Management Of Chronic Pain Nursing Essay

Management Of Chronic Pain Nursing Essay This project is a complete illustration of pain and how treated by understanding how its work, references can be visited for more detailed information or contact me. Chronic pain is defined as a painful condition that lasts longer than 3 months. Chronic pain can also be defined as pain that persists beyond the reasonable time for an injury to heal or a month beyond the usual course of an acute disease. There are four basic types of chronic pain: (1) pain persisting beyond the normal healing time for a disease or injury, (2) pain related to a chronic degenerative disease or persistent neurologic condition, (3) cancer-related pain, (4) pain that emerges or persists without an identifiable cause. Chronic pain differs from acute pain in its function. Acute pain is an essential biologic signal to warn the individual to stop a potentially injurious activity or to prompt one to seek medical care. Chronic pain serves no obvious biologic function. Chronic pain patients presenting to the emergency department (ED) have not been well studied, despite their apparent numbers. Complete eradication of pain is not a reasonable end point in most cases. Rather, the goal of therapy is pain reduction and return to functional status. Chronic pain syndromes discussed in this paper include myofascial headaches, transformed migraine headaches, fibromyalgia, myofascial chest pain, back pain, complex regional pain types I and II, post-therapeutic neuralgia, and phantom limb pain. Drug-seeking patients are also covered. EPIDEMIOLOGY Chronic pain affects about a third of the population at least once during a patients lifetime, at a cost of-80 to 90 billion dollars in health care payments and lawsuit settlements annually. Chronic pain is also common in those who do not seek medical attention. Despite similar subjective pain, those who seek medical attention are less physically active, experience more social alienation and more psychological distress than those who do not seek medical attention. The causes of chronic pain are more complex than the causes of acute pain. Chronic pain may be caused by (1) a chronic pathologic process in the musculoskeletal or vascular system, (2) a chronic pathologic process in one of the organ systems, (3) a prolonged dysfunction in the peripheral or central nervous system, or (4) a psychological or environmental disorder. In contrast, acute pain may be influenced by, but is not primarily caused by, a psychological or continuous environmental disorder. A detailed listing of all the epidemiologic factors of the various chronic pain syndromes is beyond the scope of this paper. However, in general, patients who attribute their pain to a specific traumatic event experience more emotional distress, more life interference, and more severe pain than those with other causes. PATHOPHYSIOLOGY The pathophysiology of chronic pain can be divided into three basic types. Nociceptive pain is associated with ongoing tissue damage. Neuropathic pain is associated with nervous system dysfunction in the absence of ongoing tissue damage. Finally, psychogenic pain has no identifiable cause.3 Many chronic pain states begin with an episode of nociceptive pain and then continue with neuropathic or psychogenic pain. For example, an acute injury with fracture involves nociceptive pain, but an associated nerve injury may lead to neuropathic pain. Chronic disability may lead to psychogenic pain. Nociceptive pain results from the stimulation of nicotinic receptors in tissues or organs by noxious mechanical, thermal, or chemical stimuli. Chemical mediators of inflammation such as bradykinins and prostaglandins are essential elements in the pathophysiology of nociceptive pain. Examples of chronic nociceptive pain include cancer pain and pain due to chronic pancreatitis. Patients with nociceptiv e pain usually respond well to centrally acting analgesics. Neuropathic pain is caused by disease of the central or peripheral nervous system. Examples of neuropathic pain include complex regional pain type II (causalgia), post-therapeutic neuralgia, and phantom limb pain. Neuropathic pain responds poorly to common analgesics, including narcotics. Psychogenic pain is a diagnosis of exclusion and can be difficult to establish in the ED. Patients with psychogenic pain believe their pain is physical and tend to strongly reject the concept that it is psychological. CLINICAL FEATURES To better define the psychology of chronic pain, psychiatrists have divided patients characteristics into two groups.4 The first group has normal psychological function at baseline. However, continued pain and its effects, such as inability to work or altered body image, result in psychological dysfunction. The second group has primary psychopathology that predates the onset of chronic pain. Hypochondriacally, hysterical, pain-prone, and depressive personalities are included in this group. The following set of historical inquiries may prove helpful in the ED. The patients should be asked to describe the nature of the current pain, initiating and exacerbating or relieving factors. Other useful information includes determination of the chronic nature of their pain, quantification of similar episodes, and sources and modes of treatment, including medications and dosages for physician-prescribed, over-the-counter, or alternative medications. Outcomes of previous therapeutic efforts and the effect of the condition on the patients functional