Definition of following terms Essay

Time value of money This refers to the principle that a dollar on hand today has more value than a dollar received sometime in the future. Keown, A. J., Martin, J. D., & Titman, S. (2014). Financial Management: Principles and Applications (12th ed.). : Pearson Education, Inc.. Efficient market Refers to the type of market where everyone receives the same time of information and prices are reflected based on this information. Business Dictionary.com. (n.d.). Retrieved from http://www.businessdictionary.com/definition/efficient-market.html Primary versus secondary market Primary market refers to the securities a company sells for the first time for the purpose of raising money. Securities traded after initial investment are done through the secondary market. In the primary market, the issuing firm receives the money; in the secondary market if the shareholder of the firm decides to sell he receives the money. Keown, A. J., Martin, J. D., & Titman, S. (2014). Financial Management: Principles and Applications (12th ed.). : Pearson Education, Inc.. Risk-return tradeoff This principle is based on the risk that investors are willing to take for a promise of higher returns on investments. Keown, A. J., Martin, J. D., & Titman, S. (2014). Financial Management: Principles and Applications (12th ed.). : Pearson Education, Inc.. Agency (principal and agent problems) Refers to the problem companies face in motivating their managers who act as agents in pursuing the interests of the owners (shareholders). Keown, A. J., Martin, J. D., & Titman, S. (2014). Financial Management: Principles and Applications (12th ed.). : Pearson Education, Inc.. Market information and security prices and information asymmetry Security prices change as information is provided to all investors. In contrast in information Asymmetry one party may benefit from having more sources of information and therefore making better decisions. What is Information Asymmetry. (2014). Retrieved from http://www.investorwords.com/2461/information_asymmetry.html Keown, A. J., Martin, J. D., & Titman, S. (2014). Financial Management: Principles and Applications (12th ed.). : Pearson Education, Inc.. Agile and lean principles The lean principle in Finance refers to the production practice that companies use in which they target to minimize waste and use the the least amount of resources to meet the customers’ needs. Organizations that use agile type of processes allow to work on smaller projects to revamp production, maximize collaboration and allow for more flexible schedules. What is Project Management. (2014). Retrieved from http://www.villanovau.com/resources/project-management/what-is-project-management/#.VFKo2vldW So Return on investment It’s a form of investment measurement that shows how efficiently a company is using its resources. This ratio is usually expressed as a percentage. http://www.businessdictionary.com/definition/return-on-investment-ROI.html Cash flow and a source of value This is the money a company has after it has paid its bills and after it has used the money necessary to operate the business. The value of a company’s investment lies in the amount of cash flow available to spend. The Free Dictionary. (2009). Retrieved from http://financial-dictionary.thefreedictionary.com/cash+flow Project management This refers to the processes that involves all aspects of a project, ensuring that it is done well, on time and within budget. Processes in Project management include initiating, planning, executing, monitoring, controlling, and closing. What is Project Management. (2014). Retrieved from http://www.villanovau.com/resources/project-management/what-is-project-management/#.VFKo2vldW So Outsourcing and offshoring Outsourcing happens when a company contracts the services of a third party to do the work for the purpose to increase efficiency and lower costs. As opposed to offshoring this does not have to happen out of the country. Offshoring happens when a company moves abroad to reduce the costs of running its operations. What is the Difference between Outsourcing and Offshoring. (2003-2014). Retrieved from http://www.wisegeek.com/what-is-the-difference-between-outsourcing-and-offshoring.htm Inventory turnover Inventory turnover is a form of measurement of how frequently a company sells and replenishes its inventory. The Free Dictionary. (2009). Retrieved from http://financial-dictionary.thefreedictionary.com/ Inventory+Turnover Just-in-time inventory (JIT) JIT inventory system maximizes the profit by just keeping enough inventory as needed and making more frequent orders, saving space and the money associated with keeping up with large inventories. Wise Geek. (2013-2014). Retrieved from http://www.wisegeek.org/what-is-a-just-in-time-inventory.htm Vendor managed inventory (VMI) It is the type of inventory model where the manufacturer is responsible for keeping up with the levels of the company’s inventory. Vendor Managed Inventory. (2014). Retrieved from http://www.vendormanagedinventory.com/definition.php

Engineering Is a Very Important Part of Our Society Essay

Engineering is a very important part of our society, both now and in the past. It is a major that opens a wide variety of career opportunities for you after college. Engineering is what keeps our nation moving and up to date with technology. It is a very strong appealing major in college due to the amount of average income, and also it appeals to many individuals likes in a career. It has the highest paying income straight out of college, and that increase in pay usually does not stop, it just keeps increasing. Another appealing aspect of a career in engineering is the possibility to work for a foreign company, and no matter where you live in the United States, your income never decreases due to the other local income. It is a rewarding career, both financially and mentally. This is one of those careers that you feel a great deal of self-worth after completing an assignment, or creating something new and improved to keep up with technology. It is a major that requires more time and effort than most other majors. You need to apply yourself or you will just fall behind and most likely just drop the major all together. Whether you choose general engineering or a more difficult division such as mechanical or To become a successful engineer is to ensure a spot in our future. Almost every type of engineering will be required to run our world, now and in years from now. Engineering is very important aspect of our working world. It keeps us going and up to date with technology. Without engineers, there would be no moving parts, which means no cars, planes, video games and anything else you can think of that requires moving parts to operate. Over all engineering is concerned with technology and keeping the world going. In the future, near or far, engineering most definitely has its place in our world. If the future holds a few big technological advances or a lot, engineers will still be there making sure everything runs smooth and properly. A world without engineers could only exist if everything made, was made to perfection and would never fail or break down. For now, we need to keep putting out successful engineers into our working world, and make sure that there is a future. l or aerospace, your major is the most difficult one you can choose. I recently interviewed Jack Byrd, an engineering professor at West Virginia University, on Mechanical Engineering. The interview detailed the importance of engineering and the process he went through to be where he is today. This interview would be an insight to anyone who has the slightest interest in engineering or becoming an engineer and what it takes to become a successful engineer. After college is where your education really takes its part in your life. Even though your schooling is over, it plays one of the biggest roles in all your opportunities after you graduate. Once you get your resume around, you have many possibilities and opportunities ahead of you to choose The world is changing rapidly. From the Stone Age to the Iron Age today we are living in an ultramodern era where things which were not even thought of earlier have become vital necessities in our life. For example, light in those ages was to be got only from sun for a limited part of day. But now we have electricity for all time use. Thanks to Thomas Alva Edison who by inventing electricity illuminated the whole world.

Digital Fortress Chapter 45

David Becker wandered aimlessly down Avenida del Cid and tried to collect his thoughts. Muted shadows played on the cobblestones beneath his feet. The vodka was still with him. Nothing about his life seemed in focus at the moment. His mind drifted back to Susan, wondering if she'd gotten his phone message yet. Up ahead, a Seville Transit Bus screeched to a halt in front of a bus stop. Becker looked up. The bus's doors cranked open, but no one disembarked. The diesel engine roared back to life, but just as the bus was pulling out, three teenagers appeared out of a bar up the street and ran after it, yelling and waving. The engines wound down again, and the kids hurried to catch up. Thirty yards behind them, Becker stared in utter incredulity. His vision was suddenly focused, but he knew what he was seeing was impossible. It was a one-in-a-million chance. I'm hallucinating. But as the bus doors opened, the kids crowded around to board. Becker saw it again. This time he was certain. Clearly illuminated in the haze of the corner streetlight, he'd seen her. The passengers climbed on, and the bus's engines revved up again. Becker suddenly found himself at a full sprint, the bizarre image fixed in his mind-black lipstick, wild eye shadow, and that hair†¦ spiked straight up in three distinctive spires. Red, white, and blue. As the bus started to move, Becker dashed up the street into awake of carbon monoxide. â€Å"Espera!† he called, running behind the bus. Becker's cordovan loafers skimmed the pavement. His usual squash agility was not with him, though; he felt off balance. His brain was having trouble keeping track of his feet. He cursed the bartender and his jet lag. The bus was one of Seville's older diesels, and fortunately for Becker, first gear was a long, arduous climb. Becker felt the gap closing. He knew he had to reach the bus before it downshifted. The twin tailpipes choked out a cloud of thick smoke as the driver prepared to drop the bus into second gear. Becker strained for more speed. As he surged even with the rear bumper, Becker moved right, racing up beside the bus. He could see the rear doors-and as on all Seville buses, it was propped wide open: cheap air-conditioning. Becker fixed his sights on the opening and ignored the burning sensation in his legs. The tires were beside him, shoulder high, humming at a higher and higher pitch every second. He surged toward the door, missing the handle and almost losing his balance. He pushed harder. Underneath the bus, the clutch clicked as the driver prepared to change gears. He's shifting! I won't make it! But as the engine cogs disengaged to align the larger gears, the bus let up ever so slightly. Becker lunged. The engine reengaged just as his fingertips curled around the door handle. Becker's shoulder almost ripped from its socket as the engine dug in, catapulting him up onto the landing. David Becker lay collapsed just inside the vehicle's doorway. The pavement raced by only inches away. He was now sober. His legs and shoulder ached. Wavering, he stood, steadied himself, and climbed into the darkened bus. In the crowd of silhouettes, only a few seats away, were the three distinctive spikes of hair. Red, white, and blue! I made it! Becker's mind filled with images of the ring, the waiting Learjet 60, and at the end of it all, Susan. As Becker came even with the girl's seat wondering what to say to her, the bus passed beneath a streetlight. The punk's face was momentarily illuminated. Becker stared in horror. The makeup on her face was smeared across a thick stubble. She was not a girl at all, but a young man. He wore a silver stud in his upper lip, a black leather jacket, and no shirt. â€Å"What the fuck do you want?† the hoarse voice asked. His accent was New York. With the disorientated nausea of a slow-motion free fall, Becker gazed at the busload of passengers staring back at him. They were all punks. At least half of them had red, white, and blue hair. â€Å"Sientate!† the driver yelled. Becker was too dazed to hear. â€Å"Sientate!† The driver screamed. â€Å"Sit down!† Becker turned vaguely to the angry face in the rearview mirror. But he had waited too long. Annoyed, the driver slammed down hard on the brakes. Becker felt his weight shift. He reached for a seat back but missed. For an instant, David Becker was airborne. Then he landed hard on the gritty floor. On Avenida del Cid, a figure stepped from the shadows. He adjusted his wire-rim glasses and peered after the departing bus. David Becker had escaped, but it would not be for long. Of all the buses in Seville, Mr. Becker had just boarded the infamous number 27. Bus 27 had only one destination.

Baytown Essay Example | Topics and Well Written Essays - 500 words

Baytown - Essay Example According to Feiser the moral challenge in multinational companies need to live up to moral expectations more intense for multinational companies who need to live up to moral expectations both in the US and in host foreign countries. In developed countries, the moral expectations of the host country are as stringent as our own. With third world host countries, though, the moral expectations often more lax and multinationals are tempted to lower their standards when situations permit. Morality in business plays an important role. Business would not success if employees have problems with their colleagues because something has done something wrong with someone. Business will not able to reach its goal if the staffs are having problems. It is important to understand which actions violate morality. There are actions and decisions that are mistakenly understood as violation of morality which is in fact not. To be able to avoid such problems proper definition of the term morality should be clearly defined. Maltreatment of employees is one violation of morality. The company should have a clear list of moral issues that is important for the company's success. Business ethics are the one that examines the moral problems that can arise in business environment.

