Physical Restraints on Dementia Patients Essay

Introduction A patient’s safety is one of a nurse’s primary concerns. It has become a big issue focused on by the general public and policy-makers after medical errors have been increasingly publicized and more hospital-related injuries are reported (Stanford University, 2001). The International Council of Nurses define a nurse’s role as someone who can work on his own and/or in a team to care for people of all age groups, their families, social groups, and communities, whether well or unwell, and in different settings. Nurses promote health, prevent illness, and look after the sick, disabled and the dying. Furthermore, they advocate for a safe environment, participate in research and moulding new policies to better the health care system. (International Council of Nurses, 2010). But what happens if a nurse has to decide between a patient’s safety and upholding that patient’s right to freedom, dignity, and respect? For this assignment, the researcher wishes to take a closer look on physical restraint use in the elderly, specifically on dementia patients and why nurses find the need to use restraints important despite the drive of facilities and hospitals to eradicate or lessen their use. With the decrease in cognitive capability in some of the elderly patients, how comfortable are nurses in putting them on restraints? Do they find these patients are ripped off of their independence? If restraints are not to be used, then what alternatives are nurses left with? These are some of the questions the researcher aims to answer through a review of current literature on the topic. Background Old age brings about numerous problems including physical, emotional, and functional disorders. (Butler & Lewis, 2003). Storrs (2008) describes old age as a biological change which causes diminishing powers of adjustment. This is evident when we see patients unable to cope with their surroundings. Some common physical changes in old age include decrease in cardiac output, increase in blood pressure, impairment of gas exchange, elevation of blood glucose, decline in lean body mass, and loss of muscle mass which makes an elderly person’s locomotion difficult (Boss &  Seegmiller, 2001). Not only do changes occur physically, but the elderly also experience various mental alterations. Mental changes may occur following normal aging, medication side effects, and natural functional loss. (Woodward, 2004). Common mental impairments associated with old age include decline in memory retention, depression, and increased anxiety. (Woodward, 2004). Physical and mental changes in older adults make them vulnerable to accidents, often ending with them hurting themselves. This is more so if the patients suffer from Dementia. Although not a normal part of ageing, Dementia is a common disease in people over 65 years of age. (Ministry of Health, 2013). Dementia is a term used to describe decrease of brain function resulting in memory loss, poor communication skills, absence of reasoning, and inability to perform activities of daily living. (Bupa, 2010). It causes patients to be forgetful and confused, with little or no regard to hazards around them. Confusion, lack of insight, and impulsiveness can result to a display of behavioural problems, thereby making patients with Dementia prone to accidents and injuries (Ministry of Health, 2013). A study by Cunningham (2006) investigates why institutionalised Dementia patients tend to be more â€Å"disruptive†. He states that an unfamiliar setting combined with memory problems can be a scary situation for Dementia patients and they react to how they see fit. Adding to this, hospital routines may be misinterpreted which can lead to behaviours that are challenging. (Cunningham, 2006) However, there is a strong suggestion that nurses must try to understand the meaning behind challenging behaviours, and seek ways to inculcate familiarity and lessen distress amongst Dementia patients. (Cunningham, 2006). The numerous mental, physical, and emotional problems of patients with Dementia leave nursing staff to assist and supervise these patients in most of their activities (Weiner, Tabak, & Bergman, 2003). It is therefore vital that nurses take extra precautions when looking after patients with Dementia to prevent them from doing things that may hurt them or the people around them. Because of the continuous demands to keep patients safe while allowing time to perform daily tasks, some nurses are forced to involve coercion in the form of physical restraints. (Weiner, Tabak, & Bergman, 2003). A physical restraint is any mechanical or physical means or equipment attached to a person, which restricts movement, mobility, or access to a one’s body. (Health Care Financing Administration,  2000). It may include, but is not limited to, anklets, vest, straight jacket, and lap belts. A device may be considered as a restraint depending on its effect on a person. For example, a sheet may not be a restraint when used as a blanket; however, tucking the sides under the mattress and restricting the person from getting out of bed makes it a restraint. A geri-chair or a tray table are ordinarily not restraints but if they are used to stop a person from getting up, then it becomes one. (Health Care Financing Administration, 2000) Physical restraints are not medical interventions, and its application can be based upon a caregiver’s decision. The Nursing Interventions Classification define physically restraining a patient as putting on, taking off, or causing a device to limit his mobility (Sullivan-Marx, 1996). Account of current practice Dementia is the progressive decline in cognitive function which is more than what is expected to occur as a person advances in age. It is a non-specific disease