Effectiveness of Magnesium Sulfate †Free Samples to Students

Question: Discuss about the Effectiveness of Magnesium Sulfate. Answer: Introduction Status asthmaticus is a severe form of prolonged asthma attack that makes people fail to respond to usual treatment methods. Asthma is a chronic lung disease where the respiratory airways become narrow and inflamed (Pawankar et al. 2012). The case study reports an incident of acute asthma attack on a patient Ms. Elise Wattle and he treatment upon admission to the emergency department. Asthma is a chronic inflammatory disease associated with the lungs and the airways. It affects more than 300 million people worldwide, belonging to all age groups (Ferkol and Schraufnagel 2014). It develops due to inflammation and swelling of the airways that obstructs airflow and leads to the production of thick and sticky mucus from the airways. The muscles in and around the passage constrict and this in turn reduces the diameter of the airways (Niimi et al. 2013). The most common symptoms of asthma are shortness of breath, wheezing sounds, chest tightness and cough particularly during early morning or at night. These symptoms arise due to airflow obstruction that can be reversed if a patient is subjected to proper treatment. Environmental factors like exposure to several allergens like pollen, dust and dander from dogs and cats increase incidence of asthma. Other irritants that can cause asthma are exhaust fumes from automobiles, chemicals, molds, tobacco smoke, stress and medicat ions like beta blockers and aspirin (Bisgaard, Jensen and Bnnelykke 2012). Elises condition progressed to status asthmaticus. Such acute asthma attacks can occur when the symptoms worsen over time due to bronchospasm or muscle tightening around the airways (Papaiwannou et al. 2014). Thicker mucus will be secreted and the inner lining of the airways will get more inflamed. The symptoms of acute asthma attack are severe wheezing or squeaking sound, continuous coughing, rapid breathing, retractions or tightened chest and neck muscles, difficulty in conversing, anxiety or panic attacks, sweaty face and finger nails turning blue. Airflow limitation occurs due to bronchoconstriction, edema in the airways, hypersecretion of mucus and hyper-responsiveness in bronchi. The symptom related to problems in conversing is demonstrated by the fact that Elise was able to speak in sentences. However, her condition gradually worsened over time and she could barely speak short phrases. The wheezing symptoms are quite audible, which depicts the build-up of mucus in her bronchial tubes. During the acute asthmatic attack, the bronchial airways become smaller. This is responsible for the sounds that were heard when Elise spoke. The dyspnoeic symptoms observed in the patient are due to a deficit formed between breathing demands of her body and the ability of her respiratory system to fulfill the demands. Persistent cough may be the effect of constriction in her breathing tubes. Upon admission to the emergency department, Elise was kept at high Fowlers position to facilitate easy breathing and expansion of her chest cavity. This position allows optimal diaphragm expansion and reduces shortness of breath. However, Elise continued to cough and did not show any improvements. Her blood pressure was found to be 150/90 mm Hg, which indicated stage 1 hypertension (Hoeper et al. 2013). The normal blood pressure in an adult is 120/80 mm Hg. If the readings vary between 140/90-150/99, it signifies that the blood is flowing with a higher force inside the arteries. It can lead to dizziness and will make the patient at an increased risk on the spectrum of cardiovascular diseases (coronary heart disease, stroke, and congestive heart failure), renal failure and vision impairment (Busse et al. 2012). Her pulse was found to be 126 bpm. This pulse rate is considered higher than the normal levels of 60-100 in an adult. Such elevated pulse rates are referred to as tachycardia. It occurs when the heart pumps blood at a faster rate that leads to inefficient circulation of blood to the body parts. When Elise experienced an acute asthmatic attack, there was deficiency of oxygen in her body cells. Her breathlessness made it difficult for the blood to receive enough oxygen. Thus, her heart started to pump rapidly in an effort to meet the oxygen demand and this gave rise to an increased pulse. Psychological factors may also be responsible for this increased pulse rate. An acute asthmatic attack often leads to panic