Movement and Positioning in Stroke Patients Essay

Movement and Positioning in Stroke Patients - Essay Example The effects of stroke can be divided into two categories: impairments and disabilities. Impairments are changes in the body structure and function. Disabilities, on the other hand, are limitations in the performance of the activities of daily living. These can be affected not just by the physical effects of the disease, but by psychological and social factors.Impairments and disabilities can worsen with time if no intervention is done. It may lead to further deterioration due to immobility or reduced activity, leading to complications such as thrombus formation, decubitus ulcers, and pulmonary embolism. Patients may also become more dependent on others and have decreased normal social interactions. All of these can have a profound effect on a person’s well-being. Backe, Larsson, and Fridlund (1996) investigated how patients conceived their life situation during the first week after the onset of stroke. They uncovered deep psychological trauma in the patients, wherein they had feelings of unreality, awareness of a changed role in life, feelings of a changed perception of the body, and feelings of being confused. Patients were also found to have a heightened sense of loss of capability and awareness of living in a confined space. Fortunately, some patients also developed an appreciation for the importance of support and encouragement and a will to look for new opportunities after the onset of stroke. One of the important debilitating effects of stroke is immobility. ... It also discusses the role of nurses in the management of stroke patients and in rehabilitation programs. It concludes with learnings from the literature review and critical appraisal and recommendations on how to apply these to nursing practice. The Importance of Movement and Positioning Stroke as a disease process can be progressive. Even though the cerebrovascular event that leads to the neurologic deficits is acute, its sequelae can continue to build on each other, leading to progressive deterioration of the patient. One important example of this is immobility. Due to neurologic deficits, a patient may have difficulty moving. This can lead to development of contractures, muscle atrophy, and nerve palsies (Summers et al., 2009). Current practice advocates early mobility for stroke patients. Summers et al. (2009), in their statements regarding the comprehensive care of the acute stroke patient, recommends that stroke patients may be initially kept on bed rest but should be mobilize d once hemodynamically stable. It has been found that early mobilization reduces the risk of atelectasis, pneumonia, DVT, and pulmonary embolism. Aside from early immobilization, a longer term rehabilitation program has also been found to be effective in stroke patients. Ernst (1990) reviewed the literature on rehabilitation and physiotherapy among stroke patients and found that it was associated with improvement in functional status and lower incidence of secondary complications such as pneumonia and ulcers. Furthermore, Gordon et al. (2004) found in their review of literature that aerobic exercise can enable activities of daily living to be performed

Managerial Finance and Financial Markets Essay Example | Topics and Well Written Essays - 1500 words - 1

Managerial Finance and Financial Markets - Essay Example commercial property can be used as an alternative investment during periods of high inflation, which is possible because of its low correlations with bonds and stocks. More so, the inclusion of commercial property in the portfolio will offer regular streams of income, for example in form of rent, which can be adjusted periodically thus shielding the investor from the effect of high inflation. The force behind commercial estate returns, from macroeconomics viewpoint, is different from that of equity and bonds. In this view, commercial property is an ideal source of portfolio diversification. Furthermore, the commercial property is in itself diversified, hence its performance is very unique. Commercial property can be used to diversify unsystematic risk, but not systematic risk. The reason why it is difficult to diversify systematic risk is because it influences a large number of assets (Case, 2014). The diversification, in this case, depends on risk-adjusted returns, the investor’s horizon and correlations (as shown in Table 1). Some of the types of diversification that can be generated from commercial property include that between private and public real estate, between bonds and equity, by property type, by investment strategy, within domestic market (geographically), and between domestic and foreign market. International diversification, whereby investors venture into international real estates, is a potential means of reducing risk as it offers very low return correlations. For example, by investing internationally, investors achieve low performance fluctuations, in a manner that cannot be achieved locally (Hudson-Wilson, Fabozzi & Gordon, 2003). Commercial property, relative to other asset classes, has been historically known to offer higher returns. However, in the long term, although commercial property is expected to generate a lower return compared to public equities, it is expected to perform better than bonds. Even though this relationship has