which affects brain function, memory, communication skills, problem solving, and attention. (Nordqvist, 2009). In New Zealand, it is estimated that 60% of residents in care homes are diagnosed with moderate to severe Dementia, and every year an additional 250 beds are allocated for new admissions with the same diagnosis. (Bupa, 2010). An article in The New Zealand Herald reveals that 50,000 people in New Zealand are now living with Dementia, and the number could triple by 2050 (The New Zealand Herald, 2013). However, with the increase in dependency in aged care, there is an alarming decrease in the number of qualified staff willing and able to care for these patients (New Zealand Labour, 2010). Because Dementia patients are unable to reason and decide for themselves, their welfare is almost always left in the hands of the nurses looking after them. But with the complex patients that are handled by nurses daily, it is common for staff to use physical restraints on patients to get them to do what the nurses expect them to do, within the time frame they are expected to be done. (Weiner, Tabak, & Bergman, 2003). But nurses are not just to restrain patients. As professionals governed by a specific body, nurses’ use of restraints is to be limited. In 18 July 2005,  a policy was released by the Canterbury District Health Board (CDHB) Restraint Approval and Monitoring Group stating that all care facilities and acute hospitals in the region are to limit restraint use on patients. (Restraint Approval & Monitoring Group) In the United States, 7%-10% of Dementia patients are at one point restrained during hospitalisation, with 8% actually being tied down (McHutchion & Morse, 1998). These numbers were gathered 11 years after strengthening of the Residents’ Bill of Rights in the USA which included the patients’ Right to freedom from physical restraints. (Klauber & Wright, 2001) In New Zealand, 3.4%-21% of acutely ill patients were restrained during hospitalisation, with the restraint duration of 2.7 -4.5 days. It is quite different from the number of cases of restraint use in residential care. It was reported that 12%- 47% of patients were restrained in care facilities, with 32% of them restrained no less than 20 days a month. There is a wide range of duration of restraint use from a day to 350 days in a year. (JBI, 2002) These numbers paved way for more researchers to look into the finding ways to effectively lessen restraint use. However, most studies still show that nurses are resistant to the idea of totally removing restraints as an option. Review Aim The rate of prevalence of Dementia cases, the decline in the number of qualified staff to look after them, and the rampant use of physical restraints on these patients are all very alarming. Even with policies in place to limit restraint use, nurses seem to still use physical restraints on patients. Basically, this review will circle around how much knowledge nurses have about physically restraining dementia patients. This review aims to discover nurses’ understanding of restraint use and unmask the reasons behind their choice to use physical restraint on Dementia patients. It aims to discover any restraint policy on restraint use in Dementia patients. It will compare data amongst available literature on nurses’ perception of physical restraints and their take on the drive for minimisation of its use. The effects of physical restraint on patients will also be uncovered as articles are subjected to analysis. Literature will also be analysed for any suggestions on how to totally eradicate or avoid restraint use. A study by the Centre for Medicare and Medicaid Services reveal that within the last decade, there has been a constant decrease in the number of physical  restraint use in care homes. From 1999, 21.1% of care facilities would physically restrain elderly patients. However, in 2007, the report states that less than 5% support restraints use. (Center for Medicaid and State Operations/Survey and Certification Group, 2008) The researcher aims to draw out a conclusion on the reason behind this change and discover why despite the constant drive of administrative bodies to minimise restraint use, nurses still apply physical restraints on the elderly patients. Search Strategy Search engines like the Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed, and Medline were utilised to find significant articles in relation to the review aim. Key words ‘physical restraint’, ‘dementia’, ‘long term care’, ‘nurse’ ‘attitude’ and ‘behaviour’ were used. Google and Yahoo search engines, and the New Zealand Nursing magazine Kai Tiaki, were also used to find related studies. After reading the found articles, the researcher finalised the most relative articles based on search criteria set out. The search criteria included full reports, quantitative or qualitative studies, and literature reviews. The articles have to be in English, published from 2000 to present, can be accessed fully, participated on by nurses, and limited on physical restraints used on Dementia patients. Because of the limitation in results, the researcher broadened the search and included studies done in acute settings, as long as the patient in restraint has a diagnosis of dementia. After further deliberation, 7 journal articles were chosen for the review. Critical analysis of the literature Three themes were drawn from the literatures chosen. These themes are a) factors that affect a nurse’s decision to use restraints b) why restraints are used and c) effects of restraints on dementia patients. a. Nurse Education influences decision-making The studies revealed that the nurse’s level of knowledge about restraints dictates their decision on whether to use restraints or not. According to the study by Yamamoto et al (2009), a