and anxiety. That increases the heart rate and thereby elevates the pulse. Her respiration was shallow and 30. At rest the normal breathing rate in adults is 8-16 per minute. Elise exhibited a high respiratory rate, which is generally denoted by the term tachypnea. Minimal air was drawn into the lungs by the action of intercostal muscles. The asthmatic condition of the patient is the principal reason for this vital sign. Moreover, shortness of breath and rapid pulse elevated her respiration rate (Vestbo et al. 2013). Normal human body temperature is around 37C and Elise did not show much variation (37.3C). This is due to the fact that asthma generally does not lead to chills, fever and muscle ache. Her pulse oximeter readings were 92%. An oxygen saturation level beyond 95% is considered normal. A reduction in her oxygen levels suggested oxygen deficiency in her arterial blood, which occurred as a result of breathing difficulty. Elevated levels of IgE and eosinophils in sputum and blood tests revealed persistent allergy. Allergens are a major cause of asthma . Her high IgE levels indicated that she is exposed to more than one allergy. This proves that hypersensitivity to local allergens and increase in serum IgE are associated with her symptoms of asthmatic attack and wheezing. Several research studies show that an increase in the number of eosinophils, correlate with severity of asthmatic attacks (Korevaar et al. 2015). Eosinophils and neutrophils lead to cellular inflammation of the bronchi passages. When these white blood cells reach the airways, they release chemical contents that cause airway inflammation and blockage of the nasal passage and sinuses. Thus, the increased level of eosinophil in the patient triggered exposure to asthmatic symptoms. Her ABG results showed a pH of 7.49, which is more than the normal range of 7.35-7.45. Her pCO2 is 22 mg Hg ( normal range of 35-45 mm Hg). This suggests likely presence of alkalosis or alkalemia condition in her body due to probable reduction of concentration of hydrogen ions. Her condition suggests respiratory alkalosis that might have occurred due to hyperventilation and may lead to a loss of carbon dioxide. Moreover, the pO2 levels are found to be 74 mm Hg ( normal range of 80-100 mm Hg). This low pO2 level suggests that the lungs are not effective in pulling oxygen gas into the blood stream. This occurred due to her asthmatic attacks that are a form of chronic pulmonary disease. Her HCO3 levels were 22 mEq/L, which shows compliance with the normal range of 22-26 m Eq/L. This does not provide any evidence for the presence of primary metabolic disorders in her system. Normal blood sugar levels range between 4.0-6.0 mmol/L during fasting and upto 7.8 mmol/L, 2 hours post eating. Elises serum glucose levels were 5.0mmol/L, within the normal range that suggests she is non-diabetic. Her blood urea nitrogen levels are 6.2 mmol/L that falls in the normal range of 2.5-7.1 mol/L. Normal serum creatinine levels for women are 45-90 mol/L. Her creatinine levels fall in this range. Thus, it can be deciphered that her liver and kidneys are functioning properly (Brisco et al. 2013). The serum sodium and potassium levels were 136 mEg/L and 4.5 mEg/L that fall within the normal ranges of 135-145 mEg/L and 3.5-5.0 mEg/L respectively. Her normal sodium levels indicate that she is not suffering from hypernatremia or hyponatremia and has normal electrolyte balance in her body (Sahan et al. 2013). Potassium levels within normal range show that her muscles are working properly and there is no occurrence of hyperkalemia condition (Raimondi et al. 2013). Her RBC, WBC and platelet count falls within the normal range of 3.6-5.0 millio/mm3, 5000-10,000/mm3 and 200,000-500,000/mm3 respectively. Normal haematocrit level ranges from 34.9-44.5% for women. A count of 34.7% in Elise shows little deviation which is of little significance. The pulse oximeter reading of 85% provides evidence for supplemental oxygen needs. The pH reading of 7.32 suggests presence of acidosis. pCo2 level of 60 mm Hg indicates respiratory acidosis, which probably occurred due to hypoventilation caused by the asthmatic attacks (Ionescu 2013). For a 10 unit increase in pCO2, the amount of HCO3 rises by 4 mmol/L. Elises HCO3 level of 27 supports this fact. A low pO2 level of 55 mm Hg represents a reduction in the amount of oxygen levels in the inhaled air. It also supports the occurrence of severe pulmonary disease that leads to blockage of the respiratory airways. Abnormalities in lung functioning are detected by spirometry tests that use 2 measurements, FVC (forced vital capacity) and FEV1 (forced expiratory volume one second). The normal range of FEV1/FVC is equal to or more than 70%. A mild abnormali ty of 65% means that the patients lungs are unable to fill air to their normal capacity and are caused due to decrease in the airflow. This has occurred due to the presence of obstructive lung disease. 