Essay To Kill A Mockingbird In The Widely Known Novel To Kill A Mocki

Essay: To Kill A Mockingbird In the widely known novel To Kill A Mockingbird there are two families that are very diverse and are text book examples of complete opposites on the moral ladder of success. The Cunninghams and the Ewells have two very distinct and opposite reputations. The Cunninghams which are very respected while the Ewells very much despised. The Ewells are given the privilege to hunt out of season, so that the residents of the small town of Maycomb would not have to tolerate their continuous begging twenty-four hours a day for seven days a week. These two families show the respectability of hard workers or, in the Ewells case, can fill their peers with sorrow. The Cunninghams have pride, as for the Ewells, they have a natural like anarchist nature that will eventually haunt them and hurt others because of their lurid like attitude. The Cunningham's are very respected by the citizen's of Maycomb county. The Cunninghams took nothing, unless they could pay it back. W alter the youngest in the Cunningham clan was in the same class at school as Scout Finch the daughter of Atticus Finch. While in school, a fresh young new school teacher known as Miss Caroline did not know the reputations of the predecessors of these two children. In what looked like a good day for the rookie teacher quickly turned into complete disarray and a total adversity trip for the teacher. Walter Cunningham being raised in a very hard working environment was taught not to take what he could not pay back. The teacher obviously did not know about his background in the most minute way and embarrassed him extensively by almost demanding him to take some lunch money. Knowing that he could not pay Miss Caroline back in the way that she had in mind he knew that he could take the money which he wanted to take so bad. Walter eventually ended up eating with the Finch's. While eating at the Finch's he did not know what to do with all of the food that they have offered to him. For examp le he drowned his waffles in a lake of syrup. Bob Ewell's son, Burris was also faced in the same way but in an total opposite direction and purpose. The same day as the Walter Cunningham incident there was another incident concerning the Ewells. Burris had "cooties." A "cootie" came frantically flying out of the assumed Afro of Burris's hair, and scared the overseer of the class, Miss Caroline. Miss Caroline quickly demanded that Burris go home and wash and scrub his hair with Kerosine. Burris coming from what seemed like a broken home and he had no pride so, he told the teacher off, made her cry, threatened her, and then left. The Cunninghams are given special privileges. Cunninghams paid Atticus for some legal work that Atticus did with their farm, they paid him with food, and other services. The population of Maycomb county excepted this because they know that the family is very loyal, truthful and extremely hard working. The Cunningham's would never take anything that they cou ldn't payback equally or greater of value. Then their are your slacking, lying, cootie infested, mooching Ewells. Bob Ewell is a total drunk, he takes what money he may have earned or stole and drinks it away. Mr. Ewell very rarely or if ever has bought or cooked his family a hot and total nutritious meal in his life. The kids would basically shrivel up in the little shack that they live in and starve, if they did not have the privilege to hunt and eat the food that they kill. The Cunninghams were a family of truthfulness, loyalty and able to carry on great responsibilities. They did not want to hurt anyone, they were grateful for the people that had helped them on their journey of life. When the Cunninghams were wrong they admitted it, when they were right they didn't show it. They had great respect for anyone who walked on the face of the earth. But as usual the Ewells were just the opposite, they did not tell the truth on a consistent basis, and it wasted a Essay To Kill A Mockingbird In The Widely Known Novel To Kill A Mocki Essay: To Kill A Mockingbird In the widely known novel To Kill A Mockingbird there are two families that are very diverse and are text book examples of complete opposites on the moral ladder of success. The Cunninghams and the Ewells have two very distinct and opposite reputations. The Cunninghams which are very respected while the Ewells very much despised. The Ewells are given the privilege to hunt out of season, so that the residents of the small town of Maycomb would not have to tolerate their continuous begging twenty-four hours a day for seven days a week. These two families show the respectability of hard workers or, in the Ewells case, can fill their peers with sorrow. The Cunninghams have pride, as for the Ewells, they have a natural like anarchist nature that will eventually haunt them and hurt others because of their lurid like attitude. The Cunningham's are very respected by the citizen's of Maycomb county. The Cunninghams took nothing, unless they could pay it back. W alter the youngest in the Cunningham clan was in the same class at school as Scout Finch the daughter of Atticus Finch. While in school, a fresh young new school teacher known as Miss Caroline did not know the reputations of the predecessors of these two children. In what looked like a good day for the rookie teacher quickly turned into complete disarray and a total adversity trip for the teacher. Walter Cunningham being raised in a very hard working environment was taught not to take what he could not pay back. The teacher obviously did not know about his background in the most minute way and embarrassed him extensively by almost demanding him to take some lunch money. Knowing that he could not pay Miss Caroline back in the way that she had in mind he knew that he could take the money which he wanted to take so bad. Walter eventually ended up eating with the Finch's. While eating at the Finch's he did not know what to do with all of the food that they have offered to him. For examp le he drowned his waffles in a lake of syrup. Bob Ewell's son, Burris was also faced in the same way but in an total opposite direction and purpose. The same day as the Walter Cunningham incident there was another incident concerning the Ewells. Burris had "cooties." A "cootie" came frantically flying out of the assumed Afro of Burris's hair, and scared the overseer of the class, Miss Caroline. Miss Caroline quickly demanded that Burris go home and wash and scrub his hair with Kerosine. Burris coming from what seemed like a broken home and he had no pride so, he told the teacher off, made her cry, threatened her, and then left. The Cunninghams are given special privileges. Cunninghams paid Atticus for some legal work that Atticus did with their farm, they paid him with food, and other services. The population of Maycomb county excepted this because they know that the family is very loyal, truthful and extremely hard working. The Cunningham's would never take anything that they cou ldn't payback equally or greater of value. Then their are your slacking, lying, cootie infested, mooching Ewells. Bob Ewell is a total drunk, he takes what money he may have earned or stole and drinks it away. Mr. Ewell very rarely or if ever has bought or cooked his family a hot and total nutritious meal in his life. The kids would basically shrivel up in the little shack that they live in and starve, if they did not have the privilege to hunt and eat the food that they kill. The Cunninghams were a family of truthfulness, loyalty and able to carry on great responsibilities. They did not want to hurt anyone, they were grateful for the people that had helped them on their journey of life. When the Cunninghams were wrong they admitted it, when they were right they didn't show it. They had great respect for anyone who walked on the face of the earth. But as usual the Ewells were just the opposite, they did not tell the truth on a consistent basis, and it wasted a

