Introduction to international relations class, summary related to Essay

Introduction to international relations class, summary related to course on Path to War - Essay Example However, Path to War did not only highlight the personal dilemmas that the president had to deal with during the Vietnam debacle. The movie also exposed the two lines of thought and the corresponding approaches in international relations during the time of the Cold War. In fact, many of the scenes of the debates that took place the Johnson administration’s cabinet meetings focus on these concerns. The ‘domino theory’ was a very influential concept among the politicians at that time. The U.S. government itself was its strongest believer. This theory is based on the analysis that if one country becomes communist, the neighboring countries would surely follow, just like the pieces of the domino. In Path to War, Johnson is portrayed to have firmly believed that once South Vietnam is reunited with the North, it would become communist too. Subsequently, the rest of the countries in Indochina and the entire Southeast Asia could all fall under communist regimes. With this theory in mind, the Johnson administration at the onset of the war were all one in arguing for the necessity of preventing the fall of South Vietnam to the hands of the local communist insurgents. To do so, it sent military advisers to the Southeast Asian country in order to train its armed forces.

Everyday Hero Essay Example for Free

Everyday Hero Essay When I think of the word hero, I think of the countless Spiderman figures lying at the bottom of my brother’s toy chest, or even Prince Charming rescuing Sleeping Beauty from her seemingly endless slumber. However, what usually does not come to mind, are the true real life heroes that I believe posses higher superpowers than the Incredibles ever could. Though they do not have the ability to fly or read minds, one way or another, these people have helped someone in a tough situation. A true hero can be anyone from the firefighters at the station to your older sister living in the room next door. They may have helped to save your life, or merely helped you get through your math homework last night. Whatever the case, one quality that all true heroes must possess is the ability to be an example of goodwill in the world. A hero will help someone because they want to, not because they have to. Though they are not perfect, no one is, a hero will continue to put others first when they know that it is most important to do so. Three years ago, my mother was diagnosed with breast cancer. The news came as an utter shock to everyone, considering the fact that she was one of the healthiest and most active members of my family. She played tennis and practiced yoga at least four times a week; always ate healthy and organic foods, and on top of all this, there was barely any history of breast cancer on our family tree! Though her case was not as bad as others, it still required her to undergo weeks of arduous chemotherapy and radiation. Through her darker days, she herself would be the one to calm me down and reassure me that everything would be okay. The night before my mother’s surgery, I started to cry, scared and frustrated with what was happening around me. Though she was also frightened and anxious, my mother was the one to comfort me and explain that a plastic surgeon did not actually turn people into plastic, as I had imagined. Even during her most bleak and miserable moments, she put everything aside and reached out to help me deal with her pain. For this, she is my hero. No, she is not Superwoman, or a firefighter,  or even your everyday do-gooder; but she’s my mom, and that is good enough for me. This just goes to show that a seemingly ordinary woman can be a hero to someone in her own way. Heroes are everyday characters, and if you look hard enough you will find the hero in your own life. This I believe.

The Brotherly Connection Of Sonny Blues English Literature Essay

The Brotherly Connection Of Sonny Blues English Literature Essay Both stories show the importance in having that brotherly connection and a desire to be accepted by the one you admire. In Sonnys Blues, it is established that all Sonny wants is for his brother to understand and accept his way of life. Even though the narrator does in fact care for his younger brother, Sonny, he sees it as more of a promise to his mother that I wont let nothing happen to Sonny (Baldwin 218), which gave the narrator more of an incentive to just watch Sonny rather than being there and listening to his brother, when he needed it most, ultimately severely hurting Sonny., Throughout the story Sonny cries out for his brothers attention and acceptance. In the midst of a significant conversation with one another Sonny blatantly says, I hear you. But you never hear anything I say (Baldwin 221) and which could be one of the narrators biggest mistakes. The narrator once gain ignores what Sonny is saying and starts explaining to Sonny how he will live while his brother is away at war. Experiencing the lack of his brothers affection evidently turned Sonny severely against his brother, and turned his attention to an environment where he knew hed be accepted, playing jazz with the good-time people (Baldwin 219). That choice was not made entirely by Sonny; it was formed by his experiences during childhood. Sonny plays music not only to express himself fully but also to replace the drugs that he is trying to escape from. Sonnys choice of music reflects his attitude towards life and his experiences, and if only his brother can take a moment to listen to that, instead of instantly judging Sonny, their relationship could have been a lot less deficient throughout the years. The need for acceptance between brothers is also portrayed in The Red Convertible, at the same time the reason for their separation is not as preventable as in Sonnys Blues. Unlike his brother Lyman, who was lucky when it came to numbers, Henry ws never lucky in the same way (Erdrich, 236) and was picked for the draft shortly after returning from their summer road trip. About three years had passed until theyd met again, only for Lyman to discover that Henry wasnt the same when he returned from the war. Frustrated and upset about what happened to Henry, Lyman desperately tried to find a way to bring back his old brotherly connection. Symbolic to their relaitonship, Lyman went out to the car and ran the piss right out of it (Erdrich 238) in hopes that it would bring back whatever was left of Henry. When Lyman intentionally damaged the car so that Henry would have to fix it, Henry understood what Lyman was trying to do for him. Rather than responding with anger or bitterness, he fixed the car so that Lyman would have it. Henry knew how lonesome the effect of war left himself, and Lyman also noticing just how different the war made him, they both slowly came to reality to the beginning of the end of their relationship. The brothers in Sonnys Blues and The Red Convertible both have a point in time where they grow apart and experience a major life changing occurrence. Despite Sonnys arrest and misfortune it takes the death of the narrators daughter to finally get a better understanding of his brother. It seems that the narrator could better understand Sonny now, and has decided to write to his brother. In The Red Convertible Lyman destroys the car as he views his and Henrys relationship. Henry understands what Lyman is trying to do for him, and shows his brother that he still cares. The capability to put their differences behind them and restore an old connection that was once so significant can be evident in ones want to finally change. Unfortunately some unexpected cases of events are bound to happen, that we either have no control over or as bad as it may seem, are better off. It is not until now tha tLyman realizes that Henry and he will never gain back that tight bond that they once shared. When Henry jumps into the water, in a strange way, he is showing Lyman that he is doing all he can to be the old Henry. You can dryly put it together that Lyman understands his brothers decision to end his life, in his actions following his brothers suicide. The sinking of the red convertible symbolizes the end of Henry and Lymans relationship and creates a very ironic end to what was once a very strong bond among two brothers. On the contrary, these two brothers had another chance to take up again that connection they once had. After finally beginning to understand Sonny for who he truly is, the narrator steps inside of Sonnys atmosphere, so to speak. Upon entering the Jazz club and meeting all of Sonnys acquaintances, the narrator is impressed and seems very fond of how well liked and appreciated his little brother is. The most important and influential person the narrator meets is Creole, upon meeting him the narrator says one of the most significant statements of the whole story. This is the point where the narrator finaly comes to a true appreciation about who Sonny truly is, not only as a person but for the true talent that he expresses in his music. Due to the hardships of separation and neglicence, both brothers understand the certainty of their relationships after drugs and neglecting are incorporated into the situation. Although both stories do not give the same opportunity to find a way to revive the old beat up relationship, both pairs of brothers finally realized the importance of being there for one another. The way the two brothers reuinte through addiciton, memories and strife make their bond seem stronger than ever.

Perfection According to Mayrs What is Evolution :: What is Evolution Essays Mayr

Perfection According to Mayr's What is Evolution In his book titled What is Evolution, Ernst Mayr bravely attempts to explain the complex biological processes of the development of plants and animals. His book, however, reaches beyond the realm of the science text book. With What is Evolution he attempts to educate an audience which may not have a strong science background but instead a strong literary background. Through this book Mayr strives for "a mid-level account of evolution, written not just for scientists but for the educated public." In short, he attempts to write a (non-fiction) scientific novel. Though his attempt to combine great literature and hard science is admirable he often gets himself into awkward situations when trying to please both the scientific and artistic sensibilities. His major problem in the book surrounds the use of the word "perfect." As a biologist, it may be easy to pass this word off as a synonym of "adaptedness," simply meaning well-suited to one's environment. As a literary-minded person, let al one English major, however, this word cannot slip by so easily. To the novel-reader, more than to the science-reader, this word carries a lot of baggage which cannot be ignored. So, why does Mayr use this word and what is he really trying to say? Does Mayr truly believe that evolution can be perfect? The baggage that gets snared when Mayr uses the word "perfect" in his discussions of evolution is the complicated literary definition given to this word. Exact and flawless are some common synonyms of the word perfect. Perfection is something that has reached the pinnacle, the zenith of existence. Nothing which is perfect needs any alterations, modifications or changes. When something is perfect it exists with ease. It does not struggle to remain where it is, and it does not struggle to remain alive; it works in harmony with its environment. Going beyond the definition, something that is perfect is commonly more highly valued than those things around it which have not yet reached perfection. People place a certain amount of value on things that occur with ease. The human race seems constantly to be striving for something that is faster, cleaner. Something that can achieve these goals with ease earns the title of perfection and is highly. The only problem with perfection, as least in the realm of science, is that once the peak of perfection is reached there is no place towards it can further develop.

Policies and Procedures for Promoting Positive Behaviour

Policies and procedures for promoting positive behaviour Policy/procedure |Summary | | | | | |Self esteem | | | | | |Valuing each child’s individuality, | | |Believing that children are capable of making choices, accepting responsibility and acting accordingly, | |Behaviour policy |Providing opportunities for success, | | |Viewing success in terms of personal progression rather than being in competition with others, | | |Praising achievements, | | |Promoting the acceptance of others, | | |Clearly demonstrating that we value their work, | | |Building into the curriculum activities which develop the child’s ability to express his/her feelings, through the sharing circle, co-operative games | | |and Drama. | | | | | |Physical environment | | | | |Attractive, comfortable well-resourced and well managed classrooms, | | |Displays of children’s work to show it is highly valued, | | |Tidy and accessible resources demonstrate that children are trusted to organis e themselves for work and that they know how to use and care for things. | | | | | | | | | | |Classroom management | | | | | |Work must be matched to their ability so that success is possible for all, | | |Children must know what they are doing and why, | | |Classroom rules are devised by children themselves to ensure standards of behaviour, | | |Rules should be few in number, prominently displayed and referred to often, | | |We must set high standards, praise quickly and consistently – looking out for and rewarding good behaviour, | | |We must be firm, fair and supportive, | |Know children as individuals, to be active listeners, to refer to the behaviour rather than the child, | | | | | |Be polite to everyone | |Code of conduct |Talk quietly and listen carefully | | |Always tell the truth | | |Treat others as you would wish them to treat you | | |Be patient and wait your turn | | | | |Rewards and sanctions |House points | | | | | |The children can earn house poi nts for:- | | | | | |Quality of work Good Behaviour | | |An excellent piece of work Being polite, etc. | |An improving piece of work | | | | | |Dinner Supervisors Stickers | | | | | |Dinner supervisors can award stickers for good behaviour during lunchtime. | | | | | | | |Barney Stickers | | | | | |This is Crooksbarn School’s main method of rewarding positive behaviour. It is used by the class teacher throughout the school and indicates | | |excellent standards of work and/or behaviour by a child. Only 1 may be awarded each day, the children can wear them for 1 day then they are | | |transferred to a collecting chart displayed in the classroom.Once the child has succeeded in gaining 3 ‘Barnies’ he/she is awarded a ‘Head Teacher’s| | |Barney that is presented by the Head Teacher at the whole school assembly on Monday Mornings. An additional award is given out by the Head Teacher to| | |any child who has gained 9 ‘Barnies’ during the course of the school year | | | | | |Get rid of anyone not involved in the conflict as violence thrives on witnesses. | |Don’t put yourself at risk, alert colleagues, enlist their help. | |Dealing with conflict and inappropriate behaviour |Asses a situation first. | | |Be calm, don’t take it personally. | | |Use verbal intervention first. | | |It may be worse to add another person to a gang situation, if it cannot be sorted out and the conflict/inappropriate behaviour goes out of your | | |control call another member of staff and in the worse case scenario call the police. | | | | |Positively encourage the caring and nurturing side of children whilst openly and actively discourage bullying | | |Work for a caring, cooperative ethos (home corner, paired, group work etc. ) | |Anti-bullying |Discuss friendships – this should be covered through PSHE and citizenship scheme of work. However, children should receive regular reminders of this. | | |Ensure adequa te supervision in playgrounds. | |Value and encourage being different and having high self-esteem. | | | | | | | | |Helping to create a pattern of regular attendance is everybody’s responsibility, parents, pupils and all members of school staff, | |Attendance |To help us focus on this we will report to arents/carers annually on their child’s attendance with the annual school report, | | |Contact the parent/carer if their child’s attendance falls below the school’s target for attendance, | | |Celebrate good attendance by displaying individual and class achievements, | | |Reward good or improving attendance through class competitions, certificates and outings/events. | | |Every half-day absence from school has to be classified by the school (not the parents), as either AUTHORISED or UNAUTHORISED.This is why | | |information about the cause of any absence is always required, | | |Any periods of leave taken without the agreement of the school, or in excess of that agreed, will be classed as unauthorised and may attract sanctions| | |such as a Penalty Notice. | | |The minimum level of attendance for any child at Crooksbarn School is 90% attendance |

