Free Essays on Nature Of Evil In Young Goodman Brown

The Nature of Evil in Young Goodman Brown In Nathaniel Hawthorne’s story, Young Goodman Brown, the author’s primary concern is with the concept of evil and how it affects Young Goodman Brown. Through the use of tone and setting, Hawthorne portrays the nature of evil and the psychological effects it can have on man. He shows how discovering the existence of evil brings Brown to view the world in a cynical way. Brown learns the nature of evil and, therefore, feels surrounded by its presence constantly. Brown’s attitude and actions portray a negative view of Salem and its people. He ponders the hypocrisy of the town as well as that of the Puritans. He examines the possibility that evil and corruption exist in a town that is supposedly characterized by piety and devout faith. The story is set in seventeenth-century Salem, a time and place where sin and evil were greatly analyzed and feared. The townspeople, in their Puritan beliefs, were obsessed with the nature of sin and with finding ways to be rid of it altogether through purification of the soul. At times, people were thought to be possessed by the devil and to practice witchcraft. As punishment for these crimes, some were subjected to torturous acts or even horrible deaths. Thus, Hawthorne’s choice of setting is instrumental in the development of theme. He uses contrast as a means to portray the village as good and the forest as bad. This adds significance to the fact that Brown begins his journey in the town and proceeds then to the forest. The use of imagery captures the appearance of the forest as well as lending a sense of foreboding towards the impending evil. Hawthorne says of Brown, â€Å"He had taken a dreary road, darkened by the gloomiest trees of the forest†¦It was all as lonely as it could be† (2208). Immediately following this description, Brown speculates that he may not be alone in the forest. He fears that there may be a â€Å"devilish indian† or â€Å"the... Free Essays on Nature Of Evil In Young Goodman Brown Free Essays on Nature Of Evil In Young Goodman Brown The Nature of Evil in Young Goodman Brown In Nathaniel Hawthorne’s story, Young Goodman Brown, the author’s primary concern is with the concept of evil and how it affects Young Goodman Brown. Through the use of tone and setting, Hawthorne portrays the nature of evil and the psychological effects it can have on man. He shows how discovering the existence of evil brings Brown to view the world in a cynical way. Brown learns the nature of evil and, therefore, feels surrounded by its presence constantly. Brown’s attitude and actions portray a negative view of Salem and its people. He ponders the hypocrisy of the town as well as that of the Puritans. He examines the possibility that evil and corruption exist in a town that is supposedly characterized by piety and devout faith. The story is set in seventeenth-century Salem, a time and place where sin and evil were greatly analyzed and feared. The townspeople, in their Puritan beliefs, were obsessed with the nature of sin and with finding ways to be rid of it altogether through purification of the soul. At times, people were thought to be possessed by the devil and to practice witchcraft. As punishment for these crimes, some were subjected to torturous acts or even horrible deaths. Thus, Hawthorne’s choice of setting is instrumental in the development of theme. He uses contrast as a means to portray the village as good and the forest as bad. This adds significance to the fact that Brown begins his journey in the town and proceeds then to the forest. The use of imagery captures the appearance of the forest as well as lending a sense of foreboding towards the impending evil. Hawthorne says of Brown, â€Å"He had taken a dreary road, darkened by the gloomiest trees of the forest†¦It was all as lonely as it could be† (2208). Immediately following this description, Brown speculates that he may not be alone in the forest. He fears that there may be a â€Å"devilish indian† or â€Å"the...

Prioritize

Prioritize Prioritize Prioritize By Maeve Maddox Some speakers hate to hear people use the word prioritize, complaining that â€Å"it’s a made-up word that shouldn’t be used.† Prioritize is a fairly new word, coined in the 1950s, and growing in popularity since the early 1960s. Speakers use it to mean: to give priority to to designate something as worthy of special attention to arrange items to be dealt with in order of importance to establish priorities to establish priorities for a set of tasks Here are some examples of its use online: KMT, CCP agree to prioritize service trade agreement How to Prioritize Your Debts Council Approves Two Projects That Prioritize Pedestrian and Bike Safety Four Must Know To-Do Lists To Prioritize Tasks Strengthening parliaments in nascent democracies: the need to prioritize legislative reforms As late as 1982, twenty years after prioritize entered the language, the OED acknowledged its existence, but included an apologetic note, saying, â€Å"prioritize is a word that at present sits uneasily in the language.† Thirty-two years later, the OED site employs the word prioritizing unapologetically in a discussion of the term â€Å"network neutrality†: This concept [network neutrality] has been the subject of much debate in recent years, reflecting something axiomatic for many Internet users; that all data on the net should be treated equally by Internet service providers, without favouring particular formats, products, or web sites by charging extra fees, prioritizing or blocking data of certain types, and so on. Speakers who still want to hold the line against prioritize could replace it with the phrase â€Å"to set priorities†: KMT, CCP agree to set service trade agreement priorities Council Approves Two Projects that set Priorities for Pedestrian and Bike Safety How to set priorities for your debts People who don’t like prioritize shouldn’t use it, but trying to stop other people from using it is futile. I’ll be happy to recommend a much more worthy target of opprobrium. How about the use of gift as a verb when we already have the perfectly serviceable word give: Lands gifted by donors are the foundation of SSU Preserves programs. The Greeks have gifted the world with many things. Teradata in the fall of 2010 gifted the Walton College of Business with a new Teradata 2650 system.   Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Vocabulary category, check our popular posts, or choose a related post below:Comma After i.e. and e.g.Empathy "With" or Empathy "For"?Empathic or Empathetic?

