Information for Soap Notes Essay Example for Free

Information for Soap Notes Essay Associate Level Material Case Study Information for SOAP Notes Read the following three patient visits. Rewrite the information using correct medical terminology. The visits below are written in layman’s terms and do not use the correct medical terminology. Re-write the information in medical terms for the charts. You must determine where the information is to be placed in the SOAP note. Patient One – Chapter Six 22-year-old African American female 140/60 BP 99 F Pulse is 38 Breathing is 22 per minute Patient states she is not on any medicine at the time Patient states her reason for the visit is she is having severe back pain for 5 days now Past has been told she has sickle cell anemia Physician tells patient they are going to draw blood and give her IV with fluids. Physician states the IV will contain something for the pain Blood work showed white blood cells 4300, hemoglobin 13. 1 g/dL, hematocrit 39. 9%, platelets 162,000, segs 65. 9, lymphs 27, monos 3. 4 Physician observes patient is alert Physician finds that head, ears, eyes, nose, and throat are okay Physician determines the patient is having a sickle cell crisis Physician finds that the patient has numbness in hands and feet Patient states she just has not been feeling well lately She reports â€Å"I do not test my levels daily with that machine it hurts so I just base my levels on how well I feel† Physician observes that the patient has some discoloration of her skin Physician sees that the head, eyes, ears, nose and throat are okay Physician hears that the heart sounds good, nothing sounds off Physician wants patient to come to the office in 1 month Physician tells patient to start using the machine to test her blood and record the results and bring with her to next visit

Nesting and Matrescence as a Birthing Strategy

Nesting and Matrescence as a Birthing Strategy Critique of Walsh (2006) â€Å"Nesting and ‘matrescence as distinctive features of a free-standing birth centre in the UK. Introduction The provision of evidence-based midwifery care in the current UK maternity care setting is of high priority (Rosswurm and Larrabee, 1999). According to Kitson et al (2000) the implementation of research-derived evidence into clinical practice is mediated by the relationship between the attributes of the research in question, including the type and nature of the research evidence and its rigour and perceived quality; the clinical context or setting within which the research is applied; and the process of implementation and its effects on practice. Research evidence can inform individual aspects of midwifery care, midwives’ attitudes and knowledge, or even the design and development of midwifery services. While for many midwives and other healthcare practitioners there can be ongoing challenges in the practical integration of research evidence into their work and professional role (Rosswurm and Larrabee, 1999), the value of research still lies in its rigour, usefulness and the s pecificity of findings (Stetler et al, 1998). For midwives, use of research evidence also means they can better support women to make informed choices (Magill-Cuerdon, 2006), particularly about place of birth, whilst keeping up to date (NMC, 2004). This essay addresses the critique of a qualitative research study focusing on elements of birth centre midwifery care. Birth centres have emerged as a significant driver within the UK maternity model for bringing about better client satisfaction, better clinical outcomes and more alignment with normality in midwifery. They also represent the emergence of policy which is responsive to some aspects of women’s (and midwives’) choices (Beake and Bick, 2007). The articles were critiqued using a framework derived from the work of Rees (2003), and Cluett and Bluff (2003), due to their familiarity to the author and their ease of use. Both authors have a midwifery orientation, and while this critique has been informed by a range of nursing, midwifery and general research sources, it is good to retain a midwifery orientation for the process itself. Critique Title, Authors and Focus The title of the study is clear and relates to the findings of the research and its focus on birth centre practice within the UK locality and maternity services paradigm. However, it does not refer to the nature of the research, which would have allowed the reader to immediately identify the underpinning research paradigm. The author is a Senior Lecturer in Midwifery within the UK, within a Midwifery Research Unit. It would also have been useful to know what involvement the author might have had in the unit and how specialist their knowledge of the research location was, to judge, for example, if there is any potential for bias (Polit and Hungler, 1995). Literature Review The literature review is placed within the Introduction section of the paper, and presents both a rationale for the research and a placement within the historical development of policy and practice. The nature of the review here firmly places the paper within a midwifery paradigm by critiquing historical applications of evidence within quantitative or scientific paradigms, which focus on pathology (Walsh, 2006). Conversely, theorists define the UK maternity services spectrum as being founded upon an holistic paradigm promoting normality, natural birth, choice, control and client-centred