Saturday, August 31, 2019

Nb Assessment

Table 21-2 SUMMARY OF NEWBORN ASSESSMENT *MCH pages 479-473| NORMAL| ABNORMAL (POSSIBLE CAUSES)| NURSING CONSIDERATIONS| Initial AssessmentAssess for obvious problems first. If infant is stable and has no problems that require immediate attention, continue with complete assessment. | Vital Signs| TemperatureAxillary: 36. 5– 37. 5 °C (97. 7 – 99. 5 °F). Axilla is preferred site. | Decreased (cold environment, hypoglycemia, infection, CNS problem). Increased (infection, environment to warm). | Decreased: Institute warming measures and check in 30 minutes. Check blood glucose. Increased: the excessive clothing.Check for dehydration. Decreased or increased: look for signs of infection. Check radiant warmer or incubator temperature setting. Check thermometer for accuracy if skin is warm or cool to touch. Report abnormal temperature to physician. | PulsesHeart rate 120 – 160 BPM. (100 sleeping, 180 crying). Rhythm regular. PMI at 3rd-4th intercostal space lateral t o mid-clavicular line. Brachial, femoral, and pedal pulses present and equal bilaterally. | Tachycardia (respiratory problems, anemia, infection, cardiac conditions). Bradycardia (asphyxia, increased intracranial pressure).PMI to right (dextrocardia-heart situated to right of body, pneumothorax). Murmurs (normal or congenital heart defects). Dysrhythmias. Absent or unequal pulses (coarctation of the aorta). | Note location of murmurs. Refer abnormal rates, rhythms and sounds, pulses. | RespirationsRate 30 -60 (AVG 40 -49) BrPM. Respirations irregular, shallow, unlabored. Chest movements symmetric. Breath sounds present and clear bilaterally. | Tachypnea, especially after the first hour (respiratory distress). Slow respirations (maternal medications). Nasal flaring (respiratory distress). Grunting (respiratory distress syndrome).Gasping (respiratory depression). Periods of apnea more than 20 seconds or with change in heart rate or color (respiratory depression, sepsis, cold stress). Asymmetry or decreased chest expansion (pneumothorax). Intercostal, xiphoid, supraclavicular retractions or see-saw (paradoxical) respirations (respiratory distress). Moist, coarse breath sounds (crackles, rhonchi) (fluid in the lungs). Bowel sounds in chest (diaphragmatic hernia). | Mild variations require continued monitoring and usually clear early hours after birth. If persistent or more than mild, suction, give oxygen, call physician, and initiate more intensive care. Blood Pressure Varies with age, weight, activity, and gestational age. Average systolic 65-95 mm Hg, average diastolic 30-60 mm Hg. | Hypotension (hypovolemia, shock, sepsis). BP 20 mm Hg or higher in arms than legs (coarctation of the aorta). | Refer abnormal blood pressures. Prepare for intensive care and very low. | Measurements| Weight2500-4000 g (5 lbs. 8 oz. to 8 lbs. 13 oz. ). Weight loss up to 10% in early days. | High (low gestational age LGA, maternal diabetes). Low (small for gestational age SGA, preter m, multifetal pregnancy, medical conditions and mother that affected fetal growth).Weight loss above 10% (dehydration, feeding problems). | Determine causeMonitor for complications common to cause. | Length48-53 cm (19-21 inches)| Below normal (SGA, congenital dwarfism). Above normal (LGA, maternal diabetes). | Determine causeMonitor for complications common to cause. | Head Circumference32-38 cm (12. 5-15 inches). Head and neck are approximately ? of infants body surface. | Small (SGA, microcephaly, anencephaly-absence of large part of brain or skull). Large (LGA, hydrocephalus, increased intracranial pressure). | Determine causeMonitor for complications common to cause. | Chest Circumference30-36 cm (12-14 inches).Is 2 cm less than head circumference. | Large (LGA). Small (SGA). | Determine causeMonitor for complications common to cause. | Posture Flexed extremities move freely, resist extension, return quickly to flexed state. Hands usually clenched. Movements symmetric. Slight t remors on crying. Breech: extended, stiff legs. â€Å"Molds† body to caretaker’s body when held, responds by quieting when needs met. | Limp, flaccid, floppy, or rigid extremities (preterm, hypoxia, medications, CNS trauma). Hypertonic (neonatal abstinence syndrome, CNS injury). Jitteriness or tremors (low glucose for calcium level).Opisthotonos- extreme hyperextension of body, seizures, stiff when held (CNS injury). | Seek cause, refer abnormalities. | CryLusty, strong. | High-pitched (increased intracranial pressure). Week, absent, irritable, cat-like â€Å"mewing† (neurologic problems). Hoarse or crowing (laryngeal irritation). | Observe for changes in report abnormalities. | Skincolor pink or tan with acrocyanosis (cyanotic discoloration of extremities). Vernix caseosa in creases. Small amounts of lanugo (fine,soft downy hair) over shoulders, sides of face, forehead, upper back. Skin turgor good with quick recoil. Some cracking and peeling of skin.Normal var iations: Milia (tiny white bumps). Skin tags. Erythema toxicum (flea bite† rash). Puncture on scalp (from electrode). Mongolian spots. | Color: cyanosis of mouth and central areas (hypoxia). Facial bruising (nuchal cord). Pallor (anemia, hypoxia). Gray (hypoxia, hypotension). Red, sticky, transparent skin (very preterm). Greenish brown discoloration of skin, nails, cord (possible fetal compromise, postterm). Harlequin color (normal transient autonomic imbalance). Mottling (normal or cold stress, hypovolemia, sepsis). Jaundice (pathologic if first 24h). Yellow vernix (blood incompatibilities). Thick vernix (preterm).Delivery Marks: bruises on body (pressure), scalp (vacuum extractor), or face (cord around neck). Petechiae (pressure, low platelet count, infection). Forceps marks. Birthmarks: Mongolian spots. Nevus simplex (salmon patch,† stork bite†). Nevus flammeus (port-wine stain). Nevus vasculosus (strawberry hemangioma). Cafe au lait spots (6+) larger than 0. 5c m in size (neurofibromatosis). Other: excessive lanugo (preterm). Excessive peeling, cracking (postterm). Pustules or other rashes (infection). â€Å"Tenting† of skin (dehydration). | Differentiate patient bruising from cyanosis. Central cyanosis requires suction, oxygen and further treatment.Refer jaundice in first 24 hours or more extensive than expected for age. Watch for respiratory problems in infants with meconium staining. Look for signs and complications of preterm or postterm birth. Record location, size, shape, color, type of rashes and marks. Differentiate Mongolian spots from bruises. Check for facial movement with forceps marks. Watch for jaundice with bruising. Point out and explain normal skin variations to parents. | Head Sutures palpable with small separation between each. Anterior fontanel diamond shaped, 4-5 cm, soft and flat. Many bulge slightly with crying. Posterior fontanel triangular, 0. 5-1 cm.Hair silky and soft with individual hair strands. Normal v ariations: overriding sutures (molding). Caput succedaneum or cephalohematoma (pressure during birth). | Head large (hydrocephalus, increased intracranial pressure) or small (microcephaly). Widely separated sutures (hydrocephalus) or hard, ridged area at sutures (craniosynostosis- birth defect that causes one or more sutures on a baby's head to close earlier than normal). Anterior fontanel depressed (dehydration, molding), full or bulging at rest (increased intracranial pressure). Woolly, bunchy hair (preterm). Unusual hair growth (genetic abnormalities). | Seek cause of variations.Observe for signs of dehydration with depressed fontanel; increased intracranial pressure with bulging of fontanel and wide separation of sutures. Refer for treatment. Differentiate Caput succedaneum from cephalohematoma, and reassure parents of normal outcome. Observe for jaundice with cephalohematoma. | Ears Ears well-formed and complete. Area where upper ear meets head even with imaginary line drawn fr om outer canthus of eye. Startle response to loud noises. Alerts to high-pitched voices. | Low set ears (chromosomal disorders). Skin tags, pre-auricular sinuses, dimples (may be associated with kidney or other abnormalities).No response to sound (deafness). | Check voiding if ears abnormal Look for signs of chromosomal abnormality if position abnormal. Refer for evaluation if no response to sound. | FaceSymmetric and appearance and movement. Parts proportional and appropriately placed. | Asymmetry (pressure imposition in utero). Drooping of mouth or one side of face,† one-sided cry† (facial nerve injury). Abnormal appearance (chromosomal abnormalities). | Seek cause of variations. Check delivery history for possible cause of injury to facial nerve. | Eyes Symmetric. Eyes clear. Transient strabismus. Scant or absent tears.Pupils equal, react to light. Alerts to interesting sights. Doll’s eye sign- reflex movement of the eyes in the opposite direction to that which the head is moved, the eyes being lowered as the head is raised, and the reverse (Cantelli sign); an indication of functional integrity of the brainstem tegmental pathways and cranial nerves involved in eye movement. Red reflex present- reddish-orange reflection of light from the  eye's  retina. May have subconjunctival hemorrhage or edema of eyelids from pressure during birth. | Inflammation or drainage (chemical or infectious conjunctivitis). Constant tearing (plugged lacrimal duct).Unequal pupils. Failure to follow objects (blindness). White areas over pupils (cataracts). Setting sun sign- downward deviation of the eyes so that each iris appears to â€Å"set† beneath the lower lid, with white sclera exposed between it and the upper lid; indicative of increased intracranial pressure or irritation of the brain stem. (hydrocephalus). Yellow sclera (jaundice). Blue sclera (osteogenesis imperfecta- condition causing extremely fragile bones). | Clean and monitor any drainag e; seek cause. Reassure parents that subconjunctival hemorrhage and edema will clear. Refer other abnormalities. NoseBoth nostrils open to air flow. May have slight flattening from pressure during birth. | Blockage of one or both nasal passages (choanal atresia). Malformations (congenital conditions). Flaring, mucus (respiratory distress). | Observe for respiratory distress. Report malformations. | Mouth Mouth, gums, tongue pink. Tongue normal in size and movement. Lips and palate intact. Sucking pads. Sucking, rooting, swallowing, gag reflexes present. Normal variations: precocious teeth, Epstein’s pearls-Multiple small white epithelial inclusion cysts found in the midline of the palate in most newborns. Cyanosis (hypoxia). White patches on cheek or tongue (candidiasis). Protruding tongue (Down syndrome). Diminished movement of tongue, drooping mouth (facial nerve paralysis). Cleft lip, palate or both. Absent or weak reflexes (preterm, neurologic problem). Excessive drooling (tracheoesophageal atresia). | Oxygen for cyanosis. Expect loose teeth to be removed. Obtain order for antifungal medication for candidiasis. Check mother for vaginal or breast infection. Refer anomalies. | Feeding Good suck/swallow coordination. Retains feedings. | Poorly coordinated suck and swallow (prematurity).Duskiness or cyanosis during feeding (cardiac defects). Choking, gagging, excessive drooling (tracheoesophageal fistula, esophageal atresia). | Feed slowly. Stop frequently if difficulty occurs. Suction and stimulate if necessary. Refer infants with continued difficulty. | Neck/Clavicles Short neck turns head easily side to side. Infant raises head when prone. Clavicles intact. | Weakness, contractures, or ridgidity (muscle abnormalities). Webbing of neck, large fat pad at back of neck (chromosomal disorders). Crepitus, lump, or crying when clavicle or other bones palpated, diminished or absent arm movement (fractures). Fracture of clavicle more frequent in large infants with shoulder dystocia at birth. Immobilize arm. Look for other injuries. Refer abnormalities. | Chest Cylinder shape. Xiphoid process may be prominent. Symmetric. Nipples present and located properly. May have engorgement, white nipple discharge (maternal hormone withdrawal). | Asymmetry (diaphragmatic hernia, pneumothorax). Supernumerary nipples. Redness (infection). | Report abnormalities. | Abdomen Rounded, soft. Bowel sounds present within first hour after birth. Liver palpable 1-2cm below right costal margin. Skin intact. 3 vessels in cord. Clamp tight and cord drying.Meconium passed within 12-48hr. Urine generally passed within 12-24h. Normal variation: â€Å"Brick dust† staining of diaper (uric acid crystals). | Sunken abdomen (diaphragmatic hernia). Distended abdomen or loops of bowel visible (obstruction, infection, and large organs). Absent bowel sounds after first hour (paralytic ileus). Masses palpated (kidney tumors, distended bladder). Enlarged liver (infectio n, heart failure, hemolytic disease). Abdominal wall defects (umbilical or inguinal hernia, omphalocele, gastroschisis, exstrophy of bladder). Two vessels in cord (other anomalies). Bleeding (loose clamp). Redness, drainage from cord (infection).No passage of meconium (imperforate anus, obstruction). Lack of urinary output (kidney anomalies) or inadequate amounts (dehydration). | Refer abnormalities. Assess for other anomalies if only two vessels in cord. Tighten or replace loose cord clamp. If stool and urine output abnormal, look for missed recording, increase feedings, report. | Genitals| Female Labia majora dark, cover clitoris and labia minora. Small amount of white mucus vaginal discharge. Urinary meatus and vagina present. Normal variations: Vaginal bleeding (pseudomenstruation). Hymenal tags. | Clitoris and labia minora larger than labia majora (preterm).Large clitoris (ambiguous genitalia). Edematous labia (breech birth). | Check gestational age for immature genitalia. Refe r anomalies. | Male Testes within scrotal sac, rugae on scrotum, prepuce nonretractable. Meatus at tip of penis. | Testes in inguinal canal or abdomen (preterm, cryptorchidism). Lack of rugae on scrotum (preterm). Edema of scrotum (pressure in breech birth). Enlarged scrotal sac (hydrocele). Small penis, scrotum (preterm, ambiguous genitalia). Empty scrotal sac (cryptorchidism). Urinary meatus located on upper side of penis (epispadias), underside of penis (hypospadias, or perineum.Ventral curvature of the penis (chordee). | Check gestational age for immature genitalia. Refer anomalies. Explain to parents why no circumcision can be performed with abnormal placement of meatus. | Extremities| Upper and Lower ExtremitiesEqual and bilateral movement of extremities, Correct number and formation of fingers and toes. Nails to ends of digits or slightly beyond. Felxion, good muscle tone. | Crepitus, redness, lumps, swelling (fracture). Diminished or absent movement, especially during Moro r eflex (fracture, nerve injury, paralysis). Polydactyly (extra digits). Syndactyly (webbing) Fused or absent digits.Poor muscle tone (preterm, neurologic injury, hypoglycemia, and hypoxia). | Refer all anomalies, look for others. | Upper ExtremitiesTwo transverse palm creases. | Simian crease (normal or Down syndrome). Diminished movement (injury). Diminished movement of arm with extension and forearm prone (Erb-Duchenne paralysis). | Refer all anomalies, look for others. | Lower Extremities Legs equal in length, abduct equally, gluteal and thigh creases and knee height equal, no hip â€Å"clunk†. Normal position of feet. | Ortolani and Barlow tests abnormal, unequal leg length, unequal thigh or gluteal creases (developmental dysplasia of the hip).Malposition of feet (position in utero, talipes equinovarus). | Refer all anomalies, look for others. Check malpositioned feet to see if they can be gently manipulated back to normal position. | BackNo openings observed or felt in ve rtebral column. Anus patent. Sphincter tightly closed. | Failure of one or more vertebrae to close (spina bifida), with or without sac with spinal fluid and meninges (meningocele) or spinal fluid, meninges, and cord (myelomeningocele), enclosed. Tuft of hair over spina bifida occulta. Pilondial dimple or sinus. Imperforate anus. | Refer abnormalities.Observe for movement below level of defect. If sac, cover with sterile dressing wet with sterile saline. Protect from injury. | Reflexes See table 21-3. | Absent, asymmetric or weak reflexes. | Observe for signs of fractures, nerve injury, or injury to CNS. | TABLE 21-3 SUMMARY OF NEONATAL REFLEXES *MCH page 493| REFLEX| METHOD OF TESTING| EXPECTED RESPONSE| ABNORMAL RESPONSE/POSSIBLE CAUSE| TIME REFLEX DISAPPEARS| Babinski| Stroke lateral sole of foot from heel to across base of toes. | Toes flare with dorsiflexion of the big toe. | No response. Bilateral: CNS deficit. Unilateral; local nerve injury. 8-9 mos| Gallant (trunk incurvation )| With infant prone, lightly stroke along the side of the vertebral column. | Entire trunk flexes toward side stimulated. | No response: CNS deficit. | 4 mos| Grasp reflex (palmar and plantar)| Press finger against of infant’s fingers or toes. | Fingers curl tightly; toes curl forward. | Weak or absent: neurologic deficit or muscle injury. | Palmar grasp: 2-3 mos. Plantar grasp: 8-9 mos| Moro| Let infant’s head drop back approx. 30?. | Sharp extension and abduction of arms followed by flexion and adduction to â€Å"embrace† position. | Absent: CNS dysfunction.Assymetry: brachial plexus injury, paralysis, or fractured bone of extremity. Exaggerated: maternal drug use. | 5-6 mos| Rooting| Touch or stroke from side of mouth toward cheek. | Infant turns head to side touched. Difficult to illicit if infant is sleeping or just fed. | Weak or absent: prematurity, neurologic deficit, depression from maternal drug use. | 3-4 mos| Stepping| Hold infant so feet touch soli d surface. | Infant lifts alternate feet as if walking. | Asymmetry: fracture of extremity, neurologic deficit. | 3-4 mos| Sucking| Place nipple or gloved finger in mouth, rub against palate. | Infant begins to suck.May be weak if recently fed. | Weak or absent: prematurity, neurologic deficit, maternal drug use. | 1 yr| Swallowing| Place fluid on the back of the tongue. | Infant swallows fluid. Should be coordinated with sucking. | Coughing, gagging, choking, cyanosis: tracheoesophageal fistula, esophageal fistula, esophageal atresia, neurologic deficit. | Present throughout life. | Tonic neck reflex| Gently turn head to one side while infant is supine. | Infant extends extremities on side to which head is turned, with flexion on opposite side. | Prolonged period in position: neurologic deficit. | May be weak at birth; disappears at 4 mos|