nurse must have either a positive cognition or a negative cognition about restraints to consider its use or  choose not to act on a situation. Nurses also have to analyse the situation and decide on how to cope. Their coping dictates their decision-making. (Yamamoto & Aso, 2009) For this study, the authors surveyed 272 nurses in general wards in Japan using a questionnaire involving the ethical dilemma of using restraints. This study wanted to elaborate on how nurses make up a decision of restraining a patient based on how well they cope with difficult or challenging patients. Another study by Weiner et al (2003), states that a nurse has to have knowledge on patient’s rights, code of ethics, and restraint guidelines for them to decide on restraint use. The study further shows that restraint application can be viewed beneficial either to the patient, the nurse, or the institution. Comparing nurses in acute settings to those in care homes, it was found that the latter are less likely to agree to the use of restraints. This may be because most nurses working in care facilities have more knowledge about their facilities’ restraint guidelines. (Weiner, Tabak, & Bergman, 2003) Unlike other researchers, this study involves the institution and gives light to how big a role it plays in how a nurse decides about restraints. Testad et al (2005) performed a randomised single-blind controlled trial in four nursing homes in Norway. In their study, they conducted seminars and guidance sessions over six months for nurses working in care facilities. There was a documented decline of 54% inrestraint use after the educational programmes were concluded. (Testad, Aarsland,, & Aarsland, 2005) b. Reasons for Restraint Use Though nurses are trying to keep patients safe by applying physical restraints, these restraints are more harmful. Scherder et al (2010) view restraint use as detrimental to a dementia patient’s cognition and physical activity. They emphasize that using physical restraints on dementia patients causes more harm than good. Keeping dementia patients on restraints reduce physical mobility, increase patient’s stress, and even accelerate incontinence. (Scherder, Bogen, Eggermont, Hamers, & Swaab, 2010) A study in Israel by Natan et al (2010) 120 nurses were used as samples. 67.2% of these nurses admitted to having had restrained a patient over the past year. Some decision-making factors that nurses point at are subjective norms, the resident’s physical state, and the nurse’s own stress level. Nurses turn to restraints when a patient becomes increasingly difficult to manage and starts to prevent treatments such as intravenous infusions, catheter or tube insertions. (Natan, Akrish, Zaltkina, & Noy, 2010) Cotter states there is a greater likelihood for restraints to be put on dementia patients because they pose the most threat to fall, hurt themselves or hurt others. (Cotter, 2005) â€Å"In moderate to severe dementia, the risk for falls is greater because of gait apraxia and unsteadiness. Agitation, disorientation, and pacing behaviours from delirium and dementia can precipitate staff to use restraints.† (Cotter, 2005) c. Effects of Restraints on Patients One common denominator amongst the literatures in the review is the concern for the dementia patients on restraints. Some of the listed effects of physical restraints mentioned in these articles include function decline, pressure sores, incontinence, and increased agitation. Cotter referred to dementia patients as most prone for restraint application because of their increased confusion, wandering, poor memory, poor judgement and distraught perception. (Cotter, 2005) Wang (2005) states that there is no scientific evidence that states physical restraints protect patients. Though nurses believe that restraints can keep patients safe, it may be contrary to the fact. (Wang & Moyle, 2005). Accidents like asphyxiation when patients are caught between their restraints, and falls from when they try to climb out of bed rails have been documented. Another reason that restraints are not so good to use is because patients get fatigued from struggling when in restraints and then become unsteady once they get off the restraint. (Cotter, 2005) Restraints also leave a very negative experience on the patient. Dementia patients respond with anger, resistance, fear, and humiliation. The following is statement made by a patient after being restrained: (Strumpf & Evans, 1998) â€Å"I felt like a dog and cried all night. It hurt me to have to be tied up†¦the hospital is worse than a jail† Discussion Recently not a lot of studies have been made on the use of restraint on dementia patients. Most articles are outdated and not applicable anymore. With the mushrooming of nursing care homes and the booming industry of  nursing facilities, researches should be made on how nurses feel about eradicating or lessening restraint use. The locale of these studies is also not very diverse. More studies should be conducted in various settings and environments. A patient in acute care may have a different set of concerns compared to patients in long term care facilities. A thorough analysis of why patients would need restraints in respect with the different settings they are in would have been beneficial. Like knowledge, cultural beliefs may impact on a person’s decision. A study by Hamers et al (2009) used cross-sectional method to find out about reasons, consequences, and appropriateness of restraint use as seen by nurses from different parts of the world. They discovered that some degree of cultural differences determine these nurses’ ideas towards restraint use. (Hamers, Meyer, Kopke, Lindenmann, & Groven, 2009). Conducting studies in a more global approach can draw out an idea of why some nurses prefer physically