20 Evaluation Essay Topics on Affordable Care Act

20 Evaluation Essay Topics on Affordable Care Act In the previous guide 10 facts on Affordable Care Act for an evaluation essay, we talked about interesting facts you could utilize to write an excellent evaluation essay. Now, let’s talk topics. There are several names this law goes by such as the Patient Protection and Affordable Care Act (PPACA), Affordable Care Act (ACA) and Obamacare. It is considered to be a significant law passed to reform America’s health care system since the Medicare and Medicaid law which was passed in 1965. This law aims to help hospitals and general physicians produce significantly better results at reduced costs with better and easier methods of distribution. This is established through the transformation of existing methods with respect to finances, technology and clinical practice. Here are 20 topics for an evaluation essay on the Affordable Care Act: Affordable Care Act’s Impact on the Number of Uninsured Citizens to Get Insurance. How Will Americans Get Treatment in Emergency Situations Under the ACA Initiative? How Will the ACA Help Patients With Diseases That Insurance Companies Consider Undesirable Is the ACA Making Insurance More Affordable? How Will the ACA Law Help Small Business Owners? Underlying ACA Mechanism to Reduce Premium and Out-of-Pocket Costs of Medical Care? Solutions the ACA Law Offers to People Who are Unable to Afford Coverage. Define How Competitive the Online Health Insurance Marketplace Established Under the ACA Law is at Coverage Plan Comparison Reviewing Claims of ACA Law on Reducing the Deficit by $100 Billion in Ten Years and $1 Trillion in the Second Decade. How Will Money Be Raised Under the ACA Law? Will the ACA Law Effectively Put an End to Overspending, Fraud and Abuse in the Insurance Industry? How is the Quality of Health Insurance Being Upheld Under ACA Law? How Are Arbitrary Lifetime Limits Being Handled Through the ACA Law? New Accountability Measures of Insurance Companies Under The ACA Law? Measures for Citizens with Long-Term Care Needs Under The ACA Law. What Are the Benefits for Senior Citizens Under the ACA Law? Awareness Initiatives for the Improvement Of Public Health Under the ACA Law Measures Taken for the Rural Areas Under the ACA Law Incentives For Students to Take on Healthcare Related Professions and Then Jobs Under The ACA Law Taxation of Insurance Companies Under the ACA Act Here is a sample essay on one of the topics mentioned above: Evaluation Essay: Affordable Care Act’s Impact on the Number of Uninsured Citizens to Get Insurance The ACA is considered to be one of the most significant laws passed in US history. The law was passed in March 23, 2010 by president Obama, and since been   a major part of the population having an insurance coverage plan. The ACA has achieved this through expanding the eligibility criteria of Medicaid so that citizens under 138% of the poverty line can be added. ACA has also introduced state-sponsored insurance plans where individuals and small business owners would be able to buy insurance plans with the added benefit of subsidies for those whose income lies between 100% and 400% below federal poverty levels. According to the commonwealth fund reported on July 2014, around 10 million people randomly aged between 19-64 had chosen to go for a health insurance plan, which amounts to 5% of the working-age population. According to Gallup’s report on April 2015, the uninsured rate of individuals aged 18 and over through 2013 to 2015, has drastically dropped from 18% to 11.9%. Similarly the Rand Corporation’s official report claims that there has been a drastic effect of ACA on employers offering medical insurance coverage plans, as they have increased by more than 8 million. Similarly individuals applying for Medicaid have increased in the amount by 6 million. Around 4 million people are currently being covered through the federal and state marketplaces and a little less than a million people opted to become uninsured, owing to third-party insurance coverage plans. While experts are unsure about a million people opting out of the aforementioned insurance plan, it’s still a very small number as it merely represents only 1 percent of the working population. It can be concluded that a little less than 7.5 million individuals have opted to choose marketplace insurance policies and have effectively made payments on their premiums. According to a survey on ACA law statistics, young adults have chosen to stay on their parent’s coverage plan until they are 26. The same survey has also brought forth welcoming news that after the acceptance of this law, the body mass index in young adults has reduced by an impressive rate. Once again, proof that the ACA law has helped improve quality of life and the health of citizens. The ACA legislature has also reduced the amount of medical bankruptcies which is one of country’s highest-level of bankruptcy declarations. It’s become evident that opting for an ACA-issued medical coverage plan is helping to reduce the overall costs and availability of even more affordable plans, while the number of people getting insurance plans is increasing exponentially. Further you will get your hands on our guide for writing an evaluation paper  on affordable care act. References: Landmark: The inside story of Americas new healthcare law and what it means for us all. (2010). New York: Public Affairs. Rawal, P. H. (n.d.). The Affordable Care Act: Examining the facts. Brill, S. (n.d.). Americas bitter pill: Money, politics, backroom deals, and the fight to fix our broken healthcare system. Bromley, K. (n.d.). The employers guide to ObamaCare: What profitable business owners know about the Affordable Care Act. 2015 Affordable Care Act: Law, Regulatory Explanation And Analysis. (n.d.). Askin, E., Moore, N. (n.d.). The health care handbook: A clear and concise guide to the United States healthcare system. Emanuel, E. J. (n.d.). Reinventing American Health Care: How The Affordable Care Act Will Improve Our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System.

