Operation Overload or D-Day Essay - 950 Words

D-Day, also famously known as Operation Overlord, actually stands for Day-Day. It was termed Day-Day since the Allied forces at the time did not want exact date to be known or set for the purpose of maintaining it to be a surprise attack. D-Day was a well-planned Allied invasion to gain foothold in France and the event took place on June 6, 1944 in order to liberate France which was, at the time, fully an Axis-occupied area (Kemp 75). Undoubtedly and according to the Allied forces’ plan, it was an unexpected attack to the Germans, which increased the probability of success. Troops from several countries around the world worked together to carry out the D-Day mission, including United States, Canada, Britain, and France. (Turner 44) The†¦show more content†¦More specifically, Caraquet, as well as other ships, cleared paths to allow landing craft to reach the invasion beaches, according to the D-Day plan while allowing warships to bombard enemy defences. Overall, the R oyal Canadian Navy played a significant role in the Normandy landings by contributing vessels and sailors to the massive armada of 7000 Allied forces on the D-Day. Canadians showed adept skills and abilities on D-Day from what they had learned in their previous war experiences. Canada had only one experience in its national history of large-scale combat on land before the D-Day. The Canadian corps that fought on the Western Front in WWI left behind not only a formidable combat record but an intellectual legacy as well. Just as with the British army, the lessons of 1914-1918 and the techniques of 1918 set the framework within which Canadian professional soldiers thought about any future war. (Callahan 270) In addition, Canada and other Allied forces were able to successfully perform their battle tactics after experiencing a tremendous failure in the Battle of Dieppe. They attempted to make a successful raid on German-occupied Europe over water, and then to hold Dieppe briefly; however, it was a disaster. As a result, hundreds of Canadian soldiers were killed and thousands were wounded or taken as prisoners. Despite this devastating failure, the Dieppe raid had providedShow MoreRelatedThe Battle Of The Allied Powers During World War II1528 Words   |  7 PagesII, the idea of an amphibious landing was explored thoroughly and determined to be the only way to get a foothold into Hitler’s empire. The invasion was a bloody 3 day encounter on 5 beaches that resulted in an enormous exchange between Hitler and the Allies. Because of this, it gave a rise to the power to the Allies in Europe when D-day was victorious. From 1941-1944 the Allies goal was to defeat Germany first. For many months, the Allies were trying to plan a massive invasion of Northwest EuropeRead MoreThe Battle Of The World War II2128 Words   |  9 PagesThe D-Day landings and the Battle of Midway. The invasion of Normandy occurred in the Atlantic theater whereas the Battle of Midway took place in the Pacific Theater of the war. Although these battles happened in different theaters of the war, the Allied victories sent both the Japanese and the Germans marching down the road to defeat. Throughout the United States involvement in World War II, which last from December 7, 1941 when Pearl Harbor was attacked to September 2, 1945, the battles of D-DayRead MoreR Day Deception By Mary Kathryn Barbier And Operation Double Cross1166 Words   |  5 PagesD-Day Deception by Mary Kathryn Barbier and Operation Double Cross by Ben Macintyre are both books about Operation Fortitude, the colossal allied deception operation aimed at prevent ing Germany from finding out where the D-Day landings would take place. This paper will summarize both books and then discuss the differences between them and why they exist. D-Day Deception was written by Mary Kathryn Barbier in 2007 and focuses on Operation Fortitude and the Normandy Invasion. Barbier draws almostRead MoreD Day And The African Campaign1055 Words   |  5 PagesD-Day and the African Campaign On D-Day we lost many people,up to 10,000 people! We had many people that fought during D-Day including the British,Canada,America,and Germany. As a result of the battle the Allies won and the nazis lost. For the Allies it was a victory but for others it was a devastation. On the date of September 1, 1939, it was the start of World War I when Germany invaded Poland. The fighting spun out of control and continued for six years. The leader of the AxisRead MoreEmergency Management1448 Words   |  6 Pagesmajority of those affected by a disaster will die within 72 hours after impact.[Harrald] With this type of stress there leads to either information overload or lack of needed information. The system implemented will need to be able to add contextual data to any information received to decide its relevance. This would greatly reduce any information overload that would hinder decision making. In the span of not having enough information, some decision makers will wait on making a decision, but this couldRead MoreInstructional Design For Students With Learning Disabilities1266 Words   |  6 PagesQuestions from Readings 1 (7points): Ryan Fraser EPSY 3115: Reading 1 Dr. Freeman 10/20/15 Carnine, D. (1997). Instructional design in mathematics for students with learning disabilities. Journal of Learning Disabilities, 30, 130-141. 1. What are the 5 principles of effective instructional design? Identify and describe each principle. (2.5 points) a. Big Ideas- Main ideas within a subject that will make learning specific concepts easier and more meaningful. Examples include: proportion, dataRead MoreThe Effects and Necessity of Secrecy and Element of Surprise in Operation Overlord3104 Words   |  13 PagesIntroduction I. The pathway to Operation Overlord The D-Day happened in Europe at the Omaha beach where many survived the attacks form the allies. The allies were interested in attacking Europe through the entry from various entries into the country. It is believed that the D-Day and Omaha beach was the hardest fought and significant victory for the Allies in the World War II. According to Ambrose, there were five beaches and the Omaha beach was the one that received the most devastating effectsRead MoreHydraulic Report Of Hydraulic Press1519 Words   |  7 Pagesonce issued a patent within the year 1795. As Bramah studied the present literature on the movement of fluid and place his experience into the progress of the presses. Hydraluic presses area unit the oldest of general machine instruments. In modern-day sort, is sweet tailored to presswork ranging from coiningg jewlry to formation plane components. fashionable hydraulic presses, area unit appropriate to be applied to the place the machine has been commonly a lot of modern. Hydrualic press works onRead MoreHistorical Events Portrayed During War Films1380 Words   |  6 Pageshappened in reality. The film portrayed the D-day invasion in Normandy France. The invasion was also known as â€Å"operation overload† because about 150,000 American paratroopers were dropped in Omaha beach and 2 million more soldiers followed. In the first half hour of the movie Spielberg wanted to show how â€Å"war is not glamorous and safe just brutal, cruel and bloody terrifying-and people die† (Haggith p333). It was the most faithful representation of the D-Day landings ever bought to the screen. OmahaRead MoreWorld War I And The War II1518 Words   |  7 Pagesstruggling countries because they agreed to a policy of Isolationism (Jorge 1). In March 1939, the whole country of Czechoslovakia was under German control. Next, Hitler wanted to take Poland. On September 1, 1939, Germany invaded Poland. A few days later Britain and France declared war on Germany. This marked the beginning of World War II (Woolf 25). In June 1940, Mussolini had declared war on the Allies. He already had more than a million men in the Italian army based in Libya (Jorge 1)

Banning The Advertising Of Tobacco Use - 906 Words

n this essay, I will discuss the positives and negatives related to countries banning the advertising of tobacco use, the complexities of the argument, finished with my own perspective. This is a highly argumentative debate that countries of the free world have argued for several decades. I’ll start by explaining the dangers of smoking tobacco. According to the Center of Disease Control (CDC) in the United States of America, tobacco use contributes cancers of and not limited to: mouth, esophagus, throat, and lungs. On February 6, 2001, India signed into law, a restriction that prevents tobacco manufacturers from advertising the sale of tobacco. According to a report found on the website icmrindia.org, it was described as a â€Å"bombshell† in India. This law is not uncommon globally. These types of laws have been a gradual occurrence for the past 30+ years. The United States of America was an early, freedom based, country to enact such a law. The law they created was signed into law on April 1, 1970. Countries that followed the United State’s lead, were France, Finland, and Norway. This is such a controversial topic, that it has found it’s arguments to their higher courts. ARGUMENTS IN FAVOR OF THE BAN ON TOBACCO IN INDIA It is believed that when countries ban the advertising of tobacco, consumption drops. It is also believed that it sets a standard, of health morality, for it’s citizens to live by. When it’s citizens stand behind a law that limitsShow MoreRelatedA Government And A Tobacco Company1003 Words   |  5 Pagesgovernment and a tobacco company feel that they are justified in banning or opposing tobacco advertising in India. The government of India serves the people. When a product is produced that affects the health of the people the government is justified to take action. With Tobacco products India banned the advertising and sponsorship of sport and cultural events (IBS Center for Management Research (ICMR), 2001). Those in favor of the ban cite the French who stated that Tobacco advertisingRead MoreBan Tobacco Ban On Tobacco859 Words   |  4 PagesSupporters of the ban on tobacco in India realize the major health complications that will arise from the use of tobacco. The World Health Organization estimated â€Å"over 3 million people died from tobacco related deaths in 1990,† (Ban on Tobacco Ads by the Government in India; http://www.icmrindia.org/free%20resources/casestudies/ban-tobacco-ads11.htm ). It is the government’s duty to protect the health and welfare of its citizens by banning advertising harmful products that are designed to appealRead MoreEffects of Bann ing Smoking Advertising Essay1657 Words   |  7 PagesEffects of Banning Smoking Advertising Cigarettes are some of the most abused drugs in the world and the effects associated with smoking have greatly influenced the intervention of health professionals concerning the legality of smoking advertisements. Ethical and legal issues have come up over the essence of restricting or completely banning cigarette advertising to reduce the number of affected individuals. Cigarettes have since time immemorial been established to cause a wide range of infectionsRead MoreBAN ON TOBACCO ADVERTISEMENT IN INDIA800 Words   |  4 PagesBAN ON TOBACCO ADVERTISEMENT IN INDIA In 2004 the government of India banned tobacco companies from advertising their products and sponsoring sports and cultural events. The objective was to discourage adolescents from consuming tobacco products as well as empower the government with the power to launch an anti tobacco program. . This issue created a serious problem in that it was both ethical and commercial, the government on one hand, believe it was its responsibility to protect the welfare ofRead MoreBan Banning Should Not Be Banned981 Words   |  4 Pagesavoided, but also banned. In India specifically, a country that is renowned for its high use of tobacco production and use, the idea of smoking has become a national crisis. With tobacco companies trying to push for freedom of speech† with advertisements, and the government attempting to assume a sense of responsibility, it seems almost impossible to find a solution that can encompass all perspectives. Pro-banning arguments Many feel that the Indian government should be allowed to intervene, especiallyRead MoreBan On Tobacco Advertisements By The Government Of India864 Words   |  4 PagesBan on Tobacco Ads by the Government of India A Case Study 1. A summary of the arguments in favor of the ban on tobacco advertising. The arguments in favor of the government banning tobacco advertising generally begins with the belief that the government has the right to intervene in the best interest of its citizens. The banning of cocaine, which is generally seen as worldwide, is often used as an example of this. Public health is often the motive that is cited when countries such as Belgium andRead MoreTobacco Advertising And The Indian Government997 Words   |  4 PagesTobacco Advertising and the Indian Government An Analysis of the Case Study In February of 2001, India joined many developed nations in a long-held and ongoing debate; that of the ethical responsibility of government in regards to the advertising of tobacco products. By 2001 many other nations had already decided to either place bans on or strongly restrict the advertising of tobacco products in an attempt to curb usage and thereby avoid the ill health effects associated with the product. While theRead MoreIndia s Tobacco Advertising Ban1018 Words   |  5 PagesIndia s Tobacco Advertising Ban The World Health Organization (WHO) reports that worldwide, five million tobacco users die annually and estimates that one million Indians die each year prematurely from tobacco use (2015). As late at 2009, India was â€Å"the world’s second-largest consumer and third-largest producer of tobacco† (Economist, 2009, p. 5). In an attempt to reduce consumption, India introduced its first adverting ban on tobacco in 1990, followed in 2003 by the Cigarettes and Other Tobacco ProductsRead MoreBanning Of The Law Of India1326 Words   |  6 PagesBANNING TOBACCO IN INDIA A case study in ethics management SUMMARY In order to better understand the complexities and difficulties of ethical decisions in the context of organisational management, we will examine one such decision made by the Government of India in 2001. The decision was whether to approve a bill that would place a ban on all tobacco advertising, including the sponsorship of sports and cultural events (Ban on tobacco ads by the government of India, 2001). After looking at the argumentsRead MoreAnalysis Of Case Ban On Tobacco Ads By The Government Of India Essay760 Words   |  4 PagesAnalysis of case Ban on Tobacco Ads by the Government of India Introduction Can a ban of advertising on tobacco products keep young adults from developing the habit of smoking? Can it keep them away from trying it out? The Government of India thought so when it announced on Feb 6, 2001 that it intend to forward legislation to ban advertising on tobacco. I am going to examine the case for this proposed legislation. The announcement sparked a fierce debate over the issue. Is it ethical for the

