Case: The Law Offices of Jeter, Jackson, Guidry and Boyer Essay

The issues that are presented in this case study are not uncommon problems that happen in the working environment. It was clear from the case that the partners in the law firm worked from a style of collaboration and meeting to understand the needs of their employees. However, their growth left them needing someone to take over the day to day, yet important operations of the organization like human resources, and marketing. The partners decided to create a General Operations Manager. The partners hired someone who had a background as a longtime administrator from the insurance industry seeking a final career change. This person’s leadership style was autocratic which means â€Å"the leader makes decisions on his or her own and then announces those decisions to the group† (Bateman and Snell). Hiring a person with this type of leadership style placed the firm in jeopardy of losing excellent employees and clients. As the case stated the law firm did lose clients. When the partners learned about the problems, the new General Operations Manager told them it was normal activity for what was taking place, and that they should just wait it out. This suggestion of sit back and wait given by the GM Brad Howser put a persona out to the partners that more clients would come and the employee morale would not remain low. The partners should not sit back and wait as Brad Howser has instructed them to do. Sitting back and waiting could destroy the company quicker then it took to build it up. This could cause more clients to leave the company and employees to leave the company. The partners needed to step in and develop a plan of how to address the issues that have developed since Brad Howser has taken the GM position. First, they needed to meet with Brad Howser and express their concern about losing clients and the sinking morale among their employees. This will require explaining to Brad Howser that their desired organizational culture, one that is caring, compassionate and respectful to everyone they serve. Another issue to bring up is that the autocratic leadership style Brad presents is not matching their mission and values of the company. They will need to give Brad a chance to change or leave, just as he presented the same information to the employees if they didn’t want to change. If he chooses to stay, he will need to overturn the rules he implemented. The partners must provide Brad with their vision for the company and the initial goal of hiring of a GM for Operations, which is to help manage the different offices and to continue to grow each year. They should also reinstate flex hours for employees and at the same time reinforce their importance to the firm. Having happy employees are far more productive then having unhappy employees. Brad will have to be educated on the different tasks of the jobs to know that they are not required to be done during specific hours. Finally, to finish cleaning up the disaster created, each client will need to be contacted that received one of Brad’s letters to pay up. This will cause the partners to apologize to and ensure to their customers that this will never hap pen again. They will also have to convince their clients into coming back to their company. The leadership style needed for a General Manager-Operations position is a style that can handle participation and collaboration. A style that incorporates these characteristics is called a transformational leader. â€Å"Transformational leaders get people to transcend their personal interests for sake of the larger community† (Bateman and Snell). The transformational leader will bring excitement to a company because they have the following qualities charisma, individualized attention, the ability to delegate challenging work to deserving people, keep lines of communication open and provide one-on-one mentoring to develop people. They will also bring the following skills to a vision of where they want to take the problem presented; the ablity to communicate their vision to the all the parties involved, build trust with employees and executives and hold a positive self-regard. A person in this job that is able to be dig into the weeds and find out way to lean out the company pr ocesses. They are also able to communicate about the changes being made and why they need to be made. Also the leader must be able to meet their employees where they are and figure out how to grow them as the company grows. A leader is not a stranger to hard work and putting their needs on the back burner. The leadership style I would pick for myself would be a mix of Transformational and Transactional and this person can â€Å"achieve set goals by acting within established procedures and standards. This leader assigns specific, well-defined tasks to subordinates and requires that they fulfill their responsibilities and meet standards precisely as prescribed or agreed upon† (Inc). Transactional leadership styles are good at improving processes, setting up rules and regulations and leaning out the resources used by the company. A person with this leadership style will be good at managing smaller operations and developing areas. In transformational I like to have a vision and mission for what I am currently trying to work towards. In my work place I want everyone around me to know what the vision is that we are working towards. I can be a mix of both of these depending on the situation I would be placed in. I would seek jobs in management in the technology field, military and logistics areas. Jobs that I would avoid are ones that put me in power over large groups of people like president of the country, CEO of a company and a person who is willing to make sacrifices in pursuit of the dreams they articulate in speeches. Being a public figure is not a good job for someone with these leadership styles. I believe all leadership styles can be used in various situations but you have to find a style or styles that best fit your life balance. Works Cited Bateman, Thomas S and Scott A Snell. Management Leading & Collaborating in a Competive World. New York: The McGraw-Hill Irwin , 2013. Inc, Human Metrics. Leadership Styles . 20 January 2013 .

Golden Valley Foods, Inc. Essay

In this case, that Neal Middleton is trying to decide why Golden Valley Foods, inc., isn’t as profitable as it once was. I would suggest to Neil Middleton to do a big change in the company’s policy, and do market segmentation. Golden Valley Foods has a line-forcing policy, requiring any store that wants to carry its brand name to carry most of 65 items in the Golden Valley Foods line. This policy, resulted in a decreasing in its sales. Unfortunately, smaller stores are not generally to accept the Golden Valley Foods policy. Then most of their sales come from major supermarket chain store such as Safeway, Kroger, and A$P. According to the last president of the company said â€Å"The influence of our old parent company is still with us. As long as new products look like they will increase the company’s sales volume, they are introduced. traditionally, there has been little, if any, attention paid to margins. we are well aware that profits will come through good products produced in large volume.† I think that, by reducing the large amount of items in the policy Golden Valley Foods could increase its sales; marketing is the process of discovering and translating consumer needs and wants into product and service specifications, creating demand for these products and services and then, in turn, expanding the demand. Goods and services do not move automatically from the makers to the users. A marketing segment is a meaningful buyer group having similar wants. Market segmentation is the process of grouping buyers into different categories having common desires or needs. Thus, segmentation is a consumer oriented marketing strategy.; that could increase the sales as well.

Analyze Why I went to the woods of Henry David Thoreau Essay

Analyze Why I went to the woods of Henry David Thoreau - Essay Example Since the present times are driven by digital innovations, facilities and other leverage and benefits being provided through the overall progress, therefore jungle life as is related to the historic people and stone age cannot be lived by the contemporary man based on the facilities and the environment that has been enjoyed by them. His experience is based upon the fact that he had undertaken tests and tribulation towards deciding a place prior to settling at a place. The decision came up after massive investigation and assessment of the places and subsequently deciding upon a place which he could relate to. He was in search of the place that would allow him the feel of nature and keep his soul at comfort and peace. Other purposes behind his expedition and adventure was to realize and assess for the benefits that are being provided by the nature, and the artificial environment that has been overtaken by the mankind which has led to an alienation from the real structure of society and earth and this in turn makes it difficult for the mankind to live in a natural way that comes in form of the woods and jungle life. Hence it can be safely said that these conditions do not apply to the 21st century and a person living in sophisticated urban environment may find it nearly impossible to live in the woods as he does not have any of the facilities that he is used to otherwise. Although the author has taken up the case for the purpose of bring himself closer to the nature and natural existence, yet for any other ordinary citizen it would be difficult to adjust and relate to the woods as there are hardly as facilities that may be available to them in the woods (Thoreau). The purpose of the author was to provide the readers with an insight into the differences and the possible shift over which is often questioned and desired by the person who get distasted from the civilized modern day society and

The Impact of Lord Liverpools Support of the Corn Laws of 1845 on the Coursework

The Impact of Lord Liverpools Support of the Corn Laws of 1845 on the Support for the Conservative Party - Coursework Example Despite the concerns of the parties involved, Lord Liverpool was able to consolidate the opposing political forces within the Houses of Lords and Commons to pass the legislation with a 126: 26 majority. Predictably, the poorer community fared badly as a result of artificially high corn prices and the next few years were marred by demonstrations and riots, followed by the passing of various pieces of repressive legislation in an attempt to control the rioters. Yet, despite these very unpopular measures, support for the conservative party and Liverpool rose - evidenced by the voting numbers during parliamentary business over the next few years. This has generally been attributed to post-war problems facing Britain as well as Lord Liverpool’s skills in presenting these to his peers. This explanation is not disputed, however, this paper poses that there is a powerful additional factor, namely that once the corn laws had unleashed unrest, a fear factor developed which did not, in f act, constitute support for the policies of the conservative party at all but which nevertheless caused members of the parliament to act in semblance. It is also argued that this fear was by far the strongest motivation for giving continued support to the conservative party for as long as there was a danger of further riots. There can be no doubt that the post-war problems faced by Britain in the aftermath of the Napoleonic wars were grave and that the modification to existing corn laws in 1815 can be understood as a short-term measure to avoid catastrophe. Corn laws had been in place in Britain since the 17th century and had basically consisted of a  high rate of import duty imposed on a sliding scale to prevent imports and encourage exports, with import duties decreasing as corn prices increased (Fay, C. R., 1932, pp 28-43). This had kept corn prices relatively low and exports high until the middle of the 18th century when, for a variety of reasons, constant corn shortages forced frequent short-term measures to suspend import duties.  