restraining patients while others don’t. The studies show a decline in restraint use after education sessions were presented to nurses. They occur at short term, all within a 6-month period which may influence the outcome of the study. The lectures may have influenced the participants’ attitude towards restraint use because they were recent, and not because they were meaningful to their practice. The studies in the review indicate that nursing education plays a very important role in influencing nurses’ decision on using restraints. A nurse has to be presented the rationale, risks, and alternatives to restraint use for them to be able to make a decision. The Hawthorne Effect may play a part in the studies conducted. The term Hawthorne Effect was coined Henry Landsberger in 1953 to refer to participants altering their answers because of the knowledge that they are being observed. (Sonnenfeld, 1985). The nurse-participants may have opted not to restrain patients at the time the research was being conducted because of fear of being judged for their decisions. Another grey area not thoroughly discussed in the literatures reviewed is the influence of policies set out by governing bodies or administration on nurses’ decision making. It was briefly mentioned in the study by Weiner (2003) but never really elaborated on. The study stated that the institution is taken into consideration when nurses decide on restraint use. Nurses view the institution as one that benefits if restraints are used. (Weiner, Tabak,  & Bergman, 2003) A comparison of institution policies should have been made. These institution policies on restraint use differ in most care facilities and comparisons of how well nurses are in following them can draw a different angle on the situation of physically restraining patients. Also, the effectiveness of these policies should be evaluated to allow for their improvement. The studies also focused on reasons why patients are put on restraint. Not very well discussed was what happens with the nurse before he/she decides to use the restraint. The studies in the review failed to look at the situation from a nurse’s perspective. The clear message of the literatures reviewed is that restraints can and must be avoided in patients with Dementia. No scientific evidence shows that restraints promote safety for these patients. On the contrary, more studies show detrimental effects of restraint application. Personal review and implications for nursing practice The results of the studies reviewed all indicate that there is a need to highlight lack of education amongst nurses regarding restraint use. Because knowledge and sense of accountability play major roles in restraint application, keeping nurses updated with trends and new policies should be prioritised. Even with reports of decrease in restraint use, a number of incidents involving misuse of restraints are still rising. One in particular is the incident last September 2010 involving a known nursing care facility wherein it was proven that an 85-year old patient has been wrongly restrained on numerous occasions. The patient’s wife has been repeatedly objecting restraint use but the hospital did not oblige. The staff reasoned that the patient had a high falls risk, and high levels of agitation, aggressiveness and restlessness. The cause of the breach was said to be due to systemic failure (Otago Daily Times, 2013). This shows that though policies may be put in place, it is not an assurance that they are being followed. A closer look at the effectiveness of these policies and their appropriateness to the setting has to be taken into consideration. Currently the Canterbury District Health Board (CDHB) has a restraint minimisation and safe practice guideline in place. This supports their aim to reduce restraint use and treat restraints as a last resort to protect patients from harm. Nurses can be directed with the guidelines to ensure  safe practice. (Canterbury District Health Board, 2012) As mentioned earlier, a nurse’s perspective is often looked past. A study by Lai (2007) indicate that at times nurses feel that when it comes to issues on restraints, their â€Å"inadequacy and inaccurate knowledge† have always been magnified but rarely is the pressure to â€Å"do what is right† in d ifficult situations brought up. According to the study, nurses still use restraints despite ambivalence because of fear of responsibility. A patient may fall and break his hip because he was not restrained despite poor mobility. Another reason nurses tend to use restraints is because of lack of support from management. As the nurses reported, even if they do their best, issues on short-staffing can still push them to use restraints as an aide to keep patients safe. (Lai, 2007) Another reason mentioned by Lai (2007) in her study is the constant pressure that nurses feel from management. Often it is the culture of the unit that dictates a nurse’s willingness to restrain a patient. A ward that strives to keep fall incidents at a low would be happy to apply physical restraints on patients to achieve that goal. Conclusion The researcher observes a strong connection between how a nurse views a situation and the options he has on how to act upon that situation. These nurses must be given the opportunity to learn and relearn restraints to help them make valid and safe decisions for their patients. Without available options in place of restraint use, nurses will continue to utilise physical restraints because of the pressures they have to face with regards to the patients’ needs. A discussion of available options in place of restraint application is needed to allow for a more acceptable choice. Accountability of outcomes because of failed actions, like not applying a restraint, appears to be greater