Wednesday, July 31, 2019
The Twilight Saga 4: Breaking Dawn 12. Some People Just Don’t Grasp …
12. Some People Just Don't Grasp The Concept Of ââ¬Å"Unwelcomeâ⬠I was right on the edge of sleep. The sun had risen behind the clouds an hour ago ââ¬â the forest was gray now instead of black. Seth'd curled up and passed out around one, and I'd woken him at dawn to trade off. Even after running all night, I was having a hard time making my brain shut up long enough to fall asleep, but Seth's rhythmic run was helping. One, two-three, four, one, two-three, four ââ¬â dum dum-dum dam ââ¬â dull paw thuds against the damp earth, over and over as he made the wide circuit surrounding the Cullens' land. We were already wearing a trail into the ground. Seth's thoughts were empty, just a blur of green and gray as the woods flew past him. It was restful. It helped to fill my head with what he saw rather than letting my own images take center stage. And then Seth's piercing howl broke the early morning quiet. I lurched up from the ground, my front legs pulling toward a sprint before my hind legs were off the ground. I raced toward the place where Seth had frozen, listening with him to the tread of paws running in our direction. Morning, boys. A shocked whine broke through Seth's teeth. And then we both snarled as we read deeper into the new thoughts. Oh, man! Goaway, Leah! Seth groaned. I stopped when I got to Seth, head thrown back, ready to howl again ââ¬â this time to complain. Cut the noise, Seth. Right. Ugh! Ugh! Ugh!He whimpered and pawed at the ground, scratching deep furrows in the dirt. Leah trotted into view, her small gray body weaving through the underbrush. Stop whining, Seth. You're such a baby. I growled at her, my ears flattening against my skull. She skipped back a step automatically. What do you think you're doing, Leah? She huffed a heavy sigh. It's pretty obvious, isn't it? I'm joining your crappy little renegade pack. The vampires' guard dogs. She barked out a low, sarcastic laugh. No, you're not. Turn around before I rip out one of your hamstrings. Like you could catch me.She grinned and coiled her body for launch. Wanna race, O fearless leader? I took a deep breath, filling my lungs until my sides bulged. Then, when I was sure I wasn't going to scream, i exhaled in a gust. Seth, go let the Cullens know that it's just your stupid sister ââ¬â thought the words as harshly as possible. deal with this. On it!Seth was only too happy to leave. He vanished toward the house. Leah whined, and she leaned after him, the fur on her shoulders rising. You're just going to let him run off to the vampires alone? I'm pretty sure he'd rather they took him out than spend another minute with you. Shut up, Jacob. Oops, I'm sorry ââ¬â meant, shut up, most high Alpha. Why thehellare you here? You think I'm just going to sit home while my little brother volunteers as a vampire chew toy? Seth doesn't want or need your protection. In fact, no one wants you here. Oooh, ouch, that's gonna leave ahuge mark. Ha, she barked. Tell me who does want me around, and I'm outta here. So this isn't about Seth at all, is it? Of course it is. I'm just pointing out that being unwanted is not a first for me. Not really a motivating factor, if you know what I mean. I gritted my teeth and tried to get my head straight. Did Sam send you? If I was here on Sam's errand, you wouldn't be able to hear me. My allegiance is no longer with him. I listened carefully to the thoughts mixed in with the words. If this was a diversion or a ploy, I had to be alert enough to see through it. But there was nothing. Her declaration was nothing but the truth. Unwilling, almost despairing truth. You're loyal tome now? I asked with deep sarcasm. Uh-huh. Right. My choices are limited. I'm working with the options I've got. Trust me, I'm not enjoying this any more than you are. That wasn't true. There was an edgy kind of excitement in her mind. She was unhappy about this, but she was also riding some weird high. I searched her mind, trying to understand. She bristled, resenting the intrusion. I usually tried to tune Leah out ââ¬â I'd never tried to make sense of her before. We were interrupted by Seth, thinking his explanation at Edward. Leah whined anxiously. Edward's face, framed in the same window as last night, showed no reaction to the news. It was a blank face, dead. Wow, he looks bad,Seth muttered to himself. The vampire showed no reaction to that thought, either. He disappeared into the house. Seth pivoted and headed back out to us. Leah relaxed a little. What's going on?Leah asked. Catch me up to speed. There's no point You're not staying. Actually, Mr. Alpha, I am. Because since apparently I have to belong tosomeone ââ¬â and don't think I haven't tried breaking off on my own, you know yourself how wellthat doesn ââ¬Ët work ââ¬â choose you. Leah, you don't like me. I don't like you. Thank you, Captain Obvious. That doesn't matter to me. I'm staying with Seth. You don't like vampires. Don't you think that's a little conflict of interest right there? You don't like vampires either. But Iam committed to this alliance. You aren't. I'll keep my distance from them. I can run patrols out here, just like Seth. And I'm supposed to trust you with that? She stretched her neck, leaning up on her toes, trying to be as tall as me as she stared into my eyes. will not betray my pack. I wanted to throw my head back and howl, like Seth had before. This isn't your pack! This isn't even a pack. This is just me, going off on my own! What is it with you Clearwaters? Why can't you leave me alone? Seth, just coming up behind us now, whined; I'd offended him. Great. I've been helpful, haven't I, Jake? You haven't madetoo much a nuisance of yourself, kid, but if you and Leah are a package deal ââ¬â if the only way to get rid of her is for you to go homeâ⬠¦. Weil, can you blame me for wanting you gone? Ugh, Leah, you ruin everything! Yeah, I know,she told him, and the thought was loaded with the heaviness of her despair. I felt the pain in the three little words, and it was more than I would've guessed. I didn't want to feel that. I didn't want to feel bad for her. Sure, the pack was rough on her, but she brought it all on herself with the bitterness that tainted her every thought and made being in her head a nightmare. Seth was feeling guilty, too. Jakeâ⬠¦ You're not really gonna send me away, are you? Leah's not so bad. Really. I mean, with her here, we can push the perimeter out farther. And this puts Sam down to seven. There's no way he's going to mount an attack that outnumbered. It's probably a good thingâ⬠¦. You know I don't want to lead a pack, Seth. So don't lead us,Leah offered. I snorted. Sounds perfect to me. Run along home now. Jake,Seth thought. belong here. I do like vampires. Cullens, anyway. They're people to me, and I'm going to protect them, 'cause that's what we're supposed to do. Maybe you belong, kid, but your sister doesn't And she's going to go wherever you are ââ¬â I stopped short, because I saw something when I said that. Something Leah had been trying not to think. Leah wasn't going anywhere. Thought this was about Seth,I thought sourly. She flinched. Of course I'm here for Seth. And to get away from Sam. Her jaw clenched. don't have to explain myself to you. I just have to do what I'm told. I belong to your pack, Jacob. The end. I paced away from her, growling. Crap. I was never going to get rid of her. As much as she disliked me, as much as she loathed the Cullens, as happy as she'd be to go kill all the vampires right now, as much as it pissed her off to have to protect them instead ââ¬â none of that was anything compared to what she felt being free of Sam. Leah didn't like me, so it wasn't such a chore having me wish she would disappear. She loved Sam. Still. And having him wish she would disappear was more pain than she was willing to live with, now that she had a choice. She would have taken any other option. Even if it meant moving in with the Cullens as their lapdog. don't know if I'd go that far, she thought. She tried to make the words tough, aggressive, but there were big cracks in her show. I'm sure I'd give killing myself a few good tries first. Look, Leahâ⬠¦ No,you look, Jacob. Stop arguing with me, because it's not going to do any good. I'll stay out of your way, okay? I'll do anything you want Except go back to Sam's pack and be the pathetic ex-girlfriend he can't get away from. If you want me to leave ââ¬â she sat back on her haunches and stared straight into my eyes ââ¬â you're going to have tomake me. I snarled for a long, angry minute. I was beginning to feel some sympathy for Sam, despite what he had done to me, to Seth. No wonder he was always ordering the pack around. How else would you ever get anything done? Seth, are you gonna get mad at me if I kill your sister? He pretended to think about it for a minute. Wellâ⬠¦ yeah, probably. I sighed. Okay, then, Ms. Do-Anything-I-Want Why don't you make yourself useful by telling us what you know? What happened after we left last night? Lots of howling. But you probably heard that part. It was so loud that it took us a while to figure out that we couldn't hear either of you anymore. Sam wasâ⬠¦Words failed her, but we could see it in our head. Both Seth and I cringed. After that, it was clear pretty quick that we were going to have to rethink things. Sam was planning to talk to the other Elders first thing this morning. We were supposed to meet up and figure out a game plan. I could tell he wasn't going to mount another attack right away, though. Suicide at this point, with you and Seth AWOL and the bloodsuckers forewarned. I'm not sure what they'll do, but I wouldn't be wandering the forest alone if I was a leech. It's open season on vamps now. You decided to skip the meeting this morning?I asked. When we split up for patrols last night, I asked permission to go home, to tell my mother what had happened ââ¬â Crap! You told Mom?Seth growled. Seth, hold off on the sibling stuff for a sec. Go on, Leah. So once I was human, I took a minute to think things through. Well, actually, I took all night. I bet the others think I fell asleep. But the whole two-separate-packs, two-separate-pack-minds thing gave mea lot to sift through. In the end, I weighed Seth's safety and the, er, other benefits against the idea of turning traitor and sniffing vampire stink for who knows how long. You know what I decided. I left a note for my mom. I expect we'll hear it when Sam finds out . .. Leah cocked an ear to the west. Yeah, I expect we will,I agreed. So that's everything. What do we do now?she asked. She and Seth both looked at me expectantly. This was exactly the kind of thing I didn't want to have to do. guess we just keep an eye out for now. That's all we can do. You should probably take a nap, Leah. You've had as much sleep as I have. Thought you were going to do what you were told? Right. That's going to get old,she grumbled, and then she yawned. Well, whatever. I don't care. I'll run the border, Jake. I'm not tired at all.Seth was so glad I hadn't forced them home, he was all but prancing with excitement. Sure, sure. I'm going to go check in with the Cullens. Seth took off along the new path worn into the damp earth. Leah looked after him thoughtfully. Maybe a round or two before I crashâ⬠¦. Hey Seth, wanna see how many times I can lap you? NO! Barking out a low chuckle, Leah lunged into the woods after him. I growled uselessly. So much for peace and quiet. Leah was trying ââ¬â for Leah. She kept her jibes to a minimum as she raced around the circuit, but it was impossible not to be aware of her smug mood. I thought of the whole ââ¬Å"two's companyâ⬠saying. It didn't really apply, because one was plenty to my mind. But if there had to be three of us, it was hard to think of anyone that I wouldn't trade her for. Paul?she suggested. Maybe,I allowed. She laughed to herself, too jittery and hyper to get offended, i wondered how long the buzz from dodging Sam's pity would last. That will be my goal then ââ¬â to be less annoying than Paul. Yeah, work on that I changed into my other form when I was a few yards from the lawn. I hadn't been planning to spend much time human here. But I hadn't been planning to have Leah in my head, either. I pulled on my ragged shorts and started across the lawn. The door opened before I got to the steps, and I was surprised to see Carlisle rather than Edward step outside to meet me ââ¬â his face looked exhausted and defeated. For a second, my heart froze. I faltered to a stop, unable to speak. ââ¬Å"Are you all right, Jacob?