Wednesday, October 30, 2019

Partial paralysis from the age of one Essay Example | Topics and Well Written Essays - 3000 words

Partial paralysis from the age of one - Essay Example As we proceed we will be seeing how the patient with the help of psychotherapy and the help of the Multidisciplinary Team (MDT) will be trying to live her life, making it at least a little less hindrance to both herself and her family. I would first like to say that permission has been sought from the family and their attorney authorizes me to discuss this case. However the names and some of the details have been changed to maintain and preserve confidentiality in conformity with NMC Code of Conduct (2004). Meena was born as the first child to Mr. and Mrs. Pandey, who lived in a remote village in the State of Bihar in India. She was a hale and hearty child until one unfortunate day when the doctors confirmed that she had contracted meningitis. Meena was just a year old. Subsequently for treatment her Cerebrospinal Fluid (CSF) was removed by lumbar puncture and analysed. But it was too late. Soon it became evident that Meena had become paralysed. She could just about move her limbs. Movement was slightly better in the upper limbs. She was now in a near vegetative state. The child was just two years old then. Today Meena is a 35 year old woman. She is intelligent but cannot speak properly. Most of the time she behaves like a child. She is demanding, self-centred, and uncompromising. Yet at times, she seems to perceive the grief of the family, her own state and somewhat reluctantly tries to listen to what she is told. She tries to adjust and mend her ways. It is this childlike quality, this innocence which had prompted me to select Meena as the patient. Body- Observation and Diagnosis Meena has been cared for, for all these years by her mother. Her mother today is no more. It had been a moral and emotional issue for Meena's mother to take care of her. But today, she is in the care of her brother and sister-in-law. They want Meena to be able to accept her circumstances and live life to the best of her ability. Moreover, Meena has also set into a mental development and needs help to overcome that. RATIONALE FOR PATIENT CHOICE: Friendly and innocent Intelligent Helpless First to assess properly the Aspect of Care we must understand that the patient is not mature enough to understand that she is dependent on others for everything. She thinks it is normal to depend on her family members and demand their time. Emotionally she requires constant care and reminders that she is loved. Knowingly she

Monday, October 28, 2019

The Beach Essay Example for Free

The Beach Essay On a hot summer day the best place to be is the Beach. Have you ever been so hot you could melt, and just want to play in the cold, salty ocean? I have! The best felling is the wet, grainy, sand between your toes. When you go to the beach all you see is the clear blue ocean, colorful umbrellas, and the silky white seagulls. But be careful, the seagulls will eat your food right out of your hands! Who doesn’t like the beach? If youre looking for a quiet relaxation at the beach, I dont think that will work out too well. Though out the day all you hear are the clear blue wave’s crash against the rough yellow sand, the loud motors of the boats, and the laughter of children everywhere. But in the morning or at night the beach could be quite relaxing. If you want to just relax and watch the beautiful sunrise, while the breeze blows your hair back the beach in the morning is perfect for you. The beach has many different interesting smells. There’s the smell of fruity coconut suntan lotion, the salty ocean, and the smell of delicious smores being roasted over the fire. At the beach you can also smell the dirty fish in the sea. With the bright sun shining down on you, you will forget all about the bad smelling fish. Other than the smell of fish all the other smells are really delightful. I love the beach! All of the smells, sights and felling of being at the beach are the best. The beach is a lot of fun. It is also a good place to go with your family and friends. As you can see there are a lot of good things about the beach. If you have never been to the beach you don’t know what you’re missing. Alexis Gonzalez

Saturday, October 26, 2019

Essay --

Product means a good or service that most closely meets the requirements of particular market and yields enough profit to justify its continued existence. Our company Ez-iron Shn Bhd.’s cordless automatic smart iron is the latest product to enter the market, so we will put in high effort to promote, educate and encourage our consumer to buy or use our product. Cordless automatic smart iron has its name implies that our electronic iron is cordless which using a charger to charge it, the function is that we could just plug the iron towards the socket to charge the iron and the power could be able to last for 2 hours without having any break interval. The iron designed with no power cord getting in the way is easier for us to store, convenient to bring it and the most important is there is no cord to get tangled on the end of the ironing board, so ironing become fast and easy. We also designed a reflective cloth to be placed underneath the clothes to replace ironing board and to prevent our automatic iron to go beyond the clothes and fall down from the ironi...

Thursday, October 24, 2019


The Freshman Manifesto The ideal food system is; sustainable, both in practice and in mindset, values necessity over want whenever food is concerned, and is available to all peoples while promoting equality. Sustainability at its hear Is both a practice and a mindset. One cannot be present without†¦ Premiums Words Pages Ap Human Gee Summer Assignment . AP Human Geography: Summer Assignment 2013 Pick at least one of the following books to read as your primary selected reading: – Fast Food Nation by Eric Closer ISBN 0-395-97789-4 – HOW soccer Explains the world by Franklin Fore ISBN -06-621234-0 -Why Geography Matters by Harm†¦Premiums Words Pages Geography Defining geography: translates to â€Å"Earth Describe- Write† The study of geography Is about places (objective and subjective), Regions Geographers: study the spatial and temporal distribution of phenomena, processes, and features as well as the interaction of humans with their environments Human Geo graphy:†¦ Premiums Words Pages globalization every nation. From economic to social to culture, this widespread exchange of goods, services and Ideas have Influenced changes around the world.Even though the ultra influence in globalization is of slight significance to policy makers, its power has tremendous consequences to the nations involved†¦ Premiums Words Pages Globalization in Thai the nation states which make up the modern world system'. Another meaning of globalization Is the increase In Interrelationship of culture, people, and economic globalization as any relationship between nations around†¦ Premiums Words Pages English Topics number of second-language speakers may soon exceed the number of native speakers, if it has not done so already.The working languages of the United Nations re English and French. All documents are written only in the working languages. English has become now the language of international communication†¦ Premiums Worlds 5 Pages Ea sy APP Human Geography Teacher's Guide Paul T. Gray, Jar. 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So basically when your economy is globalize and world population increases (flat plus crowded), there will be a global demand for food, energy, and natural resources which of course grew at a quick pace†¦Premiums Worlds 1 Gee Year 9 Study Notes Geography Study Notes Chapter 9: The Changing Nature of the World Every person in the world is part of t he global village Globalization brings people together from all over the world through the free flow of goods, services, money and information. The physical size of the world has†¦ Premiums Words Pages Consumption from the Perspective of Culture ABSTRACT Owing to the geography differences, society development differences, cultural value differences, ethic differences, family differ from each other in three aspects: difference†¦Premiums Worlds 5 Pages blob 109 Nor I Clause Millard South AP Human Geography Department 1 A Ability In the context of political power, the capacity of a state to influence other states or achieve its goals through†¦ Premium's Words Pages Geography Vocal List l. 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Wednesday, October 23, 2019