Friday, August 30, 2019

Langston Hughes’ “As I Grew Older”

In â€Å"As I Grew Older,† Langston Hughes describes the battle and perseverance for African-American’s freedom though numerous metaphors. In the title and first stanza, Hughes compares his dream to a child growing older. A child is born into the bright sun with the mindset with anything is possible. But as the child grows older, they face obstacles. Hughes also refers to his goals as â€Å"my dream,† which was different from the White-American's dream, expressing how personal this dream is. In the second stanza Hughes introduces the wall, his obstacles and racial separation itself. He uses commas to further elongate the seemingly never-ending process of the wall growing. With each line, Hughes is pressed to the side of the page, as if this wall is physically straining him from writing. The wall seems to grow and grow forever, until it finally touches the sky. With the wall blocking the bright light, Hughes’ dream is in the dark. Replaced by a shadow, Hughes declares: I am black. This simple statement not only refers to Hughes’ situation in the poems context but also his being African-American. A shadow of racism soon covers the country. Through the first four stanzas the attitude of the speaker is sad and hurt. The tone of the poem suddenly changes from being passive to active. Hughes urges his â€Å"dark hands,† his culture and people, to â€Å"break thorough the wall! † and help him â€Å"break this shadow / into a thousand lights of sun! † The â€Å"dark hands† can also be a reference to slavery. Hughes believes that although there have been dark times, they can break down the wall of segregation to let in the lights of equality. Hughes' use of the sun as the goal expresses how far away the dream is yet how great an accomplishment this would be. This poem is a direct metaphor for Hughes' life and struggle with racism directed towards African-Americans. His own childhood scarred, Hughes hopes to break down this wall of the dominating White America. With the support of the African-American community, Hughes believes that they can overcome racism and segregation for equal rights. Hughes, Langston. â€Å"As I Grew Older. â€Å"

Thursday, August 29, 2019

Approved and Listed Essay Example | Topics and Well Written Essays - 250 words

Approved and Listed - Essay Example If you are listed, it could mean you are permitted, therefore there is an agreement and acceptance, and so, there is an approval. A list is also a plan that is approved. It is necessary for approved item to be listed and kept for future references, in the same manner that listed items, must be set aside for future consideration. In contrast, approved things may be listed, but a list of things may not be approved. In other words, you can make a list of terms that may be approved but you may not approve of a list that is not acceptable. A listed plan may or may not be agreed upon or considered. The approval of certain lists depends on its content. There are listed items that cannot be approved or accepted. But there are approved items that need to be listed for further confirmation. Moreover, the term approved and listed may mean the same in some aspects, and contradict each other in one or two instances.

Wednesday, August 28, 2019

The Nursing Shortage Essay Example | Topics and Well Written Essays - 2250 words

The Nursing Shortage - Essay Example Unless some wise decisions are taken which result in increasing the nurse population, the ageing general public will have a hard time in the future when they need the services of a nurse. My friend Thomas, when he had an ankle injury recently while playing basketball, had to wait in the hospital emergency room for a long time till he was attended to. The reason for his long wait: there were too few nurses, and they were all too busy. This is the story in all hospitals in the country. There is a dire shortage of nurses throughout the world. and it is affecting the health services everywhere. Fewer young women are opting to take up nursing as their profession. Considered one of the noblest professions, nursing has traditionally been the territory of women. Ever since the well born Florence Nightingale took up nursing in the late nineteenth century, it has attracted intelligent, educated and dedicated women . Although there are male nurses who are indispensable, their numbers are very small. The nurse is the indispensable helpmeet of the doctor and the patient. Her work is manifold- She helps the physician in his office, she cleans and bandages minor injuries, and gives emotional support to the patient. She can even help a pregnant woman in her labor. She teaches the patient's family how to take care of the patient. Nurses write detailed report of the patient's symptoms which helps the physician to diagnose the illness and treat the patient. Some nurses work in the operating theater. The operating surgeon relies on the nurse to assist him while he is doing the surgery. The nurse in the Intensive Care unit has a different set of duties than the nurse in the Trauma Center. A trained nurse is indispensable for the care of the seriously ill patient. Many patients become emotionally dependent on their nurse. According to a report of the Bureau of Labor Statistics, "Home health nurses go to peoples' homes to help them. Flight nurses fly in helicopters to get to sick people in emergencies. "(BLA report p1) Any shortage in the number of trained Registered Nurses will be a catastrophe which should be avoided at all costs. The twenty first century is witnessing such a shortage of nurses worldwide. The reasons for the diminishing number of nurses are many. Steps must be taken immediately to arrest the shortage of nurses by all concerned so that the nurses and the public will not suffer.. The job of the nurse, besides being stressful, is emotionally exhausting. As Hingley says in The Nursing Mirror, "Every day the nurse confronts stark suffering, grief and death as few other people do. Many nursing tasks are mundane and unrewarding. Many are, by normal standards, distasteful and disgusting. Others are often degrading, some are simply frightening"(Hingly ) The daily confrontation with death and disease takes a heavy toll on the nurse's physical and emotional health. Being constantly exposed to various kinds of infection, the nurse is always in danger of catching one. She has to be extra vigilant in avoiding infection. The tasks a nurse has to do in the course of the day are sometimes disgusting. She has to put up a stoic front and do the task satisfactorily. Many times, the patients

Tuesday, August 27, 2019

Paul Klee Creative Credo Essay Example | Topics and Well Written Essays - 500 words

Paul Klee Creative Credo - Essay Example It's already existing as its own being. However, when it's placed in a painting, it's made more visible to the naked eye. It is able to be readily captured more easily than if it were standing on its own. The artist simply brought it "more" to life. Moreover, Klee does not believe that an object should be contained and not admired. He believes that it should be looked at admiringly and often in several different ways. Klee does not think that a painting starts and ends with just a simple drawing. However, he believes that a measure of thought should be put into the strokes. He believes that your mind should be focused on your painting because, when your total attention is on the painting, you will be able to notice the details that it needs. As a matter of fact, he favors Anselm Feuerbach, a German artist who believed that artists must have a chair in order to work. Feuerbach thinking is that the chair will rest the artist's legs hence enabling him to better devote his mind to his painting. He believed that time was necessary in order to make great art, and he didn't believe that it should be rushed. Klee also considers space to be a very important concept when regarding art. He believe that movement was essential to art, on both the artist's and the viewer's part.