â⬠Carlisle asked. ââ¬Å"Is Bella?â⬠I choked out. ââ¬Å"She'sâ⬠¦ much the same as last night. Did I startle you? I'm sorry. Edward said you were coming in your human form, and I came out to greet you, as he didn't want to leave her. She's awake.â⬠And Edward didn't want to lose any time with her, because he didn't have much time left. Carlisle didn't say the words out loud, but he might as well have. It had been a while since I'd slept ââ¬â since before my last patrol. I could really feel that now. I took a step forward, sat down on the porch steps, and slumped against the railing. Moving whisper-quiet as only a vampire could, Carlisle took a seat on the same step, against the other railing. ââ¬Å"I didn't get a chance to thank you last night, Jacob. You don't know how much I appreciate yourâ⬠¦ compassion. I know your goal was to protect Bella, but I owe you the safety of the rest of my family as well. Edward told me what you had to do___â⬠ââ¬Å"Don't mention it,â⬠I muttered. ââ¬Å"If you prefer.â⬠We sat in silence. I could hear the others in the house. Emmett, Alice, and Jasper, speaking in low, serious voices upstairs. Esme humming tunelessly in another room. Rosalie and Edward breathing close by ââ¬â I couldn't tell which was which, but I could hear the difference in Bella's labored panting. I could hear her heart, too. It seemedâ⬠¦ uneven. It was like fate was out to make me do everything I'd ever sworn I wouldn't in the course of twenty-four hours. Here I was, hanging around, waiting for her to die. I didn't want to listen anymore. Talking was better than listening. ââ¬Å"She's family to you?â⬠I asked Carlisle. It had caught my notice before, when he'd said I'd helped the rest of his family, too. ââ¬Å"Yes. Bella is already a daughter to me. A beloved daughter.â⬠ââ¬Å"But you're going to let her die.â⬠He was quiet long enough that I looked up. His face was very, very tired. I knew how he felt. ââ¬Å"I can imagine what you think of me for that,â⬠he finally said. ââ¬Å"But i can't ignore her will. It wouldn't be right to make such a choice for her, to force her.â⬠I wanted to be angry with him, but he was making it hard. It was like he was throwing my own words back at me, just scrambled up. They'd sounded right before, but they couldn't be right now. Not with Bella dying. Stillâ⬠¦ I remembered how it felt to be broken on the ground under Sam ââ¬â to have no choice but be involved in the murder of someone I loved. It wasn't the same, though. Sam was wrong. And Bella loved things she shouldn't. ââ¬Å"Do you think there's any chance she'll make it? I mean, as a vampire and all that. She told me aboutâ⬠¦ about Esme.â⬠Tel say there's an even chance at this point,â⬠he answered quietly. ââ¬Å"I've seen vampire venom work miracles, but there are conditions that even venom cannot overcome. Her heart is working too hard now; if it should failâ⬠¦ there won't be anything for me to do.â⬠Bella's heartbeat throbbed and faltered, giving an agonizing emphasis to his words. Maybe the planet had started turning backward. Maybe that would explain how everything was the opposite of what it had been yesterday ââ¬â how I could be hoping for what had once seemed like the very worst thing in the world. ââ¬Å"What is that thing doing to her?â⬠I whispered. ââ¬Å"She was so much worse last night. I sawâ⬠¦ the tubes and all that. Through the window.â⬠ââ¬Å"The fetus isn't compatible with her body. Too strong, for one thing, but she could probably endure that for a while. The bigger problem is that it won't allow her to get the sustenance she needs. Her body is rejecting every form of nutrition. I'm trying to feed her intravenously, but she's just not absorbing it. Everything about her condition is accelerated. I'm watching her ââ¬â and not just her, but the fetus as well ââ¬â starve to death by the hour. I can't stop it and I can't slow it down. I can't figure out what it wantsâ⬠His weary voice broke at the end. I felt the same way I had yesterday, when I'd seen the black stains across her stomach ââ¬â furious, and a little crazy. I clenched my hands into fists to control the shaking. I hated the thing that was hurting her. It wasn't enough for the monster to beat her from the inside out. No, it was starving her, too. Probably just looking for something to sink its teeth into ââ¬â a throat to suck dry. Since it wasn't big enough to kill anyone else yet, it settled for sucking Bella's life from her. I could tell them exactly what it wanted: death and blood, blood and death. My skin was all hot and prickly. I breathed slowly in and out, focusing on that to calm myself. ââ¬Å"I wish I could get a better idea of what exactly it is,â⬠Carlisle murmured. ââ¬Å"The fetus is well protected. I haven't been able to produce an ultrasonic image. I doubt there is any way to get a needle through the amniotic sac, but Rosalie won't agree to let me try, in any case.â⬠ââ¬Å"A needle?â⬠I mumbled. ââ¬Å"What good would that do?â⬠ââ¬Å"The more I know about the fetus, the better I can estimate what it will be capable of. What I wouldn't give for even a little amniotic fluid. If I knew even the chromosomal countâ⬠¦Ã¢â¬ ââ¬Å"You're losing me, Doc. Can you dumb it down?â⬠He chuckled once ââ¬â even his laugh sounded exhausted. ââ¬Å"Okay. How much biology have you taken? Did you study chromosomal pairs?â⬠ââ¬Å"Think so. We have twenty-three, right?â⬠ââ¬Å"Humans do.â⬠I blinked. ââ¬Å"How many do you have?â⬠ââ¬Å"Twenty-five.â⬠I frowned at my fists for a second. ââ¬Å"What does that mean?â⬠ââ¬Å"I thought it meant that our species were almost completely different. Less related than a lion and a house cat. But this new life ââ¬â well, it suggests that we're more genetically compatible than I'd thought.â⬠He sighed sadly. ââ¬Å"I didn't know to warn them.â⬠I sighed, too. It had been easy to hate Edward for the same ignorance. I still hated him for it. It was just hard to feel the same way about Carlisle. Maybe because I wasn't ten shades of jealous in Carlisle's case. ââ¬Å"It might help to know what the count was ââ¬â whether the fetus was closer to us or to her. To know what to expect.â⬠Then he shrugged. ââ¬Å"And maybe it wouldn't help anything. I guess I just wish I had something to study, anything to do.â⬠ââ¬Å"Wonder what my chromosomes are like,â⬠I muttered randomly. I thought of those Olympic steroids tests again. Did they run DNA scans? Carlisle coughed self-consciously. ââ¬Å"You have twenty-four pairs, Jacob.â⬠I turned slowly to stare at him, raising my eyebrows. He looked embarrassed. ââ¬Å"I wasâ⬠¦ curious. I took the liberty when I was treating you last June.â⬠I thought about it for a second. ââ¬Å"I guess that should piss me off. But I don't really care.â⬠ââ¬Å"I'm sorry. I should have asked.â⬠ââ¬Å"S'okay, Doc. You didn't mean any harm.â⬠ââ¬Å"No, I promise you that I did not mean you any harm. It's just thatâ⬠¦ I find your species fascinating. I suppose that the elements of vampiric nature have come to seem commonplace to me over the centuries. Your family's divergence from humanity is much more interesting. Magical, almost.â⬠ââ¬Å"Bibbidi-Bobbidi-Boo,â⬠I mumbled. He was just like Bella with all the magic garbage. Carlisle laughed another weary laugh. Then we heard Edward's voice inside the house, and we both paused to listen. ââ¬Å"I'll be right back, Bella. I want to speak with Carlisle for a moment. Actually, Rosalie, would you mind accompanying me?â⬠Edward sounded different. There was a little life in his dead voice. A spark of something. Not hope exactly, but maybe the desire to hope. ââ¬Å"What is it, Edward?â⬠Bella asked hoarsely. ââ¬Å"Nothing you need to worry about, love. It will just take a second. Please, Rose?â⬠ââ¬Å"Esme?â⬠Rosalie called. ââ¬Å"Can you mindBella for me?â⬠Iheard the whisper of wind as Esme flitted down the stairs. ââ¬Å"Of course,â⬠she said. Carlisle shifted, twisting to look expectantly at the door. Edward was through the door first, with Rosalie right on his heels. His face was, like his voice, no longer dead. He seemed intensely focused. Rosalie looked suspicious. Edward shut the door behind her. ââ¬Å"Carlisle,â⬠he murmured. ââ¬Å"What is it, Edward?â⬠ââ¬Å"Perhaps we've been going about this the wrong way. I was listening to you and Jacob just now, and when you were speaking of what theâ⬠¦ fetus wants, Jacob had an interesting thought.â⬠Me?What had thought? Besides my obvious hatred for the thing? At least I wasn't alone in that. I could tell that Edward had a difficult time using a term as mild as fetus. ââ¬Å"We haven't actually addressed that angle,â⬠Edward went on. ââ¬Å"We've been trying to get Bella what she needs. And her body is accepting it about as well as one of ours would. Perhaps we should address the needs of theâ⬠¦ fetus first. Maybe if we can satisfy it, we'll be able to help her more effectively.â⬠ââ¬Å"I'm not following you, Edward,â⬠Carlisle said. ââ¬Å"Think about it, Carlisle. If that creature is more vampire than human, can't you guess what it craves ââ¬â what it's not getting? Jacob did.â⬠I did? I ran through the conversation, trying to remember what thoughts I'd kept to myself. I remembered at the same time that Carlisle understood. ââ¬Å"Oh,â⬠he said in a surprised tone. ââ¬Å"You think it isâ⬠¦ thirsty?â⬠Rosalie hissed under her breath. She wasn't suspicious anymore. Her revoltingly perfect face wasall lit up, her eyes wide with excitement. ââ¬Å"Of course,â⬠she muttered. ââ¬Å"Carlisle, we have all that type O negative laid aside for Bella. It's a good idea,â⬠she added, not looking at me. ââ¬Å"Hmm.â⬠Carlisle put his hand to his chin, lost in thought. ââ¬Å"I wonderâ⬠¦ And then, what would be the best way to administer___â⬠Rosalie shook her head. ââ¬Å"We don't have time to be creative. I'd say we should start with the traditional way.â⬠ââ¬Å"Wait a minute,â⬠i whispered. ââ¬Å"Just hold on. Are you ââ¬â are you talking about making Bella drink blood?â⬠ââ¬Å"It was your idea, dog,â⬠Rosalie said, scowling at me without ever quite looking at me. I ignored her and watched Carlisle. That same ghost of hope that had been in Edward's face was now in the doctor's eyes. He pursed his lips, speculating. ââ¬Å"That's justâ⬠¦Ã¢â¬ I couldn't find the right word. ââ¬Å"Monstrous?â⬠Edward suggested. ââ¬Å"Repulsive?â⬠ââ¬Å"Pretty much.â⬠ââ¬Å"But what if it helps her?â⬠he whispered. I shook my head angrily. ââ¬Å"What are you gonna do, shove a tube down her throat?â⬠ââ¬Å"I plan to ask her what she thinks. I just wanted to run it past Carlisle first.â⬠Rosalie nodded. ââ¬Å"If you tell her it might help the baby, she'll be willing to do anything. Even if we do have to feed them through a tube.â⬠I realized then ââ¬â when I heard how her voice got all loveydovey as she said the word baby ââ¬â that Blondie would be in line with anything that helped the little life-sucking monster. Was that what was going on, the mystery factor that was bonding the two of them? Was Rosalie after the kid? From the corner of my eye, I saw Edward nod once, absently, not looking in my direction. But I knew he was answering my questions. Huh. I wouldn't have thought the ice-cold Barbie would have a maternal side. So much for protecting Bella ââ¬â Rosalie'd probably jam the tube down Bella's throat herself. Edward's mouth mashed into a hard line, and I knew I was right again. ââ¬Å"Well, we don't have time to sit around discussing this,â⬠Rosalie said impatiently. ââ¬Å"What do you think, Carlisle? Can we try?â⬠Carlisle took a deep breath, and then he was on his feet. ââ¬Å"We'll ask Bella.â⬠Blondie smiled smugly ââ¬â sure that, if it was up to Bella, she would get her way. I dragged myself up from the stairs and followed after them as they disappeared into the house. I wasn't sure why. Just morbid curiosity, maybe. It was like a horror movie. Monsters and blood all over the place. Maybe I just couldn't resist another hit of my dwindling drug supply. Bella lay flat on the hospital bed, her belly a mountain under the sheet. She looked like wax ââ¬â colorless and sort of see-through. You'd think she was already dead, except for the tiny movement of her chest, her shallow breathing. And then her eyes, following the four of us with exhausted suspicion. The others were at her side already, flitting across the room with sudden darting motions. It was creepy to watch. 