Love song of J. Alfred Prufrock Essay Example

Love song of J. Alfred Prufrock Paper The Love Song of J. Alfred Prufrock explores the emotional and conflicting thoughts of a middle-aged man who is indecisive of attending a party to meet a woman. His indecisiveness is caused by his hypocrisy towards the higher classes of society along with his self-consciousness and concern for superficial matters. He concludes that he has achieved nothing and that his life is futile. One of the poems main issues is the effect of industrialisation on society. Eliot uses personification of a cat in the extended metaphor, The yellow fog that rubs its back upon the window panes, The yellow smoke that rubs its muzzle on the window panes Licked its tongue into the corners of the evening, Lingered upon the pools that stand in drains, to convey the sordidness of pollution caused by industrialisation. His use of personifying the cat illustrates the insidious pervading movement of the smog and implies that the city is a grotesque place to live. A major theme in Prufrock is fictitious human relationships. The quote, In the room the women come and go Talking of Michelangelo, the repetition of the refrain and its mocking tone reveals the artificiality of conversation in the room and highlights that the women are misleadingly portraying an impression of sophistication and class. The suggestion that one meets on an emotional level merely a superficial one is addressed in the phrase, to prepare a face to meet the faces that you meet. The word face is used as a metaphor for the fai ade that people create for themselves in society. We will write a custom essay sample on Love song of J. Alfred Prufrock specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Love song of J. Alfred Prufrock specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Love song of J. Alfred Prufrock specifically for you FOR ONLY $16.38 $13.9/page Hire Writer The persona of the poem appears to be a middle-aged man who represents the modern man. He epitomizes disillusioned dreams and captures the sense of the unheroic nature of the twentieth century. The intertextual allusion to Hamlet, No! I am not Prince Hamlet, nor was meant to be, equates both characters who are questioning their existence. Prufrock describes himself as unimportant and isolated. The superficiality of the persona is continually revealed throughout the poem through the asides, which focus on superficial matters and Prufrocks references to his bald spot. His insecure nature is reveal through the persona constantly questioning himself, Do I dare? and how should I presume? I should have been a pair of ragged claws scuttling across the floors of silent seas, suggests that Prufrock lacks mindless craving that could have placed him on terms with the reality and permitted him to survive in the depths where he exists unnaturally. Poem Two: Portrait of a Lady Portrait of a Lady is a dramatic duologue between a young man and an older woman centering on their relationship. The poem describes three meetings between them each occurring in a different season. The poem raises a variety of issues relating to love and a need to be socially accepted. A main issue in Portrait of a Lady is the desire to conform and be accepted into society. The lines, Admire the monuments, Discuss the late events, Correct our watches by the public clocks, are images of conformity and reflect the personas and the womans need to be accepted in society. The line also reveals the lack of depth in their relationship and the facade they create for themselves. The Lady in particular craves for social acceptance this shown in the rhyming couplet, Now that the lilacs are in bloom she has a bowl of lilacs in her room. The man also is not as sophisticated as thought. In the quote, Reading the comics and the sporting page. Particularly I remark An English countess goes up on stage. A Greek was murdered at a Polish dance, Another bank defaulter has confessed. reiterates the personas need to be accepted and to say the right thing to appear cosmopolitan. A major theme in Portrait of a Lady is love. In the beginning of the poem, the lady is establishing a romantic atmosphere between her and the man, which is evident through the setting of the room and the candles. The romantic atmosphere is shattered when the woman is talking and the persona states, Inside my brain a dull tom-tom begins Absurdly hammering a prelude of its own. The line implies his feelings of tedium and frustration towards her. The ladys love is unrequited by the man. This is evident through Eliot use of comparing the personas feelings towards her by using auditory images. He appears to be bored and is disinterested in conversing with her and resorts to a means of escape, Let us take the air, in a tobacco trance. Another issue in the poem is the personas feelings towards the Lady. In the beginning of the poem, he appears to not reciprocate her love. When the persona visits to tell her about him going abroad, he starts to doubt whether leaving her is right. The line Not knowing what to feel or if I understand states his uncertainty about his feelings towards her. He realises that he has the advantage now in their relationship but wonders if it was just a hollow victory.

