Wednesday, October 30, 2019

Week 6_ DQ Essay Example | Topics and Well Written Essays - 750 words

Week 6_ DQ - Essay Example It is considered to be approximately 500 times the 3G speed. In addition, it applies internet protocol to make the connection and communication reliable. The levels of data transfer between the two networks differ. While third generation network can support 144 kbps, the fourth generation network do not have an exact rating but rather uses a series of standard depending on availability. In terms of coverage the 3G network outdo the 4G network by far since it is only a small number of centers in big cities that have implemented the lather whereas the 3G use is almost global. The stumbling block that affects the spread of 4G is the need for creation of more cell site that will accommodate it (Agbiny 2009) One strength that 4G has over 3G is its ability to accommodate and support large files. Making a video phone call is possible with the aid of high speed. In addition, one can download a video which is of high quality from the site such as YouTube and the download process will be uninterrupted. More so, one call also uploads large files directly via the 4G enabled phones with a lot of ease. Another difference is the frequency at which the two operates, while 4G runs at 1800 MHz and above; 3G has the highest frequency of 900 mhz. this implies that 4G can operate on dual band since it has short range. If the two are operating on the same network, 4G has higher speed of data transfer but when it comes to transferring of data through more than one media, 3G is averagely faster since it has a speed that is higher than 4G in some medium. Whereas many people go for 4G because of the misconceived idea that they are faster than 3G, it has a number of disadvantages since its application is still under taste. This is evident in the use of AT & T which is a 3G but provides a higher rate of data transfer than MetroPCS which is a 4G (Zheng2009 PBX or private branch exchange is a telephone switching system that belongs to a private

Monday, October 28, 2019

The Love Song of J. Alfred Prufrock by T. S. Eliot Essay Example for Free

The Love Song of J. Alfred Prufrock by T. S. Eliot Essay The Love Song of J. Alfred Prufrock (or simply Prufrock) is T. S. Eliot’s most popular poem and it is the one responsible for the launch of his career as one of the 20th century’ leading and influential poet. The poem takes the form of a dramatic monologue and it is considered as one of the most anthologized poem in the 20th century.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Prufrock is a poem which made use of lots of literary devices such as similes, personifications, repetitions, allusions, imageries and the like, all of which contributed a great deal to the tone of the poem which is miserable and unhappy, it also helped contribute to the theme of indecision (which led to lots of missed opportunities), sexuality, and paralysis. For one the use of simile is clear in the following line, â€Å"when the evening is spread out against the sky like a patient etherized upon a table† (Eliot, 1917) and it skillfully illustrates the solemn outdoor setting in contrast to the party setting which would later on take place in the poem.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Repetition is one of the most essential tools used by Eliot in the poem. For one, in the following stanza â€Å"In the room women come and go talking of Michaelangelo† (Eliot, 1917), Eliot brings the audience to the place Prufrock himself finds himself tied into, and this particular repetition contributed a lot in setting the tone of the poem as it shows the readers how Prufrock muses on how he wants to tell a woman how he truly feels and yet for some melancholic reason, he cannot.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Upon reading the poem one could envision that Prufrock is not really that old, he is probably a middle-aged man who is trying to examine what went wrong with his life, or trying to look back to the choices he made at the course of his life. Among the things he constantly look upon is the things he did not do, his regrets for acting the way he did, for his indecisions, and most of all he is looking back on his failure with regards to women thus one could then on say that one of the primary tones of the poem is that of a tired, ironic self-criticism. The character of Prufrock made many references on his going bald, most notably was a scene with a reaper who is holding his coat for him so that he could then on leave this material world. Prufrock tried to make himself feel what it is like to be young again one notable example was when he tried to dress and fashion his hair the way young men does. However, in spite of this particular endeavor he knows deep inside that it is no use since he would no longer be young again and this particular fear of approaching old age contributed a great deal to his paralysis which is the primary theme of this poem.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   From the title of the poem alone one could have an idea that Prufrock is no ordinary or traditional love poem. Prufrock then is a ludicrous name and the author wants the subconscious implication of a prude in a frock. The original title of the poem is actually Prufrock Among Women and this particular emasculation added a certain depth to the themes the author would delve into which rotates around the notion of paralysis and heroism. As was mentioned earlier this poem takes the form of a dramatic monologue in which the speaker unconsciously reveals a part of himself to the silent readers. The poem shows a great deal of Prufrock’s inability to commit and express himself to women or to love, or to other individuals for that matter.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The 2st stanza of the poem hints that Profruck and a companion are out for an evening walk. Most of the themes and tone of Profruck illustrates profound melancholy and lack of communication or inability to express himself. The city discussed in the poem appears gloomy, it seems to portray the city in a half dead, desolate, and lonely feel. The streets seems to curve to a particular conclusion or question and it seems to ask if the protagonist should dare to assert himself or to reach out and try to communicate with other people.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The fourth stanza of the poem implies to life’s triviality as could be seen on the following line â€Å"hundred indecisions†¦before the taking of toast and tea†. The readers could then envision Prufrock worrying himself over life’s trivialities such as what tie to wear at the party and what words he should use to strike up a conversation (presumably with a woman) at the party. The women the protagonist is about to meet at the party are belittled in that their primary use is to serve as some kind of a decoration and keep shallow conversation going all throughout the party as could be seen on the following line â€Å"that lift and drop a question on your plate† (Eliot, 1917).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In the sixth stanza of the poem one could envision the protagonist hesitating on whether he should continue to climb the stairs which would take him to the place where the party is being held, he keep on worrying on whether he should â€Å"dare† communicate or try to reach out to these people. In the seventh stanza the protagonist was pondering about the things he did or the trivialities he did in his life and it also shows that he knows what kinds of people would be present at the party. He knows that those people are full of life’s superficiality. These particular people were further singled out in the 9th stanza as women of women on which the protagonist seems to posit an attitude synonymous to sour-graping.   Upon close observation the readers would then on see that these elegant women have hairy arms, however, in spite of that these women still have some kind of an effect to the protagonist of the poem as could be seen when he was not able to organize his thoughts which is being diverted by the smell of the perfume of these women. It is important in this line to notice that Prufrock does not treat these women as a whole people but rather merely as part of their physicalities which attracts and mislead other people as could be seen on the following lines, â€Å"eyes that fix you in a formulated phrase†, â€Å"faces that you meet†, voices dying with a dying fall† (Eliot, 1917) and the like.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   On stanzas 79-80 the protagonist was once again pondering on whether given lots of empty times should he try to assert his personality and try to reach out to other individuals. Mainly because the protagonist talked a great deal about women on his earlier stanzas one could then assume that the line â€Å"force the moment to its crisis† (Eliot, 1917) have an innuendo of sexuality because whereas the inability to communicate himself appears to be the primary theme of the poem, the protagonist incapacity to have sexual relationship is taken care of in a more specific manner. If someone is incapable of having sexual relationship with another individual, he is cut off from the some things considered worth while in life and the protagonist is portrayed as someone who is incapable of making a move on a woman (he could not even reach out to converse to any people, much less a woman) because of his fear to look ludicrous in front of them.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The protagonist inability to make use of the time or opportunities given him is signified by the past tense found in the twelfth stanza. In this stanza the readers would be able to see that if the protagonist indeed tries to reach out to people particularly to the woman he likes he would only appear preposterous and these people would not even be able to understand him. In stanzas 95-97 the protagonist made an implication that he ever approach or make any kind of insinuation to a woman â€Å"roll†¦strength and all..sweetness up into one ball, and tearing†¦pleasures with rough strife † (Eliot, 1917) there is a huge chance that he would be misunderstood and worst they would be disgusted with him and put him off. All of these reasons among many others seem to answer the earlier question on whether he should dare to assert himself. The protagonist states â€Å"No!† because he sees himself as insignificant, he is so full of self-consciousness and because of that he is unworthy of â€Å"disturb(ing) the universe† (Eliot, 1917).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Now that the fundamental question of him asserting himself has finally been answered the protagonist is once again seen to be looking at what his life would be like (he would grow old and bald) and he would also wonder if he has the guts to eat a peach â€Å"do I dare to eat a peach† (Eliot, 1917). This particular line could be viewed in different manners one of which is that fresh fruit because of digestive problems however, the peach could also be seen to have an underlying sexual connotation. Fruits in general have a sexual connotation as the ripened ovary of a plant and peach in particular holds more sexual connotation because of its flesh like color, its soft texture and its downiness. The peach’s shape and texture symbolizes the female genitalia thus one could see in the line mentioned above that the protagonist is wondering that if he is unable to sexually assert himself to a woman while he was still in the prime of his life, how else would he be able to sexually assert himself when he becomes an old man. Peach also have other meanings. Peach is the Chinese symbol for marriage and immortality, both of which the protagonist so want to have in his life. As could be seen then, the protagonist pondering on whether he would dare eat a peach has got something to do with his sexual ineptness. As the poem ends, the protagonist was imagining mermaids, oe men’s ideal dream of women sitting on the beach, however, in spite of the fact that it only happened on his imagination, the mermaids still did not sing for him. When the protagonist was awakened from his dream by a human voice one could then conclude that even in dreams, the protagonist is still paralyzed and non-active. This particular paralysis, the protagonist’s inability to act and to grab at the opportunities given to him by life is the primary theme ever present in The Love Song of J. Alfred Prufrock. Works Cited Dempsey, Jough. â€Å"The Love Song of J. Alfred Prufrock by T. S. Eliot.† (1997).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   February 28, 2008 http://articles.poetryx.com/7/. Eliot, T. S. â€Å"The Love Song of J. Alfred Prufrock† (1917). February 27, 2008   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   http://www.bartleby.com/198/1.html. Moody, David. The Cambridge Companion to T. S. Eliot. Cambridge UP, 1994. Scofield, Martin. T. S. Eliot: The Poems. Cambridge UP, 1988. Uncgrad. â€Å"The Love Song of J. Alfred Prufrock.† (2007). February 28, 2008   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   http://www.associatedcontent.com/article/113548/the_love_song_of_j_alfred_ prufrock.html.

