached with procuring digitalized products and thus, each of the product needs to be manufactured as per the requirements of the modern day technological savvy individuals (Gurstein, 200 7). In relation to these aspects, IBM has been able to fulfill the requirements of the customers through performing effective technological integration within the organization. However, the overall IT based industry is filled with several challenges. In this context, the evaluation of technology integration within IBM provided certain factors that may pose adverse implications in near future. It has been realized that the organization follows technological integration procedure in a diversified way. However, it has also been realized that the organization does not make much efforts to tackle future business uncertainties. Numerous business issues may come into play and amongst these, IBM often face the problem of increased level of business

Does Birth Control Need to Be Implemented to Limit the Population Essay

Does Birth Control Need to Be Implemented to Limit the Population - Essay Example Although some of Joy Williams’ reasoning for her argument may be true and plausible, she has overlooked some other aspects of her view that may address and prove her argument to be null and inefficient.  Williams’ main claim is that a woman’s craving for babies leads to overpopulation and can cause detrimental problems in our world. However, her argument displays the post hoc fallacy, which underscores the author’s making a mistake of placing the causes of the overpopulation merely on the increasing rate of procreation of women today. Williams notes, according to the United Nations Population Fund, that â€Å"at current growth rates, the world will double its population in forty years† (par. 8), thereby, â€Å"overpopulation poses the greatest threat to all life on earth† (par. 8). She maintains that having babies can be considered as a selfish act, with no concern for the outside world. Williams displays the red herring fallacy when she st arts talking about adoption. This has nothing to do with the subject and can be considered a side issue. Adoption is unlike giving birth and is usually done because of pre-existing circumstances. The two points – procreation rates and adoption – are linked, but do not affect one another. Women who are unable to conceive children should not be looking down upon if they choose to adopt. This is because someone has already given birth to a child – a decision that the adopter had no part of. Adoption is a good thing because it makes sure that unwanted babies are looked after and cared for by a loving parent. It is a different matter completely if someone is able to conceive and then chooses to adopt. Williams discusses a relevant point when talking about adoption. Parents usually want to adopt children who do not have any physical flaws. This is a natural thought process but it does not allow less fortunate babies to get an opportunity in life.

Advanced Research Methods Dissertation Example | Topics and Well Written Essays - 2750 words

Advanced Research Methods - Dissertation Example Companies are expanding operations in other nations and the increasing incidence of mergers, acquisitions and joint ventures have increased the challenges before organizations in terms of managing a diversified and cross cultural work force. For example, an American company shifting its manufacturing and marketing facilities in China will have to integrate organizational HR practices in keeping with the lifestyle and culture of the local population. Such situations can result in cross cultural conflicts that can adversely impact organizational culture and productivity. It is very difficult for American executives to adapt to Chinese culture and systems of working. Such circumstances create responsibility for the HR department to ensure that cross cultural relationships within the organization are cordial and positive so that the company functions smoothly. This proposal is about a quantitative research that will be carried out in the area of human resource management in an organizati on that is shifting its manufacturing facilities from the US to China in order to benefit from the accruing economies of scale, low costs of production and cheap availability of raw material. The proposal will outline the research strategy on how to deal effectively with the emerging issues of training a culturally diversified workforce. Introduction The study will address some major issues in terms of the extent to which a cross cultural training strategy can work positively in improving the company’s performance in China. In order to achieve this objective, exhaustive research will have to be carried out on how expatriates and local employees have to be dealt with. Initially the company will have to ask Americans or nationals from other countries to work in China because key positions in the company cannot be performed by Chinese nationals. The research will ascertain the merits and demerits if cross-cultural training modules and also ascertain the approaches that will work best in the given environment. Another objective will be to develop theories of efficient cross-cultural modules for global human resource personnel. HRM is widely acknowledged as a management resource that imbibes the maximum possible management actions and decisions that impact relationships amongst the organization and workers (Beer et al, 1986). It is the process that coordinates the organization’s human resources in meeting organizational objectives. Therefore, the job of HR professionals becomes quite complicated because all aspects of the firm and workers have to be encompassed. It is believed that the most significant asset of the organization is its people that assist in achieving its goals, and this comprises the core of the HRM philosophy. Human resources are the most important asset and are the major force that drives human resource management in any organization. Human resource personnel have to take care of areas such as professional development, compensation, benefits, performance evaluation, recruitment, health and safety, job design, job analysis, labor relations and management of a diverse work force (Lipiec, 2002). According to Schermerhorn (2002), there is global inter-dependence in the global economy in terms of resources and markets whereby every business thrives because of competition. Internationalization has led businesses to act and think globally in order to succeed in a competitive environment. Some theorists have viewed globalization as providing massive growth potential for both developed and developing

