The Patriot historically accurate free essay sample

Tarletons mounted legion wore green (Fischer. Hackett). Overall. the film did not portray British soldiers accurately, making them seem cruel to an extreme. Additionally, the film got wrong the way in which people during the Revolutionary War saluted one another. The film shows the protagonist, Ben Martin, raising a hand to his forehead. resembling the modern days salute. In reality though, during the Revolutionary War. ople saluted by removing their hats and placing them on their heads once again (Hand Salute). This being a small detail but still being worth noticing. Moreover, the film depicts Benjamin Martin inaccurately by making him an honorable, loving father Of seven children who iS only looking for vengeance for both Of his sons deaths. The character Sen]arnin Martin iS based on a real life historical figure, Francs Marion (Loya, Robert). Francis Marion was an American Revolutionary soldier who fought using guerilla tactics. We will write a custom essay sample on The Patriot historically accurate? or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page He disrupted antish line of communication, captured scouting and foraging parties, and intimidated loyalists. Marion also had nickname, the swamp Fox because he had a tendency of disappearing Into swamps to escape antish troops (Francis Marion). This all sounds exceedingly similar to Benjamin who did the same things and whose nick was the Ghost because he attacked British troops and disappeared and was never seen. In fact an article from the website theguardlan states that when he wasnt forging the land ot the tree, It seems that Marion was slaughtering Indians for fun and regularly raping his female slaves. unsurprisingly. The Patriot script elected to gloss wer this aspect of Its protagonists life. For these reasons the film did not do a good job of portraying Benjamin Martin. If Martin was based on Marion then it was not correct because in no moment in the film does Martin kill an Indian. The relationship between the tilm and the society ot the time in which the tilm was made is that on April 10, 1998, Britain and Ireland made an agreement to end the war. Northern Ireland was ceded by England after the Irish War of Independence ended (Keko, Don). It is probable that the producers of the film were inspired by the Irish War of Independence to make a film about the American War of Independence. My opinion of the film is that aside from the multiple historical inaccuracies in the film, the film was able to capture the attention of its viewers persistently. Many elements made this an entertaining film. For instance, the visual elements such as the battlefields special effects. Also the romance, the faith, the hope, the honor, and the triumph made this a captivating film. This film had a lot of criticism, but people need to face the fact that this is not a historical documentary, and that it is Just entertainment. Yes the films setting is in the past, yes the film is about the Revolutionary War, and yes it deals with history, but that does not automatically make it a documentary. I would definitely recommend this to another student. The film The Patriot is not historically accurate. In fact, it is doubtful if the purpose of the film was to be historically accurate. It is most likely it was for sheer entertainment. Nevertheless, the film did not portray British soldiers, the way people saluted one another and the protagonist Benjamin Martin accurately. For these reasons is why it remains impossible to call it historically accurate. Works Cited Fischer, Hackett. Hubris, But No History.

Lab 3 essays

Lab 3 essays 1. Of the tools described, I feel that the Executive Support System (ESS) is the best tool for managers today. Not only does it have speech recognition which simplifies typing commands, but it also has expert systems which are self-learning and help aid in decision making. Also packaged in ESS is executive support software, which helps customize databases to fit executives specific needs. 2. The six characteristics of useful information are as follows: significance, reliability, consistency, timeliness, comprehensibility and action-oriented impact. 3. Calendar management software virtually eliminates the multiple phone calls required to schedule meetings; instead, meetings for ten individuals can be scheduled as quickly as a meeting for two people. The best advantage of this software is that anyone can be authorized to view the managers calendar, always seeing the same version. The least liked feature of this software is that some calendar systems dont provide full support for scheduling, which means it might not be used. 4. PDAs are much better than paper and pencil because they come with a vast amount of features that help make working easier. They include calendars, address books, to-do lists, electronic notebooks and more. The major advantage is information can be located easily by keying in a word and allowing the computer to locate it. When you think about it, there really isnt any disadvantages when it comes to PDAs because they can do just about anything you need them to do. 5. I strongly agree that video will be an integral part of the business day in the future. It will allow a business to hold meetings over television where everyone can see everyone even if they are in different states or countries. It will cut down on business travel dramatically, allowing managers to stay closer to their company to make sure business runs smoothly. 6. When it comes to teleconferencing, I feel ...

