Analysis of To Kill a Mockingbird by Harper Lee :: To Kill a Mockingbird Essays

Analysis of To Kill a Mockingbird by Harper Lee Born in Monroeville, Alabama, on April 28, 1926, Nelle Harper Lee is the youngest of three children of Amassa Coleman Lee and Francis Lee. Before his death, Miss Lee's father and her older sister, Alice, practiced law together in Monroeville. When one considers the theme of honor that runs throughout Miss Lee's novel, it is perhaps significant to note that her family is related to Confederate General Robert E. Lee, a man especially noted for his devotion to that virtue. Miss Lee received her early education in the Monroeville public schools. Following this, she entered the University of Alabama to study law. She left there to spend a year in England as an exchange student. Returning to the university, she continued her studies, but left in 1950 without having completed the requirements for her law degree. She moved to New York and worked as an airline reservation clerk. Character It is said that Miss Lee personally resembles the tomboy she describes in the character of Scout. Her dark straight hair is worn cut in a short style. Her main interests, she says, are "collecting the memoirs of nineteenth century clergymen, golf, crime, and music." She is a Whig in political thought and believes in "Catholic emancipation and the repeal of the corn laws." Sources Of To Kill A Mockingbird Among the sources for Miss Lee's novel are the following: (1) National events: This novel focuses on the role of the Negro in Southern life, a life with which Miss Lee has been intimately associated. Although it does not deal with civil rights as such - for example, the right to vote - it is greatly concerned with the problem of human dignity - dignity based on individual merit, not racial origin. The bigotry of the characters in this novel greatly resembles that of the people in the South today, where the fictional Maycomb County is located. (2) Specific Persons: Atticus Finch is the principal character in this novel. He bears a close resemblance to Harper Lee's father, whose middle name was Finch. In addition to both being lawyers, they are similar in character and personality - humble, intelligent and hard-working. (3) Personal Experience: Boo Radley's house has an aura of fantasy, superstition, and curiosity for the Finch children. There was a similar house in Harper Lee's childhood. Furthermore, Miss Lee grew up amid the Negro prejudice and violence in Alabama.

Beauty Revisited :: Japan Culture Greece Essays

"When a man has gone deep enough in the lore of love and turned his attention to things of beauty in their due order,... there shall dawn upon his eyes a vision of surpassing beauty, for whose sake he endured all his former toils; a beauty which, in the first place, is eternal, without beginning and without end, unbegotten and without decay; and secondly, is not beautiful at one time or one place or from one point of view and then ugly, as if its beauty depended upon the beholders. Nor again will that beauty to his eyes take on the likeness of a face or hands or any fleshy part, nor of speech or learning, nor will it have its being in any other creature but will have its simple and essential being ever one within itself. ..." -plato "So when any one climbs the ladder of true love in this world till he catch a glimpse of that other beauty, he has almost attained that goal. And this is the true discipline of loving or being loved: that a man begin with the beauties of this world and use them as stepping stones for an unceasing journey to that other beauty, going from one to two and from two to all, and from beautiful creatures to beautiful lives, and from beautiful lives to beautiful truths, and from beautiful truths attaining finally to nothing less than the true knowledge of Beauty itself, and so at last what Beauty is." -Plato What is art? Who cares of beauty? What really goes on when I make art. Why do I love art? Do I feel the essence of this journey which Plato speaks of? Beauty, yes, that is the focus of my life,... beauty. It sounds fantastic, but it may be true. by looking at Platonic and Japanese ideals of aesthetic beauty, I will show that art is all about a feeling, a communion with that "simple and essential being, ever one within itself." It is an ongoing dialogue with the mystery of sentient, hard to discern emotions. I'm wary to say that my artistic endeavors are aimed towards beauty, maybe skill, luck, or ingenuity. This essay is more about the glue which bind one artistic experience to another, an irrational and ever-present push towards the unmade. Plato's basic philosophy centers around the "Allegory of the Cave," which, distilled, points out that for man to think that he may know the whole truth, end all and be all in itself, is for him to declare the largess of his own ego.