Expanding the methodology in the lit. review Essay

Expanding the methodology in the lit. review - Essay Example Many children suffered with defective communication because of Autism Spectrum Disorder (ASD). In this literature review researcher put forward some teaching methods and special strategies that are in favor of the teachers who worked in the field of educating children with special education needs. Qualitative research approaches help the learner to keep reliability and authenticity. As Deborah Padgett rightly comments; â€Å"For all their demands, qualitative methods can provide the most rewarding experience a researcher will have† (Padgett, 1998, p.1). The research makes use of secondary data which include various strategies and approaches on teaching autistic children with the help of diagrams, study reports tables, survey reports, and so on the qualitative approach for the reason for the study as it best ensembles for the aims and objectives of the research. 4.1 Literature Review Beginning session of the research (2, 3, 3.1, and 3.2) includes information on autism and an ov erview about the current education status which practiced in Saudi Arabia. Then it discuss about available interventions and form of inclusive education for children with autism. Dr. Julie A. Buckley made notable researches in the field of autism spectrum disorder and its treatments. According to her autism spectrum disorder is strictly psychological disease and it needs appropriate medical treatments and behaviorally based therapies. In their joint venture entitled; Healing Our Autistic Children: A Medical Plan for Restoring Your Child's Health, Julie A. Buckley and Jenny McCarthy remark; â€Å"As your child progresses through his treatment plan, make sure not to underestimate the skills he may will be acquiring and becoming able to use† (Buckley & McCarthy, 2010, p. 192). The study provides plenty of information about various behaviorally based therapies for autistic children to ensure structured development in learning. Researchers and social activists often identify the p roblem of misunderstanding in diagnosing and healing of children with autism. Social interactive approaches prove its effectiveness in promoting better education for children with special needs. Martyn Long et al have conducted the UK based study entitled The Psychology of Education: The Evidence Base for Teaching and Learning and the study gives variety of teaching methods and strategies for children with autism and other kinds of developmental disorders. The problem of lacking teaching methods and strategies creates obstacles in the way which providing better education facilities both Britain and Saudi Arabia. Studies prove that Britain current education system in Britain keeps better improvements in providing education for children with autism. Owners of the study remarks; â€Å"Another approach to teaching children with autism, particularly those with severe and profound learning difficulties has been through social interactive approaches† (Long, Wood, Littleton, Passenge r and Sheehy, 2010, p.306). Elaine Fletcher-Janzen’s study suggests variety of teaching strategies and techniques for autistic children to achieve knowledge acquisition. The study reveals that the absence of a well planned

Does Birth Control Need to Be Implemented to Limit the Population Essay

Does Birth Control Need to Be Implemented to Limit the Population - Essay Example Although some of Joy Williams’ reasoning for her argument may be true and plausible, she has overlooked some other aspects of her view that may address and prove her argument to be null and inefficient.  Williams’ main claim is that a woman’s craving for babies leads to overpopulation and can cause detrimental problems in our world. However, her argument displays the post hoc fallacy, which underscores the author’s making a mistake of placing the causes of the overpopulation merely on the increasing rate of procreation of women today. Williams notes, according to the United Nations Population Fund, that â€Å"at current growth rates, the world will double its population in forty years† (par. 8), thereby, â€Å"overpopulation poses the greatest threat to all life on earth† (par. 8). She maintains that having babies can be considered as a selfish act, with no concern for the outside world. Williams displays the red herring fallacy when she st arts talking about adoption. This has nothing to do with the subject and can be considered a side issue. Adoption is unlike giving birth and is usually done because of pre-existing circumstances. The two points – procreation rates and adoption – are linked, but do not affect one another. Women who are unable to conceive children should not be looking down upon if they choose to adopt. This is because someone has already given birth to a child – a decision that the adopter had no part of. Adoption is a good thing because it makes sure that unwanted babies are looked after and cared for by a loving parent. It is a different matter completely if someone is able to conceive and then chooses to adopt. Williams discusses a relevant point when talking about adoption. Parents usually want to adopt children who do not have any physical flaws. This is a natural thought process but it does not allow less fortunate babies to get an opportunity in life.