1 ambled along at a slow walk. ââ¬Å"What's going on?â⬠Bella demanded in a scratchy whisper. Her waxy hand twitched up ââ¬â like she was trying to protect her balloon-shaped stomach. ââ¬Å"Jacob had an idea that might help you,â⬠Carlisle said. I wished he would leave me out of it. I hadn't suggested anything. Give the credit to her bloodsucking husband, where it belonged. ââ¬Å"It won't beâ⬠¦ pleasant, but ââ¬â ââ¬Å" ââ¬Å"But it will help the baby,â⬠Rosalie interrupted eagerly. ââ¬Å"We've thought of a better way to feed him. Maybe.â⬠Bella's eyelids fluttered. Then she coughed out a weak chuckle. ââ¬Å"Not pleasant?â⬠she whispered. ââ¬Å"Gosh, that'll be such a change.â⬠She eyed the tube stuck into her arm and coughed again. Blondie laughed with her. The girl looked like she only had hours left, and she had to be in pain, but she was making jokes. So Bella. Trying to ease the tension, make it better for everyone else. Edward stepped around Rosalie, no humor touching his intense expression. I was glad for that. It helped, just a little bit, that he was suffering worse than me. He took her hand, not the one that was still protecting her swollen belly. ââ¬Å"Bella, love, we're going to ask you to do something monstrous,â⬠he said, using the same adjectives he'd offered me. ââ¬Å"Repulsive.â⬠Well, at least he was giving it to her straight. She took a shallow, fluttery breath. ââ¬Å"How bad?â⬠Carlisle answered. ââ¬Å"We think the fetus might have an appetite closer to ours than to yours. We think it's thirsty.â⬠She blinked. ââ¬Å"Oh. Oh.â⬠ââ¬Å"Your condition ââ¬â both of your conditions ââ¬â are deteriorating rapidly. We don't have time to waste, to come up with more palatable ways to do this. The fastest way to test the theory ââ¬â ââ¬Å" ââ¬Å"I've got to drink it,â⬠she whispered. She nodded slightly ââ¬â barely enough energy for a little head bob. ââ¬Å"I can do that. Practice for the future, right?â⬠Her colorless lips stretched into a faint grin as she looked at Edward. He didn't smile back. Rosalie started tapping her toe impatiently. The sound was really irritating. I wondered what she would do if I threw her through a wall right now. ââ¬Å"So, who's going to catch me a grizzly bear?â⬠Bella whispered. Carlisle and Edward exchanged a quick glance. Rosalie stopped tapping. ââ¬Å"What?â⬠Bella asked. ââ¬Å"It will be a more effective test if we don't cut corners, Bella,â⬠Carlisle said. ââ¬Å"Ifthe fetus is craving blood,â⬠Edward explained, ââ¬Å"it's not craving animal blood.â⬠ââ¬Å"It won't make a difference to you, Bella. Don't think about it,â⬠Rosalie encouraged. Bella's eyes widened. ââ¬Å"Who?â⬠she breathed, and her gaze flickered to me. ââ¬Å"I'm not here as a donor, Bells,â⬠I grumbled. ââ¬Å"ââ¬ËSides, it's human blood that thing's after, and I don't think mine applies ââ¬â ââ¬Å" ââ¬Å"We have blood on hand,â⬠Rosalie told her, talking over me before I'd finished, like I wasn't there. ââ¬Å"For you ââ¬â just in case. Don't worry about anything at all. It's going to be fine. I have a good feeling about this, Bella. I think the baby will be so much better.â⬠Bella:s hand ran across her stomach. ââ¬Å"Well,â⬠she rasped, barely audible. ââ¬Å"I'm starving, so I'll bet he is, too.â⬠Trying to make another joke. ââ¬Å"Let's go for it. My first vampire act.ââ¬
Tuesday, July 30, 2019
Discipleship Counseling
Discipleship Counseling provides training in bible discipleship and gives descriptions and techniques on how to provide instruction to people in need according to Godââ¬â¢s word. Anderson uses the Word of God as the sole authority in his book Discipleship Counseling and discusses forms of therapy based on the biblical concept of discipleship. The purpose of this paper is to first briefly summarize the book and then discuss three major themes that were stated in Anderson's book. Discipleship Counseling widely discusses the concept of mental health and how to set valuable principles in helping Christians and non Christians alike.Showing people how to find their identity in Christ and to give up false lies of Satan shown through the worldââ¬â¢s eyes. Anderson's discipleship counseling is to give support that can help clients overcome psychological and emotional problems by setting captives free by ridding false beliefs about the true Creator, our God of the Bible and His infinite and loving character. People are transformed by the renewing of their minds (Romans 12:2) and must be conformed to the image of God to understand how the mind works; this and faith walking is an essential part of the sanctification process throughout the book (Anderson, 2003, pp.à 86-87).Discipleship Counseling also demonstrates how an individual must give up their control in order to walk in that newness which is ours through what Christ has done for all of humanity (Romans 6:4) and in that relinquishing walk people can ââ¬Å"give up the pleasure of things in exchange for the pleasure of lifeâ⬠(Anderson, 2003, p. 280). In Discipleship Counseling conflict resolution has varied levels each of those based on the maturity of the people being helped. In order to come to the very first level one must go through the sanctification process.Without a person knowing their heritage in Christ and having assurance and faith of their salvation, they will not be capable to be rooted and to grow in Christ. With no rooting, the plant will not grow and God has given us models of how people are to grow in His word, which is the ultimate truth in oneââ¬â¢s heritage. The levels laid out rely on defining who counselors are working with and by determining that personââ¬â¢s level of maturity At which time the councelor can start at root issues that need to be resolved, growth issues, and walking with Christ in life issues.At level one, thereââ¬â¢s changing from previous ways of living into a new and righteous relationship with God. If they are dealing with believers, the believer must change from their sin ways and start walking in Godââ¬â¢s truth. After which, they are instructed to walk by faith through the truth of His word. People must believe that His word is true or their faith will not be fruitful. The suffering or wounded people must be able to obtain and demonstrate their new found character of Christ even while walking through their difficulties.People at the stage of needing help must surrender to the new growth being attached to the word of God and His presence because with Him, there is no life at the root, without life the root the vine will not grow. Their first priority should be their personal relationship with God. The very basic first stage must be managed because unsettled issues will hinder the other workings of the other stages as well. If someone has harmed you, either at home or in a work situation, bring the matter to God. ââ¬Å"Trust in the LORD and do good. Then you will live safely in the land and prosper.Take delight in the LORD, and he will give you your heart's desiresâ⬠(Psalm 37:3-4) Identifying and overcoming road blocks will lead to forgiveness and reconciliation of self brokenness or broken relationships. The apostle Paul talks about how conflict can bring glory to God (Cor. 10:31-11:1) helping to serve others and to grow in Christ. If people can step through the stepping stones of resolution they will have a better and closer relationship to God, which will flow through them into the lives of others through the guiding of the Holy Spirit.The Freedom appointment was also an essential element in where the counselor helps their Christian counseleesââ¬â¢ take the responsibility of their life and consequences, claiming their personal identity and purpose in Christ and then resolving past personal and spiritual conflicts. These key points help them live life productively in Christ (Anderson, 2003, p. 198). In the Freedom Appointment section Anderson gives full credit to Jesus as the wonderful counselor and makes no assertions at his writing being solely needed to become an effective counselor.He himself claimed to have learned most through trial and error. However, he does state that it requires helpers to be dependent on God, in His character and in His truth. ââ¬Å"Just because so many lies flourish in the realm of psychology does not mean Christians should abandon it. Inste ad, Christians must bring Godââ¬â¢s truth to a deceived disciplineâ⬠(Anderson, Zuehlke, & Zuehlke, 2000). Christ came to destroy the craftiness of the devil and his scheming, He alone can conquer satan. If God alone can conquer satan, what could people do if they are walking with an omnipotent, omnipresent God?Being one with God in spirit gives much power to denounce the lies and deceit. Once a lie is found out it has no power over an individual, truth will heal the falsehood and barrier. Through prayer, declaration and generational resolutions people can be liberated from past inventory and give affirmation to their common ground with God. ââ¬Å"Where will you be stricken again, as you continue in your rebellion? The whole head is sick and the whole heart is faintâ⬠(Isaiah 1:5). Oneââ¬â¢s mind and heart must also be examined and working in compliance to His truth.Satan loves to hit the mind and his lies live in the darkness and dark thoughts, but he is overwhelme d and will flee when the truth of the light shines upon his wickedness. ââ¬Å"The heart is deceitful above all things, and desperately wicked: who can know it? â⬠(Jeremiah 17:9) The heart and mind are the first targets of satan and his lies but when in Godââ¬â¢s word and following truth, this is when people can overthrow him. ââ¬Å"This word or truth is called the seed of God, because it is introduced and made known to the mind by the Holy Ghost. Hence we are said to be ââ¬Ëbegotten of God.'It is his truth that quickens the mind into right voluntary action. Now everyone knows, by his own consciousness, that this is the way in which he was born again. â⬠(Finney) Even through hidden lies deep-set into the mind satan destroys hope and encourages spiritual suicide. A person must come to forgiveness of his past and his throw away his previous false teachings to send the lies of satan into the pit of fire. With a heart and a calling to serve the Lord in Christian couns eling, people can be trained by Anderson through his Christian counseling techniques.Along with the Holy Spirit leading them, they and their counselees can strive to conform themselves to the image of Christ through the His sufferings and to the abandoning of all self-sufficiency for living life. This is when a person gives up his own control with reckless abandon. Satan started lies and trickery in the Garden of Eden when he claimed the Eve could be like God. That human temptation of trying to control every aspect of life has still rung true through the ages.In this day and age, people have a desire for total control but when all else fails they must sacrifice themselves to God in order for a richer blessing and peace. ââ¬Å"The only real control we have is deciding whom we serveâ⬠(Anderson N. T. , 2003, p. 281). The principles described in Andersonââ¬â¢s book are laid out well and useful, and they are echoed throughout the bible. Discipleship Counseling seeks to lead the believer to the end of his own personal strength regardless of how productive such self-seeking strengths may have proven to be.The Holy Spirit will work against the believer's dependence upon the flesh and when the worldliness and self skilled ways become unproductive the believer will come seeking counseling. This is when one seeks out God and His ultimate truth for healing. God works through His peacemaker and with that peacemaking training, through the love of Christ and resembling His gentle loving direction ââ¬Å"a gentle answer turns wrath aside, but a harsh word stirs up anger (Prov. 15:1) a Christian counselor can open many doors and steps leading to the Lords ultimate healing.