care (Beake and Bick, 2007). Walsh (2006) orients the discussion towards international issues about intervention rates, and links the discussion to pace of birth. However, apart from this, there is very little critical evaluation of existing research within the topic area; rather the author refers to an earlier study to which he contributed evaluating quantitative research studies about free-standing birth centres (Walsh, 2006). The author also uses this section of the paper to define some terms and some of the focus of the paper. A more detailed research critique would have been appropriate here (Baker, 2006; Cutcliffe and McKenna, 1999; Gerrish and Lacey, 2006; Holliday, 2002). Research Methodology The author is explicit about having a qualitative approach, namely methodology, which is suitable for answering their research question (Walsh, 2006). The stated aim of the research â€Å"was to explore the culture, beliefs, value, customs and practices around the birth process within an FSBC† (Walsh, 2006 p 229). According to Cutcliffe and McKenna (1999) qualitative research methodologies can attempt to answer questions about clinical practice which may not be adequately addressed by quantitative research approaches. Ethnography is an established methodology for this kind of research, particularly relating to birth setting and to midwifery centred care, all well aligned with qualitative models (Rees, 2003) and theory generating research (Parahoo, 2006). The usefulness of research studies such as this may be linked to their ‘fit’ with the issues concerned, and also with how detailed and rich (not to mention informative) the data derived are (Kearney, 2001). Such r esearch also has the advantage of being more client-oriented (Parahoo, 2006). The methodology itself is outlined clearly and certainly suggests not only a deep grasp of the true meaning of ethnograpy but also the kind of depth of data it will produce (Baker, 2006). Sample The author defines clearly the setting of the research, which is appropriate for an ethnographic study (Goulding, 2005), and defines the sample as comprising 15 midwives, 10 maternity care assistant (all the clinical staff working at the centre) (a purposive sample) and 30 women who agreed to be interviewed of which five allowed observation of their care (Walsh, 2006). The latter is described as an opportunistic sample (Walsh, 2006), which is similar to a convenience sample and is the kind of sample most commonly required for this kind of research (Wilkinson, 2000). There is no detail provided about how this sample was recruited, and so it cannot be judged whether or not this was done ethically or if any coercion was involved (Rees, 2003). There are no details given about the types of participants, or any demographic information which might enhance transparency and allow the reader to evaluate the transferability of these findings (Grix, 2004). While sample size is not usually of iss ue in qualitative research (Rees, 2003), and in particular, in ethnographic research (Devane et al, 2004; Hicks, 1996), as it is the richness of the data which is most significant (Hek and Moule, 2006), the sample size does seem to be adequate, particularly when the timescale and span of the research is considered. Ethical Considerations Some attention is paid to ethics, in that access was requested and afforded by the local PCT who owned the building, and permission was secured from the hospital that employed the staff (Walsh, 2006). Ethics somittee was granted, and all participants provided â€Å"informed written consent† (Walsh, 2006 p 229). Again, more detail here would have allowed the reader to evaluate the nature of the information and consent, and any other ethical issues there might have been in the research process (Austin, 2001). Ethical issues should be of primary importance in carrying out research of this nature, particularly in observing women during the time of birth, when they are not only particularly vulnerable but also particularly exposed (Austin, 2001). Vulnerability of subjects should be considered in designing clinical research (RCN, 2004). Some caution is needed over understanding the kinds of women recruited to the study and their level of vulnerability, for example (Rees, 2003). A slightly more critical view of the ethical dimensions of this paper would have been useful (Cooper, 2006). For example, while ethics committees of fundamental importance in research governance and have a significant responsibility for the protection of patients and participants (Cooper, 2006), this does not mean that they can ensure true informed consent is given and has continued to be given throughout the duration of the study. The Nuremburg Code (1949) underlines the need for voluntary consent, but could there have been any sense of obligation on the part of the research participants to take part? The Nuremburg Code (1949) further places responsibility for determining the quality and nature of the consent upon each individual person who initiates, directs or engages in the research, and so this author would question whether or not having all the birth unit staff involved in the study might have introduced some pressure on women to participate. Hollway and Jefferson (2000) descri be consent as a continual understanding of the implications of the research for the participant. There is no indication of how this has been addressed here. Data Collection and Analysis