School corporal punishment Research Paper Example | Topics and Well Written Essays - 1250 words

School corporal punishment - Research Paper Example Many nations however have enacted legislations against its use while others still legalise it. In United States for example, about 20 states have it as a legal form of instilling discipline in schools (Human Rights Watch 36). This practice has received increased condemnation in the last 40 years from child rights activists and the general public but some people still advocate for its use. This paper looks into pros and cons of corporal punishment in schools while shedding light on how teachers can slowly remove its reliance as a disciplinary measure. ARGUMENTS FOR CORPORAL PUNISHMENT By use of corporal punishment students are made aware that there is an authority figure. This helps in ensuring that students respect the elder people in the society and it also draws a line between who is in authority as far as classroom management is concerned. In other instances students hail from quite lenient families who end up spoiling them. They therefore require someone to set them back on the r ight path of good discipline and respect for authority. In some regions dropping of corporal punishment in schools was followed by considerable decline in performance and heightened indiscipline among students. This is the case of Britain where teachers complained a great deal after its abolishment was followed by general decline in performance in many schools (Council of Europe 24). Corporal punishment acts as a motivation towards performance and as such it ought to be used where necessary so as to attain desirable results (27). Teachers are trained professionals who are also adults and they know what level of corporal punishment is appropriate for who and when. They should therefore be left to play their part and if they find this kind of punishment to be appropriate, then they can go ahead with it. This also shows that it is not a form of abuse to students as it is just punishment to an indiscipline student from a responsible teacher. Immediate physical punishment is more prefera ble than suspension or expulsion since after a few strokes a student goes on with their normal learning activities. The former two forms of punishment interrupt a students learning schedule. Misbehaving students are easily rewarded by suspensions due to the free time they are allowed to stay at home (54). These kinds of children usually stay home alone while their parents are at work and can easily indulge in further naughtiness. ARGUMENTS AGAINST CORPORAL PUNISHMENT Physical punishment opens doors for abuse and leads to battery tendencies in children. There is a thin line between punishment and abuse and teachers usually cross this line as they wish where the law allows for corporal punishment. Corporal punishment degrades students a great deal as others mock them for being punished. This brings shame to them and if this happens constantly, these students result to having low self esteem. Such a student is lowly motivated to learn or even conduct themselves in a disciplined manner. This type of punishment has many negative impacts psychologically (Human Rights Watch 92). Anxiety is one of them because students tend to become scared of their teachers in the classroom especially when punishment is imminent from something they had done earlier e.g. failure to have finished yesterday’s homework. Other psychological effects are rigidity, inhibition and depression all of which have far reaching consequences on a student’