Monday, July 29, 2019
The two cases Carvaho v. tool brothers developer and Herczeng v Essay
The two cases Carvaho v. tool brothers developer and Herczeng v. haptom township municpal - Essay Example Francisco Caravalho, an employee of the subcontractor Jude Enterprises who was doing the excavation work, died when an unshored portion of the trench he was working in collapsed. [Handler] Argument The prosecution charged that Bergmanââ¬â¢s site inspector hired to observe the work performed and who was present when the accident happened to monitor the progress of the work had a duty to supervise safety procedures of the construction and that the inspector had knowledge of the unsafe condition. Responding to the suit by the widow, Mrs.Carvalho, Bergman said maintained that the engineer's contract disclaimed responsibility for jobsite safety [which the court allowed].The methods, the interpretation, and the enforcement of hold harmless agreements should be governed by the intention of the parties in providing for insurance and the division of risk. [Handler].The site inspectorââ¬â¢s duty was limited to inspect only the material being used and the amount of work being done. The ra tionale behind this defense was obviously the trust of the defense in the ââ¬Å"hold harmless clauseâ⬠in the defendantââ¬â¢s contract. He also noted because of an error he was not insured.
Sunday, July 28, 2019
British Airlines Essay Example | Topics and Well Written Essays - 750 words - 1
British Airlines - Essay Example Moreover, the board was to take control of other smaller regional airlines such as Cambrian Airways, fromà Cardiff, andà Northeast Airlines, to be based atà Newcastle upon Tyne.à Later on in 1974, all the four airlines were merged to form one major airline known as British Airways (British Airways 1998; British Airways 2006a, British Airways 2006b). British Airways remained to be a parasternal until 1987 when the company was privatized by the conservative government through the sale of its shares to members of the public. The national airline later on expanded by the acquisition of British Caledonianà in 1987 andà Dan-Air, and Gatwick-based carrier, in 1992 (British Airways 1995a; British Airways 2004; Anonymous 2002; Anonymous 2011; Bannan 2007). Since its formation in 1971, the company has long been one of the largest customers of Boeing aircrafts, which are manufactured in the United States. However, beginning August 1998, the company transformed and began purchasing aircrafts from Airbus, which are manufactured in the larger European countries (British Airways 2010a; 2010b; British Airways 2010c). Their first order involved the purchase of 59 Airbus A320 family aircrafts in the same year. Later on in 2007, the aircraft bought twelve more Airbus A380s (Benady 2008; British Airways 2000a; British Airways 2004a). However, in the same year, it purchased an additional 24 Boeing 787 Dreamliner to replace its old fleet. A vital part of the British airlines planes is the 52 Boeing 747-400 which it uses both for its domestic and regional flights. This makes it the largest operator in its category in the world (British Airways 2004b; British Airways 2004c; British Airways 2003). In order for British Airways to achieve such a huge milestone, it has developed various marketing strategies that are in line with the various marketing theories. One of the major marketing tools that it uses is the SWOT
Saturday, July 27, 2019
Divorce Regulations in Great Britain Research Paper
Divorce Regulations in Great Britain - Research Paper Example One answer no doubt lies in what could be called 'the spirit of the age'. 1963 was, after all, the year in which (according to Philip Larkin) 'sexual intercourse began'. It was also the year of the so-called Profumo affair in which a Minister of the Crown admitted lying to Parliament about his relationship with a woman, and unprecedented press publicity was given to the surrounding events and rumors. (For example, another Minister was said to indulge in 'weird sexual practices' involving his appearing naked--save for a mask--at parties.) Lord Denning's exhaustive investigation into these matters (concluding that although there had indeed been orgies where guests indulged in 'sexual activities of a vile and revolting nature' and that it was true dinner had been served by a naked masked man yet there was not a 'shred of evidence' that the man in question was a Minister) did little to calm the fevered atmosphere. In the circumstances, it became increasingly difficult to believe that civ ilisation would be endangered by allowing the thousands of (often elderly and usually eminently respectable) couples living together in what came to be called 'stable illicit unions' to crush the 'empty legal shell' of an earlier marriage so that they could become in law what they had long been in fact (Castles and Flood, 1991). The massive increase in divorce associated with ...At a somewhat less lofty level, those concerned with the administration of the family justice system became preoccupied with avoiding its collapse under the apparently relentless pressure of divorce petitions. 1But even amongst those who firmly believed the ideal of marriage--in particular as a way of providing children the 'settled and harmonious life on which so much of their future happiness depends' --to be the traditional union 'for better for worse, for richer for poorer . . . till death we do part' there was concern about a lot of the hundred thousand or more people living apart from their legal spouses in stable unions to which the law denied recognition. The impossibility of legalizing such relationships against the will of an 'innocent' legal spouse denied many men and women (and in particular the children they bore) adequate social and financial protection (Ceschini, 1995).In 1951 in an attempt to meet this concern, Mrs. Eirene White had introduced a Private Member's Bill into the House of Commons, avowedly intended 'to deal with marriages in which the spouses have lived separately for seven years, but in which no hitherto recognized ground for divorce exists or in which one partner, having grounds for action, declines to take it and keeps the other partner tied against his or her will, generally for life'. The Bill did this by invoking 'a new principle, in that it looks to the breakdown of the marriage as the ground for divorce (whilst not prejudicing the right of an injured party to seek divorce under the existing matrimonial offense provisions). This was to be achieved by adding seven years' separation to the existing grounds for divorce.