The Academic Decathlon †How to Prepare for the USAD Test

The Academic Decathlon – How to Prepare for the USAD Test The Academic Decathlon – How to Prepare for the USAD Test Academic competitions are common. There are spelling bees and robotic competitions on a national level, for example. There are school-wide, regional, and state competitions. One of the most interesting national academic competitions is the Academic Decathlon, a product of the U.S. Academic Decathlon Association (USAD). The competition was created in 1968 by the Superintendent of Schools for Orange Country, California just for California. It was later expanded to a national competition, and today most states and a few international schools now participate. What is Unique About the Academic Decathlon Most competitions involve the very best students that schools can put together as competitors. But this one is different, in the following ways: Each team is made up of 9 students. 3 are considered â€Å"honors† with GPA’s between 3.75-4.0; 3 are named â€Å"scholastic, with GPA’s between 3 – 3.74; 3 are named â€Å"varsity† with GPA’s of 0.00 – 2.99). There are ten events, and all students compete as individuals in their classified divisions. Team scores are determined by taking top scores from each division in each of the events and then added up for a total score for the team. Competitions begin at the local level, and the winning team from each state then moves on to the national competition. Tests of the Competition The ten events of USAD cover all academic disciplines that typical high school students study. These are as follows: 7 multiple-choice tests in language literature, math, science, social studies, economics, art and music. There is a Super Quiz that is either in science or social studies There is an essay to write, based upon optional prompts Each student must prepare a speech on a pre-selected topic Each student will be interviewed by judges. Obviously, the multiple-choice tests are objective measurements. The other three events are assessed subjectively by the judges, although the judging criteria is published on the organization’s website. Students don’t Go In â€Å"Blind† Every year the organization publishes its curriculum in every subject on its website. This provides students with an outline of the skills and content to be included in the 7 objective tests. This curriculum is developed by a 10-member panel. Anyone contributing to the curriculum must have a Bachelor’s degree in the subject. Once the curriculum is created, it is then checked by others for accuracy. There is also a USAD â€Å"theme† developed for each year, and the tests all relate to the theme. In the language and literature section, for example, a novel or set of plays is selected each year and provided to students. In music and art, students are provided with specific works that they must research and study. If, for example, the theme were to be â€Å"Africa,† as it was one year, social studies, language and literature, economics, art, and music tests will all relate to that continent, and contestants are provided specific topics to study. The Subjective Portions of the Competition As the term implies, there are no right or wrong answers to these parts of the event. Speech: This event is divided into two parts. The first is a prepared speech on a pre-provided topic, and it is to be 3  ½ - 4 minutes long. The second part is an impromptu speech. Contestants are given three optional prompts, choose one, and then deliver a 1  ½ - 2minute speech on that topic. The Interview: This is a formal event, during which the student is asked a series of questions and expected to respond. Questions have included such things as â€Å"Who is your role model and why?† The Essay: Contestants are given three prompts, choose one, and have 50 minutes to write their essays on the chosen topic. The prompts relate to the theme of that year and come from the language and literature or the Super Quiz areas. How to Prepare for the USAD Test There is a wealth of information published and updated each year on the organization’s website. This includes the theme and â€Å"curriculum† in each of the seven objective testing content areas. Information is released according to a calendar. For the 2017-2018 USAD competition, for example, the theme and general topic was posted March 1, 2018; the outlines for each curricular topic area on May 1; and more specific curriculum materials (e.g., study guides) will began to be shipped out to team coaches and state directors on May 15. The competition takes place in November, 2018, giving teams the summer months to spend time in strong preparation. Materials for Study – The Objective Multiple-Choice Tests The study materials that are provided by the USAD, including the topic areas and outlines are all free and can be downloaded from the website, and this is a good start for preparation. The more specific study materials – resource guides, study guides, etc. must be purchased by each team, and the cost is $1000. While there have been lots of complaints about charging for these materials, the organization claims that it has to in order to meet its over $1 million budget each year. This can put an additional burden on schools and school districts that are from poorer areas, and that has been a point of controversy. There are also USAD practice tests that are developed each year by third-party for-profit companies. These are sold to teams, and, when schools are able to provide this kind of financial support, the tests can be a big help. The USAD does not support or encourage the purchase of the practice tests; however, they are well-done and can give a team a pretty big advantage. Any time students have the opportunity to take practice test, research shows that they do better on the real thing. With all of this information and all of these study materials, most teams can be well-prepared for the objective testing events, provided they have a good coach and they spend a lot of time studying the material. The objective tests are very fact-based and do not require critical or creative thinking. It is really a matter of memorization. Because of this, a number of educational associations, such as the ASCD, have criticized the objective portion of the event. The criticism relates to the fact that students are basically engaged in straight memorization of facts rather than any higher-level thinking skills, such as application, analysis, or synthesis. The Association’s response is that, because the event is theme-based, students will become â€Å"experts† of sorts on those wider curricular areas and will have a knowledge base that they would not get in a regular school curricular environment. Materials for Study – The Subjective Portion of Testing No one can completely prepare for this portion of the event. However, given that the USAD theme for each year is published, and given that the essay and speech prompts will all relate to this theme, preparation can be in the following forms: For the essay portion of the exam, students can review and study essay samples in the general topical theme areas. And just as they would practice for an ACT or SAT essay, they should write several essays on their own that also relate to the theme and the language and literature and super quiz curricula. Speech Preparation: The ability to deliver a good speech is as much about self-confidence as it is about the content. Students should practice preparing and delivering speeches on the thematic topic areas of course. It is the impromptu speech event that will probably present the greatest challenge. But there are tactics and strategies that can be learned and practiced. During the time they have to prepare for USAF test, students should be given topics from their coaches that relate to the theme and take the one-minute of allowed preparation time to gather their thoughts. The most important parts of any speech are the opening and the ending. Practice using your minute of allowed preparation time to craft a great opening sentence and a solid ending. These will be the most memorable. Again, practice is the one thing that will get you over that anxiety and nervousness. The Interview: you will not be able to anticipate the questions you might be asked in a formal interview situation. The key to success, though, will be in your ability to stay calm, focused, and poised. Again, the key to a successful interview is practice. Your USAD coach should set up several interview sessions and ask difficult questions. Your goal is to take a minute, think about the question being asked, and form a response that relates directly to that question. Part of evaluating your performance will be your ability to stick to the topic of the question, to speak clearly and with confidence, and to keep your response relatively brief. The biggest mistake that people make during interviews is veering off topic and giving an answer that is disjointed and incoherent. Outside Research – It is Valuable You have the outlines and the study guide and resource materials. You know what the theme is. This year, for example, it is Africa. So, how much do you really know about Africa – it’s history, its development, it political, economic and social challenges? Most high schools do not offer a course in African studies, so you may not know much. You can take the study guides and gain a lot of factual information about Africa, but do you really have a solid, general understanding of the continent? Chances are you don’t. Take some time during the summer months before the competition to make Africa your focus of study. There is an amazing amount of online resources about this continent and the richness of its history, geography, and societies. Your goal should be to get a broad base of general knowledge, so that the factual information you may need to memorize actually makes sense to you. For example, you can access the National Geographic website and find a huge amount of information about Africa. In fact, there is a TV series on our African beginnings, narrated by Morgan Freeman, that is soon to start. Likewise, there are news stories about Africa published daily by online news organizations. The more general knowledge you can absorb about Africa, the more you will be able to appear as an â€Å"expert,† especially during the subjective portions of the event. You just never know when you may be able to throw in some information you have about Africa that will impress the judges. Above All – Take the Time You Need When you study for final exams, you have two choices. You can organize your material regularly throughout the semester and study a bit at a time. Or, you can â€Å"cram† at the last minute, perhaps 1-2 days before that exam and get help from essay services. Students who choose either option can be successful and get good exam grades. But preparing for the Academic Decathlon is different. It’s not like a final exam in history or social studies that covers a finite amount of material. It is an examination that covers all content areas. There is no way to â€Å"cram† at the last minute. Fortunately, your team will have a coach who will prepare a schedule of work and study over a longer period of time. You can study and learn in a relatively stress-free environment, and this means that you will retain much of what you learn long-term. So, if you study a piece of literature without the stress of an immediate exam, that more relaxed environment allows you to absorb information, to think critically about the piece, and to â€Å"cement† your understanding. Likewise, the longer preparation time will allow lots of practice for the subjective parts of the event – those speeches, the interview, and that essay. In these areas, it is practice, not study, that will make the difference. Above all, you need to understand that you are a part of a team with a coach. While you will be scored on your individual performance, it is important that you have the mindset of being a member of a team. Each member’s accomplishments should be encouraged and applauded – that’s what teamwork is all about.

immigrants essays

immigrants essays Why the immigrant group chose to leave their homeland Many Europeans decided to immigrate to the United States. Most Europeans left their home countries because of crop failure, land and job shortages, rising taxes, or famine. They came because they believed the United States was the land of economic opportunity. While other Europeans came seeking personal freedom or relief from political and religious persecution. The immigrants journey was terrible; they had to endure weeks of being on the deck of a ship even when it rained. They had to bring their own food and make it last because sometimes the trip took longer than expected. And if they did run out of food the ship would have food for sale but it would be real expensive. And some people couldnt afford it because they spent their last penny on the boat ride. When they first seen the statue of liberty they were filled with joy because for them that statue stood for freedom and opportunity. Experiences when they first arrived Most Europeans came in trough the east coast in Ellis Island and had to pass a physical to be allowed into the United States, those that didnt pass were deported back to their home countries. Many states, especially those with small populations, attracted immigrants by offering jobs or land for farming. But a lot of immigrants wanted to settle where there were other settlers from their homeland. They wanted to do so because many didnt know the language and others wanted to feel like they were at home. Once settled immigrants needed to find a job, but there were never enough jobs and employers often took advantage of them. The men immigrants were paid less then the other workers and the women immigrants were paid less then the men immigrants. Social tensions were also a part of the immigrant experience. The immigrants were stereotyped and discriminated, and many immigrants su ...