Expanding the methodology in the lit. review Essay

Expanding the methodology in the lit. review - Essay Example Many children suffered with defective communication because of Autism Spectrum Disorder (ASD). In this literature review researcher put forward some teaching methods and special strategies that are in favor of the teachers who worked in the field of educating children with special education needs. Qualitative research approaches help the learner to keep reliability and authenticity. As Deborah Padgett rightly comments; â€Å"For all their demands, qualitative methods can provide the most rewarding experience a researcher will have† (Padgett, 1998, p.1). The research makes use of secondary data which include various strategies and approaches on teaching autistic children with the help of diagrams, study reports tables, survey reports, and so on the qualitative approach for the reason for the study as it best ensembles for the aims and objectives of the research. 4.1 Literature Review Beginning session of the research (2, 3, 3.1, and 3.2) includes information on autism and an ov erview about the current education status which practiced in Saudi Arabia. Then it discuss about available interventions and form of inclusive education for children with autism. Dr. Julie A. Buckley made notable researches in the field of autism spectrum disorder and its treatments. According to her autism spectrum disorder is strictly psychological disease and it needs appropriate medical treatments and behaviorally based therapies. In their joint venture entitled; Healing Our Autistic Children: A Medical Plan for Restoring Your Child's Health, Julie A. Buckley and Jenny McCarthy remark; â€Å"As your child progresses through his treatment plan, make sure not to underestimate the skills he may will be acquiring and becoming able to use† (Buckley & McCarthy, 2010, p. 192). The study provides plenty of information about various behaviorally based therapies for autistic children to ensure structured development in learning. Researchers and social activists often identify the p roblem of misunderstanding in diagnosing and healing of children with autism. Social interactive approaches prove its effectiveness in promoting better education for children with special needs. Martyn Long et al have conducted the UK based study entitled The Psychology of Education: The Evidence Base for Teaching and Learning and the study gives variety of teaching methods and strategies for children with autism and other kinds of developmental disorders. The problem of lacking teaching methods and strategies creates obstacles in the way which providing better education facilities both Britain and Saudi Arabia. Studies prove that Britain current education system in Britain keeps better improvements in providing education for children with autism. Owners of the study remarks; â€Å"Another approach to teaching children with autism, particularly those with severe and profound learning difficulties has been through social interactive approaches† (Long, Wood, Littleton, Passenge r and Sheehy, 2010, p.306). Elaine Fletcher-Janzen’s study suggests variety of teaching strategies and techniques for autistic children to achieve knowledge acquisition. The study reveals that the absence of a well planned

Eating - Pica Essay Example for Free

Eating Pica Essay Pica is a compulsion to eat non food items when it is considered to be developmentally inappropriate for a time length of no less than one month. This disorder, also known as a â€Å"phenomenon† has been around since ancient times, with certain cultures accepting this not as a disorder, but as an accepted practice. There are several categories for describing pica. Some of the most commonly described types of pica are eating earth, soil or clay (Geophagia), ice (Pagophagia), and starch (Amylophagia) in humans. (http://www. encyclopedia. com/topic/pica. aspx). Pica is usually noticed in pregnancy, developmental delay and mental retardation, psychiatric disease and autism, early childhood, poor nutrition, lack of specific nutrients, vitamins, and/or minerals, and certain specific religions and their corresponding specific traditions. The specific causes for Pica are unknown, but certain conditions and situations can increase a person’s risk: Nutritional deficiencies such as iron and zinc Dieting- consuming non food items to obtain a feeling of â€Å"fullness† Malnutrition-especially in underdeveloped countries. Cultural factors such as family practices and religious factors Parental neglect, lack of supervision, or food deprivation Developmental problems Mental health conditions Pregnancy Epilepsy Brain damage (http://kidshealth. org/PageManager. jsp? dn=KidsHealthlic=1ps=107cat_id=146article_set=22148) Research suggests that there is no known cause for this