My Super Mother Essay

For me heroes really exist in reality. And for me my super hero is my mother. My mother actually is an ordinary woman. But for me she can do extra ordinary things. She is always there in times that I feel very hopeless, that’s why I really love her. She brought me up with a strong faith and a power to face the toughest challenges in life. She is willing to help everyone’s problems or misery without anything in return. That’s why I’m so very proud of her. For me she’s the best mother in the whole world. She’s talented, pretty and very hardworking. My mother is the one who taught me how to write, read, and how to explore things in life. She provided me and my siblings the best educational opportunities that there could be. She has always pushed me to study very hard so that I can achieve my life’s goal. My mother is also the one who influenced me to have a decision in my life. My mother’s perseverance has encouraged me to live the life of an authentic person. I and my family felt so blessed to have a mother like her. She is so very protective, supportive and very caring unlike to my father. Read more:Â  Person I admire most essay Even though she is always stressed doing the household chores she has always time to help us in our assignments, projects and all the things that we need her help. That s why I and my siblings really love her she’s our living hero. For me having my mother is the luckiest thing that I had. Even though there is many times that we are having an argument. But it’s not that really serious, because my mom is very understanding. She can understand my own feelings and she’s not very strict unlike to my father. She loves cooking foods on her own, and making her own recipes. She loves spending her time cleaning the house as always, reading books and teaching my little sister her lessons. If my mom was a food I can tell that she’s the most special one. She’s one of a kind and for me she’s the most unique and delicious food that I’ve ever tasted. And if my mom was a student, she is the most talented and the brightest of all the students in class. That’s why I’m so very proud of her. And if my mom was a warrior, she is the bravest and the strongest person that I’ve ever seen. But the truth is my mom was a simple human living in this world. But for me she is the hero and the reason why I and my family keep living. I’m very thankful to God that he had given me my mother. Because the person who influences my life the most is my mother Even though sometimes she had our breakfast overcooked, we love eating the foods that she made. And even though she commits mistakes, the number of the mistakes that she did was nothing compare to the number of the times she help us to avoid to do mistakes. I admire my mother because she is a strong woman to have the courage to face our family difficulties in our everyday life, and also she always had a big heart in caring for others. My mother has sacrificed so much just to raise us. She’s not just a mother but for us she is a hero. A hero that is always there to help us in times that we feel so burdened and in times that we need her she is also always there to guide us through the right path. Pretty, supportive, protective, cheerful, brilliant, industrious, talented, understanding, amazing and unique these are just words how to describe my mother. But for me no words can tell how wonderful my mother is. That’s why I’m very happy and contented to have a mother like her.

How an Outside Influence Acts as a Powerful Force

Within ‘Othello’ Iago appears cunning, the confidence he has allows him to act as an outside force manipulating the relationship between Othello and Desdemona. The interpretations of the outside influence are questionable throughout the three texts. The issue in ‘The Great Gatsby’ of whether Jay Gatsby corrupts Daisy and Tom Buchanan’s marriage because he loves her or whether she is a material desire; and whether Jed’s mental state or Joe’s rationality in ‘Enduring Love’ is to blame for the corruption between the contemporary couple, Joe and Clarissa. Iago’s ability to observe allows him to gain control of Othello and seek revenge.Whether this is for the goodness of his community or due to jealousy is unknown. However, through language, form and structure it is clear that a gradual decay in both love and morals takes place. Iago’s performance creates the impression that he is a heartless character as no true fr iendship, love or morals are shown. â€Å"I am not what I am†, he is a devious onlooker who aims to destruct happiness, yet the reason for this remains uncertain. Iago can be classified as an outside force due to his dishonesty and cruel intentions, which often only the audience is aware of due to his mysterious actions. Beware my lord of jealousy; it is the green-eyed monster†. The audience is positioned to understand that William Shakespeare is presenting irony as Iago is warning others of jealousy, when perhaps he is tied down by his own. Utilising personification also foreshadows the cruel intention Iago has to damage the contentment in Othello’s life. A clever choice of words allows Iago to deliver the impression that he is a loyal and honest man. Throughout the play he sets the stage to ensure Othello and Desdemona’s relationship becomes corrupt, denying himself of any responsibility.This contrasts to Jed Parry in ‘Enduring Love’. Lead b y his belief in God, a strong emotional attachment is made with Joe, one which Jed is persistently honest about. With the belief that God â€Å"has sent me to you† Jed ignores Joe’s resistance and does not seek revenge, instead rejection brings him closer to Joe. This categorises Jed as a contemporary villain, as he goes against traditional values of a villain. Perhaps, due to Iago conforming to the conventional idea of a Shakespearian villain, the reader may classify him as a more effective outside.He places himself outside of situations; he observes, manipulates and watches Othello crumble. Whereas Enduring Love presents a contemporary villain who moves beyond traditional expectations of causing unhappiness; bitterness is replaced with calm tones, â€Å"Love has given me new eyes, I see with such clarity, in such detail†. Jed’s bizarre approach arguably challenges the reader more than Iago’s evasive behaviour. Written in 1603, ‘Othello†™ touched upon a major issue in Europe of this time period; the intermingling of Muslim religion and culture with the West.Ironically, Othello is sent to protect the Venetians from the influence of Muslim Turks even though he is ‘the Moor’. Iago uses the issue of Othello’s race to present him as a misfit; â€Å"Awake the snorting citizens with the bell, or else the devil will make a grandsire of you†. Shakespeare plays on 16th century beliefs through the symbolism of the â€Å"devil†. It was thought that often the devil took the shape and form of a black man. Insensitive words corrupt Othello’s reputation of â€Å"valiant†. Othello has determination, loyalty and commitment towards his â€Å"gentle Desdemona†.This causes him to resist 16th century attitudes tawards race. â€Å"Let him do his spite†¦I love thee gentle Desdemona†. Repelling obstacles is key to achieving an idyllic relationship. Jay Gatsby is similar t o Othello, not in race, but due to issues of social class. Jay Gatsby represents the ‘new’ rich from West Egg, he lacks social connections so he flaunts his wealth. This is an issue F. Scott Fitzgerald mocks throughout, as this novel presents a social commentary upon the corrupt state of materialism in the 1920’s.Fitzgerald uses many references to time throughout the novel. Fitzgerald delivers the message that everything in this lifestyle is temporary– emotions, actions, parties, or feelings, because they are all fuelled through material objects. | Nick Carraway, the narrator describes Jay Gatsby as, â€Å"running down like an over-wound clock†. The simile signifies both Gatsby’s consuming desire to stop time and his inability to do so. This may be the reason why he is selfish in pursuing Daisy as he has no respect for Tom, who lives in East Egg, a place for the established upper class.

Refugees: Human Rights and Largest Refugee Populations

Refugees Part A. Sadly and commonly throughout the world of today with its immense technology, and stature lies an ever growing and simple problem soon becoming an epidemic. Through tyranny styled governments, ignorance and even a lack of awareness and care sits 20 million refugees thrown from their countries simply because it is not safe, to a place where they are unknown. These people are children, mothers and fathers dying endlessly with nowhere to go and without a future.Under international law, a refugee is a person who is outside his/her country of nationality or habitual residence; has a well-founded fear of persecution because of his/her race, religion, nationality, membership in a particular social group or political opinion; and is unable or unwilling to avail himself/herself of the protection of that country, or to return there, for fear of persecution. They are subgroup of the broader category of displaced persons. †¦ en. wikipedia. org/wiki/Refugee A refugee can be defined in a variety of means and in many ways is a definition that often faces misconception with the general public.In many cases it is the way in which the circumstances arise that leaves people confused. Wether or not they were forced and also wether it is simply a home or a country that you become forced out of. A refugee is a person or persons that have been forced out of there natural habitat wether it simply be there home or there country and are left with no other option but to run away, out of fear of persecution, death, or because of natural disaster. They do not necessarily run away from there nation of citizenship but just to another location other then there ordinary home to take refuge.If it is decided that they are either accepted into a country or run into a country for refuge then they are to receive the same freedom and rights as any other ordinary legal resident. However this doesn’t allow them to become immediate citizens or have an extended period of ref uge in the country, if and when there country of origin returns to a state of decency they are then forced to return. These rights include; basic civil rights, freedom of thought, freedom of movement, and freedom from torture and degrading treatment.As with any other individual these people are entitled to have the right to: work, medical care, social and economical rights, and every child must have the right to schooling. We must keep in mind that these people aren’t asylum seekers or immigrants, they simply leave to take refuge and safety. Causes of extended refugee numbers. GOVERNMENT: often in third world and poorly funded nations people are forced to leave as a result of a tyranny styled government. These corrupt officials often associate with terrorists, guerrillas, and drug barons, making the country unsafe and unliveable.FARMING: poorly funded or corrupt nations often lack sufficient land and equipment for farming practices. This is made worse by a lack of education a nd farming knowledge. With this, food numbers and the economy is bought down. The farmers themselves as well as all countrymen and women are left with little food and money and are forced to leave. WAR: Corrupt and poor nations are often at the greatest threat of terrorist and war activity thanks to the government and lack of money. Terrorists prey on these areas with poor security, education and with a wide array of religions.Civilians are at great risk. This is also added to by religious and race fuelled wars. NATURAL DISASTERS: countries often with poor financial backing are worst hit by natural disasters. Farms, the lifeblood of the area as well as buildings which were poorly built originally become demolished. Furthermore infrastructure such as sewerage and water as well as electricity become unsafe and unclean as these nations lack the money not only to fix it but to have had sufficient facilities to begin with. These people are again forced to leave to avoid death.PERSECUTION : is often caused by corrupt governments. Persecution is often aimed at particular races, religious backgrounds, group memberships, and opinions. Many governments stand for unjust laws allowing people to be unfairly persecuted. Where Are the Refugees coming from? AFRICA: ASIA: 1951: 5,000 1951: 41,500 1999: 3,523,100. 1999: 4,781,800 EUROPE: SOUTH AMERICA. 1951: 1,221,200 1951: 120,000 999: 2,617,600 1999: 61,100 NORTH AMERICA. OCEANIA. 1951: 518,500 1951: 180,000 1999: 649,600 1999: 64,500. THE WORLD: 1951: 2,116,200 1999: 11,697,800 The Largest Refugee Populations, 1999. Who is taking responsibility for the care of the refugees? Part B. Solving the refugee epidemic†¦ As with each day we grow in our knowledge stature both scientifically and technologically as does, sadly a societal epidemic in that of our refugee numbers.First and foremost these nations need funding that must find its way to the citizens that need it and not the Government. From here education is a necessity where it then should be used in schools, as well as teaching for trades, farming practices, and general human rights, with social education. As said, the most simple yet in many ways unattainable solution is education, in teaching skills and tolerance. In part A, identified were major causes of the refugee numbers and in each case and example education would have been a solution, with the exception of the Government.Persecution, often caused by race and religion or even opinions is often fuelled by regular citizens who simply haven’t had the correct education and were forced into abiding by certain laws, governments and religions. The people themselves who are often persecuted are the ones who have had the ability to be educated and have their own beliefs rather than those who were taken at a young age and forced to fight or believe in a cause. When it comes to another problem that education can cure, we must look at natural disasters.Obviously the disaster itself cannot be p revented, however the original damage in many cases could have been far less and the rebuilding could be far better, resulting in fewer refugees, had education been received. This education would have helped several aspects of a natural disasters effect. Firstly buildings and farms in the areas would have been constructed and prepared in order to sustain such events and if educated awareness of the event and preparation in procedures before and after the diaster would be far better.Farming itself is extremely significant in providing sufficient aspects of these nations economy so again education is vital. Funding shouldn’t be used to supply food to these nations, but to rather supply education for correct farming practices, equipment, facilities and knowledge. This would not only significantly change refugee numbers but increase economic stability and create jobs and money in the area. This education mainly needs to be served to children of the nation at an extremely young ag e, the future of these nations, who can then provide a emocratic government, as well as having the knowledge to create a sufficiently flowing nation, with agricultural and business benefits. With such religious and social education which is a major problem, corrupt governments will no longer be running the nation and therefore unable to persecute, discriminate or steal. With this education, these nations will grow in stature to provide sufficient, social, economical, health, business, and security aspects that will no longer see citizens forced to run to other countries.

