Lamb to the Slaughter Summary free essay sample

Dahl portrays Mary Maloney as a typical ‘50’s housewife (although that very well may not be the era in which this short story was written); she waits for her husband with his drink prepared, and periodically glances at the clock for his arrival. Little did this six month pregnant wife know, her beloved spouse would be leaving her†¦ So as Patrick Maloney walked through the door she did as any unsuspecting wife would do, and lie her sewing aside and greet him with a kiss, takes his coat and makes his drink. The couple sit for a while silently as Mary accepts that her husband prefers to rest in silence while he has his drink after a long day at work. Shortly after he declares that he has to tell her something, and that he hopes she will not blame him too much. At this point in the story, Dahl does not explain what it is that Patrick Maloney tells his then wife, but makes it very clear in his next paragraph that Patrick Maloney was leaving Mary. We will write a custom essay sample on Lamb to the Slaughter Summary or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Mary then goes into shock and tries to persuade herself that she imagined the entire ordeal. She goes to retrieve something from the basement freezer and prepare dinner. She returns with a frozen leg of lamb to find Patrick standing by a window with his back to her, he hears her coming and tells her that she shouldn’t make dinner as he has decided to eat out. Dahl offers no lead up for what occurs next, Mary walks up to him and brings the leg of lamb down on Mr. Maloney â€Å" as hard as she could† on the back of his head. Patrick falls dead and Mary’s mind cleared instantaneously. She walked into her kitchen and placed the leg of lamb in the oven to cook. She hurried off to the supermarket, telling Sam, the grocer that she needed some vegetables to go along with a nice leg of lamb. She carries on a normal conversation with him and they decide that she will give Patrick cheesecake for afterwards. On her way back home she pretends that all is fine, and believes that she will find her husband waiting for dinner. As she enters the house, she calls his name, and places down her groceries. Feigning surprise she finds Patrick lying on the floor, dead. The shock and pain that she feels is genuine as she remembers the love she felt for her husband. Mary calls the police station at which Patrick worked to report his death. She told the officers that she went to the supermarket during the time of her husband’s death, and this was confirmed by Sam, the grocer. The focus of the investigation was to find the murder weapon, and the detective told Mary that he had been struck by a â€Å"heavy blunt instrument†. Meanwhile, the lamb that Mary had placed in the oven was ready and she persuaded the officers to have dinner, as it is the least she could do for the men that are â€Å"helping to catch the man who killed him† him, meaning her husband. What happens next is the perfect example of dramatic irony. When the policemen are eating the leg of lamb and discussing where the weapon may be, one says that the murder weapon is Probably right under our very noses. This is dramatic irony because the weapon used to kill Mr. Maloney really is right under their very noses. Yet they just keep eating suspecting the leg of lamb could never be the weapon used to kill Patrick Maloney, while Mary Maloney was quietly giggling in the other room. In the beginning of the short story, Dahl describes Mary Maloney as a very weak minded individual that lived solely to take care of her husband, and very soon after, Mary turns into a strong, resourceful and intelligent woman that skillfully got away with the murder of her husband, two polar opposites. Although Mary was deceived, it is very difficult to determine if the murder of her husband is justified or not under the circumstances. Many will argue that Mary Maloney is a vicious murderer and deserves to be put in jail, but others will say that she had experienced psychological trauma, and her reaction to the news of her husband leaving her made her mentally unfit to take responsibility for her actions following. In conclusion, people do not always get what they deserve. Personally I feel that in this case, Patrick Maloney did in deed get what he deserved, considering the fact that he had just informed his highly hormonal pregnant wife he would be leaving her, without any given reason disclosed to the reader.