disorder. In most studies into the disorder, the â€Å"habit† of eating non-nutritive substances usually clears up on its on terms for no known reason. Nevertheless, this disorder should be considered serious, as there are multiple risk factors up to and including death that present as outcomes. Pica has been shown to be a predisposing factor in accidental ingestion of poisons, particularly lead poisoning. The ingestion of bizarre or unusual substances has also resulted in other potentially life threatening toxicities, such as hyperkalemia after cautopyreiophagia (ingestion of burnt match heads) (http://emedicine. medscape. com/article/914765-overview) To date, there are no lab studies to show the onset, cause, and /or leading factors that contribute to this disorder. It is common practice to identify and treat a person for effects only after they have become susceptible to medical treatment. Physical examination findings are highly dispersed and depend directly on what substance has been ingested. Most research suggests that pregnant woman crave a specific nutrient missing from their diet, therefore consuming a specific non food substance rich in that nutrient to fulfill what their body is looking for. Most children up to two years old are said to simply be â€Å"exploring their environment† and do so by putting everything into their mouths. Medications used to help treat Pica disorder are commonly SSRI’s such as: Olanzapine: a drug typically used to treat the symptoms of various mental illnesses that cause a loss of interest in life, unusual thinking, or inappropriate emotions, such as schizophrenia and bipolar disorder. Clozapine: another drug used to treat the symptoms of various mental illnesses by transforming natural substance activities in the brain. Risperidone: used to treat the symptoms assoc. with manic states and bipolar disorder. Both Olanzapine and Clozapine belong to a class of atypical antipsychotics that are sometimes used in Pica patients to help change the way they see certain materials and reduce their negative eating habits. Risperidone can be used to treat the symptoms of Pica disorder, as well as some of the underlying causes, including depression and psychotic factors. The most successful approach to treating a client with Pica disorder is a behavioral approach. Behavioral strategies have been shown to be extremely effective in treating many forms of Pica, up to and including: Discrimination training. Mouth self-protection devices Reinforcement behaviors Screening techniques (ex: covering eyes) Aversive oral taste (mint, lemon, etc. ) Aversive smell techniques Aversive physical sensation (ex: alternative response) Brief physical restraint Consultations (http://www. health guideinfo. com/other-eating-disorders) In General, the use of medications for Pica disorder are commonly used for the person(s) with a mental handicap, or in combination with any other medical diagnosis (ex: depression, ADHD, obsessive compulsive disorder). Many physicians will have a focused aim on finding out if the body is lacking a nutrient†¦usually noted to be iron. There is no evidence to say that a lack of iron is linked to the disorder. Side effects will also vary depending on the type of substance was ingested. Common side effects include: constipation, cramping, pain, obstruction of bowel or intestine due to blockage, perforation from ingesting sharp objects, contamination and infection from ingesting parasites, weight gain, malnutrition, gestational diabetes false +, and decreased absorption of nutrients in the stomach (http://www. encyclopedia.com/topic/Pica. aspx). There is no true prognosis for Pica disorder as it depends on the substance and amount of the substance taken in. Usually the side effects and complications tend to dissipate as the behavior is stopped. Pica is seen in studies to subside once the labor has been successful and in children as they age, usually around two years of age. There are no specific lab studies indicated in the evaluation of a person with pica. Lab tests are generally completed when a patient has been seen by their physician for a complaint. As a patient admitted to the E. R. , the attending Dr.may order abdominal x-rays, barium swallows of the G. I. tracts, and an upper GI endoscopy in order to get a handle of what has been ingested and the location of the substances. A list of commonly ingested non-food items consumed includes: Dirt Clay Paint chips Plaster Chalk Cornstarch Laundry starch Baking soda Coffee grounds Cigarette ashes Burnt match heads Cigarette butts Feces Ice Glue Hair Buttons Paper Sand Toothpaste Soap A common approach used is education for patients in regards to a healthy approach to consumption to adequate sources of food substances. A common failure is non-information throughout the world.

