The Role Of Proprioceptive Neuromuscular Facilitation Stroke

The Role Of Proprioceptive Neuromuscular Facilitation Stroke INTRODUCTION Stroke is a rapidly developing clinical signs of focal disturbance of cerebral function, lasting more than 24 hours or leading to death with no apparent cause other than that of vascular origin (Aho K Harmsen 1980). Stroke is a disease of developed nation and its the third leading cause of death and long term disability all over the world with an incidence rate of 10 million per year (Sudlow and Warlow 1996). Stroke occurs at any age but it is more common in elderly between 55 to 85 years of age (Boudewejn Kollen and Gert Kwakkel 2006). Stroke is classified into two types based on the pathology and cause, Ischemic stroke, occurs when the blood supply to part of the brain is decreased, leading to dysfunction of the brain tissue in that area. The ischemia results when there is Thrombosis, Embolism, Systemic hypoperfusion and venous thrombosis. Hemorrhagic stroke occurs when there is accumulation of blood anywhere within the skull vault. These hemorrhage results when there is microaneurism, arterio venous malformation and inflammatory vasculitis (Capildeo and Habermann 1977). Normal cerebral blood flow is approximately 50 to 60 ml/100g/ Minutes and varies in different parts of the brain. When there is ischemia, the cerebral auto-regulatory mechanism will compensate for the reduction in the cerebral blood flow by local vasodilatation and increase the extraction of oxygen and glucose from the blood. When the Cerebral Blood Flow is reduced to below 20 ml/100g/min, an electrical silence occurs and synaptic activity is greatly diminished in an attempt to preserve energy stored. Cerebral blood flow of less than 10ml/100g/min results in irreversible neuronal injury. These neuronal injuries occurs when there is formation of microscopic thrombi, these microscopic thrombi are triggered by ischemia induced activation of destructive vasoactive enzymes that are released by endothelium, platelets and neuronal cells. These result in the development of hypoxic ischemic neuronal injury which is primarily induced by overreaction of some neurotransmitters like glutamate and aspirate. Within an hour of hypoxic-ischemic insult there will be ischemiec penumbra where auto- regulation is ineffective. This stage of ischemia is called window of opportunity, where the neurological deficit created by ischemia can be partly or completely reversed. After this stage is a stage of neuronal death, in which the deficit is irreversible (Heros 1994). Functional restrictions resulting from stroke are paralysis of upper limb lower limb function, cognitive deficit, visual disturbances, disturbance of gait and mobility, spasticity of muscle, loss of co-ordination and speech problems. The loss of upper extremity control is common after stroke with 88% of survivors having some level of upper extremity dysfunction. Basic Activities of Daily Living (ADL) skills are compromised in acute stroke, with 67% to 88% of patients demonstrating partial or complete independence (Amit Kumar Mandall 2009). Muscle weakness, or the inability to generate normal levels of force, has clinically been recognized as one of the limiting factors in the motor rehabilitation of patients with stroke. Following stroke, some patients lose independent control over select muscle groups, resulting in coupled joint movements that are often inappropriate for the desired task. These coupled movements are known as synergies and, for the upper limb flexor synergy: shoulde r flexion, adduction, internal rotation, elbow flexion, wrist flexion and finger flexion. Upper limb extensor synergy: shoulder, elbow, wrist and finger extension. The rehabilitation of upper extremity is quite challenging. Many therapeutic approaches are currently available in the rehabilitation of upper extremity function. Most commonly used treatment approaches are ROODs approach, Sensory motor approach, PNF, Brunnstroms movement therapy, Bobaths technique and neuro developmental therapy. In this Proprioceptive Neuromuscular Facilitation (PNF) is widely used in the rehabilitation of upper extremity function in stroke patients. (Amit Kumar Mandall 2009). PNF is a therapeutic intervention used in rehabilitation which was originally developed to facilitate performance in patients with movement deficits. PNF exercises are based on the stretch reflex which is caused by stimulation of the Golgi tendon and muscle spindles. This stimulation results in impulses being sent to the brain, which leads to the contraction and relaxation of muscles. When a body part is injured, there is a delay in the stimulation of the muscle spindles and Golgi tendons resulting in weakness of the muscle. PNF exercises help to re-educate the motor units which are lost due to the injury. A variety of methods fall under the rubric of PNF, including the exploitation of postural reflexes, the use of gravity to facilitate movement in weak muscles, the use of eccentric contractions to facilitate agonist muscle activity, hold relax, contract relax, rhythmic stabilization, rhythmic initiation and the use of diagonal movement patterns to facilitate the activation of bi-art icular muscles (Etnyre Abraham L D, 1987; Hardy Jones, 1986 Osternig, Robertson, Troxel, Hansen, 1987). Tomasz  Wolny, Edward  Saulicz and RafaÅ‚Â  Gnat in 2009 conducted a randomized control study on the efficacy of proprioceptive neuro-muscular facilitation in rehabilitation for activities of daily living in late post-stroke patients. In this study sixty four stroke patients were recruited from the neurological rehabilitation centre Subjects for this study were recruited based on some inclusion criteria. The patients with loss of sphincter control, loss of mobility, locomotion and communication were included in this study and patients with grade 5 or 6 Repty Functional lndex scale were included in this study. After the recruitment of patients, all the 64 patients were randomly divided into two groups, group A (control group) and group B (experimental group). Group A will receive conventional treatment like strengthening, gait training etc. Group B will receive PNF based exercise. A pre and post assessment of the functional status of the stroke patients was done using R epty Functional lndex scale. The treatment will be continued for 21 days for both the groups in the neurological rehabilitation centre. . The data were analyzed using chi-square test. Chi-square was used to study associations between the treatments and changes in the criterion measurements. ANOVA was used to compare the average changes among the two groups. The result of this study showed that PNF-based