Museum of Contemporary Art San Diego Research Paper

Museum of Contemporary Art San Diego - Research Paper Example The paper "Museum of Contemporary Art San Diego" discovers San Diego's Museum of Contemporary, MCASD. The mixed media rendition of Alexis Smith entitled Men Seldom Make Passes at Girls Who Wear Glasses 1985 was interesting as it depicted Marilyn Monroe wearing collaged glasses of various images.The paintings were done in oil, acrylic, or mixed acrylic and oil. Some paintings were very simple, like one that was rendered by Kelly Ellsworth entitled Red Blue Green which was basically a painting of these colors in simple geometric patterns. As compared with Sandow Birk’s Secretary of Defense Donald Rumsfeld Presenting His Plan for the Invasion of Iraq painting in acrylic and oil done in 2007 which was more intricate with life like depiction of real people looking at a large banner with imprinted mission accomplished on it. Another awe inspiring art piece was the bronze sculpture of Nathan Mabry, Process Art (Dead Men Don't Make Sculpture) created in 2008 and appears outside the mu seum. It is a depiction of the famous artwork, The Thinker, made more contemporary in style and image. The sculpture of the face was kind of eerie but is effective in soliciting interest from viewers. The light emitting diode installation by Erwin Redl was very contemporary in visual design and using both two and three dimensional perspectives in style. In green background color, the artwork stands out and initiates curiosity from the viewing public. Glenn Kaino’s Untitled (Reverse Inverse Ninja Law) created in 2006.

The death penalty is not a deterrent Research Paper

The death penalty is not a deterrent - Research Paper Example These criminologists confirmed the previous finding that there is no deterrent effect for capital punishment. Perceptions and attitudes of peoples towards the death penalty can change with increased knowledge. If there’s enough information campaign by people in government and those concerned, favourable opinion can be gained for the abolition of capital punishment. The European Union adopted its Charter of Fundamental Rights which states that everyone has the right to life and no one shall be condemned to the death penalty, or executed. This should be binding on all peoples and all states, big and small. But for the victim’s side, there is demand for justice or retribution. When someone in the family is a victim of a crime, such as when a daughter has been raped and murdered, the family demands justice. Rae states that there is an ‘imbalance created in the social order’. There is a demand for justice created by the imbalance and thus a demand for a restorat ion of the balance in society. While society must exercise power and all individuals must submit to that power, society must give everyone a chance. Killing does not solve social ills and it is uncivilized. 1.1 Definition Death penalty is a punishment instituted by society where a convicted criminal is punished and put to death; the crime committed is a capital offense. It is different from unauthorized form of killing, or killing committed for revenge or lynching. (Garland 70) Capital punishment or death penalty can be considered the strictest punishment for a grievous offense. The term grievous or capital offense varies in definition and commission in different countries. Capital crimes include treason, murder, manslaughter, rape, and in some countries, they include arson, counterfeiting, and theft. (Banner 5) 1.2 History of the death penalty Capital punishment is an integral part of American history. The first execution occurred in Jamestown in 1608, when Captain George Kendall w as sentenced to death for spying for Spain. By the middle of the seventeenth century, around fifty people were executed. After a century, executions were done by the thousands. By the end of 1945, more than 17,000 people had been executed. (Allen and Clubb 9) Most ancient countries enforced capital punishment for serious offenses, but sometimes other offenses like blasphemy, adultery, or magic practice and witchcraft, were considered capital offense. English common law listed eight capital crimes, such as treason, petty treason, murder, larceny, robbery, burglary, rape, and arson. (Mandery 21) By the beginning of the eighteenth century, majority of the executed were African Americans or of African descent, with whites appearing to be a minority of those executed. 1.3 Ancient Laws Early laws on the death penalty can be found in the Ancient Laws of China. The Code of King Hammurabi of Babylon enforced the death penalty for 25 different crimes. But murder was excluded from these crimes . The Code followed the principle of â€Å"an eye for an eye, a tooth for a tooth,† and set measures to compensate for injuries to slaves, domesticated animals, and property. Thieves who did not have the ability to pay restitution were put to death. The first historically recorded death sentence was done in Egypt in the sixteenth century BC, and the offender, who was convicted of committing magic, was sentenced to take his own life.

HU300 unit 8 Journal Research Paper Example | Topics and Well Written Essays - 250 words

HU300 unit 8 Journal - Research Paper Example Let’s take an example of Chinese and Japanese films. These countries portray in their films a lot about their festivals and ceremonies. This tells us how festive these countries are. Chinese films also show the heroic struggle of the Chinese soldiers who reached their destination in the 1930s after the long march. An example of this is the Chinese movie named â€Å"The Long March†. The way Chinese films are made tells us that China has a strong film industry with talented actors. Russian films, like â€Å"Faust† by Alexander Sokurov, talk more about battles and wars, and portray the Russian history. Arabian films have their own special portrayal of beauty and culture. Moreover, if we talk about German films, most of them portray the humorous nature of the Germans which they are famous for. German comedy movies, like â€Å"Miss Congeniality 2 - Armed and Fabulous† and â€Å"The Edukators†, show the sense of humor Germans possess. Hence, keeping in mi nd that films portray cultures, they should not only be a source of entertainment but should also contain moral

International Relations - Political Science Essay

International Relations - Political Science - Essay Example Globalization can be viewed as both a curse and a cure but in either case, it is inevitable. The concept of a â€Å"shrinking world,† a world wherein travel, trade and communications between countries is becoming easily accessible by all, is luring more and more companies into the worldwide market thanks to significant advances in transportation, communication and a recognition of the success of libertarian marketing systems. It is typically viewed as a necessary and unavoidable key to future world economic development. Others have denounced the process as it seems to increase the current inequalities that exist within and between nations, threatens the employment and living standards of individuals in all countries as talent is pulled from each and low-paying jobs are farmed out to others and prevents the natural social progress with which each of these countries have been involved. Much of the globalization effort is being organized and encouraged by the Western capitalist countries and the big businesses that have ever-increasing power in the political circles, forcing their own ideals, agendas and policies upon developing nations desperate for some help. The reduction of trade restrictions along with the opening of monetary incentives to foreign investments over the last two decades has combined to stimulate economic development. The expansion of free market policies is the economic tool, one already in place and expanding, which is affecting technological advancements and wealth. (Burns, 2006). Because of the increased ability for these larger corporations to move into smaller markets, bringing in their greater resources, greater capital and greater ability to undercut their competitors, smaller businesses are finding it more and more difficult to survive the globalize marketplace. Rather than leading to an increased diversification in the market, as well a s the associated opportunities for employment and