Pay For Play Essay Example | Topics and Well Written Essays - 1000 words

Pay For Play - Essay Example I have chosen to write about this topic as I have seen college athletes undergoing much sacrifice and bring money but they are not paid in return. Second reason I chose this topic is because I have been a football player in college and I understand what it means to work to get money for extra spending. So I believe that college athletes should be paid has they put lot effort in bringing advantage to college. (Thesis) College athletes have developed into uncrowned and undefined athletic heroes who strive and struggle to bring a well -defined fame and earn an overly demarcated reputation for the institute, which has been over the years counted as their performing duty that calls for no justification to be paid financially. However, I strongly believe that the regulations regarding payment of college athletes be changed because these players bring in too much money and put in too much work for them to not be earning a paycheck. Major sports played at college-Sports have been an integral part of college education and it has always encouraged and inspired students to be more active and contribute to the college heritage. The colleges hold sport events on a regular basis and it has been a way to explore the talent and skill of students from a different dimension. Sports have united and inspired young men to be able and fit to become a professional sportsman. The major sports played at college and university level are football, basketball, baseball and softball. The history of sports at college and university can be traced back to couple of centuries History of college sports-The history of college sports is thought to be originated around 1850s and since then it has been evolved to become a major mission in educational campuses across America. It has been regarded as the perfect physical activity and the desire of the young men. The competitive spirit and vigor which consisted in college sports hiked the mental and physical pleasure of the students. The college autho rities elaborately planned sports activities which motivated the students immensely and sports event on college and national level became a prestigious venture and money making phenomena for college authorities. On the other hand, the students athletes remained thrilled about being college’s selected people and representatives of college on state level. Moreover, the media kept the young athletes in the lime light and the scholarship provided by colleges to them stood as a bonus. Recruitment of college athletes -Recruiting is a significant phase in college sports. The recruitment process is headed by college coach and large amount of power is vested with him in selecting the college athletes. It has been experienced that the selection procedure of athletes many a times is subjected to bias and discriminations. For the recruitment procedure, the athletes are required to do rigorous practice and this take lot of energy and time of the students which ruined their academics. The most important point in consideration is that these institutes that have been developed to nurture, maintain and enhance the intellectual minds at the professional level and speed up the purpose of taming the existing skills into more sophisticated commercial and other practical uses, when they employ physical strengths of the same youth alongside to the above mentioned rational goals, how could they be ignorant of giving the youth the required motivation to grow in athletics? (ESPN Colleeg Sports, 2013)However, when it comes to payment

Property Land Law Essay Example | Topics and Well Written Essays - 1000 words

Property Land Law - Essay Example Felix S. Cohen suggests that property is about relationships between people. An individual's proprietary interest will depend on his ability, as accorded by law, to dispose of his property as he sees fit and prevent others from enjoying or utilizing it. Proprietary interests can be fragmented among a number of individuals or groups over different levels, making the ability to exclude others more difficult and confusing, oftentimes leading to property disputes.In Western Australia, such problems become more confusing because of two existing systems of land ownership. The case of the Hillside and Coventry properties is an example where Frederick, owner of the two properties with fee simple interests, mortgaged and consequently sold to Marjorie, Lucille, and Bernie. This left the parties with competing interests, thus calling for the need to determine whose interest is greater and what each party can do to create an interest in the aforementioned properties. According to the Old System, upon which Hillside is initially registered under, Marjorie, upon entering into a contract with Frederick possess an equitable interest in the property. With regard to Bernie, his interest depends on whether there was a conveyance of deeds and the legal interests were transferred to Lucille. Lucille’s interest, however, as second mortgagee is quite interesting.Both Lucille and Marjorie’s interests are subject to the equity of redemption.... Hence, there cannot be two legal mortgages over a single property. This, however, does not apply because in Lucille's case, although her mortgage happened subsequent to Marjorie's mortgage, the legal interest was not transferred to Marjorie because Frederick kept the deeds and gave them to Lucille. In this sense, Lucille has the legal interest in the property. However, it is important to determine whether there has been a conveyance of properties. The case only mentioned Frederick giving the deeds of the property to Lucille. If such can be considered a conveyance of the deeds, she possesses the legal interest. On the contrary, if there was no conveyance of deeds, her interest remains equitable. Both Lucille and Marjorie's interests are subject to the equity of redemption3. Thus, although a transfer was made based on the Old System, Frederick still retains certain interests in the property, including the right to redeem it, provided that he complies with his obligations. With regard to Bernie, his interest depends on whether there was a conveyance of deeds and the legal interests were transferred to Lucille. Assuming that Frederick's legal interests were transferred to Lucille by virtue of the mortgage, Bernie possesses only an equitable interest in Hillside based on the equity of redemption, which Frederick retained upon the mortgage. This is because at the time the sale took place, Frederick did not have a legal interest in the property to sell to Bernie by virtue of the mortgage. Hence, Bernie will only possess a legal interest after the mortgage is paid off and redeems his rights from Lucille. Between Lucille and Marjorie, Lucille's interest takes priority because she conducted the legal mortgage, hence possessing a legal interest. Between Lucille and Bernie,

Discussion Essay Example | Topics and Well Written Essays - 500 words - 43

Discussion - Essay Example In addition, the student portal is a crucial place to visit regularly since I get updates and information about my current school grades for the past years and it is easy to note any changes on such grades. With the school email, regular access makes me remain updated on things like course soft copies and presentations as sent by respective teachers. If I were driven by fear of consequences, being informed through the school notice board, school email, and student portal would be to gain critical information like exams and other dates that would affect my course completion. For instance, missing on exam dates would result to facing disciplinary action or expulsion, which is a big blow to my education and good grades. I believe the drive by fear of consequences is the best option. The university has set clear rules on all assignments and coursework submission. Some of the consequences of course requirements include penalizing like in late or plagiarised assignments, likelihood of expulsion for failed submission without notice, and sanctioned for disciplinary action for repeated failure. Additionally, I have some self-set goals and objectives to assist me in attaining the best grades for my career. In this case, I have to pass in my entire course works for fear that they would lower my cumulative grade. For me, this would mean missing the career of my dreams while observing time and instructions in my course work would maximize my chances of attaining a high grade. I would also gain high confidence in all my work and this would instil a sense of problem analysis, and solving that would be useful even in my real life (ODonnell, Reeve and Smith 132). If I followed my sense of obligation, there are high chances of relaxing and not being so keen on time and coursework instructions especially where the tutor is not strict. This would also increase the possibility of losing my research skills and self-dependence, and

Experience of war veterans and psychological effects of Vietnam war Assignment

Experience of war veterans and psychological effects of Vietnam war - Assignment Example From the stories of those who left the war, it can be understood that the conditions of survival were succinct to a point whereby they saw it was wise to rather die in their home countries under different circumstances than die in foreign lands under the conditions that they were living in. It is evident that the mental disturbance can arise from happenings and experiences that people undergo. With regard to humanity, there are different ways of contemplating situations, perhaps the soldiers who walked away from the war valued their humanity and opted to keep their distances from the occurrences of the Vietnam War (Salmon, 1921). To the strong-willed, those who kept the ‘Short Timer’s’ Calendar seemed to know what to expect in war and hence they were ready to uphold their motto and fight for their nations regardless of whether death would precede. Self-esteem can also play a part in explaining why one would have opted to remain in the war. The thought of what people in their motherland would think if they retreated and left the war. (Salmon, 1921). The perception of cowardice on them was not an issue to relent

Employment-At-Will Doctrine Research Paper Example | Topics and Well Written Essays - 1250 words