There Is No Free or Cheap Government Land

There Is No Free or Cheap Government Land Free government land, also known as claim-free government land no longer exists. There is no longer a  federal homesteading program and any public land the government does sell is sold at no less than fair market value. Under the Federal Land Policy and Management Act of 1976 (FLMPA), the federal government took over ownership of public lands and abolished all remaining traces of the often-amended Homestead Act of 1862. Specifically, the FLMPA declared that the public lands be retained in Federal ownership  unless as a result of the land use planning procedure provided in this Act, it is determined that disposal of a particular parcel will serve the national interest... Today, the Bureau of Land Management (BLM) oversees the use of some 264 million acres of public land, representing about one-eighth of all the land in the United States. In passing the FLMPA, Congress assigned the main duty of the BLM as the management of the public lands and their various resource values so that they are utilized in the combination that will best meet the present and future needs of the American people. While the BLM does not offer much land for sale because of a 1976 congressional mandate to generally retain these lands in public ownership, the agency does occasionally sell parcels of land when its land use planning analysis determines disposal is appropriate. What Types of Lands Are Sold? The federal lands sold by the BLM are generally unimproved rural woodland, grassland or desert parcels located mostly in the western states. The parcels are typically not served by utilities like electricity, water or sewer, and may not be accessible by maintained roads. In other words, the parcels for sale are truly â€Å"in the middle of nowhere.† Where Are the Lands for Sale Located? Usually part of the original public domain established during the western expansion of the United States, most of the land is in the 11 Western states and the state of Alaska, although some scattered parcels are located in the East. Almost all are in the Western States of Alaska, Arizona, California, Colorado, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, and Wyoming. Because of land entitlements to the State of Alaska and to Alaska Natives, no public land sales will be conducted in Alaska in the foreseeable future, according to the BLM. There are also small amounts in Alabama, Arkansas, Florida, Illinois, Kansas, Louisiana, Michigan, Minnesota, Missouri, Mississippi, Nebraska, North Dakota, Ohio, Oklahoma, South Dakota, Washington, and Wisconsin. There are no public lands managed by the BLM in Connecticut, Delaware, Georgia, Hawaii, Indiana, Iowa, Kentucky, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, North Carolina, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Vermont, Virginia, and West Virginia. How Is the Land Sold? The Bureau of Land Management sells unimproved public land through a modified bidding process that favors adjoining landowners, open public auction or direct sale to a single buyer. Minimum acceptable bids are based on land value appraisals prepared and approved by the Department of the Interior Appraisal Services Directorate. The appraisals are based on factors like ease of access, availability of water, possible uses of the property and comparable property prices in the area. States Do Offer Some Free Homesteading Land But... While government-owned lands are no longer available for homesteading, some states and local governments do occasionally offer free land to persons willing to build a home on it. However, these homesteading deals usually come with very specific requirements. For example, Beatrice, Nebraska’s local Homestead Act of 2010 gives homesteaders 18 months to build a minimum 900-square-foot home and live in it for at least the next three years. However, homesteading seems to be just as tough a row-to-hoe as it was in the 1860s. Two years after Beatrice, Nebraska enacted its homesteading act, the Wall Street Journal reported that no one had actually claimed a parcel of land. While dozens of people from across the nation had applied, they all dropped out of the program when they began to realize â€Å"how work is involved,† a city official told the newspaper.

Is Trial by Jury an Efficient and Just System Essay

Is Trial by Jury an Efficient and Just System - Essay Example Const., amend. VII). Many states have considered the right to a trial by jury so important that it is written into state constitutions as well (Saks). It is, therefore, not an exaggeration to say that the right to a trial by jury is considered a fundamental right of the American legal and judicial system. A trial by jury has its roots in Great Britain, where juries were used to provide protection against the harsh judgments of those that were in the favor of the King, and therefore handed down relatively harsh judgments for relatively small crimes (Graham, 2009). That system has grown, from Britain, to the United States, where in 2006 an estimated 154,000 jury trials were held nationwide (Mize, Hannaford-Agor & Waters, 2007). However, this does not mean that the system itself is perfect; indeed, if incarcerated criminals were questioned, most would likely say that the judicial system had not done what they hoped it would do. Trials by jury take time to put together, and can be expens ive to everyone involved (VanKoppen, 2009). Trials by jury also have the benefits, however, of fairness and impartiality, the bigger availability of resources, and because juries do not have the same concerns over image or power as a judge does. For these reasons, a trial by jury is an efficient and just system in proving guilt or innocence. One reason that trial by jury is an efficient and just system is that juries are chosen based on their ability to be impartial and fair towards the one who stands accused. This is proven during the jury selection, when both lawyers ask questions and ensure that each person impaneled on the jury can be fair and impartial during the trial (Saks). Potential jurors that have a problem with certain sets of circumstances, such as racism or even possibly voting for the death penalty in capital cases are dismissed (Saks). In this way, fairness towards the accused is ensured. In contrast, a judge must go through no such procedure. The role of a judge was created for the very reason of protecting an accused (Graham, 2009). It is taken for granted that a judge will be impartial; even though the Constitution does not say that a judge must be, it is the right of every American to enjoy such a privilege at trial (Siegel, 2010). However, this is not always the way that the judicial system works. Corruption is not unknown, and judges have, in the past, been bought or bribed to render decisions. Consider Operation Greylord, a Federal probe that exposed widespread corruption in the Cook County, Illinois court system in 1983 (Bogira, 2005). Judges had been found to be extorting money from prosecution and defense lawyers, as well as taking money directly in exchange for certain verdicts (Bogira, 2005). Had a jury trial been the route taken, instead of the judge being able to be bribed, twelve people would have had to be bribed or replaced. While it is true that jury tampering can certainly occur, it stands to reason that it is much harder to tamper with and convince twelve people to vote a certain way, as opposed to one judge. Juries, whether they are made up of six