Cost, Access, and Quality Essay

*Access to care may be defined as the timely use of needed, affordable, convenient, acceptable, and effective personal health services. Accessibility refers to the fit between the location of a provider and the location of patients. *Administrative costs are costs associated with the management of the financing, insurance, delivery, and payment functions. These costs include management of the enrollment process, setting up contracts with providers, claims processing, utilization monitoring, denials and appeals, and marketing and promotional expenses. *An all-payer system requires the participation of all major health care payers in a nationwide cost-containment program. APG stands for ambulatory patient groups, which are based on a patient classification and payment system designed to identify and explain the amount and type of resources used in an ambulatory visit. Patients in an APG have similar clinical characteristics, similar resource use, and similar cost. *Clinical practice guidelines (also called â€Å"medical practice guidelines†) are explicit descriptions representing preferred clinical processes. They are standardized guidelines in the form of scientifically established protocols designed to guide physicians’ clinical decisions. *Competition refers to rivalry among sellers for customers. In health care delivery, it means that providers of health care services would try to attract patients who have the ability to choose from several different providers. Although competition more commonly refers to price competition, it may also be based on technical quality, amenities, access, or other factors. *Cost-efficiency evaluates the relationship between increasing medical expenditures/risks and improvements in health levels. A service is cost-efficient when the benefit received is greater than the cost incurred in providing the service or the potential health risks from additional services. *Cost shifting refers to the ability of providers to make up for lost revenues in one area by increasing utilization or charging higher prices in other areas. *Critical pathways are case specific plans of medical care that identify along a time line w ho will provide what interventions and what the expected outcomes would be. *Demand-side incentives refer to the cost-sharing mechanisms that place a larger cost burden on consumers, thus encouraging consumers to be more cost conscious in selecting the insurance plan that best serves their needs and more judicious in their utilization. *Defensive medicine is the practice of medicine that involves prescribing tests and services that are not medically justified but are likely to protect physicians against possible malpractice lawsuits. *Fraud involves a knowing disregard for the truth. It generally occurs when billing claims or cost reports are intentionally falsified. It includes pro vision of ser vices that are not medically necessary and billing for ser vices that were not provided. *Outcome is the end result obtained from utilizing the structure and processes of health care delivery. Outcomes are often viewed as the bottom-line measure of the effectiveness of the health care delivery system. *Overutilization occurs when the costs or risks of treatment outweigh the benefits and yet additional care is delivered. *The term peer review refers to the general process of medical review of utilization and quality w hen it is carried out directly or under the supervision of physicians. *PRO stands for peer review organization. PROs are state-wide private organizations composed of practicing physicians and other health care professionals who are paid by the federal government to review the care provided to Medicare beneficiaries to determine whether care is reasonable, necessary, and provided in the most appropriate setting. *Quality has been defined as the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. *Quality assessment refers to the measurement of quality against an established standard. *Quality assurance is a step beyond quality assessment and is synonymous with quality improvement. It is the process of institutionalizing quality through ongoing assessment and using the results of assessment for continuous quality improvement (CQI). *Reliability reflects the extent to which the same results occur from repeated applications of a measure. *Risk management consists of proactive efforts to prevent adverse events related to clinical care and facilities operations and is especially focused on avoiding medical malpractice. *Small area variations refer to the unexplained variations in the treatment patterns for similar patients and health conditions in different parts of the country. *Supply-side regulation typically refers to antitrust laws in the U.S., which  prohibit business practices that stifle competition among providers, such as price fixing, price discrimination, exclusive contracting arrangements, and mergers deemed anticompetitive by the Department of Justice. *A top-down control over total health expenditures establishes budgets for entire sectors of the health care delivery system. Funds are distributed to providers in accordance with these global budgets. Thus, total spending remains within pre-established budget limits. The downside to this approach is that, under fixed budgets, providers are not as responsive to patient needs, and the system provides little incentive to be efficient in the delivery of services. Once budgets are expended, providers are forced to cut back services, particularly for illnesses that are not life-threatening or do not represent an emergency. *TQM stands for total quality management and is synonymous with continuous quality improvement (CQI). It is an integrative management concept of continuously improving the quality of delivered goods and services through the participation of all levels and functions of the organization to meet the needs and expectations of the customer. *Underutilization occurs when the benefits of an intervention outweigh the risks or costs, yet the intervention is not used. *The validity of a scale is the extent to which it actually assesses what it purports to measure. REVIEW QUESTIONS 1. What are the two main objectives of this chapter? 2. What are the three major cornerstones of health care delivery? 3. What is meant by the term â€Å"health care costs†? Describe the three different meanings of the term ‘cost.’ 4. Why should the United States control the rising costs of health care? 5. Name and describe the 9 major factors contributing to the high costs of health care. 6. What is a third-party payment/reimbursement? 7. Explain how, under imperfect market conditions, both prices and quantity of health care are higher than they would be in a highly competitive market. 8. Discuss price controls and their effectiveness in controlling health care expenditures. 9. Discuss the role of PROs (peer review organizations) in cost containment. 10. What are the two competition-based cost-containment strategies? 11. What does access to care mean? 12. What are the implications of access for health and healthcare delivery? 13. What is the role of enabling and predisposing factors in access to care? 14. What are some of the implications of the definition of quality proposed by the Institute of Medicine? In what way is the definition incomplete? 15. Discuss the dimensions of quality from the micro- and macro-perspectives. 16. Discuss the main developments in process improvement that have occurred in recent years.