rehabilitation exercise of late post-stroke patients significantly improved in their ADL functional performance and in locomotion when compared to the control group treated with conventional therapy. Kuniyoshi Shimura.A, Tatsuya Kasai. B in 2002 conducted a study on Effects of proprioceptive neuromuscular facilitation on the initiation of voluntary movement and motor evoked potentials in upper limb muscles activity. In this study author investigated the effect of PNF limb positions and neutral limb positions on the initiation of voluntary limb movement and motor evoked potentials in upper limb muscles. In this experimental study the patients were divided into two groups, in experimental group 1 they investigated the effectiveness of PNF by considering the effects of limb position changes on the initiation of voluntary movement in terms of electromyographic reaction times. In experimental group 2 they investigated the effectiveness of no (neutral limb position) movement by considering the effect of limb position changes on the initiation of voluntary movement with electromyographic reaction times. After signing the consent the experiment was conducted on the patients. Two upper ar m positions used in this study, a neutral position (N) and a position facilitating activity of the upper extensor muscles (PNF). The effects of these positions are observed in the EMG. The subject could passively adopt the two upper arm positions using his right (affected) arm by means of especially made arm holders. For each arm position, six blocks of 10 trials were performed. All trials of the first block and the first trial of each of the following blocks were excluded from the analysis to eliminate start-up effects. In addition, a few trials were discarded because of obvious mistakes in the recording. EMGs were recorded simultaneously from three muscles (Brachioradialis, triceps brachii and deltoid) using 3 cm diameter, bipolar, silver surface electrodes connected to an EMG-unit. The result of this study showed that the EMG discharge order differed between the two positions. PNF position improves movement efficiency of the joint by inducing changes in the sequence in which the muscles are activated. Hence PNF has an effective role in the initiation of voluntary movement and motor evoked potential in upper limb muscle activity. Pamela Duncan and Lorie Richards et al., in 1998 conducted a study on the effect of Home-Based Exercise Program for Individuals with Mild and Moderate Stroke. In this randomized controlled pilot study, 20 individuals with mild to moderate stroke who had completed acute rehabilitation program and those who were 30 to 90 days after onset of stroke were randomized to a 12-week (first 8-week will be therapist-supervised program and the next 4-week will be independent program) rehabilitation program. After signing the consent form, patients were selected based on some inclusion criteria like (1) 30 to 90 days after stroke; (2) minimal or moderately impaired sensorimotor function (3) ambulatory with supervision and/or assistive device; (4) living at home; and (5) living within 50 miles of the University. The exclusion criteria for this study are (1) a medical condition that interfered with outcome assessments or limited participation in sub maximal exercise program, (2) a Mini-Mental State score The participants for this study were selected and evaluated by a therapist based on the inclusion and exclusion criteria. If the subjects agreed to participate in this study, then the basic assessment is done after getting the informed consent. The severity of the stroke were assessed using Orpington Prognostic Scale (Sue-Min Lai and Pamela W. Duncan 1998) and Fugl-Meyer Motor Score (Pamela W Duncan 1982) that includes assessment of motor function of the arm, upper extremity proprioception, coordination, balance, and 10 cognitive questions. The functional assessments are performed using Barthel Index Activities of Daily Living (Fricke and Unsworth 1997) Lawton Instrumental Activities of Daily Living and Medical Outcomes Study-36 Health Status Measurement (Colleen and John 1992). Functional assessments of balance and gait of the participants were assessed using 10-Meter Walk, 6-Minute Walk (Kosak and Smith 2005) and Berg Balance Scale (Berg, Wood-Dauphinee and Williams 1995). Upper extremity hand function was evaluated with the Jebsen Test of Hand Function.The Jebsen is a standardized assessment to measure the time taken to perform hand activities. These includes: writing a short sentence, turning over 35 cards, picking up small objects, stacking checkers, simulated eating, moving empty large cans, and moving weighted cans(Jebsen, Taylor, Trieschmann 1969). After baseline assessment the subjects were randomly assigned into two groups, experimental group and control group. In experimental groups the PNF exercise were taught to the patients on day one as an home exercise and they were asked to continue the same exercise as an home program for eight weeks with three visits to the physical therapy department every week. The exercise includes assistive and resistive exercises using Proprioceptive Neuromuscular Facilitation Patterns and Theraband exercise to the major muscle groups of the upper and lower extremities. Subjects in the control group received usual care as prescribed by the physicians. The subjects of this group were assessed by the research assistant. The demographic data of both the groups were statistically compared using Wilcoxon rank sum tests. The results of this study showed that there is no difference in the pre and post exercise treatment. There is no change in the upper extremity function and the functional health status in both the experimental group as well as in control group after the treatment interventions. Ruth Dickstein, Shraga Hochman, Thomas Pillar, and Rachel Shaham in 1992 conducted a study on Stroke Rehabilitation with Three Exercise Therapy Approaches. One hundred and ninety-six hemiplegic patients were randomly selected for this study. All subjects were referred to the physical therapy department of a geriatric-rehabilitation hospital over a period of 18 months were admitted to the study. All patients had a recent cerebrovascular accident and came for a rehabilitation program after an average stay of 16 days in a general hospital. Sex distribution was equal with a mean age of 70.5 years. Thirteen physiotherapists were enrolled in the study for exercise administration and the subjects were assigned randomly to each therapist. The data were collected in a separate form, which has two parts; first part was used to collect the basic information like age, gender, side affected and location of the