Climatic Determinism in Aristotle’s Idea of Natural Slavery Essay

One of the more influential texts in ancient literature is Aristotle’s seminal work on governance, â€Å"Politics: A Treatise on Government. † In â€Å"Politics,† Aristotle sought to establish the superiority of Greek social and political order; particularly the rigid segregation between master and slave, by invoking the patterns of organization observed in nature which he perceived to support the moral and natural correctness of Greek society and institutions. Arguably, Hippocrates’ earlier work, â€Å"On Airs, Waters, and Places,† which emphasized the central role of climatic and environmental factors in the development of human beings and societies, plays a huge influence on Aristotle’s treatise particularly in his defense of slavery. In â€Å"Airs, Waters, and Places,† Hippocrates posits that climatic factors are responsible for differences in the physical, mental, and psychological characteristics of human populations. (Hippocrates, Airs, Waters, and Places, 2. ln. 18-20; 13. ln. 7-15) Arguably, most of Aristotle’s assumptions on the nature of relationships between races, individuals, and societies are based on Hippocratic notions of inherent differences in human physical and psychological constitution that arises from differences in climate and the forces of nature. The role of climatic determinism in Aristotle’s ideas about natural slavery is evident in his belief on the decisive part of a nation or society’s location on earth in establishing racial superiority. Among the most obvious evidence of this is his reference to the differences between European, Asian, and Greek populations owing to the differences in geographic location and climate. Aristotle argues that Northern Europeans, on the one hand, were made courageous by the cold climate in their countries but the same climate also made them unintelligent and incapable of dominating others; the Asians, on the other hand, were intelligent but their cowardice made them easy to enslave. He then rationalizes that Greece’ position between Europe and Asia enabled the Greeks to possess a balanced capacity for intelligence and courage that is necessary of conquerors and masters. (Aristotle, Politics, ln. 1327b. 14-20) Thus, Aristotle’s justification of slavery carries with it strains of climatic determinism, which espouses the natural superiority of some races over others brought about by the superiority of the particular climate in their place of habitation. Conversely, the inferiority of the climate leads to the inferior development of human populations. It is worthy to note that in making these claims, Aristotle simply echoes Hippocrate’s earlier observation of the racial dissimilarities arising from regional and climatic disparities. Hippocrates argues, for instance, that Asians display a gentler and more peaceful nature than Europeans because of â€Å"the nature of the seasons, which do not undergo any great changes either to heat or cold, or the like. † (Hippocrates, Airs, Waters, and Places, 16. ln. 2-4) Accordingly, the relative uniformity of seasons in Asia, which causes â€Å"neither excitement of the understanding nor any strong change of the body† (Hippocrates, Airs, Waters, and Places, 16. ln. 5) conditions its inhabitants to a passive existence that predisposes them to slavery. Hippocrates’ ideas therefore serve as the basis used by Aristotle in rationalizing slavery as a natural order among races. Aristotle’s idea of the existence of natural differences between races and the natural superiority of the Greek race makes it easy for him to justify the distinction between Greeks and barbarians that, in his view, justifies the enslavement of the latter by the former. This is illustrated in how Aristotle considers non-Greek cultures and societies as being â€Å"more prone to slavery than the Greeks† (Aristotle, Politics, ln. 1285a. 13) by virtue of their outsider status relative to Greek civilization. This assumption is clearly based on Hippocrates’ survey of the diverse characteristics of populations of different countries with respect to their position relative to sunlight, winds, soil, and waters. In particular, Aristotle draws his assumption of Greek superiority from Hippocrates’ assertion that a country that is â€Å"blasted by the winter and scorched by the sun† produces individuals endowed not only with superior physical beauty and composition but also finer thinking skills that make them â€Å"acute and ingenious as regards the Arts, and excelling in military affairs. † (Hippocrates, Airs, Waters, and Places, 24. ln. 40-49) Aristotle’s climatic determinist thought extends to his idea of the qualities that differentiate a superior individual from the inferior one. For Aristotle, the existence of innate differences in human beings owing to the nature’s design justifies slavery as a natural and beneficial societal arrangement (Aristotle, Politics, ln. 1255a. 1-2) Underlying this claim is clearly the belief that nature creates hierarchies between the superior and the inferior, as shown by the fact that climatic forces shape individuals either into conquerors or slaves. He claims, for instance, that â€Å"those men therefore who are as much inferior to others as the body is to the soul†¦are slaves by nature, and it is advantageous to them to be always under government. † (Aristotle, Politics, ln. 1254b. 11-13) Aristotle attributes the innate inferiority and enslavement of some individuals to â€Å"the first principles of herile and political government† (Aristotle, Politics, ln. 1254b. 2) which shows that â€Å"it is both natural and advantageous that the body should be governed by the soul. † (Aristotle, Politics, ln. 1254b. 4-5) Thus, in the same way, it is proper that â€Å"the soul governs the body as the master governs his slave. † (Aristotle, Politics, ln. 1254b. 3)

Case Study – American Apparel

The company segmented their market to young men and women in their ass, and further targeted a niche audience of environmentally conscious consumers. The company catered to this artsy, bohemian audience who resided In hip neighborhoods of large, metropolitan cities that upheld a â€Å"hip, subversive, and degenerate† culture (Wolf, 2006). Until 2008, the company used concentrated marketing by positioning themselves as a sweatshop-free manufacturer who pays their employees fair wages and provides them health care benefits.Positioning the brand by attributes and benefits led American Apparel to became known for their ethics and sustainability. As more and more retailers attempt to be â€Å"green,† American Apparel had a harder time standing out as a company trying to be good (Hill, 2010). Charley later realized that he was limiting his sales potential by targeting a niche and wanted to go mainstream by expanding to a larger market (Walker, 2008). He decided to reposition the brand to appeal to a generation and used sex as a way to bring people closer.The new generation, as Charley puts it, is exciting, mobile, and open-minded. These are the people he wants to be in business with (Wolf, 2006). The company incorporated sex into their advertising strategy as a way to position the brand by user. Since 2008, American Apparel's promotional strategies have been focused on highly sexual images of young people in provocative poses. Their amateur models and lack of photocopying reflects their honesty by showing the models' imperfect bodies and blemished skin (Wolf, 2006). Not only do they show â€Å"real† people, they also expose nipples and pubic hair.The use of shock tactics in their sexual honesty has attracted much attention, and their openness with sex has come part of their brand image, since they have worked hard to create an Image infused with youth and sex (Chuddar, 2008). The brand's undifferentiated marketing reached more people than before and crossed all genres, including high- fashion kids, clubbers, geeks, and gays (Hill, 2010). However, their controversial advertising has received backlash and negative responses from the media, labeling the brand as -porn chic† (Giving, 2014).The company claims to not be worried, since there seems to be disconnect between how young people perceive the ads and how mainstream media reports the ads. By narrowing their brand image, many people argue that American Apparel alienates their original user base, but the company asserts that they can connect many small groups together Into a big audience (Chuddar, 2008). Their most recent ad strategy tailors to different demographics, including their use of a 62-year old model, a plus-sized model, a Bangladesh model, celebrate diversity by targeting consumers of different ages, sizes, ethnicities, and religions.Additionally, the company has gone global, establishing stores in Asia and representing the American dream (Woo, 2013). The me ssage behind their advertising envoys openness and freedom, not Just in sexuality but also for people who are normally ignored (Chuddar, 2008). Suggest a future plan: In order for a brand to grow or at least stay competitive, they can't stop presenting fresh, new advertising campaigns to consumers. In American Apparel's case, they there's also an ethical issue involved. What direction should they take with their advertising campaign?Recently, founder and CEO Charley has been fired, leaving many people wondering what's next for the company's marketing aesthetic. With Charley gone, many believe that the company should completely re- rand itself (Holland, 2014), however, the company still plans to maintain their â€Å"sexy' and â€Å"edgy' image (Walker, 2014). As fashion has evolved and sex has become mainstream, shoppers have become desensitizing and started to move on. Activist groups consider American Apparel to be pass ©, sexist, and demeaning (Walker, 2014), and according to sales, sex Just isn't selling anymore (That, 2014).Consumer reports found that sexy apparel has limited appeal and consumers have been expressing that they want comfortable clothes that can be dressed-up or dressed-down (That, 2014). Consumers want it all and sexiness limits their style. American Apparel should focus their advertising campaign on the versatility of their merchandise, thus their promotional objective should be to increase awareness of the multiple functions of their apparel to yield variableness with consumers. One of the core concepts of marketing is that it is better to maintain existing customers than trying to gain new ones.In this case, American Apparel should target the same consumers, but with a different spin. Sex still appeals to their target market, the young, 20-something men and women in metropolitan areas, but as these consumers age and their style evolves, their taste will too. The advertisements used in the past are becoming increasingly tacky, therefo re sexual ads should be more tasteful and appealing to a maturing audience. To emphasize the apparel's versatility, the brand should be positioned by product attributes and benefits.The company manufactures basic apparel that can be used in a variety of ways. The clothes can be worn alone, in layers, combined with other brands, etc. Countless looks can be created, which can communicate different styles to different types of shoppers. The versatility of these pieces produces more variety ND greater product benefits. American Apparel's major selling idea should highlight the duality of people, combining both emotional and rational advertising appeal. The company's philosophy on being sweat-shop free, Made in USA puts them at odd's ends with their overly-sexed advertisements.Since people have layers, the brand can appeal to shoppers by helping them embrace their duality. Consumers want a brand that they can emotionally connect with, brands that reflect their passion and interests (That , rational consumer looking for items with multiple uses, which translates into a good alee for their money. To execute this strategy, their advertisements should demonstrate the ease of versatility with their apparel, since demonstration advertising can be effective in highlighting product benefits.An example of this approach would be to show a model wearing an article such as a cardigan, suggesting a preppy look. She could be styled with her hair in a bun and wearing glasses. In another image, the model would be shown with her hair down and wearing the same cardigan, maybe unbuttoned, revealing her bra and her sensual side. This good-girl/bad-girl image translates the regularity of apparel to the duality of personality. In this sense, usage imagery demonstrates how the product could be used. An indirect headline can be used to provoke interest for shoppers.A headline such as â€Å"Embrace your Duality' can challenge shoppers to style themselves in different ways. The visual eleme nt from the preppy/sexy example could convey the same message if stood alone. Yet, a headline attached to the visual portion is more effective for attracting attention. The subhead for the ad would be the brand's usual â€Å"American Apparel: Sweatshop free, Made in USA† tagging, which also implies the rand's duality. The sexual imagery combined with their ethical practice demonstrates the duality in brands as well as in people.