Saturday, October 26, 2019

States v. Feds :: essays research papers

One of the most important cases pending before the Supreme Court this term is Printz v. United States. On the surface, Printz appears to be a gun control matter because it involves a constitutional challenge to the hotly debated Brady law, but the underlying issue transcends the debate over gun control. The Printz case is, at bottom, a bare-knuckle fistfight between the federal and state governments over their respective turf. Make no mistake, the ruling in this case will have profound consequences for constitutional federalism in America. The provisions of the Brady law are straightforward. The law requires the prospective buyer of a handgun to wait five business days before taking physical possession of the firearm. During the five day waiting period, local law enforcement officials are supposed to check the background of the prospective buyer for a criminal record or mental instability. The ostensible purpose of the law is "to keep guns out of the hands of criminals." The issue before the Supreme Court is whether Congress can saddle state and local officials with federal legal responsibilities. The constitutional challenge was brought by Jay Printz, who is a sheriff in Ravalli County, Montana. Sheriff Printz claims that his understaffed office will be dangerously overextended if it must conduct time-consuming background checks on individuals who wish to purchase handguns. Printz’s county has thirty thousand residents spread over 2,400 square miles; only two deputies are on patrol at any given moment. According to Printz, deputies will have to be taken off patrol and investigative duties in order to do "Brady work." The Justice Department has countered that the Brady law only requires local law enforcement officials to make "reasonable" efforts at background checks. The outcome in Printz, however, will not turn upon whether the Brady Law is "unduly" burdensome. The issue to be resolved is one of principle: Can the federal government conscript state agencies and resources for its own purposes? The answer to that question is resolvable for anyone who takes seriously the text, history, and structure of the Constitution. The Constitution creates a federal government of enumerated powers. Most of the federal government’s powers are set forth in article I, section 8, and a few others are dispersed throughout the constitutional text. The Tenth Amendment was appended to the Constitution to make it clear that the powers not delegated to the federal government "are reserved to the States respectively, or to the people.

Thursday, October 24, 2019

The Real Monster in Mary Shelleys Frankenstein Essay -- Who is the Tr

Frankenstein is a classic horror novel, but with a twist of many other genres. Written by Mary Shelley, it was a novel which mixed many exciting elements, such as horror, drama and romance. The story follows a young doctor named Victor Frankenstein, who has an obsession to reincarnate the dead, but his attempts at this fail horribly, and Victor finds himself in deep peril, as the monster stalks him throughout the world. I aim to investigate the issue, however, of who is the true monster in Frankenstein. The monster or Frankenstein himself? Mary Shelley, the creator of Frankenstein, was a highly intellectual and creative woman, one of the elite writers in Britain. Her inspiration for Frankenstein was taken from several things. The plan itself for Frankenstein was taken from a dream, but her theories of life and explanation of the human anatomy came from noted scientists, philosophers and alchemists from Europe. This spawned the seed of the monster of Frankenstein, an intellectual creature, a lover of music, poetry and other such sophisticated occupancies. The basis of the whole story in itself, however, is a result of a visit to the country and place where the actual book was based in itself. In the summer of 1816, nineteen-year-old Mary Wollstonecraft Godwin and her lover, the poet Percy Shelley (whom she married later that year), visited the poet Lord Byron at his villa beside Lake Geneva in Switzerland. Normally, poor weather conditions would entreat them to go into the house, where they would often entertain each other with a volume of ghost stories Lord Byron held in his possession. . One particularly stormy evening, Byron challenged his guests to each write one themselves. Mary's story, inspired by... ... the monster with less than basic human emotions; he spurned it, and hoped never to see it again. This is an extremely irresponsible decision. It is evident that Frankenstein did not realize that, even though his â€Å"specimen† was defective on the outside, it was still a living, breathing, thinking being. A being which needed love, care and tutoring. In his misguided and blind attempts to cheat death, Frankenstein has in fact brought death on others, which is a despicable act. Some may argue that Frankenstein had no choice, but I believe that is inaccurate. He had a choice. He could have stayed, tutored the monster, and tutor it as an equal, in matters of logic and science, and given it as normal a life as it could have. Or, he could have chosen the path that he did, that path Mary Shelley laid out for this book, one which inevitably led to pain and chaos.

Wednesday, October 23, 2019

Issues in Fit Food Inc Essay

Significant part of the behavioural displacement can be related to results control system that is in place. FFI is evaluating the divisional personals’ performance based on their achievement of Annual Operating plans; some of those are like †¢Achieving 7% divisional growth rates †¢Bonuses based on achievement (upto 150%)of annual operating plans and no bonuses on failure †¢Stock options offered to corporate managers and divisional presidents †¢Sean’s (founder & chairperson) call for better financial performance during those peak recessionary period(2008-2009) These quantitative results controls can be related to those behavioural displacements. As a result presidents of Drink division and Cookie division have involved in those unacceptable fraudulent practices of aggressive revenue recognition, prepaying expenses and capitalising parts costs. Since the CFO has the information about those fraudulent practices he should initiate the process of restating those prior year financial statements accordingly and those restatements require public disclosures. It is a serious issue for a listed company. Worse impacts would include lost of investor confidence, as a result share value deteriorates. Suggestions : controls Results Control 1.Instead of determining a target based on investor’s expectations, during the recession time company should have adjusted its targets according the economic condition. May be keeping the same market share or little above that could be a better option. It might create BUDGET SLACK. However that slack can reduce the tension, and stress for those managers and build an environment to change from there. Since 2008 was the peak recession time the AOP ‘s growth rate has to be altered and it can be changed into sustainability 2.Controls should balanced with those quantitative and qualitative results oriented controls. In this case most of controls such as achieving 5%  divisional growth and bonuses of 150% when divisions exceed the AOP has lead many issues . gamesmanship , manipulated financial statements, and unethical behaviour of divisional managers are some to be named; therefore FFI should introduce various control methods which include the measurement of their performances and ethical behaviour. Such control methods would include rather than just checking increase in sales, it should increase in actual sales. Solid sales, numbers have to be real and should not be manipulated towards the end of the period. An increase in market share, customer retention 1.Results controls should be tight results control Personal control : 1.Replacement of managers Removal / replacement of those managers in cookie division and drink division including the presidents of both divisions are the first step to re build the confident in the company. Even the chair Sean needs to be replaced; however it is question since he is the founder he may have the controlling rights over the company. 2.Replacing external auditors. Because they are the ones first to know about those accounting frauds in the organisation. However they have failed. They have not had a good audit plan and scope. This could have happened due to the following reason too. since the FFI is a public company and it needs a clean opinion to keep its position in the listing. Therefore auditor might have asked to provide such an opinion based on promises such as FFI is going to implement a tighter internal control policies so it prevents most of the fraud. Further auditor has already been intimidated about cancellation of the contract based on the price it charged. Therefore auditor may not be performing well planned audit instead providing a lower service which is not good for all those three parties (auditor, users and audtiee) Action Control : 1.Behavioral Constraints Separation of duties : since FFI is one company several division it can have one administrative division. Since all the changes have to be done by those  people who different from those divisional staff, divisional heads’ data management actions would not remain secret as earlier Second thing one storage facility for all division. Have the same effect. That data management can be controlled The direct costs of this may include delay in processes and a system should be created for fast communication 2.Pre action reviews Though there are several discussions and reviews held regarding the approval of AOP, the quarterly performance review meetings are seems to be very brief. Regardless of whether the target has been achieved or not every item has to analysed thoroughly and plans for rest of the period should be altered accordingly to achieve a real performance 3.Action accountability Unlike the current system divisional managers bonuses should not be purely based on achieving AOP profit. It has to include the strategies used in achieving profit, closing stock, new product developments, and effective sales Conclusion : However costs associated with each option has to be analysed before the decision. Since all the divisions are managed by humans. Certain level goal incongruence is present in any divisionalised organisation. It is impossible to eliminate it totally. Though a very minimal level of date manipulation and game playing activities are possible since those number in the financial statements are not perfect in real world

Tuesday, October 22, 2019

Socrates and Matthew Essays

Socrates and Matthew Essays Socrates and Matthew Essay Socrates and Matthew Essay Every ancient culture seemed to have its own heretics. The Greeks and Romans were no exception. In Athens, Greece, the philosopher Socrates was perhaps the most well-known heretic, and in Rome it was Jesus of Nazareth. Both Socrates and Jesus faced political charges. However, Socrates was more of a political man than Jesus was.First, there was evidence suggesting that Socrates may have committed political crimes in Athens. Athens was an ancient Democracy, and freedom of speech was highly prized in the courts and among the common people. However, Socrates was executed despite the existence of this freedom. This implies that he tried to overthrow the democracy and begin a dictatorship. According to I. F. Stone, anti-democrats established short dictatorships in 411 B.C. and 404 B.C. Because Socrates was also a well-known anti-democrat, Athenians were afraid of another dictatorship. For this reason, Socrates was not put on trial until 399 B.C. after he had been teaching for more than 25 years, even though he was already an old man (Stone).On the other hand, Jesus was not accused of trying to overthrow the government. Instead, Judas Iscariot, one of his 12 disciples, brought Jesus to the chief priests to be crucified, in exchange for 30 pieces of silver (Matthew 26.14-15 King James Version). As a result, he was crucified, even though no specific political charges were brought against him.No one ever revoked Socratess charges. But Judas did try to revoke his bribe to crucify Jesus. In Matthew 27:4, Judas said: I have sinned in that I have betrayed the innocent blood. But in the same verse, the people did not want to hear what he had to say; their response was: What is that to us? See thou to that (Matthew 27.4).However, both Socrates and Jesus faced religious charges. For Socrates the charge was corrupting the youth, although no specific definition or explanation of the charge â€Å"Socrates and Matthew† was ever given. According to Stone, however, it may have referred to the possibility that Socrates was undermining young Athenians faith in their democracy (Stone). Jesuss charge was blasphemy, because he claimed to be the king of the Jews (Matthew 27.11). However, the governor did not recognize any evil in him (Matthew 27.23). In the end, Jesus was crucified, because the people demanded it and took responsibility for his crucifixion (Matthew 27.25).Another difference between Socrates and Jesus was the justification of each verdict. In the book of Matthew, there were no references to people feeling justified long after the crucifixion of Jesus. However, more than 50 years after the trial of Socrates, the Greek orator Aeschines said: Men of Athens, you executed Socrates, the sophist, because he was clearly responsible for the education of Critias, one of the thirty anti-democratic leaders (qtd. in Stone). This quote proves that if Socrates had not been executed, yet another dictatorship could have been established in the democratic city o f Athens. It is also interesting to note that Socrates never left Athens during the reign of the 30 tyrants, who were all dictators. It was as if he were overseeing their work, and he was one of very few people who were not banished, put into exile, or murdered for not supporting the 30 tyrants (Stone).As a matter of fact, the only reference to how people felt after the crucifixion of Jesus was one of remorse. Matthew 27:54 reads: Now when the centurion, and they that were with him, watching Jesus, saw the earthquake, and those things that were done, they feared greatly, saying, Truly this was the Son of God.In addition, Jesus was not accused of corrupting the youth, as Socrates was. In contrast, Xenophon, a witness at the trial of Socrates, later reported that during the trial, â€Å"Socrates and Matthew†   someone accused Socrates of teaching people to despise the way minor government offices were filled by lot. This unnamed accuser also said that Socrates taught his pupi ls that the government should be run by experts, rather than by popular vote in the assembly (Stone). Although Xenophon was a follower of Socrates, he did not deny these accusations. Furthermore, he later stated that Socrates was accused of corrupting the young by teaching them the things previously mentioned (Stone). Xenophon denied this charge, but it is, nonetheless, a charge and an accusation. This, along with the fact that he did not deny the first two charges, proves that Socrates was an extremely political man.There are other political reasons for the condemnation of Socrates. According to Stone, Athens granted amnesty toward the 30 tyrants, as long as they stopped being dictators. After this, their past actions were not brought up again, and Athenians kept their oath and acted honorably toward the former tyrants (Stone). However, Socrates was prosecuted and condemned, because he continued teaching his anti-democratic philosophy even after the democracy was re-established (St one). Jesus, on the other hand, was not accused of being a dictator, and there was no evidence to suggest that he continued teaching after receiving a warning like Socrates did after the Athenian democracy was rebuilt.In conclusion, Socrates was more of a political man than Jesus of Nazareth. Although there is no record of the entire trial, there is enough evidence, if not to justify the condemnation of Socrates, then certainly to conclude that he was much more political than Jesus was. This evidence includes the fact that Xenophon did not deny the charges that Socrates did not agree with how the Athenian government was run, and that Socrates â€Å"Socrates and Matthew† continued his anti-democratic teachings after the re-establishment of the Greek democracy.