The Scarlet Letter Characters Essay Example for Free

The Scarlet Letter Characters Essay Despite the fact that Hester Prynne, the protagonist of the story, committed adultery she is still an epitome of a woman with dignity. Even though her dress was marked with the symbol of disgrace she still lived a life with her head high and became an important member in her community as a seamstress (Hawthorne, 1981). Hester and her scarlet letter   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The Scarlet letter is a story that revolves around the lives of Hester and her daughter out of wedlock, Pearl.   Hester committed an adultery with a man that she refuse to name and is sentenced to wear a scarlet letter â€Å"A† on her dress for as long as she lives. This letter is a symbol of disgrace since adultery is considered a capital sin during those times. Despite the everyday indignation that she experiences from people she still bore a child and made a living through sewing. She later on gained popularity as a good seamstress. At the climax of the story wherein the father of Pearl admitted in public that he is the father and died, Hester was already freed from sin. Hester and Pearl left for Europe and lived there until Pearl got married to an aristocrat. Hester came back to her community leaving a descent life and continued on wearing the scarlet letter even though she could have stayed at Europe together with her daughter (Woloszyn,2002). Adultery and the scarlet letter   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Adultery during the 1640s was punishable by death and whipping. During the time of Hawthorne the Plymouth law of 1694 dictates that those who commit adultery should display a letter â€Å"A† on their dress (Eldred,1999). Thus, the Scarlet Letter of Hawthorne came about. The Plymouth law is viewed as a light punishment as compared to death and severe whipping however the mark of adultery will be carried as long as she lives. Her child also experienced shame and discrimination especially during her childhood when other children harass and mock her. Hester, her mother, would throw stones at them to make them stop (Eldred,1999). Despite the many sufferings that she has incurred she has had chances of escaping her current state. Choices to escape the scarlet letter   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Hester had a choice to reveal the name of the father of her child but she refuse to do so. This could have been her way out of the shame that adultery has caused her but she never did. She was made to wear the scarlet letter with the hopes that she will someday repent and reveal the name of father of her child (Hawthorne, 1981). She never did revealed his name. Perhaps out of love, respect or other factors but this only proves that as a woman she is headstrong. She chose to endure a life as an outcast despite constant discrimination and hate thread that is brought about by the Scarlet letter that she wears. She still has communication with the father of her child. This is a reflection of her strength.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Hester could have opt to live forever in England but she chose to go back to her home town. When she came back she still wore the scarlet letter. She lived a humble life and her opinions were sought and she was respected (Woloszyn,2002). She had a variety of options available for her since she has had a good life in England. For one she could have stayed there. Second she could have have came back but used a different identity. Third, she could have looked for a new husband. There are other options apart from coming back to her hometown wearing the scarlet letter. Im quite sure a lot of women who have experienced what she has gone through would not even wear the scarlet letter again. She on the other hand continued wearing it as a sign of repentance. The woman behind the scarlet letter   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Hester is but a fragment of the millions of women who commit adultery. This is a sin however Hester proved that a person should not be judged by a single mistake but by how she lived her life. There are different factors that may push one to commit adultery but what matters is that Hester repented for her sins and continued to repent until the day she died.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The scarlet letter that she has worn for so long has not penetrated in her. She is still free from bitterness and vile as she lived and showed a beautiful heart. Though she has committed a sin she refused to keep her head buried in shame. She held her head high, earned a descent living and raised a beautiful child.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   She serves as an inspiration for women. References Eldred, Eric. Notes to the Scarlet Letter. 1999. 7August 2008   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     http://www.eldritchpress.org/nh/sl02-n.html Hawthorne, Nathaniel. The Scarlet Letter. Bantam Classics. 1981 Woloszyn,Margaret. â€Å"Short Stories† 2002. 7August 2008   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   http://www.tqnyc.org/NYC00041/SCARLET/LETTER.htm

Effects of Behavioral Interventions on Disruptive Behavior and Affect in Demented Nursing Home Residents Essay Example for Free

