Wednesday, March 25, 2020
India Women Silenced by their culture large populations of women in India tolerate abuse and subsequent death because they have provided insufficient dowry. In a culture that is male dominated women are raised to be servants to their husbands often arranged to marry a man that they have never met. Women that are beaten or just unhappy must suppress their feelings to keep their husbands blissful or face shame and be turned away by their own families. Indian womens household must pay a dowry for the privilege of marrying a man of status. The dowry often consists of money, merchandise, or gold that is displayed when the couple is married. Women are being mistreated for insufficient dowry money because the grooms family may be greedy and would like more items. If the brides family cannot provide more for the in-laws they will kill her so that he may keep the dowry he already had collected and then marries another that may possess more money or status. The original dowry is determined by the perceive d value of the husbands hand in marriage. If the husband is very desirable then he commands a very high dollar figure, if the offer of money is too low then the grooms family will not accept it because it is an insult. A woman held a PHD and married a man that was a shopkeeper with less education than she possessed. Her father provided a years worth of salary and many gifts. After the couple had been married six months, the in-laws requested a washing machine and other items that the brides family could not afford to give. They taunted the bride and eventually she was found hung from a ceiling fan. The groom was never convicted because he told the police she committed suicide, because she did not love him enough. Since the death took place in his home, they had no way of knowing if it was the truth. The woman was cut off from her relatives and had once asked her father to help her because she did not feel safe with her new husband. The father told her that she should give it time because he was not to intervene to early in the marriage, he wanted her to stay married at the time. (Mandelbaum p.1) Women in India marry within their own social caste which divides people into four major groups the Brahmin, kshatryia, vaishya, and the sudra with some of the lower people being called so the untouchables. The untouchables are called so dirty that even a glass that they have drunk from cleaned, will always be contaminated. Female babies are viewed as a burden to the father, that he must work and save to marry her off and males are always preferred. The birth of a girl is mourned in most families, which contributes to female infanticide in India today. (India dowry p67) The marriages that take place are all arranged and can take place even as children, teenagers, and twenty-year-old businessmen and women that has to yield to the practice in society. Women that do choose their own mates are not exempt from the dowry and often face anger from their parents or being disowned. Parents will often look for the most suitable mate for tier daughter in classified ads, Internet, or marriage bro kers with out prior knowledge each other the bride and groom are married if the dowry is in agreement on both sides. In Hindu laws of Manu a woman is joined to her husband and has to suffer with him and act with tolerance, this religion believes that women are the cause if a marriage fails and that men are absolved from their own actions. If there is any unhappiness in the home of an Indian woman, they look at her as the cause even if the husband is in some cases beating, taunting and allowing his friends to gang rape her. These women have no choice but to stay in inhumane situations because they were raised in a culture that does not give them many rights and teaches them from an early age to be a servant. If an Indian woman needs help there are few places
Friday, March 6, 2020
The Day My Dad Didnt Make it Home from Work - by Marianne Worley, Business Writing Consultant at The Essay Expert
The Day My Dad Didnt Make it Home from Work - by Marianne Worley, Business Writing Consultant at The Essay Expert [Reposted with the permission of the very talented business/marketing writer Marianne Worley, consultant at The Essay Expert. This poignant story was originally posted on her blog, Marketing Matters and Other Stories. I didnt even have to think before asking her if I could post it to The Essay Experts blog on Memorial Day.] The day was Monday, April 21, 2008. My phone rang just after 9pm. I checked the caller IDÃ¢â¬âit was my brother Nolan. Instinctively, I knew something was wrong, very wrong. My Dad had been in an accident and was being taken to a hospital about 20 miles north of my house. We didnÃ¢â¬â¢t know anything more. I quickly got dressed, jumped in my car, and hit the gas pedal. About 5 minutes later, my brother called again. Now Dad was being transported by helicopter to the much larger hospital just a few miles from my house. I got off the freeway and drove back the other way. My brother, sister-in-law, and I arrived at the hospital around the same time. The helicopter was still in flight, so we staked out seats in the busy emergency room to wait, still