Nationalized Health Care System Essay Example | Topics and Well Written Essays - 1000 words

Nationalized Health Care System - Essay Example Unfortunately, the government was not interested in the health system and wanted to primarily deal with unemployment. When President Thoreau appointed a committee to look into the issue, the commiteee did not solicit the input of the public but gave conclusion of the National Health Insurance as of low priority as compared to other unemployment insurance and retirement benefits (Hoffman 76). Health care and its estimated costs have now been seen as one of the most fundamental concerns in the current medical strategy of the United States. In essence, a health reform office has been established in the White House, and members of the Congress are considering a proposal on the issue (Hoffman 76). This is because the country had been at the verge of national health reform for numerous times in the past. In 1912, Theodore and other reformers through the Bull Moose Party campaigned on a platform where they wanted an industrial health insurance with regard to all the eight states with a comp ulsory health system that would be addressed by the United States. ... ack of national health insurance did not hamper other major reforms from being enacted, and particularly those that were hugely popular and efficient in the improvement of health access for many Americans. These health insurances include Medicare, Medicaid and the health insurance that was meant for the children: Children Health Insurance Program (Hoffman 79). The United States and Obama Care According to a research done by the Policy Research Institute for the Region (PRIOR), in the United States, today 47 million individuals lack health insurance, where around 1.3 million of them live in New Jersey. In fact, the region has made progress in securing that insurance is available to all children in the states (Starr 20). If anything, the research discussed the latest reform on health care in the United States, including the Obama Care and the prospects of expanding the coverage further in the future. Another research done by the American Public Health Association denotes that national health care is crucial as a government role in providing cover to the entire population and understanding that the coverage can be achieved with the inclusion of private insurers to supplement the insurance market in the United States and other likeminded states. Apparently, the Obama government has come up with a health care dubbed â€Å"The Patient Protection and Affordable Care Act’’ signed in 2010 (Boerner 4). This health care reform was signed into law in order to improve the health industry in the United States. While some of the aspects in the system have already been enacted, others are continually being implemented to ensure that all citizens in the United States are incorporated. In support of national health care, various returns are present. Through the Obama Care, over 32

Client Studies Essay Example | Topics and Well Written Essays - 3250 words

Client Studies - Essay Example Or, it may be that sex itself, or lack of sex, is having a negative impact on ones relationships or general health. In addition, the organisation offers help with relationships where one or both partners are unhappy or are being hurt. In addition, help can be provided where a relationship has ended badly. Above all, the organisation offers help to anyone with worries about their sexuality.  Ã‚   The placement, which is situated in Wondsworth Borough in London, tends to provide services specific to the local community. The local population comprises many different ethnic groups, most notably Afro-Caribbean, Somali and Polish. Other counselling services share the Victorian terrace house, where the Albany Trust is located; this provides a dynamic and stimulating setting. The practice contains a waiting room with sitting facilities where clients wait to be met by an appointed therapist. Access to the practice is via an entry phone that is placed and accessed by the therapist in the waiting room. The consulting rooms are spacious and provide natural light, resulting in an environment that made me feel very comfortable. However, I realised that the only via starts access prevents us from seeing clients with disabilities or any other kinds of impediments. The client, Stephen, was self-referred and allocated to me after an assessment was made and a team, which included the practice manager, assessor and my supervisor, discussed my suitability for the case. Having discussed the case with my supervisor before meeting the client gave me the chance to explore my feelings and reactions towards the case. However, looking back on it now I possibly would have preferred not knowing as much about the clients case because in a way it prevented me from having a more open approach to the process with him, especially at the beginning of our therapeutic alliance. Stephen was offered open ending therapy, as he was seeking social benefits, and a low income fee of

The Effects of Business on the Community Essay Example for Free

The Effects of Business on the Community Essay Positive and Negative effects on the society The impact of my business on the community can consist of both positive and negative effects. Starting with positive, having the only shop in Walthamstow and the surrounding areas, my business is offering something new to the community. People do not have to struggle in finding separate businesses that offer the same services I do in a package or separately in my shop. Furthermore, with my new business will be creating new jobs which will be available to anybody seeking for a job as it is very much needed in a time of a financial crisis (recession). Also, people in working for my business will be able to generate a feasible income, thus people will be paying tax which will be given to the local government. This will evolve the community into a safer, cleaner and more enjoyable place to live in, as it contributes to community centres, rubbish collections, fire brigade and much more. In addition, they will also be paying national insurance and corporation tax, which in term will be spent by the government on what they feel, needs to be developed upon such as roads and hospitals. Negative effects include anything which has any relation towards global warming. As any business I will be using electricity, throwing away rubbish and also noise pollution with my idea to advertise my business near the market with a live production this will produce a lot of noise pollution. Positive and Negative effects on existing businesses There are many positive to my business as there is not any competition to deal with so I dont have to worry about people looking to any competitors for information and purchase their package as they can come direct to us without other businesses entering their mind. Furthermore elaborating on this idea of no competition it allows my business to put prices higher than expected as I do not have to reduce the prices to a price which is competing with competition from existing businesses, so it allows us to put the prices slightly higher and which allows me to have profit maximisation straight away. With time Economies of scale will be introduced to my business which means that the unit cost of production is to fall in size as my business grows. As my business is beginning to raise awareness and finance I will consider lowering prices if my business starts to grow in size and value. Furthermore, with no competition I can establish myself in the area and be the first one to open such a sh op in the area and surrounding then that means my business will be well known, so if new competition was to open up then I would have the upper hand as I would have the experience and the name credibility so that people would come to me first then the new competition. On to the negative aspects, without competition I cannot save money on infrastructure as with competition we could speak to each other and agree on sharing some services such as delivery, cleaning etc, this could trigger a positive multiplier effect and reduce cost by a huge margin. In addition to this, without any competition I wont be able to judge how their business is actually working and is a success or not and come up with a conclusion as to what their weaknesses are and their strengths are so that if my business are making the same mistake I can change the way Im running the problem and come up with a solution to mend it. On more point that is a problem is that my business is a innovating company new to the market so I cannot review on other business if they are doing well or not, this means that my business will be a huge gamble, as it will either be a hit or be a misfiring disaster. Solving the negative problems I will try to solve problems surrounding society, by cleaning the work place and having regular checks that my business will be in a tidy and organised environment to prevent the infestation of rodents as its unhealthy and puts a danger to society. So putting out the rubbish and also recycling papers, bottles, cans and more then I will also be helping the environment and also be helping the image of my business by having a good reputation for being green and also keeping the community as clean as possible improving the businesses name further. Also, I could cut energy usage by using electrical appliances that dont use a lot of energy and using energy efficient light bulbs than the normal ones as well. Solving problems related to no competition will be accomplished by firstly, kick starting my business and making a success so that someone else will consider establishing their own business with the same idea as they can see that my business is doing extremely well in the market and so that they can have a share of the profits and have some competition which could befit my business in the following ways. Firstly, it can be a great way to save money by sharing infrastructure this way we dont have to spend so much of our profits on bills, for material like travelling, communication and others along the same line, which then for both our business to flourish the money saved can be used to expand our business. Furthermore, with competition we can witness the positives and negatives of each others business so that we can improve on our mistakes and make my business a greater force in the market.