Care Plan Chronic Heart Failure Health And Social Care Essay

The physician to population ratio grew from 2/1000 people in 2000 to 2.4/ 1000 people in merely a mere 5 years3. Despite the rapid growing, the ratio is still short as compared to other European states viz. France, Germany or Italy. This is worsened by the fact that the figure of patients treated in NHS infirmaries rose by 15 % at the same clip interval3. It is of import to use the expertness of other health care professionals, viz. community druggists, in support of the increasing figure of patients in the community in order to better patient attention. The World Health Organization defines chronic complaints to be ‘a wellness job necessitating on-going direction over a period of old ages or decennaries ‘ . NHS Scotland has identified that chronic unwellness is farther complicated by demographical alterations, increasing co-morbidities, widening spread of wellness inequalities and the increased outlooks placed on the health care system4. Actions have been taken to promote modernisation of NHS community pharmaceutics in Scotland. The debut of the New Pharmacy Contract was the action program from the Scottish Executive ‘s scheme papers ‘The Right Medicine ‘ in which nucleus pharmaceutical attention services such as Chronic Medication Service ( CMS ) , Minor Ailments Service ( MAS ) , Acute Medication Service ( AMS ) and Public Health Service were designed to optimise the use of community druggist ‘s accomplishments to widen the range and farther better the quality of attention proviso to patients5. The contract was driven by a quotation mark by the World Health Organization ( WHO ) in 2002, adverting that reacting to the demands to patients with chronic conditions post the biggest challenge to wellness systems around the globe4. The foundation of the CMS is built upon the cardinal countries: patient centered ; clinical administration ; collaborative working ; support for execution ; monitoring and reappraisal and service development6. The nucleus aims of CMS are summarized in Appendix 1. The altering function of the druggist is in response to the increasing demand for betterment in patient ‘s medicines direction. The debut of the CMS is to further develop the parts of the community druggist to guarantee the continuity of pharmaceutical attention in patients with long-run conditions every bit good as cementing the stature of community druggists in the NHS4. Pharmaceutical attention is an effectual tool in the direction of chronic complaints and is defined as the responsible proviso of drug therapy for the intent of accomplishing definite results that improve a patient ‘s quality of life harmonizing to Hepler and Strand7. Pharmaceutical attention is hence a collaborative attempt between healthcare professionals endeavoring to better drug therapy direction via uninterrupted monitoring of inauspicious effects, effectivity and patient instruction all meeting to better patient ‘s quality of life8. Healthcare professionals play a critical function in autho rising patients to take charge of their ain wellness, as this would ease them in accomplishing their coveted quality of life relevant to their wellness believes6. Community druggist can be the accelerator in smoothing the patient ‘s journey of attention by being the gateway of information via improved entree to healthcare services and to back up self-care6. It is simple to merely purchase a battalion of medicine over the counter to handle an false unwellness but the bulk is incognizant of the possible injury it presents. Some might non take earnestly an overdose of medicines that have a broad curative index but for drugs that have a narrow curative index, a simple overdose could be fatal. There is merely so much a prescriber could make but hanker term attending is indispensable to guarantee that patients get the best out of their medicine particularly in those who have multiple co-morbidities. The attack of CMS is through the constitution of curative partnerships between general medical practicians, druggists and patients to better patient attention by guaranting better local entree to wellness care6. Fostering such commitment will minimise duplicate of functions and, with good defined functions, can advance a holistic attack to the pharmaceutical and clinical attention of patients6. The end is to assist patients harvest the most out of their medical specialties but besides minimise any associated risks4. Community druggist is frequently the first and lone point of call. Community druggists can bridge the spread in a patient ‘s journey of attention and therefore better the whole curative class by expecting, placing, deciding and forestalling medicine-related issues4,9. These medicine-related issues include: Safety and efficaciousness Side effects Conformity and harmony Identify markers of hapless control Symptom specific markers to motivate referral Supplying and advancing wellness information and instruction CMS is a service that requires patients ‘ voluntary engagement and is by and large broken down into 3 phases. Phase 1 involves the enrollment of the patient for the service. Stage 2 involves the debut of a generic model for pharmaceutical attention planning. Phase 3 is the constitution of the shared attention component between the GP and the community pharmacist6. A pharmaceutical attention program paperss the patient ‘s pharmaceutical attention demands, attention issues, desired results and actions required as portion of the pharmaceutical attention planning of the patient. Figure 1 summarizes the pharmaceutical attention be aftering rhythm. Identify and prioritise patients with pharmaceutical attention demands Identify and reexamine pharmaceutical attention issues Implement and proctor pharmaceutical attention program Formulate and document a pharmaceutical attention program Figure 1: Pharmaceutical Care Planning Cycle To get down of with attention planning, critical information that may act upon the attention program such as patient ‘s general wellness, allergic reactions or sensitivenesss, other medical conditions and hazard factors are noted. A hazard appraisal is so made to help the druggist in placing and prioritising any pharmaceutical attention needs that a patient might necessitate or is deprived from in footings of service, which as a consequence influences the therapy6. Next, an appraisal is made to place and reexamine the patients pharmaceutical attention demands and refering issues. This can enable the druggist to measure the medical specialties regimen that a patient is on in footings of efficaciousness or toxicity profile and besides allows the druggist to measure how deep the patients understand their medicines and intervention and the extend of their wellness believes. Subsequently, a pharmaceutical attention program is drafted based on the attention issues that have been iden tified with the understanding of the patient. This attention program serves as a protocol in which issues are placed on a hierarchy of precedence, outcome ends are defined, proposals to any class of action documented every bit good as clearly specifying the health care forces and their duties for assorted monitoring that ought to be conducted. Changeless reappraisals and monitoring is done to measure the results of the attention program upon execution and alterations are made along the manner, when required, to maximise the curative result. To accomplish the maximal curative benefit, the patient ‘s wellness belief and apprehension of the therapy is indispensable. Hence, reding and advice by the druggist before, during and after the procedure is good. Chronic Heart Failure ( CHF ) is one of the 13 long-run disease provinces covered in the CMS protocol stand foring the most frequent indicant for therapy4. The list of all 13 disease provinces are listed in Appendix 2. Heart Failure is one of the most crippling medical conditions which can badly impact a patient ‘s quality of life hence seting force per unit area on hospitalization and health care budgets10. The Scots Intercollegiate Guidelines Network ( SIGN ) defines CHF as a complex clinical syndrome ensuing from any structural/ functional upset that impairs the ability of the bosom to react to physiological demands for increased cardiac output11. Hence, bringing of blood is compromised12. Abnormality in cardiac construction, beat, map or conductivity can all take to unequal perfusion, venous congestion and disturbed H2O and electrolyte balance that underlie CHF13. In add-on, normal compensatory mechanisms become compromised taking to maladaptive secondary physiological effe cts that contribute to the progressive nature of the disease12. CHF can be a effect of assorted underlying complications such as myocardial infarction and/or high blood pressure and the most common being left ventricular systolic disfunction ( LVSD ) . Coronary arteria disease, aortal stricture, dilated myocardiopathy, alcoholic myocardiopathy, Chagas ‘ disease, endomyocardial fibrosis and other mechanical defects such as cardiac valvular disfunction, degenerative valve disease, arthritic valve disease, terrible anaemia and thyrotoxicosis are the more common causes of CHF around the Earth but other rarer causes do exist12,13. Management of these predisposing factors can be good in relieving the symptoms of bosom failure. Table 1 is the New York Heart Association ( NYHA ) categorization system used to sort patients with bosom failure based on their functional position. Table 2 is ACC /AHA phases of HF ; a addendum to the NYHA categorization. It is estimated that there is a prevalence of about 1-2 % for bosom failure in developed countries10,14. The life-time hazard of developing HF is approximately 20 % for patients above 40 old ages old and besides the taking cause of hospitalization for patients above 65 old ages old10,14. Harmonizing to the European Society of Cardiology, above 15 million patients are diagnosed with HF in 51 European states consisting a population of around 900 million15. The prevalence of HF is about 1-2 % in the western society and the incidences are between 5-10/ 1000 instances per annum16. A recent US population-based survey, the prevalence of bosom failure was 2.2 % ( 95 CI 1.6 % to 2.8 % ) , increasing from 0.7 % in individuals aged 45 through 54 old ages to 8.4 % for those aged 75 old ages or older17. Similar minor expense forms, 1 % for the 55-64 age group increasing to 13 % in the 75-84 age group was observed from the Rotterdam study18. In the contrary, for the below 50 age group, incidences of HF are rare16. Improved endurance from acute myocardial infarction ( MI ) coupled with the aging population contributes to the spike in incidence and prevalence of HF19. One critical function community pharmacist drama is to advice and offer guidance on a healthy life style. Lifestyle and dietetic alterations are schemes aimed at forestalling cardiovascular diseases ( CVD ) which are possible predisposing factors taking to CHF. The development of CVD is affected by multiple dietetic factors and an overall healthy diet will significantly cut down the hazard of CVD20. Consumption of fruits, veggies, grain merchandises, low-fat dairy merchandises and curtailing the sum of salt and unstable consumption are all portion of a well balanced diet11,21. Keeping a healthy organic structure weight is indispensable as fleshiness is an independent hazard factor for CVD. Morbid fleshiness has a strong association with mortality from CVD particularly in immature grownup males. Therefore, bar of fleshiness has to be taken early and in an aggressive manner22. Keeping optimum blood force per unit area, blood glucose every bit good as a desirable lipid profile is advise d to command or lower the hazard of CVD21. Maintaining physical and cardiovascular fittingness and a healthy weight can be achieved by changeless physical activities as it improves cardiovascular hazard factors every bit good as take downing the hazard of developing other chronic diseases21,23. Evidence has proven the strong association between smoking and cardiovascular jeopardies every bit good as the benefits of smoking cessation24. Therefore, look intoing the smoke