Monday, August 26, 2019

What's your point of view Essay Example | Topics and Well Written Essays - 500 words - 1

What's your point of view - Essay Example As such, can such people put away technology and embark on simple methods of operations? This could be adapted by just a few individuals while the others would like to think of concepts like an ideal thus lack the effort and self sacrifice in making the ideal a reality. However, such individuals console themselves by asserting that vast amounts of land and forests have been kept for people to experience the simplicity with which fishing, hunting, camping can bring. This does not mean that we lack our roots to the earth and world. As long as we have balance that has been kept between advancement in our civilization and the connection to nature, then we have to flourish in the both ways in the society (Wright 98). However, there have been instances when we cannot achieve this balance as some people are overly saturated by one way instead of incorporating the other ways. This rages the debate on. We can neither go back to our advancements, nor can we forget on how to move on without these advances and the connections we have to nature. Therefore, if we embrace both we are bound to succeed, but with one, we will stagnate, become our own means of destruction and falter. In the medical sector, several advancements have been carried out and there is still more advances in our daily lives. People easily access better medical attention and can live for a very long period as opposed to the earlier days. However, due to the long period number of days, people are now exposed to difficulties brought out by the advanced age and diseases such as dementia, Alzheimer and the aged have become a burden to the society as there is no specific place to take care of them (Postman 34). Video games and computers have become very popular among the teens, adults and children after undergoing several advances (Kelly 76). However, there are several debates which have come up in accordance to the appropriateness of

Sunday, August 25, 2019

Education system in Japan Essay Example | Topics and Well Written Essays - 1000 words

Education system in Japan - Essay Example The education system possesses great importance in the Japan because it has played vital role in determining the dimensions of economic and social progression of the country. Japan always strives to catch the western standards in science and education and for this purpose special emphasis has been given to the educational policies in the country (Hendry, 1987). Earlier the French and German models of educations were used for bringing reforms in the Japanese education systems. However, after the Second World War some special reforms were introduced into the system following the patterns of American education after which there were some major changes occurred within the Japanese education system. It has been regarded that the economic recovery and development of Japan became possible due to the effective management and policies of education system that not only emphasize upon providing formal education to the students but also focus upon developing and polishing their socializing skill s (Rebecca and Gerald, 2000). Japan is among the world best countries having the population with 100% enrolment in the compulsory classes due to which the illiteracy rate is zero in Japan. The education system of Japan follows the Japanese characteristics of group behaviour and heavily insists upon group interaction and peer connections. Unlike American education system Japan stresses upon controlled individual responsibility by observing the group rules. It is unveiled that the teaching culture in Japan significantly differs from the western countries. The Japanese education system has a different approach towards preparing the students to take place in the wider society. The education system widely insists upon maintaining cooperative relationship with the peers, to follow the routine of the school and to give critical importance to punctuality (Peak, 1992). Right from the beginning the students are trained to become responsible. They learn to focus upon management of certain task s starting from desks cleaning and classroom floors scrubbing. The education specifically insists upon developing loyalty with the social groups like class, sports teams, friends, after school circles etc. due to focus upon the maintaining strong social relationship the students become able to act as effective leaders in their future lives. They learn to play the roles of leaders as well as subordinates because their organization and socializing skills are well developed during their school life by performing the roles of monitors, class chairperson and lunchtime etc. The socializing skills of the students are further developed through different activities and events like class meetings and group discussions. Through these activities the public speaking skills of the students are polished and they become able to perform active role in their future lives. As the students move from the school to higher education they are further trained to take part is wider society through the develo pment and refinement of their socializing skills. The student school committees are generally established to train them about the organized and disciplined hierarchical work (Sugimoto, 1997). During the high school years the peer group culture reached its peak and the students are trained to become active members of the school committees, groups and class as well as the society. At this stage, they have been taught to learn about nature and ranking of high school because it has obvious impact upon their professional careers and future. The students are also prepared for different destinations so that they become able to adjust them is different type of circumstances and situation. The education system also insists upon fostering consensus and harmonious nature within the Japanese society for which the societal problems are also addressed by creating caring environment within the schools and other educational institutions (Hendry, 1987). The Japanese

Toxic Asset (Business Law) Essay Example | Topics and Well Written Essays - 1500 words

Toxic Asset (Business Law) - Essay Example Toxic assets are also known as dead assets because they have been utilized in the past and they are of no more value at present. â€Å"Toxic assets had a value at some point in time† (Smith, 2010). Toxic assets do not have any present value whereas many people, who have such assets, believe that their toxic assets are still of the same value as they had in the past. However, the reality of the value of those toxic assets is quite different. Toxic assets often result in minimizing the liquidity of the organizations that possess such assets. It is because of the fact that toxic assets have no clear value and if the financial organizations such as banks acquire a large number of toxic assets assuming them to be of great value, minimal liquidity occurs because the value of the assets does not increase in reality, rather it just increases in the bankbooks. The banks find it very difficult to sell the assets in order to get the blocked money back in hands. Toxic assets are neither good for financial organizations nor for the economy of a country. They are worthless for the banking institutions as it becomes difficult for the banks to sell them to some other person at a reasonable price. Even if the financial sector of a country attempts to cope with toxic assets, the result is most likely to be the radical freefall of the country’s economy. Toxic asset is a form of Mortgage-Backed securities. Mortgage-Backed securities include loans that are given by a bank to a person to help the person build his own house. Banking institutions provide loan to the people, which is taken back from them along with interest on monthly basis. The repayment of loans to the banks is not an easy process for the people as the repayment is composed of high interest and the principal amount. When the people are not left with enough money to repay the loans to the banks due to increased sub-prime mortgage interest rates, the cycle stops and

Saturday, August 24, 2019

The study of Market Entry Strategies of SGP to expand into China Literature review

The study of Market Entry Strategies of SGP to expand into China - Literature review Example During its expansion programs SGP already had bought a stake in China’s Liquid Petroleum Gas market and is looking forward to become the market leader for the product. (Forbes.com, 2010). Literature Review One of the largest Liquid Petroleum Gas distributors, SGP based in Thailand as studied focuses on its strategic move on gaining entry into the Chinese soil. To this end, Levi (2006) states that the strategy devised by a company to make its entrance into a totally new or sub-divided market is better known as the ‘market entry strategy’ for the company. These firms further adopt another strategy to support its expansion to newer markets. This strategy helps the firm to make reasonable allocation of its resources to gain the potential of effectively operating in the newer markets. Levi (2006) further states that through the employment of the ‘market entry strategy’ the firm successfully draws out a plan to tap the newer markets. The plan incorporates a n outlook through which the newer market is properly segmented and effective plan of actions are chosen to meet the demands of the target group through acquisition and expansion operations. The central component of the strategy taken by the company to enter into newer markets is constituted by ascertaining the ‘mode of entry’ by the company into the foreign market. Research made along several firms on a global scale confirms that there are mainly five modes through which a firm plans to make a foray into foreign markets. (Levi, 2006, p.34). Levi (2006) states in this regard that entry models like ‘exporting’, ‘licensing’, ‘financing’, ‘building up a joint venture with the foreign firms and establishment of subsidiaries in the foreign land are considered feasible by a firm willing to enter into foreign markets. Each of the several modes of entry has significant advantages and disadvantages which can be underlined as follows. T he company through the export mode targets to push the products produced in its own country to the foreign market. Thus the company is not required to set up a new factory in the foreign market. The company through the export mode endeavours to build huge amount of revenues by exporting a large number of products to the foreign nations. Export strategy used by the firm to enter into foreign markets however faces some distinct disadvantages. The company using such strategy may have to face the stringent regulations and market policies of the foreign market which can prove detrimental to its expansion. The cost of transferring products along the borders also tends to impose huge costs to the production firm. Again the foreign market may happen to be non-demanding to the products produced by the exporting firm. The level of obstruction can also result out from the barriers relating to difference of culture between the exporting and the receiving nation. Thus the above reasons may happe n to make the export mode unsuccessful for the exporting firm. Levi (2006) further observes that the company can also take help of transferring the license to produce a stated amount of the products and thereby to market the same in the foreign market. In that the company renders a sum to the firm in the foreign nation taking such task. The company operating through the licensing mode gains the advantage of cost for not

Friday, August 23, 2019

Reflective essay Example | Topics and Well Written Essays - 750 words - 14

Reflective - Essay Example However, my far-reaching plans were overshadowed by the terrible news: one day I learned that my mother was diagnosed with breast cancer. My loving parents did not want me to know, yet I learned it accidentally. I just found an abstract of mother’s medical record when looking for my notebook in the drawer. And I was shell shocked. The feelings were as if a bucket of ice-cold water was poured on me. I understood that she wanted to protect me from worries, but I was adamant about what I needed to do as a loving child. When your dearest person finds herself in the mire, there are no other possible options but staying near and doing your best to help and relieve the personal hell she is going though. Therefore, I decided to postpone my study in the U.S., so that my mom could rely on me anytime during her treatment. I have to admit that giving up my dream was very hard, and so was watching mom going through the painful course of chemotherapy, but I do not regret anything. This experience, though rather p stressful, has produced a profound effect on my life and attitude. Usually, I tended to distance myself from thoughts that some of my dearest people and particularly family members can be possible affected by a serious disease, get into an accident or die. Therefore, hearing about other people die of cancer in the news programs, I often thought: â€Å"Well, that is awful, but fortunately it will never affect me, my parents or my friends†. I remember that when I was at school, I read about Kylie Minogue being diagnosed with breast cancer. Well, I liked this singer and was a little upset, but still I perceived cancer as a distanced and abstract thing. However, when I saw mother’s weary eyes after a chemotherapy session and understood that cancer can reach anyone, nobody is completely secure even with healthy lifestyle or strong immune