Contract law Assignment Example | Topics and Well Written Essays - 500 words
Contract law - Assignment Example The language of the contract is suffice to identify the mutual intent of the parties in a case where the language used is definite and clear. Courts always consider the course of the partiesââ¬â¢ dealings if the language of the contract is unclear. The course of dealings refers to the initial contract and transactions the parties might have had in the past to interpret their conduct and expressions. When determining the clarity and definiteness of the language of a contract, the court views the terms in their common and ordinary construct of meaning unless it is apparent that the parties constructed the language in some technical or special sense (Gillies 71). If the words are used in a technical sense, the courts will apply a concept known as trade usage, which is the courtââ¬â¢s consideration of constructing the meaning as per how it is used by a person in the same profession or business and formulate interpretation from that context unless the parties had not intended to use them as such. Generally, courts one of the two problematic rules governing admissions of evidence that is extrinsic to interpret a contract. One of the rules is the Plain Meaning Rule, which connects contract terms interpretation to the subjective notions of a Judge of the meaning of the words and deter parties from issuing evidence to change the meanings that are publically used are unanimously acknowledge. The Context Rule on the other side looks at the partiesââ¬â¢ evidence subjective intention exclusive of the public meaning of the terms, which also, undermines the function of contract predictability (Gillies 63). The third rule, which is The Public Meaning Rule, only admits the extrinsic evidence produced by the public and constructs the meaning of the language as interpreted by the public. It considers the public domain while making assumptions on the extrinsic evidence of the subjective intent of the parties. This rule has epistemological element that relies on the fact
Friday, July 26, 2019
Corporate Strategy Assignment Example | Topics and Well Written Essays - 2500 words - 2
Corporate Strategy - Assignment Example organisation has a worldwide network and international presence, a strategy that enable it to earn a substantive share of the market in the most competitive markets like the USA, UK and China. Dysonââ¬â¢s success can be attributed to the exceptional and robust strategic abilities that boost its competitive edge. The company corporate strategies can be analysing through investigating its current position in terms of environment and competitors, as well as its strategic options. Political: Dyson Company is a UK appliances manufacturer. The raising of funds in UK is not usually easy because the rates of interest that has been high. Fortunately for the company has been able to sign a deal with a Japanese company, which led to it invest in R & D. Dyson Company requires a considerably huge amount of money to engage in R & D. The organization does certainly not receive considerable favour from UK governing bodies; it was, nevertheless, bold enough to come up with startling innovations that have startled the industry (Hollensen, 2007). Economic: the contemporary market situation does not offer favourable conditions to any industry to expand its business, mostly for those that relate directly to consumers. There has been an unfavourable demand of the vacuum cleaner manufacturers in Wiltshire, and hence the organization has to close down its manufacturing plant. Dyson Company is considering relocating its vacuum cleaner manufacturing firm to the Far East where the cost of labour is relatively cheaper (Hollensen, 2007). The company presently have 1150 human resource that still work in its factory despite the layoff. According to research the market share of the company by volume, has gone down 25% over the past five years. Social: The critical factor that attributed to company success in the vacuum cleaner industry is the ability to mollify the apparently shifting demand. A burdensome aspect for many organizations in the vacuum cleaner sector has been tracking the tastes,
Thursday, July 25, 2019
Concepts Learned to a Real-life Simulation Experience Research Paper
Concepts Learned to a Real-life Simulation Experience - Research Paper Example Now, on the right hand side of the equation, ââ¬Ëeââ¬â¢ is taken as the number of times the interest is compounded. Now if we substitute the values in the equation we can get the following results. National First à Prime Rate 3.25% Floor Rate 6.75% Number of times compounded Semiannually i 0.1 e 2 a 10.25% Regions Best à Prime Rate 13.17% Number of times compounded Monthly i 13.17% e 12 a 13.99% (ii) Thus it is apparent from the above calculation that the company should borrow from National First Bank as it is charging interest at a lesser Equivalent rate which is 10.25%. If we suppose that the company acquires loan amounting to $ 8 million, then following will be the annual interest charge that the company will have to record in its income statement Loan Amount Bank Rate on interest Interest Charge $ 8,000,000 National First 10.25% $ 820,000.00 $ 8,000,000 Regions Best 13.99% $ 1,119,200.00 Thus it is apparent from the above calculation that in case of National First Ban k, the company would have to pay lesser amount of interest as compared to that if the loan amount was obtained from Regions Best Bank. By adopting to obtain funds from National First, the company will save $299,200 on account of interest payments. (iii) Evaluating the proposal of Regions Best, the following formula is to be used (Figure a) The above mentioned formula is termed as the formula for ââ¬Ëannuityââ¬â¢ in which ââ¬Å"Pâ⬠is the present value of the cumulative amount, ââ¬Å"Râ⬠is the period payments, ââ¬Å"Iâ⬠is the period interest rate and ââ¬Å"nâ⬠is the number of period for which the funds were borrowed. As per the terms decided with the Regions Best, the company will pay interest at 8.6% which shall be compounded monthly (that is why the ââ¬ËIââ¬â¢ in the formula of annuity has been divided by 12). Substituting the values we get P $ 6,950,000 i 8.60% n 5 years R $142,925 monthly Following is the loan schedule further explaining the computation Loan Schedule Months Opening Balance Annual Payments Interest Charged (8.6/12) Principal Paid Closing Balance 1 6,950,000 142,925 49,808 93,117 6,856,883 2 6,856,883 142,925 49,141 93,784 6,763,099 3 6,763,099 142,925 48,469 94,456 6,668,643 4 6,668,643 142,925 47,792 95,133 6,573,510 5 6,573,510 142,925 47,110 95,815 6,477,695 6 6,477,695 142,925 46,423 96,502 6,381,193 7 6,381,193 142,925 45,732 97,193 6,284,000 8 6,284,000 142,925 45,035 97,890 6,186,110 9 6,186,110 142,925 44,334 98,591 6,087,519 10 6,087,519 142,925 43,627 99,298 5,988,221 11 5,988,221 142,925 42,916 100,010 5,888,212 12 5,888,212 142,925 42,199 100,726 5,787,485 13 5,787,485 142,925 41,477 101,448 5,686,037 14 5,686,037 142,925 40,750 102,175 5,583,862 15 5,583,862 142,925 40,018 102,907 5,480,955 16 5,480,955 142,925 39,280 103,645 5,377,310 17 5,377,310 142,925 38,537 104,388 5,272,922 18 5,272,922 142,925 37,789 105,136 5,167,786 19 5,167,786 142,925 37,036 105,889 5,061,897 20 5,061,897 142,92 5 36,277 106,648 4,955,249 21 4,955,249 142,925 35,513 107,412 4,847,836 22 4,847,836 142,925 34,743 108,182 4,739,654 23 4,739,654 142,925 33,968 108,958 4,630,696 24 4,630,696 142,925 33,187 109,738 4,520,958 25 4,520,958 142,925 32,400 110,525 4,410,433 26 4,410,433 142,925 31,608 111,317 4,299,116 27 4,299,116 142,925 30,810 112,115 4,187,001 28 4,187,001 142,925 30,007 112,918
Wednesday, July 24, 2019
Does The Internet Affect Body Practice and Culture Essay
Does The Internet Affect Body Practice and Culture - Essay Example Currently, many people gain access to effective communication in their daily lives. Cultures have come to believe that instead of purchasing a radio, they would rather buy cell phones since the modern technology has made cell phones more accessible than radios. Advanced cell phones come with access of television networks. Therefore, many people consider owning one of the electrical products as a means of reducing complexity (Greenblatt 35). The internet and the workplace The current place of work in majority of organizations worldwide is changing at a fast rate. The workplace is turning out to be huge as the business surrounding increases in terms of demographic and financial aspects. Nevertheless, comprehending means by which effective communication can be made is the difficult part that these organizations encounter. The workplace consists of people who talk using different languages to arrive at a common objective. Cross-cultural communications approaches are hence being implement ed in these organizations for effective management and communication purposes (Durham & Kellner 98). One cross-cultural communication strategy is introduction of the new norm. The internet and advanced technology fall in the category of new norms being adapted by numerous multinational corporations. The internet has created novel markets for the organizations, not to mention permitting the promotion of these organizations to new demographic locations and traditions. Given technological advances such as the internet, the staff can communicate remotely making cross-cultural communication the new norm (Greenblatt 51). Another cross-cultural communication approach enhanced by organizations involves accepting cultural diversity. Novel communication confrontations are brought about by various traditional backgrounds in the place of work. These differences are currently considered in an effort to maximize communications between the staff (Greenblatt 69). Another cross-cultural communicatio ns strategy enhanced by organizations is the development of responsiveness of particular cultures. Some organizations have opted offering basic lessons of the various cultures that make up the staff. Such a strategy will provide knowledge on the proper greetings and bodily contact; a difficult field in inert-cultural training (Greenblatt 77). Demanding tolerance is another cross-cultural communications approach enhanced by organizations. Demanding open-mindedness can be easily implemented through the cultivation of little knowledge towards the employees. Different employees should be handled in different manners through the provision of different information that will properly address all the cultural demands for effective communication to take place. Electronic data interchange (EDI) will enable the company to place orders or administer inventories, this result in cutting of stock inventories thus saving millions on the cost of maintaining it can also be applied to procurement of p roducts. The internet also enables customers to transact business directly with the company through the internet saving time and reducing the operational costs. In addition, the companyââ¬â¢s business transactions with its suppliers and contractors are eased. With the internet, people can purchase items such as books and clothing, furniture and groceries through a website. Even servicing a car or making a doctorââ¬â¢
Tuesday, July 23, 2019
Code of Ethics in nursing Term Paper Example | Topics and Well Written Essays - 750 words
Code of Ethics in nursing - Term Paper Example Ethics forms an integral part on the foundation of nursing. The profession has a distinguished history in the concern of the welfare of individuals who seek social justice; the vulnerable and injured. Apprehension is embodied towards the provision of required nursing care to the community and individuals. Nursing combines the alleviation of suffering, prevention of illness, promotion, protection and restoration of health. Nurses act to change the aspects of social structure that branch away from well-being and health. Individuals who aspire to study nursing are expected to adhere to the moral norm and ideals of the profession, and embrace these aspects as part of what make them nurses. The ethical tradition of the nursing profession is self reflective, distinct and enduring. The nurses have to follow a code of ethics that make explicit the values, primary goals and obligations of the profession. This paper analyzes my professional code from an ethical perspective through the identifi cation of four ethical concepts. Introduction Nurses respect the dignity, rights and the worth of all humanity. This should be irrespective of the nature of the health problem. A personââ¬â¢s worth is not defined by sickness, disability, proximity to death or functional status. This respect should extend to all those who require the services of a nurse for health promotion or prevention, and for the restoration of health. ... They actively assure and assess the appropriate and responsible use of interventions aimed at minimizing unwarranted treatment and patient suffering. The importance and acceptability of carefully considered decisions that regard the resuscitation status, withholding and withdrawal of life sustaining therapies, foregoing of medially provided hydration and nutrition; symptom management and advance directives are more evident (American Nurses Association, 2005). Patient autonomy (informed consent) The respect for human dignity requires that there be recognition of patient rights. The most important of this is the right to self-determination. This is also known as autonomy this is the philosophical basis for an informed consent in the health care profession. All patients have the legal right to be part of the medical decision; to be given complete and accurate understandable information in a manner that will facilitate the patient to make an informed decision, and to be assisted in the w eighing of the benefits, available options and burdens in their treatment (American Nurses Association, 2005). They also have the right to be given support through the decision-making and treatment processes. Such support includes the opportunity to discuss the decisions with family members and other significant people. The patients should be involved in planning their own health care to the extent that they will be able to choose and participate in the treatment process (Fowler, 2008). Each nurse has an obligation to have the knowledge regarding moral and legal rights of all patients. The nurses must protect, preserve and support these interests when assessing the patientââ¬â¢s understanding of the medical information presented and the implications of these