Data collection is dealt with as briefly as the sample, analysis and literature review are treated. The author carried out observation followed by follow up interviews, taking field recordings (audio) which were transcribed the next day, and interviews with women, midwives and MCAs, all of which were audio recorded and transcribed (Walsh, 2006). This kind of data collection is suited to the research design (Moore, 2006; Easton et al, 2000). Walsh (2006) describes the analytical process as ‘thematic analysis’ (p 230), using line by line coding which again is an established process for analysing qualitative textual data (Goulding, 2005; Holloway and Jefferson, 2000; Rees, 2003). The thematic analysis process is outlined, and one example of how the researcher arrived at the themes and meanings is provided, which enhances transparency and auditability (Cluett and Bluff, 2006). The author also discusses the process with reference to other literature. However, more detail here would have enhanced this section (Easton et al, 2006). Findings As is fitting for a qualitative paper, the findings are discussed in some detail, under sub-headings which clearly signpost the discussion for the reader and make it easy to read and assimilate the information (Baker, 2006). The author also includes quotes from the textual data to exemplify the discussion (Rees, 2003). The findings are commented upon throughout, and there is an extension exploration of each theme. The themes were: The turn to birth environment and setting Affect of the first visit Nesting responses Vicarious nesting Care as mothering Discussion and Implications for Practice The findings from this paper have clear implications for the understanding of the design and provision of birth locations within the UK maternity services. They also have significance for understanding the nature of midwifery practice, particularly within such a setting. The ‘human’ side of caring was evident, from the behaviours of staff in making the environment positive and supportive, to the behaviours of women and staff during their time in the centre. The discussion section of the paper focuses on two elements of these findings, that of nesting as â€Å"psychosocial safety† (p 235) and â€Å"Psychological safety and ‘matrescence’† (Walsh, 2006 p 236). The author contextualises these findings within the current medical model, demonstrating a level of engagement with women on the part of midwives that goes beyond clinical actions to something more nurturing and much more intimate. The complexities of women’s experiences of birth are continually referred to in the literature, and yet there is little apparent significance paid to these when the overarching concern of ‘live mother and live baby’ is trotted out as the final justification for any kind of maternity care that transgresses women’s preferences or emotional responses. Choices in childbirth are in particular complex, and the kinds of decisions that women make about their birth location, experience and preferences are not only related to their individual preferences and knowledge but to the socially-acquired knowledge and attitudes they have developed, which are significantly affected by obstetric models and concerns over ‘safety’ (Magill-Cuerden, 2006). It is apparent from this article that understanding the psychosocial, emotional and even spiritual dimensions of the birth environment, including the relationship with maternity care providers, provides depth of insight into women’s needs and into what can realistica lly be offered them under that all-encompassing, frequently-touted term ‘support’. Women need to understand the factors that influence their decisions (Magill-Cuerden, 2006), but women and midwives also need to understand the ethical, emotional and relationship dimensions of their ‘matrescence’, the process of becoming a mother (Walsh, 2006). The implications for practice here are significant, because, working in the medical model of care, midwives are often hampered in their ability to provide the psycho-emotional or spiritual aspects of care and nurturing which are highlighted as so significant in this paper. Also, there may be midwives and maternity care assistants who do not have the requisite sensitivity, trust in women and themselves, and emotional intelligence to reach this level of practice. Walsh (2006) cites all-too-family â€Å"unhelpful behaviours† including â€Å"paternalism, being patronising† and â€Å"indifference and fear of intimacy† (p 238). Thus, it can be seen that for many midwives achieving what is described in this paper is not suitable. The anecdotal evidence from clinical midwifery practice is that, in the opinion of many, midwives who can achieve this state work in the community or in birth centres, and those who cannot opt for high risk, centralised maternity care areas in which they either can avoid this level of engagement with the client or are actively discouraged by organisational or ward culture from doing so. Walsh (2006) makes the following recommendation: â€Å"These findings lead me to believe that midwives should seek ways to rehabilitate ‘nurture’ and ‘love’, derivative of matrescence, as familiar childbirth language and as mainstream caring activities in childbirth.