Voyages of Self-discovery free essay sample

My life has been somewhat like a mosaic. As a child, I have been raised in a proud Taiwan culture (proud both in terms of its Chinese language heritage and tradition). Yet I have a family who greatly values independent thought and thus exposed me to a myriad of environments and diverse cultures. I spent the majority of my elementary in Canada where my dreams and aspirations took shape. The free and idyllic atmosphere there (both in school and in social situations) fostered my risk-taking and inquisitive spirit. Even after I had gone back to Taiwan, the image of Canada was planted in my mind. Though I love my home country, growing up there was not what I really wanted. At school, students were just expected to â€Å"follow the directions.† That was not me. I wanted to doubt, to question, and to be skeptical even towards authority. Curiosity is in my nature. We will write a custom essay sample on Voyages of Self-discovery or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page I could not help myself. It was then I decided to coming to the States in hopes of better pursuing my dreams and figuring out my life. Here, I have seized every opportunity to broaden my horizons and work for the benefit of the larger community. I flew to the Amazing Meeting at Las Vegas, a convention of some of the world’s best science communicators, and conversed about the importance of science literacy in today’s society. I traveled to the stone coasts of Vancouver and worked alongside a dozen whale researchers, helping me recognize the fragility and tentativeness of life on Earth. I attended Secular Humanism gatherings and equipped myself with the weapons of reason against the nonsensical and the irrational—ultimately, to safeguard freedom of inquiry and investigation from religion and superstition. During these experiences, I had a plethora of opportunities to explore my inner self. I discovered qualities that are harmonious with those that I value and place in high esteem: appreci ation of beauty, honest inquiry, and love for the truth. In the middle of high school, my exploratory journey continued. Carrying a deep will to question, I embarked on a philosophical exploration quite unlike those during my childhood times. Why am I here? What am I here for? What is the meaning and purpose of existence? This time, my vehicle was my mind, and my voyage was one of self-discovery. My love of contemplating courageous questions eventually (or perhaps inevitably) led my winding path to gates of science. Previously blinded by the trivialities of daily life, science opened my eyes and my senses to the larger universal reality outside of my own little shell. The scientific outlook of the universe shattered my self-conceived vanity in daily life. It unveiled a world far beyond my wildest childhood imaginations—the vastness of astronomical space, the immensity of geological time, and the elegant complexity and richness of life on Earth. Think about it! Our brains may be the only objects in the entire universe capable of con templating its own existence! From my lonely point in cosmos, a sudden awareness of the immense inexplicability of the universe dawned on me. It was then T.S. Eliots words wafted a new profound personal meaning, We shall not cease from exploration, and the end of all our exploring will be to arrive where we started, and know the place for the first time.† Sometimes in my sleepless nights, whenever existential doubts threaten to come back and haunt me, I would lie on the grass on my backyard and silently stare skywards. I would sit on the edge of the pond as the Milky Way gradually comes into view, extending across the sky and slowly claiming the night. The clear waters reflect both the shimmering brilliance and the immensity of the heavens. Infinity above. Eternity below. While pondering the deepest questions of human existence, I would lie there, enchanted by Andromeda, Gemini, Orion, and tearful with the unheard symphony of the cosmic harmony. I would set my mind free and gaze across the millennia to view humanity residing in space, having built a glorious civilization among the stars. Imagine! They will have glimpsed inventions, ideas, and worlds undreamt of in our present day. Even though I may not live to witness that monumental moment, I take comfort in the fact that I have the potential to comprise a small but important role in this timeless pursuit of knowledge and wisdom—the uniquely human endeavor we call science. Over the years, I have come to realize that science is itself a voyage of self-discovery—although my lifelong search for who I am and how I fit into the world has come to an end, I have just begun the eternal adventure of finding out what it truly means to be human. In understanding the world around us, we are in turn searching for our place in the universe. I am an explorer still. At times, Carl Sagans immortal words ring in my mind, The scientific enterprise spans the generations; we remember those who prepared the way, seeing for them also. Thus in my time and my generation, I carry a special responsibility to further our understanding of the cosmos and ourselves. And in doing so, I will contribute my part and advance anot her step on humanitys ladder reaching for the stars.

Free Essays on Divine Images

come preceded by the word "And". This makes the reader connect cruelty with terror and jealousy with secrecy. We can notice that the stress of the lines in this first stanza falls onto the main word, giving an emphasizing effect. Unlike many other Blake poems, such as "The Tyger" or "The Lamb" we Herrera 2 cannot find rhyming couplets in this stanza, but the rhyming and stressing effect is enough for the reader to tie the ideas together. This effect is strengthened by the repetition of the word "human" in every line and the repetition of the "y" ending sounds in lines one, two and four. The structure of the second stanza differs from the structure of the first one. We notice that each of the lines provide an "answer" in a "symmetrical" way to each one in the first stanza. This structure can also be found in "The Lamb". This gives the impression to the reader that the poem is a closed circle, ending were it started. On a deeper level, this way of structuring can represent the inflexibility and stiffness of these negative human aspects, like immovable objects buried deep inside human nature. We can see that the most outstanding rhythmical feature of this stanza is fore grounding. In fact, ... Free Essays on Divine Images Free Essays on Divine Images Rhythm an Rhyme In "A Divine Image", Blake uses several techniques and literary devices to transmit his thoughts about social injustice, cruelty, and human nature. Rhyme and rhythm are two of the main features in this poem. This poem is the rhythm; it affects the whole mood, tone and meaning of the poem. The poet has chosen different methods to give the poem specific sounds that affect the pace and structure of the rhythm. The structure of the first stanza helps us understand the relationships between the four aspects of human nature presented through cruelty, jealousy, terror and secrecy. The first and third lines start with the main word, while in the second and fourth words come preceded by the word "And". This makes the reader connect cruelty with terror and jealousy with secrecy. We can notice that the stress of the lines in this first stanza falls onto the main word, giving an emphasizing effect. Unlike many other Blake poems, such as "The Tyger" or "The Lamb" we Herrera 2 cannot find rhyming couplets in this stanza, but the rhyming and stressing effect is enough for the reader to tie the ideas together. This effect is strengthened by the repetition of the word "human" in every line and the repetition of the "y" ending sounds in lines one, two and four. The structure of the second stanza differs from the structure of the first one. We notice that each of the lines provide an "answer" in a "symmetrical" way to each one in the first stanza. This structure can also be found in "The Lamb". This gives the impression to the reader that the poem is a closed circle, ending were it started. On a deeper level, this way of structuring can represent the inflexibility and stiffness of these negative human aspects, like immovable objects buried deep inside human nature. We can see that the most outstanding rhythmical feature of this stanza is fore grounding. In fact, ...