Effects of Behavioral Interventions on Disruptive Behavior and Affect in Demented Nursing Home Residents Essay Behavioral interventions might ameliorate them and have a positive effect on residents’ mood (affect). Objectives: This study tested two interventions—an activities of daily living and a psychosocial activity intervention—and a combination of the two to determine their efficacy in reducing disruptive behaviors and improving affect in nursing home residents with dementia. Methods: The study had three treatment groups (activities of daily living, psychosocial activity, and a combination) and two control groups (placebo and no intervention). Nursing assistants hired specifically for this study enacted the interventions under the direction of a master’s prepared gerontological clinical nurse specialist. Nursing assistants employed at the nursing homes recorded the occurrence of disruptive behaviors. Raters analyzed videotapes filmed during the study to determine the interventions’ influence on affect. Results: Findings indicated significantly more positive affect but not reduced disruptive behaviors in treatment groups compared to control groups. Conclusions: The treatments did not specifically address the factors that may have been triggering disruptive behaviors. Interventions much more precisely designed than those employed in this study require development to quell disruptive behaviors. Nontargeted interventions might increase positive affect. Treatments that produce even a brief improvement in affect indicate improved quality of mental health as mandated by federal law. Key Words: affect †¢ Alzheimer’s disease †¢ behavior therapy †¢ dementia †¢ nursing homes Nursing Research July/August 2002 Vol 51, No 4 proximately 1. 3 million older Americans live in nursing homes today (Magaziner et al. , 2000). By 2030, with the aging of the population, the estimated demand for long-term care is expected to more than double (Feder, Komisar, Niefeld, 2000). Thus, nursing home expenditures could grow from $69 billion in 2000 to $330 billion in 2030 (Shactman Altman, 2000). About half of new nursing home res idents have dementia (Magaziner et al. , 2000). The disease has an impact on four major categories of functioning in persons with dementia. These are disruptive behavior (DB), affect, functional status, and cognition (Cohen-Mansfield, 2000). This article will focus on the first two categories. Disruptive behavior has received much more attention than affect has (Lawton, 1997), perhaps for three reasons. First, more than half (53. 7%) of nursing home residents display DB with aggression (34. 3%) occurring the most often (Jackson, Spector, Rabins, 1997). Second, DB threatens the wellbeing of the resident and others in the environment. Consequences include: (a) stress experienced by other resiCornelia K. Beck, PhD, RN, is Professor, Colleges of Medicine and Nursing, University of Arkansas for Medical Sciences. Theresa S. Vogelpohl, MNSc, RN, is President, ElderCare Decisions. Joyce H. Rasin, PhD, RN, is Associate Professor, School of Nursing, University of North Carolina. Johannah Topps Uriri, PhD(c), RN, is Clinical Assistant Professor, College of Nursing, University of Arkansas for Medical Sciences. Patricia O’Sullivan, EdD, is Associate Professor, Office of Educational Development, University of Arkansas for Medical Sciences. Robert Walls, PhD, is Professor Emeritus, University of Arkansas for Medical Sciences. Regina Phillips, PhD(c), RN, is Assistant Professor, Nursing Villa Julie College. Beverly Baldwin, PhD, RN, deceased, was Sonya Ziporkin Gershowitz Professor of Gerontological Nursing, University of Maryland. A Note to Readers: This article employs a number of acronyms. Refer to Table 1 to facilitate reading. 219 220 Effects of Behavioral Interventions Nursing Research July/August 2002 Vol 51, No 4 TABLE 1. Acronyms Term Activities of daily living Analysis of variance Apparent affect rating scale Arkansas Combined Disruptive behavior(s) Disruptive behavior scale Licensed practical nurse(s) Maryland Mini mental status exam Negative visual analogue scale Nursing home nursing assistant(s) Observable displays of affect scale Positive visual analogue scale Project nursing assistant(s) Psychosocial activity Research assistant(s) Acronym ADL ANOVA AARS AR CB DB DBS LPN MD MMSE NVAS NHNA ODAS PVAS PNA PSA RA decreases in targeted behaviors (Gerdner, 2000; Matteson, Linton, Cleary, Barnes, Lichtenstein, 1997). However, others reported nonsignificant reductions (Teri et al. , 2000), no change (Churchill, Safaoui, McCabe, Baun, 1999), or increased behavioral symptoms (Mather, Nemecek, Oliver, 1997). These studies used nursing home staffs to collect data, had sample sizes below 100, and measured an array of DB with different assessments. Only in the last decade have researchers investigated affect. Compared to studies to reduce DB, far fewer studies have measured interventions using affect as an outcome measure. Studies reported positive outcomes on affect from such interventions as simulated presence therapy (Camberg et al. , 1999), Montessori-based activities (Orsulic-Jeras, Judge, Camp, 2000), advanced practice nursing (Ryden et al. , 2000), music (Ragneskog, Brane, Karlsson, Kihlgren, 1996), rocking chair therapy (Watson, Wells, Cox, 1998), and pet therapy (Churchill et al. , 1999). The studies on affect used global measures that relied on observer interpretation, which could have compromised objectivity. Theoretical Bases A number of conceptual frameworks have guided intervention research on persons with cognitive impairment (Garand et al. , 2000). The theoretical basis for this study was that individuals have basic psychosocial needs, which, when met, reduce DB (Algase et al. , 1996) (Table 2). The interventions, one focusing on activities of daily living (ADL) and the other focusing on psychosocial activity (PSA), and a combination (CB) of the two, were developed to meet most of the basic psychosocial needs that Boettcher (1983) identified. These included territoriality, privacy and freedom from unwanted physical intrusion; communication, opportunity to talk openly with others; self-esteem, respect from others and freedom from insult or shaming; safety and security, protection from harm; autonomy, control over one’s life; personal identity, access to personal items and identifying material, and cognitive understanding, awareness of surroundings and mental clarity. The section on study groups specifies which interventions were designed to meet which needs. Positive affect usually accompanies interventions that meet basic psychosocial needs (Lawton, Van Haitsma, Klapper, 1996). Several researchers and clinicians have suggested that displays of affect may offer a window for revealing demented residents’ needs, preferences, aversions (Lawton, 1994), and responses to daily events (Hurley, Volicer, Mahoney, Volicer, 1993). The study reported here dents and staff; (b) increased falls and injury; (c) economic costs, such as property damage and staff burn-out, absenteeism, and turnover; (d) emotional deprivation such as social isolation of the resident; and (e) use of physical or pharmacologic restraints (Beck, Heithoff, et al. 1997). Third, before the Nursing Home Reform Act (Omnibus Budget Reconciliation Act, 1987), nursing homes routinely applied physical and chemical restraints to control DB with only moderate results (Garand, Buckwalter, Hall, 2000). However, the Act mandated that residents have the right to be free from restraints imposed for discipline or convenience and not required to treat the residents’ medical symptoms. Thus, researcher s have tested a wide range of behavioral interventions to reduce DB and replace restraints. The Act (1987) also stipulated that all residents are entitled to an environment that improves or maintains the quality of mental health. Interventions that promote positive mood or affect fulfill this entitlement. Therefore, this article will report the effects of an intervention to increase functional status in activities of daily living (Beck, Heacock, et al. , 1997), a psychosocial intervention, and a combination of both on reducing DB and improving affect of nursing home residents with dementia. TABLE 2. Basic Psychosocial Needs Relevant Literature Literature suggests that behavioral interventions offer promise in managing DB. A wide range of modalities and approaches have been tested: (a) sensory stimulation (e. g. , music); (b) physical environment changes (e. g. , walled garden); (c) psychosocial measures (e. g. , pet therapy); and (d) multimodal strategies. Many studies found significant Territoriality Communication Self-esteem Safety and security Autonomy Personal identity Cognitive understanding Nursing Research July/August 2002 Vol 51, No 4 Effects of Behavioral Interventions 221 adopted the inference by Lawton et al. (1996) that frequent displays of positive affect when basic psychosocial needs are met might indicate improved emotional wellbeing. is leg continually and without apparent reason needs redirection. This intervention lasted 45–60 minutes a day during various ADL. PSA Intervention. A PNA also conducted the PSA intervention, which involved 25 standardized modules designed to meet the psychosocial needs for communication, selfesteem, safety and security, personal identity, and cogni tive understanding through engagement in meaningful activity while respecting the individual’s unique cognitive and physical abilities (Baldwin, Magsamen, Griggs, Kent, 1992). The intervention was chosen because it: (a) provided a systematic plan for the PNA to address some of the participant’s basic psychosocial needs; and (b) represented clinical interventions that many long-term care facilities routinely used, but had not been formalized into a research protocol or systematically tested. Each module contained five psychosocial areas of content (expression of feelings, expression of thoughts, memory/recall, recreation, and education) and stimulated five sensory modalities (verbal, visual, auditory, tactile, and gustatory/olfactory). For instance, Activity Module I involved life review, communicating ideas visually (identifying and making drawings), clapping to different rhythms, massaging one’s face, and eating a snack. Initially, many participants tolerated less than 15 minutes of the activity but eventually habituated and participated 30 minutes. CB Intervention. This treatment consisted of both the ADL and PSA interventions and lasted 90 minutes daily. Placebo Control. This involved a one-to-one interaction between the participant and PNA. It controlled for the effect of the personal attention that the PNA provided to the three treatment groups. The PNA asked the participant to choose the activity, such as holding a conversation or manicuring nails. It lasted 30 minutes a day. No Intervention Control. This condition consisted of routine care from a NHNA with no scheduled contact between participants and the PNA. Instruments: Disruptive Behavior Scale. The 45-item disruptive behavior scale (DBS), designed to construct scores based on the occurrence and severity of behaviors, assessed the effect of the interventions on DB (Beck, Heithoff et al. 1997). Gerontological experts (n 29) established content validity, and interrater reliability tests yielded an interclass correlation coefficient of . 80 (p . 001). Geropsychiatricnursing experts weighted the behaviors using a Q-sort to improve the scale’s capacity to predict perceived patient disruptiveness. Factor analysis identified four factors (Beck et al. , 1998). Two corresponded to two—physically aggressive and physically nonaggressive—of the three categories from the factor analysis of the Cohen-Mansfield Agitation Inventory (Cohen-Mansfield, Marx, Rosenthal, 1989). The third category of the Inventory was verbally agitated; in contrast, the factor analysis of the DBS produced a third and fourth category—vocally agitated and vocally aggressive. To obtain a score for the DBS, a trained individual completed a DBS form for every hour of a shift by check- Methods The primary aim was to conduct a randomized trial of the ADL and PSA interventions individually and in combination (CB) for their effect on DB and affect on a large sample of nursing home residents. The experimental design consisted of three treatment groups (ADL, PSA, and Combined) and two control groups (placebo and no intervention). Individual residents were assigned to one of the five groups at each of seven sites in Arkansas and Maryland, which controlled for site differences. To demonstrate the practicability of the interventions and assure adherence to the treatment protocols, certified nursing assistants were hired and trained as project nursing assistants (PNA). They implemented the interventions Monday–Friday for 12 weeks. Afterward, one-month and two-month follow-up periods occurred. Nursing assistants employed by the nursing homes (NHNA) recorded DB. To measure affect, raters were hired for the study to analyze videotapes filmed during intervention. Research Subjects: The sample initially consisted of 179 participants. The study design allowed for the detection of an improvement in DB scores on the Disruptive Behavior Scale (DBS) (Beck, Heithoff et al. , 1997) across time of at least 1. 