Qualities of Servant Leadership

QUALITIES OF SERVANT LEADERSHIP (From the life of Nehemiah) If we look around the world today people are crying for leaders who will be able to bring changes for the betterment of society, community, organizations, and nations. This has been true in the secular world and Christian organizations throughout history. Today, specifically talking about Christians, we know that different churches and Christian organizations are in need of good godly leaders, and this has been one of the greatest needs since the beginning of the Church. So we know that leaders are vitally important for the well-being and growth of the Church.Leaders play an important role in churches and societies, yet their responsibilities are not easy at all. Throughout history we can see that leaders have played an important part in leading, guiding, encouraging, and leaving a heritage for the generations to come. Many leaders fail to do the task they were responsible to perform, and some perform with flying colors but last for only a short time. But no matter how good a leader is, he does not stay forever. So, the most important thing a leader can do is leave a heritage for the generations to come and glorify God in all he does.Good leaders will always leave godly footprints which will guide future generations in the way they should go. If one were going to talk about good leaders in the Bible, Nehemiah would be a prominent one. There are not many leaders like Nehemiah who completed the task of leadership successfully. Many leaders in the Bible are known as good ones, but they failed at certain points in their live. However, the Bible has no record of failure for Nehemiah. So in this paper, my intention is to present qualities that made Nehemiah a great leader.It is my prayer that we will be encouraged and learn something from the life of Nehemiah. I hope we will truly be applying these principles in our lives and be challenged and transformed. I believe we will be effective servant leaders if we prepare our hearts to do God’s work as Nehemiah did. Background History of Nehemiah To talk about Nehemiah it would be good to begin with his historical background and a brief history of the Israelites so that we can better understand him. Nehemiah was the son of Hachaliah. He was born of Jewish parents in exile. His name â€Å"Nehem-Yah† means â€Å"the comfort of Jehovah. From this it is possible to assume that Nehemiah’s home was a godly one. (Jensen, 46) He also had a brother Hanani (Neh. 1:2) Looking back on the history of Israel, we know that after King Solomon reigned in Israel, the nation split into two kingdoms in 931 B. C. – the northern kingdom (Israel) and the southern kingdom (Judah). After that there were no good kings in Israel, but in Judah there were a few partially good kings. Kings like Asa, Jehoshaphat, and a few others followed God’s will for some time; but they did not continue to follow God fully and wholeheartedly. So they failed at some time in their lives.Josiah was the only good king without blame that Judah had after Israel became two kingdoms (2 Kings 22:2). Due to their wickedness God punished Israel and Judah. The two kingdoms were taken into captivity several times. The Northern Kingdom fell first, and the people were taken into captivity by the Assyrians in 772 B. C. After a few years, the southern kingdom was conquered by the Babylonians, and they were taken into captivity in 586 B. C. After forty-eight years in captivity, in 538 B. C. , the Israelites first returned to Judah from captivity under the leadership of Zerubbabel (Ezra 1:1-2:2).The second return was in 458 B. C. led by Ezra (Ezra 7:1-10). In 444 B. C. Nehemiah returned to Judah, and God used him to guide Judah in rebuilding the city walls and reordering the people’s social and economic lives (Zuck, 673). So there is a possibility that Nehemiah’s great-grandparents were taken into captivity in 586 B. C. when Jerusal em fell into Babylonian hands. This tells us that Nehemiah was born in Persia. Dr. Knoblet says, â€Å"Nehemiah was probably born in Persia around Susa sometime during or soon after Zerubbabel’s ministry in Jerusalem. (Knoblet, 19) Apart from all this information Nehemiah’s genealogy is not known. Nehemiah was just a mere man; but he left his mark on history because he was an available man. (Stewart, 22) We don’t know how a Jewish born, son of a slave become a palace servant; but we do know that Nehemiah was the king’s cup bearer while he was in Susa. (Neh 1:11). When Artaxerxes, the king of Persia gave permission to Nehemiah to return to Judah with his people and rebuild the wall, Nehemiah returned to Judah and served as the governor of Judah and led his people in rebuilding the city wall.Though there are different views on the chronology of the years of Nehemiah’s service as governor, it is probable that he was in Jerusalem for twelve years (444 -432 B. C. ), went to Susa for two years (432-430 B. C. ), and returned. (Knoblet, 129) If we are going to find a man in the Bible who shows us what true leadership is really all about, it is no doubt Nehemiah. (Knoblet, 150) Now, the question is – What made him a great leader? Why was he so effective in his ministry? Let us discuss the qualities that made Nehemiah a great leader. Qualities of Nehemiah Without spirituality one cannot be a good leader.Jenses says, â€Å"Nehemiah was not a priest, scribe, prophet, rabbi, theologian or pastor. As a public official his vocation was secular, not religious. And yet, he clearly demonstrated in his service that spirituality is for the secular as well as for the religious vocation. † (Jensen, 64) So, what makes Nehemiah a good and effective leader must obviously be his spiritual walk with God. Let us discuss some of his qualities – 1. A Man who Feared God: Nehemiah’s qualities of leadership are all tied to his fea r of God. It would not be possible for him to do what he did without the fear of God.When Nehemiah returned to Judah he found the Jews were going through hard times. Talking about the condition of the Jews in Judah, George and Syme said, â€Å"There had been drought, poor crops and recession. But people had to eat, and taxes inexorably fell due. Many were so heavily in debt that, having no more property to mortgage, they were reduced to selling their children into slavery. † (George and Syme, 92) All these things happened due to the corrupt practices of the leaders and moneylenders; but Nehemiah, unlike the other leaders, stayed pure.So, it is evident that when Nehemiah was the Governor of Judah, he did not practice any corruption because he feared God. (Neh. 5: 15) Not only in reference to corruption, but in everything Nehemiah feared the Lord; and as a result, he lived a life which was pleasing to the Lord. His fear of God gave him boldness for he knew God was happy with hi s life. So, when Shemiah told Nehemiah to meet him in the house of God, intending to kill him, Nehemiah was not scared because he knew that God was with him. Seume comments on Nehemiah’s boldness by saying, â€Å"He feared man little because he feared God much. (Seume, 71) That’s the secret of his success in his leadership. 2. A who Knew God’s Word: Though Nehemiah was born and brought up in the land of captivity, it is evident that he read and learned God’s Word and knew God’s promises for his people. This is evident because he quotes the book of Leviticus, Deuteronomy, and Exodus in Nehemiah 1: 8-11. It would not be possible for Nehemiah to enquire about his brethren in Judah from Hanani who returned from Judah, if he was not aware of God’s promise for His people. 3.A Man of Right Burden: When Nehemiah heard that the survivors who were left from the captivity in the province were there in great distress and the wall of Jerusalem was also broken down, and its gates were burned with fire, he was burdened by it. (Neh. 1:3) This was the right burden because he knew God’s promises for the Israelites. But what he heard was the opposite of what God had intended for the Israelites. Since Nehemiah knew God’s promises for the Jews he was burdened because the Israelites were in distress and Jerusalem wall was broken. He was so burdened that the king Artaxerxes could see it in his face. Neh. 2: 2) He wanted to rebuild the wall and point his people back to God’s promises and commandments. That’s the right burden because it is God’s burden. It is not possible to have the right burden without knowing the Almighty God and His promises. If Nehemiah’s burden was not right he could have just enquired and been emotionally sad but never acted upon it to put things back in order. What a leader was by having a burden about God’s work! 4. A Man of Prayer: When Nehemiah heard about the situat ion of Jerusalem and the Jews in Judah, he prayed to God. (Neh. :5-11) He interceded for his people and begged God’s forgiveness for himself and his people. Paul N. Benware says, â€Å"Nehemiah spent about four months in prayer. He confessed the sins of Israel and prayed for the favor of king Artaxerxes. † (Benware, 152) This makes it clear that before Nehemiah did something he saught God’s will first. 5. A Man of Patience: After Nehemiah heard about the reproach and distress of the Jews and the broken down wall of Jerusalem, he prayed to God and wept. (Neh. 1: 3-4) He also prayed to God so that the king would have mercy on him and llow him to go to rebuild the city wall. (Neh. 1: 11) But four months passed, and Nehemiah was patient to wait for God’s time. Wiersbe comments on Nehemiah’s patience saying, â€Å"†¦Nehemiah patiently waited on the Lord for directions; because it is through faith and patience that we inherit the promise (Heb. 6:12 ). He that believeth shall not make haste. (Isa. 28:16). True faith in God brings a calmness to the heart that keeps us from rushing about and trying to do in our own strength what only God can do. We must know not only how to weep and pray, but also how to wait and pray. (Wiersbe, 638) 6. A Man of Action and Example: Nehemiah not only interceded for himself and his people, he prayed to God that he would find favor in the sight of the king. (Neh1: 11b) Moreover, he boldly told his burden to the king and asked his favor to go to Judah to do the business of the Lord. (Neh 2: 3-8) God never fails those who seek His will and do His work. It is because of God’s work that Nehemiah found favor in the sight of the king. (Neh. 2: 8b) As a leader Nehemiah did not just give commands, but he associated himself with his people, and he took part in rebuilding the wall. Neh. 4:21-23) Moreover, he did not depend on people, but he used his own things for his business. (Neh. 5: 15-16) It is be cause of his actions that he was respected as a leader. He guided and led his people by setting an example. He put into practice what he said. 7. A Man of Careful Planning: As a leader Nehemiah studied the problems before he did the work. He was careful to select a few men along side of him, and they enquired about the walls and gates at night and told no one before they knew what needed to be done. Neh 2: 12-16) Before Nehemiah began the work, he already had an inspection of the place and knew what the situation was and what needed to be done. (McGee, 86) Secret goals and plans are what leaders should have in any ministry. Also, be careful not to make the secret too concealed that no one will know anything about it and it will bring no fruit at all. Nehemiah carefully handled this. Though he had a secret, he knew when and what to share about his secret plan. In the right time he revealed enough things to his people so that they would get to work and be able to achieve the set goals . Neh. 2: 16) Commenting on Nehemiah’s secret plans Swindoll says that before Nehemiah began his work, he did not say anything about his plans for three days. (Swindoll, 49) This shows that Nehemiah kept secrets when he planned, and after he carefully studied and made an architectural plan of the way to achieve the goals, he shared the plans with his people. That showed his incredible ability to balance things at the right time and in the right place. 8. A who Motivates: After Nehemiah studied the problems and had a plan, he motivated his people to build the wall of Jerusalem.It is because of his preparation that he knew what to say and the people understand his intention. So, without any hesitation all the Israelites followed his leadership. (Neh. 2: 18b) The source of his motivation was in the Lord. Nehemiah trusted the Lord in all things. He had seen many things that the Lord had done for Israel and he believed that the Lord would continue to do so. In motivating his peopl e Nehemiah said, â€Å"Remember the Lord, who is great and awesome! † (Neh. 4: 14) By saying this Nehemiah meant to say that, â€Å"God helped us before and He’ll help us again! He is our covenant God! That’s why I’m here!That’s why the wall is half up! He is great! He is awesome! Let’s continue to trust Him! Let’s not give up now! † (Getz, 81) What an encouragement for the Israelites, having such a leader who motivated in the right way! 9. A Who knows well his People: When the time came to rebuild the wall of Jerusalem, Nehemiah appointed leaders in different areas; and they began the work. Looking at the work strategy, it is evident that Nehemiah knew his people’s ability, talents, and strengths. (Neh. 3) This is an extraordinary ability of Nehemiah. As a leader it is important to know well the people that we serve.This also tells us that Nehemiah was good in building relationship because it would not be possible to kn ow people well without knowing them well. 10. A Man who is ready to face Challenges: As rebuilding of the wall began there was opposition from enemies. Nehemiah was not afraid of them, and he was not discouraged. In the midst of challenges Nehemiah prayed to God and was ready to defend. (Neh. 4: 9) But that was not the end for him. It is important to pray, but it was not the only thing they needed. To have prayed only would have been presumption and to have watched only would have indicated a lack of faith. Campbell, 39) Nehemiah balanced it all, and he was ready for challenges that came along his way. 11. A Man who relies on God: When the Jews were opposed, Nehemiah turned to God and prayed to Him. Not only that, he directed his people to rely on God’s strength and readied to fight for the Lord. (Neh. 4: 14) Throughout the course of rebuilding the wall, opposition came. But Nehemiah always prayed to God which tells us that he always relied on God for God’s work. Foull ah says that, â€Å"as a godly leader, Nehemiah was dependent upon God from whom he received his personal support and encouragement, which motivated him enough to succeed. Foullah) What a leader, seeking God’s will and relying on God’s strength rather than self confidence! 12. A Man of Compassion and Justice: With the poverty situation among the Jews, there were richer people who did business with their fellow brothers. When the rich oppressed the poor in many unjust ways, there was an outcry of the poor against their own Jewish brethren, and Nehemiah acknowledged that. So, he assembled all his Jewish brethren and rebuked all those who treated others unjustly. (Neh. 5: 9) Nehemiah was bold to stand up for the poor and rebuke the sins of the rich because of his compassionate and just heart.His justice resulted in taking action against any sin immediately. Commenting on Nehemiah’s instant reaction with sin Kidner says, â€Å"Ever realistic, Nehemiah leaves no ro om for postponement or for second thoughts, and make sure that the promises are upgrade into oaths, properly sworn in the presence of the priests. † (Kidner, 97) Nehemiah was a leader who was impartial. He valued all people equally. 13. A Man of Generosity: Nehemiah not only spoke for the poor he also shared what he had with others. He fed one hundred and fifty Jews and rulers.Moreover there were others from the nations around them. So, Nehemiah prepared one ox and six sheep daily for them. Also, fowl, and once every ten days an abundance of all kinds of wine was prepared. (Neh. 5: 18) 14. A Man of Wisdom: When Nehemiah was invited by the enemy to meet in the house of the Lord to talk about business, Nehemiah sensed that he would be in trouble if he went there so he decided not to go. (Neh. 6) This is wisdom. Leaders should be sensitive of dangers and should deal with things carefully and wisely. That’s the wisdom Nehemiah had as a leader. 5. A Man who Respects others: Though Nehemiah was the governor of Judah and knew God’s Word, he had a high respect for Ezra the scribe and worked together with him. (Neh. 8: 1-9) Nehemiah did not ever rule his people as his property but allowed others to serve in different ways. Moreover, he also appointed many leaders in different ways. (Neh. 3) This makes it clear that Nehemiah highly respected others. This is a good attitude for leaders. 16. A Man who is bold for God: After Nehemiah returned from Jerusalem he found that Eliashib repared a room for Tobiah in the courts of the house of God. Nehemiah was angry and threw all the household goods of Tobiah out of the room and commanded the room to be cleansed. He also found out that the Levites had not been given their portions. So, Nehemiah gathered the leaders and commanded that portions for Levites should be brought to the house of the Lord. (Neh. 13: 1-13) Moreover, Nehemiah strongly forced the people to observe the Sabbath, and gave warning to those who broke the law. (Neh. 13: 21) He also contended with the Jews who married foreign women.Nehemiah cursed them, struck some of them, and pulled out their hair, and made them swear in God’s name that they should not allow their sons and daughters to intermarrying with foreigners. (Neh. 13: 25) It is evident that Nehemiah was bold for the things of the Lord. His actions would not be necessarily bad for that time period, in that culture and with the situations. If Nehemiah was bold enough to do that, it shows that he was right in doing what he did because no one was against what he did. As a leader, dealing with problems takes courage and Nehemiah did it successfully.Moreover, he cleansed every pagan thing and assigned duties to the priests and the Levites, each to his service. (Neh. 13: 30) 17. A Man with a Thankful Heart: After the wall was completed they dedicated it to the Lord. They celebrated the dedication with gladness, both with thanksgiving and singing. (Neh. 12: 27) Neh emiah brought the leaders of Judah up on the wall, and appointed two large thanksgiving choirs. (Neh. 12: 31) This shows that Nehemiah always remembered how he prayed to God from the very start, and now he came to God with a thankful heart because God allowed him to complete his project.The city was full of joy at the day of dedication. McIntire comments of Nehemiah’s joyful heart saying, â€Å"The fullness of the joy of Jerusalem is in the heart of Nehemiah, too. Speaking of the people upon the walls, he says, ‘So stood the two companies of them that gave thanks in the house of God, and I, and half of the rulers with me. ’ Jerusalem is a city of joy. Jerusalem is the city of the king. Jerusalem is the holy city. † (McIntire, 99-100) A godly leader will always remember God’s goodness and will worship God with a thankful heart. 18. A Man of Humility: In whatever he did Nehemiah did not seek fame or popularity.He did what he ought to do with humility. Talking about Nehemiah’s humility Maciariello says it well – Whatever his strengths or weaknesses of character, Nehemiah does not seek temporal rewards. Although, after completing the city wall, he leads remarkable religious and social reforms during his two terms as governor of Judah, his account ends with a simple request that God remember his deeds on behalf of the people: â€Å"Remember me, O my God, for good† (Neh 13:31). Nehemiah's behavior exemplifies the Christ-exalting characteristics of leadership enumerated in this article (sincerity, tenacity, mood, scope, realm, and rewards).His example endures as proof of the wisdom of godly principles of leadership and management. (Maciariello, 8) What can we Learn from Nehemiah The story of Nehemiah gives us an extraordinary example of a servant-leader motivated and acting for God's ends. It also provides an example of the use of godly means in the pursuit of excellence in leadership and management, and the focu s upon achieving positive results. Looking at the footsteps Nehemiah left for the generation to come is incredible. What a great model of leadership he was! Today in the Christian and secular world, there are great things that need taken care of.How are we going to begin the process? I believe the only way to begin is to turn our hearts to the Lord as a leader, and motivate others to do so. It is so evident from Nehemiah’s life that without God nothing is possible. Man’s strength is fallible and weak in itself, but God is infallible, mighty, and powerful. So, leaders should trust God in everything. That’s what Nehemiah did! The leadership qualities of Nehemiah mentioned above are important for leaders in communities, Churches, and any Christian organization. The only way to begin is to fear the Lord and submit ourselves to Him.If we honestly take God seriously, I believe the other leadership qualities will be evident in our lives. The problem with leaders today in the secular and Christian world is the lack of the fear of God. We fail time and time again because we try to do things by our own strength. The Psalmist says it well in Psalm 127:1, â€Å"Except the LORD build the house, they labour in vain that build it: except the LORD keep the city, the watchman waketh but in vain. † Let us remember that God is the source of every good thing, and to make the world better we have to turn to the Lord.Leaders should seek God first for wisdom and understanding in all they do. I believe there will be a difference in community, society, churches and any ministry if God is the first and foremost priority that every leader seeks as Nehemiah did. Bibliography Benware, Paul N. Survey of the Old Testament. Chicago, Il: Moody, 1993. Campbell, Donald K. Nehemiah Man in Charge. Wheaton, Il: Victor, 1979. Foullah, Leopold A. â€Å"The Characteristics of Good Leadership. † Ezine Articles. Web. . Getz, Gene A. Nehemiah A Man of Prayer and Persis tance. Ventura, CA: Regal, 1981.Jensen, Irving L. Ezra, Nehemiah, Esther. Chicago, Il: Moody, 1970. Kidner, Derek. Ezra, Nehemiah. Leicester, England: Inter-Varsity, 1979. Maciariello, Joseph. â€Å"Lessons in leadership and management from Nehemiah. † BNET, Oct. 2003. Web. . McGee, J. Vernon. Ezra, Nehemiah, Esther. Nashville. TN: Thomas Nelson, 1991. McIntire, Carl. The Wall of Jerusalem is Broken Down. Collingswood, NJ: Christian Beacon, 1954. Stewart, Paul A. Nehemiah the Involved Layman. Glendale, Ca: Gospel Light, 1974. Sueme, Richard H. Nehemiah God's Builder. Chicago, Il: Moody, 1978. Swindoll, Charles R.Hand Me Another Brick. Nashville, TN: W Group, 1998. Syme, George S. Ezra, Nehemiah, Esther. Denver, CO: Accent-B/P Publications, 1981. Walvoord, John F. , and Roy B. Zuck. The Bible Knowledge Commentary: The Old Testament, Colorado Springs, Colorado: Victor, 1983. Wiersbe, Warren W. The Bible Exposition Commentary: Ole Testament History (Joshua-Esther). Colorado Spri ngs, CO: Victor, 2003. Williamson, H. G. M. Israel In The Books of Chronicles. New York, NY: Cambridge UP, 1977. Knoblet, Jerry. Exile and Restoration. Bradley, WV: Appalachian Bible College, 2010.