Class Actions Essay Example | Topics and Well Written Essays - 250 words

Class Actions - Essay Example wsuit on behalf of several thousand or a larger group of unnamed plaintiffs who share common grievances caused by similar actions, products or defects such as consumer products, pharmaceutical drugs, medical devices and motor vehicles. People have also submitted class actions with regards to corporate misconduct, employment practices, consumer fraud and securities fraud. A class action is the best way of handling cases with similarly situated and multiple plaintiffs. This is so because, many a times, there are many people who have suffered similar or same injuries, and their individual injuries are minor, as such, they might not independently pursue legal redress. However, there are instances in which it may be impractical to submit individual lawsuits, especially when the numbers of those affected by defective products or conduct of actions is high (Hensler, 2001). As a result, class actions have become an efficient way of bringing together and disposing off thousands of claims that would otherwise be impractical to be individually litigated. Class actions still remain the most viable way of handling thousands of similar claims since it aggregates small claims, thereby lowering the cost of litigation. Class actions also ensure that all plaintiffs, both unnamed and named, receive some compensation (Backhaus et al., 2012). Backhaus, J. G., Cassone, A., & Ramello, G. B. (2012). The Law and Economics of Class Actions in Europe: Lessons from America. (J. G. Backhaus, A. Cassone, & G. B. Ramello, Eds.). Northampton, Massachusetts: Edward Elgar

Legal Rights of Students with Disabilities Term Paper

Legal Rights of Students with Disabilities - Term Paper Example IDEA incorporates six key components (Mash & Barkley, 2006). Firstly, IDEA provides that each disabled child have access to â€Å"Free and Appropriate Public Education† (FAPE), where the parent is not obliged to contribute financially. This ought to be in the normal public schools. However, the child can receive the care in other specialized schools or at home, due to the fragility of his health. Additionally, a child suspected to have a disability ought to undergo an appropriate evaluation by a team of trained personnel. Besides, the multi-disciplinary team ought to employ various relevant sources in the appraisal process. The child should not undergo unwarranted tests that have a racial and cultural bias. Additionally, the evaluators should gear their tests towards scheduling for the child’s suitable education (Mash & Barkley, 2006). The concerned personnel should be able to determine the child’s eligibility, once they conclude these tests. Evaluation is impera tive, since it helps in documentation of the child’s disability. Therefore, all children suspected of any disabilities ought to undergo the process despite the way it is apparent. The parent should also recognize the usefulness of the information. Moreover, after the evaluation, the child ought to receive personalized education, owing to their exceptional needs. As such, a team of experts places the child under â€Å"Individualized Education Program† (IEP). Besides, if a child is below 3, the multidisciplinary team as well as the parents arranges for an â€Å"Individualized Family Service Plan† (IFSP), where he or she receives exceptional care within their home settings. Additionally, the parents are equal constituent of the team, and they ought to be actively involved in all processes of the program. In addition, IDEA aims to ensure that the disabled child has a favorable environment for education, which should be free from restrictions. This improves the child ’s learning capacity, thereby reducing chances of being disadvantaged. Besides, experts recommend that children with disabilities should opt for normal school system as their first choice and interact with other children without disabilities. Moreover, IDEA advocates for LRE, where the child with disability learns together with others for the longest time possible. The act explicitly provides for all learning institutions to educate all children, disregarding their disabilities nature. It is unlawful to discriminate children with disability. Before IDEA implementation, children with disability encountered such discrimination that hampered their development. The fifth principle of IDEA implies that parents and the disabled student (where possible) should actively become involved in the formulation of decisions concerning the education plan of the student (Mash & Barkley, 2006). In addition, parents or caregivers ought to receive notice from these trained personnel in cases whe re teachers and other trained personnel change the education plan for the child. The parents and guardians have the obligation to play a part in all meetings and thereby contribute fully in all decision-making processes. The last principle champions for both the parents’, as well as the child’s rights in provision of care and education to the disabled

Pre-Research ( Alhilal Saudi Football club ) Essay

Pre-Research ( Alhilal Saudi Football club ) - Essay Example Ever since its launch fifty-seven years ago, the club has excelled in Saudi Arabia and Asia to win fifty-five official championships. These include seven Arabian Gulf Championships, six Asian championships and forty national championships. As mentioned earlier, Al-Hilal has been very successful in Saudi Arabia and the Asian continent, therefore, earning the nickname Al-Zaeem, meaning ‘The Boss’ (FIFA, 2014). In recent years, its dominance in the Asian continent has dwindled down Al-Hilal club but it remains one of the most successful football club in the continent. The International Federation of Football History and Statistics named Al-Hilal FC as the Asian Football Club of the past century (Wikipedia, 2014). Al Hilal FC’s home games are played at the King Fahd International Stadium, which was built in 1987 and has a capacity of sixty seven thousand fans. Some of the key people in the management and coaching include Abdulrahman bin Musaad who is the chairperson, Sami Al-Jaber as the manager and Cosmin Olaroiu as the team coach (Al Hilal Saudi Club, 2014). The club has signed some of the best football players like Thiago Neves, Christian Wilhelmsson, and Osama Hawsawi among others. In the past, the club had signed some football legends such as Roberto Rivelino, Mohamed Al-Deayea, and Yousuf Al-Thunayan among others (Wikipedia, 2014). Throughout the years, the club has displayed great football and teamwork; therefore, receiving recognition through the numerous tournaments that it has won. Al-Hilal FC lifted its first trophy in in 1961 when it won the King’s Cup tournament. In 1964, the team was able to overpower its main rivals, Al-Ittihad through penalties to recapture the King’s cup. Many people had started to see the great potential in the team and this attracted a huge following. The club did not disappoint when the Saudi Premier League was started in 1976, as it emerged the first winners (FIFA, 2014). Up to