Thursday, August 22, 2019

Mutations in Dna Essay Example for Free

Mutations in Dna Essay Although most mutations are either neutral or harmful they are also the raw material for evolution. Such mutations from alleles, alternate forms of a given gene that may produce differences in structure or function such as black, brown or blond hair in humans, or different mating calls in frogs. Stages of Mitosis~ 1)Parent cell. 2)Chromosomes make identical copies of themselves. 3)They line up along the centre. 4)They move apart. 5)Two daughter cells form with identical chromosomes to the parent cell. Homologous chromosomes have the same genes, but each homologue may have the same alleles of some genes and different alleles others. The cell cycle is tightly controlled. Both during the embryonic development and during the maintenance and repair of the adult body, progressing through the cell cycle is regulated primarily by two interacting processes. (1)Production of, and responses to, growth factors that generally speed up the cell cycle; (2)Intracellular checkpoints that stop the cell cycle if problems such as mutations in the DNA or misalignment of the chromosomes have occurred. Most cancers develop because one of both of these processes goes awry. Many different molecules control the cell cycle; Porto-oncogenes:Any gene whose proteins tends to promote mitotic cell division if called a proton-oncogene. The genes for growth factors, grow factor receptors, and some cyclins and Cdks are proton-oncogenes. In most cases, progress through the cell cycle beings when a growth-stimulating protein such as epidermal growth factor (EGF) binds to a receptor on the surface of a cell. This stimulates the synthesis of cyclins which bind to Cdks and activate them. Thus, these proton-oncogenes are essential to the normal control of the cell cycle. Tumor suppressor genes:The protein products of tumor suppressor genes prevent uncontrolled cell division and the production of daughter cells with mutated DNA, both of which are common in tumors. Cdks regulate the activity of other proteins by adding a phosphate group to them. One such protein is Rb. Normally, Rb inhibits transcription of several genes whose protein products are required for DNA synthesis. Phosphorylation of Rb by Cdks relieves this inhibition in the G, phase of the cell cycle, allowing the cell to proceed to the S phase and replicate its DNA. This chain of events, from growth faction stimulation to phosphorylation of Rb, ensures that the cell cycle starts up only when the body needs it to. Another tumor suppressor protein, called P53 monitors the integrity of the cells DNA and indirectly regulates Rb activity. Healthy cells with intact DNA, contain little P53. However, when DNA has been damaged (for example by ultraviolet rays in sunlight), P53 levels rise. The P53 proteins that inhibit Cdks. If Cdks are inhibited then Rb is not phosphorylated and DNA synthesis is blocked; this prevents the cell from producing daughter cells with damaged DNA. The P53 stimulated the synthesis of DNA repair enzymes. After the DNA has been repaired, P53 levels decline, Cdks become active, Rb becomes phosphorylated and the cell enters the S phase. If the DNA cannot be repaired, P53 triggers a special from of cell death called apoptosis, in which the cell cuts up its DNA and effectively commits suicide.

Wednesday, August 21, 2019

Mental Illness Analysis of Film Session 9 (2001)

Mental Illness Analysis of Film Session 9 (2001) Erica Moghtader Session 9: Mental Illness Analysis Deemed as one of the major cult films of all time, Session 9 invokes terror in the most realistic way possible- through abnormal psychology. In the end of the story, the character Mary Hobbes’ evil personality alternate, Simon, chillingly states when asked where he lives to the psychologist: â€Å"I live in the weak and the wounded, Doc (Anderson, 2001). Statements such as this lead to the notion that anyone could end up in a situation with, or actually like, the main character Gordon. In this paper I will discuss the various characters’ mental illnesses shown in Session 9 along with their symptoms, portrayal, and treatment amongst peers. This intense psychological horror film, directed by Brad Anderson, is centered on the restoration of a large mental asylum, built in 1871 and closed in 1985. Gordon Fleming (Peter Mullan), owner of an asbestos removal company, agrees to restore the building in an impossible turnaround time of one week. Gordon hires a crew: Phil (David Carusoe), Hank (Josh Lucas), Jeff (Brandon Sexton III), and Mike (Stephen Gevedon). Mike, secretly listens to nine old recorded therapy sessions that he found, which focused on patient #444 Mary Hobbes. Each employee has personal issues that get in the way of the job, and in combination with stress, it leads to the pinnacle of the story. The movie ends with all characters dead except Gordon, who has made patient room #444 his home. Considering the aforementioned synopsis, there are three characters that portray mental illness throughout the movie. Gordon, the main character, seems disturbed from the beginning of the movie. As the scenes unfold, symptoms of schizophrenia begin to arise. In one of the first scenes as Gordon and Phil tour the asylum for an asbestos removal bid, Gordon has his first auditory and visual hallucination. As Gordon intently focuses on a specific room, #444, he sees a shadow move across his face while hearing â€Å"Hello, Gordon† (Anderson, 2001). Both kinds of hallucinations go on throughout the movie, in particular when his hallucination eggs him on to kill his wife and baby: â€Å"Do it, Gordon!† (Anderson, 2001). In the final scenes of the movie, the voice reappears repeating the same statement as he murders all the employees. Susan Nolen-Hoeksema (2011) deliberates that schizophrenic auditory hallucination such as these â€Å"often have a negative quality, criticizing or threatening the individuals or telling them to hurt themselves or others† (p. 223). Persecutory delusion for ms towards the end of the movie when Gordon believes that Phil is lying about a certain phone call because he thinks Phil killed/hurt Hank. Catanotic excitement is also displayed as Gordon runs aimlessly throughout the asylum looking for Hank, whom had been missing for days. There were several scenes that contained avolition. Many times Gordon sat â€Å"daydreaming† in the cemetery, room 444, and in front of his home. Gordon also presented a symptom of sleepwalking, or somnambulism, when he gave Hank a frontal lobotomy. Dr. Prakash Masand (1995) associated sleepwalking with schizophrenia: â€Å"The prevalence of somnambulism is 1 to 6 percent in the general adult population, although a higher incidence has been reported in patients with schizophrenia, hysteria and anxiety neuroses.† Not only did Gordon suffer from a mental illness, so did his nephew Jeff. Jeff, a young chap who needed a job, suffered from situational phobia. In particular he suffered from nyctophobia or in layman’s terms, fear of the dark. On his first day in the asylum, the breaker flips and in turn Mike asks Jeff to go down in the basement to turn it on. Jeff directly tells him he has nyctophobia and will not go down. When he is forced to go down in the basement the first time and has to walk through a slightly dark room, he hurriedly remedies the problem. At the end of the movie in the tunnels, as the lights slowly go out putting Jeff in complete darkness, he has a severe panic attack. The DSM-5 states that Specific Phobia disorder can be diagnosed if the individual shows immediate fear, avoidance and out of proportion reaction to the phobic situation (Nolen-Hoeksema, 2011, p. 119). By the same token, patient Mary Hobbes also displays mental illness in the film. Although former, deceased patient Mary Hobbes never physically appears in Session 9, she makes quite an impression. Mary Hobbes was admitted into the asylum and diagnosed with dissociative identity disorder. She had been traumatized by her brother Peter after he scared her causing her to fall on her porcelain doll, which in turn severely cut up her chest. At this point Simon took over Mary and killed Peter with his new hunting knife. In the taped sessions of Mary’s therapy, she does not remember anything that happened, even hysterically stating: â€Å"Nothing happened! No! I can’t remember!† (Anderson, 2001). Susan Nolen-Hoeksema (2011) explains that people suffering from dissociative identity disorder usually report significant periods of amnesia when the other personalities are in control (p. 163). Mary displayed three different identities: the Princess as the child alter, which is often associated with the development of dissociative identity disorder; Billy, the protector alter, who protects the individual from trauma; and Simon, the persecutor alter, who often inflicts pain or punishment (Nolen-Hoeksema, 2011, p. 162). Subsequently, the treatment amongst the mentally ill characters was different than the sane characters. Depending on the situation, characters Gordon, Jeff and Mary were stigmatized or treated with compassion, At first Phil empathizes with Gordon over his fight with his wife. Phil then quickly takes advantage of the situation to get a bigger bonus; he discusses with Mike that they should force Gordon off the project due to his behavior/health. Phil knows Gordon is not in the state of mind to handle being removed, and even says so when he’s smiling to himself on the roof: â€Å"It’s gonna get ugly† (Anderson, 2001). Jeff is stigmatized from the moment he announced his phobia. Mike was irritated and called him names like â€Å"Mullet Head.† Phil completely disregarded Jeff’s phobia, which forced him to go down into the basement to fix the breaker in the dark. Though Jeff’s mistreatment did exasperate his illness, the mistreatment of Gordon by Phil led the persecutory delusions of Phil hurting Hank. Though I do not condone the mistreatment, there are several other aspects I do enjoy about Session 9. Session 9 is one of the best independent horror movies, winning best director at the Catalonian International Film Festival in 2001. Considering myself a horror buff since my early twenties, this is one of my favorites. In my opinion, movies are the scariest if they could really happen. The realistic production and general plot make this movie even scarier. As I compared the mental illnesses of the characters to factual data, I realized that the symptoms portrayed were very close to being true to form. Every time I have watched Session 9 I find different aspects to debate or admire. Now that I added abnormal psychology to my mental list, there are even more to ponder! In conclusion, various mental illnesses symptoms, portrayal, and treatment amongst peers were shown in Session 9. From Gordon’s schizophrenia to Mary’s dissociative identity disorder, to Jeff’s nyctophobia, Session 9 accurately portrays the symptoms and typical mistreatment of the mentally ill. Many fans of the movie think that Mary Hobbes was possessed by Genius Loci, an ancient ideology that a spirit is attached to a place, and in turn possessed Gordon. And in all actuality, who is to say something like a Genius Loci does not exist? Maybe one day science will mesh with the supernatural, or at least get along with each other. References Anderson, B. (Director). (2001).Session 9[DVD]. Masand, Prakash. (1995). Sleep Walking.American Family Physician. http://www.drplace.com/Sleepwalking_-_includes_patient_notes.16.21241.htm Nolen-Hoeksema, S. (2011). Abnormal psychology (6th ed.). Boston, MA: McGraw-Hill.