Cause and effect essay Example | Topics and Well Written Essays - 250 words

Cause and effect - Essay Example â€Å"Cell phone distraction causes 2,600 deaths and 330,000 injuries in the United States every year† (Britt 2005). This is because talking on a cell phone distracts the driver. Talking and driving at the same time slows down a driver’s response. "If you put a 20-year-old driver behind the wheel with a cell phone, their reaction times are the same as a 70-year-old driver who is not using a cell phone† (Britt 2005). If a reaction time is slowed, accidents and fatalities occur. Because driver X thought keeping in touch with his mom was a good idea, a person could be hurt or killed as a result or effect. Another effect of driving while talking is the annoyance. Everyone has been behind a driver on a cell phone. The light turns green and they are too busy talking to pay attention. People get frustrated at the wait. Road rage is not uncommon in today’s society. A person on the cell phone could create the effect of road rage. The causes of talking on a cell phone in the car do not make people think about the effects. Unless an individual is in an accident, most drivers believe they are the exception to the rule. The effects should be weighed more carefully by the chatty cell phone users than the cause. Britt, R.R. (2005). Drivers on cell phones kill thousands, snarl traffic. LiveScience. Accessed 26 April 2011 from

Destination Management Assignment Example | Topics and Well Written Essays - 3000 words - 1

Destination Management - Assignment Example This is done with the aim of improving the wealth of the experience for both tourists and locals as well as ensures sustainability of the environment and activities that promote tourism. When the content of this discussion are considered in line with the definition of sustainable tourism, it is evident that development is core in achieving the latter. According to the WTO (1981), sustainable tourism development has to do with meeting the desires and expectants of visitors and the host regions but also protecting the areas and the culture for posterity (p.89).Tourism should ideally be carried through careful resource management in such a way that aesthetic needs are met while cultural integrity and biological diversity are preserved. Stage of development According to Butler (1980), there are seven stages of tourism development â€Å"lifecycle †(1980, p. 6)and they will be discussed herein in relation to the city of Venice in an effort to understand its growth and changes in reg ard to the tourism industry. The first stages are exploitation then involve of locals in providing facilities which results in the place becoming a popular destination (Garay & Ca`noves, 2010). Venice being one of the oldest cities in the world underwent these centuries ago and kept rising and falling depending on prevailing regional political stability. In the last few decades, Italy recognized the potential of Venice as a tourist destination and made efforts to advertise it, the world has recognized it as such too and millions of visitors flood there every year. However, due to the high number of tourists, they have destabilized the lives of the locals by making the city crowded and making it so expensive that many venetians are driven to live elsewhere. This is the fourth stage currently most dominantly manifested by the city today. Tourism facilities may also likely start to fade, as indeed they are due to the impact of too heavy a flow and if no action is taken to restore the o ld Venice tourism in the region will likely stagnate. The tourism managers in Venice have clearly noticed this and much effort has been put in restoration especially after the flood of 1968, this is the sixth stage of restoration, it has to a large extent been successful thanks to the combined efforts of the stakeholders. Should restoration fail, Venice would decline and ultimate previously tourist supported systems would fail. Approach to destination management A workshop on report produced by UNESCO on tourism in Venice asserted on the need for a diversified and sustainable cultural tourism and improved tourism management so as to effectively prioritize the needs of the host community. The need for better destination management stems from, among others, the fact that despite hosting over 22 million guests, only about 4 million spend the night, ergo, this makes tourism in the city more of a free ride than a cultural experience (UNESCO, 2011). The former is however neither sustainab le nor healthy for the industry since â€Å"free riders† will rarely appreciate the sights and experiences enough to contribute to their growth by coming back An major managerial challenge facing the municipality of Venice ensuring a regular flow of visitors all year round to increase productivity as well as reduce the high costs of short