Tuesday, October 22, 2019

Your Personal Writing Vision Statement What, Why, and How

Your Personal Writing Vision Statement What, Why, and How A personal vision statement for your writing career is a simple line that distills your values and ambitions into a practical mantra you can live and work Many of these are full of corporate speak, but the best are pithy and compelling. LinkedIns is to connect the worlds professionals to make them more productive and successful, while Kickstarters is simply to help bring creative projects to life. As a writer, you are a business, too. Your personal vision statement will help you decide what activities to focus on and where to spend your time and energy. Its a great guide at times of indecision or difficult choices. An example: My writing vision statement is simply: To earn a living as a full-time, family-first writer of humorous, engaging fiction novels and short stories.   Theres a lot packed into this for me. Im interested in a sustainable career, rather than fame and fortune. I dont write poems or scripts (for now anyway). Humour and emotion are my key ingredients. But I dont want any of this at the expense of my family. Using your statement A simple statement like this is that it can give you a reason to say No to things as well as Yes. Should I take on that freelance opportunity? No, because although it might make me some money, its not in my area and will eat into my time for creative writing. Should I go for a run? Yes, because staying fit and healthy has a positive impact on productivity. Should I enter that comp? No, because the prize is a week in a writers retreat in Mexico and that wont work for me, family-wise. Shall I submit a flash to that magazine? No, because flash isnt my target genre. Should I stop writing and make my sons breakfast, even though I got up early specially to write and he shouldnt be up for another hour?! Yes, because family comes first. Developing your mission statement Heres my suggestion for how to develop yours: 1.      Jot down your perfect writing future. Is it about awards or critical kudos? Is it about a sustainable income or writing a bestseller? Do you have an idea of your ideal workspace, or how much you want to make each month? 2.      Ask: What do I want to stop doing? Do you want to give up your day job? Do you want to be able to turn down certain kinds of work? 3.      Ask: What do I want to do more of? Are you a natural world-builder or a cozy mystery type? If nonfiction, what sort of topics do you love writing about? Is there a particular book or genre you want to be writing? Where would your books sit in a bookshop? 4.      Ask: What effect do I want to have on readers? Do you want them to escape from everything for a while or make them think about society? Putting it all together Now boil it down to a powerful sentence you can remember. Dont include every detail – this statement is just for you, remember, so you dont have to spell everything out. In my statement, family-first is shorthand for a lot of my personal values, for example. Print your statement, stick it over your computer, and use it to help you stay on track. And as you get closer to your goal, be ready to update it to reflect the next stage of your journey. If you have a statement to share, wed love to hear itHope will post some of them next week.

Monday, October 21, 2019


Gavroche GavrocheGavroche might no be the protagonist of this novel, but nevertheless, his presence through the plot is essential for many reasons.At the begging when we meet Gavroche it appears to the reader that he is just a simple character who would not have much transcendence in the novel, the only thing that he was suppose to do was to tell Marius where Cosette lived.The novel continues and Gavroche reappears in the novel with a more important role in the plot. Gavroche is shown as a little boy who fights alone to survive because he has no family, he lives in a monument in a shape of an elephant and sometimes he has to steal things to sell them so he has something to eat.Poor is a characteristic of this character but he is poor only in the aspects money because he a person who has a big heart who is always willing to give away what he has to others.Gavroche