Monday, October 21, 2019

The Royal Road of the Achaemenids in Darius Empire

The Royal Road of the Achaemenids in Darius Empire The Royal Road of the Achaemenids was a major intercontinental thoroughfare built by the Persian Achaemenid dynasty king Darius the Great (521–485 BCE). The road network allowed Darius a way to access and maintain control over his conquered cities throughout the Persian empire. It is also, ironically enough, the same road that Alexander the Great used to conquer the Achaemenid dynasty a century and a half later. The Royal Road led from the Aegean Sea to Iran, a length of some 1,500 miles (2,400 kilometers). A major branch connected the cities of Susa, Kirkuk, Nineveh, Edessa, Hattusa, and Sardis. The journey from Susa to Sardis was reported to have taken 90 days on foot, and three more to get to the Mediterranean coast at Ephesus. The journey would have been faster on horseback, and carefully placed way stations helped speed the communication network. From Susa the road connected to Persepolis and India and intersected with other road systems leading to the ancient allied and competing kingdoms of Media, Bactria, and Sogdiana. A branch from Fars to Sardis crossed the foothills of the Zagros mountains and east of the Tigris and Euphrates rivers, through Kilikia and Cappadocia before reaching Sardis. Another branch led into Phyrgia. Not Just a Road Network The network might have been called the Royal Road, but it also included rivers, canals, and trails, as well as ports and anchorages for seaborne travel. One canal built for Darius I connected the Nile to the Red Sea. An idea of the amount of traffic that the roads saw has been gleaned by ethnographer Nancy J. Malville, who examined ethnographic records of Nepali porters. She found that human porters can move loads of 60–100 kilograms (132–220 pounds) a distance of 10–15 kilometers (6–9 miles) per day without the benefit of roads. Mules can carry loads of 150–180 kg (330–396 lbs) up to 24 km (14 mi) per day; and camels can carry much heavier loads up to 300 kg (661 lbs), some 30 km (18 mi) per day. Pirradazish: Express Postal Service According to the Greek historian Herodotus, a postal relay system called pirradazish (express runner or fast runner) in Old Iranian and angareion in Greek, served to connect up the major cities in an ancient form of high-speed communication. Herodotus is known to have been prone to exaggeration, but he was definitely impressed with what he saw and heard. There is nothing mortal that is faster than the system that the Persians have devised for sending messages. Apparently, they have horses and men posted at intervals along the route, the same number in total as the overall length in days of the journey, with a fresh horse and rider for every day of travel. Whatever the conditions- it may be snowing, raining, blazing hot, or dark- they never fail to complete their assigned journey in the fastest possible time. The first man passes his instructions on to the second, the second to the third, and so on. Herodotus, The Histories Book 8, chapter 98, cited in Colburn and translated by R. Waterfield. Historic Records of the Road As you might have guessed, there are multiple historical records of the road, including such as Herotodus who mentioned the royal waystations along one of the best-known segments. Extensive information also comes from the Persepolis Fortification Archive (PFA), tens of thousands of clay tablets and fragments incised in cuneiform writing, and excavated from the ruins of Darius capital at Persepolis. Much information about the Royal Road comes from the PFAs Q texts, tablets which record the disbursement of specific travelers rations along the way, describing their destinations and/or points of origin. Those endpoints are often far beyond the local area of Persepolis and Susa. One travel document was carried by the individual named Nehtihor, who was authorized to draw rations in a string of cities through northern Mesopotamia from Susa to Damascus. Demotic and hieroglyphic graffiti dated to Darius Is 18th regnal year (~503 BCE) has identified another important segment of the Royal Road known as Darb Rayayna, which ran in North Africa between Armant in the Qena Bend in Upper Egypt and the Kharga Oasis in the Western Desert. Architectural Features Determining Darius construction methods of the road is somewhat difficult since the Achmaenid road was built following older roadways. Probably most of the routes were unpaved but there are some exceptions. A few intact sections of the road which date to Dariuss time, such as that at Gordion and Sardis, were constructed with cobblestone pavements atop a low embankment from 5–7 meters (16–23 feet) in width and, in places, faced with a curbing of dressed stone. At Gordion, the road was 6.25 m (20.5 ft) wide, with a packed gravel surface and curbstones and a ridge down the middle dividing it into two lanes. Theres also a rock-cut road segment at Madakeh which has been associated with the Persepolis–Susa road, 5 m (16.5 ft) wide. These paved sections were likely limited to the vicinities of cities or the most important arteries. Way Stations Even ordinary travelers had to stop on such long journeys. A hundred and eleven way-posting stations were reported to have existed on the main branch between Susa and Sardis, where fresh horses were kept for travelers. They are recognized by their similarities to caravanserais, stops on the Silk Road for camel traders. These are square or rectangular stone buildings with multiple rooms around a broad market area, and an enormous gate allowing parcel- and human-laden camels to pass under it. The Greek philosopher Xenophon called them hippon, of horses in Greek, which means they probably also included stables. A handful of way stations have been tentatively identified archaeologically. One possible way station is a large (40x30 m, 131x98 ft) five-room stone building near the site of Kuh-e Qale (or Qaleh Kali), on or very close to the Persepolis–Susa road, known to have been a major artery for royal and court traffic. It is somewhat more elaborate than would have been expected for a simple travelers inn, with fancy columns and porticoes. Expensive luxury items in delicate glass and imported stone have been found at Qaleh Kali, all of which leads scholars to surmise that the site was an exclusive way station for wealthier travelers. Travelers Comfort Inns Another possible but less fancy way station has been identified at the site of JinJan (Tappeh Survan), in Iran. There are two known near Germabad and Madakeh on the Pesrpolis–Susa road, one at Tangi-Bulaghi near Pasargadae, and one at Deh Bozan between Susa and Ecbatana. Tang-i Bulaghi is a courtyard surrounded by thick walls, with several smaller ancient buildings, which fits other types of ancient buildings but also caravanserais. The one near Madakeh is of similar construction. Various historic documents suggest that there were likely maps, itineraries, and milestones to aid travelers in their journeys. According to documents in the PFA, there were also road maintenance crews. References exist of gangs of workmen known as road counters or people who count the road, who made sure that the road was in good repair. There is also a mention in the Roman writer Claudius Aelianus De natura animalium indicating that Darius asked at one point that the road from Susa to Media be cleared of scorpions. Archaeology of the Royal Road Much of what is known about the Royal Road comes not from archaeology, but from the Greek historian Herodotus, who described the Achaemenid imperial postal system. Archaeological evidence suggests that there were several precursors to the Royal Road: that portion which connects Gordion to the coast was likely used by Cyrus the Great during his conquest of Anatolia. It is possible that the first roads were established in the 10th century BCE under the Hittites. These roads would have been used as trade routes by the Assyrians and Hittites at Boghakzoy. Historian David French has argued that the much later Roman roads would have been constructed along the ancient Persian roads as well; some of the Roman roads are used today, meaning that parts of the Royal Road have been used continually for some 3,000 years. French argues that a southern route across the Euphrates at Zeugma and across Cappodocia, ending at Sardis, was the main Royal Road. This was the route taken by Cyrus the Younger in 401 BCE; and it is possible that Alexander the Great traveled this same route while conquering much of Eurasia in the 4th century BCE. The northern route proposed by other scholars as the main thoroughfare has three possible routes: through Ankara in Turkey and into Armenia, crossing the Euphrates in the hills near the Keban dam, or crossing the Euphrates at Zeugma. All of these segments were used both before and after the Achaemenids. Sources Asadu, Ali, and Barbara Kaim. The Acheamenid Building at Site 64 in Tang-E Bulaghi. Achaemenet Arta 9.3 (2009). Print. Colburn, Henry P. Connectivity and Communication in the Achaemenid Empire. Journal of the Economic and Social History of the Orient 56.1 (2013): 29–52. Print.Dusinberre, Elspeth R. M. Aspects of Empire in Achaemenid Sardis. Cambridge: Cambridge University Press, 2003. Print.French, David. Pre- and Early-Roman Roads of Asia Minor. The Persian Royal Road. Iran 36 (1998): 15–43. Print.Malville, Nancy J. Long-Distance Transport of Bulk Goods in the Pre-Hispanic American Southwest. Journal of Anthropological Archaeology 20.2 (2001): 230–43. Print.Stoneman, Richard. How Many Miles to Babylon? Maps, Guides, Roads, and Rivers in the Expeditions of Xenophon and Alexander. Greece and Rome 62.1 (2015): 60–74. Print.Sumner, W. M. Achaemenid Settlement in the Persepolis Plain. American Journal of Archaeology 90.1 (1986): 3–31. Print.Young, Rodne y S. Gordion on the Royal Road. Proceedings of the American Philosophical Society 107.4 (1963): 348–64. Print.