5 mg salbutamol is administered to the patient through a nebulizer owing to its bronchodilator properties. Salbutamol is a drug that stimulates the 2 adrenergic receptors in the smooth muscles of the bronchi. Upon stimulation, these receptors activate the adenyl cyclase enzyme to form cyclic AMP form ATP. Increased cyclic AMP leads to relaxation of the bronchial smooth muscles and reduces the blockage in airways (Patel et al. 2013). Furthermore, it leads to inhibition of histamine, mast cell and leukotreine release in the airways. Nasal prongs are used to deliver supplemental oxygen to Elise to increase the airflow in her lungs. It will help to deliver oxygen at a concentration of 22-50% flow rate for 1-6 L/min. Magnesium sulphate used in the nebulizer acts as an inhibitor of smooth muscle contraction and reduces the release of histamine and acetylcholine. It therefore functions as a bronchodilator, opens the airways and reduces inflammation of the respiratory passages (Torres et al. 2012). Dose of 500 mcg ipratropium bromide is given to control shortness of breath and wheezing symptoms reported by Elise. This is used in combination with salbutamol to reduce congestion of the respiratory tract and prevent further worsening of symptoms of obstructive pulmonary diseases (Short et al. 2013). Venturi mask was used to deliver specific oxygen concentration in her blood. A 6 hourly administration of hydrocortisone is administered based on its property of reducing inflammation of the bronchial tubes (Short et al. 2012). This is a systemic corticosteroid that controls narrowing of the airways and decreases the amount of mucus formed. Thus, breathing gets facilitated. Administration of adrenaline with 5% dextrose is followed based on their bronchodilator effects. Adrenaline reduces bronchospasms that opens the airways and allows better airflow through the lungs. It also reverses any kind of allergic reaction in the body that may have led to the development of asthma. IV drip of 5% dextrose is given to compensate for the excess loss of water from the lungs (Sellers 2012). Dextrose administration helps in augmenting fluid loss and reduces the tenacity and thickness of the sputum. It helps in adequate hydration of the patient and in restoring the electrolyte balance in the body (Albertson, Sutter and Chan 2015). If salbutamol exceeds the prescribed dose, it can lead to uneven heart beat, hypokalaemia (low potassium levels), muscle cramps, dryness of mouth, headache and dizziness. Potential side effects of magnesium sulphate include hypotension, flushing, anxiety, muscle tightness, dizziness and irregular heart beat (Vasquez et al. 2014). Side effects of ipratropium and hydrocortisone include sedation, dryness of mouth, skin flushing, nausea, glaucoma, tachycardia and palpitations (Coondoo et al. 2014). Administration of ipratropium through a nebulizer often leads to urinary retention among patients. Salbutamol can interact with other bronchodilators and show severe effects on the cardiovascular and nervous system. Dietary components that include caffeine can interact with salbutamol and cause excitability in the patient (Skidmore-Roth 2013). Interaction of the bronchodilators with grilled meat can lead to unmanageable asthmatic attacks. Conclusion Thus, from the above case study it can be deciphered that Elise Wattle suffered from an asthmatic attack following which she was admitted to the hospital. When her condition worsened, the ABG levels showed huge deviations from the normal values indicating that there was less supply of oxygen in her blood stream due to blockage of the airways. She was given proper medications of bronchodilators and her fluid balance was also restored. On reaching a stable condition, she was transferred to the ICU. Thus, it can be concluded that the medications worked well to relieve her asthmatic symptoms. References Albertson, T.E., Sutter, M.E. and Chan, A.L., 2015. The acute management of asthma.Clinical reviews in allergy immunology,48(1), pp.114-125. Bisgaard, H., Jensen, S.M. and Bnnelykke, K., 2012. Interaction between asthma