Is Bipolar Disorder Curable - Free Essay Example

Sample details Pages: 8 Words: 2317 Downloads: 6 Date added: 2019/08/06 Category Medicine Essay Level High school Tags: Bipolar Disorder Essay Did you like this example? Definition of bipolar disorder What is Bipolar mania disorder Diagnosis of bipolar mania disorder Manic episodes Hypomania and the Symptoms Depressive Episode and symptoms Causes of bipolar disorder Genetical reasons Childhood/Stress Autobiography Manic: A memoir An unquiet mind Treatments What is DSM and DSM-5 Drugs and Medication Cognitive therapy Interpersonal therapy Social rhythm therapy Cannabis Use Possible Cure’s What is bipolar disorder? Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. [1]. Don’t waste time! Our writers will create an original "Is Bipolar Disorder Curable?" essay for you Create order Bipolar might be more common than one might thing, according to a study conducted by the National Institute of Mental Health bipolar disorder affects about 5.7 million American adults, or about 2.6% of the U.S. population 18 and older. [6] Some people think of bipolar disorder as mood swings, however an expert Matthew Rudford says that ‘The mood swings associated with bipolar disorder are very different than those of people without the condition’. Matthew focusses on what bipolar isn’t than what it is when relating mood swings and bipolar disorder. [6] There is no test to diagnose a patient with bipolar disorder. The symptoms exhibited by the patients is the only test which can prove whether or not the patient has the disorder. Hypomania One of the ends of the spectrum is mania. This elevated mood is called mania or hypomania. Depending on the severity and if psychosis is present as one of the patient’s symptoms. [1,2, pg. 154] The overall functioning of the patient can increase during this episode. Some people who show hypomania also show increased creativity and while others be irritable and demonstrate poor judgement [3]. Some people might feel uplifted, happy and enthused when in this phase. However, once their phase passes they might end up forgetting what they had done when in the pahse. Even when family and friends recognize mood swings, the individual will most likely to deny that anything is wrong. [4] This is called a hypomanic event, if not accompanied by depressive episodes, it is not deemed problematic, unless the mood changes are uncontrollable, or volatile.[3] There are quite a lot of symptoms which might suggest that a person is in a manic phase and might have bipolar mania disorder. [5] euphoric, elevated, expansive, or irritable mood with increased energy; racing thoughts; pressured speech (rapid, excessive, frenzied speaking); decreased need for sleep; grandiose ideas (for example, false/delusional beliefs of paranoia, superiority, or failure); tangential speech (repeatedly changing conversational topics to ones that are hardly related); restlessness/increased goal-directed activity; and Impulsivity, poor judgment, or engaging in risky activity (like spending sprees, promiscuity, or excess desire for sex). These being the most crucial and important ones. Identifying these in a person can assure one that he/she is having a manic episode. [5] Depression During periods of depression, there may be crying, a negative outlook on life, and poor eye contact with others. [1] The risk of suicide among those with the illness is high at greater than 6 percent over 20 years, while self-harm occurs in 30–40 percent. [1] Other mental health issues such as anxiety disorders and substance use disorder are associated with bipolar disorder. [1] Major depressive episodes can cause major difficulty in day to day life, such as work, school, social-activity, relationships etc. An episode might include five or more of these symptoms as mentioned below. [7] Depressed mood, such as feeling sad, empty, hopeless or tearful (in children and teens, depressed mood can appear as irritability) Marked loss of interest or feeling no pleasure in competing or activities Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in children, failure to gain weight as expected can be a sign of depression) being insomniac or sleeping too much feeling restlessness or slow behavior Fatigue or loss of energy Feelings of worthlessness or excessive or inappropriate guilt Decreased ability to think or concentrate, or indecisiveness Thinking about, planning or attempting suicide Some might say that the depressive episode is much worse than the manic episode. The symptoms displayed by the patients tend to be extremely damaging and negative to the self-esteem. Suicidal thoughts and catatonic behavior can be very damaging. Causes Explaining and going through some of the causes might explain how and why an individual can get bipolar disorder. While some researchers haven’t concluded the exact causes of bipolar disorder, they certainly have identified factors which are likely to increase the chance of getting this disorder. Genetic Factors Some studies have suggested that there may be a genetic component which may play a role in a person making him/her more prone to bipolar disorder. It is more likely to come about in a person who has a family member with the condition [10]. One the largest and most recent study at the GWAS failed to find any particular evidence to prove that one single gene is responsible for bipolar disorder in most cases. Some genes like BDNF, DRD4 were associated with bipolar disorder but after recent testing and meta-analysis, failed after correction for multiple testing [11]. However, 2 other genes were associated with bipolar disorder [12]. Biology might play a significant role in bipolar disorder, but it certainly isn’t the only factor which decided why one might have it. The brain structure and neurotransmitters play a large role in the cause of bipolar disorder. Research taken place over decades have made a link between neurotransmitters and mood disorder. Some studies suggest that a low or high level of a specific neurotransmitters such as norepinephrine, serotonin or dopamine are involved. In short, all studies conducted by researchers are definite that neurotransmitter systems is the least part of bipolar disorder, however further research still has to be conducted to be certain of their role in the brain. [13] Episodes can easily set off by stressful events or circumstances. Even though the root of how stress occurs in one’s mind is not fully understood, experts and researchers still found an explanation. They believe that a stress hormone cortisol is released causing alteration to the functions and communications in the human body. In fact, people who have depression or bipolar disorder have high levels of cortisol in the brain even when stress isn’t present. Stress can be caused by multiple things like loss of job, loss of a spouse etc. It is not definite how stressful and even might be since everyone may not experience much stress. Many other environmental factors have been identified as a potential reason for the disorder. This includes, early childhood trauma, virus infections, cannabis use. Keeping this in mind, research has found that a stressful life can lead to an onset of symptoms in bipolar disorder. However, once this disorder is triggered it progresses and develo ps a â€Å"life of its own† and the psychological and/or biological factors take over and might keep the illness active. [13] How can we create a cure for a disorder we understand so little about. The causes are unknown there is no hard scientific evidence to prove that there is one or more reason which causes bipolar disorder. Treatments and Cures. Treatments are best guided and recommended by medical doctors who tend to specialize in diagnosing and treating mental health condition. These individuals tend to be skilled. A treatment team may be used. It compiles of psychologists, social workers and psychiatrics nurses. Drug’s and Medicines can be used to treat certain symptoms. Mood Stabilizers are used to control the manic or depressive episodes. These drugs keep your mood in check. Drugs like lithium (Lithobid), divalproex sodium (Depakote). The drugs can only control a certain part of the disorder and cannot cure it. Antidepressant are used to treat and manage the depressive episodes. However, antidepressant can sometimes trigger a manic episode. It is usually prescribed along with a mood stabilizer or antipsychotics. Consuming these drugs have side effects. often improve as you find the right medications and doses that work for you, and your body adjusts to the medications. If you stop your medication, you may experience withdrawal or even your treated symptoms may return and worsen. You may become in turn become very depressed, feel suicidal, or go into a manic or hypomanic episode. Psychotherapy is counseling or talk therapy which can provide precious time for an individual to learn and practice effective strategies for overcoming and coping with the disorder and learning how to manage with their episodes and symptoms. CBT (Cognitive Behavioral Therapy) can immensely help an individual and their challenges educating them on how to control their negative thinking pattern and behaviors. Family therapy can also be used as it will help family members learn to communicate effectively and calmly reduce overall tension and stress between the family and the victim. Psychotherapy will also provide valuable psychoeducation for developing self-care habits, building resilience and problem solving [14]. This will help the victim cope and understand their disorder better. Teaching him/her how to manage themselves and live a healthy and happy life even with the disorder. However, this treatment too cannot cure the patient in the long term. A social rhythm therapy is another method of controlling the disorder. This type of therapy helps the victim develop maintain and control a sleep schedule and have a more predictable daily routine. An article written by Rev. Marilyn Redmond who is a BA, CHT, IBRT is an award-winning international writer, syndicated columnist, consultant, counselor, and speaker who shares the dynamics of life. Marilyn is an ordained minister for spiritual counseling and does Past Life Regressions. According to Rev. Marilyn Redmond the medical society has come from a typical solution of medication, which is only drugs, which are ‘toxins and poison’. These have not helped solver the root cause of the problem but just masking the emotional causes since the ‘fact’ seems to be that bipolar disorder comes from a person not facing his/her own reality and fears. Actually, drugs stop the ability to grow emotionally surpassing the basis of past trauma. Encouraging the use of drugs can never resolve the issue. Rev. Marilyn Redmond also goes onto explain what bipolar truly is. These episodes are just a signal that you are maladjusted to life as well as running from reality while th inking irrationally. The ego’s fear tries to protect the threatening experiences. When one changes their thinking to being rational and stop reacting inappropriately to trauma than they might move towards reality. Russ Federman, Ph.D., A.B.P.P., is in private practice and specializes in psychotherapy with individuals diagnosed with bipolar disorder. He is the coauthor of Facing Bipolar. Talked about Rev. Marilyn Redmond and her â€Å"Black and white thinking† towards the serious issue of bipolar disorder. He says that articles and psychologists like this end up causing more harm than good. Russ Federman states that Marilyn’s ideology on how the bipolar mind functions is poor. Marilyn conveying ideas through statements like â€Å"The medical society comes from a typical solution of medication which are drugs†¦ Bipolar disorder comes from a person’s reality and their fears†¦ Drugs stop the ability to grow emotionally beyond the basis of past trauma†¦ The manic and depressive episodes are just a signal that you are maladjusted to life and running from reality.† These efforts to bring about hope that cure is within reach is potentially guild-inducing for those individuals with bipolar disorder who experience the prospect of cure as being beyond their reach. From the authors perspective, that those who are taking medications are wrong and are in a pure attempt to hide their self’s behind â€Å"drugs and toxins†. However even Russ Federman agrees that unresolved personal issues can contribute to bipolar symptoms. Nevertheless, Marilyn’s approach to curing bipolar disorder is extremely unsafe and dangerous. Since it does not use drugs or other scientific methods to treat bipolar disorder. After studying and reading multiple researches and articles written by experts I have concluded that as of early 2019 there is no cure for bipolar disorder. This life altering mental disorder can be very threatening and confusing to the victim and those around. This disorder has multiple safe and tested treatments which teach and educate the victim of this disorder and how he/she can treat it to an extent where it just becomes a habit and a part of their life. Visiting the doctor and taking the required medication, changing and having a strict diet along with supplements, dealing with sleep problems and requesting support when needed is important. The victim has the potential to etch a healthy lifestyle into their lives. If this is successful than bipolar will not interrupt their life significantly since managing the issues will be easier and they will arise and regain a meaningful, purposeful life. Research shows that this is something the majority of people, even those with bipolar disorder can achieve. References: [1] Anderson IM. Bipolar disorder(Clinical Research) Haddad PM, Scott J, 2012. Print [2] American Psychiatry Association. Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington: American Psychiatric Publishing, 2013. Print [3] Bowins B (2007). Cognitive regulatory control therapies. Am J Psychother. 67 (3): 215–36. [4]â€Å"Bipolar II disorder Symptoms and Signs†. Web M.D. Archived from the original on December 9, 2010. Retrieved December 6, 2010. [5]www.medicinenet.com/mania_vs_hypomania/article.htm#what_are_the_signs_and_symptoms_of_mania_and_hypomania [6]Matthew Rudford MD. https://www.webmd.com/bipolar-disorder/features/8-myths-about-bipolar-disorder#1 [7] https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955 [8] Rev. Marilyn Redmond https://www.groundreport.com/change-bipolar-disorder-by-changing-your-mindset/ [9] Russ Federman https://www.psychologytoday.com/intl/blog/bipolar-you/201206/can-bipolar-disorder-be-cured [10]Barnett JH, Smoller JW (November 2009). The genetics of bipolar disorder. Neuroscience. 164 (1): 331–43. [11] Seifuddin F, Mahon PB, Judy J, Pirooznia M, Jancic D, Taylor J, Goes FS, Potash JB, Zandi PP (July 2012). Meta-analysis of genetic association studies on bipolar disorder. American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics [12] Craddock N, Sklar P (May 2013). Genetics of bipolar disorder. Lancet. 381 (9878): 1654–62. [13]https://www.verywellmind.com/what-causes-bipolar-disorder-378711 [14] https://www.psycom.net/bipolar-disorder-treatment