Bilateral Ankle Fusion in Leak Syndrome Induced Deformity

Bilateral Ankle Fusion in Leak Syndrome Induced Deformity ABSTRACT INTRODUCTION: Systemic capillary leak syndrome is a rare condition of unknown etiology defined by sudden episode of hypotension, high hematocrit and low serum protein concentration due to capillary hyperpermeability. Several treatments have been published for this pathology and eventual compartment syndrome but not for the disabling consequences. This clinical case highlights the negative orthopaedic consequences of a severe systemic attack and reports a subsequent deformity treatment option that resulted in patient quality of life improvement. To our knowledge, orthopaedic surgery for systemic capillary leak syndrome induced foot and ankle deformity is presented for the first time. CASE PRESENTATION: A 40-year-old caucasian female patient was referred to our institution for bilateral foot and ankle deformity after compartment syndrome during systemic capillary leak syndrome attack. She presented a bilateral rigid equino-cavo-varus-adductus deformity causing walk impairment. Bilateral ankle fusion by retrograde nailing was performed in a two-staged procedure. Rigid claw toes were also surgically addressed in an additional procedure. Radiologically, apparent ankle fusion occurred at 3 months post-op in both sides. Deformity correction allowed the patient to regain walking capacity. A right ankle tibiotalar failed arthrodesis was noticed at 24 months post-op. Prophylactic human immunoglobulin therapy was initiated after the last surgery with no recurrent attack registered during the 38 months follow-up period. CONCLUSION: Bilateral ankle fusion improved this patient quality of life by restituting walking capacity and lowering the probability of lower limb deformity related ulcers and infections. Major and minor complications are also discussed. This report contributes to the global knowledge about this syndrome and elicits the importance of the induced deformities surgical correction. Keywords: systemic capillary leak syndrome, (SCLS), compartment syndrome, equino-varus, ankle fusion, ankle retrograde nailing, human immunoglobulin. INTRODUCTION Systemic capillary leak syndrome (SCLS), describedby Clarkson et al. in 1960 [1], is a rare condition defined by sudden episodes of hypovolemic shock, elevated hematocrit and hypoalbuminemia without albuminuria [2, 3]. The etiology is still unknown, although several possible triggers have been reported as upper respiratory tract infections, sustained physical effort and menstruation [1, 4]. It results in generalized or segmental edema and, in severe cases,compartment syndrome requiring emergent fasciotomy [2-5]. The sudden intracompartimental high pressure often originates vascular and neurological damage and consequent lower limb deformity [3, 6]. Prolonged hospital stay may also aggravate this condition with osteoporosis following a long-term immobilization or limb disuse. Deformity frequently leads to walk impairment and decreased quality of life [7]. A few retrospective studies report ankle fusion for correction of compartment syndrome induced deformity. None of them included SCLS etiology for compartment syndrome [6,7]. Several treatments have been published for SCLS and compartment syndrome [1-5] but not for the disabling consequences. To our knowledge, orthopaedic surgery for SCLS induced foot and ankle deformity is presented for the first time. CASE PRESENTATION A 40-year-old caucasian female patient was referred to our institution due to bilateral foot and ankle deformity. She had been previously diagnosed with systemic capillary leak syndrome after sudden episode of hypotension, high hematocrit and low serum protein concentration. This acute phase was managed by fluid resuscitation.The consequent generalized compartment syndrome was treated with extensive fasciotomies of both arms, forearms, hands, thighs and legs. She stayed three weeks in the intensive care unit and eight months hospitalized. Although an intense physical therapy program was applied, she was unable to walk and autonomy was limited to a wheelchair. On examination she presented a bilateral severe stiff equino-cavo-varus-adductus deformity with retraction due to subcutaneous and muscle scarring and neurological deficit. Claw hallux and lesser toes were also present bilaterally. Plantigrade weight bearing was not possible (Fig. 1). American Orthopaedic Foot and Ankle Society (AOFAS) score was 20 points. Plain radiographs showed bilateral equinovarus ankle deformity with supinated feet (Fig. 2). Achilles, posterior tibial and flexor digitorum longus tendons lengthening was performed by medial approach associated to right tibio-talocalcaneal arthrodesis with a retrograde locked intramedullary nail (PANTA ® IntegraTM) by lateral approach. Distal fibula bone was used as an autograft. At 8 weeks of follow-up, plastic surgery applied a free skin graft over a persistent post-operative medial blister (Fig. 3). Apparent fusion was obtained at three months post-operatively (Fig. 4). Six months after the initial surgery, fusion of the left ankle was performed in exactly the same fashion. Surgical wound dehiscence was the short-term complication and was resolved with dressing changes. Fusion was obtained at three months post-operatively. (Fig. 4). Fourteen months after the first surgery, we documented recurrent dorsal proximal interphalangeal (PIP) joints inflammation with shoe wear. Right foot Moberg osteotomy, resection arthroplasty of PIP joints and flexor tendon tenotomy of all the lesser toes were performed. Left foot Moberg osteotomy, PIP joints fusion of the 2nd and 3rd toes with intramedullary guide implant (Ipp-On ® IntegraTM), PIP joints resection arthroplasty of the 4th toe and flexor tendon tenotomy of all the lesser toes were performed. Failure of the left hallux Moberg osteotomy staple caused hardware removal at 6 weeks post-op (Fig. 5). The rehabilitation protocol included immediate weight-bearing with walking boots and lower limb drainage. Prophylactic human immunoglobulin therapy was initiated after the last surgery. She regained walking capacity with balanced shoes and returned to work four months after left foot surgery. AOFAS score was 61 points. No toes related complaints, pressure ulcers or terminal necrosis of the toes were found. Twenty-four months after initial surgery she complained of right ankle pain de novo with weight bear and local swelling. Radiologically, failed arthrodesis with tibiotalar and subtalar bone reabsorption, peri-implant proximal radiolucency and distal calcaneus screw fracture were shown (Fig. 6). No local drainage or blood test infection parameters were found. Only symptomatic treatment and nonsteroidal anti-inflammatory drugs were prescribed. At 38 months of follow-up the patient refers no significant right ankle pain and no SCLS attacks recurrence were registered. DISCUSSION This high-risk patients and the unpredictable course of the disease required a multidisciplinary treatment options discussion. The patient never accepted irreversible autonomy loss and was aware of all the possible negative surgery consequences when she signed the surgery consent. There are few treatment options for long-term sequelae of compartment syndrome that include arthroscopic assisted arthrodesis, fusion with external fixator or internal devices such as plates or intramedullary nails. Arthroscopic arthrodesis is an excellent option when sparing the soft tissues is needed, however, this correction is limited to mild deformities. External fixation represents a serious risk of pin tract infection with no consensus about prevention treatment [8] and therefore we advocate as a potential risk for SCLS relapse. Fusion with plate and screws implies a considerable aggression to the already damaged soft tissues, although it represents a high stiffness construct. The authors managed this