and lung function growth in early life.American journal of respiratory and critical care medicine,185(11), pp.1183-1189. Brisco, M.A., Coca, S.G., Chen, J., Owens, A.T., McCauley, B.D., Kimmel, S.E. and Testani, J.M., 2013. The Blood Urea Nitrogen to Creatinine Ratio Identifies a High Risk but Potentially Reversible Form of Renal Dysfunction in Patients with Decompensated Heart Failure.Circulation: Heart Failure, pp.CIRCHEARTFAILURE-112. Busse, W.W., Morgan, W.J., Taggart, V. and Togias, A., 2012. Asthma outcomes workshop: overview.Journal of Allergy and Clinical Immunology,129(3), pp.S1-S8. Coondoo, A., Phiske, M., Verma, S. and Lahiri, K., 2014. Side-effects of topical steroids: A long overdue revisit.Indian dermatology online journal,5(4), p.416. Ferkol, T. and Schraufnagel, D., 2014. The global burden of respiratory disease.Annals of the American Thoracic Society,11(3), pp.404-406. Hoeper, M.M., Bogaard, H.J., Condliffe, R., Frantz, R., Khanna, D., Kurzyna, M., Langleben, D., Manes, A., Satoh, T., Torres, F. and Wilkins, M.R., 2013. Definitions and diagnosis of pulmonary hypertension.Journal of the American College of Cardiology,62(25 Supplement), pp.D42-D50. Ionescu, C.M., 2013. The human respiratory system. InThe Human Respiratory System(pp. 13-22). Springer London. Korevaar, D.A., Westerhof, G.A., Wang, J., Cohen, J.F., Spijker, R., Sterk, P.J., Bel, E.H. and Bossuyt, P.M., 2015. Diagnostic accuracy of minimally invasive markers for detection of airway eosinophilia in asthma: a systematic review and meta-analysis.The Lancet Respiratory Medicine,3(4), pp.290-300. Niimi, A., Ohbayashi, H., Sagara, H., Yamauchi, K., Akiyama, K., Takahashi, K., Inoue, H., Wakayama, T., Kobayashi, H., Hasegawa, M. and Kimura, G., 2013. Cough variant and cough-predominant asthma are major causes of persistent cough: a multicenter study in Japan.Journal of Asthma,50(9), pp.932-937. Papaiwannou, A., Zarogoulidis, P., Porpodis, K., Spyratos, D., Kioumis, I., Pitsiou, G., Pataka, A., Tsakiridis, K., Arikas, S., Mpakas, A. and Tsiouda, T., 2014. Asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS): current literature review.Journal of thoracic disease,6(Suppl 1), p.S146. Patel, M., Pilcher, J., Reddel, H.K., Pritchard, A., Corin, A., Helm, C., Tofield, C., Shaw, D., Black, P., Weatherall, M. and Beasley, R., 2013. Metrics of salbutamol use as predictors of future adverse outcomes in asthma.Clinical Experimental Allergy,43(10), pp.1144-1151. Pawankar, R., Canonica, G.W., Holgate, S.T. and Lockey, R.F., 2012. Allergic diseases and asthma: a major global health concern.Current opinion in allergy and clinical immunology,12(1), pp.39-41. Raimondi, G.A., Gonzalez, S., Zaltsman, J., Menga, G. and Adrogu, H.J., 2013. Acidbase patterns in acute severe asthma.Journal of asthma,50(10), pp.1062-1068. Sahan, M., Y?lmaz, M., Gokel, Y., Erden, E.S. and Karakus, A., 2013. Nebulized salbutamol for asthma: Effects on serum potassium and phosphate levels at the 60min.Revista portuguesa de pneumologia,19(5), pp.200-203. Sellers, W.F.S., 2012. Inhaled and intravenous treatment in acute severe and life-threatening asthma.British journal of anaesthesia,110(2), pp.183-190. Short, P.M., Williamson, P.A. and Lipworth, B.J., 2012. Effects of hydrocortisone on acute ?adrenoceptor blocker and histamine induced bronchoconstriction.British journal of clinical pharmacology,73(5), pp.717-726. Short, P.M., Williamson, P.A., Anderson, W.J. and Lipworth, B.J., 2013. Randomized placebo-controlled trial to evaluate chronic dosing effects of propranolol in asthma.American journal of respiratory and critical care medicine,187(12), pp.1308-1314. Skidmore-Roth, L., 2013.Mosby's 2014 nursing drug reference. Elsevier Health Sciences. Torres, S., Sticco, N., Bosch, J.J., Iolster, T., Siaba, A., Rocca, R.M. and Schnitzler, E., 2012. Effectiveness of magnesium sulfate as initial treatment of acute severe asthma in children, conducted in a tertiary-level university hospital: a randomized, controlled trial.Archivos argentinos de pediatria,110(4), pp.291-296. Vasquez, M.I., Lambrianides, A., Schneider, M., Kmmerer, K. and Fatta-Kassinos, D., 2014. Environmental side effects of pharmaceutical cocktails: what we know and what we should know.Journal of hazardous materials,279, pp.169-189. Vestbo, J., Hurd, S.S., Agust, A.G., Jones, P.W., Vogelmeier, C., Anzueto, A., Barnes, P.J., Fabbri, L.M., Martinez, F.J., Nishimura, M. and Stockley, R.A., 2013. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary.American journal of respiratory and critical care medicine,187(4), pp.347-365.