Reproductive Technologies: Does Choice Mean Freedom? :: essays research papers fc

Reproductive Technologies: Does Choice Mean Freedom? "One does not, it might be said, increase a person's freedom simply by increasing the sheer quantity of possibilities which he or she can choose from." n Richard Norman The issue of reproductive technologies in our society today raises an interesting question. Do they increase a women's freedom of choice or do they expand the power of men and science over women. Is freedom to choose what they can do with their bodies truly freedom. Freedom, as a core, is the absence of external impediment. In this sort of area can women truly be free of external impediment, also is this truly freedom of choice? "The range of physical possibilities from which a person can choose at a given moment has no direct relevance to freedom†¦Whether a person is free or not does not depend on the range of choice." (Haylek 1960, p.12f). This subject is so socially charged that a women could not possibly have true freedom of choice but a choice which is basically decided for her, whether it be by the limited choices made available to her by medical science or by the men which are directly involved with them in the decision. In order to truly understand this issue we must look at it's core, reproductive technology. This is a vast area to discuss because it ranges from artificial insemination to abortion to contraception to genetic engineering with many area in between. Artificial insemination is the introduction of sperm to an ovum artificially either inside or outside the female genital tract. Abortion is the "extermination of pregnancy before the fetus is capable of independent life." Birth control is a huge area of reproductive or contraceptive technology, in effect though all sub areas of this main area deal with the prevention of fertilization of the ovum or egg, also in some cases such as the condom it can stop the spread of disease. Genetic engineering is a new and extremely scary technology which hopes to enable the precise engineering of an unborn child. The previous examples are just some of the areas of reproductive technologies but they are sufficient to cover the basic scope of the issue. What is freedom. In the Webster's dictionary the definition is "The state of being free or at liberty rather than in confinement or under physical restraint". This is the core of freedom but to truly understand freedom one must define it with much more detail. two people who have concentrated their efforts on the subject of freedom are Norman and Haylek. Norman feels that freedom is equated to the absence of social pressure yet the possession of

Boeing:how low can they fly? Essay

Prepare problems 3, 5 and 7 on pp.521 and the additional problem, Principles of Economics, Case, Fair and Oster. Problem 3 p.521 For each of the following statements, decide wether you agree or disagree and explain your answer : 1. During period of budget surplus (when ? < ? ), the government debt grows. 2. A tax cut will increase the equilibrium level of GDP if the budget is in deï ¬ cit but will decrease the equilibriumm level of GDP if the budget is in surplus. 3. If the ? ? ? = 0.90, the tax multiplier is actually larger than the expenditure multiplier. Problem 5 p.521 Expert economists in the economy of Yuk estimate the following : Real output/income 1000 billion Yuks Government purchases 200 billion Yuks Total net taxes 200 billion Yuks Investment spending (planned) 100 billion Yuks Assume that Yukers consume 75 percent of their disposable incomes and save 25 percent. 1. You are asked by the business editor of the ? to predict the events of the next few months. By using the data given, make a forecast. (Assume that investment is constant.) 2. If no changes were made, at what level of GDP (? ) would the economy of Yuk settle ? 3. Some local conservatives blame Yuk’s problems on the size of the government sector. They suggest cutting government purchases by 25 billion Yuks. What effect would such cuts have on the economy ? (Be speciï ¬ c) 1 Problem 7 p.521 Assume that in 2008, the following prevails in the Republic of Nurd : Y=200$ C=160$ S=40$ I(planned)=30$ G=0$ T=0$ Assume that households consume 80% of their income, they save 2% of their income, ? ? ? = 0.8 and ? ? ? = 0.2. That is, ? = 0.8 and ? = 0.2 . 1. Is the economy of Nurd in equilibrium ? What is Nurd’s equilibrium level of income ? What is likely to happen in the coming months if the government takes no action ? 2. If 200$ is the  « full-employment  » level of ? , what ï ¬ scal policy might the government follow if its goal is full employment ? 3. If the full-employment level of ? is 250$, what ï ¬ scal policy might the government follow ? 4. Suppose ? = 200$, ? = 160$, ? = 40$ and ? = 40$. Is Nurd’s economy in equilibrium ? 5. Starting with the situation in part (4), suppose the government starts spending 30$ each year with no taxation and continues to spend 30$ every period. If ? remains constant, what will happen to the equilibrium level of Nurd’s domestic product (? ) ? What will the new level of ? and ? be ? 6. Starting with the situation in part (4), suppose the government starts taxing the population 30$ each year without spending anything and continues to tax at that rate every period. If ? remains constant, what will happen to the equilibrium level of Nurd’s domestic product (? ) ? What will the new level of ? and ? be ?. How does your answer to this question differ from your answer to question (5) ? Why ? 2 Additional problem INCOME 2000 3000 4000 5000 6000 7000 8000 9000 10000 TABLE 1 – Add caption TAX C G I 200 1400 1600 1000 200 1900 1600 1000 200 2400 1600 1000 200 2900 1600 1000 200 3400 1600 1000 200 3900 1600 1000 200 4400 1600 1000 200 4900 1600 1000 200 5400 1600 1000 ? 1. Fill in the disposable income ( ) and the saving (?) columns. 2. Deï ¬ ne  « equilibrium income/output  » and then ï ¬ nd the equilibrium income / output by two different methods. 3. Deï ¬ ne ? ? ? and ? ? ?, and ï ¬ nd their numerical value. 4. How much is the : – Government expenditure multiplier ? What is the formula ? – Consumption multiplier ? What is the formula ? – Investment multiplier ? What is the formula ? – Tax multiplier ? What is the formula ? 5. From the above data : – Derive the consumption equation – Derive the saving equation – Derive the investment equation – Derive the government expenditure equation 6. What will be the new equilibrium income when the government increases its expenditure from 1600 to 3100 ? 7. What will be the new equilibrium income when the government increases the taxes from 200 to 1200 ? 8. Assume that the equilibrium level on income/output is the one found in question (2) above. If the potential income/output is 9000 and the government intends to bring the economy to the potential level : – By how much government expenditures should increase/decrease ? Explain. – By how much taxes should increase/decrease ? Explain. 3