Sunday, October 20, 2019

French News Vocabulary

French News Vocabulary The French you learn in classes and grammar books is not always enough when dealing with the real world. This list of French vocabulary related to current events will help you understand news in French. la une  - on the front page les achats de prà ©caution  -  panic buying lactualità ©, les actualità ©s  -  news affolà © (adj)  -  panic-stricken allà ©guà © (adj)  -  alleged un appel  -  appeal, call une arme  -  weapon, gun une arme blanche -  knife les armes de destruction massive -  weapons of mass destruction assassiner  -  to murder un attentat  -  attack un attentat-suicide  -  suicide bombing lavortement  -  abortion la banlieue  -  suburb un bilan  -  appraisal, assessment, death toll blessà © (adj)  -  injured, wounded une bombe  -  bomb la canicule  -  heat wave un cas de force majeure​  -  disaster (natural or man-made) les Casques bleus  -  UN peacekeeping forces un casseur  -  rioter une catastrophe aà ©rienne  -  air disaster une catastrophe à ©cologique  -  environmental disaster une catastrophe naturelle  -  natural disaster un cessez-le-feu  -  cease-fire le chà ´mage  -  unemployment un collecte au profit des sinistrà ©s  -  disaster fund un coup dEtat  -  coup detat, overthrow une coupure de courant  -  power outage le crime  -  crime un criminel, une criminelle  -  criminal une crise  -  crisis un cyclone  -  cyclone, hurricane des dà ©gà ¢ts  -  damage le deuil  -  bereavement, mourning un dà ©sastre financier  -  financial disaster un dà ©sastre politique  -  political disaster les drogues (fem)  -  drugs un à ©boulement  -  rockslide une à ©lection  -  election une à ©meute  -  riot une enquà ªte  -  investigation une à ©pidà ©mie  -  epidemic extrader  -  to extradite un feu  -  fire un flic (informal)  -  cop la garde vue  - police custody à ªtre mis/placà © en garde vue  - to be kept in custody, held for questioning le gaz lacrymogà ¨ne  - tear gas un glissement de terrain  - landslide une grà ¨ve (faire la grà ¨ve)  -  strike (to be on strike) la guerre  -  war la grippe aviaire  -  bird flu la grippe porcine  -  swine flu hexagonal  -  French lHexagone  - France un immigrant, un immigrà ©Ã‚  -  immigrant les impà ´ts (masc)  -  tax es un incendie  - fire une inondation  - flood inonder  - to flood un insurgà ©Ã‚  -  insurgent des intempà ©ries  -  bad weather IVG  - abortion​ le kamikaze  - suicide bomber la loi  - law la lutte (literal/figurative) - struggle, fight une manifestation  - demonstration le meurtre  - murder la mondialisation  - globalization une navette spatiale  - space shuttle un obus  - explosive shell opà ©ration escargot  - rolling blockade un ouragan  - hurricane une panne dà ©lectricità ©Ã‚  - blackout, power cut la peine de mort  - death penalty la pà ©nurie  - shortage, lack la police  - police un policier  - police officer la politique  -  politics, policy le politique  -  politician poursuivre en justice  -  to sue le pouvoir dachat  -  buying power prà ©sumà © (adj)  -  alleged un procà ¨s  -  trial le rechauffement de la planà ¨te  -  global warming la rà ©gion sinistrà ©e  - disaster area une rà ©plique  - after-shock, counter-attack la retraite  - retirement un scrutin  - ballot, election un sà ©isme  - earthquake, upheaval selon (prep) - according to un sinistrà ©, une sinistrà ©e  - disaster victim un soldat  - soldier un sondage  - po ll le suicide assistà ©Ã‚  - assisted suicide un syndicat  - union le systà ¨me de santà © publique  -  health care system un tà ©moin  -  witness une tempà ªte  -  storm le terrorisme  -  terrorism tirer (sur)  -  to shoot (at) les titres  - headlines, headline news une tornade  - tornado les transports en commun  - public transit un tremblement de terre  - earthquake une trà ªve  - truce tuer  - to kill un vaccin  - vaccine une victime  - victim (Note that this word is always feminine, even when referring to a man) voter  - to vote

Saturday, October 19, 2019

Labour Relations in Canada in relation to hospitality industry(It can Term Paper

Labour Relations in Canada in relation to hospitality industry(It can be any topic of interest in relation to this.) - Term Paper Example cation between workers and managers, inform managers of potential trouble, provide an outlet for complaints, and avoid slowdowns, absenteeism, strikes and damages.† Here we take a look at why grievance procedures are important in improving labor relations. The ILO states that grievance procedures help solve a variety of issues that are likely to crop up in any work environment some of which are explained as follows (â€Å"Good Practice Guide†). Many a times, problems in the work place occur when the terms and conditions of employment which were guaranteed to the employees at the time of hiring are not implemented correctly by the management. Grievance procedures help to give employees the necessary motivation and support to continue in their work place without feeling betrayed by their employer. It gives them a sense of job security and an ability to understand what they rightly deserve. It also helps them to seek legal counsel or aid in the circumstances where their terms of contract have been compromised or violated in any unfavorable way. Lack of proper health and safety measures is another major concern for employees in an industry. In some cases, workers are subjected to risky and dangerous conditions and sadly many of them are unaware of the potential hazard to their personal health and well being. However, the presence of effective grievance procedures makes sure that employees can ask for compensation in the occurrence of any form of occupational harm or injury. Sometimes, changes in policies or in the organizational structure can cause a disturbance in the flow of activities for a regular employee. In some cases, employees are not notified of crucial changes in policies which consequently lead them through the wrong path. It is the right of any employee to know of significant changes or alterations in the policies, procedures and organizational structure of the company where he / she belongs if such changes are intended to have significant direct or

Friday, October 18, 2019

Fabrication in architectural design process Thesis Proposal

Fabrication in architectural design process - Thesis Proposal Example If a 3d printing or other fabrication method is employed, then there is the need to convert into a particular file for the sake of digital models. Digital fabrication tools are very essential in architecture because of attainable mitigation of the building costs. Free form shaped design in the design stage for countless unique components need some rationalization of the structural constituents so that they are materialized into buildings. In post-rationalization period, the structural system has been assigned to the already polished designs that at times need compromising final form of design (Laseau, P, 1980). The egg shaped form had to be reshaped with the use of Planar Quadrilateral Strips for it to meet the criteria for fabrication. While the relationship between design objects and the fabrication parameters has been explored previously, their independent was quite limited to integration of manufacturing constraints into developing a form, as it is the case of co-rationalized and pre-rationalization design approaches. In consideration of the application of a particular digital fabrication method, this paper proposes a research to be conducted to investigate the design-fabrication relation, approaching it from a different angle. This is in an attempt to respond to the question inquiring how the manufacturing parameters are integrated in the design process in facilitating the design-to-production communications. Design rationalization parameters, in this respect, are the driving force of any design in a generative procedure having imbedded fabrication. Digitally driven Architectures has significantly influenced the modernist architecture, as well as contemporary architecture (Malcolm, M, William, J, & Patrick, P, 1990). The influence of digital media, as well as Information Technology on the architectural education

Quality and Process Improvment Essay Example | Topics and Well Written Essays - 750 words

Quality and Process Improvment - Essay Example These three processes of quality and process improvement are interdependent and, hence, to be successful in our improvement process, we have to undertake all the three processes. As for quality and process improvement, I have learned how re-engineering of business processes can assist in achieve substantial improvement in business performance. This process involves rethinking and radical redesigning of business processes. Using this knowledge, I can redesign the business processes of my father’s small appliance repair company to enhance its performance. The knowledge I have obtained could help me in putting into consideration various critical measures of business performance like operational cost, reliability of services, and the speed of the processes during the re-engineering process. This could enhance the success of the process and thus making me a successful business manager. The knowledge I have obtained about quality and process improvement can help me to be able to ref ine various elements of the processes during the re-engineering process. Some of the elements of the processes that require refining during the re-engineering process are jobs and tasks undertaken by different individuals in the business. Preference constraints that determine what to be done first and what to follow and the flow management protocol also need refining. By refining these elements, I could increase the chances of obtaining the dramatic change that I will be seeking to obtain through the re-engineering process. I have also learned the importance of incorporating information technology during the process of quality and process improvement. One of the advantages of incorporating information technology in this process is that it can help in increasing the efficiency of various elements of the business processes. Moreover, introducing this technology can increase chances of obtaining more accurate performance measures, thus, enhancing the process of re-engineering. It can a lso enhance the process of evaluating the re-engineering process. With all these knowledge about the importance of information technology in promoting quality and process improvement in the business, I could select the appropriate information technology to apply. This will enhance the quality of services it provides, as well as improving its processes of business. Another thing that I have learned that will be very important in my career as a business manager is the importance of having a comprehensive trouble-shooting catalogue. This could give an inexperienced person in business an idea on the services provided, the time they can take, and their costs implications. The customers would, thus, get the required information without consulting the person who has specialized in proving those services. In return, the turnaround time on service delivery will reduce, thus, resulting in more customer satisfaction and, hence, customer loyalty. Using this knowledge, I would design a trouble-s hooting catalogue for my father’s small appliance repair company, thus, improving how it serves its customers in order to increase customer satisfaction. During my learning on quality and process improvement, I have come to understand the importance of inculcating the process of monitoring and evaluation in the business structure. This could help in revealing the places in which the business is

Thursday, October 17, 2019

How do the Bankers Bonuses Affect the Investment Behaviour Research Paper

How do the Bankers Bonuses Affect the Investment Behaviour - Research Paper Example The concerns and the perception have changes and numerous controversial ideas have changed the bankers’ bonuses ideologies significantly. Therefore, the research aims at identifying and analyzing the effects of bankers’ bonuses to the banking investment especially in relation to the performance of the banks. The main aim of the bonus banking is to balance long-term and short-term value creation and satisfying accountability of the stakeholders with the intent of attracting, retaining, and motivation talent. However, what is the underlying reality of this motivational system The research shall answer this concern by seeking the  response to the following question: In the journal, Banker’s pay structure and Risk, John Thanassoulis addresses the contrasting problems facing the banks and bankers. According to Thanassoulis, these contrasting banking problems are embedded in the competitive labor market where the banks are seeking best talents. Additionally, Thanassoulis notes that banks often use various motivation efforts that vary with the remuneration. However, the introduction of the remunerations motivations makes banks risk shifting problems by creating incentives that will only inflate the early earnings of the managers. In most cases, the management of some bonuses is of deferred optimally. Thanassoulis further notes that

Amicus (Friend of the Court) (3rd party) Brief for specified current Research Paper

Amicus (Friend of the Court) (3rd party) Brief for specified current Suprem Court case - Research Paper Example Human Rights Watch also has a role of investigating and exposing incidences of human rights abuse abuses and violation, with an aim of putting the abuses to the task of being accountable. The organization also seeks to challenge the government and other bodies or people who hold powers to observe human rights and to end human rights abuses, particularly with reference to international human rights standards as well as that of the municipal laws. As a leading human rights body, with the aforesaid specific roles, which are highly tangential to the issues of justice , the organization has a legitimate interest to participate in the case and to present an Amicus brief for the same. The organization has a lot of interest in ensuring that justice is done to the defendant. It is the Human Rights Watch that this honorable court safeguards future systematic human rights abuses by the state, and in particular the police, against the citizens. It is the interest of the organization that the pol ice and all government organs concerned are held accountable for human rights abuses that they perpetrate. ... Incarcerated on a disorderly conduct charge, the deputies were hoping to learn more about Fields' relationship with an underage male. Fields was not given his Miranda warnings, but was told he could leave the conference room where the questioning took place at any time. During the 7 hour questioning, Fields repeatedly told the deputies that he did not want to talk about the allegations of sexual misconduct that they had leveled against him. Eventually, however, he did admit to some of the behavior that had been alleged. On the basis of that information, and over the strenuous objection of his counsel, Fields was later convicted of two counts of third-degree criminal conduct and sentenced to a term of 10-15 years.   Fields appealed claiming that when he was first removed from his cell to go to the conference room, he was given no notice of what the deputies wanted. Further, because they had not Mirandized him and continued to question him even after he told them he did not want to s peak to them, the incriminating statements should be thrown out. Throughout his appeals in the state judicial system, his arguments were denied.   Upon making a habeus corpus motion to the U.S. District Court for the Eastern District of Michigan, however, Fields' contention that his rights had been violated was upheld. The Sixth Circuit Court affirmed that lower court ruling which contrasted with decisions made in similar cases in other federal courts. The split in the circuits virtually guaranteed that the Supreme Court would take the case. On January 24, 2011, the Supreme Court granted certiorari.   The present case presents a question as to what amounts to being in custody and in particular whether or not a prisoner is always â€Å"in