Tuesday, August 20, 2019

Effects of advertising in hospitals

Effects of advertising in hospitals Hospitals are basically perceived to be organisations that provide essential medical services to people from various social segments. They are associated with medical ethics, which traditionally prohibit doctors from advertising their services.  [1]  Whilst hospital advertising is a common feature of modern society, it is perceived favourably only when it attempts to provide important information and not when it plainly engages in attracting clients for commercial purposes.  [2]   Hospital advertising should thus be carefully conducted to ensure that the public feel that such advertising provides needed information and is not meant to entice people to come to the hospital in order to improve its revenues and profits. People in the UAE will appreciate hospitals that provide useful information about their services and other medical issues. 2. Hospital Ads increase Costs Whilst advertising is an essential part of modern day commercial activity, it is mainly perceived to be an expensive tool that is associated with glamour and used to attract new customers by business organisations.  [3]  Whilst hospitals also operate commercially and do need to be profitable to expand their operations and meet stakeholder needs, they are expected to fulfil the medical needs of different social segments and people by and large expect medical services to be provided at economic and affordable rates.  [4]  Extensive advertising by hospitals can thus easily create an impression of such an institution being more interested in commercial benefits than in providing important medical services to people in need. Such advertising should thus be done carefully in order to ensure that wrong or negative perceptions are not created in the minds of the public.  [5]   With the majority of people in the UK being expatriates, they are likely to be tolerant of hospital advertising, even as some of them may feel such advertising to be unnecessary expenditure. 3. I donà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒ ¢Ã¢â‚¬Å¾Ã‚ ¢t trust Hospitals that Advertise Such emotions essentially arise from people who think all medical and associated activities to be service oriented and noble in nature.  [6]  They look down upon medical professionals and institutions that appear to be using their skills and their professional capacities and abilities for personal or organisational financial benefit.  [7]  Whilst healthcare and its associated activities continue to be concerned with the provisioning of services that benefit humans, the altruistic offering of such services is an anachronism in modern neoliberal society.  [8]  Although the majority of healthcare institutions and indeed many of healthcare customers associate medical services with profitable professional or organisational activity, some conservative and traditional individuals think poorly of healthcare associations that are associated, directly or indirectly, with the soliciting of customers. Such people are likely to distrust hospitals that advertise their products and serv ices.  [9]   Whilst the expatriates in the UAE may well adopt a tolerant and even appreciative view of hospital advertising, traditional members of UAEà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒ ¢Ã¢â‚¬Å¾Ã‚ ¢s conservative society may react with distrust to hospital advertising. 4. Ads are useful in Choosing Hospitals Much of contemporary hospital advertising is conducted by expert advertising people who understand social sensibilities and perceptions about medical services and take care to ensure that hospital advertising provides important information and messages without appearing to be commercial in nature.  [10]  Hospital advertising often deals with services provided by such institutions in different areas and particularly in their areas of specialisation like maternity care, cardiac health or oncology.  [11]  Such advertising plays an extremely useful role and helps prospective users with useful and relevant information.  [12]   With education and literacy rates increasing steadily in the UAE and the region having a significant proportion of expatriates, information about hospital services will be welcome and is likely to be greatly appreciated. 5. Hospital Ads often exploit peopleà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒ ¢Ã¢â‚¬Å¾Ã‚ ¢s anxieties Hospital advertising by and large is informative and encourages people otherwise to engage in timely checkups for diseases like cancer and diabetics as well as to check for hypertension and other conditions associated with cardiac health.  [13]  Exploitation of anxieties is far more associated with the life and medical insurance sectors rather than with hospitals. Very few people in the UAE will be disturbed on account of hospital advertising exploiting their anxieties. 6. Hospital Ads make people aware of health related issues The overwhelming majority of hospital advertising, directly or indirectly, informs people about different health related issues.  [14]  Even direct advertising about the services provided by healthcare organisations is essentially concerned with health and provides information about it and associated issues.  [15]  A large portion of hospital advertising, irrespective of use of media channels, essentially concerns information about health.  [16]  The provisioning of such information is one of the biggest benefits of healthcare and hospital advertising. People in the UAE will surely appreciate such information and use it for their personal medical and health associated benefits. Section 2 Advertising for healthcare in the U.A.E Healthcare is an important activity in the UAE, particularly in the urban concentrations of Dubai and Abu Dhabi. The quality of healthcare is also high and is accepted to generally be equal to that available in Western Europe and the USA, except for highly specialised medical and surgical services. With Dubaià ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒ ¢Ã¢â‚¬Å¾Ã‚ ¢s population being small and being serviced by numerous medical facilities in the public and private sector, advertising is routine and common, especially so for organisations in the private sector.  [17]   Such advertising is carried out through various media channels like billboards, print advertising, digital signage and flyers.  [18]  Healthcare advertising targets specific market segments and communicates the unique selling points of various institutions in the sector to consumers.  [19]  Apart from advertising through regular channels, healthcare organisations in the UAE make significant use of PR that works towards developing workable and sustainable communication solutions for individual organisations.  [20]   The UAE also has a number of healthcare publications that provide information on different aspects of health and provide a forum for healthcare advertising.  [21]  Many healthcare organisations in the UAE have well developed online presence and informative websites, even though online commerce is not commonly used by these organisations.  [22]   Recent months have witnessed a growing concern in the region about protecting citizens and residents from unethical advertising by healthcare organisations.  [23]  Authorities are clamping down on advertisements that are targeted at vulnerable customers. Guides on advertising have also been released outlining practices that are considered to be unacceptable and could attract sanctions for breach of code.  [24]   Section 3 Exit and Entry Barriers All business sectors are characterised by entry and exit barriers. The barriers to entry represent hurdles or obstacles that prevent or create difficulties for business organisations to enter a particular sector or area of activity.  [25]  Barriers to exit on the other hand comprise of the numerous difficulties that organisations may face in withdrawing from a business sector or in closing down a business.  [26]  The healthcare sector in the UAE is likely to have numerous barriers to entry as well as to exit. Five such potential entry and exit barriers are detailed below. One of the most important barriers to entry to the sector is likely to be the cost of establishing a new healthcare establishment. The UAE is one of the richest areas in the world and is experiencing inflation. The cost of a new healthcare institution is likely to be expensive and beyond the reach of many organisations. Most healthcare institutions require sophisticated and modern equipment. With medical equipment not being manufactured in the Emirates, all such equipment will have to be ordered and purchased from organisations in different countries. With such equipment being manufactured by a range of organisations in the advanced countries, efficient procurement is likely to be a challenging task. New healthcare organisations can also be expected to face difficulties in obtaining specialists for provisioning of healthcare services to customers. The majority of such specialists will have to be attracted from different countries, mainly from the west and from the Indian subcontinent. Apart from scarcity of medical specialists, the UAE also has a shortage of local paramedical staff like physiotherapists and nurses. Arranging for proper individuals to handle these functions can also prove to be a challenging task. Last but not least the issue of arranging for proper housing of healthcare facilities is also likely to be difficult. With the UAE being one of the most expensive real estate markets in the world, obtaining appropriate land and buildings for the healthcare facility could be a difficult task. The preceding paragraph lists five barriers to entry for healthcare organisations. Healthcare institutions that wish to close down their operations and exit from the market could also face different types of exit barriers. Some organisations may be popular for the quality of their services and their loyal clientele. Such customers could become very disturbed on hearing the news of closure and make efforts to persuade the organisational management to desist from taking such actions. Healthcare organisations that have taken loans from financial institutions and are in debt may face objections from their financiers in closing down operations. Other healthcare organisations who want to sell their operations could again face difficulties in locating appropriate buyers who are willing to offer suitable prices. The organisational staff of healthcare institutions could resist closure because of the threat to their jobs and livelihood. Finally healthcare organisations might face resistance from governmental and political authorities, who may think that such a closure could affect the lives and wellbeing of people. Section 4 Application of BCG Matrix The BCG matrix is a strategic tool that helps organisations in classifying their business units by virtue of their potential to add to organisational wellbeing and competitive advantage.  [27]   Business units are, with the BCG matrix, segregated into four cells, namely cash cows, stars, dogs and others.  [28]  Cash cows represent businesses that have good market share but low growth potential. Such products are the mainstays of corporations and are likely to be profitable and should thus be maintained. Surgery can be considered to be a member of this category. Stars are products or services that have high growth potential, high market share and need to be supported with reinvestment. An imaging centre can be considered to be a star. Dogs are businesses that are distinguished by low growth potential and market share. Businesses are usually started to be stars but some of them turn out to be unsuccessful and fall into the category of dogs. Such businesses need to be closed as soon as possible. An expensive CAT scan facility that has now become obsolete and is not drawing customers can be considered to be a dog. Business units of indeterminate potential and low market share are generally placed in the category of others. The potential for an ambulatory-surgery service could be very strong even though it may not be providing good returns. Such a service can turn either into a star or into a dog with time. The application of the BG matrix to a healthcare institution is provided below: High Low High Stars Others Low Cash Cow Dogs Application of GE Matrix The GE matrix was developed to overcome the problems commonly associated with the BCG Matrix like lack of plausible business information and its focus on commodities.  [29]  The GE screen has a 3X3 matrix that includes a medium category, uses industry attractiveness rather than market growth and substitutes the market share element of the BCG matrix with competitive position.  [30]  Book on strategic marketing The GE Matrix for a healthcare institution is provided below. Market attractiveness is on the vertical axis and competitive position is on the horizontal axis. Strong Average Weak High Oncology Surgery Radiology Med Cardiac Care Orthopaedics Pathology Low Dental care X Ray Medical Stores Nine functions of a healthcare institution have been graded with the use of the GE matrix in terms of market attractiveness on the vertical scale and competitiveness on the horizontal scale. A certain amount of approximation and estimation has been applied because of the compulsion of putting only one unit in a box. The organisation has special skills, including the services of high quality specialists in oncology, cardiac care, and surgery and should reinforce these functions with appropriate investments in equipment, staffing and resources. The three squares on the right hand bottom of the matrix represent functions that are commonly available and do not tangibly add to the competitive position or the market attractiveness of the organisation. These functions are however required and should be carefully consolidated. The three other functions, namely dental care, orthopaedics and radiology have strengths either market attraction or in competitiveness and should be selectively and c arefully strengthened.

Monday, August 19, 2019

Irony and Symbolism in Willa Cathers Pauls Case Essays -- Cather Pau

Irony and Symbolism in Willa Cather's Paul's Case   "Paul's Case," by Willa Cather, is a story that deals with a young boy who does not feel that he lives a life befitting of him. Upon a close reading, it is evident that "Paul's Case" is ruled by irony and symbolism, which are apparent in the story through the words of the narrator. The irony woven throughout the text builds up to an epiphonic moment, a main paradox in the story, which reveals to the reader Paul's true nature. Paul believes that everyone around him is beneath him. He is convinced that he is superior to everyone else in his school and in his neighborhood. He is even condescending to his teachers, and shows an appalling amount of contempt for them, of which they are very aware. In one class he habitually sat with his hand shading his eyes; in another he always looked out of the window during the recitation; in another he made a running commentary on the lecture, with humorous intention. Paul wanted everyone to think he was better than they were. Not only did he try to dress as if he were rich and important, his very actions displayed a great amount of disdain for everyone around him. Paul sees himself as superior. He carries himself with a haughty countenance and air about him, apparent in the description "Paul entered the faculty room suave and smiling." His attempts to portray himself as elegant is obvious in the adornments with which he tries to accentuate his attire: "he wore an opal pin in his neatly knotted black fourin-hand, and a red carnation in his button-hole." The irony in Paul's self-delusion lies in the way he is, in reality, seen by the rest of the world. While he thinks that he is dapper and winning in his ornamented garb, t... ...ft who is actually honest. To Paul, the ultimate place in life is to be a part of the upper class. Paul had to try very hard, and be very dishonest, to convey a certain image so that he would be accepted as a part of that class. At this moment, since the best place to be is the upper class, and if one must be dishonest to achieve high social status, Paul wonders how there can be anyone in the world who is honest because everyone should be striving to be a part of the upper class. As far as Paul is concerned, his deceitful measures were an acceptable means for achieving his goal. Works Cited and Consulted Brown M. & Crone R. Willa Cather the Woman and Her Works. New York: Charles Scribner’s Sons. 1970. Cather, Willa. â€Å"Paul’s Case.† The Norton Anthology of Short Fiction. Eds. R.V. Cassill and Richard Bausch. Shorter 6th ed. New York: Norton, 2000. 198-207.