Great Expectations Essay

Great Expectations, a novel by Charles Dickens, was first published in England as a serial in the years 1860 and 61 then later as a novel. It runs to 448 pages in modern paperback. The work is considered to be autobiographical and told in first person as a memoir of the orphan boy, Pip. Dickens’ thesis is moral in nature, saying that love, loyalty and a clean conscience are more important than wealth, social class and ambition. Pip believes he is in love with the Estella, a ward of the rich Mrs. Havisham and seeks to become a gentleman in order to win her heart. He comes to realize his sister and her husband and the convicted criminal, Magwitch, though low in social class, display more character than those he knows of the upper class. Dickens, through his protagonist, advances the idea that nobility is not noble by nature, and one can advance on his own intelligence and work ethic (183). Mrs. Havisham’s family earned their money in commerce but she still represents wealth. Dickens depicts her as a bitter and vengeful old woman, full of hatred for men. She uses Pip and encourages the like-minded Estella to break his heart (60). Pip comes into money and believes that the upper class Mrs. Havisham is his benefactress, which is not true. His money comes from the convict Magwitch who wants to make Pip a gentleman for his own reasons (335). Bentley Drummle, while a minor character, is used by Dickens to show that nobility does not confer morality on a person. Dickens proves his thesis by the relating the callous behavior of the upper classes, compared and contrasted to the kindness of his poor family and the lower classes represented. He produces a litany of noble scoundrels and lowborn citizens with high moral fiber for the reader to consider.