perplexed about what had happened to our Dad. After my stepmom and sister rushed in, we learned the whole story. My Dad usually came home from work around 5 or 6, so when it started to get dark and he still wasnÃ¢â¬â¢t home, my stepmom picked up the phone to make some increasingly frantic calls. My Dad was notorious for sporadically answering cell calls. As a contractor, he was constantly breaking and losing mobile phones. She wasnÃ¢â¬â¢t surprised when he didnÃ¢â¬â¢t answer, so she dialed his friends and clients. He had left the job site hours earlier, but no one knew where he was. My stepmom and sister decided to drive to the job site to look for him. They found his empty work truck on the side of the road with the driverÃ¢â¬â¢s side door open. They called 911 and nearby friends who could help with the search. There was a small creek parallel to the road with a steep bank covered in thick, muddy vegetation. My athletic sister charged down the hill and found him lying unconscious in the creek, pale and covered with dirt. The paramedics pulled him up on a rescue stretcher and loaded him into the helicopter. This process doesnÃ¢â¬â¢t take a few minutes, like it does on TV and in the movies. The rescue actually took more than an hour. The helicopter finally arrived, but still we knew nothing about his condition. We assumed it was a stroke, or something similar. When they finally let us in to see him, we discovered that he had suffered some sort of episode, possibly a seizure, and was experiencing pronounced weakness on one side of his body. It looked like a stroke, but he was stable. So they admitted him and scheduled an MRI for the next morning. The following day, the doctors confirmed that the MRI results showed that it looked like a stroke. We felt relieved. We knew a brain tumor would be a much more deadly diagnosis. But they still wanted to get a new MRI, with contrast, the next day to be sure. On Wednesday, April 23, 2008, our lives changed forever. The new MRI showed that it wasnÃ¢â¬â¢t a strokeÃ¢â¬âit was a brain tumor. They called in a neurosurgeon for a consultation. My education in neurology commenced that day. I carried a notebook at all times. I scribbled down details from the doctors during the day and did online research at night. Over the next 7 months, my Dad had a biopsy and was diagnosed with glioblastoma multiforme, the most aggressive form of brain cancer. Our doctor decided to treat with radiation and chemotherapy, not surgery. I knew that without surgery, the 6-month survival rate was almost zero. When I pressed him, he said he could do the surgery if we got a second opinion from one of the neurosurgeons he recommended. After many phone calls, I got an appointment with one of the top experts in the country at Cedars-Sinai in Los Angeles. The neurosurgeon just needed to see my DadÃ¢â¬â¢s (now enormous) medical file, along with all of his MRI results. We got his opinion, and my Dad had surgery to remove the tumor. Although the surgery was successful, he still needed radiation and chemo to stave off regrowth, which is incredibly common. I researched clinical trials and spoke to doctors at UCLA and UC San Francisco. My Dad didnÃ¢â¬â¢t qualify for any trials and his prognosis was grave. By September, the tumor was back, bigger than before. We tried some experimental chemo drugs, but nothing helped. My Dad wasted away before our eyes, until we finally called in hospice care in November. On December 3rd, the hospice nurse told us that the end was near, so we gathered together to say goodbye. We stayed up pretty late, but finally succumbed to our own fatigue and reluctantly went to bed. Just before 4:30am, I awoke suddenly and sat bolt upright. I went downstairs and the nurse told me she had just checked on my DadÃ¢â¬âhe was still hanging in there. When I went to his bedside, I touched his hands and face. I didnÃ¢â¬â¢t think he was breathing, so I woke up my stepmom, who had decided to take a quick nap just minutes before. He was gone. We all gathered around his bed and cried again. A week or so later, my sister Whitney and I, always the DaddyÃ¢â¬â¢s-Little-Girl types, decided to get tattoos to celebrate our DadÃ¢â¬â¢s life. She got an elegant Ã¢â¬Å"WÃ¢â¬ and I got an infinity sign with a Ã¢â¬Å"WÃ¢â¬ in the middle. Worley forever. My Dad was never called to battle in Vietnam, but that doesnÃ¢â¬â¢t mean he didnÃ¢â¬â¢t fight a war. So on this Memorial Day, I remember all who have fallen in war, including the continuing war on cancer. ____________________ I havenÃ¢â¬â¢t met anyone who hasnÃ¢â¬â¢t been touched in some way by cancer. The next time youÃ¢â¬â¢re thinking about making a cash donation to a charity, please consider one of the organizations in the fight against cancer, including the American Brain Tumor Association. Thanks for reading this very personal story. IÃ¢â¬â¢m sharing it because it shaped who I am today. Many thanks to my fellow blogger The JackBÃ¢â¬âhis post from yesterday inspired me to write this. I havenÃ¢â¬â¢t met anyone who hasnÃ¢â¬â¢t been touched in some way by cancer. The next time youÃ¢â¬â¢re thinking about making a cash donation to a charity, please consider one of the organizations in the fight against cancer, including