status are also important. Addiction to drugs or alcohol or experience with detoxification programs should also be noted. Finally, a review of systems should be done to rule out any other conditions. Substance abuse is a frequent problem in chronic pain patients. Patients referred to chronic pain clinics meet Diagnostic and Statistical Manual of Mental Disorders, third revised edition (DSM III-R) criteria for active substance abuse disorders in 12 to 24 percent of cases, while 9 percent meet criteria for remission diagnosis. Drug detoxification is often the first step of the therapeutic plan for new patients referred to a pain clinic. Objective findings of acute pain include tachycardia, hypertension, diaphoresis, and muscle spasms on stimulation. Objective evidence of chronic pain includes muscle atrophy in the distribution of pain due to disuse, skin temperature changes due to the effects of the sympathetic nervous system after disuse or secondary to nerve injury, and trigger points, which are focal points of muscle tenderness and tension. However, these findings do not have to be present for the pain to be factual. BACK PAIN   Ã‚  Ã‚   Risk factors for chronic back pain following an acute episode include male gender, advanced age, evidence of nonorganic disease, leg pain, prolonged initial episode, and significant disability at onset. Chronic back pain symptoms and causes can be divided into myofascial or muscular, articular, and neurogenic types. Myofascial back pain is characterized by constant dull and occasional shooting pain that does not follow a classic nerve distribution. Pain may or may not be exacerbated by movement. Usually trigger points can be found at the site of greatest pain, and muscle atrophy is not found. Range of motion of the involved muscle is reduced, but there is no actual muscle weakness. Previous recommendations for bed rest in the treatment of back pain have proven counterproductive. Exercise programs have been found to be helpful in chronic low back pain. Articular back pain is characterized by constant or sharp pain that is exacerbated by movement and associated with local muscle spasm. Myofascial and articular back pain may be indistinguishable from each other except by advanced imaging techniques beyond the usual scope of practice in the ED. Neurogenic back pain is classically characterized by constant or intermittent pain that is burning, shooting, or aching. The pain is usually more severe in the leg than in the back and follows a dermatome. Muscle atrophy as well as reflex changes can be seen over time. DIAGNOSIS The most important task of the emergency physician is to distinguish chronic pain from an exacerbation that heralds a life- or limb-threatening condition. A complete history and physical examination should either confirm the chronic condition or point to the need for further evaluation when unexpected signs or symptoms are elicited. An electrocardiogram (ECG) may be needed in some cases of chronic myofascial chest pain to help differentiate it from acute ischemic chest pain. Because chronic pain patients may be frequent visitors to the ED, the entire staff may prejudge their complaint as chronic or factitious. Physicians should insist that routine procedures be followed, including a full triage assessment and a complete set of vital signs. Rarely is a provisional diagnosis of a chronic pain condition made for the first time in the ED. The exception is a form of post-nerve-injury pain, complex regional pain. The sharp pain from acute injuries, including fractures, rarely continues beyond 2 weeks duration. Pain in an injured body part beyond this period should alert the clinician to the possibility of nerve injury, and proper treatment, discussed below, should be instituted. Definitive diagnostic testing of chronic pain conditions is difficult, requires expert opinion, and often expensive procedures such as magnetic resonance imaging (MRI), computed tomography (CT), and thermography. Therefore, referral back to the primary source of care and eventual specialist referral are warranted to confirm the diagnosis. TREATMENT Emergency physicians must avoid labeling patients with pain as either drug seekers or legitimate patients deserving narcotics for pain relief. With these labels, emergency physicians may exacerbate the problem and promote the learned pain response, where patients believe that they must come to the ED for pain relief. Chronic pain patients often request narcotics, although the lure of going to the ED can be just as strong without receiving narcotics. Any drug that alters sensorium can exacerbate the learned pain response. The external rewards of visiting the ED for medication or evaluation are many: attention and comforting from family and nursing staff, status as a special patient who must go the ED for pain control, avoiding responsibilities at work and at home, potential money if litigation is involved, and potential income if a disability claim is pending. Treatment with opiates frequently contributes to the psychopathologic aspects of the disease. Chronic pain and disability lead to distress and increased stress in the life of the patient. The potentiated psychological stress heightens physiologic arousal, which increases pain sensations. Elevated pain sensations exacerbate the patients disability. Opiate use only temporarily relieves the pain sensations, but the side effects frequently increase the disability associated with chronic pain, therefore exacerbating the psychological