Effects of Drowning on the Body

Effects of Drowning on the Body According to the new definition adopted by the WHO in 2002, Drowning is the process of experiencing respiratory impairment from submersion/immersion in liquid. Drowning is defined as death from asphyxia that occurs within the first 24 hours of submersion in water. Near drowning refers to survival that lasts beyond 24 hours after a submersion episode. Hence, it connotes an immersion episode of sufficient severity to warrant medical attention that may lead to morbidity and death. Drowning is, by definition, fatal, but near drowning may also be fatal. (2) Drowning is the seventh leading cause of accidental death in the United States. Though the exact incidence in India can only be a crude estimate, one keeps coming across incidences of drowning fatalities. Many boating accidents lead to fatalities, possibly due to concomitant accidental injuries or trapping in submerged boat. Motor vehicle accidents with a fall in streams or ponds are also being reported with similar settings. Drowning can also occur in scuba divers but may be associated with cardiac event or arterial gas embolism. Other possibilities to be kept in mind include hypothermia, contaminated breathing gas, oxygen induced seizures. Even community swimming pool and home bathtubs and buckets are known to be adequate for young children to drown accidentally. Majority of such events are due to unsupervised swimming, esp in shallow pools or pools with inadequate safety measures. One look for features of closed head injury or occult neck fractures while management of such cases. Intentional hyperventilation before breath-hold diving is associated with drowning episodes.(3) Weak swimmers attempting to rescue other persons may themselves be at risk of drowning. Males are more likely than females to be involved in submersion injuries. This is consistent with increased risk-taking behavior in boys, especially in adolescence.(4) CAUSES OF DROWNING Alcohol consumption, which impairs coordination and judgement Failure to observe water safety rules e.g. having no life preserver or unsupervised swimming. Sustaining a head and neck injury while involved with a water sport Boating accidents Fatigue or exhaustion, muscle and stomach cramps Diving accidents including scuba diving Medical event while in the water e.g. seizure, stroke, and heart attack Suicide attempt Illicit drug use Incapacitating marine animal bite or sting Entanglement in underwater growth Drowning and near-drowning events must be thought of as primary versus secondary events. Secondary causes of drowning include seizures, head or spine trauma, cardiac arrhythmias, hypothermia, syncope, apnea, and hypoglycemia. PATHOPHYSIOLOGY Drowning occurs when a person is submerged in water. The principal physiologic consequences of immersion injury are prolonged hypoxemia and acidosis, as a result of immersion in any fluid medium. The most important contribution to morbidity and mortality resulting from near drowning is hypoxemia and its consequent metabolic effects. Immersion may produce panic with its respiratory responses or may produce breath holding in the individual. Beyond the breakpoint for breath-hold, the victim reflexly attempts to breathe and aspirates water. Asphyxia leads to relaxation of the airway, which permits the lungs to take in water in many individuals (wet drowning). Approximately 10-15% of individuals develop water-induced spasm of the air passage, laryngospasm, which is maintained until cardiac arrest occurs and inspiratory efforts have ceased. These victims do not aspirate any appreciable fluid (dry drowning). It is still controversial whether such a drowning occurs or not.(5) Wet drowning is caused by inhaling large amounts of water into the lungs. Wet drowning in fresh water differs from salt water drowning in terms of the mechanism for causing suffocation. However, in both cases water inhalation leads to damage to the lungs and interfere with the bodys ability to exchange gases. If fresh water is inhaled, it passes from the lungs to the bloodstream and destroys red blood cells. If salt water is inhaled, the salt causes fluid from the body to enter the lung tissue displacing the air. The pathophysiology of near drowning is intimately related to the multiorgan effects secondary to hypoxemia and ischemic acidosis. Depending upon the degree of hypoxemia and resultant acidosis, the person may develop cardiac arrest and central nervous system (CNS) ischemia.CNS damage may occur because of hypoxemia sustained during the drowning episode per se or may occur secondarily because of pulmonary damage and subsequent hypoxemia. Additional CNS insult may result from concomitant head or spinal cord injury. Although differences observed between freshwater and saltwater aspirations in electrolyte and fluid imbalances are frequently discussed, they rarely of clinical significance for people experiencing near drowning. Most patients aspirate less than 4 ml/kg of fluid. 