DB 4-2 Essay Example | Topics and Well Written Essays - 500 words

DB 4-2 - Essay Example There are large national firms as well as small firms working in this sector. Among these small and big firms H&R Block is the largest firm filing over 21 million tax returns in the year of 2008. Next to them is Jackson-Hewitt filing approximately 3 million returns. The factor which is unavoidably making this industry lucrative is that practically each and every working household of U.S. has to file annual tax return. This helps to create a stable stream of revenue for these tax preparing firms. This industry is almost free from the effect of economic environment and it is a low capital investment business. Another factor which catalyzed the performance of the company named H&R Block was the Refund Anticipation Loans (RALs). These short-term loans enabled the tax-payers to get immediate cash which they used to repay during the time of tax refund. The interest calculated on the RAL is very steep, the annual interest rate ranges from 50-300% (Has The Tax Preparation Industry Lost its L uster?, 2010). A fair part of the interest paid by the tax-payers used to be earnings of the company. It indirectly enabled the tax preparing firms to earn huge revenues. These two are the prime factors which helped these two companies to thrive. In U.S.

Investment Risks Essay Example | Topics and Well Written Essays - 1000 words

Investment Risks - Essay Example It is also important to note that the relative degree of risk against the return does not need to be in linear relation i.e. it is not necessary that the risk and return increase in same proportion however, if risk increases, it is necessary that the return must increase too in order to compensate the investors for taking increased risk. (Ante, 2009). The above graph therefore indicates that the investment four has the highest risk and highest return whereas investment 1 has the lowest risk and lowest return. This graph also indicate that the investors may be preferring different combinations of the investments i.e. the investment that is providing lowest returns may be made in the government treasury securities whereas investment providing highest returns may made in the stocks of a corporate as the stocks provide highest returns and also carry greatest risk among all instruments of investment. It is important to understand that the expected return is always calculated by multiplying the return with the probability and the resulting figure is called the expected return on any investment. Therefore the investment that provides highest expected return shall be chosen over other investment. The investor should choose an investment that pays a guaranteed return of 7% because given the overall probability of different returns, the investors will get the expected return of 5% with a probability of 0.5 whereas the investment providing 7% result has the probability of 1 that means the expected return will be 7% which is highest as compared to other investment. The higher the probability greater are the chances that the return will be guaranteed therefore an investment with a lower probability will yield lower expected returns whereas an investment with higher probability of getting the same return will yield higher expected returns. Therefore in this case, since the probability of getting 7% return is

What can coins excavated at a roman villa tell us about the site and Essay

What can coins excavated at a roman villa tell us about the site and it's wider context - Essay Example It takes a lot of effort to divine some of these social dealings by the use of numismatics. Besides archaeologists and academicians, other groups of people are also very interested in studying these coin finds in ancient Roman sites such as social scientists, numismatists, and economists who try to impute social contexts using these Roman coins as guides for their study. However, it is often the case where there is no standard way of how to properly and scientifically catalogue these finds and moreover, and also no set standard for their coinage analysis. Be that as it may, it is still possible to know how the people in a Roman villa had lived and in relation to the surrounding communities through the study of these archaeological coins. It just takes some time and lengthy effort for archaeologists and others interested in these sites to come up with their findings and conclusions based on a careful consideration of all the artifacts in an excavation site but admittedly, there are no set standards for doing this but rather only some set patterns which may be useful to make any comparable analyses with other similar sites. This paper examines and discusses how the coin assemblage can give some useful and pertinent ideas of the wider social context in which these people lived in relation with their neighbors. A case in point of how Roman coins determined the wider context of social living in an area surrounding an ancient Roman villa is the fairly recent excavations at the San Felice Villa, which is located in the Basentello River Valley of Italy that separated the ancient vicus (Roman word for neighborhood) of Apulia from Lucania. This site is a rich archaeological dig in terms of the old architectural remains (buildings and houses), artefactual assemblage, and environmental evidence within the site itself. Preliminary evidence suggests it was a part of a larger estate; it was important in fostering local and regional connections for the villa’s

My experience and the impact of growing up with a parent with a Essay

My experience and the impact of growing up with a parent with a disability - Essay Example The first teacher in any child’s life is the parent; the parent provides life lessons that will be useful in a child’s life. Most children do not spend quality time with their parents due to tight working schedules. My mother’s disability has restricted her movement; thus, she spends most of her time at home. Having a flexible schedule meant that my mother was always there for me. She assisted me in my studies and taught me that having a positive attitude in life would make me stronger. I was taught never to give up and never shy away from assistance as it always leads to success (Ostalecki 47). Having a disabled mother has made me a social person. My mother ensured that I made friends in my life to help me deal with challenges that I faced. I help my mother by doing errands at home and assisting her with any challenges she may encounter. Through my mother, I have learned the importance of existing in a society where people love and care for others. I have also learned that traits like humility and kindness are valuable for any individual in society. Having a disabled mother has made me a self reliant individual. Although my mother has been there for me emotionally, her disability restricts her from helping me with physical activities. This made me learn and adapt to caring for myself and helping her with physical activities in the house. Compared to other students in my age group, I am capable of doing many basic chores without any assistance. Doing chores and caring for my mother has made me gain physical and emotional strength (Ostalecki 89). I and my mother are close, and we shared a lot as I grew up. Every time I have a troubling issue, I consult her, and she is always there to give me advice. Through her experience, she teaches me to be courageous and never give up. She insists that it is always beneficial to hope when faced with any challenge in life. Her disability has made her strong

Convince my teacher to pass english class Essay Example | Topics and Well Written Essays - 500 words

Convince my teacher to pass english class - Essay Example I have been able to make new friends because I speak English, the communication barrier which existed earlier is not there anymore and they have also accepted me in their friend circle with open arms and it has been a great change, earlier it was not the same. They are a very welcoming group but there was a communication barrier which restricted my progress but I have worked on removing that barrier and I firmly believe that it has been completely removed now. I consider this a really big achievement and I also feel that not everyone can learn a new language, it requires a lot of hard work and understanding to learn a new language and I have done exceedingly well. English language is considered to be one of the toughest languages and I felt the same initially but as we went along I started getting a grasp of it and now I have started reading novels and other pieces of literature which has helped me even more. Finally, I deserve to pass because I have made great progress and there is no denying this fact. I have shown keen interest in the course and I have worked on both my writing as well as spoken skills and as a result of that I am able to write and speak well in English. I also deserve to pass this class because I have performed better than my peers, there are many who are yet to learn even a single sentence but my growth has been at a different level when compared to them, this is why I deserve to pass this

A Farewell to Arms an Ironic Metaphor to Explore Physical and Literature review

A Farewell to Arms an Ironic Metaphor to Explore Physical and Emotional Death - Literature review Example   Ã¢â‚¬Å"A Farewell to Arms† is a novel set during World War I. It is filled with human despair, loneliness, and confusion (Bloom 17). It is told in the first person, using the character of Lt. Frederic Henry, who is an American serving in the Italian army as an ambulance driver. He falls in love with an English nurse, Catherine Barkley, and the whole story revolves around how each character tries to survive life, conquer death, and placate their loneliness and misery (Burden and Hemingway 9). If one is familiar with the life of the author, Ernest Hemingway, one could easily see several allusions to the events that occurred in the author's life, particularly in the relationship between the main characters Frederic and Catherine. Hemingway served in the Red Cross in Italy during the war (Hewson 53). Not surprisingly, he was an ambulance driver, much like the main character in the story, Frederic. Hemingway got wounded and during his hospitalization, met and developed a relatio nship with nurse Agnes von Kurowsky (Hewson 56). A large part of the story is based on the realities that Hemingway encountered during the war, and to explore this in the novel, he utilizes several metaphors (Harrington 60) mainly using rain or the weather to forecast major events in the characters' lives (Bloom 19). Rain, or water for that matter, is usually seen as something that supports life, yet Hemingway effectively utilizes this as an ironic representation of gloom, pain, and destruction (Harrington 60-1). From start to finish, rain symbolizes the many emotions associated with death. At the beginning of the novel, one can see the immediate turning of summer into autumn. Summer is â€Å"rich with crops,† while autumn is where â€Å" the branches were bare and the trunks black with rain† (Hemingway 7). This alone forecasts the turning of events from happy to desolate. This is because, in that same chapter, death is foreshadowed. â€Å"In the fall when the rains c ame, the leaves all fell from the chestnut trees and the branches were bare and the trunks black with rain† and â€Å"The vineyards were thin and bare-branched too and all the country wet and brown and dead with autumn† (Hemingway 7). This is followed by the line â€Å"At the start of the winter came the permanent rain and with the rain came cholera. But it was checked and in the end, only seven thousand died of it in the army† (Hemingway 8). Here, the link between death and the pouring of the rain is stated clearly. However, there is no reference to emotions usually associated with death.  

Dream of the Red Chamber Essay Example for Free

Dream of the Red Chamber Essay In the first chapter, the author first writes about the origin of the stone. Then it comes to the very end of the story and writes a conversation between the stone and the Taoist called Vanitas. Next, it starts to talk about the story which first starts with the decline of Shi-yin Zhen`s family. When reading the origin of the stone, I find the description of the stone provides me with a great sense of mystery, which keeps me reading forward. Maybe it is because the stone is of magic power which makes it unreal from the reality. However, the story happens in the real world. As a result, it forces me to read and explore what will happen if the unreal meets with the real. Then it continues to write about the conversation between the stone and Taoist after â€Å"countless aeons†. The conversation suggests a lot of clues about the whole book. According to the self description of the stone, the story`s main theme is love, and purpose of this story is to record the real events and make those who indulge in the eroticism aware of their wrongdoing. Although it gives some clues to the story, but it never gives the detail to readers. Thus, it is just like it gives you soul of the book, but it never gives the appearance or skin of the book, which makes the reader know something about the book but not everything about it. Consequently, as one of the readers, there is no doubt that I want to get to know more about the book. It is very surprising that the whole story starts with the tragedy of Shi-yin Zhen`s family. Personally, I myself very compassionate him. Before I read the book, I thought the book should be very light and happy since it was a book about love among young boys and girls. It is widely acknowledged that the first impression about one thing will keep affecting your view for a long time. Maybe the author wants to suggest something about the later story, so he writes such a tragedy and makes the atmosphere sad and dark. Shi-yin is a good man who helped Yu-cun. He does not deserve such misfortune. Maybe it is the â€Å"Fate† that the author wants to focus on. Another feature that I find in the first chapter is that Taoist and monk frequently appear in the context. In my impression towards Taoist, such kind of people, who are totally different with the ordinary ones, have higher-level thoughts towards the world. They always have deeper thoughts towards everything. I am quite confused by the frequently appearance of Taoist. Is it very common at that time to have Taoist or is there any other reason? What does the author want to express with the use of Taoist? According to my point of view, maybe he wants to compare the Taoist and the ordinary people to emphasis what ordinary people do are always secular and profane, which is because they lack of the understanding of the true life and indulge in the real material world. The first chapter tells us much and also leaves many unsolved questions which force us to explore the answer by reading the rest of the book. I will keep on reading and figure out the answer myself.

