Jesus and Caravaggio Essay Example for Free

Jesus and Caravaggio Essay Caravaggio (1573-1610) Originally named Michelangelo Merisi, Caravaggio was born on September 28, 1573 in the Lombardy hill town of Caravaggio near Milan, which he is named after. He was born to relatively privileged parents who were victims of an epidemic and he became an orphan at the age of eleven. When Caravaggio was only 13 years old his family decided he would devote his life to painting. Caravaggio began as an apprenticed in 1584 to Simon Peterzano, a Milanese painter in oils and fresco. His earliest years in Rome, from-1588 were very difficult for Caravaggio. He was employed for a while in the workshop of Mannerist painter Giuseppe Cesari, also known as the Cavaliere dArpino as a fruit and flowers specialist, the only Caravaggios still life work known without figures is a Basket of Fruit (1597 Pinacoteca Ambrosiana, Milan) the facts about this piece are not really clear although it is possible the painting was made as a trial piece, since the background was added later (the piece is now lost). Basket of Fruit (1597)- In 1592, Caravaggio arrived in Rome at the age of 21. His first five years in Rome were the hardest period for Caravaggio. He had no money and lived a very modest life style because he couldn’t find a suitable work place, therefore he moved from one workshop to another frustrated from working as an assistant to painters who had much smaller talent than his own. He earned his living mostly from uncreative routine work and never stayed more than a few months at each studio. Finally in 1595, he decided to set out on his own and began to sell his pictures through a dealer, Maestro Valentino, who brought Caravaggios work to the attention of Cardinal Francesco Del Monte, a bishop of great influence in the Vatican. Caravaggio soon came under the protection of Del Monte and was invited to receive a place to live, and a pension in the house of the cardinal. Despite spiritual and material deficiency, Caravaggio had painted approximately 40 paintings for Francesco Del Monte. The subjects of this period are mostly adolescent boys, such as the above paintings: Boy with a Fruit Basket (1593; Borghese Gallery, Rome). The boy with a fruit basket has similarities with another painting the- Fruit seller by the Lombard painter Vincenzo Campi, painted about 1580, nevertheless, Caravaggio is not following his footsteps and using innovative drawing techniques. Differently from Vincenzo Campis drawing posing a young woman in the center of the piece, Caravaggio preferred a teenage boy which was his most common theme of drawing at the time. Also his subject is brought almost to the front of the picture, so that the boy seems to offer himself as well as the fruit to the observers. There is a sign of uncertainty in the way that the boys long neck raises out of his shoulders edge. Caravaggios incredible techniques of light and shadow are already seen in his early work. Against a near-blank ground, attention is focused on the right side of the boys upper body, his right arm and the fruit basket, displaying very rich variety of fruits. The Young Bacchus (1593; Uffizi Gallery, Florence). Caravaggios Bacchus no longer seems like an ancient god, or the Olympian vision of the High Renaissance. Instead, Caravaggio paints a rather vulgar and soft yang boy, who turns his chubby face towards the viewer and offers wine from a large glass held by his small thin fingers. This is not Bacchus himself, but some perfectly ordinary individual dressed up as Bacchus, who looks at the viewers rather exhaustedly. It appears that Caravaggio used real people for his paintings even in his early work. The Music Party (Metropolitan Museum of Art, New York). The two figures seen in the front of the piece are the main characters of the composition. They are shown in an oppositional structure, and only one of them is fully shown. The figure of the instrument player and the corresponding figure that we see from behind. The face between these two is Caravaggios; the figure on the left is taken from an earlier composition (Young Peeling a Pear). Caravaggios usage of a narrow range of earth colors which was his signature method of painting is shown from his earliest work as well as in his most famous ones. Also his amazing use of details, he describes every part of the figures anatomy and he always creates movement in his paintings. These early pictures show an innovative, direct, and empirical approach; they were painted directly from life and show almost no usage of the academic method of painting which was used in Rome at the time.

Benefits of Postnatal Debriefing

Benefits of Postnatal Debriefing 215133 POSTNATAL DEBRIEFING STILL VALUED BY WOMEN Introduction Providing debriefing for women in the postnatal period is believed by many midwives to help women to adjust to their childbirth experiences, and to help reduce postnatal psychological morbidity. The evidence base is equivocal in relation to the efficacy of these kinds of interventions, which are typically delivered by midwives in clinical practice. This essay will review several pieces of research relating to postnatal debriefing associated with the psychological distress and potential post traumatic stress disorder associated with childbirth. It will look at the quality of evidence available and discuss some of the parameters of the arguments surrounding the provision of postnatal debriefing, listening and counselling services. It will also make recommendations for practice in relation to this kind of provision, and in relation to future research. Discussion Lavender and Walkinshaw (1998) carried out a randomised trial of a postnatal ‘debriefing’ service provided by midwives, to see what effect it had on psychological morbidity after childbirth. The authors comprise one midwife and one obstetrician, and the midwife has a postgraduate degree, suggestive that they have the skills to carry out and report on such a study. Using a randomised trial design is aimed at filling an apparent gap in the research at the time of the study, in relation to this area of practice (Lavender and Walkinshaw, 1998). This study was carried out â€Å"in a regional teaching hospital in northwest England, and used a sample of â€Å"one hundred and twenty postnatal primigravidas†, who were â€Å"allocated by sealed envelopes to receive the debriefing intervention (n 4 56) or not (n 4 58).† (Lavender and Walkinshaw, 1998 p 215). The study involved the collection of baseline intrapartum and demographic information in order to assess a wid e variety of variables in the study (Lavender and Walkinshaw, 1998). The intervention is described as follows: â€Å" Women randomised to the intervention participated in an interactive interview in which they spent as much time as necessary discussing their labour, asking questions, and exploring their feelings. One research midwife, who had received no formal training in counselling, conducted the interviews, which lasted between 30 and 120 minutes, the duration being guided by the needs of the respondent. Hospital notes were available throughout the interview so that direct questions could be answered. No interview schedule was defined, since the interviews were respondent led.