Analysis Of The Book The Night Of The Missouri River

From a hill above the eastern bank of the Missouri River, Jake peered across the busy streets of St. Joseph. â€Å"There must be a house and a storefront on every hill. Duvall could use any of those for a hideout.† He let out an exasperated breath before settling back in the saddle. Kat pulled her hat further down her forehead. â€Å"You’ll find him.† â€Å"Confident in getting the reward, are you?† Quick sarcasm sharpened his voice. He wouldn’t apologize for it. In the past three days, she’d perplexed and annoyed him by stirring up debates over politics and the war, most of which ended in angry silence. Every time she looked behind them, he suspected she watched for Emmett. She refused to talk about the man, and in that regard, Jake showed some patience. He’d become accustom to her habits, but he knew her alliance meant nothing. She was there for one reason—the reward. Now that they were in St. Joseph, he’d find a nice hotel and be rid of her. â€Å"You have no right to . . .† A locamotive drowned out the rest of her words as it pulled away from the Hannibal and St. Joseph train depot. When the noise dissipated, he said, â€Å"We should find a place to stay.† For once, Kat consented without a fuss. They rode past several suitable hotels before he pointed to an impressive four-story building. â€Å"This will do.† They dismounted and tied the horses to the hitching post. Kat swatted at her pants, attracting attention from a family walking along the sidewalk. â€Å"I don’t know, Jake, this place looks prettyShow MoreRelatedThe Adventures Of Tom Sawyer . __________________. 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Core Value of Coca-Cola Free Essays

Core values and beliefs: Coca-Cola has the most valuable brand name in the world, and as one of the most visible companies worldwide. The culture of it is defined by the seven core values: leadership, the courage to shape a better future; passion, Committed in heart and mind; Leverage collective genius; integrity, be real; collaboration, diversity, as inclusive as our brands; quality, what we do, we do well; and accountability. The central promise is to refresh the world in mind, body, and spirit, and inspire moments of optimism; to create value and make a difference in the world. We will write a custom essay sample on Core Value of Coca-Cola or any similar topic only for you Order Now As a global business, our ability to understand, embrace and operate in a multicultural world — both in the marketplace and in the workplace is critical to our sustainability. Their diversity workplace strategy includes programs to attract, retain, and develop diverse talent; provide support systems for groups with diverse backgrounds; and educate all associates so that we master the skills to achieve sustainable growth. Their diversity workplace strategy includes programs to attract, retain, and develop diverse talent; provide support systems for groups with diverse backgrounds; and educate all associates so that we master the skills to achieve sustainable growth. Rules of behavior: The vision serves as the framework guide every aspect of the company business by describing what the employees need to accomplish in order to continue achieving sustainable, quality growth from the following five aspects: people, Be a great place to work where people are inspired to be the best they can be; portfolio, Bring to the world a portfolio of quality beverage brands that anticipate and satisfy people’s desires and needs. Partners: Nurture a winning network of customers and suppliers, together we create mutual, enduring value; planet, be a responsible citizen that makes a difference by helping build and support sustainable communities; profit, Maximize long-term return to shareowners while being mindful of our overall responsibilities; and productivity, Be a highly effective, lean and fast-moving organization. In the world of international trade, products also carry cultural values and many of these products remain as commodities but others emerge as cultural icons. How do certain products take on a special symbolic status and are idealized in a culture? The answer to this question is a rather complex one. It has to do with how cultural artifacts are embedded into the cultural space of the past. Language used: Coca Cola has been sold in more than two hundred countries under their local languages. But the official language of coca cola is English. In the language they have already used in the local language because that’s another marketing strategy to appeal to the local customers. Relationship with employees: Respecting human rights and protecting workplace rights is fundamental to its culture and imperative for a sustainable business. An essential ingredient in every one of the products is profound commitment to human rights and workplace rights. Its human rights statement is guided by the United Nations Declaration of Human Rights, the ILO declaration on fundamental principles and rights at work and related international covenants. Every worker has a fundamental right to a safe and healthy workplace. Providing a safe and healthy working environment for all of our people is a core element of our Workplace Rights Policy and fundamental to the success of our business. In recent years, they have more clearly defined what we stand for with respect to human and workplace rights. They have also begun the complex work of ensuring that their entire business system and supply chain align with our policies. They expect their company, their bottling partners and their suppliers to avoid causing, or contributing to, adverse human rights impacts as a result of business actions and to address such impacts when they occur. Important symbols and artifacts: The distinctive symbol is recognized the world over on Coca-Cola adverts, bottles and cans – but it has also undergone a few changes over the last century and a quarter. In the world of international trade, products also carry cultural values and many of these products remain as commodities but others emerge as cultural icons. How do certain products take on a special symbolic status and are idealized in a culture? The answer to this question is a rather complex one. It has to do with how cultural artifacts are embedded into the cultural space of the past. In the world of international trade, products also carry cultural values and many of these products remain as commodities but others emerge as cultural icons. How do certain products take on a special symbolic status and are idealized in a culture? The answer to this question is a rather complex one. It has to do with how cultural artifacts are embedded into the cultural space of the past. Appropriateness and the relevance to organizational history and the culture: As a global business, our ability to understand, embrace and operate in a multicultural world — both in the marketplace and in he workplace is critical to our sustainability. Their diversity workplace strategy includes programs to attract, retain, and develop diverse talent; provide support systems for groups with diverse backgrounds; and educate all associates so that we master the skills to achieve sustainable growth. Our diversity workplace strategy includes programs to attract, retain, and develop diverse talent ; provide support systems for groups with diverse backgrounds; and educate all associates so that we master the skills to achieve sustainable growth. How to cite Core Value of Coca-Cola, Papers