Stryker Corporation

Stryker Corporation is a Fortune 500 medical technologies firm based in Kalamazoo, Michigan. Stryker's products include implants used in joint replacement and trauma surgeries; surgical equipment and surgical navigation systems; endoscopic and communications systems; patient handling and emergency medical equipment; neurosurgical, neurovascular and spinal devices; as well as other medical device products used in a variety of medical specialties. In the United States, most of Stryker's products are marketed directly to doctors, hospitals and other healthcare facilities.Internationally, Stryker products are sold in over 100 countries through Company-owned sales subsidiaries and branches as well as third-party dealers and distributors. Business Segments – Stryker segregates their reporting into three reportable business segments: Reconstructive, Medical and Surgical, and Neurotechnology and Spine. Reconstructive products consist primarily of implants used in hip and knee joint re placements and trauma and extremities surgeries.MedSurg products include surgical equipment and surgical navigation systems (Instruments); endoscopic and communications systems (Endoscopy); patient handling and emergency medical equipment (Medical); and reprocessed and remanufactured medical devices as well as other medical device products used in a variety of medical specialties. Stryker Neurotechnology and Spine products include a portfolio of products including both neurosurgical and neurovascular devices.Their neurotechnology offering includes products used for minimally invasive endovascular techniques, as well as a line of products for traditional brain and open skull base surgical procedures, orthobiologic and biosurgery products including synthetic bone grafts and vertebral augmentation products, as well as minimally invasive products for the treatment of acute ischemic and hemorrhagic stroke. Stryker also develops, manufactures and markets spinal implant products including cervical, thoracolumbar and interbody systems used in spinal injury, deformity and degenerative therapies.Contents: 1 History †¢2 Corporate governance †¢3 Recent acquisitions †¢4 Sponsorships †¢5 Regulatory controversies †¢6 References †¢7 External linksHistoryThe Orthopedic Frame Company, precursor of Stryker Corporation, was formed on February 20, 1941 by Dr. Homer Stryker, a Kalamazoo, Michigan based orthopedist. Stryker developed the Turning Frame—a mobile hospital bed that allowed for repositioning of injured patients while providing necessary body immobility, the cast cutter—a cast cutting apparatus that removed cast material without damaging underlying tissues, and the walking heel, among others.In 1964, the company name underwent revision and was officially changed to Stryker Corporation. [2] In 1979 Stryker made an initial public offering of stock and later acquired Osteonics Corporation, entering the replacement hip, knee, and ot her orthopaedic implants market (Stryker). In 1999 annual sales reached $2. 1 billion and in 2000 Stryker was included in the S&P 500 and the Forbes Platinum 400 for the first time. In 2002 sales reached $3.0 billion and Stryker was listed in the Fortune 500 for the first time.In 2003 Stephen P. MacMillan joined Stryker as President and COO. In 2005, annual sales reached $4. 9 billion and John W. Brown transitioned to the single role of Chairman of the Board while Steve MacMillan became President & CEO. By 2007, Stryker sold its Physiotherapy Associates division to private equity firm Water Street Healthcare Partners for $150 million. In February 2012, Mr.  MacMillan resigned and Curt R. Hartman was named Interim Chief Executive Officer and Vice President and Chief Financial Officer.Mr. William U. Parfet was named Non-Executive Chairman of the Board. On October 1, 2012 Mr. Kevin A. Lobo was appointed as President and Chief Executive Officer. At the end of 2012, Stryker had approxi mately 22,000 global employees, annual sales of $8. 7 billion, and 35% of those sales were outside the U. S.Stryker Roll-In-StretcherAs of a 2012 global market overview of top medical technology firms, Stryker maintains a number 10 locus with total portfolio sales in excess of $8. 6 billion. Moreover, the firm maintains 35% worldwide reconstructive market share; 50% worldwide MedSurg market share; 15% worldwide Neurotechnology and Spine market share. The company was recognized in by Hermann Simon as a role model for other small to medium sized business in his book Hidden Champions.Corporate governance As of 2013, members of the board of directors of Stryker Corporation are: †¢John W. Brown, Chairman Emeritus †¢Kevin A. Lobo, President & CEO †¢William U. Parfet, Non Executive Chairman †¢Howard E. Cox, Jr. †¢Srikant M. Datar, Ph.D. †¢Dr. Roch Doliveux †¢Donald M. Engelman, Ph.D. †¢Louise L. Francesconi †¢Allan C. Golston †¢Howard L. La nce †¢Ronda E. StrykerRecent acquisitionsIn 1998, Stryker purchased Howmedica, the orthopaedic division of Pfizer, for $1. 65 billion. Howmedica became Stryker Orthopaedics. In August 2000, Stryker acquired, with stock, Guided Technologies, Inc. , a developer and manufacturer of optical localizers purposed for use in healthcare and industrial.   In August 2004, Stryker acquired, for $120 million, SpineCore Inc. , a company involved in the development of artificial spinal disks. About two years preceding this date, in June 2002, the firm acquired the Spinal Implant Business of Surgical Dynamics Inc.for $135 million. In March 2006 Stryker absorbed the Haifa, Israel based Sightline Technologies Ltd. into its operations. Sightline, a manufacturer of gastrointestinal endoscopy apparatuses, propelled Stryker into the flexible endoscopy market. In February of the same year, the firm acquired eTrauma. com Corp. , a privately held entity involved in the development of software for Pic ture archiving and communication system (PACS); the company was incorporated into Stryker Endoscopy Business. December 2005 marked the company’s acquisition of PlasmaSol Corp. for $17. 