Employment-At-Will Doctrine - Research Paper Example This discussion is based on four cases of employee-at-will doctrine and liability of an organization on these cases. The objective of the discussion is to find out the possible actions and responses on certain circumstances of employees’ behavior and performances in an organization. Case 1 In the first case, it can be observed that Jennifer (an employee) is unable to learn the usage of certain computer applications which is one of the core tasks of her job. It can be observed that the employee does not comply with the job skills requirements in order to perform the assigned tasks. Hence, it can be assumed that her employment is dependent on her request and interview procedure. Although the organization has recruited her on the basis of her qualifications, she is incapable to perform her assigned job. Thus, she could no longer be termed as a valuable human resource for the organization. The employment-at-will principle describes that an employee who is recruited on the basis of his/her own consent can choose to leave at any moment. The same is true for the organization, as it can also terminate, Jennifer on appropriate grounds. In case of termination, the organization will not embrace any kind of legal liability if no agreement was contracted between Jennifer and the organization with respect to employment. However, there is one exemption to the principle of employment-at-will which states that the organization cannot dismiss Jennifer if public policy supports her. Since Jennifer is not protected by any kind of public policy, the organization can easily dismiss her from employment. The other exception of employment-at-will is implied contract which is termed as oral covenant. Thus, this implied contract or oral pledges can prevent the organization to terminate Jennifer. Thus, the organization must arrange documentations in order to prove the basis for termination of Jennifer (Muhl, 2001). Case 2 With respect to second case, it can be observed that the emp loyee (Jennifer) has certain behavioral problems in the workplace, as she frequently arrives late at work and also demonstrates rage when she is criticized. Furthermore, she also demonstrates self-justifying attitude to the organization. In this context, it can be stated that the organization can dismiss her in a legalized way. In order to do so, the organization will need to record her every absence and late. Furthermore, each occurrence of defensive attitude shown by her and comments on behalf of employee rights also must be documented appropriately. The organization can bring this matter in front of her in order to make appropriate solution to the problem. With respect to her defensive attitude and comments about employee rights, the management must prepare in order to face any kind of legal proceedings while dismissing the employee (Urhuogo, 2010). Case 3 Concerning the third case, it can be observed that the employee (Jennifer) had taken a day off from work due to the observanc e of certain religious activities without taking proper consent of the management. Furthermore, the day off occurred during extremely busy period for the organization, during which the employer had informed that its employees will not be permitted to take any leave without any previous approval

ASSIGNMENTREADING SKILL PowerPoint Presentation Example | Topics and Well Written Essays - 500 words

ASSIGNMENTREADING SKILL - PowerPoint Presentation Example Since she can afford to spend more on her food and "tube", we can assume she has some back-up financial arrangement to fall back upon in case of need. Moreover, she had been doing this job out of curiosity and adventure instead of a real need; therefore it would be safe to think she was leading a comfortable life outside the hotel. 4(b) The dissatisfaction among the workers at the hotel was at its peak. The employees were under-paid and never happy with their wages. They had reservations about unpaid hours and little bonuses as they were hardly making both ends meet. There were also concerns about the nature of job they were doing as most of them would not want to perform the toilet-cleaning and similar kind of chores. 5 I think both writers have given a balanced picture of life on the minimum wage. Article 1 gives the experiences of people coming from different backgrounds; nevertheless they are working under the same roof and leading their lives in the same city. The general economic and social environment is same for the whole set of people and all of them are getting the same "minimum wage". Furthermore, the writer has not compared the situation to other countries. Similarly in the second article, the writer has compared the situation in different countries but in the similar economic conditions.

The Gift of Magi Essay Example for Free

The Gift of Magi Essay Country Lovers Alyssa Helm English 125 Instructor: David Makhanlall November 7, 2011 Themes: The Gift of Magi It is always great to read stories where the author is able to show love between two characters. â€Å"The Gift of Magi† was a great example of this. This story showed how a couple’s love was so strong between the two, that they were able to give up their most prize possessions for one another. â€Å"The Gift of Magi† allows the reader to be able to relate to this love story with a heartwarming theme of love vs. material things. As a reader reading this story there were a lot of themes or meanings that this story has. A theme: â€Å"it is not a statement about a dominant impression or mood; it is not a moral or proposition; it is not the attitude of the writer. Theme is more complex than any of these elements of fiction; it cant be defined in a single word† (Clugston, R. W. (2010). The most important would be showing the limits a person would go for someone that they love, even if it means giving up the most important thing to them. Della, with only $1. 7, wanted to make sure that she was able to provide her husband with what she felt would be the best Christmas gift. Della considered her long, brown hair as one of her most prized possessions. But, when it came down to her hair or getting her husband Jim a Christmas gift she did not think twice about cutting it. The twenty dollars that the woman offered her at the hair shop seemed to be just enough for her to be able to purchase the perfect gift. Ther e were many literary elements that contributed to the theme of this story. The first one would be symbols. There are two main symbols that are represented in this story. This would be Della’s long brown hair and her husband Jim’s gold watch. . Had the queen of Sheba lived in the flat across the airshaft, Della would have let her hair hang out the window some day to dry just to depreciate Her Majestys jewels and gifts. Had King Solomon been the janitor, with all his treasures piled up in the basement, Jim would have pulled out his watch every time he passed, just to see him pluck at his beard from envy(Clugston, R. W. (2010). These two things are focused on the most in this story. The end result in this story has a twist on it. Della and Jim both bought things to compliment each other’s prized possessions. The focus was mainly put on Della’s hair however at the end of the story it reveals how her husband Jim had sold his watch so that he was able to purchase the hair barrettes that she couldn’t use now because she cut her hair. Della didn’t know what reaction she would get from her husband, she even went home to style her now short hair so that it maybe her husband would accept her drastic cut. The couple did this only to find out at the end of the story that they both got rid of what was most important so they could buy each other a gift for the holidays. The second literary element that would contribute to this them would be the point of view. This story was told in third person. This means that the story contained a narrator. â€Å"Its important to remember that the narrator, whether a character inside the story or one looking on from outside the action, is a voice invented by the author for the purposes of the story. Clugston, R. W. (2010). I feel like with this story it helps set the mood and was able to allow the reader to sympathize with the couple. I say this because the narrator is able to describe in full detail the feelings of each character. We are able to see things that we would not if the character had been telling the story. The narrator is able to provide us with full detail about each facial expression, or feeling that is told. Although this couple was only trying to make sure they each had something for Christmas, I feel like if they had communication they would have been able to avoid losing items that meant the most to them. I totally understand how much it means to be able to buy your loved one something on a holiday, but it’s not always about materialistic things as you have each other. Reference Page 1) Clugston, R. W. (2010). Journey into Literature.