stress and the syndrome. Furthermore, a new problem is created as the patient becomes preoccupied with seeking pain relief from opiates. Another essential consideration is that many types of chronic pain are poorly controlled by opiates, and yet the side effects remain. It is interesting to note that the presence of objective evidence of pain does little to influence a physicians administration of narcotics. Physicians opiate-prescribing habits are most commo nly prompted by observed pain behaviors, such as facial grimacing, audible expressions of distress, or patients avoidance of activity regardless of the physical findings. With the exception of cancer-related pain, the use of opioids in the treatment of chronic pain is controversial. Many pain specialists feel that they should not be used. There are two essential points that affect the use of opioids in the ED on which there is agreement: (1) opioids should only be used in chronic pain if they enhance function at home and at work, and (2) a single practitioner should be the sole prescriber of narcotics or should be aware of their administration by others. Finally, a previous narcotic addiction is a relative contraindication to the use of opioids in chronic pain. In contrast to the concerns listed above, narcotics are both recommended and effective treatment for cancer pain. Long-acting narcotics such as methadone or transdermal fentanyl may be more effective than the short-acting agents. . The medications listed under Primary ED Treatment are familiar to emergency physicians. While NSAIDs are most helpful in conditions where there is ongoing tissue injury, such as chronic inflammatory arthritis or cancer-related nerve or bone damage, they are also helpful in many cases of chronic pain where no evidence of tissue damage or inflammation is evident. Non-steroidal anti-inflammatory drugs have been shown to be more helpful in acute than in chronic pain. However, the need for long-standing treatment of chronic pain conditions may limit the safety of the NSAIDs. Standard dosing procedures may be followed except in the elderly: Antidepressants and, most commonly, the tricyclic antidepressant drugs, are the most frequently used drugs for the management of chronic pain. Often, effective pain control can be achieved at doses lower than typically required for relief of depression. Tricyclic antidepressants appears to enhance endogenous pain inhibitory mechanisms. When antidepressants are prescribed in the ED, a follow-up plan should be in place. Discussion with a pain specialist is often beneficial. The most common drug and dose is amitriptyline 10 to 25 mg, 2 h prior to bedtime. Anticonvulsants are used for several pain disorders, especially neuropathic pain. Anticonvulsants prevent bursts of action potentials, which may prevent the severe lancinating pain of certain neuropathic syndromes. Carbamazepine (start 100 to 200 mg/d), valproic acid (start 15 mg/kg/d divided), and clonazepam (start 0.5 mg/d) are the most frequently used. Muscle relaxants, such as cyclobenzaprine 10 mg every 8 h, have been useful for chronic pain patients. Their sedating effects may limit their success. Tramadol is an atypical centrally active analgesic. It has less respiratory depression, less tolerance, and less abuse potential than do opiates. Tramadol has been used with success in patients with fibromyalgia, migraine headaches, low back pain, and neuropathic pain. The dose of tramadol is 50 to 100 mg every 4 to 6 h by mouth. Chronic Pain in the Elderly Elderly patients frequently complain of chronic pain. Unfortunately, many of the commonly used medications for pain have higher complication rates in the elderly. In particular, the non-steroidal anti-inflammatory drugs (NSAIDs) are associated with higher rates of gastrointestinal bleeding and renal disease in the elderly. Opioids also may cause debilitating sedation and/or constipation in the elderly; however, opioids may have less debilitating side effects than NSAIDs. Doses of many agents should be reduced when treating the elderly, to avoid side effects, and it is essential that a follow-up plan be in place at the time of discharge. There is a perception that the elderly are under medicated for pain control. While this may be true, the elderly do not seem to be under medicated more than other age groups. Conclusion In the end you can notice that pain can affect any one at any age, and its management is not easy as anyone think, especially in chronic moderate to severe pain. The variety of drugs that synthesized for this purpose are too much now, but no class of these drugs can cure the different causes of pain, and scientists now a days improving the activity of these drugs. In fact the now by the end of 2009 working on new formulation that is said to cure pain caused by inflammation. Thus aspirin will only be used for its anticoagulant and antipyretic activities, but not for anti-inflammatory action, this will reduce the toxicity cases caused by the aspirin over doses if it is used as anti-inflammatory or pain relief agent. Most important is that people with pain must ask doctor to find the cause of pain, so he/she can give the right medication and cure any type of inflammation or cancer if there is any early before the exacerbating of the current case, then it will be too late to try to cure the advanced disease and death may occur in most of the cases, so be careful any small pain can be the start for any kind of disease starting from stress ending with fatal cancer.