Bulfinchs Version of the Story of Apollo and Daphne

Bulfinchs Version of the Story of Apollo and Daphne The slime with which the earth was covered by the waters of the flood produced an excessive fertility, which called forth every variety of production, both bad and good. Among the rest, Python, an enormous serpent, crept forth, the terror of the people, and lurked in the caves of Mount Parnassus. Apollo slew him with his arrows - weapons which he had not before used against any but feeble animals, hares, wild goats, and such game. In commemoration of this illustrious conquest he instituted the Pythian games, in which the victor in feats of strength, swiftness of foot, or in the chariot race was crowned with a wreath of beech leaves; for the laurel was not yet adopted by Apollo as his own tree. The famous statue of Apollo called the Belvedere represents the god after this victory over the serpent Python. To this Byron alludes in his Childe Harold, iv. 161: ...The lord of the unerring bow,The god of life, and poetry, and light,The Sun, in human limbs arrayed, and browAll radiant from his triumph in the fight.The shaft has just been shot; the arrow brightWith an immortals vengeance; in his eyeAnd nostril, beautiful disdain, and mightAnd majesty flash their full lightnings by,Developing in that one glance the Deity. Apollo and Daphne Daphne was​ Apollos first love. It was not brought about by accident, but by the malice of Cupid. Apollo saw the boy playing with his bow and arrows; and being himself elated with his recent victory over Python, he said to him, What have you to do with warlike weapons, saucy boy? Leave them for hands worthy of them, Behold the conquest I have won by means of them over the vast serpent who stretched his poisonous body over acres of the plain! Be content with your torch, child, and kindle up your flames, as you call them, where you will, but presume not to meddle with my weapons. Venuss boy heard these words, and rejoined, Your arrows may strike all things else, Apollo, but mine shall strike you. So saying, he took his stand on a rock of Parnassus, and drew from his quiver two arrows of different workmanship, one to excite love, the other to repel it. The former was of gold and sharp pointed, the latter blunt and tipped with lead. With the leaden shaft he struck the nymph Daphne , the daughter of the river god Peneus, and with the golden one Apollo, through the heart. Forthwith the god was seized with love for the maiden, and she abhorred the thought of loving. Her delight was in woodland sports and in the spoils of the chase. lovers sought her, but she spurned them all, ranging the woods, and taking no thought of Cupid nor of Hymen. Her father often said to her, Daughter, you owe me a son-in-law; you owe me grandchildren. She, hating the thought of marriage as a crime, with her beautiful face tinged all over with blushes, threw her arms around her fathers neck, and said, Dearest father, grant me this favour, that I may always remain unmarried, like Diana. He consented, but at the same time said, Your own face will forbid it. Apollo loved her, and longed to obtain her; and he who gives oracles to all the world was not wise enough to look into his own fortunes. He saw her hair flung loose over her shoulders, and said, If so charming, in disorder, what would it be if arranged? He saw her eyes bright as stars; he saw her lips, and was not satisfied with only seeing them. He admired her hands and arms, naked to the shoulder, and whatever was hidden from view he imagined more beautiful still. He followed her; she fled, swifter than the wind, and delayed not a moment at his entreaties. Stay, said he, daughter of Peneus; I am not a foe. Do not fly me as a lamb flies the wolf, or a dove the hawk. It is for love I pursue you. You make me miserable, for fear you should fall and hurt yourself on these stones, and I should be the cause. Pray run slower, and I will follow slower. I am no clown, no rude peasant. Jupiter is my father, and I am lord of Delphos and Tenedos, and know all things, present and future. I am th e god of song and the lyre. My arrows fly true to the mark; but, alas! an arrow more fatal than mine has pierced my heart! I am the god of medicine, and know the virtues of all healing plants. Alas! I suffer a malady that no balm. can cure! The nymph continued her flight, and left his plea half uttered. And even as she fled she charmed him. The wind blew her garments, and her unbound hair streamed loose behind her. The god grew impatient to find his wooings thrown away, and, sped by Cupid, gained upon her in the race. It was like a hound pursuing a hare, with open jaws ready to seize, while the feebler animal darts forward, slipping from the very grasp. So flew the god and the virgin- he on the wings of love, and she on those of fear. The pursuer is the more rapid, however, and gains upon her, and his panting breath blows upon her hair. Her strength begins to fail, and, ready to sink, she calls upon her father, the river god: Help me, Peneus! open the earth to enclose me, or change my form, which has brought me into this danger! Scarcely had she spoken, when a stiffness seized all her limbs; her bosom began to be enclosed in a tender bark; her hair became leaves; her arms became branches; her foot stuck fast in the grou nd, as a root; her face became a tree-top, retaining nothing of its former self but its beauty, Apollo stood amazed. He touched the stem, and felt the flesh tremble under the new bark. He embraced the branches, and lavished kisses on the wood. The branches shrank from his lips. Since you cannot be my wife, said he, you shall assuredly be my tree. I will wear you for my crown; I will decorate with you my harp and my quiver; and when the great Roman conquerors lead up the triumphal pomp to the Capitol, you shall be woven into wreaths for their brows. And, as eternal youth is mine, you also shall be always green, and your leaf know no decay. The nymph, now changed into a Laurel tree, bowed its head in grateful acknowledgment. That Apollo should be the god both of music and poetry will not appear strange, but that medicine should also be assigned to his province, may. The poet Armstrong, himself a physician, thus accounts for it: Music exalts each joy, allays each grief,Expels diseases, softens every pain;And hence the wise of ancient days adoredOne power of physic, melody, and song. The story of Apollo and Daphne is of ten alluded to by the poets. Waller applies it to the case of one whose amatory verses, though they did not soften the heart of his mistress, yet won for the poet wide-spread fame: Yet what he sung in his immortal strain,Though unsuccessful, was not sung in vain.All but the nymph that should redress his wrong,Attend his passion and approve his song.Like Phoebus thus, acquiring unsought praise,He caught at love and filled his arms with bays. The following stanza from Shelleys Adonais alludes to Byrons early quarrel with the reviewers: The herded wolves, bold only to pursue;The obscene ravens, clamorous oer the dead;The vultures, to the conquerors banner true,Who feed where Desolation first has fed,And whose wings rain contagion: how they fled,When like Apollo, from his golden bow,The Pythian of the age one arrow spedAnd smiled! The spoilers tempt no second blow;They fawn on the proud feet that spurn them as they go. More Stories From Greek Mythology by Thomas Bulfinch Dragons TeethMinotaurPomegranate SeedsPyramus and Thisbe

SOCIO-ECOLOGICAL MODEL Essay Example | Topics and Well Written Essays - 500 words

SOCIO-ECOLOGICAL MODEL - Essay Example In our next league of discussion, we will emphasis on the interpersonal relationship of the smokers. Smoking and Family The problem pertaining to smoking starts percolating in the fate of our new born baby. A smoking mother not only loads his unborn child with loads of vulnerability but also paves the way for a future smoker as the recent study suggests that the smoking habit alters the genetic codes which make the child more prone to smoking in days to come. Besides the legacy of pulmonary diseases, cancer is quite evident in these babies (1). Naturally, this type of child, when grow up, will seldom depict its respect etc to the institution called family. He or she will came to know through ages who are responsible for this ailment. In another paradigm of this discussion, the smoking habit of the adults is also equally responsible for the interpersonal strained relationship in a family. In today’s urban set up where a family of four or five of the members is being forced to l ive in the dingy apartment, the much hyped question of â€Å"Passive Smoking† can not be ruled out.

Statutory Regulations on Consumer rights Essay Example | Topics and Well Written Essays - 1750 words

Statutory Regulations on Consumer rights - Essay Example The various legislations related to the consumer law protect the rights of a person as a consumer, whether it is of dispute regarding the sale and purchase of the goods/services, or it is of dispute regarding the quality of the goods. As a consumer, a person's rights are expressed as a series of "guarantees" that a seller automatically makes to you when you buy any good or service ordinarily purchased for personal use. These dictums manifest there always exist an agreement in between the seller and buyer/consumer while entering in a transaction. The parties to commercial contracts were considered to be themselves the best judges of what obligations should be imposed. For the most part the legislation was drafted from the buyer's perspective, and the legislation seems generally to prefer the interests of buyers. But some provision of the sale of goods legislations(1) does not impinge greatly on party autonomy like the Sale of Goods Act 1893 (UK). Even though the buyer enjoys such privileges, the law always ponders to lay down some provisions to regulate the consumer civil rights, amidst of numerous issues regarding the magnitude of the enhancement of such provisions. The provisions regarding the consumer's rights against the seller under sales law are to be found in the Sale of Goods A... The provisions regarding the consumer's rights against the seller under sales law are to be found in the Sale of Goods Act 1979, which is the derived version of Sale of goods Act 1863, as amended by the Sale and Supply of Goods Act 1994. Sections 12-15 of the Act lays down some implied terms into contracts for the sale of goods relating to title, conformity with description and sample, quality and fitness. The consumer's basic remedies are rejection of the goods and/or damages. The Supply of Goods (Implied Terms) Act 1973 and the Unfair Contract Terms Act 1977 implemented recommendations for the control of clauses purporting to restrict or exclude liability under the implied terms as to title, correspondence with description, fitness etc. The Sale and Supply of Goods Act 1994 implemented recommendations relating to the reformulation of the implied term as to merchantable quality , making it clear that it applies to minor defects and covers durability of goods.(2) ------------------------------------------------------------------------------------------------------------2. Carter, J. W. (1993) Party Autonomy and Statutory Regulation: Sale of Goods Commentary on rights of Termination, Journal of Contract Law and rejection: Impact of the CISG on Australian, English and Canadian law, 93-122 3. Select Committee on European Communities, (1997) Tenth Report, www.parliment.uk 3 The recent statutes extend the protection not only to individual consumers but to business entities also. Unfair Terms in Consumer Contracts Regulations 1994(4) provides that they apply to any term in a contract concluded between sellers or supplier and a consumer where the said term has not been individually

Personal statement Example | Topics and Well Written Essays - 750 words - 23

Personal Statement Example Further, I would like to educate people on classical music so that people can appreciate it more. It is a rich and informative genre of music that has a lot of significance1. I also believe that the masters in music will empower me to teach more people how to compose music. Composition can be a mentally and financial enriching activity that more young people need to indulge in. I am convinced that your masters program is the best option to facilitate this ambition. In addition, I believe that the facilities at institution are one of the best in the country and it would be an honor to acquire my masters in music from your institution. I would like to be a master pianist who plays for big crowds. In recent times, I developed a keen eye for charity. I want to be able to play at huge concerts and give the proceeds to charity. I can use my skills and expertise acquired at your institution to help millions of people out there. I am particularly interested in charitable initiatives for safe drinking water, social amenities and health services. I started playing piano when I was 4 years old. I have wanted to become famous pianist and professor. When I was young I took part in a piano contest and won a prize in the piano competition several times. I got into Yewon Art Middle School which is most famous art school in Korea. I wanted to go there so I could have many opportunities to enjoy and listen to beautiful musical performances. I entered Walnut Hill School for the Arts on the recommendation of my teacher, Have-Sun Paik. At the school I was a student of a Russian teacher. While studying with her, I came to realize how much I love music, how deeply I understand a composers feeling and his historical background and what I want to show and express to the audience when they listen to my music. I held a mini concert with my teacher as a volunteer at Hebrew Senior Life in Boston every Sunday morning for the elderly who kept coughing

Introduction to Rhetorical Studies Essay Example | Topics and Well Written Essays - 500 words

Introduction to Rhetorical Studies - Essay Example This essay will examine an example of a symbolic action, identify the audiences, and identify the second and the third persona show what the audience agency is. Language can be used as a symbol Kenneth Burke gives an example where while in class he saw a bird flying up in order to get out of a room. This action of the bird flying up in order to get out is due to tropisms; although the windows were open the bird kept flying nervously about the ceiling. The windows were high, they extended almost to the ceiling; yet the bird kept trying to escape by batting against the ceiling rather than dipping down and flying out of one the open windows (4). This particular bird’s instinct was to escape by flying up; hence it ignored the easy exit through the windows. Burke imagines how different things would be if the bird could speak his language. A simple statement would have served to solve the problem. Fly down just a foot and out one of those windows would have solved the problem if the bird could hear the language of human beings this shows how symbolic language can be. Burke gives another example where a bird uses the principle of leverage as an improved method for Unnesting or de birding a Nest but it cannot spread the information to other birds because of lack of language to communicate the invention and make it spread throughout all birddom. Man is considered to be a symbol-using animal; he clings to a kind of naà ¯ve verbal realism that refuses to realize the full extent of the role played by symbolicity in his notions of reality (Burke, 5). The second persona in the example of the bird is the reader because he is the one representing the pronoun ‘you’. The third persona is the bird because it because it is the one used to depict the pronoun they. The audience agency in the examples of symbolism above is to show clearly how symbolic language can

Project 2 Case Study Example | Topics and Well Written Essays - 750 words

Project 2 - Case Study Example Salient features of the statement would have included concise project plan, amount of funding to be required, a flexible but well defined timetable for completion of the project and success criteria set beforehand. A prudent thing would have been to match payments with milestones agreed beforehand- this would have provided greater incentive for the workforce to give proper time and attention to the project. Information about the means to generate funding for the project and cooperation between different utilities department should have been included in the SOW to provide an idea about the supporting elements of the metro project and the requirement that any problems which arose because of them should be handled properly and quickly. Ans.2 The problems faced by the project were serious enough to have lengthened the time of completion by almost 2 decades. The problems were manifold; from the unexpected bureaucracy of the labors and the shopkeeper’s demands to the utility lines proving to be a hindrance in construction. However, these were only to be expected from a project of this scope and it was the poor management that was at fault for being unable to anticipate these problems. While it may not have been possible to be have been prepared to handle these problems from the start the project should have included the possibility that they might happen and how the teams would deal with them. The lack of information about the utilities and poor forecast of traffic needs were one of the basic failings of the project design which led to these problems and it seems the designers were unaware of the exact scope. Problems in a project which affects the daily life of millions of people are not bad luck; they are to be expected. Ans.1 The most important thing for the organization is to form an action plan to help their project managers with the client problems they are facing. The project managers all state the same kind of problems with having to

Critical thinking essay 2 Example | Topics and Well Written Essays - 500 words

Critical thinking 2 - Essay Example While water scarcity has always been a source of concern around the world, it had never got so much attention from the governments. But today, economies have begun preparing themselves for a water crisis and the Middle East which is one of the most poorly endowed regions in terms of water is faced with formidable task of providing clean and safe drinking water to its growing populations. What is challenging about the water scenario in the Middle East is the power it holds on economies and governments. In fact, countries here are divided and ranked on the basis of those who can manage to pay for access to or the creation of new sources of water and those who do not have the pecuniary prowess to do so. Conflict here is invoked not because water is not accessible but because it is not equally accessible. Water is extremely important for human survival but given its inequitable distribution in the Middle East, there is a mad scramble by governments to control and possess whatever they can get their hands on. For example, in the Upper Nile Basin, the Ethiopian government planned to build dams to secure its water supply for irrigation which was strongly opposed by the Sudanese and Egyptian governments because once a dam is constructed on a river it not only reduces the flow of water to downstream users but can also cause harm by affecting soil and water qualities downstream. Similarly, in the Euphrates Basin, the Southeast Anatolia Development Project (Dam) is causing much tension by benefiting Turkey but exhausting the water supply to Syria and Iraq and polluting the soil there. Conflict over water is not just about possession, it also has a lot to do with the modifications to the quality and quantity of the resource. Like Abu Saeed of Jiftlick Popular Committee points out in the Documentary, Jordan Valley Blues, â€Å"The Israeli side has done a good job stealing water by drilling deep into the aquifers specifically in many