Examination of the Cardiovascular System

Examination of the Cardiovascular System The child should be undressed appropriately to the waist. In the older child, the examination easily performed with the patient sitting over the edge of the bed or even on a chair. Preferably, examine the younger child on the parents lap. Removing a toddler from his parents is less likely to yield good clinical signs and more likely to yield a screaming child. For examination of femoral pulses, the child should be in the supine position. Warm your hands by rubbing them against each other. STEPS OF THE TASK You should use the middle three fingers of your dominant hand to palpate the pulses against the underlying bone. The finger tips are used for palpation as they have maximum sensitivity. While palpating, the artery is stabilized by the proximal and distal fingers and the thrust of the pulse is felt by the middle finger. Partial occlusion of the artery by the distal finger improves the thrust of the pulse wave on the middle finger. Palpate all the pulses listed below first on the right and then on the left side. Always compare the respective pulses on both sides except the carotids. In case of carotids, palpitating both sides can induce cerebral ischemia and can cause the patient to faint. Carotid (dont palpate both sides simultaneously) Palpated at the level of thyroid cartilage along the medial border of the sternomastoid muscle either with finger tips or thumb (left thumb for the right side and vice versa) Brachial Palpated with the elbow flexed along the medial aspect of the lower end of the arm Radial felt at the lower end of the radius on the anterior aspect of the wrist, medial to the styloid process with the patients forearm slightly pronated and wrist semiflexed Femoral (DO NOT FORGET FEMORALS) felt in the middle of the groin with the leg slightly flexed and abducted and foot externally rotated. Dorsalis pedis can be felt on the dorsum of the foot lateral to the extensor hallucis tendon in the middle third of the foot Posterior tibial felt posterior to the medial malleolus and anterior to the Achilles tendon. For assessing the pulse rate, use brachial pulse in an infant or toddler and radial pulse in older children While counting the pulse rate, count for 15 seconds and multiply by 4. But tell the examiner that ideally, you would like to count for one minute. However, if the pulse is irregular, then count for one full minute and also count the heart rate by auscultation. Rhythm while looking for the rhythm, one looks for the gap between the pulse waves and comment on their regularity. Volume This is a highly subjective sign. It describes the thrust (expansion) of the pulse wave and reflects the pulse pressure. If high volume, always check for collapsing nature. (Hold the right forearm of the patient by your hand in such a way as the radial artery is under the head of the metacarpals of our hand. Lift the patients entire upper limb vertically by 90à ¯Ã¢â‚¬Å¡Ã‚ °and feel for the sudden and exaggerated rise and fall of the pulsations of radial artery.) Character This describes the form of the wave and various types are decided by the rise, peak and waning of the wave. It is best appreciated in carotids. Radio femoral delay (femoral pulse appears following a time delay after radial suggests coarctation of aorta) POST- TASK Make sure you dont leave the child exposed. Thank the child/ parent for co operation if no further examination is planned VIGNETTE Characteristics of pulse should be described as follows Rate Rhythm Volume Character Symmetry Radio-femoral delay Rate Comment on rate as normal, tachycardia or bradycardia based on age specific heart. In general, for children over 3 years of age pulse rate >100 beats per minute is tachycardia and pulse rate Tachycardia has poor specificity and always make sure child is not anxious/ febrile before attributing significance Bradycardia in a child is usually point to underlying pathology once exercise (athletes), drug intake (Digoxin, beta blockers) is ruled out. Rhythm Reported as regular, Regularly irregular and Irregularly irregular Regular there is a normal variation of heart rate on breathing sinus arrhythmia. It is present in most children. Regularly Irregular: abnormal beats occur at regular intervals pulsus bigeminus, coupled extrasystoles (digoxin toxicity), Wenckebach Phenomenon Irregularly Irregular no specific gaps between the waves Extrasystoles are common in normal children and disappear with exercise. Atrial fibrillation is another common condition which causes an irregularly irregular pulse. Comment on the pulse deficit i.e. the difference between heart rate and pulse rate Volume High volume anemia, carbon dioxide retention or thyrotoxicosis Low volume pulse is seen in low cardiac output states. Character Slow rising and plateau (pulsus parvus et tardus) severe aortic stenosis Collapsing pulse e.g. aortic incompetence Pulsus Paradoxus- pulse is weaker or disappears on inspiration e.g. Constrictive pericarditis, tamponade, status asthmaticus Jerky pulse normal volume, rapidly rising and ill sustained.-suggestive of hypertrophic obstructive cardiomyopathy Pulsus bisferiens two peaks felt during systole, seen in the presence of moderate artic stenosis and severe aortic regurgitation Pulsus alternans Pulse wave with alternate small and large waves seen in severe left ventricular failure and arrhythmias Symmetry Unequal or absent pulses may be suggestive of previous surgery e.g. Blalock-Taussig shunt, repaired coarctation, cervical rib or absent radial pulse OSCE CHECKLIST PRIOR TO THE TASK Hand washing or using alcohol rub Asks the name and age of the child, if already not told by the examiner Explains the purpose of his/ her visit and what he/ she is going to do Positions the patient appropriately TASK Uses the middle three fingers of the dominant hand to palpate the pulses Palpates all the pulses first on one side and then on the other side Compares pulses bilaterally Does not palpate the carotids simultaneously Counts the pulse rate at least for 15 seconds If pulse is irregular, then counts for one full minute and also counts heart rate Looks for Radio femoral delay While describing the pulse, comments on rate, rhythm, character, volume, symmetry and radio-femoral delay POST- TASK Makes sure that the child is not left exposed Thanks the child / parent for co operation Task: MANUAL Measurement of blood pressure PRIOR TO THE TASK Mercury sphygmomanometer should be used as aneroid sphygmomanometer loses accuracy on repeated usage. Choose the appropriate size cuff the cuff bladder should cover at least 2/3 of the length of the arm and 3/4 of the circumference . Cuff size should always be documented. Make sure that the child is calm and not crying or agitated Child can be either seated or in the supine position Any clothing over the arm should be removed THE TASK The convention is to measure BP in the right arm in a calm but awake subject. If conditions differ from this they should be documented with the reading. The elbow should be supported and flexed and should be at the level of the heart. The cuff is wrapped around the upper arm with the bladder centered over the middle of the arm. Approximate estimation of the systolic blood pressure is done initially by inflating the cuff fully and then deflating slowly and smoothly while palpating the radial pulse. Systolic blood pressure is noted at the point when the radial pulse returns. Following this, the blood pressure is recorded by auscultatory method which is the more accurate measure. The diaphragm of the stethoscope is placed over the brachial artery along the medial aspect of the lower end of the arm below the edge of the cuff. The cuff should be inflated to 30 mm above the palpatory systolic blood pressure and then deflated slowly and smoothly at the rate of 2-3 mmHg per second. Systolic blood pressure is recorded at the point when clear, repetitive tapping sounds are just heard. Diastolic blood pressure is recorded when the sounds disappear. In some children, instead of disappearing, the sounds muffle first before disappearing. In this case, the value at which the sounds muffle should be recorded as the diastolic pressure if the difference between the point of muffling and disappearance of the sounds is greater than 10 mmHg. POST- TASK Make sure you do not leave the child exposed. Thank the child/ parent for co operation if no further examination is planned While interpreting the readings, the state of the child should be taken into account. Values should be compared to normal values with reference to the age/height and sex of child. VIGNETTE In infants, instead of radial, brachial pulse should be palpated. Sometimes, auscultation can be difficult in infants in which case systolic pressure by palpation should be documented. If measuring a lower limb pressure, the same cuff can be applied to the lower leg and a foot pulse palpated. It is advisable to measure the blood pressure in both upper and lower limbs. When coarctation is suspected, it is imperative that blood pressure is recorded in both arms and one leg. The same should be done is cases of hypertension and in those who have had shunt surgeries as in Blalock Shunt. While recording blood pressure in the lower limb, a larger appropriate size cuff should be used and auscultation is done over the popliteal artery. The sounds which are heard while auscultating are called as Korotkoffs sounds and has five phases. Phase 1 is the first heard clear, tapping sound, phase 2 is intermittent murmur like sound, phase 3 is the loud tapping sound, phase 4 is the muffling of sounds and phase 5 is disappearance of the sounds. Occasionally, the sound might disappear after the Korotkoff sound phase 1 before reappearing later. This auscultatory gap can lead to either underestimation of the systolic blood pressure (if prior estimation of blood pressure by palpation is not done) or overestimation of diastolic blood pressure is the auscultation is not continued till the end. In atrial fibrillation, phase 4 of Korotkoff sound should be used for recoding diastolic blood pressure. Pulsus paradoxus is best appreciated while recording blood pressure by auscultation and is identified by recording the value at which the tapping sounds are heard only during expiration and the value at which the sounds are heard both during inspiration and expiration. When the difference between the two values is greater than 10 mmHg, pulsus paradoxus is said to be present. Pulse pressure is the difference between systolic blood pressure and diastolic blood pressure. A weak pulse is associated with narrow pulse pressure and is seen in cardiac failure, shock, aortic stenosis and constrictive pericarditis. Pulse pressure is wide in aortic regurgitation, hyperthyroidism, anemia and febrile states. OSCE CHECKLIST PRIOR TO THE TASK Washes hands or uses alcohol rub Explains the purpose of his/ her visit and what he/ she is going to do Positions the patient appropriately Chooses mercury sphygmomanometer Chooses the appropriate size cuff Removes any clothing over the arm TASK Supports the elbow and keeps it at the level of the heart. Wraps the cuff around upper arm with the bladder centered over the middle of arm Estimates systolic blood pressure by palpatory method Uses brachial pulse in infants for palpatory method Estimates systolic blood pressure by auscultatory method Uses diaphragm of the stethoscope for auscultation POST- TASK Makes sure that the child is not left exposed Thanks the child / parent for co operation Records blood pressure as estimated by palpatory and auscultatory method including the site and the position of the child Interprets the blood pressure Task: Evaluation of jugular venous pulse PRIOR TO THE TASK The room should be adequately lit for the assessment of jugular venous pulse The patient should be in semi-reclining position with the trunk at 45à ¯Ã¢â‚¬Å¡Ã‚ ° to the bed. The head and the back should be well supported with a pillow under the head. The head should be positioned in the midline THE TASK Stand on the right side of the patient and assess the jugular venous pulse. The torch should be shined from the left in an oblique direction and the jugular pulsation is observed Jugular venous pulse is located just lateral to the clavicular head of the sternomastoid muscle. Pulsations of the jugular veins should be differentiated from the carotid pulsations as discussed below. The jugular venous pressure is assessed by measuring the vertical distance between the top of the jugular venous pulsations and the sternal angle (angle of Louis). In cases where the top of the jugular pulsations is not visible at 45à ¯Ã¢â‚¬Å¡Ã‚ °, increasing the reclining angle up to 90à ¯Ã¢â‚¬Å¡Ã‚ ° can make the top of the pulsations obvious. The assessment is done when the child is breathing quietly Look for hepato-jugular reflex. This performed by exerting firm and sustained pressure on the right upper quadrant of the abdomen and looking for an elevation in the jugular venous pressure by 2-3 cm. POST- TASK Make sure you do not leave the child exposed. Thank the child/ parent for co operation if no further examination is planned VIGNETTE Assessment of jugular venous pressure is rarely important in the younger child. It is also difficult to obtain an accurate reading because of the short neck in children It can be generally measured easily if the child is greater than 10 years Jugular Venous Pulsation Carotid Pulsation Pulse lateral to sternomastoid Pulse medial to sternomastoid Better seen Better felt Multiple waves seen Single wave Abdominal pressure makes the pulsations prominent Abdominal pressure has no effect Valsalva maneuver makes the pulsations prominent Valsalva maneuver has no effect Can be obliterated with pressure Cannot be obliterated with pressure The right jugular vein is in a straight line with the right atrium and is more likely to show the pressure effects than the left jugular vein which has more tortuous course and is more likely to kinked. This can lead to false elevation of the jugular pressure. In patients with highly elevated JVP, the pulsation may be seen only below the angle of jaw. In such cases, increasing the reclining angle to 60à ¯Ã¢â‚¬Å¡Ã‚ ° or more makes the pulsations more obvious. Turning the head slightly towards the contralateral side can make the pulsations prominent, if the pulsations are not obvious. JVP consists of a, c and v waves and x and y descent. a wave is due to right atrial contraction, c