Case Study of Janet Jackson-Free-Samples -Myassignmenthelp.com

Question: Discuss about the Case Study of Janet Jackson. Answer: Introduction In the presented case study, Janet Jackson is diagnosed with uterine fibroids. Uterine fibroids are growths of the uterus which are noncancerous and are usually experienced during the childbearing years in the lifetime of a woman. A contraction of uterine fibroids increases the chances of being infected by cancer of the uterus. Uterine fibroids vary in size from as small as seedlings which are not noticeable by the naked eye to enormous masses which can lead to permanent distortion and enlargement of the uterus. The disease can expand the uterus to the extent of reaching the rib cage in extreme cases. In as much as the exact cause or causes of uterine fibroids have not been proved yet, scientific literature articles now contain information of significant size informative of the epidemiology, hormonal aspects, genetics and molecular biology that can give enough information regarding the causes.(Lee, 2012) These factors are divided into four categories namely: effectors, predisposing, initiators, and promoters. Risk factors involve those conditions that which have been generally identified through epidemiologic studies. Through such knowledge, the etiology of the tumors responsible for uterine leiomyomas as well as the preventive measures can be sought. The initiators of uterine leiomyomas are known which more consideration given to genetic aberrations. Despite the massive and in-depth investigations done, no clear information can be presented regarding the primary or secondary characteristics of the changes of these genes and their effect on promotion and/or initiation of uterine leiomyomas tumors. The ovarian hormones estrogen and progesterone are found to be playing a significantly greater role in the promotion of the growth of uterine leiomyomas tumors(McKay, 2012). This is a proof that has been developed through clinical and laboratory experiments. Risk factors associated with uterine leiomyomas Age: An increase in age is a promoter of uterine leiomyomas especially during the reproductive years of an individual. The increase is found, through studies, to be rapid among women when they are in the age bracket of the forties(David R. Gambling, 2013). This increase in prevalence can be associated with increased growth of already existing fibroids besides an increased willingness of women in the later reproductive years to undergo gynecologic surgery. Obesity: Studies that show a strong correlation between obesity and the prevalence of uterine leiomyomas. The correlation is such that for every 10-kg increase in the weight of an individual, there is an estimated 21% increase in the risk. This applied to the body mass index as well. An increase in the adult BMI corresponds to an increased uterine leiomyomas risk besides an associated risk of gain in weight. The correlation between uterine leiomyomas risk and obesity can be linked to the hormonal factors which are associated with obesity. Still, other pathologic factors can as well be involved in this course(Lee, 2012). The conversion of adrenal androgens to estrogen with the help of adipose tissue is a major hormonal activity that increases the risk factor for uterine leiomyomas(David R. Gambling, 2013). More unbound and physiologically active estrogen is produced as a result of the hepatic production of sex hormones. Menopause: The absence of stimulations of the hormones due to menopause increases the risks of uterine leiomyomas(Lombardi, 2012). Uterine leiomyomas among postmenopausal patients can be reduced through selection bias resulting from the tendency of a clinical approach that is more conservative as well as nonsurgical. Diet: An association has been found to exist between the consumption of ham and red meat among them beef and the risk of the prevalence of uterine leiomyomas. On the contrary, consumption of foods that are rich in green vegetable has a reverse effect and is found to reduce the risk. Beef and ham are foods rich in fats which in turn increase the bioavailability of progesterone and estrogen hormones(Goldman, 2015). Uterine leiomyomas known for being a tumor which is responsive to hormones will then be promoted to grow and multiply. Smoking: The correlation between smoking and uterine leiomyomas has been found to be inverse with current smokers found to be having a 50% risk reduction as compared to past smokers(Foundation, 2010). The more cigarettes individual smoke per day, the lower the risk of the attack by uterine leiomyomas. This correlated has been attributed to the effect of smoking which has been found to be anti-estrogenic. Still, there have been numerous derangements of steroid metabolism which have been noticed in smokers(Foundation, 2010). These metabolisms have been found to decrease the bioavailability at tissues that are targeted by estrogen. At the same time, inhibition of aromatase by nicotine reduces the rate of conversion of androgens to estrone. Other risk factors include menarche, parity, exercise, and use of oral contraceptives etc. therefore, taking a back reflection of the case of Janet Jackson, numerous factors can be alluded to the cause of her uterine fibroids condition such as smoking and age(Tulandi, 2013). She is at her childbearing years hence the high risk of infection by uterine fibroids. A surgical operation is the most recommended treatment for uterine fibroids. It is important to consider the size of the growth before the operation is carried out to ascertain the extent of destruction and expansion the disease has done to the uterus(Goldman, 2015). The treatment aims at reducing or completely relieving the patient of the pain she is experiencing. In this case study, Janet undergoes a surgical operation so as to remove the growth in her uterus that is causing her a lot of pain. The most appropriate nursing management for postoperative hysterectomy is that which aims at reducing the pain would be undergoing through(Stoelting, 2014). Being a surgical operation, the process must be accompanied by pain that requires proper care and maintenance to help the patient gain her self-worth even after undergoing the process. A surgical intervention is the best option in handling the case of Janet as in will minimize pain as well as increasing the quality of her life. Upon completion of the surgical operation process, Janet is transferred to post anesthetic recovery unit in which she undergoes close monitoring before she is further transferred to the general ward. While in the PARU, anesthetist informs the nurse of the general conditions of the patient, the type of anesthesia used for the operation and the operation type performed. The anesthetist also informs the nurse of any complications experienced during the operation process. In the comparison of Janet's baseline observation regarding the given case with the observations taken before the surgical operation, her blood pressure when she was transferred to the PARU was 90/50 mmHg which is a considerably low since the normal adult systolic blood pressure should range between 100-120 mmHg with the diastolic pressure ranging 60-80 mm Hg. She does not experience any pain and a normal body temperature. She experiences a high pulse rate of 130 bpm above the normal rate which ranges from 60-100 beats a minute. This may be attributed to anxiety and depression. The lowered blood pressure of Janet can be attributed to the use of a general anesthesia during the operation of Janet which caused a diminution of her sympathetic nervous system culminating into considerable levels of blood loss. Janet Jackson was also found to be having a respiratory rate higher than that of a normal adult. Her respiratory rate was 30 rpm which is way above the normal range which is 12-20 rpm(McKay, 2012). A high respiratory rate shows respiratory depression which is one of the side effects of uterine fibroids. The PARU nurse is tasked with the role of conducting a detailed assessment of the airway of the patient, the heart rate, temperature among other conditions of the body. The nurse does this by assessing the health conditions of the patient at intervals of 15 minutes. The nurse should conduct a cardiovascular assessment so as to monitor the heart rate and blood pressure. Monitoring of the blood pressure levels and the heart rates is important for the case of Janet since the hysterectomy operation led to side effects such as depression(Glaser, 2013). It would also be important to monitor peripheral circulation in case the extent of the uterine fibroids attack was extreme and reached the rib cage. This would have effects on level and degree of mobility. The nurse should also be continuously conducting the orientation to the patient on strategies on how to reduce depression and anxiety levels. Plans of discharge usually begin as soon as the patient conditions begin to stabilize. During discharge, the family and the patient may be stressed over fears of the patient not being able to get back to normal. Upon the patient gaining stability, the family may be informed on any surgical and medical appointments(Tulandi, 2013). They will also be educated on how to take care of the patient in a way that helps in improving the quality of her life(David R. Gambling, 2013). In order to manage the pain, the patient can be put on the most appropriate analgesia depending on the level of pain. From the given case, Janet did not report any pain from the hospital hence did not necessarily need any pain relieving drugs. Instead, she only needed advice and education on how to manage and care for her wound, any symptoms, and signs that she may need to report to the hospital. An assessment should as well be conducted by a multidisciplinary team consisting of occupational therapists, social worke rs, and continence nurses. Occupational therapists team: This is a team of experts that would assist the patient with movement. Janet having undergone surgical operation may develop problems and challenges with moving from one place to another(Page, 2016). Occupational therapists would assist Jane with improving her ability with doing tasks that would be associated with her daily life. Such assistance will help the patient improve her skills and movement when doing such activities as cooking, dressing, and bathing. Social workers team: Diseases and disease conditions usually come with challenges that may not only affect the patient but also the family(Miller, 2009). Social workers are known for conducting the psychological functioning of the patients and then establish important interventions that would help the patient adjust to the challenges and conditions that she could be facing. Conclusion The complicated nature of medicine makes the treatment of the diseases of patients as just one of the ways of caring for patients. At times it may require a team of professionals who are working in collaboration in order to fully address the needs of a patient. Such needs include emotional issues, pain management, rehabilitation as well as treatment. The field of medicine encompasses adverse healthcare specialists and professionals with each professional having a different and distinguished role to play. An understanding of the role of each of the medical practitioners is important in ensuring proper coordination and appropriate service delivery to patients. References David R. Gambling. (2013). Obstetric Anesthesia and Uncommon Disorders. Cambridge: Cambridge University Press. Durham, R. (2013). Maternal-Newborn Nursing: The Critical Components of Nursing Care. Chicago: F.A. Davis, Foundation, F. H. (2010). International Abstracts of Surgery, Volume 21. Chicago: Franklin H. Martin Memorial Foundation. Glaser, o. P. (2013). Health Care Information Systems: A Practical Approach for Health Care Management. New York: John Wiley Sons. Goldman, M. A. (2015). Pocket Guide to the Operating Room. Washington: F.A. Davis. Lee, J. B. (2012). The ... Year Book of Obstetrics and Gynecology. New York: MD Consult (Online service). Lombardi, D. N. (2012). Handbook for the New Health Care Manager. Salt Lake: John Wiley Sons. McKay, R. S. (2012). The Medical Age, Volume 20. New York: .E. G. Swift,. Miller, R. D. (2009). Miller's Anesthesia: .... 1. London: Elsevier Health Sciences. Page, A. (2016). Keeping Patients Safe: Transforming the Work Environment of Nurses. London: National Academies Press. Stoelting, R. K. (2014). Stoelting's Anesthesia and Co-existing Disease. Oxford: Elsevier Health Sciences. Tulandi, T. (2013). Uterine Fibroids: Embolization and Other Treatments. Cambidge: Cambridge University Press. Waugaman, W. R. (2012). Principles and Practice of Nurse Anesthesia. Manchester: Appleton Lange.