Safeguarding and Protection in Health Essay Example for Free

Safeguarding and Protection in Health Essay 1.1- Diversity means the difference between people and the values and beliefs that they have, there is lots of ways in which people differ, for example, ability, beliefs, race, religion, gender, culture, the differences in people are what makes an individual and as a care worker it is important to recognise these and respect their individuality to ensure that they feel valued and included, if I treated everyone the same or made assumptions or decisions for my service user’s or stereotyped people this would cause them to feel unvalued which would dent their self-esteem and more seriously would mean I was working in a discriminatory way and the service user would not have their needs met. It is very important to value diversity in individuals and work in ways that ensure that their needs, wishes and preferences are taken into account all of us as individuals have this right. By stereotyping individuals, this is the main cause of discrimination in which we, at times have a lack of understanding of differing cultures, beliefs, for example ‘all black people are drug dealers,’ ‘Jewish people are mean with money,’ ‘the Irish are thick,’ labelling and stereotyping is a form of being prejudice and media and television programmes can have a big influence on us all and the way we look at people and instantly make judgements, we are if completely honest guilty of doing this, but as a professional care-worker it is very important to challenge this behaviour and to value everyone’s choice, beliefs, cultures, not make assumptions because of the way they look, dress or their personal beliefs and cultures, it is important to respect their diversity and work in ways that respect their decisions and meet their needs even if they differ entirely from my own, spending time with individuals finding out how and where and when the y want my support, how they would like the support given, documenting their wishes is very important as this will ensure the individual feels valued, included, a care plan which is person-centred will give the best support to the individual and outcomes will be met. Read more: Principles of safeguarding and protection in health and social care  essay Equality is about everyone being equal and ensuring that their diversity is valued and individuals are given the same services and support wherever they are from, to promote equality it is important to find the correct level of care to ensure the individual can reach his/her goals in life and encourage them to reach them even if there is perceived disadvantages for them, individuals deserve the correct level of support to maintain and achieve their goals and can participate the same as someone who needs none or less support, by lifting the barriers this will enable the individual to feel valued and build self esteem and independence. Governments definition of social class allows them to determine what planning services are needed around the country, but there are many ways that social class is perceived, this could be lower class, middle class and upper class, how we determine this is by example: I would say individuals who have very well paid professional careers and live in affluen t area’s of the country with top of the range cars, who send their children to private schools are the upper class of our society, but individuals from lower class through education can move around the class system. These systems of social classes can cause at times inequality, individuals from the lower class can suffer from ill health and poverty which create many more social and economical factors for example: poor nutrition, mental health problems, infant and childhood deaths, heart disease, diabetes. Gender, disability and age can also be causes of inequality, this can be made worse if poverty is a factor particularly in the elderly who live on low income, over 30% of the elderly who are entitled to pension credits do not claim it and this in turn means that they live in severe deprivation, poverty and socio-economic deprivation are the leading causes of inequality in the united kingdom and is made worse by attitudes for example, racism, sexism and discrimination against people with disabilities. inclusion is about equal opportunities for individuals, whatever their age, gender, ethnicity, attainment and background, feeling respected, feeling a sense of belonging, being valued for who you a re. 1.2 The possible effects of discrimination can be very serious and can affect an individuals self-esteem and can reduce their ability to maintain their self belief and identity, being discriminatory because of their, for example sex, age, disability, colour of their skin, religion, can and will have a detrimental affect on a persons well-being and causing the individual to feel, angry, humiliated, depressed, low self esteem, worthless and unvalued. To eliminate the above as a care worker I should always strive to work in a anti-discriminatory way and respect a person and their choices whatever they are, respect their diversity as an individual, some examples of this would be to work to a person centred approach to ensure that the individuals needs, wishes and preferences are met, this could be cultural meal choices, ensuring language barriers are supported, not ignoring a person because of their differences, treating everyone equally, challenge discriminatory behaviour in my workplace, respect diversity of individuals and not push my own views on them. 1.3 Inclusive practice promotes equality and supports diversity of the individual, if we as care workers ensure that the individuals needs are met and ensuring that no barriers are there that would mean that they could not feel included and made to feel worthless. By understanding the individuals needs and what needs to be implemented for them to fully participate is important, this could be ‘a fully working hearing aid, good lighting, wheelchair, flash cards. Also being aware of any changes in the individuals overall health and recognising that at times extra support may be needed so they can still be included and fulfil an active life, mentally, physically and emotionally and ensure these are implemented. Question 2 2.1 2.2 2.1There are many legislations and codes of practice relating to equality, diversity and discrimination in my work role. It is my responsibility to adhere to these legislations and follow also my organisational policies and procedures relating to the above, my responsibility is about protecting and improving and not infringing rights of others, by dis-regarding a persons choice, entitlement is an infringement of their rights, so it is vitally important as a care worker to have the correct balance of rights and responsibilities. There are rights that do not have the force of law, these are rights under national standards, codes of practice, guidelines and policies, they are enforceable within social care and will help to improve the quality of services that individuals receive. National Minimum Standards England, Scotland, Wales and Northern Ireland, have their own individual body and they are responsible for inspecting social care facilities to ensure that they are complying with the National Minimum Standards, they are: The Quality Care Commission in England, Care Commission in Scotland, The Care and Social Service Inspectorate in Wales and The Regulations Quality Improvement Authority in Northern Ireland, all these bodies will have there minimum standards to inspect the quality of care, there will be different standards for different types of services for example, one set of standards would be for a care home for the older adult and different set for young people or a children’s home, also these organisations would have policies in place to outline what services and support that the individuals using these can expect to receive. All these regulatory bodies in the UK have codes of practice for both employers in social care and also their employees, it is my responsibility to promote and protect the individuals rights and their interests and maintain them so they feel valued, respected, included, they will feel have control over their own lives, respect for equal opportunities, diversity and always maintain dignity and privacy. It is also my responsibility to promote their independence and also to protect them from danger or harm, also recognise that at times they have a right to take risks, so ensure risk assessments are in place to try minimise this and all the people involved in the care of the individual that need to know are aware. Maintain trust and confidence of the individual and others, building trust and never exploiting an individual, showing any discrimination towards them, keep a professional relationship at all times, not take any unnecessary risks, keeping confidentiality, not accepting gifts, effective communication skills, declaring conflicts of interests, challenge discriminatory behaviours, being accountable for my own development, attending training courses, pin pointing where additional training will be needed, report any unsafe practice, follow regulations. Maintain rights of individuals and empower them to use them. There are also responsibilities of the employer to adhere to which are employers must ensure that individuals who are in their social care setting know their roles and responsibilities, employers must have written policies and procedures so that employees reach and meet the codes of practice for social care workers this will include area’s on risk assessment, confidentiality, keep records, equal opportunities, acceptance of gifts and substance abuse, also the employer will and should provide supervision, effective management systems, systems to report inadequate resources, training and support to enable the employees to meet the standards of the code of practice criteria’s. Employers must provide training for employees, ongoing supervision and development meetings, respond to employees who are finding any difficulties and provide support, support employees to acetane eligibility criteria’s. Employers also have a responsibility to ensure that they put in place written policies and procedures to deal with discriminatory, dangerous or exploitive behaviours and practice, policies and procedures also must be written for the following equal opportunities, minimising risks of violent and managing violent incidents, bullying, harassment and discrimination, support networks for employees who experience any violence, trauma, bullying and harassment, and also support in connection with health needs. 2.1 Employers have a responsibility to promote the codes of practice for social care workers, service user’s and primary carers and co-operate with the councils proceedings for example, informing workers of the code, co-operate with any investigations, use the code to assist in any decisions that need to be made, inform social care user’s and also to report any misconduct to the council. By adhering as an employee to the codes of practice this will ensure that care will be delivered in the highest possible quality and will ensure the service user is valued, their rights have not be infringed in any way, it will promote their independence, the care they are given is person-centred, dignity and respect is promoted, the care they are given is confidential, diversity is promoted and they have the correct level of support that will maintain that they have control over their own lives. It is also important to understand the balance between rights and responsibilities as one service user who is exercising their rights may on some occasions restrict the rights of others, for example, a care home who does not take into account cultural diets or free speech of one individual who is communicating discriminatory behaviours which will infringe on another individuals rights to be respected and valued it is racist and discriminatory and un-acceptable and is not justified on any level, individuals have the right to be different and it is my responsibility to respect their diversity, individuals have a right to choice over how they live their life, diet and routines, dignity and respect should always be maintained, people have a right to feel safe and secure and not feel threatened in any way, individuals have a right to take risks, choice in order to maintain the individuals identity and its my responsibility not to impose unnecessary risk or put the individual at any risk d anger or harm. Human Rights Act came into force on 2/10/2000, this act applies in England, Scotland, Wales and Northern Ireland, individuals are entitled to seek help from the courts if they believe that their human rights have been infringed, it is my responsibility to work within the provisions of the Human Rights Act which for example guarantee the rights to: life, freedom from slavery, liberty and security of the individual, freedom from torture, a fair and public trial, respect for private and family life, home and correspondence, freedom of thought, conscience and religion, freedom of expression, freedom of assembly and association, marry and found a family, access to education, free elections, not to be subjected to the death penalty. Legislation about equality and rights are: All these Acts and Regulations have been superseded by a single Equality Act 2010 and covers all the previous legislations and gives individuals more protection and includes all older people and also protection for individuals not to be discriminated against on the grounds of sexual orientation, a few of the points of the act are as follows:- Protection against direct and indirect discrimination, harassment, victimisation in services and public functions, premises, work, education, associations and transport. Applying the detriment model to victimisation protection(aligning with the approach in employment law) Introducing a new concept of discrimination arising from disability. This act will give protection to individuals on rights, equality and diversity and maintain that individuals are respected and given choice 2.2 As a care worker it is vitally important to respect the beliefs, culture, values and preferences of all the individuals I support, the ways that I can do this is to set myself a high standard of working which takes all individuals choices into account and respect these and impose my own preferences on the individual, recognising my own prejudices however hard this may seem is important as these are a result of my own values and beliefs and can create conflicts in the working environment, it is important to seek advice and speak with my supervisor if I feel I will struggle with any issues in the work setting, being professional and understanding that we are all different and we have a right to be cared for which respects diversity will ensure individuals feel valued even if this care is not what I think is best for them because of my own beliefs and what I think is better for the person, I must ensure that the individuals I support feel valued and respected and not discriminated a gainst in any way, individuals need to make choices about how they wish to live their lives, having the correct balance is vitally important it will give the individual empowerment to make these choices which exercise their rights, feel valued and build self-esteem. What also is very important is to never tolerate any discriminatory behaviours in the workplace and I should always challenge these behaviours at every level and report these concerns to my manager immediately, my workplace policies and procedures need to be adhered too which will have procedures in place that respect diversity are acknowledged and respected and these must be followed, the types of behaviours that are unacceptable for example: meal choices that does not cater for cultural preferences, not respecting individuality, removing individuals choice to make their own informed decisions, not maintaining independence for the service user, not showing empathy and giving dignity and respect. Question 3 3.1 3.2 3.3 3.1 As a care worker it is important to recognise that individuals have a right to be supported in ways that will ensure that they are valued, respected and are included and also that their diversity is valued and are treated equally, individuals have a right to participate in everyday life and activities as independently as possible, the support they receive should be person-centred which will maintain they have the correct level of support and promotes choice of the individual and access to other services that may be needed so the individual can achieve their best potential and will build self-esteem, I must be as a care worker flexible in the support that I give as support can change, so it is my responsibility to be aware of changes so correct levels of support is still to be given that maintains the individual is at the centre of any changes and decisions to be made and their choice, wishes and preferences are maintained. Care and support should be given to the individuals in the ways that they require and not to suit the establishment that I work in, social support services have changed dramatically over recent years as personalisation agenda’s is ensuring choice and control are firmly in the hands of the service user’s using care support services, direct payments and individual budgets are widely used today which will give service user’s control over, how, when and who gives them support. The impact of powerlessness is detrimental to service user’s as this will contribute to their self-esteem and how valued that they will feel, as human beings we all like to feel valued and for others to understand and respect who we are, also to respect the choices and the way we live, if this was taken away from us or service user’s they would feel un-valued and would have negative effects on their well being behaviours and confidences, also would have impact on their independence and control over their own life which in turn would make the individual more dependent , they also could then in turn have low self-esteem and feel useless and depressed. Individuals who feel confident and happy, valued and loved will be far more enthusiastic to participate and try to do as much for themselves as possible. 3.2 At one time individuals were told the level of care they can receive, how it would be given and the times they would receive it, in 2005 the White Paper Our Health, our care and a further policy Putting people first in 2007 changed the way care was given and is still to date developing, it is essential that control is given to the individuals, once assessments have been made and a budget given to the individual they can decide the amount and type of care they wish for and also they can choose to have the carer they want. 3.3Thier could be times when supporting an individual, that I identify a persons rights but they are unable to exercise their right through either physical or mental barriers, it is my responsibility as a care worker to recognise this and access further assistance or information, this could be for example: involve an advocate who will argue a case for another person, they will try to understand the individuals perspective and argues their case, my own organisation will have procedures in place that will assist me in gaining the services of people who will act as advocates for them. It may also arise that I will need to support an individual in a more informal way this could be for example ‘A day centre that is not fulfilling a cultural need of an individual’ it is my responsibility to challenge this with the manager and ensure that this will be corrected immediately and the individuals cultural needs are being met. It is important to ensure that I provide support that will encourage the individual to take control and make their own choices and decisions that will enable them maximum participation in every aspect of their lives and if possible make their own decisions and only put the support in on the gaps that the cannot possibly do for themselves. if I witnessed a discriminatory incident I would address the situation by reporting it to my manager and recording it immediately. By doing this it is more likely to be dealt with in the appropriate manner If I overheard someone making a discriminatory remark or not promoting equality or valuing diversity I would challenge them in a calm and professional way and tell them that what they were saying or doing, is unacceptable and explain why. I could also add that I am upset and offended by their discriminatory words and actions and that it is unlawful. In a work setting, discrimination can be a disciplinary matter and policies and procedures are in place to deal with this. I could actively challenge discrimination by acting as a role model for positive behaviour and by empowering people to challenge discrimination themselves. Discrimination usually occurs through ignorance. By making a person aware of the facts it will educate them and hopefully change their opinions and actions in the future.