Principle Discussed Completely Overruled - Myassignmenthelp.Com

Question: Discuss About The Principle Discussed Completely Overruled? Answer Introducation The identification doctrine helps us to recognize and point any frauds or wrongs that are done by a member, officer or Agent of the said organization by laying down principles that would make the task handier. By what is discussed above, it can be concluded that the ideas and minds responsible for the working of an organization are the brain of the entity in legal terms, hence, the doctrine is a theory used to administer the wit and the will of an organization. It was in the famed Lennard's Carrying Co Ltd v Asiatic Petroleum Co Ltd [1915] AC 705 case that the doctrine was formulated. It was stated in the court of law that liability can only be inflicted if any entity from the organisation is involved, when it was questioned if a ship was liable for the loss of goods if directed on a wrong course. Daimler Co Ltd v Continental Tyre and Rubber Co (Great Britain) Ltd [1916] 2 AC 307 was a case in which it was very clearly stated by the jury that the companys residence can be considered as a place where the minds that work together to administer the company reside in. El Ajou v Dollar Land Holdings plc [1993] EWCA Civ 4 case became a turning point as it re-shaped the idea of the doctrine. It was ruled that all people can take command as the brain and the administrator of a company, hence, the principle that was discussed above was completely overruled. Before we discuss the case of Salomon v A Salomon Co Ltd [1896] UKHL It can be said that the stockholders are inclined to follow a doctrine that induces them either to lift the veil in question or simply to pierce the said corporate veil. It is known that a financial institute or a company is an unrelated and a unique legal entity, not bound by the identities of any other of its members. Something similar can be said for its losses and liabilities, for it is known that the company is a separate legal entity so all the losses and liabilities that are inflicted upon it are subjected to the organization only, not on its members. Hence getting into the above case, the foundations of the company was based on a fraud. If a company is formed properly, it is bound to be a totally separate legal entity no matter what; hence the court has the choices to lift or to pierce, convicting the members of breach of law, though it is quite rare for companies to apply for such conditions in many countr ies of the world. In the Adams v Cape Industries plc [1990] Ch 433 case, the court ruled that piercing will only be done when the roots of the company are based on a fraud or if a member applies for an exit. There was a debate on this very topic in the of Prest v Petrodel Resources Ltd [2013] UKSC 34 case and the same opinion was held up by the court. References Adams v Cape Industries plc [1990] Ch 433 Daimler Co Ltd v Continental Tyre and Rubber Co (Great Britain) Ltd [1916] 2 AC 307 El Ajou v Dollar Land Holdings plc [1993] EWCA Civ 4 Lennard's Carrying Co Ltd v Asiatic Petroleum Co Ltd [1915] AC 705 Prest v Petrodel Resources Ltd [2013] UKSC 34 Salomon v A Salomon Co Ltd [1896] UKHL

To Puff Or Not To Puff Essay free essay sample

, Research Paper To Puff or Not to Puff Smoking coffin nails is non a good wont ; it is a unsafe dependence that has the possibility of a fatal consequence. Yet, I wittingly have picked up, and continued this emphasis alleviating ritual. I am a tobacco user of two old ages, and have found nil but examination from my parents, far excessively many times. It is clip to accept the fact that your boy or girl is a tobacco user. Your biggest concerns, for those of you whose kids fume, are lung malignant neoplastic disease and other medical jeopardies that goes along with the hazards of smoking coffin nails. Although it may look that there are merely drawbacks to smoke, you will happen your son/daughter giving such grounds as, it takes your head off things, it is a societal wont, it is something to make when you are bored, or he/she enjoys the rite of illuming up a coffin nail and inhaling/ expiring the nicotine. We will write a custom essay sample on To Puff Or Not To Puff Essay or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Smoking creates a societal ambiance that makes it easier to run into people. You ask a individual for a light, or a coffin nail and minutes subsequently a conversation has been formed. True, there are other ways of meeting people, without seting your wellness in danger, but smoke is an effortless manner to get down up a speedy conversation. I believe I am an stripling with a strong head and organic structure, and that my parents have Ra ised me to do good judgements. Therefore, I besides believe that it is my prerogative if I feel the demand to smoke. Not everyone is a na ve adolescent that does non cognize the factors that go into the determination to smoke coffin nails. There are many articles on lung malignant neoplastic disease. I have had excessively many old ages of in-between school, and high school wellness categories prophesying against smoke, yet I still chose to sit down in the park, with a good book, and my battalion of Marlboros. I still insist on smoke when I am basking a good pot of java at the local diner. Parents should hold plenty faith to cognize their son/ girl will make what’s best for them. As a individual who smokes coffin nails, I understand that my parents have had a difficult clip hold oning the fact that their girl has wittingly picked up a wont that has been proven fatal to her wellness. I understand that they merely have what # 8217 ; s in my best involvement at bosom. However, I am a well- informed tobacco user. I know that it would be in my best involvement to discontinue every bit shortly as possible. That takes twice every bit long as the period of clip it takes for 1s lungs to retrieve wholly. Knowing how much I know about the jeopardies of smoke, and taking to go on to smoke, should demo them that I am an # 8220 ; educated # 8221 ; tobacco user, and should be left entirely to make what I feel is the best thing for me.

Comparison and differences between Conan Doyle Essays

Comparison and differences between Conan Doyle Essays Comparison and differences between Conan Doyle Essay Comparison and differences between Conan Doyle Essay Explore the points of comparison and differences between Conan Doyles The Adventure of the Speckled Band and Rendells Bloodlines Wider Reading  The Adventure of the Speckled Band by Sir Arthur Conan Doyle and Bloodlines by Ruth Rendell diverge in a number of ways. These two stories were written at different times during history. The Adventure of the Speckled Band was written in the late eighteenth to early nineteenth century, where as Bloodlines was written in the mid to late nineteenth century. These two stories are set about one hundred years apart. The differences in the stories can be compared in the following ways: The character and method of the detectives in each short story are not the same. In The Adventure of the Speckled Band, Sherlock Holmes is the detective and Dr. Watson is his accomplice. Holmes has appeared in many of Conan Doyles previous works of literature. He comes across to the reader as mysterious and clever. He is regarded as mysterious due to his alleged brown cape and hat. This vision of him makes the reader think that he likes to keep things to himself (which he does). He is quiet when he is not absorbed in a case, and he is calm and collected for the majority of the time. He rarely loses his temper throughout the whole of the story. Sherlock Holmes is also delineated as extremely clever in the way he thinks and acts. He has meritorious analytical and observatory skills. One can perceive these skills very early on in the story. I observe the second half of a return ticket in the palm of your left glove you had a good drive in a dogcart, along heavy roads, before you reached the station. From the quote, one can see that Holmes uses ratiocinative skills to come to that conclusion. Holmes works alone and does not share the information he has achieved until he is sure that it is true. From this, one can see that Holmes has pride in his work. This can be seen from the following, located at the very end of the story. I had come to these conclusions before I had entered this room The fact that Watson is telling the story keeps the reader in suspense. Due to the fact that Holmes doesnt share his clues with anyone else, not even Watson causes tension and suspense and it makes the reader become even more submersed into the story. Sherlock Holmes comes across as quite a strong character. From the following taken from the narrative, Holmes demonstrates his strength: he picked up the steel poker and, with sudden effort, straightened it out again. One can also tell that Holmes is a very placid and collected character because when Dr. Roylott confronted him, he remained composed and dignified in front of the erratic Dr. Roylott. Holmes showed that Dr. Roylott did not intimidate him by perplexing him. The following demonstrates this: But I have heard that the crocuses promise well  Ha! You put me off, do you?  Here, Holmes is demonstrating his superiority, to the reader. He shows no remorse in doing so. When Holmes straightens out the poker, he is effectively insinuating that he is just as good as Dr. Roylott, possibly even more so. He is also proving that he has equal physical strength.  Holmes tells Watson after his interlude with Dr. Roylott that he does not wish to be associated with the police. Fancy his [Dr. Roylotts] insolence to confound me with the official detective force! Again, this shows that he thinks he is better than the police as he is implicitly rude to them here. We can see that Holmes enjoys working independently from the following (at the beginning of the story): As to reward, my profession is its own reward This shows the reader that Holmes is only a detective because he enjoys the occupation. It is also saying that Holmes is not concerned about money. On the other hand, Bloodlines by Ruth Rendell is dissimilar in terms of the character and method of the detectives. In Bloodlines, there are two detectives involved. Only one main detective features in the story and that is Wexford, but the other detective, Burden, has his own place in the story as well. Wexford comes across to the reader as very persistent. He is very qualified in his job and gets on with it. One can see that he does so right at the beginning of the play when he is interviewing Arlene Heddon. You wont mind if I come back in a day or two and well have another talk. It is Wexford that takes charge throughout the story, and he voices his opinion the most. Wexford does have a personality, but Rendell doesnt show it to the readers. He does not reveal much information about himself throughout the duration of the story. One can also see that Wexford is very competent. He realises from the clues in the facts that it was Carol Fox that had killed Tom. The following is taken from the narrative towards the end of the story. From those pictures he suddenly knew who had killed Tom Peterlee and why. This is the only time in the story in which the narrative withholds information about what Wexford thinks. It is Wexford that puts all the clues together to solve the crime. Burden, the other detective, is not really involved in the murder of Tom Peterlee, but he helps Wexford out. This act shows the reader that Wexford and Burden are quite close acquaintances. Burden is a very busy man and he has other things to do. The reason why Burden does not appear to be on the same level as Wexford is because he is working on a different case to Wexford. He is very judgemental when he meets Arlene, he comments about her and he says that: Intelligent girls dont live in caravans with married welders. This quote shows that although Burdens views are very set and prejudiced, he is still observant enough to see Arlenes intelligence.