Monday, July 22, 2019
An Evaluation of Academic Performance of Grade 1 Pupils with and Without Early Childhood Experience Essay Example for Free
An Evaluation of Academic Performance of Grade 1 Pupils with and Without Early Childhood Experience Essay ââ¬Å"Bright minds make bright future!â⬠Preparatory children nowadays are far better than before they are more advanced in teaching and more capable of absorbing the methods of learning that used with them. Modern teaching accompanied with modules and analytical measures develop the preschoolerââ¬â¢s memory retention that serves as the foundation of their education. Kids today are more willing and not afraid to try to discover new ways and methods of learning. The value of preschool is a hot topic these days. A small but growing number of studies link enrolment in preschool or child care centers (which typically include a preschool curriculum) to higher cognitive and language scores on kindergarten-entry tests The early childhood stage is a permanent learning stage. Whatever they learn now, they will take home. This preschool education is the provision of education for children before the commencement of statutory education, usually between the ages of three and five, dependent on the jurisdiction. The institutional arrangements for preschool education vary widely around the world, as do the names applied to the institutions. Effective preschool education can help make all children ready to learn the day they start school and, more importantly, help close the enormous gap facing children in poverty. Preschool gives our kids the strong foundation they need to be successful in school and in life. Children who attend pre-kindergarten programs have bigger vocabularies and increased math skills, know more letters and more letter-sound associations, and are more familiar with words and book concepts, according to a number of studies (Patson P. Opido 2010). The child is the ultimate concern in all educational processes. He is the beginning at the end of all educational efforts. The goal of education is to help every child grow up well-rounded; physically well-developed, mentally healthy, intelligently alert, emotionally secure and socially well adjusted. These can be truly achieved by giving attention to the childââ¬â¢s foundation. The first day of the children in school is a unique experience. It may be their first contact with big group of children. The difference among first grade pupils in their level of preparedness to grade one work may vary. The grade I teacher should be aware of the differences in the childrenââ¬â¢s readiness; some readiness is the springboard to do actions. Knowing pupilââ¬â¢s differences will guide the teacher on what to do to develop them to the fullest ( Lindberg and Swedo, 1995). A child born of a healthy, responsible and emotionally mature parents has a good foundation. His parents, especially the mother, guide him through the proper habits of eating, sleeping and cleanliness. An individualââ¬â¢s attitude toward himself and others, his behaviour either at work or at play, and his emotional roots in his early childhood experiences. What he learns at home constitutes the basis for future learning and adjustment. As the child develops social awareness, he needs to experience association with a larger group outside his home. Parents send their children to school simply because they want them to develop basic health habits and self sufficiency. Furthermore, this also includes the ability to use language patterns for simple and correct social attitudes in relation to the company of people around him, whether adults or other children and the appreciation of the aesthetic attributes of his immediate surroundings. Modern teaching accompanied with modules and analytical measures develop the preschoolerââ¬â¢s memory retention serving as the foundation of their education. Kids today are more willing and not afraid to try to discover new ways and methods of learning. The value of preschool is a hot topic these days. A small but growing number of studies link enrolment in preschool or child care centers (which typically include a preschool curriculum) to higher cognitive and language scores on kindergarten-entry tests. The early childhood stage is a permanent learning stage. Whatever they learn now, they will take home. This preschool education is the provision of education for children before the commencement of statutory education, usually between the ages of three and five, dependent on the jurisdiction. Parents on the other hand, play a vital role in educating their children because they are their first teachers, which is the greatest contribution before a child ever begins his formal education in school. When a child enters the formal school, he carries out with him the acquired values from his parents. Just like the teacherââ¬â¢s task, if parents fail to perform their responsibilities, it may bring misbehaviour on their children which may directly or indirectly affect the childââ¬â¢s academic performance. In the Philippine public elementary schools today, inner tensions have been continuously affecting the learners going to grade one level, especially those who had never gone to any kind of schooling before. These learners entering grade one have many apprehensions. Most of them have no experiences in going to school. Parents are not capable of sending them to school especially those in remote and slum areas. Instead of giving their children a chance to study in Day Care Centers and Kindergarten in some public elementary schools, they ended up waiting for their to be accepted in Grade One. With these scenarios the pupils encounter difficulties in catching up with different skills like numeracy and literacy which are now the basic skills necessary in the first grade level of formal schooling. These children also suffer in relating themselves to their new environment, the school. In order to have a smooth transition from home to school and to prepare them socially and psychologically, the curriculum on the Early Childhood Experiences was recommended for adoption in all public elementary schools as included in Every Child A Reader Program ( ECARP). It aims to developing the reading readiness and developmental reading in Grade one as launched by the Department of Education. One of the major goals of the 2015 Education for All (EFA) is the expansion of the coverage and improvement of the quality of the Early Childhood Care and Development (ECCD) programs in the country. The present government administration in its Ten-Point Agenda has declared a policy calling for the standardization of preschool and day care centers. The Department of Education (DepEd) in support of this thrust will administer School Readiness Assessment Test to All Grade One Entrants, effective SY 2005-2006. The School Readiness Assessment (SRA) is a tool to determine the readiness of Grade One entrants in tackling formal Grade One work. The School Readiness Assessment Tool will be administered by Grade One teachers assisted by the Grade Two and Three teachers one week before opening of classes. The assessment shall not be treated as an entrance test or examination. No child shall be refused entry to Grade 1 based on the results neither of this assessment nor without preschool experience. To continuously determine the school readiness of all Grade One Entrants, the School Readiness Assessment (SReA) was administered. One of the objectives of SReA is to assess pupilsââ¬â¢ readiness across the different developmental domains ââ¬â gross and fine motor, receptive/ expressive language, cognitive domain and socio- economic domain. The result obtained was the basis for grouping the Grade One entrants. It was also used to guide Grade One teachers in providing appropriate instruction and assistance to address specific needs of the pupils. The result of the School Readiness Test in May 2011 identified that there were at least forty two point ninety eight percent of the school population of Grade One entrants were not ready. Children with No Early Childhood Care and Development (ECCD) has low average in pupilsââ¬â¢ readiness across the different developmental domains ââ¬â gross and fine motor, receptive/ expressive language, cognitive domain and socio- economic domain. Background of the Study The researcher is motivated by the above mentioned situation and this led to the conceptualization of this study. As an educator, the researcher is faced with the fact that there is an imperative need to strengthen and streamline the internal management of educational arrangements in order to achieve efficiency and responsiveness to trends and challenges of the next millennium. It is therefore the aim of this study to empower parents and positively influence them on affirmative effects of pre-school education in the holistic development of their children particularly on the advancement of their academic performance. The value of preschool is a hot topic these days. A small but growing number of studies link enrolment in preschool or child care centers (which typically include a preschool curriculum) to higher cognitive and language scores on kindergarten-entry tests. The early childhood stage is a permanent learning stage. Whatever they learn now, they will take home. This preschool education is the provision of education for children before the commencement of statutory education, usually between the ages of three and five, dependent on the jurisdiction. The institutional arrangements for preschool education vary widely around the world, as do the names applied to the institutions ( Bustos Alicia and Espiritu 1985). The Early Childhood Experiences Curriculum, hence all Grade One teachers are expected to implement it. Teachers are also encouraged to make use of local songs, games, dances and indigenous materials to enrich the curriculum. It is hoped that the Early Childhood Experience for Grade One will greatly benefit the children and strengthen efforts to make the schools child-friendly. Theoretical Framework This study is anchored on Edward Thorndikeââ¬â¢s, Jerome Brunerââ¬â¢s, and B.F. Skinnerââ¬â¢s Theories of Learning. These theories enabled the researcher in the conceptualization of this work. The Law of Readiness as advocated by Thorndike is associated with mind set. It states that when an organism is prepared to respond to a stimulus, allowing doing so would be satisfying while preventing him would be annoying. This law works well in this study because the children is mentally ready to learn. The Law of Exercise states that the constant repetition of response strengthens its connection with the stimulus, while disuse of response weakens it. The exercises given to the children using a modifiable connection like instructional materials enables them to acquire the learning easier and faster because the responses will be utilized, the stronger the connection to be developed. Thus, when a modifiable between a stimulus and a response has been made, it is strengthened if its results in satisfaction as the Law of effect proves. Jerome Brunerââ¬â¢s (1915) theory of Instrumental conceptualization is also applied as it involves (3) three simultaneous processes as: Acquisition, Transformation and Evaluation. This theory of learning believes that the acquisition of whatever form of knowledge acquisition, who selects structures, retains and transforms information. Teaching without the use of proper strategic plans will result to failure. Through School Readiness Assessment Test (SReA), pupils will acquire knowledge through different techniques used by the researchers. Hence, learning to read is facilitated by Skinnerââ¬â¢s Theory. Conceptual Framework This study focused on the evaluation of academic performance of Grade One pupils with and without Early Childhood Experience of Sto. Nià ±o Elementary School. The independent variable consist of School Readiness Assessment Test (SReA) for children with and without Early Childhood Experience while the dependent variable is the academic performance of the respondents in terms of the following: Sensory Discrimination, Concept Formation, Numeracy, Reading Readiness and Construction and Visual Motor Integration.