The Adventures of Huckleberry Finn Critical Lens free essay sample

It is only with the heart that one can see rightly†. He implies that humans understand and comprehend the world by different means and rely on different sources to provide the truth. People use their senses, reasoning, emotion, and what others have taught them. However, Antoine de Saint-Exupery expressed that in order to understand something for what it is truly, emotion is the most truthful and applicable source of knowledge. This source implies that what is true is equal to what is morally correct and just. Antoine de Saint-Exupery’s statement is true and this is represented by the thoughts and actions of the characters throughout Mark Twain’s novel, Adventures of Huckleberry Finn. In the beginning of the novel Huck Finn is not able to â€Å"see† with his heart because he is taught how to see every other way possible. Therefore he is conflicted and unable to see things for what they actually are. We will write a custom essay sample on The Adventures of Huckleberry Finn Critical Lens or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Miss Watson is Huck’s teacher and she symbolizes conventional education. She teaches Huck to view things based on societal norms, this is exemplified by her teachings of Christianity and etiquette. Christianity in its simplest form is a religion based on love, forgiveness, and purity. Overtime the religion was misrepresented and misinterpreted by many people. Heaven, or according to Huck, â€Å"the good place†, became some kind of a finish line to the competitive mindset of humans, and also sinning became a very shallow part of the religion. Not meeting the proper standards of society was considered a sin. Mark Twain uses satire to mock how people have changed an innocent sanctity into a competitive and shallow establishment. Miss Watson is reprimanding Huck and explains to him the â€Å"good† and â€Å"bad† places, and how if he always misbehaves then he will not be able to go to the good place. He thinks to himself, â€Å"Now she had got a start, and she went on and told me all about the good place. She said all a body would have to there was to go around all day long with a harp and sing, forever and ever. So I didn’t think much of it† (Twain 4). This shows how Huck was misled and he was not taught how to see with his heart, he was taught very simply, like Miss Watson when she was taught all of this information. Therefore he is not able to see Christianity for what it truly is, and not taught to see with his heart. When Huck became free from other influences and the conventional society that indoctrinated him before, he started to learn how to make decisions based upon emotion, and evidence shows that these actions he took were morally correct and right. Huck’s character completely changes when he gained the ability to act on his emotional connection to something as opposed to the societal mask that hides the truth. This character change is exemplified when Huck was faced with an internal conflict. When on the raft to freedom with Miss Watson’s runaway slave, Jim, he started to worry about whether or not he was doing the moral thing by helping Jim escape. He couldn’t decide if doing wrong by Miss Watson, who had never done anything to him, was worse than doing wrong by Jim, who, although had become his friend, was still a â€Å"nigger†. The conflict inside Huck’s head worsened when Jim expressed his gratitude, â€Å"’Pooty soon I’ll be a-shout’n for joy, en I’ll say, it’s all on account o’ Huck; I’s a free man, en I couldn’t ever ben free ef it hadn’t ben for Huck; Huck done it. Jim won’t ever forgit you, Huck; you’s de bes’ fren’ Jim’s ever had; en you’s de only fren’ ole Jim’s got now. ’ I was paddling off, all in sweat to tell on him; but when he says this, it seemed to kind of take the tuck all out of me† (Twain 83). Eventually when Huck was forced to decide whether or not to turn in Jim, he decided to not and to continue helping him to freedom. Huck therefore decided against the societal establishment of slavery, obviously an immoral practice, and chose to listen to his emotions, which allowed him to understand what was actually morally just. When Huck and Jim were not on the raft, and landed ashore, morals became unclear. Mark Twain made the land symbolize social injustices and immoral societal conventions, and when Huck and Jim went on shore, they were exposed to people that were meant to represent all inequalities and immorality that were present at that time. Huck met a family that had a family rivalry based on an issue that neither of the family remembered. Twain meant to signify these families as nonsensical and ridiculous, and within the family were â€Å"star-crossed lovers† of some sort. These characters are meant to contrast the stupidity of each of their families and symbolize that understanding the world through love and other emotions is the most truthful way of seeing. Also, ignoring social pretense in order to do what is morally right was represented towards the end of the novel, when Huck decided to once again help Jim escape from slavery. He expressed a conflict that he had between what he sees is right through society’s eyes, and what he sees is right through his own emotions. He couldn’t choose what to do, but finally decided on taking the risk of freeing Jim himself. When conflicted he thought, â€Å"I felt good and all washed clean of sin for the first time I had ever felt so in my life, and I knowed I could pray now. But I didnt do it straight off, but laid the paper down and set there thinking- thinking how good it was all this happened so, and how near I come to being lost and going to hell. And went on thinking. And got to thinking over our trip down the river; and I see Jim before me, all the time; in the day, and in the night-time, sometimes moonlight, sometimes storms, and we a floating along, talking, and singing, and laughing. But somehow I couldnt seem to strike no places to harden me against him, but only the other kind. Id see him standing my watch on top of hisn, stead of calling me, so I could go on sleeping; and see him how glad he was when I come back out of the fog; and when I come to him agin in the swamp, up there where the feud was; and such-like times; and would always call me honey, and pet me, and do everything he could think of for me, and how good he always was; and at last I struck the time I saved him by telling the men we had smallpox aboard, and he was so grateful, and said I was the best friend old Jim ever had in the world, and the only one hes got now; and then I happened to look around, and see that paper. It was a close place. I took it up, and held it in my hand. I was a trembling, because Id got to decide, forever, betwixt two things, and I knowed it. I studied a minute, sort of holding my breath, and then says to myself: ‘All right, then, Ill go to hell’- and tore it up† (Twain 193). Huck saw with his heart and was then able to make the most ethical assessment. He also understood the truth behind Christianity and morality itself; not simply the shallow and conventional representation that he was taught. Therefore, Antoine de Saint-Exupery’s statement, â€Å"It is only with the heart that one can see rightly† is true and is exemplified through Huckleberry Finn and his growth and maturity as he unveils what is truly moral. He ignored the influences of society that cause people to overlook emotion and discovered what was right.

Lombards history Essay Example

Lombards history Essay Example Lombards history Essay Lombards history Essay ONeill: (Very angry, in Tyrone accent) I think so. And this is my country. (Quietly, in his usual accent) I have married a very talented, a very spirited, a very beautiful young woman. This sudden change of accent is a method of gaining presence and making a point for ONeill, the use of his Irish accent shows he is in command and he is still in charge of his country. ONeills outburst of anger is also whilst defending and justifying his marriage to Mabel this really shows how loyal he is to her deep down and that he respects Mabels betrayal of her own country.ONeills description of Mabel (talented, spirited) is very accurate and is how Friel portrays her throughout the play. Mabel is a unique character as she manages to stay neutral to both opposing factions, as a character she represents peace and harmony because of this. Archbishop Lombard is described by the narrator, By profession he is a church diplomat and his manner is careful and exact. These careful choice of words tell the audience that Lombard is quite a sly character with a good sense of language and means to talk his way out or in to a situation well.He is not likely to be very religious but exploits his profession in order to gain himself an advantage. Lombard decides to write ONeills history, and, true to his character, refers to history as a story (p. 8), avoiding ONeills questions when asked if he will be telling the truth. Lombard: Im not sure that truth is a primary ingredient is that a shocking thing to say? (p. 8-9) It is clear from this conversation that both ONeill and Lombard have completely different stances on writing history.ONeill believes it should be an accurate document of events whereas Lombard believes it should be twisted in order to become an entertaining tale based on events. This presents ONeill with another pair of identities Hero vs. the real ONeill. How he will be portrayed through Lombards history will certainly not be the real, womanising, careless ONeill, but a brave leader and hero of Ireland.These ideas Friel has implemented challenges the audience to think about what they would themselves prefer as history the truth or a fairytale created to entertain in order to be passed down to others. Lombards rhetorical question ( is that a shocking thing to say? ) shows he knows that it is slightly devious, but its the truth never the less. The second act contrasts entirely with the first. Only eight months have passed in the play, but the Battle of Kinsale has been lost and ONeill is now living in poverty, He is using a wooden box as a table the narrator describes. ONeill: Have you any food? (p. 43) The mood is now desperate and sinister, ONeill is no longer the charismatic and talkative character he was eight months ago, but now an ageing man with growing regret, his rich and happy life no longer apart of him but now placed with a criminal identity.Wanted by both the Irish and English, both of ONeills identities have abandoned him. The end of Act 1 Scene 1 announces the death of both Mabel and her baby the cross-breed that Mabels sister Mary had warned her about. Friels use of herbs have also pre-empted the inevitable fate of Mabel and the baby. ONeill: (Almost in a whisper) Yes, I think Ill take some of that whiskey now, Hugh. Just a thimbleful, if you please. And no water. Oh, dear God (Quick black. ) (p. 54) The stage directions that show ONeill almost unable to speak after hearing the shocking news shows how unexpected it is for him.The quick black tells the audience it is the end of the scene and also adds further dramatic effect to the abrupt news the way this is delivered most probably leaves the audience is a state of shock also. Scene 2 is set in Rome, many years later (p. 54), ONeill and the others have been forced to flee, where they are no longer welcome in both Ireland or England. The narrator tells us he has a volatile and bitter temper, carries a walking stick and has begun to lose sight in his eyes. This image paints the picture of an elderly, dishevelled man burdened with the regret of many terrible mistakes.Throughout most of this final scene ONeill is scarcely sober, this indicates he must be very unhappy with his life and how it has ended up for him to drink so much. ONeill: (He bumps into a stool and knocks it over. As he straightens it) Forgive me. (p. 54) As ONeill drunkenly bumps into a stool and then apologises to it for knocking it over, you feel instantly embarrassed and sympathetic for ONeill. He is now a shadow of his former self, no longer his bubbly, talkative and distracted character.It appears to the audience that ONeill has lost sense of any identity he once had, which isnt hard to believe considering he has been banished from not one but both of his homes, and now resides in a foreign country that has been alien to him most of his life. ONeill: You said Mabel will have her place. That place is central to me. (p. 63) As the play draws to an end we see a scene shared by Lombard, Harry and ONeill, ONeill desperately trying to convince Lombard to tell the truth in his history, about his failure and corruption, and most interestingly to include Mabel.This shows how deeply he cared for her and enforces the idea of the bond they had over their dual identities. This must have comforted ONeill and made him feel at home, to lose that was really the turning point in his personality, almost as if when Mabel died she took his identity with her, as she was the last thing holding it together and making sense from it all. Act 2 Scene 2 reaches a close as ONeill finally accepts defeat and realises Lombard will write the history how he wants it, Lombard continuously asks What changes do you want me to make? But despite the details ONeill wants included, Lombard will still tell it in a way that is entertaining. Lombard begins to read the history as ONeill starts to cry and mourn for Mabel, (ONeill is now crying. Bring the lights down slowly. ) (p. 71). The slow fade of lights signifies the end of the play. Friel presented identity by portraying a man who had everything, and slowly stripped him of every last meaningful thing he had in order to convey the message of what makes us who we are.ONeill lost both of his countries, and his wife and baby, the loss of Mabel being pivotal she was the one person he could relate to and feel close to, and the baby symbolised a new beginning where the English and Irish could live in harmony together. Through Lombards history we will not learn about ONeills duality, his close friend Harry or wife Mabel that helped shape his character, but a Hero who fought a tough battle for Ireland, fled with the Flight of the Earls, and shall be king for the span of his life (p. 71), thus telling us that identity exists in many forms.