Trumans Decision to use the atomic mom Essay -- American History, War

Truman’s decision to use atomic weapons has long been a controversial subject throughout the decades after he used it. Many scholars and people who surrounded the president at the time published memoirs and books about the decision to use the weapon. As years went, more works of writing and information were released which added more information to the vast knowledge we have of the decision to drop the bomb and of what the Japanese faced after the event took place. J. Samuel Walker wrote a book called Prompt & utter destruction which uses new knowledge gained about the bomb and new information the Japanese released, which Walker said, â€Å"has greatly enriched our understanding of the agonizing deliberations in Tokyo over ending the war† (ix).Walker did not take any sides in the book, however, he uses what material from the first book and new sources of information to evaluate why President Truman made his decision. The main focus of Walker’s book is to answer w hy President Truman used atomic bombs against Japan and open more discussion to the question â€Å"was the bomb militarily necessary or was it used primarily for political/diplomatic reasons that had more to do with impressing the Soviets than winning the war against Japan?† (xii), which Walker said the question â€Å"divided specialists† (xii). Throughout Walker’s book, he focuses on President Truman’s choice of using the atomic bomb on Japan, Truman’s advisers who were General George C. Marshall and Secretary of War Henry L. Stimson agreed that the bomb was necessary. President Truman believed that the bomb was necessary to spare â€Å"the lives of hundreds of thousands of American soldiers† (4). The book points out that Truman never had a â€Å"categorical choice† (5) when choosing to use the... ...e forever by the bomb. On the Japanese side they did decline the Potsdam Declaration. Truman gave the Japanese the choice to accept but the declaration. I admired the United States for giving warning. Walker did give some history of post-WWII, but I am particularly interested in the environmental effect of Hiroshima and how did Japan rebuild after the bomb. I think he lacked in this department when he wrote the book. My final say is the first bomb was necessary and I thought being in American hands was the best thing at the time to have. I think the second bomb was unnecessary and I also blame the Americans for not giving ample of time for the Japanese to surrender. The Japanese did downplay the destruction of the bomb and I think this was a flaw. Lastly I thought the book should have had more on post war and onwards of the effects on both sides.

Business Model of Amazon Essay

Amazon.com is the pioneering bookstore on the Internet that first opened in July 1995 by Jeff Bezos. The firm offers online shopping services and partnership opportunities such as online search for books, music and video items. The products that they sell include an array of audio, video and book titles. Amazon has one of the widest selections and employs international shipping to virtually every corner of the globe in just a few days. Amazon’s focus is having the biggest selection of free-electronic greeting cards, online auction and millions of books, CDs, videos, DVDs, toys and electronics. They have expanded to different areas of the world, such as Amazon.co.uk and Amazon.de, to service consumers outside of the United States. They aim to be a Cost leader in which their firm has lower costs than the competitors. They have employed different Amazon branches in different parts of the world to lower costs. This allows Amazon to ship their products at a lower price from each po int of shipment to the consumer. In recent years, Amazon.com has expanded from being just an online bookstore to an all around online shopping experience. They have coined the tag line â€Å"Earth’s biggest selection†. Amazon has diversified into different websites. These are the Internet Movie Database (www.imdb.com), LiveBid.com, amazon.livebid.com, drugstore.com (an online retail and information about health and wellness), gear.com (online sporting goods company), homegrocer.com (online grocery shopping and delivery), pets.com (largest pet supply online shopping site), ashford.com (online luxury and premium shopping) and eZiba.com (online retailer of handcrafted products). Five Forces Model for Industry Analysis New Entrants The online bookstore industry that Amazon.com has pioneered in was, at first, very hard to penetrate. There were different barriers such as distributing capabilities and the variety of the selection offered that are supposed to be hurdled. Amazon successfully solved the tricky parameters as being the first one to get into the whole idea of online retail. With being the first, they had the luxury to set what were the norms for the industry. Factors that may lower these barrier tactics would be a wider selection and the  ability to go to an actual bookstore to exchange or return books or other products. This network of â€Å"actual† retail spaces makes it easier for the consumer to return or exchange the products they were not satisfied with. These handicaps of Amazon were the basis for the emergence of book retail giants Barnes and Noble and Borders in the online shopping industry. Industry Competitors The major competitors of Amazon are Barnes and Noble and Borders. Barnes and Noble is a retail giant offering books and CDs both in their outlets all over the country. It opened their online industry in 1997 and has become the fourth largest e-commerce sites today. Focused largely on the sale of books, music, software, magazines, prints, posters, and related products, the company has capitalized on the recognized brand value of the Barnes & Noble name to become the second largest, and one of the fastest growing, online distributors of books. Their â€Å"advantage† to Amazon is the brand name and the availability of actual retail outlets in which consumers could go in to exchange or return products easily. They also have an established book selection based