position of patients and offering intercession where appropriate will be good to patients peculiarly in those who are at hazard of enduring from cardiovascular events24. Patients with CHF should be advised to discontinue smoking11. Moderate ingestion of intoxicant should besides be advised as extra alcohol ingestion can increase the hazard of CVD11,25. The above are merely the chief life style and dietetic parametric quantities that should be addressed with precedence to command or lower CVD hazards. Such steps should non be seen as stairss taken to forestall CVD but instead as stairss taken to promote everybody to populate a healthy life style to forestall any signifier of disease provinces. Psychosocial and psychological hurt have a important impact in morbidity and mortality after HF and hence societal and relationship factors may play an of import function in pull offing chronic conditions such as CHF26. The ends of intervention are to better quality of life11,13. Angiotensin Converting Enzyme Inhibitors ( ACEi ) Evidence has shown that ACEi therapy is good in take downing mortality, MI and rehospitalization for patients enduring from HF with LVD or HF with or without a recent MI27. A meta-analysis has shown that patients with CHF prescribed with an ACEi have a 23 % decrease in mortality and a 35 % decrease in rehospitalization27. Further meta-analysis is patients with LVSD, HF or both after MI has a comparative decrease in mortality rate of 26 % 27. Therefore, ACEi therapy is recommended in patients with all NYHA functional categories of HF due to LVSD11. Adverse effects include cough, hypotension, nephritic damage, angio-oedema and hyperkaelaemia. Dose titration and nephritic and electrolyte monitoring should be included in the attention program particularly in susceptible patients utilizing other medicines so that intercession could be established in instances where inauspicious effects are marked. Beta Blockers Treatment with bisoprolol, carvedilol and Lopressor Forty shows a decrease in mortality in patients with advanced HF based on the CIBIS- II, COPERNICUS, and MERIT-HF tests severally. Beta-blockers benefits in HF by demoing a 29 % decrease in hazard of mortality in CVD, 36 % decrease due to pump failure and all cause mortality decrease of 23 % 28. All patients with HF due to LVSD of all NYHA functional category should be started on beta-blockers every bit shortly as their status is stable and should be the first line picks for patients with CHF due to LVSD11. The effects of beta-blockers might non be seen instantly. Furthermore, deterioration of HF and hypotension might be present at the get downing hence dose should be titrated up suitably upon supervising. Beta-blockers are contraindicated in those with asthma, bronchospasm, 2nd or 3rd degree auriculoventricular bosom block or diagnostic hypotension11. Angiotensin II Receptor Blocker ( ARB ) ARBs antagonizes the binding of angiotonin II to its type 1 receptor hence exercising its action similar to ACEi ‘s with the benefit of non bring forthing dry cough as a side effect13. In CHARM Alternative, ARB intervention led to a comparative decrease of 23 % in primary result of CV deceases or rehospitalsation for patients with CHF having candesartan who are intolerant to ACEi29. The add-on of ARB to ACEi or beta-blocker intervention non merely had no consequence on mortality but markedly reduced HF rehospitalisation and mortality combined30. Patients with CHF due to LVSD, HF or LVSD or both station MI who are intolerant to ACEi should be considered for ARBs whilst patients with HF due to LVSD who are still diagnostic despite already on ACEi and beta-blockers, add-on of candesartan might be beneficial11. Aldosterone Adversaries Aldosterone adversary has been studied in patients with terrible diagnostic HF, led to a pronounced decrease in mortality and morbidity and improved symptoms13,31. It is recommended for patients with HF in NYHA category III and IV despite being on ACEi and beta-blocker while there is no grounds that Aldactone has any benefits in mild HF11,13. The RALES test has shown that the add-on of Aldactone to an ACEi yielded an all cause mortality of 30 % and cardiac mortality by 31 % 31. However, aldosterone adversaries produce many inauspicious effects on vascular map and myocardial fibrosis11. Spironolactone produces gynaecomastia, hyperkaelaemia, and nephritic disfunction hence blood carbamide, creatinine and electrolyte monitoring is essential11. Patients with terrible HF due to LVSD should be on Aldactone unless contraindicated11. Eplerenone can be used if patients are intolerant to spironolactone as grounds from EPHESUS survey has demonstrated a 13 % decrease from CVD or hospitalization for CVD and 21 % comparative rate of sudden decease in patients on eplerenone32. Diuretic drugs Fluid keeping doing ankle hydrops, pneumonic hydrops or both consequences in symptoms of dyspnea in most patients enduring from HF11. A meta-analysis supports that diuretic therapy is good for patients with dyspnea or hydrops with a 75 % decrease in mortality and 63 % betterment in exercising capacity33. The hazard of loop water pills doing hypokalaemia is offset by ACEi, ARBs and Aldactone. Therefore, monitoring of serum K is of import. Doses of water pills should be individualized to minimise unstable keeping taking into history the possibility of desiccation and nephritic impairments11. Digoxin In a Cochrane reappraisal, patients on Lanoxin showed a 64 % betterment in symptoms and a 23 % decrease in hospitalization but unluckily no betterment seen on survival34. Digoxin should be considered as an accessory therapy for instances in which patients with HF in fistula beat are non relieved on optimal therapy11. There are many issues associated with the usage of Lanoxin because of its narrow curative index, some of which are fatal such as its ability to increase the possibility of sudden decease and the hazard of toxicity in instance of hypokalaemia11. Therefore, the hazard over benefit of Lanoxin therapy should be carefully considered in the best involvement of the patient. Care Plan Chronic Heart Failure Health And Social Care Essay The physician to population ratio grew from 2/1000 people in 2000 to 2.4/ 1000 people in merely a mere 5 years3. Despite the rapid growing, the ratio is still short as compared to other European states viz. France, Germany or Italy. This is worsened by the fact that the figure of patients treated in NHS infirmaries rose by 15 % at the same clip interval3. It is of import to use the expertness of other health care professionals, viz. community druggists, in support of the increasing figure of patients in the community in order to better patient attention. The World Health Organization defines chronic complaints to be ‘a wellness job necessitating on-going direction over a period of old ages or decennaries ‘ . NHS Scotland has identified that chronic unwellness is farther complicated by demographical alterations, increasing co-morbidities, widening spread of wellness inequalities and the increased outlooks placed on the health care system4. Actions have been taken to promote modernisation of NHS community pharmaceutics in Scotland. The debut of the New Pharmacy Contract was the action program from the Scottish Executive ‘s scheme papers ‘The Right Medicine ‘ in which nucleus pharmaceutical attention services such as Chronic Medication Service ( CMS ) , Minor Ailments Service ( MAS ) , Acute Medication Service ( AMS ) and Public Health Service were designed to optimise the use of community druggist ‘s accomplishments to widen the range and farther better the quality of attention proviso to patients5. The contract was driven by a quotation mark by the World Health Organization ( WHO ) in 2002, adverting that reacting to the demands to patients with chronic conditions post the biggest challenge to wellness systems around the globe4. The foundation of the CMS is built upon the cardinal countries: patient centered ; clinical administration ; collaborative working ; support for execution ; monitoring and reappraisal and service development6. The nucleus aims of CMS are summarized in Appendix 1. The altering function of the druggist is in response to the increasing demand for betterment in patient ‘s medicines direction. The debut of the CMS is to further develop the parts of the community druggist to guarantee the continuity of pharmaceutical attention in patients with long-run conditions every bit good as cementing the stature of community druggists in the NHS4. Pharmaceutical attention is an effectual tool in the direction of chronic complaints and is defined as the responsible proviso of drug therapy for the intent of accomplishing definite results that improve a patient ‘s quality of life harmonizing to Hepler and Strand7. Pharmaceutical attention is hence a collaborative attempt between healthcare professionals endeavoring to better drug therapy direction via uninterrupted monitoring of inauspicious effects, effectivity and patient instruction all meeting to better patient ‘s quality of life8. Healthcare professionals play a critical function in autho rising patients to take charge of their ain wellness, as this would ease them in accomplishing their coveted quality of life relevant to their wellness believes6. Community druggist can be the accelerator in smoothing the patient ‘s journey of attention by being the gateway of information via improved entree to healthcare services and to back up self-care6. It is simple to merely purchase a battalion of medicine over the counter to handle an false unwellness but the bulk is incognizant of the possible injury it presents. Some might non take earnestly an overdose of medicines that have a broad curative index but for drugs that have a narrow curative index, a simple overdose could be fatal. There is merely so much a prescriber could make but hanker term attending is indispensable to guarantee that patients get the best out of their medicine particularly in those who have multiple co-morbidities. The attack of CMS is through the constitution of curative partnerships between general medical practicians, druggists and patients to better patient attention by guaranting better local entree to wellness care6. Fostering such commitment will minimise duplicate of functions and, with good defined functions, can advance a holistic attack to the pharmaceutical and clinical attention of patients6. The end is to assist patients harvest the most out of their medical specialties but besides minimise any associated risks4. Community druggist is frequently the first and lone point of call. Community druggists can bridge the spread in a patient ‘s journey of attention and therefore better the whole curative class by expecting, placing, deciding and forestalling medicine-related issues4,9. These medicine-related issues include: Safety and efficaciousness Side effects Conformity and harmony Identify markers of hapless control Symptom specific markers to motivate referral Supplying and advancing wellness information and instruction CMS is a service that requires patients ‘ voluntary engagement and is by and large broken down into 3 phases. Phase 1 involves the enrollment of the patient for the service. Stage 2 involves the debut of a generic model for pharmaceutical attention planning. Phase 3 is the constitution of the shared attention component between the GP and the community pharmacist6. A pharmaceutical attention program paperss the patient ‘s pharmaceutical attention demands, attention issues, desired results and actions required as portion of the pharmaceutical attention planning of the patient. Figure 1 summarizes the pharmaceutical attention be aftering rhythm. Identify and prioritise patients with pharmaceutical attention demands Identify and reexamine pharmaceutical attention issues Implement and proctor pharmaceutical attention program Formulate and document a pharmaceutical attention program Figure 1: Pharmaceutical Care Planning Cycle To get down of with attention planning, critical information that may act upon the attention program such as patient ‘s general wellness, allergic reactions or sensitivenesss, other medical conditions