Struggles of Slavery and the Economy Essay Example for Free

Struggles of Slavery and the Economy Essay The economy was the underlying factor affecting multiple aspects of Uncle Tom’s Cabin. The novel takes place in the 1850’s antebellum era, when slavery was a large portion of the economy – especially in the South. The moral division between the North and South illustrates how the economy differed between those two separate geographical areas. The economy drove the South’s â€Å"need† for slavery which, in turn, also affected family, education, law and government as depicted throughout the novel. The author portrayed this through his characters and specific events. At the beginning of the novel, there was a discussion between Mr. Shelby and Mr. Haley about selling slaves. Mr. Shelby was in debt and needed to sell two of his slaves to get money to support his family and land. To do this, he enlisted the assistance of Mr. Haley, a slave trader. Small farm owners could not afford many slaves, even though they were the most important component to crop production in the south. Mr. Shelby’s small portion of land was genuinely special to him. Without slavery, crop growth would be slowed because the slaves did all the work in the fields and factories. It would adversely affect income for most southern farm and factory owners. Mr. Shelby was so desperate for extra money that he was forced to consider selling his most valuable slave, Tom, to Mr. Haley. He trusted Tom to the point of allowing him to go out alone, knowing he would always return. Unfortunately, the difficult economy forced Mr. Shelby to give up both Tom and a young boy named Harry in order to keep his plantation. During this specific time period, it was not uncommon for slave owners to sell their slaves because of the economic turmoil they endured. As expected, the slave families involved were adversely affected. Eliza, the mother of Harry, overheard Mr. Shelby explaining his decision to sell her son, so she took him and escaped. She could not allow her little boy to be sold off to another family and lose him for good. Eliza did what any mother would do to protect their child. Being on the run during this era was a huge risk, but Eliza had no choice. She and Harry fled to Canada, with Mr. Haley after them. Luckily, she found different families and places to rest and get food for her journey. Thanks to the help of this â€Å"Underground Railroad† and her fellow slaves, Mr. Haley was unable to find Eliza and her son. He finally gave up and sold Tom, who was then taken away in shackles. Fortunately for Eliza, the Quaker families who helped her and Harry were not scared off by the risks involved in helping slaves. The Fugitive Slave Act of 1850 stated that any person who knew where an escaped slave was must return them to their master in the South. The slaves that were able to escape and make it to the North were continuously hunted by the law. Later, the law was revised to punish anyone aiding and sheltering a slave with prison and fines of one thousand dollars. After this act went into effect, officials were rewarded when they returned runaway slaves and punished if they helped them escape to freedom. Eliza and her son were fortunate to stumble upon Senator Bird’s home to ask for food and shelter. Senator Bird had just signed in favor of the Fugitive Slave Act yet he did not truly believe in it. He gave Eliza ten dollars and brought her to another home, even though he knew he was violating the law. Eliza, after reuniting with her husband George, found another family of Quakers who were more than willing to help her and her family. These families, aware of the law and the financial consequences did what was right to help these people escape to freedom. Tom, however, was initially not as fortunate as Eliza and her family. He was sold off into the slave market with Mr. Haley as his current owner. On a boat headed towards the deep South, Tom met a young white girl named Eva. Tom saved her when she fell overboard. After Tom rescued Eva, her father, Augustine St.  Clare, offered to buy Tom in order to â€Å"make him happy† as requested by his daughter. St. Clare was not a typical Southern slave owner. He was kind and gentle with each of them. He had a different agenda for owning slaves rather than the economic advantage it would give him and his plantation. St. Clare knew that not one single person could end slavery, but he felt he could do everything he could to help protect some slaves like Tom and a girl named Topsy. Topsy was purchased by St. Clare from a slave master who brutally abused her. St.  Clare wanted to give her a better life, including an education like his current slaves had. His alternative views from most of his southern neighbors regarding slavery are obviously displayed when he says, â€Å"I heartily wish that there were not a slave in the land; but, then, I don’t know what is to be done about it! † His wife Marie, a very selfish, unloving person, was an advocate of slavery and that caused altercations within the St. Clare family. This difference within St. Clare’s family member created conflict on how to treat the slaves and resulted in hatred towards one another. Eva and Tom’s friendship grew so strongly that before she died due to illness, she asked her father to promise to set Tom free. Unfortunately, St. Clare, being the caring man he was, died trying to break up a fight before he was able to sign for the slave’s freedom. They were left to Marie. She used this opportunity to obtain money and sold Tom to another slave owner. Marie had different beliefs and morals than the rest of her family. She used the slaves for financial gratification when she was finished ordering them around. Marie’s view on slavery is best represented when she says, â€Å"I’m thankful I’m born where slavery exists; and I believe it’s right, I’m sure I couldn’t get along without it. † Educated slaves had a large impact on the economy of the South. For example, George, who was a mulatoo, invented a machine while working as a slave at a factory. This machine sped up the process of cleaning hemp, which impressed the factory’s owner. This invention greatly increased productivity in the south, because they were able to sell hemp much quicker increasing profit. Having educated slaves was extremely rare during this era, but when they were, it was usually because their owners taught them. â€Å"Mulatoo† is a term used to describe a slave whose one parent was white (most likely the father) and the other was African American (most likely the mother). This is just another example of how slavery impacted African American families. Slave Masters did not like to educate their slaves because they believed the slaves would then become more likely to want to improve their lowly status. African Americans in the 1850’s were bought for cheap labor on the farms, factory work, and typical house duties. The slave masters feared that if they were successful, like when George invented his machine, they would feel superior towards the other slaves and even their white masters. They would probably no longer be satisfied being a slave; this would lead to unrest. Owners did not want the slaves to be educated because they could then learn about freedom, which may entice them to escape. Yet, if slaves were given a basic education, they could have used that knowledge to increase the productivity of the Slave Master’s farms and businesses and improved the economy. On the contrary, the North had a different form of income. Instead of armland, they were industrialized with factories that any race could work in. The abolitionists in the north were against slavery and did not believe in having servants like the south did. Some Northerners, however, were not as opposed to slavery. Many northern people turned their heads and allowed slavery to continue because without it, crop production would be slowed and be more expensive. The north relied on purchasing crops from the south so their economy would also have been negatively impacted. Throughout this novel, it is obvious that the economy was the underlying factor affecting multiple aspects of Uncle Tom’s Cabin. These aspects varied from the pressures of selling slaves in order to get out of debt to whether or not African Americans were educated. Also, the economy affected families, especially the slaves but also the Quakers who helped the runaways. Harriet Beecher Stowe did a fine job illustrating these points throughout Uncle Tom’s Cabin. She was able to humanize the slaves which helps create sympathy for them. While her main objective was to convince others of the horrors of slavery, she was smart enough to use the economy as a motivating factor to achieve her goal.