in their retail operations. Borders is another multi-media retail store found in major cities around the country. Started out as a small bookshop in the college town of Ann Arbor, Michigan, it has since expanded into one of the finest bookstores. In 1992, Borders was bought by the Kmart group which further flourished the company into a Multi Media Giant with a wide selection of Audio, Video and Books found throughout the United States. The Online Bookstore industry have become a fierce business which involves discounts, varied selections and fast delivery in which all three companies are challenging each other. Buyers The consumers of this industry can be found in every corner of the population. These are mostly people who have had some form of higher education and have access to the Internet and computers. The segment of online shoppers has increased dramatically in recent years due to the convenience of shopping in the comforts of the home and the accessibility of the Internet. These developments have made it easier for consumers to log on and buy on the Internet. Consumers also tend to compare prices among the retail leaders such that buyers are able to buy products with very big  discounts compared to ones bought in â€Å"actual† retail outlets. The bargaining power of the consumer is based on the competitive strategies of each active firm in the industry. Thus, consumers can challenge one firm for charging more than the other one such that the firm will beat the price of the competing firm. Suppliers Amazon’s suppliers range from the publishing and media houses to electronics’ manufacturers. Amazon buys all their books, videos and audio CDs from the multi media houses and publishing giants such as Time Warner, Doubleday etc. Amazon also has alliances with other bookstores to cover orders that they cannot serve. Substitutes The substitutes for Amazon and other online bookstores are the â€Å"actual† book retailers and music stores such as Barnes and Nobles, Virgin Megastore, Tower Records, Sam Goody and other small mom-and-pop outlets. With the rise of online retail, there will be little impact from these substitutes. One impact would be some consumers who would like to hold or listen to their purchases prior to buying and those who are into the whole â€Å"shopping experience†. Barnes and Nobles have jumped into online retail and have succeeded into diversifying into the new e-commerce industry. Industrial Organization Model Degree of Competition Due to the shift of focus for Amazon, it has become the â€Å"Earth’s biggest anything store†. Its competitors have expanded from just online book retailers Barnes and Nobles and Borders to top audio retailers CDNOW.com and online auction house EBAY.com. Amazon has an overall lead of 40% market share against the other online retail firms. Their international business has more than doubled over the past 2 years and this growth increased Amazon’s share in the online business market. Life Cycle Amazon, in it’s first years, had negative income but the rise of e-commerce sites and being the pioneer made the succeeding years led to boom time for them. Their growth period was during 1994 to 1995 when they were the first of its kind in the world. They incurred very high costs in terms of  distributions to customers. Still with a negative income, Amazon went public in 1997 and had one of the biggest IPOs of the time. With investors banking on future positive cash flow for this company, Amazon’s market value soared. Many people caught on with the idea of online shopping, thus, Amazon’s success. Amazon’s success as an online retailer prompted bricks-and-mortar rivals Barnes and Noble and Borders to join in. Competition decreased Amazon’s profitability so in the past couple of years, Amazon has expanded to more than books, audio and video to electronics and other retail concepts. Social Relevance Amazon’s products are marketed for every consumer possible. Books, audio, video and electronics are appreciated by majority of the population especially those who have access to the Internet. Amazon is active in pursuing literacy programs for young children by collaborating with the makers of the Dr. Seuss books. They have actively participated in the Dr. Seuss shops, story telling sessions and Dr. Seuss days. Degree of Globalization Amazon’s strength internationally lies within its networks in major ports and cities around the Globe. Amazon first started out in Seattle but as soon as they have established a niche market, they have opened shop all over the nation and in cities such as London, Berlin, The Hague, Paris, Tokyo, Singapore and many more. These branches overseas improves their delivery service to a wide consumer base. Extent of Government Control There has not been many government regulations regarding online retailing. A group of CEOs whose firms that are engaged in such practices have formed an organization called Global Business Dialogue. This GBD group supports the development of a seamless global system that delivers the broadest array of goods and services to the largest number of consumers at the most competitive prices. This work effort will: offer recommendations to the WTO, including making the moratorium on online tariffs permanent; and collaborate with governments to target and eliminate discriminations against, or other non-tariff barriers to global trade in, electronic commerce. This working group will also provide an avenue for the GBDs to consider and promote the  growth of the electronic marketplace in an environment unencumbered by detrimental taxation. Degree of Vertical Integration Amazon’s primary value chain includes purchasing/sourcing, marketing, distribution and after-sales services, which includes returns and exchanges from unsatisfied customers. Their main focus is in the purchasing/sourcing and in the distribution of the products to the consumers. Their investments are therefore, geared towards warehouses in key points of high consumer demand areas and an efficient delivery and distributing system to service all its consumers. Thus, Amazon controls most of its distributing