† (Lavender and Walkinshaw, 1998) This approach raises several points. To being with, it is positive that there is such transparency in explaining the intervention, even if the intervention is brief, because it allows the reader to understand the nature, it aids replication, and it demonstrates the lack of specialist knowledge required to perform the intervention. Secondly, it shows that a research midwife, who was not a counsellor, was carrying out the intervention. And thirdly, it demonstrates a woman-focused, midwifery-oriented approach, in that the interviews were respondent led and the length was not limited. Such an approach reflects midwifery philosophies which makes the article useful for midwifery practice. Lavender and Walkinshaw (1998) used an established data collection instrument, the Hospital Anxiety and Depression (HAD) scale, which was administered by postal questionnaire 3 weeks after delivery. Using an established data collection instrument adds strength to the study, but there is a small amount of unreliability about postal questionnaires, because there is never any guarantee that they are filled out by the person they are sent to. Using the pre-tested scale allowed the authors to compare the proportion of women in each group with anxiety and depression scores of more than 10 points, using odds ratios and 95% confidence intervals, both of which are acceptable statistical applications for these data. The 95% response rate ensured a good sample size (Lavender and Walkinsahw, 1998), although the study would have had even more statistical significance if it could have been carried out across more than one site. The benefits of this intervention were established by the study, but the authors raise some concerns, including concern at the high levels of morbidity detected, and question whether using the chosen scale was appropriate for measu ring psychological morbidity after childbirth (normal or abnormal) (Lavender and Walkinshaw, 1998). This study is limited now by its age, and by being superceded by more recent studies. Kershaw et al (2005) carried out a prospective randomised controlled trail with two arms, which compared debriefing methods after birth which were aimed at reducing fear of future childbirth. As can be seen, this studied a more specific intervention, in relation to a very specific outcome, rather than measuring psychological morbidity per se. This would make it more applicable to specific aspects of practice. This study was also carried out in one site, and the authors provide details of the hospital site, which this author would question due to the issue of confidentiality. Kershaw et al (2005) focused on mothers whose first birth was an operative delivery, and gained ethical approval. More details about the ethics of this study would have enhanced its quality. Kershaw et al (2005) provide their inclusion and exclusion criteria, but do not discuss controlling for other variables. They also use a pre-established measurement tool to assess the fear of childbirth experienced by the stu dy participants (Kershaw et al, 2005). They do subsequently present demographic information, and they use a range of suitable statistical tests, explaining the significance of these, which makes it easier for the novice reader to begin to assess the quality of the data analysis. This again was a debriefing intervention carried out by midwives in the postnatal period (Kershaw et al, 2005). However, unlike the previous study, this one differed because the debriefing was held on two separate occasions, and sessions were held at home (Kershaw et al, 2005). Another significant element of this study was that the midwives involved received training in critical incident stress debriefing (Kershaw et al, 2005). The authors justify their study as follows: â€Å" In this study fear of childbirth and post-traumatic stress were measured rather than maternal depression and general health. It was decided not to measure maternal depression as research has suggested this is frequently associated with factors not related to childbirth. Women were allowed sufficient time to debrief, sessions lasted up to an hour and a half.† (Kershaw et al, 1508). This shows some strengths, including a focus on specific psychological features, rather than on general health and depression, which can be difficult to assess. Although the authors state women were allowed sufficient time for the session, this study does not reflect the kind of midwifery philosophy that the Lavender and Walkinshaw (1998) study did. The findings from this study do not support the use of this particular intervention in this particular population. â€Å"The findings of this study demonstrated in the short term no significant difference in the WDEQ fear of childbirth scores and IES emotional distress scores. These findings show community-led debriefing is not proven to be of any value in reducing women’s fear of childbirth following an operative delivery.† (Kershaw et al, 2005 p 1508). However, this study may not be the last word on this kind of intervention, and there are limitations, including the focus only on women who had operative deliveries, focusing on one site, and in the intervention itself. Maybe the nature of the intervention, and the training provided for midwives, was limited. The authors agree that a longer-term evaluation might show different results (Kershaw et al, 2005). It might be that the data collection tool was inappropriate, as with the previous study. However, this study, as with the previous one, does establish the usefulness and facility of midwives providing postnatal support of this kind. Kershaw et al (2005) show that midwives identified those women who would be needing debriefing, but this author would argue that midwives are not experts in mental health, and limiting debriefing to those identified by midwives as at higher risk might miss important cases. Reading between the lines of this study seems to imply that this intervention is valued by midwives and by patients, despite the findings of the statistical analysis. Small et al (2000) carried out a randomised controlled trial of midwife led debriefing to reduce maternal depression after operative childbirth, again, focusing on women who are viewed as potentially at higher risk of mental health morbidity postnatally. This study was carried out in a large maternity teaching hospital in Melbourne, Australia, unlike the previous two studies, which were carried out in the UK. Small et al (2000) had a sample of 1041 women who had given birth by either caesarean section (n = 624) , by assisted vaginal delivery using forceps (n = 353) or vacuum extraction (n = 64), and these women were randomised to the intervention group or the control group (Small et al, 2000). The sample size was statistically calculated for significance, which is a strength of the study. The methodology is clear and the randomisation process described. The intervention â€Å"provided women with an opportunity to discuss their labour, birth, and post ­delivery events and expe riences† (Small et al, 2000 p 1044). Although there is a woman-centred focus in this study, only 1 hour maximum was allowed for the discussion, which this author would suggest is a severe limitation of this intervention in relation to woman-centred debriefing. The midwives were not trained but described as experienced and skilled. The main outcome measures were â€Å"maternal depression (score >13 on the Edinburgh postnatal depression scale) and overall health status (comparison of mean scores on SF ­36 subscales) measured by postal questionnaire at six months postpartum† (Small et al, 2000 p 1044). Again, established scales are being used to lend strength to the study. Small et al (2000) found that â€Å"more women allocated to debriefing scored as depressed six months after birth than women allocated to usual postpartum care (81 (17%) v 65 (14%)), although this difference was not significant (odds ratio = 1.24, 95% confidence interval 0.87 to 1.77)† and â€Å"they were also more likely to report that depression had been a problem for them since the birth, but the difference was not significant (123 (28%) v 94 (22%); odds ratio = 1.37, 1.00 to 1.86).