and hazard factors are noted. A hazard appraisal is so made to help the druggist in placing and prioritising any pharmaceutical attention needs that a patient might necessitate or is deprived from in footings of service, which as a consequence influences the therapy6. Next, an appraisal is made to place and reexamine the patients pharmaceutical attention demands and refering issues. This can enable the druggist to measure the medical specialties regimen that a patient is on in footings of efficaciousness or toxicity profile and besides allows the druggist to measure how deep the patients understand their medicines and intervention and the extend of their wellness believes. Subsequently, a pharmaceutical attention program is drafted based on the attention issues that have been iden tified with the understanding of the patient. This attention program serves as a protocol in which issues are placed on a hierarchy of precedence, outcome ends are defined, proposals to any class of action documented every bit good as clearly specifying the health care forces and their duties for assorted monitoring that ought to be conducted. Changeless reappraisals and monitoring is done to measure the results of the attention program upon execution and alterations are made along the manner, when required, to maximise the curative result. To accomplish the maximal curative benefit, the patient ‘s wellness belief and apprehension of the therapy is indispensable. Hence, reding and advice by the druggist before, during and after the procedure is good. Chronic Heart Failure ( CHF ) is one of the 13 long-run disease provinces covered in the CMS protocol stand foring the most frequent indicant for therapy4. The list of all 13 disease provinces are listed in Appendix 2. Heart Failure is one of the most crippling medical conditions which can badly impact a patient ‘s quality of life hence seting force per unit area on hospitalization and health care budgets10. The Scots Intercollegiate Guidelines Network ( SIGN ) defines CHF as a complex clinical syndrome ensuing from any structural/ functional upset that impairs the ability of the bosom to react to physiological demands for increased cardiac output11. Hence, bringing of blood is compromised12. Abnormality in cardiac construction, beat, map or conductivity can all take to unequal perfusion, venous congestion and disturbed H2O and electrolyte balance that underlie CHF13. In add-on, normal compensatory mechanisms become compromised taking to maladaptive secondary physiological effe cts that contribute to the progressive nature of the disease12. CHF can be a effect of assorted underlying complications such as myocardial infarction and/or high blood pressure and the most common being left ventricular systolic disfunction ( LVSD ) . Coronary arteria disease, aortal stricture, dilated myocardiopathy, alcoholic myocardiopathy, Chagas ‘ disease, endomyocardial fibrosis and other mechanical defects such as cardiac valvular disfunction, degenerative valve disease, arthritic valve disease, terrible anaemia and thyrotoxicosis are the more common causes of CHF around the Earth but other rarer causes do exist12,13. Management of these predisposing factors can be good in relieving the symptoms of bosom failure. Table 1 is the New York Heart Association ( NYHA ) categorization system used to sort patients with bosom failure based on their functional position. Table 2 is ACC /AHA phases of HF ; a addendum to the NYHA categorization. It is estimated that there is a prevalence of about 1-2 % for bosom failure in developed countries10,14. The life-time hazard of developing HF is approximately 20 % for patients above 40 old ages old and besides the taking cause of hospitalization for patients above 65 old ages old10,14. Harmonizing to the European Society of Cardiology, above 15 million patients are diagnosed with HF in 51 European states consisting a population of around 900 million15. The prevalence of HF is about 1-2 % in the western society and the incidences are between 5-10/ 1000 instances per annum16. A recent US population-based survey, the prevalence of bosom failure was 2.2 % ( 95 CI 1.6 % to 2.8 % ) , increasing from 0.7 % in individuals aged 45 through 54 old ages to 8.4 % for those aged 75 old ages or older17. Similar minor expense forms, 1 % for the 55-64 age group increasing to 13 % in the 75-84 age group was observed from the Rotterdam study18. In the contrary, for the below 50 age group, incidences of HF are rare16. Improved endurance from acute myocardial infarction ( MI ) coupled with the aging population contributes to the spike in incidence and prevalence of HF19. One critical function community pharmacist drama is to advice and offer guidance on a healthy life style. Lifestyle and dietetic alterations are schemes aimed at forestalling cardiovascular diseases ( CVD ) which are possible predisposing factors taking to CHF. The development of CVD is affected by multiple dietetic factors and an overall healthy diet will significantly cut down the hazard of CVD20. Consumption of fruits, veggies, grain merchandises, low-fat dairy merchandises and curtailing the sum of salt and unstable consumption are all portion of a well balanced diet11,21. Keeping a healthy organic structure weight is indispensable as fleshiness is an independent hazard factor for CVD. Morbid fleshiness has a strong association with mortality from CVD particularly in immature grownup males. Therefore, bar of fleshiness has to be taken early and in an aggressive manner22. Keeping optimum blood force per unit area, blood glucose every bit good as a desirable lipid profile is advise d to command or lower the hazard of CVD21. Maintaining physical and cardiovascular fittingness and a healthy weight can be achieved by changeless physical activities as it improves cardiovascular hazard factors every bit good as take downing the hazard of developing other chronic diseases21,23. Evidence has proven the strong association between smoking and cardiovascular jeopardies every bit good as the benefits of smoking cessation24. Therefore, look intoing the smoke position of patients and offering intercession where appropriate will be good to patients peculiarly in those who are at hazard of enduring from cardiovascular events24. Patients with CHF should be advised to discontinue smoking11. Moderate ingestion of intoxicant should besides be advised as extra alcohol ingestion can increase the hazard of CVD11,25. The above are merely the chief life style and dietetic parametric quantities that should be addressed with precedence to command or lower CVD hazards. Such steps should non be seen as stairss taken to forestall CVD but instead as stairss taken to promote everybody to populate a healthy life style to forestall any signifier of disease provinces. Psychosocial and psychological hurt have a important impact in morbidity and mortality after HF and hence societal and relationship factors may play an of import function in pull offing chronic conditions such as CHF26. The ends of intervention are to better quality of life11,13. Angiotensin Converting Enzyme Inhibitors ( ACEi ) Evidence has shown that ACEi therapy is good in take downing mortality, MI and rehospitalization for patients enduring from HF with LVD or HF with or without a recent MI27. A meta-analysis has shown that patients with CHF prescribed with an ACEi have a 23 % decrease in mortality and a 35 % decrease in rehospitalization27. Further meta-analysis is patients with LVSD, HF or both after MI has a comparative decrease in mortality rate of 26 % 27. Therefore, ACEi therapy is recommended in patients with all NYHA functional categories of HF due to LVSD11. Adverse effects include cough, hypotension, nephritic damage, angio-oedema and hyperkaelaemia. Dose titration and nephritic and electrolyte monitoring should be included in the attention program particularly in susceptible patients utilizing other medicines so that intercession could be established in instances where inauspicious effects are marked. Beta Blockers Treatment with bisoprolol, carvedilol and Lopressor Forty shows a decrease in mortality in patients with advanced HF based on the CIBIS- II, COPERNICUS, and MERIT-HF tests severally. Beta-blockers benefits in HF by demoing a 29 % decrease in hazard of mortality in CVD, 36 % decrease due to pump failure and all cause mortality decrease of 23 % 28. All patients with HF due to LVSD of all NYHA functional category should be started on beta-blockers every bit shortly as their status is stable and should be the first line picks for patients with CHF due to LVSD11. The effects of beta-blockers might non be seen instantly. Furthermore, deterioration of HF and hypotension might be present at the get downing hence dose should be titrated up suitably upon supervising. Beta-blockers are contraindicated in those with asthma, bronchospasm, 2nd or 3rd degree auriculoventricular bosom block or diagnostic hypotension11. Angiotensin II Receptor Blocker ( ARB ) ARBs antagonizes the binding of angiotonin II to its type 1 receptor hence exercising its action similar to ACEi ‘s with the benefit of non bring forthing dry cough as a side effect13. In CHARM Alternative, ARB intervention led to a comparative decrease of 23 % in primary result of CV deceases or rehospitalsation for patients with CHF having candesartan who are intolerant to ACEi29. The add-on of ARB to ACEi or beta-blocker intervention non merely had no consequence on mortality but markedly reduced HF rehospitalisation and mortality combined30. Patients with CHF due to LVSD, HF or LVSD or both station MI who are intolerant to ACEi should be considered for ARBs whilst patients with HF due to LVSD who are still diagnostic despite already on ACEi and beta-blockers, add-on of candesartan might be beneficial11. Aldosterone Adversaries Aldosterone adversary has been studied in patients with terrible diagnostic HF, led to a pronounced decrease in mortality and morbidity and improved symptoms13,31. It is recommended for patients with HF in NYHA category III and IV despite being on ACEi and beta-blocker while there is no grounds that Aldactone has any benefits in mild HF11,13. The RALES test has shown that the add-on of Aldactone to an ACEi yielded an all cause mortality of 30 % and cardiac mortality by 31 % 31. However, aldosterone adversaries produce many inauspicious effects on vascular map and myocardial fibrosis11. Spironolactone produces gynaecomastia, hyperkaelaemia, and nephritic disfunction hence blood carbamide, creatinine and electrolyte monitoring is essential11. Patients with terrible HF due to LVSD should be on Aldactone unless contraindicated11. Eplerenone can be used if patients are intolerant to spironolactone as grounds from EPHESUS survey has demonstrated a 13 % decrease from CVD or hospitalization for CVD and 21 % comparative rate of sudden decease in patients on eplerenone32. Diuretic drugs Fluid keeping doing ankle hydrops, pneumonic hydrops or both consequences in symptoms of dyspnea in most patients enduring from HF11. A meta-analysis supports that diuretic therapy is good for patients with dyspnea or hydrops with a 75 % decrease in mortality and 63 % betterment in exercising capacity33. The hazard of loop water pills doing hypokalaemia is offset by ACEi, ARBs and Aldactone. Therefore, monitoring of serum K is of import. Doses of water pills should be individualized to minimise unstable keeping taking into history the possibility of desiccation and nephritic impairments11. Digoxin In a Cochrane reappraisal, patients on Lanoxin showed a 64 % betterment in symptoms and a 23 % decrease in hospitalization but unluckily no betterment seen on survival34. Digoxin should be considered as an accessory therapy for instances in which patients with HF in fistula beat are non relieved on optimal therapy11. There are many issues associated with the usage of Lanoxin because of its narrow curative index, some of which are fatal such as its ability to increase the possibility of sudden decease and the hazard of toxicity in instance of hypokalaemia11. Therefore, the hazard over benefit of Lanoxin therapy should be carefully considered in the best involvement of the patient.