Technological advance in law enforcement and the use of force Research Paper

Technological advance in law enforcement and the use of force continuum - Research Paper Example The government flooded the border patrol with many high-tech tools in order to overcome this challenge. Since then, the rate of illegal immigration reduced a big deal and this shows how effective this technology is in law enforcement. The use of this technology is revolutionizing the ability of law enforcement bodies to combat crime and aid in service of justice. The use of force continuum is the policy that stipulates how much force the law enforcement officials can use against a resisting subject. This policy is clear in such a way that both the law enforcement and the citizens understand how and why the officers use force. Although this is usually under use during training, the use of force continuum is also applicable by a review board when determining whether use of force by an officer is justifiable. As the technology rapidly advances, so does its use in law enforcement. There has been gradual improvement in technology but it has happened in stages. The first stage was between 1881 and 1945 and these were due to the work of August Vollmer. Under his jurisdiction in California, the department increased mobility through more vehicles for patrol. During this period, there was increase in precinct-patrol communication through radio and telephone. During this period, there was establishment of the first forensic laboratory that was applicable in evidence analysis. This laboratory was the precursor to use of polygraph, fingerprint and handwriting classification system therefore exponentially facilitating technology. This stage had significant effects on the improvement of the the police force. During this period, the force became more complex with several organizations arising, each with a specialized target. This is when the force started recruiting people to handle leach arm of the technology independently but in an integrated manner so the whole

Analyse the component of a web-marketing strategy and explain how the Assignment

Analyse the component of a web-marketing strategy and explain how the HRBP can add value to the marketing department - Assignment Example The purpose of this paper is to analyze web marketing and how the human resource business partner (HRBP) position can add value to the marketing department. Internet marketing is a new brand of marketing that was born in the 1990’s. During that decade the business world was taken by storm as new dot com companies began to appear by the hundreds each day. At the end of the decade the infamous internet bubble burst as too many companies penetrated the marketplace at once with less than innovative ideas. The business world has changed and web marketing has become a critical success factor in the 21st century. The amount of e-commerce volume has increased a lot. The US e-commerce marketplace reached $153 billion in sales in 2010 (Plunkett Research, 2011). Due to the size of the market companies have to look for ways to improve their web marketing function in order to increase their overall volumes of sales. There are advantages and cons associated with the use of web marketing. On e of the greatest features of web marketing is the ability to increase the customer base of a company. Through the power of the internet web marketing in theory has the capability of reaching 100% of the global population once the world becomes fully online. Another advantage of the implementation of web marketing is cost. Web marketing campaigns are much cheaper than the use of traditional media. It can cost thousands or even millions of dollars to run a 30 second advertisement on television. In 2010 CBS charged between $2.5 million to $2.8 million for a 30 second ad during the Super Bowl (Cbsnews, 2010). A third advantage of the use of web marketing is that a campaign can be implemented very fast. Also web marketing can be beneficial because the advertiser can customized the ads based on the target audience. Despite all the benefits associated with web marketing there are also cons. The use of marketing advertising techniques such as email advertising or pop up ads can be perceive d by the general population as spam. Spam can be defined as unsolicited email often of a commercial nature that are sent indiscriminately to multiple mailing lists, individuals, or newsgroups (Answers, 2011). Another con of the use of web marketing campaigns is that at times it can be difficult to measure the results of a web marketing initiative. A third disadvantage of web marketing is that people can become skeptical about the trustworthiness of the deals offered in the internet due to the large amount of internet scams that have occurred in the past (Tun, 2009). The HRBP position can add a lot of value to the marketing department. Most marketing departments are limited by the internal capabilities and resources within a company. A firm could accomplish more if it joined forces with other marketing teams. The HRBP can help a company by negotiating strategic alliances with other firms. A strategic alliance can be defined as an arrangement between two or more companies that decided to share resources for a particular project (Answers, 2011). The use of strategic alliances is a market entry strategy that can enable firms to penetrate foreign locations. The marketing depar

Organisational behaviour Essay Example | Topics and Well Written Essays - 500 words - 1

Organisational behaviour - Essay Example Leadership plays a significant role in organizational management through offering directions and influencing people towards the direction. This involves development of effective teams and effective links between management and other employees. Effective leadership also ensures motivation in an organization (Gupta 2008, p. 110). Consequently, existence of effective leadership in Ecobot Plastics would have prevented or resolved the problems by identifying lack of motivation as the main factor to the problem areas, developing a recovery plan, and influencing implementation of the plan. Leadership traits such as knowledge on effective leadership, â€Å"integrity,† â€Å"initiative,† â€Å"communication skills,† â€Å"motivation skills† (Tulsian 2009, p. 7-22), interpersonal skills, flexibility, and analytical skills are however necessary for addressing the organization’s problems (Gupta 2008, p. 111). Ensuring these traits in the organization, through training and development is therefore necessary and the neo-human relations’ approach to motivation supports this. Maslow’s hierarchy of needs theory explains the approach that focuses on need to realize self-actualization in people (Wilkinson 2003, p. 90). According to Maslow’s theory, desire to satisfy human needs motivate people (Griffin and Moorhead 2013, p. 93). The needs are further hierarchical, with self-actualization at the highest level, and once needs at a level have been satisfied, they cease to motivate and needs at higher levels becomes new motivato rs (Mosley, Mosley, and Pietri 2014, p. 207). Leadership development will change the organization’s culture from focus on machinery and processes to focus on employees through identification of need for the change and influencing the change. Developed leadership, with motivational skills as a product, will then help in