Religion in Crime and Punishment

Religion in Crime and Punishment Dostoevsky was a very religious an after he got out of jail. Because of this, when he wrote Crime and Punishment he incorporated teachings and symbolism from his own religion to help the characters progress. There are several instances where the use of symbolism along with water portrays rebirth and regeneration. There are also instances where water represents death, whether it is because of murder or suicide. Another symbol used in the novel is the cross. As if the cross did not represent enough already in Christianity, Dostoevsky uses it to represent the ordinary, along with its classic representation of suffering. Finally, Dostoevsky incorporated the stories of Lazarus and Jesus. These are meant to represent the characters spiritual awakening and spiritual death. The outstanding strands of symbolic imagery in the novel are those of water, and stories of Lazarus and Jesus (Gibian 2). Dostoevskys personal beliefs are portrayed through the use of symbolism within Crime and Punishment including the use of religious symbols such as water and the cross, and through biblical stories such as that of Lazarus, which help the characters evolve. The use of water is a recurring theme within Crime and Punishment. To the protagonist of the book, water is a symbol of rebirth and regeneration, always there when something positive occurs (Gibian 2). This is saying that whether it be when Rodya (Raskalinkov) is turning himself in, or when he returns to his faith, water is always present. Inside of Raskalinkovs inner fight, there is still receptivity to water as beauty (Gibian 2). This is saying that no matter how difficult life can get, Rodya always sees the beauty in water which has a calming effect on him. For him, water is soothing and a source of life, such as with the flowers along the bank of a river. He understood the beauty of the river, and therefore that of the water (Gibian 2). Even though he sees this beauty, the rest of his life is so confusing he contemplates suicide within the river. HE then realizes that the river is life, not death. The river which Raskalinkov sees is no longer a means for committing suicide, nor a sight inducing melancholy; it is the river of life (Gibian 4).This is a major step because he realizes he needs to fall onto the road of redemption, which ironically begins by the river as well, along with Sonia (A woman Rodya meets who helps him on his road to redemption.) Rodyas regeneration begins with Sonia at his side at the bank of the river (Gibian 6). During his regeneration, he realizes that even though he has seen the beauty of the river, it was not as it was; he used to see it with more concentration. It occurs to Rodya that he has not fully enjoyed the beauty of the river because his thoughts have banished him (Gibian 6). His reaction to water has changed since becoming a student with his new views (Gibian 4). The religious symbol of water represents rebirth and regeneration to many characters such as Raskalinkov. Even though water can be seen as rebirth and regeneration, it can also be a representation of death, whether it is murder or suicide. For the protagonists, water has a generally positive effect, but this is not the case when dealing with the antagonists. Water has a negative influence on the antagonists, always there when bad events occur (Gibian 2). Whenever anything negative happens to an antagonist, water is involved. One example of this is the situation with Svidrigalov, who, to Raskalinkov, is threatening. Instead of being a positive influence, water is negative for Svidrigalov because it is in the rain that he decides to take his life and shoot himself (Gibian 2). Before this, he also confirms his repulsion of water. Water holds the terror of death for the corrupt Svidrigalov who confirms his depravity by saying Never could I stand water, not even in a landscape painting. (Gibian 2). This shows that water holds a position above Svidrigalov, as a higher power causing harm to him . Unlike the protagonists, the antagonists have a negative reaction with water leading to death. Dostoevsky used another symbol from his religion, the cross, to help develop