system that spans across borders. Inter Organization of Network Economics Amazon in its efforts to sustain its market leadership in the online retailing industry has tied up with various online organizations. Netscape Navigator and Amazon will offer members of Netscape Netcenter a co-branded storefront where Earth’s Biggest Bookstore will be easily accessed through Netscape Netcenter (home.netscape.com). In addition, Amazon.com has multi-year exclusive and premier bookseller relationships with 5 of the top 6 sites on the World Wide Web: AOL.com, Yahoo!, Netscape, GeoCities, and Excite. These partnerships widen Amazon’s presence in the World Wide Web. Sensitivity to Business Cycles The Online retailing business has a very quick cyclical growth. Amazon being one of the firsts to venture in this type of commerce are all ready in what seems to be in their decline stage where market share is declining. Therefore, Amazon is expanding to different industries within online retailing. Amazon and other online retailing firms are very sensitive to business cycles due to the speed of technology involved in the services they offer. Dynamics of New Knowledge Generation Online retailing relies on the work of an excellent distribution system. Amazon has invested their money into expanding their network of distribution centers around the globe. They also have investments in creating better technology for tracking orders and giving efficient delivery systems for their customers. Amazon.com has remained on top of the online retailing  business despite the entrance of giants such as Barnes and Nobles and Borders. Their success is attributed to two factors; timing and continuing to invest heavily into the inventory and distribution systems. Amazon, by being the first of its kind, has a big lead over the nearest competitors due to their experience and its reputation as the first movers. Their thrust remains on improving efficient delivery systems across borders and to build name recognition as the number one retailing firm in the Internet. They have also ventured into different retail options to keep that lead. Marketing, Innovative inventory and distribution systems, and name recall have helped Amazon build a sustainable competitive advantage. In order for any online retail company to remain prosperous and income generating, they must invest a lot of time and money into research and development of more efficient operations and distributions systems. This proved to be key for the Market Leader in online retailing, Amazon.Com. Mary Grace Velasco,College of Business Administration,Senior, Fordham University,Fall 2000

How to Write a Description Essay on Business Communication

How to Write a Description Essay on Business Communication When you write a description essay you want to recognize that the piece of writing you are tackling is something intended to describe a person or thing, something that appeals to all five senses. You want to first pick your subject. Then you want to look for the most dominant details involved in that subject. You want to make sure that you select supporting details that can help you review for the reader that one key idea. Once this is done you want to organize the details in whatever organizational method seems most appropriate to you. You might want to focus on details from specific to general, from general to specific, or in a chronological order. The choice is yours. You want to incorporate description words that help you to be specific and to explore the senses. You never want to just say that something was beautiful. Beautiful is a word that might conjure different ideas in the minds of different readers. In order for your final work to be most effective, you need to be able to describe things with such specific senses and details that every reader who stumbles upon your work will read it and have the exact same image pop into their head. This is the real goal. The Five Senses When you sit down to write a description, you should aim to utilize all five senses. By using all given senses you can guarantee that your reader will be put into the exact place you want. If you are writing about a specific location, use all five senses to place the reader’s imagination in that location. If you are writing about a specific food, plant, person, or landscape, use all five senses to place the reader exactly where you want them. Remember that people have vivid imaginations and what someone else images may not be what you imagine. The more details you include, the better it will be for the reader and their experience. Your goal here is to incorporate as many of the sensory details as you can to give your reader a comprehensive mental image. How to List Information If you are unsure whether or not you’ve included enough sensory details, you can use an outline. If you are not sure whether or not you adequately covered the different senses you need to include for your writing assignment, you can also rely on an organizational planning method. To do this, begin by listing the senses you want to cover in your paper. Pick either a Roman numeral, letter, bullet point, or number and then make a list for each of the senses with that. Beneath the different senses, you should use a lower case Roman numeral, lower case letter, different bullet point, or different number to denote each of your supporting details, the insight you want to include, or the adjectives you will highlight in your paper. **Note: There is not necessarily a right or wrong way to organize your paper. This means that you should feel free to use the outline as a tool to move around the organization, to play with various styles, and to work with different orders of information until you find the one which best suits the purpose of your paper. You want the organizational method which helps you best present your thoughts. ** Isn’t this guide fantastic? Hope it will provide sufficient help for you to complete your assignment. Don’t forget to check our 10 facts on business communication for a description essay as well as 20 topics and 1 sample for paper of this kind of an essay.