than putting a restraint on a patient. A dementia patient is still a human being entitled to his rights of freedom and dignity, and nurses have to weigh this with the notion that these patients may also be challenging. It is therefore necessary to refer to available guidelines to assist nurses in making a decision with regards to patients care. Also, keeping updated with trends in patient care may help nurses make informed decisions. Restraint use can easily become a norm when nurses feel it has been a common occurrence in a unit. All decisions have to be weighed in and thought of properly, exerting all other possible  interventions before restraints are utilised. A restraint-free environment is far from being realised when nurses, families and administration still regard it as a solution and not a problem. With that said, nurses should not be viewed as the culprits in restrai nt application. Instead, nurses should be part of the solution.

Posting on Reading Essay

Education   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   How education is valued and how it is tied up with culture and the structure of society is the focus of the article. Moreover, several factors that encourage people to attend higher education are also explored in the article. For instance, several examples about the South Korean culture were revealed in the article in order to emphasize how the view of education changes depending on the culture. For the South Koreans, education is seen as a status symbol and not a stepping-stone to acquire a job in the future. The good thing about it though is that statistics has shown that the percentage of dropouts is less in areas that believe in the relationship between education and societal value.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   People from different walks of life have varying points of view regarding education. A survey conducted in order to determine the reasons why people choose to attend higher education reveals that reputation or culture and the enhancement of an individual’s disposition are the topmost reasons why people value their education. At this point, people view the learning and understanding of the English language as an instrumental skill in order to accomplish an individual’s aims to gain a high and respectable social status. Koreans nowadays are struggling to learn the English language, as it gives one a high rank in the social climate. Koreans spend time and effort in studying English that they are willing to undergo rigorous testing just to speak English well.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Perhaps, the article does not only discuss education as part of culture. I think the issues in this article also have strong connections with globalization. As the world moves to become a global village, people are forced to increase their chances of belonging to the international community. This objective shall only be accomplished through further education. This is probably one of the reasons why education is seen as a form of earning a high rank in society because being well educated and learning to speak English well keeps you in a range of belongingness with the rest of the global community. The Costs of Educational Zeal   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The article explores the effects of Korea’s valuing of education to the costs of attending the educational institution. Apparently, with the Korean’s growing value for education and the educational institution’s goals to enhance the quality of education, the costs of higher educations have also reached a high. The reasons underlying the high cost of education in the country was explored under different regimes. The influence of colonialism to the educational system of the country contributed much to the high cost that they require of education. Moreover, majority of educational institutions in the country require expensive rates for their services because most of them are privately owned. At this point, I ask myself, why do they need to pay expensive taxes for education when most of the educational institutions are private?   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   There was not any change during the Park Chung Hee’s term as president of the country. During this time, education was neglected, therefore there were no efforts coming from the government to fix the problem expensive costs of education. Reflecting on it, education in the country has really become a social status, such that only those who can afford it are able to gain the quality education that they deserve. Moreover, the government does not care less whether the people are able to afford education. This reveals how the voices of those people who cannot afford to attend educational institutions are not being heard.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Another factor that influenced the high costs of education was what the people called Kwaoe. Kwaoe is the Korean term for tutoring. This service requires large amounts of money that people cannot help but complain about its cost. At this point of time, the government was able to address this issue and ban tutoring all over the country. Throughout the years, noticeable efforts to alleviate the rising cost of education were evident when reviewing the performances of past governments. However, their efforts were not enough to lessen the cost of paying for an individual’s education. The failure of governments to remodel their educational system is understandable, because from the beginning, the faulty budgeting and financing for educational institutions was adapted by the country. What the country needs to work on is modifying the educational system in order to identify its flaws and once and for all end the high costs of education.