† (p 1043). According to this study, the authors demonstrated that midwife led debriefing following operative births was not only not effective in reducing maternal morbidity (in particular, psychological morbidity), at the six month point after delivery, but that it may have been a contributing factor to emotional health issues for certain women (Small et al, 2000). This author would suggest that it might be the nature of the intervention that is the issue here, because it was provided in hospital, soon after birth, and may not have been particularly woman-centred. Cultural differences between Australian women and UK women cannot be ruled out; neither can cultural differences in models of care and practice. Priest et al (2003) carried out a randomised single-blind controlled trial, stratified for parity and delivery mode, to test whether critical incident stress debriefing after childbirth reduces the incidence of postnatal psychological disorders, also in Australia, in two maternity hospitals. They had a large enough sample size, consisting of 1745 women who delivered healthy term infants between a specificed time period, with 75 allocated to the intervention group and 870 to control group (Priest et al, 2003). Again, the study design is transparent, and the randomisation process clear. As with the previous study by Small et al (2000), the intervention was carried out soon after delivery, but this intervention consisted of an individual, standardised debriefing session based on the principles of critical incident stress debriefing. The intervention is described briefly, and it is stated that the midwives were trained in the intervention (Priest et al, 2003). However, the intervention i tself and the training is not really described in great detail, which affects replication of the study. The intervention is based on theories which are not specifically developed for childbirth trauma, but that have been adapted, and this may be a weakness. As with the other studies, recognised outcome measures are used. Priest et al (2003) found that â€Å"there were no significant differences between control and intervention groups in scores on Impact of Events or Edinburgh Postnatal Depression Scales at 2, 6 or 12 months postpartum, or in proportions of women who met diagnostic criteria for a stress disorder (intervention, 0.6% v control, 0.8%; P = 0.58) or major or minor depression (intervention, 17.8% v control, 18.2%; relative risk [95% CI], 0.99 [0.87–1.11]) during the postpartum year. Nor were there differences in median time to onset of depression (intervention, 6 [interquartile range, 4–9] weeks v control, 4 [3–8] weeks; P = 0.84), or duration of depression (intervention, 24 [12–46] weeks v control, 22 [10–52] weeks; P=0.98).† (p 544). This leads to the conclusion that this single session of midwife led, specific debriefing was ineffective as a means of prevention of postnatal psychological disorders (Priest et al, 2003). While the authors conclude that the intervention had no ill effects (Priest et al, 2003), this author finds these findings significant in their lack of support for the intervention, and would suggest, again, that it may be the nature of the intervention that is leading to these kinds of results. Gamble et al (2005) carried out a randomised controlled trial to assess the effectiveness of a counselling intervention after a traumatic childbirth, based on a midwife-led brief counselling intervention for women deemed at risk of developing symptoms of psychological symptoms postnatally. This was a smaller study group, with only 50 in the intervention group and 53 in the control group, and the intervention was also provided as face to face counselling within 72 hours of birth, as with the previous study, but also had a telephone counselling session at between four and six weeks postnatally (Gamble et al, 2005). The allocation/randomisation process is described, but the midwife was not blind to the randomisation, which may represent a potential source of bias. Established data collection scales were used as with all the previous studies: â€Å"Edinburgh Postnatal Depression Scale (EPDS) , Depression Anxiety and Stress Scale-21 (DASS-21) , and Maternity Social Support Scale (MSSS)â €  (Gamble et al, 2005 p 13). Gamble et al (2005) measured the following outcome measures: posttraumatic stress symptoms, depression, self-blame, and confidence about a future pregnancy. Gamble et al (2005) provide great detail about the underpinnings of the therapeutic intervention, and there is a midwifery/woman-centred focus to the intervention (and, by association, to the study). Gamble et al (2005) found their intervention to be effective in reducing symptoms of trauma, depression, stress, and feelings of self-blame. All of these studies fall within the scope of good standards of evidence for practice, but find marked differences between studies in relation to efficacy and non-efficacy of interventions. There may be a number of reasons for this. Only one study suggests potential negative effects of this kind of intervention, but this was not conclusive and warranted further investigation. However, the literature around this subject does seem to predominantly suggest that such interventions are useful for women following birth. Axe (2000) suggests that women can use such support to help them cope with the difference between their expectations and experiences of birth. Robinson (1999) argues for the increasing occurrence of post traumatic stress disorder following traumatic childbirth, and suggests that this is under-diagnosed and represents a significant maternal morbidity which needs addressing, a suggestion also found by Ayers and Pickering (2001). Creedy et al (2000) state that â€Å"posttraum atic stress disorder after childbirth is a poorly recognized phenomenon,† and that â€Å"women who experienced both a high level of obstetric intervention and dissatisfaction with their intrapartum care were more likely to develop trauma symptoms than women who received a high level of obstetric intervention or women who perceived their care to be inadequate† (p 104). Therefore, the focus on debriefing may not be the only way forward to improve psychological morbidity – there may be a need for research to explore ways of reducing the trauma that occurs in the first place. Czarnocka and Slade (2000) suggest that there may be opportunities for prevention of post traumatic stress and psychological morbidity after birth, through providing care in labour that enhances perceptions of control and support. One study demonstrates that negative experiences of interactions with maternity staff can contribute to psychological morbidity (Wijma et al, 1997). Kenardy (2000) suggests that it is the nature of the debriefing that may be ineffective in those studies that have found such results. Gamble et al (2002) also suggest that the kind and timing of the debriefing warrants further investigation. Hagan et al (1996) did not find any reduction in psychological morbidity following this kind of intervention. Alexander (1999) suggests that some of the problems may be linked to the lack of clarity and understanding that exists about these processes, which are neither necessarily formal psychological counselling nor a simple sharing session. Yet there does seem to be some indication that these kinds of supportive therapies are found to be useful by women and by midwives. Westley (1997) describes providing women with the opportunity to talk about their birth experiences, and have their questions answered, as useful, a finding supported by Smith et al (1996), Phillips (2003), Inglis (2002), Dennett (2003), Charles (1994), Charles and Curtis (1994), Baxter et al (2003), and Allott (1996). Certainly, a range of literature established post-traumatic stress disorder as a potential and/or real psychological morbidity for women having had a baby (Ayers and Pickering, 2001; Creedy et al, 2000; Laing, 2001; Menage, 1996; Robinson, 1999; Ballard et al, 1995; Crompton, 1996). Psychological debriefing interventions may be effective in preventing or managing post traumatic stress disorder in a range of situations (Rose et al, 2004), but there would seem to be some dangers inherent in some of the interventions found in the literature ( Kenardy, 2000; Madden, 2002). Conclusion It would appear from the randomised controlled trials analysed here that while some evidence supports postnatal debriefing as a means of reducing psychological morbidity, significant evidence shows no correlation between postnatal interventions of this kind and improved emotional health outcomes. However, anecdotal evidence and other literature suggests that midwives and women find some benefit from opportunities to talk about their childbirth experiences. Some of these simply allow women an opportunity to talk and to ask questions about what happened to them. This leads to the conclusion that such interventions require much more research, preferably research which includes detailed, qualitative evaluations of interventions, and interventions which are specifically designed for this client group. However, this author would also recommend that such interventions be provided, as they are not proven to do harm in the majority of studies, and represent a woman-centred approach to good mi dwifery care. References Alexander J (1998) Confusing debriefing and defusing postnatally: the need for clarity of terms, purpose and value. Midwifery 14: 122-124. Allott H (1996) Picking up the pieces: the post-delivery stress clinic. British Journal of Midwifery 4(10): 534-536. Axe S (2000) Labour debriefing is crucial for good psychological care. British Journal of Midwifery 8(10): 626-631. Ayers S, Pickering A D (2001) Do women get post-traumatic stress disorder as a result of childbirth? A prospective study of incidence. Birth 28(2): 111-118. Ballard C G, Stanley A K, Brockington I F (1995) Post-traumatic stress disorder (PTSD) after childbirth. The British Journal of Psychiatry 166: 525-528. Baxter J, McCrae A, Dorey-Irani A (2003) Talking with women after birth. British Journal of Midwifery 11(5): 304-309. Charles J L (1994) Birth afterthoughts: a listening and information service. British Journal of Midwifery 2(7): 331-334. Charles J, Curtis L (1994) Birth afterthoughts. Midwives Chronicle 107(1278): 266-268. Creedy D K, Shochet I M, Horsfall J (2000) Childbirth and the development of acute trauma symptoms: incidence and contributing factors. Birth 27(2): 104-111. Crompton J (1996) Post-traumatic stress disorder and childbirth. British Journal of Midwifery 4(6): 290-294. Czarnocka J, Slade P (2000) Prevalence and predictors of post-traumatic stress symptoms following childbirth. British Journal of Clinical Psychology 39: 35-51. Dennett S (2003) Talking about the birth with a midwife. British Journal of Midwifery 11(1): 24-27. Gamble J A, Creedy D K, Webster J, Moyle (2002) A review of the literature on debriefing or non-directive counselling to prevent postpartum emotional distress. Midwifery 18: 72-79. Inglis S (2002) Accessing a debriefing service following birth. British Journal of Midwifery 10(6): 368-371. Kenardy J (2000) The current status of psychological debriefing. It may do more harm than good. British Medical Journal 321:1032-1033. Laing K G (2001) Post-traumatic stress disorder: myth or reality? British Journal of Midwifery 9(7): 447-451. Lavender T, Walkinshaw S A (1998) Can midwives reduce postpartum psychological morbidity? A randomized trial. Birth 25(4): Dec 215-219. Madden I (2002) Midwifery debriefing – in whose best interest? British Journal of Midwifery 10(10): 631-634. Menage J (1993) Post-traumatic stress disorder in women who have undergone obstetric and/ or gynaecological procedures. A consecutive study of 30 cases of PTSD. Journal of Reproductive and Infant Psychology 11: 221-228. Menage J (1996) Post-traumatic stress disorder following obstetric/ gynaecological procedures. British Journal of Midwifery 4(10): 532-533. Page L (1996) Positive care in childbirth. British Journal of Midwifery 4(10): 530-531. Phillips S (2003) Debriefing following traumatic childbirth. British Journal of Midwifery 11(12): 725-730. Robinson J (1999) When delivery is torture – postnatal PTSD. British Journal of Midwifery 7(11): 684. Robinson J (1998) Dangers of debriefing. British Journal of Midwifery 6(4): 251. Rose S, Bisson J, Wessely S (2004) Psychological debriefing for preventing post-traumatic stress disorder (PTSD) (Cochrane Review). In: The Cochrane Library, Issue 1. Chichester: John Wiley Sons. Small R, Lumley J, Donohue L, Potter A, Waldenstrà ¶m U (2000) Randomised controlled trial of midwife led debriefing to reduce maternal depression after operative childbirth. British Medical Journal 321:1043-1047. Smith J A, Mitchell S (1996) Debriefing after childbirth: a tool for effective risk management. British Journal of Midwifery 4(11): 581-586. Wessely S, Rose S, Bisson J (1999) A systematic review of brief psychological interventions (â€Å"debriefing†) for the treatment of immediate trauma-related symptoms and the treatment of post traumatic stress disorder. In: Cochrane Collaboration. Cochrane library. Issue 4. Oxford: Update Software. Westley W (1997) ‘Time to talk’ listening service. Midwives 110(1309): 30-31. Wijma K, Soderquist M A, Wijma B (1997) Post traumatic stress disorder after childbirth: a cross-sectional study. Journal of Anxiety Disorders 11: 587-597.