Modified Radical Mastectomy for Contralateral Breast Cancer

Modified Radical Mastectomy for Contralateral Breast Cancer Abstract Breast cancer is the most common malignancy in women worldwide. With improving survival figures and early breast cancer detection, treatment related long term adverse effects of radiotherapy have become a concern. Contralateral breast cancer due to scatter radiation from during radiotherapy of diseased breast is one of them. This prospective clinical study was conducted to measure the dose received by the contralateral breast and compare the different techniques which influence this dose. It was found that in post mastectomy patients, treatment with telecobalt medial tangential field contribute more dose to contralateral breast compared to supraclavicular field and lateral tangential fields. The mean dose received by contralateral breast during irradiation of chest wall was 168.29 cGy which 3.36 percentage of the prescribed dose. Key Words; contralateral breast dose, breast malignancy, thermoluminescent disc, scattered radiation Introduction Breast cancer is the most common malignancy among the women worldwide. [1] With improved survival figures due to early breast cancer detection and multimodality treatment, long term adverse effects in the form of second malignancy of contralateral breast (CLB) has become a concern. In patients getting radiotherapy to the affected breast, CLB also receives radiation in the form of scattered radiation due to scattered from primary. Second malignancy is a late sequel of radiation appearing at an interval of 10-15 years. [2, 3, 4, 5, 6, 7] Since breast is highly radiosensitive structure this dose to CLB is a major concern especially in younger women and patients with longer life expectancy. Although radiation induced malignancy is a stochastic effect but the intensity increases linearly with increase in dose. [8] Studies have measured CLB dose on phantom and patients and have observed that the dose to CLB is more for medial tangential (MT) than supraclavicular field (SCL) field and later al tangential (LT) field. In our centre 22% of female patients are suffering from breast cancer and majority of them belong to low socio economic status and presented with advanced disease. In the present study we measure the dose to CLB in patients receiving radiotherapy following modified radical mastectomy (MRM). The radiation dose to CLB were measured with the help of CaSO4: Dy thermoluminescent discs (TLD). The TLD are highly sensitivity and can measure even very small doses. Materials and methods Measurement of CLB was done in 25 patients undergoing for EBRT by cobalt teletherapy machine (THERATRON 780 C and E) following MRM. Precalibrated TLD (9mmÃâ€"13mm) were placed on the surface of CLB. Total three discs were placed one at the nipple and other vertically on either side of nipple 3 cm apart. We tried our best to place the TLD on the same position each time. Skin tattooing was done to demarcate the exact position at the first sitting and this was used subsequently to replicate the position. After delivery of radiation dose for a particular field the discs were removed and another set of three discs were placed for next reading. In this way total six discs were used daily, three for SCL field and three for MT or LT field as MT and LT fields were treated on alternate days and SCL field was treated daily. For MT and LT fields breast cone was used for half beam block. Total dose delivered was 50 Gy in 25 fractions, 2 Gy per fraction, 5 fractions per week in 5 weeks. The expos ed TLD were stored in radiation free zone and the readings were taken after 24 hours and within 7 days after exposure because after seven days the TLD start to loose electrons. The scattered dose received by TLD were measured on NUCLEONIX TL 10091 TLD reader. After one set of measurement, the discs were annealed by heating 400 degree celcius and then used for next measurement. For each patient, measurements were carried out at first week, third week and last week, total three times during the course of treatment. Statistical Analysis Mean dose calculation received by CLB. Total dose received by CLB, this was calculated by multiplication of mean dose to number of fractions. The percentage of radiation dose received by CLB with respect to the prescribed dose to diseased breast (Total doseÃâ€" 100 / prescribed dose to diseased breast). We also stratified data based on gantry angle at which EBRT was delivered (≠¤50 degree and > 50 degree). The statistical software SPSS version 20.0 was used for the data analysis. Results The age wise distribution of patients and the mean dose received by CLB is shown in table 1. 19 out of 25 patients in our study were 50 years or younger. 52% patients had left sided breast cancer. Table 2 shows the contribution of SCL, MT and LT field dose with the gantry angle at which the radiation dose was delivered. Total dose received by CLB varies from 1.22% to 5.82% of the prescribed dose of 50 Gy to the affected breast. Mean total dose received by CLB was 105.55 cGy with MT field followed by SCL field, (33.96 cGy) and LT field {(28.97 cGy) as shown in table 2. This data shows that the maximum contribution of dose to CLB was with MT field followed by SCL field and LT field. Mean dose with all three fields received by CLB was 168.48 cGy with SD  ±62.23 which corresponds to 3.36% of prescribed dose to affected breast. 11 patients were treated on cobalt unit with gantry angle ≠¤ 50 degree having 3.00% contribution of CLB dose (table 3). 14 patients treated with gantry angl e > 50 degree had 3.79% contribution of CLB dose (p=0.199). The mean, median and range were 3.66, 3.34 and 4.60 respectively. Discussion It is well known that exposure to ionizing radiation causes carcinogenesis in healthy tissues. Although it is a stochastic effect having no threshold dose but the intensity increases with increase in radiation dose. CLB must be considered as an organ at risk during radiotherapy planning for treatment of cancer breast. Many previous studies conducted to calculate the dose received by CLB, were based on patients, phantom or treatment planning system. Boice et al analyzed the record of 41109 patients of cancer breast and they found the mean CLB dose was 2.82 Gy. [9] They also hypothesized that there was increased relative risk of CLB malignancy due to exposure to ionization given to diseased breast. The relative risk was 1.19 for all patients, however the relative risk was more (1.49) for younger patients who were less than 45 years old. In our study, the maximum dose received by CLB in women below 40 years which was 3.93 percentage (196.437 cGy) of prescribed dose. The minimal dose was received in patients who were above 60 years of age {(1.96 %) (97.875 cGy)}. The possible reason could be the increased laxity of breast tissues in older women cause more lateral shifting of CLB away from the radiation at the time of exposure. Half beam block technique is routinely used while irradiating the breast with tangential beams. [10, 11] Kelly et al measured CLB dose on Alderson Rando phantom using TLD with four different techniques of breast cancer treatment using 6 MV photon beam on linear accelerator. [12] The used half beam block with asymmetrical jaws, custom blocks and symmetrical collimator jaw. Another technique used was isocentric method with non divergent posterior border. They observed highest dose to CLB in MT field with wedge. In our study radiation was delivered using half beam block with breast cone. The dose to CLB was maximum with MT field because in half block beam, the breast cone is placed near to surface of breast which cause increased dose due to secondary collimator scattering. Bhatnagar et al compared dose to CLB during EBRT to chest wall irradiation using conventional tangential technique and intensity modulated radiotherapy (IMRT). [13] They observed 20 percentage reduction of dose to CLB using IMRT. According to a study by Chougule, the average contralateral nipple dose was 152.5-254.75 cGy and the percentage was 3.05-6.05% for a dose of 5000 cGy in 25 fractions for post mastectomy breast cancer. [14] In our study, the measured mean contralateral nipple dose on was 171.88 cGy (55.5-303.80 cGy) which accounts to 3.47% (1.11%-6.07%) of prescribed dose (table 2). Dose to CLB were higher for dose calculated at the level of nipple as compared to dose received by whole CLB. This may be due to TLD at level of nipple being closest to the radiation source. According to Rankel et al with high gantry angle the beam will be closer to the surface leading higher dose to the CLB. [15] In this study, it was found that with gantry angle >50 °, more dose was delivered to the CLB though the difference is not statistically significant (p=0.199). Conclusion In our patient cohort, higher inadvertent CLB dose was delivered in younger patients with MT field; overall, dose being 3.36 percentage of prescribed dose.