While the Wheel Keeps Spinning A Gradual Descent into Delightful Madness

Table of Contents Introduction: When Life Is at Stake Watching the Lead Character: Through Misery Lens Escaping the Tight Grip of Despair A Playing of Fortune: Take Him Where the Wind Blows The Moment the Earth Stood Still Conclusion: Watch the Wheel Spinning Reference List Introduction: When Life Is at Stake Though it is truly hard to say that the motif of gambling is new to most of the world literature would be a considerable stretch, it goes without saying that Ellison adds a specific touch to it, making his story – that is, the story of a man who is slowly descending into madness – incredibly vivid. Instead of moralizing over the issueAdvertising We will write a custom essay sample on While the Wheel Keeps Spinning: A Gradual Descent into Delightful Madness specifically for you for only $16.05 $11/page Learn More Watching the Lead Character: Through Misery Lens When knowing what the story is going to end with, it is quite shocking t o see that it starts from a typical setting in the most typical place ever. Telling a story of a man whose wife is gradually dying while he cannot do a thing about it, the story immediately sets a gloomy background. Even though it is generally considered that the protagonist loses his mind in the process of the game: â€Å"His faith in a bingo game turns into madness that ends with violence† (Thomas, 2008, 98). However, it can be argued that the character starts his descent into madness much earlier – to be more exact, from the very beginning of the novel. â€Å"I ain’t crazy† (Ellison, n.d., 469), he says, as if trying to convince himself. Ellison only sets the mood for the rest of the story, but also indicates that the character will be soon undergoing a series of changes. Escaping the Tight Grip of Despair Another circle of madness begins at the point where Ellison explains that the protagonist’s wife is terminally ill. Devoting a great chunk of the story to developing these two characters and the relationships between them Ellison makes it clear that her being unwell adds to the lead character’s torments. Another spin of insanity starts as the author reveals that the lead character drinks quite a lot. However, the major point, which is practically the gateway to insanity for the leading character, starts with a sudden stream of consciousness bursting under the pressure of the alcohol fumes: â€Å"The bottle gurgled again. He closed his eyes [†¦] and seeing the train coming, and running back as fast as he could go, and hearing the whistle blowing [†¦]† (Ellison, n.d., 470). One of the most graphic scenes in the book, this one in particular shows the readers how far the lead character’s insanity can go.Advertising Looking for essay on american literature? Let's see if we can help you! Get your first paper with 15% OFF Learn More A Playing of Fortune: Take Him Where the Wind Blows Slowly gaining momentum, the madness of the lead character manifests itself in the most obvious way during the game. One can see it picking a faster pace in every single sentence: â€Å"He watched the wheel whirling past the numbers and experienced a burst of exaltation: This is God! This is the really truly God! He said it out loud, ‘This is God!’† (Ellison, n.d., 473). Finally, as the lead character’s turn comes to take part in the game, he loses control over his feelings, and all hell breaks loose: â€Å"’Who am I?’ he screamed† (Ellison , n.d., 475). As the madness progresses, the turmoil enters into an even more intense phase. It is quite peculiar that the magnificence of madness that grips the lead character is spilled out in the form of a silly song: â€Å"Shoot the liquor to him, Jimmy boy! / Clap-clap-clap† (Ellison, n.d., 476). The pace of the entire story somehow reminds of a music tempo, which starts at the slowest pace: â€Å"The woman in front of him was eating roasted peanuts† (Ellison, n.d., 469), progresses to the fastest one: â€Å"He stumbled down the aisle and up the steps to the stage† (Ellison, n.d., 471) and ends with the slowest pace again: â€Å"he did not see the man’s slow wink† (Ellison, n.d., 477). The Moment the Earth Stood Still One must give Ellison credit for being extremely subtle with the ending of the novel. It is quite peculiar that author does not say that the lead character dies. Ellison does not need to state the painfully obvious; instead, he develops even more details and conveys the subtle message of despair, making