11 ml/kg is required for alterations in blood volume, and more than 22 ml/kg of aspiration is required before significant electrolyte changes develop. Regardless, most patients are hypovolemic at presentation because of increased capillary permeability from hypoxia resulting in losses of fluid from the intravascular compartment. Hyponatremia may develop from swallowing large amounts of fresh water. The temperature of the water, not the patient, determines whether the submersion is categorized as a cold or warm drowning. Warm-water drowning occurs at a temperature greater than or equal to 20Â °C, cold-water drowning occurs in water temperatures less than 20Â °C, and very cold-water drowning refers to temperatures less than or equal to 5Â °C. Hypothermia reduces the persons ability to respond to immersion, finally leading to helplessness or unconsciousness. Pulmonary Effects Aspiration of only 1-3 ml/kg of fluid can result in significantly impaired gas exchange. Fresh water moves rapidly across the alveolar-capillary membrane into the microcirculation. It causes disruption of alveolar surfactant, producing alveolar instability, atelectasis, and decreased compliance with marked ventilation/perfusion (V/Q) mismatching. As much as 75% of blood flow may circulate through hypoventilated lungs which acts as a shunt. Salt water, which is hyperosmolar, increases the osmotic gradient, and therefore draws fluid into the alveoli. Surfactant washout occurs, and protein-rich fluid exudates rapidly into the alveoli and pulmonary interstitium. Compliance is reduced, alveolar-capillary basement membrane is damaged directly, and shunt occurs. This results in rapid induction of serious hypoxia. Both mechanisms cause pronounced injury to the alveoli/capillary unit resulting in pulmonary edema. Fluid-induced bronchospasm also may contribute to hypoxia. Increased airway resistance secondary to plugging of the patients airway with debris (vomitus, sand, silt, diatoms, or algae), as well as release of inflammatory mediators, result in vasoconstriction and reactive exudation, which impairs gas exchange. A high risk of death exists secondary to the development of adult respiratory distress syndrome (ARDS), which has been termed postimmersion syndrome or secondary drowning. Late effects include pneumonia, abscess formation, and inflammatory damage to alveolar capillary membranes. Postobstructive pulmonary edema following laryngeal spasm and hypoxic neuronal injury with resultant neurogenic pulmonary edema also may play roles. Cardiovascular Effects Hypovolemia is secondary to fluid losses from increased capillary permeability. Profound hypotension may occur during and after the initial resuscitation period. Ischemic metabolic acidosis due to lactic acid accumulation impairs cardiac function. This may often be a large component especially when the victim struggles violently trying to save himself. In addition, hypoxemia may directly damage the myocardium. Myocardial dysfunction result from ventricular dysrhythmias and asystole, decreasing cardiac output. Pulmonary hypertension may result from the release of pulmonary inflammatory mediators, which increase the right ventricular afterload, thus decreasing contractility. CNS Effects If hypoxemia and decreased cardiac output persists long enough, anoxic brain damage can ensue. Improvement in the management of pulmonary dysfunction caused by near drowning has left CNS injury the major determinant of subsequent survival and long-term morbidity. Hypothermia Thermal conduction of water is 25-30 times that of air. The temperature of thermally neutral water, in which a nude individuals heat production balances heat loss, is 33Â °C. Physical exertion increases heat loss secondary to convection/conduction. A significant risk of hypothermia usually develops in water temperatures less than 25Â °C. Other Effects The clinical course may be complicated by multiple organ failure resulting from prolonged hypoxia. Disseminated intravascular coagulation, hepatic and renal insufficiency, metabolic acidosis, and gastrointestinal injuries must be considered and appropriately managed. CLINICAL FEATURES (6) History All aspects leading to the submersion episode should be determined. Most patients are found after having been submerged in water for an unobserved period. Rarely does a patient present with the classic story of a novice swimmer stranded in water, frantically struggling and flapping arms in desperation. It is important to extract certain relevant factors in the beginning of resuscitative efforts, which include submersion time, associated trauma (especially cervical spine and head), drug or alcohol ingestion, type of water, degree of water contamination, water temperature, and response to initial resuscitation maneuvers. Pertinent past medical history must be obtained to look for secondary causes of drowning, particularly trauma, seizures, cardiac disease, syncope, exhaustion, alcohol and drug use, hypothermia, diabetes mellitus, psychiatric history with suicidal tendencies or panic disorder, poor neuromuscular control such as severe arthritis or neuromuscular disorder. Physical Examination The clinical presentation of people who experience submersion injuries varies greatly. A victim of a submersion incident may be classified initially into one of the following four groups: a) Asymptomatic b) Symptomatic, manifesting with: Altered vital signs (eg, hypothermia, tachycardia, bradycardia) Anxious appearance Tachypnea, dyspnea, or hypoxia Metabolic acidosis (may exist in asymptomatic patients as well) Altered level of consciousness, neurologic deficit. Vomiting. c) Cardiopulmonary arrest, manifesting as: Apnea Asystole, ventricular tachycardia or fibrillation, bradycardia Immersion syndrome d) Obviously dead, as noted by: Normothermic with asystole Apnea No apparent CNS function Rigor mortis Dependent lividity The following clinical conditions need to be excluded Spinal Cord Injuries Head trauma Cardiac Arrhythmias Seizures Laboratory workup An electrocardiogram is indicated if there is evidence of significant tachycardia, bradycardia, or dysrhythmia or risk of underlying cardiac disease. Arterial blood gas analysis is probably the most reliable clinical parameter in patients who are asymptomatic or mildly symptomatic. A surprising degree of