Advanced pathophysiology Essay

If available lab results, I would like to see the resulted complete blood count with differential and complete metabolic profile. Possibly supplying the patient with supplemental oxygen if deemed so by her oximetry and perfusion status review. As such the following would be the initial assessment and treatment: Obtain vital signs: blood pressure, temperature, pulse, respiratory rate with auscultation, as well as pain scale rating Note her capillary refill time and skin color and turgor, especially around lips for color and for turgor Seeing if she has sunken eyes or dry mucous membranes indicative of dehydration. Place a pulse oximeter on her finger for oxygenation levels. Place EKG monitor for heart rate and rhythm analysis. Place IV for obtaining blood works and order stat CBC, CMP, PT/INR/PTT, ABG, CXR, cardiac and liver enzyme profiles. Perform blood glucose monitoring with glucometer for immediate assessment of her diabetic state, is she hypo or hyperglycemic. Review airway for any obstruction as she is dyspneic. While conscious review pain level, duration and site of pain and medical history-hopeful to review current medications, with attention to evaluate current mental status such as orientation to person, time and place. Note that she is in acute distress with disorientation that is progressing to unresponsiveness (Gerontological nursing, 2010). If unresponsive at the time of arrival, the nurse needs to be vigil in looking for clues to how she is experiencing pain by looking for signs such as moaning, agitation, restlessness and facial grimacing. Assess skin is intact with no abscesses or open wounds or sores. Consider value of inserting a urinary catheter. Tools that will be utilized in the assessment of Mrs. Baker may include: Stethoscope- will be used for listening to heart beat to ascertain dysrhythmia above 90 beats/minutes would be indicative of concern and comparing radial/peripheral pulses with baseline of heart apex rate to ascertain if variance exists , auscultation of lungs for clearness of lung fields and respiratory rate should be 16 per minute if she is over 20 breaths/ minute concern for hyperventilation and oxygen delivery and consumption would arise . Tachypnea and dyspnea are noted, oxygen would be applied. blood pressure cuff (sphygmomanometer)- The blood pressure cuff will determine if she is normotensive or hypo-hypertensive, expected range is 120/80 mmHg if below 90 mm hg systolic or 70mm hg diastolic is cause for concern. Glucometer-ascertain rapidly, serum blood glucose level range expected 70 – 130 (mg/dL) before meals, and less than 180 mg/dL after meals (as measured by a blood glucose monitor). blood tubes with needle access for blood testing (vacutainers)-to conduct CBC- to monitor white blood cell, red blood cell and platelet counts, CMP- for fluid and electrolyte imbalance, kidney and liver function, ABG-, analysis for acid/base imbalance liver and cardiac enzyme for indication of liver or cardiac impairment as well as blood coagulation profile such as PT/INR/PTT- for elevation in bleeding time . Blood cultures and antibiotic sensitivities for sepsis pulse oximeter-to rapidly measure the oxygenation of her hemoglobin saturation 95 to 99 percent expected. continuous cardiac monitoring via electrocardiogram(EKG)-to examine rhythm and rate-expect normal sinus rhythm and rate 80-100 beats per minute. Thermometer-measure the core temperature which should be 37 c if above 38 c or below 36 c if hypothermic bladder catheterization kit chest x-ray- cardio pulmonary function The benefits of using these tools, as time is critical for an older patient who has multiple organ dysfunction syndrome(MODS), is to have precise and state-of-the-art information to effectively treat the patient. Maintaining and monitoring tissue perfusion would be key goals in her care and I would utilize these tools to evaluate blood pressure and respirations, monitoring pulse and assessing for any cardiac arrhythmias. To evaluate for any underlying respiratory disease, pneumonia, PE, or pulmonary edema a chest x-ray would be advantageous. A bladder catheter would give accurate accounting of urinary output. The patient became unresponsive; her respirations became more labored, so breathing became the main priority while reading the scenario. The patient is unable to verbalize how she is feeling and with her dyspnea it is clear she is in respiratory distress. Evaluating the electrocardiogram would be done to ascertain if there are any dysrhythmias that could be causing the symptoms. I would review the vital signs, is the patient having hypo- hypertension? Review the patient’s pain assessment, is the patient experiencing any pain? I would then review lab results, focusing on abnormal results. The prioritization was done with basis for basic needs first, that of breathing effectively to promote oxygenation then focus of vital sign monitoring that is compatible with sustaining life. I would assess pain in a geriatric patient who is alert by questioning the patient directly, do they have any pain, asking them where the pain is, what is the duration of the pain and when was onset. On a numeric pain scale 0 to 10 what is their level of pain. Are they taking any pain medication at home? In a geriatric patient who is not alert, I would need to assess the patient based on signs such as moaning, agitation, restlessness and facial grimacing. I would manage the pain in a geriatric patient experiencing multisystem failure and showing signs of pain but not alert with caution. The elderly are susceptible to polypharmacy and often have impaired renal function that increases risk or potentiates the medication such as barbiturates. Knowing I have a standing order for acetaminophen and by judgment of the pain with a lot of moaning, restlessness and grimacing, I would elect to give the morphine 0.1mg/kg IM. She cannot take the acetaminophen by mouth as she not responsive, the 0.05 mg/kg Morphine IV will likely obtund the patient with the rapid absorption and likely decrease her blood pressure severely as she is dehydrated. The patient’s pain level would need to be reevaluated approximately 20 minutes after administration for effectiveness and then again in one hour. It is likely with her being unconscious , I would assess by a presence or lack of grimacing, moaning or agitation. I found her to have been relieved of pain when reassessing her I have learned it is very important to recognize the fragility of the elderly related to polypharmacy, agedness of vital organs, key focus on concern of cognitive ability and its role in assessment by nursing. It is likely that the metformin (Glucophage) can have decreased effects when combined with Hydrochlorothiazide (diabetes forum, 2012). The patient recently added lisinopril to her regimen and this in the form of Zestoric has hctz in it as well. It is possible she has had too much hctz and the prescribing physician needs to be alerted. The recommendation for this possible interaction is to monitor blood sugar levels when taking all three of these medications. This is especially important when starting, stopping or changing the dosage of your lisinopril/HCTZ. The collaborative team members pertinent to her care are the emergency room physician for immediate assessment, diagnosis and treatment recommendation, the medical physician involved in her current care, possibly an endocrinologist who is managing her diabetes, a pulmonologist or intensivist who is caring for her current state as a consultant and the radiologist and cardiologist who will review her lab, radiology and EKG results. In the event where her status became unconscious the respiratory therapist and emergency room physician and ER code team responded to facilitate returning her to stable vital signs. It is likely she will need social work involvement and discharge care planning as she will be admitted until the current situation is diagnosed, treated and stabilized. References Gerontological Nursing: Competencies for Care, Second Edition, 2010. http://www.diabetesforums.com/forum/type-2-diabetes/48316-lisinopril-hctz-20-12-a.html accessed November 24, 2012.