Introduction to Rhetorical Studies Essay Example | Topics and Well Written Essays - 500 words

Introduction to Rhetorical Studies - Essay Example This essay will examine an example of a symbolic action, identify the audiences, and identify the second and the third persona show what the audience agency is. Language can be used as a symbol Kenneth Burke gives an example where while in class he saw a bird flying up in order to get out of a room. This action of the bird flying up in order to get out is due to tropisms; although the windows were open the bird kept flying nervously about the ceiling. The windows were high, they extended almost to the ceiling; yet the bird kept trying to escape by batting against the ceiling rather than dipping down and flying out of one the open windows (4). This particular bird’s instinct was to escape by flying up; hence it ignored the easy exit through the windows. Burke imagines how different things would be if the bird could speak his language. A simple statement would have served to solve the problem. Fly down just a foot and out one of those windows would have solved the problem if the bird could hear the language of human beings this shows how symbolic language can be. Burke gives another example where a bird uses the principle of leverage as an improved method for Unnesting or de birding a Nest but it cannot spread the information to other birds because of lack of language to communicate the invention and make it spread throughout all birddom. Man is considered to be a symbol-using animal; he clings to a kind of naà ¯ve verbal realism that refuses to realize the full extent of the role played by symbolicity in his notions of reality (Burke, 5). The second persona in the example of the bird is the reader because he is the one representing the pronoun ‘you’. The third persona is the bird because it because it is the one used to depict the pronoun they. The audience agency in the examples of symbolism above is to show clearly how symbolic language can

Critical thinking essay 2 Example | Topics and Well Written Essays - 500 words

Critical thinking 2 - Essay Example While water scarcity has always been a source of concern around the world, it had never got so much attention from the governments. But today, economies have begun preparing themselves for a water crisis and the Middle East which is one of the most poorly endowed regions in terms of water is faced with formidable task of providing clean and safe drinking water to its growing populations. What is challenging about the water scenario in the Middle East is the power it holds on economies and governments. In fact, countries here are divided and ranked on the basis of those who can manage to pay for access to or the creation of new sources of water and those who do not have the pecuniary prowess to do so. Conflict here is invoked not because water is not accessible but because it is not equally accessible. Water is extremely important for human survival but given its inequitable distribution in the Middle East, there is a mad scramble by governments to control and possess whatever they can get their hands on. For example, in the Upper Nile Basin, the Ethiopian government planned to build dams to secure its water supply for irrigation which was strongly opposed by the Sudanese and Egyptian governments because once a dam is constructed on a river it not only reduces the flow of water to downstream users but can also cause harm by affecting soil and water qualities downstream. Similarly, in the Euphrates Basin, the Southeast Anatolia Development Project (Dam) is causing much tension by benefiting Turkey but exhausting the water supply to Syria and Iraq and polluting the soil there. Conflict over water is not just about possession, it also has a lot to do with the modifications to the quality and quantity of the resource. Like Abu Saeed of Jiftlick Popular Committee points out in the Documentary, Jordan Valley Blues, â€Å"The Israeli side has done a good job stealing water by drilling deep into the aquifers specifically in many

The Primal Teen Essay Example for Free

The Primal Teen Essay The purpose of Barbara Strauch’s book, The Primal Teen: What the New Discoveries About the Teenage Brain Tell Us About Our Kids, is to describe the new scientific findings regarding the teen brain in order to help bewildered parents, teachers and other members of society to understand the irrational behavior of teenagers.   The book fulfills its purpose by relating this experience of bewilderment to scientific discoveries that reveal that teenagers are truly not at fault; rather, it is the teen brain that is going through changes that were not understood in the past. As a matter of fact, the scientific discoveries discussed in the book happen to be its main strength.   This is because readers cannot refute the scientific discoveries, even as parents who have misunderstood their teenage kids and believed them to be difficult may change their opinions about their kids after reading the book.   Moreover, the book describes various experiences of parents that the readers, who are parents, may easily relate to. By discussing the scientific discoveries in relation to the parents’ experiences, the book allows parents of teenage kids to easily change their misconceptions about their kids.   If The Primal Teen had described scientific findings about the teen brain without relating them to real experiences of parents, perhaps most parents without a scientific background would have shunned the contents of the book altogether.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   But, The Primal Teen does not just help the parents of teenagers thus.   In point of fact, it helps all readers to understand the topics more fully by relating scientific findings to real life experiences.   All adults are cognizant of the typical relationships between parents and teenagers.   Still, the book reminds them of these relationships, for example, by relating the experience of a mother whose thirteen year old son refused to obey the rule at the school dance. The boy seemed to refuse to understand the consequences of his behavior.   But, Strauch explains that the boy was truly not at fault, given that the prefrontal cortex of the teen brain is under development.   It is the prefrontal cortex that allows individuals to know the consequences of their actions and helps them to plan ahead.   This is the reason why the parents of the thirteen year old should have understood that their kid simply could not help doing what he did.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   I would definitely recommend the book to parents of teenagers who mistakenly believe that their teenage kids are complete adults even though they are not.   Even adults who have experienced disturbing teenage years should be asked to read the book.   I am certainly better off by having read the book.   It helps me to understand my own teenage experiences.   I have made plenty of irrational decisions during teenage years.   Furthermore, I have experienced conflicts in my relationships because of my own irrational behavior during teenage years. The Primal Teen helps me to forgive myself.   What is more, it helps me to forgive the friends I had in my teenage years for their irrational behavior.   I remember taking their behavior very seriously at the time.   The Primal Teen is very helpful because it allows the reader to understand that teenagers are kids even if their bodies are those of adults.

Impact of Technology on Information

Impact of Technology on Information Task Write 1500-2000 words explaining with example how technology has changed the way information is used. Your essay should cover four technologies. For the purpose of this essay it is recommended that you do comparative research on technologies and their impact on information. What is the Information Technology? Information technology (IT) The Application of computers and telecommunications equipment to store, retrieve, transmit and manipulate data, often in the context of a business or other enterprise. Information technology made human life is so easy in the 21 century. Our life is changed greatly more and more in last few year. What the reason behind that? Ofcource Technology is a main factor producing and promoting of changing human life. All technologies who use information that are most important of in the world. In Google map, you can find any location easily and reach there. In transport, you can get information of timing of arrival and depart of buses, trains, planes etc. Everyone is listening music or reading news or viewing movies from the palm electrical stuff, Mp3, I pad, mobile or other similar things. This essay is look back of technologies which are conduct or related information spreading, collection, retrieving and application. It would be ungrateful on our part not to recognize how immense the boons are which modern technology has given to mankind. Can we think of living without computers, mobile phones, electricity or modern methods of publishing? We all know the impact of technology in medical science education system on us. EDUCATION How education system change in past years. So many changes are made compare to past. At the past student learn from his teacher. They had book knowledge. All information can find from only book. It is so time consuming. Finding information from book is get bored the student. Teacher ask question to student and student answer the questions. Information can get so far from books. How Changes made in education system? First change in education system is E-Learning method. In past year if student want information and study about that then they want to go at particular place or get information from book. Now in E-Learning system student get information at the home using internet. They can easily learn from so many easy method without moving place. Student get directly get information from web. Using this method so many change made in education system. Bernard Luskin, an educational technology pioneer, advocated that the e of e-learning should be interpreted to mean exciting, energetic, enthusiastic, emotional, extended, excellent, and educational in addition to electronic. Parks suggested that the e should refer to everything, everyone, engaging, easy. These broad interpretations focus on new applications and developments, as well as learning theory and media psychology. (Education technology article) Main purpose of E-Learning system is that to share method and information on E-Learning, development of common and Euro control deliverables, such as the best practice and service provide documentation for E-Learning development and the digital learning asset sharing platform A learner can get more knowledge and information from visual ex. Video, Poster Board etc. compare to audio. Poster board take place of audio visual in this modern system. In school, Colleges everywhere learning can done by projector or board. It is easy to catch up information for user. Speaking of textbooks, e-books are becoming more prevalent in schools with the advancements of e-reader and tablet computers. I think in the near future that students will not carry around big bulky Backpacks filled with heavy textbooks. In past student carry the heavy book and get information. That the boring thing to do. In present year, student can download e-book in your laptop, phones, and tablets. And whenever they information or anything they take phone and get information in easy way. In this present year people can expand yourself from knowing different languages. Technology facilitates our ability to extend classroom community by using web-based platforms. Teachers and students can use this platform to discuss homework, post assignments, and interact with peers as they work on projects. We now use libraries, but so much of our research and learning is now more web-based. What used to take hours in the library to find, we find instantaneously. As a result, we need to sort through huge amounts of information efficiently. We know how to get and use information. I would argue that because it takes less time to find information, we spend more time digesting, thinking, and learning about new information. Radio Radio is the device that get information from any place in world. The meaning and usage of the word radio has developed in parallel with developments within the field of communications and can be seen to have three distinct phases: electromagnetic waves and experimentation; wireless communication and technical development; and radio broadcasting and commercialization .(http://en.wikipedia.org/wiki/History_of_radio). Radio technology began with wireless technology. Radio technology is related to other wireless invention â€Å"TELEGRAH†, â€Å"TELEPHONE†. In fact all three technology are similar. In 1873 James Clerk Maxwell experiments with the radio waves through free space. After more experiment by David E. Hughes and Heinrich Rudolf Hertz in signal from radio waves, they invent the concept of radio. Radio is first device that allow the mass communication. It has able to information transfer from far and wide area, not only for national wide, it include also international wide. Following image of old radio. First mainly use of radio is contact between ships in the sea. During time of distress, a sinking ship would use a radio messaged nearby vessels and stations on the land to ask for aid. The radio saw a surge of use during the First World War. Both sides used the radio to relay messages to troops and top officials as well as people not on the battle front. At the end of the war, President Woodrow Wilson’s Fourteen Points was sent to Germany via use of the radio. After the war’s end, with the grow up broadcasting began in Europe and United State. Radio-telegraphy is the sending by radio waves the same spot dash message (Morse code) utilized as a part of a telegraph. At starting transmitters were called flash whole machines. It was created and utilized generally for the correspondence of boat to-shore and boat to-ship. The imparting was between two focuses, and it was not open radio television as what we are utilizing these days. It was an upheaval in human data change and transmitting. As early as 1899 the United States Army set up wireless communications with a lightship off Fire Island, New York. Before a wireless system was used by US navy, they even used homing pigeons for communication. As early as 1899 the United States Army set up wireless communications with a lightship off Fire Island, New York. Before a wireless system was used by US navy, they even used homing pigeons for communication. Though we have plenty of choice of new products to listen to news or other things but radio with AM function is still used now by many people, probably by more senior users who are used to listen to the traditional radio sets in daily life.In fact home radio receivers portable or dest one had long been used as a main device for people to get news around the world before the Television was invented.As for radio broadcasting, it took place in 1915, when human speech was first transmitted across the continent between New York City and San Francisco and across the Atlantic Ocean between Naval radio station NAA at Arlington, Virginia and the Eiffel tower in Paris. We need to recall that we can get gigantic measure of data however we need to utilize our cerebrum to anaalise those data. Since data we go anyplace like online or radio or etc, it doesnt mean they are genuine or helpful. In the event that we are utilized with one gadget for quite a while we may lose one capacity around there. Case in point when individuals use GPS to drive, without GPS, they may not know to discover the home. Perhaps we can not stop the new innovations to enter our life, we can not stop ourselves to purchase new versatile, new I-pad, however the paramount thing is that how we utilize them as a part of right way in light of the fact that they have effectively changed the way we used to get data. Marketing Marketing is changed in past years. So many changes made. Main purpose of marketing is attract and retain customer valuable content with the intention of changing or enhancing consumer behavior. In past year, Marketing is done throw paper advertisement, by poster, audio concept etc. Marketing is concern with the business strategy. In past hundred years many principles had change in marketing strategy. In past year, Marketing is done throw paper advertisement, by poster, audio concept etc. In this present year marketing done throw Facebook, YouTube, Twitter type social media where people can interest in product, so Marketing is done very easily. According to Tech Target, more than 64% of car buyers use the Internet to research car models, features, and prices. Even more, 68% of new car buyers attest to visiting an average of seven different sites, such as Kelly Blue Book, Autobytel, and Edmunds. In past year, marketing done throw paper. All paper wrote by himself by people and give other for marketing. They can write document by hand writing. There are time consuming and waste of paper. In this generation that work done by printing machine. All document write in computer and you can copies easily available. As long as people still read newspapers and magazines, text marketing will remain important. Early mail frameworks were utilized principally for sending individual letters and interchanges between organizations, however dashing advertisers soon found that mail could be an extraordinary approach to market organization and its products. while numerous individuals whine uproariously about garbage mail, there are still ways to utilize mail promoting viably, and it can be an extraordinary approach to assemble a client base when beginning a business. Mail promoting is not the least expensive advertising system accessible, however it can be massively viable if utilized accuratel y. In present year marketing also done throw audio and video visual. You can record your advertisement and advertisement on radio. You can make video transfer throw internet or view video advertisement on film interval, on online web advertisement or on television. You can easily marketing your product. The fame and regulation of radio gave advertisers a fresh out of the box better approach to connect with potential clients. Since it was difficult to charge for access to a radio station, early stations depended on promoting, and radio promotions are still the essential means by which radio stations produce income. Indeed online radio stations still depend on sound recordings for promoting. TV promoting came a bit later, however it stays as prominent as ever, and all promotion backed feature wholesalers will proceed to use feature promoting for future. Early web browsers began allowing images, website operators began running advertisements. These advertise were typically banner ads, and operators would charge for each ad shown. Later, only ads that users clicked resulting in charges. Today, many ads are based on text, and advertisers only pay when users click on them. On popular platforms, advertisers compete based on price for better advertise placement. Like facebook and other social networking website advertisement Technology has long changed how we live our lives, but some of us fail to realize how profound the changes it brings are. When it comes to advertising, businesses can no longer create a sign and hope that others will spread the news. Fortunately, there are a number of effective an d affordable options for businesses of all sizes, and those who take advantage of what advertising can do using modern technology stand to make tremendous strides. Communication Communication is process of interaction or interchange word between people. Changing on technology effect the communication technology. Many device find for the communication as example like phone, messages service, internet call, new application for communication all that. Many year ago people communicate with the symbol. People can pass the message by symbol. Communication done also by writing. Few year ago people can write letter and post. And other people receive post read and get answer. That waste the time. Phone is the most important innovation by graham bell that change the communication and information exchange way. So many innovation can made in communication. In past people can communicate just with talking and writing paper and this present time people can get information throw telephone. Just call and ask and get information. In communication that has two main part. Telecommunication Videocommunication Telecommunication means communication at distance with technology. In this present time so many changes has done. Many invention done. Like phone, calling, messeging Audio-video transfer. Tele-communication included audio messages such as coded drumbeats, lung-blown horns, and loud whistle. Telecommunication can increase the ability to access throw film and music. Telecommunication and videocommunication play most important role in social activities. In 1920-1930 social dimensions of the device became a prominent theme in telephone advertisements. Using Television people can seen films or entertain at home. They cannot travel for video entertainment. With Radio and internet people can listen music at the home. At the past that all thing not available. Now in this generation wireless telecommunication is available that people can communicate with anyone at any place. Internet, radio, television, telephone all the major components of telecommunication. Video-communication is the conduct of a video conferencs by a set of telecommunication technologies which allow two or more locations to communicate by simultaneous two-way video and audio transmissions . In past there are no any video chatting is available. Now in a days Skype, viber so many application that use for video communication. References www.necsi.edu.research/management/education www.wikipedia.org.wiki/e-learning www.wikipedia.org/wiki/history_of_radio www.personal_psu.edu/jtk187/art2/radio.htm www.MBA-exchange.com/candidates http://en.wikipedia.org/wiki/telecommunication http://en.wikipedia.org/wiki/Videoconferencing