wave is due to bulging of the tricuspid valve and v wave is due to atrial filing. x descent is due to atrial relaxation and y descent results from ventricular filling and tricuspid valve opening. The sternal angle (angle of Louis) is taken as the reference point as it roughly corresponds to the middle of the right atrium. JVP is elevated in congestive cardiac failure, fluid overload, constrictive pericarditis, pericardial tamponade, tricuspid stenosis and tricuspid regurgitation. Non-pulsatile elevation of JVP is seen in superior vena cava obstruction. a wave are absent in atrial fibrillation. Large a waves: are caused either by hypertrophied right atrium in response to decreased right ventricular compliance as in pulmonary hypertension and pulmonary stenosis or contraction of atrium against resistance as in tricuspid stenosis. Cannon a waves are giant a waves seen in early systole and is caused by contraction of the atrium against a closed tricuspid valve. It is usually seen in complete heart block and ectopics. Large v waves are seen in tricuspid insufficiency. Sharp x and Sharp y descents are seen in constrictive pericarditis and restrictive cardiomyopathy. OSCE CHECKLIST PRIOR TO THE TASK Washes hands or uses alcohol rub Explains what he/ she is going to do Makes sure that the room is adequately lit Positions the patient in semi-reclining position with the trunk at 45à ¯Ã¢â‚¬Å¡Ã‚ ° to the bed Supports the head with pillow to ensure relaxation of the neck Positions the head in midline TASK Stands on the right side of the patient and assesses the right jugular venous pulse. Locates the jugular pulse correctly If the jugular pulse is not obvious, then makes it obvious by turning the head slightly to the left and shines the torch from left obliquely if necessary Measures the jugular venous pressure correctly Looks for hepato-jugular reflex. POST- TASK Makes sure that the child is not left exposed Thanks the child / parent for co operation Lists the differences between carotid pulse and jugular pulse Task: general inspection of the body with reference to cardiovascular system PRIOR TO THE TASK Introduce yourself to the child and carer and ask for permission to examine For inspection, the room should be well lit. Ensure that the lights are turned on and the windows are open The child should be undressed appropriately to the waist. In older child, the examination is easiest to perform while they sit over the edge of the bed or even on a chair Examine the younger child on the parents lap. STEPS OF THE TASK LOOK GENERAL General well being Well/ Ill looking child Interest in the surroundings Sick child will not be interested Size of the child thin small, thin tall, well nourished and tall, well nourished and short. Degree of breathlessness classify as none, mild or severe Environment (Equipment) oxygen mask, nasal cannula, intravenous catheter, pulse oximetry, feeding tube/ gastrostomy, LOOK SPECIFIC Head look at the size (microcephaly or macrocephaly) and shape (dolichocephaly) Face Normal or dysmorphic features, malar flush Conjunctiva pallor, jaundice (refer chapter on general examination) Mouth Using the pen torch, take a quick look in the mouth and look for the presence of age appropriate teeth, abnormal teeth and caries. Ask the child to stick their tongue outwards and upwards towards the nose and examine the tongue for central cyanosis. Hands and fingers pallor; clubbing; polydactyly and syndactyly; Oslers nodes; Janeway lesions; splinter haemorrhages. Examine both the hands quickly. Difference in colour between limbs POST- TASK Make sure that the child is not left exposed Thank the child / parent for cooperation VIGNETTE Always think whether the findings combine to form a recognizable clinical syndrome. It is preferable to inspect the child in sunlight than in artificial light. Children with chronic cardiac conditions are usually thin and small for age. Breathlessness is classified as mild when the child has only chest recession, and there is no contraction of sternocleidomastoid or nasal flaring and severe when all three are present Microcephaly can be associated with some of the intrauterine infections and genetic disorders like congenital rubella syndrome and Edwards syndrome Dolichocephaly (increased antero-posterior diameter) is seen in ex-preterms Syndromes with dysmorphic facial features Downs syndrome almond shaped eyes (due to epicanthal folds); Brushfield spots (light colored spots in the iris); small, flat nose; small mouth with a protruding tongue; small, low set ears; round faces; flat occiput Turners syndrome prominent, posteriorly rotated auricles with looped helices and attenuated tragus; infraorbital skin creases; mildly foreshortened mandible Williams syndrome broad forehead; short nose with broad tip; full cheeks; wide mouth with full lips Noonans syndrome downwards slanting eyes with arched eyebrows; epicanthal folds; broad forehead; nose with wide base and bulbous tip; pointed chin Marfans syndrome long, thin face; deep-set eyes; down-slanting palpebral fissures; receding chin; dolichocephaly; malar hypoplasia; enophthalmos DiGeorge syndrome small ears; asymmetric facies; small mouth and chin Malar flush plum coloured malar eminences Hutchinson (conical) incisor is seen in congenital syphilis (patent ductus arteriosus) and enamel hypoplasia in Ellis-van Creveld Syndrome (atrioventricular canal, ventricular septal defect, atrial septal defect, and patent ductus arteriosus). Caries tooth may be a cause of infective endocarditis in congenital heart disease. In preaxial polydactyly, the extra digit is on the radial (thumb) side while in postaxial polydactyly, it is on the ulnar (little finger) side of the hand. Oslers nodes are painful, red, raised lesions found on the hands and feet and is seen in infective endocarditis Janeway lesions are nontender, macular lesions, most commonly involving the palms and soles and seen in infective endocarditis. Splinter hemorrhages appear as narrow, red to reddish-brown lines of blood that run vertically under nails. Splinter hemorrhage can be associated with infectious endocarditis, systemic lupus erythematosus, and trauma OSCE CHECKLIST PRIOR TO THE TASK Washes hands or uses alcohol rub Explains what he/ she is going to do and ask for permission to examine Positions and exposes the child appropriately Makes sure that the room is adequately lit TASK Looks for the following general points General well being Interest in the surroundings Size of the child Degree of breathlessness Environment (Equipment) Looks for the following specific points Head size and shape Face Conjunctiva Mouth Hands and fingers Difference in colour between limbs POST- TASK Makes sure that the child is not left exposed Thanks the child / parent for co operation Task: INSPECTION OF THE CHEST PRIOR TO THE TASK Introduce yourself to the child and carer and ask for permission to examine For inspection, the room should be well lit. Ensure that the lights are turned on and the windows are open The child should be undressed appropriately to the waist. In older child, the examination is easiest to perform while they sit over the edge of the bed or even on a chair Examine the younger child on the parents lap. STEPS OF THE TASK Look tangentially from foot end of the bed in supine patients and from the sides in sitting patients. Look for the following and comment Shape of the Chest symmetrical or asymmetrical Symmetry of chest expansion Scars Pulsations Observe for apical impulse, parasternal, suprasternal, epigastric pulsations. Spine for scoliosis POST- TASK Make sure that the child is not left exposed Thank the child / parent for cooperation VIGNETTE Common asymmetrical chests Pectus carinatum: also called pigeon chest, deformity of the chest characterized by protrusion of the sternum and ribs. It may occur as congenital abnormality or in association with genetic disorders such as Marfans syndrome, Morquio syndrome, Noonan syndrome, Trisomy 18, Trisomy 21, homocystinuria, and osteogenesis imperfecta. Pectus Excavatum: also called funnel chest, deformity of the anterior wall of the chest producing sunken appearance of the chest. It may occur in rickets, Marfans syndrome and spinomuscular atrophy. Harrisons sulcus: horizontal indentation of the chest wall at the lower margin of the thorax where the diaphragm attaches to the ribs. It may occur in conditions with increased pulmonary blood flow or chronic asthma. Scars: lateral thoracotomy scar results from closure of patent ductus arteriosus, tracheoesophageal fistula repair and Blalock Taussig shunt. Central sternotomy scar is seen after open heart surgery and lobectomy. Children can have drainage scars in epigastrium, subclavian/axillary scars from pacemakers and scars following cardiac catheterization in the groin and neck. Pulsations: Apical impulse will be shifted peripherally due to cardiomegaly, collapse of left lung or fluid in the right pleural cavity Parasternal pulsations can occur due to right ventricular enlargement or enlarged left atrium pushing the right ventricle. The most common cause of suprasternal pulsations is dilated aorta due to aneurysm or markedly increased blood flow. Epigastric pulsation may be seen in thin children, right ventricular hypertrophy and abdominal aneurysm. Scoliosis should be looked for in the standing and not in sitting position OSCE CHECKLIST PRIOR TO THE TASK Washes hands or uses alcohol rub Explains what he/ she is going to do and ask for permission to examine Positions and exposes the child appropriately Makes sure that the room is adequately lit TASK Looks tangentially from foot end of the bed in supine patients and from the sides in sitting patients Looks for the following points and comments Shape of the Chest Symmetry of chest expansion Scars Apical impulse, parasternal, suprasternal, epigastric pulsations Spine for scoliosis POST- TASK Makes sure that the child is not left exposed Thanks the child / parent for co operation Task: PALPATION OF THE CHEST PRIOR TO THE TASK Introduce yourself to the child and carer and ask for permission to examine The child should be undressed appropriately to the waist. Position the older child so that they sit over the edge of the bed or lie down on the couch Examine the younger child on the parents lap. Warm your hands for palpation STEPS OF THE TASK Be gentle with palpation Apical Impulse: Place the palm of the whole hand flat over left chest wall to get a general impression of the point of maximal impulse. Next, lay the ulnar border of the hand on the chest parallel to rib space where the impulse was felt and try to locate the apex. Finally palpate with the fingertip of the index or middle finger to localize the apical impulse and define its character. Use the left hand to palpate the carotid artery to time the apical impulse. With the finger of the right hand still in place over the apex beat, palpate the manubriosternal joint (angle of Louis) which is present just below the suprasternal notch and is felt as a prominence with the left hand. It corresponds to the second intercostal space. Slide the index finger and count down the next few intercostal spaces until you locate the intercostals space that is level with the apex beat. Look at the position of the apex with reference to the midclavicular line. If the apical impulse is not readily palpable in the supine position, ask the child to lie on their left side. If the apex beat is not still palpable, try on the right side in case of dextrocardia. Parasternal pulsation and heave: With the fingertips, palpate over the left sternal edge to find the parasternal pulsations. With the child lying in supine position, place a pencil lateral to the left sternal edge and look tangentially for lifting of the pencil. Next, place the base of your hand just lateral to the left sternal edge and palpate for a parasternal heave. If parasternal heave is present, try suppress it by exerting pressure with base of the hand. Thrills are best felt with fingertips. Time the thrill with carotid or brachial pulse. Palpate the following areas. Apex of the heart 3rd to 5th intercostal space along the left sternal border Pulmonary area (left second intercostal space) Aortic area (right second intercostal space) Suprasternal area Carotids POST- TASK Make sure that the child is not left exposed Thank the child / parent for cooperation VIGNETTE Apical impulse is the farthest inferior and lateral maximal cardiac impulse on the chest wall. It results from the heart rotating, moving forwards and striking against the chest wall during systole. Apical impulse is normally felt in the 4th left intercostal space on the midclavicular line. It may be difficult to palpate in obese children and in pericardial effusion. Displaced apex Tension pneumothorax and pleural effusion (push apex away from the lesion) Pulmonary fibrosis and collapse (pull towards the side of the lesion) Left ventricular hypertrophy apex is displaced down and out Right ventricular hypertrophy apex is displaced outwards Skeletal abnormalities Quality of apical impulse (normal apex lifts the palpating fingers briefly) Sustained (increased amplitude and duration) pressure overload (aortic stenosis) Hyperdynamic or forceful (increased amplitude but not duration) volume overload (mitral incompetence and aortic incompetence) Tapping palpable first heart sound of mitral stenosis Parasternal pulsations Palpable 2nd heart sound reflects pulmonary hypertension. Parasternal heave is present in right ventricular hypertrophy or left atrial enlargement pushing the right ventricle. There are three grades of parasternal heave Grade I heave identified by lifting of the pencil alone and not the heel of the hand Grade II easily identified, can be suppressed with pressure Grade III lifts the heel of the hand and cannot be suppressed with pressure Thrill is a palpable murmur that felt like a purring cat. While describing the thrill, describe the site and phase of cardiac cycle. When thrill is present, the accompanying murmur is by definition at least 4/6 in intensity. OSCE CHECKLIST PRIOR TO THE TASK Washes hands or uses alcohol rub Explains what he/ she is going to do and ask for permission to examine Positions and exposes the child appropriately Warms hands before TASK Palpates gently Apical Impulse Places the palm flat over left chest wall to get a general impression Keeps the ulnar border of the hand parallel to rib space Palpates with the fingertip to locate the apical impulse Palpates the carotid artery