STRATEGY consulting brief about Air Australia Essay

STRATEGY consulting brief about Air Australia - Essay Example Michael James joined Strategic Group in 2002 as an equal shareholder, alongside Shaun Aisen, and executive director. However, in 2011, Shaun Aisen exited the company resulting in Michael James becoming the sole owner. A few months later, other key members of staff, including the chief executive, commercial manager, and chief operating officer, left the company citing disagreements with Mr. James’ leadership as the main cause. On February 17, 2012, the company’s directors agreed that the company be placed into voluntary administration. Finally, in March of the same year, the company’s creditors voted, for Air Australia to be placed into liquidation. This was because the company could not be sold since nobody had expressed interest, and the company’s assets were not enough to cover the debts it had incurred. Air Australia’s main appeal was their cheap tickets since the company was a low-cost carrier. The budget airline provided affordable travel and, therefore, families could opt to travel short distances by air rather than spend several hours on the road. By providing low-priced, convenient, and frequent flights, Air Australia obtained its competitive advantage over its competitors. Air Australia competitive strengths also include the company’s superior customer service and capability to offer the lowest fares. Although, the company was knee-deep in debt, it had an unequaled customer service within the airline industry (Horst, 2011). Air Australia had debts amounting to an estimated $90 million but only had assets worth $1 million, since the company leased much of its equipment. The company had also been unable to pay aviation charges and fees to Air Services Australia, and owed both Melbourne Airport and Perth Airport vast amounts for terminal leasing. The company’s business had been ailing for a long time but had managed to survive, because it was cash

Air pollution Essay Example for Free

Air pollution Essay Introduction to Air Pollution Air pollution is the presence of foreign substances in the atmosphere, emitted by industries and motor vehicles that cause damage to living organisms. Air pollution characteristics Air pollution characteristics in a particular region are influenced by: The type and amount of pollutant and their source of emission. The topographical and meteorological conditions affecting dispersion, concentration and transboundary transport of pollutants. The type of technology and various raw materials used in the manufacturing process and the type and quantum of emissions. The extent of industrialization and population density. Air Pollutants Sources of air pollutants Major sources of air pollution are natural sources and man-made source. A. Natural sources: Volcanic eruptions, forest fires, deflation of sands and dusts, storms, etc. Pollutants from natural sources Volcanoes: ashes, smokes, carbon dioxide dust and other gases. Land surface: salts spray from seas and ocean, dusts and soil particles from ground-surface. Extraterrestrial bodies: cosmic particles and rays, chest produced due to bombardment of asteroid materials, comets etc. with the earth. B. Man-made (anthropogenic) sources Industries, automobiles, agriculture, power plants, domestic sources, etc. Pollutants from manmade sources Industries: smokes, fumes, dust, particulate matters. Domestic sources: gases from kitchen, domestic heating. Automobiles: smoke, fumes, emissions from different vehicles. Agriculture: insecticides, pesticides and herbicides. Power plants: heat from the power plants, smokes, fly ash. Introduction to Air Pollution Air pollution is the presence of foreign substances in the atmosphere, emitted by industries and motor vehicles that cause damage to living organisms. Air pollution characteristics Air pollution characteristics in a particular region are influenced by: The type and amount of pollutant and their source of emission. The topographical and meteorological conditions affecting dispersion, concentration and transboundary transport of pollutants. The type of technology and various raw materials used in the manufacturing process and the type and quantum of emissions. The extent of industrialization and population density. Air Pollutants Sources of air pollutants Major sources of air pollution are natural sources and man-made source. A. Natural sources: Volcanic eruptions, forest fires, deflation of sands and dusts, storms, etc. Pollutants from natural sources Volcanoes: ashes, smokes, carbon dioxide dust and other gases. Land surface: salts spray from seas and ocean, dusts and soil particles from ground-surface. Extraterrestrial bodies: cosmic particles and rays, chest produced due to bombardment of asteroid materials, comets etc. with the earth. B. Man-made (anthropogenic) sources Industries, automobiles, agriculture, power plants, domestic sources, etc. Pollutants from manmade sources Industries: smokes, fumes, dust, particulate matters. Domestic sources: gases from kitchen, domestic heating. Automobiles: smoke, fumes, emissions from different vehicles. Agriculture: insecticides, pesticides and herbicides. Power plants: heat from the power plants, smokes, fly ash.