damaged artery. The second part was used to record the variable data. Each therapist tr eated their first five patients with conventional method, next five with PNF method and the last five with Bobath method. All patients were treated for five days a week for six weeks, and each treatment sessions were last for 30 to 45 minutes. The outcomes of each patient are measured before the treatment and every week thereafter. The functional independence is measured with Barthal index. Muscle tone of the involved extremities was checked by passive movements of the extremities with the patients in supine position. Muscle tone was graded using an ordinal scale composed of five points: a) flaccid, b) low, c) normal, d) high, and e) spastic. Ambulatory status of the patient was assessed and classified with a nominal four category scale: a) patient does not walk, b) patient walks with an assistive device and persons help, c) patient walks with an assistive device, and d) patient walks independently. The treatment was continued for 6weeks in both the groups. The data were analyzed using chi-square test. Chi-square was used to study associations between the treatments and changes in the criterion measurements. The Kruskal-Wallis one-way analysis of variance (ANOVA) was used to compare the average changes among the three groups. The results of this study showed that there is no significant difference in the improvement of activities of daily living and in the walking ability. But there is significant difference in the improvement of muscle tone in PNF group and in Bobath group when compared to the conventional treatment group. CONCLUSION: The poor quality of the trials reviewed severely limits the conclusions that can be drawn. However, it seems that currently there is no evidence, that interventions based on the Proprioceptive Neuro-muscular Facilitation (PNF) are more effective than other approaches. One Study done by Ruth Dickstein on PNF vs. Bobath concluded that PNF exercise given in conjunction with Bobath technique are more effective in improving wrist strength and upper limb function than giving PNF alone. But the outcomes used in these studies are ordinal rating scales, which may not be sensitive enough to differentiate the effect of the two techniques. The number of subjects recruited for these studies is very less. We cannot come to conclusion on the effect of PNF in upper limb function with these less number of studies. Stroke patients may vary widely on factors such as physical impairments, speech impairments, severity of impairments, cognitive impairments, and also in the individual personality and learning styles. So, we cannot assume that this PNF technique is superior to all other techniques, because we cannot say this technique can be used in individuals with stroke and at every stage of recovery. For example one approach may be effective in initial stage of stroke, but the same approach may not be effective for chronic stroke patients. Factors such as depression, spatial awareness, cognition, comprehension and sensory loss could also have an impact on the response of a technique. In most of the studies there is no exact clinical finding about the problem, size of lesion and the site of lesion. Characteristics of the lesion may explain the variability in responsiveness to the intervention. There is no ideal timing of the interventions, whether the technique should be given in the initial stage or late stage of stroke. In this review on the effect of PNF in upper limb function in stroke, evidence on the current practice is lacking. Because of the lack of evidence on current practice it is very difficult to make a conclusion. Evidence of support and treatment used in these articles is not standard to use in todays health care practice. It is suggested that further studies comparing the effect of PNF with other approaches using sensitive, reliable outcome measures and with homogenous sample size should be done. Therefore it is important that future studies clarify the analysis and interventions used within the PNF technique to enable accurate evaluation of the study. No studies on this review assessed the efficacy and the effectiveness adequately, so further studies should be done to get an effective and optimal approach in the rehabilitation of upper limb function in stroke patients.

Oxygen Product and Recycling in Artificial Ecosystem

Oxygen Product and Recycling in Artificial Ecosystem Discovering Terrestrial and Aquatic life The Ecosystem Simulation Purpose/ Hypothesis The purpose of this experiment was to create an artificial ecosystem in order to observe the natural changes in life. The column was put together including a terrestrial and an aquatic section to see how the two interact as one. Plants, insects, and fish were added to the column in order to observe how oxygen is produced, used and recycled. The eco-column experiment was done in order to familiarize us with testing water for pH, temperature, and dissolved oxygen levels. Along with familiarizing the participants with the process and meaning of certain environmental tests the eco-column simulation helped to show how life and nature works. It gave insight to how one element affects another in nature. The eco-column simplified the mast works of nature. Methods Two liter bottles were brought in and the bottoms were cut out of all but one and the tops out of all. After cut, the bottles were assembled together and taped. The eco-column was composed of three different sections; aquatic, decomposition and terrestrial. There was a filter inserted between the decomposition and the terrestrial chambers in order to catch the soil that would try to make its way down to the aquatic chamber. The eco-column was first assembled September 24th. For the aquatic chamber water was brought in, nearly a gallon, from local lakes, ponds, and creeks. For the decomposition and terrestrial the soil was taken from local forest. After assembling the column and inserting water and soil there were instructions to insert rocks, sticks, and insects. After assembly was complete test were done. The aquatic chamber went through various test including turbidity, dissolved oxygen, pH and temperature, along with subjective test such as odor and color. Observations were comple ted, as well as soil test. At first the columns were tested every week, but after 3 weeks the teacher instructed the class to complete test and observations every two weeks versus every week. The teacher gave out aquatic plants in order to help with dissolved oxygen levels. Once the dissolved oxygen levels and temperature became constant and safe fish were placed into each of the aquatic chambers of the eco-columns. The