The Life Saving Benefits of Organ Donation Essay -- Expository Exempli

The Life Saving Benefits of Organ Donation There is one clear fact that every person in this world can agree on: at some point in our lives, we are all going to face the reality of death. Death is imminent to each and every one of us, and the prospect of death is usually unknown and very tragic to most people. It is the unknown that can instill the fear of dying in a person or a family. Tragic accidents and terminal diseases are often the source of many deaths, and invariably in those instances we are unable to control the end result, which is death. However, in the course of life and death, there are life- threatening situations that we do have the ability to control. It becomes a choice by a person or a family to offer the greatest gift, life to another person. Life is spared for many through organ donation. Organ donation is truly a gift of life that saves hundreds of lives each day, however, even greater than the number of lives saved is the number of deaths that occur each day as people on a organ transplant waiting list continue to wait. Organ donation is a precious gift that can be given by anyone and can save many lives. All human beings should understand the importance of being an organ donor. Young or old, rich or poor, any one of us may one day get the chance to save or enhance someone's life by becoming an organ donor. Also of greater importance is that someone else may give you or your loved one a chance to live because they chose to become an organ donor. The choice you or your family makes allows a person that may be following a road to death, the chance to take a different road to the gift of life. This ultimate choice can be a precious gift of life, care, and concern for our fellow human being. In a life o... ....29 January 2002. 12 November 2003 http://olympics.belointeractive.com/snowboarding/0130klug.2fle292.html * Illinois Hospital Association. "Organ/Tissue Donation and Transplantation. 28 October 2003. 12 November 2003 http://www.ihatoday.org/public/organ/ * Diehl, Cynthia. "My Mom Is A Survivor-Organ/Tissue Donor. 12 November 2003 http://www.moms-dads.com/sim7.html * Chicago Sun-Times. "A Transplant Journey". 14 January 2002. 12 November 2003 http://www.robi.org/newsandfeatures/issues/remarks_atransplantjourney.asp * "More Facts About Organ Donation and Transplantation". 1995. 12 November 2001 Http://my.inil.com/-paulh/FACTS.HTM * Journal of the American Medical Association. "Organ Donations Increase When Families Have Good Information about the Donation Process". 3 July 2001. 12 November 2003 http://www.ahrg.gov/news/press/pr2001/organpr.htm

My Papa’s Waltz - Battered Knuckles Essays -- My Papas Waltz Essays

My Papa’s Waltz - Battered Knuckles  Ã‚  Ã‚   Many people look back on memories with a pleasant slant. A backpacker may love to go to the mountains, but every time that person ventures out he encounters a blizzard. The weather is not always conducive to the backpacker and can cause great discomfort. However, when the hiker returns to his normal routine he usually forgets about the bad experience so that he can continue loving the mountains and happily plan his next adventure. Similarly, Theodore Roethke's, "My Papa's Waltz" is a poem about a man who tries to make a horrible event into something much more pleasant to think about. The speaker seems to be remembering back to his childhood and finally uncovers dark memories about his father. The child in the poem finally realizes that childhood was full of scary nights in which he sometimes feared for his life. The speaker has tried for years to believe that he loved his father, but he finally understands what really happened in his boyhood home. The speaker in this poem begins by commenting on how much his father drinks. The father ...

Essays --

Dear Sir/Madame, It is with much pleasure that I submit my application for a Master’s Degree Programme in â€Å"Healh and Business† starting in September 2014 at University of Eastern Finland. As for my educational background, I obtained from Highest Medical School â€Å"Aieti† on a faculty of medicine where I completed all courses in English. Currently I work as an interpreter/translator at United Water Supply Company of Georgia. I have also taught Histology to first-year international students at Petre Shotadze Medical Academy. Medicine is a tradition in my family. My great grandparents, grandparents, parents, even godfather and godmother are doctors. This is a path that I am passionate about and while being part of it, I am surrounded by amicable environment. I decided to follow the footsteps but accomplish the goal in a different manner. I would like to engage myself in activity where I would have a chance to combine and link medicine to business - the mix that explores the framework for medical management systems. While doing internship in Chemotherapy department of Klaipeda Medical Center in Lithuania, each day proposed challenging but fascinating discovery. Themes connected to organization of the hospital and service delivered to patients was especially engaging. I had read and learnt about various methods about organizing and providing service to patients but I was still thrilled as it was my first time when I actually had to perform everything myself. At the start, I encountered a lot of failures but thanks to persistence and determination I grasped the procedure and became one of best students. As a result, having participated in diverse conferences and congresses related to medicine, health management and development, I would l... ...n insurance, health and government regulations and parallel its model to ones of developed countries, propose/suggest solutions to abate the adversity of medical system. As for my financing plan for studies, I have savings specially designed for my further studies. Since the University of Eastern Finland is tuition-free, with the help of my savings from work remuneration, family and a sponsor I will be able to cover all living costs. I am interested to live in a shared apartment first of all it is more affordable and it will be easier to live with other students as it helps to overcome cultural shock while living in a foreign country. Sharing a roof with other students is also beneficial to learn more about the hosting or other countries and their culture. Thank you for considering my application, and I look forward to your acceptance. Sincerely, Nino Tevzadze

Iraq iran war of 1980 – major facts

Key Dates Context – Iraq 13 Millions inhabitants Saddam Hussein is still contested in his own parti by A1 Bakr supporters and with Islamic revolution in Iran, Shiis start a revolt in 1979. 1st military power in the region. Arabs = 75%, Kurds = 17%, perstan 2%. 2/2 Sunni, 1/2 Shii and 3% of minority (christians, Jews,†¦ ) Economic dependency on oil. Others sectors were developping. Baasist regim since 1968 and the second â€Å"coup d' ©tat† (1st in 1963).July 1979, Saddam Hussein finally take supreme power after the ‘elimination' of his cousin Hassan A1 Bakr, former Iraq president. Context – Iran 35 Million inhabitants Islamic regim after the 1979 revolution Persian = 61 %, Azeris = 16%, Kurds = 90% Shii, 9% Sunni, 1% non muslim (Christians, Jew, Zoroastrians). Economic dependency to oil (79% of government revenues). Others sectors are badly developped. But still contested. Weakness of military forces due to purges of new regims.Religious differences – Sunni / Shii Had split in 661 after the assassination of All, the 4th Caliph and especially the nephew and son in law of Muhamad as the first one who have convert himself to Islam. Political differences at start. Shii thinks the Caliph should be a descendant of Ali and o Muhamad to have the prophete blood. Sunni gives the caliphate to the best muslim. Religion practice also differs. For Shii, they think Caliphs and Imams can interpret the coran. For Sunni, interpretation. are not really accepted.There is also the 7 revealed / 7 hidden imman theory in Shiism. Today : 90% of Muslim are Sunni. In the 10th Century, 50% and the two main caliphate were ruled by Shii. Arabs / Persians Economic and Political stakes (Iraqi motivations) Shatt al Arab first reason of the conflict Geostrategic Waterway close to the Persian gulf. – Use to be Iraqi – Since the Alger agreements (1975) the two ountries share the area Iraqi wants to get back Shatt al Arab. The Saddam Hussein g overnmant (BAAS) is a lay party: Stop the Islamic expansion in the region.Factors leading to the War Iraqui political and economical motivations Iran is weakened because of the Islamic revolution Saddam feels invincible (30 days of war maximum) Ayatollah Rouhollah khomeini, Islamic revolution leader has bad relationship with Saddam Hussein Saddam Hussein thinks that he has support within Iran (Socialist and non-revolutionary partisants) Saddam Hussein thinks that he has gulfs countries support Iranian Stakes for winning the war After having won 1% of the Iranian territory, Saddam strengthened his trust in winning the war and proposed a ceasefire.