Stereotyping in Nursing Care | Reflection

Stereotyping in Nursing Care | Reflection PLACEMENT REFLECTION Introduction Reflection has been defined within healthcare as the active process of reviewing, analysing and evaluating experiences, drawing upon theoretical concepts or previous learning, in order to inform future actions (Reid, 1993). A reflective practitioner often reflects on experience and is capable of reflecting-in-action, continually learning from experience to the benefit of future actions (Schon, 1983). This essay is a reflective account based on the recurrence of an incident that took place during my placements in a forensic and an acute ward as part of my mental health nursing training. This reflection is based on Gibbs (1988) definition of reflection which is shown in his reflective cycle in the diagram below. The model will be used to describe the incident, my feelings following the incident and an evaluation of my experience. An analysis of what sense can be made of the situation and thoughts of what else could have been done under the circumstances. The final stage is an action pl an for what has to be done if the incident eventuates in future during practice (NHS, 2006). In accordance with the NMC code of conduct (2008) on confidentiality, the names used for the patients are pseudonyms. Reflection in nursing is important as it generates practice knowledge, enhances the ability to adapt to new situations, develops self-esteem, leads to satisfaction and improves professional practice (Baird and Winter, 2005, p.156). Similarly, Siviter (2004, p.165) explain that reflection is about gaining self-confidence, identifying when to improve, learning from own mistakes and behaviour, looking at other people’s perspectives, being self-aware and improving the future by learning from the past. Description of the incident During my first week of placement at a forensic ward, I was cautioned to be careful of some patients whom the nurses had labelled as ‘difficult’. This was a perception I carried with me till the end of my placement, unfortunately. At one instance I was with a nurse in the office when Yosef, one of the ‘so-called’ difficult patients came to request for the patients phone to make a call. The nurse appeared to be very busy and ignored the patient. As the patient kept knocking at the window, I asked the nurse if I could facilitate the request, but I was told the patient had to wait because he has a habit of always making requests. Yosef walked away after waiting for a few more minutes without help. He was fuming and very upset. I looked at the nurse in despair as I really could not understand what he had to wait for in the first place since in my view, the request could have easily been facilitated. I felt a sense of guilt because at that moment I felt we had le t down a service user as facilitators of service. I carried this guilt with me to my second placement which was a female acute admissions ward. I found that here too, the labelling of some patients as ‘difficult’ existed. Bridget, a 59 year old patient who presented as isolative, interacting minimally with peers and staff was also labelled as such. During a ‘plan of the day’ meeting which all patients and staff are expected to attend, Bridget was surprisingly very forthright. She spoke about staff negative attitudes towards patients during the ‘any other business session’. After lunch that day, I decided to have a conversation with her. I started by introducing myself and congratulated her for being outspoken at the meeting, empathising with her on some of the concerns she raised at the meeting. This was meant to make the prospect of engaging her more appealing to her. The conversation took off slowly, but I had to adopt emphatic listening whic h according to Wold (2004, p.73) is about the willingness to understand the other person and not just judging the person’s facts. During the conversation, I maintained eye contact in order to express a sense of interest in what she was saying (Caris-Verhallen et al, 1999). To my surprise, Bridget was participative, and very pleasant throughout the conversation, dispelling the earlier impression I had been given about her. At the meeting that morning, she had mentioned nurses’ insensitivity which I wanted her to elaborate on. In her response, she said ‘Nurses must know that mental illness is invisible unlike physical illness. The therapy is not all about medication, but it is also about relationships that show warmth towards us as patients. But some nurses feel so important and insensitive; their attitude sometimes makes me feel slighted and frustrated. This can easily lead me on to kick off and explode when I shouldn’t’. She was very thankful and said she felt ‘lifted’ after the conversation. My feelings I had mixed feelings after this conversation; a feeling of disappointment and regret. The disappointment was associated with the fact that there appeared to be a thread of a culture of neglect instead of support at the two wards towards patients. My regret was borne out of the fact that I had allowed some nurses to colour my perceptions of some of the patients. It was clear after this conversation that some nurses have failed to understand and respond to the needs of some patients because they failed to form sound therapeutic alliances with patients which is an essential component of all therapeutic interventions through effective communication Stevenson (2008, p.109). It is important in a mental health setting that nurses promote a therapeutic rapport with patients that is underpinned by a sense of trust, respect and mutual understanding. According to Harkreader and Hogan (2004, p. 245) these are ingredients that would raise the patient’s self-esteem and personal growth. Even more important, according to Arnold and Boggs (2007, p.200) is the need for effective therapeutic communication which can improve the patient’s ability to function. In order to establish therapeutic nurse-patient interaction, a nurse must demonstrate caring, empathy and trustworthiness (Kathol, 2003, p.33). These involve the implementation of interpersonal skills which Johnson (2008) defines as the total ability to communicate effectively with patients and all those involved in their care. Communication is the exchange of information, and effective communication must involve both verbal and non-verbal communication through the use of gestures, postures, facial e xpressions, tone and level of volume. I had a feeling that this intervention was a good starting point to develop my communication and interpersonal skills in future. Evaluation I realised that through communication, I got to know how some patients feel about nurses and the kind of interaction that they expect would contribute to their therapy. At least, my intervention had helped to alleviate her stress to some extent, calmed her frustration and anger through the use of effective communication skills which underpins the promotion of therapeutic relationships necessary to handle aggression more effectively (Duxbury 2002). Analysis Caring which consists among other things of the provision of comfort, concern and support, the development of trust and the alleviation of stress (Leninger, 1994) is a primary duty of nurses. But arguably, caring can only be demonstrated when people interact with each other and get to understand their needs. My interaction with Bridget was part of my duty to provide nursing care, and this was achieved by putting her at the centre of the conversation by way of making her: feel listened to; feel that her concerns are being validated and not trivialised; feel emotionally supported; feel understood. A conducive atmosphere for effective communication was created which enabled her to express her feelings. The Department of Health (DH) (2004) and the National Health Service (NHS) Modernisation Agency (2003) lay emphasis on the importance of patient-focused communication between health professionals and patients. This is seen as vital to achieving patient satisfaction, inclusive decision making in caregiving and an efficient health service. Nursing literature also promotes these concepts as indicative of best practice. For example, McCabe and Timmins (2006) and Charlton et al. (2008) found that, by using a person-centred approach in the interaction between nurses and patients, care outcomes were improved in: patient satisfaction; adherence to treatment options; patient health. Effective communication is also essential to practice and improving interpersonal relationships in the workplace between professional groups and peers (Grover, 2005) Conclusion The nurse is seen as the therapeutic agent in the nurse-patient relationship. This involves the application of effective communication and interpersonal skills which can lead to a sense of safety and protection, improved levels of patient satisfaction and greater adherence to treatment options and increased recovery rates. Furthermore, a successful communication through a patient-centred approach also serves to reassure relatives that their loved ones are receiving the necessary treatment. Action Plan My action plan for future clinical practice is to avoid stereotyping of some patients, but to try to understand them as individuals and treat them with the care that ensures recovery. This can only be done by forming therapeutic alliances with them through effective communication and interpersonal skills. REFERENCES Arnold, E. C. and Boggs, K. (2007) Interpersonal Relationship: Professional Communication Skills for Nurses, Copyright  © 2006, Elsevier, London. Baird, M. and Winter, J. (2005) Reflection, practice and clinical education in Philadelphia: ElsevierChurchill Livingstone. Caris-Verhallen, W. M. C. M., Kerkstra, A. and Bensing, J. M. (1999) Non-verbalbehaviour in nurse-elderly patient communication. Journal of Advanced Nursing, 29 (4), 808-818. Charlton, CR, Dearing, KS, Berry, JA and Johnson, MJ (2008) Nurse practitioners’ communication styles and their impact on patient outcomes: an integrated literature review. Journal of the American Academy of Nurse Practitioners, 20: 382–8. Duxbury J.A. (2002) An evaluation of staff and patients’ views of and strategies employed to manage patient aggression and violence on one mental health unit. Journal of Psychiatric and Mental Health Nursing 9, 325–337. Gibbs, G (1988) Learning by doing: a guide to teaching and learning methods. Oxford: Further Education Grover, S. M. (2005). Shaping Effective Communication Skills and Therapeutic Relationships at Work, The foundation of Collaboration. AAOHN Journal, 53(4), 177-182. Harkreader, H. and Hogan, M. A. (2004) Fundamental of Nursing: Caring andClinical Judgment. Johnson, D. (2008) Interpersonal skills [onlinehttp://www.mtsu.edu/~jsanborn/iskills/interpersonal.htm[Accessed on 21 March 2014] Kathol, D. D. (2003) Communication in Kockrow, E. O. and Christen, B. L. (eds) Foundation of Nursing, Missouri: Mosby. Leninger, M. (1994). Evaluation criteria and critique of qualitative evaluation studies. (Ed.), Critical issues in qualitative research methods (pp. 95-115). Thousand Oaks, CA: Sage. McCabe C, Timmins F. (2006) Communication Skills for Nursing Practice, Palgrave MacMillan NHS Modernisation Agency (2003) Available at: http://www.institute.nhs.uk/index.php?option=com_joomcartmain_page=document_product_infoproducts_id=230cPath=67 Accessed on April 2014 Nursing and Midwifery Council. (NMC). (2008). The Code Standards of Conduct, Performance and Ethics for Nurses and Midwives. London: NMC Reid, B. (1993) But we’re already doing it! Exploring a response to the concept of reflective practice in order to improve it’s facilitation. Nurse Education Today. 13 pp. 305-309. Schon, D.A. (1983) The reflective practitioner. New York: Basic Books. Siviter, B. (2004) The Student Nurse Handbook. USA: Baillere Tindall. Stevenson (2008, p.109). Unit, Oxford Polytechnic. Wold, G. H. (2004, p.73) Basic Geriatric Nursing 3rd ed. USA: Mosby https://www.gov.uk/government/publications/amending-the-national-health-service-act-2006