School Days are the Happiest Days of your Life? :: Creative Writing Examples

School Days are the Happiest Days of your Life? When I was given this assignment, my initial reaction was this is easy! Half an hours writing- homework complete. Fifteen minutes later I find that it is incredibly difficult to sort out the jumble of thoughts, memories and feelings, that are fighting each other in the race to be the first to blot this pristine white page.(melodramatic, but true) I suppose I could take the easy way out, and write that looking back; my school days were happy, carefree days. The sun always shone. I had no real worries. Friends were plentiful and life was all about, fun, fun, fun. Well I could, but that would entail not being completely honest. I mean, certainly a not immodest percentage of school, (compared with life today) was carefree but by no means all of it. My over-riding recollections of school are the memories of never quite fitting in; the never quite making it into the 'in crowd.' Not that I wanted in, you understand. I wanted to be different (not another lemming) just not so different that I stood out. I blame my mother for that mentality for she drummed it into us all. If I spoke the usual refrain," but all my friends are her response was always." if your friend stuck her hand in the fire- would you do it too?" Well the answer to that was no, and when you said so, mum would smile and say," of course not love, you have your own mind. You're not a lemming; don't be afraid to be different." I was left feeling proud of myself for being 'different', but oh God, I still wanted that denim jacket, or those Adidas trainers, or to stay out for that extra half an hour; or the myriad of other 'things' that would have enabled me to fit in. Money was always tight when I was at school. With four kids to buy for - I feel mum used the lemming story no us, just so she wouldn't have to say "I can't afford it." At school, every deficit, both real and imagined between you and the 'in crowd' made you insecure. It could be your haircut, shoes or even just the number of pleats our gym skirt had. (Mine had none.) Plain skirts were cheaper. Positive Body Image, or lack of it in my case, was a major problem. I went through school convinced that I was fat and ugly. Fat!? I was only 81/2 stones! I would kill to be that weight again - and as for my

Flowers for Algernon :: essays research papers

Medical operations are carried out everyday, but for some, an operation can change a person's life. One experiment was done on a mentally retarded person to try to raise his intelligence. The experiment worked, but after months, the patient regressed dramatically. In the book, Flowers for Algernon,this intelligence operation was preformed, and the patient was Charlie Gordon. After the operation, Charlie was very bright, but experienced psychological traumas, loneliness, disillusionment, and social inadequacies. After his operation, he remembered every aspect of his childhood, whether it was good or bad. Charlie had dreams of how his mother was ashamed of him. Charlie's sister also ignored him. To her, Charlie was dumb and could not do anything. Charlie had dreams of his sister yelling at him and making fun of him. He also had memories of the night his parents took him to the Warren Home. He was terrified and his dad would never answer his questions. Charlie remembered his childhood and through his memories, he felt guilty for hurting his family. In the bakery he used to have friends. Friends that would talk to him and care about him. Charlie then realized that he had no friends but merely knew people that made fun of him. The bakery employees just liked him because they could blame their mistakes on Charlie. Then, they could not do this after the operation, so they all turned against Charlie. Charlie felt like an lab specimen. Charlie had lost his friends and knew now he was just a like a lab rat. veryday Charlie lost a piece of himself. He would become mad at people very quickly and then yell at them. People stayed away from him because he was becoming unpredictable. Charlie lost his job because he was to smart to work in a bakery. He could not interact with people he worked with and the people he met. The "Charlie" inside of himself emerged and started to regain control of his mind. All in all, Charlie suffered from the pain of not knowing how to d eal with his peers and decisions.

Meaning of Arbitration

Courts are over bounded with a large number of cases and their disposal takes long time. Therefore a need was felt for a faster dispute resolving mechanism. That’s why â€Å"Arbitration Act† was provided with a view to give speedy justice to the people and also to avoid unnecessary court case expenses. It is an informal dispute settlement mechanism. Bangladesh has recently enacted a new arbitration law, known as â€Å"The Arbitration Act, 2001. The Act came into force on April 10, 2001. The Act has repealed The Arbitration (Protocol and Convention) Act, 1937 and The Arbitration Act, 1940. With this new enactment Bangladesh has kept pace with the recent trends in the field of international arbitration in the rest of the world. According to the topic of this assignment, I also agree that although arbitration was introduced for settling dispute but it is not serving it purpose entirely and precisely. Now I’m going to discuss about the reasons which are making difficulty for arbitration to serve its purpose completely. Meaning of Arbitration: Before discussing about the ineffectuality’s of arbitration, first we should briefly know what Arbitration really means. The word â€Å"Arbitration† means mediation, negotiation, adjudication etc. This means settlement of arguments, disagreement, and clash between two parties. It is a process in which a disagreement between two or more parties is resolved by impartial individuals, called arbitrators, in order to avoid costly and lengthy court case or legal actions. Arbitration is the most traditional form of dispute resolution. Arbitration is a binding procedure. It is often administered by a private organization that maintains lists of available arbitrators and provides rules under which the arbitration will be conducted. Such organizations can also manage the arbitration in whole or in part. Parties often select arbitrators on the basis of substantive expertise. Arbitration is adjudicatory, as opposed to advisory, because of the fact that the arbitrator (usually a retired judge or attorney) renders a decision at the end of an arbitration hearing, and that decision is final and binding, subject only to a very limited court review. Arbitration is sometimes referred to as â€Å"non-binding† if the parties agree to make it so, but that is really a misnomer. Think of arbitration as a binding, adjudicatory process. Arbitration is a process of resolving a dispute or a grievance outside a court system by presenting it for decision to a neutral third party. Both sides in the dispute usually must agree in advance to the choice of arbitrator and certify that they will agree to the arbitrator's decision. The Arbitration procedures differ from the procedures of courts, especially presentation of evidence. Arbitration avoids costly litigation and offers a relatively speedy resolution as well as privacy for the disputants. The main disadvantage is that setting guidelines is difficult therefore the outcome is often less predictable than a court decision. The reasons for selecting Arbitration rather than Court: * Speedier resolution; however, there can be exceptions due to multiple parties, arbitrators, lawyers and litigation strategy. * Less costly; however, there can be exceptions due to multiple parties, lawyers, arbitrators and litigation strategy. Not a public hearing; there is no public record of the proceedings. Confidentiality is required of the arbitrator and by agreement the whole dispute and the resolution of it can be subject to confidentiality imposed on the parties, their experts and attorneys by so providing in the arbitration agreement. * From defense point of view, there is less exposure to punitive damages and run away juries. * Limited discovery because it is controlled by what the parties have agreed upon and it is all controlled by the arbitrator. Often, the arbitration process is less adversarial than litigation which helps to maintain business relationships between the parties. * The arbitration is more informal than litigation. * The finality of the arbitration award and the fact that normally there is no right of appeal to the courts to change the award. So after the discussion we can say that, arbitration is a dispute resolution processes in which the disputing parties present their case to a third party intermediary (or a panel of arbitrators) that examine all the evidence and then make a decision for the parties. This decision is usually binding. Like court-based adjudication, arbitration is adversarial. The presentations are made to prove one side right, the other wrong. Thus the parties assume they are working against each other, not cooperatively. Arbitration is generally not as formal as court adjudication, however, and the rules can be altered to some extent to meet the parties’ needs. Why arbitration as dispute settlement mechanism is not effective: Now let’s discuss the about the chapters of arbitration which are making Arbitration less effective. Although settling dispute through arbitration is one of the most traditionally approved to methods for resolving disputes between individuals and parties, there are some lacking. Some disputes may not prove best resolved through arbitration either. Arbitration, itself, is a process of two parties mutually agreeing to allow a third, impartial party make a decision regarding an outstanding dispute. The decisions from an arbitrator are legally binding, and are enforceable in the court of law per the Arbitration Act, as well as numerous state and local laws following the federal legislation. Unless in cases of corruption, fraud, or other circumstances that would affect an arbitrator’s ability to remain neutral, almost all arbitration rulings are final. Additionally, the courts may rule against the decision and rulings of an arbitrator if the decision is against one party without basis. Arbitration also leaves no room for an appeals process in the vast majority of instances. This is a risk parties and individuals should seriously assess prior to engaging in arbitration, as well as when considering the methods for resolving their disputes. Following are some limitation which makes arbitration less effective: * There is no right of appeal even if the arbitrator makes a mistake of fact or law. However, there are some limitations on that rule, the exact limitations are difficult to define, except in general terms, and are fact driven. * There is no right of discovery unless the arbitration agreement so provides or the parties stipulate to allow discovery or the arbitrator permits discovery. * The arbitration process may not be fast and it may not be inexpensive, particularly when there is a panel of arbitrators. An arbitration award cannot be the basis of a claim for malicious prosecution. * Except in certain circumstances, non-signatories of the arbitration agreement cannot be compelled to arbitrate. * The large cost of legal fees in litigating a dispute. * The ability of parties to appeal to a higher court after losing at the trial court level and the lack of finality. * The fact that neither the jury or the judge may not have any knowledge nor experience with the subject matter of the dispute between the parties which results in the parties having to educate the judge as to the law and custom and practice. The ability to appeal to higher court adverse rulings on procedural. * Unknown bias and competency of the arbitrator unless the arbitration agreement set up the qualifications or the organization that administers the arbitration, has pre-qualified the arbitrator. Also, in the arbitration process, there is a limited period of discovery, which can lead to surprise evidence or testimony occurring during an arbitration process, which a party may or may not be able to effectively refute at the time of their arbitration hearing. Likewise, there is no jury to decide the outcome of a dispute, but rather, the decision rests solely in the hands of the arbitrators, whom usually consist of one individual or a panel of three persons, that may or may not be able to remain entirely impartial during all proceedings regarding all matters. Why â€Å"Arbitration Act 2001† is not fully serving according to its purpose? Arbitration in Bangladesh is governed by the Arbitration Act 2001. This Act repealed both the Arbitration (Protocol and Convention) Act 1937 and the Arbitration Act of 1940 and consolidates the domestic and international arbitration regime in Bangladesh. In mid-2004, the Bangladesh Council of Arbitration (BCA) was established as an arbitral body. The BCA rules have not yet been finalized. Arbitration in Bangladesh is governed by the Arbitration Act 2001. This is based on the UNCITRAL model law. Here are some reason for which Arbitration Act 2001 is failing to serve the purpose for which it was enacted: * There are difficulties in enforcing arbitration awards in Bangladesh. The difficulty is greater if it is a foreign party seeking to enforce an award against a local party. Where the arbitration is convened abroad, there have been instances where the Bangladeshi courts have allowed legal proceedings which interfered with the issues raised in the foreign arbitration. The Act provides that an international arbitral award can be enforced as if it were a decree of the domestic court. * Arbitration varies on the subject matters that mean weather parties will go for arbitration or not it depends on the context of arbitration contract. That contract has to be a written contract. Moreover, only those disputes on which parties has agreed previously will be considered as arbitration context. So, if someone wants to add another context which is far more important as well can’t do it as it was not mentioned before. * In case of cost it also may be huge sometimes. Although it is considered that parties goes for arbitration for lowering the cost of court case still some arbitrator may ask for big amount of money from the parties. So fee of the arbitrator is both expensive and inexpensive. As for the parties who does not want to give huge amount of money faces difficulties for going for arbitration. Generally, costs are not awarded to the winning party, although there is no law preventing the tribunal from doing so. * Thus, according to the new Bangladesh Act, a party to international commercial arbitration has to qualify as: (i) an individual who is a national of, or habitually resident in, any country other than Bangladesh; (ii) A body corporate which is incorporated in any country other than Bangladesh; (iii) A company or an association or a body of individuals whose central management and control is exercised in any country other than Bangladesh; or (iv) The government of a foreign country. This means that a commercial dispute between two Bangladeshi nationals having places of business even in different States cannot be considered the subject matter of international commercial arbitration under the new Act, which would be otherwise possible under the Model Law * In section 3 of Arbitration Act 2001, it says that this act will be only applied if the place of arbitration is in Bangladesh. * The Arbitration Act does not make provision for confidentiality in arbitration proceedings. If this is important to the parties then this should be dealt with in the arbitration clause. They are bound to maintain confidentiality. But they don’t maintain it properly. * There are no available institutional rules specific to Bangladesh. Parties are free to agree on the rules to govern the arbitration. In the absence of an agreement, and where the rules selected by the parties do not cover a particular circumstance, the Act sets certain default rules. * Under the Act, no judicial authority (including the courts) is allowed to hear any legal proceedings commenced by any of the parties to an arbitration agreement. However, section 7A of the Act contains an exception to this general rule. Under section 7A, the High Court Division, before or during arbitration may, inter alia, take interim protective measures in respect of goods or property included in arbitration agreement. * Under the Act, the only grounds for challenge are if: (i) circumstances exist that give rise to justifiable doubts as to their independence and impartiality (ii) The arbitrator does not possess the qualifications agreed by the parties. Where international commercial arbitration is concerned, a challenge against an arbitrator must first be made to the arbitral tribunal. An appeal against the decision of the tribunal goes to the High Court Division of the Supreme Court. The procedure for challenge may be modified by agreement. * As in court-based adjudication, arbitration outcomes are typically win-lose, not win-win. Thus, the arbitrator usually decides that one side was right and the other wrong. They do not often go out of their way to develop new approaches for meeting the interests of both sides simultaneously, as a mediator would do, though if a win-win solution is apparent, the arbitrator would probably recommend it. Conclusion and recommendation: The prior examination of the new Bangladesh Act, 2001 from a comparative perspective shows that the Bangladesh legal regime has embraced the fundamental tenets of modernization of international arbitration such as (i) party autonomy; (ii) minimal judicial intervention in arbitration; (iii) independence of the arbitral tribunal; (iv) fair, expeditious and economical resolution of disputes and (v) effective enforcement of arbitral awards. This modernization has also been brought about in the context of domestic arbitration. As the new Act is now about ten years old, it will be more mature to express any judgment on its efficacy as an arbitral legal regime and the impact it will have in the future for Bangladesh as a place for settlement of international commercial and investment disputes by arbitration. Certainly, Bangladesh, being a prospective destination for increasing foreign investment in the future, has made a positive step in the right direction by enacting the new law on arbitration. No doubt, there is still room for improvement in the Act itself as indicated above. It must be appreciated that in order to make Bangladesh an attractive place for much-needed foreign investment, for economic growth and development, and for alternative dispute resolution. Bangladesh needs more than a mere piece of legislation on arbitration at the present time. The Government and the judiciary, as well as the legal profession, must take initiatives and make constant efforts towards the development of legal infrastructure and institution building in the field of alternative dispute resolution, including arbitration. In this respect the following tentative suggestions may be worth considering: * When interpreting the new Act Bangladesh courts should not be detracted from the spirit of modernization of arbitration as a global phenomenon. * The members of the judiciary as well as the legal profession must appreciate the reality that in this era of globalization dispute settlement by alternative methods is not only a domestic matter, but also an increasingly growing international phenomenon in the context of cross-border transactions. They have to be open to absorbing international values, norms and principles while performing their professional functions in the field of international dispute settlement. * The need to create a specialist arbitration bench in the High Court Division may arise for the purpose of dealing with international arbitration matters more effectively and professionally. * Specialist bench may be constituted by appointing a certain number of judges in the High Court Division with the appropriate expertise and background in the field of arbitration. The Government, the Bar and the Bench must attend to the development of the culture of arbitration in Bangladesh. Judges and lawyers must be aware of the value of alternative dispute resolution when the courts are heavily overburdened with caseloads. They must actively promote arbitration. * The Government and professional organizations should promote arbitration and ADR and enhance the understanding of them by sponsoring and conducting educational and training programs for both the bar and the bench and for arbitration.