5 million.PlasmaSol produces technologies allowing sterilization of various MedSurg equipments. In 2009, Stryker acquired Ascent Healthcare Solutions, Inc. the market leader in the reprocessing and remanufacturing of medical devices in the U. S. In Jan 2011, Stryker acquired the Neurovascular Division of Boston Scientific, which includes products used for the minimally invasive treatment of hemorrhagic and ischemic stroke. In June 2011, Stryker purchased Malvern, Pennsylvania-based Orthovita, a biomaterials company specializing in bone augmentation and substitution technologies.The Orthovita business now makes up the Stryker Orthobiologics division, which specializes in biomaterials for all Stryker divisions. In July 2011, Stryker completed the acquisition of privately held Memometal Technologi es S. A. (Memometal). France based Memometal develops, manufactures and markets products for extremity indications based on its proprietary methods for preparing and manufacturing a shape memory metal alloy. In August 2011, Stryker signed a definitive agreement to acquire privately held Concentric Medical, Inc. (Concentric) in an all cash transaction for $135 million.Concentric's products include devices for the removal of thrombus in patients experiencing acute ischemic stroke along with a broad range of AIS access products. In November 2012, Stryker acquired the Tel Aviv, Israel based Surpass Medical Ltd. a company developing a flow diversion stent technology to treat brain aneurysms using a mesh design and delivery system, for $135 million. [10] In March 2013, Stryker acquired Trauson Holdings Company Limited (Trauson). Trauson is a trauma manufacturer in China and a major competitor in the spine segment.SponsorshipsStryker maintains relationships with, but not limited to, the fo llowing professional and trade organizations:†¢The Advanced Medical Technology Association (AdvaMed) †¢The Medical Devices Manufacturing Association (MDMA) †¢The Orthopedic Research and Education Foundation (OREF) †¢National Electrical Manufacturers Association (NEMA) †¢European Federation of National Associations of Orthopaedics and Traumatology (EFORT) †¢International Society of Orthopaedic Surgery and Traumatology (SICOT) †¢International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) †¢Foundation for Orthopaedic Trauma; Speaking of Women’s Health †¢Arthritis Foundation and American Academy of Orthopaedic Surgeons (AAOS) †¢Association of Perioperative Registered Nurses (AORN) †¢American Orthopaedic Society for Sports Medicine (AOSSM) Additionally, the following athletes publicly endorse Stryker Orthopaedics products: †¢Johnny Bench †¢Fred FunkRegulatory controversiesOn Jan 27, 20 00, Stryker Corporation restated its operating results for the year ended December 31, 1998 to reduce acquisition-related charges by $30. 9 million. Since early 2007 the company has received three Warning Letters from the Food & Drug Administration citing issues in compliancy. The first of these, a seven-page correspondence, named various issues at an Ireland-based manufacturing facility such as untimely fix of failures and procedural noncompliance in the testing of failed or otherwise problem-prone devices.The second, sent November 2007, cites issues at the firm’s Mahwah, N. J. facility including poor fixation of hip implant components, in some instances requiring mitigation by revision surgeries; exceeded microbial level violations in the cleaning and final packaging areas of the sterile implants; and failure to institute measures in prevention of recurrence of these and other problems. The final warning letter, sent April 2008, cites issues at the firm’s Hopkinton, MA biotechnology facility.Again, issues relate to quality and noncompliance including falsification of documents relevant to the selling of products to hospitals which are to be sold under a limited, government-mandated basis. Stryker maintains that employees involved in the falsification of documents have since been terminated. In the Fall of 2007, Stryker, along with the related companies: Biomet, Zimmer Holdings, DePuy Orthopaedics and Smith & Nephew, were involved in civil ligation with the U. S. Department of Health and Human Services, Office of Inspector General.This litigation called for a net payout of $311 million as the governmental department maintains the aforementioned companies engaged in unlawful kickbacks to physicians who urged hospitals to purchase their respective products. Stryker, however, having cooperated early in the investigation, was not fined. As of February 2008, a dispute exists between Stryker Corp. and the U. S. Department of Justice concerning a subpo ena linking the company to aforementioned misconduct in sale of products.Since governmental filing of the injunction, Stryker notes that it has produced in excess of 300,000 pages of documentation in compliance with the mandate. U. S. Government counters, however, that the documentation was not proper in scope and format. Law officials expect the investigation to continue for several months. Stryker recalled several models of medical vacuums sold under the Neptune Waste Management System brand in June and September of 2012. The devices, some of which had not been approved by the Food and Drug Administration, caused a fatal accident when the vacuum was mistakenly used to suction a passive drainage tube.