the American Brain Tumor Association. Category:UncategorizedBy Brenda BernsteinMay 31, 2011 8 Comments Nancy Anderson says: May 31, 2011 at 12:50 pm What a beautiful story. I too lost my dad to cancer and as I read your words, I could feel myself going through the same feelings, thoughts and anguish. God bless your father and your family. Thank you for sharing your story with us. Log in to Reply The Essay Expert says: May 31, 2011 at 1:55 pm Youre very welcome Nancy. This was Mariannes story. My father died 14 years ago after a week-long battle with pneumonia, so Mariannes piece spoke loudly to me. Im so glad it is being appreciated. Log in to Reply Alejandra Leiva says: October 6, 2016 at 10:43 am Hi The Essay Expert, I was wondering how I can submit a question about some words. Here I have one: Do we stand in the snow or on the snow? Log in to Reply Brenda Bernstein says: October 6, 2016 at 11:12 am Hi Alejandra! If you are standing on top of the snow, in snow shoes or skis for instance, you would be standing on the snow. If you are waist-deep in snow you would be standing in the snow. Or if you are in a snowstorm you would be in the snow. I hope that helps! Log in to Reply Alejandra Leiva says: October 6, 2016 at 4:27 pm Awesome that helps a lot! Could you help me with another question? Which of these is correct? Or what do they mean? count with me count on me Brenda Bernstein says: October 22, 2016 at 6:54 am Count on me means you can rely on me. Count with me would mean something like count to 10 with me! The Essay Expert says: May 31, 2011 at 1:55 pm So true Pedro. Even a week-long battle, like the one my father fought, is a battle indeed. Log in to Reply The Essay Expert says: May 31, 2011 at 4:40 pm Thank you Jan. Its amazing how many this disease has touched. My heart goes out to you. Log in to Reply
Wednesday, February 19, 2020
Has Kuwait Prospered with Western Relations - Essay Example Surrounded by warring neighbors Kuwait is well noted for its wealth and stability (Crystal). Long time a bulwark for the West and the United States against many of the more radical regimes of the day, the United States had very close ties both politically and economically with the affluent rulers in Kuwait (Sharp). It was by using these relations to first put themselves into a position of prosperity, then reclaim their nation from Iraq, followed by the remarkable accomplishment of not only rebuilding but improving their position in the world society, that Kuwait managed to remain intact. Working with the vast resources of the West, the clever rulers of Kuwait have turned tragedy into fortune. By first examining the state of the Kuwaiti Ã¢â¬â United States/Western relations before the Gulf War and then researching the effects that the war itself had on the country, followed by the method that the Kuwaitis have used these results to its advantage to recover, we will answer the question: Is Kuwait better off because of Western Relations? This paper will seek to prove if indeed sometimes war can be good for a country and that if in the long term, security and economic concerns, for both countries, were and continue to be to this day, the driving factor behind the United States Ã¢â¬â Kuwaiti relations. ... , security and economic concerns, for both countries, were and continue to be to this day, the driving factor behind the United States Ã¢â¬â Kuwaiti relations. The country of Kuwait Kuwait, in a region prone to chaos and unrest is a remarkable example of exactly the opposite. Founded in the eighteenth century, with aid from the British, Kuwait has been ruled continuously by one family, the Sabah clan (Crystal). This style of government has produced a positive and growing economy which easily transitioned to the oil industry with the discovery of large reserves within the countryÃ¢â¬â¢s borders Continuing after the death of ruler Mubarak the Great, the Sabah family has accomplished a rare feat in holding power and satisfying their population. This has been made substantially easier by the amount of foreign interest money that is consistently pumped in their economy (Bennet). United States foreign policy has long focused on offering assistance and influence in the Middle East in a reas that would help produce stability for the United States National Interests (Sharp). Long a top priority, the oil Fields of Kuwait were among the first assets protected by the United States under their defense agreement with the Sabah rulers. Although terrorism in the Kuwaiti area has remained low, the continued threat made by various terrorist organizations, both in the past and today made it imperative that workable defense treaties exist. By allowing other countries to provide a major portion of the defensive forces in the country, Kuwait was able to focus their wealth and influence on other issues. It was the aggression of Saddam and Iraq that tipped the balance of power in the region to one that required a response by the western powers (Hassan). The actions caused by the overreaching
Tuesday, February 4, 2020