The Puzzle of Motivation

The Puzzle of Motivation Dan Pink makes a very interesting proposal on how employees should be motivated. His argument basically seeks to show that the kind of jobs done in the 21st century require a new approach to answering the question on how employees are to be maximally motivated to do these jobs.Advertising We will write a custom assessment sample on The Puzzle of Motivation specifically for you for only $16.05 $11/page Learn More The theme of his talk is that there is a disagreement between what science advocates for in the management of business and how business management should be undertaken. The talk significantly shows that the carrot-stick approach is increasingly losing significance in today’s workplace. The speaker starts off his argument by examining the candle problem – an experiment created in 1945 by Karl Duncker. The speaker argues that solving the candle problem requires overcoming functional fixedness. The speaker further notes that creativity is also important in solving the problem. When the experiment was undertaken, the results showed that incentives did not help to solve problems that required cognitive performance. Actually, the results showed that giving incentives in cognitive based problems reduced productivity of workers. These results and the argument of the speaker seem illogical at first. But as he continues to offer more evidence to his argument, a lot of sense emerges out of his talk. I find the talk convincing. Pink uses ample evidence to pass across his argument. I am in agreement with him about the dynamics of the 21st century workplace. It is true that people are becoming more interested in doing what they enjoy doing rather than doing what earns them more cash. Pink argues that the carrot-stick approach works in environments where there is a routine schedule to be followed. He goes ahead to note that few workplaces have fixed routines to be followed. I find this to be true. This is because even in workpla ces which seem to have fixed routines, there is always a room for creativity – it cannot be said that there are routine jobs per se. For instance, take the work done by a receptionist. This work may be perceived to be of a fixed nature. But the truth is, a receptionist has plenty of room for creativity and thus can avoid doing his or her work routinely. This is possible if the ROWE (Result Oriented Workplace Environment) approach proposed by Pink is applied to this job.Advertising Looking for assessment on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More Pink suggests the ROWE approach for the 21st century workplace. He argues that this approach works better than the carrot-stick approach because it gives autonomy to employees. He goes further to buttress this view by quoting few examples where the ROWE approach has led to realization of brilliant outcomes. The examples include Gmail, a product of a Google ’s â€Å"20 percent autonomy hours†. Definitely, Pink makes a powerful proposal but something that I find out of order in his talk is his insistence on incentives almost having no place in the workplace today. In as much as people are looking for autonomy in their workplace and jobs which can give them satisfaction, I believe incentives still play a significant role in increasing productivity. A better stand would be marrying ROWE and carrot-stick approaches in a manner that would optimize productivity. It is obvious that doing away with incentives will be demoralizing to employees especially if an organization keeps on making huge profits and what the employees get in turn is their normal salaries and just the joy of doing their work. Pink, Dan. â€Å"The puzzle of motivation.† TED, 2013. Web. https://www.ted.com/talks/dan_pink_on_motivation.

Romeo and Juliet Essays

Romeo and Juliet Essays Romeo and Juliet Essays Romeo and Juliet Essays Romeo and Juliet essays are hard to write because of the wealth of criticism available online. You may think differently. However, you should not forget that wealth of information leaves little space for your own creative writing. It means that you can hardly write something new when everything has already been written.   Read the following sample essay on Romeo and Juliet.   It is well-written and you will definitely get some interesting ideas out of it. If you are looking for individual help with writing, we offer you to try our custom essay writing services. We are never late with essay delivery and we guarantee quick and adequate revisions. Our writers will not let you down because we value your trust and choice of our writing services! You may also take a look at tips on how to write a good college essay or critical literary essay . In addition, review the following article outlining characteristics of great essays! Romeo and Juliet Essay Sample In Romeo and Juliet, remarks an acute analyst of Shakespeare's symbolism, 'the dominating image is light, every form and manifestation of it'. The tapers and torches that burn for Capulet's ball are put to shame by the flood of moonlight that lies beneath his daughter's window, and 'tips with silver all these fruit-tree tops'; Juliet appears in a brightly-lit casement As glorious to this night, being o'er my head,As is a winged messenger of heavenUnto the white-upturned wondering eyesOf mortals that fall back to gaze on himWhen he bestrides the lazy-passing clouds . . . She compares the shock of Romeo's sudden wild declaration to the effect of a glimmering sheet of summer lightning: ... Although I joy in thee,I have no joy of this contract tonight:It is too rash, too unadvised, too sudden,Too like the lightning, which doth cease to beEre one can say 'It lightens' . . . The lovers' moment of happiness ends with the dawn, as 'envious streaks' begin to lace the East, and 'Night's candle s' slowly pale and die; and the beauty and brevity of love itselfthat 'brief light', doomed to quick extinction, celebrated in Catullus' famous lyric-are set off by the 'perpetual darkness' of ancient Capulets' sepulchral vault. Yet Shakespeare's play has its sensuous undertones, and is alive with worldly bustling characters. His wit is seen at its boldest and bawdiest. The opening passage, where Sampson and Gregory, servants of the Capulets, decide to pick a quarrel with the retainers of the Montagues, is already rich in sexual jokes; and Mercutio is a fount of genial obscenities, including one reference so abstrusely phrased that it escapes the average modern reader. 1 Shakespeare's bawdy has often puzzled his critics. Robert Bridges believed that it was imposed on him by his disreputable contemporary audience, 'those wretched beings who can never be forgiven their share in preventing the greatest poet and dramatist of the world from being the best artist'; while Bernard Shaw sugg ested that his 'incorrigible addiction to smutty jokes' was fostered by his snobbish anxiety to resemble a member of the upper classes, the aristocrat, according to Shaw, being always particularly lewd in speech. Shakespeare, however, was representative of his period; and, although the Elizabethans' attitude towards love was not uncomplicated by neurotic feelings-with a pagan delight in the flesh went disgust, remorse and guilty fearthey understood that the Heavenly and the Earthly Venus are twin manifestations of the same divinity, and that, if one is to be properly served, the other must be duly honoured. Romeo and Juliet Essay Custom Writing Did you like the above sample essay?   Do you want to get a unique essay about Romeo and Juliet written especially for you?   We guarantee adequate support and on time delivery of custom written essays. We are ready to write your essay even if your deadline is in less than 12 hours from now! You will be pleasantly surprised with our prices. Is high quality possible at the low price? At our site – yes!