6 units with a power of 80%. This power calculation assumed that the repeated measures would be correlated with one another at 0. 60. Inclusion criteria were age 65; a dementia diagnosis; a Mini Mental Status Exam (MMSE) (Folstein, Folstein, McHugh, 1975) score of 20; and a report of DB in the previous two weeks. To form a more homogeneous group for generalizing findings, exclusion criteria were a physical disability that severely limited ADL; a psychiatric diagnosis; and a progressive or recurring medical, metabolic, or neurological condition that might interfere with cognition or behavior. Study Groups: ADL Intervention. A PNA used the ADL intervention during bathing, grooming, dressing, and the noon meal based on successful protocols that improved functional status in dressing (Beck, Heacock et al. , 1997). It attempted to meet residents’ psychosocial needs for territoriality, communication, autonomy, and self-esteem to promote their sense of safety and security. The intervention also tried to respect participants’ cognitive and physical abilities by prescribing three types of strategies specific to the individual participant. First, strategies to complete an ADL address specific cognitive deficits. For example, the person with ideomotor apraxia needs touch or physical guidance to start movements. Second, standard strategies are behaviors and communication techniques that work for almost everyone with dementia. For example, the caregiver gives a series of one-step commands to guide the resident to put on her shoe. Third, problem-oriented strategies address particular disabilities such as fine motor impairment, physical limitations, or perseveration. For example, a subject who rubs his hand back and forth on 222 Effects of Behavioral Interventions ing the behaviors that occurred. The score for a behavior was the frequency (0–8) times the weight. The item scores were summed to obtain each of the four subscale scores. Mini Mental Status Exam. The Mini Mental Status Exam (MMSE) (Folstein et al. 1975) provided a global evaluation of participants’ cognitive statuses for screening subjects for the study. Test-retest reliability of the MMSE is . 82 or better (Folstein et al. ). Cognition is assessed in seven areas, and scores lower than 24 out of 30 indicate dementia. Nursing Research July/August 2002 Vol 51, No 4 Observable Displays of Affect Scale. The Observable Displays of Affect Scale (ODAS) (Vogelpohl Beck, 1997), designed to rate videotaped data, contains 41 behaviors categorized into six subscales of positive and negative facial displays, vocalizations, and body movement/posture. Raters indicate presence/absence of each behavior during five 2-minute intervals from a 10minute videotape. Scores range from 0–5 for each item. The range of scores for each scale is: facial positive (0–20), Aggression during bathing facial negative (0–20), vocal positive (0–45), vocal negative (0–50), body could stem from physical positive (0–30), and body negative discomfort or rough (0–40). Interrater reliabilities (Kappa handling coefficients) for the ODAS range from . 68–1. 00, and intrarater reliability is . 97–1. 00. Ten gerontological nursing experts established content validity (Vogelpohl Beck). Apparent Affect Rating Scale. The Apparent Affect Rating Scale (AARS) (Lawton et al. , 1996) is designed for direct observation of persons with dementia and contains six affective states: pleasure, anger, anxiety/fear, sadness, interest, and contentment. (In later work, Lawton, Van Haitsma, Perkinson, Ruckdeschel [1999] deleted contentment). Each item has a noninclusive list of behaviors that might signal the presence of the affect from which observers infer the affect. The observer assigns a score of 1 to 5 to measure the duration of the behavior. Visual Analogue Scales. The Positive Visual Analogue Scale (PVAS) and Negative Visual Analogue Scale (NVAS) (Lee Kieckhefer, 1989; Wewers Lowe, 1990) are two 10centimeter lines on separate pages for rating positive and negative affect. The PVAS has end anchors of â€Å"no positive affect† and â€Å"a great deal of positive affect. † The NVAS has end anchors of â€Å"no negative affect† and â€Å"a great deal of negative affect. † Scores range from 0 to 100. Procedure: The study consisted of six phases: (a) preliminary activities, (b) a three-week normalization/desensitization period, (c) a 12-week intervention period, (d) a onemonth follow-up period, (e) a two-month follow-up period, and f) a videotape analysis. Preliminary Activities. The institutional review boards at the University of Arkansas for Medical Sciences and the Univer- sity of Maryland approved the research. Each nursing home identified residents with dementia and sent letters informing persons responsible for the residents that researchers would be contacting them. Responsible persons could return a signed form if they did not want to participate. Willing responsible persons received a telephone call explaining the study followed by a mailed written description along with two consent forms. Those willing kept one consent form for their records and signed and mailed back the other. Screening involved a review of the residents’ charts, recording their diagnoses, and interviews with the staff to find evidence of DB during the previous two weeks. Each resident took the MMSE to meet inclusion criteria. Within each home, female residents who passed these screens were randomized to one of the five groups by a drawing, but males were assigned to the five groups to ensure even distribution of their small number. Simultaneously, research staff members were hired and trained. Normalization/Desensitization. For the next three weeks, each PNA accompanied a NHNA to learn the routines of the facility but did not help care for potential study participants. A videotape technician placed a camera that was not running in the dining and shower rooms to desensitize residents and staff to its presence. In addition, nursing home staffs participated in two-hour training sessions on the DBS. Throughout the study, a gerontological clinical nurse specialist trained any new NHNA and retrained if behaviors reported on the DBS differed from those she observed during randomized checks. Intervention. During the 12-week intervention period, the first three weeks were considered baseline and the last two weeks postintervention. The PNA administered the treatment/s or placebo five days a week. Every day, they asked participants to give their assent and espected any dissents. During weeks 11–12 (postintervention), the PNA prepared the participants for their departure by telling them that they were leaving soon. To facilitate data collection, a separate form of the DBS for each of the three eight-hour daily shifts was developed. Eight one-hour blocks accompanied each item of the scale. The NHNA placed a check mark in the block that corresponded to the hour when the NHNA observed the behavi or. The NHNA completed the DBS on all participants during or at the end of a shift. In addition, a technician videotaped participants in the treatment and placebo groups every other week during an interaction with the PNA and no intervention group monthly during an ADL. The technician monitored positioning and operation of the camera from outside the room or behind a curtain to respect the participants’ privacy. One-Month and Two-Month Follow-up. One month and two months after the research team left the nursing home, Nursing Research July/August 2002 Vol 51, No 4 Effects of Behavioral Interventions 223 esearch assistants (RA) retrained nursing home staffs on the DBS. The NHNA then collected DB data on their shifts Monday–Friday for one week. tervention, week 16 as one-month follow-up, and week 20 as two-month follow-up. Participants with fewer than six observations at any time period were omitted. For each period, a total DBS score represented an averVideotape Analysis. The videotapes ranged in length from age of the participant’s data for the t hree shifts of each day less than five minutes to 40 minutes, depending on the across the five days of the observation week. Therefore, activity and the participant’s willingness to cooperate with total DBS scores were obtained for baseline (M of weeks the treatment (baseline and control participants’ tapes 1–3), intervention (M of weeks 4–10), postintervention (M tended to be shorter). To standardize the opportunity for of weeks 11–12), first follow-up (M of week 16), and secbehaviors to occur, an editor took 10-minute segments ond follow-up (M of week 20). The same procedure from the middle of baseline and final treatment eek tapes yielded subscale scores for physically aggressive, physically and randomized them onto videotapes for rating. Because nonaggressive, vocally aggressive, and vocally agitated videotaping occurred to ensure appropriate implementabehaviors for each of the five time periods. tion of interventions, the treatment groups had more A repeated measures analysis of variance (ANOVA) usable videotapes than the control groups did. consisted of two between- subjects and one within-subjects A master’s prepared gerontological factors. The between-subjects factors nurse specialist intensively trained six were intervention group and state (AR raters on the Observer III Software or MD) to account for regional differSystem (Noldus Information Technolences in scoring DB, and the withinogy, 1993) for direct data entry and subjects factor represented DBS scores the affect rating scales. The raters for the five different time periods. Each reached . 80 agreement with the speanalysis allowed for testing by intervencialist on practice tapes before they tion group, time period, and state. The Screaming may started rating the study videotapes. nalysis of the interaction effect of She monitored reliability for each tape intervention group by time period express pain or monthly, retrained as needed, and rantested the hypothesis that the intervenself-stimulation domized the sequence of rating the tions would decrease DB across time in scales. The raters entered the ODAS treatment conditions as compared to and AARS data directly into a comcontrol conditions. The analysis was puter using the Observer. The system repeated five times, once for each suballowed raters to watch videos repeatscale of the DBS and once for the total edly in actual time and slow action to score. Level of significance was set at document behaviors objectively and 0. 