robert the bruce :: essays research papers

Appeals of the Seven Earls, in Anglo - Scottish Relations 1174 - 1328, ed. and trans. by E.   Ã‚  Ã‚  Ã‚  Ã‚  L. G. Stones, (London: Thomas Nelson and Sons Ltd., 1965) Baigent, Michael and Leigh, Richard, The Temple and the Lodge (New York: Arcade   Ã‚  Ã‚  Ã‚  Ã‚  Publishing, Inc, 1989) Balliol, John, 'Defiance' By King of Scotland, in Anglo - Scottish Relations 1174 - 1328,   Ã‚  Ã‚  Ã‚  Ã‚  ed. and trans. by E. L. G. Stones, (London: Thomas Nelson and Sons Ltd., 1965) Barrow, G. W. S., Robert Bruce and the Community of the Realm of Scotland, (Berkely:   Ã‚  Ã‚  Ã‚  Ã‚  University of California Press, 1965) Bingham, Caroline, The Kings and Queens of Scotland, (New York: Taplinger   Ã‚  Ã‚  Ã‚  Ã‚  Publishing Company, 1976) Bull of Pope Gregory [4 Jan. 1235], in Anglo - Scottish Relations 1174 - 1328, ed. and   Ã‚  Ã‚  Ã‚  Ã‚  trans. by E. L. G. Stones, (London: Thomas Nelson and Sons Ltd., 1965) Bull of Pope Innocent IV [ 6 Apr. 1251], in Anglo - Scottish Relations 1174 - 1328, ed. and   Ã‚  Ã‚  Ã‚  Ã‚  trans. by E. L. G. Stones, (London: Thomas Nelson and Sons Ltd., 1965) Charter of King Richard, in Anglo - Scottish Relations 1174 - 1328, ed. and trans. by E. L.   Ã‚  Ã‚  Ã‚  Ã‚  G. Stones, (London: Thomas Nelson and Sons Ltd., 1965) Cowan, Samuel, J.P., Life of the Princess Margaret Queen of Scotland 1070 - 1093,   Ã‚  Ã‚  Ã‚  Ã‚  (Newcastle-on-Tyne, Mawson Swan and Morgan Limited, 1911) Dart, J., Westmonasterium or the Histories and Antiquities of the Abbey Church of St.   Ã‚  Ã‚  Ã‚  Ã‚  Peters, Westminister. 2 vols, (London, 1723), iii, Chap. 1, p. 12, quoted in Michael   Ã‚  Ã‚  Ã‚  Ã‚  Baigent and Richard Leigh, The Temple and the Lodge (New York: Arcade   Ã‚  Ã‚  Ã‚  Ã‚  Publishing, Inc, 1989) Declaration By the Clergy of Scotland, in Anglo - Scottish Relations 1174 - 1328, ed. and   Ã‚  Ã‚  Ã‚  Ã‚  trans. by E. L. G. Stones, (London: Thomas Nelson and Sons Ltd., 1965) The Declaration of Arbroath, in Scottish Historical Documents, Gordon Donaldson,   Ã‚  Ã‚  Ã‚  Ã‚  ed.,(Edinburgh & London: Scottish Academic Press, 1974) Edward I, Judgement Upon the Petitions, in Anglo - Scottish Relations 1174 - 1328, ed.   Ã‚  Ã‚  Ã‚  Ã‚  and trans. by E. L. G. Stones, (London: Thomas Nelson and Sons Ltd., 1965) Homage of the King of Scotland [1278], in Anglo - Scottish Relations 1174 - 1328, ed. and   Ã‚  Ã‚  Ã‚  Ã‚  trans. by E. L. G. Stones, (London: Thomas Nelson and Sons Ltd., 1965) Knappen, M. M. , Constitutional and Legal History of England (New York: Harcourt,   Ã‚  Ã‚  Ã‚  Ã‚  Brace, and Company, 1942)  Ã‚  Ã‚  Ã‚  Ã‚   Letter of King John of Scotland, in Anglo - Scottish Relations 1174 - 1328, ed. and trans.   Ã‚  Ã‚  Ã‚  Ã‚  by E. L. G. Stones, (London: Thomas Nelson and Sons Ltd.

Sunday, August 18, 2019

Cigarettes - Addiction And Product Dangers :: essays research papers fc

It is clear that businesses have an obligation to inform their customers about their product's ingredients and dangers. Looking at the case of Rose Cipollone we see that she was a heavy smoker. Her doctor's had to remove part of her right cancerous lung and informed her that she had to quit smoking. Unfortunately, she was addicted. Her doctor's removed the rest of her lung that year and she finally quit smoking. She then sued the Liggett Group, the makers of the cigarettes she smoked. The lawsuit charged that the company knew of the link between cancer and smoking in the early 1940's. The company was found innocent of conspiring with other tobacco companies to hide the dangers of cigarette smoking but guilty on the grounds of falsely claiming its products were safe. However, things have changed. It is not 1940 anymore, when people were ignorant about the dangers of smoking. Tobacco companies now have Surgeon General warnings on cigarette packs. Unless they have been living under a rock, the general public should have been exposed to enough information by this time when it comes to cigarettes and addiction. Nicotine information is but a click away. Tobacco companies should no longer have the obligation to warn their customers, except if a new ingredient is added, in which case they should be notified. No one is saying get rid of the Surgeon General warnings, but enough is enough! If a person wants to smoke 3 packs of cigarettes a day, then that is their choice; tobacco companies should not be held responsible. Let us examine the hype surrounding the supposed danger and addition of nicotine. The Food and Drug Administration tells us that nicotine (the addictive drug found in cigarettes) is just as addictive as cocaine and should be illegal."Much of the rhetoric of the anti-smoking movement seeks to demonize tobacco smokers as "nicotine addicts". In the past, of course, the term "addict" has been generally applied only to mind-altering drugs, e.g., heroin and cocaine. Even alcohol, which is mind-altering, is not generally referred to as "additive". So, the argument is one of semantics. If nicotine is addictive, so are chocolate candies, pies and cakes, etc. Indeed, if "addiction" is defined as dependence upon some chemical, everyone is addicted, to air!" Nicotine and cocaine are two different things. They may be just as addictive as each other but they certainly do not produce the same effect.