How far, and in what ways, do you agree that the story Essay Example for Free
How far, and in what ways, do you agree that the story Essay Hamlet is a revenge tragedy; a genre originally developed by plays such as The Spanish Tragedy by Thomas Kyd from 1585-1590. The genre is characterized by the inclusion of death, murder, betrayal, madness, poison, surveillance and the supernatural in the narrative themes that all frequently occur in Hamlet. However to what extent does the story of Polonius, Ophelia and Laertes conform to this idea of a revenge tragedy; and more broadly, how does the story of the family conform to the genre of tragedy as a whole? One issue is how to define a tragedy; Thomas Heywood wrote: Comedies begin in trouble and end in peace; tragedies begin in calm and end in tempest, Apology for Actors, 1612. By this definition, tragedy generally can be summarised as a sequence of events that lead to the destruction of the majority of its characters. In this sense, the story of Polonius and his family conforms to the basic skeleton of a tragedy by the end of the play Polonius, Laertes and Ophelia are dead. However the familys story does not conform as simply to other definitions of tragedy. [Tragedy] would look with a sceptical eye at what was happening in the world around, M. Mangan (1991). Tragedy would look with a sceptical eye implies that tragedy has the role of both viewing and criticising society. This concept can be applied to Polonius, a character remarkably similar to Queen Elizabeth Is spymaster, Sir Francis Walsingham. Shakespeare spent the majority of his life under Elizabeths rule; hence the Elizabeths gentry may have aided Shakespeare in creating his constructs. Polonius is characterized by his long, rambling speeches, for example in Act 2 Scene 2; Either for tragedy, comedy, history, pastoral, pastorical-comical, historical-pastoral, tragic-historical, tragical-comical-historical-pastoral unlimited The absurd repetition of the words tragedy, comedy, history and pastoral emphasize the loquaciousness of Polonius, but is perhaps also mocking Sir Francis Walsingham. Shakespeare is crafting a stereotype that spymasters are loquacious, obsequious characters. Perhaps Shakespeare is criticising society; society does not require spymasters spawning insincerity and deceit. If so, Shakespeare is using satire as a tool to portray this viewpoint. Polonius may be used by Shakespeare as a means to act as such a sceptical eye on society, conforming to Mangans concept of the relevance of tragedy in real life. Aristotle was a key figure in defining tragedy, and stated in his Poetics that a typical tragedy consisted of a noble protagonist, with a hamartia (tragic flaw), whose peripeteia (reversal of fortune) is brought about by an anagnorisis (moment of recognition). However it would be unwise to assume that Aristotles Poetics, written in c. 335 BC would still be completely relevant to Shakespearean tragedy, written some two thousand years later. However several aspects of Aristotles tragedy can be applied to Polonius and his family. Polonius has his tragic flaw: his obsession with spying. He tells Reynaldo before departing to France to spy on Laertes: By indirections find directions out (Act 2 Scene 1) Not only does this indicate his unnatural interest in his sons affairs, so much that he is willing to send a spy to observe his sons possible hedonism in Paris; but it also shows that he is experienced as a spymaster. Such advice is most likely to be learned from several years of manipulating people to his advantage. Essentially what he is saying is the most direct method of finding the truth is through being indirect, which holds to be true as we see later in the play with Hamlets The Mousetrap; a play within a play which exposes Claudius villainy through indirect and subtle methods. Furthermore on the topic of hamartia Laertes has his tragic flaw of overreaction; a stark contrast to Hamlet whose tragic flaw is procrastination. When asked by Claudius what he will do when Hamlet returns to Denmark to avenge his father in Act 4 Scene VII, he replies To cut his throat i the church. This directly mirrors the church scene, where Claudius is vulnerable yet Hamlet refrains from acting out his revenge. This displays Laertes as a traditional revenger, willing to act, unlike Hamlet who considers the legitimacy of the ghosts claims before even considering revenge. Laertes does not take much persuading from Claudius. However it is this over-willingness to act that is the cause of his death. In his rage at the death of both his father and sister, he plots with Claudius to kill Hamlet; a move which kills him as he himself is poisoned by the sword intended for Hamlet. Over-willingness to act is Laertes hamartia; and so Laertes also conforms to this tragic skeleton laid out by Aristotle. However perhaps more tragic, although not conforming to Aristotles works, is the question; why is Laertes so willing to act? His father was voyeuristic, deceitful and loquacious he used Ophelia as a tool to gain favour with the king, and spied on Laertes to ensure his name was not tarnished. He was a far from noble man, his life summarised accurately by his death; behind an arras spying on someone. In this regard, it is questionable whether Laertes brashness in relation to revenge is justified. From the aspects of Polonius character seen in the play, it does not appear that he was a good father; in fact he seems villainous at times for example when he disallows Ophelia to express her love for Hamlet, then makes her feel to blame when Hamlet puts on his antic disposition. It is questionable whether Polonius deserves to be avenged. Hamlet seems to simply shrug off the murder of Polonius, noting of what the little worth he was when referring him simply as guts. This could be seen as tragic, as the worthlessness of Polonius character implies that Laertes died for nothing. One explanation is that Laertes may have been inclined to act out revenge with such little persuasion due to the fact Polonius was all he and his sister had. Since Hamlet put on his antic disposition, Ophelia lacked a love interest, as did Laertes assuming he did not have a lover in Paris; moreover they were not allowed to have a love interest due to Polonius caring too much about his image than the wishes of his children. With no love interests, and apparently no motherly figure, they were left with no figure of authority but Polonius, which may be the cause for Laertes brash attitudes towards revenge. Also likely is the concept of family honour driving Laertes revenge, a concept which an Elizabethan audience may have empathised with. The death of Ophelia in a modern day sense is considered tragic, like any suspected suicide. However during Elizabethan times her death would be considered on a more religious basis; the priest comments on the questionable nature of her death, and whether it would warrant a Christian burial. This is an example of how the definition of tragedy shifts over time; even Laertes does not seem as shaken by the announcement of his sisters death compared to his fathers, perhaps due to the nature of her death. Ophelias death is considered a tragedy in a modern day sense, but at the time her death not so much tragic, but rather symbolised the death of innocence in the play, as part of the build up to the climatic deaths in the final act. However, Ophelias death is an example of how Hamlet is able to transcend traditional ideas on tragedy, and can hold relevance to modern day interpretations of what is considered tragic. In the 21st century, a tragic event is where an individual or group suffers to a greater extent than they are perceived to deserve. It could be argued that however you spin the story of Polonius and his family, they will always conform to this modern interpretation of tragedy, as well as the traditional tragedy theorised by Aristotle. Ophelia is being perpetually commanded and ordered throughout the play by the significant characters in her life; first Laertes, when he displays his disapproval of her intimacy with Hamlet, and Polonius when he conducts his own play within a play, ordering her to talk to Hamlet while he observes behind an arras. She has little to no freedom, despite the fact she has done nothing wrong; unlike her brother who had enjoyed the primrose path of dalliance while in Paris, and the voyeuristic indulgence of Polonius. The death of Ophelia to a modern audience is tragic, so in this sense the story of Polonius and his family is a tragedy. I agree that the story of Polonius and his family should be considered a tragedy within a tragedy. Their story contains many of the frequently occurring aspects of a tragedy; death, love, murder, revenge and surveillance. As well as this, the family conforms to the concept of a tragedy as laid out by Aristotle. Finally, the story of Polonius and his family conforms to what is considered tragic in the present, as the tragedy has transcended the period in which the play was written. References Primary Text Shakespeare, W (~1600) Hamlet London: Penguin (2005) Secondary Texts Aristotle (350 BC) Poetics London: Penguin (1997) Heywood, T (1612) An Apology for Actors New York: Scholars Facsimiles Reprints (1999) Mangan, M (1991) A Preface to Shakespeares Tragedies London: Longman.
Sunday, July 21, 2019
Case Study Of The Unhealthy Hospital
Case Study Of The Unhealthy Hospital A seminal 1963 article has been credited for giving rise to the concept of health economics, and its establishment as a discipline. It focuses on issues that are related to scarcity in the allocation of health and health care. Amid growing concerns for health care and global health reform it has been recognized that health finances are finite, a view substantiated by Basch (1999), and that neither developed nor developing countries are immune to the scarcity of resources that plagues our health care system. Levine (2005) argues that the problems in health care systems have been hampered by chronic financing shortfalls, compounded by weak management and crippled by rigid budgeting. Against this backdrop the case of Bruce Hudson, Seven Seas Memorial Hospital is not so farfetched. Robert et al. (2004), underwriters of many health policies in developing countries, put forward the argument that the elements of any form of systematic policy cycle, first seeks to define the problem, form a diagnosis to policy development, political decision making, implementation and evaluation. From the given case study it is clearly identified that the operating policies need to be revised, a decision needs to be made on how the new operating policies will be developed, how much political influence will be incorporated into it and how will these policies be evaluated. With the ever increasing demand for improved efficiency in the health care sector there has been the ever increasing need to revise and change hospital structures. That has included the use of strategies such as mergers and downsizing, as modifications are made to cut down on expenditure. The difficulties of Bruce Hudson, in the given scenario, are not unlike the challenges that Hospital administrators face in developing countries. They grapple with limited finances and are often faced with the difficult decision of restructuring staff. Fulop et al. (2002) and Braithwaite et al. (2005) argue that in such cases as administrators seek to contain cost and cut down on over heads, there is increased emphasis on redefining job roles to ensure the delivery of health care in a more cost effective way. They go on to argue that there is very little evidence to suggest that restructuring actually improves efficiency or programme outcomes. Hospital administrators face the difficult task of how to restructure and not affect quality. It is recognized that nurses are the largest component of the health care workforce and as a direct result they would be the largest operating expenditure. Attempts to cut back on labour costs could mean a cut back on the number of nurses operating within the facility. While the case study goes on to note that Mr. Hudson is not new to effectively running an operation with less than the current number of staff at Seven Seas Memorial Hospital, Kearin et al. (2006) cites in their work the view of Akien et al. (2002) who put forward the view that patient outcomes are linked to appropriate nurse-patient ratios and the proportion of registered nurses operating within the health care facility. As Di Frances (2002) indicated, the downside to downsizing is the fact that as a process it creates distrust and low morale among staff, not an environment to promote efficiency and greater work outcomes. Whi le Mr. Hudson may want to expand roles and employ the use of organizational report cards to monitor performance, as a result of improving quality of care, retrenchment may not, according to the aforementioned arguments, be the best way of dealing with the problems or securing the future of Seven Seas Memorial. While with continued financial constraints it may inevitably come down to re-engineering or downsizing the work force, the potential negative impacts needed to be assiduously guarded against. Having decided on the merits of delaying retrenchment as the first option to save cost, there is need to improve the flow of clients through the facility and by extension the clinics that serve the facility. This move allows for the program to care for more clients without actually lowering quality, hiring more providers, or increasing staff hours. The example of what obtained at a clinic in Guatemala providing maternal and child health services can be examined. They were able to improve client flow after a self-assessment by staff and a survey of clients. It was identified that clients used to wait, have a pre-visit discussion, return to the waiting room, see the provider, return to the waiting room, and then have a post-visit discussion, a process that was not only time consuming but also made the operations inefficient. By improving the flow of clients to have them wait just once and receive all services in one visit with one provider allowed staff to process 33% more clients. Tha t move allowed the facility to meet the needs of the clients more efficiently. In the given case study, there are six clinics attached to the health care facility. These clinics, as is often seen in many developing countries, serve the