buy custom Congestive Heart Failure essay

buy custom Congestive Heart Failure essay Congestive heart failure (CHF) has become a serious health issue throughout the world. By 1999, five to seven million people in North America were living with this disease. In addition, there were twenty million others in the rest of the world (Jobin, Maltais, LeBlanc, 2000). According to statistics from different studies, the hospitalization cost for heart failure patients, is more than double of all forms of cancers. Congestive heart failure (CHF) refers to the hearts inability to meet oxygen requirements of the body tissue when operating normally or at elevated filling pressure (Wolfsthal, 2007). Congestive heart failure (CHF) is a syndrome arising from the combination of many diseases that affect the working of the heart. CHF can result either due to systolic dysfunction or diastolic dysfunction. Normally, the heart works by contraction and relaxation thereby pumping the blood throughout the body. Systolic dysfunction results from problems with contraction of the heart. Diastolic dysfunction results from problems in relaxation (Wolfsthal, 2007). In CHF, circulatory congestion can result, either as systemic venous circulation resulting to peripheral edema or can result to pulmonary circulation congestion leading to pulmonary edema. Pulmonary edema is a life threatening condition (Tuttle-Yoder Fraser-Nobbe, 1995). It should, however, be noted that, acute CHF in most cases results from myocardial infarction. The signs and symptoms of the congestive heart failure (CHF) differ depending on the side of the heart affected. When the congestion is on the left side, pulmonary circulation congestion occurs which in turn leads to dyspnea (shortage of breath). On the other hand, if it occurs on the right hand side, systemic venous circulation results. Systemic venous circulation manifests itself by distended neck veins, hepatomegaly and edema (Tuttle-Yoder Fraser-Nobbe, 1995). In systolic dysfunction, the contraction of the heart in terms of degree of contractility reduces. In the contractility, the heart is unable to withstand the afterload (force against contraction) and preload (the sarcomere stretch before contraction). Decreased contractility can be caused by myocardial infarction (MI), valvular heart disease, hypertension, and cardiomyopathies (Wolfsthal, 2007). In myocardial infarction, a part of the myocardium undergoes necrosis and, therefore, cannot generate the force required to pump t he blood effectively. MI normally results to weakening of the ventricle. If large areas are affected, myocardium results to CHF. Valvular heart disease results due to stenosis (regurgitation of the cardiac valves) thereby placing a lot of load on the heart. In most cases, cardiomyopathies results due to the injury on the myocardium. This injury can be due to toxic chemicals or the diseases. Increased afterload makes it harder for the heart muscles to shorten, thus resulting to reduced cardiac output (Wolfsthal, 2007). In diastolic dysfunction, alteration of active and passive factors that affect the diastole results. Active relaxation result due to pumping out of calcium from the myocardium. Active relaxation occurs before the passive filling of ventricles with the blood previously stored in the atria. Diastolic dysfunction can result due to abnormalities in the active relaxation, abnormality in the passive filling also due to the neurohumoral hypothesis of heart failure. In abnormalities, in the active relaxation, this dysfunction can result due to impairment of the calcium reuptake at the beginning of the diastole. The abnormalities in the passive filling can be due to the myocardium being stiffer than normal. The stiffness can be caused but the increase in the thickness of the chamber walls than normal. Lastly in the neurohumoral hypothesis, the heart failure leads to the activation of related neurohumoral systems and hormones. When persistently over activated, they turn into cardio toxic agent s. They, therefore, lead to the decline in the cardiac function. According to this hypothesis, the blockage of these systems should be beneficial to the treatment of congestive heart failure (CHF). Some of the physical signs are tachycardia, pulmonary rales, cardiac enlargement, fourth (S4) and third (S3) heart sounds. Other physical factors include the neck vein distention, hepatic enlargement, edema and ascites. In tachycardia, elevated heart rate results due to increased releae of the catecholamine. They occur as a compensating mechanism, in the attempt, to maintain the normal cardiac output even in the decreased stroke volume. In pulmonary rales, increased hydrostatic pressure results to the transudation of the fluid into alveoli. Then as the air circulates, cracking sounds results when taking the heart sounds. Not all of these cracking sounds are symptoms of CHF and, therefore, care should be taken. The fourth heart sounds (S4) results from patients in sinus rhythm and heart failure due to the noncompliance of the left ventricle. Therefore, they are also excellent indicators of the CHF. This S4 probably arises due to the reverberation of the blood during ejection of blood into the left ventricle. Aging can also lead to the production of S4. Therefore, more tests should be done to ascertain the presence of CHF. Third heart sounds also known as ventricular gallop occurs mainly in early diastole and is the most reliable sign of the left heart failure. It also occurs due to the rapid filling of the left ventricle. Although it is a reliable sign of heart failure, S3 is common in individuals older than forty years and young athletes. Increased systemic venous pressure results to transudation of fluids into peritoneal space. This consequently leads to elevated neck veins and ascites which can indicate the presence of CHF. Other signs of left-side heart failure include cough, fatigue, crackles, weakness and fatigue (Singh, 2011). The clinical symptoms and features that assist the physical ones in the identification of the CHF are paroxysmal nocturnal dyspnea and orthopnea. In addition, Nocturia and edema can also be used. In dyspnea, the individual experiences the feeling of breathlessness and reduced cardiac output to the periphery (Wolfsthal, 2007). Orthopnea refers to dyspnea that occurs due to lying in a recumbent position. It can be relieved by the raising of the head. Paroxysmal nocturnal dyspnea refers to dyspnea that awakens the patient from the sleep. It may also occur due to lying in the recumbent position thereby resulting to the pooling of blood in the vasculature and increase, in left ventricular filling pressure, (Wolfsthal, 2007). For paroxysmal