clinical case as an equino-varus-cavo-adductus deformity after lower extremity compartment syndrome. Retrograde nailing avoided extensive striping and Berend et al. has demonstrated better biomechanics stiffness compared to crossed screws [9]. Wang et al. [6] described excellent satisfaction rate after retrograde nailing for lower extremity compartment sequelae. No tendinous transfers were considered due to neurological deficit, scarred muscles and stiff joints. Claw toes deformity has a high risk of pressure ulcers by shoe wear conflict. Local infection in SCLS patients may represent a potential trigger for relapse and therefore must be corrected. Considering the stiff interphalangeal joints, hallux claw deformity was managed by bilateral Moberg osteotomy. Lesser toes were addressed by resection arthroplasty of PIP joints with the exception of the stiffer left second and third toes that were fixated with an intramedullary guide implant [10]. Fusion rate of only 50% (1/2 ankles) was low compared to another published study that show rates around 91% of primary bony union after bilateral ankle arthrodesis. However, none of these patients had post-compartment syndrome ankle deformity and related sequelae [11]. With no signs of infection, late failed arthrodesis may be related to compartment syndrome, local vascular and neurological damage, technical error or even SCLS per se. Three minor complications were registered. One large posteromedial blister required skin grafting six weeks after right ankle procedure. A left ankle lateral surgical wound dehiscence healed by secondary intention only with dressing changes. Failure of left hallux Moberg osteotomy staple was managed by hardware removal. These complications are relatively common and have been previously described in foot and ankle deformity correcting arthrodesis [6, 12]. They are usually due to poor skin and vascular conditions. No delayed weight bearing was noticed in rehabilitation program due to prompt and successful treatment. Concerning deformity correction, the results were very satisfactory. The AOFAS score increased from 20 to a total of 61 points even after tibio-talocalcaneal arthrodesisthat does not allow any hind foot movement. Moreover, the painless plantar support permitted walking without crutches after 24 months confined to wheelchair. Returning to work was also an important milestone for this patient. At 38 months of follow-up the patient is now asymptomatic with minor local right ankle edema and no walking limitation. Radiologically the bone reabsorption appears to have stabilized. Anecdotal evidence has shown good results in ankle arthrodesis revision after compartment syndrome [6]. However, one must consider unpredictable consequences of fusion revision in a SCLS patient, including a severe attack during the anaesthesia or post-op infection with potential lethal consequences. This patient has been diagnosed with idiopathic form of SCLS. Although no direct cause was identified she had been taking azithromycin for a respiratory tract infection which may represent a potential trigger [4,13]. Monoclonal gammopathy was also present at follow-up lab blood tests as seen in more than 90% of cases [2, 4]. There are several possible prophylactic treatments, which include B2-agonists, thalidomide, calcium channel blockers and chemotherapy with limited evidence considering the rarity of the disease. Intravenous immunoglobulin was administered in the last 12 months of follow-up with no relapses adding to the hypothesis that this may represent an effective prophylaxis [4,14]. CONCLUSION Bilateral ankle fusion improved this SCLS patient functional outcome by restituting the walking capacity. One late failed arthrodesis was the major complication and may require a secondary procedure although the patient is currently asymptomatic. Four surgeries were performed with no SCLS attacks recurrence registered at 38 months follow-up period. Prophylactic human immunoglobulin may have contributed to the absence of relapses. Although surgical correction of SCLS skeletal deformities sequelae represents an orthopaedic challenge, we believe that this treatment should be considered in previously autonomous highly motivated active patients. REFERENCES 1. Clarkson B, Thompson D, Horwith M, Luckey EH. Cyclical edema and shock due to increased capillary permeability. Am J Med. 1960 Aug;29:193-216. http://www.sciencedirect.com/science/article/pii/0002934360900188 2. Atkinson JP, Waldmann TA, Stein SF, Gelfand JA, Macdonald WJ, Heck LW, Cohen EL, Kaplan AP, Frank MM. Systemic capillary leak syndrome and monoclonal IgG gammopathy; studies in a sixth patient and a review of the literature. Medicine (Baltimore) 1977 May;56(3):225-39. http://journals.lww.com/md-journal/Citation/1977/05000/SYSTEMIC_CAPILLARY_LEAK_SYNDROME_AND_MONOCLONAL.4.aspx 3. Sanghavi R, Aneman A, Parr M, Dunlop L, Champion D. Systemic capillary leak syndrome associated with compartment syndrome and rhabdomyolysis. Anaesth Intensive Care. 2006 Jun;34(3):388-91. http://www.aaic.net.au/document/?D=2005303 4. Gousseff M, Arnaud L, Lambert M, Hot A, Hamidou M, Duhaut P, Papo T, Soubrier M, Ruivard M, Malizia G, Tieulià © N, Rivià ¨re S, Ninet J, Hatron PY, Amoura Z. The systemic capillary leak syndrome: a case series of 28 patients from a European registry. Ann Intern Med. 2011 Apr 5;154(7):464-71. http://annals.org/aim/article/746914/systemic-capillary-leak-syndrome-case-series-28-patients-from-european 5. Kyeremanteng K, DEgidio G, Wan C, Baxter A, Rosenberg H. Compartment Syndrome as a Result of Systemic Capillary Leak Syndrome. Case Rep Crit Care 2016;2016:4206397. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027304/ 6.   Wang X, Ma X, Zhang C, Huang JZ, Gu XJ, Jiang JY. Ankle fusion with a retrograde locked intramedullary nail for sequela of lower extremity compartment syndrome. Chin J Traumatol. 2012;15(3):140-4. http://www.sciencedirect.com/science/article/pii/S1008127515302911 7. Lintz F, Colombier JA, Letenneur J, Gouin F. Management of long-term sequelae of compartment syndrome involving the foot and ankle. Foot Ankle Int. 2009 Sep;30(9):847-53. http://fai.sagepub.com/content/30/9/847.abstract 8. Jennison T, McNally M, Pandit H. Prevention of infection in external fixator pin sites. Acta Biomater. 2014 Feb;10(2):595-603. http://www.sciencedirect.com/science/article/pii/S1742706113004790 9. Berend ME, A biomechanical comparison of intramedullary nail and crossed lag sure fixation for tibiotalocalcaneal arthrodesis. Foot Ankle Int. 1997; 18(10). https://www.ncbi.nlm.nih.gov/pubmed/9347301 10. Coillard JY, Petri GJ, van Damme G, Deprez P, Laffenà ªtre O. Stabilization of proximal interphalangeal joint in lesser toe deformities with an angulated intramedullary implant. Foot Ankle Int. 2014 Apr;35(4):401-7. http://fai.sagepub.com/content/35/4/401.long 11. Henricson A, Kamrad I, Rosengren B, Carlsson Ã…. Bilateral Arthrodesis of the Ankle Joint: Self-Reported Outcomes in 35 Patients From the Swedish Ankle Registry. J Foot Ankle Surg. 2016 Sep 7. pii: S1067-2516(16)30176-4. http://www.jfas.org/article/S1067-2516(16)30176-4/abstract 12. Asomugha EU1, Den Hartog BD, Junko JT, Alexander IJ. Tibiotalocalcaneal Fusion for Severe Deformity and Bone Loss. J Am Acad Orthop Surg. 2016 Mar;24(3):125-34. https://www.ncbi.nlm.nih.gov/pubmed/26829585 13. Amoura Z, Papo T, Ninet J, Hatron PY, Guillaumie J, Piette AM, Blà ©try O, Dequiedt P, Talasczka A, Rondeau E, Dutel JL, Wechsler B, Piette JC. Systemic capillary leak syndrome: report on 13 patients with special focus on course and treatment. Am J Med. 1997 Dec;103(6):514-9. http://www.amjmed.com/article/S0002-9343(97)00272-6/abstract 14. Marra AM1, Gigante A, Rosato E. Intravenous immunoglobulin in systemic capillary leak syndrome: a case report and review of literature. Expert Rev Clin Immunol. 2014 Mar;10(3):349-52. http://www.tandfonline.com/doi/full/10.1586/1744666X.2014.882771