A Study on Religious Believes of Anglo-Saxon Society based on The Seafarer, The Wanderer, and The Wifes Lament

A Study on Religious Believes of Anglo-Saxon Society based on The Seafarer, The Wanderer, and The Wife's Lament Synthesis Essay on the Anglo-Saxons The Anglo-Saxons were a religious group of people as other generations of people were. Religion played a role in the Anglo-Saxon people’s lives and as a result it reflected in their writings. Poems written by the Anglo-Saxons have shown significant signs of religious influence including â€Å"The Seafarer,† â€Å"The Wanderer,† and â€Å"The Wife’s Lament.† Each writer of each poem gives their own testament regarding God’s influence on their situation. The Anglo-Saxon practiced their belief beyond religious establishments by writing of them within their poems. The Anglo-Saxons seemed to have correlated their everyday lives to their religious beliefs as shown in â€Å"The Seafarer.† The poem is written by a man fond of the sea and mentally drained by dwelling on the land. He understands the hardships of travelling by sea but simply cannot stay away. â€Å"Grown so brave, or so graced by God, That he feels no fear as the sails unfurl†¦Ã¢â‚¬  The writer is fearless of what the sea offers and correlates his bravery to being graced by God. Religion may have motivated many actions amongst the Anglo-Saxons as they believed to be protected and thus fearless. The Anglo-Saxon people being religious had no conflicting ideals of evolution instead pointing to God for it all. The writer goes on to talk about how God essentially created the Earth and life itself. â€Å"We all fear God. He turns the Earth, He set it swinging firmly in space, Gave life to the world and light to the sky. Death leaps at the fools who forget their God.† Scientific beliefs such as evolution may have been non-existent to the Anglo-Saxons as the writer of â€Å"The Seafarer† notes on how everyone fears God and how He gave life to the world. Religion played a key role to everything the Anglo-Saxons believed in from their everyday activities to basis of life itself. The Anglo-Saxon’s often looked to religion and God in times of distress to mediate the best of a bad situation. As shown in â€Å"The Wanderer,† the writer finds himself alone following the slaughter of many people he had once knew. With nowhere else to turn, the speaker turns to his religion for comfort. â€Å"This lonely traveller longs for grace, For the mercy of God†¦Ã¢â‚¬  The speaker falls to God in his lonesome travels to remedy the hardships he had just experienced. The Anglo-Saxons believed and stood by God’s impact on their lives despite what they’ve been through. The Anglo-Saxon people went to God and religion as a reason behind everything they do. â€Å"It’s good to find your grace In God, the heavenly rock where rests our every hope.† The speaker goes on to state how giving your life despite hardships to God is good as religion holds all the hope in the world. â€Å"The Wanderer† gives example of one dweller of many who may have found themselves in a lonesome situation who in turn, turned to God. The Anglo-Saxon people believed in religion greatly as their only source of hope through hardships such as war. As supported by â€Å"The Wanderer† speaker, the Anglo-Saxon’s sought after religion during times of distress. â€Å"The Wife’s Lament† is a poem written by the ‘wife’ of a man who seemingly is exiled himself and the speaker seeks him. The speaker in the poem however is exiled herself and forced by her husband’s kinsman to remain in the woods â€Å"in the den of the earth.† â€Å"Blithe was our bearing often we vowed that but death alone would part us two naught else.† The speaker motions towards her marital vows towards her husband to counteract his decision to hold her in the woods against her will. Marriage often seen as a lifelong relationship established by God, the speaker feels her Lord betrayed both her and God by abandoning her and their commitments. As with all religions, the Anglo-Saxons consisted of individuals who had went against their beliefs. â€Å"May on himself depend all his world’s joy.† The speaker wishes upon the â€Å"curse† that her husband depend on everything given to him on Earth rather than what awaits him later in the afterlife. The speaker in â€Å"The Seafarer† notions at how the wealth of the world does not reach the Heavens nor does it remain important when you die and thus the wife wishes her husband depends heavily on the joys he experiences now. Religion to the Anglo-Saxon’s explained every aspect to their life including marriage and those who opposed it were seen as deserters as noted in â€Å"The Wife’s Lament.† Religion explained many aspects within the Anglo-Saxon’s lives through the three poems, â€Å"The Seafarer,† â€Å"The Wanderer† and â€Å"The Wife’s Lament.† The three speakers of the poems noted God’s ability to guide them through times of distress and as a result gave their life to their faith. The three poems reflected the impact of religion to Anglo-Saxon people’s lives and thus this was reflected in their writings.