The Physiology and Psychology of Bulimia Essay -- Eating Disorder Weig

The Physiology and Psychology of Bulimia Bulimia is a disorder centered around an individual’s obsession with food and weight. This obsession involves eating large quantities of food, feeling guilty about the food consumption, and taking drastic measures to prevent caloric/fat absorption. Measures vary with each individual and include one or all of the following: forced vomiting, abuse of laxatives or diuretics, or excessive exercise. This disease affects one to three percent of adolescent and young women in the United States, and bulimic behaviors are displayed by ten to twenty percent of adolescent and young women in the United States (http://dcs.engr.widener.edu/galla/gal la.htm). In the studies of bulimia nervosa there is a continuing debate concerning the underlying cause of the disease - whether it is physiological or psychological. Studies have found convincing results for both theories. Numerous links have been found between eating regulation and neurotransmitters. However, there is no clear evidence that neurotransmitter dysfunction is the underlying cause of bulimia nervosa. Of the neurotransmitters that have been tested, serotonin has had one of the largest roles in the regulation of food intake among patients with bulimia. Progress has also come through treating bulimia as a psychological disorder. Treatment under this theory often involves psychotherapy and the use of antidepressants. However, it is widely accepted that the path to the best results involves the combination of both physiological and psychological methods of treatment. First, the physiological aspect will be explored. Assuming that eating regulation is controlled primarily by the brain, disturbances could exist in several places: (1) the br... ... Kaye, Walter H. and Harry E. Gwirtsman, eds. (1985). The Treatment of Normal Weight Bulimia, Washington, DC: American Psychiatric Press. Pope, H.G., Jr. and Hudson, J.I. (1982). "Treating Bulimia with Antidepressants." Psychopharmacology, 78, 176-179. Stunkard, Albert J. and Eliot Stellar, eds. (1984). Eating and Its Disorders: Research Publications, 62, 84; 259-260. Walsh, Timothy B. (1988). Eating Behavior in Eating Disorders, Washington, DC: American Psychiatric Press. Winik, Myron, ed. (1988). Control of Appetite: Current Concepts in Nutrition, 16, 27-34; 82-83. Wurtman, J.J. and R.J. Wurtman, et al. (1981). "Carbohydrate Craving in Obese People: Suppression of Serotoninergic Transmission." International Journal of Eating Disorders, 1, 2-14. Wurtman, J.J. and R.J. Wurtman, eds. (1979). Disorders of Eating: Nutrition and the Brain, 3, 121. The Physiology and Psychology of Bulimia Essay -- Eating Disorder Weig The Physiology and Psychology of Bulimia Bulimia is a disorder centered around an individual’s obsession with food and weight. This obsession involves eating large quantities of food, feeling guilty about the food consumption, and taking drastic measures to prevent caloric/fat absorption. Measures vary with each individual and include one or all of the following: forced vomiting, abuse of laxatives or diuretics, or excessive exercise. This disease affects one to three percent of adolescent and young women in the United States, and bulimic behaviors are displayed by ten to twenty percent of adolescent and young women in the United States (http://dcs.engr.widener.edu/galla/gal la.htm). In the studies of bulimia nervosa there is a continuing debate concerning the underlying cause of the disease - whether it is physiological or psychological. Studies have found convincing results for both theories. Numerous links have been found between eating regulation and neurotransmitters. However, there is no clear evidence that neurotransmitter dysfunction is the underlying cause of bulimia nervosa. Of the neurotransmitters that have been tested, serotonin has had one of the largest roles in the regulation of food intake among patients with bulimia. Progress has also come through treating bulimia as a psychological disorder. Treatment under this theory often involves psychotherapy and the use of antidepressants. However, it is widely accepted that the path to the best results involves the combination of both physiological and psychological methods of treatment. First, the physiological aspect will be explored. Assuming that eating regulation is controlled primarily by the brain, disturbances could exist in several places: (1) the br... ... Kaye, Walter H. and Harry E. Gwirtsman, eds. (1985). The Treatment of Normal Weight Bulimia, Washington, DC: American Psychiatric Press. Pope, H.G., Jr. and Hudson, J.I. (1982). "Treating Bulimia with Antidepressants." Psychopharmacology, 78, 176-179. Stunkard, Albert J. and Eliot Stellar, eds. (1984). Eating and Its Disorders: Research Publications, 62, 84; 259-260. Walsh, Timothy B. (1988). Eating Behavior in Eating Disorders, Washington, DC: American Psychiatric Press. Winik, Myron, ed. (1988). Control of Appetite: Current Concepts in Nutrition, 16, 27-34; 82-83. Wurtman, J.J. and R.J. Wurtman, et al. (1981). "Carbohydrate Craving in Obese People: Suppression of Serotoninergic Transmission." International Journal of Eating Disorders, 1, 2-14. Wurtman, J.J. and R.J. Wurtman, eds. (1979). Disorders of Eating: Nutrition and the Brain, 3, 121.