Project Evaluation and Review Technique - Essay Example PERT analysis first identify the three risk scenarios i.e. Most optimistic that is fewer risks will occur, Most likely which is weighted average of the all the risks and most pessimistic which is the estimation that the many risks will occur during the project life time. PERT than take three risks into account and calculate the single most accurate estimate of risk. The most important advantage of PERT include that PERT allow the project managers to do the detailed planning which is considered as the backbone of the project management. Further once detailed planning is done, it forces management to plan and make commitment and devise plans to follow them. (http://www.zetamuhendislik.com, 2008). Further to this, PERT estimates allow to account for the uncertaintiy into project management however its most important disadvantages incldue the fact that it is time and labor intensive apart from the fact that it is used for usually large and complex projects with huge magnitude requiring extra ordinary resources. PERT is also a techniqu where assumptions made are considered little over ambitious as it lacks the functional ownership of the estimates. The problem with the task estimation is because of the fact that the objectives as in fast changing external
Monday, January 27, 2020
Assessing Pain in in Post Operative Breast Cancer Patients Comparison between BriefÃ PainÃ Inventory (BPI) and Numerical Rating Scale (NRS) for post-operative pain assessment in Saudi ArabianÃ breast cancer patients. Questions DoesÃ BPI assessÃ post-operative breast cancer painÃ moreÃ accurately than NRS? Summary: Effective pain assessment is one of theÃ fundamentalÃ criteriaÃ of theÃ management ofÃ pain. It involvesÃ theÃ evaluation of pain intensity, location of the pain and response to treatment. There areÃ aÃ numberÃ of multi and one-dimensional assessment toolsÃ thatÃ have already been established to assess cancer pain. Among theseÃ are theÃ Brief Pain Inventory (BPI) andÃ theÃ Numerical Rating Scale (NRS), Breast cancer isÃ a growing publicÃ concern in Saudi ArabiaÃ as rates continue to escalate, with patientsÃ alsoÃ suffering multiple problems after surgery. Therefore, my research aim is toÃ conduct aÃ comparative studyÃ of toolsÃ used toÃ assess post-operative breast cancer painÃ inÃ Saudi ArabianÃ patientsÃ and determine which is the most effective. In this process I will use questionnaires for both nurses and patients to collect data,Ã followed by statistical analysis andÃ aÃ comparativeÃ study betweenÃ theÃ BPI and NRS. Research Hypothesis: BPI assessesÃ post-operative breast cancer painÃ in Saudi ArabianÃ patientsÃ moreÃ accurately than NRS.Ã Null hypothesis: There is no significant difference between BPI and NRSÃ as tools forÃ assessing post-operative breast cancer painÃ inÃ Saudi ArabianÃ patients Background: Pain is defined asÃ Ã¢â¬Ëthe normal, predicted physiological response to an adverse chemical, thermal or mechanical stimulus related with surgery, trauma or acute illnessÃ¢â¬â¢ (Carr and Goudas, 1999).Ã Pain assessment is a crucial component for the effective management of post-operative pain in relation to breast cancer. The patientÃ¢â¬â¢s report is the mainÃ resourceÃ of informationÃ regarding theÃ characterisation and evaluation of pain; as such, assessment isÃ the Ã¢â¬Ëdynamic method of explanation of the syndrome of the pain, patho-physiology andÃ the basis forÃ designing a protocol for its managementÃ¢â¬â¢Ã (Yomiya, 2011). A recent surveyÃ questioned almost 900 physiciansÃ 897 and foundÃ thatÃ 76% reported substandardÃ pain assessmentÃ proceduresÃ as the single most important barrierÃ toÃ suitableÃ pain management (RoennÃ et al, 1993). Breast cancer is characterized byÃ aÃ lump or thickening inÃ theÃ breast, discharge or bleeding,Ã aÃ change in colour ofÃ theÃ areola, redness or pitting of skinÃ and aÃ marble like area underÃ theÃ skin (WebMD, 2014[A1]). Breast cancerÃ has a high prevalence rate globally and is the second most diagnosed cancer in women. ApproximatelyÃ 1.7 million cases were reported in 2012Ã aloneÃ (WCRFI, 2014). In 2014,Ã just overÃ 15,000Ã womenÃ haveÃ alreadyÃ beenÃ diagnosed with breast cancer: this figure is predicted to rise to around 17,200 in 2020 Breast cancerÃ has also been identifiedÃ as one of the major cancer related problems in Saudi Arabia, with 6,922 women wereÃ assessed[A2]Ã for breast cancer between 2001-2008 (Alghamdi,Ã 2013[A3]). DÃ Pain assessment tools PolitÃ et alÃ (2006) conductedÃ a systematic review of the evidence baseÃ andÃ recorded a total ofÃ 80 different assessment tools thatÃ containedÃ at least one pain item. TheÃ tools were thenÃ categorised into pain toolsÃ (n=48)Ã and general symptoms toolsÃ (n=32) . They were thenÃ separated into uni-dimensionalÃ toolsÃ (which measure the pain intensity)Ã and multi-dimensional toolsÃ (include more than one pain dimension). 33%Ã of all pain toolsÃ (n=16) were uni-dimensional, andÃ 50% of allÃ general symptom toolsÃ (n=16)were uni-dimensional. 58% of the uni-dimensional toolsÃ employedÃ singleÃ item scales such asÃ theÃ VisualÃ AnalogueÃ Scale (VAS), Verbal Rating Scales (VRS)Ã and NRS (NumericalÃ RatingÃ Scale). The most common dimensionÃ includedÃ was pain intensity, present in 60% ofÃ tools. InÃ the assessed tools, 60% assessed painÃ in aÃ multi-dimensionalÃ format. AmongÃ pain tools,Ã 67% were found Ã to beÃ multi-dimensionalÃ compared with 50% of the general symptom tools.