Chapter 4 Assignment Example | Topics and Well Written Essays - 250 words - 1

Chapter 4 - Assignment Example During the 1950s-1980s, Matsushita was able to make use of the post-war effects on the Japanese economy; most Japanese were grateful to receive job security at a time of uncertainty. As the Japanese economy expanded and the workforce grew older, suddenly employees had found the freedom to find a job to best suit their needs. This resulted in a shaky business environment from the point of view of Japanese business, but it greatly benefitted the average employee. 4. What is Matsushita trying to achieve with human resource changes it has announced? What are the impediments to successfully implementing these changes? What are the implications for Matsushita if (a) the changes are made quickly or (b) it takes years or even decades to fully implement the changes? Matsushita is trying to offer more options for its employees be being flexible in working conditions. The impediment to this change is an older generation set in its ways that refuses to either change or move on. If the changes are made quickly, older employees may quit in protest and the company may lose some of its most valuable assets. On the other hand, if it takes too long to implement the changes, Matsushita may grow at a slower pace than its competitors and lose significant market share. The Matsushita case shows that societal culture and business success are linked. Culture is always changing, so business needs to do the same. If a business remains the same for too long, productivity decreases and workers lose interest in their

Triple entry accounting and financial statements Assignment

Triple entry accounting and financial statements - Assignment Example Today many companies often use statements from previous periods or years in order to project the likely outcomes of current finances. This method is not always accurate. Triple-entry accounting is intended to provide predictive accounting that is more accurate than basing results solely on previous outcomes.(Henke)The process of triple-entry accounting is a complex process. It is believed that these methods may be able to predict the future of the business and, even allow, for unforeseen expenditures and happenings. The intention of the triple-entry accounting is to give businesses a clearer view of financial earnings based on an equation that takes into consideration the past, present and future; not just historical data.(Henke)This could be considered a great improvement over current financial statement methodology. Essentially the articulation of the four relevant financial statements simply means that the numbers in the statements among all the statements provided are in agreement with one another. However, there is a lot that goes along with that simple definition The four statements that need to articulate properly are the balance sheet, income statement, Statement of Stockholder Equity, and the Statement of Cash Flow. The balance sheet, is divided into three sections: assets, liabilities, and stockholders’ equity, provides the information concerning the available resources the resources to management and any claims against those resources by present creditors and shareholders. ("Cambridge Publications") All the gains and losses are recorded and then transferred to the income sheet as necessary. The Stockholders Equity reflects the all of the financing provided by the company’s owners. The stockholders hold a claim on residual interest which is accrued via, common stock, prefe rred stock, treasury stock, retained earnings, additional paid capital, any other accumulated income or loss. the statement of cash flows provides