The Fifth Child Essay -- essays research papers

The Fifth Child The word "monster" has many definitions. Some define it as a creature having a frightening or strange appearance. It is also defined as one that inspires horror or disgust. Ben certainly fits into all of these categories. He was different right from pregnancy. He looks extremely frightening, almost like a Neanderthal. Ben is an outcast even in an institution for "nature's mistakes." From the moment Harriet became pregnant it was apparent to her that something was obviously wrong. She loved having children and had planned on a total of eight or perhaps even ten. However, something was different this time. Early in the pregnancy, she began feeling ill. She had been keeping herself very busy in order not to feel the "demands" from the new being. It was unlike anything she had known before. At five months the pain was so intense that Harriet began taking tranquilizers. Even during her pregnancy, Harriet began referring to Ben as the "monster." During a conversation with Dr. Brett after he refused to induce the baby, she is quoted as saying, "It's because you don't want to. It's not you who is carrying this" (She cut off monster afraid of antagonizing him.) (p. 47) At eight months she went into labor. Although she had never gone to the hospital before for her other deliveries, this time she insisted. This shocked everyone, especially her husband David. Ben was not your typical baby. ...

Situational Leadership Analysis Essay -- Leadership

Hersey and Blanchard’s Situational Leadership Theory (SLT) asserts that a leader’s effectiveness is dependent upon the readiness, or ability and willingness, of the leader’s followers to complete a task. This leadership style is an amalgamation of task-oriented and relationship-oriented characteristics that are employed depending upon the situation and the followers involved. According to the SLT, as followers increase in readiness the leader’s style is to adapt accordingly (Kinicki & Kreitner, 2009). The table below (Babou, 2008) summarizes the leadership behaviors that the SLT presumes are appropriate to the various stages of follower readiness. Each quadrant of the Leadership Behaviors chart corresponds to the same quadrant in the Follower Readiness chart. Leadership Behaviors Style 1 (S1 or Directing): High task/low relationship This leader uses above-average amounts of task behavior and below-average amounts of relationship behavior. Style 2 (S2 or Coaching): High task/high relationship This leader uses greater-than-average amounts of both task and relationship behaviors. Style 3 (S3 or Supporting): High relationship/low task This leader exhibits greater-than-average amounts of relationship behavior and below-average amounts of task behavior. Style 4 (S4 or Delegating): Low relationship/low task This leader uses below-average amounts of both relationship and task behaviors. Follower Readiness For example, under this theory the leader would employ High Directive/High Support leadership behaviors to the Disillusioned Learner. Ideally, the leader helps the followers as they progress through the stages to achieve the Self-Reliant Achiever/Delegating level. While I do not necessarily ... ...ul leader. Without high competence in these areas, the leader is unlikely to find success to any significant degree regardless of how well he or she performs in the other areas. Overall I am pleased with where I currently am in these fundamental areas, particularly in those areas that define me as a person and would otherwise be extremely difficult to change. The areas of weakness reveal adjustments that I can make in my style and how I outwardly present myself, but I do not believe there are any gaps that cannot be bridged as I continue my quest to become a better leader. Works Cited Babou. (2008, March 26). Variations in situational leadership Web. 28 March 2015 http://leadershipchamps.wordpress.com/2008/03/26/variations-in-situational-leadership/ Kinicki, A., & Kreitner, R. (2009). Organizational behavior (4th ed.). New York, NY: McGraw-Hill/Irwin.

The Identity and History of the Caribbean Essay -- Caribbean History C

The Identity and History of the Caribbean The Caribbean is a vastly diverse area representing the effects of colonialism, slavery, and the combination of many cultures. Since the arrival of Europeans the Caribbean islands have been going through constant change. The loss of native peoples and the introduction of the plantation system had immediate and permanent reprocussions on the islands. The Plantation system set up a society which consisted of a large, captive lower class and a powerful, wealthy upper class. As the plantation systems became successful labor was needed in order to progress. Slavery became the answer to the problem. Slavery played an important role in the how the economy changed the islands because there was a shift on the main economic ingredient, Sugar. Section 2 of Caribbean Slave Society and Economy shows how the economy shifted during this expansion. Before sugar became the main export in 1643, tobacco, sugar, indigo and ginger were the main exports in the English and French Antilles. Tobacco and cotton became important in "pre-sugar era because it was easy to cultivate and did not need as much labor as the sugar plantations. Robert Carlylebatie in the essay "Why sugar? Economic Cycles and the Changing of Staples on the English and French Antilles, 1624-54" writes, "the mastery of the art of making sugar required time, skill and money. It is no wonder, then, that colonists waited until tobacco values reached very near their long-run levels before seriously committing themselves to learning how to produce muscovado, the common brown sugar later exported from the islands" (44). As sugar became difficult to cultivate with little labor more labor were needed. The sugar production lead to the core o... ...ings that Slavery created a transformation in the Caribbean’s identity and history. New societies, culture, identities, divisions between race and more were created. A social and political hierarchy was created which gave power to the whites while the blacks received no respect. Due to the emergence of the marroonage, revolts shows the slaves are becoming stronger as one and are revolting against their masters. New cultures are emerging and struggles for identity and rights are beginning to form. Bibliography Beckles, Dr. Hillary, Verene Shepherd. Caribbean Slave Society and Economy. The New Press, New York. New York, N.Y. 1991. Benitez-Rojo, Antonio: "The Repeating Island" Duke University Press Cliff, Michelle: "Abeng" Plume Books Knight, Franklin W. The Caribbean, The Genesis Of a Fragmented Nationalism. Oxford University Press, New York, N.Y. 1990

