English Topic on 'CONFLICT' comparing two micro fiction Essay

English Topic on 'CONFLICT' comparing two micro fiction - Essay Example She then goes on to describe what the neighbor would hear, and what she would think: â€Å"I would say to myself how glad I was not to be her, not to be sounding the way she is sounding, with a voice like her voice and an opinion like her opinion†. From this, the reader can infer that this person does not like how she sounds when she talks to this man, and perhaps she does not even like herself. The conflict is thus internal, precisely in being who she is. The conflict in this story is psychological, and we are not given the reasons why the neighbor would not like to be her upon hearing her voice and her opinions. The narrator in fact stipulates that the neighbor would not like what she hears, and would be glad not to be her. One can say that this is a sort of projection upon the neighbor of the narrator’s own dislike of herself when she talks to this man. The dilemma is thus in this woman’s ambivalence between liking herself and not liking However, all of this up to this point has been stipulated on the supposition that she were not herself, i.e. that she were not who she was. She resolves this conflict by saying: â€Å"But I cannot hear myself from below, as a neighbor, I cannot hear how I ought not to sound, I cannot be glad I am not her, as I would be if I could hear her.† Thus, to hear herself as a neighbor, from below, is an impossibility, as she is â€Å"not her†, meaning the neighbor, because she is herself, and she cannot put herself in the neighbor’s shoes and not like herself. The conflict is resolved in the final sentence: â€Å"Then again, since I am her, I am not sorry to be here, up above, where I cannot hear her as a neighbor, where I cannot say to myself, as I would have to, from below, how glad I am not to be her.† Given that this imaginary situation is an impossibility, the conflict is simply resolved by this

Personal reflection on design Essay Example | Topics and Well Written Essays - 1500 words

Personal reflection on design - Essay Example ve teaching design to pass information across to the target group will aid in the learning process as pupils will be able to grab much of what they are being told (Agostinho, 2006). Moreover, teachers will be able to pursue their careers with much ease as they provide quality education without investing a lot of time. The core purpose of a teacher is to offer quality education to his/her students. This can only be measured through the outcomes of an assessment exercise (McAndrew, Goodyear and Dalziel, 2006, p. 216). I believe that a concerned teacher will offer an assessment exercise to her/his pupils after a lesson to assess how much the pupils have understood what has been presented. Consequently, the teacher’s satisfaction will be attained if only he/she will find out that the pupils have extensively comprehended what was taught. Waters and Gibbons (2004, p. 57) state that a teaching design can be conducted in order to: illustrate the tasks assigned to the pupils, the resources available to the students to assist them in carrying out those tasks and how as their teacher, you are going to offer them support. As a primary teacher I have had to go through a lot of challenges in my teaching career. While in college we were taught on how to prepare prior to conducting lessons (Goodyear, 2005, p. 85). Among the things you have to do before undertaking a lesson is to prepare a simple lesson plan. A lesson plan is to give a teacher a guideline on the sequence of events during the lesson and what he/she has to accomplish at the end of a lesson. During the early years of my teaching career I had problems with preparing a lesson plan because I considered it to be time wasting. With five years of practice in the teaching field, I understand only too well the essential role of a lesson plan (Waters and Gibbons, 2004, p. 61). Dealing with a young mind I have to be very careful with what I do or say. According to Goodyear (2005, p. 101) children in primary schools

Private and corporate information Essay Example | Topics and Well Written Essays - 250 words

Private and corporate information - Essay Example Moreover, there are hackers who victimize other people for their own benefit of breaking into computer systems to destroy or steal information in the form of cyber-terrorism. Lastly, there is the spyware, adware, and Trojans, usually installed with other programs without the users consent. They monitor an individual’s behavior on the internet, display targeted advertisements, and even download other malicious software onto a computer. It is the every responsibility of individuals to protect their own information. I play my role in ensuring information security through keeping it safe in backup devices. I secure the information from the system by the use of safe browsing practices. This occurs through an evaluation of the browser’s security settings before making any online transactions. In addition, I am keen when using email attachments, using safely the instant messaging and chat rooms. To improve information security I will install antivirus and antispyware software program and make sure they are up to date for the protection against any attacks. Furthermore, I will disable non-essential software’s from the computer as they increase the opportunities for attack. In conclusion, I will ensure the use of strong passwords to prevent unauthorized access to