Benign Prostatic Hyperplasia Causes, Signs and Treatments

Benign Prostatic Hyperplasia Causes, Signs and Treatments As a man matures, the prostate goes through two main periods of growth. The first occurs early in puberty, when the prostate doubles in size. Around of the age 25, the gland begins to grow again. This second growth phase often results, years later, in BPH. Though the prostate continues to grow during most of a mans life, the enlargement doesnt usually cause problems until late in life. BPH rarely causes symptoms before age 40, but more than half of men in their sixties and as many as 90 percent in their seventies and eighties have some symptoms of BPH. As the prostate enlarges, the layer of tissue surrounding it stops it from expanding, causing the gland to press against the urethra like a clamp on a garden hose. The bladder wall becomes irritable and thicker. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination. Eventually, the bladder weakens and loses the ability to empty itself. Urine remains in the bladder. The narrowing of the urethra and partial emptying of the bladder cause many of the problems associated with BPH. Prostate enlargement is as common a part of aging as gray hair. As life expectancy rises, so does the occurrence of BPH (NucleusMedicalMedia, 2013). Clinical Findings Most men with BPH complain of symptoms of the lower urinary tract. Doctors should ascertain whether the symptoms are really caused by BPH or by another pathology. In the assessment, distinction needs to be made between obligatory and optional investigations which follow in the cases where diagnostic uncertainties persist after the basic examination (Dr. med. Matthias Oelke, 2013). Obligatory Examinations Patient history: A family history of prostatic disease and prostatic cancer, a history of lower urinary tract disease such as bladder stones, cystoscopic examination, transurethral surgery, and systemic disease and a history of alpha-blockers, 5-alpha-reductase inhibitors, antimuscarinics, or neurological medications should be recorded (Dr Hann Chorng Kuo, 2008). In addition to the general and neurourological history, a detailed history with regard to micturition should be taken. In the micturition history, obstructive and irritative symptoms are elicited and possibly quantified (Table 1). The history should also clarify whether drugs are being taken that might affect the functioning of the lower urinary tract (Dr. med. Matthias Oelke, 2013). Symptom and quality of life questionnaires: The frequency and extent of symptoms can be quantified by using a questionnaire, and changes during therapy can thus be documented. The International Prostate Symptom Score (IPSS) is the most commonly used questionnaire (Table 2). The first 7 questions capture the frequency of symptoms of the lower urinary tract within the preceding 4 weeks, the 8th question the extent to which the patients quality of life is compromised. The symptom score is obtained by adding up the answers to questions 1 to 7 and will be a number between 0 and 35 (Dr. med. Matthias Oelke, 2013). On the basis of this score, the symptoms can be classed as mild (IPSS score 0-7), moderate (IPSS score 8-19), or severe (IPSS score 20-35) as shown in the Table 3. Physical Examination: Patients should be examined systemically and locally. Examination of the abdomen includes checking for a palpable bladder. This may indicate chronic outflow obstruction or a neurogenic bladder. The presence of an abdominal scar, a palpable, distended bladder and genital lesions should be carefully examined. Obviously, any further abnormalities require a full neurological history and examination. In addition to a general physical examination, the patients neurourological status should be assessed. This provides information on the anal sphincter muscle tone and the sensorimotor state of the lower extremities, the perineum, and the genitals. During the basic neurological examination, the reflex pathways of the lower extremities should also be assessed (Table 3), to enable conclusions about the functional fitness of the neural pathways in the bladder and the bladder sphincter (Dr. med. Matthias Oelke, 2013). A digital rectal examination (DRE) of prostatic consistency, prostatic size, surface and abnormal nodularity should be carefully done. It includes noting the tone of the anal sphincter and the pelvic floor (Diagram 2.2.1A). It may be poor with a neurogenic bladder. Urologists report their findings in terms of the size of the prostate, a normal gland in a young adult weighing about 20 g. A useful guide for those less familiar with prostates is that a fingers breadth represents about 15 to 20 g and so a gland that is three fingers in breadth across is 45 to 60 g. Symptoms are unusual below two fingers in breadth. It is also important to note the texture and contour of the gland. It should be firm but not hard, and smooth without nodules. The median sulcus should be clearly defined. A gland that is hard rather than firm, nodular and lacks a clear median sulcus suggests carcinoma of prostate (Dr Laurence Knott, 2012). Compared with transrectal ultrasonography, the prostate volume is usua lly underestimated by 10 to 20% on digital rectal examination (Dr. med. Matthias Oelke, 2013). A Digital rectal exam (DRE) is done to assess the prostate size and shape. After putting on a lubricated glove, the physician gently inserts a finger through the anus into the rectum and assesses the size and hardness of the prostate gland. Laboratory tests: Urine test (urinalysis). When a patient complains of urethral symptoms (micturition pain, burning sensation) a urinalysis should be performed (Dr Hann Chorng Kuo, 2008). Analyzing a sample of the urine in the laboratory can help rule out an infection or other conditions that can cause similar symptoms (MayoClinic, 2011). When the urinalysis shows a miscroscopic hematuria or pyuria, a KUB radiograpgh should be done to investigate whether there are bladder or lower ureteral stone. Blood urea nitrogen and creatinine levels should be investigated when chronic urinary retention is noted (Dr Hann Chorng Kuo, 2008). Prostate-specific antigen (PSA) blood test. The prostatic specific antigen (PSA) level is indicated in all patients with an enlarged prostate or abnormal DRE findings (Dr Hann Chorng Kuo, 2008). Its normal for the prostate gland to produce PSA, which helps liquefy semen. PSA levels increase with an enlarged prostate. However, PSA levels can also be elevated due to prostate cancer, recent tests, surgery or infection (prostatitis) (MayoClinic, 2011). Men with high PSA levels have a higher risk of future growth of the prostate, symptom and flow rate deterioration, acute urinary retention and BPH-related surgery. BPH levels increase with age and approximately 25% of men with BPH have a PSA of >4ng/ml. PSA testing is more appropriate for patients whose future natural life span is likely to be more than 10 years (Dr Hann Chorng Kuo, 2008). Uroflowmetry. It is a dynamic test that measures the volume of urine released from the body, the speed with which it is released, and how long the release takes. Both average and maximum flow rates can be measured (U.S National Library of Medicine, 2012). As shown in the Diagram 2.2.1B and Graph 2.2.1A, the patient will be asked to urinate into a funnel connected to the electronic uroflowmeter, which records and translates the urine flow into a graph which gives a good indication of the degree of bladder blockage (Chin Chong Min Urology Robotic Surgery Centre, 2013). The peak flow rate, also known as Qmax is generally used as the basis for determining the severity of any blockage or obstruction. Low flow may indicate such conditions as obstruction of the urethra, enlarged prostate or poor bladder function (UrologyCare, 2011). This technique, which is used to detect an obstruction of the  urethra and  bladder neck, is widely used in the diagnosis of BPH (EhealthMD, 2012). A Qmax value over 15 mL/s is usually considered normal. A Qmax below 7 mL/s is accepted as low. Results can vary according to effort and volume and so the usual compromise is to obtain at least two readings with at least 150 mL of urine each time (Dr Laurence Knott, 2012). Postvoid residual urine: One of the important subjects of tests for urinary incontinence is the postvoid residual urine volume (PVR), the amount of urine left after urination. Normally, about 50 mL or less of urine is left; more than 200 mL is a definite sign of abnormalities. Measurements in between require further tests. This test is done using  ultrasonography  or it can also be done with a small tube (catheter), being put into the bladder through the urethra. By using the transabdominal ultrasonography, it uses a device placed over the abdomen. It can give an accurate measure of postvoid residual urine and is less invasive and expensive than transrectal ultrasonography (TRUS) (UrologyCare, 2012). Postvoid residual urine can occur in bladder outlet obstruction in BHP, but also in other forms of bladder outlet obstruction or detrusor underactivity. (Dr. med. Matthias Oelke, 2013). Urosonography: The bladder and kidneys should be examined in every patient. Since a raised serum creatinine concentration occurs only after about 50% of nephrons have failed, an ultrasound investigation of the kidneys can diagnose upper urinary tract dilatation even in the absence of raised creatinine. Since bladder outlet obstruction results in compensatory hypertrophy of the detrusor muscle, ultrasound measurements of the detrusor thickness when the bladder contains at least 250 ml urine can be used as an additional variable in assessing the degree of obstruction. A detrusor wall thickness of †°Ã‚ ¥ 2 mm indicates a bladder outlet obstruction with 95% certainty (Dr. med. Matthias Oelke, 2013). Optional Examinations TRUS: Transrectal ultrasonography (TRUS) can determine the volume of the prostate more precisely than transabdominal volumetry, the methods differ by about 10%. Only TRUS can visualize and assess the zonal anatomy of the prostate (Dr. med. Matthias Oelke, 2013). Transrectal ultrasonography (TRUS) uses a rectal probe for assessing the prostate. TRUS is significantly the most accurate method for determining prostate volume. It can sometimes detect cancer (UrologyCare, 2012). Urodynamic studies and pressure flow studies.  With these procedures, a catheter is threaded through your urethra into your bladder. Water is slowly injected into your bladder. This allows doctor to measure bladder pressures and to determine how well your bladder muscles are working (MayoClinic, 2011). These should be used only if standard diagnostic tests have not been able to assess the degree of obstruction. (Dr. med. Matthias Oelke, 2013). Cystoscopy.  Also called urethrocystoscopy, may be performed in men diagnosed with BPH, particularly if they are surgical candidates or if other urinary tract problems are suspected (Chin Chong Min Urology Robotic Surgery Centre, 2013). This procedure allows your doctor to see inside your urethra and bladder. After you receive a local anesthetic, a lighted flexible telescope (cystoscope) is inserted into your urethra to look for signs of problems as shown in the Diagram 2.2.2A (MayoClinic, 2011). Intravenous pyelogram or CT urogram.  These tests can help detect urinary tract stones, tumors or blockages above the bladder. First, dye is injected into a vein, and X-rays or CT scans are taken of your kidneys, bladder and the tubes that connect your kidneys to your bladder (ureters). The dye helps outline the drainage systems of the kidneys (MayoClinic, 2011). Etiology of Benign Prostate Hyperplasia The actual cause of prostate enlargement is unknown.  However, most urologists agree that age is most definitely a factor in the development of an enlarged prostate (ProstateHealthGuide, 2012). Several theories have been proposed to explain benign cell growth in older men (University of Maryland Medical Center, 2009). Benign prostatic hyperplasia is probably a normal part of the aging process in men, caused by changes in hormone balance and in cell growth (Healthwise, 2012). Hormonal Changes Male Hormones.  Androgens (male hormones) most likely play a role in prostate growth. The most important androgen is  testosterone, which is produced in the testes throughout a mans lifetime. The prostate converts testosterone to a more powerful androgen,  dihydrotestosterone  (DHT). DHT stimulates cell growth in the tissue that lines the prostate gland (the glandular epithelium) and is the major cause of the rapid prostate enlargement that occurs between puberty and young adulthood. DHT is a prime suspect in prostate enlargement in later adulthood (University of Maryland Medical Center, 2009). Female Hormones.  The female hormone estrogen may also play a role in BPH. (Some estrogen is always present in men.) As men age, testosterone levels drop, and the proportion of estrogen increases, possibly triggering prostate growth (University of Maryland Medical Center, 2009). Late Activation of Cell Growth Another theory focuses on cells in a certain section of the gland that may become active late in life, signaling other prostate cells to replicate or causing them to be sensitive to growth-stimulating hormones (University of Maryland Medical Center, 2009). The incidence of Benign Prostate Hyperplasia Interest in alternative treatments for BPH increased after epidemiologic studies showed a lower incidence of BPH and prostate cancer in Asians compared with persons from Western countries.   The incidence of BPH is also low in vegetarian men. It is an interesting finding that BPH incidence is lower in Asian countries than in Western countries whereas Asian immigrants in the United States have the same incidence of clinical BPH as their white American counterparts. It is also to note that the lower incidence of clinical BPH of Asian men increases in immigrant generations after they have started to live in North America. One postulated explanation is the higher soy content of the typical Asian diet. Genistein, a major isoflavone ingredient of tofu, has been found to decrease the growth of hyperplastic prostate tissue in histoculture. Dietary factors are accused to explain this phenomenon since Asian people consume low-fat, high-fiber diets than Western people. In different series, it was shown that high energy and animal product diet increase the risk of BPH while fruit and vegetable based diet has a protective effect against BPH (Dr Praveen R, 2008). The incidence of BPH is 34.4 per 1,000 persons per year in the U.S. in men over age 55. The prevalence of lower urinary tract symptoms secondary to BPH in the U.S. population is 41% in black men and 34% in white men. The prevalence of BPH increases with age. Histologic BPH is present in approximately 8% of men aged 31 to 40, 50% of men aged 51 to 60, 70% of men aged 61 to 70, and 90% of men aged 81 to 90. Correspondingly, symptomatic (clinical) BPH is present in approximately 26% of men in the fifth decade of life, 33% of men in the sixth decade, 41% of men in the seventh decade, and 46% of men in the eighth decade of life and beyond (Elsevier, 2012). Mortality and Morbidity Benign prostatic hyperplasia (BPH) is a common problem among older men, and is responsible for considerable disability. However, it is an infrequent cause of death. According to the World Health Organization database, the mortality rates for most developed countries in the 1980s were 0.5 to 1.5/100,000. Death from BPH is rare in the United States. The large number of men with the symptoms of this disorder, the easy access to diagnostic tests, and the availability of drug therapy make it appropriate for the primary care provider to participate in the management of men with this disorder (Wolters Kluwer Health, 2012). BPH associated mortality is rare and serious complications are uncommon (Dr. Dan Van Syoc, 2010). Benign prostatic hyperplasia (BPH) is a common cause of morbidity among older men, (Annual Reviews, 2013) causing morbidity primarily through lower urinary tract symptoms (LUTS). The primary physician should attempt to distinguish LUTS due to BPH from the other causes of such symptoms, objectively determine symptom severity, and, when the symptoms are bothersome enough, work with the patient on a therapeutic approach to reducing symptoms while minimizing side effects (Lippincott Williams Wilkins, 2009). Surgery  consists of various approaches that resect or ablate prostate tissue.   While effective in expanding the urethral lumen and relieving symptoms, tissue resection or ablation also contributes to significant morbidity (NeoTract, 2011). However, because of the morbidity associated with the surgical treatment of this condition, alternative treatments are being developed and are coming into increasing use (National Health and Medical Research Council, 2011). Histopathology Microscopically, the prostate consists of glandular epithelium and fibromuscular stroma elements. Smooth muscle cells, fibroblasts and endothelial cells are in the stroma and the epithelial cells are secretory cells, basal cells and neuroendocrine cells (Diagram 2.6A) (Mark Frydenberg, Nathan Lawrentschuk, 2012). Both the glandular epithelial cells and the stromal cells (including muscular fibers) undergo hyperplasia in BPH. Most sources agree that of the two tissues, stromal hyperplasia predominates, but the exact ratio of the two is unclear (Wikipedia, 2013). The columnar secretory cells are tall with pale to clear cytoplasm. These cells stain positively with prostate specific antigen. Basal cells are less differentiated than secretory cells and so are devoid of secretory products such as prostate-specific antigen (PSA). Finally, neuroendocrine cells are irregularly distributed throughout ducts and acini, with a greater proportion in the ducts .The prostate has the greatest number of neuroendocrine cells of any of the genitourinary organs. Glands are structured with open and closed cell types with the open type facing the inside of the duct having a monitoring role over its contents. Most cells contain serotonin but other peptides present include somatostatin, calcitonin, gene-related peptides and katacalcin. The cells co-express PSA and prostatic acid phosphatase. Their function is unclear but it is speculated that these cells are involved with local regulation by paracrine release of peptides. Prostatic ducts and acini are distinguished by architectural pattern at low power magnification. The prostate becomes more complex with ducts and branching glands arranged in lobules and surrounded by stroma with advancing age (Mark Frydenberg, Nathan Lawrentschuk, 2012). Pathophysiology Prostatic enlargement depends on the potent androgen dihydrotestosterone (DHT). In the prostate gland, type II 5-alpha-reductase metabolizes circulating testosterone into DHT, which works locally, not systemically. DHT binds to androgen receptors in the cell nuclei, potentially resulting in BPH. In vitro studies have shown that large numbers of alpha-1-adrenergic receptors are located in the smooth muscle of the stroma and capsule of the prostate, as well as in the bladder neck. Stimulation of these receptors causes an increase in smooth-muscle tone, which can worsen LUTS. Conversely, blockade of these receptors (see Treatment and Management) can reversibly relax these muscles, with subsequent relief of LUTS. Microscopically, BPH is characterized as a hyperplastic process. The hyperplasia results in enlargement of the prostate that may restrict the flow of urine from the bladder, resulting in clinical manifestations of BPH. The prostate enlarges with age in a hormonally dependent manner. Therefore, castrated males (ie, who are unable to make testosterone) do not develop BPH. The traditional theory behind BPH is that, as the prostate enlarges, the surrounding capsule prevents it from radially expanding, potentially resulting in urethral compression. However, obstruction-induced bladder dysfunction contributes significantly to LUTS. The bladder wall becomes thickened, trabeculated, and irritable when it is forced to hypertrophy and increase its own contractile force. With the increased sensitivity (detrusor overactivity [DO]), even with small volumes of urine in the bladder, is believed to contribute to urinary frequency and LUTS. The bladder may gradually weaken and lose the ability to empty completely, leading to increased residual urine volume and, possibly, acute or chronic urinary retention. 25In the bladder, obstruction leads to smooth-muscle-cell hypertrophy. Biopsy specimens of trabeculated bladders demonstrate evidence of scarce smooth-muscle fibers with an increase in collagen. The collagen fibers limit compliance, leading to higher bladder pressures upon filling. In addition, their presence limits shortening of adjacent smooth muscle cells, leading to impaired emptying and the development of residual urine. Signs and Symptoms     When symptoms (known as lower urinary tract symptoms, or LUTS) occur, they may range from mild and barely noticeable to serious and disruptive. The amount of prostate enlargement not always related to the severity of the symptoms. Some men with only slight enlargement have serious symptoms, and some men with a great deal of enlargement have few symptoms (WebMD, 2010). The signs and symptoms of BPH (benign prostatic hyperplasia) can vary, but usually involve changes or problems with urination (eMedTV, September 2008). According to eMedTV, the following are the most common symptoms of benign prostatic hyperplasia. However, each individual may experience symptoms differently. Symptoms may include: Leaking or dribbling of urine More frequent urination, especially at night A strong or sudden urge to urinate Urine retention inability to urinate A hesitant, interrupted, weak stream of urine Trouble starting a urine stream or making more than a dribble Feeling that the bladder has not fully emptied Stopping and starting again several times while passing urine At their worst, common BPH symptoms can lead to severe symptoms such as: A weak bladder Backflow of urine causing bladder or kidney infections Complete block in the flow of urine Kidney failure. Symptoms can be quantitated by scores, such as the 7-question American Urological Association Symptom Score in Table 2.   As shown in Table 3, this score also allows doctors to monitor symptom progression from mild to severe. Sometimes these symptoms can reduce the quality of life to such a great extent that those affected build their daily routines around the condition. They avoid drinking or plan their errands around easy access to toilet facilities. If BPH is not treated, it holds considerable risks (Roehrborn CG, McConnell JD, et al. 2010).