Symmetrical family Essays

Symmetrical family Essays Symmetrical family Paper Symmetrical family Paper The family is the basic structural unit of society. The detailed structure of the family varies enormously due to circumstances such as social class, ethnic background and cultural influences. The family system in Britain is sometimes loosely referred to as patrilineal. This is down to surnames and titles are inherited from our fathers not our mothers, but there is no moral code in Britian that says a mothers family is not important, it is usually down to personal preference. Britain can be best described as multi-lineal system. All though Britain is not strictly patrilineal some people believe we still live in a patriarchy society, where men have more power than women. And some feminists believe there is still the patriarchal family. Where the family is dominated by the male and women are classed as inferior and have no equality. This paper is going to look at the way relationships between men and women have changed within the family in Britian. Firstly it will look at the way structures of men and womens roles within the family have changed with time and the social and demographic occurances for these changes. It will look at the research on family life in London by Willmott and Young and their theory that there was a rise in the symmetrical family. The paper will then move onto the feminists views of the Symmetrical family and review Oakleys own research onto shared conjugal roles within the family which provided evidence against Willmott and Youngs theory. Moving then to look at other research carried out by Pahl, Edgell, Yeandle which like Oakleys research was to measure the symmetry in roles within the family. The structure of familys and relationships between husband and wife have changed considrebly over the years. Sociologists divided these changes into phases. About 150 years ago before britian became based on industry, most people worked in argriculture. Husband and wife were generally equal. This phase 1 pre-industrial family was characterized by shared purpose of economic production where home and work was one. Although husband and wife relied upon one another, sociologists have stated they didnt have close relationships. 2nd phase industrial family saw women lose their independence. Equality laws which were put in place restricted the hours women could work. Roles between Husband and wife became segregrated. Men were the sole breadwinners and were the ones whom would take charge within the family. The role of mother and housewife became the norm for women. There was however a difference between the working and middle class. The middle-class women were not expected to do any work only to supervise the cleaning lady or nanny, while the husband would go out to work to provide for the family. In the working class child-rearing and household chores were solely the responsibility of the women. The men would work all day then socialize outside the home. The women was increasingly home centred and often close to other females members of their family. Phase 3 the contemporary family happened between 1930s and 1950s. There was a significant change between the relationship between middle-class husband and wife. They had a more closer relationship, made joint decisions and enjoyed leisure activities together . This marked a move towards equality. The wife was still responsible for housework and child-rearing but the husband would help. (Moore, 159) Now that we have briefly looked at the changes in the history of families the paper will now look at Wilmott and Young studies. They researched family life in London and found that family life in britian was becoming increasingly symmettrical. Abbott, pg140) The family is home centered and there conjugal roles are similar. The ideal-type symmetrical family is balanced. Both husband and wife work, each contributing to the family income. Domestic roles along with caring for children are shared. (Wilson, pg 64) The rise in Symmetrical family is down to social and demographic changes. Contraception meant women could choose to limit having children. There was better living conditions aswell which meant home was more attractive with men choosing to stay at home watching television. (Moore, pg 185). There were a number of legal changes also which some say brought women near equality to men particurly in the employment sector. There was the Equal Pay Act in 1970, Sex Discrimination Act in 1975 and Employment Protection Act also in 1975. Women gained financial independence from their husbands by working. (Wilson, pg58) Other legal changes that which could of affected men and womens relationships was the 1969 Divorce Reform Act which introduced new grounds for divorce aswell as changing the way people looked upon women who divorced. Marriage was now seen as mutual commitment rather than legal enforceable contract (Allan, Crow, pg 24) Feminists argue that the family is not Symmetrical. They state that household roles are not joint and it is still regarded as the womens duty to look after the children, cook, do house hold chores and go out to work. With men only helping occassionnaly and then being seen as good husbands. (Moore, pg 185) Feminist Ann Oakley critisised Willmott and Youngs theory that husbands help around the home is not accurate, as could just mean washing up once a week. She conducted her own research on 40 housewives aged 20 30. She found that middle-class husbands did help with some domestic chores the majority was left to their wives. Only a quarter of them helped to a high level with childcare. In Oakleys view even though there has been an increase in women working being a housewife is still seen as there primary role. Yeandle (1984) argues women now face a double burden of responsibility by contributing to the family budget, childrearing and domestic chores. Women seem to have less time to concentrate on their careers as they are never off duty. The domestic division of labour does have its critics. Oakleys investigation may have overlooked tasks which men generally seem to do such as DIY, fixing the car and decorating. This approach also ignores that a women may get satisfaction from keeping a home, being a mother and going to work. Also Oakley only interviewed wifes therefore making her claims bias as the husband got no say as to what jobs he did. Another approach to measuring the symmetry of the family is to examine the division of decision making. Pahl (1993) interviewed 102 couples with children. She focused her study on each partners financial contribution to the family income and whether it effects who makes the decisions within a family. His results showed that the most common result was that the money was shared but the husband had the most control over it and the wife had a lower income. The least common result was where the women had most control. Overall in some couples there was equality but most cases it was the men who had more patriarchal power. Stephen Edgell (1980) conducted research on middle-class and professional couples. He found that women had the bulk of decision making responsibilities such as buying food, clothing and decorating whereas the men dominated important decisions such as moving home, holidays or major purchases such as a new car. His theory for this was that men usually earn more than their wifes, meaning they are financially dependant on their husbands which means they have a smaller right in decision making. From all this evidence it shows that all though womens employment opportunities have increased it has little affect on conjugal roles. It backs up the theories of Marxist and Feminists who see womens domestic labour as exploitation. Radical feminists see their biological role of childbearing as the reason for oppression by men whereas Marxists see economic power as their oppression. After looking at the above it does show that there has been a move forward to equality between men and women. It would seem there is still quite a way to go before there is real symmetry between family roles as shown by Edgell, Pahl. Yeandle and Oakley. From the studies though it does show that men are becoming more involved at home within the family and the relationship between husband and wife has greatly improved in terms of decision making, its the roles of domestic housework which seems largely segregated. All though there is still some patriarchal power it is nothing like it once was.