U.S Economy Cause and Effect Essay Example for Free

U.S Economy Cause and Effect Essay As America is going through economical disfunctions, Â  it is apparent that many people fear for losing their job because in such a depression it would make it impossible to be well off comfortably due to the demand of money needed for all the basic essentials especially in Orange County. Orange County happens the be one of the more expensive areas in the state and it is crucial to always have a steady income as life here is not cheap but well worth it. Many Americans are in search for work and are struggling to make a living. As the job hunting goes on, many job opportunities are overseen to due to programs such unemployment. The percentage of unemployment has sky rocketed over the past few years leaving it up to us, tax payers with job to pay for such needs. Unemployment is not fair for all, most people would say. There are a percentage of people who truly have no other choice of surviving unless they depend on this crucial unemployment program. Although unemployment is crucial for some, it is not necessary for a portion of the people due to the simple fact that they are not trying hard enough to seek new job opportunities. Instead they a letting opportunities slide right past them every single day they are not looking for work. Many people depend on unemployment alone, because most people would prefer to get paid for doing nothing while they have the chance too. Many people take advantage of this privilege and only it do they follow. A huge downfall due to unemployment for us people with a steady income and a consistent employment is the fact that we have to pay for the unemployed. Hardworking people work to support themselves also end up paying taxes which a percentage of that goes to the unemployed. By increasing our taxes the government collects money all around. This dramatically decreases the standard of living for us citizens. Although unemployment has its pros and is a huge opportunity for people in struggles or going through loss of unemployment. It also puts a major dependability on hard working citizens who are forced to pay high taxes which a certain percentage are collected to pay for the unemployed. Many people abuse unemployment for as long as they can and only pretend to seek work but instead just prefer to do nothing but make something which not only is unfair but also not right. Unemployment not only affects certain individuals but it also puts a decrease on the standard of living here in the United states which affects everybody around us.