Ã 38% of all multi-dimensional tools were two-dimensional.Ã The mostÃ commonly usedÃ dimension wasÃ Ã¢â¬ËintensityÃ¢â¬â¢,Ã presentÃ in 75% ofÃ allÃ multi-dimensional tools. Other commonÃ dimensionsÃ includeÃ interference, locationÃ and beliefs. All the dimensions were specifically targeted by two particular tools which were disease-specific tools and tools that measure pains affect, beliefs, and coping-relatedÃ issues[A4]. Multidimensional Pain assessment tools: FÃ TheÃ adequate measurement of painÃ requiresÃ more than one tool. Melzack and Casey (1968)Ã highlight thatÃ pain assessmentÃ Ã¢â¬Ëshould include three dimensions which are sensory-discriminative, motivational-affective and cognitive-evaluativeÃ¢â¬â¢.Ã This builds on theÃ earlierÃ proposal ofÃ Beecher (1959)Ã who considered that all tools should include theÃ two dimensionsÃ ofÃ pain and reaction to pain. Cleeland (1989)Ã considered thatÃ theÃ two dimensionsÃ should be classifiedÃ as sensory and reactive. Sensory dimensionsÃ should recordÃ the intensity or severityÃ of painÃ and the reactive dimensions should include accurate measures of interferenceÃ in theÃ daily functionÃ of the patient.Ã Multi-dimensional pain assessments generally consist ofÃ sixÃ dimensions: physiologic, sensory, affective, cognitive, behavioural and sociocultural (McGuire, 1992). Cleeland (1989)Ã interviewed patients andÃ foundÃ thatÃ seven items could effectively measure the intensity and effects of the pain in daily activities: theseÃ compriseÃ ofÃ general activity, walking, work, mood, enjoyment of life, relations with others and sleep. These elements were later subdividedÃ into two groups: Ã¢â¬ËREMÃ¢â¬â¢Ã (relations with others, enjoyment of life and mood) andÃ Ã¢â¬ËWAWÃ¢â¬â¢Ã (walking, general activity and work). Later, CleelandÃ et alÃ (1996) developedÃ theÃ BriefÃ PainÃ Inventory (BPI) in bothÃ itsÃ short and long form.Ã It was designedÃ to capture twoÃ categoriesÃ of interference such asÃ activity and affect onÃ emotions.Ã TheÃ BPI providesÃ a relativelyÃ quick and easy methodÃ of measuringÃ theÃ intensityÃ of pa inÃ and theÃ level ofÃ interferenceÃ in theÃ daily activities of theÃ sufferer. With the BPIÃ tool, patients are gradedÃ onÃ a 0-10 and itÃ wasÃ specificallyÃ designedÃ for theÃ assessment ofÃ cancer related pain. PatientsÃ areÃ askedÃ about the intensity of the pain that they are experiencing at present, as well as the pain intensity overÃ the last 24 hours asÃ theÃ worst, leastÃ orÃ averageÃ pain (alsoÃ on a scale of 0-10). EachÃ scale is boundÃ by the words Ã¢â¬Ëno painÃ¢â¬â¢Ã (0) andÃ Ã¢â¬Ëpain as bad as you can imagineÃ¢â¬â¢Ã (10). Patients are alsoÃ requestedÃ to rate the degree to which pain interferesÃ with theirÃ daily activities within the sevenÃ domainsÃ on a scale of 0-10.Ã that comprise general activity, walking, mood, sleep, work, relations with other persons, and enjoyment of life using similar scales of 0 toÃ 10[A5]. These scales are only confined by the words Ã¢â¬Ëdoes not interfereÃ¢â¬â¢ and Ã¢â¬ËinterferesÃ completely[A6]Ã¢â¬â¢ (TanÃ et al, 2004).Ã Validation of BPI across the world among the different language people has already been justified.Ã [A7]Additionally, the localization of the pain in the bodyÃ could beÃ [A8]assessed and details of current medication are assessed (CaraceniÃ et al, 1996). Uni-dimensional pain assessment tool: Ã Previous studiesÃ haveÃ shownÃ thatÃ theÃ NumericalÃ RatingÃ Scale (NRS) had the power to assess pain intensity for patientsÃ experiencing chronic pain and was also an effective assessment tool for patients with cancer related pain. TheÃ NRS consists of a numerical scale range between 0-100 where 0 was considered as one extreme point represented no pain and 100 was considered other extreme point which represented bad/ worse painÃ (Jensen et al, 1986). TurkÃ et alÃ (1993) developedÃ anÃ 11 pointÃ NRS (scale 0-10) where 0 equalledÃ no pain and 10Ã equalledÃ worst pain. Though cancer pain differs from acute, postoperative and chronicÃ pain experiences, the most common feature is its subjective nature. [A9]Ã In this regard a consensus meeting on cancer pain assessment and classification was held in Italy in 2009Ã with theÃ recommendation thatÃ pain intensity should be measuredÃ on aÃ scaleÃ ofÃ 0-10 withÃ Ã¢â¬Ëno painÃ¢â¬â¢Ã andÃ Ã¢â¬Ëpain as bad as you canÃ imagine[A10]Ã¢â¬â¢Ã (HjermstadÃ et al.,Ã 2011). KrebsÃ et al.