FundsforWriters to the Rescue

FundsforWriters to the Rescue I have been writing in my spare time for more than 40 years. My file cabinets are crammed full of research notes, ideas for future articles, and manuscripts in various stages of completion. Fortunately, I have sold many magazine and newspaper articles, as well as two dozen children’s books, but I still have quite a collection of rejected picture book and early reader manuscripts. I also have the letters stating why they were rejected in the first place. When I wrote about Cathy Williams, the only female buffalo soldier in U.S. history, multiple editors told me she was â€Å"too obscure† to be the subject of a nonfiction picture book. I protested, pointing out that teachers and librarians are always looking for new stories for Black History Month, Women’s History Month and even Veterans Day. But no, they still weren’t interested. Cathy, they insisted, was just not marketable. Editors also rejected my fictional children’s story, â€Å"Oh-So-Clever,† a tale inspired When I wrote a nonfiction reader for youngsters in first through third grades about Admiral Peary returning from Greenland with the largest meteorite â€Å"in captivity,† editors deemed the subject too obscure as well - even though that particular 34-ton space rock remains on display in the Hall of Meteorites at the American Museum of Natural History in New York. Thousands of school children take field trips there each year. From a marketing aspect, it would seem like a perfect book to sell in the museum gift shop there and at other museums with meteorites on display. Undaunted, I retrieved these rejected manuscripts from the file cabinet and looked at them again. I decided to think outside the picture book box and transform my manuscripts into articles instead. Reasoning that if children’s book editors considered my proposed topics too obscure, then children’s magazine editors might be equally shortsighted. Instead, I decided to use my extensive research notes to transform the original manuscripts into articles suitable for adult publications, which pay more generously than children’s magazines anyway. The market listings posted on the FundsforWriters website proved to be quite inspirational.   To my delight, the editor at Rural Missouri, (http://ruralmissouri.coop/submissions.php) the state where Cathy Williams was born and raised, promptly bought my article, â€Å"The Buffalo Soldier’s Secret.† It appears in the November 2014 issue. The Elks Magazine (https://www.elks.org/elksmag/WritersGuidelines.pdf) bought first North American serial rights to the Robert Peary meteorite article, as well as the one about the amazing globetrotting photographers, Osa and Martin Johnson - another topic I had hoped to pursue for a children’s book. This article appears in the May 2015 issue. â€Å"Oh-So-Clever† sold to the Center for Education Testing and Evaluation at the University of Kansas - a market mentioned in one of the weekly Society of Children’s Book Writers and Illustrators electronic newsletters (https://cete.submittable.com/submit) that I receive each week. The center administers a variety of standardized tests and continues to accept submissions for poetry, informational and narrative texts suitable for students in grades 3-12. I have been successful in recycling this first batch of manuscripts and will retrieve another handful from the file drawer with the intention of giving them a makeover as well. I simply need to shift mental gears and think imaginatively outside the box - and review the market listing at FundsforWriters again.

Marketing Heineken Case Study Example | Topics and Well Written Essays - 750 words

Marketing Heineken - Case Study Example The company focuses on continuous improvement of the environment in which it operates its business. When it expanded the business in different countries, it has made it sure that the business of the company should not hamper the environment factors of the nation. Thus it improved the effect of the business in the environment. Under this factor it tries to take the initiative to introduce the green brewer and green commerce. It means the company focuses on the fact that brewing should not affect the environment and it increases the employment levels of the country. It has empowered the people who work with the company by providing them a quality lifestyle and it has also improved the society and communities in which it operates through its various corporate social responsibilities. It has started to engage local people as the employees to increase the level of employment. This strategy has helped many people to find jobs and a way of living and has also reduced the unemployment level of the countries. Especially in developing countries like India, Africa and east Asia, brewing has improved the level of employment. It has also implemented some healthcare policy to take care of the health of its employees and their families. It has always tried to enhance the positive impact of beer in the society because in many developing countries Beer is seen as alcohol and is prohibited. But Heineken improved the positive impact of Beer in society through responsible consumption.

Individual report based on an observation of an establishment Essay

Individual report based on an observation of an establishment - Essay Example Observation of the Hawthorn effect In order to examine the Hawthorne effect specific tests are performed. These tests mainly included examining the efficiency level of the employees. The employees and staff were informed beforehand that their actions will be kept under observation for the purpose of conducting successful experiments (Abratt, Beffon and For, 2011). Two different sets of experiments are performed one without the acknowledgement of the participants and one with the acknowledgement of the participants. The experiment indicated that the there is marked difference between e two experiments. So it can be concluded that Hawthorn effect was present in the observations. Details of the Hyatt Regency Different kinds of accommodations are available at Hyatt. Some of the types of rooms are standard rooms, triple or family rooms and suite. The hotel is present in 7 different international countries. Altogether there are about more than 500 plus bedrooms in Hyatt. Some of the well k nown brands are Park Hyatt, Andaz, Grand Hyatt, Hyatt Regency and many more. The hotel offers a diverse range of facilities starting from plush services like room services, online hotel and resort booking services, bag drops and pulls, dining and cuisine, baby sitting services, bell services, business centre services, concierge services, and currency exchange services (Aiken and West, 2001). The other kinds of services are engineering services, exhibit halls, food and beverage services, gift certificates. The different types of clubs, lounges and restaurants are Regency Club, Peppercorn Duck Club, Skies Restaurant, the Terrace restaurant, Coffee Express, Market segment of Hyatt Regency Table 1: Market segment of Hyatt Amerisuites Corporate business and family weekend leisure traveller, 30 to 59 years of age, 50% male/50% female, Household income $85,000+ Park Hyatt High income, Professionals, high level executives, celebrities Grand Hyatt Upper to high level income, Professionals, s enior and mid-level executives, upscale meetings, Hyatt Regency Middle to upper income, Professional, managerial, convention groups, Hyatt resorts Middle to upper income depending on branding, Professionals, mid to senior level executives, meetings and incentive groups Spa Hyatt Culturally sensitive acknowledging deep local customs and traditions Hyatt vacation club Middle to upper income, University educated with post-graduate degree courses Source: (Anderson and Mittal, 2002) Details of the information gathering process The resorts and hotels of Hyatt are connected to a central server of each hotel. The central servers are connected to each other in a network of interlinked and interconnected system. All the hotels and resorts of Hyatt use as single source software which helps to create an inter link between the various departments as well as between hotels and resorts (Berman and Evans, 2007). The implementation of the central reservation system at Hyatt has led to a record incre ase in the number of rooms sold (almost 31%). Whereas the industry average indicates that the number of rooms sold increased by only 20% to 25% (Craig and Douglas, 2005). The central reservation system is used for collecting information like the operational efficiency and revenue generation. The diagram given below gives an indication of the grading system of restaurant. Fig 2: Auditing process of restaurants Source: (Anderson and Sullivan, 2002) B Details of the administrative and accommodation departments The different typ

Lennie is mourning the death of his puppy Essay Example for Free

Lennie is mourning the death of his puppy Essay At the beginning of the extract, Lennie is mourning the death of his puppy by his own hand when Curleys wife enters the barn and attempts to comfort him and she allows Lennie to stroke her hair. When Lennies big fingers fell to stroking her hair we see that something is going to happen as the mood changes and the tension is heightened. We have an inclination to what is about to happen as we have seen the inevitability of the scenario with Lennies strength and Curleys wifes desire for affection and attention. When Curleys wife tells Lennie not to muss it up, Lennie strokes harder, as he is overcome with the pleasure of the experience, this shows that Lennie doesnt listen to anyone except from George, thus reinforcing what we already know. Curleys wife says you stop it now and jerks her head sideways and Lennie then panics and automatically his fingers close on her hair and hung on, this is because it is the only thing he can think to do, this emphasises his child-like mentality as his reaction is physical as opposed to psychological. Lennie was in a panic and his face was contorted, these two short simple sentences portray the innocence and naivety of Lennies actions as well as reflecting the way Lennies mind works, short and simple. He begs Curleys wife to stop screaming because Georgell be mad and aint gonna let him tend no rabbits showing that he has a one-track mind, much like a child. Lennie then gets angry and tells Curleys wife I dont want you to yell, this again shows his child-like mindset and his anger leads him to shake her. So hes shaking her, not in an aggressive manner, but to protect his part in the dream, her body flopped like a fish and she was still, for Lennie had broken her neck. At this point we see Lennie, not just kill Curleys wife, but kill the dream too. Lennie does not realise he has killed her as he continues to speak to her, he lifts her arm and lets it drop and is, for a moment, bewildered. His mind cant capacitate why she is not responding, all he thinks he did was shake her, showing just how unaware he is of his own strength. Animal imagery is used to describe how Lennie pawed up the hay until it party covered her, this connotes Lennies clumsiness and density. In the concluding paragraph of the extract we see Lennie become conscious of the outside for the first time, he recalls what George told him to do if he gets into trouble and goes to hide in the brush, taking the dead puppy with him to throw it away because its bad enough like it is. Here we see Lennie make a decision himself, be it the right one or not, he seems to have matured slightly because of the situation at hand and this event could be something that changes Lennies childish behaviour. Throughout the death of Curleys wife, we still feel more sympathy for Lennie, because he is so unaware of the danger his actions can cause and he is still a naive and innocent character, despite the unintentional harm he has brought to many things. Show preview only The above preview is unformatted text This student written piece of work is one of many that can be found in our GCSE John Steinbeck section.