My role in this project Essay Example | Topics and Well Written Essays - 500 words

My role in this project - Essay Example arners acquire the language the language acquisition skills of the learners and how they the manner and ways in which they differ in terms of their optimisty optimism and attitudes towards learning a particular language. Teachers in different various fields, therefore, are required to possess a high degree of should awareness regarding such widespread individual differences which exists among the learners of learners’ individual differences in order to have a clear understanding of how to deal with different students with variable age and abilities in monolingual and multilingual classrooms. Learning style theme has been always an issue of second language acquisition. In our second project s, we dealt with learning style among of some a group of Arabic students. 20 of our participants were Saudi males and 6 Saudi females. My role in this project was divided into three parts. First, I was assigned to summarize an article by Angus Duff The titled of this article is (The Revised Approaches to Studying Inventory (RASI) and its Use in Management Education, 2004). As for the second part, Rasha and I were assigned to find participants and gather information from them. Since we did the survey online on (SurveyMonkey) Website, I sent the link of the survey to 20 of our participants. I know those participants and their educational background as well as to their current educational positions. The third part was analyzing the data. I tried my best to understand how the SPSS work. Adel and I persistently strived tried many time to analyze the data using the SPSS. Although, I encountered several obstacles during the process in achieving a perfect understanding of the mode of operation of the program, I At some point I stuck and could not perfectly understand how the program works but I got managed to get a general idea about it. This project helped me to get acquire some valuable knowledge regarding understanding of how the manner in which data are analyzed by either

Why Parents are Sometimes Strict to their Childeren Essay

Why Parents are Sometimes Strict to their Childeren - Essay Example This paper examines the issue of strict parenting by first defining what this means, and then exploring the multiple reasons why parents might choose to be strict to their children on occasion. A number of scholarly findings are reported, along with illustrative examples, in order to demonstrate the type of situations which call for strictness, and finally a comparison is drawn between strictness which is appropriate, and strictness which is unhelpful for a child’s development. Most people can remember instances from their childhood when their parents punished them because of something that they did. It is entirely natural and proper for a certain amount of conflict to arise between parents and children because the only way children can learn about the world is by being gradually introduced to it in a safe and practical way. Babies and young children have to be taught that certain objects are hot, or sharp, or in some other way dangerous, and caring parents are generally very strict about things like fire and matches, crossing roads, talking to strangers, and other kinds of behavior which could bring harm to the child. Strictness in this context is a fundamental parental duty. It would be criminal and negligent to allow children to freely experiment with such dangerous behaviors and so in this sense strictness is a positive quality which protects the child by teaching it what must be avoided. There is another kind of strictness, and this relates to the social behavior of a child, for example in learning to say hello and goodbye, or to say polite phrases like please and thank you. There is an element of culture in this kind of strictness, because it has more to do with what people think about the child (and by implication also the parents) than what the child wishes or needs. Some families are very strict about using titles such as â€Å"Sir† or â€Å"Ma’am† when the child is addressing adults, while other parents are much more relaxe d, and some even allow children to address parents by their first names, rather than by polite phrases or the labels â€Å"Mom† and â€Å"Dad†. The purpose of this kind of strictness, when it occurs, is to make sure that the child learns to fit into the norms of the social setting in which the family lives. Parents who have been in the military, or who have a strong faith in a major religion, are often more concerned about this kind of behavior, because they have high moral standards themselves and wish to pass these same standards on to their children. Parents who work in the arts and media, or who are unemployed, or who are of a more gentle disposition may, on the other hand, value a free and easy approach to life, or perceive such good manners as something irrelevant, or elitist. The moral, religious and political views of the parent, therefore, are often a key factor in determining how strict they are with their children. A number of studies have been carried out o n parents and strictness, including a recent exploration of the relationship between teenage drinking behavior and parental strictness levels (Aubrey, 2010). Researchers at Brigham Young University found that children whose parents are indulgent and easy-going tend to be the most likely to become involved in binge drinking of alcohol. The same study found also that parents who are very strict try to prevent the child from coming into contact with alcohol, but unfortunately this has the effect also of removing the opportunity for children to make their own judgements. (Aubrey 2010). An earlier study on parental strictness in the United Kingdom found that â€Å"Children are more likely to grow into well-adjusted adults if their parents are firm disciplinarians.†