Hamlet: The Dionysian Character Essay -- GCSE Coursework Shakespeare H

Hamlet: The Dionysian Character      Ã‚  Ã‚  Ã‚   Hamlet, from Shakespeare's The Tragedy of Hamlet, is the embodiment of the Dionysian man. Time and time again, Hamlet displays the traits of Frederick Nietzche's Dionysian individual: Hamlet's inability to think rationally, his illusion between his emotional reality and true reality, his rejection of pleasurable human desires, his impotent personality prevents action, and his realization that if justice is brought to his uncle, that will not change what has already happened (The Birth of Tragedy, section 7) (Dictionary.com, "dionysian"). Hamlet exemplifies these characteristics throughout the play, which ultimately bring about his own death. Had Hamlet's character embraced physical action rather Dionysian thought, the "something rotten" in the state of Denmark would not have led to his own self destruction (HAMLET, 1.4, 96).    Hamlet's inability to think rationally plagues him through the entire play. If Hamlet had not sworn to his father's ghost to avenge his death, he could have instead confronted Claudius about the matter instead of thinking irrationally by plotting and testing his uncle for guilt (1.5, 94-114). Earlier in the play, Hamlet has the first player "speak the speech" that he has told him to speak in "The Mouse-trap," which he uses to determine Claudius's guilt in his father's death. Hamlet believes that this modification to the play will incite a reaction from King Claudius, which it in fact does, but the king's words of "Give me some light: away!" is not adequate evidence to prove Claudius's guilt of his father's death nor does it appear to anyone, besides Hamlet, as a rational method for testing his guilt (3.2, 256). Shortly after the play in Hamlet, Hamlet proc... ...ented with a situation in which they need to take action, the Dionysian person is unable to take the correct action at the necessary time in order to do justice to the situation. Thinking about the situation and not acting will do nothing for the Dionysian individual except satisfy the indulgence of thought. This is Hamlet's downfall; he cannot act at the necessary time and change his own fate.    Sources Cited Dictionary.com Nietzsche, Friedrich. The Birth of Tragedy. New York: Dover Publications, 1995. Hoy, Cyrus, ed.   Hamlet: An Authoritative Text, Intellectual Backgrounds, Extracts from the Sources, Essays in Criticism.   New York: W. W. Norton & Co., Inc., 1963. Shakespeare, William. The Complete Works of Shakespeare. Updated Fourth Edition. Ed. David Bevington. New York: Addison-Wesley Educational Publishers, Inc., 1997.

Staging of a Tragic Drama :: essays research papers

â€Å"Staging of A Tragic Drama†   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Much of our knowledge of Greek theater comes from archaeological studies and historical writings of the time. By the 600s B.C., the Greeks were giving choral performances of dancing and singing at festivals. Tradegies were performed as part of an important yearly religious celebration. Greeks then later staged performances in the Theater of Dionysus.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ancient Greek theaters were outdoors, that seated thousands of spectators for annual contests in acting, choral singing, and writing comedy and tradegy. Beyond the circle and facing the audience was the skene, originally used as a dressing area and later as a background for the action. According to Webster, pg. 326. The theater seated about 14,000 people. It consisted of rows of stadiumlike seats that curved about halfway around the orchestra. The stage house, that was facing the audience had three doors. The action may have taken place on a raised platform, or perhaps entirely in the orchestra. A wide central opening, to which were added later two smaller side openings, a rolling platform which can be pushed through the central opening, a roof, and a crane.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Greek tragedy, perhaps because it originally was associated with religious celebrations, was solemn, poetic, and philosophic. Nearly all the surviving tragedies were based on myths. The main character was an admirable, but not perfect, person confronted by a difficult moral choice. According to Webster, pg. 326. Greek tragedies were performed by a few actors, never more than three on stage at one time. The main characters struggle against forces ended in defeat and in most Greek tragedies, his or her death.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  The actors wore masks to indicate the nature of the characters they played. Men played women’s roles and the same actor appeared in several parts. The acting style was probably far from realistic. The poetic language and the idealized characters suggest that Greek acting was formal. According to Webster, pg. 326. The dancers were men wearing a kind of jersey which held in the padding. Sometimes they danced with women, padded, naked or clothed. Men wear masks, tights, and over the tights any other clothing that suits his part.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Greek tragedies consisted of a series of dramatic episodes separated by choral odes. The episodes were performed by a few actors, never more than three on stage at a time, during the 400s b.c. A chorus danced and sang and chanted the odes to musical accompaniment. According to Webster, pg. 327. The performances was a unique performance to please the god Dionysos. The earliest record of Greek drama dates from about 534 b. Staging of a Tragic Drama :: essays research papers â€Å"Staging of A Tragic Drama†   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Much of our knowledge of Greek theater comes from archaeological studies and historical writings of the time. By the 600s B.C., the Greeks were giving choral performances of dancing and singing at festivals. Tradegies were performed as part of an important yearly religious celebration. Greeks then later staged performances in the Theater of Dionysus.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ancient Greek theaters were outdoors, that seated thousands of spectators for annual contests in acting, choral singing, and writing comedy and tradegy. Beyond the circle and facing the audience was the skene, originally used as a dressing area and later as a background for the action. According to Webster, pg. 326. The theater seated about 14,000 people. It consisted of rows of stadiumlike seats that curved about halfway around the orchestra. The stage house, that was facing the audience had three doors. The action may have taken place on a raised platform, or perhaps entirely in the orchestra. A wide central opening, to which were added later two smaller side openings, a rolling platform which can be pushed through the central opening, a roof, and a crane.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Greek tragedy, perhaps because it originally was associated with religious celebrations, was solemn, poetic, and philosophic. Nearly all the surviving tragedies were based on myths. The main character was an admirable, but not perfect, person confronted by a difficult moral choice. According to Webster, pg. 326. Greek tragedies were performed by a few actors, never more than three on stage at one time. The main characters struggle against forces ended in defeat and in most Greek tragedies, his or her death.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  The actors wore masks to indicate the nature of the characters they played. Men played women’s roles and the same actor appeared in several parts. The acting style was probably far from realistic. The poetic language and the idealized characters suggest that Greek acting was formal. According to Webster, pg. 326. The dancers were men wearing a kind of jersey which held in the padding. Sometimes they danced with women, padded, naked or clothed. Men wear masks, tights, and over the tights any other clothing that suits his part.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Greek tragedies consisted of a series of dramatic episodes separated by choral odes. The episodes were performed by a few actors, never more than three on stage at a time, during the 400s b.c. A chorus danced and sang and chanted the odes to musical accompaniment. According to Webster, pg. 327. The performances was a unique performance to please the god Dionysos. The earliest record of Greek drama dates from about 534 b.

Maturity: Being Considerate :: Psychology Essays

Maturity: Being Considerate According to Webster's dictionary, maturity is due care or consideration. There are many different kinds of maturity depending on what a person places their emphasis on. One type of maturity, intellectual, is caring about your personal well being. The level of one's intellectual maturity shows their ability to handle certain tasks set before them. A person who is considerate of others shows signs of social maturity. The ability to interact with others is necessary in order to function as part of this society. Different types of maturity can be independent of each other; you can have a high level of intellectual maturity and a low level of social maturity or vise versa. As you will see from e-mails of former students, levels vary greatly from one person to the next. Maturity is not only how you interact with others, but also how you manage your own responsibilities and affairs. An intellectually mature person demonstrates certain characteristics. The ability to follow instructions shows that you are willing to do things correctly in order to learn from the experience. To illustrate this point, say a student had difficulties using a particular program for an assignment. Even though this person disliked using the program that was required for the assignment, he understood the importance of doing his work correctly and he finished it despite the inconvenience. An example of a student who follows directions poorly is that of the student who just pasted in random responses for his log entry instead of doing the assignment as instructed. Another quality that a person must possess is open-mindedness. Being willing to explore new ideas and ways of doing things enriches a person's life. A Christian who is willing to learn the theory of evolution in order to broaden his mind set and to secure his beliefs is a good example of this characteristic. However, one student in particular believes that he does not need to use the library as a source in research because he believes that his information is better and more relative to his subject, which demonstrates his close mindedness because he is not willing to use other sources for information. A person's ability to understand their weaknesses and utilizing their abilities to the maximum shows their intellectual maturity. Take Timothy for example, he cannot grasp the concept of mathematics, so instead of failing the course, he takes the initiative to hire a tutor in order to assure that he will pass the class.