Kite Runner – Chapter 9

ENGLISH LITERATURE COMMENTARY THE KITE RUNNER The paragraph shows the moment of epiphany as it is the moment where Amir realizes that Hassan know that Amir had hide behind the alley when the incident happened. Amir discovers Hassan’s love for him is endless and accepts his flaws despite after everything that has happened shows in the phrase â€Å"led to another understanding: Hassan knew†. Hassan proves that his love for Amir is so great that he forgives Amir and willing to cover up for Amir once again.Hassan knows that Amir has betrayed him and yet he still takes the blame. â€Å"My heart sank† shows that Amir is shock that Hassan is willing to sacrifice again and take the blow. However it will be â€Å"Hassan’s final sacrifice† as it will be the ultimate sacrifice of Hassan and break the pain they both are undergoing. The situation isn’t the same anymore after the incident happened as their friendship is broken already and with Hassanâ€⠄¢s final sacrifice it puts down the curtain down to what happened in the alley.The connotation of the ‘snake’ shows that it is Amir who is responsible for everything and the sneaky evil. The simile also interjects the fact Amir is not loyal. â€Å"The monster in the lake† refers the dream that Hassan had before the kite competition but in this reference Amir is telling that monster do exist and he compares himself to a monster in which he is cruel and a wicked person who is liable for the whole event. â€Å"I wasn’t worthy of this sacrifice. I was a liar, a cheat, and a thief.And I would have told, except that a part of me was glad† shows that Amir realizes all his drawbacks and that he wasn’t worthy of Hassan’s sacrifice but at the same time he is glad that everything will be over. He is glad that maybe he would be able to move on and continue to his normal life again without having to think about his mischief because so far everythi ng reminds him of the incident. â€Å"I wanted that, to move on, to forget to start with a clean state.I wanted to be able to breathe again† conveys a message that after the incident he is not able to breathe properly because he always recall the bad memories and how he feels so desolate. He believes the only way to start a new clean state is for one of them to leave and with the presence of Hassan it is harder for Amir to erase the guilt and memory from his mind and he wants the memory to stop haunting him like a ghost. He wants to be able to breathe again and with the fact that Hassan is leaving he thinks that the pain would at least be over, his guilt will lessen, he wont be haunted anymore.

Business Portfolio Presentation and Paper Essay

The business organization of the consulting company is that the leadership group will work hands-on with the consultants to ensure internal customer knowledge and external customer satisfaction. The consultant staff will work with the sales staff for a week to understand the tasks that they have. The sales staff will work with the consultants at the business to better understand the customer’s expectation. The Human Resources Department will work all facets of the business to have an understanding, this will allow them to speak to performance issues if they should arise. The potential legal issues that this business might face are if there are inaccuracies with billing. The consultants will also face challenges with following both policies of the consulting company, and adhering to the policies of our client’s business. Failure to do so on our behalf will result in a breach of contract by our company. The ethical issues that the business will have is to act as if the co nsultant was an employee of the company. The consultant should refrain from the fraternization of employees of our client. Our client needs to know where they can optimize profit and fraternizing with their employees would hinder the consultant’s ability to give a fair assessment if they were looking to cut jobs to save costs. The business culture of the consulting firm will be customer-centric. Every employee with put the customer at the core of everything that we do. The leaders of the company will put the internal customers at their core and employees will put the clients at theirs. The company will build on the foundation of putting people first. The Human Resources Department will be in charge of following-up to ensure that we are executing at the highest level in this area. The company will use anonymous employee surveys and customer surveys to ensure the highest satisfaction to internal and external customers. The motivation that the company will utilize will be a comprehensive benefits  package to include 401K with a 5% match, health insurance, and performance based bonus program. The co mpany will also have a variety of cross-training to all employees to ensure that the employees are well trained to perform their tasks efficiently. The technology that the company will use will be computers, laptops, cell phones, and tablets. The computers will be used to process all the customers’ invoices and will store the customers’ contacts also. The company will store any excess information on an external hard drive. The laptops will be given to the sales, consulting, and to Human Resources Departments. The cell phones will be given to all employees to stay in contact with company personnel and the customers. The tablets will be given to the consultants to document notes while at the client’s location. The Human Resources Department will handle the five components of human resources management in the following manner: 1) Recruitment and Selection – The applicant selection process is based off their experience and education, with an emphasis on experience. Human Resources will also look into job history and background. Once HR screens the potential employee, they will schedule a second interview with operations leadership with the applicant. 2) Training and Development – HR will setup the training schedule for the new employees and will schedule the new employee with a top performer in the department. For the existing employees, HR will also schedule and track all the employees to ensure that they get cross-training in the other departments to understand the business better. 3) Performance Appraisal and Feedback – HR will be in charge of tracking performance appraisals and feedback. However, the leaders of each department will be responsible for executing this and forwarding the information to the HR Department. HR will put this information into the employees’ personnel files. 4) Pay and benefits – The pay structure and benefits will be looked at and setup with collaboration of the owner and the HR Department. HR will keep leadership aware of current pay in this field in order to retain employees. HR will ensure that employees receive the benefits package that the company offers when they become eligible for them. 5) Labor relations – HR will schedule employee commitment and satisfaction surveys and compile the results for the leadership of the company. Pulse surveys will also be used by HR to follow-up on results from the commitment and satisfaction survey opportunities that the employees highlight. The costs of operations  on the business would include the following: lease, payroll, insurance, taxes, legal fees, utilities, cell phone, and office supplies. The business would need all of these items to run the operations effectively. The company is relying on their quality service for their clients business to cover all these costs, and to ensure that the business is profitable.