nocturnal dyspnea, the symptoms disappear after the patient has been standing for five to twenty (5-20) minutes. Nocturia, on the other hand, results due to increased renal blood flow when the patient is in the recumbent position or asleep. Lastly, edem a and particularly cardiac edema occur when systemic hydrostatic venous pressure is higher than systemic oncotic venous pressure. The laboratory assessment of congestive heart failure in patients, involve the use of chemicals, waves and measuring of the blood pressures in many parts of the body. In the determination of the extent of myocardial infarction (MI), an electrocardiogram (ECG) can be used. When using the electrocardiogram the presence of Q waves helps in the confirmation that the MI has been the cause of the CHF (Wolfsthal, 2007). A chest radiograph can also be used. Chest radiograph can monitor cardiac chamber enlargement and congestion. An echocardiogram can also be used to identify the chamber enlargement as well as quantifying the ventricular and valve function (Wolfsthal, 2007). Use of radionuclide ventriculography can be used in measuring range of the right and left ventricular ejection fractions. In addition, the use of Doppler interrogation techniques can be applied in determining the direction and rate of blood flow. Doppler interrogation can detect quantify valvular stenosis. Any variation f rom the individuals normal may indicate the possibility of valvular regurgitation and intra-cardiac shunts. Lastly during the cardiac catheterization, many cardiac characteristics can be evaluated. These include the chamber size, valvular stenosis, intra-cardiac pressures and other coronary anatomy. The extent of stretching in the heart muscle cells can also be monitored by the use of the Brain Natriuretic Peptide (BNP). This is a polypeptide secreted by the muscles of the heart ventricles in response to overstretching. Increased filling pressures in the heart leads to dyspnea, production of the atrial natriuretic peptides (ANP) and Brain natriuretic peptides (BNP) (Siegenthaler, 2007). By monitoring the levels of ANP and BNP, we can rule on the possibility of heart failure, pulmonary hypertension, pulmonary embolism, acute coronary syndrome and renal failure. High levels of BNP (BNP 400pg/mL) are strongly suggestive of cardiac dyspnea. Normal levels (BNP 100pg/mL) highly excludes any cardiac cause. In addition, high levels of BNP may suggest general volume overload or liver failure that may occur in response to hepatic cirrhosis. The level of the BNP also correlates to the severity of the heart failure, if detected (Siegenthaler, 2007). The best diagnosis tool for the CHF is the echocardiography. It can be used in the determination of congenital defects or cardiomyopathy presence. Echocardiography can also be used in the assessment of heart size, cardiac function, hypertrophy and dilation (Potts Mandleco, 2011). All therapies aim at reducing of the volume overload, improvement of the contractility, reducing afterload and in the decreasing of cardiac work. These therapies are in the form of drug therapy and nursing care (Potts Mandleco, 2011). The patients of CHF are in most cases edematous and compromised respiratory functions arising from the fluid overload. They, therefore, need fluid restriction drugs for the lungs. Therefore to lower the amount of the fluid that has accumulated, diuretics can be administered. In addition to decrease the hearts overload, Angiotensin-Converting Enzyme (ACE) inhibitors can be used (Singh, 2011). ACE inhibitors can restore the cardiac and hormonal response to volume overloads, and thus, reduce natriuretic in mild heart failure (Jobin, Maltais, LeBlanc, 2000). Administration of morphine reduces pain also lowers the peripheral resistance. In severe cases, oxygen (O2) should also be given, in order to reduce anxiety and facilitate breathing. In cases where th ere are chest pains, nitroglycerin (nitro) can be used. Nitroglycerine also acts as a vasodilator (Singh, 2011). Normally these patients require rest to conserve energy. Other therapies include administration of Angiotensin II Receptor blockers to reduce the effects of angiotensin II. To patients who are intolerant to ACE inhibitors the Angiotensin II Receptor blockers can be administered. Other medical related therapies are diuretics (for improvement of congestive symptoms), digitalis (to increase the ejection fraction of the left ventricle) as well as administration of -Blockers. The -Blockers can be administered for inhibition of sympathetic nervous system thereby limiting progression of heart failure (Jobin, Maltais, LeBlanc, 2000). In infants whose the heart failure is secondary to congenital defects then, the primary treatment is the surgical correction (Potts Mandleco, 2011). Although no long-term randomized study on the effects of ACE inhibitors exists, the adverse effects of ACE inhibitors and Angiotensin II Receptor blockers can be related to angiotensin suppression and potentiation. Angiotensin refers to hypotension, potassium retention and worsening renal function. On the other hand, potentiation refers to coughing and angioedema (Jobin, Maltais, LeBlanc, 2000). The use of beta blocker medication has led to the increased cases impotence among the older men (Wallace, 2007). These drug-disease interactions encourage the discontinuation of the medication, and the search of the alternatives that do not impact on related disease processes. When diagnosed with CHF, Patients need to be prepared psychologically on how to live positively with the illness. Another part of the patient that should be considered is the family relations. These members should also be prepared psychologically on how to assist their patients at home psychologically and physically. Regardless of age, patient teaching is a vital component in disease management (Wallace, 2007). Unhealthy behaviors like drinking, smoking, or poor nutrition should be broken as they deteriorate the disease. The patients of CHF should eat less salt and limit fluid intake. Patients diagnosed with CHF should monitor their weight regularly. This should be done every morning at the same time. During measuring of the weight, same clothes and scale should be used. The patient should call the doctor if he notices sudden change in weight, increased swelling of the legs or ankles as well as having trouble in breathing when resting or sleeping at night. While dealing with the olde r adult population, ultimate care should be given to the management of pathological diseases of aging. Lastly, exercises and better night sleep should be encouraged for continued improved health (Wallace, 2007). Buy custom Congestive Heart Failure essay