Comparison of Moses and Odysseus Essay

The stories of heroes have been at the axis of nearly all cultures throughout history. Each different type of religion or culture has their own heroes or legends, each one of them having their differences to go along with the beliefs at hand. On the other hand, each and every hero also has their similarities, which therefore makes them the hero. The setting, events, and characters in each and every story may change, but the characteristics of the hero remain basically the same. Each person is usually made into a hero in a somewhat similar fashion. For example, many heroes begin as imperfect characters, and then begin some sort of quest which leads to them becoming a leader of what they are doing, and then the character goes through a personal transformation into a legendary hero of their people. Therefore, both Odysseus of the Greeks and Moses of the Jewish can both be considered as heroes to their people. In both cases, the person does not decide to be a hero, but they are instead chosen by a greater force, such as a god, to become the one. Both Moses and Odysseus perform three similar tasks. These are for the person to fulfill a destiny handed down to them by a greater power, undertake a journey where great sacrifices are made on his part to overcome difficult obstacles, and finally complete their legacy through the sharing of their stories for the greater good of the people that believe in the hero. Both Moses and Odysseus can be compared in that neither were perfect heroes, they both experienced some sort of quest, and they both experienced personal limitations along with a transformation. The major differences between Odysseus and Moses are mostly relative. They both share practically the same qualities. They are universal heroes who could exist in any culture, context or time. Just like Odysseus and Moses, many heroes are made from the same qualities and have similar stories about how they came to be heroes. As a young man, Moses murdered an Egyptian who was harassing a Jew. A savior who kills someone seems contradictory, but the action served as a metaphor for Moses’ freeing of the Jews from Egypt. Odysseus had a habit of raping, burning and looting villages, which is hardly appropriate conduct for someone who is supposed to bring peace to a civilization. However, his cunning proved useful in both defeating monsters and killing the suitors that had taken over his palace. The reality that each hero was and device of God or the Greek gods was important in both  cultures. Moses was picked by God to be the one who would free the Jews and take them across the desert and into the Promised Land. He spoke directly with God in the burning bush and through various angels. Information was given to Moses from God when instruction was needed. Similarly, Athena visited Odysseus frequently with Zeus’ consent through different disguises to help him along his journey. Though Greek and Hebrew culture varies, their heroes are considerably similar. Both Odysseus and Moses could represent model heroes in any culture at any time. But these universal heroes are not perfect as nobody on Earth is. Many heroes do something of questionable moral action at some point in their early life. As mentioned earlier, Odysseus was constant to raping, burning and pillaging villages, and continually had affairs though his wife Penelope always remained faithful. As also stated earlier, when Moses was young, he killed an Egyptian who was harassing a Jew. But these actions do not abolish they hero, they are instead necessary for the development of his character. Moses spoke directly with the Lord and was given specific instructions to embrace his destiny. He did not choose to lead the Hebrews out of Egypt, but God chose that destiny for him. Faced with many different challenges of his own, Odysseus also received a divine message, but it was from the goddess, Athena. The theme of being chosen by a higher power is a recurring theme that is seen in most hero stories of every culture. No matter when or where these heroes were destined for greatness, they each were a part of a quest or journey where they had to overcome many obstacles, trials, and tribulations. Odysseus’s voyage had to be completed before saving his people, while Moses’ exodus and his people’s salvation were simultaneous. In either case, the journey is vital to the hero in order for him to undergo a personal transformation into the legendary hero they became. Moses fought a Pharaoh, the desert, his own people, and himself during his long journey to the Promised Land. Odysseus also had a long journey home and while on that journey battled Poseidon, the sea, his men, and himself. Not only are the stories of The Odyssey and Exodus the similar, but the heroes, Odysseus and Moses, share many of the same attributes and behaviors. Both,  despite having murderous pasts, were chosen by their God or gods to be the savior of their people. Each had a specific limitation that directly interfered with the completion of their mission. And since they were helped by God or the Greek gods along the way, Moses and Odysseus ultimately had faith that they would be successful, regardless of the obstacles ahead. Their similarities exist on a personal level as well. Both heroes had to make great sacrifices for the good of the whole. They each underwent a personal transformation as a result of the trials they faced. And each learned a lesson that they passed on as a message for their people. The hero’s journey is also determined by how each story originated. The Hebrews passed down Moses and the Exodus orally, in the form of a linear story with a beginning, middle and end. Moses’ linear journey took the Jews out of Egypt, through the desert and to the Promised Land. In contrast, Homer’s poetic writing of the Odyssey is circular in that the ending is a new beginning. It begins and ends in Odysseus’ palace in Ithaca. Like the story, his journey back home is a circular one. In spite of all the divine intervention, Moses and Odysseus both had to overcome a personal limitation in order to become successful in their endeavors. The limitation itself was directly in contrast with their main task at hand. Moses was given the job of spokesman for all Jews, yet had poor public speaking skills. â€Å"O Lord, I have never been eloquent, neither in the past nor since you have spoken to your servant. I am slow of speech and tongue (Exodus 4:10).† Odysseus was sent home to save his people from a civil war, but his lust for conquest and adventure took him on many detours and prolonged his eminent return. Both were able to rise above these limitations. Perhaps the most shared attribute these heroes had been their faith that they would make it through the journey and complete their mission. Moses struggled with the Egyptians, the desert, God, his people and himself yet still believed that he would accomplish his goals set for him. Odysseus lost all his men, more than one ship, and continually battled monsters, weather, and captors but still succeeded due to his faith in Athena’s word that he would persevere. The way the hero acts towards outside events only tells half the story but the thoughts in his mind and soul makes up the rest. Odysseus and Moses both had to make sacrifices for the good of their people and both experienced a personal transformation during their quest for significance. The transformation of Moses was found in his lack of public speaking, which held him back from fully becoming a leader of the people. As he confronted the Pharaoh and commanded the Hebrew people, he eventually gained confidence in himself and his ability. Moses went from being a timid servant to an authoritative leader of a nation of God. He was responsible for constructing the ways of their new civilization. Likewise, Odysseus transformed from a restless adventurer to dependable husband and king. Both experienced an epic journey that altered them from within. In conclusion, both Odysseus of the Greeks and Moses of the Hebrews can be compared because they perform three similar tasks: to fulfill a destiny handed down by divine inspiration, undertake a journey where great sacrifices are made on his part to overcome difficult obstacles; like Odysseus traveling home after the Trojan War or Moses Leading his people out of Egypt, and finally, the mission is not complete until the message learned throughout is shared for the greater good of the people whom the hero represents. Neither Odysseus nor Moses was perfect, but they both experienced some sort of quest and overcame personal limitations, which led to their personal transformation into heroes. Because of all the parallels between Odysseus and Moses, there is not much surprise that they both exemplified the same message. Even though the messengers were different, whether it was Athena, a burning bush, or angels sent by God, the message is still the same: listen to and obey the words of one’s God/gods. This is the message they both brought back for their people to live by and led to their legacy as heroes of their culture.

Essay on Jane Eyre’s character Essay

From her troubles with the abusive Reed family, her friendships at Lowood, her love of Mr Rochester and her time with the Rivers family, Jane’s character remains strong and vigilant despite the hardships she endures. Through the course of the novel, Jane’s character changes slightly but moreover reinforces itself as Jane uses people, situations and her personal experiences to gain knowledge, and assist her gaining her full character. From when she was a child, Jane had forthright values of herself and an example is when she reprimanded John Reed for attacking her with a book, Wicked and cruel boy! I said. You are like a murderer you are like a slave driver You are like the Roman emperors! She was exiled and alienated by the Reed family, creating a very independent spiritHer character is more quick to concise and imaginative whilst also being perceptive. I was a discord in Gateshead Hall. I was like no one there; I had nothing in harmony with Mrs Reed or her children or her chosen vassalage. She knew that the Reed family strongly dislike her and the reason behind it. Justice and principle was also seemingly very important to her then. At Lowood School, there was a harsh and strict environment but the environment was eased for Jane by friends such as Helen and Miss Temple who treated her with respect and care. Miss Temple is described by Helen as Miss Temple is very good, and very clever ; she is above the rest because she knows far more than they do. This is also the way that Jane feels about Miss Temple due to her understanding of the children’s feelings and needs. This was contrasted with Mr Brocklehurst who was a hypocrite and treated Jane and the rest of the students with contempt. Jane became to understand of the many different types of people with different characters who would come into her life. She rejects the extremist model of Helen’s character but uses it to become more understanding as she learned to balance conflicting aspects throughout the rest of the novel. It is far better to endure patiently a smart which nobody feels but yourself, than to commit a hasty action whose evil actions will extend to all connected to you.. Helen believes in strongly enduring the pain and from Jane’s rebellious and angry spirit, a development of  understanding and endurance contrives. Although Jane is changed, she never really accepted the full model of Helen and still believed in justice and principle. Jane’s character was afraid of rejection, as so had been done throughout her previous years with the Reed family. Mr Rochester’s proposal had been as stepping-stone for her to overcome the troubles she carried in her past. Mr Rochester was Helen’s first love yet her character hindered her from dependency. She merely wanted freedom and independency in a form where she would be able to love as well as find a balance between her values. Leaving Thornfield was her search for the independency and freedom that she needed to have as part of her character and Jane here struggled hard with her love and need for independency after discovering Mr Rochester’s previous wife. But then a voice revered me that I could do it; and foretold that I should do it. I wrestled with my own resolution†¦ Jane wants to be weak and just love Mr Rochester and be with him yet her character was strong, leading her away from Thornfield and into a whole new perspective of the world. Penniless and hungry, Jane is forced to sleep outdoors and beg for food and this shows how her sense of autonomy is so much ardent than her sense of pride. To find that the Rivers family were cousin related to her; This was a blessing , bright, vivid and exhilarating; not like the ponderous gift of gold. Jane was overjoyed to find that she had family whom she loved and she valued this over the inheritance that she was given. Another part of the love she had been searching for had been fulfilled and through this, Jane’s character’s became more loving and was ready to let go of some of the self-sufficiency she valued so much. As she did to Helen, Jane rejects the extremist model of St John although she still respected him and the freedom that he had offered were still not suited to her needs for self reliance. She knew there was no love or passion between her and St John therefore would not go as his wife, showing that love was still important in her character. This triggered the need to go see  Mr Rochester, and finding him dependent of her believed that this was the solution and happiness she had been searching for. The development of Jane Eyre’s character is central to the novel and as she keeps escaping the surroundings and people around her to find the balance of freedom and love that her character values. Through situations, Jane remains vigilant in character and it develops from a rebellious orphan to a mature independent woman so that she eventually finds contentment. Bibliography: Jane Eyre by Charlotte Bronte

Factors that affect talent planning Essay

1. Introduction This report aims to assesses factors that affects organisations’ approaches towards: attracting talent; recruitment and selection (including an investigatory approach to specific methods used); obtaining a diverse workforce; the process of induction (including a model of an effective induction plan). 2. Attracting Talent 2.1 Brand Identity â€Å"‘Brand Identity’: How a business wants a brand’s name, communication style, logo and other visual elements to be perceived by consumers.† (www.investopedia.com 07/10/14) An organisation with positive image will find it easier to attract and retain employees than the organisation with the negative image, this is due to the aspiration qualities associated with a positive image (i.e. wealth, style, charitable nature etc). A business who hasn’t been well established in its market will find it more difficult to attract new employees than business who is well know, because it’s perceived to be more economically stable. 2.2 Economic Environment The economic stability and funds available to expend on recruitment will have a direct impact on the quality of recruitment processes. One way in which this affects recruitment is effect on how and where the company advertises,  premium recruitment sites charge high fees (however, have very high foot-fall), which non-established or struggling companies would not be able to afford, thus not reaching out to as wide an audience as more successful businesses. Another key factor is the salary and benefits that can be offered to potential employees, either showing competitive rates or lower rates, therefore reducing interest from potential employees. 2.3 Legal restrictions Laws also have influence on organisations’ approaches to attracting talent. For example The Agency Workers’ Regulations that came into force on 1st October 2011 (www.gov.uk/government/publications/agency-workers-regulations-2010-guidance-for-recruiters 07/10/2014). The regulations states that agency workers are entitle to the same working conditions as permanent staff after completing a 12 weeks period in a particular job. It is clear from the following quote that this has reduced agency staff recruitment substantially: â€Å"One-quarter of organisations report they reduced their use of agency worker in 2012 compared to 2011, rising to a third of large organisations† ( The 2013 Resourcing and talent planning survey report www.cipd.co.uk/hr-resources/survey-reports/resourcing-talent-planning-2013.aspx 07/10/2014) 2.4 Business Objectives The aims and suggested targets of businesses, has a direct influence on the amount of recruitment completed and in which manner. For example: if a business has agreed to take on a new contract, they will need to recruit swiftly and in high volume. However, if a recruiter aims to appoint a higher-managerial position within subsequent months they may need more specific and targeted recruitment to ensure the position is filled more effectively than simply swift, high-volume appointment. For the later it is more commonly seen to use a company’s career progression path( management succession planning ), recruiting or training from existing members of staff. This can have a positive impact on the company’s recruitment as a whole as it shows current and potential staff members that progression is available within the business. 3. Diverse Workforce 3.1 Increasing Productivity It is suggested that diversity in the workplace increases morale and thus employees work more efficiently and effectively. Rose Johnson of Demand Media goes on to say: â€Å"diversity within leadership in a firm allows managers to bring in new skills and methods for achieving unity within their teams.† (smallbusiness.chron.com/advantage-diverse-workforce-18780 07/10/2014) 3.2 Increasing Creativity Acas state: â€Å"having a diverse workforce†¦opens up a wealth of possibilities and helps to encourage and foster innovation.† (www.acas.org.uk/indesx.aspx?articleid=3725 07/10/14). People from different background, ethnic origin or age, will approach tasks in different manners, therefore gaining a wider range of outcomes to potential problems. 3.3 Positive Reputation The advantage of obtaining a diverse workforce is clear. â€Å"An organisation is well placed to understand the needs of a wide-range of customers, interacting with a larger client base.† (www.acas.org.uk/indesx.aspx?articleid=3725 07/10/14). This therefore means that companies with a diverse recruitment policy will be more likely to gain customers and be generally more successful in their market. Clearly a company who recruits diversely does not discriminate, which is another characteristic consumers, potential employees and recruiters will aim to be associated with. 4. Factors that affect recruitment and selection 4.1 Labour market Labour market is : ,,..the market in which employers look and compete for workers and in which workers look and compete for employment ..† (http://www.collinsdictionary.com/dictionary/english/labour-market 10/10/2014) tight/ loose 4.2 Legislations National min wage /eligibility to work in the UK/the Equality Act 2010 4.3 Business context