How to Conjugate Mentir (to Lie) in French

How to Conjugate Mentir (to Lie) in French The French verb  mentir  means to lie. While that may be relatively easy to remember, youll also want to know how to conjugate the verb. This will allow you to use it appropriately in the present, past, or future tense and form a complete sentence.  Mentir  is not the easiest conjugation, so be sure to find out the basic forms you need to know. Basic Conjugations of  Mentir Mentir is an irregular verb, which is what makes its conjugations a little more challenging than others. It doesnt follow a regular pattern in the infinitive endings, though most French verbs ending in -mir, -tir, or -vir are conjugated in the same way. You might find it helpful to study a few at once to make memorizing each a little easier. The imperative verb mood is used most often and allows you to express  mentir  in the present, future, and imperfect past tenses. Since it is irregular, you will notice that the verb stem- men-  - has some unusual endings in this chart. However, with enough practice, you can commit them to memory. Using the chart, match the subject pronoun to the appropriate tense for your sentence to find the correct conjugation. For example, I am lying is  je mens  and we lied is  nous mentions. Present Future Imperfect je mens mentirai mentais tu mens mentiras mentais il ment mentira mentait nous mentons mentirons mentions vous mentez mentirez mentiez ils mentent mentiront mentaient The Present Participle of  Mentir The present participle of mentir is produced by adding -ant to the verb stem. This gives you the word mentant. Mentir  in the Compound Past Tense In French, the  passà © composà ©Ã‚  is a compound past tense. It is constructed by combining a present tense conjugate of the  auxiliary verb  avoir  with the  past participle  menti. For example, I lied is  jai menti  and we lied is  nous avons menti. More Simple Conjugations of  Mentir Beyond those basic conjugations, you may find yourself needing a few other forms of  mentir  at times. These can be rather useful if, for instance, the action of lying is uncertain, in which case youll use the subjunctive. Or, the lying may depend on something else, so the conditional can be used. On occasion, you may also encounter the passà © simple or the imperfect subjunctive. Yet, these are rarely used so they do not have to be a priority in your studies. Subjunctive Conditional Passà © Simple Imperfect Subjunctive je mente mentirais mentis mentisse tu mentes mentirais mentis mentisses il mente mentirait mentit mentà ®t nous mentions mentirions mentà ®mes mentissions vous mentiez mentiriez mentà ®tes mentissiez ils mentent mentiraient mentirent mentissent With  mentir  you will find  the imperative  form  useful for short commands. When using it, skip the subject pronoun: use  mens  rather than  tu mens. Imperative (tu) mens (nous) mentons (vous) mentez

Alcohol Use Disorder

Diagnosis The DSM-IV-TR classifies drug disorders into substance use disorders (substance dependence and abuse) and substance-induced disorders (substance intoxication, substance withdrawal, induced delirium, anxiety, depression, psychosis and mood disorders). Sometimes it is difficult assessing patient’s psychiatric complaints because heavy drinking is associated with alcoholism can co-exist with, contribute to or result from several different psychiatric syndromes. (Shivani, Goldsmith Anthenelli, 2002) In order to improve diagnostic accuracy, distinguishes among alcohol-related psychiatric symptoms and signs, alcohol-induced psychiatric syndromes and independent psychiatric disorders that are commonly associated with alcoholism emerges to be essential. Patients’ gender, family history, and course of illness over time also should be taken into account. Alcohol-related psychiatric symptoms and signs Heavy alcohol consumption directly affects brain function and brain chemical and hormonal systems known to be involved in many common mental disorders thus can manifest itself in a broad range of psychiatric symptoms and signs. (Koob, 2000) And this usually the first problem which brings the patients seek help. The symptoms vary depending on the amount of alcohol used, how long it is used and how recently it was used as well as patient’s vulnerability to experiencing psychiatric symptoms in the setting of consumption. For example, during intoxication, smaller amount alcohol may produce euphoria whereas larger amount may produce more dramatic changes in mood. Alcohol also impairs judgment and aggressive, antisocial behaviours that may mimic certain externalizing disorders such as ASPD. Alcohol-induced psychiatric syndromes The essential feature of alcohol-induced psychiatric syndromes is the presence of prominent and persistent symptoms, which are judged- based on their onset and course as well as on the patient’s history, physical exam, and laboratory findings to be the result of the direct physiological effects of alcohol. Given the broad range of effects of heavy drinking may have on psychological functioning, these alcohol-induced disorders span several categories of mental disorders, including mood, anxiety, psychotic, sleep, sexual, delirious, amnestic and dementia disorders. Alcoholism with comorbid, independent psychiatric disorders Alcoholism is also associated with several psychiatric disorders that develop independently of the alcoholism and may precede alcohol use and abuse. One of the most common of these comorbid conditions is ASPD, and axis II personality disorder marked by a longstanding pattern of irresponsibility and violating the