Comparing the Relationship between Man & Gods(s) in Genesis & Odyssey Essay

Comparing the Relationship between Man & Gods(s) in Genesis & Odyssey - Essay Example The different translations do not make me look at the passage differently. There is certain sentence and word variations but the man ideas are all the same. The point of the passage was clearly shown in all three translations. My first impression is that Abraham is a very loyal individual to the Lord. When your willing to sacrifice your only son to the lord it’s clearly shown that you are faithful. My feelings of sorrow goes to Isaac, I can’t imagine what must have been going through his head when his father Abraham had him tied down and was about to kill him with a knife. He probably felt hopeless, confused, and scared at the same time. The only life experience I can think of that relates to his passage his the time my dog had to be put to sleep. My dog was my best Pal and for somebody to say she had to be put to sleep for her own good was in a sense a sacrifice for me that I didn’t want to go through. Checking the context before your passage and after your passage is helpful in understanding the passage. There is a relationship in an earlier passage Genesis 21. Ismael Abraham’s child was let go by the lord leading onto Abraham’s test in Genesis 22 with the sacrifice of Isaac. The NOAB refers to the literature as a story from a narrative point of view. The words and expressions of the passage in all 3 translations are clear to understand. The footnotes in the NOAB are much more in detail than the NJB. The NOAB footnotes are very vivid in looking into his future. For example verse 5 in NOAB ‘Abraham’s promise that he and Isaac will return’ may suggest a faith that God will work out and alternate sacrifice’. The author’s concerns are to inform the reader to the extent that we have to follow the lord, willing to give up something of great value to glorify him. Important words that the author used was the word tested. It shows this was a test exclusively

Fragile X Syndrome PowerPoint Presentation Example | Topics and Well Written Essays - 500 words

Fragile X Syndrome - PowerPoint Presentation Example Many of the people who suffer from the syndrome have some cognitive weaknesses in their cognitive development, including the processes of thinking, problem solving, concept understanding, information processing and overall intelligence. Their overall potential tends to be lower than that of their peers and siblings, but they can nonetheless have patterns of strength too in their development and do very well in certain aspects of learning and cognition. As many as 80% of males with the syndrome are described as "cognitively delayed". Older studies suggested that nearly all the boys or men with the syndrome have a moderate or severe mental retardation. Today there is more accuracy in the testing and in recognizing all those with the syndrome (not only those who were institutionalized, on which these previous studies were carried out), and only 10-15% of the males tested have the IQ that fits a borderline or mild mental retardation. There are a number of boys and girls with the full mutation of the syndrome. They are described as learning disabled, as their overall intelligence is at least at the low average range but they have specific strengths and weaknesses in their cognitive learning ("Cognitive Development Characteristics", 2009). Cognition is also affected by Attention Deficit Hyperactivity Disorder (ADHD), seizure disorders, anxiety, disorders in speech and language, sensory motor problems and other factors ("Cognitive Development Characteristics", 2009). In boys and men, there are several points of strength in cognition. These include verbal labeling, single word vocabulary and receptive (listening) vocabulary. Also, the vocabulary for subjects of interest may be higher than expected. Furthermore, visual matching and visual perception tasks with meaningful information (a familiar object, for example) are often performed well. Memory for situations and for favorite TV shows, song and videos is

Using Italic and Abbreviations in Writing Process Essay

Using Italic and Abbreviations in Writing Process - Essay Example Italics can be used in writing when foreign words are discussed in a sentence (Kirszner & Mandell, 2009). Example when using Latin words that are acceptable in writing the italics is applied. Italics also can be used for foreign words or phrases that are not considered fully part of the English language. Also, the use of italics can be when citing English words in writing. Instead of using single quotes you can use italics when citing English words that are being talked about in writing. The italics can also be used to italicize the names of vehicles. Italicize the names of ships, airplanes missiles, and man-made satellites. Italics also can be used when writing the name of the case in legal cases (Foster, 2010). Italics are used in the practice test in the tips section to improve your knowledge of when to italicize text. Titles of full-length books are to be italicized. Even if they are not books as long as they are longer than of a short few types pages these pieces get italicized. Titles of anthologies of pieces such as songs, poems, short stories, and short plays/essays should be italicized. Title of movie and television shows can be italicized in the writing process; individual scenes are to be enclosed in quotes. Another writing process written by Kirszner & Mandell is an abbreviation which is writing of short forms of names. The proper use of abbreviations can help the writer to put clear what is contained in the text. Also, if these abbreviations are used in excess they can bring about confusion. According to the MLA publication manual, it provides some of the effective suggestions concerning the use of abbreviations in writing. These suggestions include the general use of using the abbreviations that are; any expression that will be written in abbreviation form should be in full the first time it is used followed by the abbreviation in the parentheses and abbreviated thereafter.

SSK 12 Log B Essay Example | Topics and Well Written Essays - 2000 words

SSK 12 Log B - Essay Example I realize now that it is OK for me to identify myself with all the parts of my culture I currently possess and that I can add to these by being successful at university. This knowledge is empowering to me because I have never identified strongly with academia as I envisioned it. This has at time made me wonder if university was really right for me. I now realize that succeeding at university adds another layer to who I am. It does not destroy the experiences I have had so far. It doesn’t have to change who I am unless I want to. I understand that at the university there are many cultures coming together. I have the power and opportunity to help shape the university culture in a small way by bringing by personal strengths and abilities to add to all of the other students. This past week has broadened my understanding of culture at university and how I fit into it. This week I discovered that there are many different ways to look at what it means to be a literate person. I always thought that I had to have read lots of books on all kinds of different subjects and that’s what literate meant. I have discovered this week after reading some of the assignments and interacting with my classmates and communicating with some professors, that I am a literate person even though I haven’t read the classics. I can see that I am entering a very specialized, professional type of education. And what I realized is that I am going to be very literate within that field. I want to have a broad understanding of how the world works and how to analyze the things that are happening in the broader world, but I don’t need to feel guilty if my focus is on my studies in my specific field at this point. This new understanding is helpful to me in the sense that I don’t need to worry about the things I don’t know yet. I don’t need to feel less than someone else simply because they have read a book that I haven’t or if they understand a concept