Sunday, October 20, 2019

An Analysis Of Chimes Of Slience Essays - Yoruba People, Literature

An Analysis Of Chimes Of Slience Essays - Yoruba People, Literature An Analysis Of Chimes Of Slience An Analysis of Chimes of Slience Wole Soyinka is a Nigerian playwright, and the author of the prose poem Chimes of Silence. In order to describe his experience in solitary confinement Soyinka uses descriptive language involving his vision to better enlighten the reader to his experience. The most dramatic passages in Chimes of Silence describe his limited vision, which expresses to the reader how difficult and horrible of an experience it must have been. Soyinkas efforts to see any sign of life through peepholes in order to have some way of connecting with the outside world, shows just how lonely he really is. The poem opens with Soyinka struggling to see through a peephole in the door of his cell. His interest in the boring details outside of his cell shows just how lonely he is, and how much he longs to have any kind of contact with reality. A little square hole cut in the door, enough for a goalers fist to passenough for me tosteal a quick look at the rare flash of a hand, a face, a gesture(140). Soyinka is desperate to see anything that he can relate to human life. Anything that assures him that even though he has no contact with humans that life is still going on. Anything that reminds him that theres the possibility that he could one day enter back into the life that he has been exiled from. Soyinka continues describing things he strains to see thorough the peephole including, more often a blur of khaki, the square planted rear of the guard on the other side (140). Not only does Soyinka strain to see any part of the human body itself, but also anything else that reminds him of human beings. Something we take for granted everyday Soyinka finds as a connection to the outside world. Its clear through his description of vision seeing through the peephole that Soyinka is desperate for human interaction and is clearly very lonely. Later in the essay Soyinka makes reference to the limited but present amount of sky that he is able to see in his cell; a sky the size of a napkin trapped by small spikes and broken bottles, but a sky (140). Through his describing the sky Soyinka finds another way of connecting to the outside world. The sky that he looks upon is the same one that people look upon everyday, and to him it makes the correlation to the human life he longs to be living. Soyinka knows that when he was once living and surrounded by human contact that he was covered by the same sky that he sees in his cell. It serves as a reminder to him that although trapped he can still carry a piece of his old life within him. His memories of his old life can help make up for the emptiness inside of him in his time of being alone. Soyinka also describes the birds he can see from his cell, Vultures perch on a roof just visible from another yard. And crows. Egrets overfly my crypt and bats swarm at sunset (140). Through his description of the birds Soyinka once again describes something living in order to make up for the fact that he feels so alone, and in a sense dead. It seems that in Soyinkas description of the birds that he almost longs to be them, to be able to fly and be free. Soyinka envies the birds for they arent trapped alone and they have access to the world unlike him. Soyinka eventually discovers a new peephole in his cell and once again he strains to see anything he can to keep himself from being so lonely. Soyinka talks of counting feet walking by in order to keep some kind of reality And now feetthe procession goes by and I count (141). By counting the feet Soyinka can establish the slightest relationship to any kind of outside life. Its almost as if by counting the feet Soyinka can relate to the prisoners and make up for the emptiness he is feeling, and not seem to be so alone. Although they arent trapped there with him the

Saturday, October 19, 2019

Dewey's Democratic Individualism Essay Example | Topics and Well Written Essays - 750 words

Dewey's Democratic Individualism - Essay Example Even crime is becoming corporate. What happens nowadays is that "these corporations [effect] a change of social life from an individual to corporate affair." Reactions of the individual and society as a whole to this change are manifold: they affect the psychological, professional, and political sphere. According to Dewey, "they affect the working ideas, beliefs and conduct of all of us." However there is a split within individual and in a society, and most specifically-the split within the new business mind. The split comes about because "the results of industry.. are corporate and collective" while the inner motives are private and individual. Dewey calls resolution to this state "a law of mental integrity"; this will come about when inner motives become concerned with corporate goals-that is to say, shared goals. Dewey says: "When the corporateness becomes internal, that is, it is realized in thought and purpose, it will become qualitative Law will be realized not as a rule arbitrarily imposed from without but as the relations which hold individuals together." According to Dewey, these two statements are closely connected with essential question pertaining to individuality: the need for a new theory and new morals which would explain human nature and its connection to society in these new economic conditions. This would be the basis of democracy in current American society. Dewey states that "Dewey states that "[a]ssured and integrated individuality is the product of definite social relationships and publicly acknowledged functions." These relationships being established, as well as the public acknowledgment of the role of different human endeavors within a current society, the split of the business mind would be healed. There needs to be "some consensus of belief as to the meaning of finance and industry in civilization as a whole". This would supply a sense of meaning to the business mind and its importance within a society. Dewey further analyzes this social and individual split. What is lacking as a reward for achieving one's ends, (the reward presently being financial profit), is a sense of social fulfillment. Social fulfillment of individuals is a key factor in new democracy. The current standards of value are "derived from pecuniary success and economic prosperity". This is not enough for individual fulfillment, as human beings need a sense of solidarity and participation. This then implies shared and common values. The essential trait of human nature, according to American tradition, is love of liberty, but Dewey wonders if men would surrender their liberties in the name of solidarity, with the sense of union that it entails and respect by others it provides. What is needed is new psychological and moral theories to explain human nature, and which are in accordance with society at present and its corporateness. Culture is another important element of new democracy. For political freedom, freedom of culture is essential: "positive conditions, forming the prevailing state of culture, are required". Everybody should share in enjoyment of the arts. Culture is extremely important because it determines the patterns of behavior of any given group in a specific period-as proved by recent anthropological findings. It also puts a new spin on the problem of relation of the individual to the social -as it defines current customs, rules, traditions, and institutions. Dewey

Friday, October 18, 2019

The Meaning of Genotype and Phenotype and the Effect of the Coursework

The Meaning of Genotype and Phenotype and the Effect of the Environment on the Phenotype of an Organism - Coursework Example    The CFTR gene which for encodes a protein that transports chloride ions across cell membranes has two genes. The dominant gene (A), which is the normal version of the gene. The recessive gene (a), which is the mutated version of the gene. Those with cystic fibrosis receive both the recessive alleles. The genotype of individuals is then (a, a). While the phenotype of the recessive genotype, is the absence of protein that transports chloride ions, and so, cystic fibrosis. The phenotype is not only expressed by the effects of the phenotype alone. The environmental condition also affects the expression of phenotype. The effect of the environment on the phenotype of an organism is best understood through an experiment. Taking two samples of the colors plant, both samples originate from the same plant. The samples are grown in two separate chambers. The environmental condition varied is the amount of light delivered. All other factors are kept constant in both samples. Though both sam ples have similar genotypes, the growth of both samples varies. The sample that receives higher proportion of light compared to the other grows faster and thrives. While the sample that receives lesser light compared to the other, has stunted growth and is weak. The environmental condition has affected the phenotype irrespective of the genotype being common to both samples. Explain how DNA replicates itself. (200 words) DNA replication is based on the model presented by Watson and Crick. The model suggests semi-conservative replication of DNA strands. This replication is called so, because a half of the strand is conserved while the other half is newly formed. DNA replication occurs in the nucleolus of the nucleolus.DNA replication takes place in the interphase of the cell cycle. In order for DNA replication to take place, the DNA strands must first be separated. The DNA strands are separated by the enzymatic action of an enzyme. The enzyme breaks the hydrogen bonds present between the complementary base pairs. The two DNA strands are separated. The four bases involved in DNA replication are adenine, thymine, cytosine and guanine. Nucleotides when paired with an additional phosphate become activated nucleotides. The activated nucleotides are capable of pairing up with their complementary base pairs with the help of enzyme DNA polymerase. The activated nucleotides form bonds with their complementary base pairs. DNA polymerase links the sugar and innermost phosphate groups of adjacent nucleotides together. The extra phosphate ions are released. This marks the replication of DNA from a single DNA molecule; both new DNA molecules conserve a single strand of the old DNA molecule. Explain the type of mutation that resulted in the sickle cell anaemia. (200 words) Mutation is the change in genetic material of an organism as results of base deletion, base substitution or base addition. The change in genetic material causes a different allele of a gene to be expressed, which in turn causes different phenotypic characteristic. Sickle cell anaemia is an inherited blood disorder that causes a change in haemoglobin characteristic. Haemoglobin is composed of four polypeptide chains. That is two alpha chains and two beta chains. The normal coding for haemoglobin in the beta chains is; Val-His-Leu-Thr-Pro-Glu-Glu-Lys-. These coding codes for normal hemoglobin. However, a base substitution, causes the normal base sequence CTT to be expressed as CAT.  