Analysis And Recommendations On Impact Accounting Essay

With the alterations of Bursa Malaysia Listing Requirement and Malayan Corporate Code Governance from the past few old ages up to twelvemonth 2012, it is going indispensable for the populace listed company to measure the alteration in order to follow with the jurisprudence and ordinance and besides to guarantee sound administration in the organisation. Furthermore, there are non merely alterations in BMSLR and MCCG but the general legal, regulative and administration model besides have undergone major and minor alterations in past old ages. Therefore, the intent of this study is to urge and educate all officers of the company harmonizing to the alterations in functions and responsibilities of executive direction and besides the actions program should be implement by president of the board and other officer in order to guarantee the encourage internal stakeholder engagement and guarantee sound administration of the company. 2.0 Content2.1 Changes in the functions and responsibilities of executive directionIn old clip, the duty of the managers and executives are merely to do certain that the company is following with the Torahs and ordinance of the state and besides to accomplish their mark which maximize the company net income and besides the stockholder wealth. However, in today society, there is non plenty for managers that merely concentrate on net income of the company and stockholder wealth but besides require concentrating more on administration. In today organisation, a company board of managers is charged with the duty of keeping good corporate administration. The following are the functions and duties of the executive direction alterations in today ‘s organisations, including: Formalize ethical criterion in the workplace- In chief 1 recommendation 1.3 of MCCG 2012 had recommended that the board should formalise ethical criterion through a codification of behavior and guarantee all members of the company will follow with it. Therefore, the responsibility of the Board is to develop a corporate civilization of moralss, brewing throughout the company. The board needs to implement an appropriate internal system to back up, promote and guarantee its conformities by design its ain codification and system based on the values it prizes as appropriate concern behaviour. The codification of behavior should includes the appropriate channels of communicating, contributing to expose employees, clients, providers or other stakeholders concerned about possible or suspected misdemeanors of the codification behaviour, or any non-compliance with the jurisprudence and ordinances of the company. For illustration, the Board may set up a communicating nexus or steer employees ho w to pass on straight with the Board and chances for whistle blowing. The board besides should reexamine the codification of behavior sporadically and the abstract of the codification of behavior should be set out on the corporate functionary web site. Therefore, as compared to old MCCG regulative model, MCCG 2012 had required the board of the company concern non merely on jurisprudence and ordinance but besides ethical criterion of the company. Oversight scheme to cover with sustainable development- In recommendation 1.4 of MCCG 2012 besides recommended that the board should guarantee that the company scheme to advance sustainable development. The scheme of the company should be pay attending on three facets of concern which include environmental, societal and administration which underpin sustainability of the company. Therefore, equilibrating ESG facets with the involvement of assorted stakeholders in the company will be the indispensable responsibility for the manager to heightening investor perceptual experience and public trust. In order to carry through the three facet of the concern, company should formalise the policies on sustainability and stakeholder direction. The strategic of the company must convey benefit to the environment and society such as manager can implement travel green undertaking. For illustration, company can be after to bring forth eco friendly merchandise such as intercrossed autos which can assi st to cut down air pollution and convey a batch of benefit to the consumers and besides increase the net income of the company. Other than this, the board besides should guarantee the company discloses these policies and their execution in the one-year study and besides the corporate functionary web site which can assist to heighten answerability. Harmonizing to chief 7 recommendation 7.1 of MCCG 2012 recommended that the board should guarantee the company has appropriate corporate revelation policies. The board should set up an internal corporate revelation policies and processs which are practical and include feedback from direction. The board should guarantee these policies and processs are following with the revelation demands as set out in the Bursa Malaysia listing demands. In explicating these policies and processs, the board should follow the best patterns and processs. Other than this, the boards of managers besides have the duty to move as the defender of equity, transpare nce and answerability in all of the company ‘s policies, execution and commercial minutess, and safeguard the involvements of investors and the broader involvements of stakeholders. In order to carry through this duty, the manager board should stay active, informed and in charge of the supervising of the company. Overall, the MCCG 2012 had recommended the board should be concern environment, societal, administration and besides Torahs and ordinance but non as the former manager of its chief duties focus on maximising stockholder wealth Review and public its board charter- By mentioning to principal 1 recommendation 1.7 of MCCG 2012 had recommended that the board should formalize, reexamine on a regular basis and do its board charter transparent to the populace. Board Charter contains the strategic purpose of the Board of Directors, and an overview of the Board of Directors functions and duties. The board charter represents a beginning mention and primary initiation literature, supply penetrations to future members of the Board and senior direction. It will besides help the Board to measure their ain public presentation include its single managers public presentation. In set uping a board charter, it ‘s important for the board to sketch the key values, rules, and ethos of the company as the preparation of policies and schemes development of the company are based on these considerations. The board should clearly distinguish the duties and powers between the board and direction, the different type of commissions set up by the board, and different between the president and the CEO in the board charter Other than that, the board besides should include the procedures and processs for convening board meetings inside the board charter and the board charter besides should be review regulative by the board and the board charter should print on the company functionary web site. Committees of the board besides play an of import function in the administration procedure and each commission of the board should hold a written charter, which has been approved by the board and disclosed in the one-year study. Therefore, we can see that in MCCG 2012 had recommended that a company should do it board charter transparent to the populace which the old MCCG do non set concern on that.2.2 Reason for board to reexamine their maps and placeReinforce independence- Harmonizing to recommendation 3.1 of MCCG 2012 recommended that the board should set about