Introduction for Currys Essay Example for Free

Introduction for Currys Essay For this assignment I am investigating Currys and I will be getting information about my investigation from the customer service of Currys, but to do this I will need to know also a little bit about the customers profiles and what the customers think about Currys products and services that they provide. Background: Currys is the leading choice for families buying electrical devices for the home and other businesses. Currys also delivers their goods to their customers seven days a week to households and businesses throughout the UK. While delivering new products the Group collects 750,000 ends of life white goods appliances, fridges, freezers, cookers, computers, printers, radios, televisions, phones and washing machines, from customers homes each year, of which, until November, approximately 300,000 were fridges. Until November 2001 these were recycled or refurbished by a network of contractors, relieving Local Authorities, who would otherwise be obliged to collect or receive these products, of a significant burden. Many units were refurbished and resold at low cost, providing cheap products for families on low income (including through create, a Dixons supported project to re-train long term unemployed people as engineers). Others were exported for further use and the remainder recycled and disposed of following CFC gas extraction meeting environmental standards. In effect Dixons Group provided a cost-free channel for the disposal of this domestic waste and one which minimised the generation of extra journeys by householders or local authority collectors and is thus more environmentally acceptable. This shows how much Dixons group has been acting ethically. Services that Currys provides and competitive background: For my assignment, it is important to understand why retailers offer such services. Electrical retailing is highly competitive, like: Currys, Comet, John Lewis, Debenhams, House of Fraser, Argos, Powerhouse, Dixons and many thousands of small independent retailers all compete for trade in what many customers view as a product market. Low margins demonstrate the offer and that is the competitive nature of the industry. Because this is a competitive market, price pressure is intense and retailers will normally try to offer the lowest price in the market. So the customer gets used to the idea that prices will be similar in most outlets. Therefore there is a strict pressure to make different either by offering exclusive products or by excelling on service. That is why all retailers will offer competitive service offers including suitable delivery and after sales. No retailer will want to risk for too long a competitor being able to offer a new service recognized. As yet the leaving of take-back has had incomplete things on sales; however one of the two main peaks for sales, the hot summer months and this is the period of sales and a period that businesses look to maximise their sales. Customers profile: Most of customers of Currys are from a mixed group of age, gender and races. Most of customers that I personally see coming to the store of Currys in Chadwel heath are parents or just adults who are able to purchase products by credit cards or any other ways of payments. There are also other customers of Currys who are of an average age like teenagers who are able to pay musical items or games. Currys does not have any geographical customers because their customers are most of the time locally. Some customers have their information stored into Currys system due to their customers loyalty and due to Currys market researches. Currys gives to its customers a guarantee of purchasing items from their stores in case that the customer is not satisfied with the products or services that Currys provides to them, then the customer can take the products back and get a replacement or if possible get the customer can get his/her money back but this depends with the case. Some times if Currys cannot sort out the problem that the customer has with the products, they usually give to the customer the phone number of the company or the manufacturer of that particular product for further information or instructions about the usage of the product.

The ultimate relationship :: essays research papers

Doing good? We’ve been here since sept. and people always ask what have you been doing. WE’ve been trying to fit in. We’ve stopped saying yall. Plural. We’ve started using utensils. Potholes, you have obstacle courses In cincy we drive the speed limit. I’m thinking we vote to have ish printed on the speed limit signs. Accent. People ask us how its going? How are things for the new church coming along. Let me tell you. We learned a few weeks ago that the financial support we would receive from our sponsoring organizations was a little bit less than we’d expected. 10’s of thousands of dollars less. The day I found out I began furiously running numbers. How can I make this work. How can I make this work? Do I call my mommy? I’m 31 years old and my mother still gives me lunch money. I know I’m spoiled, but its true, if I’m at home in Cincinnati, my mother will just slip me a twenty. Mom, I wonder if I could get a 50 year advance on my lunch money. I wanted to fix it but I couldn’t. We were just plain short ten’s of thousands of dollars. I prayed. God, I’m not sure what to do here. I prayed and prayed but I didn’t really feel any better. I read my Bible. All the verses I could remember about God providing for his people and God being faithful, but honestly it didn’t really provide much comfort. And then I did something I’m almost embarrassed to tell you. I was desperate to hear from God and so I flipped through my Bible and asked God to speak to me. I landed on John 6. â€Å"Jesus Saw a large crowd coming and asked phillip where will we find enough food to feed all of these people. Hah-I thought kind of like us launching this church. WE’ve got this crowd coming on launch day, and we don’t have enough money to buy the equipment we need to resource these people spiritually. John 6:? â€Å"Jesus asked this only to test him, because he already knew what he was going to do.† I wondered. â€Å"Is this verse for me?† Jesus has allowed this lack of funds to happen to test us, and he already has in mind what he’s going to do.† I started to feel a little better. A little more confident and I read on.