Saturday, August 17, 2019

Chapter 25 The Egg and the Eye

Harry had no idea how long a bath he would need to work out the secret of the golden egg, he decided to do it at night, when he would be able to take as much time as he wanted. Reluctant though he was to accept more favors from Cedric, he also decided to use the prefects' bathroom; far fewer people were allowed in there, so it was much less likely that he would be disturbed. Harry planned his excursion carefully, because he had been caught out of bed and out-of-bounds by Filch the caretaker in the middle of the night once before, and had no desire to repeat the experience. The Invisibility Cloak would, of course, be essential, and as an added precaution, Harry thought he would take the Marauders Map, which, next to the cloak, was the most useful aid to rule-breaking Harry owned. The map showed the whole of Hogwarts, including its many shortcuts and secret passageways and, most important of all, it revealed the people inside the castle as minuscule, labeled dots, moving around the corridors, so that Harry would be forewarned if somebody was approaching the bathroom. On Thursday night, Harry sneaked up to bed, put on the cloak, crept back downstairs, and, just as he had done on the night when Hagrid had shown him the dragons, waited for the portrait hole to open. This time it was Ron who waited outside to give the Fat Lady the password (â€Å"banana fritters†), â€Å"Good luck,† Ron muttered, climbing into the room as Harry crept out past him. It was awkward moving under the cloak tonight, because Harry had the heavy egg under one arm and the map held in front of his nose with the other. However, the moonlit corridors were empty and silent, and by checking the map at strategic intervals, Harry was able to ensure that he wouldn't run into anyone he wanted to avoid. When he reached the statue of Boris the Bewildered, a lost-looking wizard with his gloves on the wrong hands, he located the right door, leaned close to it, and muttered the password, â€Å"Pine fresh,† just as Cedric had told him. The door creaked open. Harry slipped inside, bolted the door behind him, and pulled off the Invisibility Cloak, looking around. His immediate reaction was that it would be worth becoming a prefect just to be able to use this bathroom. It was softly lit by a splendid candle-filled chandelier, and everything was made of white marble, including what looked like an empty, rectangular swimming pool sunk into the middle of the floor. About a hundred golden taps stood all around the pools edges, each with a differently colored Jewel set into its handle. There was also a diving board. Long white linen curtains hung at the windows; a large pile of fluffy white towels sat in a corner, and there was a single golden-framed painting on the wall. It featured a blonde mermaid who was fast asleep on a rock, her long hair over her face. It fluttered every time she snored. Harry moved forward, looking around, his footsteps echoing off the walls. Magnificent though the bathroom was – and quite keen though he was to try out a few of those taps – now he was here he couldn't quite suppress the feeling that Cedric might have been having him on. How on earth was this supposed to help solve the mystery of the egg? Nevertheless, he put one of the Huffy towels, the cloak, the map, and the egg at the side of the swimming-pool-sized bath, then knelt down and turned on a few of the taps. He could tell at once that they carried different sorts of bubble bath mixed with the water, though it wasn't bubble bath as Harry had ever experienced it. One tap gushed pink and blue bubbles the size of footballs; another poured ice-white foam so thick that Harry thought it would have supported his weight if he'd cared to test it; a third sent heavily perfumed purple clouds hovering over the surface of the water. Harry amused himself for awhile turning the taps on and off, particularly enjoying the effect of one whose jet bounced off the surface of the water in large arcs. Then, when the deep pool was full of hot water, foam, and bubbles, which took a very short time considering its size, Harry turned off all the taps, pulled off his pajamas, slippers, and dressing gown, and slid into the water. It was so deep that his feet barely touched the bottom, and he actually did a couple of lengths before swimming back to the side and treading water, staring at the egg. Highly enjoyable though it was to swim in hot and foamy water with clouds of different-colored steam wafting all around him, no stroke of brilliance came to him, no sudden burst of understanding. Harry stretched out his arms, lifted the egg in his wet hands, and opened it. The wailing, screeching sound filled the bathroom, echoing and reverberating off the marble walls, but it sounded just as incomprehensible as ever, if not more so with all the echoes. He snapped it shut again, worried that the sound would attract Filch, wondering whether that hadn't been Cedric's plan – and then, making him jump so badly that he dropped the egg, which clattered away across the bathroom floor, someone spoke. â€Å"I'd try putting it in the water, if I were you.† Harry had swallowed a considerable amount of bubbles in shock. He stood up, sputtering, and saw the ghost of a very glum-looking girl sitting cross-legged on top of one of the taps. It was Moaning Myrtle, who was usually to be heard sobbing in the S-bend of a toilet three floors below. â€Å"Myrtle!† Harry said in outrage, â€Å"I'm – I'm not wearing anything!† The foam was so dense that this hardly mattered, but he had a nasty feeling that Myrtle had been spying on him from out of one of the taps ever since he had arrived. â€Å"I closed my eyes when you got in,† she said, blinking at him through her thick spectacles. â€Å"You haven't been to see me for ages.† â€Å"Yeah†¦well†¦Ã¢â‚¬  said Harry, bending his knees slightly, just to make absolutely sure Myrtle couldn't see anything but his head, â€Å"I'm not supposed to come into your bathroom, am I? It's a girls' one.† â€Å"You didn't used to care,† said Myrtle miserably. â€Å"You used to be in there all the time.† This was true, though only because Harry, Ron, and Hermione had found Myrtle's out-of-order toilets a convenient place to brew Polyjuice Potion in secret – a forbidden potion that had turned him and Ron into living replicas of Crabbe and Goyle for an hour, so that they could sneak into the Slytherin common room. â€Å"I got told off for going in there.† said Harry, which was half-true; Percy had once caught him coming out of Myrtles bathroom. â€Å"I thought I'd better not come back after that.† â€Å"Oh†¦I see†¦Ã¢â‚¬  said Myrtle, picking at a spot on her chin in a morose sort of way. â€Å"Well†¦anyway†¦I'd try the egg in the water. That's what Cedric Diggory did.† â€Å"Have you been spying on him too?† said Harry indignantly. â€Å"What d'you do, sneak up here in the evenings to watch the prefects take baths?† â€Å"Sometimes,† said Myrtle, rather slyly, â€Å"but I've never come out to speak to anyone before.† â€Å"I'm honored,† said Harry darkly. â€Å"You keep your eyes shut!† He made sure Myrtle had her glasses well covered before hoisting himself out of the bath, wrapping the towel firmly around his waist, and going to retrieve the egg. Once he was back in the water, Myrtle peered through her fingers and said, â€Å"Go on, then†¦open it under the water!† Harry lowered the egg beneath the foamy surface and opened it†¦and this time, it did not wail. A gurgling song was coming out of it, a song whose words he couldnt distinguish through the water. â€Å"You need to put your head under too,† said Myrtle, who seemed to be thoroughly enjoying bossing him around. â€Å"Go on!† Harry took a great breath and slid under the surface – and now, sitting on the marble bottom of the bubble-filled bath, he heard a chorus of eerie voices singing to him from the open egg in his hands: â€Å"Come seek us where our voices sound, We cannot sing above the ground, And while you re searching, ponder this: Wove taken what you'll sorely miss, An hour long you'll have to look, And to recover what we took, But past an hour– the prospect's black, Too late, it's gone, it wont come back† Harry let himself float back upward and broke the bubbly surface, shaking his hair out of his eyes. â€Å"Hear it?† said Myrtle. â€Å"Yeah†¦'Come seek us where our voices sound†¦' and if I need persuading†¦hang on, I need to listen again†¦.† He sank back beneath the water. It took three more underwater renditions of the egg's song before Harry had it memorized; then he trod water for a while, thinking hard, while Myrtle sat and watched him. â€Å"I've got to go and look for people who can't use their voices above the ground†¦.† he said slowly. â€Å"Er†¦who could that be?† â€Å"Slow, aren't you?† He had never seen Moaning Myrtle so cheerful, apart from the day when a dose of PolyJuice Potion had given Hermione the hairy face and tail of a cat. Harry stared around the bathroom, thinking†¦if the voices could only be heard underwater, then it made sense for them to belong to underwater creatures. He ran this theory past Myrtle, who smirked at him. â€Å"Well, thats what Diggory thought,† she said. â€Å"He lay there talking to himself for ages about it. Ages and ages†¦nearly all the bubbles had gone†¦.† â€Å"Underwater†¦Ã¢â‚¬  Harry said slowly. â€Å"Myrtle†¦what lives in the lake, apart from the giant squid?† â€Å"Oh all sorts,† she said. â€Å"I sometimes go down there†¦sometimes don't have any choice, if someone flushes my toilet when I'm not expecting it†¦.† Trying not to think about Moaning Myrtle zooming down a pipe to the lake with the contents of a toilet. Harry said, â€Å"Well, does anything in there have a human voice? Hang on -â€Å" Harry's eyes had fallen on the picture of the snoozing mermaid on the wall. â€Å"Myrtle, there aren't merpeople in there, are there?† â€Å"Oooh, very good,† she said, her thick glasses twinkling, â€Å"it took Diggory much longer than that! And that was with her awake too† – Myrtle jerked her head toward the mermaid with an expression of great dislike on her glum face – â€Å"giggling and showing off and flashing her fins†¦.† â€Å"Thats it, isn't it?† said Harry excitedly. â€Å"The second task's to go and find the merpeople in the lake and†¦and†¦Ã¢â‚¬  But he suddenly realized what he was saying, and he felt the excitement drain out of him as though someone had just pulled a plug in his stomach. He wasn't a very good swimmer; he'd never had much practice. Dudley had had lessons in his youth, but Aunt Petunia and Uncle Vernon, no doubt hoping that Harry would drown one day, hadn't bothered to give him any. A couple of lengths of this bath were all very well, but that lake was very large, and very deep†¦and merpeople would surely live right at the bottom†¦. â€Å"Myrtle,† Harry said slowly, â€Å"how am I supposed to breathe?† At this, Myrtle's eyes filled with sudden tears again. â€Å"Tactless!† she muttered, groping in her robes for a handkerchief. â€Å"What's tactless?† said Harry, bewildered. â€Å"Talking about breathing in front of me!† she said shrilly, and her voice echoed loudly around the bathroom. â€Å"When I can't†¦when I haven't†¦not for ages†¦Ã¢â‚¬  She buried her face in her handkerchief and sniffed loudly. Harry remembered how touchy Myrtle had always been about being dead, but none of the other ghosts he knew made such a fuss about it. â€Å"Sorry,† he said impatiently. â€Å"I didn't mean – I just forgot†¦Ã¢â‚¬  â€Å"Oh yes, very easy to forget Myrtle's dead,† said Myrtle, gulping, looking at him out of swollen eyes. â€Å"Nobody missed me even when I was alive. Took them hours and hours to find my body – I know, I was sitting there waiting for them. Olive Hornby came into the bathroom – Are you in here again, sulking, Myrtle?' she said, ‘because Professor Dippet asked me to look for you -‘ And then she saw my body†¦ooooh, she didn't forget it until her dying day, I made sure of that†¦followed her around and reminded her, I did. I remember at her brother's wedding -â€Å" But Harry wasn't listening; he was thinking about the merpeople's song again. â€Å"We've taken what you II sorely miss.† That sounded as though they were going to steal something of his, something he had to get back. What were they going to take? â€Å"-and then, of course, she went to the Ministry of Magic to stop me stalking her, so I had to come back here and live in my toilet.† â€Å"Good,† said Harry vaguely. â€Å"Well, I'm a lot further on than I was†¦.Shut your eyes again, will you? I'm getting out.† He retrieved the egg from the bottom of the bath, climbed out, dried himself, and pulled on his pajamas and dressing gown again. â€Å"Will you come and visit me in my bathroom again sometime?† Moaning Myrtle asked mournfully as Harry picked up the Invisibility Cloak. â€Å"Er†¦I'll try,† Harry said, though privately thinking the only way he'd be visiting Myrtle's bathroom again was if every other toilet in the castle got blocked. â€Å"See you. Myrtle†¦thanks for your help.† â€Å"Bye, ‘bye,† she said gloomily, and as Harry put on the Invisibllity Cloak he saw her zoom back up the tap. Out in the dark corridor, Harry examined the Marauders Map to check that the coast was still clear. Yes, the dots belonging to Filch and his cat, Mrs. Norris, were safely in their office†¦nothing else seemed to be moving apart from Peeves, though he was bouncing around the trophy room on the floor above†¦.Harry had taken his first step back toward Gryffindor Tower when something else on the map caught his eye†¦something distinctly odd. Peeves was not the only thing that was moving. A single dot was flitting around a room in the bottom left-hand corner – Snape's office. But the dot wasn't labeled â€Å"Severus Snape†Ã¢â‚¬ ¦it was Bartemius Crouch. Harry stared at the dot. Mr. Crouch was supposed to be too ill to go to work or to come to the Yule Ball – so what was he doing, sneaking into Hogwarts at one o'clock in the morning? Harry watched closely as the dot moved around and around the room, pausing here and there†¦. Harry hesitated, thinking†¦and then his curiosity got the better of him. He turned and set off in the opposite direction toward the nearest staircase. He was going to see what Crouch was up to. Harry walked down the stairs as quietly as possible, though the faces in some of the portraits still turned curiously at the squeak of a floorboard, the rustle of his pajamas. He crept along the corridor below, pushed aside a tapestry about halfway along, and proceeded down a narrower staircase, a shortcut that would take him down two floors. He kept glancing down at the map, wondering†¦It just didn't seem in character, somehow, for correct, law-abiding Mr. Crouch to be sneaking around somebody else's office this late at night†¦. And then, halfway down the staircase, not thinking about what he was doing, not concentrating on anything but the peculiar behavior of Mr. Crouch, Harry's leg suddenly sank right through the trick step Neville always forgot to jump. He gave an ungainly wobble, and the golden egg, still damp from the bath, slipped from under his arm. He lurched forward to try and catch it, but too late; the egg fell down the long staircase with a bang as loud as a bass drum on every step – the Invisibility Cloak slipped – Harry snatched at it, and the Marauder's Map fluttered out of his hand and slid down six stairs, where, sunk in the step to above his knee, he couldn't reach it. The golden egg fell through the tapestry at the bottom of the staircase, burst open, and began wailing loudly in the corridor below. Harry pulled out his wand and struggled to touch the Marauder's Map, to wipe it blank, but it was too far away to reach – Pulling the cloak back over himself Harry straightened up, listening hard with his eyes screwed up with fear†¦and, almost immediately – â€Å"PEEVES!† It was the unmistakable hunting cry of Filch the caretaker. Harry could hear his rapid, shuffling footsteps coming nearer and nearer, his wheezy voice raised in fury. â€Å"What's this racket? Wake up the whole castle, will you? I'll have you, Peeves, I'll have you, you'll†¦and what is this?