hypoxia can exist without clinical signs. Draw blood for serum glucose levels, complete blood cell count, serum electrolyte levels, liver enzymes, lactate level, and coagulation profile, if indicated. Continuous pulse oximetry and cardiorespiratory monitoring may be needed. Chest radiography should be done for evidence of aspiration, pulmonary edema, or segmental atelectasis suggesting foreign body aspiration. Acute renal impairment is known to occur frequently in near drowning, and while usually mild, severe renal impairment requiring dialysis may occur. If initial tests show elevated serum creatinine, marked metabolic acidosis, abnormal urinalysis, or significant lymphocytosis, serial estimations of serum creatinine should be performed. Cervical spine radiograph or computerized tomography (CT) scanning is helpful in individuals with history of trauma, neck pain, or if doubt exists about the circumstances surrounding the submersion injury. Non contrast head CT scanning is helpful in an individual with altered mental status and a suggestive or unclear history of head trauma. Treatment Pre Hospital Care Optimal pre-hospital care is the most significant determinant of outcome in the management of immersion victims. The patient should be removed from water at the earliest opportunity. If spinal trauma is suspected the individual should be moved the least amount possible, with attention to cervical spine stabilization. The primary aims of treatment of the near drowning cases should be in the order of priority, as below.(7) Effective immediate relief of hypoxia. Restoration of cardiovascular stability. Prevention of heat loss. Speedy evacuation to hospital. As in any rescue initiative, initial treatment should be geared toward ensuring patency of the airway, breathing, and circulation. Initiate rescue breathing immediately, if feasible even while the patient is still in the water. Chest compressions are not effective in the water and waste valuable time. The Heimlich maneuver has not been shown to be effective in removing aspirated water. In the patient with an altered mental status, the airway should be checked for foreign material and vomitus and debris visible in the oropharynx should be removed with a finger-sweep maneuver. Higher pressures may be required for ventilation because of the poor compliance resulting from pulmonary edema. Supplemental 100% oxygen by mask should be administered as soon as available. The degree of hypoxemia may be difficult to determine on clinical observation. Begin rewarming; wet clothing is ideally removed before the victim is wrapped in warming blankets. Hospital Care (7-9) Even those victims who appear normal on arrival at hospital can deteriorate rapidly. An accurate and rapid initial assessment of the victim is essentialInitial management of near drowning should place emphasis on basic life support algorithms and on immediate resuscitation and treatment of respiratory failure, with establishment of an adequate airway and cardiopulmonary resuscitation, if necessary. Associated injuries must be considered, as in any other form of accidental injury. Consider potential spinal injuries, especially in diving accidents. The need for hospitalization is determined on clinical evaluation. Provide all victims of a submersion injury with supplemental oxygen during their evaluations. Noninvasive continuous pulse oximetry is valuable. Patients with completely normal findings on examination and trivial history may be discharged after a 6-hour observational period. Admit any patient with respiratory symptoms, altered oxygenation by pulse oximetry or blood gas analysis, or altered mental status. The most critical role in management is prompt correction of hypoxemia and acidosis. Immediate use of supplemental oxygen with laryngeal mask or other devices achieving high fractional inspired oxygen should be instituted. Consider intubation and mechanical ventilation in any patient with poor respiratory effort, altered sensorium, severe hypoxemia, severe acidosis, significant respiratory distress, if a patient is unable to maintain a PaO2 of greater than 60-70 mm Hg (>80 mm Hg in children) on 100% oxygen by face mask or PaCO2 is > 45 mm Hg. Endotracheal intubation and mechanical ventilation may be indicated in awake individuals unable to maintain adequate oxygenation on oxygen, by mask or via continuous positive airway pressure (CPAP) or in whom airway protection is warranted. Intubated victims of submersion injury may require 5-10cm H2O PEEP may improve oxygenationpositive end expiratory pressure (PEEP) with mechanical ventilation to maintain adequate oxygenation. PEEP has been shown to improve ventilation patterns in the noncompliant lung in several ways, including 1) shifting interstitial pulmonary water into the capillaries, 2) increasing lung volume via prevention of expiratory airway collapse, 3] providing better alveolar ventilation and decreasing capillary blood flow, and 4) increasing the diameter of both small and large airways to improve distribution of ventilation. Pulmonary insufficiency due to drowning may warrant use of surfactant, though its efficacy to be used routinely in all cases has not been demonstrated. Bronchoscopy may be necessary for removal of significant inhaled foreign bodies, such as water debris or aspirated food Intravascular volume depletion is common, secondary to pulmonary edema and intracompartmental fluid shifts, regardless of the type of fluid aspirated. Rapid volume expansion may be indicated using isotonic saline. Ventricular dysrhythmias (typically, ventricular tachycardia or ventricular fibrillation), bradycardia, and asystole may occur as a