Ikea Essay

Ltd. is a furniture operations company that offers â€Å"quick assembly† furniture with 15% lower price than its competitors. IKEA’s success brought imitators, such as Sears. In order to analyze IKEA’s competitive position in the Canadian Furniture Industry as well as Sears competitive threat, a model of competitive rivalry was used. IKEA and Sears both compete against each other in multiple markets across Canada, they both have market commonality and resource similarity. The Sears catalogue has almost the same format of an IKEA catalogue, and they both offer knock-down, self-assembled line products which allows the customers to create particular designs. In addition, the price for Elements’ products in Sears seemed almost identical to IKEA prices. They both go closely to the supplier in marketing, research, design and development, production standards and production planning. Some of the suppliers of the Elements line for Sears were from Sweden, which is the same as IKEA, but it didn’t show that they had any suppliers in common. It’s evidently that both of the market commonality and resource similarity are very high between those two companies. The market commonality and resource similarity can influence the drivers of competitive behaviour. The awareness of IKEA to recognize the degree of imitation by Sears is very high. High awareness enables IKEA to understand the consequences of Sears’ actions and responses. IKEA has a high motivation to respond Sears’s imitation. In order to protect IKEA’s position in the furniture market, IKEA has a philosophy to dealing with the copyright. IKEA would like to make a new model to replace the stole one rather than bring a lawsuit. Furthermore, IKEA has the ability to attack or respond to Sears’ actions. Since they both hold the similar resources, the ability to attack and respond is similar. IKEA should consider all important issues before taking action or respond to Sears. First-mover incentives, organizational size, and quality are the three factors that IKEA may take action to its competitors. As a first mover, IKEA’s business approach was fundamentally different from the traditional Canadian retailers. IKEA focus on â€Å"quick assembly† furniture and allow the customers assembled at home. Due to this reason, its price is 15% below the lowest prices for traditional furniture. The size of IKEA Canada is relatively small than Sears. The smaller size enables IKEA to launch competitive actions to defend their market position. The quality of IKEA’s product can be guaranteed. As one of the competitive strategy, IKEA had nearly 100 production engineers to assist suppliers in every way to low costs, introduce new technology, and design. The company has a philosophy to â€Å"create a better everyday life for the majority of people. † In order to defend its market position, IKEA may response Sears’ imitation in the following ways. IKEA may implement some strategic action, such as new innovation, to replace the stolen model from Sears. IKEA may lower its price, always by 10 to 15 percent on a particular item, than Sears. If IKEA can’t do it, IKEA may just drop the item and select some other one, to compete against Sears. Sears is one of Canada’s largest merchandising operations, and offering a wide range of medium price and quality goods. IKEA can predict that Sears with relatively lower market dependence are less likely to respond strongly to attacks threatening their market position.

9’Ms of Quality Essay

Different meaning could be attached to the word quality under different circumstances. The word quality does not mean the quality of manufactured product only. It may refer to the quality of the process (i.e., men, material, and machines) and even that of management. Where the quality manufactured product referred as or defined as â€Å"Quality of product as the degree in which it fulfills the requirement of the customer. It is not absolute but it judged or realized by comparing it with some standards†. Quality begins with the design of a product in accordance with the customer specification further it involved the established measurement standards, the use of proper material, selection of suitable manufacturing process etc., quality is a relative term and it is generally used with reference to the end use of the product. Crosby defined as â€Å"Quality is conformance to requirement or specifications†. Juran defined as â€Å"Quality is fitness for use†. â€Å"The Quality of a product or service is the fitness of that product or service for meeting or exceeding its intended use as required by the customer.† Fundamental Factors Affecting Quality The nine fundamental factors (9 M’s), which are affecting the quality of products and services, are: markets, money, management, men, motivation, materials, machines and mechanization. Modern information methods and mounting product requirements. 1.Market: Because of technology advancement, we could see many new products to satisfy customer wants. At the same time, the customer wants are also changing dynamically. So, it is the role of companies to identify needs and then meet it with existing technologies or by developing new technologies. 2.Money: The increased global competition necessitates huge outlays for new equipments and process. This should be rewarded by improved productivity. This is possible by minimizing quality costs associated with the maintenance and improvements of quality level. 3.Management: Because of the increased complex structure of business organization, the quality related responsibilities lie with persons at different levels in the organization. 4.Men: The rapid growth in technical knowledge leads to development of human resource with different specialization. This necessitates some groups like, system engineering group to integrate the idea of full specialization. 5.Motivation: If we fix the responsibility of achieving quality with each individual in the organization with proper motivation techniques, there will not be any problem in producing the designed quality products. 6.Materials: Selection of proper materials to meet the desired tolerance limit is also an important consideration. Quality attributes like, surface finish, strength, diameter etc., can be obtained by proper selection of material. 7.Machines and mechanization: In order to have quality products which will lead to higher productivity of any organization, we need to use advanced machines and mechanize various operations. 8.Modern information methods: The modern information methods help in storing and retrieving needed data for manufacturing, marketing and servicing. 9.Mounting product requirements: Product diversification to meet customers taste leads to intricacy in design, manufacturing and quality standards. Hence, companies should plan adequate system to tackle all these requirements.