† Filch's footsteps halted; there was a clink of metal on metal and the wailing stopped – Filch had picked up the egg and closed it. Harry stood very still, one leg still Jammed tightly in the magical step, listening. Any moment now, Filch was going to pull aside the tapestry, expecting to see Peeves†¦and there would be no Peeves†¦but if he came up the stairs, he would spot the Marauder's Map†¦and Invisibility Cloak or not, the map would show â€Å"Harry Potter† standing exactly where he was. â€Å"Egg?† Filch said quietly at the foot of the stairs. â€Å"My sweet!† – Mrs. Norris was obviously with him – â€Å"This is a Triwizard clue! This belongs to a school champion!† Harry felt sick; his heart was hammering very fast – â€Å"PEEVES!† Filch roared gleefully. â€Å"You've been stealing!† He ripped back the tapestry below, and Harry saw his horrible, pouchy face and bulging, pale eyes staring up the dark and (to Filch) deserted staircase. â€Å"Hiding, are you?† he said softly. â€Å"I'm coming to get you, Peeves†¦.You've gone and stolen a Triwizard clue, Peeves†¦.Dumbledore'll have you out of here for this, you filthy, pilfering poltergeist†¦.† Filch started to climb the stairs, his scrawny, dust-colored cat at his heels. Mrs. Morris's lamp-like eyes, so very like her masters, were fixed directly upon Harry. He had had occasion before now to wonder whether the Invisibility Cloak worked on cats†¦.Sick with apprehension, he watched Filch drawing nearer and nearer in his old flannel dressing gown – he tried desperately to pull his trapped leg free, but it merely sank a few more inches – any second now, Filch was going to spot the map or walk right into him – â€Å"Filch? Whats going on?† Filch stopped a few steps below Harry and turned. At the foot of the stairs stood the only person who could make Harry's situation worse: Snape. He was wearing a long gray nightshirt and he looked livid. â€Å"Its Peeves, Professor,† Filch whispered malevolently. â€Å"He threw this egg down the stairs.† Snape climbed up the stairs quickly and stopped beside Filch. Harry gritted his teeth, convinced his loudly thumping heart would give him away at any second†¦. â€Å"Peeves?† said Snape softly, staring at the egg in Filch's hands. â€Å"But Peeves couldn't get into my office†¦.† â€Å"This egg was in your office. Professor?† â€Å"Of course not,† Snape snapped. â€Å"I heard banging and wailing -â€Å" â€Å"Yes, Professor, that was the egg -â€Å" â€Å"- I was coming to investigate -â€Å" â€Å"- Peeves threw it. Professor -â€Å" â€Å"- and when I passed my office, I saw that the torches were lit and a cupboard door was ajar! Somebody has been searching it!† But Peeves couldn't -â€Å" â€Å"I know he couldn't, Filch!† Snape snapped again. â€Å"I seal my office with a spell none but a wizard could break!† Snape looked up the stairs, straight through Harry, and then down into the corridor below. â€Å"I want you to come and help me search for the intruder, Filch.† â€Å"I – yes, Professor – but -â€Å" Filch looked yearningly up the stairs, right through Harry, who could see that he was very reluctant to forgo the chance of cornering Peeves. Go, Harry pleaded with him silently, go with Snape†¦go†¦Mrs. Norris was peering around Filch's legs†¦.Harry had the distinct impression that she could smell him†¦.Why had he filled that bath with so much perfumed foam? â€Å"The thing is, Professor,† said Filch plaintively, â€Å"the headmaster will have to listen to me this time. Peeves has been stealing from a student, it might be my chance to get him thrown out of the castle once and for all -â€Å" â€Å"Filch, I don't give a damn about that wretched poltergeist; it's my office that's -â€Å" Clunk. Clunk. Clunk. Snape stopped talking very abruptly. He and Filch both looked down at the foot of the stairs. Harry saw Mad-Eye Moody limp into sight through the narrow gap between their heads. Moody was wearing his old traveling cloak over his nightshirt and leaning on his staff as usual. â€Å"Pajama party, is it?† he growled up the stairs. â€Å"Professor Snape and I heard noises, Professor,† said Filch at once. â€Å"Peeves the Poltergeist, throwing things around as usual – and then Professor Snape discovered that someone had broken into his off -â€Å" â€Å"Shut up!† Snape hissed to Filch. Moody took a step closer to the foot of the stairs. Harry saw Moody's magical eye travel over Snape, and then, unmistakably, onto himself. Harry's heart gave a horrible jolt. Moody could see through Invisibility Cloaks†¦he alone could see the full strangeness of the scene: Snape in his nightshirt, Filch clutching the egg, and he, Harry, trapped in the stairs behind them. Moody's lopsided gash of a mouth opened in surprise. For a few seconds, he and Harry stared straight into each other's eyes. Then Moody closed his mouth and turned his blue eye upon Snape again. â€Å"Did I hear that correctly, Snape?† he asked slowly. â€Å"Someone broke into your office?† â€Å"It is unimportant,† said Snape coldly. â€Å"On the contrary,† growled Moody, â€Å"it is very important. Who'd want to break into your office?† â€Å"A student, I daresay,† said Snape. Harry could see a vein flickering horribly on Snape's greasy temple. â€Å"It has happened before. Potion ingredients have gone missing from my private store cupboard†¦students attempting illicit mixtures, no doubt†¦.† â€Å"Reckon they were after potion ingredients, eh?† said Moody. â€Å"Not hiding anything else in your office, are you?† Harry saw the edge of Snape's sallow face turn a nasty brick color, the vein in his temple pulsing more rapidly. â€Å"You know I'm hiding nothing, Moody,† he said in a soft and dangerous voice, â€Å"as you've searched my office pretty thoroughly yourself.† Moody's face twisted into a smile. â€Å"Auror's privilege, Snape. Dumbledore told me to keep an eye -â€Å" â€Å"Dumbledore happens to trust me,† said Snape through clenched teeth. â€Å"I refuse to believe that he gave you orders to search my office!† â€Å"Course Dumbledore trusts you,† growled Moody. â€Å"Hes a trusting man, isn't he? Believes in second chances. But me – I say there are spots that don't come off, Snape. Spots that never come off, d'you know what I mean?† Snape suddenly did something very strange. He seized his left forearm convulsively with his right hand, as though something on it had hurt him. Moody laughed. â€Å"Get back to bed, Snape.† â€Å"You don't have the authority to send me anywhere!† Snape hissed, letting go of his arm as though angry with himself. â€Å"I have as much right to prowl this school after dark as you do!† â€Å"Prowl away,† said Moody, but his voice was full of menace. â€Å"I look forward to meeting you in a dark corridor some time†¦.You've dropped something, by the way†¦.† With a stab of horror. Harry saw Moody point at the Marauders Map, still lying on the staircase six steps below him. As Snape and Filch both turned to look at it, Harry threw caution to the winds; he raised his arms under the cloak and waved furiously at Moody to attract his attention, mouthing â€Å"It's mine! Mine!† Snape had reached out for it, a horrible expression of dawning comprehension on his face – â€Å"Accio Parchment!† The map flew up into the air, slipped through Snape's outstretched fingers, and soared down the stairs into Moody's hand. â€Å"My mistake,† Moody said calmly. â€Å"It's mine – must've dropped it earlier -â€Å" But Snape's black eyes were darting from the egg in Filch's arms to the map in Moody's hand, and Harry could tell he was putting two and two together, as only Snape could†¦. â€Å"Potter,† he said quietly. â€Å"What's that?† said Moody calmly, folding up the map and pocketing it. â€Å"Potter!† Snape snarled, and he actually turned his head and stared right at the place where Harry was, as though he could suddenly see him. â€Å"That egg is Potters egg. That piece of parchment belongs to Potter. I have seen it before, I recognize it! Potter is here! Potter, in his Invisibility Cloak!† Snape stretched out his hands like a blind man and began to move up the stairs; Harry could have sworn his over-large nostrils were dilating, trying to sniff Harry out – trapped. Harry leaned backward, trying to avoid Snape's fingertips, but any moment now – â€Å"There's nothing there, Snape!† barked Moody, â€Å"but I'll be happy to tell the headmaster how quickly your mind jumped to Harry Potter!† â€Å"Meaning what?† Snape turned again to look at Moody, his hands still outstretched, inches from Harry's chest. â€Å"Meaning that Dumbledore's very interested to know who's got it in for that boy!† said Moody, limping nearer still to the foot of the stairs. â€Å"And so am I, Snape†¦very interested†¦.† The torchlight flickered across his mangled face, so that the scars, and the chunk missing from his nose, looked deeper and darker than ever. Snape was looking down at Moody, and Harry couldn't see the expression on his face. For a moment, nobody moved or said anything. Then Snape slowly lowered his hands. â€Å"I merely thought,† said Snape, in a voice of forced calm, â€Å"that if Potter was wandering around after hours again†¦it's an unfortunate habit of his†¦he should be stopped. For – for his own safety.† â€Å"Ah, I see,† said Moody softly. â€Å"Got Potter's best interests at heart, have you?† There was a pause. Snape and Moody were still staring at each other, Mrs. Norris gave a loud meow, still peering around Filch's legs, looking for the source of Harry's bubble-bath smell. â€Å"I think I will go back to bed,† Snape said curtly. â€Å"Best idea you've had all night,† said Moody. â€Å"Now, Filch, if you'll just give me that egg -â€Å" â€Å"No!† said Filch, clutching the egg as though it were his firstborn son. â€Å"Professor Moody, this is evidence of Peeves' treachery!† â€Å"It's the property of the champion he stole it from,† said Moody. Hand it over, now.† Snape swept downstairs and passed Moody without another word. Filch made a chirruping noise to Mrs. Norris, who stared blankly at Harry for a few more seconds before turning and following her master. Still breathing very fast. Harry heard Snape walking away down the corridor; Filch handed Moody the egg and disappeared from view too, muttering to Mrs. Norris. â€Å"Never mind. my sweet†¦we'll see Dumbledore in the morning†¦tell him what Peeves was up to†¦.† A door slammed. Harry was left staring down at Moody, who placed his staff on the bottommost stair and started to climb laboriously toward him, a dull clunk on every other step. â€Å"Close shave. Potter,† he muttered. â€Å"Yeah†¦I – er†¦thanks,† said Harry weakly. â€Å"What is this thing?† said Moody, drawing the Marauder's Map out of his pocket and unfolding it. â€Å"Map of Hogwarts,† said Harry, hoping Moody was going to pull him out of the staircase soon; his leg was really hurting him. â€Å"Merlins beard,† Moody whispered, staring at the map, his magical eye going haywire. â€Å"This†¦this is some map. Potter!† â€Å"Yeah, its†¦quite useful,† Harry said. His eyes were starting to water from the pain. â€Å"Er – Professor Moody, d'you think you could help me -?† â€Å"What? Oh! Yes†¦yes, of course†¦.† Moody took hold of Harry's arms and pulled; Harry's leg came free of the trick step, and he climbed onto the one above it. Moody was still gazing at the map. â€Å"Potter†¦Ã¢â‚¬  he said slowly, â€Å"you didn't happen, by any chance, to see who broke into Snape's office, did you? On this map, I mean?† â€Å"Er†¦yeah, I did†¦Ã¢â‚¬  Harry admitted. â€Å"It was Mr. Crouch.† Moody's magical eye whizzed over the entire surface of the map. He looked suddenly alarmed. â€Å"Crouch?† he said. â€Å"You're – you're sure. Potter?† â€Å"Positive,† said Harry. â€Å"Well, he's not here anymore,† said Moody, his eye still whizzing over the map. â€Å"Crouch†¦that's very – very interesting†¦.† He said nothing for almost a minute, still staring at the map. Harry could tell that this news meant something to Moody and very much wanted to know what it was. He wondered whether he dared ask. Moody scared him slightly†¦yet Moody had just helped him avoid an awful lot of trouble†¦. â€Å"Er†¦Professor Moody†¦why d'you reckon Mr. Crouch wanted to look around Snape's office?† Moody's magical eye left the map and fixed, quivering, upon Harry. It was a penetrating glare, and Harry had the impression that Moody was sizing him up, wondering whether to answer or not, or how much to tell him. â€Å"Put it this way. Potter,† Moody muttered finally, â€Å"they say old Mad-Eye's obsessed with catching Dark wizards†¦but I'm nothing – nothing – compared to Barty Crouch.† He continued to stare at the map. Harry was burning to know more. â€Å"Professor Moody?† he said again. â€Å"D'you think†¦could this have anything to do with†¦maybe Mr. Crouch thinks there's something going on†¦.† â€Å"Like what?† said Moody sharply. Harry wondered how much he dare say. He didn't want Moody to guess that he had a source of information outside Hogwarts; that might lead to tricky questions about Sirius. â€Å"I don't know,† Harry muttered, â€Å"odd stuffs been happening lately, hasn't it? It's been in the Daily Prophet†¦the Dark Mark at the World Cup, and the Death Eaters and everything†¦.† Both of Moody's mismatched eyes widened. â€Å"You're a sharp boy. Potter,† he said. His magical eye roved back to the Marauder's Map. â€Å"Crouch could be thinking along those lines,† he said slowly. â€Å"Very possible†¦there have been some funny rumors flying around lately – helped along by Rita Skeeter, of course. It's making a lot of people nervous, I reckon.† A grim smile twisted his lopsided mouth. â€Å"Oh if there's one thing I hate,† he muttered, more to himself than to Harry, and his magical eye was fixed on the left-hand corner of the map, â€Å"its a Death Eater who walked free†¦.† Harry stared at him. Could Moody possibly mean what Harry thought he meant? â€Å"And now I want to ask you a question. Potter,† said Moody in a more businesslike tone. Harry's heart sank; he had thought this was coming. Moody was going to ask where he had got this map, which was a very dubious magical object – and the story of how it had fallen into his hands incriminated not only him, but his own father, Fred and George Weasley, and Professor Lupin, their last Defense Against the Dark Arts teacher. Moody waved the map in front of Harry, who braced himself- â€Å"Can I borrow this?† â€Å"Oh!† said Harry. He was very fond of his map, but on the other hand, he was extremely relieved that Moody wasn't asking where he'd got it, and there was no doubt that he owed Moody a favor. â€Å"Yeah, okay.† â€Å"Good boy,† growled Moody. â€Å"I can make good use of this†¦this might be exactly what I've been looking for†¦.Right, bed, Potter, come on, now†¦.† They climbed to the top of the stairs together, Moody still examining the map as though it was a treasure the like of which he had never seen before. They walked in silence to the door of Moody's office, where he stopped and looked up at Harry. â€Å"You ever thought of a career as an Auror, Potter?† â€Å"No,† said Harry, taken aback. â€Å"You want to consider it,† said Moody, nodding and looking at Harry thoughtfully. â€Å"Yes, indeed†¦and incidentally†¦I'm guessing you werent Just taking that egg for a walk tonight?† â€Å"Er – no,† said Harry, grinning. â€Å"I've been working out the clue.† Moody winked at him, his magical eye going haywire again. â€Å"Nothing like a nighttime stroll to give you ideas, Potter†¦.See you in the morning†¦.† He went back into his office, staring down at the Marauders Map again, and closed the door behind him. Harry walked slowly back to Gryffindor Tower, lost in thought about Snape, and Crouch, and what it all meant†¦.Why was Crouch pretending to be ill, if he could manage to get to Hogwarts when he wanted to? What did he think Snape was concealing in his office? And Moody thought he. Harry, ought to be an Auror! Interesting idea†¦but somehow. Harry thought, as he got quietly into his four-poster ten minutes later, the egg and the cloak now safely back in his trunk, he thought he'd like to check how scarred the rest of them were before he chose it as a career.