Euripides Medea Essay -- Papers Medea Euripides Essays Papers

Euripides' Medea I see Medea as a woman who took a chance and stood up for herself. The kind of behavior that Medea displays was very rare for these times: she doesn?t accept the dramatic change in her life; she does something about it. On the other hand, Medea becomes so obsessed she loses herself to revenge. Medea is only heroic to an extent. Medea?s thirst for revenge begins when she finds out about her husbands unfaithfulness. Medea?s husband Jason decides to marry the princess Glauce to establish a position of power in Corinth. Jason claims he did it so Medea and their two sons could have better lives. Jason fails to tell Medea of his plans. Medea, who has committed her life to Jason, is enraged when she finds out. Rather than accept Jason?s betrayal and her own humiliation, she vows revenge. Here is where Medea is heroic and clever. Medea says just the right words to plead her case to Creon. Medea set her plan for revenge in motion when King Creon comes to exile her from Corinth. Medea: This one day...

Social Networking Is Bad for Teens

Imagine this: A utopian society that doesn’t have the dangers of cyber bullies or cyber bullying. No more headlines or news articles talking about the girl who killed herself because she was cyber bullied on a social networking site. In a society where you can relax and relinquish those thoughts at the back of your mind about what people think about you over that social networking site. Unfortunately, that’s fantasy, because teens are always using these sites, which can lead to a danger little by little every day.For those teens that abundantly use social networking sites, you may think it gives you jubilance and entertainment, but social networking sites are much worse than you think. Social networking is terrible for teenagers because it is distracting, it often leads to miscommunications and misunderstandings, and it is dangerous. To begin with, social networking is terrible because it is distracting to teenagers. Some teens that have homework to do are sometimes hoa rding the computer, social networking instead of doing their homework.When their parents would tell them to do their homework, they’ll say they’ll get to it. Do you think they were actually listening while commenting on their friend’s picture on Facebook? They were probably not. This distracting â€Å"obsession† can also have an effect on their English grammar. Some English teachers are disappointed to see some students use the â€Å"chat language†, which is commonly used in social networking sites. This includes: lol, btw, brb, ttyl, l8r, etc. Social networking can also lead to the loss of focus in school.According to News Today News, â€Å"[N]early half of the five hundred teachers surveyed believe that this [obsession] affects children’s ability to concentrate in class and follow the lessons. † Students can be distracted during a lesson, thinking about that person they sent a friend request to, or if anyone commented on their newly uploaded picture. This â€Å"obsession† about social networking is distracting to teens, and is preventing them to from getting back on track in school. Not only is social networking terrible because it is distracting, but it can also cause miscommunications and misunderstandings.Now imagine you have your birthday party coming up and you invite your new friend. The problem is that your new friend doesn’t know where your house is. Through Twitter, you give directions to your house. Your big day is here, and an hour later, your friend still didn’t show up. Eventually, you find out that she ended up somewhere else from the directions that were written in a kind of â€Å"chat language† that she couldn’t understand. The next thing you know is that you’re in a fight with your friend over a miscommunication through a social networking site.Fights commonly occur between teens through a miscommunication or a misunderstanding from a social networking site. Another conflict that could result in a fight is if you post a comment or upload a picture on a social networking site, and your friend takes it for something else and finds it offending. Maybe you were just trying to be sardonic, but that’s not how your friend saw it. One of the most common results for this misunderstanding is a fight between the two. There are so many miscommunications and misunderstandings that happen every day because of social networking sites.Besides social networking being terrible because of the many miscommunications and misunderstandings it causes, it can be terrible because it is very dangerous. The dangers of a social networking site can start with sending a friend request to someone that you don’t know. All you know is what’s written on their profile, but could all of that be true? Maybe they say they’re around your age and live near you, and you think they could be fun to hang out with. The reality is that they could be an ominous serial killer who’s three times your age, lives on the other side of the country, and is trying to track you down.That person can do this if you put too much information on your profile and make it public for everyone to see. On a social networking site, anyone can find you, if it’s either a family member or a complete stranger. Another danger is the dangers of cyber bullying. Very easily, someone at your school can post a comment about something embarrassing that happened to you for everyone to see. Once you know that everyone knows about that embarrassing incident, you don’t want to show your face anywhere anymore, and you just can’t go on. This can lead to suicidal thoughts, which is the dangerous part.Just because someone said something about you, it doesn’t mean that you should end everything right there. Still, many teens do try to end their life because of what people are saying about them through a social networking site, and they just can’t take in all of the bullying and cyber bullying from that. Social networking sites come in a package deal: either you get it with accepting all the dangers, or you don’t get it at all. Social networking is a big problem in our modern-day society, but there can be a solution to that. The problem is that many teens don’t try.That’s why social networking is terrible for teenagers; it is a distraction that they can’t get away from, it can cause miscommunications and misunderstandings that can’t be fixed because some teens don’t know how to deal with their feelings, and it has so many dangers that teens don’t know how to react to. There could be many ways to end the negative side of social networking, but many people don’t try. To those who abundantly use social networking sites, now is the time to face the facts. Try to put an end to the distractions, the miscommunications and misunderstandings, and the danger s.