Summary of Federation #10 essays

Summary of Federation #10 essays James Madisons Federalist #10 was somewhat confusing, but in laymen terms it basically stated the factions actions towards the Federalist Government, causes of the actions, and solutions. The factions were the countryside attempts to overpower the Federal Government by the states. As Federalist #10 stated (translated in laymen terms), the importance of keeping the Union together, and not having it break due to violence, deserves careful examination, all of which, while respecting the values of the principles of liberty. Madison proclaimed two methods of curing the mischief of the factions, which were to remove its cause, and by controlling its effects. To control the effects would be nearly impossible, due to the size of the factions, and would surely lead to the fall of the Union by a civil war. The only way was to change its cause, to change the government. Madison set his sites on creating a more powerful Federal Government, one for and by the people; however, such a governm ent did not exist. It was Madisons goal to set out to make America a more perfect union. The Federalist #10 brought new rights for the common man, such as statesmen having no more rights than the average American, all men are to be judges by peers, and not by the bias, and lastly, all money earned is money kept. Although these thoughts were not the backbone of the American Constitution, they are a solid foundation of what America stands for; a nation created by the people, for the people. ...

Bilateral Trans-Scaphoid Perilunate Fracture Dislocation

Bilateral Trans-Scaphoid Perilunate Fracture Dislocation BILATERAL TRANS-SCAPHOID PERILUNATE FRACTURE DISLOCATION OF THE CARPUS. (CASE REPORT) Abstract: Trans-scaphoid perilunate fractures-dislocations are rare lesions. They occur in a high-energy trauma. The concomitent lesion of both wrists is exceptional. We report a case of bilateral trans-scaphoid perilunate dislocated wrist fracture in a 21-year-old man. The dislocation was treated by opened reduction and fractures by internal fixation. The functional outcome was satisfying after two years of follow-up. Introduction: Trans-scaphoid perilunate fracture-dislocations are relatively uncommon. 1 These are the most common form of the complex carpal dislocations 2,3 causing marked disruption of the carpal anatomy. Time from injury to treatment (delay in treatment), anatomic classià ¯Ã‚ ¬Ã‚ cation, and open or closed nature of the injury are the major factors that determine the clinical outcome in trans-scaphoid perilunate fracture-dislocations. 4,5 Late presentation combi ned with missed diagnosis often causes critical delay in the treatment of these injuries. If the acute phase is missed, then some authors recommend alternative procedures such as wrist arthrodesis and proximal row carpectomy which are relatively mutilating surgeries that leave a significant functional deficit. 4,6,7 The acute phase is defined as the first week after injury, whereas the delayed phase is the period between the seventh and 45th day and after 45 days the injury is said to be in the chronic phase. 4 We report the case of a patient who referred to our department two weeks after the initial trauma with bilateral dorsal trans-scaphoid perilunate fracture-dislocations of the carpus. Anatomic reduction, percutaneous pin fixation of the carpus and fixation of scaphoid fractures of both wrists were performed by opened reduction under fluoroscopic control. Presentation of case: A 21-year-old, right-hand-dominant man sustained an isolated injury to his both wrists after a fall from a height of approximately 4.5 m. The carpal injuries of both wrists were missed initially and both wrists had been bandaged for two weeks after the trauma. He was referred to our department two weeks later with increasing pain. The patient reported that he fell on his outstretched hands with both wrists in extension. Both wrists were deformed in marked dorsiflexion, painful, swollen, and tender to palpation, with limitation of movement. The patient complained of paresthesia in both of his hands. On physical examination, meticulous cutaneous sensory mapping was performed of both hands to determine the area of decreased sensation. This was done with the use of the sharp end of a paperclip while applying a constant pressure. This revealed minor numbness in the median nerve distribution area of both hands (thumb, index, middle finger, and the radial side of the ring finger). The two-point discrimination was normal on both sides. The mobility of the fingers was normal but pai nful, and there was a slight decrase in grip strength of both hands. Motor power in abductor pollicis brevis and opponens pollicis muscles was full (5/5) on both sides. The Tinel’s sign was negative over the carpal tunnel in both sides. The findings of the patient led us to think that there is not any condition like acute carpal tunnel syndrome due to fracture-dislocation.We thought that the numbness of the patient was due to temporary traction injury of the median nerve caused by dislocation on both sides. The vascular status was normal on physical examination. Study of the anteroposterior, oblique and lateral plane radiographs showed that the patient had bilateral dorsal trans-scaphoid perilunate fracture-dislocations of the carpi ( Fig. 1 ). According to the classification described by Herzberg et al., the fracture-dislocations were trans-scaphoid as path of trauma and Stage 1 as displacement of capitate on both sides. 4 The patient was informed about his pathology and a dvised to undergo surgery. If possible the patient’s preference was closed treatment. Therefore, we initially recommend closed reduction and percutaneous fixation. However, if this was not possible or in the situation of a failure we informed him about the open procedure. Under general anesthesia, a closed reduction was attempted with traction manoeuvre described by Tavernier 8 under fluoroscopic control. The reduction was not satisfactory,we opted for the open reduction by posterior approach.After anatomical reduction was achieved, intercarpal fixation was applied to carpal bones using three K-wires. The first K-wire was applied to scaphoide- lunate, the second K-wire was applied to- lunate-triquetrum and the third K-wire was applied to capitatum-lunate. After the procedure, reduction and fixation of carpal bones was confirmed under fluoroscopy. The same procedure was repeated for the other wrist. We noticed that the scaphoid fracture was reduced spontaneously along with t he reduction of the carpal bones. So we performed   fixation of the left scaphoid fracture using a 3.5 mm mini Acutrak headless compression screw through the fracture line from a dorsal-proximal to a volar-distal direction. Intraoperative fluoroscopic control confirmed anatomic reduction of the scaphoid fracture.. Finally, standard