James A. Michners: TEXAS :: essays research papers

In this magnificent historical novel, James A. Michner skillfully combines fact and fiction to present one of our most expansive and diversified states. Spanning nearly four and a half centuries, Michner begins with the first Spaniards to explore parts of present day Texas, Cabeza de Vaca and Francisco Vasquez de Coronado and continues on to the emergence of Texas as one of our most powerful states. Michner’s use of historical fact is extremely accurate in his portrayal of events in Texas history. Particularly when he writes of the fight for Independence from Mexico. Michner only strays to fiction in an attempt to illustrate to the reader what the lives of early Texans must have been like. His characters interact with actual historical figures and create very believable scenarios of the events depicted in his novel. One Scenario in particular is the Battle of San Jacinto. This is a historical event which ended in a decisive victory for the Texas Army and Independence for Texas. Michner’s depiction of this battle is very accurate except for two important points. In his novel, Stephen F. Austin is sent to destroy a ferry owned by a former lover, Mattie Quimper. This was to prevent the Mexican Army, under the command of General Antonio Lopez de Santa Anna, from crossing the river and give more time to the Texans to prepare for the inevitable battle. This incident is fictional, but it is similar- to another factual event. At San Jacinto, General Sam Houston sent one of his men to destroy a bridge crossing the San Jacinto River. This was to prevent reinforcements from joining Santa Anna’s forces, which were already on the Island. The second point which was fictional ,but was based on an actual event, was the capture of General Santa Anna. In Michner’s novel, a bumbling Yancy Quimper, comes across a half naked Santa Anna, who was trying to evade capture by hiding in the trees. Quimper, being a coward, nearly shoots himself in the process. This alerts another fictional character, Otto MacNab. MacNab takes Santa Anna into custody and presents him to General Houston. In actuality, a Texas Army Sergeant captured Santo Anna the day following the battle. Michner includes these fictional characters as part of a sub-plot designed to keep the reader interested in what is a purely military campaign. He remains true to historical facts and only adds fiction to color his amazing storytelling abilities.