Public Relations (Case Study) Essay Example | Topics and Well Written Essays - 1750 words

Public Relations (Case Study) - Essay Example The village is currently barren; this makes it viable for any business opportunity ranging from tourism to manufacturing plants owing to the readily available resources. By exploiting such, the stakeholders can easily revamp the economy of the township. However, among the vital weaknesses in the structure of are the low population which also makes it a poor market and may probably discourage investment since labor is costlier in the less populated village. The current state of the village presents it with various investment opportunities key among which is tourism. The stakeholders can position the village as a tourist destination in the state and therefore attract both domestic and foreign tourists. The village’s rich cultural and political history coupled with various contemporary developments may position the village as the most favorable tourist destination in the state by attracting city residents who require a peaceful environment. The greatest threat to the development of the village is its social structure. The local authorities records accounts of drug abuse and rising crime rates in the village. Such trends would stifle the efforts to develop the village into a tourist destination in the state. ... The economic factors that affect the growth of the village include the lack of investment opportunities in the village. The rising crime rates and the abuse of drugs constitute specific social factors that affect the development of the village. Additionally, technological factors will equally affect the development of the country; the villagers must assume the new communication features and ways of doing business in other parts of the country (Davis, 2007). Legal factors such are consumer laws and employment laws apply in the country just as in any other part of the country. Environmentally, the village is a barren opportunity with desirable flora and fauna. Stakeholders map The individuals who are likely to influence any development plan in the Luddenden Village include the locals. The category includes the old people who have witnessed the growth of the village and the young people who seek to foster the development plan. Additionally, the involvement of the government is equally v ital. This occurs sequentially with the involvement of the local leaders who relay the plans to the central government. The entire national population will also affect the development of the village. With the identification of the stakeholders in the village development project, stakeholders map provides for ways of reconciling conflicts among such and therefore determining an appropriate management system (Blackshaw, 2008). The rising crime rate and drug abuse among the youth is an eminent impairment in the cohesive generational transition. The villagers must therefore use every means possible including the incorporation of the local authorities in order to curb such since they are capable of thwarting

Shroud of Torin Research Paper Example | Topics and Well Written Essays - 1250 words

Shroud of Torin - Research Paper Example Shroud of Turin The Shroud of Turin is a linen cloth that bears the image of a tortured and crucified person and that is believed by many people to be the actual cloth that wrapped Jesus Christ during his burial. The authenticity of the Shroud of Turin has been a subject of a very controversial debate; the proponents of the Shroud of Turin argue that the Shroud of Turin is indeed the real cloth that Jesus Christ of Nazareth was wrapped in during his burial, while the critiques of the Shroud of Turin on the other hand dismiss the Shroud of Turin as a medieval Christian hoax meant to win Christianity more converts (Stapylton, 2003). This paper looks at the history of the Shroud of Turin, and also at the controversies that characterize the history of the Shroud. And since the History of the Shroud of Turin is too broad to be covered in this paper, the paper focuses on the highlights of the history of the Shroud of Turin. At the end of the paper, an objective conclusion is made based on the history and the debates on the authenticity of the Shroud of Turin. For better analysis of the history of the Shroud of Turin, the history of the Shroud of Turin can be divided into two periods. The first period is before the year 1350, and the second period is after the year 1350. Researchers are agreed that the year 1350 is the beginning of the documented history of the Shroud of Turin (Shroud History, n.d.). But