† (p 238). However, attention would also need to be paid to the effects on midwives themselves, who may suffer from emotional backlash or even burnout, particularly in the current UK context. This would also have implications for the nature of pre-registration midwifery education in the UK, because it would have to become part of the process of becoming a midwife, and it is much harder to teach abstract aspects of ‘becoming’ than it is to run emergency drills and teach students how to critique research papers. However, if such a paper can be used as evidence to change practice, then it would, overall, be a positive change. Conclusion A critical evaluation of this qualitative paper has highlighted its strengths and weaknesses, in that the author has adhered to principles of qualitative research, has selected a question or area of enquiry which demands a qualitative approach, and has demonstrated an ability to use such research to reflect woman-oriented ways of knowing (Hicks, 1996). There are limitations to the study, one of which is that the author does not really explore its limitations in any great depth, but overall the quality of data analysis, exploration and discussion is such that the lack of detail about basic research principles is eclipsed. The author firmly locates the study within the current context, but could go further in exploring the impact on midwives if such principles do succeed in changing practice. While Cluett and Bluff (2006) state â€Å"practice based on traditional knowledge is no longer acceptable† (p 276, Walsh (2006) has taken ‘traditional knowledge’ and ‘tes ted’ it through a study of one particular birth setting, and provided a reasonable level of evidence (in terms of midwifery care at least) for the benefits of certain underlying principles of what has been discarded by the medical profession as the unimportant emotional side of maternity care. References Austin, W. (2001)Nursing Ethics in an Era of Globalization. Advances in Nursing Science. 24(2) 1-18. Baker, L. (2006) Ten common pitfalls to avoid when conducting qualitative research. British Journal of Midwifery 14 (9) 530-531. Beake, S. and Bick,D. (2007) Maternity services policy: does the rhetoric match the reality? British Journal of Midwifery. 15 (2) 89-93. Cluett, E.R. and Bluff, R. (2006) Principles and Practice of Research in Midwifery Edinburgh: Churchill Livingstone/Eslevier. Cooper, T. (2006) Research ethics committee approval: the good, the bad and the ugly. British Journal of Midwifery 14 (7) 439-440. Cutcliffe, J.R. McKenna, H.P. (1999) Establishing the credibility of qualitative research findings: the plot thickens Journal of Advanced Nursing, 30(2), 374-380 Declaration of Helsinki (1964) Available from: http://www.cirp.org/library/ethics/helsinki/. Accessed 30-7-08. Devane D., Begley C.M. Clarke M. (2004) How many do I need? Basic principles of sample size estimation Journal of Advanced Nursing 47(3), 297–302 DoH (2001) Governance arrangements for NHS Research Ethics Committees. Available from: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4005727. Accessed 30-7-08. Easton, K, McComish, J.F., Greenberg, R.(2000). Avoiding common pitfalls in qualitative data collection and transcription. Qualitative Health Research 10 (3) 705-707. Elliott, J. (2001) Making Evidence-based Practice Educational . British Educational Research Journal 27 (5) 555 574 . Gerrish, K. Lacey, A. (eds) (2006) The Research Process in Nursing, 5th edition Oxford: Blackwell Science Goulding, C. (2005) â€Å"Grounded theory, ethnography and phenomenology.† European Journal of Marketing 39 (3/4) 294-208. Grix, J. (2004) The Foundations of Research Basingstoke: Palgrave. Holliday, A. (2002) Doing and Writing Qualitative Research London: Sage Publications. Hek, G. and Moule, P. (2006) Making Sense of Research (3rd ed) London: Sage Publications Hicks, C.M. (1996) Undertaking Midwifery Research London: Churchill Livingstone. Hollway, W. and Jefferson, T. (2000) Doing Qualitative Research Differently London: Sage Publications. Kearney, M.H. (2001) â€Å"Levels and Applications of Qualitative Research Evidence.† Research in Nursing and Health 24 145-153 Kitson, A., Harvey, G. and McCormack, B. (2000) Enabling the implementation of evidence based practice: a conceptual framework. Quality in Health Care 7 149-158. Magill-Cuerden, J. (2006) Information giving or receiving: helping women make informed choices. British Journal of Midwifery 14 (10) 614. Moore, N. (2006) How To Do Research (3rd ed). London: Facet Publishing. NMC (2004) Code of Professional Conduct Available from www.nmc-uk.org. Accessed 4-8-08. Nuremburg Code (1949) Available from : http://ohsr.od.nih.gov/guidelines/nuremberg.html Accessed 30-7-08. Parahoo, K. (2006)Nursing Research: Principles, Process and Issues. Basingstoke: Macmillan. Polit, D.F. and Hungler, B.P. (1995 ) Nursing Research: Principles and Methods. (6th ed.) Philadelphia: Lippincott. RCN (2004) Research Ethics: RCN Guidance for Nurses London: RCN. Rees, C. (2003) Introduction to Research for Midwives Edinburgh: Books for Midwives. Rosswurm, M.A. and Larrabee, J.H. (1999) A model for change to evidence-based practice. Journal of Nursing Scholarship. 31(4) 317-22. Stetler, C.B., Brunell, M., Giuliano, K.K. et al (1998) Evidence-based practice and the role of nursing leadership. Journal of Nursing Administration. 28(7-8) 45-53. Walsh, D.J. (2006) ‘Nesting’ and ‘Matrescence’ as distinctive features of a free-standing birth centre in the UK. Midwifery 22 228-239. Wilkinson, D. (2000) Researchers Toolkit: The Complete Guide to Practitioner Research. London: Routledge.