When to Pull the Plug Professor Ramos Blog

When to Pull the Plug Fig. 1.Living will. â€Å"Silly Sunday: Life Support.† https://joycelansky.blogspot.com/2012/09/silly-sunday-life-support.html Death is inevitable. It is topic not many people would like to think about much less be comfortable to talk about.However, it is a very sensitive issue that should be discussed between family members. Many of these patients have no written legal documents that state their end-of-life wishes. If a brain dead patient is placed on a breathing machine and other forms of life support, who would be the one in charge of making life-and-death decisions such as when to pull the plug? When the choice to take a loved one off of life support after brain death is declared to families, the choice is not always easy. Today, doctors and family members face challenging ethical questions concerning when and if they should pull the plug. Therefore, to relieve both sides from making such a difficult decision, a brain dead patient should be pulled out from any means of life support per patient’s wish as indicated: in his/her living will, per doctor’s pronouncement based on neurological crit eria of brain death, per hospital’s concern as to minimize financial burden, and unnecessary suffering of both the patient and their family. Fig. 2.Who do you wish to make health care decisions for you when you can’t make them for yourself any longer? https://www.winstonmedical.org/visitors-patients/advanced-directive/ Brain Death Scenario: There are many cases of brain dead patients who are placed on life support machines. The most recent case is JahiMcMath, a 13-year-old African American girl from Oakland, California, who got admitted in the hospital for sleep apnea (breathing repeatedly stops and starts when asleep) and had her tonsils removed, was pronounced brain dead on December 12, 2013 after she suffered massive blood loss from surgery (Schmidt 1). She had no living will before the surgery, which directly made her parents as surrogates to make decisions for her. She was placed on life support for four years. When her parents decided to pull the plug, Jahi stopped breathing and her heart stopped beating. She was pronounced dead the second time on June 22, 2018 (2). Fig. 3. Brain death. http://1.bp.blogspot.com Brain Function: What is the function of the brain? Kasule states the brain is the command, coordination, and communication center for the body to work (2). He continues, when an injury to the brain happens due to lack of oxygen, the brain is very sensitive to such abuse, that it dies irreversibly first before other major organs like the lungs and the heart. The injured brain cannot recover or be replaced. Therefore, the brain controls all the other organs, and when it dies, the other organs imminently follow. Fig. 4.Neurological criteria for death (Brain Death Protocols).CrashMaster, http://crashingpatient.com/intensive-care/neurologic-criteria-for-death.htm/ Reason #1: Why Unplug – Patient is Brain Dead Based on Neurological Assessment Criteria The neurological assessment for brain death is a universal law or criteria followed by doctors when examining and confirming if a patient is dead or alive, based on neurological criteria as lack of responsiveness (coma), absence of brainstem reflexes (i.e. pupils do not react to light, no facial muscle movement, no gag reflexes), absence of breathing drive, and no brain waves activity as shown in figure 4. If there is no change, the test is repeated after 24 hours to confirm death (Jakusovaite et al 206). This has become the criteria for brain death confirmation that doctors follow. As opposed to comas, when patients are in comas whether medically induced or through the patient’s health process, tests are done such as those indicated above that show that the body is still responsive and the brain is not dead. There is also a test to check for brain waves and in coma patients, brain waves are still present. However, in the brain dead patient, waves are no longer present or acti ve. In 1973, brainstem death was identified as the point of no return and the United States Uniform Determination of Death Act was enacted (Kasule 2). The brain dead patient is not able to cough or swallow, breathe on their own, do not display brain waves, and have no hope in quality of life. Thus, by pulling the plug, it will cause the patient’s breathing to cease and thereby causing the heart to stop. Reason #2: Why Unplug – It Drains Family Resources When Patient Has No Point of Return (Dead) The purpose of protecting resources is attained by earlier confirmation of death using brain death criteria to stop expensive life support in the Intensive Care Unit (ICU). The daily costs in the ICU are higher during the first 2 days where the cost of mechanical ventilation is $10,794 on day 1 and $4,796 on day 2 (Dasta 1266) in addition to ICU equipment supplies. As of January 1, 2018, the cost of room and board in critical care or trauma pediatric intensive care unit in University Hospitals in Cleveland Medical Center is $10, 140 per day (Patient Pricing Information 1). The indirect costs are expenses when family leave their work and travel to the hospital daily. However, once death is confirmed any further ICU care is a waste of resources (Kasule 5). In fact one of the reasons a patient is taken out of life support is when the family can no longer afford the financial cost of the treatments. The cost is so high that it takes toll on the family’s finances. It is a lose-lose situation if a patient will never recover and the family will end up in debt.Due to this financial burden, it is important that staff have a realistic conversation with the family to discuss the patient’s quality of life and the need to pull the plug. Fig. 5.Advanced directive.https://www.winstonmedical.org/visitors-patients/advanced-directive/ Fig. 6.Percentatge of Americans without advanced directive. â€Å"Your Resolution for Advance Directives.