Ã (2007) categorised NRS scores as mild (1Ã¢â¬â3), moderate (4Ã¢â¬â6), or severe (7Ã¢â¬â10). A rating ofÃ 4 or 5Ã isÃ the most commonly recommended lower limitÃ for moderate pain and 7 or 8 for severe pain. Aimed at moderate pain assessment,Ã For the purpose of clinical and administrative use theÃ recommendation for moderate pain assessment on the scale is a score of 4. Importance of post- operative pain assessment: Post-operative painsÃ isÃ very common after surgeryÃ andÃ theÃ use ofÃ medicationÃ oftenÃ dependsÃ on the intensity of painÃ that the patient is experiencingÃ (ChungÃ et al, 1997). Insufficient assessment of post-operative painÃ can have aÃ Ã¢â¬Ësignificant detrimentalÃ effect on raised levels of anxiety, sleep disturbance, restlessness, irritability, aggression, distress and sufferingÃ¢â¬â¢Ã (CarrÃ et al,Ã 2005). AdditionalÃ physiologicalÃ effects can includeÃ increasedÃ blood pressure, vomiting and paralytic ileus, increased adrenaline production, sleep vein thrombosis and pulmonary embolus (Macintyre and Ready, 2002). Effective post-operative pain assessment ensures better pain managementÃ and can significantly reduce the risk of the symptoms listed above, giving minimal distress or sufferingÃ to patientsÃ and reducingÃ potential complications (Machintosh, 2007). References: Alghamdi IG, Hussain II, Alhamdi MS, El-Sheemy MA (2013) Arabia: an observational descriptive epidemiological analysis of data from Saudi Cancer Registry 2001-2008. Dovepress. Breast cancer: Targets and therapy; 5: 103-109. Caraceni A, Mendoza TR, Mencaglia E (1996) A validation study of an Italian version of the Brief Pain Inventory (Breve Questionario per la Valutazione del Dolore). Pain; 65: 87-92. Carr D and Goudas L. C. (1999) Acute pain. Lancet 353, 2051-2058. Carr EC, Thomas NV, Wilson-Barnet J (2005) Patient experiences of anxiety, depression and acute pain after surgery: a longitudinal perspective. International Journal of Nursing Studies. 42(5): 521-530. Chung F, Ritchie E, Su J (1997) Postoperative pain in ambulatory surgery. Anaesthesia and Analgesia 85: 808-816.Ã Cleeland CS (1989) Measurement of pain by subjective report. Issues in pain measurement. New York: Raven Press; pp. 391-403. Cleeland CS, Nakamura Y, Mendoza TR, Edwards KR, Douglas J, Serlin RC (1996) Dimensions of the impact of cancer pain in a four country sample: new information from multidimensional scaling. Pain 67 (2-3): 267-273. Hjermstad MJ, Fayers PM, Haugen DF, Caraceni A, Hanks GW, Loge JH, Fainsinger R, Aass N, Kaasa S (2011) Studies comparing numerical rating scale, verbal rating scale and visual analogue scales for assessment of pain intensity in adults: a systematic literature review. Journal of pain and symptom management. 41 (6): 1073-1093. Jensen MP, Karoly P, Braver S (1986) The measurement of clinical pain intensity: a comparison of six methods. Pain 27: 117-126. Krebs EE, Carey TS, Weinberger M (2007) Accuracy of the pain numeric rating scale as a screening test in primary care. Journal of general medicine. 22(10): 1453-1458. Machintosh C (2007) Assessment and management of patients with post-operative pain. Nursing Standard. 22 (5): 49-55. Macintyre PE, Ready LB (2002) Acute pain management. Second edition, WB Saunders, Edinburgh. McGuire DB (1992) Comprehensive and multidimensional assessment and measurement of pain. Journal of pain and symptom management; 7(5): 312-319. Melzack R and Casey KL (1968) Sensory, motivational and central control determinants of pain: a new conceptual model. In: Kenshalo DR, editor. The skin senses proceedings. Springfield IL: Thomas; pp. 423-439. National Breast Cancer Foundation (NBCF): 2014;Ã http://www.nbcf.org.au/Research/About-Breast-Cancer.aspx Polit JCHC, Hjermstad MJ, Loge JH, Fayers PM, Caraceni A, Conno FD, Forbes K, Furst CJ, Radbruch L, Kaasa S (2006) Pain assessment tools: Is the content appropriate for use in palliative care? Journal of pain and symptom management, 32 (6): 567-580. Roenn JHV, Cleeland CS, Gonin R, Hatfield AK, Pandya KJ (1993) Physician attitudes and practice in cancer pain management. A survey from the Eastern Cooperative Oncology Group. Annals of Internal Medicine, 119(2): 121-126. Tan G, Jensen MP, Thornby JI, Shanti BF (2004) Validation of the brief pain inventory for chronic non-malignant pain. The Journal of Pain. 5(2): 133-137. Turk DC, Rudy TE, Sorkin BA (1993) Neglected topics in chronic pain treatment outcome studies: determination of success. Pain (53):3Ã¢â¬â16. WebMD (2014)Ã http://www.webmd.com/breast-cancer/guide/overview-breast-cancer. World cancer research fund international (WCRFI): 2014;Ã http://www.wcrf.org/cancer_statistics/data_specific_cancers/breast_cancer_statistics.php. Youmiya K (2011) Cancer pain assessment. The Japanese Journal of Anesthesiology. 60(9): 1046-1052. [A1]I would consider using a more reputable source for describing medical symptoms themselves (GreyÃ¢â¬â¢s Anatomy, WHO guidelines etc) [A2]and treated? [A3]Is it worth commenting that breast cancer reporting rates in SA might be different from actual prevalence? Lack of awareness regarding certain cancers often results in late diagnosis or misdiagnosis. [A4]This sentence is unclear. I am assuming that you are stating that all dimensions are present in two particular tools? [A5]IÃ¢â¬â¢ve deleted this as you have highlighted the same domains in the previous paragraph and the reader will already be familiar with this term. [A6]Sentence shows up on copyscape / turnitin but itÃ¢â¬â¢s fine as a directly referenced quote. [A7]Is this sentence stating that the BPIs valid internationally because it has been adjusted culturally / linguistically for all groups? [A8]Are you making a suggestion that it could be assessed, or stating that sometimes people do assess localised pain in the body? [A9]Deleted as the next sentence deals with this already. [A10]Again shows up in turnitin: any quotes must be in inverted commas so that tutors / markers will not downgrade or suspect plagiarism.