The Help by Kathrynn Stockett: Themes

In fact, the Justice system, thought to promote equality in â€Å"the and of the free,† was useless towards the idea of racial harmony and African Americans were treated bitterly and relentlessly during this time. The author Kathy Stocked wrote a novel In the perspective of mistreated black maids and one helping white woman during the time of the call rights movement. Through the historical events, characters, and setting compiled Into Kathy Stockpot's novel, The Help, the theme of Injustice and racial Inferiority Is portrayed.During the novel, the bus Abilene is riding stops at a roadblock and all the black people are told to get off the us. The civil rights leader and NAACP field secretary, Meager Veers, had been shot and killed by the UK Klux Klan. Abilene states, â€Å"White peoples with guns, pointed at colored peoples. Cause who gone protect our peoples? Into no colored policeman's† (230). The blacks are trapped and have no jurisdiction to control what happens in the community, or to themselves.Even a person with authority, Mayor Thompson, denoted the idea of a biracial committee and said that he â€Å"believes in the separation of races† (231). Instead of protecting the blacks, the government was useless In aiding them. The Jim Crow laws, found by Skitter In the library, also resembled how government only contributed to the destruction of racism. The events that are embedded throughout the novel reveal how the characters feel helpless to what occurs around them.In addition to resembling the theme of injustice, Hilly Holbrook is the symbol for whites who used power and influence to have blacks fired, evicted, imprisoned, fined, and even subjected to physical violence. She used her social status to influence the courts and businesses in the community to punish black omen, like Yule May, whom she targeted. After Yule May went to trial for stealing one of Hills rings, Abilene states that â€Å"A regular sentence be six months for petty stealing, but Miss Holbrook, she get it pushed up to four years† (295).For many of the black characters in the novel, and the black maids during that time, there was little justice. Acts of violence and injustice were committed against them and there was nothing they could do to fight it. The scale was of Justice was Imbalanced, heavily sloping downwards for the blacks who had no power compared to the whites. The eating also reinforces the theme of Injustice and racial Inferiority. The novel Is set In Jackson, Mississippi, one of the most segregated towns in the united States, during ten time AT ten call relents movement.I Nils was a parlor consisting AT organelle boycotts, student protests, and mass marches towards the struggle against racial segregation. The Jim Crow laws were enforced and there were strict rules and norms concerning the actions of blacks. Jackson, Mississippi was teeming with racial tensions and this affected the characters and events of the novel. Kathy St ocked rote the novel, The Help, and captured the image of life as a black maid during the sass's.In her novel, she compiled historical events, characters, and the setting to portray the emotions and hardships of blacks during this time in history. By using these devices, Stocked formed the theme of injustice that readers can either relate to or comprehend. Through her writing, she accurately demonstrated how racial inequality, injustice, and inferiority played a role in the lives of many blacks. The Help represents how the blacks, the inferior, began to stand up to the whites, the superior, through words and stories.