Quality Improvement Email Essay

Quality management in healthcare facilities is organized to meet the needs of the organization. Today, most organizations have a program of continuous improvement in all functional areas. Data collection and analysis and resulting improvements have become an accepted way of doing business. An organization must address how it is going to achieve a successful Quality Improvement program (LaTour, p. 520). This paper is going to discuss the quality improvement in the health care industry along with stakeholders, roles, and resources to name a few. The purpose of quality management in the health care industry is to enhance the safety, efficiency and effectiveness of all businesses from health care processes and the performance of delivering products to human resources (The Purpose of QI Healthcare, 2014). The improvement is achieved using various methods, both qualitative and quantitative. With the passing of time, healthcare delivery has become more complex. There is a requirement for ne w and enhanced methods that will reduce costs and provide access to new technologies (The Purpose of QI Healthcare, 2014). Bringing a change into the system can facilitate the achievement of a new performance level. When a system remains unchanged over time and no enhancements are made, it cannot generate better results than the ones already created. The inefficient parts of the structure are replaced with new inventions that can prove to be worthy (The Purpose of QI Healthcare, 2014). Quality Management is needed because of competition. The primary goal is to beat the competition. It will add value at each stage of production defining long term plans for your company while at the same time providing a framework for it. The stakeholders define quality of care in various ways. Each stakeholder has different concerns relative to the  project’s objectives and goals (LaTour, p.808), which can translate, into different ratings of quality. â€Å"Exploratory interviews suggest that ratings are influenced by past experience, expectations, definitions of quality of care, and perceived power relationship s between stakeholders† (Campbell, 2004). Agency for Healthcare Research and Quality has defined â€Å"stakeholders† as persons or groups that have a vested interest in a clinical decision and the evidence that supports that decision (The Effective Health Care Program Stakeholder Guide Chapter 3: Getting Involved in the Research Process). Stakeholders may be patients, caregivers, clinicians, researchers, advocacy groups, professional societies, businesses, policymakers, or others. Each group has a unique and valuable perspective. With quality improvement, there are roles that are involved. The leader’s role in promoting and developing quality improvement begins with creating and sustaining a personal and organizational focus on the needs of internal and external customers (Quality Improvement, 2014). A leader demonstrates a clear commitment to the organizational mission, values, goals, and expectation that promote quality and performance excellence through its actions. Key staff roles in a quality improvement p rogram are day-to-day leader, data entry person, provider champion, operations person, and data specialist. Monitoring provides the method to identify how the organization compares with the original opportunities for improvement and achieving those goals. (Wiley, 2007) Every area needs monitored because of providing every needs monitored because of providing patient can with any deficiency affect the entire hospital. Leaders determine the areas that need monitoring for improvement, monitoring the compliance of policies and procedures and standards for the hospital. The accrediting and regulatory agencies that are involved in the quality improvement process are The Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Joint Commission evaluates the quality of health care provided to the patient. They also requires that organizational leadership set expectations, plan, manage how to measure, assess, and improve in all aspects of providing care (LaTour, p.521). Another agency that is involved is the United States Department of Health and Human Services (HHS) which represents the federal funded agency that focuses on improving the health care. The federal government mandates the areas for monitoring for quality, for example, preventive care,  infection control, fall rates, and chronic disease management. (HRHA, 2013) National Committee for Quality Assurance (NCQA) represents the accrediting agencies for the hospitals. It also evaluates the quality of health care provided to the patient. In conclusion, there are many resources for helping the improvement of quality. The patient, providers, nurses and management plays a part in the improvement that will guide to reach desired levels of performance. An organization that affects quality improvement is Agency for Healthcare Research and Quality (AHRQ). AHRQ is the lead Federal agency charged with improving the quality, safety, efficiency, and effectiveness of health care for all Americans. (Quality Improvement Organizations) The accrediting and regulatory organizations protect the public the regular reporting quality measures of the health care facility. References: LaTour, K. (2010), Health Information Management Quality Improvement Organizations Retrieved from: http://www.aap.org/en-us/professional-resources/practice-support/quality-improvement/Pages/Quality-Improvement-Organizations.aspx Quality Improvement, Retrieved from: http://www.hrsa.gov/quality/toolbox/methodology/qualityimprovement/part2.html The Effective Health Care Program Stakeholder Guide: Chapter 3: Getting Involved in the Research Process. February 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/evidence-based-reports/stakeholderguide/chapter3.html The Purpose Of Quality Improvement in Healthcare, Retrieved from: http://www.sixsigmaonline.org/six-sigma-training-certification-information/the-purpose-of-quality-improvement-in-healthcare.html Campbell, S. (2004) How do stakeholder groups vary in a Delphi technique about primary mental health care and what factors influence their ratings?

Structure of the lungs. essays

Structure of the lungs. essays Structure of the respiratory system. The respiratory surface of a mammal consists of many air sacs called alveoli inside a pair of lungs. The lungs are situated next to the heart in the thoracic cavity and are connected to the atmosphere by tubes. Air passes into the lungs through these tubes. Twelve pairs of bony ribs surround and protect the lungs and heart. Intercostals muscles are attached to the ribs, and a large diaphragm separates the thorax from the abdomen. These are involved in the ventilation mechanism. Air enters the body through two nostrils, each of which possesses a boarder of large hairs, which trap particles in the air and filter them out of the system. While passing through the nasal passages the air is warmed and moistened and its odour detected. Air passes from the nasal passages, through the pharynx and into the trachea. This is a tube, which lies in front of the oesophagus and extends into the thoracic cavity. The wall of the tube is strengthened and held open by horizontally arranged C-shaped bands of cartilage. The open section of the C is next to the oesophagus. The cartilage prevents collapse of the tube during inspiration (breathing in). At its lower end the trachea splits into two bronchi. Within the lungs each bronchus subdivides many times into much smaller tubes called bronchioles. These in turn branch into finer and finer tubes, ending with the alveolar ducts, which lead into sacs called alveolar sacs. Into each alveolar sac opens a group of alveoli. The walls of most of the respiratory passage are lined with ciliated epithelial cells and goblet cells, which secrete mucus. Mucus traps any particles, such as dust and bacteria that have managed to pass through the hairs of the nostrils. The beating of the cilia then carries the trapped particles to the back of the buccal cavity where the mucus is swallowed. Mucus also moistens the incoming air. The alveoli form the gas exchange surface. There a...