Wednesday, October 16, 2019

How do the Bankers Bonuses Affect the Investment Behaviour Research Paper

How do the Bankers Bonuses Affect the Investment Behaviour - Research Paper Example The concerns and the perception have changes and numerous controversial ideas have changed the bankers’ bonuses ideologies significantly. Therefore, the research aims at identifying and analyzing the effects of bankers’ bonuses to the banking investment especially in relation to the performance of the banks. The main aim of the bonus banking is to balance long-term and short-term value creation and satisfying accountability of the stakeholders with the intent of attracting, retaining, and motivation talent. However, what is the underlying reality of this motivational system The research shall answer this concern by seeking the  response to the following question: In the journal, Banker’s pay structure and Risk, John Thanassoulis addresses the contrasting problems facing the banks and bankers. According to Thanassoulis, these contrasting banking problems are embedded in the competitive labor market where the banks are seeking best talents. Additionally, Thanassoulis notes that banks often use various motivation efforts that vary with the remuneration. However, the introduction of the remunerations motivations makes banks risk shifting problems by creating incentives that will only inflate the early earnings of the managers. In most cases, the management of some bonuses is of deferred optimally. Thanassoulis further notes that

Tuesday, October 15, 2019

Social Learning Theory and Role Model Essay Example | Topics and Well Written Essays - 2250 words

Social Learning Theory and Role Model - Essay Example The outcome of the experiment was that children imitated what was done on the doll (hitting, punching, shouting at it) without waiting first for any reward approximated to the person in the experiment initially hitting it. This is where social learning theory was derived, which is an observational learning or modeling (ibid). Social learning suggests that both the environment and psychological factors create a kind of behavior, which an individual acts upon. It outlines four steps, which are involved in the modeling process: attention, retention, reproduction, and motivation. With the social learning theory, Bandura goes on to say that individuals, especially children, learn and act according to what they see in the environment, which are basically based on imitation. They act what they see and are socialized within that system, which pursues such behavior. It is then significant to point out that since children imitate values, actions, and social behavior modeled to them, it is then better that these actions and values are good and correct in order for them to act as good and valuable social beings. Even though Bandura claims that an individual learns behavior from his environment coupled with some psychological factors that trigger such behavior, a particular behavior does not always result in remodeling. This is due to the presence of punishments, which could be past, promised (e.g. threats), or vicarious (Boeree 1998). The social learning theory has a continuous reciprocal interaction among behavioral, cognitive, a and environmental influences. It has extensively been applied to understanding aggressive behaviors and how an individual may be influenced to trail the path of aggression. It also received a fair degree of attention on psychological disorder, specifically on the context of behavior modification (Bandura 1969). Television commercials and computer games are few of the most

Monday, October 14, 2019

Skellig Film Analysis Essay Example for Free

Skellig Film Analysis Essay 1) At first sight, Skellig does not want Michael’s friendship and wants to be left alone. Directly Skellig says ‘You again? Thought you’d gone away’. This implies that he never wanted to see Michael there and is hoping, through the conversation, for him to leave ask quickly as possible. I strongly believe that Skellig does not want anyone visiting him and that he wants to be left isolated. 2) The reader suggests to us that there is a relationship between Michael and Skellig because Skellig is like an angel and Michael’s sister is like an angel too. Skellig says â€Å"They say that shoulder blades are where your wings were, when you were an angel, she said. They say theyre where your wings will grow again one day.† This shows that Skellig knows about Michael’s sister. 3) At the end Skellig is getting stronger. He was playing football with other people and was more active, before he wanted to be very lonely and isolated. He would be in his own world. 4) The author suggests that Skellig is not a normal person, when Skellig could not stop drinking 27 and 53. Skellig says â€Å"More 27 and 53 †¦ Ah the food of the gods.† This suggests that he is not normal because he is drinking too much stuff he should not be. 5) We first realised that Skellig might save Michael’s baby sister when he went over to the hospital and saw her wings. This shows that he tried his best to save her by taking off her wings and healing her back. This made Michael’s sister ready for the operation. 6) 27 and 53 have a big effect on Skellig, they make him feel more relaxed but energetic, and he is able to visit other places, when he drinks it. Like when he went to the hospital to save Michael’s sister. He ate 27 and 53 before going then saved her.

Sunday, October 13, 2019

Skills Required in Phlebotomy

Skills Required in Phlebotomy Objectives To acquire the knowledge and skills to perform phlebotomy and finger prick. To learn the order of draw and its significance. To learn various devices and preparation techniques before phlebotomy. Introduction Phlebotomy is referred to the cutting of a vein. It is a procedure often involving invasion that invades the body through cutting or puncture normally carried out by professionals called phlebotomists. Among the major roles involving a phlebotomist is to obtain blood specimens for diagnostic testing. This can be done either by dermal puncture which is done by puncturing the skin or venepuncture which is done by puncturing the veins. Other than that, a phlebotomist is also responsible in redrawing blood from donors during blood transfusion of from any patients having polycythemia which is known for overproduction of blood cells. Phlebotomist are also responsible for collecting and properly packaging urine specimens, accepting incoming specimens (blood and body fluids, etc.), and routing specimens to the proper departments to be tested and analysed. In order for a phlebotomist to withdraw blood from a patient, he should make sure that the tubes are labelled and all the materials are pr epared before carrying out the procedure. The best sites for venipunture are normally the superficial veins of the upper limbs. The superficial vein most commonly used for venipuncture is the median Cubital Vein which lies over the cubital fossa and serves as an anastomosis between the basilica veins and the cephalic veins. The next most common vein is the cephalic vein where it can be followed proximally where it empties into the axillary vein. The basilic vein is also a location for venipunture as it divides to join the brachial vein. The usual sites for capillary puncture or finer prick in adults and children are the fingertip. In adults, the ring finger is often selected because it usually is not calloused. Capillary blood can be obtained from the great toe in infants and babies. In new-borns, the lateral or side portion of the end of the heel pas is used. The BD Discussion Among the inappropriate sites for venipuncture are the site affected by a mastectomy. This is because mastectomy causes lymphostasis which means stoppage of lymph flow where the bodys ability to fight infection is compromised if lymph nodes are removed therefore patients are more prone to infections. Edematous sites, an abnormal accumulation of fluid on the intracellular space of the tissue must also be avoided as it can cause difficulty in palpating the veins due to the excess fluid. The specimen can also be contaminated with the fluid. Venipuncture performed at sites of scars and burns are also inappropriate as it causes unusual pain for the patients. This is caused by the veins that are very difficult to palpate and also susceptible to infections as the protective barrier (epidermal layer) has been disrupted. Other than that, patients who have IV running in their arm should not be used for venepuncture as it may be a contaminant to the blood collected. Lastly, dermal punctures mus t never be performed on the fingers of a new-born or very young infant. This is because there is very little distance between the skin and the bone. Therefore, the bone could be easily pierced during the puncture, causing injury to the bone, infection, or gangrene. The order of draw is as follows, Blood Cultures Coagulation Tube (light blue top) Plain red AND/OR Serum Separator Tube (red gel/SST) Heparin Tube (green top) Plain Sodium Heparin Plain Lithium Heparin Lithium Heparin Gel EDTA Tube (purple and pink top) Fluoride/ Oxalate Tube (grey top) Miscellaneous tubes (these are drawn in no specific order) Heavy metal dark blue top (EDTA and plain red) b. ACD yellow top The purpose of the order of draw is to avoid possible test result error due to cross contamination from tube additives. Potassium results can be falsely elevated as EDTA is rich in potassium. Therefore test for potassium must be collected before tubes containing EDTA. Other than that, the microscopic appearance of the red blood cells on a WBC differential test will be distorted due to the additives in the Fluoride/ Oxalate tube as oxalate interferes the red blood cell membrane and fluoride alter its morphology. Moreover, coagulation tests such as Activated partial thromboplastic time (aPTT) and prothrombin (PT) can be affected with the presence of clot activators by shortened test results. Bacteria from non-sterile tube stoppers/shields can contaminate blood collected into bottles/tubes used for blood cultures, resulting in the growth of bacteria erroneously leading a physician to think his/her patient has a blood infection. A hematoma is a collection of blood beneath the skin. Hematomas are the most common adverse reaction to venipuncture. Precautions that can be taken to prevent hematoma in phlebotomy are by puncturing only the uppermost wall of the vein. Other than that, the phlebotomist can also remove the tourniquet before removing the needle. The needle should fully penetrate the upper-most wall of the vein as partial penetration may allow blood to leak into the tissue surrounding the vein. Lastly, adequate pressure should be applied to stop the bleeding once the phlebotomy is complete. Haemolysed blood specimens are not be acceptable for testing. Hemolysis occurs when the red cells rupture and haemoglobin and other intracellular components spill into the serum. Hemolyzed serum or plasma is pink or red, rather than the normal clear straw or pale yellow colour. Steps that can prevent haemolysis are by mixing tubes gently or about 5 – 10 times after collection. The tubes should not be shaken too vigorously and drawing blood should be performed on hematoma individuals. Other than that, when using a needle or syringe, avoid drawing back the plunger to forcefully. Moreover, if a blood transfer device is used to fill vacutainer tubes, always allow the vacuum to pull the blood into the tubes. Do not use he plunger or syringe to force the blood into the tubes quickly. References Akron Childrens Hospital, 2015, Lab Test Procedure : Performing A Venipuncture. [Online]. Available at : [ Accessed 29/01/2015]. Johnson. L, 2013, National Center for Competency Testing : Phlebotomy order of draw, [Online]. Available at : [Accessed 29/01/2015]. MediaLab incorporated, 2015, Hematoma, [Online]. Available at :, [ Accessed 29/01/2015]. Turgeon., M,. L, 2005, Clinical Hematology: Theory and Procedures, Volume 936, [Online], Available at : , [Accessed 29/01/2015]