Reflection on Situated Knowledge Map

Reflection on Situated Knowledge Map For the Situated Knowledge Map, I created five pins titled Hairy Legs, Get On The Scale, Talk To Your Sister, Crazy Feminist, and No under the pseudonym BS. These pins focus on body image, fatphobia, the feminist killjoy, and racism. In this reflection, I will examine how these moments in my life changed my perspective then reflect on the system and other posts I read while placing my own pins. While I found the assignment slightly difficult due to the nature of the content, I believe the analysis caused by the assignment is valuable and I found the system utilized simple but possibly exclusive. Hairy Legs, Get On The Scale, and Talk to Your Sister all focus on body image with the last two focusing specifically on fatphobia in our society. Hairy Legs discusses the first time I recognized gender performance and how it affects body hair for men and women. As a 3rd grader at the time, I did not understand why my hairy legs were a problem but the boys hairy legs were fine. Now I recognize hairlessness is a societal standard of gender performance for women. This was the first time I had a negative comment directed towards my body and the first time I thought of my body in term of good and bad. Get On The Scale and Talk to Your Sister are 2 events about a decade apart that made me realize how people treat my sister and I differently due to our weights. As a small girl and woman, my mother only mentioned my weight when she believed I might have an eating disorder. However, my mother started talking about weight with my sister more frequently when she began to gain weight; even goin g as far as to try to convince me to talk to me sister about losing weight. After the events in Talk to Your Sister, I recognized it and the events of Get On The Scale as the double standards surrounding weight women face and the general fatphobia in our society. These events remind me of a quote from The Body Politic-Meditations on Identity by Elana Dykewomon: Women in almost every society offer their daughters up to the prevailing cultural standards of beauty and usefulness for womenif women dont prepare their daughters to meet institutionalized male demands, they know their daughters will suffer in life (Dykewomon 453). I believe this accurately describes what my sister and I went through in these events. The third post, Crazy Feminist, describes the beginning of how I came to understand my identity as a feminist and how grateful I am for taking that step. I had not thought of feminism or considered calling myself a feminist until I joined Women in Learning and Leadership (WILL). I had been discouraged from joining and staying in the group during my first and second year of college. First from my friends sister commenting on how it is a crazy feminist group then with my parents continued attempts to convince me to drop the group and Women and Gender Studies minor for a more useful math minor. It was these attempts and the influences of WILL the led me to my crazy feminist identity which has been more helpful to me and given me more skills, in my opinion, than a math minor would have as a woman in science. The final post, No, is the story of the day I discovered my father holds racists beliefs. I was shocked when he came to me asking me to explain to my sister that she could not date a n African American boy. This event did not change my view of racism so much as it made me realize how truly wide spread it is in my own life. It made me look more closely for subtle racism in my life as well. I found the system used for the Situated Knowledge Map simple to use overall. I believe it is important to create online tools that are easy to navigate if the group creating the tools want them to be accessible for everyone. In the article Invisible feminists? Social media and young womens political participation, Julia Schuster argues that the use of social media and the internet by young feminists make them invisible to older feminists and the use of these tools leads to the exclusion of certain groups of feminists. This effect seems to be happening with this tool, as the clear majority of the pins I looked at were authored by apparent college students, and may be invisible to older feminist groups who are not using these forms of media. I also examined interesting perspectives from reading several of the pins on the map. One particular pin that made me examine my standpoint was Church; a pin written from the perspective of a Methodist discussing the Catholic ceremony of Confirmat ion. This pin made me think about religious privilege from the perspective of a child not experiencing violent religious percussion but subtle religious exclusion. Before reading this pin, I had never considered how a child may feel excluded and othered by other childrens shared experiences from and dislike of their parents religion. I found this project to be slightly difficult for me because I had to admit, not only to myself but to possible hundreds of people, that these experiences affected my behavior, particularly in Hairy Legs, and that my family holds these beliefs. However, I also think it is important that I analyze these events that have clearly shaped who I am today. In regards to the system used for this project, I found it simple to use; however, I am an individual who has had the privilege of growing up surrounded by this technology. People and groups who do not have this privilege may be excluded from using these tools. In addition, reading the perspective of previous posters led me to thought processes I would not have if I had not read their experiences. Work Cited Dykewomon, Elana. The Body Politic-Meditations on Identity. This Bridge We Call Home-Radical Visions for Transformation. Ed. Gloria Anzaldà ºa and Anaouise Keating. New York: Routledge,2002. 450-457. Print. Schuster, Julia. Invisible feminists? Social media and young womens political participation. Political Science 65.1 (2013): 8-24.