acts of non-conformity: admonished or admired? Essay -- essays researc

Acts of non-conformity should either be admonished or admired, I feel, depending on circumstance and the effect that act has on people. Each and every act is unique and different and may either have a negative or positive effect on people. It is the result of the act of non-conformity where we can truly decide whether it should be admired or admonished. Acts of non-conformity which have a positive effect on people, or show that a person is comfortable being an individual, should be admired as they take great courage to perform them. If an act of non-conformity also displays a person’s individuality and self pride I feel this should be greatly admired because it is often hard for many people in today’s society to be different and individual, because great emphasis is placed on conformity i...

Advantages and Disadvantages of Organizational Structures Essay

Departmentalization: Advantage- More specialized in certain fields, communication is excellent because of the knowledge one has about the function of the job, easier to work as a team to get better results. Disadvantage-Staff does not always know the case of the client in detail, other organizations may not always talk to the same person, and very specific job knowledge is required, hard to find a fill in for positions. Matrix Organizations: Advantages-more flexible than departmentalization, more than one person in charge that one can go to for assistance, wider choice for employees that fit the need. Disadvantages-employees are harder to manage due to independence, could increase expenses, more employees needed, lack of loyalty to position, constant team work needed. The Project Team: Advantages-less managers, better communication, less stress on one person. Disadvantages-who is in charge may create conflict, lack of consideration for others, lack of accountability, lack of job focus. The collegial model: Advantages-independent functioning, independent decision making, each person is equal in responsibility, each generates own income, total flexibility. Disadvantages-lack of accountability, lack of authority. In day to day operations the Matrix structure would serve well for a counseling center as its advantages are stronger than its disadvantages, Project Team structure would be the better choice for the center as it has a stronger back bone to carry the center. The Departmentalization structure is the strongest of all choices as it divides the employees by knowledge and has a better opportunity to assist clients. The collegial model would not be efficient in a counseling center as there is no real set structure for day to day operations; its disadvantages are stronger than its advantages.