eco-column experiment lasted around three months; from September to December. The tests were completed five times. Dissolved oxygen and temperature were both tested using a probe in which was placed in the water. The pH levels were tested using a a special paper stick pH tester. In order to test turbidity water samples were taken from the aquatic chamber and put in a machine which read the level. The soil test were completed by taking out a cup of soil from the eco-column the week before. They were then tested for various elements such as; pH, nitrogen, potassium, an d phosphorus by putting them in the directed containers in which powder was added to test for the specific element. The eco-column was taken down on December 3rd. The water and soil was dumped outside of the school and the bottles were given to our teacher in order to be used again. Results The table below shows how the dissolved oxygen, temperature, and pH levels changed throughout the experiment. It is visible that the pH levels and temperature remained fairly constant over time. The temperature remained around 21 degrees Celsius and the pH levels neutral, 7. The dissolved oxygen levels however were constantly changing. The first day of our experiment, September 24th, the dissolved oxygen level was 1.0. At that level the water was unsafe for marine life, such as fish. There was barely any oxygen circulating throughout the chamber. A week later the level was up to 7.6. Our teacher stated that the range of 7 is a safe number. She ensured her class that they would receive plants and fish when the levels were suitable. About the second week in she added a plant into the aquatic chamber which really helped with the dissolved oxygen levels. Once suitable (about the third week) the fish were added and one can see from the table that the tested fields remained fairly constant . Water Quality (figure 1) The table below shows the observations of the aquatic, decomposition, and terrestrial chambers over time. When the eco-column was first assembled, the water was not in very good condition. It reeked of sewage, was yellow and from the chart above the dissolved oxygen levels were as low as they could be. Not only was the aquatic chamber bad, but the decomposition and terrestrial habitats smelled fowl, were full of mold, and life did not survive. From the chart one can easily see that over time the conditions greatly improved and by the end was an ecosystem sustainable for life. By October 22nd the eco-column had greatly improved. There were signs of growth, clear water and the mold was nearly gone. By the last day of the experiment there was no smell, no algae and no signs of mold. From observations and data it is clear that the presence of plants and animals helped to improve water and soil quality. They helped to minimize bacteria and fungus while improving the state of the air and o xygen levels. Observations of Biomes (Table 1) Discussion Identify two Food Chains or Food Webs in each of your habitats (chambers). Use arrows to illustrate these food chains and food webs; complete sentences are not required. Use extra paper if needed. Aquatic Chamber Decomposition Chamber (top soil chamber) Terrestrial Chamber On separate sheet Identify and briefly discuss the biogeochemical cycles which are taking place/which are present in your EcoColumns. Do not merely state that â€Å"they are all present†; instead, provide more specific information The sunlight brings in warmth , energy, and oxygen. While the animals ( fish and insects) breathe in oxygen CO2 is produced. The CO2 is then taken in by the plants and oxygen is released. The cycle then repeats. Is your ecosystem column a closed or open system? or is it something in between a closed or open system? Explain how this (closed, open or other) influences the ecosystem column overall. The eco-column is in between an open and a closed system. It is closed in the sense that it is isolated from the rest of nature. It is open because it has all the regular cycles and interactions of an ecosystem but just in a smaller, and confined. Although it is technically a closed system it is open because it has natural cycles. What kind of niches are available/present for the various organisms in the column? Be specific, descriptive, and use terminology that is pertinent to the topic. The fish niche is to clean up the algae present in the aquatic habitat. While the aquatic plants niche is to take in the CO2 produced from the fish and produce oxygen in order to keep the fish alive and dissolved oxygen levels high. Discuss evidence of ecological succession taking place in your column (or in the column of another lab group if you have not observed any signs of succession in your column). Our eco-column started out lifeless. The water was dark, the smell was unbearable, the chemical levels were high, and the dissolved oxygen levels were low. Over time the water began to clear, the smell went away the chemicals leveled out and the dissolved oxygen levels rose. The presence of plants cleared up the water and made it livable. After the first plant other plants were able to grow and the ecosystem was able to support life (fish). Discuss the stability and sustainability of the ecosystem columns in the lab, including your own. After the first week my groups eco-column became stable, the levels remained constant from that point forward, ours was also capable of sustaining life. However, everyone’s eco-columns weren’t as stable. Several groups struggled with clearing up their water and raising their dissolved oxygen levels. Because of this they were unable to have fish. One groups water turned black due to a fungus and eutrophication occurred. Discuss three trends or patterns which stand out as you think back on the data which you have been recording for 6 weeks. These trends or patterns should apply to the water quality tests or other observations which you have made over this multi-week time period. Briefly discuss these three trends or patterns, providing possible explanations based on environmental science principles. My group’s pH, dissolved oxygen, and temperature all follow the same pattern. They started out very low, rose quickly, dropped, and then leveled back out. Many of our terrestrial insects died so this could have possibly affected the levels, as well as lack of sunlight. Explain what eutrophication refers to and how this occurs. Apply this explanation to your ecosystem column. How might eutrophication take place in your column? Explain fully. Eutrophication refers to the increase in nutrients in water such as nitrates and phosphates; it depletes the oxygen and turns the water different colors. Eutrophication happened in one group’s column