Comparing Neo of the Matrix and Ender Wiggen of Ender’s Game :: Movie Film Movies Films

Comparing Neo of the Matrix and Ender Wiggen of Ender’s Game From the first moment that we wake up we know that we are awake, but have you ever had a sensation that you are dreaming but you know you are awake? This is the same way Neo felt in his world in the movie the Matrix. Ender Wiggen was in the same situation in the novel Ender’s Game, written by Orson Scott Card. He was living in a place where no one accepted him because he was a third, which means that he belongs to the government for a special purpose. The comparisons of Neo and Ender through their different conflicts made believe, important decision to make and stimulus that people need and the consequences that brings after making decision. The first similarly that Ender and Neo have was that both were put in the world to complete a mission. First, they needed to believe that they were the one to save the world. Neo, in the movie, The Matrix was living in a world where everything seems normal. But he knows that there is something wrong in the world. This is when Morpheus appears. Morpheus, for many years, was searching for the one. He blindly believed that Neo was the one. When Neo knew that his world was not real, he felt that his whole life was living in a dream world. Morpheus was the man that guided Neo, training him and making him believe that he is the one. On the other hand, Ender’s story is very similar. Ender was a young man: independent, strong willed, mentally tough creative and mature. Even though he is only six years old, he is capable of having the ability of leadership. Ender also had a man with no mercy that believed that he was the one. Colonel Graff was Ender’s teacher. He guides, him tra ins him, isolates him from his peers, and drives him to the point of exhaustion. These two men have a conflict that they do not find themselves in their world. They feel that they do not belong in the world that they are living in. Ender is living in a place where the government controls a system that everyone must follow. Ender does not believe that this system was right for the people. He is fighting with his internal and external conflict. His external conflict involves his struggles to overcome the obstacles places in his path, and the internal conflict is the result of the external that affect his emotional life.

Ceremony: Native Americans in the United States Essay

In Leslie Marmon Silko’s Ceremony, the use of storytelling is quite prevalent. Within the framework of Ceremony there are references of the tradition of Native American storytelling along with the progression of telling a story. Storytelling within the Native American culture is oral, traditionally. The method of storytelling within Ceremony at the beginning lays down the framework of the entire book. Silko starts out the novel with a series of stories. The first of which is about Ts’its’tsi’nako (or more easily said) â€Å"Thought Women†, who thinks of things and they appear. She happens to be thinking of a story and it just so happens to be the story being told to us. This then leads us to the next story (1). The next story turns out to be a story about stories. This story tells us (the reader) the importance of stories, and that they aren’t merely for entertainment, but are used to fight off death and illness. The narrator then states, â€Å"You don’t have anything, if you don’t have the stories.† Thus telling us the true importance of the stories of Native American culture, seeing as everything was passed down orally, and not much was written down if any at all (2). Now, for Tayo, these stories embody the understanding of the Native American world Tayo grew up with. Only the army, the doctors, and the white schools try to convince Tayo that the stories are wrong. As Tayo recreates and recalls the old tales, he begins to reunite with the community, pulls through the trauma of war, and ultimately brings back the rain to his land. Tayo learns from these stories that he is not alone, because the stories are shared within a community, and because the contents of the stories show him that others have shared like experiences (Notes/Class Discussions). The rest of the stories within the text of Ceremony announce elements that will reoccur within the novel. As the story is told either by a single person or by a group of people, it can fashion between those people a sense of community. As stated previously, that stories have the power to fight of death and illness. The stories contain the ceremonies and rituals that have the ability to cure individuals and the communities. Stories are able to provide this ability by restoring the affiliations betwixt all things and people. The stories within Ceremony are an integral part of the story line. The stories within the novel show us how important they are to the Native American culture and way of life. They provide us with the impending points of the plot, of how a ceremony is what can cure the people. Bibliography: Silko, Lesie Marmon; Viking Peguin Inc. 1977

Conditions on Each Planet

Mercury : Due to mercury being extremely close to the sun, causes its planet to have no atmosphere. If any air was ever around Mercury, it would have been within its early years and from that point to now, it is gone because of all of the heat being given off of the sun. Mercury has crazy weather issues because of the lack of atmosphere, which includes a drastic weather change within day to night. Whenever the sun touches the surface of Mercury, that is when the climate reaches its highess at 801 degrees Fahrenheit in the day time. Because of the lack of atmosphere in mercury, the Mercurial sky is black and the stars can be seen in broad daylight. The night time becomes a different situation, at this point it leaves it at a chilling climate where it is -300 degree Fahrenheit. Venus : Venus contains a wonderful thick atmosphere which is made up of 97% carbon dioxide. Venus's pressure at the surface is 92 times stronger than on Earth. Its temperature goes to an extreme result of 900 degrees Fahrenheit, which mkes it the hottest planet of all. Its atmosphere is this way because of a strong volcanic activity during the past. Venus deals with sulfuric acid rain falls that come from its swirling clouds but is gone before even reaching the ground. Earth: Earth has the most dynamic weather in the solar system compared to the rest. The atmosphere has changed a lot compared to the Earth's early atmosphere, but for the last billion years, it has remained pretty constant. There are 3 very different atmospheric problems that is needed to be kept close attention to. The three atmospheric problem are the greenhouse effect, damage to the ozone layer, and acid rain. The earth is surrounded by a blanket of gases, this blanket traps energy in the atmosphere, much the same way as glass traps heat inside a greenhouse. This results in an build up of energy, and the overall warming of the atmosphere. The greenhouse effect is a natural process which made life on Earth possible. Ozone is oxygen that contains molecules that have 3 oxygen atoms. There is a layer of ozone high p in the atmosphere which shields the Earth from the sun's harmful UV rays, these rays can lead to an increase in skin cancer. The ozone is present in very small quantities but it is enough to absorb the UV rays preventing them reaching the surface. Concentrations of ozone appeared to be dropping in certain areas of the world (the layer was starting to thin-out). The cause of this reduction was thought to be man-made. Rain water is naturally acidic due to carbon dioxide which partially reacts with water to give carbonic acid. Acid rain is caused by other gases released when fossil fuels are burnt. Mars: Mars's atmosphere made up of carbon dioxide, Venus's atmosphere is much more than Mars. The temperatures on Mars ranges from 80 degrees to -200 degrees Fahrenheit. Mars experiences seasons too. There is dust storms that are frequently occurring. Mars's atmosphere, has fog and frost forming on the Red Planet because of the water vapor. Jupiter: Jupiter's atmosphere has clouds which are striped with dark belts and light zones. High winds and lightning are a regular feature on Jupiter. Other small eddies and whorls form and dissipate in the cloud layers. The temperature on Jupiter is approximately -234 degrees Fahrenheit only. Saturn: Like the other gas giant planets, Saturn's atmosphere is mainly hydrogen and helium. Saturn is a windy planet, with 1,000 mile an hour, winds do a good job of mixing the atmosphere and making it appear homogeneous through Earth based telescopes. Saturn's tilt creates seasons and uneven temperatures on the planet. The top of the clouds have an average temperature of -285 degrees Fahrenheit, with warmer temperatures deeper in. A churning hexagonal cloud formation has been spotted near the North Pole and has persisted for a few decades now. Uranus: Uranus is unlike the other planets in that it is tipped on its side, and, in essence, rolls along in its orbit. At -350 degrees Fahrenheit, its atmospheric conditions stay the same for many years at a time (its year is 84 Earth years), until it experiences seasonal changes, sparking storms in its atmosphere. Neptune: Neptune is the record holder for the windiest place in the solar system. At about 1,250 miles per hour, the winds of Neptune makes it a stormy place, evidences by a Great Dark Spot that is a giant hurricane-like storm, similar to the Great Red Spot on Jupiter. The methane gas in the atmosphere is what makes the planet appear blue. White storms clouds that zip across the planet are common. Neptune's temperature averages -373 degrees Fahrenheit. Pluto: Pluto holds the place as the farest object in the solar system feom the sun. Pluto's distance from the sun gives it a large range of temperature on its surface, its stated as the coldest by Earth's standards. It is so cold on Pluto that a regular theromater can not state its coldness, scientist have to use a Kelvin scale. Using Kelvin scale, Pluto's temperture is at 44 K which is approximately -239 degrees. Its maximum reaches at 55 K ( -218 F ) and a minimum of 33 K ( -240 F ). Pluto maybe the coldest planent but surprisely, it has a warmer atmosphere than the surface of the dwarf planet. Its warm atmosphere is from the presence of unexceptly large amounts of methane.

Thesis Ideas

Thesis Ideas Thesis Ideas Thesis Ideas One of the best ways to learn about writing is to start write, to re-read and to edit your work in accordance to the required style and specified thesis format. Sometimes, a supervisor can seem to be a real pest in exhorting students to 'write it down'. But this is often the best advice. Start by writing your thesis ideas down, and ask yourself whether there is a logical flow of ideas in your writing. There is something about transferring knowledge or information from its mental repository or from some conceptual domain on to a page that tends to clarify thought and build coherence. We think a couple of basic tools are needed: an open mind; a dictionary; a thesaurus and/or style guide. If you possess these, you are in a good position to gather thesis ideas! Thesis Dissertation Writing Your writing will determine whether people understand what you have to say, and whether they agree with it and remember your conclusions. This brings us to the hard reality of who you are writing your thesis for. If you think huge hoards of fellow scholars are going to fall over themselves to borrow your thesis from a library - forget it! In reality, very few people will read your thesis, but many more will (you hope) read subsequent articles, chapters and/or even book derived from your thesis ideas. Your thesis will usually be read only by your supervisor and your examiners. The examiners, your most important audience, are also likely to read the thesis in a short period of time. Thesis Writing Consider this analogy: writing a chapter is like watching the news on television. You turn on the evening news, and what do they tell you? The answer is simple: they tell you the headlines, then they tell the news in detail, then they sum up the highlights. Formal academic writing is much the same: the entire thesis and each chapter should contain some form of introduction, a body and a conclusion. The main ideas or arguments should be captured within the introduction in order to focus the reader's attention on the main theme and motivate them to continue reading. The various sections comprising the body of your project should then continue in a logical format. The conclusion should summarize what has been written in the thesis, and link this summary with the original argument outlined in the introduction. There should always be a coherent, logical and consistent thread woven through each section, through each chapter and throughout the thesis. offers you an opportunity to order professional thesis writing assistance.   We will help you thesis ideas, writing, and editing. Do not miss this chance to ease your academic struggles!