Hydrogen bomb essays

Hydrogen bomb essays On August 6, 1945 the atomic bomb was dropped on Japan and the world stood back horrified at the destructive force that man had created with nature and technology. Tens of thousands of people were killed, most of which by terrible burns and radiation poisoning. Everyone thought that the ultimate military weapon had been discover short of the wrath of god, but they were wrong. In 1952 the first Hydrogen bomb was tested in Enewetok. Enewetok is an island that was originally given to Japan by the League of Nations. It was later captured during World War II and designated as a nuclear test site. Of course before the testing began the islands inhabitants were evacuated. It was later deemed safe to come back there and resume life in 1980. The bomb which was nicknamed "Mike" had a mushroom cloud eight miles across and twenty seven miles tall and the canopy was 100 miles across. It made a crater two hundred feet deep and six thousand five hundred feet across. Eighty million tons of Earth was vaporized. In comparison the atomic bomb to the hydrogen bomb is a match to a stick of dynamite. In 1953 the USSR (or Russia now a days) detonated a hydrogen bomb of their own. Later Great Britain, France, and China tested hydrogen bombs of their own. This created a sort of "nuclear club-nations". The requirements for this so-called "club" is that you must have nuclear capabilities and willingly admitting to stockpiling these bombs. The way that this bomb works is very complicated. But the bang for the buck you get out of one of these things is literally going to stop your enemy "dead" in his tracks. The reaction starts with fusion of the hydrogen isotopes. An isotope is one of two or more atoms having the same atomic number but differing in atomic weight and mass number. This fusion creates heavier elements because of the number of lighter elements joined together. This difference in mass creates energy. This is called an en ...

Social and Political Upheaval During the Seventeenth Century in British North America Essays

Social and Political Upheaval During the Seventeenth Century in British North America Essays Social and Political Upheaval During the Seventeenth Century in British North America Essay Social and Political Upheaval During the Seventeenth Century in British North America Essay For every student, historian, profession, or average civilian, when you ask the question about early American history they will immediately and ultimately respond with one exact answer; the Puritans came to New England in search of freedom and new religion. During the late seventeenth century, religion gave the Puritans the opportunity to begin a new life, achieve social class, gain respect in the colonies, and have individual morality. Although that was a bit difficult to overcome for most Puritans; because the founders of the colonies on the mainland of British North America were in no hurry to arrange religious establishments. Laws were introduced by the Church that sidetracked the Puritans beliefs and aspirations. Political stress comes into play as soon as the civil government appoints only Puritan men the right to vote. In these colonies, a few brave Puritans were not afraid to speak their minds and stand in front of the civil government and the Church. Anne Hutchinson, Roger Williams, William Penn, Nathaniel Bacon, and many other colonists weren’t afraid to disagree and go against this new Puritan way. Gender role, race, and social class were amongst many of priorities of forming British North America, formally known as the thirteen colonies. With the influence of the civil government, the founders, and the Church, life for the Puritans wasn’t as sweet and pleasant as they hoped for when they journeyed over to this country many centuries ago. Roger Williams, the founder of Rhode Island, played an important role throughout the Puritans. Williams believed that no matter what your religious views are, the freedom to fully enjoy your religion with your own judgments and consciences, you are a good Puritan. The civil government however, did not believe in that statement. Roger Williams published his most famous text, The Bloody Tenant of Persecution. His book defines many principles that defend the liberty of conscience and portrays a great dialogue between truth and peace. The first principle starts you off with a pretty distinct image, â€Å"That the blood of so many hundred thousand souls of Protestants and papists, split in the wars of present and former ages, for their respective consciences, is not required or accepted by Jesus Christ the Prince of Peace†. In my own opinion, I believe Williams is not a fan of war. The next few principles he lists are all about the blood of poor souls, the use of weapons, and enforcing uniformity to be the destruction of millions. Roger Williams’ next book, To the Right Honorable Both Houses of the High Court of Parliament, mainly focuses on the persecution of conscience and the rights of mankind. â€Å"I acknowledge that to molest any person, Jew or Gentile, for either professing doctrine, or practicing worship merely religious or spiritual, it is to persecute him; and such a person, whatever his doctrine or practice be, true or false, suffers persecution for conscience†. That statement he makes in this passage really reveals a bit of United States law today. No matter what crime he or she might commit, they should all be persecuted, not mattering who you are, because it is the right thing to do under conscience. Anne Hutchinson was another brave soul who came forth to speak to the colonies. Hutchinson held private bible meetings for young women and eventually more women and men attended. Anne Hutchinson is a key figure in the development of religious freedom in the early British North American colonies. She is a very courageous woman and is a fine representation of what the struggle a Puritan woman’s life was like living during this time. The Trial and Interrogation of Anne Hutchinson in 1637 can further explain her fight against the Church and State. John Winthrop, the governor of the Massachusetts Bay Colony, interrogated Hutchinson during this trial. â€Å"Mrs. Hutchinson, you are called here as one of those that have troubled the peace of the commonwealth and the churches here; you are known to be a woman that hath had a great share in the promoting and divulging of those opinions that are causes of this trouble, and †¦Ã¢â‚¬  Anne Hutchinson held her ground throughout the interrogation very well. She answered the questions that were put upon her very intelligently and respectively. Hutchinson was accused for holding private bible meetings that were not organized and approved by the Church. She of course thought there was nothing wrong with her teaching women and some men much more than what was being said during normal church meetings. Winthrop and the rest of the committee believed that her sermons going beyond the normal Bible study were offensive and disrespectful to the community and ultimately God. â€Å"Your course is not to be suffered for, besides that we find such a course as this to be greatly prejudicial to the state, besides the occasion that it is to seduce honest persons that have called to those meetings and your opinions being known to e different from the word of God may seduce many simple souls that resort unto you†¦Ã¢â‚¬  This trial clearly shows how serious religion was to these people. No way would you see this kind of trial happening in the United States court system today, it would be made a mockery! Religion is what gave these Puritans hope, social ranking, gender power, and belief of anything. John Winthrop created a few statements justi fying his establishment for the New England colonies and as a defense against their enemies. Statement number two states, â€Å"All other churches of Europe are brought to desolation, , or sins, for which the Lord begins already to frown upon us to cut us short, do threaten evil times to be coming upon us, who knows, but that God hath provided this place to be a refuge for many whom he means to save out of the general calamity, seeing the Church hath no place left to fly into but the wilderness, what better work can there be, then to go provide tabernacles food for her against she comes hither†. What justified the New England colonies during the seventeenth century was the Church and State. There was no formal judicial system; the government was not the highest power during this time, technically the government was just the law. Religion was the almighty power during that century, until the civil government started to take control once the Church and its people started to act up. The late seventeenth century dealt with many orders of transformations that caused big amounts of social and political stress throughout the colonies. But as stated, â€Å"Extreme social and political stress often results in social and political upheaval and transformation†; everything that is challenging and hard to achieve, always has a greater and stronger outcome. The most vivid and the most striking event during the seventeenth century was the revolution known as Bacon’s Rebellion. William Berkeley, governor of Virginia, wasn’t a favorite amongst the people of Virginia. When the Native Americans started to attack the lands on the frontier settlements, Berkeley never set any action to resolve this issue. Nathaniel Bacon decided to take this matter into his own hands starting a rebellion and attack the Indians. Ultimately Bacon and his followers chased Berkeley straight out of town from Jamestown, Virginia and ended the fight with torching the capital. This rebellion was the first fight that actual civilians took part in. There were many protests, torching, and an alliance that had a great control over the court. Unfortunately this rebellion did not remove all the Native Americans from the Virginia frontiers, but Bacon was happy when he got recalled to England. Bacon’s Declaration and Manifesto are big primary sources that conclude his rebellion. Bacon’s Declaration in the Name of the People was pronounced on July 30, 1676. This list of complaints towards William Berkeley articulated unjust taxation and the failure to protect the colonists from Native American attacks. Bacon’s Manifesto was a furthermore to his Declaration. Obviously he mentioned religion, freedom, and political intentions to declare and ensure safety to the people of Virginia from the Native Americans. Nathaniel Bacon had a lot of courage and strength to defeat the governor of Virginia and take over Jamestown at only twenty years old. Another key figure during the seventeenth century was John Locke. Locke was very liberal; in fact he was a firm believer in modern liberalism. His many formal essays that all had to do with some political meaning gave him the upper hand in the government. An Essay Concerning Human Understanding†, â€Å"Two Treatises of Government†, and â€Å"A Letter Concerning Toleration† were his most valuable pieces of work. Locke was a very political man and came from a very political background. He was a great asset to New England during the seventeenth century. The history of British North America during the seventeenth century focused a lot on religion, the government, and above all, the fight f or freedom and trust. Many Puritans dealt with social stress that ultimately saw the light and gave them a better, more valuable life to live in New England. For the government, there were times where new settlements were being fought over, territories were being stolen, battles were being fought, etc. , but in the end, New England is still here today right? Everything happens for a reason, no matter how stressful and challenging, all that seems terrible at the time, only turns out to be extraordinary when it’s all over.