Outline of Lamentations Essay -- essays research papers fc

Outline of Lamentations1 I. LAMENTATIONS 1 A. Complaint made to God and request for his mercy 1:1-11 B. Complaint made to friends 1:12-17 C. Appeal to God 1:18-22 II. LAMENTATIONS 2 A. Anger of God as the cause 2:1-9 B. Sorrow of Zion’s children 2: 10-19 C. Complaint is made to God 2: 20-22 III. LAMENTATIONS 3 A. God’s displeasure and the fruits of it 3:1-20 B. Words of comfort to God’s people 3:21-36 C. Duty prescribed in this afflicted state 3:37-41 D. The complaint renewed 3:42-54 E. Hope in God and to wait for his salvation 3:55-66 IV. LAMENTATIONS 4 A. Injuries and indignities done to those who used to be respected 4:1, 2 B. Effects of the famine by the siege 4:3-10 C. Sacking of Jerusalem 4:11, 12 D. Acknowledges the sins 4:13-16 E. Gives up all as doomed to utter ruin 4:17-20 F. Foretells the destruction of Edomites 4:21, 22 V. LAMENTATIONS 5 A. Representation of the present calamitous state of God’s people in their captivity 5:1-16 B. Protestation of their concern for God’s sanctuary 5:17, 18 C. Supplication to God and expostulation with him for return of mercy 5:19-22. Lamentations, written by the prophet Jeremiah, is a poem mourning the passing of Judah by the Babylonians in 586 B.C.E. (Bailey, 82) through siege and battle. Prior to the destruction, Jeremiah had warned or rather prophesized that Judah must change its ways or suffer the consequence of the Lords wrath. Before the Babylonians destroy the city of Jerusalem, Jeremiah warns the people to live by the laws of Babylon and even wrote the warning down to be presented to the people and even to the King. The King, who was placed on the throne by Egypt, in anger, burns the paper and has Jeremiah thrown in jail. While in Jail, Jeremiah conti... ...usalem that they sought prophets who would tell them that they were doing good, and to ignore the wrongs that they were committing. He tells them in a blunt manner as one who had the authority to, which leaves one to believe that this man was not above lecturing and berating his people when they did wrong. Instead he let them have it sort of like a father who doesn’t just punish but teaches by pointing out the mistakes made. In this verse I saw Jeremiah as a stern father figure as well as a prophet. Bibliography Bailey Lloyd. Jeremiah, The New Book of Knowledge, Grolier Incorporated, 1998. Beza, Theodore. Commentary on Lamentations, The 1599 Geneva Study Bible. www.biblestudytools.net Henry, Matthew. Matthew Henry, A Commentary on The Whole Bible Volume 4 Isaiah to Malachi, Old Tappan New Jersey, Flemming H. Revell Publishers 1981. Scofield, C.I. The New Scofield Study Bible, New York, Oxford University Press, 1967 Mears, Henretta C. What the Bible is All About, Minneapolis, MN, World Wide Publications Carol L. Meyers, "Lamentations," World Book Online Americas Edition, www.aolsvc.worldbook.aol.com/wbol/wbPage/na/ar/co/310820, January 1, 2002.