Factors affecting quality of MRI image.Benefits of circular or square Essay

Factors affecting quality of MRI image.Benefits of circular or square spiral EPI methods - Essay Example For example, if a spin is exposed to a magnetic field different from the expected value due to magnetic susceptibility, geometric distortions will be seen from the MRI image (Reinsberg, Doran, Charles-Edwards, and Leach, 2005). In particular, an increased spin produces MRI signals of low intensity, while high magnetic susceptibility areas are seen as areas of total signal loss (Zhou and Gullapalli, 2006). Figure 1 shows an example of metallic susceptibility distortions in the presence of metallic implants. Magnetic susceptibility In magnetic resonance imaging, tissues are temporarily magnetized by the large magnetic field that the imaged subject is exposed to, with the extent of magnetization varying among tissues that differ in magnetic susceptibility. For example, relative to other tissues, air and bone are less susceptible to magnetization. On the other hand, metallic implants have high magnetic susceptibility as compared to the body tissues. These differences in magnetic suscepti bility cause field inhomogeneity, especially in tissue boundaries, particularly air-tissue and bone-soft tissue boundaries (Zhou and Gullapalli, 2006). That is why magnetic susceptibility distortions are sometimes seen in such boundaries, like the sinuses (Reinsberg, Doran, Charles-Edwards, and Leach, 2005). 1. Discuss various methods to correct for magnetic susceptibility distortions, while maintaining a good EPI image. ... a.) Parameters that can optimize EPI image ESP can be decreased through the use of powerful gradients, such as increased gradient slew rate (~20, 000 T/m/s), increased maximum amplitude (350 mT/m), increased rise time rate, increased accuracy, decreased eddy currents, increased voltage, and decreased field strength. In addition, these parameters decrease signal-to-noise ratio. Meanwhile, a decreased ESP results to a smaller total train length time. In fact, it has been estimated that decreasing ESP to 40 ms limits the distortion to only one pixel wide. Similarly, increased data gathering via decreased frequency- and phase encoding steps and ramp sampling, fast analogue to digital converters and large receiver bandwidth decrease the time in which phase errors can accumulate (McMahon, 2012). On the other hand, phase and read directions can be swapped, so that the phase encoding gradient is along the same axis as susceptibility gradients. Although this may not totally prevent distortion , it shows the image in a more presentable and understandable manner (McMahon, 2012; Zhou and Gullapalli, 2006). Figure 2 shows the decrease in magnetic susceptibility upon converting from left-right phase encoding to anterior-posterior phase encoding. Other ways to minimize magnetic susceptibility distortions include decreasing the resolution, use of SE sequence, increased acquisition matrix and proper shimming before image acquisition. It should be noted, however, that heating of nearby tissues can occur when using fast SE acquisition with a high bandwidth to decrease magnetic susceptibility distortions resulting from metallic implants (Zhou and Gullapalli, 2006). b) Chain of consequences after increasing the receiver bandwidth Receiver bandwidth is a

Marketing SLP 1 Essay Example | Topics and Well Written Essays - 750 words

Marketing SLP 1 - Essay Example Location and its current market strength: Best Buy Co., Inc. (BBY) is a company with its stock traded on the New York Stock Exchange (NYSE) and is also listed in the Fortune 100. It is the largest specialty retailer of consumer electronics in the USA and Canada. Its total market share stands at 21% of the market. Its Headquarters are located in Richfield, Minnesota, USA. The company has a few subsidiaries such as Pacific Sales, Magnolia Audio and Geek Squad. The Best Buy Canada subsidiary does not operate its original name. In fact, it operates under the Future Shop label, which has a quite large market share in Canada (Hill, June 2008, retrieved July 2, 2008). Products : BBY sells all categories of consumer electronics – television sets, computers, i-phones, i-pods, mobile phones, digital and video cameras, Blu-ray discs, computer software, video games, DVD players, washing machines, dryers, refrigerators, music and so on. Each store also has a separate department for audio and video equipment. Global operations: Its global network spans Canada, China, Mexico, Puerto Rico and Turkey. The company has plans afoot for further expansion. For example its current network of stores amounting to 1150 in the USA will expand up to 1400 by the end of the current year. It’s planning string of acquisitions in the UK in 2009. For instance it will buy up rivals like Kesa Electricals and DSG International to position itself with a strategic advantage over other competitors. Chinese market: In June 2006, the company negotiated a deal with Feidiao Electrics Co. Ltd., in Shanghai to buy space on one of its buildings at a cost of $31.25 million. This figure includes the cost of decoration and outsourcing. Electronics retailers in China responded to this news with their own marketing tactics. Right now, despite Best Buy’s international presence Chinese electronics retailers have not fallen far behind in competition and sales revenue. Yongle which has nearly 50% of

Smoking Research Proposal Example | Topics and Well Written Essays - 1000 words

Smoking - Research Proposal Example This stage is called metastasis. On the contrary, in some cases cancer cells do not display uncontrolled growth, they are non-invasive and do not spread, such stage of cancer only forms benign tumors (Alberts et al, 2007). Numerous factors are responsible for the proliferation of cancer, these could be environmental factors- tobacco and alcohol consumption; obesity- sedentary life style and higher intake of calorific fast food may lead to the trigger of cancer genes (Bassen- Engguist, 2011), pollution, obnoxious agents with carbon particles including polycyclic aromatic hydrocarbons from the industries releases toxic chemicals may act as carcinogens; heredity factors, radiation hazards, by viruses, food items, pesticides and other organophosphorous compounds and cosmetic agents may act as carcinogenic agents (Irigaray, 2007). The present research proposal is to highlight the significance of smoking in treating cancer. Treatment of cancer involves chemotherapy and radiotherapy. However, studies reveal that investigative studies presents neurobiological, pharmacological implications of marijuana and its therapeutic propositions for HIV wasting, glaucoma and cancer chemotherapy ("American College of Physicians", 2008). However, an impediment to pursue research is attributed to the intricacies exhibited by the federal approval methodology, insufficient availability of research-level marijuana and disagreements over its legalization. Essentially, it is necessary for the physicians to realize the therapeutic implications of marijuana and encourage abusers co-operation in the management and cure of numerous disease conditions that are hard to cure because of extreme pain and the association of the underprivileged ("American College of Physicians", 2008). Marijuana, commonly identified as cannabis, comprises about 60 compounds unanimously described as cannabinoids. The foremost chemical component accountable for psychoactive

Critical Discussion on Watson’s and Skinner’s Versions of Behaviourism Essay Example for Free

Critical Discussion on Watson’s and Skinner’s Versions of Behaviourism Essay Behaviourism concept emerged at a period when the societal disarticulation as a result of speedy industrialization of American society needed novel approaches of social organization. This was to act as a replacement to Victorian mores of minute-town rural lifestyle (Wightman Kloppenberg 1995, p. 68). At this time, positivists like Walter Lippmann invited psychologists to assist devise approaches, and the lately recognized science of psychology, enthusiastic to signify its position as an autonomous discipline, responded by assertively endorsing itself in terms of societal utility (Wightman Kloppenberg 1995, p. 68). That said, behaviourism premise emanated from the work of an American psychologist John B. Watson. He did assert that psychology as a discipline was never concerned with human mind or consciousness, but rather concerned with just behaviour. This way, Watson claimed that humans could be examined, studied or evaluated impartially just like apes and rats (Cohen 1987, p. 71). Behaviourism according to Watson’s version was a stab to shun the complexities of trying to study human consciousness by limiting scientific attention to evident, overt or blatant behaviour. This version was coupled with a pivotal ambition to put in place much more thorough ways or methods to experimental research as well as report writing. Thus, the key task of psychology was none other than recognition of laws governing the link between behavioural responses and environmental stimuli, and psychology was cast as an attachment to physiology (Richards 2009, p. 35). In this way, Watson believed that psychology would provide knowledge that could be utilized to the prediction as well as control of behaviour. Therefore, his version of classical behaviourism did possess several distinct characteristics, such as: †¢ It was tremendously environmentalist †¢ Its practical vocabulary was mainly limited to not many non-mentalistic terms †¢ Its explanations were exceedingly reductionist, and †¢ The version was majorly concerned with investigational methodology (Richards 2009, p. 35). In the early 1920s, Watson assimilated the concepts of Ivan Pavlov, a Russian psychologist and included Pavlov’s ideas of reinforcement and conditioning as key theoretical notions to his classical behaviourism version. Pavlov had done a number of studies on the animal’s responses to environmental conditioning. In his best triumphant experiment, he did ring a bell as he took a number of meals to some dogs. In doing so, each and every time dogs did hear the bell ringing they knew pretty well that a meal was ready, and would start salivating (DeMar 1989, p. 1). On one instance, Pavlov did ring the bell devoid of taking food, but the dogs continued salivating since they had been habituated, conditioned or trained to salivate each time they hear a bell ringing. Watson asserted in his behaviourism version that humans responded to environmental stimuli just in the similar way (DeMar 1989, p. 1). However, Watson’s classical behaviourism was regarded too crude, he himself did refrain from academia after a divorce scandal. In his wake, several neo-behaviourists, including B. F. Skinner, Clark L. Hull and Ernest R. Hilgard took over the doctrine in an array of directions. On a different perspective, the well-known architect of a radical or less mechanistic behaviourism version was B. F. Skinner, whose premises of operant conditioning did attest potent enough to be utilized in a number of settings (Wightman Kloppenberg 1995, p. 68). At times grounded in stylish mathematical learning theories, but much more frequently established on instinctive rules of thumb, behavioural techniques were used in psychotherapy, medicine, education, advertising, business and management of mental hospitals and prisons. Given its predictable comparing of lower animals to humans, together with its firm permeation into such conventionally humanist territories as the curative education and art, it’s doubtless that Skinner’s version of radical behaviourism has long provoked controversy (Wightman Kloppenberg 1995, p. 68). What’s more, today’s behaviourism is associated with B. F. Skinner, who attained his reputation as a radical behaviourist by experimenting Watson’s assertions in the laboratory. His laboratory experiments coupled with a number of researches led him to snub Watson’s exclusive allegations on conditioning and reflexes. Skinner avowed that humans not only respond to their surroundings, but operate on their surroundings to give rise to explicit consequences (Skinner, Catania Harnad 1988, p. 3). Furthermore, Skinner came up with the ‘operant conditioning’ theory, the notion that human behave the way they do as this sort of behaviour has had explicit effects long-ago. For instance, if a boy kisses a girl when she gives him flowers, then the girl will be expected to come with flowers when she wants a kiss from him. Thus, the girl will be acting in anticipation of specific reward. Contrary to Watson, Skinner rejected the idea that feelings or the human mind play a part in determining behaviour. He instead insisted that an individual experience of reinforcements determines his or her behaviour (Skinner, Catania Harnad 1988, p. 10). Therefore, according to radical behaviourism version, one of Skinner’s objective was to shape humans’ behaviour in away to respond in a much more socially tolerable way. In his operant conditioning theory he was absolutely clear that his theory ought to be applied to guide human behaviour (Shaffer 2005, p. 45). Moreover, Skinner’s experimental analysis of human or general behaviour has resulted in an effectual, effective and efficient technology, pertinent to psychotherapy, education, as well as the design of cultural practices generally (Shaffer 2005, p. 46). In conclusion, the ethical effects of both Watson’s and Skinner’s versions of behaviourism are immense. An individual is stripped off his or her freedom, dignity, responsibility and reduced to a merely natal being, to be ‘shaped’ by behaviourists who encompass the ability to apply the tools of behaviourism efficiently. Bibliography Cohen, D. (1987). Behaviorism, Oxford Companion to Mind, Richard, L. , ed. NY; Oxford University Press. DeMar, G. (1989). Behaviorism. [Online] available http://www. forerunner. com/forerunner/X0497_DeMar_-_Behaviorism. html Richards, G. (2009). Psychology, key concepts. Milton Park; Routledge. Shaffer, D. (2005). Social personality development. Belmont; Walworth. Skinner, B. , Catania, C. , Harnad, S. (1988). Selection of behaviour, operant behaviourism of Burrhus Frederic Skinner. Melbourne; Cambridge Syndicate Press. Wightman, R. , Kloppenberg, J. (1995). A companion to American thought. Massachusetts; Blackwell.