rights of others with alcohol. (Stinson et al. , 2006) Assessment The three major purposes for a comprehensive assessment are to determine a diagnosis, devise a treatment plan and to make appropriate referrals. The assessment should provide a clinical picture of the client’s personal level of functioning, history, presenting problems, family and social context in the client’s life. It is very important that the assessment process requires the gathering of comprehensive, accurate information, for a valid diagnosis and appropriate treatment. – It is vital that the counsellor needs to collect valid and reliable information. Both formal diagnosis, as listed in the Diagnostic and Statistical Manual of Mental Disorders (APA, 1994) and informal diagnosis, if the client has had therapy in the past can be made. – Comprehensive assessment is essential in designing a treatment plan. The more information provided concerning the etiology, functioning level and prognosis of the problem, the better the treatment plan. – Comprehensive assessment also provides information in order to made appropriate referral. The counsellor may decide to provide treatment solely or in conjunction with some other drug treatment specialists. Generally there are three categories of assessment measures: subjective data and physiological data. -Subjective data To collect information of demographics, family and living situations, mployment, education, drinking history (including development of the drinking problem and current drinking) and the effects on the subject’s cognitive, psychosocial, behavioural and physiological functioning. (Aalto Seppa, 2005) For example, some questionnaires focus on problems caused by alcohol consumption, the Alcohol Use Disorder Identification Test (AUDIT) (Saunders, Aasland, Babor, de le Fuente, Grant, 1993) There are ones with diaries focussing on the quantification of alcohol consumption, such as quantity-frequency, time-period or time-line follow-back methods. Webb et al. , 1990) More recently, a low level of response (LR) to alcohol (the need for higher amounts to have an effect) is a genetically influenced characteristic that is both found in populations at high risk for future alcoholism and that predicts alcohol related life problems in future. This Self-Rating of the Effects of Alcohol (SRE) questionnaire asks for estimate of number of drinks required to produce each of four effects at different times in their lives. Miller, Thomas, Mallin, 2006) In addition, the survey included the Alcohol Use Disorders Identification Test-C (AUDIT-C), a three-question alcohol screening test adapted from the original AUDIT developed by the World Health Organization for use in primary health care. The AUDIT-C is a simple, reliable screening tool that focuses on the frequency of drinking, quantify consumed on the typical occasion and the frequency of heavy episode drinking. (Bush, Kivlahan, McDonnell, al. , 1998) Again, there is no such perfect measure that SRE was found to be biased and not able to identify high functioning middle-age women. Schuckit, Smith, Danko, Isacescu, 2003) The difficulty with these specific questionnaires is that people who drink alcohol in general tend to neglect or underestimate their alcohol consumption. (Koch et al. , 2004) The accuracy of these measures is based on the patient’s awareness of and willingness to acknowledge his or her pattern and level of alcohol use as well as negative effects of drinking. At least some individuals who drink excessively will fail to do this. (Allen Litten, 2001) – Physiological data Comparing to subjective data, physiological data can overcome the subjectivity, underestimation in particular thus provides more precise and objective information about the drinking issue. It includes general medical and psychiatric history and examination. This is conducted through screening of blood, breath or urine for alcohol used, further on laboratory tests for abnormalities that may be accompanied acute or chronic alcohol use such as gamma-glutamy-transferase (GGT) or mean corpuscular volume (MCV), a measure of the average size of red blood cells. These may also be used during treatment for potential relapse. GGT is the most commonly used biochemical measure of drinking. However, it is not clear how much drinking is actually needed to cause GGT levels to elevate. And MCV tends to miss more alcoholics than GGT as MCV may be elevated by a variety of conditions other than heavy drinking such as non-alcoholic liver disease, smoking, advanced age or use of anticonvulsants etc. Thus applying the usual cut-off points for these tests, GGT turns out to have a low specificity whereas MCV shows a low sensitivity. This may lead to a gross misunderstanding with the patient and unnecessary further testing. Carbohydrate deficient transferring (CDT) has been recently approved as a marker for identification of individuals with alcohol problems as well as an aid in recognizing if alcoholic patients in treatment have relapsed. CDT and GGT appear to validly detect somewhat different groups of people with alcohol problems. GGT may best pick up those with liver damage due to drinking, whereas CDT seems to be related to level of consumption with or without liver damage. It should be kept in mind that biomarkers do not identify women or adolescents with alcohol problems as they do for male or adults in general. (Similarly, self-report screening tests are also generally less able to detect alcohol problems) (Allen Litten, 2001) Previous studies showed that over 80% of internists and family clinicians report that they usually or always