Saturday, January 18, 2020
Executive Privilege| | | | Virginia Commonwealth University November 14, 2012| | In the past, the power of executive privilege has been used by Presidents to conceal information that has to do with foreign affairs and negotiations, military, national security issues as well as deliberations and policy making that is done between the President and his top aides. This power is only used when Congress asks the President or one of his top aides to produce all of the information pertaining to an event or situation.If the President then feels that parts of this information needs to be kept secret to protect the best interest of the public, or the other issues listed previously, then he will use executive privilege in order to not give that information to Congress. A huge part of executive privilege is to protect the deliberations and advice given by the PresidentÃ¢â¬â¢s aides. When the PresidentÃ¢â¬â¢s advisors give him advice, they need to be able to give him the best advice possible and if there is a chance that everything they said could be made public.For instance if the President and advisors are discussing what needs to be done in relation to a foreign power and one suggests to nuke them, one suggests a covert attack and one suggests a peaceful resolution. If the final decision is a peaceful resolution, and Congress asks for all of the information on the subject, then the President should use executive privilege to keep those other possible outcomes from going public, both to keep the public from getting out of control or uneasy and to keep the other country from finding out the other options and retaliating.This power ensures that the PresidentÃ¢â¬â¢s advisors can be completely honest and say what needs to be said without being worried about their words being taken the wrong way or too harsh or hurt their image. A big argument for those against executive privilege is that there is nothing in the constitution about it even though there is something about Congress keeping secrets.Article I states that Ã¢â¬Å"Each House shall keep a journal of its proceedings, and from time to time publish the same, excepting such parts as may in their judgment require secrecyÃ¢â¬ (US Constitution, Article 1 Section 5). Their argument is that the Constitution states that each House can withhold information that they think should be kept secret and there is nothing about secrecy when it comes to the PresidentÃ¢â¬â¢s powers, however just because the words are not explicitly in the constitution does not mean that this power was not intended for the President.Even our founding fathers appreciated the importance of executive privilege and that is highlighted by this passage taken from The Works of Alexander Hamilton. In 1794, the Senate asked President George Washington, Ã¢â¬Å"Ã¢â¬Ëto lay before the Senate the correspondences which have been had between the Minister of the United States at the Republic of France, and said Republic, and between said Minister and the office of Secretary of State. Ã¢â¬ Washington consulted his cabinet members, Henry Knox, Alexander Hamilton, and Edmund Randolph.Alexander Hamilton later wrote: General Knox is of the opinion that no part of the correspondences should be sent to the Senate; Colonel Hamilton is of the opinion that the correct mode of proceeding is to do what General Knox advises; but the principle is safe, by excepting such parts as the President may choose to withhold; Mr. Randolph is of the opinion that all correspondence proper, from its nature, to be communicated to the Senate, should be sent; but that what the President thinks is improper, should not be sent.Washington later told the Senate Ã¢â¬Å"After an examination of [the correspondence], I directed copies and translations to be made; except in those particulars, which, in my judgment, for public considerations, ought not to be communicated. Ã¢â¬ (Hamilton 1851) Three of these men signed the constitution and contribut ed a great deal towards it and they clearly believe that it is the PresidentÃ¢â¬â¢s right to withhold information that he deems unfit to be made public. When it comes to foreign affairs it is very important that the President has the ability to use executive privilege.For instance, if the United States was making a treaty with another country, both countries may have to give things up in order to come to an agreement, and everything considered by both sides as well as everything agreed upon should not be made public for everyone, including other countries to see. This is best stated in 1796 by George Washington after the House of Representatives requested that he give them information concerning his instructions to the United States Minister to Britain regarding the treaty negotiations between the United States and Britain.Washington replied by saying: The nature of foreign negotiations requires caution, and their success must often depend on secrecy; and even when brought to a co nclusion a full disclosure of all the measures, demands, or eventual concessions which may have been proposed or contemplated would be extremely impolitic; for this might have a pernicious influence on future negotiations, or produce immediate inconveniences, perhaps danger and mischief, in relation to other powers.The necessity of such caution and secrecy was one cogent reason for vesting the power of making treaties in the PresidentÃ¢â¬ ¦the boundaries fixed by the Constitution between the different departments should be preserved, a just regard to the Constitution and to the duty of my office.. , forbids a compliance with your request. Ã¢â¬ (Richardson 1897) As Washington states, we cannot simply make every detail public because other countries may retaliate and they will also be less likely to deal with the United States in the future. However, by invoking executive privilege the President can protect that information from causing such havoc.As he stated, it is not only the PresidentÃ¢â¬â¢s right to use executive privilege, but it is his duty to use it in situations that require secrecy. Without a doubt executive privilege can have its usefulness, but it should only be invoked in certain, specific situations. In our recent history this has not been the case, some of our Presidents have tried to abuse the power of executive privilege, giving it a bad name and encouraging people to believe it should be done away with. When President Richard Nixon was in office, the Watergate scandal surfaced and Congress asked him to produce all of the information he and his aides had on the case.In an attempt to conceal what had been done as well as to protect everyone from punishment, President Nixon tried to use executive privilege. This case was brought to the United States Supreme Court because the executive privilege was being used to protect one of NixonÃ¢â¬â¢s advisors from criminal prosecution, thus obstructing justice. This was by far an abuse of executive privilege and leads many to want it gotten rid of, however just because a power can be abused does not mean that its use should stop; it just means that restrictions need to be put in to place.This is highlighted by the ruling of the Supreme Court. The Court acknowledged the need for the President to used executive privilege, but determined that in cases of inquiry into possible criminal actions, the Executive has to release relating information. If we want to curb the abuse of executive privilege, we need to put guidelines into place, because without them, the meaning of executive privilege is at the discretion of the President until checked by other branches. President Nixon was neither the first nor last President to abuse this power (United States v Nixon 1974).President Bill Clinton also tried to invoke executive privilege in a very wrong way as well. Clinton tried to