05. The researchers believed that the precisely. The raters indicated their small group sizes justified the liberal perception of the participants’ positive and negative level of significance. For the videotape analysis, analyses of affect by placing a vertical mark at some point between covariance occurred for the 14 variables observed from the the two end anchors of the PVAS and NVAS. They videotapes during intervention. The baseline score served marked neutral affect as negative. s a covariate for the final score. While a multivariate analysis would have been desirable, it would have had Intervention Integrity: The PNA and video camera techniinsufficient power with this number of variables and subcian underwent two weeks of intensive training on general jects. The 14 univariate analyses do inflate the Type I error aging topics, stress management, information on dementia, rate. and confidentiality/privacy issues. Training also involved instruction on the study interventions, DBS, and research Results protocols. Of the 179 initial participants, 36 did not finish; the greatA gerontological clinical nurse specialist viewed treatest attrition occurred in the no intervention control group. ment and placebo videotapes biweekly in a private office to Attrition resulted from death (39%), withdrawal of fammonitor PNA compliance with research protocols, provide ily’s consent or at nursing home staff’s request (26%), discorrective feedback to PNA, and help PNA recognize and charge (18%), and change in health status/medications meet participants’ needs as they changed during treatment. hat did not meet inclusion criteria (17%). This left 143 The possibility for contamination appeared to be low participants: 29 in the ADL, 30 in PSA, 30 in CB, 30 in the because NHNA were unlikely to change their care practices placebo, and 24 in the no intervention, but 16 with incomand had little opportunity to observe PNA. Further, NHNA plete data were dropped. Table 3 gives the demographic were b linded to the hypothesis of the study, the nature of the statistics for the 127 participants with complete data. No interventions, and the participants’ group assignments, statistically significant demographic differences emerged although they probably could identify the no intervention among the five groups. In short, this sample primarily conparticipants. sisted of elderly, white females with severe cognitive impairment. Analysis: Reviewers checked for completeness of all data. For the videotape analysis, the final number was 84 The researchers designated intervention weeks 1–3 as baseparticipants with 168 videotape segments. Most were line, weeks 4–10 as intervention, weeks 11–12 as postin- 224 Effects of Behavioral Interventions Nursing Research July/August 2002 Vol 51, No 4 TABLE 3. Description of the Sample by Intervention Group No Intervention 19 89. 5 78. 9 84. 2 86. 47 (6. 37) 11. 47 (6. 43) ADL Number in group Percent female Percent white Percent widowed Mean age (SD) M MMSE (SD) 28 78. 6 82. 1 64. 3 82. 29 (8. 40) 11. 44 (7. 69) PSA 29 82. 1 85. 7 66. 7 82. 18 (7. 64) 10. 65 (6. 76) CB 22 81. 8 77. 3 77. 3 82. 82 (9. 81) 7. 91 (5. 41) Placebo 29 75. 9 86. 2 75. 9 86. 45 (6. 92) 11. 11 (6. 39) Total 127 81. 0 82. 5 72. 8 83. 64 (7. 97) 10. 55 (6. 64) Note. ADL = activities of daily living; PSA = psychosocial activity; CB = combination. emale (79%) and widowed (69%) with a mean age of 83 (SD 7. 44). Participants had a mean score of 10 (SD 6. 34) on the MMSE, indicating moderate to severe cognitive impairment. Table 4 displays the means and standard deviations for the DBS overall and the four subscales across the five time periods for the five groups. No significant differences emerged for the interventi on-by-time interaction for any of the dependent variables. Thus, the results failed to support the hypothesis that the interventions would decrease DB across time in treatment groups as compared to control groups (statistical analysis tables on Website at: http://sonweb. nc. edu/nursing-research-editor). However, the main effect of state was significant in three analyses. Arkansas recorded significantly more behaviors than Maryland did for the dependent variables of physically nonaggressive (p . 001), vocally agitated (p . 001), and overall DBS (p . 002). Further, the main effect of time was significant for overall DBS (p . 002) and the four subscales of physically aggressive (p . 001), physically nonaggressive (p . 027), vocally aggressive (p . 021), and vocally agitated behaviors (p . 008). The significance resulted from increased DB after the PNA had left the home (generally from intervention or postintervention to first follow-up). For the videotape analysis, the hypothesis stated that treatment groups, compared with control groups, would display more indicators of positive affect and fewer indicators of negative affect following behavioral interventions. In general, neither the positive nor the negative affect scores were particularly high, indicating that this sample had relatively flat affect. Results from the analysis of covariance tests supported increased positive affect but not decreased negative affect. Compared to the control groups, the treatment groups had significantly more positive facial expressions (p . 001) and positive body posture/movements (p . 001), but not more positive verbal displays on the ODAS. The treatment groups displayed significantly more contentment (p . 037) and interest (p . 028) than the control groups did on the AARS. For the negative affects on the AARS, the treatment groups had a shorter duration of sad behaviors (p . 007) than the control groups did. Comparison of VAS scales likewise showed that the treatment groups displayed more positive affect (p . 012). Discussion In contrast to other studies (e. . , Hoeffer et al. , 1997; Kim Buschmann. , 1999; Whall et al. , 1997), this study found no treatment effect on DB. The interventions were a synthesis of approaches believed to globally address â€Å"triggers† of DB and meet psychosocial needs (Boettcher, 1983). They did not address the specific factors that might have been triggering the particular behavior (Algase et al. , 1996). Such triggers include under/over stimulation, unfamiliar or impersonal caregivers, and particular individual unmet psychosocial needs. For example, aggression during bathing could stem from physical discomfort or rough handling (Whall et al. 1997). Interventions much more individually designed require development. Increasing DB across all groups was reflected in the DBS scores at 1-month follow-up. Two factors may explain this increase. First, the PNA had warned participants that they would be leaving. Second, the ADL and CB participants no longer received care from the familiar PNA, and PSA, CB, and placebo participants no longer had a daily activity or visit. The increased stress and time constraints for NHNA as they resumed caregiving of the ADL and CB participants may explain the heightened DB in the control groups. Such changes may trigger increased behavioral symptoms in persons with dementia (Hall, Gerdner, Zwygart-Stauffacher, Buckwalter, 1995). Two measurement issues may have affected outcomes. First, observers view behaviors differently (Whall et al. , 1997) and come to expect particular behaviors from certain residents (Hillman, Skoloda, Zander, Stricker, 1999). If the NHNA were accustomed to a participant’s DB pattern, such as persistent screaming, they may have overlooked decreases in that behavior. Initial training and retraining of raters occurred as needed; however, some Nursing Research July/August 2002 Vol 51, No 4 Effects of Behavioral Interventions 225 TABLE 4. Weighted Scores for Disruptive Behavior by Intervention Group and Time Period No Intervention (n = 19) Mean (SD) 408. 71 (427. 24) 303. 69 (408. 44) 281. 97 (410. 85) 418. 31 (630. 58) 292. 85 (405. 15) 114. 66 (202. 89) 90. 85 (182. 70) 77. 98 (173. 15) 130. 92 (257. 12) 128. 20 (195. 67) 191. 97 (157. 75) 117. 11 (112. 30) 118. 23 (137. 08) 154. 46 (225. 05) 100. 45 (153. 30) 55. 16 (74. 70) 42. 89 (54. 54) 33. 26 (47. 06) 64. 72 (77. 89) 28. 09 (37. 02) (continues) DB Category Time Period DBS total Baseline ADL (n = 28) Mean (SD) 172. 51 (191. 47) 182. 45 (181. 3) 164. 56 (154. 95) 207. 22 (205. 58) 190. 70 (291. 06) 20. 67 (30. 52) 32. 59 (51. 29) 15. 02 (26. 10) 44. 18 (100. 62) 21. 45 (36. 47) 95. 50 (105. 28) 87. 58 (87. 58) 85. 04 (89. 60) 88. 81 (85. 69) 148. 75 (187. 28) 22. 85 (32. 10) 28. 37 (32. 50) 21. 15 (26. 54) 30. 72 (48. 95) 18. 28 (24. 55) PSA (n = 29) Mean (SD) 348. 02 (467. 50) 306. 81 (393. 03) 303. 24 (367. 54) 373. 17 (533. 05) 300. 20 (366. 42) 85. 87 (199. 01) 83. 94 (167. 53) 82. 82 (166. 93) 113. 49 (235. 71) 81. 30 (151. 85) 162. 41 (206. 65) 130. 82 (142. 72) 133. 92 (145. 97) 141. 47 (188. 99) 164. 92 (223. 63) 49. 64 (93. 15) 43. 80 (64. 6) 37. 90 (53. 43) 54. 47 (90. 33) 40. 26 (45. 26) CB (n = 22) Mean (SD) 287. 66 (373. 73) 300. 84 (379. 33) 286. 21 (365. 78) 374. 10 (510. 10) 312. 83 (433. 18) 68. 84 (126. 18) 67. 14 (137. 79) 61. 04 (127. 78) 92. 68 (205. 52) 60. 40 (131. 54) 136. 67 (189. 03) 124. 64 (164. 49) 125. 99 (157. 78) 159. 97 (202. 75) 146. 53 (201. 83) 34. 49 (55. 91) 40. 73 (52. 60) 31. 18 (33. 85) 36. 95 (42. 70) 32. 82 (51. 32) Placebo (n = 29) Mean (SD) 325. 96 (337. 14) 337. 60 (328. 94) 336. 80 (366. 55) 389. 92 (434. 43) 319. 15 (384. 59) 49. 26 (90. 24) 62. 10 (112. 71) 59. 67 (106. 37) 76. 79 (165. 45) 48. 25 (101. 4) 167. 01 (177. 80) 164. 62 (161. 48) 175. 36 (189. 80) 201. 68 (212. 06) 87. 67 (127. 38) 47. 20 (79. 70) 39. 55 (57. 74) 32. 69 (55. 77) 29 . 30 (47. 60) 30. 18 (52. 85) Intervention Postintervention 1 month follow-up 2 month follow-up Physically aggressive Baseline Intervention Postintervention 1 month follow-up 2 month follow-up Physically nonaggressive Baseline Intervention Postintervention 1 month follow-up 2 month follow-up Vocally aggressive Baseline Intervention Postintervention 1 month follow-up 2 month follow-up 226 Effects of Behavioral Interventions Nursing Research July/August 2002 Vol 51, No 4 TABLE 4. Weighted Scores for Disruptive Behavior by Intervention Group and Time Period (Continued) NoIntervention (n = 19) Mean (SD) 47. 65 (97. 22) 68. 32 (103. 13) 68. 01 (116. 62) 84. 50 (112. 48) 73. 07 (117. 12) DB Category Time Period Vocally agitated Baseline ADL (n = 28) Mean (SD) 33. 49 (84. 39) 33. 91 (62. 52) 43. 17 (72. 10) 43. 48 (64. 39) 50. 53 (117. 95) PSA (n = 29) Mean (SD) 46. 92 (98. 70) 52. 84 (96. 03) 52. 50 (90. 78) 68. 22 (98. 89) 48. 89 (92. 33) CB (n = 22) Mean (SD) 62. 49 (98. 97) 70. 43 (110. 85) 69. 08 (107. 29) 82. 14 (118. 97) 75. 80 (129. 67) Placebo (n = 29) Mean (SD) 50. 0 (92. 05) 48. 25 (81. 63) 48. 59 (72. 20) 63. 74 (95. 30) 54. 11 (80. 61) Intervention Postintervention 1 month follow-up 2 month follow-up Note. Scores were created by assigning each behavior with a severity weight prior to summing and then averaging across day and then week(s). DBS = disruptive behaviors; ADL = activities of daily living intervention; PSA = psychocial activity inte rvention; CB = combination of the two interventions. NHNA appeared to continue to consider participants’ behaviors, such as repetitive questioning, to be personality characteristics or attention-seeking efforts rather than DB. Thus, they may have under-reported behaviors. Further, staff may prefer withdrawn behaviors, such as isolating self and muteness (Camberg et al. , 1999), and view them as nonproblematic. Second, categorizing a behavior as disruptive without understanding its meaning to the person with dementia may be conceptually flawed. For example, screaming may express pain or self-stimulation. Two design features may explain differences between the findings of this study and others. First, this study had both placebo and no intervention control conditions. Just a few other studies randomized subjects to treatment or control groups or included two control groups (e. g. , Camberg et al. , 1999). In most studies, control conditions preceded or followed treatment conditions (e. g. , Clark, Lipe, Bilbrey, 1998). In both designs, subjects served as their own controls, which limits examination of simultaneous intra- and extra-personal events that might affect DB frequency. Second, many control groups came from separate units or different nursing homes (e. g. , Matteson et al. , 1997), which makes it difficult to control for differences in environment, staff relationships, and personalities. This study occurred at seven sites in two different geographical areas, but at each site, the randomization of female participants distributed the groups across all nursing units to control for environmental and staff characteristics. Acknowledged limitations include the following. First, in spite of the large overall sample, the group sizes were small (range 19–30) with the greatest loss in the no inter- vention group. Larger groups might have provided more definitive findings on the relationship between behavioral interventions and DB frequency as Rovner et al. (1996) did (treatment group 42; control group 39). Second, NHNA served as data collectors because using independent observers would have been cost-prohibitive. These results suggest that future intervention research should consider the individual characteristics of the person with dementia (Maslow, 1996) and the triggers of the behavior (Algase et al. , 1996). Studies that have individualized interventions have demonstrated decreased DB (Gerdner, 2000; Hoeffer et al. , 1997). Researchers need to continue to refine methods for identifying what works for whom (Forbes, 1998) to minimize the prevalent trial-anderror approach to DB management.