†https://www.hhhc.org/resources/news/advance-directives/resolution-advance-directives/ Reason #3: Why Unplug – Respect One’s Wishes Not to Be on Life Support if No Quality of Life Many critically ill patients opt out of life support and state their wishes in an advanced directive or living will in the event there is no chance of recovery or quality of life. Tejwani defines advance directives as a set of instructions recognized under state law in reference to the provision of health care when the individual is incapacitated (772). It communicates one’s wishes to family, friends, and health care professionals in the event of becoming unable to voice one’s own wishes. It may also include durable power of attorney (POA), a document designating a surrogate decision-maker if the individual is incapacitated and can include orders for withdrawal of life support. Patients with advance directive are much more likely to receive end-of-life care consistent with their preferences. A majority of the population in United States do not have advance directives as shown in figure 6. A surrogate or proxy speaks for the patient and is to follow the patient’s specific views on end-of-life values and preferences. If the patient’s preferences are unknown, the surrogate should make decisions in the best interest of the patient (772). It can be difficult to begin the conversation on end-of-life preferences, however, a simple and/or quick discussion can make a huge difference. In the instance of Jahi, had her parents and medical staff asked her what her preferences were prior to her surgery, it may have made a difference for her and her family’s suffering afterward. Thus, the growing consensus is that every adult, regardless of age, should consider preparing an advance directive because unforeseeable accidents can and do occur. Fig. 7.Ventilator/ventilator support.https://www.nhlbi.nih.gov/health-topics/ventilatorventilator-support Addressing Opposite Side #1 – Family believes Patient on Life Support is Alive Family members often believe that a patient on a breathing machineor ventilatoris still alive because the patient is breathing and the heart is beating even when the brain is dead. The use of life support is that it sustains life for a longer period of time to allow for the processing a traumatic event, acceptance of the situation, more time to grieve, and possible solutions. However, it is wrong to keep someone alive without their consent, possibly prolonging their suffering. The downside to this situation is difficult to determine when is the right time to pull the plug? In the case of JahiMcMath, who was on life support, her parents believe that it is morally wrong according to their religious belief to let someone die (Schmidt 1). Emotionally, it is difficult for Jahi’s family when confronting the issue of her brain dead status and it would be difficult for them if they are asked to pull the plug. Her parents were hoping she would recover, that is why they opted for life s upport (Schmidt 2). However, after 4 years of being on life support, Jahi’s organs started to fail. Her parents decided to pull the plug because that is the only realistic option for them and for their daughter. Had the parents understood the meaning of brain death and what it means in terms of her quality of life, it is possible that they would have pulled the plug sooner. Because after they turned off the ventilator, Jahi stopped breathing and her heart stopped beating. The only support to keep her alive was the breathing machine. Fig. 8.Brain-dead patients deserve to be laid to rest. https://sundial.csun.edu/2014/01/brain-dead-patients-deserve-to-be-laid-to-rest/ Addressing Opposite Side #2 – Family Belief of Miracle Religious family members of a dying patient believe that miracles can happen. Tejwani states the patient’s family rejected the recommendation of considering comfort care of terminally ill patient and expressed strong feeling that a miracle would occur and the patient would regain consciousness and recover (773). Based on this hope, they requested continuation of unlimited life-sustaining measures. Despite being repeatedly informed that these measures would not alter the patient’s outcome, the family persisted on their requests. The care team felt the family’s expectations to be unrealistic and their demands unreasonable. Providing invasive care to a brain death patient with no hope of recovery creates emotional and moral distress on care providers, and providers may consider themselves agents of harm. Blindly following the surrogate’s wishes is not always in the patient’s best interest and most surrogates tend to request to â€Å"do everything poss ible.† Although in some circumstances this achieves nothing more than inflicting bodily injury on the patient (774). The appropriate time to pull the plug is after the confirmation of brain death using the brain death criteria and only after a very thorough discussion with the patient’s family. Jahi’s mother was not able to move on with her life thinking that her daughter was still alive and was stuck in the stage of denial (first stage of the grieving process) for 4 years. Magic miracle cures do not happen for a brain dead patient. Conclusion True, death is inevitable and talking about it should not be avoided among family members because unforeseeable accidents can happen anytime. The important message for patients and their families is, before a family member ends up in ICU or undergoes a surgery no matter how minor, they need to talk about what one would want in advance. End-of-life decision-making is extremely challenging for patient’s family to make without an advanced directive or living will. With an advance directive, the surrogate, family, and care providers have proof as to what the brain-dead patient’s values and preferences are. Nobody wants to be kept alive when such life would be a meaningless existence. Everyone wants a sentient existence in which one has the ability to think, read, speak, write, and communicate. Anything that could not restore a person to this is a purposeless and meaningless life. Moreover, state laws meeting should revise the Universal Declaration of Death Act (UDDA) to eth ically make the doctors pull the plug the moment a patient has been pronounced brain dead. Brain stem death should remain the mainstay of defining death so as to give families closure and prevent the patient’s suffering. Dasta, J.F. et al. Daily Cost of an Intensive Care Unit Day: The Contribution of Mechanical Ventilation.Critical Care Med.Jun 2005, 33(6).p. 1266.PubMed. https://www.ncbi.nlm.nih.gov/pubmed/15942342 Jakusovaite, Irayda et al. Determination of Death: Metaphysical and Biomedical Discoure. Medicina.Vol. 52 issue 4. 2016. p. 206. ScienceDirect. https://doi.org/10.1016/j.medici.2016.06.02 Kasule, Omar Hasan. Brain Death: Criteria, Signs, and Tests. Journal of Taibah University Medical Sciences. Vol. 8 issue 1, April 2013. P. ScienceDirect. https://doi.org/10.1016/j.jturned.2013.02.001 Patient Pricing Information.University Hospitals Cleveland Medical Center. p.1. uhhospitals.org/cleveland/patients-and-visitors/billing-insurance-and- medical-records/patient-pricing-information Schmidt, Samantha. JahiMcMath, the California Girl in Life-Support Controversy, is Now Dead. The Washington Post. 29 June 2018. pp. 1-2. https://www.washingtonpost.com/news/morning-mix/wp/2018/06/29/jahi-mcmath-the- calif-girl-declared-brain-dead-4-years-ago-is-taken-off-life- support/?noredirect=onutm_term=.b4a260ced3a6 Tejwani, Vickram et al. Issues Surrounding End-of-Life Decision-making.Patient Preference Adherence, (2013).pp. 771-775. https://doi.org/10.2147/PPA.S48135