Study on the Outcome of Damage Control Surgery

Study on the Outcome of Damage Control Surgery A RETROSPECTIVE STUDY ON THE OUTCOME OF DAMAGE CONTROL SURGERY IN SPMC FROM YEAR 2005 TO 2010. A RETROSPECTIVE STUDY Submitted by: Chris George C. Pales, MD Co-Author: Benedict Edward P. Valdez, MD INTRODUCTION: WHAT IS THE TOPIC ALL ABOUT? The traditional approach to combat injury care is surgical exploration with definitive repair of all injuries. This approach is successful when there is limited number of injuries. These are usually performed in patients with unstable conditions such as profound hemorrhagic shock which known to affect the over-all survival of the patient. Prolonged operative times and persistent bleeding lead to the lethal triad of coagulopathy, acidosis, and hypothermia, resulting in a mortality of about 90%. The Three stages of damage control are as follows: Control of hemorrhage and contamination. Also known as bail-out surgery is the first stage. It is a life-saving procedures and is rapidly performed by the surgeon. The main goal this time is to control blood loss and minimizing contamination. It includes control of hemorrhage from bleeding major vessels and solid organs through packing of abdomen, deviation from intestinal anastomosis and temporary closure of abdomen. Resuscitation: Once control of hemorrhage is achieved, patient is now transferred to ICU for correction of any derangement. Rewarming of the patient to avoid hypothermia, correction of blood loss, hydration and stabilization of BP, and avoiding coagulopathy. Reoperation. One patient has been stabilized, especially within 24-48 hours, definite procedure will be done at operating room. WHAT IS ALREADY KNOWN ABOUT THE TOPIC? Damage control surgery is relatively new technique, about 20 years old. It is well recognized that trauma patients especially those with profound shock has a higher chance to die secondary to intra-operative metabolic failure than from the trauma itself. The analogy of damage control surgery is to stop all haemorrhage and gastrointestinal spillage as quickly as possible while patient is having unstable vital signs at the operating room. It is coined from a U.S. Navy technique which is â€Å"the capacity of a ship to absorb damage and maintain mission integrity.† Speed of decision and surgery in severely injured trauma patients is the key to avoid death to patient. The well recognized consequence of hypovolemic, hypothermic patient is what we call the â€Å"lethal triad.† It comprises the vicious cycle of hypothermia, acidosis, and coagulopathy. It is a viscous cycle that is very lethal if not recognized and controlled immediately. Patient who is stable with acceptable laboratory results, good ventilator response, non-hypothermic, are then returned to the operating for the â€Å"definitive operation.† (figure 1). Bowel anastomoses and colostomy maturation, definitive vascular repair, removal of hemostatic packing, and closure of abdominal fascia where is done. Figure 1. The documented mortality for the damage control approximately 50% with a documented morbidity of approximately 40% as summarized in the following table. WHAT IS NOT YET KNOWN ABOUT THE TOPIC? With the advent of modern technology and numerous studies, what is the outcome of patients undergoing Damage control surgery in SPMC from January 1, 2005 to December 31, 2010. WHAT IS THE SIGNIFICANCE OF THE STUDY? This study will give us data on the effectiveness of Damage Control Surgery done at SPMC from January 1, 2005 – December 31, 2010. It will give the surgeons the data of factors that determine the outcome of damage control surgery, thus giving ways of improving healthcare management to patients. WHAT WILL THIS STUDY DO? General Objective: The study aims to determine the outcome of damage control surgery done in SPMC from January 1, 2005 to December 31, 2010 Specific Objective: To describe the demographic and clinical profile of patients who underwent damage control surgery To determine the number of patients who underwent definitive surgical procedure after damage control surgery 3. To determine the mortality rate of patients who underwent undergoing damage control surgery in SPMC from January 1, 2005 to December 2010. 4. To determine the factors that affects the outcome of patients undergoing damage control surgery in SPMC from January 1, 2005 to December 2010 in terms of nature of injury, time of operation from injury and pre-operative vital signs. Patient’s Demographic Profile Describe the trauma patients according to the following variables: Sociodemographic characteristics Age Sex Clinical characteristics: Pre-operative vital signs Associated Injuries GCS score Organs Involved Co-morbidities Determine the interventions and clinical outcome of patients Duration of Operation Operations performed Mortality rate Re-operation performed Disposition Figure 1. Conceptual Framework METHODOLOGY General Design The study employed is a retrospective, descriptive study design. Chart review of all patients who underwent damage control surgery during January 1, 2005 to 2010 will be done by the author with the permission of the medical records section and the hospital research committee. Setting The study will be will be conducted at Southern Philippines Medical Center, a tertiary hospital in Davao City in June 2013. PARTICIPANTS: INCLUSION CRITERIA: This study will include all patients admitted and underwent Damage control surgery at Southern Philippines Medical center in 2005-2010. Damage control surgery includes resection of major injuries to the gastrointestinal tract