the latter shoot the entire novel through: â€Å"He only felt the dull pain exploding in his skull, and he knew even as it slipped out of him that his luck had run out on the stage† (Ellison, n.d., 477). It is also quite peculiar that for a moment, the leading character does get in touch with reality, only to underst and that he is going to be dead in the next few moments. A tragic climax to a tragic story, the ending leaves the impression that a delicate mechanism suddenly went wrong and finally broke into pieces.Advertising We will write a custom essay sample on While the Wheel Keeps Spinning: A Gradual Descent into Delightful Madness specifically for you for only $16.05 $11/page Learn More Conclusion: Watch the Wheel Spinning Though King of the bingo game cannot be called the most thrilling read, it definitely has a unique flair and a specific touch to it, which makes the reader sink into the imaginary world, taking it for granted. Though told in a very brief manner and pointing at the most essential moments and details, the story still makes the audience sympathize with the lead character. With the help of specific pacing, the author adds a sharp edge to the narration, taking the reader into the imaginary reality. Let the game begin. Reference List Ellison, R. ( n.d.) King of the bingo game. Retrieved from https://www.csus.edu/indiv/m/maddendw/King%20Bingo%20Game.pdf Thomas, P. L. (2008). Reading, learning, teaching Ralph Ellison. New York, NY: Peter Lang. This essay on While the Wheel Keeps Spinning: A Gradual Descent into Delightful Madness was written and submitted by user Yaretzi Williamson to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Library Career Goals Essay Mistakes

Library Career Goals Essay MistakesWhen it comes to writing a library career goals essay, there are some things that you need to keep in mind. These may help you in completing your library career goals essay without making any mistakes. In fact, some of the mistakes may actually improve your library career goals essay writing.The first mistake that many people make when writing a library career goals essay is making some grammatical errors. This happens because they either cannot read the content of the library career goals essay sample or else they do not know how to write the content. So, they make the mistakes in their writing. Make sure that you pay attention to the writing styles of the sample so that you can put the same style to your own essay. If you want to make the writing style in the sample for your own essay, make sure that you are going to put the same format to your own.Some of the basic mistakes that people commit in writing a library career goals essay include adding links and acronyms to the content. Some people even add the word 'yet' after every sentence or paragraph. Make sure that you do not add such mistakes to your essay. Even if you do not add such errors, it will not be bad at all if you just change your formatting.The second mistake that many people commit in writing a library career goals essay is choosing the correct college for the college major that they are going to choose. Before you start your library career goals essay, make sure that you check out whether the college is offering the best possible degree program for the college major that you have chosen. If not, then change your college choice. If it is not possible to change the college that you have chosen, then try to find a college that has the same subject matter but different name. The name of the college is not important while writing the library career goals essay.One of the other mistakes that many people commit in writing a library career goals essay is choosing the wrong topic. Many people simply want to write about the job that they have been offered by the college. The essay should not just focus on the career. The topic of the essay should be related to the course that you have chosen.Another thing that many people forget while writing a library career goals essay is the timeline of the job. You need to add the date of joining the library service or the date of getting a job. Thus, the content of the essay will be more relevant.These are some of the mistakes that you need to avoid while writing a library career goals essay. These mistakes are not only confined to the writing itself but also to the content. If you do not know how to write the content of the essay, then you should hire an editor to help you with this. However, if you do not know how to write the content, then do not worry.