ask new outpatients whether they drink alcohol. Less than 20% of primary care physicians routinely use validated self-report alcohol screening instruments (e. g. CAGE questions or AUDIT) Fewer than half ask about maximum alcohol consumption on one occasion. Alcohol biomarker laboratory tests are rarely used. Reasons given by clinicians for not following recommended alcohol screening guidelines range from lack of time, to insufficient knowledge and skills, to pessimistic attitudes about the ultimate benefits of screening. A current study conducted by Miller, et al. , (2004), they found that approximately 60% of clinicians surveyed frequently screen patients for alcohol use with quantity/frequency and CAGE questions. This is comparable to the incidence of screening found in previous studies. (Miller, Ornstein, Nietert, Anton, 2004)Miller, et al. 2006) further found that over 90% of patients were in favour of screening and guidance about alcohol use and very positive about the use of biological alcohol markers. These findings suggest that physicians and clinicians may be convinced that patients are open to alcohol screening and would not be offended by it. Heavy drinkers may have more of a tendency to be embarrassed by such questions but there is no evidence they would be object to screening. The majority of patients would also be willing to receive alcohol biomarker blood tests, if their physicians and clinicians deemed such tests necessary. Alcohol Use Disorder Diagnosis The DSM-IV-TR classifies drug disorders into substance use disorders (substance dependence and abuse) and substance-induced disorders (substance intoxication, substance withdrawal, induced delirium, anxiety, depression, psychosis and mood disorders). Sometimes it is difficult assessing patient’s psychiatric complaints because heavy drinking is associated with alcoholism can co-exist with, contribute to or result from several different psychiatric syndromes. (Shivani, Goldsmith Anthenelli, 2002) In order to improve diagnostic accuracy, distinguishes among alcohol-related psychiatric symptoms and signs, alcohol-induced psychiatric syndromes and independent psychiatric disorders that are commonly associated with alcoholism emerges to be essential. Patients’ gender, family history, and course of illness over time also should be taken into account. Alcohol-related psychiatric symptoms and signs Heavy alcohol consumption directly affects brain function and brain chemical and hormonal systems known to be involved in many common mental disorders thus can manifest itself in a broad range of psychiatric symptoms and signs. (Koob, 2000) And this usually the first problem which brings the patients seek help. The symptoms vary depending on the amount of alcohol used, how long it is used and how recently it was used as well as patient’s vulnerability to experiencing psychiatric symptoms in the setting of consumption. For example, during intoxication, smaller amount alcohol may produce euphoria whereas larger amount may produce more dramatic changes in mood. Alcohol also impairs judgment and aggressive, antisocial behaviours that may mimic certain externalizing disorders such as ASPD. Alcohol-induced psychiatric syndromes The essential feature of alcohol-induced psychiatric syndromes is the presence of prominent and persistent symptoms, which are judged- based on their onset and course as well as on the patient’s history, physical exam, and laboratory findings to be the result of the direct physiological effects of alcohol. Given the broad range of effects of heavy drinking may have on psychological functioning, these alcohol-induced disorders span several categories of mental disorders, including mood, anxiety, psychotic, sleep, sexual, delirious, amnestic and dementia disorders. Alcoholism with comorbid, independent psychiatric disorders Alcoholism is also associated with several psychiatric disorders that develop independently of the alcoholism and may precede alcohol use and abuse. One of the most common of these comorbid conditions is ASPD, and axis II personality disorder marked by a longstanding pattern of irresponsibility and violating the rights of others with alcohol. (Stinson et al. , 2006) Assessment The three major purposes for a comprehensive assessment are to determine a diagnosis, devise a treatment plan and to make appropriate referrals. The assessment should provide a clinical picture of the client’s personal level of functioning, history, presenting problems, family and social context in the client’s life. It is very important that the assessment process requires the gathering of comprehensive, accurate information, for a valid diagnosis and appropriate treatment. – It is vital that the counsellor needs to collect valid and reliable information. Both formal diagnosis, as listed in the Diagnostic and Statistical Manual of Mental Disorders (APA, 1994) and informal diagnosis, if the client has had therapy in the past can be made. – Comprehensive assessment is essential in designing a treatment plan. The more information provided concerning the etiology, functioning level and prognosis of the problem, the better the treatment plan. – Comprehensive assessment also provides information in order to made appropriate referral. The counsellor may decide to provide treatment solely or in conjunction with some other drug treatment specialists. Generally there are three categories of assessment measures: subjective data and physiological data. -Subjective data To collect information of demographics, family and living situations, mployment, education, drinking history (including