SAD in the Winter Essay -- Journalism Journalistic Essays

SAD in the Winter Could Seasonal Affective Disorder Be Disrupting the Lives of Northeastern Students? Becky Venne, a 31-year-old Northeastern graduate student, says she doesn’t socialize much in the winter. In fact, she claims that she finds it hard to get out of bed and spends most of her day watching T.V., satisfying her cravings for carbohydrates and starchy foods. We’ve all experienced it at some point or another. The weather gets colder, the days become shorter, and no matter how much sleep you had the night before, you still feel tired. These, along with weight gain and feelings of sadness and lethargy are common during the winter months. But what happens when these feelings become debilitating, and begin affecting one’s personal life? â€Å"There is a period of time that I think most people who have SAD realize there is more to it,† said Venne. â€Å"It wasn’t until I had some quiet time that I realized this isn’t normal.† What Venne is referring to is Seasonal Affective Disorder (SAD), a mood disorder that more commonly affects people of all ages in the Northern regions of the Unites States. Although most people experience some forms of depression during the winter months, SAD is diagnosed when this change in mood becomes debilitating, causing a sever impact on the daily life of the individual. Venne says she was diagnosed with SAD about five years ago, shortly after she moved to Boston. She describes her diagnoses as a long, drawn out process, jumping from doctor to doctor, until finally she found the right psychopharmacologist. Dr. Elisa Castillo works at the Center For Counseling at Northeastern University, where she works with many students who have been diagnosed with SAD. She explained that there are... ...the answer to SAD? Castillo suggests seeking help through Counseling, such as the Center for Counseling and Student Development. â€Å"The counseling center can provide support, help diagnose SAD, help with referrals to psychiatrists that have experience in this area and follow up with students to make sure the treatment is working,† said Castillo. Castillo also says that it is important to learn how to manage winter, and can be difficult, especially if someone has moved from a warmer climate to Boston. She recommends finding ways to exercise, socialize, and learn how to have fun both indoors and out. Venne agrees that it is important to find help if a person is experiencing symptoms of SAD. â€Å"Once I was able to realize what the problem was, I was able gain some sort of control,† said Venne. â€Å"I just take one day at a time, and know that summer is on its way.†

Forgivenesses of sins Essay

Pardoners were supposed to issue papal indulgences (forgivenesses of sins) in exchange for alms money, which was to be given to the sick, poor, or another worthy cause. But many pardoners were out-and-out frauds, selling worthless pieces of paper, and even legitimate ones often kept more than their share of the proceeds. This Pardoner is from Rouncivalle, a London hospital well known for the number of illegal pardons connected with it. Most pardoners, like this one, claimed to have come â€Å"straight from the court of Rome,† with a bagful of pardons â€Å"al hoot† off the presses, though of course our Pardoner hasn’t set foot outside England. NOTE: Fake pardoners claimed they could do almost anything for the right sum of money, even remove an excommunication. Despite widespread abuses, though, there still were plenty of people gullible enough to believe in a pardoner’s â€Å"powers. † There’s something suspect in the fact that the Pardoner sings â€Å"Come hither, love, to me,† to the Summoner, who accompanies him in a strong bass voice. Some see more than a hint of sexual perversion in this young man who has thin locks of yellow hair that he wears without a hood because he thinks it’s the latest style. His small voice and the fact that he has no beard, â€Å"ne never sholde [would] have,† leads Chaucer to suspect â€Å"he were a gelding or a mare†Ã¢â‚¬â€œa eunuch or effeminate man. NOTE: Scientific opinion of the day believed that thin hair represented poor blood, effeminacy, and deception, while glaring eyes like the Pardoner’s indicated folly, gluttony, and drunkenness. Chaucer’s audience would catch the references just as we would instantly see the significance of a villain in a black cape and with a black moustache. As if the description weren’t bad enough, the Pardoner tricks people into buying phony relics of saints, such as a pillowcase that he says was â€Å"Our Lady’s veil,† or a piece of sail allegedly belonging to St. Peter. No wonder he makes more money in a day than the poor Parson does in two months. Ironically, Chaucer calls him â€Å"a noble eccesiaste,† since he can sing a church lesson beautifully–for money, of course. His tale is right in character: he tells what the pilgrims say they want to hear. He says he bases his sermons on money being the root of all evil (he ought to know). But he admits he’s not a moral man, although he can tell a moral tale. In his tale about three rowdies, he ironically delivers a sermon against gluttony and other sins. Afterwards, the Host lights into the Pardoner’s hypocrisy with such force that the Pardoner is speechless with anger. Chaucer is probably the earliest English poet you’re likely to read. A first glance at the original Middle English of the Canterbury Tales, with all those strange-looking words, might be enough to tempt you to slam the book shut, either in disgust or in terror at having to learn it all. But take a closer look and examine some of the words. You’ll see that many aren’t any harder to understand than when some people, trying to be â€Å"olde†-fashioned, write shoppe instead of