Ethnic group Essay

Race in America is one of those subjects that scholars rarely broach and are heavily criticized for these omissions by their constituents. For this reason, the subject of race and urbanization felt a proper choice for this final paper. Following, we will incorporate data from multiple sources including Khaled Hosseini’s The Kite Runner, a novel that examines the harrowing trials of different groups in Afghanistan and what happens to the ones lucky enough to escape the violence of their homeland into the safety net of American soil; in an attempt to show the inalienable link between race and urbanization. This discussion on urbanization and race in American will also include a brief discussion on classism. Classism is a part of the structural organization of society that can be measured as part of the contributing factors to the socioeconomic divisiveness experienced in this urbanized world. Some argue that gentrification, in all of its wonders is class based. Others argue it more a matter of ethnicity and race, both may be correct. Nevertheless, the issue of race, as aforementioned should be granted a closer look. By examining the ideas and experiences of anthropologists and sociologists past and present this paper will attempt to specify on how classism, racism, and urbanization are connected. Growing Cities and Ghettos The Industrial Revolution sparked an enormous wave of migrants and immigrants into American cities creating an urban ecology. Chapter 3 of the Giddens et. al. text, describes the social movement from Gemeinschaft to Gesellschaft; from a community based ideology in society to a more individualized world. Afghanistan is an agriculturally based society. Urbanization is a global process that draws people away from rural areas and into the cities. Once in those cities, people tend to gravitate to areas that are inhabited by people of their same cultural fabric. In discussing theories of urbanization, gentrification and displacement, John Bentacur (2010) in Gentrification and Community Fabric in Chicago points out how people are drawn to areas that have a cultural/ethnic connectivity, â€Å"immigrants with different characteristics compete for space until they get accommodated with alike others in locations that correspond to their competitive strengths† (p 384). In the novel, The Kite Runner, Amir and his father make the arduous migration from Kabul, Afghanistan to Fremont, California. Their low income neighborhood of Fremont is ethnically diverse but with a notable concentration of Afghani residents. It makes sense that when people leave their countries of origin to settle in a new place, they will be drawn to people and areas that are familiar to them. Even with familiarity problems arise, urban studies reveal several difficulties that plague densely populated urban neighborhoods; poverty, crime and dilapidated conditions to name a few. In Afghanistan Baba, Amir’s father, was rich and even wielded some power for being a respected business man and serving the community by creating an orphanage that would later be destroyed by the Taliban regime. In America, there would be no such accolades to speak of for their family. In fact, they would live in a type of poverty, they had never experienced nor hardly imagined. They would experience the existence that many black Americans face with no end in sight. A growing world population combined with globalization and the heightened mobility that comes with it has led to the creation of cities and a scramble for affordable housing. Gentrification also known as ‘urban regeneration’ or ‘re-urbanization’ is the process that happens in a community when it becomes urbanized and consists of the higher income families moving into lower income areas. During this process demographic changes are notable; in America, gentrification is notably marked by white families moving into black neighborhoods. Race and Ethnicity America is a multicultural nation. Our history of slavery created the black and white groups and the immigrant populations from around the world contributes to a high variety of culture and ethnic background. The macro-sociological issue of race and ethnicity has been the source of much debate and discussion. The reason for this is that the issue of race has been the root cause of social and political turmoil. Douglas Massey and Nancy Denton provide the backdrop in history when segregation by race was created in America in their book American Apartheid: Segregation and the Making of the Underclass. Massey and Denton edify that racial segregation was not always a fact of life in American society and that in fact; blacks and whites lived in close proximity to each other, albeit in the alley ways of the big homes occupied by their white neighbors, â€Å"industrialization in the north unleashed a set of social, economic and technological changes that dramatically altered the urban environment in ways that promoted segregation between social groups† (1993:19-26). Urbanization and technological advancement (causing blacks in the south to migrate to northern cities by the tens of thousands) would be the foundation for residential segregation where blacks and other minorities would be relegated to the outskirts of town. Black ghettos would remain isolated from society in a manner that was rarely, experienced by the European immigrants that came to this country during industrialization. Blacks and later, Latinos, would be destined to live isolated and neglected from social organizations and deprived from many of the benefits enjoyed by white communities with little hope of escape, â€Å"not only was the segregation of European ethnic groups lower, it was also temporary. Whereas Europeans isolation indices began to drop shortly after 1920, the spatial isolation characteristics of blacks had become a permanent feature of the residential structure of large American cities by 1940† (Massey and Denton 1993:57). In America, race and ethnicity is more clearly defined than in places like Afghanistan. According to data gathered from the PBS News Hour website, Afghanistan has nine different ethnic groups that reside in different territories of the country. They have fought and continue to fight civil wars, over culture (religion), legislative power and territory. Afghanistan and the U. S. are similar in their historical oppression of one ethnic group over another. In Afghanistan, the Pashtun/Sunni have for a long time ruled the land and claimed dominion over the Hazara/Shites. The Hazara group can be considered the equivalent to the Black demographic in America where historically they were the slave class, but are currently represented in government. Statistics In a rapidly modernizing world, Afghanistan is among the severely underdeveloped countries of the Middle East. As previously mentioned, Afghanistan is a multiethnic/multifaith, agriculturally based democracy, with a history of violence. And it perhaps it is this history, in addition to deep religious belief systems that have kept this land from joining the rest of the modern world. In reviewing the Millennium Development Goals indicators, data collected by the United Nations Statistics Division (UNSD), I reviewed several indicators that point to the fact that Afghanistan has a long road ahead. Afghanistan is making slow but sure progress trying to bring itself into a socially, politically and economically stable place. The first indicator measured the number of underweight children less than 59 months. The UNSD defines this indicator as a high number of moderately to severely underweight children, â€Å"whose weights for age are less than two standard deviations†. According to the report a healthy population will have 2. 3 percent of their children in this category. In 2004, 32. 9 percent of Afghanistan’s children were reportedly underweight, compared to 44. 9 percent in 1997. This indicator points to the poverty level and lack of nourishment recorded within a seven year period in Afghanistan. A second indicator measures women’s rights and representation in government. This indicator is defined as, â€Å"the portion of seats held by women in national parliament† increased from 3. 7 percent in 1990 to 27. 3 percent in 2006. The measurement was sustained through 2012 at 27. 7 percent. More work needs to be done and educating the population should be the place to start. Theological Link The Modernization Theory discussed in the text looks to explain the underdevelopment of countries like Afghanistan. Marx worried about capitalism and the effects it had on the lower-class population and thereby, the democratic process. Marx’s Conflict Theory dictates that societies are ruled by a small group of elite that create social order for the larger population. In this, we have the creation of divisions by class (division of labor), a central topic of discourse since the beginning of industrialized times. The French Revolution of 1787 (also known as the revolt of the bourgeois or middle-class society) creating capitalism and thereby usurping government power from monarchs. Karl Marx hated democracy. â€Å"Democracy is the road to socialism† (Karl Marx) Capitalism created tensions between the working and bourgeois classes. Summary Race and urbanization are indivisibly linked. Marxism and Class Conflict is the most applicable theory of today’s society. Considering the current events and status of world order, it is undeniable; capitalism continues to be the most powerful ideology in the world. The United States is a powerful country and the way it retains power is by unwaveringly maintaining capitalistic ideology and participating in global conflict around the world in defense of this ideology, â€Å"power, ideology, and conflict are always closely connected† (Giddens 2012:20). Societies are based on trust and these trusts are broken by the people that create and uphold unjust rules for the population of color and the poor. Works Cited Betancur, John. 2010. â€Å"Gentrification and community fabric in Chicago. † Urban Studies Journal Foundation. Sage 48(2): 383 – 407. Retrieved from http://usj. sagepub. com/content/48/2/383 Giddens, Anthony, Mitchell Duneier, Richard P. Applebaum and Deborah Carr. 2012. â€Å"Introduction to sociology. † New York: W. W. Norton and Company. Eighth ed. , pp. 15-78. Massey, Douglas and Nancy A. Denton. 1993. â€Å"The construction of the ghetto. † Pp 17-59 in American Apartheid: Segregation and the Making for the Underclass. Harvard University Press. Retrieved from http://ereserve. baruch. cuny. edu. remote. baruch. cuny. edu/eres/coursepage. aspx? cid=3155&page=docs United Nations Statistics Division. (1991-2011) [Table Data on Gender Parity Index in Primary Enrollment retrieved November 5, 2012. ] Millenium Development Goals Indicators. Retrieved from http://mdgs. un. org/unsd/mdg/Metadata. aspx? IndicatorId=0&SeriesId=559 United Nations Statistics Division. (1991-2011) [Table Data on Gender Parity Index in Primary Enrollment retrieved November 5, 2012. ] Millenium Development Goals Indicators. Retrieved from http://mdgs. un. org/unsd/mdg/Metadata. aspx? IndicatorId=0&SeriesId=557.