How to Add and Subtract Fractions 3 Simple Steps

How to Add and Subtract Fractions 3 Simple Steps SAT / ACT Prep Online Guides and Tips Adding and subtracting fractions can look intimidating at first glance. Not only are you working with fractions, which are notoriously confusing, but suddenly you have to contend with converting numerators and denominators, too. But adding and subtracting fractions is a useful skill. Once you know the vocabulary and the basics, you’ll be adding and subtracting fractions with ease. This guide will walk you through everything you need to know for adding and subtracting fractions, including some example problems to test your skills. Key Vocabulary for Adding and Subtracting Fractions Before we can get into the math for adding and subtracting fractions, you need to know the terminology. We’ll be using these terms throughout, so brush up on them to be sure you always know what part of the fraction we’re referring to. Fraction: A number that is not a whole number; a part of a whole. For our purposes, a fraction will refer to a number written with a numerator and a denominator, such as $1/5$ or $147/4$. Numerator: The top number in a fraction, reflecting the number of parts of a whole, such as the 1 in $1/5$. Denominator: The bottom number in a fraction, representing the total number of parts, such as the 5 in $1/5$. Common Denominator: When two fraction share the same denominator, such as $1/3$ and $2/3$. Least Common Denominator: The smallest denominator two fractions can share. For example, the least common denominator of $1/2$ and $1/5$ is 10, because the smallest number both 2 and 5 go into is 10. Pies make great fractions. How Do You Add and Subtract Fractions? Now that you have the vocabulary, it’s time to put that into action. You can’t simply add or subtract fractions as you would a whole number $1/4 - 1/2$ doesn’t equal $0/2$, for example. Instead, you’ll need to find a common denominator before you add or subtract. There are many ways to find a common denominator, some of which are easier or more efficient than others. One of the easiest ways to find a common denominator, though not necessarily the best, is to simply multiply the two denominators together. For example, a possible least common denominator for $1/2$ and $1/12$ would be 24, which you find by multiplying the 2 denominator by the 12 denominator. You can solve a problem using the common denominator of 24 using the steps below, but if you do, you’ll run into a problem- your fraction will need to be reduced. To eliminate the need to reduce once you’ve added or subtracted, instead try to find the least common denominator. Sometimes that will be the same as multiplying two denominators together, but it often won’t be. However, finding the least common denominator isn’t hard- you’ll just need to be familiar with your multiplication tables. For example, let’s try to find the least common denominator, rather than just a common denominator, for the same fractions we used above: $$1/2\: \and \: 1/12$$. To do this, list out a few multiples of each denominator Multiples of 2: 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24 Multiples of 12: 12, 24, 36, 48, 60 Then, look at both lists of multiples and find the lowest number both share. In this case, both 2 and 12 share the multiple 12. If we kept going, we would end up with other multiples they share, such as 24, but 12 is the smallest, meaning it’s the least common multiple. You can do this with any pair of numbers, though larger numbers may present more of a challenge. For adding or subtracting, you can always return to simply multiplying one denominator by the other if you’re having trouble finding the least common denominator, but do keep in mind that you will likely have to reduce. Fractions are the tastiest part of math. How to Add Fractions - Method 1 Now that you know how to find a common denominator, you’re ready to start adding and subtracting. Let’s return to the example of $1/2$ and $1/12$- in this case, let's look at this problem: $$1/2 + 1/12$$ Remember, you can’t add straight across; $1/2 + 1/12$ does not equal $2/14$. #1: Find a Common Denominator We’ll find the least common denominator first, since that’s generally the best way to go about it. We already did the work above, but as a reminder, you’ll want to write out a series of multiples of each number until you find a match. In this case, both 2 and 12 have a multiple of 12. #2: Multiply to Get Each Numerator Over the Same Denominator Always remember that anything you do to the denominator must also be done to the numerator. So let’s take a look at these two fractions we need to get over the denominator 12. $1/12$ is easy- it’s already over the denominator of 12, so we don’t have to do anything to it. $1/2$ will need some work. What number multiplied by 2 will equal 12? To rephrase that question as a problem we can solve, $2*?=12$. Or, even simpler, we can invert the operation to get $12/2=?$, which we can easily solve. So now we know that to go from a denominator of 2 to a denominator of 12, we need to multiply by 6. Again, remember that everything you do to the denominator needs to be done to the numerator as well, so multiply the top and bottom by 6 to get $6/12$. #3: Add the Numerators, but Leave the Denominators Alone Now that you have the same denominators, you can add the numerators straight across. In this case, that will mean that $6/12 + 1/12 = 7/12$. Ask yourself if you can reduce the fraction by diving both the numerator and the denominator by the same number. In this case, you can’t, so your answer is a simple $7/12$. How to Add Fractions- Method 2 Alternatively, we could simply multiply the two denominators together to find a different common denominator. This is a different way to solve the problem, but will end up with the same answer. #1: Multiply the Denominators Together No fancy tricks here- simply multiply 2 by 12 to get 24. That will be your common denominator. #2: Multiply to Get Each Numerator Over the Same Denominator Just as we did when we found the least common denominator, we’ll need to multiply both the top and bottom number of each fraction. In this case, use inverse operations to find out what number you’ll need to multiply. If $1/2$ needs to be $?