Eriksons stage of evelopemnt (Ego Integrity vs Despair) Article

Eriksons stage of evelopemnt (Ego Integrity vs Despair) - Article Example This psychosocial stage has specific characteristics that explain late adulthood behavior. According to Erickson’s theory, the ego integrity versus despair is a crisis that involves deepened mental engagements (Carducci, 2006). The individual in this stage reflects on the past. They consider the impacts of the decisions they made during the earlier stages of development. The ego of an individual develops when the individuals reflect of the choices they made earlier in their development (Newman, 2012). Ego integrity occurs when the individual reflects on the past decisions of earlier developmental stages as pleasant. In this case, the individual celebrates his/her life through the mentorships and developments they have accomplished to other people. Ego integrity is therefore pleasurable (Carducci, 2006). The individuals perceive their lives as complete. In the case of the deceased client, ego integrity is unattainable to him. Reflection of his life shows sadness and misfortune through the sicknesses within his family, and also his unfulfilled career. In despair, the individual reflects on the life they have lived and they experience a sense of incompleteness (Newman, 2012). The failures in achievement tend to dominate their thoughts and reflections during this stage of their life. They realize that time has lapsed and they lack control to many situations (Newman, 2012). Therefore, their thoughts are directed towards what cannot be modified and rectified in their old age. Consequently, the individual manifests feelings of anger and intense bitterness (Fry, 1989). The case client in the nursing home may be suffering from despair. He might not have the wisdom to negotiate through the crisis. This case client will undergo despair due to the incomplete feeling upon the reflection of his

Thursday, October 17, 2019

Service operations and manufacturing operation Essay

Service operations and manufacturing operation - Essay Example This is to create a basis for comparison. For the article, it is evident that the service operation system has higher capabilities than the manufacturing operations system because of its structural functionalities. The system has the capability to relate with the customer on healthy grounds; it is also able to markets its services, as there are direct relationships with the consumers. On the other hand, there is an analysis on the deficiencies of the manufacturing system. There is also a discussion on the benefits behind the integration of the two systems. From the discussion relating to the difference, it is evident that, there will be an improvement in supervision, operations, and the cost of production. Introduction Service, manufacturing, and agriculture are the key economic activities in any economy. In most of the developed nations, services and manufacturing sectors of the economy constitute around 75% of the Gross Domestic Product. However, in the recent decades the growth and development is as a result of these sectors of the economy. For the last ten years, it is evident that the service sector in the economy has steadily increased from 40% to 53%. This is in reference to the world’s economy. Growth of sectors such as the IT sector is the key factors leading to the admirable change. If we refer to the history of economics, it is evident that exceedingly few governments had a taxing system to charge the service industry.

Case Analysis Report Essay Example | Topics and Well Written Essays - 500 words

Case Analysis Report - Essay Example Additionally they were given the rights to explore and exploit two gas properties. However, the company required funds to develop and exploit the sites. Thus, it went into an agreement with Macquarie Bank which agreed to finance them with US $45million, with an interest of 15% p.a and 50% equity stake. After the agreement, the reserves were extensive and profitable, so the East Cameroon Company was able to repay the loan quickly. The case study is one that the Macquarie bank is not willing to finance the company, two, and it still owns a 50% stake in the East Cameroon Company. The East Cameroon Company, Chief Executive Officer (CEO), Campbell Evans established that the company could not move on since they had little control of the company. The bank now had 50% stake. Meaning the original founders could no longer control the business as before. Evans is, therefore, looking for alternative funding options. At first he is more interested in getting the financial support to continue with the exploration (Cunningham, 2002). The most financial proposals he has received are from banks and require equity component. Evans and the other shareholders are not ready to give out more equity to banks. Evans would like to return the company’s shares as before so that they can control the company. Evans was approached by Bemo Securitisation (BSEC) financier who offered an interesting financial solution. The solution is the use of Sukuk bond. This is an Islamic finance that would allow East Cameroon to reverse Macquarie’s equity stake. Additionally, it would replace it with a high yielding bond-like channel. However, Evans was not certain of how the Sukuk bond works. He therefore, decided to research before making any decision. The Sukuk structure was more complex that what he had thought. One, It consisted of securitizing hydrocarbon

Wednesday, October 16, 2019

Service operations and manufacturing operation Essay

Service operations and manufacturing operation - Essay Example This is to create a basis for comparison. For the article, it is evident that the service operation system has higher capabilities than the manufacturing operations system because of its structural functionalities. The system has the capability to relate with the customer on healthy grounds; it is also able to markets its services, as there are direct relationships with the consumers. On the other hand, there is an analysis on the deficiencies of the manufacturing system. There is also a discussion on the benefits behind the integration of the two systems. From the discussion relating to the difference, it is evident that, there will be an improvement in supervision, operations, and the cost of production. Introduction Service, manufacturing, and agriculture are the key economic activities in any economy. In most of the developed nations, services and manufacturing sectors of the economy constitute around 75% of the Gross Domestic Product. However, in the recent decades the growth and development is as a result of these sectors of the economy. For the last ten years, it is evident that the service sector in the economy has steadily increased from 40% to 53%. This is in reference to the world’s economy. Growth of sectors such as the IT sector is the key factors leading to the admirable change. If we refer to the history of economics, it is evident that exceedingly few governments had a taxing system to charge the service industry.

Tuesday, October 15, 2019

Culinary Class - Food and Religion Term Paper Example | Topics and Well Written Essays - 1000 words

Culinary Class - Food and Religion - Term Paper Example Many christen faiths associate various events with food regulation practices for instance. Orthodox and Catholic Church associate fasting with the strengthening of prayer during hardships. This is related to the story of Jesus in the mountain the night before he was crucified. He knew he was going to go through a lot of suffering thus used his last moments to pray and fast in the mountain (Sanford, 2013). Christians also use this opportunity to share what they may have saved in form of food with the poor societies and people living in harsh desert environments. During the lent period in the catholic calendar, Christians tend to avoid eating meat on Fridays to honour the death of Jesus Christ. Other Christians use this opportunity to sacrifice what they love in the form of food and distribute it to the needy communities (Wildman, 2010). Feeding the hungry is considered as an important practice in the Christian world. This is a way of following the example of Christ as he fed 5000 peop le with two fish and four loafs of bread. The ritual of communion is celebrated by Christians in many occasions. This ritual involves the eating of bread and drinking wine to commemorate the body and blood of Christ. Seventh day and Mormon Adventists are refrained from taking alcoholic and caffeinated beverages. The ‘seventh day’ Adventists do not take dairy products or meat due to their belief that dairy animals are productive animals just in the same way God provides for His people. The Buddhism religion considers all living beings as sacred. This has led to the practice of veganism and vegetarianism among religious members in the religion. It is a belief in the religion that all foods obtained from a form of violence or human aggressions are indeed considered to be bad (Diaz. 2012). The religion tries to maintain the principle of Ahisma which involves harmless and non-violence activities thus

Assumptions and Fallacies Essay Example for Free

Assumptions and Fallacies Essay †¢ What are assumptions? How do you think assumptions might interfere with critical thinking? What might you do to avoid making assumptions in your thinking? Assumption is an idea one believes to be true based on prior experience or ones belief systems. (Elder Paul, 2002) Assumptions are a part of our belief system but we don’t know that they are true or not. Assumptions are a vital part of our critical thinking. If we used assumptions all the time then we would not be able to use critical thinking. It doesn’t matter where we are at, it is imperative to know all the facts prior to drawing any kind of conclusion or it becomes an assumption. It may be difficult at times to utilize critical thinking but by keeping an open minded aspect will help to prevent assumptions. There is nothing worse than making an assumption and then to be confronted by someone who has all the facts can shatter your confidence. You can avoid this by researching all the facts and utilizing your critical thinking abilities to cover every corner and aspect of your idea or topic. This is the key to keep from making assumptions. †¢ What are fallacies? How are fallacies used in written, oral, and visual arguments? What might you do to avoid fallacies in your thinking? Fallacies are deceptive or misleading arguments that are untrue or unreliable. Fallacies are mainly used to help support a person’s argument when they can’t find factual evidence to back up their statements. Fallacies can be used in many different ways. They are used on purpose in fictional writing and magazines like People. Fallacies can be orally used by someone when they are telling a firsthand story but are only versed in their side so it may come off as unintentional. I see fallacies being mostly used visually popliteal ads and propaganda media campaigns. They get away with most of these fallacies because the amount of time it takes to research the truth usually takes too long before the psychological damage is already done on the public. People tend to trust what others say unless they have found previous fallacies in their statements. I avoid believing fallacies by being conservative in my thoughts. If I see something that I might consider to be fallacious by my past experiences then I do the research to find out the facts. Fallacies and assumptions hold the same key as research will reveal them all.