without re-anastomosis; control of hemorrhage through peri-hepatic packing and temporary closure of abdomen and use of an alternate closure of a cervical incision, thoracotomy, laparotomy, or site of exploration of an extremity. EXLCLUSION CRITERIA: None SAMPLING PROCEDURES: The study subjects (target population) of this research are the patients admitted and underwent Damage control surgery at Southern Philippines Medical Center in 2005-2010. Randomization: None DATA GATHERING Dependent Variable: Number of Damage Control Surgery from 2005-2010 Main outcome measures and other dependent variables: Number of patients who expired and number of patients survived. Independent Variables Age and Sex Nature of injury Time of intervention from time of injury Pre-Operative vital signs Glasgow coma scale Organs involved Duration of Operation Availability of Blood Interventions: None Data Handling and Analysis: All data will be computed as to the mortality rate by computing the number of patients who expired to the total number of patients who underwent Damage control surgery. Furthermore, determination of mortality will be computed by computing the ratio of mortality as of Age and Sex, Nature of injury, Time of operation from injury and Pre-op vital signs, Duration of Operation, Availability of blood, Organs involved. ETHICAL CONSIDERATIONS Ethics Review The proponent of the study will secure an approval from the Cluster Ethics Research Committee of The Southern Philippines Medical Center prior to doing the research. A similar approval is also secured from the Department of Surgery of the same institution with the approval of a consultant in-charge. Privacy No phone calls or home visits as follow up to participants. Confidentiality The researchers will not disclose the identities of the patients at any time. The data obtained during the study will be under the Department of Surgery of Southern Philippines Medical Center and will be kept in confidentiality. Extent of Use of Study Data The data collected by the researcher will only be used to answer the objectives of stated in the protocol. Data will be available to others as a finished paper. Authorship and Contributorship The main proponent of the study is the main author and researcher of the study. Consultant guidance and support will be provided Dr. Benedict Valdez, head of Section of Trauma, Department of Surgery, SPMC. He is the co-author who will aide in the study design. A professional statistician will help in the study write-up and data analysis. The author and co-author gives consent to use the data collected for further research. Conflicts of Interest The main proponent and the co-authors declare no conflict of interest. Publication The research will be submitted for national and international publication groups and may be chosen for publication. In all portions in the paper, the author and co-authors will be duly acknowledged. Funding The main proponent of the study is using personal funds to conduct the study. Funding of the braces will depend on the patients and their guardians . REFERRENCES Schwartz book of Surgery 8th Edition by F. Charles Brunicardi Trauma, Fifth Edition by David Feliciano, MD A logical approach to trauma – Damage control surgery Shibajyoti Ghosh, Gargi Banerjee, Susma Banerjee, D. K. Chakrabarti Department of Surgery, R. G. Kar Medical college, West Bengal, India. Townsend: Sabiston Textbook of Surgery, 17th ed., Copyright  © 2004 Elsevier Combat Damage Control Resuscitation: Today and Tomorrow ;Colonel Lorne H. Blackbourne, MDUS Army Institute of Surgical Research, 3400 Rawley E. Chambers Ave. Fort Sam Houston, TX 78234USA Damage Control: Beyond the Limits of the Abdominal Cavity. A Review Maeyane S. Moeng, MB, BCh, FCS(SA),1 Jerome A. Loveland, MB, BCh, FCS(SA),2 and Kenneth D. Boffard, BSc(Hons), MB, BCh, FRCS, FRCS(Edin), FRCPS(Glas), FCS(SA), FACS, FCS(SA) Feasibility of Damage Control Surgery in the Management of Military Combat Casualties Ben Eiseman, MD, Ernest Moore, MD, Daniel Meldrum, MD, Christopher Raeburn MD DUMMY TABLES TABLE 1: Demographics and Clinical Characteristics. TABLE 2: OUTCOME TABLE 3: BUDGET TABLE 4: TIMETABLE CURRICULUM VITAE Name: Chris George C. Pales Address: Unit 303, Palmetto Place, Maa road, Davao City Telephoneà ¢Ã¢â€š ¬Ã‚ ¨Cell: 09238060856 Phoneà ¢Ã¢â€š ¬Ã‚ ¨Email: [emailprotected]/[emailprotected] Personal Informationà ¢Ã¢â€š ¬Ã‚ ¨ Date of Birth: April 9, 1983 à ¢Ã¢â€š ¬Ã‚ ¨Place of Birth: Koronadal City, South Cotabato à ¢Ã¢â€š ¬Ã‚ ¨Citizenship: Filipino à ¢Ã¢â€š ¬Ã‚ ¨Status: Married à ¢Ã¢â€š ¬Ã‚ ¨Gender: Male Education: Elementary: Kipalbig Elementary School, Kipalbig, Tampakan, South Cotabato (SY 1990-1996) High School: Notre Dame of Marbel University, Koronadal, South Cotabato (SY 1996-2000) Colllege: West Visayas State University, Iloilo City (SY 2000-2004) Medicine: West Visayas State University, Iloilo City (SY 2004-2008) DATA COLLECTION SHEET A RETROSPECTIVE STUDY ON THE OUTCOME OF DAMAGE CONTROL SURGERY IN SPMC FROM YEAR 2005 TO 2010. A RETROSPECTIVE STUDY Chris George C. Pales, MD/Benedict Edward P. Valdez, MD Hospital #: Age: Sex: NATURE OF INJURY Stab wound______ Gunshot wound______ Blunt Trauma______ Penetrating Injuries______ VITAL SIGNS ON ADMISSION BP: HR: RR: TEMP: GCS score: TIME OF ARRIVAL SINCE INJURY _______ Minutes _______ Hours _______ Days DURATION OF OPERATION: UNITS OF BLOOD TRANSFUSED: INTRA-OP VITAL SIGNS: BP: CR: ORGANS INVOLVED: RE-OPERATION DONE FOR DEFINITIVE PROCEDURE? ____Yes ____No NUMBER OF HOSPITAL STAY: DISPOSITION: ______DISCHARGED IMPROVED ______DIED CAUSE OF DEATH:

Achieving the American Dream in Death of a Salesman by Arthur Miller Es

Achieving the American Dream in Death of a Salesman by Arthur Miller Willy Loman is a man on a mission. His purpose in life is to achieve a false sense of the "American Dream," but is this what Willy Loman really wants? In Death of a Salesman, Arthur Miller analyzes the American Dream by portraying to us a few days in the life of a washed up salesman named Willy Loman. The American Dream is a definite goal of many people, meaning something different to everyone. Willy's version is different from most people though; his is based more on being well-liked and achieving monetary successes rather than achieving something that will make him happy. Willy never becomes part of the "American Dream" because he never follows his true dreams and aspirations. He chooses a career that will make him money, but not much, rather than a career that he will enjoy. This is the big mistake that Willy makes in his life and in the end he never overcomes it. Willy never becomes part of the American Dream because he tries to become successful and wealthy rather than spending his life doing something that would bring him and his family joy. "The American Dream " is a term used to summarize the basic ideals held by the American public. Death of a Salesman focuses on this dream and analyses the dreams significance in the American social order. The basic principal behind the "American Dream" is the belief that if people have an aspiration and they work for it they will achieve their dreams. Furthermore, what lies at the heart of the American Dream is the desire to achieve wealth and power based on one's looks and appearance rather than the value and quality of their work. The American Dream is supposedly what everyone wants to end up with; a family, a house, a car and a well paying job. The problem is that not everyone wants these things. People all over the world desire to immigrate to America because they have heard of this "American Dream" and they want to be a part of a country that makes it seem so easy to make a fortune. The problem with this dream is the theory at the basis of it; the fact that success is not assure d, but if people work for their dreams they will eventually achieve them. People can work their entire lives thinking that they are contributing to humanity when in fact they are not. They believe that as long as they put something into civilization, at the end ... ...e something better. This is evident when Linda tells Willy "be happy right here, right now. Why must everybody conquer the world? You're well liked, and the boys love you" (Movie). Willy never listens to his heart and because of this, he follows the wrong dream. Willy was never really a part of the American Dream. In the end, we see Willy's foolishness for killing himself. Willy has too much pride to take a job from Charley and would rather end his own life than work under his friend for money. Willy thinks he is helping everyone by giving them his life insurance money but everyone would rather have him still alive than the money. Striving for his dream of becoming well liked and successful leaves Willy with nothing that will make him happy. In the end, Willy's dream ends up being for Biff to achieve everything that he himself could not achieve. Willy's plan backfires though when Biff chooses the opposite of what Willy wants and leaves the city to try to find out what will make him happy. In the end, Willy's obsession with the American Dream is his undoing. Willy never really becomes part of the American Dream because he never understands what he needs to make himself happy.

Education Cannot Be Found in a Book :: Personal Narrative Writing

While baby-sitting my younger cousin, I noticed that she was frantically searching through a stack of books. When I questioned what she was looking for she responded frankly, "An education." I had to laugh at such a childish remark. Many individuals believe that education is simply obtained by reading books, listening to lectures or sitting in classrooms. However, education is not received by being an active listener, or an excellent reader. College does not guarantee a higher education; rather, it provides the atmosphere and tools that are required to develop into an educated, and scholarly individual. Education therefore is achieved by progressing through the different stages of knowledge, and acquiring the skills required to be an active observer and participant in the real world. Education is too often emphasized by the regurgitation of facts, which diminishes the use of critical thinking. There are too many dualistic students in society today who think topologically. That is, they believe that there are only two different answers to every question, the right one, and the wrong one. This type of thinking not only limits the quality of education that the student receives, but it also exploits the teacher's indolence and insufficient ability to bestow a higher education upon their students. Although I was ranked number four in my graduating class of 371 students, I do not feel like I have received a higher education than the student who was ranked number 371. Why? Simply because high school is equivalent of a board game, one repeats what the teacher said, one's thinking is emulative of the teachers, and one turns in the "busy work" on time. Hence, high school has educated an individual on how to be resistant to critical thinking. On the other hand, college professors attempt to make students think critically about issues, which concern their lives, and the lives of others. A good college education is not bestowed to the students by their professors; rather, the students furnish their own quality of education. A student can choose to remain resistant to critical thinking, or the student can maneuver into the next stage of education, which is thinking with multiple perspectives. In this multiple stage, the student begins to regard issues with diverse perspectives and to consider multiple answers to questions (Mitchell, 2000).