Care Plan Chronic Heart Failure Health And Social Care Essay

The physician to population ratio grew from 2/1000 people in 2000 to 2.4/ 1000 people in merely a mere 5 years3. Despite the rapid growing, the ratio is still short as compared to other European states viz. France, Germany or Italy. This is worsened by the fact that the figure of patients treated in NHS infirmaries rose by 15 % at the same clip interval3. It is of import to use the expertness of other health care professionals, viz. community druggists, in support of the increasing figure of patients in the community in order to better patient attention. The World Health Organization defines chronic complaints to be ‘a wellness job necessitating on-going direction over a period of old ages or decennaries ‘ . NHS Scotland has identified that chronic unwellness is farther complicated by demographical alterations, increasing co-morbidities, widening spread of wellness inequalities and the increased outlooks placed on the health care system4. Actions have been taken to promote modernisation of NHS community pharmaceutics in Scotland. The debut of the New Pharmacy Contract was the action program from the Scottish Executive ‘s scheme papers ‘The Right Medicine ‘ in which nucleus pharmaceutical attention services such as Chronic Medication Service ( CMS ) , Minor Ailments Service ( MAS ) , Acute Medication Service ( AMS ) and Public Health Service were designed to optimise the use of community druggist ‘s accomplishments to widen the range and farther better the quality of attention proviso to patients5. The contract was driven by a quotation mark by the World Health Organization ( WHO ) in 2002, adverting that reacting to the demands to patients with chronic conditions post the biggest challenge to wellness systems around the globe4. The foundation of the CMS is built upon the cardinal countries: patient centered ; clinical administration ; collaborative working ; support for execution ; monitoring and reappraisal and service development6. The nucleus aims of CMS are summarized in Appendix 1. The altering function of the druggist is in response to the increasing demand for betterment in patient ‘s medicines direction. The debut of the CMS is to further develop the parts of the community druggist to guarantee the continuity of pharmaceutical attention in patients with long-run conditions every bit good as cementing the stature of community druggists in the NHS4. Pharmaceutical attention is an effectual tool in the direction of chronic complaints and is defined as the responsible proviso of drug therapy for the intent of accomplishing definite results that improve a patient ‘s quality of life harmonizing to Hepler and Strand7. Pharmaceutical attention is hence a collaborative attempt between healthcare professionals endeavoring to better drug therapy direction via uninterrupted monitoring of inauspicious effects, effectivity and patient instruction all meeting to better patient ‘s quality of life8. Healthcare professionals play a critical function in autho rising patients to take charge of their ain wellness, as this would ease them in accomplishing their coveted quality of life relevant to their wellness believes6. Community druggist can be the accelerator in smoothing the patient ‘s journey of attention by being the gateway of information via improved entree to healthcare services and to back up self-care6. It is simple to merely purchase a battalion of medicine over the counter to handle an false unwellness but the bulk is incognizant of the possible injury it presents. Some might non take earnestly an overdose of medicines that have a broad curative index but for drugs that have a narrow curative index, a simple overdose could be fatal. There is merely so much a prescriber could make but hanker term attending is indispensable to guarantee that patients get the best out of their medicine particularly in those who have multiple co-morbidities. The attack of CMS is through the constitution of curative partnerships between general medical practicians, druggists and patients to better patient attention by guaranting better local entree to wellness care6. Fostering such commitment will minimise duplicate of functions and, with good defined functions, can advance a holistic attack to the pharmaceutical and clinical attention of patients6. The end is to assist patients harvest the most out of their medical specialties but besides minimise any associated risks4. Community druggist is frequently the first and lone point of call. Community druggists can bridge the spread in a patient ‘s journey of attention and therefore better the whole curative class by expecting, placing, deciding and forestalling medicine-related issues4,9. These medicine-related issues include: Safety and efficaciousness Side effects Conformity and harmony Identify markers of hapless control Symptom specific markers to motivate referral Supplying and advancing wellness information and instruction CMS is a service that requires patients ‘ voluntary engagement and is by and large broken down into 3 phases. Phase 1 involves the enrollment of the patient for the service. Stage 2 involves the debut of a generic model for pharmaceutical attention planning. Phase 3 is the constitution of the shared attention component between the GP and the community pharmacist6. A pharmaceutical attention program paperss the patient ‘s pharmaceutical attention demands, attention issues, desired results and actions required as portion of the pharmaceutical attention planning of the patient. Figure 1 summarizes the pharmaceutical attention be aftering rhythm. Identify and prioritise patients with pharmaceutical attention demands Identify and reexamine pharmaceutical attention issues Implement and proctor pharmaceutical attention program Formulate and document a pharmaceutical attention program Figure 1: Pharmaceutical Care Planning Cycle To get down of with attention planning, critical information that may act upon the attention program such as patient ‘s general wellness, allergic reactions or sensitivenesss, other medical conditions and hazard factors are noted. A hazard appraisal is so made to help the druggist in placing and prioritising any pharmaceutical attention needs that a patient might necessitate or is deprived from in footings of service, which as a consequence influences the therapy6. Next, an appraisal is made to place and reexamine the patients pharmaceutical attention demands and refering issues. This can enable the druggist to measure the medical specialties regimen that a patient is on in footings of efficaciousness or toxicity profile and besides allows the druggist to measure how deep the patients understand their medicines and intervention and the extend of their wellness believes. Subsequently, a pharmaceutical attention program is drafted based on the attention issues that have been iden tified with the understanding of the patient. This attention program serves as a protocol in which issues are placed on a hierarchy of precedence, outcome ends are defined, proposals to any class of action documented every bit good as clearly specifying the health care forces and their duties for assorted monitoring that ought to be conducted. Changeless reappraisals and monitoring is done to measure the results of the attention program upon execution and alterations are made along the manner, when required, to maximise the curative result. To accomplish the maximal curative benefit, the patient ‘s wellness belief and apprehension of the therapy is indispensable. Hence, reding and advice by the druggist before, during and after the procedure is good. Chronic Heart Failure ( CHF ) is one of the 13 long-run disease provinces covered in the CMS protocol stand foring the most frequent indicant for therapy4. The list of all 13 disease provinces are listed in Appendix 2. Heart Failure is one of the most crippling medical conditions which can badly impact a patient ‘s quality of life hence seting force per unit area on hospitalization and health care budgets10. The Scots Intercollegiate Guidelines Network ( SIGN ) defines CHF as a complex clinical syndrome ensuing from any structural/ functional upset that impairs the ability of the bosom to react to physiological demands for increased cardiac output11. Hence, bringing of blood is compromised12. Abnormality in cardiac construction, beat, map or conductivity can all take to unequal perfusion, venous congestion and disturbed H2O and electrolyte balance that underlie CHF13. In add-on, normal compensatory mechanisms become compromised taking to maladaptive secondary physiological effe cts that contribute to the progressive nature of the disease12. CHF can be a effect of assorted underlying complications such as myocardial infarction and/or high blood pressure and the most common being left ventricular systolic disfunction ( LVSD ) . Coronary arteria disease, aortal stricture, dilated myocardiopathy, alcoholic myocardiopathy, Chagas ‘ disease, endomyocardial fibrosis and other mechanical defects such as cardiac valvular disfunction, degenerative valve disease, arthritic valve disease, terrible anaemia and thyrotoxicosis are the more common causes of CHF around the Earth but other rarer causes do exist12,13. Management of these predisposing factors can be good in relieving the symptoms of bosom failure. Table 1 is the New York Heart Association ( NYHA ) categorization system used to sort patients with bosom failure based on their functional position. Table 2 is ACC /AHA phases of HF ; a addendum to the NYHA categorization. It is estimated that there is a prevalence of about 1-2 % for bosom failure in developed countries10,14. The life-time hazard of developing HF is approximately 20 % for patients above 40 old ages old and besides the taking cause of hospitalization for patients above 65 old ages old10,14. Harmonizing to the European Society of Cardiology, above 15 million patients are diagnosed with HF in 51 European states consisting a population of around 900 million15. The prevalence of HF is about 1-2 % in the western society and the incidences are between 5-10/ 1000 instances per annum16. A recent US population-based survey, the prevalence of bosom failure was 2.2 % ( 95 CI 1.6 % to 2.8 % ) , increasing from 0.7 % in individuals aged 45 through 54 old ages to 8.4 % for those aged 75 old ages or older17. Similar minor expense forms, 1 % for the 55-64 age group increasing to 13 % in the 75-84 age group was observed from the Rotterdam study18. In the contrary, for the below 50 age group, incidences of HF are rare16. Improved endurance from acute myocardial infarction ( MI ) coupled with the aging population contributes to the spike in incidence and prevalence of HF19. One critical function community pharmacist drama is to advice and offer guidance on a healthy life style. Lifestyle and dietetic alterations are schemes aimed at forestalling cardiovascular diseases ( CVD ) which are possible predisposing factors taking to CHF. The development of CVD is affected by multiple dietetic factors and an overall healthy diet will significantly cut down the hazard of CVD20. Consumption of fruits, veggies, grain merchandises, low-fat dairy merchandises and curtailing the sum of salt and unstable consumption are all portion of a well balanced diet11,21. Keeping a healthy organic structure weight is indispensable as fleshiness is an independent hazard factor for CVD. Morbid fleshiness has a strong association with mortality from CVD particularly in immature grownup males. Therefore, bar of fleshiness has to be taken early and in an aggressive manner22. Keeping optimum blood force per unit area, blood glucose every bit good as a desirable lipid profile is advise d to command or lower the hazard of CVD21. Maintaining physical and cardiovascular fittingness and a healthy weight can be achieved by changeless physical activities as it improves cardiovascular hazard factors every bit good as take downing the hazard of developing other chronic diseases21,23. Evidence has proven the strong association between smoking and cardiovascular jeopardies every bit good as the benefits of smoking cessation24. Therefore, look intoing the smoke position of patients and offering intercession where appropriate will be good to patients peculiarly in those who are at hazard of enduring from cardiovascular events24. Patients with CHF should be advised to discontinue smoking11. Moderate ingestion of intoxicant should besides be advised as extra alcohol ingestion can increase the hazard of CVD11,25. The above are merely the chief life style and dietetic parametric quantities that should be addressed with precedence to command or lower CVD hazards. Such steps should non be seen as stairss taken to forestall CVD but instead as stairss taken to promote everybody to populate a healthy life style to forestall any signifier of disease provinces. Psychosocial and psychological hurt have a important impact in morbidity and mortality after HF and hence societal and relationship factors may play an of import function in pull offing chronic conditions such as CHF26. The ends of intervention are to better quality of life11,13. Angiotensin Converting Enzyme Inhibitors ( ACEi ) Evidence has shown that ACEi therapy is good in take downing mortality, MI and rehospitalization for patients enduring from HF with LVD or HF with or without a recent MI27. A meta-analysis has shown that patients with CHF prescribed with an ACEi have a 23 % decrease in mortality and a 35 % decrease in rehospitalization27. Further meta-analysis is patients with LVSD, HF or both after MI has a comparative decrease in mortality rate of 26 % 27. Therefore, ACEi therapy is recommended in patients with all NYHA functional categories of HF due to LVSD11. Adverse effects include cough, hypotension, nephritic damage, angio-oedema and hyperkaelaemia. Dose titration and nephritic and electrolyte monitoring should be included in the attention program particularly in susceptible patients utilizing other medicines so that intercession could be established in instances where inauspicious effects are marked. Beta Blockers Treatment with bisoprolol, carvedilol and Lopressor Forty shows a decrease in mortality in patients with advanced HF based on the CIBIS- II, COPERNICUS, and MERIT-HF tests severally. Beta-blockers benefits in HF by demoing a 29 % decrease in hazard of mortality in CVD, 36 % decrease due to pump failure and all cause mortality decrease of 23 % 28. All patients with HF due to LVSD of all NYHA functional category should be started on beta-blockers every bit shortly as their status is stable and should be the first line picks for patients with CHF due to LVSD11. The effects of beta-blockers might non be seen instantly. Furthermore, deterioration of HF and hypotension might be present at the get downing hence dose should be titrated up suitably upon supervising. Beta-blockers are contraindicated in those with asthma, bronchospasm, 2nd or 3rd degree auriculoventricular bosom block or diagnostic hypotension11. Angiotensin II Receptor Blocker ( ARB ) ARBs antagonizes the binding of angiotonin II to its type 1 receptor hence exercising its action similar to ACEi ‘s with the benefit of non bring forthing dry cough as a side effect13. In CHARM Alternative, ARB intervention led to a comparative decrease of 23 % in primary result of CV deceases or rehospitalsation for patients with CHF having candesartan who are intolerant to ACEi29. The add-on of ARB to ACEi or beta-blocker intervention non merely had no consequence on mortality but markedly reduced HF rehospitalisation and mortality combined30. Patients with CHF due to LVSD, HF or LVSD or both station MI who are intolerant to ACEi should be considered for ARBs whilst patients with HF due to LVSD who are still diagnostic despite already on ACEi and beta-blockers, add-on of candesartan might be beneficial11. Aldosterone Adversaries Aldosterone adversary has been studied in patients with terrible diagnostic HF, led to a pronounced decrease in mortality and morbidity and improved symptoms13,31. It is recommended for patients with HF in NYHA category III and IV despite being on ACEi and beta-blocker while there is no grounds that Aldactone has any benefits in mild HF11,13. The RALES test has shown that the add-on of Aldactone to an ACEi yielded an all cause mortality of 30 % and cardiac mortality by 31 % 31. However, aldosterone adversaries produce many inauspicious effects on vascular map and myocardial fibrosis11. Spironolactone produces gynaecomastia, hyperkaelaemia, and nephritic disfunction hence blood carbamide, creatinine and electrolyte monitoring is essential11. Patients with terrible HF due to LVSD should be on Aldactone unless contraindicated11. Eplerenone can be used if patients are intolerant to spironolactone as grounds from EPHESUS survey has demonstrated a 13 % decrease from CVD or hospitalization for CVD and 21 % comparative rate of sudden decease in patients on eplerenone32. Diuretic drugs Fluid keeping doing ankle hydrops, pneumonic hydrops or both consequences in symptoms of dyspnea in most patients enduring from HF11. A meta-analysis supports that diuretic therapy is good for patients with dyspnea or hydrops with a 75 % decrease in mortality and 63 % betterment in exercising capacity33. The hazard of loop water pills doing hypokalaemia is offset by ACEi, ARBs and Aldactone. Therefore, monitoring of serum K is of import. Doses of water pills should be individualized to minimise unstable keeping taking into history the possibility of desiccation and nephritic impairments11. Digoxin In a Cochrane reappraisal, patients on Lanoxin showed a 64 % betterment in symptoms and a 23 % decrease in hospitalization but unluckily no betterment seen on survival34. Digoxin should be considered as an accessory therapy for instances in which patients with HF in fistula beat are non relieved on optimal therapy11. There are many issues associated with the usage of Lanoxin because of its narrow curative index, some of which are fatal such as its ability to increase the possibility of sudden decease and the hazard of toxicity in instance of hypokalaemia11. Therefore, the hazard over benefit of Lanoxin therapy should be carefully considered in the best involvement of the patient. Care