development of the drinking problem and current drinking) and the effects on the subject’s cognitive, psychosocial, behavioural and physiological functioning. (Aalto Seppa, 2005) For example, some questionnaires focus on problems caused by alcohol consumption, the Alcohol Use Disorder Identification Test (AUDIT) (Saunders, Aasland, Babor, de le Fuente, Grant, 1993) There are ones with diaries focussing on the quantification of alcohol consumption, such as quantity-frequency, time-period or time-line follow-back methods. Webb et al. , 1990) More recently, a low level of response (LR) to alcohol (the need for higher amounts to have an effect) is a genetically influenced characteristic that is both found in populations at high risk for future alcoholism and that predicts alcohol related life problems in future. This Self-Rating of the Effects of Alcohol (SRE) questionnaire asks for estimate of number of drinks required to produce each of four effects at different times in their lives. Miller, Thomas, Mallin, 2006) In addition, the survey included the Alcohol Use Disorders Identification Test-C (AUDIT-C), a three-question alcohol screening test adapted from the original AUDIT developed by the World Health Organization for use in primary health care. The AUDIT-C is a simple, reliable screening tool that focuses on the frequency of drinking, quantify consumed on the typical occasion and the frequency of heavy episode drinking. (Bush, Kivlahan, McDonnell, al. , 1998) Again, there is no such perfect measure that SRE was found to be biased and not able to identify high functioning middle-age women. Schuckit, Smith, Danko, Isacescu, 2003) The difficulty with these specific questionnaires is that people who drink alcohol in general tend to neglect or underestimate their alcohol consumption. (Koch et al. , 2004) The accuracy of these measures is based on the patient’s awareness of and willingness to acknowledge his or her pattern and level of alcohol use as well as negative effects of drinking. At least some individuals who drink excessively will fail to do this. (Allen Litten, 2001) – Physiological data Comparing to subjective data, physiological data can overcome the subjectivity, underestimation in particular thus provides more precise and objective information about the drinking issue. It includes general medical and psychiatric history and examination. This is conducted through screening of blood, breath or urine for alcohol used, further on laboratory tests for abnormalities that may be accompanied acute or chronic alcohol use such as gamma-glutamy-transferase (GGT) or mean corpuscular volume (MCV), a measure of the average size of red blood cells. These may also be used during treatment for potential relapse. GGT is the most commonly used biochemical measure of drinking. However, it is not clear how much drinking is actually needed to cause GGT levels to elevate. And MCV tends to miss more alcoholics than GGT as MCV may be elevated by a variety of conditions other than heavy drinking such as non-alcoholic liver disease, smoking, advanced age or use of anticonvulsants etc. Thus applying the usual cut-off points for these tests, GGT turns out to have a low specificity whereas MCV shows a low sensitivity. This may lead to a gross misunderstanding with the patient and unnecessary further testing. Carbohydrate deficient transferring (CDT) has been recently approved as a marker for identification of individuals with alcohol problems as well as an aid in recognizing if alcoholic patients in treatment have relapsed. CDT and GGT appear to validly detect somewhat different groups of people with alcohol problems. GGT may best pick up those with liver damage due to drinking, whereas CDT seems to be related to level of consumption with or without liver damage. It should be kept in mind that biomarkers do not identify women or adolescents with alcohol problems as they do for male or adults in general. (Similarly, self-report screening tests are also generally less able to detect alcohol problems) (Allen Litten, 2001) Previous studies showed that over 80% of internists and family clinicians report that they usually or always ask new outpatients whether they drink alcohol. Less than 20% of primary care physicians routinely use validated self-report alcohol screening instruments (e. g. CAGE questions or AUDIT) Fewer than half ask about maximum alcohol consumption on one occasion. Alcohol biomarker laboratory tests are rarely used. Reasons given by clinicians for not following recommended alcohol screening guidelines range from lack of time, to insufficient knowledge and skills, to pessimistic attitudes about the ultimate benefits of screening. A current study conducted by Miller, et al. , (2004), they found that approximately 60% of clinicians surveyed frequently screen patients for alcohol use with quantity/frequency and CAGE questions. This is comparable to the incidence of screening found in previous studies. (Miller, Ornstein, Nietert, Anton, 2004)Miller, et al. 2006) further found that over 90% of patients were in favour of screening and guidance about alcohol use and very positive about the use of biological alcohol markers. These findings suggest that physicians and clinicians may be convinced that patients are open to alcohol screening and would not be offended by it. Heavy drinkers may have more of a tendency to be embarrassed by such questions but there is no evidence they would be object to screening. The majority of patients would also be willing to receive alcohol biomarker blood tests, if their physicians and clinicians deemed such tests necessary.