but not ours. Eutrophication could happen by nutrients from the soil in the terrestrial chamber dropping down to the aquatic chamber and polluting the water. Once the water is polluted the oxygen depletes and the water changes colors and becomes unsafe. Pick another group in your class. How do your data compare to theirs? Brainstorm some causes/reasons for any differences. Since we worked at lab stations other groups were always around. I observed that most people had similar results to us. Good temperatures, steady levels of pH and dissolved oxygen with rather clear water. Some groups however were not similar. Some had bad levels, could never get oxygen levels to healthy state and had vast amounts of mold and algae. Some eco-columns were lifeless because insects and plants were unable to survive. Finally, address any sources of error in this lab. This should be narrated in a â€Å"cause and effect† manner and talk about specific problems. A good example would be â€Å"water did not drain from the terrestrial chamber so †¦Ã¢â‚¬  while a bad example would be â€Å"we messed up the measuring one day.† The only error my group could find in the lab was the soil test. We could never get enough soil to do the test, so our data is very scarce and not one week could we actually complete the task. The only time we had enough soil was the last time and the results did not seem to be very accurate. I believe something could be done to improve the soil test and raise the accuracy. Conclusion Before this experiment I was clueless on the various water and soil test; as well as how to conduct them. I now feel confident that I could complete each test on my own and I am aware of the temperature, pH level, and dissolved oxygen number needed to sustain life. This experiment was very helpful in demonstrating how an ecosystem works and how everything needs and plays off one another. The eco-column gave us the opportunity to experience biogeochemical and life cycles. We learned what is necessary to sustain life and I feel as if that was the most important thing learned from the eco-column experiment. References Botkin, D. B., E. A Keller (2011). Environmental Science (8th ed.). Hoboken, NJ: John Wiley Sons. The EcoColumn. (2013). Retrieved December 12, 2013, from Annenburg Learner website: http://www.learner.org/courses/essential/life/bottlebio/ecocol/ EcoColumn Lab. (2013, February 7). Retrieved December 14, 2013, from Teaching Real Science website: http://teachingrealscience.com/2013/02/07/eco-column-lab/

Character Development In Sense And Sensibility :: essays research papers

Book Review 1 Development of Major Characters Sense and Sensibility   Ã‚  Ã‚  Ã‚  Ã‚  The first of Jane Austen’s published novels, Sense and Sensibility, portrays the life and loves of two very different sisters: Elinor and Marianne Dashwood. The contrast between the sister’s characters results in their attraction to vastly different men, sparking family and societal dramas that are played out around their contrasting romances. The younger sister, Marianne Dashwood, emerges as one of the novel’s major characters through her treatment and characterization of people, embodying of emotion, relationship with her mother and sisters, openness, and enthusiasm.   Ã‚  Ã‚  Ã‚  Ã‚  Marianne is in the jejune business of classifying people- especially men- as romantic or unromantic (Intro II). Marianne’s checklist mentality is observed by Elinor: â€Å"Well, Marianne†¦for one morning I think you have done pretty well†¦. You know what he thinks of Cowper and Scott; you are certain of his estimating their beauties as he ought, and you have every assurance of his admiring Pope no more than proper.† (Chapter 10) To site a specific incident, Marianne describes her opinion of Edward Ferrars- her sister’s interest- as being very amiable, yet he is not the kind of man she expects to seriously attach to her sister. She goes on to find, what in her opinion are flaws, that Edward Ferrars reads with little feeling or emotion, does not regard music highly, and that he enjoys Elinor’s drawing, yet cannot appreciate it, for he is not an artist (15). In a man, Marianne seeks a lover and a connoisseur, whose tastes coincide with her tastes. He must be open with feelings, read the same books, and be charmed by the same music (15). Marianne seeks a man with all of Edward’s virtues, and his person and manner must ornament his goodness with every possible charm (16). Marianne’s mother relates Marianne’s maturity beyond her years by reminding Marianne â€Å"Remember, my love, that you are not seventeen. It is yet too early in life to despair of such an happiness (16).† Marianne’s brand of free expression sometimes has little else to recommend it (Intro, I). What is true of Marianne’s classification system is true of her manners in general: In her refusal to place social decorum and propriety above her own impulses and desires, she is absolutely unbending (Intro, II). Marianne is also characterized as being very charming. For example, she believes her poetic effusions to be striking in themselves as well as accurate expressions of her inner life (Intro, VII).

Greed :: essays papers

Greed Greed Greed is a selfish desire for more than one needs or deserves. Greed can make honest men murderers. It has made countries with rich valuable resources into the poorest countries in the world. We are taught it is bad and not to practice it. But consider a world without greed, where everyone is as sharing as Mother Theresa was. The progress of humankind would be at a standstill. Greed has given our society faster travel, better service, more convenience, and most importantly, progress. Greed has created thousands of billionaires and millions of millionaires. But why is greed associated with evil? In their day, most capitalists like Cornelius Vanderbilt and John D. Rockefeller were depicted as pure evil. Vanderbilt stole from the poor. Rockefeller was a snake. But the name-calling did not come from the consumers; it was the competing businesses that complained. The newspapers expanded on these comments, calling them "robber barons." These are inaccurate terms for these busine ssmen. They were not barons because they all started penniless and they were not robbers because they did not take it from anyone else. Vanderbilt got rich by making travel and shipping faster, cheaper, and more luxurious. He built bigger, faster, and more efficient ships. He served food on his ships, which the customers liked and he lowered his costs. He lowered the New York to Hartford fare from $8 to $1. Rockefeller made his fortunes selling oil. He also lowered his costs, making fuel affordable for the working-class people. The working-class