underprivileged and the underserved. The Brundtland (1987) report describes sustainable development as development that will not impede the ability of future generations to meet their needs and enjoy a comparable or even better quality of life. Mowforth Munt (2003:232) argue that sustainability is considered a contested concept, a concept that is socially and politically constructed and reflects the interest and values of those involved. Regardless of the definition attached to it, or the constructs under which it operates there is a need to ensure that an innovative way to address the issue of providing a sustainable health service be employed in the situation involving the clinics. The structure and scope of the clinics can be revisited to ensure that they are most cost effective. The use of the concept of a mobile health clinic is such a way to cut cost, continue to provide the service and doing so in a cost effective manner. Mobile clinic services can be structured in such a way that the services continue to be pro vided for free on a walk-in or appointment basis, where the mobile travels to low-income or underserved communities twice per week. They are able to rotate and maximize staff use as well as continue to provide the service that the stationed clinic provided. The added benefit it that instead of six physical buildings two mobile facilities can be established. Oriol et al. (2009) argues that the use of mobile health clinics provides an alternative into the healthcare system for the medically disenfranchised. They go on to further define that group as those who are undernourished, underinsured and do not trust the healthcare system. For them mobile units serve the purpose of providing triage into mainstream healthcare for the underserved. There has been established precedence for the use of mobile clinics that provide the specific care that the community based clinics provided. Edgerley (2007), in a study looked at whether the use of a community mobile health van in an underserved population allowed for earlier access to prenatal care and increased the rate of adequate prenatal care, as compared to prenatal care initiated in community clinics. Their findings were able to confirm that the use of the mobile health van not only increased early access to adequate prenatal care in these communities but was able to reduce the barriers of accessing care; barriers such as the lack of insurance, inability to meet costs, transportation, language, and the need for an appointment. Their study successfully showed that the use of a community mobile health van to provide prenatal care may be one way of cutting down restricting community clinics and cutting on operating costs. That initiative is not isolated to just prenatal clinics but could be employed for clinics providing other types of services such as HIV treatment and testing. A forty-foot primary health care clinic on wheels was used in Kentucky. Staffing was made up of a medical director, a social worker, a nurse practitioner and specialty physicians that are rotated, (www.hhnmag.com, 2006). The question is, how cost effective is such a service as opposed to community based clinics. Oriol et al. (2009) calculated in their study the return on investment of mobile healthcare. In their findings they were able to elucidate a mobile clinic that had been serving the medically disenfranchised in Boston was able to have a return investment of thirty-six dollars ($36) for every one dollar ($1) invested into the programme. If such a venture were to be employed at Seven Seas Memorial hospital, not only would it save and recover cost on the six clinics that currently exist but it would get an opportunity to see returns on investment, while keeping the politicians satisfied. One of the primary triggers to rising cost of health care, and by extension, hospital operating cost, is the rising health expenditures for costly new technologies. Jones (2005) argues that rising health care cost may be a natural reflection of economic growth. He goes on to postulate that as we get richer, one of the most valuable and productive opportunities for our spending is to purchase better health and longer lives. Other factors such as aging populations and rising cost of health insurance that were directly influenced by the discovery and use of novel and expensive medical technologies. The inventions of MRIs and CAT scans as well as newer drugs meant that if hospitals are to remain competitive they had to spend money on the delivery of such services. Basch (1999) warns that there is a need in developing countries to ensure that if they are to be not only efficient, but also cost effective, there is the inherent need to keep cost down. As such it is not always possible to pu rchase every, or even most of the newer medical technological equipment that private facilities could offer in a market driven health care system. The purchase and use of generic drugs can significantly reduce the cost of health care, as seen in the case of most parts of Africa, (Ford, 2010). This affords them an opportunity to circumvent the chasm that exist between the prices mandated by the pharmaceutical giants that develop the drugs in the industrialized world and the ability of developing countries, and by extension their people, to afford them. Further to that another way to combat cost would be to encourage programmes to buy supplies in bulk. There exist many procurement agents that allow health care facilities to merge their orders in an effort to qualify them for volume discounts from manufacturers, even as they ensure that the quality of the products. Further to that health care facilities that are facing budget constraints or that simply wish to be more cost effective in their operations can adjusting procurement to match demand. They are able to do this by monitoring use via a logistics management system. This syst em of operation will allow them to identify changes in demand and in the method mix and as a result will prevent programmes and sectors from overstocking. Further to that health care facilities could seek to set up services in existing buildings and share facilities with other health services. Meeting rising demand efficiently The market for costly medical equipment is limited in most developing countries, and many hospitals, especially public facilities are unable to afford them, (Ford, 2010). He goes on to note that the demand for high-cost medical equipment will continue to rise in developing countries, largely due in part to the need for patient monitoring and diagnostic equipment. He cautions that in many public facilities in the developing world, health care facilities may also lack the expertise to operate as well as maintain such equipment and so should limit such purchases. The lack of technical support from suppliers leads to chronic equipment failure. In this case health care facilities, to make them more competitive with the facilities that can offer such specialized care should focus of being recognized for a particular product or brand. There is a plethora of information on branding in the marketing literature. Branding is defined by the American Marketing Association (2005) as: A name, term, sign symbol or design or a combination of these, intended to identify the goods or services of one seller or group of sellers and to differentiate them from those of competitors. `(p.28) Kotler and Gertner (2002; 65) postulate that brands not only, `differentiate products and represent a promise of value but also incite beliefs, evoke emotions and prompt behaviours`. By branding his facility Mr. Hudson is able to incite confidence in clients of his facilitys ability to deliver on that service for which it is known. Muhammad Yunus, is cited as saying, poor people need health insurance, they deserve it and it can be done, (Ford, 2010). That saw the birth of the concept of micro-insurance in South Asia, where the very poor are now able to purchase life insurance as well as healthcare insurance in return for a relatively small monthly payment. The International Labour Organization (2005) postulate that countries need to continue to fight against social exclusion and poverty in health and can do so by shifting focus to social health insurance. They argue that apart from tax-funded health care as obtains for formal economy workers and their families, social health insurance is the other major concept when it comes to health protection. For them, social health insurance seeks to include informal economy workers and their families as well as the poor. What obtains is that affiliates of such a scheme are able to contribute according to their financial ability, rather than according to their current health condition. Financial resources are pooled and benefit all members of the system in case of illness. A purely market-oriented approach to health insurance will exclude the poor and as a result would not work. Other countries are able to offer a more elaborate and detailed plan to deal with insurance and the provision of governm ent funded coverage. Singaporeà ¢Ã¢â ¬Ã ¦.
Saturday, July 20, 2019
Comparison of 3 Stocks :: essays papers
Comparison of 3 Stocks All my stock market choices are technology based. nVIDIA is a producer of video card software, AMD a provider of motherboard processors and Electronic Arts a videogame publisher. nVIDIA is an example of a decreasing-cost industry. While a rather early new comer to the video card industry, nVIDIA was showing potential from the start. Major competition to nVIDIAââ¬â¢s foothold in the industry included 3dfxââ¬â¢s voodoo technology and ATIââ¬â¢s Rage. Although 3dfxââ¬â¢s foothold seemed unmovable, the next wave of technology to rise brought about their eventual downfall in the market. 3dfxââ¬â¢s lack of support for their next generation video cards (the voodoo4 & voodoo5) resulted in their being bought out by the nVIDIA Corporation. While nVIDIA released patches to over double the performance of the GeForce2ââ¬â¢s technology, 3dfxââ¬â¢s patches for the Voodoo4 and Voodoo5 were riddled with flaws, resulting in performance issues for all of their customers. After the buyout, nVIDIA were now free to utilize the voodoo technology and excel in the market. Now ready to explode even bigger than before, will be the arrival of the GeForce3; boasting results over ten fold that of previous video cards, the GeForce3 will have unparallel performance in the market. This is observed by the slow increase in the percent gain, which will rise dramatically with the release of their new board. AMD, Advanced Micro Devices Inc., was a company entering a seemingly unbreakable market. Processor technology with a high initial cost categorizes it as a decreasing-cost industry. AMD, now the most popular provider of processor technology, came in against the multi-billion dollar corporation of Microsoft. Microsoftââ¬â¢s Pentium processor currently held a foothold in the market; however, AMDââ¬â¢s cheaper K-6 series (although not as powerful processor) provided an economical alternative to Microsoftââ¬â¢s more powerful Pentium II processor. With sales being lost to the more economical K6 series, Microsoft released the Celeron processor, which was widely accepted as a poor alternative to AMDââ¬â¢s K6. However, customer familiarity with the Microsoft brand name, allowed for Microsoft to recoup some of its losses in the field, but with AMDââ¬â¢s following rising, the K7 (Athlon) processor, took a firm hold in the field against the Pentium III. Furthermore, the Athlon Thunderbird (the successor to the K7) has now taken a majority control of the market, by outperforming the Pentium IV in most performance tests.
Friday, July 19, 2019
Orwells such, Such Were The Joys....: Alienation And Other Such Joy :: essays research papers
Orwell's "Such, Such Were the Joys....": Alienation and Other Such Joys George Orwell expresses a feeling of alienation throughout "Such, Such Were the Joys...." He casts himself as a misfit, unable to understand his peers, the authorities placed over him, and the laws that govern his existence. Orwell writes, ââ¬Å"The good and the possible never seemed to coincideâ⬠(37). Though he shows his ability to enumerate what is ââ¬Å"good,â⬠he resigns himself to a predestined state; uncertain of where exactly he fits in society, his attitude is irreconcilable with what he knows society expects of him. Orwell's childhood understanding of society forces him into only one possible direction, failure. This essay is the maturing Orwell's response to childhood subjugation, a subtle exposure to the evolution of Orwell's thought. Orwell's life as a boarding school student at Crossgates occupies his memory of childhood and serves as the platform for his views on life. Repeatedly Orwell describes the society of the school from which he is outcast: That bump on the hard mattress, on the first night of term, used to give me a feeling of abrupt awakening, a feeling of: ââ¬ËThis is reality, this is what you are up against.' Your home might be far from perfect, but at least it was a place ruled by love rather than by fear, where you did not have to be perpetually taken out of this warm nest and flung into a world of force and fraud and secrecy, like a goldfish into a tank full of pike. (23) Young Orwell, impacted by this, ââ¬Å"hard,â⬠disorienting situation, realizes he is alone in a hostile, harsh environment. Orwell uses the image of the ââ¬Å"warm nest,â⬠a womb, from which the child is thrown, then innocently forced into a destructive reality. This reality is Crossgates, an educational institution but also a primary residence, the ââ¬Å"homeâ⬠Orwell lives in on a daily basis for a number of years. Far from the ââ¬Å"loveâ⬠of his familial home, Orwell finds that Crossgates does not nurture nor raise a boy to manhood, but rather destroys all that he loves and trusts. Hopelessly dominated in this environment, he is compelled to accept a mentality of insecurity and inferiority and becomes the fodder of others--the winners of society. Sim and Bingo, the spiritual and emotional guides of Crossgates, feed off of this pitiful mentality and their carefully constructed school environment. By the social standards that prevailed about me, I was no good, and could not be any good. But all the different kinds of virtue seemed to be mysteriously interconnected and to belong to much the same people.
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