Social effects of hurricane Katrina in the Gulf region Essay

Social effects of hurricane Katrina in the Gulf region - Essay Example Social effects of hurricane Katrina in the Gulf region Research suggests Hurricane Katrina negatively impacted the Gulf region because it led to loss of lives, civil disturbances, and property damages. This included the invasion of Afghanistan and Iraq in a type of political revenge attack against the terrorist activity led by Osama bin Laden. The hurricane Katrina hit New Orleans in one of the worst times for America in Iraq, when the opposition attacks were at their strongest. The failure of the American government to help its own people in the aftermath of the hurricane contrasted sharply with the political rhetoric of the Bush administration, exposing its hypocrisy internationally on truly humanitarian and vital issues of domestic security. From this point on, the Bush administration would lose whatever political authority and respect it retained in America, eventually ending in the election of President Obama in the 2008 election. It is important to recognize how Hurricane Katrina eroded the political authority of the Bush administr ation at a time when it was conducting two unpopular political wars abroad. The symbolic effect of the images broadcast internationally displayed America as no different from the â€Å"Third World† nations that it perennially derides and rejects in building its political myth of superiority. The public, both domestically in America and internationally in civil society, are aware of the duality between the ideals proclaimed by the political leadership in America, and the actual actions taken by authority. For example, in talking about peace and justice, the U.S. administration at the time was practicing torture, extraordinary rendition, and other forms of illegal detention such as in undisclosed, secret prisons and Guantanamo Bay. This is a hypocritical stance in many ways, despite the way that it was posited by the Bush administration under the rhetoric of Homeland Security and public safety. What Katrina did is publicly expose the hypocrisy in this rhetoric to full internati onal view, showing that the Bush administration really was not concerned with people’s safety, health, and welfare at all, especially if they were not in a wealthy, Wall St. constituency. Thus, the first major effect of the Katrina disaster was to erode the public authority of the Bush administration and to associate it publicly with hypocrisy. (Brinkley, 2007). This result is quite important as the theme carried over into the 2008 Presidential election and led to the election of Barrack Obama and a Democratic majority in both the House of Representatives and the Senate. As a political symbol, Katrina showed the dichotomy between rich and poor in America, and how those in positions of power are more likely to be serving their own interests rather than that of the public good or public need. This is important as it creates a type of despair popularly, a political vacuum of sorts that the â€Å"hope and change† mantra of the Obama administration capitalized on in 2008. F rom this it is legitimate to conclude that Hurricane Katrina caused a major change in political perceptions in America, and that this included a loss of faith in the ability of the government to provide services in an emergency situation. (Brown, 2005) Consider the vast destruction and number of deaths and injuries that took place in the aftermath of Hurricane Katrina, and it is evident that this is precisely a situation where the

Essay Questions Example | Topics and Well Written Essays - 250 words - 4

Questions - Essay Example The government can address this by penalizing through the imposition of high taxes those companies who are subcontracting or exporting jobs abroad. This will in effect discourage companies to export jobs because it will become expensive to subcontract jobs. This arrangement is still possible because the government did not prohibit companies to relocate work but only formulated a strategy that does not give business incentive to export jobs. 2. Explain the importance of East Asia as an economic powerhouse. Is economic or political power shifting from North America (and specifically the United States) toward East Asia? Explain. Which historical and economic reasons might prevent East Asia from acting as a unified region in world politics? In economics, US economy is about eight times bigger than China and has also massive industrial and technological complex that can sustain the output and growth of its economy.   Its currency is still used as the worlds  reserve currency and it is not likely that the US dollar will be replaced by other currency soon (Business Monitor International, 2009 pg. 23).  China on the other hand lacks multinational corporations and does not  even  have its own industrial complex making its economy heavily dependent on Western enterprise Also, the huge  size of US economy enables it to allocate a military budget equaled by none.   It only allocates 4% of its total GDP on defense but due to the sheer size of its economy, this translates to a $600 billion military budget (Jinghao, 2008).   US has also the most advance weaponry in the world.   US military arsenal is already capable of stealth combat with its F22 fighters and B52 long range bombers.   To date, US has already completed the informationalization of its military that is leading to the  Ã¢â‚¬Å"no man†, networking orientation which is a powerful global combat strength (Pastor, 2001).   United States is also capable of projecting power beyond its border.   Its 12