Advantages And Disadvantages Of Cloud Computing

Advantages And Disadvantages Of Cloud Computing In this essay Im going to talk about the structures, types, uses and some of the most famous service providers of Cloud Computing. . Furthermore I will discuss what I understood about this technology what it actually means and provides. Lastly I will discuss how ethical and technological risks associated with Cloud Computing. The first element I will talk about is the technological advantages and disadvantages for a company using a Cloud Computing. This is an important part in essay. Cloud computing is the new trend in IT. It refers to the technology used to access different services over the internet. By using different services through the internet means that the data will be stored on servers, rather than individual drives. Cloud computing allows people to access their files from anywhere, despite of the computer they are using. Cloud computing has made an important impact on the way we store and run applications. It also has made it easier for teams to collaborate, and communicate across the borders. Although it sounds very good, but there are also some disadvantages of cloud computing. Cloud computing became a viable business model because certain companies like Amazon had assembled enormous amount of servers and resources to handle their customers demands during peak seasons. This entire IT infrastructure wasnt used efficiently for the rest of the year. Therefore, they decided to rent out their resources to the public. This way the public is able to use computing resources over the internet, any time of the day, and from any place in the world. The third party service provider is responsible for linking the users with the type and amount of IT resources they need, for their document management, and backup storage. There are three types of cloud computing. The first one is known as infrastructure-as-a-service (IaaS), in which the servers and the software are fully outsourced, and are billed based on the usage of resource. The second type of cloud computing is platform-as-a-service (PaaS), in which the service provider facilitates the use of different applications. The last type of cloud is known as software-as-a-service (SaaS), in which the user doesnt need to install the software, and can access it over the internet. Famous cloud service providers include Amazon, Google, Zoho, and Salesforce. There are four types of ways in which a cloud can be structured. The first type is the public cloud, in which the services are available through the internet from third party sources. The second type of cloud is the community cloud, in which many organizations realize that theyve got similar needs and requirements, and hence, should share the infrastructure. An example of a community cloud is Googles Gov cloud, in which the services are specifically modified for the public sector agencies. The third type of structure is the private cloud, in which the business buys, and maintains the software, so that its employees could centrally store the date, and collaborate efficiently. The last type of structure is the hybrid cloud, in which a combination of public and private clouds is used. The advantage of such a structure is that it makes it easier to archive and back up the data on the public cloud. There are numerous advantages of cloud computing. Firstly, cloud computing lowers computer costs. As the services are provided over the internet, and theres no need to install any software, the desktop PC doesnt need to be powerful processing powers. Along with the hardware requirements, it also reduces software costs. Most of the cloud computing services are free. For example, Google docs can be used for free, instead of paying for the Microsoft Office suite. The software is also up-to-date in cloud computing, and there are no format compatibility issues. Perhaps the biggest advantage of cloud computing is that there is unlimited storage capacity. Users of clouds dont need to worry about backing up their data, because even if their computer crashes, they will be able to access it again from another computer. Furthermore, cloud computing allows users to access their data from anywhere. Another advantage of cloud computing is that it makes it easier for groups to collaborate their files. Multiple users can edit a document at the same time, and have discussions over the internet. With cloud computing, organizations can truly run a business without borders. They wont be restricted to a specific location as all their data is available on the internet. Lastly, cloud computing gives device independence; there is no need to download specific software to view the file, or a specific network to access the files. With cloud computing, the user interface and the software remains the same regardless of the network, or location. (Miller, 2009) Along with the numerous advantages, there are some disadvantages of cloud computing. Firstly, cloud computing is dependent on the internet. If the internet connection is down, then the whole cloud doesnt work. It requires a constant internet connection; otherwise a user may not be able to access own files. The same is the case with low internet speeds. Furthermore, even if there is a good internet connection, cloud computing may be slow. As the files need to be accessed on the internet, the back and forth communication between the computer and the cloud may be slow to respond because it is busy handling other users. Another disadvantage of cloud computing is that the features that they offer are limited. For example, Zoho Presentations, another cloud service provider, dont have the same features as of Microsofts PowerPoint. Lastly, the data on the cloud is as secure as the cloud itself. What would happen if the cloud crashes? Can other users gain unauthorized access? If the cloud cra shes, the data might go missing unless its backed up on multiple servers. (Miller, 2009) As cloud computing is relatively new, and has grown at a significant pace, its ethical and technological implications need to be discussed so as to understand the risks associated with it. Firstly, companies will need to realize that they are sharing their data with another business, which is a huge risk itself. It will be sharing the information of its users with the cloud. Companies will need to define how much access does the cloud have over the data, and has it encrypted so that it is safe from unauthorized access. Furthermore, the security measures should be reviewed before selecting a cloud service provider. To provide assurance to the users, cloud service providers should have a level of transparency in their operations. Another issue is of the privacy of the customers. With the data being shared with the third party, it can use the data for all kind of purposes. Along with the security and privacy issues, another concern is the availability and performance of clouds. The cloud community still needs to define the acceptable level of performance of their applications. A third risk with cloud computing is that of integration. If a business chooses a cloud service provider, it should make sure that it can be fully integrated into the business processes for consistency, and efficiency. Furthermore, the business will also need to address the operational challenges that arrive during the IT replacement period. There is also a bankruptcy risk of the cloud service provider. Once the third party has the data, it can lockout the business and refuse to let it access its files. The biggest risk with cloud computing is that the service provider becomes a partner in the business, which makes it difficult to end the relationship. Businesses and individuals will need to do a background check on the cloud service provider before deciding on him. Another technological risk with cloud computing is that the third party controls the data. For example, Amazon deletes already purchased books from Kindle without the users permission. Another example would be that when the user gives a request to delete a file, the cloud service provider doesnt delete the file. Instead, he keeps the file for his own usage. The only way to deal with these risks is to conduct a background check on the cloud service provider. Furthermore, the security measures of the cloud service provider should be checked. The growing trend in cloud computing raised a number of issues regarding the best way to use this technology. A document was therefore created called the open cloud manifesto. The cloud computing manifesto is a document that describes a core set of principles for cloud service providers. It was formed to gather the worldwide cloud community on a single core set of rules, which are flexibility, and freedom of choice. They believe that the open cloud gives users choice, flexibility, speed and agility. There are four key advantages of cloud computing. Firstly, cloud computing allows organizations to scale their hardware and software on demand. When an organization faces change, computing needs increase significantly. With cloud computing, the organization is able to expand it IT resources to handle peak times. Another feature of cloud computing is that it allows organizations to streamline their data centre by backing up their documents over the internet. Thirdly, cloud computing improves business processes by providing an existing infrastructure. Lastly, the most important key feature of cloud computing is that it reduces start up costs. As all the infrastructure is already in place, no investment is needed to build a data centre to backup your data. Although cloud computing has many advantages, there are many security and reliability related issues that still need to be answered. As it is still in its initial stages, there is a lot of room for improvement. To increase its usage in the IT industry, cloud service providers will need to address some major issues like security, application interoperability, application and data portability, and governance. Theyll also need to come up with consistent variables so as to monitor and measure the performance of cloud applications. With big companies like HP, Dell, IBM, and Fujitsu reaping the benefits of cloud computing, it seems that in the future more and more data will be stored on clouds rather than on individual drives. Furthermore, many small businesses are also benefiting from cloud computing because of its low cost.