How to Get a CDL in Massachusetts

How to Get a CDL in Massachusetts This article applies to anyone who wants to apply for a CDL in Massachusetts. If you want to learn about getting a CDL in other states, TheJobNetwork has put together a very comprehensive CDL guide on every state of the country. MassachusettsEligibilityIf you are at least 21 years old  and have not had your driver’s license or right to operate revoked, you may apply for an interstate transport CDL permit. If you are at least 18 years old  and have not had your driver’s license or right to operate revoked, you may apply for an intrastate (Massachusetts only) transport CDL permit.RequirementsFederal law requires all  commercial drivers have a social security number that verifies with the Social Security Administration.Drivers of commercial vehicles over 10,000 lbs. must carry a valid US Department of Transportation (D.O.T.) approved medical certificate. Also, drivers transporting 15 or more passengers or carrying placarded hazardous materials, regardless of vehicle size, are required to carry a D.O.T. medical certificate.Written TestObtain a   CDL, you must first fill out an application (available at any RMV full-service office or on the RMV website).  Then,  present the application, the required identification, and the $30.00 written test fee, and the fee for any endorsements, in person, to any RMV full service office to take the written test.  If you pass the written test, you will receive a 2-year permit.Road TestFinally, a road test is usually required when applying for a CDL. When you are ready to take a road test, you must call the RMV Telephone Center to schedule your road test. All road tests must be scheduled by the Telephone Center. You may NOT make a road test appointment in person.For the road test,  you you must  supply a properly equipped, legally registered and insured vehicle with  a valid inspection sticker. It must be of the proper type and manufacturer’s GVW  rating for the class license you are applyi ng for, and it must pass a safety check by the examiner.The skills that will be tested during a CDL road test are pre-trip vehicle inspection, basic vehicle control, and   an on-road test

Cause-Effect essay Example | Topics and Well Written Essays - 750 words

Cause-Effect - Essay Example For couples in the countryside, a little leeway is given. They are allowed two children. Any succeeding child though is equivalent to heavy fines. This restriction has resulted into mass abortions, abusive behavior from officials and a lot of male children. In China, it is customary for the sons to take care of their parents in their old age. Between having a son or a daughter, the obvious choice then is to have a male child. The girls are married off, implying a transfer of responsibilities to the girls’ in-laws. Daniela Deane writes â€Å"in the absence of a social security system, having a son is the difference between starving and eating when one is old†. (80) Because of China’s one-child policy, this has brought in a generation of male children who are obese, lazy and rude. As Deane continues, there exists a 4-2-1syndrome – four grandparents and two parents who zealously ensure that their son has a comfortable life. (78) They feed him anything he wants. They lavish him with attention. They spend hard-earned money on extra-curricular lessons for him. They act like he’s the most precious thing in the world and he is. He is their ticket to a secure life as senior citizens. One example in Deaneâ€⠄¢s essay would be the woman who wanted an operation to revert a previous ligation she had just to have another child as her only son had perished in a car accident. (83) This obsession with male children has other effects than only spoiled male offsprings. For those who are capable of paying fines for another child, their daughters are often neglected. For some who are not so fortunate, daughters are abandoned, neglected or worse, killed. Some moms give birth in seclusion. Baby girls are left in hospitals or in empty lots and open fields, sometimes even on sidewalks. Those who belong to families are not given as much love or attention as the male children. As Deane reported in her essay, the number of missing