people, who use to go to bed after sunset, could now afford fuel for their lanterns. The people, who worked an average 10-12 hours a day, could now have a private and social life. The consumers were happy, the workers were happy, and they were happy. Bill Gates, CEO of Microsoft Corporation is another example of a greedy person. He is the richest man in the world with about $40 billion and he continues to pursue more wealth. Just because he has $40 billion does not mean the rest of the world lost $40 billion, he created more wealth for the rest of the world. His software created new ways of saving time and money and created thousands of new jobs. Bill Gates got rich by persuading people to buy his product. His motive may have been greed, but to achieve that, he had to give us what we wanted. Greed :: essays papers Greed Greed Greed is a selfish desire for more than one needs or deserves. Greed can make honest men murderers. It has made countries with rich valuable resources into the poorest countries in the world. We are taught it is bad and not to practice it. But consider a world without greed, where everyone is as sharing as Mother Theresa was. The progress of humankind would be at a standstill. Greed has given our society faster travel, better service, more convenience, and most importantly, progress. Greed has created thousands of billionaires and millions of millionaires. But why is greed associated with evil? In their day, most capitalists like Cornelius Vanderbilt and John D. Rockefeller were depicted as pure evil. Vanderbilt stole from the poor. Rockefeller was a snake. But the name-calling did not come from the consumers; it was the competing businesses that complained. The newspapers expanded on these comments, calling them "robber barons." These are inaccurate terms for these busine ssmen. They were not barons because they all started penniless and they were not robbers because they did not take it from anyone else. Vanderbilt got rich by making travel and shipping faster, cheaper, and more luxurious. He built bigger, faster, and more efficient ships. He served food on his ships, which the customers liked and he lowered his costs. He lowered the New York to Hartford fare from $8 to $1. Rockefeller made his fortunes selling oil. He also lowered his costs, making fuel affordable for the working-class people. The working-class people, who use to go to bed after sunset, could now afford fuel for their lanterns. The people, who worked an average 10-12 hours a day, could now have a private and social life. The consumers were happy, the workers were happy, and they were happy. Bill Gates, CEO of Microsoft Corporation is another example of a greedy person. He is the richest man in the world with about $40 billion and he continues to pursue more wealth. Just because he has $40 billion does not mean the rest of the world lost $40 billion, he created more wealth for the rest of the world. His software created new ways of saving time and money and created thousands of new jobs. Bill Gates got rich by persuading people to buy his product. His motive may have been greed, but to achieve that, he had to give us what we wanted.

Tree Imagery in Hurston’s Novels, Their Eyes Were Watching God and Sera

Tree Imagery in Hurston’s Novels, Their Eyes Were Watching God and Seraph on the Suwanee Hurston uses the fruit tree as an important image in both of the texts: the blossoming pear tree for Janie and the budding mulberry tree for Arvay. Each holds a unique meaning for its counterpart. In looking at Janie’s interaction with her tree, I chose to focus on the passage on page 11, beginning with â€Å"She was stretched on her back beneath the pear tree†¦Ã¢â‚¬ . For Arvay, I chose the passage on page 37, beginning with â€Å"They entered the place under the tree†¦Ã¢â‚¬ . The two tree passages have many similarities and differences. The most obvious difference is that Hurston first introduces us to the pear tree with Janie alone, whereas we have our first experience of the mulberry tree with both Arvay and Jim. This in itself is symbolic of important aspects of both of the characters. For Janie, it points to her independence and strength. For Arvay, it seems to show her dependence and frailty. Another difference lies in the position and shape of the tree itself. In Their Eyes, â€Å"the gold of the sun†, â€Å"t...

Genicon: a Surgical Strike Into Emerging Markets. Essay

Genicon is a company with 10 years of experience domestic and some real international success , Genicon was successful in USA, but it quickly realized that it would be difficult for them to have sustainable growth, because the health care purchases medical equipment through GPOs. And as a small company it was so hard to obtain a contract from GPOs because their financial structure encourages them to purchase equipment from giants companies.So Genicon decided to go international and capture increasing demand there. It became smallest company to sell product to European markets with the assistance of BSI.Genicon was already in over 30 international markets and was looking in particular at the rapidly emerging markets – Brazil, Russia, India and China – as potential new opportunities for growth.So the question facing Genicon where it should go next? I. Case key players/Contributors: a.Gary Haberland,president and founder of GENICON. b.small development team of Genicon. c.MEDICA in Germany large tradeshows for medical devices. d.employee of British Standards Institution(BSI) e.Genicon shareholder. II. Problem Identification a.Domestic business i.Lack of a favorable channel in the US. ii.High bargaining power of buyers through group purchases (GPO) . iii. High regulatory costs. b.International business. i.Sales of medical devices associated with the number of tenders which have different regulatory than US and its just for short term. ii.Due to GENCION’s limited resources it was hard to decide which country to invest in, depend on: 1-Regulation/ Compliance. 2-Bargaining power of buyers. III. Suggestions a.Uncertainty Avoidance i. Haberland and his company appear to be strong Uncertainty Avoidance very structure and having conservative investments.Hesitance toward new products in medical devices. ii.Should go with weak UAI and make some risky investments.and to be more flexible and adaptable to any chaos. b.Short and Long term orientation i.Almost all the contract that Haberland had with the international country are being traditional and current short term . ii.Try to find international country Long term orientation and sacrifice present for futere. IV. Recommendation a.Should go with Brazil due to international accepted! Fast process, zero tariff. Easy Regulation/ Compliance.