British Television Comedy Essay Example | Topics and Well Written Essays - 1500 words

British Television Comedy - Essay Example Negative health effects can become evident if a person sits around the house all day watching TV. But is there anything positive that can be said about television? Educational programs are believed to be a positive element ÃŽ ¿f television, since those watching will learn from the show. Television is also viewed as being a way for anyone to connect to the world. Basically, television allows us to gain knowledge about events occurring in China, Brazil, and all around the world. Television allows us to communicate with each other. And ÃŽ ¿f course, the main positive aspect ÃŽ ¿f television is that it provides us with entertainment. Feeling bored with nothing to do? Turn on the TV for a half hour and enjoy your favourite television show. As you can see, there are both positive and negative effects associated with television. But no matter what anyone says, one thing is clear: television is here to stay. The technology keeps getting better, as more and more channels become available to us. Television ratings today are higher than ever. People are tuning in, and television is a part ÃŽ ¿f almost everyones life. Violence on TV effects people, especially children, in negative ways. Before the average American child leaves elementary school, researchers estimate that he or she will have witnessed more than 8,000 murders on television. Nearly 3,000 studies have found a connection between television violence and real violence. For example, studies involving children show that the more violence a child watches on TV, the more violent he or she will act. People that watch TV are influenced by what they watch. For example, a person might watch a man swearing on television, and then they use the same swear words as the person on television did. Or a young girl might watch a show in which all ÃŽ ¿f the main characters are skinny, and because ÃŽ ¿f this she might want to make herself thinner, endangering her health in the process. Some people become addicted to TV. They watch

Mass Murderer Case Study Example | Topics and Well Written Essays - 750 words

Mass Murderer - Case Study Example When looking at the case of Charles Manson, one could begin to list a myriad of reasons for his crimes, starting all the way at the beginning of his life. Even in his younger years, Manson was subjected to crime, and went in and out of several different protection camps until he was finally sent to the National Training Schools for Boys in Washington D.C. His turn to crime can be traced back to his unstable family life, his mother was a drunk and he may never have known his real father. He lived between family members, and even at one time in his life was sold by his mother so she could get some alcohol. His uncle had to go take him back, and thus began Manson's movement in and out of family homes, as well as the prison and rehabilitation crimes schools he would go in and out of for the next years of his life. Manson's life of crime only continued, as his criminal behavior in jail kept him in prison until March 21, 1967. Upon his release then, he had spent less than his thirty two years in various prisons across the country. However, for Manson, his worst crimes were still yet to come. They could easily be foreshadowed by his previous record of crime and unwillingness to cope with the law. If one simply was to glance at this past record, it is not a surprise that Manson turned out the way that he did. Now that Manson was out of jail, he was able to amass alm... and always being shuffled in and out of homes and schools, I feel Manson did not grow up as he should, and suffered from a lack of a stable conscience. As he continued to grow, this is evident through his massing of a "Family", as it would later be called, and the gruesome murders that would later be carried out on his command. As his Family continues to grow, his supports became even more loyal to him. A huge Beatles fan, Manson preached to his followers that mass murders were to come, and that riots between blacks and whites due to racial tension were due to break out at any time. However, it was Manson's family themselves who broke out the murders, and in an odd way brought Manson's teachings to life. Although it is uncertain if Manson committed any of the murders himself, it is for sure that he ordered them and played a pivotal role in what happened the nights of all the murders. After all of these murders, Manson would be sentenced to death on seven counts of murder and one count of conspiracy. Manson was just recently denied parole again, and is not up for parole until 2012. His case is often connected with the counter culture of the time, and Manson may be one of the most infamous murderers of this age. Throughout his whole life, Manson never really stood still. Being brought up in a shaky, unstable environment, and having to go through all those prisons at such a young age, and even having a lack of strong role models, all seem to compact into the idea of what he turned into. He seemed to somewhat loose touch with right and wrong, possibly because he never really was taught what right and wrong was. I believe that these reasons all strongly weighed on Manson, and ultimately made him become who he turned out to be. If Manson had had a better childhood, been