Literature Review and Conceptyal Framework

Running head: LITERATURE REVIEW 1 Literature Review and Conceptual Framework Juvenile Diversion Programs/IPS Julie I Carter Capella University PSF8374-Currenr Research on Violent Behavior Dr.Rob Hanser LITERATURE REVIEW 2 Literature Review and Conceptual Framework History The history of diverting arrested juveniles from formal processing began with the birth of the juvenile courts. Conceived in the late 19th century, juvenile justice provided for a rehabilitation-based response to juveniles’ illegal behavior.Punitive sanctions being received by youth in criminal courts were being set aside in the juvenile courts. Thus, in its infancy, juvenile justice could be construed as a â€Å"diversion program†. Considered to be in the best interest of the juvenile and society, juvenile justice diverted youth from criminal proceedings by providing dispositions that were more attuned to the potential to change the young offender’s behavior, and lives through clinical servi ces, special rehabilitation programs, and tight educational guidance. (Models, 2010) First adopted by the adult criminal justice system, was the idea of diversion.This idea became the topic of discussion within the juvenile justice system in the 1960’s. The President’s Commission on Law Enforcement and Administration of Justice recommended exploring alternatives for addressing the needs of troubled juveniles outside of the court system in 1967. In 76, the Office of Juvenile Justice and Delinquency Prevention Special Emphasis Branch supplied 10 million dollars in funding specifically for the development of diversion programs. These efforts were strictly driven by the belief that these types of programs would yield many enefits, such as allowing juveniles the option to choose an alternative to court, providing more treatment at the community level, increasing family participation, and most important, reducing the â€Å"stigma† associated with the formal juvenile j ustice system. (Models, 2010) As diversion has been practiced and even discussed for nearly four decades, some would contend that there is little consistency in the terms of what actually constitutes a diversion process or program, they do however agree on the common goal among these programs which is to minimize the juveniles’ involvement in the juvenile justice system.LITERATURE REVIEW 3 Theoretical Concepts As measured by program evaluations and follow-up studies, the effectiveness of diversion programs has varied greatly from one program to the next. The successful programs, such as the Intensive Prevention Services (IPS) initiative in Philadelphia, provide very direct services that include but are not limited to parenting education, intensive family counseling, and behavioral contracting.One of the main concepts that gave birth to the development of this program was the labeling perspective. This theory or perspective, if you will, argues that juveniles who commit mino r offences become habitual offenders due to being singled out for negative recognition. This has been noted as creating and reinforcing the juvenile’s, as well as society’s view, that they are criminals. Diversion programming then is designed to assist in avoiding these negative labels that accompany formal case processing. Roberts, 2004) In 1979, Paternoster, et al. explored the extent to which juveniles discriminate between formal court processing that results in incarceration and informal diversion processing with reference to perceptions of accrued stigma and/or liabilities. The perception of the juveniles was measured in terms of school performance; parental relationships, relationships with peers; desired employment, and future involvement with the law. (Blomberg, n. d. The findings indicated only in the peer relationships area was there a notable difference between the perceptions of diverted and incarcerated juveniles. When control was made for the effects of p rior social liabilities, such as social class or race, the results remained constant. Therefore one could conclude that to the extent perceptions of stigma have implications for subsequent behavior, it makes little difference whether or not juveniles receive diversion or formally imposed jail time.In simple terms, the type of treatment would appear to not be significant in shaping self-perceptions. (Blomberg, n. d. ) LITERATURE REVIEW 4 Supporters of diversion continue to argue that programs are less stigmatizing than formal court involvement, provide juveniles with services that they would not have otherwise received, and result in reductions in the rate of recidivism.In contrast, opponents argue that diversion programs have extended social control to juveniles who would ordinarily be released back to the community, may actually increase recidivism, do not prevent stigmatation, and can lead to the disproportionate representation of minorities. As Akers (1994) explains, the labelin g theory pushes forward the thesis that persons who are labeled and/or dramatically stigmatized as deviant, are more than likely to take on a deviant self-identity and become more, rather than less deviant than if they had not been so labeled.Theoretically, a label of deviant, juvenile offender or delinquent can affect the way that a juvenile comes to define him/herself which influences future criminal behaviors, and dictates the social roles the juvenile is allowed to assume. (Dick, Pence, Jones & Geertsen, 2004) With that noted, some research has also suggested that diversion actually increases recidivism, however early studies found little or no difference in the recidivism rates between diverted and non-diverted youth.Yet still others have found that, regardless of the setting, interventions can as well increase â€Å"perceived† labeling and self-reported delinquency among youth. (Elliott, Dunford & Knowles, 1978) What was found to be consistent with the last group of fin ding was the work done latter by Lemet (1981) that suggest that these treatment interventions can impose stigma on juveniles which leads to secondary deviance. This study would be responsible for raising the possibility that diversion programs may widen the net of the state system by taking in juveniles who otherwise may have not come into contact with the system.What is important to point out here is that many of these studies were flawed due to the difficulties researchers encountered when constructing comparison groups for the purpose of evaluation. LITERATURE REVIEW 5 Contemporary Research There have been so many different policies called â€Å"diversion† that the term has come to cover polices as diverse as doing nothing to programs indistinguishable from the existing practices of juvenile justice.While these policies have produced better procedural justice for juveniles, reduced the detained and institutionalized population of juveniles placing them under the jurisdict ion of state and/or local family service agencies, these polices have not resulted in the intended changes in the behaviors of the diverted youth. (Akers & Sellers, 2009) Recent studies on diversion programs have produced more positive results. In fact, in a study of the Detention Diversion Advocacy Project it was found that juveniles that were diverted to diversion programs were less likely than their counterparts to be referred to out-of-home placement. Sheldon, 1999) In Michigan an evaluation of their state diversion project yielded that juveniles that were randomly assigned to one of the several diversion program strategy groups were significantly less likely to have any court petitions filed against them during the two years following release from the program compared to the control group. The results shown here cannot help but suggest that the â€Å"active† hands on intervention provided by diversion programming works better that the normal process of court processing j uvenile offenders. The catch, it works best if they have been thoroughly separated from the system. Davidson, Redner, Blakely, Mitchell & Emshoff, 1987) There is a wealth of evaluations of pretrial diversionary programs, and more comprehensive literature about the pretrial diversion field is dated. One of the critical challenges noted for the criminal justice field is developing and cataloging an appropriate research design for diversion programs. Researchers in the field need to actively pursue this challenge in order to determine the scope, as well as the worth of diversion programming in the criminal justice community. (Bellassai, Galloway.Hubbard, Oeller & Sayler, 2006) LITERATURE REVIEW 6 In Philadelphia, there are several emerging practices in the diversion program initiative. First they have implemented written policies and procedures for diversion programs that are backed by a formal mission statement. This is deemed as critical as a clearly defined and articulated mission statement, goals, and objectives are the cornerstone of effective programs.In a survey conducted by the National Association of Pretrial Services Agencies, nearly 90% of all respondents in their study had written policies and procedures in place. (Bellassai et al. , 2006) Nationwide, pretrial diversion concepts have found increased legitimacy. Nearly all states now have pretrial statues that have either been enacted or updated since 2000, and are as diverse as diversion programs themselves. Diversion program today tend to feature a wider array of programs that are more diverse than their predecessors in practice, and administrative location.However, these programs are still united by the ultimate goal of offering viable alternatives to juveniles whose criminal behaviors are addressed much more effectively outside the realm of traditional case processing. (Bellassai, 2006) Recommendations The biggest challenge to pretrial diversion programs and criminal justice planners is the lack of the strong research that is needed in the field.One accomplishment of such a broad-based study would be the examination of the nature of the relationship with the theory of labeling and the potential synergy within the current problem-solving court model. The benefit here would come as such a study would be enumerable and provide an evidenced-based foundation for communities to make sound decisions about diversion programming. (Bellassai. 2006) LITERATURE REVIEW 7 References Akers, R.L. & Sellers, C. S. (2009) Criminological Theories. New York, NY: Oxford University Press Bellassai, J. , Galloway, K. , Hubbard, A. , Oeller, C. & Sayler, J. (2006) Promising practices in pretrial diversion. Retrieved November 10, 2012 from http://www. ojp. usdoj. gov/BJA/about/index. html Blomberg, T. G. (n. d. ) Widening the net: An anomaly in the evaluation of diversion programs. Retrieved November, 9, 2012 from http://www. criminology. fsu. edu/crimtheory/blomberg/netwidening. html Davidson, W. S. , Redner, R. , Blakely, C. H. Mitchell, C. M. & Emshoff, J. G. (1987) Diversion of juvenile Offenders: An experimental comparison. Journal of Consulting and Clinical Psychology 55(1) 68-75 Dick, A. J. , Pence, D. J. , Jones, R. M. & Geertsen, H. R. (2004) The need for theory in assessing peer courts. American Scientist 47:1448-61 Elliot, D. S. , Dunford, F. W. & Knowles, B. A. (1978) A Study of Alternative Processing Practices: An Overview of Initial Study Findings. Boulder, CO: B. R. Institute Models for Change Systems: Reform in Juvenile Justice, July 2010.Retrieved from http://www. modelsforchange. net Paternoster, R. , Waldo, G. , Chiricos, T. & Anderson, L. (1979) The Stigma of Diversion: Labeling in the Juvenile Justice System. Beverly Hills. CA: Sage Publications Roberts, A. R. (2004) Emergence and proliferation of juvenile diversion programs. New York, NY: Oxford University Press Sheldon, R. G. (1999) Detention Diversion Advocacy: An Evaluation. Juvenile Justice Bulletin . Washington, D. C. : U. S. Department of Justice, Office of Juvenile and Delinquency Prevention.

How Do People Fall into Debt? Essay

Debt in society is an overwhelming stress factor for many individuals and families. I know that I am one of those individuals and have been for years now. I made a lot of stupid mistakes when I was younger and now that I have a family, it unfortunately is effecting me still today. So how do people fall into debt? There are several contributors like job loss, family, illnesses, poor judgment and management. I will go over effects and consequences, solutions, and prevention people go through and what steps to take to avoid and take control of your debt. Effects and consequences of being in debt can be a long term and severe issue for an individual or family. This can cause an individual to become very depressed and pick up on drinking or may possibly start using drugs because they feel they have no other way to cope with it. You find yourself living paycheck to paycheck because your weekly budget no longer exists and your credit is maxed where no other funds become available. As things get tighter, the ability to keep paying decreases and more debt increases. It could become so severe that it may affect your personal relationships with family, friends and significant other where your family no longer wants to associate with you. This could be because you are always begging for money or your problems are too much for your family to handle. Your significant other may not be able to handle the issue either because it is just as a heavy burden on him or her as it is on yourself. Effects and consequences of not being able to pay your debt is you start losing things. Your house can be foreclosed on, cars repossessed and extracurricular things like boats and recreational vehicles can be taken away. You can get your wages garnished if you have defaulted on certain loans, or even go into tax collection for not paying your property taxes. When and if you can start getting out of the red and into the black, your credit score could be highly effected and will prevent you from getting any new credit loans. Certain employers run credit checks and if you do not clear their standards, you can lose your job or it can affect any future  employment. Solutions can be created to help you get back on your feet and become debt free. It certainly is not an overnight fix and will take some time possibly. One suggestion is to attend a consumer credit counseling class. This is where a counselor can sit down with you and review all of your debt. They will help you set up a budget and work on decreasing your debt over time. They also suggest seminars and workshops that can better educate you on managing your money and debt. You can find a local counselor through the yellow pages or online. Another approach is bankruptcy which is more severe but necessary to clearing your plate and getting a new start. It takes a total of 7 to 10 years to fully have this removed off your credit but if you are willing to wait and can mentally handle what this entails, you should consider this option. Any local attorney with specialty in bankruptcy can review your debt and help finalize. If you have retirement accounts, savings accounts, bonds, life insurance you can close these out and apply the money to your debt. If you have family that is willing to help, you may be able to obtain a small loan from them and pay them back after the debt is gone if they can wait that long. Obtaining more loans through an actually financial institution is not a solution I find to be a smart one. This will cause more debt and more issues down the road. If you have to, sell off items that are paid off in full to help. It is something no one wants to do but sometimes you have to give a little to get a little. Once you have eliminate some of your debt by the suggestions above and preventing yourself from falling back into debt, is to start a savings account and put so much in it a week. Over time this will add up that you have a significant amount set aside in case there is a job loss, family, illnesses, poor judgment and management. Instead of buying the most expensive items, look for bargains or off brands. Biggest suggestion is set a monthly budget so you have a clear outlook of what will be spent and what is left over. I certainly can say when I was younger my greediness of getting things I wanted and not thinking of the outcome overtook my clear decision making. At an early age you don’t really think of what it will do to you in the future and to your family. I have done credit counseling and I can say it has been an effective and positive experience for me. In order to stay out of debt you really have to want to try and stick to it. It will require a lot of willpower and change in your spending habits. I am still today trying to get myself out of this hole I dug myself into and I take it one day at a time. It is a known fact that our society is in debt from all the news we hear every day on television, radio or read in the newspapers. There are some people that will try, won’t try and some that just can’t do it. Everyone needs to think about the future of your children and what you want to leave them when you are gone. Considering the consequences and ask yourself is it worth the long term repayment? Do I really need to take that much? Can I buy that somewhere else at a better price? Taking the time and researching things you are potentially buying will help you in the long run. If you or a family member are subject to a job loss, family issues, illnesses, poor judgment and management; contact your debtors and explain the situation. Find out your options instead of ignoring the issue. A lot of companies have deferment payments for 6 months or so. There is help out there it’s just a matter how people want to stay out of debt or fall into it.