Simile vs Metaphor The 1 Big Difference

Simile vs Metaphor The 1 Big Difference SAT / ACT Prep Online Guides and Tips Ever wonder what makes creative writing, well, creative? A big part of creative writing is coming up with a compelling way to express something.And similes and metaphors can be especially helpful when trying to do this. But what exactly are similes and metaphors? More importantly, what is the main difference between a simile and metaphor? This comprehensive simile vs metaphor guide answers both these questions and gives you several examples so you can learn how to differentiate between these two key literary devices.This article also includes key tips for using similes and metaphors in your own writing. Simile vs Metaphor:How Do They Differ? Both similes and metaphors are literary devices used by writers to compare two unalike things, ideas, actions, etc. in a non-literal manner. The two things being compared typically have one thing in common but are completely different in all other respects. Peopleuse similes and metaphors to make their writing more descriptive, more persuasive, more poetic, and more emphatic.Similes and metaphors areoften used in fiction/prose, poetry, and song lyrics. So what is the main difference between a simile and metaphor? Although the two devices are very similar- both serve the exact same purpose of comparing two different things in a figurative (non-literal) way- metaphors and similes are not identical. A simile is a type of metaphor that specifically uses the words "as" or "like" to make a comparison between two things. This usually takes the form of "A is like B" or "A is as(insert adjective)as B." By contrast, metaphors do not use the words "as" or "like." For example, you could write, "A is B" to make your comparison, even though A is not literally the same thing as B. The main takeaway here is that all similes are metaphors but not all metaphors are similes. 6 Real Simile and Metaphor Examples To help you understand the difference between a simile and metaphor, we'll look at six examples of the two. Examples of Metaphors Belowarethree examples of famous metaphors. As a reminder, metaphors compare two things without using the words "like" or "as." Metaphor Example 1 Eyes are the windows to the soul. Many famous sayings andidiomatic phrases take the form of metaphors in which the meaning is not literal but implied through a comparison. You clearly cannot literally see a person’s soul through his or her eyes; the implication here, then, is that one’s eyes and expression can reveal that person’s true feelings or character. In this sense, eyes are similar to windows because they can reveal information to the observer. Metaphor Example 2 "But thy eternal summer shall not fade"- William Shakespeare, Sonnet 18 This line of poetry comes from one of William Shakespeare’s most beloved sonnets, often called "Shall I Compare Thee to a Summer's Day?" In this poem, Shakespeare is comparinga young man's beauty to that of a warm summer day. In this particular line,the speaker assertsthat the man's "eternal summer" will never end, meaning that the speaker believes the essence of the man will live onthrough these very words. Shakespeare was a fan of metaphors- and earrings, apparently. Metaphor Example 3 "'Cause, baby, you're a firework / Come on, let your colors burst"- Katy Perry, "Firework" In her mega-hit song "Firework," Katy Perry uses a metaphor to compare "you" (the listener) to a firework. Fireworks are bright, captivating, and attention-grabbing, and so the implication here is that "you," too, are important and need to be confident in the value you bring. Examples of Similes Next up, here are some examples of famous similes. Remember that althoughsimiles perform the same function as metaphors in that theymake a comparison between two different things, similes always use the words "as" or"like" to make the comparison,whereas metaphors do not. Simile Example 1 My dad always wears glasses. Without them, he's as blind as a bat. The above simile "[as] blind as a bat" is a particularly well-knownsaying that compares a person's inability to see to the (alleged) blindness of bats, which hunt for prey primarily using echolocation instead of sight. Basically, this simile means that someone’s ability to see is quite poor. (Note that this saying isn't normally used to describe someone who is actually blind- it’s purposefully hyperbolic!) In this example, although the dad is evidently not blind- he just wears glasses to see- this simile implies that his ability to see things clearly without glasses is shockingly (and even laughably) low, comparable to a bat's inability to see clearly. Simile Example 2 "I wandered lonely as a Cloud / That floats on high o'er Vales and Hills"- William Wordsworth, "I Wandered Lonely as a Cloud" You’ve possibly already read this famous poem in English class. These two lines, the first of which contains the simile "lonely as a Cloud," come from William Wordsworth’s renowned 1807 poem, "I Wandered Lonely as a Cloud." The simile here draws a unique and compelling comparison between the loneliness of the speaker, who wanders around without accompaniment, and the "loneliness" of a cloud that floats around in the sky all by itself. Note: This simile uses another literary device called personification, whereinan inanimate object is given human-like qualities. In this case, the cloud "wanders" just as a human does. Simile Example 3 "My momma always said life was like a box of chocolates. You never know what you’re gonna get."- Tom Hanks in Forrest Gump Even if you’re not a die-hard Tom Hanks fan, you’ve probably heard this memorableline from the 1994 classic Forrest Gump. The phrase "life was like a box of chocolates" is a clear simile in that "life" is being compared to "a box of chocolates" using the word "like" (which once again shows us that this is a simile and not a metaphor). The meaning of this simile is clearly explained in the sentence that follows: "You never know what you’re gonna get." In other words, life is random and mysterious in the same exact way a box of chocolates is. You can't predict what kind of chocolate you'll get,just asyou can’tpredict what will happen in your life. As long as it's not that weird, mushy, cherry-filled chocolate, I'm good. Simile vs Metaphor Quiz Here’s a short simile vs metaphor quiz to see whether you truly know the difference betweenthe two literary devices. Mark an X under "Metaphor" or "Simile" for each phrase depending on whether you think it has a metaphor or simile. Be aware that a phrase might contain both a metaphor and simile, or neither! Phrase Metaphor Simile 1. "But soft, what light through yonder window breaks? / It is the east, and Juliet is the Sun." - WilliamShakespeare, Romeo and Juliet 2. Poor thing, your hands are as cold as ice! 3. "Elderly American ladies leaning on their canes listed toward me like towers of Pisa."- Vladimir Nabokov, Lolita 4. "Dying is a wild Night and a new Road."- Emily Dickinson 5. The song was an array of bright colors swirling around in the air. Like medicine, it made the boy perk up almost instantly. 6. "Fire away, fire away / You shoot me down but I won't fall / I am titanium"- David Guetta ft. Sia, "Titanium" 7. That girl over there looks a lot like my sister. 8. "Just like a moth drawn to a flame / Oh, you lured me in, I couldn't sense the pain"- Shawn Mendes, "Stitches" Answers Metaphor Simile Simile Metaphor Both Metaphor Neither Simile Answer Explanations 1. "But soft, what light through yonder window breaks? / It is the east, and Juliet is the Sun."- William Shakespeare, Romeo and Juliet In this classic line from Shakespeare'sRomeo and Juliet, Romeo spots a light coming from Juliet’s bedroom, causing him to compare Juliet to a sunrise- an image that evokes a sense of wonder, hope, and happiness. Because Romeo doesn’t use the words "like" or "as,"this line is a metaphor. 2. Poor thing, your hands are as cold as ice! Here, the speaker is comparing the low temperature of the listener's hands to the (literal) coldness of ice with the phrase "as cold as ice." This saying is commonly used to indicate that a person or an object is extremely cold to the touch (even thoughthe thing being described is likely not literally the same exact temperature of ice). The word "as" is used to make the comparison, so this example is a simile. This bubble is literallyas cold as ice. 3. "Elderly American ladies leaning on their canes listed toward me like towers of Pisa."- Vladimir Nabokov, Lolita This beautifully descriptive sentence from Vladimir Nabokov’s controversial 1955 novel Lolita compares the image of hunched elderly women to the Leaning Tower of Pisa, a historical Italian building most famous for its noticeable tilt. Because Nabokov uses the word "like" to make the comparison between the women and "towers of Pisa," this sentence is a simile. 4. "Dying is a wild Night and a new Road."- Emily Dickinson Renowned American poet Emily Dickinson wrote this grave, albeit poignant, sentence in a letter penned in 1869. Dickinson compares the act of dying to "a wild Night and a new Road," implying that death is a natural course of action in life. Because the comparisondoes not use the words"like" or "as," it is a metaphor. 5. The song was an array of bright colors swirling around in the air. Like medicine, it made the boy perk up almost instantly. This example uses both a metaphor and a simile to express the overall positive feelings a boy has when listening to a particular song. The first sentence is a metaphor: the song he is listening to is described as "an array of bright colors," even though music isn’t actually visible to the human eye. Since this comparison doesn’t use the words"like" or "as," it is a plain metaphor. The second sentence, however, makes another comparison, this time using the word "like." The song is described as being"like medicine" because it makes the boy feel better- the same effect medicines are supposed to have on people when they feel sick. Because the word "like" is used, this second sentence is a simile. 6. "Fire away, fire away / You shoot me down but I won't fall / I am titanium"- David Guetta ft. Sia, "Titanium" This line, taken from the chorus of the 2011 hit song "Titanium" by David Guetta, describes the speaker asthesuper-strong metal titanium. This image, then, tells us that the speaker is really similar to titanium in that he or she is both strong and resilient. Because neither"like" nor "as" ispresent here,this lyric is an example of a metaphor. 7. That girl over there looks a lot like my sister. In this sample sentence, the physical appearance of "that girl" is being compared to that of the speaker’s sister. Although you might be tempted to say this is a simile because it uses the word "like," you’d be wrong! There is no metaphor or simile at play here.The "like" we see here is still being used to make a comparison, but it is a comparison between two similarthings (the two girls). Recall that the basis for any metaphor or simile is that you must be comparing two unalike things. Comparing a duck to another duckwon't give you a metaphor but WILL give you a ton of quacking. 8. "Just like a moth drawn to a flame / Oh, you lured me in, I couldn't sense the pain"- Shawn Mendes, "Stitches" This line comes from the 2015 pop hit "Stitches" recorded by Shawn Mendes. The speaker here is describing howmesmerized he is by his lover by comparing his situation to that of "a moth drawn to a flame." Because he uses the word "like" in this particular line, this lyric is an example of a simile. How to Use Similes and Metaphors in Writing: 4 Tips Now that we’ve gone over the major difference between a simile and metaphor, let’s take a look at four tips to keep in mind when you want to use one of these literary tools in your own writing. #1: Avoid Clichà ©s One big tip you’ll want to remember when writing anything- whether it’s a poem or a story- is to avoid clichà ©d metaphors and similes as much as possible. Using clichà ©d metaphors in your writing generally indicates to readers that you don’t find it necessary to take time to come up with original comparisons; it’s also often interpreted to mean that you lack creativity and are a lazy writer. Clichà ©s include any overused sayings or idiomatic expressions, such as the following: Strong as an ox Sick as a dog Time flies Hot as hell White as snow Scared to death Fish out of water Two peas in a pod Check out this website for a longer list of clichà ©s to avoid. Though you should generally avoid using these types of sayings, if you’re writing dialogue for a story, colloquial expressions such as these would beperfectly fine to use, especially if you’re trying to capture a more realistic conversation between people. That being said, definitely try toavoidusing clichà ©s in descriptions and expository passages. Coming up with your ownsimiles and metaphors will ultimately make your writing more creative, more authentic, and more compelling. #2: Don’t Overuse Similes and Metaphors Be careful of overusing similes and metaphors in any type of writing you do. Obviously, the definition of what counts as overusing figurative language will vary depending on the person. Indeed,whereas somerenowned writers adore metaphors andhave a penchant for flowery passages, others opt to avoid them as much as possible la Ernest Hemingway. No matter your preferred writing style, you don’t want your text to be ambiguous, confusing, or completely devoid of concrete substance. A passage that is 90% metaphorical is a lot more likely to exhaust and confuse readers than it is to impress or inspire them. Moreover, toomuch figurative language will weakentheimpact of each metaphor,and you want theseto be particularly powerful. So tread lightly and always err on the side of less is more! #3: Be Sure the Comparison Makes Sense Although the two things being compared in a metaphor or simile should be pretty different from each other, you need to make sure that there's still something similar between them so that the comparison makes sense to the reader and can be readily understood and interpreted. For example, if you’re trying to describe the delicious, tantalizing smell of freshly baked chocolate chip cookies, it wouldn’treally make sense to compare it to the smell of a dumpster or something else notoriously gross and stinky. Similarly, the connection between the two things must be immediately clear to the reader. If you were to write, "He looked as comfortable as a penguin," readerswould very likely have no idea how this feeling of being comfortable relates to penguins specifically. Instead, you could write, "He looked as comfortable as a penguin on ice," since penguins are mostat ease incold, icy settings. Alternatively, you could use asimile or metaphor to make an ironic or sarcastic statement. In the example given above, say you want to point out how uncomfortable the man is. This means you could write something like, "He looked as comfortable as a penguin in a Miami zoo." Because penguins' natural habitat is in the (much colder) Antarctic, the irony here is that the man is clearly not comfortablein the same way penguins must feel in a hot, caged environment. If you’re not sure whether a metaphor or simile you’ve written makes sense, ask a family member or friend to read it (ideally in context) and see whether they can grasp the meaning you’re trying to make with it. Be as comfortable (and as adorably fluffy) as these baby penguins. #4: Avoid Sticking With the First Metaphor You Think Of This final tip is for serious writers and one I got from my own creative writing professor in college. The basic point here is that you should never feel compelled to go with the first metaphor or simile you come up with. When people write stories, they can be tempted to stick with the very first "clever" metaphor or simile they think of- but oftentimes these phrases can be drastically improved upon and made clearer and more relevant. But is it really bad to stick with the first metaphor you think of? Of course not! Sometimes people do come up with amazing metaphors right away and end up keeping them as is, even in the final version of the text. But this certainly isn’t the case for most people.In reality,the best writers will be the ones who take time to reread, tweak, and improve sentences and passages- including metaphors and similes- they’ve written. Doing all this will not only give you practice with metaphors and similes, but will also help you get used to the long-winded, albeit worthwhile, process that is creative writing! What’s Next? Got questions about other common literary devices? Then check out our in-depth guide to the 31 most important literary devices you should know. Working on a story or prepping for the AP Literature test?Learn all about the most important literary elements that make up a story. Thinking about amajor in creative writing? Then you'll definitely want to take a look at the top creative writing programs in the country!