Fifth business by Robertson Davies Essays

Fifth business by Robertson Davies Essays Fifth business by Robertson Davies Paper Fifth business by Robertson Davies Paper In a way he is imprisoning himself with Boys affairs yet Boy doesnt seem to mind at all. The narrator has nothing and nobody in his life and the only thing he relates to are Boys affairs and he explains everything Boy does against Leola that Boy truly loves her and that all the other girls mean nothing. Then in the final paragraphs the narrator remembers Hahn 4 his past experiences with the physical act of love and how much pleasure it provided him. Now it annoyed [him] that Boy had her, although he doesnt want her but he wants to simply find someone to love his disfigured body. The narrator believed that Leola really loved him but that Boy made her believe differently. With this fact in the back of his had he was sour about the whole business although he didnt even want her back. The last paragraph talks about the narrator wanting what he had last when Diana left him since he often yearned for her. The relationship between Leola and Boy has revoked the inner feelings in the narrators heart, causing him to want somebody to love and simply become a normal human being again; accepting who he was and what has happened to him. : In the middle of this passage the narrator describes Leola staying an engaged girl and about Boys weekly visits to do some heavy petting with Leola. It also talks about Boys experience with gay girls who were experts in French kisses. This part of the passage as explained very thoroughly. Foreshadowing, which is present in this section. The narrator talks about this so in detail because later on in the passage he mentions that Leola had once thought she loved him, meaning the narrator could be the lucky man not Boy. It also foreshadows that the narrator wants to find some other girl like Leola, so he can share with her what he had with Diana. This extract ends with an allegory, the narrator realizes that what Boy has he doesnt really want but he wants a girl to love and that loves him. He knew Diana would try to make him something he was not but that did not stop [him], often and painfully, Hahn 5 from wanting her. He rejects the fact that he wants what Boy has all along yet what he really wants is a girl like Leola or Diana. This passage can be very deceiving at first sight, it seems as if it is about the narrator having a struggle between himself and comparing himself to Boy who seems to have everything but he doesnt want any of it. Yet underneath all this allusion it can be observed that the narrator really wants a girl and someone to love him. He also doesnt think Boy has earned everything he has since he hasnt been disfigured like the narrator has. I think this is a very powerful passage, of course I cant relate to it since I dont know how it feels to be so disfigured. Yet I do know how it feels to love someone and be with him or her all the time and then all of a sudden lose them. This was the worst feeling I have ever had, and that feeling combined with a disfigured body must be terrifying. Also seeing Boy who hasnt been injured in the war and has a woman like the narrator wants, using her simply as an object of lust. I believe the narrator couldnt experience more pain at moment. He has experienced pain, jealousy and envy as thoroughly as anyone will ever experience these feelings.