an appraisal or rating of its independent managers yearly. In dependent managers can assist to cut down hazards originating from struggle of involvement or undue influence from interested parties by brings independent and nonsubjective judgement to the board. Exercise and nonsubjective judgement of the being independent managers on the board by itself can be compromised by, amongst others, acquaintance or close relationship with other members of the Board. Therefore, it is important for the board to carry on an one-year appraisal of the independency of its independent managers. When carry oning independency, the board should concentrate beyond the independent manager ‘s household relationships, background and economic to see whether the independent manager is able to go on supply independent and nonsubjective judgement deliberations. Criteria to measure independency should be establishes by the nominating Committee. The board of managers should use these standards at the clip of admittance, yearly and development of any new involvements or relationships. The board of managers should disclosed that the company has carried out the rating on assignment or reappointment of independent managers in the one-year study and any notice convening a general meeting. Other than relationships, background and economic, the rating standards for independency of managers should besides include term of office. By mentioning to the chief 3 recommendation 3.2 of MCCG2012 had recommended that the term of office of the independent managers should be no more than a cumulative period of nine old ages. Upon completion of the nine old ages, an independent manager may redesign as a non- independent manager and continue to function on the board. Independence may impair by long term of office. Therefore, the maximal term of office of an independent manager is 9 old ages. The nine old ages periods can be either uninterrupted service for 9 old ages or accumulated nine old ages of service with intervals. However, after the 9 old ages period, the i ndependent manager may still go on to function for the board as non- independent manager. However, in chief 3 recommendation 3.3 of MCCG 2012 had stated that an independent manager can stay as an independent manager after functioning a cumulative term of nine old ages may subject to the appraisal of the nominating commission. Other than this, individual who appointed as independent managers must run into the definition of an independent manager to 1.01 and pattern are set out in Note 13 of the Listing demands. Ensure balance of the board- One of the grounds that the board or president should reexamine their map or place is to guarantee that balance of power and authorization. Harmonizing to chief 3 recommendation 3.4 of MCCG 2012 which had recommended that the places of president and CEO should non be held by a same individual but different persons and the president must be a non-executive member of the board. The ground is because of uniting these places concentrate excessively much power in a individual individual. Furthermore, the board shall consist a bulk of independent managers if the president is non an independent manager in order to guarantee the balance of power and authorization on the board. Separation of the place of Chairman and CEO, can assist to advance answerability and to advance the division of duties between them, can besides assist to keep a balance of power and authorization, so that no one individual has unfettered powers of determination. Dynamic and complex concern environment- Harmonizing to chief 4 of MCCG 2012 recommended managers should give sufficient clip to carry through their duties, and on a regular basis update their cognition and better their skills.. In chief 4 recommendation 4.2 of MCCG 2012 stated that the board should guarantee its members have entree to allow go oning instruction coders. In a dynamic and complex concern environment, it is necessary that managers devote sufficient clip to update their cognition and better their accomplishments through appropriate go oning instruction coders and life-long acquisition which will assist to enable managers to prolong their active engagement in board deliberations. Therefore, the manager able to bring forth a quality scheme and do more dependable determinations, and be able to confront different challenges from a altering environment. . Furthermore, the listing demands states that companies must continuously measure and find the preparation needs that are r elevant to their managers. One of the specifying features of professional managers is wisdom and honestness. An single manager ‘s committedness to sustainable development will advance rational honestness which is a of import portion of good administration and is by extension a portion of each manager ‘s fiducial duty. Sustainable development will fit Directors with the best serve the involvements of the company.Actions plan to guarantee internal stakeholder thrust and sound administration.There are few actions that the board and executive can take to guarantee sound administration. One of the actions is development of codification of moral principle of the company. The company can formalise ethical criterion through a codification of behavior and guarantee all members of the company will follow with it.Development of codification of behavior and moralss within organisationMeasure 1: Involve senior directionA strong leading is a of import factor in making an ethical civil ization in the organisation. Chairman and top executive direction should show leading with regard to values and moralss in the development of an organisational codification of behavior. Engagement of the top executive can assist raise the profile of the codification of behavior within the organisation, and the board and other officer should guarantee that it is aligned with the organisation ‘s vision and strategic results, and ease the blessing procedure.Measure 2: Establish a diversified, multi-disciplinary consulting groupIn order to increase the effectivity of the organisation codification of behavior, it needs to be relevant to all employees who are capable to it. Therefore, they are stand foring cardinal stakeholders and with cognitive and cultural diverseness which signifier by the multidisciplinary squad and diverse squad. However, if board and executive direction are non able to organize a multidisciplinary squad, the assorted maps within the organisation and particula r involvement groups should at least consult in order to understand their demands. Since the believing around values, ethical hazards and expected behaviours will hold been inclusive of the organisation ‘s work force diverseness, so this will assist to ease the confirmation procedure with employees.Measure 3: Put the Aims for your Organizational CodeThe aims of the codification of behavior demand to be set start from the beginning, as the aims of the codification will act upon the picks made with regard to the content highlighted in the codification. The executive direction of the company should put the aims of the codification at the beginning of clip and explicating to employees what the organisation intends to accomplish with its codification. The effectivity of the codification can be reviewed to mensurate whether the aim are being achieved through linked the aims to expected results.Measure 4: Customized Code of Conduct for the demands and values aˆâ€ ¹aˆâ€ ¹of the organisationTo find the organisation ‘s nucleus valuesThe first measure in the constitution of the organisation ‘s Code of Conduct is the board and executive squad demand to find the