result of acidosis and hypoxemia, rather than due to electrolyte imbalances. Inotropic support may be required using dopamine or dobutamine. Central venous pressure monitoring may be warranted. Most acidosis is restored after correction of volume depletion and oxygenation. Sodium bicarbonate may be administered in cases of severe acidosis that do not correct using the above measures, but only administer it after adequate ventilation has been established. Most immersion victims become hypothermic gradually and are at risk for ventricular fibrillation and neurologic injury. Re-warming method is dependent on the degree of hypothermia and the patients response. Aggressively rewarm hypothermic patients to restore normal body temperature. Core rewarming with warmed oxygen, continuous bladder lavage with fluid at 40Â °C, and intravenous infusion of isotonic fluids at 40Â °C should be initiated during resuscitation. Warm peritoneal lavage may be required for core rewarming in severely hypothermic patients. Place a nasogastric tube for removal of swallowed water and debris and to assist in rewarming efforts. Urinary catheterization for ongoing urine output measurement may be warranted to assess urine output. The benefits of resuscitative efforts should be continuously reassessed in such situations. Initiate appropriate treatment of hypoglycemia and other electrolyte imbalances, seizures, bronchospasm, cold-induced bronchorrhea, dysrhythmias and hypotension as necessary. Corticosteroids have been shown to be of no benefit in the management of near drowning. Routine antibiotic prophylaxis is not indicated unless the patient was submerged in grossly contaminated water or sewage. Patient disposal depends on the history, presence of associated injuries, and degree of immersion injury. Victims, who only have mild symptoms that improve during observation and have no abnormalities on arterial blood gas studies or pulse oximetry and chest radiograph, should be observed for a more prolonged period of time in the emergency department (about 6 hours). Certain patients may display mild to moderately severe hypoxemia that is corrected easily with oxygen. Admit these patients to the hospital for observation and discharge only after resolution of hypoxemia, if they have no further complications. All patients requiring intubation and mechanical ventilation should be admitted to the Intensive Care Unit. Varying degrees of neurologic as well as pulmonary insults typically complicate their courses. COMPLICATIONS Immediate complications are secondary to hypoxia and acidosis. The immediate threat is the effect on the cardiovascular system. Hypoxia and acidosis may lead to cardiac dysrhythmias, including ventricular fibrillation and asystole. Myocardial damage may lead to cardiogenic shock. Monitor and maintain intravascular volume and blood pressure. Central venous pressure (CVP) monitoring is useful in those patients requiring intensive care. Aspiration of fresh or salt water alters the function of surfactant, causing injury to the alveoli and pulmonary capillaries. Increased capillary permeability can worsen the hypoxia. Continuous pulse oximetry is useful. The early use of supplemental oxygen with high levels of positive end-expiratory pressure is helpful in reversing hypoxemia. Central nervous system effects depend on the severity and duration of hypoxia. Post hypoxic cerebral hypo perfusion may occur. Cerebral edema and intracranial hypertension secondary to hypoxic neuronal injury is frequently observed, but studies have shown that invasive monitoring of intracranial pressure is neither useful nor necessary in near-drowning incidents. Near-drowning patients frequently develop pneumonia, often due to secondary bacterial infections. Whether prophylactic antibiotics are beneficial is still controversial. Chemical pneumonitis also is not infrequent, especially if the submersion occurs in chlorinated or severely contaminated pools. PROGNOSIS The most significant impact on morbidity and mortality occurs before the patient arrives at the hospital. The prognosis is related directly to the duration and magnitude of hypoxia. Poor survival is associated with the need for continued cardiopulmonary resuscitation efforts on arrival to the hospital. Many survivors have long-term neurologic sequelae. If they recover from the pulmonary effects of the submersion, patients who are fully awake on arrival to the hospital generally do very well. Neuro-protective effects only seem to occur if the hypothermia occurs at the time of submersion and only with very rapid cooling in water less than 5Â °C. PREVENTION In most instances, drowning and near drowning can be prevented with simple safety measures and common sense. Most young children enter a swimming pool directly adjacent to their home or one with inadequate fencing or unlatched gates or doors. Adult supervision is essential in the prevention of drowning. Because lapses of supervision are inevitable, other safety precautions must be in place. The use of adequate fencing around swimming pools decreases the number of immersion injuries significantly. The enclosure may be a wall or fence at least 4 feet tall that completely surrounds a pool on all four sides. Doors and gates to the pool should be self-closing and self-latching. The use of personal flotation devices may reduce the incidence of drowning among children when playing in natural bodies of water or when boating. Pool owners should be trained on basic life support. Both children and adults should be instructed to never swim alone or unsupervised. Alcohol and drugs should not be used when operating or riding in motorized watercraft.