the period before 1350 is quite controversial; some scholars are of the view that the Shroud of Turin existed even before 1350 while other scholars, basing their evidence on Carbon dating, believe that the origin of the Shroud of Turin can be traced in the medieval period. But before we get into the debate of the authenticity of the Shroud of Turin, let us first look at the documented history of the Shroud of Turin. The following are the significant events in the history of the Shroud of Turin as documented by the Shroud Historian Ian Wilson (1978). According to the d ocumented history of the Shroud, Geoffrey de Charny, a French knight, is mentioned as the person who was first found with the Shroud of Turin (Wilson, 1978). In the year 1349, Geoffrey had written to pope Clement V1 expressing his wish to build a church in honour of the Holy Trinity. Geoffrey had been a prisoner of the English and he claimed that the Holy Trinity had miraculously saved him from the English prison. The pope gave him the permission to build the church and Geoffrey built it at Lirey in France. Geoffrey is said to have been in possession of the Shroud of Turin during this time and he kept the Shroud in the Church that he built at Lirey. Some people have argued that Geoffrey had got the Shroud from Constantinople; while other people disagree with this view (Shroud History, n.d). The first public exposition of the Shroud of Turin was done in 1355 at the church that Geoffrey had built at Lirey in France. Bishop Henri, however, was quite sceptical of the Shroud and he order ed that the expositions be halted. The expositions were halted and the Shroud was hidden away. In the year 1356, Geoffrey and his wife died, but the Shroud remained in the family of Geoffrey. In the year 1389, King Charles V1 of France requested the bailiff of Troyes to seize the Shroud at lirey and deposit in another church in Lirey waiting further decisions on the Shroud from the king (Shroud History,

Sickle cell disease Essay Example | Topics and Well Written Essays - 500 words

Sickle cell disease - Essay Example The chance of one of her parents being a carrier is 1 in 2 (1/2). Assuming that one of her parents had normal copies of CFTR and the other parent was a carrier, the chances of their siblings being a carrier is 1 in 2 (1/2). So the chances of my friend being a carrier is x , i.e , one out of four. Assuming that both my friend and her fianc are carriers, the chances of their baby having the disease are 1 in 4. Therefore, the overall chance of their baby having cystic fibrosis is x x . 1/32, one in a 32. Sickle cell disease: Sickle cell disease is a genetic disorder caused by mutations of the -globin gene. There is a mutation of one single nucleotide from A to T, which results in a glutamic acid being replaced by valine at position 6 of the -globin gene. GAG, a codon, which codes for glutamic acid is changed to GUG resulting in replacement with valine (Pauling et al., 1949). In several forms of this disease, the red blood cells (RBC's) change their shape (Herrick, JB., 1910), upon deoxygenation caused by polymerization of abnormal sickle hemoglobin (Hanh and Gillespie, 1927). This results in the damage of the RBC's and can lead to these cells getting stuck in capillaries. The downstream tissues that are supplied by these capillaries are deprived of oxygen causing ischemia, leading to organ damage, as in stroke.

Persuasive apology Assignment Example | Topics and Well Written Essays - 250 words

Persuasive apology - Assignment Example I am also a family man with a lovely God-fearing wife and a son and have great respect for them. I have constantly taught my son the value of being polite and honest as well as not letting emotions overcome the situation. I clearly let my emotions for failing the course repeatedly take control against my better judgment. I sincerely pray that you may find it in your heart to forgive my actions and words and not throw me out of the school. The book of First John 1: 9 says that â€Å"If we confess our sins†¦he will forgive us and purify us from all unrighteousness.† My actions have been unrighteous and I seek forgiveness. The good book also says in Mathew 6: 14 â€Å"For if you forgive men when they sin against you, the heavenly father will also forgive you.† Your forgiveness to me will mean a lot to not only me but my family and the Lord our father. I assure you and the entire fraternity that I will be an obedient, honest and honorary student from now henceforth if you only find it in your heart to grant me another chance to complete my remaining