Monday, October 14, 2019

Medication Adherence And Treatment Satisfaction In Patients Nursing Essay

Medication Adherence And Treatment Satisfaction In Patients Nursing Essay Abstract Background and Objective: Medication adherence and treatment satisfaction are important for successful therapeutic outcome. The objectives of this study were to (1) assess antipsychotic medication adherence using 8-item Morisky Medication Adherence Scale (MMAS), (2) assess treatment satisfaction using Treatment Satisfaction Questionnaire for Medication (TSQM 1.4), and (3) correlate adherence and satisfaction with psychiatric symptoms measured using 24-item expanded Brief Psychiatric Rating Scale (BPRS-E) in patients with schizophrenia. Methodology: This is a cross sectional study Admin2010-12-25T10:07:00 Also, You should mention your design of study inside the textcarried out at governmental out-patient psychiatric unit in Nablus/ Palestine during summer 2010. Two hundred and sixty seven schizophrenic patients were registered at the clinic. Patients included in the study were those whose medications have not been changed in the past six months and those who did not have an acute attack in the past year. Data were entered and analyzed using SPSS 16 for windows. Results: One hundred and fifty patients Admin2010-12-25T12:46:00 In cross sectional study, you should calculate the sample size to give a good precision for reliability and validity. These terms increase the quality and acceptance rate of articles.out of 267 registered schizophrenic patients met the inclusion criteria. Nineteen patients refused to participate while 131 patients agreed giving a response rate of 87.3%. The mean  ± SD of MMAS was 6.1  ± 1.7 in which 44 patients (33.6%) had low rate, 58(44.3%) had medium rate 29 (22.1%) had high rate of adherence to their antipsychotic medications. The means of satisfaction with regard to effectiveness, side effects, convenience global satisfaction were 72.6  ± 20.5, 67.9  ± 31.47, 63.2  ± 14.3 63.1  ± 18.8 respectively. The mean BPRS score of the patients was 68.4  ± 24.5 with 14.4  ± 6.7 13.7  ± 6.1 means for positive and negative symptoms scores respectively. Pearson correlation showed that there was a positive and significant correlation between effectiveness (P = 0.002, r = 0.27), side effects (0.006, r =0.24), convenience (P Discussion and Conclusion: conclusions can be summarized as follows: First, the majority of the patients had low to medium rate of adherence. Second, adherence was positively and significantly correlated with satisfaction. Third, adherence was significantly but negatively correlated with most psychiatric symptoms. Fourth, no significant difference in adherence was found among patients receiving various antipsychotic therapeutic regimens. Finally, various antipsychotic regimens significantly differ in side effects satisfaction domain only. Key words: adherence, satisfaction, psychiatric symptoms, antipsychotics Introduction Schizophrenia is a chronic psychiatric disorder that impairs the quality of patients life and requires pharmacological and non-pharmacological interventions (Palmer et al., 2002; Pinikahana et al., 2002; Sharma and Antonova, 2003). Antipsychotic drug therapy is considered as the key element in schizophrenia management and has been reported to minimize the frequency of acute schizophrenic episodes and hospitalization (Awad and Voruganti 2004; Campell et al., 1999). Adherence (compliance) to antipsychotic medications is necessary in order to achieve these therapeutic goals. Furthermore, adherence has been reported to lead to considerable cost savings (Damen et al., 2008). However, non-adherence (non-compliance) to antipsychotic medications is common and is considered as an integral barrier to the successful treatment of schizophrenia (Dolder et. al, 2003; Weiden 2007; Byrne et al., 2006; Kim et al., 2006). There are several factors that can cause treatment non-adherence in schizophreni c patients. Such factors include those derived from schizophrenic disorder itself, patient characteristics, those associated with the health-care system, and the antipsychotic treatment regimen (Svestka Bitter 2007; Misdrahi et al., 2002). Patients related factors contributing to non-adherence include gender, age, socio-economic status, race, and religion (Lowry 1998; Borras et al 2007). Cultural differences might be a potential factor for non-adherence. For example, a review article about psychotropic medications found that rates of non-adherence were higher among Latinos than Euro-Americans and clinical and research interventions to improve adherence should be culturally appropriate and incorporate identified factors (Lanouette et al., 2009). Although patients satisfaction with treatment regimen is crucial for medication adherence (Atkinson et al., 2004; Taira et al. 2006), few studies had examined the relationship between adherence, treatment satisfaction and therapeutic outcome in patients with schizophrenia (Fujikawa et al.; 2004; Freudenreich et al., 2004 Watanabe et al, 2004). Therefore, the objectives of this study were to: (1) Assess the degree of adherence to antipsychotic medications among schizophrenic outpatients using eight-item Morisky Medication Adherence Scale (MMAS), (2) Assess the degree of patients satisfaction with their treatment regimen using Treatment satisfaction Questionnaire for medication (TSQM 1.4), (3) Evaluate patients clinical symptoms, Positive Symptom Score (PSS) Negative Symptom Score (NSS) using Brief Psychiatric Rating Scale (BPRS), and finally (4) Investigate relationships and correlations between medication adherence, subjective patients treatment satisfaction and psychiatric symptoms in patients with schizophrenia. Methodology 2.1. Patient selection: This study was conducted between July 2010 September 2010 at Al-Makhfya psychiatric Health Center in Nablus, Palestine. Approval to perform the study was obtained from the Palestinian ministry of health and IRBAdmin2010-12-25T10:09:00 Define this abbreviation committee at An-Najah National University. Patients who met the following criteria were invited to participate in this study: 1) their age was between 20 65 years, 2) they were diagnosed with schizophrenia as defined by DSMAdmin2010-12-25T13:29:00 Define this abbrev.-IV, 3) they had not been suffering from an acute attack of illness during the past year, and 4) their drug regimen had not been changed in the past 4 months. 2.2. Assessment and measures The instrument used in this study consisted of three parts: part one collected socio-demographic and medication data from patients medical files; part two was the Arabic version of the validated eight-item Morisky Medication Admin2010-12-25T13:31:00 . The final version of the Arabic questionnaire should be assessed to know if the Arabic version is reliable and valid to be used in your population. This a routine question by high impact journal Also, I suppose you are the first who use this score in Arab country, and this is good for you because you can write new article related to validity and reliability and it is preferred to be published before this article.Adherence Scale (MMAS) (Morisky et al., 2008, Morisky et al., 1986) and part three was the Arabic version of Treatment Satisfaction Questionnaire for Medication (TSQM 1.4) which the researchers obtained from Quintiles Strategic Research Services. The English version of the MMAS was translated into Arabic and was approved by professor Morisky through e-mail communication. The translation process was carried out according to the following procedure: 1) A forward translation of the original questionnaire was carried out from English to Arabic language to produce a version that was as close as possible to the original questionnaire in concept and meaning. Translation was carried out by two qualified independent translators; both native speakers of Arabic and proficient i n English. Each translator produced a forward translation of the original questionnaire into Arabic language without any mutual consultation. The corresponding author, who is a native Arabic speaker, reviewed the two primary versions and compared them with the original. (2) A back translation from Arabic language to English was carried out by two different translators after lengthy discussion between the translators and the corresponding author. (3) The back translated questionnaire was approved by Professor Donald Morisky through e-mail. The Arabic version of MMAS is an 8-item questionnaire with 7 yes/no questions while the last question was a 5-point likert question. Based on the scoring system of MMAS, adherence was rated as follows: high adherence (= 8), medium adherence (6 The TSQM 1.4 is a 14-item psychometrically robust and validated instrument consisting of four scales [Bahramal et al., 2009]. The four scales of the TSQM 1.4 include the effectiveness scale (questions 1 to 3), the side effects scale (questions 4 to 8), the convenience scale (questions 9 to 11) and the global satisfaction scale (questions 12 to 14). The TSQM 1.4 domain scores were calculated as recommended by the instruments authors, which is described in detail elsewhere (Atkinson et al., 2004; Atkinson et al., 2005). The TSQM 1.4 domain scores range from 0 to 100 with higher scores representing higher satisfaction on that domain. Psychiatric symptoms, positive and negative schizophrenic symptoms were evaluated by a psychiatrist and well trained psychologists using the expanded Brief Psychiatric Rating Scale (BPRS-E) (Overall and Gorham, 1962; Overall 1988; Lukoff et al., 1986; Ventura et al, 1993) at the same visit. The BPRS-E consists of 24 items measuring psychiatric symptoms. It measures four different dimensions: manic excitement/ disorganization, positive symptoms, negative symptoms, and depression/ anxiety (Ruggeri et al., 2005). Positive symptoms were the followings: grandiosity, suspiciousness, hallucinations, unusual thought content and conceptual disorganization. Negative symptoms included disorientation, blunted affect, emotional withdrawal, motor retardation, and mannerism and posturing. 2.3. Data analysis Continuous variables like Morisky score, satisfaction domain scores, BPRS, positive and negative symptoms scores were expressed as mean  ± SD. Correlation between continuous variables was carried out using Pearson correlation test. Difference in means was carried out using one-way ANOVA test. All statistical analyses were conducted using Statistical Package for Social Sciences (SPSS; version 16.0) for Windows. The conventional 5 percent significance level was used throughout the study. Results Demographic and clinical characteristics of patients One hundred and fifty patients out of 267 registered schizophrenic patients met the inclusion criteria. One hundred and thirty one (131) patients agreed to participate giving a response rate of 87.3%. Of the 131 patients, 40 (30.5%) were female and 91 (69.5%) were male. The mean age of the patients was 42.9  ± 10.3 years (range = 20 65 years). The mean duration of illness was 16.23  ± 9.59 years. Eighteen patients (13.7%) had other non-psychiatric diseases mainly diabetes mellitus (10 patients; 7.6%). Smoker schizophrenic patients represented 55% (72 patients) of the sample. None of the patients were reported to have any type of drug abuse. Details regarding demographic and clinical characteristics of the studied patients are shown in Table 1. Regarding treatment regimens, patients were grouped into 7 categories based on the type of antipsychotic medications they were using: Twenty four patients (18.3%) had been treated with oral typical antipsychotics only, 8 patients (6.1%) were using combination oral typical antipsychotics, 19 (14.5%) had been treated with typical depot injections only, 37 (28.2%) had been treated with typical oral and depot injections, 18 (13.7%) had been treated with oral atypical only, 12 patients (9.2%) had been treated with typical and atypical oral antipsychotics, and finally 13 patients (9.9%) had been treated with atypical oral and typical depot injection combination. The most common oral typical antipsychotic used by the patients was chloropromazine while the most common atypical antipsychotic was clozapine. Based on MMASAdmin2010-12-25T13:34:00 It is preferred to classify the characteristic of patients according to the adherence groups. Also, indicate if there is differences between the 3 groups , 44 (33.6%) of patients were rated as having low adherence, 58 (44.3%) were rated as having medium adherence 29 (22.1%) were rated as having high adherence to their antipsychotic medications. The average adherence score (6.1  ± 1.7) for the patients generally indicates medium rate of adherence. Upon investigation using 8-item Morisky scale (questionnaire ), we found that about 33.6% of patients forgot to take their medications; 15.3% of patients missed taking their medication for reason other than forgetting in the past two weeks before the interview; 13.7% stopped taking their medication without doctor counseling when they felt worse upon taking them; 16.8% forgot to take their medications with them when they leave home for long time; 10.7% didnt take their medication in the day before interview; 26% stopped taking their medica tion when they felt that their health is under control; and 55.7% felt hassled about sticking to their treatment plan. As for remembering to take their medications; 27.5% of the patients faced a difficulty in doing this once in a while; 6.1% of the sample sometimes had difficulties in remembering to take their medications; 6.9% of patients usually found difficulties; while 0.8% of schizophrenic patients faced these difficulties all the times. However 58.8% didnt show any difficulty in remembering to take their medication on time. Response to each question in the modified Morisky questionnaire is shown in Table 2. The average score of satisfaction with regard to effectiveness, side effects, convenience global satisfaction was 72.6  ±20.5; 67.9  ± 31.5; 63.2  ± 14.3; 63.1  ± 18.8 respectively. The mean BPRS score of the patients was 68.4  ± 24.5 with 14.4  ± 6.7 13.7  ± 6.1 means for positive and negative symptoms scores respectively Correlation between adherence scores and other variables There was a significant positive correlation between age and adherence (P = 0.028; r = 0.19Admin2010-12-25T13:35:00 As recommended, when correlation is less than 0.25 this considered as no or week correlation, 0.25-0.50 considered fair correlation. You can take this comments in your consideration. ). However, no such correlation was observed with the duration of illness (P = 0.13). Furthermore, no significant difference in the means of adherence was found between male and female (P = 0.76). Patients having other chronic diseases have significantly higher adherence score compared to those who do not, but the significance was at the borderline (P = 0.049). Pearson correlation showed that there was a positive and significant correlation between all satisfaction domains like effectiveness (P = 0.002, r = 0.27), side effects (P= 0.006, r =0.24), convenience (P Adherence, Treatment Satisfaction and type of antipsychotic regimen Adherence score was not significantly different (P = 0.6) among patients having different