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Informal Memo Proposal - Coursework Example The first proposal seeks to address the procedures that businesses can adopt when contemplating transactions with another business. The organizations can adopt proper consultation and procurement procedures to create room for growth and stay afloat in the market. The second proposal aims at finding the current strategies that are used by organizations to prevent credit card fraud and data breaches that happen behind closed doors. The data breaches and card fraud activities are illegal, and they hamper efficient operations that relate to customers and the organizations. The main purpose of proposal #1 is to address the b2b transactions for the interest of the customers and individual organizations. The transactions help business to institute pricing strategies, contracts and product and services as per the prevailing demands in the market. The primary aim of proposal #2 is to provide a platform that can be used to educate institutions on the methods they can take to prevent card fraud. Cards that are lost stolen or counterfeited affect consumers and businesses that offer the credit card services. The consequences come in the form of profits and legal action. Proposal 2 targets credit card companies, individual online business owners and legal entities that fight card fraud. The card fraud activities defraud shoppers, account owners that lose their card information to online thieves. For example, over 70 million Target Company customers lost their card accounts after the 2013 data breach hit the company. The cards were used later for illegal shopping activities. Analysis of business-to-business transactions will use pricing information, valuation strategies and innovations from individual companies. The strategies or procedures adopted by businesses provide an efficient mechanism for dealing with business dilemmas. Highlighting

Vedio Analyze Essay Example | Topics and Well Written Essays - 1000 words

Vedio Analyze - Essay Example The company has strived to maintain a corporate culture that fosters creativity and innovation. In that respect, it has fostered an environment that acknowledges good performances by employees. The Human Resources department has played a critical role in ensuring that these demands are met, through establishment of relationships. This approach prepares leaders and managers to deal with various extraordinary situations that may arise. There are various laws that prohibit various forms of discrimination in the United States. By adhering to these standards, the company has been able to meet its strategic objectives as well as customer requirements (Nickels, 2013). Determination of human resource needs takes place through a 5-step process. The first involves preparation of an inventory of its employees. Secondly, the company needs to analyse what different jobs entail. Thirdly, the company needs to examine future demands on the human resource. Subsequently, it should examine supply of th e required labour. This is required for prior training of staff, thus acquiring a competitive advantage. Finally, a strategic plan for hiring should be established (Nickels, 2013). The hiring process involves pre-screening and interviews that assess skills, while emphasising a cultural fit for the candidate, with the company. This fit is important for enhancing the company’s leadership, through organic development. ... Similarly, mentors are useful for guiding staffs that have lesser experiences at the workplace. Performance appraisals are useful for determining the right levels of compensation needed for retaining staff and boosting their motivation levels. This may be done through salaries, bonuses, stock options and other perquisites such as fringe benefits. The staffs are, therefore, able to focus on creative and innovation needed for success at work (Nickels, 2013). The key challenge in human resource management in the United States is attracting and retaining skilled talent in the organization. The country has experienced a shift from a manufacturing economy to service-based. As a result, there has been growing a demand for skilled graduates in high-tech jobs such as software engineering. However, the problem lies in capturing and retaining them. To lure such talent, HR managers need to create several benefits. For example, they need to develop good compensation schemes that appeal to the tal ent. This is also necessary for retaining the talent. The difficulties in attraction and retaining of skilled employees may be attributed to a variety of reasons. Firstly, there may have been limited effort in determining future trends in the labor market. As a result, HR managers within the organization were unable to develop means of acquiring or developing talent in the organization. As a result, the organizations are left with limited access to skilled workers in the market. Secondly, development of compensation schemes is difficult due to financial needs. It is important to note that modern labor markets are characterised by competitive salaries and other forms of compensation. Companies focused on cost-cutting may not be able to capture the interest

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Why Do I Need This Scholarship Essay My name is , and currently I am a senior at . After high school I plan to go to college and major in Nursing and minor in Physical Therapy. Throughout my life there have been a number of people giving me advice, but the one person that stuck on me the most is Minister George M. Howard Jr. my youth minister. This man has been like a father to me knowing that he will always be there when I need lifts my spirit. Minister George M. Howard Jr. told me that â€Å"It’s not about who you know, it’s about who knows you because there will always be someone watching you†. See more: how to write a winning scholarship essay My dreams and aspirations are to be so successful so that I’m not dependent on anyone else. Ever since I was little I have wanted to be in charge of everyone and everything. To in charge, I first have to obtain the knowledge and in order to do that I have to go to college. I have seen so many people become dependent on others as well as the emptiness in the lives of people who can only do one thing well and I don’t want that happening to me. I plan to work and study hard, make good grades and become the head nurse in the biggest hospital. However, with my new-goal oriented mind, I realize that I am working towards my Nursing degree and my successful future. I finally understand that my least favorite subject will greatly contribute to my ultimate goal of living a rewarding life and fulfilling my career goals. I know that the courses will be challenging, but I am willing to do what it takes to achieve my ultimate goal. Now my appreciation of those classes is stronger than ever because those classes are what will prepare me for my college education. The colleges that I have chosen will not only provide me with hands-on training, but it will also teach me real life skills and communication.