Social Learning Theory Assignment Example | Topics and Well Written Essays - 1000 words

Social Learning Theory - Assignment Example This assignment discusses the Social Learning Theory developed by Berger, that primarily focuses upon that a child develops while observing the sequential patterns that go on around him/her. Thus, it is through modeling and repeating or doing things that are already done by others is an important way a child learns different behaviors and adopt certain attitudes. However, while observing and modeling, one feature that is in a continuous functioning state is the child’s own cognition. The cognition works in a way that if a child sees someone getting acknowledgement and rewards upon his behavior or deed, the child would him/herself like to receive the same kind of acknowledgement and appreciation from others. This desire leads the child to incorporate the same attitude in his daily practice so that he too can be socially recognized and accepted. Once the child gets success due to the modeled behavior, he learns to practice the same thing throughout his lifespan. The problem migh t occur when the child is not able to model the exact behavior to receive acknowledgement. In such a situation, he/she modifies the same behavior multiple times and in multiple ways as long as he might achieve success. In the same way, punishment and discouragement act as negative stimulators for the child not to adopt a certain behavior if someone else is punished on its basis. In conclusion, the researcher states that this further retains throughout the child’s lifetime shaping his personality in a particular direction.

Advance Directives Essay Example | Topics and Well Written Essays - 250 words

Advance Directives - Essay Example End-of-life wishes are not common among many people. This is because individuals allow life to take its natural course. In the process, aggressive care is provided until life is lost, whether or not the illness is terminal. Moreover, many people fail to draft a living will citing ethical concerns in the society. For others, executing advance directives is deemed to conflict with the essence of medicine. As a result, majority of people shun advance directives. In order to complete an advance directive, it is important for people to know what it takes or entails to make an end-of-life decision (Understanding Advance Directives). More people will complete advance directives following a vibrant awareness creation. Without awareness, people will continue to shun advance directives. On the same note, understanding the complexities surrounding a terminal illness is critical. Costs keep accumulating as the patient nears death every day that passes. It is, therefore, important for people to understand the ethics, rights, and benefits associated with end-of-life

Case Study Example | Topics and Well Written Essays - 1000 words - 29

Case Study Example Each of the hospitals has their own unique culture that can either help or prevent the coping ability of the employees with the stress of working in their demanding environments. As the individual in charge of socializing the new nurses, I would first communicate the desired behaviors through either written or verbal communication. I would ensure that I role model the required behaviors on daily basis. I would also develop a mentorship program for them to encourage them to engage in a two-way communication and build confidence in them in their early career. This will ensure that they remain motivated all the time. I would also create a time out for some few hours to give them a break from their works and make them feel rejuvenated. There are various challenges that hospitals face when creating a culture that helps in the reduction and management of stress among the employees. One of them is that they have to come up with a creative strategy of ensuring that they manage on the time spent on motivating employees. The reason is that the hospital has to continue with its normal operations while the supportive culture is still going on. Thus, they have to divide the employees into shifts to take them out in shifts for instance, and this can be costly in the long run. Secondly, some hospitals lack the required time to motivate their employees in the required levels. This is considering that hospital nurses, doctors and nurses are under pressure on time and they have to give their undivided attention to patients. If the hospital lacks enough number of nurses, doctors and staff, then coming up with an organizational culture to reduce and manage stress levels in the hospital might be difficult (Ivancevich, Konopaske, & Matteson, 2013). There was a certain organization that I worked for that had inadequate employees. The few employees that worked there had high-stress levels and had to deal with a lot in the organization setting. Thus, the

Critique of the Ramayana Modern Prose Translation Essay Example for Free

Critique of the Ramayana Modern Prose Translation Essay In a just world, Mr. R. K. Narayan’s estate would be responsible for reimbursing seventeen-fifty, plus applicable taxes, to all those who purchased the Penguin Classics 2006 publication of his book, The Ramayana: A Shortened Modern Prose Version of the Indian Epic. Stated clearly on the back of the cover is the promise that R. K. Narayan â€Å"recounts [The Ramayana] with the narrative flair of a master novelist’’. The back cover lied. Narayan’s re-telling condenses the epic poem so much to the point of nearly listing a series of events. No matter the inspiration, Narayan’s The Ramayana is still a story, and should therefore be able to stand on it’s own as a captivating tale—with further literary research or expansion being used to enhance it’s appeal, not explain it. Arguably, the ‘narrative flair’ of this re-telling is little more expressive than unsolicited summaries found on the Internet, and without further literary aide or instruction, does not stand as a solid piece of literature. What is worse, is that instead of allowing a greater breadth of readers to relate and experience tale of the Ramayana, new readers are alienated by it’s convoluted atmosphere. While the task is grand, Narayan’s translation is not listed as an aide to a larger, more in-depth version; it is still a novel and as such needs to be able to stand strong in its own right when evaluated alone. People who have no prior knowledge of the original Sanskrit story, and who have not been raised with the Hindu epic as a part of their life, should be able to pick up this book, read it, and—regardless of how far the tale may go in global history—be able to enjoy one hundred and fifty one pages of literature, without having any prior knowledge, or requiring further research. Having more knowledge, and doing more research on the original epic tale should increase what readers are able to receive from the book, but it should not be necessary in order to understand it. As it stands, without knowing the original tale, new readers are left with very little literary flow and a patchy depiction of what is supposed to be a lush world. At one point, while Bharatha and Rama argue as to who should be the rightful king, their entire episode is related with: â€Å" The argument went on at a highly academic and philosophical level, the entire assembly watching with respect. (Narayan 60) That assertion does not express a deep academic and philosophical argument, but rather states that one was occurring; the reader doesn’t get to experience what transpired between the brothers, or garner any emotion from it. It goes on to almost quite literally depict the event with a he-said/he-said monotony: So be it; if I have the authority—then I confer it on you as the ruler,† said Bharatha at one stage. â€Å"On my command as the ruler, if you desire to think so, you shall be the King. † It went on thus. Rama went on repeating that there could be no word higher than that of a father; no conduct other than obedience to it. Throughout he referred to Kaikeyi in the gentlest terms and always as â€Å"mother†. (Narayan 61) The listed manner in which the plot is unfolded by Narayan’s re-telling is barely more narrative as a piece of literature than an excerpt from that of the free online encyclopedia Wikipedia: Bharatha refuses to profit from his mothers wicked scheming and visits Rama in the forest. He requests Rama to return and rule. But Rama, determined to carry out his fathers orders to the letter, refuses to return before the period of exile. However, Bharatha carries Ramas sandals, and keeps them on the throne, while he rules as Ramas regent. (Wikipedia Contributors) There is very little more efficiency or flair in Narayan’s telling, and in fact, Wikipedia depicts the stages of the long tale with better clarity; if the prose is not going to be linguistically lush and evocative, it may as well be clear (Wikipedia is not only clear, but free of charge as well). It is of course not a simple task to undertake translating an epic poem from a rhythmic language, into prose with a language devoid of the same musicality. However, to the novice reader of The Ramayana, they would not know the difficulty of the task, and thus—however harsh it may seem— should not be a factor in the reviewing of the story as it stands alone. Narayan was by no means an incapable writer, and as winner of numerous awards and accolades—not the least of which being multiple nominations for the Nobel Prize in Literature (Rajnish Wattas), he does not need defending that he has great ability as a writer, yet the bottom line remain that when it is stripped of further discussion, research, and introductions, The Ramayana: A Shortened Modern Prose Version of the Indian Epic just does not stand on it’s own as captivating modern prose. With nearly each new episode of the tale, Narayan prefaces the action with even more listed information, take for example the introduction to the chapter of Vali: The characters in the drama that follows are Vali, Sugreeva, Hanuman, and Rama. The action takes place in the mountainous forest regions of Kiskinda, a kingdom ruled and inhabited by monkeys. In the Ramayana, the articipants are not only human beings, but many others from God’s creation, intelligent, cultured and with their own achievements of spirit as well as physique: Jambavan was a bear, Jatayu was an eagle, Lakshmana—Rama’s brother—was himself a human incarnation of the Great Serpent Adisesha in whose coils Vishnu rested. (Narayan 90) Again, the story is told by listing statements of what is going on. As with the landscape, and even the characters themselves, nothing is depicted in the story-writing of the prose, but stated, as if the entire epic was a news article being reported by Narayan, as opposed to a vivid history with grand escapades and extreme characters. By translating an epic tale from poetic verse into shortened modern prose, the objective is ultimately to enable a broader audience to relate to and appreciate a classic tale. Poetry is a secluded literary world that does not have the mass appeal that modern prose does; yet Narayan’s re-telling is too constrained and overwhelmed by the amount of story condensed into it. By trying to constrain the length of the story to allow for more readers to get through it, Narayan’s ‘master narrative flair’ seems lost, and the epic tale is a heavy list of events that merely occur on the page.