Definition and Examples of Determiners in English

Definition and Examples of Determiners in English In English  grammar, a determiner is a word or a group of words that specifies, identifies, or quantifies the noun  or noun phrase  that follows it. It is also known as a  prenominal modifier. Basically, determiners come at the start of a noun phrase and tell more about what comes after it (or them, in the case of a phrase that has more than one determiner before the noun). Determiners include articles  (a, an, the),  cardinal numbers (one, two, three...) and ordinal numbers (first, second, third...), demonstratives  (this, that, these, those),  partitives  (some of, piece of, and others),  quantifiers  (most, all, and others), difference words (other, another), and possessive determiners  (my, your, his, her, its, our,  their). Authors Martha Kolln and Robert Funk describe them this way: Determiners signal nouns in a variety of ways: They may define the relationship of the noun to the speaker or listener (or reader); they may identify the noun as  specific  or  general; they may  quantify  it specifically or refer to quantity in general. (Understanding English Grammar,  5th ed. Allyn and Bacon, 1998) A Slippery Grammatical Label Determiners are functional elements of structure and not formal  word classes, because the group of words contains some items that are nouns, some that are pronouns, and some that are adjectives. Authors Sylvia Chalker and Edmund Weiner explain: Determiners  are sometimes called  limiting adjectives  in  traditional grammar. However, they not only differ from the class of  adjectives  by  meaning,  but also must normally precede ordinary adjectives in  noun phrase  structure. Further, among determiners  themselves  there are co-occurrence restrictions and fairly strict rules of  word order. (Oxford Dictionary of English Grammar. Oxford University Press, 1994) Rules on Multiple Determiners English has rules on word order, such as when there are multiple adjectives in a row modifying the same noun (quantity before age, before color, for example). The same goes for when you use multiple determiners in a row.   When there is more than one determiner, follow these useful rules:a) Place all and both in front of other determiners.E.g. We ate all the food. Both my sons are at college.b) Place what and such in front of a and an in exclamations.E.g. What an awful day! Ive never seen such a crowd!c) Place many, much, more, most, few, little after other determiners.E.g. His many successes made him famous. They have no more food. What little money I have is yours.​   (Geoffrey N. Leech, Benita Cruickshank, and Roz IvaniÄ , An A-Z of English Grammar Usage, 2nd ed. Longman, 2001) Count and Noncount Nouns Some determiners work with count nouns, and some dont. For example,  many  attaches  to count nouns, such as The child had  many  marbles. In contrast, you would not use  much  to attach to count nouns such as  marbles  but noncount nouns such as  work,  for example in, The college student had  much  work to finish before finals week. Other determiners work with either one, such as all: The child had  all  the marbles and The college student had  all the  work to finish before finals week.

The Rocking Hourse Winner Essay Example | Topics and Well Written Essays - 1000 words

The Rocking Hourse Winner - Essay Example Looking back at the earlier events in the story, it can be seen that it was Hester; Paul's mother is solely responsible for his death. It should be noted that Hester's desire to maintain the lifestyle she was accustomed to started the voices in their house proclaiming that "There should be more money." Furthermore, it was also Hester who introduced the concept of luck to Paul. With this, the life of Paul became a quest to stop the voices and to find luck. These desires, which both originated from his mother, killed him in the end. The story started by drawing a portrait of Hester "who was beautiful, who started with all the advantages, yet she had no luck." Though this woman married the one that she really loves and was blessed with three children, there stood this deep feeling of incompleteness in her heart. Within her, there is always this strong longing for the things that she does not have like beautiful clothes, cars, jewelries, and other material possessions that only money can buy. She finds no joy in parenting as she considers her three little children as additional burden that she must live with. Even though she tries to be gently and loving to them, she knows that in the center of her heart, she cannot love them. For some reasons, her children are aware of her lack of affection and compassion to them. This is an unspoken understanding between the parent and their child: "They read it in each other's eyes." This is even aggravated that the fact that even though she leaves her longing for money unspok en, her children constantly hears her desire. As the story progresses, it can be seen that Paul developed the notion that his own mother does not love him. Her single desire is to have money. Thus, in order to win the affection of her mom, Paul devised his own way of giving her the money that she needs. It can be seen that Paul was doing everything to stop the whispers that haunts their house by generating more money. It can be seen that the little boy does this not only to quench his mother's insatiable desire for money. It can be seen that Paul is just like any other ordinary child whose main desire is to feel the warmth of his mother's affection. It can be seen that Paul associated the voices to the mother's lacking sense of completeness and contentment. The little boy assumed that if he can stop the whispers from haunting their house, his mother will stop wanting more money. This way, his mom can love him the way he really wants to. However, instead of stopping the voices in the house, the arrival of more money in Paul's house caused the whispers to become louder, asking for more money. It should be noted that the arrival of the money did not satisfy Hester. After reading the letter from the lawyer "her face become hardened and become more expressionless." She wants even more money causing Paul hears the voices growing much louder. This caused him severe depression as it signifies his failure to bring enough money. This is even worsened by the inability of the little boy to guess the winning horse in the two previous races. Thus, Paul was seized by tensions as he intensely wanted to know the winning horse for the Derby. After wildly riding his rocking horse one night, Paul was finally able to know the winning horse for the race. This might have overwhelmed him with ecstasy because this means that he will be able to bring more money into their house, stopping