Lipid Profiles In Postmenopausal Women Health And Social Care Essay

Aim: Aromatase inhibitors are presently used in accessory to the former gold criterion Tamoxifen or as first line hormone therapy in postmenopausal adult females with chest malignant neoplastic disease. Suppressing the aromatase mechanism of action impedes the synthesis of estrogen, forestalling estrogen protection on lipid profiles. This literature reappraisal examines, discusses, and analyzes peer-reviewed published clinical tests analyzing the effects of anastrozole, exemestane, and letrozole, on lipid profiles in postmenopausal adult females with estrogen dependent chest malignant neoplastic disease. Decisions: Overall, there are minimum, if any, unfavourable effects of aromatase inhibitors on lipid profiles. However, restrictions of little population sizes, fluctuations in design methods, and old Tamoxifen usage, make it hard to accurately assess hazard. Long term prospective surveies utilizing big sample sizes and patients with no exposure to any other hormone intervention besides aromatase inhibitors, are needed to accurately measure if inauspicious effects on lipid profiles exist from the utilizing aromatase inhibitors. Healthcare professionals should go on to supervise lipoids in postmenopausal adult females with chest malignant neoplastic disease and develop individualized intervention programs utilizing current recommendations. Cardinal Wordss: aromatase inhibitor, chest malignant neoplastic disease, post-maturity, lipid, Anastrozole, Letrozole, Exemestane, cholesterin, and lipid metamorphosis. Aromatase Inhibitors Risk of Adverse Effects on Lipid Profiles in Postmenopausal Women with Breast Cancer: A Literature Review Introduction Breast malignant neoplastic disease pestilences about 2.5 million adult females in the United States, 1 doing it one of most prevailing signifiers of tumor that healthcare practicians dainty today. The hazard of developing chest malignant neoplastic disease increases with age, with one in 13 postmenopausal adult females developing the disease.2 Nearly 70 per centum of those postmenopausal adult females will hold a endocrine dependant ( estrogen positive ( ER+ ) , progesterone positive ( PR+ ) ) signifier of chest malignant neoplastic disease that utilizes estrogen as its chief alimentary beginning for the proliferation of the tumour. 2, 3, 4 In postmenopausal adult females, estrogen is chiefly synthesized in the peripheral tissues, chest, musculus, adipose, tegument by the enzyme aromatase.4,5 Aromatase converts adrenal androgens into estrogen via the CYP450 enzyme pathway.4, 5, 6, Suppressing aromatase and hindering this transition limits the sum of estrogen available for use by tum our cells, later forestalling growing and spread. Through this mechanism of action, steroidal ( Exemestane ) and non-steroidal ( anastrozole and letrozole ) aromatase inhibitors have shown to be extremely efficacious in the intervention of ER+/PR+ chest malignant neoplastic disease in postmenopausal adult females compared to that of Tamoxifen.5 Multiple landmark surveies ( MA.17, 2 ATAC, 7 BIG 1-98, 8 and EORTC9 ) , suggest that Tamoxifen is no longer a gilded criterion, and now recommend utilizing AIs as first line hormone therapy in these patients.5 With the spread outing usage of AIs by practicians in the intervention of endocrine dependent chest malignant neoplastic disease and the subsequent betterment in disease free endurance rates, more postmenopausal adult females are populating long plenty to see other comorbidities, such as cardiovascular disease ( CVD ) .4 Since CVD is the primary cause of mortality in postmenopausal adult females, 10 understanding the associated inauspicious effects AIs pose on cardiovascular hazard factors is pertinent. Lipid biomarkers are often assessed clinically to find a patients hazard of developing CVD. Previous epidemiologic surveies have shown that estrogen is protective and good to some cardiovascular hazard factors, specifically lipid profiles, via its direct effects on the endothelial cells found in blood vessels.6,11 Estrogen alters concentrations of lipoids in the blood ; diminishing serum concentrations of entire cholesterin ( TC ) , low-density lipoprotein ( LDL ) , and triglycerides ( TRG ) , while increasing serum concentrations of high-density lipoprotein ( HDL ) .11, 12 Therefore, it is thought that postmenopausal adult females taking AIs are deprived of this cardioprotective consequence of estrogen since its synthesis is being prevented by suppressing the aromatase transition mechanism. Therefore, the inquiry can be proposed: Make aromatase inhibitors adversely affect lipid profiles and later present an increased hazard of developing cardiovascular disease in postmenopausal adult females with ER+/PR+ chest malignant neoplastic disease? This literature reappraisal of current clinical test informations examines and assesses the usage of AIs, Exemestane ( Aromasin ) , Anastrozole ( Arimidex ) , and Letrozole ( Femara ) , on the inauspicious effects of the lipid profiles of postmenopausal adult females with ER+/PR+ chest malignant neoplastic disease. Search footings included cardiovascular, aromatase inhibitor, chest malignant neoplastic disease, post-maturity, lipid, Anastrozole, Letrozole, Exemestane, plasma lipoid, cholesterin, and lipid metamorphosis. MEDLINE in Pubmed, MEDLINE ( on EBSCO ) , and OVID were used to seek for peer-reviewed diary articles published between the old ages 2005 to 2010. Recent grounds showing the effects AIs render on the lipid profiles of postmenopausal adult females with estrogen dependent chest malignant neoplastic disease is discussed, analyzed, and reviewed in the undermentioned subdivisions. AROMATASE INHIBITORS EFFECT ON LIPID PARAMETERS Depriving chest malignant neoplastic disease stricken postmenopausal adult females of the benefit of estrogen via the AI mechanism is thought to hold damaging effects on CVD hazard factors. Several clinical tests utilizing assorted design methods have been conducted and show variable effects of AIs on the different cholesterin parametric quantities and lipoproteins. Table 1 summarizes the effects of AIs on assorted lipid biomarkers in the postmenopausal adult female with ER+/PR+ chest malignant neoplastic disease, and all surveies in the tabular array are discussed in the following subdivisions. Placebo Controlled Tests Two surveies have evaluated the consequence of AIs versus placebo on lipid biomarkers. As a secondary end point, Cigler et al13 studied the effects of Letrozole versus placebo on serum lipid parametric quantities ( TC, HDL, LDL, TRG ) in 60 seven postmenopausal adult females utilizing a random, placebo-controlled design. Lipids were measured at baseline and during the 3rd, 6th, 12th, and 24th months, and the per centum alteration from baseline was calculated for each month. Researchers noted a statistically important lessening in the TC at month 3 ( P value=0.052 ) in the Letrozole arm of the survey. The other parametric quantities ( TRG, LDL, and HDL ) measured were non significantly changed from baseline in either the Letrozole or the placebo weaponries. Writers concluded that Letrozole modestly decreases TC at 3 months ; nevertheless, the consequence is non sustained throughout the intervention clip period.13 The cogency of consequences in the lipid part of this survey are questio nable because of the imbalanced figure of participants in each intervention group, and the little population size that remained at the terminal of the 24 months ( Letrozole: 26 patients, and placebo: 16 patients ) . It is hard to measure accurate tendencies in informations with little population sizes, and consequences should be verified utilizing similar survey methods with larger population sample sizes. A confusing variable in this survey was the old usage of Tamoxifen in some patients and non others. Tamoxifen has shown to hold good effects on lipoids ; 14, 15 therefore, the consequences from patients that had antecedently taken Tamoxifen may non be a true representation of the effects of the AI entirely on lipid profiles. Another placebo controlled test utilizing different design methods was conducted by Lonning et al16 and contrasting consequences were found. The effects of Exemestane versus that of placebo on plasma lipoids in postmenopausal adult females with resectable chest malignant neoplastic disease was studied by Lonning et al.16 In a dual blind manner, one hundred 40 seven patients were indiscriminately assigned to an Exemestane intervention group or a placebo intervention group. Measurements of lipid biomarkers ( TC, HDL, LDL, TRG, ApoLipoprotein A1, lipoprotein A, ApoLipoprotein B, homocysteine ) were taken at baseline, and at the 3rd, 6th, 12th, and 24th month. Results revealed that the Exemestane intervention group had a statistically important ( P value & A ; lt ; 0.001 ) lessening in HDL versus that of the placebo intervention group. Besides, a statistically important ( p=0.004 ) lessening in Apolipoprotein A1 occurred in the Exemestane intervention group versus that of the placebo intervention group. Writers concluded that the steroidal AI, exemestane has modest effects on HDL lipid biomarkers and those hazard factors for CVD should be followed overtime.16 This survey included more participants than Ciglers study ; hence, the consequences seen here may hold more cogency. Besides, a different AI was used in each test, and this variable could account for the disagreement in consequences between the two surveies. No old Tamoxifen usage was denoted in the survey by Lonning et Al ; 16 therefore, the consequences are a better representation of the effects of the AI on lipoids without confusing influences of Tamoxifen. More placebo controlled tests are necessary to to the full understand the effects of AI on lipoids in postmenopausal adult females with endocrine dependent chest malignant neoplastic disease, and to denote if a true lessening in HDL exists. The following subdivision discusses tests in which AIs were compared with Tamoxifen alternatively of a placebo as the intercession intervention groups to be assessed. Tamoxifen Comparative Tests Surveies have been conducted utilizing Tamoxifen as a comparative intervention group to that of Exemestane, and their several inauspicious effects on lipid profile alterations are discussed. The TEAM Greek bomber study17 randomized postmenopausal adult females with early chest malignant neoplastic disease into an Exemestane arm ( 77 patients ) or into a Tamoxifen arm ( 65 patients ) , and evaluated HDL, LDL, TRG, and TC at baseline, and at 12, 18, and 24 months. Results indicate that TC decreased overtime in both intervention groups ; nevertheless, those in the Tamoxifen arm had a crisp diminution at month 18 and 24, doing the difference between groups at that clip period statistically important with P value=0.020 and P value=0.0087, severally. Both interventions had a statistically important lessening in HDL ; nevertheless, the Tamoxifen group maintained higher degrees of HDL, leting for a more favourable consequence than exemestane, with a statistically important average difference ( P=0.011 ) between the intervention groups. The Tamoxifen intervention group had a important consequence on the LDL parametric quantity doing a steep lessening in values overtime. exemestane had failed to demo any important alteration on LDL. The TRG parametric quantity revealed no noticeable tendencies for either intervention regimen. Research workers concluded that Tamoxifen has a favourable consequence on TC and LDL, while Exemestane has a more indistinct consequence on lipid biomarkers.17 The lessening in HDL in this survey is in harmony with that of Lonning et al.16 One restriction is that all four lipid parametric quantities were non accounted for in all patients in each intervention group ; hence, tendencies seen in each parametric quantity may non stand for the true tendency that would be present if all values were recorded for all patients at all measurement clip periods. This survey reiterates the idea that Tamoxifen has good effects on lipoids ; accordingly, it is hard to accurately measure the hazard of AI when the comparative intervention group is Tamoxifen. 