U.S. Dollar Exchange Rate And Oil Price

Both U.S. Dollar exchange rate and the oil monetary value are foremost variables which coerce the patterned advance of the universe economic system. Fluctuations in these variables deeply affect international trade and economic activities in all the states. Determination of the nexus between these cardinal variables is one of the critical issues, whether they are correlated or non. Is at that place any empirical grounds on the nexus between the variables? In this literature, I initiate by appraising all theoretical grounds that could clarify the relationship between U.S. Dollar exchange rate and oil monetary values. To get down with, as oil monetary value and oil trade is denominated in United State ‘s Dollars, motions in the effectual exchange rate of U.S. Dollar impact the monetary value of oil as alleged by all states outside United States. Therefore, fluctuation in the dollar exchange rate can arouse alterations in demand and supply of oil, which cause alterations in the oil monetary value. Second, the opposite tendency can besides be found, i.e. , oil monetary value fluctuation trigger alterations in effectual exchange rate. The ground can be found in the literatures on the effectual exchange rates. In the theoretical account proposed by Farquee ( 1995 ) , if a state stocks foreign assets, its effectual exchange rate appreciates and this motion occurs without hindering its current history balances. This is due to the ground that capital income absorbs the loss in trade grosss induced by the deteriorated fight. Change in oil monetary value affects all the universe instabilities and this induced alteration in international assets may hold an impact on effectual exchange rates of different states of the universe. Last but non the least, I take aggregation of different portfolio theoretical accounts, most significantly the 1s by Golub ( 1983 ) and Krugman ( 1983a ) which are developed to account for trade and fiscal interactions such as assistance and grants between United States, oil manufacturer states and the remainder of the universe particularly Europe. The comprehensive study of theoretical and empirical interactions between the two cardinal variables opens the manner for every possible nexus between the two variables either negative, positive and in both waies of causality. If there are some theoretical grounds for every possible nexus, so one has to be stronger than others. Therefore, the inquiry is to unknot the alternate theoretical account by facing to the informations. I hence, conduct an empirical survey of the relationship between dollar existent effectual exchange rate and the oil monetary values over the period straddling from 2007 to till day of the month. Prime focal point is on the long term relationship between these two vital variables. Among the possible account reviewed, the one affecting the equilibrium exchange rate is the exclusive account which fit the found relationship. The possible continuance of a long-run relationship between the dollar effectual exchange rate and oil monetary value assume causality between these variables. Earlier surveies show a causality way from oil monetary values to the U.S. dollar ( Amano and van Norden, 1995 among others ) . However, there are some statements which justify opposite way of causality i.e. , from U.S dollar to the oil monetary value. In this literature, I study the two types of causality and seek to measure the resulting of the relationship which determines the tendency of motion. The effectual dollar exchange rate has significant impact on the demand and supply of oil since it had influence on the monetary value of oil. The depreciation in the dollar reduces the monetary value of oil in the local markets of the states holding their several currencies under drifting exchange rate like Japan or Euro Zone. The states which have pegged their currency with the dollar have impersonal affect such as China. Generally, a lessening in the dollar exchange rate reduces the oil monetary value in the local markets of the consumer states. The lessening in monetary value of oil finally increases the demand for oil monetary value. This can be stated that dollar depreciation has positive impact on demand for oil and this addition demand contributes towards the rise in the monetary value of the oil. Oil companies use local currencies of manufacturer currencies to pay the fiscal liabilities and current fiscal duties such as rewards, revenue enhancements and other runing cost. These currencies are frequently linked or pegged to the dollar due to the fact that they fall in fixed-exchange rate governments adopted by most manufacturer states ( Frankel, 2003 ) . The alterations in monetary value of oil due to the alteration in the dollar exchange rate is less as estimated by the manufacturer states than estimated by the demander or consumer states. Necessary boring activities are linked straight to the oil monetary value. When oil monetary value addition, oil production besides addition by the manufacturer states to gain extra net incomes. This fact has been proved by different empirical surveies in states like North America, Latin American and Middle East. But this fact has non been proved true for African and European states. It is of import to that the relationship between boring a ctivities and oil monetary value in dollars has well changed since 1999. But it is difficult to happen that whether this alteration occur due to the debut of Euro currency in 1999 or due to the decrease in oil monetary value in 1998. Depreciation in the dollar monetary value novices rising prices ensuing decrease in the income of oil manufacturer states, the currencies which are pegged to the dollar. All the states are non affected in the say manner, states which mostly import from USA like OPEC is less affected than states than states which imports from Europe or Asia. Overall, depreciation in the dollar monetary value may cut down the supply of oil. On the short tally, supply is less or decrepit elastic to the monetary value in upward and downward way. The upward weak flexibleness is due to the production restraint and the downward flexibleness is weak due to really little fringy cost. Demand is besides inelastic in the short tally due to the deficiency of replacements available in the short tally ( Carnot and Hagege, 2004 ) . In short, demand and supply of oil in short is about inelastic in the short tally. Noticeable alterations in the supply and demand are chiefly discernible on the long term period. At this phase supply is more elastic due to the capableness of new investing and demand is more elastic due to the handiness of close replacements. By and large, a dollar effectual exchange rate depreciation cause an addition in the demand and supply of the oil significantly merely in the long tally, which tends to increase oil monetary value. The early old ages of 2000 ‘s period are an first-class illustration of this mechanism. Hagege and Carnot ( 2004 ) underlined that the addition in oil monetary values stems from two coincident factors on the one manus, incorrect appraisal of utmost demand for oil from United States and China. On the other manus, decreasing investing in the oil sector causes stagnancy in the capacity sweetening of oil supply. If this mechanism of demand and supply can right explicate the state of affairs of 2000s so this mechanism is unable to account for the relationship found in different empirical surveies. There are