/24$, you can do $24Ã ·2$ to figure out what number you’ll need to multiply by- 12. Multiply the top and the bottom by 12 to get $12/24$. Repeat the process with $1/12$. If $1/12$ needs to be $?/24$, solve $24Ã ·12$ to get 2. Now multiply the numerator and denominator of $1/12$ by 2 to get $2/24$. #3: Add the Numerators Together Now you can simply add straight across. $$12/24 + 2/24 = 14/24$$. #4: Reduce Here’s where the extra step comes in. $14/24$ is not a fraction in its lowest form, so we’ll need to reduce it. To reduce, we need to divide both the numerator and the denominator by the same number. To do so, we’ll need to find the greatest common factor. Much like finding the least common multiple, this means listing out numbers until we find two factors that both the numerator and the denominator have in common, excluding 1, like so: 14: 2, 7 24: 2, 3, 4, 6, 8, 12 What number do they have in common? 2. That means that 2 is our greatest common factor, and therefore the number we’ll be dividing the numerator and denominator by. $14Ã ·2=7$ and $24Ã ·2=12$ giving us the answer of $7/12$. The answer is the same as when we solved using the least common multiple, and can’t be reduced any further, so that’s our final answer! If you ever find yourself writing out lots of factors without much luck, there are some quick ways to figure out potential factors. If a number is even, it can be divided by 2. If you can add a number's digits a number that is divisible by 3, the number is divisible by 3- such as 96 ($9+6=15$ and $1+5=6$, which is divisible by 3). If the number ends in a 5 or a 0, it is divisible by 5. If you’re not sure when to stop looking for factors, subtract the smaller number from the larger one. That number will be the largest possible common factor, but not the greatest common factor itself.For example, let’s take 50 and 32. Sure, we could just divide both by 2 and keep reducing from there, but if you do $50-32$ you get 18, telling us to stop looking for the greatest common factor once we hit 18.In practice, that looks like this:50: 2, 5, 1032: 2, 4, 8, 16Instead of continuing on, we know to stop when the next factor would be 18 or above, stopping us from spending more time figuring out factors we don’t need. We can see a lot quicker that the greatest common factor is 2 and move on with the problem! $1/1 - 1/? = yum$ How to Subtract Fractions Once you’ve mastered adding fractions, subtracting fractions will be a breeze! The process is exactly the same, though you’ll naturally be subtracting instead of adding. #1: Find a Common Denominator Let’s look at the following example: $$2/3-3/10$$ We need to find the least common multiple for the denominators, which will look like this: 3: 3, 6, 9, 12, 15, 18, 21, 24, 27, 30 10: 10, 20, 30 The first number they have in common is 30, so we’ll be putting both numerators over a denominator of 30. #2: Multiply to Get Both Numerators Over the Same Denominator First, we need to figure out how much we’ll need to multiply both the numerator and denominator of each fraction by to get a denominator of 30. For $2/3$, what number times 3 equals 30? In equation form: $$30Ã ·3=?$$ Our answer is 10, so we’ll multiply both the numerator and denominator by 10 to get $20/30$. Next, we’ll repeat the process for the second fraction. What number do we need to multiply by 10 to get 30? Well, $30Ã ·10=3$, so we’ll multiply the top and bottom by 3 to get $9/30$. This makes our problem $20/30-9/30$, which means we’re ready to continue! #3: Subtract the Numerators Just as we did with addition, we’ll subtract one numerator from the other but leave the denominators alone. $$20/30-9/30=/30$$. Since we found the least common multiple, we already know that the problem can’t be reduced any further. However, let’s say that we just multiplied 3 by 10 to get the denominator of 30, so we need to check if we can reduce. Let’s use that little trick we learned to find the greatest possible common factor. Whatever factors and 30 share, they can’t be greater than $30-$, or 19. : 30: 2, 3, 5, 6, 10, 15 Since they don’t share any common factors, the answer cannot be reduced any further. $1/10$pizza is still $10/10$ tasty. Adding and Subtracting FractionsExamples Let’s go over a few more sample problems! $$8/15-4/9$$ #1: Find a common denominator 15: 15, 30, 45, 60 9: 9, 18, 27, 26, 45 #2: Multiply to get both numerators over the same denominator $$45/15=\bo3$$ $$8Ã ·3=24$$ $$15*3=45$$ $$24/45$$ $$45Ã ·9=\bo5$$ $$4*5=20$$ $$9*5=45$$ $$20/45$$ #3: Subtract the numerators $$24/45-20/45=\bo4/\bo45$$ $$6/+3/4$$ #1: Find a common denominator : , 22, 33, 44 4: 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44 #2: Multiply to get both numerators over the same denominator $$44Ã ·=\bo4$$ $$6*4=24$$ $$*4=44$$ $$24/44$$ $$44Ã ·4=\bo$$ $$3*=33$$ $$4*=44$$ $$33/44$$ #3: Add the numerators $$24/44+33/44=\bo57/\bo44$$ or $$\bo1 \bo13/\bo44$$ $$4/7-/21$$ #1: Find a common denominator 7: 7, 14, 21 21: 21, 42, 63 #2: Multiply to get both numerators over the same denominator $$21Ã ·7=\bo3$$ $$3*4=12$$ $$3*7=21$$ $$12/21$$ $/2$ is already over 21, so we don’t have to do anything. #3: Subtract the numerators $$12/21-/21=\bo1/21$$ $$8/9+7/13$$ #1: Find a common denominator 9: 9, 18, 27, 36, 45, 54, 63, 72, 81, 90, 99, 108, 7 13: 13, 26, 39, 52, 65, 78, 91, 104, 7 #2: Multiply to get both numerators over the same denominator $$7Ã ·9=\bo13$$ $$8*13=104$$ $$9*13=7$$ $$104/7$$ $$7Ã ·13=\bo9$$ $$7*9=63$$ $$13*9=7$$ $$63/7$$ #3: Add the numerators $$104/7+63/7=\bo167/\bo7$$ What’s Next? Adding and subtracting fractions can get even more simple if you start converting decimals to fractions! If you're unsure what high school math classes you should be taking, this guide will help youfigure out your schedule to be sure you're ready for college! Now that you're an expert in adding and subtracting fractions, challenge yourself by learning how to convert Celsius to Fahrenheit!