Case Study - Early Alzheimers Essay Example for Free

Case Study Early Alzheimers Essay This paper reviews the use of cognitive rehabilitation treatment of early stage of dementia Alzheimer’s type. The case study examines a 72 year old male patient diagnosed with early stage dementia of Alzheimer’s Type. This study used visual imagery, as well as cues and expanding rehearsal during the cognitive rehabilitation. The evaluation of cognitive rehabilitation treatment included the psychological, physiological, neurological assessments and self-reports. Results suggested that extended use of cognitive rehabilitation treatment ensued longer lasting improved cognitive functioning.  With the results of the study discussed, implications suggest that combining longer treatment of cognitive rehabilitation could help reduce the progression of early onset dementia of the Alzheimer’s Type. Case Study Clare, Wilson, Carter, Hodges, and Adams (2001) studied a 74-year old single man, named â€Å"VJ† who lived with his sister in a single case study. VJ was formerly employed in the construction industry. VJ started to attend the memory clinic in 1993. He was then diagnosed having an early stage of dementia of Alzheimer type (DAT). His sister joined him at the clinic. The researchers started with a process called, cognitive rehabilitation (CR) intervention. Cognitive rehabilitation (CR) focuses on memory functioning. Although CR was at first developed for patients with traumatic brain injuries, it was proven to be efficient for people experiencing cognitive difficulties (Savage, 2009, p. 31). In order to define CR, it is necessary to define cognition. Katz and Hadas (1995) quote Lidz in defining cognition, â€Å"†¦as the individuals capacity to acquire and use information to adapt to environmental demands† (p. 9). Sigelman and Rider (2012) say that cognition is, â€Å"the activity of knowing and the process through which knowledge is acquired and problems solved† (p. 210). Cognitive rehabilitation is quoted by Katz and Hadas (1995) â€Å"†¦the therapeutic process of increasing or improving an individuals capacity to process and use incoming information so as to allow increased functioning in everyday life, this includes both methods to restore cognitive functioning and compensatory techniques (p. 29). Interventions aimed in CR are divided into remedial and adaptive/functional strategies (Katz Hadas, 1995). The main aim of the remedial strategy is the individuals impaired capabilities. The functional strategies are aimed to enhance the strengths of the individual for functioning. The assumption these two strategies are built upon is, â€Å"†¦that functional activities require cognitive perceptual skills†¦Ã¢â‚¬  (Katz Hadas, 1995, p. 30) and cognitive impairments can be modified and treated in the adult dysfunctional brain which will enhance reorganisation or recovery of the brain. Based on these assumptions the remedial strategy is directed towards functional abilities by retraining perception skill components of behaviour, while the functional strategy in contrast assumes that the affected adult brain has limited recovery potential and that retraining of the brain should be focused on specific activities as required (Katz Hadas, 1995). The unique feature of all occupational therapy models, are the emphasis that treatment is based on purposeful activities that are analyzed and adapted to the patients cognitive and functional ability level. This therapy is not without controversy. As the critics of CR indicated, memory training for people with DAT increases frustration for the patients, because the improvement in cognition is short term (Clare et al. , 2001). Sigelman and Rider (2012) agree by saying, â€Å"†¦over time, individuals cannot recall even with the aid of cues and become increasingly frustrated† (p. 541). Neuroplasticity is possible before or in the early stages of AD, but diminishes in later phases of AD. Clare et al. 2001) found empirical research to prove that CR is an effective method of slowing the decline of cognitive functions in early AD. Questions about CR which remain to be answered include impact of CR on well-being and life quality, the ability to sustain longevity of gains in cognitive therapy and what type of contributions can CR make in AD? (Clare et al, 2001). Lately, â€Å"identifying cognitive markers of a preclinical phase of Alzheimer’s disease (AD) has been a major research focus in neuropsychology† (Jacobson et al. 2009, p. 278). Cognitive Rehabilitation Intervention Clare and colleagues, (2001) predicted in theory, that the possibility cognitive rehabilitation may be responsible for the maintenance of memory gains over time. The researchers set to prove through long-term follow-up data that memory retraining had lasting effects and showed gains beyond the treatment sessions as demonstrated by previous cognitive rehabilitation studies. The researchers used 11 Polaroid photos of VJ’s club members to teach the face-name associations. This was performed by the method of combining visual imagery, vanishing cues, and expanding rehearsal (Clare et al. , 2001). The researchers took VJ to the familiar environment of the club to do generalisation sessions using the photos and found the initial recall was 20% and raised to 98% over time and became 100% at the one, three, six and nine months follow-up sessions. VJ practiced every day using the photographs. â€Å"In the early stages of Alzheimer’s disease, free recall tasks are difficult but memory is good if cues to recall are provided†¦Ã¢â‚¬  (Sigelman Rider, 2012, p. 41), like the photos in this case study. After the ninth months, the researchers took the photos away