Early Childhood Education Essay Example for Free

Early Childhood Education Essay Children are our future. This explains to you, the reader, why I chose to dive into the career path of Early Childhood Education. In this essay I will explain to you what the job of an early Childhood professional is, what training they need and what standards they are expected to maintain. These are all important facts in becoming an Early Childhood professional. First of all, what is the job of an Early Childhood professional? Well, their job is to nourish the growth of children, support families, and work closely with coworkers. Their work with children begins before the first child arrives, and continues until after the last child leaves. Early Childhood educators spend a lot of time with not only the children, but with the families of the children. The book, Who Am I in the Lives of Children states that young children cannot be separated from the context of their homes, so relating to and working with families is an important part of the role of the Early Childhood educator. If your not a people person, this job may not be for you. Educators provide a safe and secure environment for the children, allowing them to grow and blossom into an independent child, with a personality of their own. Early Childhood education may take a number of faces including family childcare providers and nannies, teacher aides or teacher assistants, assistant teachers or assistant care givers, teachers or care givers, master teachers or head teachers and lastly, directors. Members of this field share a mission, commitment and set of values. Also, they have agreed on standards, in the form of a code of ethics. In one single day, an Early Childhood professional may function as a teacher, friend, secretary, parent, colleague, nurse, janitor, counselor, entertainer, and a diplomat. Second of all, what training are Early Childhood professionals expected to have? Well, paraphrasing from the book, Who Am I in the Lives of Children, the training and experience required will be determined by program licensing. Requirements vary from state to state. In some states being in good health and having a diploma are all that is necessary. Most states require that teachers and care givers in center based programs be qualified for their jobs through training, either by having a college degree, or a CDA credential(Child Development Associate). From what I know you need approximately 12 units of ECE training to go into the field of Early Childhood education. Lastly, what standards are Early Childhood professionals expected to maintain? I think the core values of early childhood education are very important to maintain. These core values are: appreciating childhood as a unique a valuable stage of the human life cycle basing our work with children on knowledge of child development appreciating and supporting the close ties between the child and the family recognizing that children are best understood in the context of family, culture and society Respecting the dignity, worth and uniqueness of each individual (child, family member and colleague) Helping children and adults achieve their full potential in the context of relationships that are based on trust, respect and positive reguard. The NAEYC Code of Ethical Conduct is also important is the field of Early Childhood education. (A copy of the code is found in the appendix of, Who Am I in the Lives of Children) These two things are important because young children are vulnerable and lack the power to defend themselves. In conclusion, when people say that you just babysit kids they are wrong. Being an Early Childhood professional is a very important job. You are helping shape and raise our futures leaders.