THE COMPARISON OF CONTRAST MEAD AND BOURDIEU THEORIES Essay

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Idiopathic Pulmonary Fibrosis: An Overview

Idiopathic Pulmonary Fibrosis: An Overview Jennifer Beardsley Abstract Idiopathic pulmonary fibrosis (IPF) is a devastating interstitial lung disease that has no cure. The term fibrosis refers to scarring, in IPF particularly the scarring of the lungs. The scarring causes irreversible destruction and progressive decline of the lungs. When the tissue thickens, the lungs cannot properly exchange oxygen. The term idiopathic, in medicine, means that the origin of the disease is unknown. The exact cause of IPF is unknown, however, certain risk factors such as smoking, exposure to inhaled toxins such as asbestos, lung injury, viral, and bacterial infections, acid reflux and genetics associated with the disease. IPF mainly affects people ages 50 and up. â€Å"Many people live only about 3 to 5 years after diagnosis. The most common cause of death related to IPF is respiratory failure† (â€Å"What Is Idiopathic Pulmonary Fibrosis? NHLBI, NIH,† n.d.). â€Å"40,000 people die each year to IPF, the same as to breast cancer† (â€Å"Facts Abou t Idiopathic Pulmonary Fibrosis | Coalition For Pulmonary FibrosisCoalition For Pulmonary Fibrosis,† n.d.), yet IPF is still an unknown disease to many people. This paper will discuss the risk factors, disease process, complications, management, and new drug therapy clinical trials. Idiopathic Pulmonary Fibrosis: An Overview Etiology Idiopathic Pulmonary Fibrosis first started to become recognizable around the late 1800’s (Noble Homer, 2005). While currently the exact cause is unknown, there have been several risk factors that are recognized to contribute to the disease. As mentioned above, smoking, exposure to inhaled toxins such as asbestos, lung injury, viral and bacterial infections, acid reflux and genetics are associated with the disease (Noble Homer, 2005). Smoking accelerates the loss of lung function by destroying the cilia inhibiting the lungs natural ability to clean and repair itself (Oh, Murray, Molfino, 2012). Smoking also damages alveoli, causing poor gas exchange. The chemicals in cigarettes contribute to lung decline and disease and coat the lungs with tar and toxins (Oh et al., 2012). Inhaled substance and toxins such as asbestos are hypothesized to increase IPF probability (Meltzer Noble, 2008). When toxins invade the lungs, they interfere with the alveoli gas exchange process (Meltzer Noble, 2008). Lung injury can cause permanent damage. Acute lung injury has been hypothesized to accelerate an underlying progression of IPF. When cells of the lungs are damaged, it can be irreversible (Kottmann, Hogan, Phipps, Sime, 2009). Viral and bacterial infections cause a build of mucus in the lungs. When the alveoli get clogged they cannot properly exchange oxygen and carbon dioxide. Each infection acquired can cause more damage and can lead to permanent damage. When the lungs lose their ability to exchange gas, oxygen is inhibited from reaching the body’s vital organs (Kottmann et al., 2009). GER, commonly known as acid reflux, occurs when acid is aspired into the esophagus. â€Å"Researchers have found that 9 out of 10 people who have IPF also have gastroesophageal reflux disease† (â€Å"What Causes Idiopathic Pulmonary Fibrosis? NHLBI, NIH,† n.d.) Recent research has found that genetics may play an important role in the risk factor of developing IPF. â€Å"Over the past decade, one aspect that has held great promise in helping the medical community to better define the pathogenesis of IPF is the recognition that genetic factors may play a role in this disease† (Lawson, Loyd, Degryse, 2011). Pathophysiology The cause of IPF is unknown. Despite considerable advancement in understanding the progression of IPF, the knowledge of the beginning stages of IPF re still inadequately understood (Noble Homer, 2005). Originally, in the 1970’s, it was thought that inflammation of the alveoli was the cause (Noble Homer, 2005). It was believed that untreated inflammation leads to the scarring of the lungs. Anti-inflammatory and corticosteroids were widely used to treat the inflammation. However, those therapies have proven ineffective, making it evident that inflammation was not the cause (Dempsey, Kerr, Gomersall, Remmen, Currie, 2006). The second theory that came about in the 1980’s suggesting growth termed â€Å"alveolar macrophage-derived growth factor† (Noble Homer, 2005). Known as the ‘growth factor hypothesis’, it is believed that abnormal healing of trauma within the lungs exaggerates the response and growth of profibrogenic causing the scarring of IPF (Noble Homer, 2005). This theory still proves to be a highly important discovery in the pathophysiology of IPF (Dempsey et al., 2006). A third theory also came out of the 1980’s, known as the epithelial-mesenchymal hypothesis, suggests that tissue death of alveolar epithelial cells can lead to alveolar collapse (Noble Homer, 2005). The epithelial- mesenchymal cell conversion can alter and change motility and the ability to heal. â€Å"Imbalance of the normal homeostatic microenvironment might be, per se, a cause of fibroblast proliferation and myofibroblast differentiation leading to fibrosis† (Prunotto et al., 2012). Clinical Manifestation According to the Coalition for Pulmonary Fibrosis, â€Å"Idiopathic pulmonary fibrosis (IPF) is a progressive and generally fatal disease characterized by scarring of the lungs that thickens the lining of the lungs, causing an irreversible loss of the tissue’s ability to transport oxygen. IPF ultimately robs a patient of the ability to breathe†(â€Å"Facts About Idiopathic Pulmonary Fibrosis | Coalition For Pulmonary Fibrosis,† n.d.). IPF usually occurs in older adults in their 50’s or 60’s, and tends to occur more in men than in women (Lawson, Loyd, Degryse, 2011). According to the Coalition For Pulmonary Fibrosis, IPF affects about 128,100 people in the United States, with 48,000 new cases diagnosed annually (â€Å"Facts About Idiopathic Pulmonary Fibrosis | Coalition For Pulmonary Fibrosis,† n.d.). â€Å"IPF has been reported to occur throughout the world in many different racial and ethnic groups. Studies in the United States have sugge sted that Caucasians are more likely to be diagnosed with IPF and have higher mortality rates from IPF than African Americans. It is unclear if these findings are due to real differences in racial characteristics or to an under-diagnosis of this condition in minority populations† (Siegel, 2011). IPF symptoms develop over time and usually are not diagnosed until serious damage has already been done to the lungs (â€Å"What Are the Signs and Symptoms of Idiopathic Pulmonary Fibrosis? NHLBI, NIH,† n.d.). Patients are often misdiagnosed with diseases that present similar symptoms such as Chronic Obstructive Pulmonary Disorder (â€Å"Facts About Idiopathic Pulmonary Fibrosis | Coalition For Pulmonary Fibrosis,† n.d.). Idiopathic pulmonary fibrosis usually present gradually with a nonproductive cough and dyspnea. (Hyzy, Huang, Myers, Flaherty, Martinez, 2007). The main symptom patients complain of being shortness of breath (Noble Homer, 2005). Other common symptoms include: â€Å"dry, hacking cough; rapid, shallow breathing; gradual, unintended weight loss; Fatigue (tiredness) or malaise (a general feeling of being unwell); clubbing, which is the widening and rounding of the tips of the fingers and toes† (â€Å"What Are the Signs and Symptoms of Idiopathic Pulmonary Fibrosis? NHLBI, NIH,† n.d.). The gold standard for diagnosis of patients with IPF is a surgical lung biopsy (SLB), however critical risk for these patients usually prevent a high-risk surgical procedure (Kaarteenaho, 2013). â€Å"The mortality, which can occur shortly after the procedure, has probably been the major reason to refrain from performing SLB† (Kaarteenaho, 2013). With that in mind, diagnosis of IPF includes clinical, radiologic and histopathologic aspects (Wolters, Collard, Jones, 2014). The American Thoracic Society states, â€Å"in the absence of a definitive lung biopsy, the presence of all four major criteria and three minor criteria, as set forth in the current guidelines, increases the likelihood of a correct diagnosis of IPF: Major Criteria †¢Exclusion of other known causes of interstitial lung diseases, such as certain drug toxicities, environmental exposures, and connective tissue diseases †¢Abnormal pulmonary function studies that include evidence of restriction (reduced vital capacity often with an increased FEV:FVC ratio) and impaired gas exchange (increased AaPO2 with rest or exercise or decreased DLCO) †¢HRCT scan showing bibasilar reticular abnormalities with minimal ground-glass opacities †¢Transbronchial lung biopsy or BAL showing no features to support another diagnosis Minor Criteria †¢Age >50 years †¢Insidious onset of otherwise unexplained dyspnea on exertion †¢Duration of illness greater than or equal to 3 months †¢Bibasilar inspiratory crackles (dry or â€Å"Velcro-like† in quality)† (Raghu et al., 2011). The physical assessment is an important part of diagnosis, however, symptoms can mimic other diseases and make it hard to differentiate (Meltzer Noble, 2008). Attention should be paid to key risk factors such as work related inhaled chemical exposure and smoking. Fine inspiratory â€Å"Velcro-like† crackles can be heard upon examination and advance