Saturday, October 12, 2019

Calorimeters :: Papers

Calorimeters This is a investigation into how heat transfer is effected when different variables are changed, when boiling water is in a colorimeter. Variables These are the variables which are available for me to change: 1. Different insulators e.g. Foam or Cotton Wool, Polystyrene. 2. The temperature of the water at the start of the experiment. 3. Whether or not the calorimeter has a lid on or not. 4. Different conductors e.g. Copper, Wood, other metals. 5. The amount/Volume of water. Prediction These are my predictions for each variable: 1. Different insulators work better than others. Different insulators will have different effects, because of what they are made of, if the material is a metal, it will conduct the heat, a non-metal will insulate the heat, some better then others. 2. If the starting temperature is higher, then I predict it will be higher at the end too, because the energy lasts longer in the hotter water. 3. If the lid isn't on more heat will be lost, because the heat will rise. 4. Different conductors have different effects too. Some conductors conduct the heat quicker than others. e.g. Copper will transfer the heat quicker than wood. 5. If there is less water there would be a smaller surface area to volume ratio so less water will transfer less heat, and more will enhance the transfer Planning I will investigate different amounts of water and different insulators. I will use these different quantity's of water: à ¢Ã¢â€š ¬Ã‚ ¢ 20cm cubed à ¢Ã¢â€š ¬Ã‚ ¢ 40cm cubed à ¢Ã¢â€š ¬Ã‚ ¢ 60cm cubed à ¢Ã¢â€š ¬Ã‚ ¢ 80cm cubed à ¢Ã¢â€š ¬Ã‚ ¢ 100cm cubed ( I will also change the insulator on this one) Equipment Used I will use the following equipment: à ¢Ã¢â€š ¬Ã‚ ¢ Calorimeter. à ¢Ã¢â€š ¬Ã‚ ¢ Kettle. à ¢Ã¢â€š ¬Ã‚ ¢ Thermometer. à ¢Ã¢â€š ¬Ã‚ ¢ Measuring Cylinder à ¢Ã¢â€š ¬Ã‚ ¢ Insulators (Available insulators e.g. Foam). à ¢Ã¢â€š ¬Ã‚ ¢ Stopwatch. Method I will measure the five different amounts of water and poor them into

Friday, October 11, 2019

Permanent Change In An Individuals Knowledge Or Behaviour

Learning can be ocular, kinesthetic, musical, interpersonal, intrapersonal, lingual, logical, realistic, religious and moral, and, consequentially, scholars have really differing degrees of intelligence in these different sorts of larning. It is per se of import for instructors to hold a on the job cognition of how different pupils learn because of this fact that non all pupils learn in the same manner. An educators occupation is to ease acquisition for a pupil, and hence must be adaptable to these assorted acquisition manners in order to adequately supply for them, and this can non be done without an apprehension of different larning theories and manners. A pupil who is kinesthetic or visually intelligent is non traveling to profit from certain manners of learning every bit much as a pupil who is a logical scholar, presuming the pedagogue is merely learning in a logical manner. Therefore it is necessary for pedagogues to understand the differing sorts of larning so that they can pro vide for multiple intelligences within their lessons, both by admiting their being and leting pupils the chance to larn in different ways every bit good as developing pupils abilities to interact with intelligences that they might otherwise be non as accustomed to. Equally good as different intelligences there are different worldviews on how learning occurs, whether it is inactive or active, whether it is societal or personal, and these theories straight affect the teaching method embraced by the instructor keeping them. Therefore the acquisition theories will needfully order the types of intelligences most supported by the acquisition that is taking topographic point, and it is up to the pedagogue to understand these learning theories so that they may use them in a manner to outdo explore all of the multiple intelligences and give their pupils the best opportunity of making a higher order apprehension of any capable affair. Behaviourism is a theory that operates upon an ‘action-reaction ‘ or ‘stimulus-response ‘ construct of larning. At its kernel this worldview places the scholar in the place of being a ‘blank slate ‘ , an empty vas or ‘tabula rasa ‘ , which is so filled with the coveted cognition or acquisition. Behaviourism assumes that the scholar is inactive and that they respond to any and all environmental stimulations that they are exposed to. The environment acts on the scholar, non the scholar on the environment. Behaviorism can be broken down into two possible signifiers of conditioning: classical conditioning and operant conditioning, the late of which was founded by B. F. Skinner and is one of the most outstanding larning theory places. Skinner ‘s operant conditioning position is non-dualistic, it denies that the head is a separate thing to the organic structure, alternatively situating ideas to be private behaviors, analysable in the same manner that public behaviors are. Essentially learners learn to ‘operate ‘ on the environment. Functionally, operant conditioning plants on a footing of support and penalty. Reinforcement is a procedure by which a targeted behavior is caused to happen with greater frequence and penalty a lesser frequence. Both these effects have positive and negative fluctuations, by positive and negative we refer to their linear or subtractive qualities, non their moral deductions. Positive support is when a rewarding stimulation is to happen following a desirable behavior, therefore increasing its frequence. Negative support occurs when an unwanted stimulation is removed after a desirable behavior, besides increasing its frequence. Positive penalty is the happening of a penalty or negative stimulation following an unwanted behavior, diminishing its likelihood, while negative penalty is the remotion of a positive or honoring stimulation following a unsought behavior, besides diminishing the opportunity of reoccurrence. In contrast to behaviorism, constructivism positions the scholar as an active participant in the acquisition procedure. The scholar is an â€Å" information builder †[ 3 ], one of the basic premises behind constructivism is that â€Å" people are active scholars and must build cognition for themselves. †[ 4 ]This base premise is that the scholar is a â€Å" alone person with alone demands and backgrounds. †[ 5 ] Learning is a constructive, contextualized and active procedure by which the scholar is engaged in actively making a subjective reading of an otherwise nonsubjective world. One of the cardinal differences between constructivism and behaviorism is that the scholar is seen as conveying past experience and cognition to the acquisition, and that it is this past experience that is the specifying factor in the defining and constructing of new cognition. This construct at work postulates that people generate their appreciation on cognition through an interaction between their thoughts and experiences. Furthermore the scholar acts upon the environment, interacting with it to make significance, instead so being acted upon. Constructivism, nevertheless, is non a incorporate theory. Under the streamer of constructivism subsists three chief positions dubbed the exogenic position, the endogenous position and the dialectical position. An exogenic constructivism â€Å" position posits a strong influence of the external universe on cognition building, such as by experiences, instruction, and exposure to theoretical accounts. Knowledge is accurate to the extent it reflects that world. †[ 6 ]On the other manus, endogenous constructivism provinces that cognition is derived from earlier mental constructions and focal points on a coordination of â€Å" cognitive actions †[ 7 ], while dialectical constructivism is a blend of the two, situating that cognition is non wholly construed from the external universe, nor is it entirely of the head but instead is the consequence of interactions between the scholar and the environment. – Schunk, Dale H. ( 2008 ) Constructivist Theory ( Chapter 6 ) . In Learning Theories: An Educational Perspective. 5th Edition. ( pp.234-277 ) . Upper Saddle River, New Jersey: Pearson, Merrill Prentice Hall. ISBN 9780132435659 pg 239 A behaviorist schoolroom places the scholar in a inactive function, as earlier mentioned, they are ‘tabula rasa ‘[ 8 ]. As a consequence the pedagogue is positioned in an active function, basically ‘acting ‘ on the scholar to instil cognition. This can take to a schoolroom where the scholar is non needfully encouraged to prosecute with the cognition presented to them, but instead to basically digest it, taking the cognition in to regurgitate ‘as is ‘ when needed. There is nil incorrect with this type of acquisition, so for certain topics and certain countries of topics it is arguably the most efficient signifier of acquisition. However a failing nowadays within the behaviorist theory is that it does non let the scholar to come on much further so the ‘applying ‘ phase in the new blooms taxonomy. It may be wrong to state that it does non ‘allow ‘ , but it surely does non promote the scholar to come on farther into the analysin g, measuring and making phases of the theoretical account without proper motion into determining the scholars behaviour. Even though they may acquire their ain their ain, the attack does non supply scaffolding to back up the scholar to these more advanced interactions with the cognition. This is because the scholar is non forced to prosecute with the cognition in an active manner, they do non hold to do it their ain, alternatively expected to be able to retrace what the instructor has presented to them, demoing an ability to retrieve and reproduce, but non needfully to grok on a meaningful degree. On the other manus a constructivist attack efforts to guarantee that the scholar interacts on a degree that allows them to prosecute in making from the footing of the cognition conveyed, hence promoting higher order thought. However In a behaviorist schoolroom the instructor will be actively seeking to place behavior to be changed, and, one time identified, they will be after specific intercessions to change that behavior in a coveted manner utilizing ancestors and effects. The instructor invariably accumulates informations on the consequences of these intercessions and modifies their attack to more efficaciously ‘shape ‘ the pupils behaviour. Praise, although contingent upon the behavior of the pupil, will strategically and often be given out to reenforce coveted behaviors. Each lesson will hold clear and precises ends in footings of cognition, attitudes and accomplishments to be transferred to the pupils, and cues and prompts will be utilized in order to put up behavioral forms and determine the pupils into the coveted acquisition form. This would so be scheduled with uninterrupted regular support to get down with, followed by more intermittent and sporadic support to ease the pupil into ego regula ted acquisition. This defining is necessary because a rigorous behaviorist attack is merely utile for a short period of clip, determining is required to foster the pupils larning. In an English schoolroom it would be expected that the instructor would be actively reenforcing the battle of pupils in category treatment with prima and directed oppugning accompanied with congratulations for engagement. The teacher*/*** As a instructor it is of import to gain that behaviorism does work, it is a important portion of any instruction and has a really effectual and functional intent but that it is non all of the image. As with the demand to be various in learning to cover the multiple intelligences, so excessively do we hold to be various in the theories we use in our pattern. While behaviorism is a really of import tool we can utilize, and basically covers a big part of the behaviour direction and positive forms we can put in the category, we still need constructivism in order to ease * Piaget posited four phases that all human existences go through in the procedure of ripening. The sensorimotor phase is that phase â€Å" from birth to age 2. Children experience the universe through motion and senses ( utilize five senses to research the universe ) † -Santrock, John W.. Children. 9. New York, NY: McGraw-Hill, 1998. The preoperational phase consists of kids from ages two to seven and consists of egoism and begins to see the universe symbolically, so the kids begin to believe logically and travel into the concrete operational phase between ages seven and twelve and eventually from age 12 onwards reach the formal operation phase and develop abstract logical thinking. â€Å" the fact that many of the voluntary responses of animate beings and worlds are strengthened when they are reinforced ( followed by a desirable effect ) and weakened when they are either neglected or punished. † â€Å" †¦ organisms learn new behaviors and when to exhibit them and E »unlearnE? bing behaviors. † â€Å" †¦ all behaviors are accompanied by certain effects, and these effects strongly influence whether these behaviors are repeated and at what degree of strength. † â€Å" Positive interactions between instructor and pupils can bring forth successful acquisition results in the presence of complex kineticss of individuals, conditions and results. † Snowman et Al. ( 2009 ) . Chapter 7. â€Å" Behavioural Learning Theory: Operant Conditioning † . In Psychology Applied to Teaching. 1st Australian Edition. Milton, QLD: John Wiley & A ; Sons Australia Ltd. Bibliography