Plan Chronic Heart Failure Health And Social Care Essay The physician to population ratio grew from 2/1000 people in 2000 to 2.4/ 1000 people in merely a mere 5 years3. Despite the rapid growing, the ratio is still short as compared to other European states viz. France, Germany or Italy. This is worsened by the fact that the figure of patients treated in NHS infirmaries rose by 15 % at the same clip interval3. It is of import to use the expertness of other health care professionals, viz. community druggists, in support of the increasing figure of patients in the community in order to better patient attention. The World Health Organization defines chronic complaints to be ‘a wellness job necessitating on-going direction over a period of old ages or decennaries ‘ . NHS Scotland has identified that chronic unwellness is farther complicated by demographical alterations, increasing co-morbidities, widening spread of wellness inequalities and the increased outlooks placed on the health care system4. Actions have been taken to promote modernisation of NHS community pharmaceutics in Scotland. The debut of the New Pharmacy Contract was the action program from the Scottish Executive ‘s scheme papers ‘The Right Medicine ‘ in which nucleus pharmaceutical attention services such as Chronic Medication Service ( CMS ) , Minor Ailments Service ( MAS ) , Acute Medication Service ( AMS ) and Public Health Service were designed to optimise the use of community druggist ‘s accomplishments to widen the range and farther better the quality of attention proviso to patients5. The contract was driven by a quotation mark by the World Health Organization ( WHO ) in 2002, adverting that reacting to the demands to patients with chronic conditions post the biggest challenge to wellness systems around the globe4. The foundation of the CMS is built upon the cardinal countries: patient centered ; clinical administration ; collaborative working ; support for execution ; monitoring and reappraisal and service development6. The nucleus aims of CMS are summarized in Appendix 1. The altering function of the druggist is in response to the increasing demand for betterment in patient ‘s medicines direction. The debut of the CMS is to further develop the parts of the community druggist to guarantee the continuity of pharmaceutical attention in patients with long-run conditions every bit good as cementing the stature of community druggists in the NHS4. Pharmaceutical attention is an effectual tool in the direction of chronic complaints and is defined as the responsible proviso of drug therapy for the intent of accomplishing definite results that improve a patient ‘s quality of life harmonizing to Hepler and Strand7. Pharmaceutical attention is hence a collaborative attempt between healthcare professionals endeavoring to better drug therapy direction via uninterrupted monitoring of inauspicious effects, effectivity and patient instruction all meeting to better patient ‘s quality of life8. Healthcare professionals play a critical function in autho rising patients to take charge of their ain wellness, as this would ease them in accomplishing their coveted quality of life relevant to their wellness believes6. Community druggist can be the accelerator in smoothing the patient ‘s journey of attention by being the gateway of information via improved entree to healthcare services and to back up self-care6. It is simple to merely purchase a battalion of medicine over the counter to handle an false unwellness but the bulk is incognizant of the possible injury it presents. Some might non take earnestly an overdose of medicines that have a broad curative index but for drugs that have a narrow curative index, a simple overdose could be fatal. There is merely so much a prescriber could make but hanker term attending is indispensable to guarantee that patients get the best out of their medicine particularly in those who have multiple co-morbidities. The attack of CMS is through the constitution of curative partnerships between general medical practicians, druggists and patients to better patient attention by guaranting better local entree to wellness care6. Fostering such commitment will minimise duplicate of functions and, with good defined functions, can advance a holistic attack to the pharmaceutical and clinical attention of patients6. The end is to assist patients harvest the most out of their medical specialties but besides minimise any associated risks4. Community druggist is frequently the first and lone point of call. Community druggists can bridge the spread in a patient ‘s journey of attention and therefore better the whole curative class by expecting, placing, deciding and forestalling medicine-related issues4,9. These medicine-related issues include: Safety and efficaciousness Side effects Conformity and harmony Identify markers of hapless control Symptom specific markers to motivate referral Supplying and advancing wellness information and instruction CMS is a service that requires patients ‘ voluntary engagement and is by and large broken down into 3 phases. Phase 1 involves the enrollment of the patient for the service. Stage 2 involves the debut of a generic model for pharmaceutical attention planning. Phase 3 is the constitution of the shared attention component between the GP and the community pharmacist6. A pharmaceutical attention program paperss the patient ‘s pharmaceutical attention demands, attention issues, desired results and actions required as portion of the pharmaceutical attention planning of the patient. Figure 1 summarizes the pharmaceutical attention be aftering rhythm. Identify and prioritise patients with pharmaceutical attention demands Identify and reexamine pharmaceutical attention issues Implement and proctor pharmaceutical attention program Formulate and document a pharmaceutical attention program Figure 1: Pharmaceutical Care Planning Cycle To get down of with attention planning, critical information that may act upon the attention program such as patient ‘s general wellness, allergic reactions or sensitivenesss, other medical conditions and hazard factors are noted. A hazard appraisal is so made to help the druggist in placing and prioritising any pharmaceutical attention needs that a patient might necessitate or is deprived from in footings of service, which as a consequence influences the therapy6. Next, an appraisal is made to place and reexamine the patients pharmaceutical attention demands and refering issues. This can enable the druggist to measure the medical specialties regimen that a patient is on in footings of efficaciousness or toxicity profile and besides allows the druggist to measure how deep the patients understand their medicines and intervention and the extend of their wellness believes. Subsequently, a pharmaceutical attention program is drafted based on the attention issues that have been iden tified with the understanding of the patient. This attention program serves as a protocol in which issues are placed on a hierarchy of precedence, outcome ends are defined, proposals to any class of action documented every bit good as clearly specifying the health care forces and their duties for assorted monitoring that ought to be conducted. Changeless reappraisals and monitoring is done to measure the results of the attention program upon execution and alterations are made along the manner, when required, to maximise the curative result. To accomplish the maximal curative benefit, the patient ‘s wellness belief and apprehension of the therapy is indispensable. Hence, reding and advice by the druggist before, during and after the procedure is good. Chronic Heart Failure ( CHF ) is one of the 13 long-run disease provinces covered in the CMS protocol stand foring the most frequent indicant for therapy4. The list of all 13 disease provinces are listed in Appendix 2. Heart Failure is one of the most crippling medical conditions which can badly impact a patient ‘s quality of life hence seting force per unit area on hospitalization and health care budgets10. The Scots Intercollegiate Guidelines Network ( SIGN ) defines CHF as a complex clinical syndrome ensuing from any structural/ functional upset that impairs the ability of the bosom to react to physiological demands for increased cardiac output11. Hence, bringing of blood is compromised12. Abnormality in cardiac construction, beat, map or conductivity can all take to unequal perfusion, venous congestion and disturbed H2O and electrolyte balance that underlie CHF13. In add-on, normal compensatory mechanisms become compromised taking to maladaptive secondary physiological effe cts that contribute to the progressive nature of the disease12. CHF can be a effect of assorted underlying complications such as myocardial infarction and/or high blood pressure and the most common being left ventricular systolic disfunction ( LVSD ) . Coronary arteria disease, aortal stricture, dilated myocardiopathy, alcoholic myocardiopathy, Chagas ‘ disease, endomyocardial fibrosis and other mechanical defects such as cardiac valvular disfunction, degenerative valve disease, arthritic valve disease, terrible anaemia and thyrotoxicosis are the more common causes of CHF around the Earth but other rarer causes do exist12,13. Management of these predisposing factors can be good in relieving the symptoms of bosom failure. Table 1 is the New York Heart Association ( NYHA ) categorization system used to sort patients with bosom failure based on their functional position. Table 2 is ACC /AHA phases of HF ; a addendum to the NYHA categorization. It is estimated that there is a prevalence of about 1-2 % for bosom failure in developed countries10,14. The life-time hazard of developing HF is approximately 20 % for patients above 40 old ages old and besides the taking cause of hospitalization for patients above 65 old ages old10,14. Harmonizing to the European Society of Cardiology, above 15 million patients are diagnosed with HF in 51 European states consisting a population of around 900 million15. The prevalence of HF is about 1-2 % in the western society and the incidences are between 5-10/ 1000 instances per annum16. A recent US population-based survey, the prevalence of bosom failure was 2.2 % ( 95 CI 1.6 % to 2.8 % ) , increasing from 0.7 % in individuals aged 45 through 54 old ages to 8.4 % for those aged 75 old ages or older17. Similar minor expense forms, 1 % for the 55-64 age group increasing to 13 % in the 75-84 age group was observed from the Rotterdam study18. In the contrary, for the below 50 age group, incidences of HF are rare16. Improved endurance from acute myocardial infarction ( MI ) coupled with the aging population contributes to the spike in incidence and prevalence of HF19. One critical function community pharmacist drama is to advice and offer guidance on a healthy life style. Lifestyle and dietetic alterations are schemes aimed at forestalling cardiovascular diseases ( CVD ) which are possible predisposing factors taking to CHF. The development of CVD is affected by multiple dietetic factors and an overall healthy diet will significantly cut down the hazard of CVD20. Consumption of fruits, veggies, grain merchandises, low-fat dairy merchandises and curtailing the sum of salt and unstable consumption are all portion of a well balanced diet11,21. Keeping a healthy organic structure weight is indispensable as fleshiness is an independent hazard factor for CVD. Morbid fleshiness has a strong association with mortality from CVD particularly in immature grownup males. Therefore, bar of fleshiness has to be taken early and in an aggressive manner22. Keeping optimum blood force per unit area, blood glucose every bit good as a desirable lipid profile is advise d to command or lower the hazard of CVD21. Maintaining physical and cardiovascular fittingness and a healthy weight can be achieved by changeless physical activities as it improves cardiovascular hazard factors every bit good as take downing the hazard of developing other chronic diseases21,23. Evidence has proven the strong association between smoking and cardiovascular jeopardies every bit good as the benefits of smoking cessation24. Therefore, look intoing the smoke position of patients and offering intercession where appropriate will be good to patients peculiarly in those who are at hazard of enduring from cardiovascular events24. Patients with CHF should be advised to discontinue smoking11. Moderate ingestion of intoxicant should besides be advised as extra alcohol ingestion can increase the hazard of CVD11,25. The above are merely the chief life style and dietetic parametric quantities that should be addressed with precedence to command or lower CVD hazards. Such steps should non be seen as stairss taken to forestall CVD but instead as stairss taken to promote everybody to populate a healthy life style to forestall any signifier of disease provinces. Psychosocial and psychological hurt have a important impact in morbidity and mortality after HF and hence societal and relationship factors may play an of import function in pull offing chronic conditions such as CHF26. The ends of intervention are to better quality of life11,13. Angiotensin Converting Enzyme Inhibitors ( ACEi ) Evidence has shown that ACEi therapy is good in take downing mortality, MI and rehospitalization for patients enduring from HF with LVD or HF with or without a recent MI27. A meta-analysis has shown that patients with CHF prescribed with an ACEi have a 23 % decrease in mortality and a 35 % decrease in rehospitalization27. Further meta-analysis is patients with LVSD, HF or both after MI has a comparative decrease in mortality rate of 26 % 27. Therefore, ACEi therapy is recommended in patients with all NYHA functional categories of HF due to LVSD11. Adverse effects include cough, hypotension, nephritic damage, angio-oedema and hyperkaelaemia. Dose titration and nephritic and electrolyte monitoring should be included in the attention program particularly in susceptible patients utilizing other medicines so that intercession could be established in instances where inauspicious effects are marked. Beta Blockers Treatment with bisoprolol, carvedilol and Lopressor Forty shows a decrease in mortality in patients with advanced HF based on the CIBIS- II, COPERNICUS, and MERIT-HF tests severally. Beta-blockers benefits in HF by demoing a 29 % decrease in hazard of mortality in CVD, 36 % decrease due to pump failure and all cause mortality decrease of 23 % 28. All patients with HF due to LVSD of all NYHA functional category should be started on beta-blockers every bit shortly as their status is stable and should be the first line picks for patients with CHF due to LVSD11. The effects of beta-blockers might non be seen instantly. Furthermore, deterioration of HF and hypotension might be present at the get downing hence dose should be titrated up suitably upon supervising. Beta-blockers are contraindicated in those with asthma, bronchospasm, 2nd or 3rd degree auriculoventricular bosom block or diagnostic hypotension11. Angiotensin II Receptor Blocker ( ARB ) ARBs antagonizes the binding of angiotonin II to its type 1 receptor hence exercising its action similar to ACEi ‘s with the benefit of non bring forthing dry cough as a side effect13. In CHARM Alternative, ARB intervention led to a comparative decrease of 23 % in primary result of CV deceases or rehospitalsation for patients with CHF having candesartan who are intolerant to ACEi29. The add-on of ARB to ACEi or beta-blocker intervention non merely had no consequence on mortality but markedly reduced HF rehospitalisation and mortality combined30. Patients with CHF due to LVSD, HF or LVSD or both station MI who are intolerant to ACEi should be considered for ARBs whilst patients with HF due to LVSD who are still diagnostic despite already on ACEi and beta-blockers, add-on of candesartan might be beneficial11. Aldosterone Adversaries Aldosterone adversary has been studied in patients with terrible diagnostic HF, led to a pronounced decrease in mortality and morbidity and improved symptoms13,31. It is recommended for patients with HF in NYHA category III and IV despite being on ACEi and beta-blocker while there is no grounds that Aldactone has any benefits in mild HF11,13. The RALES test has shown that the add-on of Aldactone to an ACEi yielded an all cause mortality of 30 % and cardiac mortality by 31 % 31. However, aldosterone adversaries produce many inauspicious effects on vascular map and myocardial fibrosis11. Spironolactone produces gynaecomastia, hyperkaelaemia, and nephritic disfunction hence blood carbamide, creatinine and electrolyte monitoring is essential11. Patients with terrible HF due to LVSD should be on Aldactone unless contraindicated11. Eplerenone can be used if patients are intolerant to spironolactone as grounds from EPHESUS survey has demonstrated a 13 % decrease from CVD or hospitalization for CVD and 21 % comparative rate of sudden decease in patients on eplerenone32. Diuretic drugs Fluid keeping doing ankle hydrops, pneumonic hydrops or both consequences in symptoms of dyspnea in most patients enduring from HF11. A meta-analysis supports that diuretic therapy is good for patients with dyspnea or hydrops with a 75 % decrease in mortality and 63 % betterment in exercising capacity33. The hazard of loop water pills doing hypokalaemia is offset by ACEi, ARBs and Aldactone. Therefore, monitoring of serum K is of import. Doses of water pills should be individualized to minimise unstable keeping taking into history the possibility of desiccation and nephritic impairments11. Digoxin In a Cochrane reappraisal, patients on Lanoxin showed a 64 % betterment in symptoms and a 23 % decrease in hospitalization but unluckily no betterment seen on survival34. Digoxin should be considered as an accessory therapy for instances in which patients with HF in fistula beat are non relieved on optimal therapy11. There are many issues associated with the usage of Lanoxin because of its narrow curative index, some of which are fatal such as its ability to increase the possibility of sudden decease and the hazard of toxicity in instance of hypokalaemia11. Therefore, the hazard over benefit of Lanoxin therapy should be carefully considered in the best involvement of the patient.