Improving Tissue Support- Altered Cast Technique

Improving Tissue Support- Altered Cast Technique ABSTRACT Aim: Cast partial denture made using altered cast technique creates an environment in which the teeth and the edentulous tissues support the denture bases as compatible as possible, resulting in a more stable cast partial denture. Background: The tissues of the edentulous ridge in distal extension removable partial denture are liable to be displaced under occlusal pressure. This is a result of the displaceability of the mucosa. The difference between the resiliency of the residual ridge tissues and the teeth causes disparity of support, that causes the denture to rotate about its distal abutment, inducing heavy tortional stresses on the teeth and possible traumatisation of alveolar ridge. Studies have proved that better support and stability can be achieved in distal extension cases using functional impression along with altered cast technique. Case description: The following article is a case report of a distal extension cast partial denture using altered cast technique for better tissue adaptability and stress distribution. Conclusion: For recording Kennedy’s class I and II edentulous areas, optimum residual ridge coverage with a well fitting denture base is required. This reduces stresses, preserving the remaining supporting structures which can be achieved with the use of altered cast technique. Clinical significance: The altered cast technique allows the residual alveolar ridge to be recorded in functional form and relates to the teeth so that when the prosthesis is seated, it derives support simultaneously from the teeth and the soft tissues. Keywords: distal extension, stress distribution, functional impression, altered cast technique. BACKGROUND: The most important consideration in replacement of missing teeth for a distal extension removable partial denture as per DeVan’s statement must be â€Å"the perpetual preservation of that which remains, and not the meticulous replacement of that which has been lost.†1-4. When occlusal forces are applied to distal extension removable partial dentures, the forces must be distributed equally to the abutments and the tissues of the residual ridge.2 This cannot be accomplished on a master cast made from a single impression. A dual impression technique is used in which a â€Å"corrected cast† can be generated which can record and relate the tissues under uniform loading, distribute the load over as large an area as possible and accurately delineate the peripheral extent of the denture base.2 Functional impressions are defined as â€Å"The impression which records the form of the residual alveolar ridge under some loading whether by occlusal loading, finger loading, specially designed individual tray or consistency of recording medium.†5 Several methods may be used for registering the alveolar mucosa in its supporting form. The dual impression techniques are categorised as 1). Physiologic impression techniques. a). McLean-Hindel method, b). The functional reline method, c). The fluid wax method. 2). Selective pressure techniques.2 According to Leupold6 , the functional reline method is accomplished after the denture base has been processed onto the framework. The disadvantage being it requires a greater degree of occlusal adjustment after processing of acrylic resin and so it is necessary to modify the new denture before delivering it to the patient.6 So to overcome this the master cast is altered to accommodate the secondary impression and thus altered /corrected cast is generated.2,6. Cast partial denture made using the altered cast technique helps create an environment in which the teeth and the edentulous tissues support the base as compatibly as possible resulting in a more stable denture that improves the support for the occlusal relationship of the opposing dentition and the removable partial denture restoration.2,3. For preservation of the residual ridge, Becker and his colleagues, critically reviewed the evolution of removable partial denture and outlined six principles for its design which include a rigid major connector, multiple positive rest seats, mesial rests, parallel guide planes, the I-bar clasp design and the altered cast technique.7 This technique has the potential benefits of reducing the number of postoperative visits, preserving the residual ridges, improving stress distribution, decreasing food impaction and decreasing the torquing of abutment teeth leading to increased patient satisfaction.8-11. The following case report will explain the use of altered cast technique used in the fabrication of a distal extension cast partial denture. CASE DISCRIPTION: A 60 year old male patient reported to the Department of Prosthodontics Dr. D.Y.Patil Dental College and Hospital, Navi Mumbai with the chief complaint of missing teeth and difficulty in eating. Extra-oral examination revealed that the patient had an ovoid tapered face, with mild prognathism, competent and thick lips. Patient had a habit of cigarette smoking since 20 years and so was advised to stop the habit. Intraoral examination revealed that there was only one tooth 23 remaining in the maxillary arch and 31,32,33,41,42,43 in the mandibular arch. The teeth were lost due to caries and periodontitis. (fig.1,2) Radiographs were evaluated and the treatment was planned. Tooth supported overdenture for maxillary arch and cast partial denture for mandibular arch was planned. Diagnostic impressions were made in irreversible hydrocolloid (Imprint, DPI). The impressions were poured using dental stone (type III, kalrock) and casts were procured. For the maxillary arch, the canine was endodontically treated. Pattern resin (DPI) was then used to make a Thimble-shaped coping for the canine which will help in additional retention of the maxillary denture. Primary impression was made using irreversible hydrocolloid (Imprint, DPI) and custom tray was made. The coping was then cemented with zinc phosphate cement (Dentsply). Border moulding was done with low fusing compound (greenstick, DPI) and wash impression was made using polyether impression material (3M ESPE). Master cast was poured in dental stone (type III, kalrock). For the mandibular arch, Diagnostic cast were surveyed and cast partial framework design was planned. The design included Lingual Plate as the Major Connector, Modified Ladder shapped minor connector. RPI system was planned for the rests and guide planes on 33 and 43. Mouth preparation was done which included the preparations of rest seats on 33 and 43, guide planes on distal of canines. Composite build up on the mandibular anterior teeth was done for better anterior giudance. Impression was made in a custom tray using medium bodied polyether impression material (3M ESPE) and master cast was poured using dental stone (type III, kalrock). Cast partial denture framework was fabricated on the master cast. The cast partial denture framework was checked on the master cast and in the patient’s mouth for the fit. (fig.3,4). The cast partial framework was used as a part of the custom tray for recording the functional impression. Spacer wax (DPI) was adapted on the saddle area of the framework and acrylic custom tray was made using Self cure acrylic resin material (DPI). The custom tray was checked in the patient’s mouth for correct extension. Border moulding was done using low fusing impression compound (green stick, DPI). Spacer wax was removed to provide space for the wash impression material. Tray was coated with a layer of adhesives so that the elastomeric impression material adheres to it. Wash impression made using polyether impression material (3M, ESPE). The master cast was sectioned into 3 pieces with the help of a hand saw and the distal edentulous area was removed. (fig.5). The wash impression made on the framework was placed on the sectioned master cast making sure that it seats completely in the rest seat areas. (fig 6). The entire assembly was sealed using utility wax to prevent its dislogement or movement during pouring of the cast. Beading and boxing was done around the framework and sectioned master cast and the impression was poured using a different coloured dental stone (type IV, kalrock) to distinguish with distal extension areas. The cast thus obtained was the altered cast. (fig.7). Jaw relation was recorded and teeth arrangement was done. Try in of the maxillary and mandibular trial dentures was done and dentures were fabricated using Heat cure acrylic resin (Leucitone,Dentsply). At the denture insertion stage dentures were checked in the mouth for retention and stability. (fig. 9,10). Post insertion instructions were given and follow up at the interval of 1month and 3 months was done. DISCUSSION: The fabrication of distal extension partial denture is a difficult task since it involves taking support from both the tissues and the teeth. Both of them have different amount of movements when forces of mastication are applied to them. Thus, the use of special impression techniques becomes necessary. However, in some cases, soft tissue displacement is slight. As a result, the functional and anatomic contours of the ridge may be virtually identical. However, that was not in this case. The decision to use dual impression technique along with altered cast technique was determined in the beginning using a test. Here, first the acrylic denture base was made on the diagnostic cast and placed in the mouth and finger pressure was applied to the base. There was some amount of lift seen in the framework suggesting that there was some soft tissue displacement. So by using the dual impression technique we can get a precise and functionally formed denture border and seal.2,3,7,8. The dual impre ssion used is indicated for mandibular distal extension cases because of a limited ridge area, the mobility of the floor of the mouth, to record the stress bearing area and proper peripheral extension.2 There are two categories of dual impression techniques mainly the physiologic impression techniques and selective pressure techniques. Physiologic impression techniques record the tissues of the residual ridge in its functional form by placing an occlusal load on the impression tray during impression procedures. The methods are the McLean-Hindels method; the functional reline method; and the fluid wax method.2 The need for physiologic impressions was first proposed by McLean and others. He recorded the tissues of the residual ridge in a functional form and the remaining teeth in anatomic form. However the disadvantage of this technique being that the dentists could not produce the same functional displacement generated by occlusal forces because of design of tray being used.2,12 In response to this shortcoming, Hindel developed his impression procedure by modifying the tray as a result of which the finished impression was a reproduction of the anatomic surface of the ridge and the surfaces of the teeth. Disadvantage being that the tissues recorded in this technique continue to be in a functional form all the time. This results in compromised blood flow with adverse soft tissue reaction and resorption of the underlying bone. Also sometimes because of this there is presence of premature contacts of the teeth replaced which will not be acceptable to the patients.2,13,14 The Functional Reline technique and the Fluid wax method where fabrication of the distal extension denture is done before and the new surface is added to the intaglio of the denture base afterwards. It can be done in cases where the denture becomes loose. However, as in the earlier methods this method too, has some difficulties mainly, the problems caused by failure to maintain the correct relationship between the framework and the abutment teeth during impression making procedure and also failure in achieving accurate occlusal contact following the reline procedure.1,2,3,15. To overcome this, along with this method corrected cast procedure was used yielding a better result.1,2,3,9,10,15 In the mentioned case report we have made use of the altered cast technique along with selective pressure impression procedure. The main advantage of this procedure is that the framework was ready before we make the final impression and alter the master cast. So the adaptation of the framework to the teeth and the soft tissues doesn’t change after the final impression. Also the other advantages are, 1. Remarkable stability of the denture base in distal extension removable partial dentures. 2. A positive occlusion which will be maintained for long periods of time. 3. Reduced stress on abutment teeth from unfavorable forces. 4. Reduced numbers of post-insertion adjustments.2,7,10 CONLCUSION: Fabrication of a cast partial denture for mandibular distal extension class I cases is a challenge for the prosthodontist. Several functional methods have been proposed for recording the edentulous area and the abutment teeth. An altered cast technique for fabricating cast partial denture was used in the above article. This impression technique helps in registering and co-relating tissues of different resiliency. This improves the stability and support of the denture, resulting in optimal load distribution. CLINICAL SIGNIFICANCE: An altered cast technique is a way better and faster as compared to other techniques. In this technique the cast partial framework is kept ready before the recording of functional impression. Because of the correct fit of the cast partial framework this technique helps in recording the hard and soft tissues in a better way. Thus, it can be routinely utilized for the recording of distal extension area. 1

Remember The Titans :: essays research papers

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Part I Figure 3.3 on page 67 illustrate the influence of the Roman Empire in relation to road construction and transportation and the similarities of those early systems with modern day Europe. A great deal of events has occurred between the time periods of the two maps. The first major road system was established by the Roman Empire from 300 BC and onwards, mainly for economic, military, and administrative reasons. The road system relied on solid road engineering methods, including the laying of foundations and the construction of bridges. This was also linked with the establishment of pan-continental trading routes like the Silk Road that linked Europe and Asia by 100 BC. After the fall of the Roman Empire after the 5th century, integrated road transportation fell out of favor as most roads were locally constructed and maintained. Due to the lack of maintenance of many road segments, land transport became a very dangerous activity. It wasn’t until the creation of modern nation-stat es in the 17th century that national road transportation systems were formally established. Through central government efforts the French built their Royal Roads system spanning 24,000 km, over which a public transport service of stage-coaches carrying passengers and mail was created. The British built a 32,000 km system of turnpikes where tolls have to be paid for the use of a road. It was mostly a private sector effort. 1794 introduced the beginning of modern road transportation with the first ...

Guilt in the Scarlet Letter

Undoubtedly, Hester, Dimmesdale, and Chillingworth had all committed sin in one form or another, but Chillingworth’s sin lies on a much larger scale because while Hester and Dimmesdale repent for their sin Chillingworth fails to even recognize his own. Throughout The Scarlet Letter, the author illustrates Chillingworth’s transformation towards a devilish personality. This transformation is fueled by what becomes Chillingworth’s obsession for revenge through the psychological torture of Reverend Dimmesdale.Furthermore, because Chillingworth has allowed himself to become consumed with his thirst for revenge he himself has committed a sin, and although Hester and Dimmesdale have both sinned, their sin does not carry a similar weight to that of Chillingworth’s sin. Hester and Dimmesdale have sinned against themselves; their sin does not, directly or indirectly, affect those around them. Chillingworth, on the other hand, purposefully torments Dimmesdale and thr ough this torture he externalizes his sin.The sense of the harmful nature about Chillingworth’s sin would be further developed in saying that Hester and Dimmesdale’s was born out of love, Chillingworth’s came from spite. A sin directed to harm someone is certainly more inhumane than a sin that came out of love. Another point, which further intensifies the magnitude of Chillingworth’s sin, is his lack in ability to forgive those around him. Chillingworth continually exacerbates Dimmesdale’s pain until the day he dies and even on his dying day Dimmesdale makes it a point to forgive Chillingworth’s sin.This places further shame on Chillingworth’s sin because he has yet to realize that, even though Dimmesdale may deserve to be shown justice, he was in the wrong as well and that there should be a mutual form of forgiveness. Because Chillingworth is lacks the ability to be forgiving, which may in turn explain the oversight of his own sins, he does not come forth seeking forgiveness in the community, in his victim, or in God. Both Hester and Dimmesdale sought public forgiveness for their sin which shows willingness for change on their part. Chillingworth, however, did not.Hester, from the very beginning, accepted her punishment with dignity. She did not give up the father of the child and continued her stoicism throughout the book, saying that when she had served her punishment it was not up to those in a local position of power to say so and that when her time was up it would simply just fall off. Dimmesdale’s last efforts were put forth into seeking public forgiveness. The words he spoke to the people explaining his sin were near the last words he said before he dies which could be said to be portrayed as almost noble.However, Chillingworth would never admit he was also at fault of wrongdoing. This stubbornness further plays into his transformation into a devil like figure. Chillingworth’s sin was born out of an evil spite for Dimmesdale, thus making his sin inherently evil where as Dimmesdale and Hester bore a sin out of love. This contrast, along with Chillingworth’s self-consuming quest for revenge serves to illustrate his transformation towards the devil. This highlights his sin as the lowest of the three