antipsychotic therapeutic regimens. Analysis of satisfaction based on the antipsychotic drug regimens showed that there was a significant difference in satisfaction with regard to side effects among different antipsychotic regimens ( P = 0.006, F = 3Admin2010-12-25T13:35:00 When you use one way ANOVA, it is recommended to use the Tukey post-hoc test to test the differences in the means between categories. To determine which group or groups are significant. ). Patients on atypical antipsychotic drug therapy showed the highest satisfaction with side effects (86.5  ± 4.8) compared with (51.3  ± 5.17) to those on typical antipsychotic mono-therapy. No significant difference with regard to other satisfaction domains (effectiveness, convenience and global satisfaction) among patients with different psychiatric regimens. Similarly no significant difference was found in BPRS scores (P = 0.6), positive (P = 0.6) and negative symptoms (P= 0.8) among different antipsychotic drug regimens. Details regarding adherence scores, BPRS, positive and negative symptoms with different antipsychotic drug regimens are shown in Table 4. Discussion This studyAdmin2010-12-25T13:36:00 This study is the first of its type in Palestine and the first study used an Arabic version for Morisky. You can add this points as originality of the article was conducted to assess medication adherence and treatment satisfaction among schizophrenic outpatients. The conclusions of the study can be summarized as follows: First, the majority (78%) of the patients had low to medium adherence rate. Second, adherence was positively and significantly correlated with treatment satisfaction. Third, adherence was significantly correlated with positive but negative psychiatric symptoms. Fourth, no significant difference in rate of adherence was found between patients using typical or atypical antipsychotic therapeutic regimens. Finally, patients on typical or atypical antipsychotic medications had similar scores in all domains of satisfaction except for that of side effects. Regarding rate of adherence, several studies have shown that up to 80% of all schizophrenic patients discontinue antipsychotic medications and that non-adherence rates ranging from 20% to 89%, with an average rate of approximately 50%, have been reported (Fenton et al, 1997; Lacro et al 2002, Young et al, 1986). Differences in rate of adherence among different reports might be attributed to different instrument used to assess adherence, social and cultural differences among different countries and differences in healthcare systems (Breen et al., 2007). In our study, younger patients had significantly lower adherence score than elderly patients. This finding is in agreement with other researchers who reported that younger schizophrenic patients have lesser adherence than older patients (Sajatovic et al 2007; Hui et al reported that younger age is a predictor for discontinuation of antipsychotic therapy (Hui et al.; 2006). However, other researchers reported equal non adherence among m iddle aged and elderly patients (Jeste et al., 2003) . Many factors have been cited as a potential cause for poor adherence. Side effects are key factors influencing compliance with antipsychotic medication (Weiden et al., 2004). (Liu-Seifert et al., 2005; Fleischhacker et al., 2003). There are few reports suggesting that treatment satisfaction is positively associated with antipsychotic medication adherence [Gharbawi et al., 2006,], improved clinical outcomes [Masand and Narasimhan, 2006], and quality of life [Hofer 2004,]. Our results give further support that treatment satisfaction is positively associated with adherence and symptom improvement, particularly psychotic positive symptoms. A study by Maneesakorn 2008 indicated that antipsychotic medication adherence has positive impact on psychiatric symptoms and satisfaction with medication (Maneesakron et al., 2007). Furthermore, Mohamad et al 2009 demonstrated an association between positive attitudes toward medication among schizophrenia patients and lower rates of study discontinuation (Mohamed et al., 2009). Thus, it is important to accurately evaluate patient satisfaction with medication treatment using validated instruments that can be utilized in clinical trials and practice. Medication non-adherence had a significantly negative impact on treatment response, highlighting the importance of adherence to achieve satisfactory treatment outcome (Lindameyr et al., 2009). A study by Liu-Seifert et al 2005 has found that discontinuing of treatment may lead to exacerbation of psychiatric symptoms and undermining therapeutic progress (Liu-Seifert et al., 2005). In these studies, poor response to treatment and worsening of underlying psychiatric symptoms, and to a lesser extent, intolerability to medication were the primary contributors to treatment being discontinued. Fewer extrapyramidal symptoms and tardive dyskinesia of atypical compared to typical antipsychotics led researchers to speculate that patients receiving atypical antipsychotics will show greater adherence, satisfaction and psychiatric improvement compared to patients receiving typical antipsychotics (Kane et al., 1988; Tollefson et al., 1997; Marder et al., 1994; Small et al., 1997 Jeste et al., 1999; Marder SR, 1998). However, our findings regarding adherence, satisfaction and psychiatric symptoms measured by BPRS-E were similar between patients on typical and atypical antipsychotic medications. Rosenheck and colleagues evaluated medication continuation and regimen adherence in 423 patients taking haloperidol or clozapine as part of a double-blind, randomized trial. Although the patients who received clozapine continued their medication significantly longer, the treatment groups did not differ in the proportion of pills returned each week (Rosenheck et al., 200). Olfson and colleagu es examined the effect of antipsychotic type on adherence 3 months after 213 inpatients with schizophrenia or schizoaffective disorder were discharged while receiving typical (84.5% of patients) or atypical (14.5% of patients) antipsychotics. A non-significant trend toward increased adherence was reported among patients with prescriptions for atypical antipsychotics (Olfson et al., 2000). Cabeza and colleagues retrospectively studied the relationship of adherence to antipsychotic type in 60 inpatients with schizophrenia. No significant association was found between adherence and type of antipsychotic (Cabeza et al., 2000). Dolder reported that patients on either typical or atypical had similar low rates of adherence (Dodler et al., 2002). Gianfransessco et al 2006 indicated that none of the atypicals showed treatment durations significantly different from the typical (Gianfransessco et al 2006). A study by Jones et al, 2006 has found that in people with schizophrenia whose medicatio n is changed for clinical reasons, there is no disadvantage across 1 year in terms of quality of life, symptoms, or associated costs of care in using FGAs rather than nonclozapine SGAs (Jones et al., 2006). Schulte et al concluded that, in general, very few or no advantages are to be gained from using SGAS rather than FGAS and the clinical effectiveness is not increased, but the side-effects are different. (Schulte et al 2010). In contrast, Al-Zakawani reported that atypical antipsychotic users were significantly more adherent to therapy, and had lower rates of office, hospital and emergency room utilization (Al-zakawani 2003). Actually, efficacy variations within SGAs and FGAs result in overlaps between the two groups and classification of antipsychotics into the two groups is no longer useful (Volvoka 2009). One might argue that cost of atypical antipschyotics is the barrier for medication adherence (Gibson et al., 2010). However, in our study, all patients had governmental insura nce and therefore cost of medications was not a reason of poor adherence of atypical antipsychotics. Regarding results of depot IM antipsychotic injections, we found no difference between oral and long acting antipsychotics with regard to adherence, satisfaction or psychiatric symptoms. Some researchers reported similar or better adherence, satisfaction and outcome with long acting injection than oral antipsychotics (Olivares et al., 2009; Gutierrez et al., 2010; Kane and Garcia 2009; Haddad et al., 2009). In contrast, vehof reported that patients on depot antipsychotics were less adherent and have more side effects than oral antipsychotics (Vehof et al., 2008). Our study has few limitations. The sample size might be relatively small to draw conclusions for assessing adherence, satisfaction and psychiatric symptoms. Instruments that we used to assess adherence, satisfaction and BPRS are might not be the gold standard for this purpose. A third Admin2010-12-25T13:16:00 Must be preceded by first and secondpotential limitation of our study is that the patients selected were homogenous in that all of them had governmental insurance and tends to use similar medications. Non-adherence among schizophrenic patients might be inherent in the context of the disease itself. Despite these limitations, results of this study were useful in understanding adherence, satisfaction and psychiatric symptoms. ReferencesAdmin2010-12-25T10:45:00 The number of references is too much, after delete the repeating ref. the number still 75 Al-Zakwani IS, Barron JJ, Bullano MF, Arcona S, Drury CJ, Cockerham TR. Analysis of healthcare utilization patterns and adherence in patients receiving typical and atypical antipsychotic medications. Curr Med Res Opin. 2003;19(7):619-26. Arana GW: An overview of side effects caused by typical antipsychotics.J Clin Psychiatry 2000; 61:5-11 Atkinson MJ, Kumar R, Cappelleri JC, Hass SL: Hierarchical construct validity of the treatment satisfaction questionnaire for medication (TSQM version II) among outpatient pharmacy consumers. Value Health 2005, 8(Suppl 1):S9-S24. Atkinson MJ, Sinha A, Hass SL, Colman SS, Kumar RN, Brod M, Rowland CR. Validation of a general measure of treatment satisfaction, the Treatment Satisfaction Questionnaire for Medication (TSQM), using a national panel study of chronic disease. Health Qual Life Outcomes. 2004 Feb 26;2:12 Awad AG, Voruganti LN. Impact of atypical antipsychotics on quality of life in patients with schizophrenia.. CNS Drugs. 2004;18(13):877-93. Review Bharmal M, Payne K, Atkinson MJ, Desrosiers MP, Morisky DE, Gemmen E. Validation of an abbreviated Treatment Satisfaction Questionnaire for Medication (TSQM-9) among patients on antihypertensive medications. Health Qual Life Outcomes. 2009 Apr 27;7:36 Borras L, Mohr S, Brandt PY, Gillià ©ron C, Eytan A, Huguelet P. Religious beliefs in schizophrenia: their relevance for adherence to treatment. Schizophr Bull. 2007 Sep;33(5):1238-46 Breen A, Swartz L, Joska J, Flisher AJ, Corrigall J. Adherence to treatment in poorer countries: a new research direction? Psychiatr Serv. 2007 Apr;58(4):567-8 Byrne MK, Deane FP, Caputi P. Mental health clinicians beliefs about medicines, attitudes, and expectations of improved medication adherence in patients. Eval Health Prof. 2008 Dec;31(4):390-403 Cabeza IG, Amador MS, Lopez CA, Chavez MG: Subjective response to antipsychotics in schizophrenic patients: clinical implications and related factors. Schizophr Res 2000; 41:349-355 Campbell M, Young PI, Bateman DN, Smith JM, Thomas SH The use of atypical antipsychotics in the management of schizophrenia.. Br J Clin Pharmacol. 1999 Jan;47(1):13-22. Review Clinical and resource-use outcomes of risperidone long-acting injection in recent and long-term diagnosed schizophrenia patients: results from a multinational electronic registry. Curr Med Res Opin. 2009 Sep;25(9):2197-206 Cost-sharing effects on adherence and persistence for second-generation antipsychotics in commercially insured patients. Manag Care. 2010 Aug;19(8):40-7 Damen J, Thuresson PO, Heeg B, Lothgren M. A pharmacoeconomic analysis of compliance gains on antipsychotic medications. Appl Health Econ Health Policy. 2008;6(4):189-97. De Hert M, McKenzie K, Peuskens J. Risk factors for suicide in young people suffering from schizophrenia: a long-term follow-up study. Schizophr Res. 2001 Mar 1;47(2-3):127-34 Dingemans PM, Linszen DH, Lenior ME, Smeets RM. Component structure of the expanded Brief Psychiatric Rating Scale (BPRS-E). Psychopharmacology (Berl). 1995 Dec;122(3):263-7 Dolder CR, Lacro JP, Dunn LB, Jeste DV. Antipsychotic medication adherence: is there a difference between typical and atypical agents? Am J Psychiatry. 2002 Jan;159(1):103-8. Erratum in: Am J Psychiatry 2002 Mar;159(3):514 Dolder CR, Lacro JP, Jeste DV. Adherence to antipsychotic and nonpsychiatric medications in middle-aged and older patients with psychotic disorders. Psychosom Med. 2003 Jan-Feb;65(1):156-62. Dolder CR, Lacro JP, Leckband S, Jeste DV. Interventions to improve antipsychotic medication adherence: review of recent literature. J Clin Psychopharmacol. 2003 Aug;23(4):389-99. Review Fenton WS, Blyler CR, Heinssen RK: Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophr Bull 1997; 23:637-651 Fleischhacker WW, Oehl MA, Hummer M. Factors influencing compliance in schizophrenia patients. J Clin Psychiatry. 2003;64 Suppl 16:10-3 Freudenreich O, Cather C, Evins AE, Henderson DC, Goff DC. Attitudes of schizophrenia outpatients toward psychiatric medications: relationship to clinical variables and insight. J Clin Psychiatry. 2004 Oct;65(10):1372-6 Fujikawa M, Togo T, Yoshimi A, Fujita J, Nomoto M, Kamijo A, Amagai T, Uchikado H, Katsuse O, Hosojima H, Sakura Y, Furusho R, Suda A, Yamaguchi T, Hori T, Kamada A, Kondo T, Ito M, Odawara T, Hirayasu Y. Evaluation of subjective treatment satisfaction with antipsychotics in schizophrenia patients. Prog Neuropsychopharmacol Biol Psychiatry. 2008 Gharabawi GM, Greenspan A, Rupnow MF, Kosik-Gonzalez C, Bossie CA, Zhu Y, Kalali AH, Awad AG. Reduction in psychotic symptoms as a predictor of patient satisfaction with antipsychotic medication in schizophrenia: data from a randomized double-blind trial. BMC Psychiatry. 2006 Oct 20;6:45 Gianfrancesco FD, Rajagopalan K, Sajatovic M, Wang RH. Treatment adherence among patients with schizophrenia treated with atypical and typical antipsychotics. Psychiatry Res. 2006 Nov 15;144(2-3):177-89. Epub 2006 Sep 27. Gibson TB, Jing Y, Kim E, Bagalman E, Wang S, Whitehead R, Tran QV, Doshi JA. Gutià ©rrez-Casares JR, Caà ±as F, Rodrà ­guez-Morales A, Hidalgo-Borrajo R, Alonso-Escolano D. Adherence to treatment and therapeutic strategies in schizophrenic patients: the ADHERE study. CNS Spectr. 2010 May;15(5):327-37. Haddad PM, Taylor M, Niaz OS. First-generation antipsychotic long-acting injections v. oral antipsychotics in schizophrenia: systematic review of randomised controlled trials and observational studies. Br J Psychiatry Suppl. 2009 Nov;52:S20-8. Herings RM, Erkens JA. Increased suicide attempt rate among patients interrupting use of atypical antipsychotics. Pharmacoepidemiol Drug Saf. 2003 Jul-Aug;12(5):423-4. Hofer A, Kemmler G, Eder U, Edlinger M, Hummer M, Fleischhacker WW. Quality of life in schizophrenia: the impact of psychopathology, attitude toward medication, and side effects. 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Sunday, October 13, 2019