shop. (Chaucer’s English is in fact where this idea originated. ) Try to get a dual-language edition of the Canterbury Tales, in which the Middle English original is printed on one side of the page and modern English on the other. When you’ve gotten some practice reading the original words and checking against the modern English, you’ll find that the rhythm of Chaucer’s poetry gets easier to understand. Why is it called â€Å"Middle English†? Simply because it’s at the midpoint between the ancient language spoken by the Anglo-Saxons of England and the English we speak today. In fact, you might feel grateful that you’re reading Chaucer instead of the poetry of some of his fellow fourteenth-century poets, because Chaucer’s dialect–the Middle English spoken in London–is the language that evolved into our English, while the dialects the other poets used died out. Imagine trying to read something written in a hillbilly drawl or in a Scottish brogue; standard English, even if it’s not what we speak all the time, is easier to read. Even if Chaucer had never written a word, it makes sense that the speech of London, the hub of English society, should develop into the standard English that eventually came over on the Mayflower. But Chaucer gave a great boost to the prestige of English, as Shakespeare did later on. It’s partly because of Chaucer’s terrific (though unintentional) public relations job that the poet John Dryden, three hundred years later, called him â€Å"the father of English literature. † There is a robust flavor to Chaucer’s language that we can’t get in a translation, no matter how good it is. You won’t be able to get the nuances of all the old words. But after a while you’ll almost be able to hear the pilgrims chatting away. The opening of the General Prologue bursts with spring, with new life, and shows that Chaucer is both similar to and different from his poetic predecessors. He uses many images of spring that would be familiar to a medievel audience: the April showers (familiar to us too) â€Å"piercing† March’s dryness, the â€Å"licour† in each plant’s â€Å"vein,† the breezes â€Å"inspiring† the crops. It’s short, but enough of a description to give us a sense of waking up to new and exciting events. Even the birds sleep with â€Å"open eyes† because of the rising sap. Then, instead of moving from the conventional spring setting to a description of courtly romantic or heroic deeds, as his audience might expect, he draws us into a very down-to-earth world. Spring isn’t romance; it’s the time of year â€Å"when people long to go on pilgrimages. † We can all identify with the feeling of â€Å"spring fever,† when we want to travel and shake off the winter doldrums. What’s more, in case we or Chaucer’s listeners are expecting a conventional medieval description of moral allegorical types–Greed, Love, Fortune, etc. –or battles, we’re in for a shock. Other poets presented characters for moral purposes or to embody ideals such as courtly love. But Chaucer doesn’t deal in types, whether religious or courtly, but in portraits of real people. He even ignores the unwritten rule of the time that, if you’re describing someone, you start at the top, very orderly, and work down. Chaucer will start with someone’s beard, then hat, boots, tone of voice, and finally his political opinions! (That’s just a partial description of the Merchant. ) He’s not reporting for a moral purpose, but out of love of life and the people around him. Imagine that you’re minding your own business in a wayside tavern and in burst 29 people representing every facet of society. For Chaucer, that meant the nobility, embodied in the Knight and Squire; the church, in the form of the Prioress, Monk, and others; agriculture (the Plowman); and the emerging middle class (the Merchant, Franklin and tradesmen). Rather than shy away from this motley crew, Chaucer the narrator (who is not the same, remember, as Chaucer the poet) befriends and describes them, inserting his own opinions freely.

East Coast Yachts cash flows Essay

When looking at a statement of cash flow it’s essential to find out what resources are being used under the operations category. As our text states, operating cash flow is really the cash flow generated by business activities, including sales of goods and services. Under this category organizations can also calculate tax payments, but not financing, capital spending, or changes in net working capital (Ross, Westerfield, Jaffe, & Jordan, 2009). When examining the East Coast Yachts cash flow statement we can see operating costs are just high enough to finance the company’s purchase of fixed assets. Understanding what information is under each category is a key concept to understanding how the cash flow statement is set up. Which cash flows statement more accurately describes the cash flows at the company? The most accurate cash flow statement that describes the cash flows of East Coast Yachts would be the official accounting statement of cash flows. In this exercise there is only on cash flow statement so I would have to say this one would be the most useful when making business decisions. In light of your previous answers, comment on Larissa’s expansion plans. Overall, when and if Larissa plans an expansion for this company they must find a way to raise additional capital. Currently as it stands the company really doesn’t have the assets to make an expansion. They are barely covering their costs as is and the amount of money to expand is really not available to them at this time. Looking into  other investors to fund this expansion could be an option. Reference Ross A Stepehen, Westerfield W Randolph, Jaffe F Jeffrey, Jordan D Bradford. (2009). Corporate Finance, Core principles and applications. Second edition. McGraw-Hill & Ir