the characters. The main representation of the cross is suffering. Raskalinkov wears the cypress cross that Sonia gives to him, because now he is ready to suffer for his murdering of the pawnbroker. Sonya gives Raskalinkov the cross as if saying You are no forgiven. Go suffer. (Knopps 1). Sonia convinces Raskalinkov to wear the cross as he confesses which shows he is ready to suffer (Gibian 3). The other reason Dostoevsky used the cross was to show that Raskalinkov and his victim were ordinary people. The cross that Sonya gives to Rodya once belonged to his innocent victim, Lizavita. The cross was also made of an ordinary wood, cypress. Rodya wears the cross of his innocent victim, which is made of an ordinary wood cypress. This represents how his victim was random and innocent (Salvation 2). His victim was ordinary who happened to be in the wrong place at the wrong time, just like the ordinary cypress. The other connection that can be made is between the ordinary cypress and Raskalinkov being ordinary. After he killed the pawnbroker and her sister, Raskalinkov believes he is a higher power, above the law. This is why he has trouble with religion; he believes he is a god. However, when he takes the cross, this changes. When he takes the cross, he admits he is an ordinary man, now part of society (Salvation 5). This is cutting Rodya down to the level of everyone else. Now he is not above the law and must turn himself in. It also means that he can have faith again and believe in God and Jesus, coming back to religion. Since Dostoevsky was religious, it is not a surprise that he incorporated stories from the bible into his novel. The author uses parallels to the stories of Jesus and Lazarus from the main characters in his novel. The first comparison is to show how Raskalinkov is spiritually dead, but with hope of being awakened. The reading of the story of Lazarus is important because Rodya has experienced a sort of spiritual death (Hutt 1). Before the story of Lazarus, a man whom Jesus raised from the dead after four days, was read to him, Rodya had abandoned faith and was spiritually dead. He asks Sonya to read him the story because he is spiritually dead and needs hope (Salvation 2). Even though Sonya is trying, Raskalinkov doesnt understand and is still not figuring out the connections between him and Lazarus. Even though there is seems to be no chance of it working, Rodyas soul can be raised. The other comparison to Jesus and Lazarus is to show how Raskalinkov can be spiritually awoken. Raskalinkov feels like Lazarus in that one day he may have a resurrection that would end his spiritual depravity (Hutt 1). Rodya asks Sonya to read him the story of Lazarus to give him hope that he can gain faith. Dostoevsky has Raskalinkov ask Sonya to read him the story of Lazarus because it is the best example of a human being resurrected to a new life (Gibian 3). This is because there was a need for Rodya to overcome his feelings of being somewhat God-like. Not only does Raskalinkov identify with Lazarus, but also with Jesus. Rodya is raised from his spiritual death just as Jesus ad, while there were many who did not believe it was possible. Also, as Raskalinkov is going through his regeneration, he keeps a bible under his pillow to symbolize Jesus resurrection (Gibian 5). Raskalinkov can identify with Lazarus and Jesus because of their resurrections back to life. Dostoevsky uses his religion to influence his novel and help develop the characters. The author, a deeply religious man, uses allusions to stories of his faith heavily in order to show how religion can bring about redemption (Hutt 1). There are several instances in which Dostoevsky uses his own religion to influence the characters. One of the main symbols is water. Water is used to help the regeneration and rebirth of the protagonists, helping them realize the beauty of life. On the other side, water is used to show death for the antagonists. The Christian symbol of the cross is used in a traditional sense of suffering and a new view, as ordinary. There is also evidence of stories such as Lazarus helping the characters progress. Dostoevsky used his own religion to impact the characters within his novel.