How Do You Define Patriotism? Essay -- Definition of patriotism

Patriotism   Ã‚  Ã‚  Ã‚  Ã‚  Patriotism is defined as a love for or a devotion to one’s country. With the events that happened in America on September 11th, patriotism has been in everyone’s mind and heart. Young men and women have been enlisting in the armed forces to support America. Americans are flying flags on their cars and homes to show their patriotism. Millions of Americans are donating money and blood in support of the victims of the attacks. I would define patriotism as a loyalty and commitment to America and the people in our country.   Ã‚  Ã‚  Ã‚  Ã‚  One way to define patriotism is to look at an example of my enlistment in the Army and the training that I received in Basic. I decided to join the Army in 1996 after an unsuccessful attempt at college. I decided I wanted to serve my country by defending our freedom in the event that a war should happen and help other countries abroad defend their freedom also. It was in Basic Training that I was taught hand-to-hand combat, how to accurately fire a M16 machine gun, ground tactics and camouflage. The training I received prepared me to be ready to defend America. I was committed to serve and protect the country where I lived. I was displaying my patriotism for America by defending the freedoms that I and other Americans have in this country.   Ã‚  Ã‚  Ã‚  Ã‚  Another way to define patriotism is to look at the effect the attack on September 11th had on how Americans show their patriotism. The attacks on the World Trade Center and the Pentagon aff...

Saturday, October 12, 2019

Societys Conception of Sex Essay -- Exploratory Essays Research Paper

Society's Conception of Sex    The connotation of the word sex is so vague that it can be manipulated to mean virtually anything, however the definition of the word within society has remained the same.   Penetration is the defining factor of sex in its literal sense, however it can be altered to include a variety of acts.   Anthropologist Margaret Mead, and President Clinton found loopholes in the connotation of sex, and used it to the benefit.   The context in which Mead used the word was to encompass the various acts that accompany intercourse, such as oral sex, to prove that Samoan society is far more promiscuous than our own.   President Clinton also used the vagueness of the word to his benefit.   He manipulated the connotation of sex to only include intercourse, so that he may escape incrimination of adultery and perjury. In both cases the hazy connotation of the word was used as an advantage, but society's definition of the word remained clear. Mead manipulated the definition to include acts other than penetration in order to prove that Samoan society is more open in their sexuality.   She used the word to create a utopian Samoa, where people freely engaged in promiscuous sexual acts, like oral sex.   Her definition of penetration included more than just penetration, it encompassed other actions such as oral sex.   By altering the definition of sex to include other actions, Mead was trying to prove that Samoan society was better off because of their sexual freedom.   She claimed that the openness to sex in Samoa created a sense of free love, a quality that our country lacked at the time.   Her alteration of the word was used to criticize the co... ...p; Mead's definition of sex included many other acts, to prove that free love was rampant in Samoa.   Society did not agree with her because the popular definition of sex did not include any other actions.   Penetration has been the defining factor of sex.   President Clinton used this social law to claim his innocence concerning his involvement with Monica Lewinsky.   He asserted that he did not have sexual relations with his intern.   This term sexual relations is so broad that any sexual act could fit under its definition.   The American public did not agree with his statement, because under society's beliefs, oral sex falls into the category of sexual relations.   These two situations prove that individuals have tried to manipulate the connotation of sex to their advantage, but society's conception of sex has remained static.

Friday, October 11, 2019

Qualities of a Good Parent Essay

Love and Discipline Raising children can be extremely difficult at times. While there are numerous qualities required to be a good parent, there are two basic qualities that every parent should consist of while raising their children. By a parent obtaining love and discipline in the raising of their children will result in good parenting. A good parent must make his or her child feel cherished at times; however, a parent must also discipline children when necessary. Love is extremely important for a parent to provide while raising children and should be a main goal of any parent. A parent can provide this quality to a child by doing activities that he or she enjoys. For example, a parent can play games or read a favorite book of the child’s desire. If a child is shown attention by a parent it gives them a sense of feeling important and cared about by a loved one. When a child consumes of the feeling of importance it allows confidence to increase. Another way a parent can express love to a child is by being affectionate. A hug, kiss on the cheek, or simply saying, â€Å"I love you† can allow a child understand that his or her parent truly does love them. When a child is shown affection by his or her parent then they can assure themselves that the love from the parent it always present. It is common for children to feel as if their parent does no longer love them after they have done something wrong; therefore, by a parent reassuring his or her child that they will love them no matter what can relieve a child of that fear. If a parent provides love as quality while raising children, then good parenting will be a result. Another quality a good parent should have while raising children is discipline. When a child has done something wrong a parent must perform some type of disciplinary action to force the child to understand what he or she did is wrong and cannot happen again. If a parent allows a child to misbehave without any discipline, then the child will have the mentality that what he or she did is okay and will continue to misbehave. By a parent performing disciplinary action with his or her child, then the child will understand that their parent has authority over the choices made and the consequences to follow. Discipline does not always mean a parent must hit or  spank a child; restricting the child’s limitations on what he or she may enjoy can also do solve the problem. For example, if a child enjoys playing video games or going places with friends a parent can restrict the child’s ability to do these things after they have misbehaved. By a parent provides discipline to their children when needed, it will then teach a child that misbehaving is not tolerated and can result in punishment. Disciplinary actions are necessary for a parent to accomplish being a good parent. All in all, parenting is a lot of work, and is not easy. There are many responsibilities that come along with parenting. Parents must always provide love for children, but also discipline when needed. Every child is unique, and needs to be handled differently.