outlooks of the organisation, for illustration, the intent, powers, duties, responsibilities and duties. Once aspirations have been defined, the top direction should get down audiences with employees on their core organisational values. The nucleus values specify what the organisation represent and the rules by which it will accomplish its ends.Identifying Hazards: Measuring the potency for behaviors inconsistent with the valuesIn custom-making the codification to the organisation ‘s demands, it is of import to concentrate on the hazard countries where behavior may be inconsistent with organisational value because it will increase the relevancy and effectivity of the codification. Examination of countries of hazard for struggles of involvement should include in the hazard appra isal reappraisal. Effective hazard appraisals should done in audience with senior direction, and are validated by center directorsMeasure 5: The confirmation organisation codification ( bill of exchange ) behaviour with the bargaining agents and employees.An effectual organisational codification of behavior is required to consultation with bargaining agents and employees. Therefore, one time the bill of exchange codification of behavior and moralss has been completed, it is necessary to verify its contents with these stakeholders through audience. This will guarantee that the values aˆâ€ ¹aˆâ€ ¹and outlooks of behaviour related to employees and the environments of their workplace. This is an first-class chance for executive direction and their employees prosecute in the duologue about values aˆâ€ ¹aˆâ€ ¹and moralss and organisational committedness to keep an ethical civilization in the workplace. Consultations between executive direction and employees may besides place some of the countries where increased preparation, consciousness or farther treatments will be needed during the development stage of the organisational codification and moralss.Measure 6: Execution and Monitoring organisation codification of behavior and moralssDevelopment of codification of behavior and moralss of an organizationally is an of import first measure in reenforcing and making an ethical civilization, other of import cardinal factors are communicating, acquisition, leadings, public presentation direction, and training. The boards of the company demand to carefully see how to carry on the codification, in order to maximise its effectivity. Furthermore, board should go oning monitoring and rating of the codification which can assist organisations to find whether the codification is to accomplish its expected consequences.Execution of corporate societal duty policyIn today organisation, it is important for the company to implement plan of corporate societal duty. A corporate societal duty can assist the company to derive competitory advantages compare to the other company which had non implement the CSR plan. Basically, Corporate societal duty is means that a corporate enterprise to measure and take duty for the company ‘s effects on the environment and impact on societal public assistance and besides provide just intervention of all stakeholders such as employees, consumers, provider. The followers will be the stairss for the company to implement a corporate societal duty policy: Measure 1: Explore commercial chances and analysis of the concern environmentInternal CSR working groupActively affect your employees in the design and execution of CSR policies. This will forestall deficient support for the CSR policy from the administration in the hereafter. Ensure that the relevant sections are represented in the working group, i.e. the direction, buying, production, HR, selling and communications. Make the treatment of CSR an built-in portion of squad meetings and be originative. CSR demands an advanced expression at the company.In order to find the concern instance of corporate societal duty for the company, it is of import for the board to first cognize what is the outlook of stakeholders from company in the field of CSR.. Therefore, the president and executive direction should later associate the outlook of the stakeholder to the company nucleus activities and interpret into concern chances every bit many as possible. However, the board of company should non t o make this alone but put together an internal working group to travel through together and supported on the policy program. An illustration of the internal working group will be the employees of the company who executing the twenty-four hours to twenty-four hours operation work of the company. The board can pass on with employees about CSR attempts. The board should take an involvement non merely in what their employees say, but besides in what they really know. In order to guarantee internal stakeholder thrust, the board besides can ask for employee sentiment or believing about where the company directs its CSR attempts or promote employees direct engagement in those attempts. Beside this, the board besides should necessitate the stakeholders regular communicating about CSR end and acknowledge the parts of the employees, as they have invested the most energy, clip and committedness towards accomplishing those ends. Measure 2: Evaluation on the company After the completion of measure 1, the executive direction should hold an thought of the precedence corporate societal duty offers to the company and how to react to stakeholder outlooks on the corporate societal duty of the company. The following measure for the board is to size up company within the context of corporate societal duty. By making this, it can assist to give the board an thought of what company CSR policy program should be aimed. Measure 3: Put the ends of CSR policy In measure 3, the executive direction can choose the hazard, betterment points and concern oppurtunity that need to concentrate, so later formulate selected betterment point, rish and concern oppurtunity. After that, the board and executive direction should find which are short term ends and long term ends. After that, the direction besides can find whether extra informations and research are neccessary for the CSR aims and see whether to. fall in a sector-specific CSR ( audit ) programme which can assist to give the company CSR policy more impact. Measure 4: CSR policy program After the company determined which CSR ends have precedence, so the executive manangement can get down conform the aims and actitivies of corporate societal duty aims and activities into the current procedure and system. The executive manangement required to apportion the duty and responsibility to the staff for achieve the end. After allocated responsibility for the staff, policy program is now ready and company can take action. Futhermore, direction of the company demand to put out CSR policy program on the company offficial web site and to reexamine and update it on a regular basis. Last, executive direction should do certain the employees are understand their function in implementing corporate societal duty.DecisionAs a decision, it is of import for all board members to reconsider their function and responsibility in today organisation in order to follow with the jurisprudence and ordinance such as the Bursa Malaysia Listing Requirement and other administration model. Futhermore, its is important for the president of the board and other officer of the company to implement some action program such as development of codification of behavior and moralss of the company, and execution of corporate societal duty policy of the company in order to guarantee sound administration while facilitate the company to stay its competitory advantages.