The Cambrian Explosion: Proof of ID? Essay -- Biology Biological Essay

The Cambrian Explosion: Proof of ID? In our studies of Intelligent Design (ID) theory and Creation Science, I found little information that seriously challenged the theory of evolution. However, there was one event that appeared to defy the logic of Darwinian gradualism: the Cambrian Explosion. This event was presented by ID theorists as proof of design--something which science is unable to account for. Unfortunately for ID proponents, this is not the case. There are several scientific explanations for the Cambrian Explosion. I will give an account of the Cambrian Explosion, present the ID arguments relating to it, and give some scientific explanations of the event. The so called ‘Cambrian Explosion’ was a period of rapid diversification of animal life on earth. It took place approximately 550 million years ago (it bears mentioning that estimations of geological time this far back are fairly rough). There is some dispute over just how long the ‘explosion’ lasted. Scientists traditionally proposed a duration of about 30 million years (Ward and Brownlee, p. 137). However, some new evidence collected in Russia may indicate a much shorter timescale- 5 to 10 million years (Kerr 1993, p. 1274). The truly unique thing about the Cambrian Explosion was the rapid generation of extremely diverse life forms. Life is generally classified with a system going from broad to specific description. Kingdom, the broadest classification, describes whether a given specimen is plant, animal, fungi, protist, or moneran. The next most specific indicator is phylum. The phyla indicate the body design of a taxonomical specimen. Humans, along with all other species that poses a spinal ... ...ore Explosive. Science, New Series Volume 261, Issue 5126. September 3, 1993. Kerr, Richard A. Crowding Innovation out of Evolution. Science, New Series, Volume 266, Issue 5188. November 18, 1994. Kerr, Richard A. Timing Evolution’s Early Bursts. Science, New Series, Volume 267, Issue 5194. January 6, 1995. McMenamin and McMenamin. The Emergence of Animals: The Cambrian Breakthrough. Columbia University Press, New York. 1990. Ohno, Susumu. The Notion of the Cambrian Pananimalia Genome. Proceedings of the National Academy of Sciences of the United States of America, Volume 63, Issue 16. August 6, 1996. Ward and Brownlee. Rare Earth: Why Complex Life is Uncommon in the Universe. Copernicus, New York. 2000.