Thursday, October 10, 2019


Maslow’s Hierarchy of Needs by Bob Poston, cst An Exercise in Personal Exploration: Maslow’s Hierarchy of needs is a valuable assessment tool that is used in many different professions, particularly those in the fields of education and health care. the ideas of needs are addressed in order, as the body resolves the most basic needs for survival before moving on to more complex needs. M ny educational programs in the health care field teach Maslow’s hierarchy in order to address the needs of patients and where they are in their life from a psychological perspective, simply because it helps identify and address the needs of those particular patients. The idea of using a hierarchy pyramid helps us to lay out the stages of need, starting with the base of the pyramid, which looks at physiological needs. As we work our way up the pyramid, the needs start to become more complex, and include safety needs, social needs, esteem needs, and finally, at the very top, we have self-actualization.This article explores the theories of Abraham Maslow in detail, as well as addresses the controversies that have been questioned in his theory. This article will also evaluate the impact of these theories on human behavior and assess each of the components comprised within Maslow’s Hierarchy Pyramid. learning OBJec tives s identify the different levels of Maslow’s Hierarchy of needs s Compare and contrast the differences between being needs and deficit needs s explain the process of selfactualization s examine how Maslow’s Hierarchy of needs impacts patient careBiographical outline Born on April 1, 1908, in Brooklyn, New York, Abraham Maslow was the first of seven children. 1 The son of under-educated Jewish immigrants, Maslow didn’t have many friends as a young s Consider the challenges to Maslow’s theories and formulate a response  © 2009 Association of Surgical Technologists For reprint permission: [email  protected] org A UGUST 2009 | the surgical technologist | 347 food and play, they would in more cases choose the food. The same was true when it came to the monkeys’ choice between water and food.The water would always be chosen as the Selfpriority over food. Self-fulfullment actualization: needs achieving one’s As the observations continued, a full potential, pattern emerged. Maslow could see, on including creative a physiological level, that if the monactivities keys didn’t have food, but had water, Esteem needs: the group was less aggressive than prestige and feeling of accomplishment Psychological those that had the water taken away needs Belongingness and love needs: from them. 1 The same held true with intimate relationships, friends safety needs.If all of the physiologiSafety needs: cal needs were met, then the monkeys’ security, safety Basic behavior became more profound when needs Physiological needs: it came to establishing social roles and food, water, warmth, rest dominance. Maslow later transitioned this idea over to human behavior and was able to establish physiological needs over child, but found his sense of self by reading books. He safety needs, safety needs over belongingness needs, belongbegan his college journey by attending City College of New ingness needs over esteem needs, and esteem needs.The York, and later transferred to Cornell University, before needs, in turn, form the first four components of the pyragoing back to City College of New York. After realizing a mid, and are addressed as deficit needs. Self-actualization, keen interest in psychology, he moved to Wisconsin, where the fifth component, addresses the need of being, which he studied at the University of Wisconsin. Throughout defines one’s own place in the universe. the 1930s, Maslow earned his BA, MA and PhD. Later, When an individual does not have enough of something, he returned to New York, where he not only taught full he or she has a deficit, ultima tely creating what Maslow has time at Brooklyn College, but he also became interested in termed â€Å"deficit needs. †1 When individuals eat and drink, human sexuality. for example, the need for water and food is met, so there Maslow served as chair of the Department of Psy- is no longer a motivating factor to obtain water or food, chology at Brandeis from 1951-61. While there, he met and the deficit need has temporarily been satisfied. Deficit a well-established researcher named Kurt Goldstein, who needs comprise or make up the four lower components of developed the idea of â€Å"self-actualization. † This concept Maslow’s hierarchy pyramid. fascinated Maslow, and it was through this notion that he On the other hand, Maslow also mentions the idea of pursued the idea of humanistic psychology, which he ultiâ€Å"being needs. † Being needs have nothing to do with deficit mately valued more than his own research.Maslow died needs. Being needs are internal, a nd are at the very top of on June 8, 1970. 1 Maslow’s hierarchy pyramid, which ties into self-actualization. 2 An example here might be drawing one’s own conclucreating the hierarchy of needs sions of where and who he or she is spiritually. This internal Abraham Maslow is well known for the creation of the concept is addressed as self-actualization. hierarchy of needs. The way he came up with this idea The following sections of this article will address each was by studying and observing monkeys.During observalevel of Maslow’s Hierarchy of Needs in more detail in an tion, he noticed that they displayed a very unusual pattern effort to see how they apply to individuals, and how they of behavior that addressed priorities based on individual can define who and where an individual is in his or her life. needs. If, for example, the monkeys had a choice between FIGURE 1: MASLOW’S HIERARCHY PYRAMID 348 | the surgical technologist | AUGUST 2009  © 2009 Associat ion of Surgical Technologists For reprint permission: [email  protected] orgPHYSIOLOGICAL NEEDS With so many different capabilities, from the regulation of temperature and hormones to the processing of water, food and the elimination of waste, the living body is the most unique machine in the universe. Despite its relative fragility, the human body can live for many years. Every single detail is so integral, from how the body processes oxygen through millions and millions of tissue cells, to the thousands of miles of arteries that carry blood and nutrients to those tissues. With this being said, there is still the need to meet the very basic essentials of ife: the body must take on oxygen, water and food. Before any further growth can take place, this very basic need has to be met. This is what Maslow addresses as a physiological need—the need for the body to work in unison to accomplish the task of basic survival. Physiological needs are influenced generally through the cr avings that we have. If a person is thirsty, he or she finds a drinking fountain. Similarly, if the individual is hungry, he or she will find food. If the body is being deprived of oxygen, it will surely react. If there is a vitamin deficiency, the body has subtle ways of fulfilling that need.One example of how the body regulates itself on a physiological level is by homeostasis. Homeostasis simply means to regulate. A part of the human brain, called the hypothalamus, plays an important role in keeping the body regulated by controlling the body’s thermostat, which is controlled by the release of several hormones called gonadotropins. If a female produces too much estrogen, the hypothalamus releases a hormone called luteinizing hormone that triggers ovulation, therefore acting like a shut-off switch for the amount of estrogen present.If the thyroid gland produces too much thyroxin, the hypothalamus produces a hormone to switch off the flow of the thyroxin. These are Throughout life, the idea of physiological needs remains consistent. The need to maintain adequate physiological balance will always be essential†¦ just a few examples of homeostasis at work, however, there are many circulatory hormones that are needed to maintain normal bodily functions. Another prime example is the release of the â€Å"fight or flight† hormones that are secreted by the adrenal medulla of the adrenal glands.If there is a need for the body to defend itself, these hormones will surge into action to prepare the body for fight or flight. These hormones, although they play an important role, are kept in compliance by regulatory mechanisms within the brain. 3 Throughout life, the idea of physiological needs remains consistent. The need to maintain adequate physiological balance will always be essential, and may kick into action in very different ways at various different times, whether the individuals experiencing it are aware of it or not.For example, how would anyone ever get a good night’s sleep if they had to literally think about their breathing pattern, heart rate or blood pressure on a conscious level? Sure some people may have to get up during the night to use the restroom or grab a glass of water, but remember that this is all part of how the body regulates itself. The notion that physiological needs tie into other, more complex needs of the hierarchy is very relevant. Maslow The basic principles of Maslow’s hierarchy have been observed in primates.  © 2009 Association of Surgical Technologists For reprint permission: [email  protected] rg AUGUST 2009 | the surgical technologist | 349 Again, this need will change depending on where an individual is in his or her life. For a young child, approvalseeking behaviors may become more commonplace. The child may engage in activities to get his or her parents’ attention by exploring or asking lots of questions. In a sense, the child needs to feel an emotional or social co nnection with SAFET Y NEEDS his or her parents. As the child evolves into a teenager, he Much like physiological needs require maintenance throughout life, so does the need to feel secure.This need is or she will more than likely become more socially active in more psychological. With that being said, safety needs may peer groups. Generally, whatever gets reinforced, supported, be different for each individual, depending on where he or or accepted by these peer groups will often determine which type of group the adolescent will affiliate him or herself she is in life. For a child, this need may manifest as the need with. This idea can be noticed at any point throughout an individual’s life. Safety needs may be different for each individual, depending on As youths ature into adulthood, they tend to affiliate with those indiwhere he or she is in life. For a child, this need may manifest as viduals or groups who accept them. A sense or a need to belong, at any the need for a saf e family environment. There has to be security stage, is influenced by several factors. in the home, with warmth and love. Some of these influences, for example, are socio-economic influences: the education level of parents and family, 4 the neighborhood in which the child grows up and the type for a safe family environment.There has to be security in the home, with warmth and love. When a family is dysfunc- of schools where they are educated, as well as the children tional, it makes it difficult for that child to move up to the who attend those schools. Whatever type of behavior is learned and accepted, based on these variables, is likely the next level of social needs because fear is often present. For adults, this need may be economic in nature. If a behavior that will form a particular individual’s character person loses his or her job, for example, fear and anxiety and self-esteem.The level of belonging must be established because of its will have an impact on that perso n’s social life, and may effect on one’s self-esteem. If the level of belonging in the cause him or her to regress. 5 Additionally, adults are not hierarchy model is low, or an individual is viewed negatively immune to the need of safety. In some parts of the world, where there is chaos, people are stuck at this level of need- by peers in that group, he or she may develop social anxiety ing to feel safe. The goal of consistently meeting the need for and may withdraw toward a level of people in which he or safety is to have stability in one’s life.It is the idea of being she fits in socially. If a child grows up in a neighborhood able to walk around the block at night without the worry of where there are street gangs, and attends schools in that being mugged. It is the idea of feeling secure in the work- neighborhood with the families of those street gangs, then place. It is conclusive that fear hinders one’s ability to move the likelihood of the child to adapt and take on that form of character becomes more likely. According to Maslow, the on to the more advanced platforms of Maslow’s pyramid. eason for this behavioral pattern is likely due to the peer groups that the child grew up with. BELONGING NEEDS This is not meant to imply that all children who grow up Advancing up the hierarchy pyramid, the next level reprein this type of neighborhood will join a gang, simply that sents the need to belong on a social level. The social level generally becomes the priority only after the physiological there is a higher likelihood of that outcome. On the other and safety needs have been sufficiently met and maintained. and, if a child is brought up in a more affluent neighborhood, it is likely that the parents will also be more educated. A sense of belonging can be felt when an individual becomes more focused on the desire to build relationships with others. In this scenario, it is more likely that the child will develop This includes th e desire for a romantic partner, to have close and adapt to the peer groups in which education is more of a priority. The influence in a child’s upbringing starts friends, and maybe to get married and have children. 