14 Though some restrictions were present in this survey, comparative consequences were seen by Francini et al14 in another test utilizing different methods than the TEAM Greek bomber survey. Francini et al14 conducted a survey in which 55 postmenopausal adult females who had antecedently been treated with no less than 2 old ages of Tamoxifen were randomized into two intervention groups: either continue Tamoxifen or exchange from Tamoxifen to Exemestane. Lipid parametric quantities were measured at baseline and at 6 and 12 months. Consequences yielded were statistically important in the Exemestane arm of the survey entirely demoing a lessening in HDL overtime ( p value & A ; lt ; 0.05 ) , an addition in LDL overtime ( p value & A ; lt ; 0.01 ) , and a lessening in TRG overtime ( P value & A ; lt ; 0.01 ) . The differences between the Tamoxifen and Exemestane intervention group were non important except for the LDL biomarker ( p value & A ; lt ; 0.05 ) . Writers concluded that the addition in LDL of the Exemestane group may be due in portion to participants being antecedently treated with Tamoxifen, which is known to hold good effects on LDL.14 Francinis survey and the TEA M Greek bomber study17 indicate that there was a lessening in the HDL parametric quantity in the Exemestane intervention group versus that of the Tamoxifen intervention group, proposing that AIs may hold an inauspicious consequence on HDL degrees. This lessening in HDL was besides noted in the ATENA trial18 in which Tamoxifen had been antecedently used for 5-7 old ages before the patients were assigned to have either Exemestane or no intervention, merely observation. The addition in LDL found in the survey by Francini14 was besides seen in the ATENA test ; 18 nevertheless, the TEAM Greek bomber study17 did non back up this determination. It must be kept in head that patients in the survey by Francini14 and the ATENA trial18 had antecedently been treated with Tamoxifen before get downing intervention with AIs, while patients in the TEAM Greek bomber study17 were non. Hence, the design differences could account for the fluctuation of consequences between surveies on the LDL, TRG, and TC parametric quantities. A likewise designed survey by Montagnani et al15 exposed comparable consequences to the survey by Francini. Montagnani et al15 investigated the effects of Exemestane after anterior intervention with Tamoxifen, and indiscriminately assigned 60 eight postmenopausal adult females to go on taking Tamoxifen ( 20 milligrams daily ) or exchange to the aromatase inhibitor, Exemestane ( 25 milligrams daily ) for 2 old ages. Parameters ( TC, HDL, LDL, TRG ) were measured at baseline and at 12 and 24 months. Consequences showed that the Exemestane intercession had a important lessening in HDL, while the Tamoxifen group showed no significance in alteration from baseline. Therefore, a important difference between the intercession groups ( p value & A ; lt ; 0.05 ) was noted. Besides in the Exemestane group, LDL was increased from baseline ; nevertheless, no alteration was seen in the Tamoxifen group. The between group differences were besides statistically important with a P value & A ; lt ; 0.05. The Exemestane group besides had a statistically important lessening in TRG doing the between group differ ences important with a p value of & A ; lt ; 0.05. The consequences found in this survey showed some similarities with those discovered by Francini et al.14 Montagnani revealed important differences between groups for HDL, LDL, and TRG parametric quantities, while Francinis survey merely showed important differences between groups for LDL. In both surveies, the aromatase inhibitor was compared with go oning Tamoxifen after the patients had already used Tamoxifen, hence some of the consequences may hold occurred from taking the good effects of Tamoxifen instead than uncovering damaging effects of the AI. Both Francini and Montagnani revealed lessenings in TRG in the Exemestane arm. This would be considered a favourable consequence of utilizing AI, but since Tamoxifen negatively affects TRG and Tamoxifen was antecedently used by the Exemestane patients, the simple remotion of the unfavourable consequence of Tamoxifen could account for the consequence. To increase the respectability of these findings, comparable consequences should be confirmed in likewise designed surveies utilizing larger sample population sizes without old exposure to Tamoxifen. Banerjee et al19 designed yet another survey comparing a different AI, Anastrozole, to Tamoxifen, and to a combination of Anastrozole with Tamoxifen. The IMPACT trial19 compares the effects of utilizing Anastrozole, Tamoxifen, or a combination of Anastrozole/Tamoxifen on the lipid profiles of postmenopausal adult females with chest malignant neoplastic disease. In a stage III, randomized, double-blind multicentre trial,19 three hundred 30 patients were assigned to have either Anastrozole ( 1 milligrams daily ) + Tamoxifen placebo, Tamoxifen ( 20 milligrams daily ) + Anastrozole placebo, or a combination of both ( Tamoxifen 20 mg day-to-day + Anastrozole 1mg daily ) for a period of 12 hebdomads. Measurements for TC and HDL were taken at baseline and three months. Results revealed that the Tamoxifen merely intervention group had a statistically important lessening in the TC lipid parametric quantity ( p value & A ; lt ; 0.05 ) , while the Anastrozole merely intervention group had an addition in TC lipid parametric quantity that was non statistically important ; nevertheless, the difference between the two groups was important. The c ombination group consequences showed a important lessening in TC ( P value & A ; lt ; 0.05 ) , nevertheless the between groups differences were non important. A statistically important addition in HDL from baseline was noted overtime in all intervention groups ( P & A ; lt ; 0.05 ) , nevertheless the difference between the groups was non important. Writers suggest that, although there was a little addition in TC in the Anastrozole merely group, this negative consequence was counterbalanced with the positive consequence of the addition of HDL in the Anastrozole group, and that there is no damaging consequence on the lipid profile when utilizing the AI, Anastrozole.19 Measurements were merely taken over a 3 month clip period, therefore consequences are limited and the effects seen may non prolong through longer intervention tests. This addition in HDL in the AI intervention group is contrary to the consequences seen in antecedently discussed surveies. Different AIs were used in each t est and this unsimilarity in methods could account for the differences. Studies reexamining the disparities between AIs are necessary to find their several effects on lipid profiles and to measure if an AI is more good or damaging than the others. Comparison between Aromatase Inhibitors It is of import to understand the differences between each aromatase inhibitors several effects on lipid profiles to assist healthcare practicians choose the appropriate drug regimen for each single patient. In a multi-centre, unfastened, randomized survey, McCloskey et al5 compared the effects of Anastrozole, Letrozole, and Exemestane on lipid profiles in one hundred and two postmenopausal adult females, and randomized them into one of three intervention groups: Anastrozole ( 1 milligrams daily ) , Letrozole ( 2.5 milligrams daily ) , or Exemestane ( 25 milligrams daily ) , for 24 hebdomads with a 12 hebdomad follow up period. Measurements of lipid biomarkers ( TC, TRG, LDL, HDL, LDL/HDL ratio, Apolipoprotein B/Apolipoprotein A-1 ratio ) were taken at baseline and at the 12th, 24th, and 36th hebdomad. Consequences revealed that Exemestane had a important lessening from baseline in TC, nevertheless the differences between the three intervention groups were non statistically important ( p value=0.535 ) . The LDL/HDL ratio parametric quantity was significantly different for all three groups at the 12th and 24th hebdomad measuring, with Exemestane giving the greatest alteration ( p=0.007 ) compared to Letrozole ( p=0.025 ) and Anastrozole ( p=0.045 ) . This increased ratio in the Exemestane intervention group was due to the statistically important lessening in HDL ( p value & A ; lt ; 0.001 ) . The TRG measuring for all groups showed much variableness, with Letrozole demoing a statistical important addition at 12 hebdomads ( p=0.011 ) versus the other AIs. This alteration from baseline did non last through the 24 hebdomad measurement period. No other alterations were noted between the three intervention groups. Writers suggested that those treated with Exemestane have an addition in hazard of inauspicious effects on the ratios finding atherogenesis.5 The lessening in the HDL parametric quantity in patients utilizing Exemestane is in understanding with the antecede ntly mentioned surveies that used Exemestane as an AI comparator of pick. Since Tamoxifen was non a confounding factor here, the suggestion that Exemestane perchance adversely effects HDL, now becomes a more significant and valid statement because the consequence is still seen without Tamoxifen act uponing the consequence. However, it must be considered that this survey used healthy postmenopausal adult females, non breast malignant neoplastic disease patients, as the sample population evaluated, and the consequences can non be imposed as the same consequences that might hold occurred if the population had used a sample of postmenopausal adult females with chest malignant neoplastic disease. Long clinical surveies utilizing the right population sample and sample size should be conducted to further understand the impact of each AI on the postmenopausal chest malignant neoplastic disease patient. This is one of the lone surveies available measuring the inauspicious effects of each par ticular AI compared to one another. More surveies are necessary to corroborate the consequence that Exemestane offers more inauspicious hazard compared to Letrozole and Anastrozole. Decision Tamoxifen has been in usage for more than 30 old ages, and was considered the gilded criterion hormone therapy for handling postmenopausal adult females with endocrine dependent chest cancer.15, 20 Large epidemiologic surveies have shown that AIs are more efficacious than Tamoxifen in overall and disease free endurance rates, and hence are now recommended as first line accessory hormone therapy for postmenopausal adult females with chest cancer.3,15 With their known mechanism of action of striping postmenopausal adult females of serum estrogens, therefore taking estrogens protective effects on these cardiovascular hazard factors,6, 11 there is concern that AIs may hold inauspicious effects on lipid profiles. Most writers concluded that aromatase inhibitors have minimum effects or no inauspicious effects on lipid profiles in postmenopausal adult females with chest malignant neoplastic disease. However, it is hard to measure the true consequence of AIs on lipid profiles with Tamoxifen as the comparator since it has proved benefit on some lipid parameters,14 and because of the many different design methods used. Small sample sizes were restrictions in a few surveies ; therefore, the tendencies yielded in those tests may non be genuinely declarative of postmenopausal adult females with chest malignant neoplastic disease. Long term prospective surveies utilizing big sample sizes and patients with no exposure to any other hormone intervention besides AI, are needed to accurately measure if inauspicious effects on lipid profiles exist from the usage of AIs. From the current available information, though minimally, HDL is the parametric quantity most adversely affected by the usage of AI. This may be a cause of concern for some practicians since lessenings in go arounding sums of HDL are linked with additions in cardiovascular disease.15 Since HDL is considered good cholesterin and a positive hazard factor, diminishing the sum available in blood could perchance hold damaging effects on CVD. Healthcare practicians should be cognizant of this possible hazard of diminishing HDL with AI usage so that proper monitoring in their patients may be performed. Given that a current intervention option still includes the usage of Tamoxifen followed by exchanging to an AI, it is particularly of import to supervise lip id profiles since some studies14, 15, 17 have shown unfavourable effects on lipid profiles when doing this switch. To find if an existent hurt on CVD hazard factors occurs in adult females taking the non steroidal and steroidal aromatase inhibitors, more long term clinical tests should be conducted. In decision, aromatase inhibitors are being used more and more as first line accessory intervention in postmenopausal adult females with chest malignant neoplastic disease. Though it depletes estrogen beginnings, surveies show no well damaging effects on lipid profiles, with most merely demoing minimum, if any, inauspicious consequence. Placebo controlled surveies utilizing equal patient populations and sample sizes for appropriate sums of clip, are necessary to accurately depict the hazards of AIs on cardiovascular hazard factors. Healthcare practicians should go on to supervise lipid profiles in postmenopausal adult females with chest malignant neoplastic disease and develop individualized intervention programs utilizing current recommendations. Specific safety steps for patients utilizing AIs are non necessary,16 and the effects seen in the surveies mentioned in this reappraisal suggest that long term monitoring of all lipid parametric quantities should be a portion of the postmen opausal adult female with chest malignant neoplastic diseases intervention program. Surveillance of hazard factors overtime in these adult females with should assist forestall unfavourable cardiac events.