Night6 essays

Night6 essays The Nazis caused more destruction than just killing innocent Jews, they destroyed their peace, God, and humanity. Elie Wiesels Night, illustrates that by telling his experience in the concentration camps. Elie begins to question his strong feelings for God. He is left only with is memory of having privacy and peace as he did in Sighet. Elie loses his respect of being treated as a human rather than an animal. The experience of Night is fatal to Elie as it destroys his peace, his God, and his humanity. Elies faith for God weakens more and more. In the beginning, Elies love for the Lord is very powerful. During the day, I studied Talmud, and at night, I run to the synagogue to weep over the destruction of the temple. (1) Elie practices Judaism every day by going to the synagogue where he prays. Elie first sees the crematories and the ditches that were deaths to so many Jews. For the first time, I felt revolt rise up in me. Why should I bless his name? The eternal, Lord of the Universe, the All-powerful and Terrible was silent. What had I to thank him for? (31) Elie is unsure about God and what he is doing to them. Elie is finally convinced that God has given up on him. I felt very strong. I was the accuser, God the accused. My eyes were open and terribly alone in the world without God and without man. (65) Elie no longer relies on God. He is on his own. By the end of the book, Elies faith for God has been so watered down, and it will take him a long time to regain that faith. In the beginning of the book, Elie and his family lived undisturbed and very peacefully. A wind of calmness and reassurance blew through our houses. (7) Elie and his family had their own personal space and just went with the flow. When Elie arrives at the camps, he soon realizes that it wont be like at home at all. Even if you were simply passing from one to the other, sever...

Author decide Essay Example | Topics and Well Written Essays - 2750 words

Author decide - Essay Example They include (taken randomly) the agenda setting theory, classic rhetoric, hypodermic needle theory, face negotiation theory, cognitive dissonance theory, and uncertainty reduction theory. This random list was provided to illustrate the seriousness and earnestness by which communication is seen by scholars and scientists. Another line of thought that emerged with regard to communication and culture was the Frankfurt School during the 1930s primarily through scholars associated with the Institute for Social Research in Frankfurt, Germany. This paper is a study on communication theories with special relevance of the Frankfurt School of thought in modern day capitalistic structure. The one term that comes to mind regarding language is glottogony. Campbell and Mixco, in their book A glossary of historical linguistics define the term as â€Å"the emergence (origin) of human language, the study of the origin and earliest development of human language, the name for a kind of linguistics concerned with the origin and evolution of language† (Campbell & Mixco 72). There is no clear evidence as to when language evolved. It is believed that communication started with guttural sounds and actions or pantomimes which later led to the development of a pidgin language. According to Ellis, â€Å"when a pidgin language becomes more accepted and standardized, when it becomes the native language of a generation of children, then it is called a Creole† (Ellis 149). Language further developed with structure and grammar and came to be referred to as prestigious forms of speaking, for example the English language. As mentioned earlier, both humans and species in the a nimal kingdom communicate. In the latter case, communication is primarily through sounds (including variations in pitch) and actions. The monkey watchman on the tree top will cry in alarm at the approach of the predator.

Anyone interested in Scottish family and Scottish local history should Essay

Anyone interested in Scottish family and Scottish local history should be aware of the changes in legislation in the nineteenth - Essay Example However, there had been previous laws, which concerned the relief of the poor within the country before the enactment of the 1845 act. Nevertheless, this particular act is particularly important to the history of the Scottish local family in that it was wholly intended to empower the individual parishes to enumerate own poor. Moreover, besides just enumeration of the poor, the enactment of the law empowered the state to enquire more into the poverty status of the people.Through the enquiry, the state would understand the circumstances around the poverty, understand whether the ‘poor’ would be in a position to work and establish whether there existed other family members who would be depended on by the family for survival. A characteristic feature that existed in the Scottish law previously had been a poor rate or levy, which had been imposed within the state in order to assist the poor. However, therefore was the need to evaluate the effectiveness of the legislations as they were prior to the 1845 enactment of the legislation, which saw the amendments, which led to the 1845-act formulation. The act of 1845 had main provisions, which revolved around the establishment of a supervisory board whose mandate was to effect poor law system regulation. It also provided for retaining the already existing ‘parish based systems’ via Parochial boards (The National Archives of Scotland, para 3). The boards had also powers to regulate taxes. Outdoor relief services for the poor were meant to remain with an attention to building more poor houses for the sick. Moreover, the act empowered the inspector of the poor to legitimize the applications of relief to the poor. The effects of the enactment of the legislation saw the able-bodied poor segment of the population miss an automatic entitlement to the poor relief, as was the case previously in England. However, under the legislation, the poor had the capacity to engage legal procedures to appeal for poor relief denied on them. Nevertheless, in spite of such a promising legislation as it were, it suffered a major drawback on the fact that it lacked a framework to address outdoor relief mismanagement, which was very prevalent. The nineteenth century legislations had great impacts on the records to the Scottish local family and as such, anyone interested in Scottish family and Scottish local history should be aware of these changes in legislation. This paper therefore intends to discuss the specific changes brought about by the legislation and the impact brought about to the records. The previous regimes of legislation ware more open and inclusive where the disabled as well as the poor were entitled to assistance with the blind, orphans, the sick as well as the old having the priority over the assistance though the able bodied had special provision to the relief under special occasions (Milner, 2). Under such instances, the able bodied were included in the provision of the ‘occa sional’ poor during hard times. It was the responsibility of the Kirk sessions and the landowners to oversee dispensation of the relief within the rural areas whereas the town councils as well as magistrates over saw the process within the urban areas (Milner, 1; General Register office for Scotland, 1).1 Each parish took care of its own poor through church collections, voluntary donations as well as through fines inflicted on the convicted sinners (Mitchison, 109; Clark,