use executive privilege to prevent his advisors from testifying on whether he had sexual relations with Monica Lewinski or not. However, this claim of executive privilege was shot down, rightfully so (Baker 2012). These instances of abuse may lead some to think it is just a better option to not have executive privilege, but as long as barriers and restrictions can be put into place on it to prevent this from happening in the future, this power needs to stay around.This comes with some exceptions; this power should only be used when the President truly believes that if this information were to get out it would either be damaging to the public or in the best interest of the public to not find out. This power should also be used in situations where the President needs to protect national security intelligence and other matters as well as being used to protect military secrets, operations and intelligence.Lastly, this power should be used in situations where the United States is dealing with a foreign power, whether it is a treaty, a negotiation, a meeting or anything else containing sensitive m aterial that either the United States or the foreign power needs to be kept secret. This brings up another argument against executive privilege. Some feel that this power should be done away with because Congress does not have the power of checks and balances over executive privilege; however that is not the case.If the President is refusing to give Congress the information that they are asking for, they can decide to stop funding things that the President is trying to do. They can also hold people in contempt of Congress, which was done as recently as this year in the Fast and Furious case where Congress demanded that Attorney General Eric Holder give them all the information on this case. President Obama stepped in and claimed executive privilege, however in a response to this, Congress moved, then voted to hold Holder in contempt of Congress unless he hands over the information (Silverleib 2012).Another thing Congress can do if the President continues to refuse to cooperate is to impeach him. This would obviously be only done in serious situations, but would work either to get their message across or to show future Presidents that they cannot just invoke executive privilege without consequence. On top of this, the courts can rule on cases where the President tries to use executive privilege like they did in the case with President Nixon.Articles II of the Constitution states that the President Ã¢â¬Å"shall from time to time give to the Congress information of the state of the union, and recommend to their consideration such measures as he shall judge necessary and expedientÃ¢â¬ (US Constitution Article II Section 3) As the Constitution says, the President does need to inform Congress on the State of the Union from time to time, however it does not say anywhere that the President is required to divulge all the information having to do with certain incidents.Between Article I and Article II, others take this to mean that Congress has an unlimited power of inquiry, but in reality that is not the case. This fact has been ruled on multiple times by different courts, where usually they determine that either the President does not have to give up the information, or that the President has to give up certain aspects of that information based on other laws. It is also CongressÃ¢â¬â¢s right and duty to challenge the President when he uses executive privilege, in order to make sure that the power is not being abused, which is the exact reason for having separate branches and a balance of power.If it wasnÃ¢â¬â¢t for executive privilege, other countries might be less inclined to deal with the United States because they fear that every detail could go public. Along the same lines the presidentÃ¢â¬â¢s advisors canÃ¢â¬â¢t give their best advice if they have to worry that anything they say could be made public. Military secrets and intelligence also needs to be protected to better ensure our troops safety as well as protect our country and citizens from retaliation after an exposed military operation. There is also information that needs to remain secret because it is in the best interest of the public to not find out.Lastly and most importantly, if it wasnÃ¢â¬â¢t for executive privilege, national security and military intelligence matters could be made public, exposing our informants and jeopardizing our national security. In order to keep this power alive and protect sensitive information, the United States needs to add guidelines or an amendment that properly codifies executive privilege to prevent its abuse. Once this is done, in theory, there would not be any more issues of whether power can or cannot be used.Everything would be stated to say that the President can only use executive privilege in the situations previously stated and any other instance where executive privilege is claimed would be thrown out. Executive privilege helps to protect our citizens, our national security and our good standing and abili ty to negotiate with other countries. If we were not able to guarantee that level of secrecy it would be nearly impossible to conduct policy making, decision making, foreign negotiations, treaties, as well as threaten the United States and their citizensÃ¢â¬â¢ safety.References Baker, Peter, and Susan Schmidt. Ã¢â¬Å"Washingtonpost. com Special Report: Clinton Accused. Ã¢â¬ Washington Post: Breaking News, World, US, DC News & Analysis. N. p. , 6 May 1998. Web. 8 Nov. 2012. http://www. washingtonpost. com/wp-srv/politics/special/clinton/stories/starr050698. Hamilton, Alexander, and John C. Hamilton. The works of Alexander Hamilton comprising his correspondence, and his political and official writings, exclusive of the Federalist, civil and military. New York: J. F. Trow, 1851.Print. Richardson, James D.. A compilation of the messages and papers of the presidents. New York: Bureau of national literature, 1897. Print. Silverleib, Alan. Ã¢â¬Å"House holds Holder in contempt Ã¢â¬â CNN. com. Ã¢â¬ CNN. com Ã¢â¬â Breaking News, U. S. , World, Weather, Entertainment & Video News. N. p. , 29 May 2012. Web. 5 Nov. 2012. http://www. cnn. com/2012/06/28/politics/holder-contempt/index. html. United States v. Nixon, 418 U. S. 683 (1974) (Justice Burger Opinion of the Court) United States Constitution, 1789
Friday, January 10, 2020
This year so far milk sales have decreased and dairy farmers are stuck with large amounts of inventory that they can't do anything with. This called for them to lower the price of the milk to under three dollars a gallon in hopes that people would buy more milk. The content of this article is relevant to the class because it covers supply and demand. In addition to this it also covers business strategy. Ultimately dairy farmers were making a lot more money in 2014 because there was a very high demand for milk.When milk ales decreased the dairy farmers were left with inventory that they could not do anything with. At this point they had to make a decision to try to save some of the inventory they had left over. In regards to food products It's a little different compared to items that do not have a sell by date. Milk expires after a certain day and it can no longer be sold. For this reason the dairy farmers and retailers were forced to cut costs to try and get more people to but more milk. This could ultimately fix their overstock problem.By lowering he cost they were hoping that people would buy more milk. If people purchase more milk it can potentially help them get rid of left over inventory. This can also be bad for dairy producers because it they are losing money on every gallon of milk they sell. If they purchased more heavy machinery and hired more workers they may have to lay people off due to plummeting costs.