A Night to Remember in Mexico Essay -- Mexico Personal Narratives Viol

A Night to Remember in Mexico When the event was over, it all seemed like a blur. I didn’t know what had just happened but I knew that I didn’t like it. The night was filled with frenzy in the air and liveliness in the streets. The Security guards, and for that matter the people that we had come with, departed. My friend and I, although surrounded by masses of people, stood alone on a street corner. There I was, standing in a place that was foreign to me, in which I had only two companions. The night air slapped me in the face, and I awoke to reality. I was surrounded by drunken Americans laughing and enjoying themselves on the streets. This is a night that would be burned into my memory forever; an event that would change who I am and how I looked at life, but for now it was time to figure out how to get out of Mexico. Earlier that week I had hopped in my car and headed for my friends house in Tucson. He had told me to meet him the night before we were supposed to leave so that we could pack and then get going early the next day. When I arrived at his house, still early in the day, I greeted my friend and then proceeded to throw my bags into the back of his truck. We gathered all of our things and made sure that we had all of our items. We settled in for the night at his house, excited about what was to come. Maybe these expectations would be falsified later on sure but for now all that was in our minds was the salty sea air, and the electrified dance clubs. The next day my friend Danny and I got up early to meet the people that we would be staying with, in the house we had rented in Mexico. When Danny and I arrived at the house where these people lived, I exited the truck and looked around. From first glance there s... ...he face numerous times. This problem between the group left us all defenseless in an area where none of us could let down our guards for fear of what might happen resulting from our presence in a foreign land. The three of us were able to find a cab to take us back to the house we had been staying at. Danny told me that we needed to leave that night before Mike and Matt got back. He then continued to inform me that the two had carried guns across the border and would have no qualms with coming into the house and using them on myself and the other involved in the conflict while we were asleep. We went back to the house, packed our things and headed for the border. As a result of this experience I have started to look more carefully at my first perceptions of people and going with what I believe. I was lucky to escape from this situation, not in jail and not dead.

God Is Great

‘God is great, God is good, now we thank him for our food. ’ This simple prayer reflects twin commitments in Christian belief to God’s greatness and God’s goodness. Yet Christian theodicies have often averred to God’s greatness to the detriment of his goodness. Let us interpret God’s greatness in a manner other than power. Indeed, let us consider God’s greatness, as the medievals understood God’s goodness, in terms of being: goodness and being are interchangeable; 1God is the most real being; hence, God is the greatest being. God is great. Let us interpret God’s goodness in a manner analogous to human goodness. I take God’s goodness as analogous primarily to the parent-child relationship; God is good, according to this analogy, as a father or mother is to his or her children. 2Caring for one’s children is a paradigm metaphor in Scripture for God’s carefor his creatures. God is good. The purpose of this essay is to explore the ramifications of these two views for the problem of evil and especially for the problem of hell. Judgements typically viewed hell as an eternal torture chamber perhaps with God himself as the torturer. I shall expound both views of divine goodness, present some arguments in their defense, and then locate them within the context of a Theodoric of human suffering. I shall argue that neither is singly adequate as an understanding of the divine nature; but, if both are maintained, a trilemma arises for the traditional doctrine of the eternal punishment of the damned. That is, I shall argue that one can hold the following three views only on pain of inconsistency: 1. God is great. 2. God is good. 3. There is a hell (an eternal torture chamber).