to use them only once a month, at the club with VJ. VJ was to recall the first names of the people in the photos with zero feedback given to VJ. After the first and second year, magnetic resonance imaging (MRI) was completed. At the same times neuropsychological assessment were completed to evaluate the results of changes in cognitive functioning compared to the initial and post-intervention assessments. Several tests were used in the neuropsychological assessment such as the Mini-Mental State Examination (MMSE); National Adult Reading Test (NART); Standard Progressive Matrices (SPM); Speed and Capacity of Language Processing (SCOLP); Visual Object and Space Perception Battery (VOSP); Unfamiliar Face Matching; Digit span, forwards and backwards; Rivermead Behavioural Memory Test (RBMT); Doors and People; Famous Faces and Famous Names. Self-report measures were used as well to assess VJ’s perceptions of memory problems, behaviour, affect and VJ’s sister on caregiver strain. The following measures were used: Memory Symptoms Questionnaire; Hospital Anxiety and Depression Scale (HADS); Caregiver Strain Index (CSI) VJ’s sister rated herself on strain experienced (Clare et al. , 2001). The initial and post-intervention neuropsychological assessments shown VJ’s general cognitive abilities before he contracted DAT were in the high average ranges, his post-intervention scores were above average, though speed of processing was slower. VJ’s perceptual skills and processing of unfamiliar faces were in normal ranges. Memory was severely impaired, having difficulty recalling names of famous people. Overall there was not much of a change between the initial and post-intervention assessments, but only a mild decline in abstract reasoning and speed of processing information. While some of VJ’s cognitive functions remained the same, â€Å"†¦a gradual decline in abstract reasoning, speed of information processing, working memory, episodic memory, and semantic memory over the study period was evident. MMSE scores, too, showed a mild decline†¦assessment of coronal T1 images (MRI) revealed mild, but definite, bilateral hippocampal atrophy as indicated by enlargement of the temporal horn of the lateral ventricle and reduction in height of the hippocampal formation† (Clare et al. , 2001, p. 486-487). After all the results were taken in consideration it seems that this case study provides the evidence that long-term maintenance of specific gains can be achieved with a CR procedure. The use of CR in dementia was criticised as not being an intervention that can assure any gains beyond the treatment sessions. It is clear from the results of this study that this claim is untrue. Another case study in 2003 was done with the same interventions. The same results were found and support the finding that CR maybe a valuable comprehensive intervention for persons with early identified dementia of the Alzheimer type (Clare, Wilson, Carter, Hodges, 2003). Conclusions The results of this case study indicate the importance of length in cognitive rehabilitation for individuals diagnosed with early staged dementia of the Alzheimer’s type. The use of cognitive rehabilitation over an extended period of treatment allowed the researchers to evaluate the importance of visual imagery, recall and extended rehearsal strategies in treatment. The positive results indicated possible development in the treatment of diagnosed patients, as well as duration and techniques applied. Future studies will need to focus on the exact parameters of duration for treatment with cognitive rehabilitation in patients diagnosed with early stage dementia of Alzheimer’s Type. Implications arrived from the longevity of treatment could also improve the overall quality of treatment, evidence to substantiate financial support/funding for treatment and improve motivation and expectations from patients and family members. The importance to involve cognitive stimulation with patients diagnosed with early stages of Alzheimer’s disease is apparent in subsequent research and continues to be implicated in other similar cognitive dysfunctions.

The Declaration of Independence Essay example -- essays research paper

The Declaration of Independence   Ã‚  Ã‚  Ã‚  Ã‚  Ã¢â‚¬Å"We hold these Truths to be self-evident, that all men are created equal and that they are endowed by the Creator with certain unalienable rights, that among these are Life, Liberty, and the Pursuit of Happiness-That to secure these Rights, Governments are instituted among Men, deriving their justice Powers from the consent of the Governed, that whenever any form of Government becomes destructive of these Ends, it is the Right of the People to alter or to abolish it, and to institute new Government† (The Declaration of Independence, www.founding.com). Upon these words, the founding fathers of the United States of America declared independence from Great Britain. In July of 1776, the thirteen colonies: New Hampshire, Massachusetts, Connecticut, Rhode Island, New York, New Jersey, Pennsylvania, Delaware, Maryland, Virginia, North Carolina, South Carolina, and Georgia, signed the completed Declaration of Independence and formally marked their separation f rom Great Britain (The Declaration of Independence, Microsoft Encarta Encyclopedia 2000). Even more, the document established the new American revolutionary government and officially declared war against Britain.   Ã‚  Ã‚  Ã‚  Ã‚  The Declaration of Independence was the colonists’ reaction to King George’s III new policy of control over all of British North America. Upon gaining new land from France following the French and Indian War, King George and th...