radiograms were obtained and both wrists were immobilized in a short arm cast ( Fig. 2 ). The patient noted complete relief of symptoms the day after surgery. The pain and the paresthesia that the patient complained preoperatively was relieved dramatically and the function recovered. The post-operative period was uneventful. Four weeks after surgery, the casts and the K-wires were removed. New casts were applied for another 4 weeks when union was visible on radiographs. The casts were removed eight weeks after surgery. There was radiographic evidence of union of the scaphoid on the left side, but on the right side radiography revealed delayed union of the scaphoid. The patient subsequently underwent 3 months of intensive range-of-motion and muscle-strengthening exercises. Intermediate clinical and radiographic examinations were performed 6 and 12 months after surgery. At the two-year follow-up, the radiographs showed normal carpal bone relationships on both sides, complete union of the scaphoid on the left side(Fig.3). Wrist motion on the left side was excellent with 70 ° of palmar flexion, 80 ° of dorsiflexion, full supination and pronation, full radial and ulnar deviation. The right wrist could achieve 60 ° of palmar flexion and 70 ° of dorsiflexion, full supination and pronation, but with a mild decrease in radial and ulnar deviation. The grip strength of the right hand was 30 kg while that of the left side was 38 kg, measured with the Jamar dynamometer (J.A. Preston, Jackson, Michigan) . Fig.3 Right wrist and Left wrist anteroposterior and   lateral view after two-years. At the two-year follow-up, the patient was symptom-free concerning median nerve functions. The patient was free of pain on the left side. On the right side there was mild pain with wrist motions due to non-union of the scaphoid.The patient was able to perform activities of daily living and he had returned to all of his previous activities. The functional outcome was good on the left side, with a Mayo wrist score of 80/100. The functional outcome was satisfactory on the right side, with a Mayo wrist score of 65/100. Radiographs of both wrists revealed no evidence of radiocarpal or midcarpal arthritis. No osteonecrosis of the lunate or the scaphoid was evident. The lunate position was correct, without signs of instability. Anatomic relationships of the carpal bones were maintained. Discussion Carpal fracture-dislocations are rare injuries; thus their classification and treatment are rather difficult. Osseous variants of this injury are common; the trans-scaphoid perilunate fracture-dislocation constitutes 61% of all perilunate dislocations and 96% of fracture-dislocations. 4 The trans-scaphoid perilunate fracture-dislocation is an uncommon injury sustained due to force transmission through a hyperextended wrist. 9,10 These injuries may be easily overlooked or misdiagnosed. 4 After a delay in diagnosis of several weeks or months, the clinical prognosis is poor compared with injuries that are treated acutely. 11 According to the classification described by Herzberg et al., we initially diagnosed our patient in the delayed phase. 4 Regarding the literature, the management of such injuries in case of delayed presentation is rare. 12,13 Dislocation in this region requires rapid realignment, as untreated perilunate dislocation will lead to serious secondary damage. 13,14 Perilunate fracture-dislocations are high-energy injuries, produced by wrist hyperextension. 3,15 There is disruption of the palmar capsuloligamentous complex, starting radially and propagating through the carpus in an ulnar direction. 3,15 This dislocation takes a transosseous route through the scaphoid resulting in a trans-scaphoid perilunate fracture-dislocation. 10 In trans-scaphoid perilunate dislocations the fractured scaphoid is the initial destabilizing factor of the carpus. 16 Regarding the literature, we believe that the mechanism of injury in our patient was fall from a height on the outstretched hands. Treatment options currently used for perilunar instability patterns include closed reduction and cast immobilization, closed reduction and percutaneous pinning, and open reduction. As the awareness of the anatomy and biomechanics of these injury patterns has evolved, authors have tended toward treatment approaches that attempt to repair the injured intrinsic and extrinsic carpal ligaments, that is, open techniques. 4,8,11 Most authors agree that closed reduction is the initial treatment of choice for trans-scaphoid perilunate fracture-dislocations. 2,8,17 In addition, treatment often r equires intercarpal fixation within the proximal carpal row. Most authors have agreed that the key to a good clinical result in the management of trans-scaphoid perilunate dislocation is the anatomic union of the scaphoid and the restoration of proper alignment of the carpal bones. 17 In this case, we prefer a opened reduction and intercarpal fixation with K-wires, as well as screw fixation of the scaphoid, because we didn’t achieve a good fracture alignment after closed reduction . Gellman et al. suggested that anatomical reductions of the scaphoid, as well as the mid-carpal joint, and the restoration of the articular surface of the lunate are the most important aspects determining the prognosis. 11 An open reduction further increases the risk of a scaphoid blood supply interruption, whereas percutaneous screw fixation of the scaphoid minimizes this risk. 3,17,18 In addition, a rigid fixation with a percutaneous screw can also reduce the immobilization period and allow for an earlier rehabilitation. Acutrak screw fixation allows earlier discontinuance of the cast than K-wire fixation. In our case, the range-of-motion exercises of the wrist were started earlier after the initial operation. The nonunion rate was relatively higher in the series that were treated by closed reduction. 19,20 In our case study the radiographs obtained two years after surgery revealed a non-union of the right scaphoid. We believe that the delay in treatment and maybe the malrotation of the scaphoid that we overlooked on the initial radiographs led to the interruption of the blood supply which was possibly responsible for the non-union of the scaphoid. Despite the non-union of the scaphoid, the functional outcome of our patient was satisfactory, with mild pain, good range of movement and good grip strength. Similarly, Herzberg et al. 4 reported that unsatisfactory radiographs did not equate to a poor clinical outcome. We planned to perform open reduction and internal f ixation with grafting for the non-union of the right scaphoid. Conclusion As the injury have led bilateral dorsal trans-scaphoid perilunate fracture-dislocations,  we therefore recommend minimally invasive techniques if an anatomical closed reduction and  a percutaneous rigid fixation of the scaphoid is achieved on the intraoperative evaluations.