several groundss and grounds to believe that oil monetary value could impact dollar effectual exchange rate. Most frequent account of this impact that oil bring forthing states prefer fiscal investing in dollars ( Amano & A ; van Norden, 1993 & A ; 1995 ) . This model, explains that a haste in the oil monetary value boot the wealth of the oil manufacturer states which in bend addition the demand for dollar. Another account of this impact of oil monetary value on exchange rate can be found in the theoretical accounts such as Farguee ( 1995 ) and BEER theoretical account proposed by McDonald and Clark ( 1998 ) . In this attack, two independent variables are often used for explicating the exchange rate i.e. , net foreign investing and the footings of trade. A speedy initial concluding leads to a negative relation between oil monetary value and the dollar exchange rate. Addition in oil monetary value should deteriorate the United States footings of trade which consequences in t he dollar monetary value depreciation. A more comprehensive account would let explicating the positive relationship normally found in the literature by taking in history the comparative consequence on the United States compared to its trade spouses. If United States is an of import oil importer, an oil monetary value addition can deteriorate its state of affairs, nevertheless, if US import less than some other states like Japan or Euro zone, its place may good better compared to the other states. In this state of affairs, addition in the oil monetary value would take to the grasp in the dollar monetary value comparatively to the hankering and the euro, finally it leads to grasp in effectual footings in dollar. In an attack proposed by Krugman ( 1983a ) uses a vivacious symmetricalness of model to pattern how manufacturer states use the gross of their oil exports in dollars. Change in demand for dollar will impact the dollar exchange rate. The proposed theoretical account can be expressed mathematically as:Ten = CYWhere Ten = Oil monetary value denominated in dollar Y = Effective exchange rate of dollar C = Correlation Co-efficient This theoretical accounts help to find the correlativity between the oil monetary value and the effectual dollar exchange rate, either it is positive, negative or impersonal. This theoretical account besides explains the short term and long term impact of oil monetary value on the effectual exchange rate of the dollar and frailty versa. This empirical survey use monthly informations of oil monetary value denominated in the U.S dollar. Oil monetary values are expressed in existent footings and the exchange rate of dollar is effectual exchange rate. This survey tests the hypothesis at 5 % degree of significance. Hypothesis to be tested is as follows: Ho = There is a no correlativity between the oil monetary value and effectual exchange rate of dollar H1 = There is a correlativity between the two variables. Ho = There is a negative correlativity between the two variables H1 = There is positive correlativity between the oil monetary value and effectual exchange rate Above hypothesis are tested by Spearman rank correlativity utilizing SPSS, renowned statistical package. Data for this variable is collected through different beginnings such as Central Bank of Germany, Data Stream and Economagic which maintain the monthly norm informations of oil monetary value, effectual exchange rate and international gold monetary values. Sample size is of 42 values from each class. Oil monetary values and gold monetary values are denominated in the US dollar. Apparent observation of the natural information indicates the positive relation between oil monetary value and effectual dollar exchange rate.TestingThe testing of the hypothesis is done through SPSS v.16. Econometric technique of Spearman Rank Correlation is applied as it falls in the categorization of non-parametric trial. The consequences of econometric analysis shows that there is a medium positive correlativity between the oil monetary value and effectual exchange rate of dollar as co-efficient of correlativity is 0.316 which means that 1 dollar or 1 percent addition in oil monetary value will increase 0.316 % in the effectual dollar exchange rate. The oil monetary values show more variableness as compared to the exchange rate. The graphical presentation of the original information is as follows:Graphic Presentation of Oil Price and Exchange RateAbove graph shows a general positive tendency between the two variables over the period crossing from January 2007 to October 2010. The graph besides reveals greater variableness in the oil monetary value and less in the exchange rate. The variables are assigned as OP referred to oil monetary value and ER referred to effectual exchange rate of US dollar. The tabulated consequences show that there is a somewhat negative correlativity between the oil monetary value and gold rate. If oil monetary value addition by 1 % gold monetary value will diminish by 0.05 per centum under the influence of oil monetary value. The graphical presentation of the original values of oil monetary value and gold rate are as follows: The tabulated consequences show that there is little positive correlativity between the gold rate and the oil monetary value which means that 1 % addition in the exchange rate gives 0.085 % addition in the gold rate. The graphical presentation of the original informations of gilded monetary value and the exchange rate is follows:DecisionIn this literature, I have tried to happen the nexus between the US dollar effectual exchange rate and existent oil monetary values. Overall this survey focal point on merely the US dollar effectual exchange rate and existent oil monetary values but subsequently one other critical factor besides included in the theoretical account which helps to happen the corresponding dealingss between the variables. This survey shows that there is a important relation between the existent oil monetary values and the effectual exchange rate. In the short tally, consequences may be reverse but in the long tally consequences are in support of earlier surveies, which c oncluded that there is positive relationship between the exchange rate and the effectual dollar exchange rate. The fluctuation in the oil monetary value is far more intense than the fluctuation in the oil monetary value. This phenomenon is evident through the tested results and the besides in the graphical presentation. The adjustment velocity of effectual exchange rate is less than the oil monetary value. Results besides reveal that addition in the oil monetary value will increase the net foreign assets of the United States of America. The states whose currency is pegged to the US dollar will endure less with the addition in the oil monetary value and those states who falls in the floating exchange rate is affected more. The consequences besides reveals the of import fact, which is that the United States of America is basking the benefits of low monetary value and cheapest oil based energy over the period of more than half century as oil monetary value is denominated and traded worldwide in the US dollar. The addition in the oil monetary value will increase the demand for more US dollars to purchase the same quantum of oil and this increased demand will impact the exchange rate of the state with regard to the US dollar and this addition the import measure of the several consumer states and the manufacturer states will bask the benefits of more wealth.