1 elieved that once the physiological needs are met in sufficient detail, people move on to address these more complex needs. Safety and security make up the next platform of the pyramid. 350 | the surgical technologist | AUGUST 2009  © 2009 Association of Surgical Technologists For reprint permission: [email  protected] org with a home and family that secures the previous levels of Maslow’s hierarchy by meeting and maintaining the foundation levels of needs. Relieving any anxiety or fear will help put more emphasis on social development, and with this will come a healthier self-esteem.ESTEEM NEEDS Once the needs of physiology, safety and belonging have been met, the individual will now move on to the needs of their self-esteem. Self-esteem, like all th e prior needs, must also be maintained. This is the highest platform in the category of deficit needs. 1 The process of growth, when addressing one’s self-esteem, builds the bridge to one’s awareness. Self-esteem begins to establish itself in life as early as age two. Maslow’s hierarchy addresses two levels of self-esteem. One of those is a lower level and the other is a higher level.Maslow’s hierarchy is a two-way street. A person can spend a lifetime traveling between the two extremes. The lower form of self-esteem is directly related to an individual’s ego, meaning that there is a strong need to be respected by others. 4 Within this lower form, the individual still remains focused on acceptance by others. This lower form of self-esteem is met when an individual has established a level of status, recognition, fame, reputation and appreciation, just to name a few. These areas in a person’s life take work to maintain.They may also require so me reinforcement or validation of some kind in order for this lower form of self-esteem to be maintained. The higher form of self-esteem that Maslow addresses is that of self-respect. This higher form of self-esteem requires less maintenance because through accomplishment, it becomes a permanent part of who the individual is. We can say that once a person has gained respect for himself or herself, it is much harder to lose that respect or to have it taken away. People on the higher end of selfesteem generally like who they are.The idea of confidence in ability, the mastery of something, or the competence that is established in what these people do, supports this higher form of self-esteem. These forms of self-esteem should not be confused with an individual having high or low self-esteem. Individuals with low self-esteem often have a low opinion of themselves and their self-image. As a result, inferiority complexes are present in the individual. With this idea in mind, Maslow conten ds that the majority of people’s psychological problems are due to low self-esteem.The realism here is that if a person don’t like himself or herself, or who he or she is or what he or she has accomplished, then that person will be more critical of himself or herself. Through that process, negative self talk is born, and can create a barrier to achieving personal success. How does low self-esteem impact these lower and higher forms of selfesteem in general? If an individual has low self-esteem, the lower form of self-esteem affects the individual on a social level. The individual may, for example, constantly attempt to seek or validate feedback and acceptance on a social level from his or her peers.With regard to the higher form of selfesteem, in the individual with low selfesteem may display a lack of respect for himself or herself and the expectations that they place upon themselves would be unrealistic, or perhaps in some cases these expectations would be placed by others rather than being placed by the individuals themselves. It is amazing that all of the prior needs within Maslow’s hierarchy, including physiological, safety, and even belongingness needs are frequently met, especially in modern society and developed countries.Imagine if more people just had a little respect for themselves in the grand scheme of things.  © 2009 Association of Surgical Technologists For reprint permission: [email  protected] org AUGUST 2009 | the surgical technologist | 351 THE CONTROVERSY As we take a look at Abraham Maslow’s hierarchy pyramid, there is some controversy as to how it relates directly to humanistic psychology. Is there enough evidence to support this hierarchy when it comes right down to how people develop emotionally?Maslow set forth with the notion that these stages along Self-actualizers are focused on what matters most in defining the course of development match up with how people experience psychowho they are. Once self-re spect is gained, the individual can take logical growth. The primary contention is that a more proactive approach to bettering themselves, as well as anyone in society can regress back to, being able to remain focused on resolving any dilemmas †¦ or value an alternative aspect of the hierarchy pyramid in a way that is not parallel with Maslow’s model.For example, some cultures may be more fixated on belongto figure out, or it can be the determining factor of how well ing over safety, or esteem over belonging. 5 To answer these he or she is connected with his or her self and abilities. People who are self-actualizers are focused on what challenges, many experts believe that Abraham Maslow’s matters most in defining who they are. Once self-respect is hierarchy doesn’t always follow in sequence with how it gained, the individual can take a more proactive approach was intended.If the notion of self-esteem, for example, is thought to develop in children as early as two years of age, to bettering themselves, as well as being able to remain focused on resolving any dilemmas that may arise regarding then why does Maslow address esteem needs so high up in the deficit stages. Self-actualizers may be more generative in the hierarchy pyramid? Humanistic psychology does challenge some of these notions, even though Maslow was a the sense that the focus is no longer as much about pleasbeliever in humanistic psychology. ng others as it is giving back or sharing this part of who Another oft-challenged aspect of his work is that Maslow they are. 6 In other aspects, it can also appear to be spiritual. himself defined self-actualizers as people of great accomLooking at one’s life as to who he or she is in the universe is a good example. Once a person is able to come to terms plishment, such as former presidents, dignitaries and great discoverers. With that being said, it is very difficult to place with who they are, and they are ultimately satisfi ed with an emphasis on the concept of self-actualization.How sigthat, then they have truly reached the point of being able nificant is the concept of the self-actualizer? The only way to self-actualize. With this level of intuition comes a sense of peace, which that to answer that question is to say that all people are at in turn serves as a motivator to focus on more advanced different stages of development, and all of them are selftasks in life, such as supporting the moral and ethical stan- actualizers in some form. SELF-ACTUALIzATION Self-actualization is defined by Maslow as the single component of being within the hierarchy model.Being, in this sense, means not being a part of the deficit needs as they appear within the lower chain of the hierarchy. 1 This need is independent—there must be some accomplishment of all the other deficit needs, which are best defined as what we appear to be, according to the standards of society. Selfactualization is the internal dialogue t hat everyone establishes at some point in their lives. In order to do that, there must be some establishment or satisfaction of the prior needs. Once all of the previous needs have been met, an individual can direct his or her focus toward a true calling.Usually when a person is hungry, or they don’t feel safe, or they feel unloved, the focal point leans towards resolving those issues, therefore disrupting the focus on self-actualizing. With self-actualization, being able to pinpoint how one truly feels about something is often a little more challenging dards in life. There is a more in-depth focus on bettering oneself and expanding one’s knowledge and talents. The real definition to self-actualizing is getting to know oneself, while being okay and unconditionally accepting of whatever it is that he or she discovers.The question every individual must face is, do you like and accept who you are? Once that question is answered, then self-respect is gained. Once an indivi dual establishes that respect for his or herself, no one can take that away. In this context, Abraham Maslow is justified in establishing self-actualization in a category by itself that quantifies the need of being separately from the need of deficit. 352 | the surgical technologist | AUGUST 2009  © 2009 Association of Surgical Technologists For reprint permission: [email  protected] org verview When looking at Maslow’s hierarchy pyramid, an important concept to remember is that anyone at anytime can regress back to any point within the hierarchy structure that Maslow addresses. How does this impact human behavior? Looking back at the very basics of physiological needs for example, people need to feel good. It does not matter if a person is employed as a janitor or a top-notch cardiac surgeon, if he or she is diagnosed with a disease that impacts them physically, he or she is likely to regress back towards satisfying any physiological needs that may come about.The affecte d individual’s attitude towards the prognosis of this disease will likely contribute towards a shift in his or her priorities. Emotionally, the feelings of love and belonging may be impacted in the sense that they may want to ensure that their loved ones are safe when they pass. With regard to esteem, for some, there may be a great sense of loss, while others may come to terms with the fact. With that being said, there are circumstances that affect each individual with regard to where he or she stands in the hierarchy pyramid. Is everyone a self-actualizer? Yes. For each individual, this experience is different.It is experienced at different depths depending on individual life experiences. The more in touch one is with one’s inner self, the better he or she can control, and often master, one’s self-talk. It is also important to remember that all individuals are constantly impacted by the forces of life, some of which are far beyond personal control. When the opp ortunity arises to experience this hierarchy, and the needs of deficit are fully met, it allows the individual to make a closer connection with the concept of self-actualization. Also, when these deficit needs are met, self-actualization, in a sense, is likely to become even more enhanced.The bottom line is that everyone is effected emotionally at every level of Maslow’s Hierarchy of Needs. If early life experiences as a child are positive, and needs are being met, that individual will excel in the area of self-confidence and self-esteem at much faster rate. It helps to establish a strong foundation for life. Later, the individual is able to establish a much stronger set of coping mechanisms when one of the deficit needs isn’t being met. Additionally, when adverse circumstances confront the individual, he or she is often better-equipped with the ability to problem solve and confront the challenge confidently.Conversely, if early life experiences as a child are negative , and needs are not met, that individual’s foundation isn’t as secure, and he or she is not as likely to excel in selfconfidence and self-esteem, rather, he or she is likely to get trapped a state of constantly seeking approval from peers. He or she may develop a fear of making mistakes. The majority falls somewhere in between what is positive in life and what is negative. Ultimately, individuals who develop a strong, well-established foundation are likely to be emotionally strong and can exercise a stronger sense of self control.Those whose foundation is shaky and not very stable will focus more on protecting it, therefore having less confidence in that foundation. ABOUT THE AUTHOR Robert A Poston, cst has been a surgical technologist since 1993. He began his work in education with Concorde Career College in North Hollywood, California in 1997. He has been a guest speaker with the California State Assembly of Surgical Technologists in 2001 and 2003. Robert Poston is c urrently the Program Chair for Surgical Technology at Everest College in Thornton, Colorado. He has also served as an item writer for the National Certification Exam for Surgical Technology.RefeRences 1. Boeree, George C. â€Å"Abraham Maslow, 1908-1970. † Personality Theories. 2006. Available at: http://webspace. ship. edu/cgboer/maslow. html. Accessed 4/9/2009. 2. BambooWeb Dictionary. â€Å"Maslow’s Hierarchy of Needs. † 2009. Available at: http://www. bambooweb. com/articles/m/a/Maslow’s_hierarchy_of_needs. html. Accessed: 4/9/2009. 3. Applegate, Edith. The Anatomy and Physiology Learning System. 2000. p 214-215. 4. Drinnien, Beverly; Irwin, Donald; Simons, Janet. Psychology—The Search for Understanding. West Publishing Company. New York. 1987. Available at: http://honolulu. awaii. edu/intranet/committees/FacDevCom/guidebk/ teachtip/maslow. htm. Accessed: 4/9/2009. 5. NetMBA Business Knowledge Center. â€Å"Maslow’s Hierarchy of Needs. † 2007. Available at: http://www. netmba. com/mgmt/ob/motivation/maslow/. Accessed: 4/9/2009. 6. Van Wagner, Kendra. â€Å"Self-Actualization and the Hierarchy of Needs. † 2009. Available at: http://psychology. about. com/od/theoriesofpersonality/a/ hierarchyneeds_2. htm. Accessed: 4/9/2009.  © 2009 Association of Surgical Technologists For reprint permission: [email  protected] org AUGUST 2009 | the surgical technologist | 353