Domestic Violence Research Paper Example | Topics and Well Written Essays - 1000 words

Domestic Violence - Research Paper Example Commitments in personal and professional life have been increased a lot at present. All these factors may end up in some kind of conflicts between the family members and the ultimate result would be some kind of physical assault, mental torture or verbal torture. â€Å"Domestic violence, be it physical, emotional, sexual or verbal, changes everyone in the family unit† (Domestic Violence Information: The Process Of Healing). Domestic violence has lot of moral, social and family dimensions and implications. Sociologists and criminal justice system have different opinions about how to control or regulate domestic violence incidents. Some people argue that the abusers should be isolated from the family for a particular period of time in order to settle the issues and continue the life normally. Many others are of the views that such isolations may not help either the victim or the abuser in the long run. In most of the cases, the victim forced to continue his/her life with the abu ser; however the relationships between the abuser and the victim need not be the same as before. Moreover, â€Å"Abusers who engage in one instance of domestic violence are several times more likely to engage in similar behavior again† (Breaking the Cycle: Life After Domestic Violence). This paper analyses whether a victim should continue his/her life with the abuser even after serious clashes between them. You have been beaten. The bruises will fade and time will pass but that does not mean that this terrible thing that has happened to you will disappear. Domestic violence damages both internally and externally. You need to aim for a healing process that incorporates your whole person. This may be a lonely time no matter how many friends and family and supportive measures there are around you. Go inside of yourself and find out what you need to do to heal your heart. What hurts the most? How can you start to rebuild your wounded soul? Where can you get help and what type of help will be best for you? (Watson) Domestic violence is a crime which can affect not only the body, but also the mind or soul. The decision whether to continue with the abuser or not should be taken only after the correct assessment of the damage done, the reasons which forced the abuser to engage in such violent acts, possibilities of repetition of such acts in future, character and behavior of the abuser, family atmosphere and opinions of others. Most of the victims respond emotionally after the abusive incidents. They do not bother much about the future consequences since they may reach an excited mental state during and immediately after the abusive incident happens/happened. According to Natasha Kemp (2007), â€Å"The most dangerous time for a women in a violent abusive relationship is right after she has made the decision to leave the relationship, it is the most likely time that she will be murdered, by her intimate partner† (Kemp). Most of the domestic violence cases are happening because of a momentary lapse of mental control. It is quite possible that the abuser may regain his control immediately after the incident. He may feel repentance also. If the victim responds emotionally and takes a decision to leave the company of the abuser, the vengeance of the abuser could be increased and more serious problems may arise later. Jennifer-Crystal Johnson (2008) has pointed out that most of the â€Å"