towards the upper airway as the disease progresses (Meltzer Noble, 2008).Clubbing of the fingers and toes is found in 50% of patients (Meltzer Noble, 2008). Lab results are often inconclusive to IPF, but as part of a puzzle can help to identify the disease. An ABG will more than likely read normal (Meltzer Noble, 2008). The pulmonary function test (PFT) can lend valuable information to diagnosing IPF. While IPF is a restrictive disease, it can often imitate obstructive disorders or congestive heart failure (CHF) (Meltzer Noble, 2008). â€Å"Routine spirometry reveals decreased measures of forced vital capacity (FVC) and forced expiratory volume in one second (FEV1). The ratio of FEV1/FVC remains normal (or increased) in IPF, consistent with restrictive physiology† (Meltzer Noble, 2008). Subsequently, the PFT can also reveal reduced TLC, RC, and RV. Reduced gas transfer may also be noted with a DLCO (Meltzer Noble, 2008). Almost every patient with Idiopathic Pulmonary Fibrosis will have abnormal radiological findings (Meltzer Noble, 2008). The imaging modality of choice in diagnosing IPF is High-resolution computed tomography (HRCT) (Hospenthal, 2006). â€Å"Patchy, predominantly peripheral, subpleural, bibasal reticular opacities, often associated with traction bronchiectasis† (Harari Caminati, 2005). A phenomenon referred to as honeycombing is a prevalent finding in IPF, seen below is figure 3. Figure 1: Chest radiograph of a patient with IPF. Chest radiograph reveals peripheral, subpleural reticular opacities, most profuse at the lung bases (Harari Caminati, 2005). Figure 2: Chest HRCT in a patient with IPF. HRCT shows patchy, predominantly peripheral, subpleural, bibasal reticular abnormalities, traction bronchiectasis and bronchiolectasis and irregular septal thickening. There is also ground glass (Harari Caminati, 2005). Figure 3: Chest HRCT in a patient with IPF. HRCT shows predominantly peripheral and subpleural fibrosis with honeycombing (Harari Caminati, 2005). Complications Idiopathic pulmonary fibrosis is a highly progressive disease. Because the tissues in the lungs are scarred, they cannot properly exchange gas and the low amount of oxygen delivered to the body causes several complications and puts strain on the right side of the heart. According to the America Thoracic Society, â€Å"There is an increasing awareness of complications and comorbid conditions frequently associated with IPF† (Raghu et al., 2011). Some of the most common complications are: Pulmonary hypertension, cor pulmonale, respiratory failure and lung cancer (Daniels, Yi, Ryu, 2008). Depression is also often seen in people with IPF because of its devastating prognosis (â€Å"Living With Idiopathic Pulmonary Fibrosis NHLBI, NIH,† n.d.). Acute exacerbations (unexplained worsening of dyspnea) of IPF represent the most destructive and deadly complication (Raghu et al., 2011). â€Å"It is presently unclear if acute exacerbation of IPF is simply a manifestation of an unid entified respiratory complication (such as pulmonary emboli, infection) contributing to an acute worsening in a patient with IPF or represents an inherent acceleration in the pathobiological processes involved in IPF† (Raghu et al., 2011). Medical Management There is currently not a cure for idiopathic pulmonary fibrosis (â€Å"What Is Idiopathic Pulmonary Fibrosis? NHLBI, NIH,† n.d.). Until recently, primary methods of management have been anti-inflammatories and lung transplants (Dempsey, Kerr, Gomersall, Remmen, Currie, 2006). While Anti-inflammatory are still used today it is not due to the effectiveness of treatment, but lack thereof for alternatives (Dempsey et al., 2006).â€Å"Immunosuppressive or cytotoxic agents are used among steroid nonresponders, patients experiencing serious adverse effects from corticosteroids, and patients at high risk for corticosteroid complications† (Harari Caminati, 2005). â€Å"Single-lung transplantation results in an actuarial survival of 73% at 1 year and 57% at 3 years† (Harari Caminati, 2005). Unfortunately, most patients are not eligible for transplant due to age or comorbidity factors (Harari Caminati, 2005). In the spring of 2014 the FDA announced two new drugs for the management of IPF (â€Å"CPF Celebrates Historic Year of Progress in Pulmonary Fibrosis | Coalition For Pulmonary Fibrosis Coalition For Pulmonary Fibrosis,† n.d.). Ofev (nintedanib) and Esbriet (pirfenidone) were both shown to slow the progress of IPF in clinical trials. â€Å"Pirfenidone is a transforming growth factor-beta inhibitor and tumor necrosis factor-alpha inhibitor† (Gohil, 2015). Ofev is a â€Å"fibroblast growth factor receptor (FGFR) antagonist, platelet-derived growth factor receptor (PDGFR) antagonist, and vascular endothelial growth factor receptor (VEGFR) antagonist† (Gohil, 2015). The two treatments are still in the early stages with little known about their effectiveness. Prognosis Prognosis for IPF is dim. It is a fatal disease (Meltzer Noble, 2008). The median survival rate is 3 years after diagnosis (Peljto et al., 2013). Factors associated with â€Å"shortened survival time include: older age, smoking history, lower body mass index (BMI), more severe physiologic impairment, greater radiologic extent of disease, and the development of other complications or conditions, in particular, pulmonary hypertension, emphysema, and bronchogenic cancer† (Ley, Collard, King, 2011). Clinical Trials During the past decade, there has been a notable amount of research into the treatment of idiopathic pulmonary fibrosis. IPF is no longer believed to be due to inflammation, but multiple injuries with atypical cell repair. According to The Coalition for Pulmonary Fibrosis, â€Å"there are many therapies under investigation in clinical trials that include: †¢Antifibrotic or antifibrogenic agents (such as Pirfenidone, interferon and certain blood-pressure-lowering medications) to suppress the scarring process †¢Antioxidants (such as N-acetylcysteine) to prevent damage to lung tissue †¢Monoclonal antibodies to inhibit â€Å"bad† cytokines (protein growth factors, such as TGF-beta, TNF-Alpha, or CTGF, that activate inflammation)† (â€Å"Active Clinical Trials and Investigational Research in IPF | Coalition For Pulmonary FibrosisCoalition For Pulmonary Fibrosis,† n.d.). References Active Clinical Trials and Investigational Research in IPF | Coalition For Pulmonary FibrosisCoalition For Pulmonary Fibrosis. (n.d.). Retrieved February 17, 2015, from http://www.coalitionforpf.org/active-clinical-trials-and-investigational-research-in-ipf/ Facts About Idiopathic Pulmonary Fibrosis | Coalition For Pulmonary FibrosisCoalition For Pulmonary Fibrosis. (n.d.). Retrieved February 17, 2015, from http://www.coalitionforpf.org/facts-about-idiopathic-pulmonary-fibrosis/ Hospenthal. (2006). Diagnosis and management of idiopathic pulmonary fibrosis: Implications for respiratory care. Respir Care, 51, 382–391. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/16563193 Hyzy, R., Huang, S., Myers, J., Flaherty, K., Martinez, F. (2007). Acute exacerbation of idiopathic pulmonary fibrosis. Chest, 132, 1652–1658. doi:10.1378/chest.07-0299 Kaarteenaho, R. (2013). The current position of surgical lung biopsy in the diagnosis of idiopathic pulmonary fibrosis. Respiratory Research, 14, 43. doi:10.1186/1465-9921-14-43 Lawson, W. E., Loyd, J. E., Degryse, A. L. (2011). Genetics in pulmonary fibrosisfamilial cases provide clues to the pathogenesis of idiopathic pulmonary fibrosis. The American Journal of the Medical Sciences, 341(6), 439–43. doi:10.1097/MAJ.0b013e31821a9d7a Ley, B., Collard, H. R., King, T. E. (2011). Clinical course and prediction of survival in idiopathic pulmonary fibrosis. American Journal of Respiratory and Critical Care Medicine, 183(3), 431–440. doi:10.1164/rccm.201006-0894CI Meltzer, E. B., Noble, P. W. (2008). Idiopathic pulmonary fibrosis. Orphanet Journal of Rare Diseases, 3, 8. doi:10.1186/1750-1172-3-8 Noble, P. W., Homer, R. J. (2005). Back to the future: Historical perspective on the pathogenesis of idiopathic pulmonary fibrosis. American Journal of Respiratory Cell and Molecular Biology, 33(8), 113–120. doi:10.1165/rcmb.F301 Peljto, A. L., Zhang, Y., Fingerlin, T. E., Ma, S.-F., Garcia, J. G. N., Richards, T. J., †¦ Schwartz, D. A. (2013). Association between the MUC5B promoter polymorphism and survival in patients with idiopathic pulmonary fibrosis. JAMA, 309(21), 2232–9. doi:10.1001/jama.2013.5827 Raghu, G., Collard, H. R., Egan, J. J., Martinez, F. J., Behr, J., Brown, K. K., †¦ Schà ¼nemann, H. J. (2011). An Official ATS/ERS/JRS/ALAT Statement: Idiopathic pulmonary fibrosis: Evidence-based guidelines for diagnosis and management. American Journal of Respiratory and Critical Care Medicine, 183, 788–824. doi:10.1164/rccm.2009-040GL Siegel, M. D. (2011). Breathing in America: Diseases, Prognosis, and Hope. Critical Care Medicine, 39, 1857. doi:10.1097/CCM.0b013e31821b1e92 What Are the Signs and Symptoms of Idiopathic Pulmonary Fibrosis? NHLBI, NIH. (n.d.). Retrieved February 17, 2015, from http://www.nhlbi.nih.gov/health/health-topics/topics/ipf/signs What Is Idiopathic Pulmonary Fibrosis? NHLBI, NIH. (n.d.). Retrieved February 14, 2015, from http://www.nhlbi.nih.gov/health/health-topics/topics/ipf Wolters, P. J., Collard, H. R., Jones, K. D. (2014). Pathogenesis of idiopathic pulmonary fibrosis. Annual Review of Pathology, 9, 157–79. doi:10.1146/annurev-pathol-012513-104706