Learning to Edit News Stories Quickly

Learning to Edit News Stories Quickly Students in news editing classes get plenty of homework that involves - you guessed it - editing news stories. But the problem with homework is that its often not due for several days, and as any experienced journalist can tell you, editors on deadlines must usually fix stories within a matter of minutes, not hours or days. So one of the most important skills a student journalist must cultivate is the ability to work fast. Just as aspiring reporters must learn to complete news stories on deadline, student editors must develop the ability to edit those stories quickly. Learning to write rapidly is a fairly straightforward process that involves building up speed by banging out stories and exercises, over and over again. There are editing exercises on this site. But how can a student journalist learn to edit more quickly? Here are some tips. Read the Story All the Way Through Too many beginning editors try to start fixing articles before theyve read them from start to finish. This is a recipe for disaster. Poorly written stories are minefields of things like buried ledes and incomprehensible sentences. Such problems cant be properly fixed unless the editor has read the entire story and understands what it SHOULD say, as opposed to what it IS saying. So before editing a single sentence, take time to make sure you really understand what the story is all about. Find the Lede The lede is by far the most important sentence in any news article. Its the make-or-break opening that either entices the reader to stick with the story or sends them packing. And as Melvin Mencher said in his seminal textbook News Reporting Writing, the story flows from the lede. So its no surprise that getting the lede right is probably the most important part of editing any story. Nor is it surprising that many inexperienced reporters get their ledes horribly wrong. Sometimes ledes are just very badly written. Sometimes theyre buried at the bottom of the story. This means an editor must scan the entire article, then fashion a lede thats newsworthy, interesting and reflects the most important content in the story. That can take a little time, but the good news is that once youve created a good lede, the rest of the story should fall into line fairly quickly. Use Your AP Stylebook Beginning reporters commit boatloads of AP Style errors, so fixing such mistakes becomes a big part of the editing process. So keep your stylebook with you all the time; use it every time you edit; memorize the basic AP Style rules, then commit a few new rules to memory every week. Follow this plan and two things will happen. First, youll become very familiar with the stylebook and be able to find things more quickly; second, as your memory of AP Style grows, you wont need to use the book as often. Dont Be Afraid to Rewrite Young editors often worry about changing stories too much. Maybe theyre not yet sure of their own skills. Or maybe theyre afraid of hurting a reporters feelings. But like it or not, fixing a really awful article often means rewriting it from top to bottom. So an editor must cultivate a confidence in two things: his own judgment about what constitutes a good story vs. a real turd, and his ability to turn the turds into gems. Unfortunately, theres no secret formula for developing skill and confidence other than practice, practice and more practice. The more you edit the better youll get, and the more confident youll be. And as your editing skills and confidence grow, so too will your speed.

Is Islamic Financing better for Real Estate financing than the Essay

Is Islamic Financing better for Real Estate financing than the conventional Financing - Essay Example (Tarek El Diwany, 2003) While conventional banking is more of a profit oriented business seeking interest on the finance provided to the consumer, being part of the capitalistic interest based financial system, etc. (Kabir Hassan and Mervyn Lewis, 2007) Islamic banking activities are mostly clustered around three parts of the world; Middle East, South Asia and Southeast Asia. It is further reported that Islamic banking system provides services in the real estate sector in many Muslim countries and banks have started special windows to attract petrodollars from the Muslim people. It is further reported there is high scope for investing Islamic financing in real estate market in Singapore, Malaysia, Saudi Arabia, Pakistan, Bahrain and other Muslim nations as it offers more ethical and efficient alternatives as compared to the interest based conventional banking system.(M. Mansoor Khan and M. Ishaq Bhatti, 2008) Since the Islamic financing has strong foothold in many of the Muslim count ries and provides services in various fields, it is believed that Islamic finance is better than the conventional financing system with regard to the financing in real estate sector as it provides more customer oriented services unlike the conventional banking where profit is the first objective of the organization. Hence the present study is proposed into the research of Islamic financing system and conventional financing system, and which is the best suited in the area of real estate financing to the public. Zamir Iqbal et al (2009) mentioned that the conventional financing system which is based on debt financing has taken a set back after the recent credit crisis that started with the initial collapse of the sub prime real estate market in the United States in 2007. Islamic banking and finance represents the worldwide phenomenon that is taking place in Malaysia, Indonesia, the United

Historical Developments Essay Example | Topics and Well Written Essays - 250 words

Historical Developments - Essay Example This was further intensified when the Royal Proclamation was issued by King George III, prohibiting the colonists to settle beyond the Appalachian Mountains. This was a move to strengthen the British relationships with the Native Americans. Followed by this, there were a number of Acts, namely Sugar Act (1764), Currency Act (1764), Quartering Act (1765) and Stamp Act (1765) increased the duties and taxes of the colonists. When the colonists resisted, these Acts were enforced on them. The Boston Massacre of 1770 ignited the fire between the parties and the colonists used this event to showcase the cruelty of the British. The Intolerable Act (1774) which placed restrictions on meetings and Boston harbor in response to the Boston Tea Party, was a milestone, as it resulted in the colonies forming an Association (First Continental Congress) to boycott British goods in retaliation. The open warfare at Lexington and Concord (1775) resulted in the death of 8 American men and 70 British soldi ers. This was followed by all the 13 colonies meeting to form the Second Continental Congress in May 1775 and George Washington was named the head (Gipson, 1954). Thus the growing grievances of the colonists against the restrictions placed by the British, finally resulted in the American