The Guilt of Macbeth and Lady Macbeth Essay -- Macbeth essays

     Ã‚  Ã‚  Ã‚   Characters in the Shakespearean tragedy Macbeth scarcely feel guilt - with two exceptions: Macbeth and Lady Macbeth. In this essay let's consider their guilt-problem. In his book, On the Design of Shakespearean Tragedy, H. S. Wilson comments regarding the guilt of the protagonist: It is a subtler thing which constitutes the chief fascination that the play exercises upon us - this fear Macbeth feels, a fear not fully defined, for him or for us, a terrible anxiety that is a sense of guilt without becoming (recognizably, at least) a sense of sin. It is not a sense of sin because he refuses to recognize such a category; and, in his stubbornness, his savage defiance, it drives him on to more and more terrible acts. (74) Blanche Coles states in Shakespeare's Four Giants that, regarding guilt in the play: Briefly stated, and with elaborations to follow, Macbeth is the story of a kindly, upright man who was incited and goaded, by the woman he deeply loved, into committing a murder and then, because of his sensitive nature, was unable to bear the heavy burden of guilt that descended upon him as a result of that murder. (37) A.C. Bradley in Shakespearean Tragedy demonstrates the guilt of Macbeth from the very beginning: Precisely how far his mind was guilty may be a question; but no innocent man would have started, as he did, with a start of fear at the mere prophecy of a crown, or have conceived thereupon immediately the thought of murder. Either this thought was not new to him, or he had cherished at least some vaguer dishonourable dream, the instantaneous recurrence of which, at the moment of his hearing of prophecy, revealed to him an inward and terrifying guilt. (316) In "Memoranda: Remarks on the C... ...1957.    Frye, Northrop. Fools of Time: Studies in Shakespearean Tragedy. Toronto, Canada: University of Toronto Press, 1967.    Kemble, Fanny. "Lady Macbeth." Macmillan's Magazine, 17 (February 1868), p. 354-61. Rpt. in Women Reading Shakespeare 1660-1900. Ann Thompson and Sasha Roberts, eds. Manchester, UK: Manchester University Press, 1997.    Shakespeare, William. The Tragedy of Macbeth. http://chemicool.com/Shakespeare/macbeth/full.html, no lin.    Siddons, Sarah. "Memoranda: Remarks on the Character of Lady Macbeth." The Life of Mrs. Siddons. Thomas Campbell. London: Effingham Wilson, 1834. Rpt. in Women Reading Shakespeare 1660-1900. Ann Thompson and Sasha Roberts, eds. Manchester, UK: Manchester University Press, 1997.    Wilson, H. S. On the Design of Shakespearean Tragedy. Toronto, Canada: University of Toronto Press, 1957.

Reader Response to Memoirs of a Geisha Essay -- Memoirs of a Geisha Es

Reader Response to Memoirs of a Geisha Memoirs of a Geisha is Arthur Golden's debut novel, written exquisitely with great detail. It was initially written as a novel that would depict the son borne of a geisha and a Japanese businessman, but once he had learned the true nature of a geisha, he changed his topic. Golden discovered the intrigue of the geisha - the attributes that draw in the geisha's customers, that make them an irreplaceable part of Japanese history, that make them human as well as the ideal of what a woman should be. When these features were displayed through Sayuri's voice, the novel became an emotionally enrapturing story, which drew in the reader and captivated the heart. I, personally, was affected deeply by this novel. I have always been drawn in by Japanese culture, even as a child. When I learned of the geisha for the first time, I thought I even wanted to be one someday. While reading this novel, any fantasies I may have had of what a geisha was were completely reshaped. Thi s novel convinced me that the geisha truly were artists - they were trained and hired as musicians, dancers, conversationalists, jokesters, and "drinking buddies", so to speak. The geisha incorporate both the demure and the vulgar aspects of the human spirit, and created instead a playful and desirable companion for the stressed and lonely businessmen. When I learned of the "mizuage," the supposed Japanese term for the occasion upon which a young geisha's virginity is auctioned off to the highest bidder, I was absolutely shocked. Here was a culture that had prided... ...d my eyes to new styles of writing. While the writing was simple, it crossed the same barriers that were emotionally crossed throughout the novel. Initially I did not think it possible, but after reading the novel I found it to be true - it is possible for people to truly understand one another despite any boundaries. Whether they be due to gender, age, culture, politics, or any other reason, these boundaries can be overcome by simply learning about one another, about everyone's own personal histories, and trying to understand them as people rather than objects. Memoirs of a Geisha defied many boundaries and was able to create an intimate - and greatly appreciated - relationship between the reader and a fictional geisha from, essentially, another world. It was truly an incredible novel.

Importance of Sports Essay

Sports such as football or baseball involve lots of physical activities. Sports and exercises help in strengthening and toning the muscles and bones in the body. In short, the importance of sports for kids is that it keeps them in an excellent shape. When children or adults plays team sports, be it cricket or hockey, they learn to work in groups. They learn that if the team wins, they win and if the team loses, they lose. This way they learn how to work in groups. Thus, the importance of sports for kids is that they understand what is team spirit and thus, when they grow and actually start working, it will help them immensely in building relationships with their co-workers, and also to work in harmony with others. Sports makes people mentally strong. Success and failure are both parts of sports as well as life. A sportsman knows that there will be times when he will win matches, there will also be times when he will lose them. A sportsperson knows how to handle defeat and thus, treats success and failure equally. This is an important life lesson too, which sports can teach a person. Besides this, another importance of sports for children or for adults is that it teaches them how to handle competition, and be fearless when facing the adversaries. Children and adolescents ooze with physical energy. When they are involved in sports, their physical energies are used up in a constructive way. Teenage is such an impressionable age, if adolescents are given free time they might get involved in wrong activities or may fall in bad company or may also display anti-social behavior. Thus, the importance of sports in society is that it keeps adolescents from becoming anti-social elements, who might otherwise disturb the delicate fabric of society. Here’s hoping that now you know what is the importance of sports. Besides being important for kids, taking up a sports career in adult life, has its own benefits. A sportsperson often travels to other countries to play matches and in the process, learns a great deal about the cultures of these countries. Even the spectators or TV viewers are thoroughly entertained while watching professional sports, making it an excellent recreational activity.

The Western Roman Empire – the Rise & Fall

Western Roman Empire | A map depicting the separate empires of Rome| Mediterranean Society: The Roman Phase From Kingdom To Republic The Etruscans and Rome (Previous Wiki notes) There are many different versions on how Rome started the ones told to kids are very simple with very few names: . Ancient Rome for Kids  The story of Romulus and Remus for adults have dates, more names and details:  Wolf Country, Myth and Stories You can find many versions of myths, however the version the text book talks about Aeneas, a refugee from Troy who migrated to Italy when Greek invaders destroyed his land.Tow of his decedents, twins; Romulus and Remus, almost didn't survive infancy because and evil uncle abandoned them by a flooded Tiber River. A she-wolf found them and nursed them back to health. When the boys grew older, Romulus founded the city of Rome and established himself as its first kind in 753 B. C. E. However scholars tell a different story. Some Greek historians believe that Aeneas settled at Rome, which was a small city-state. In the fourth century B. C. , Rome began to expand and Romans came into greater contact with the Greeks, which suggest that Aeneas has a role in the creation of the great city.In the first century B. C. , the Roman Poet Virgil developed the Aeneas myth in his epic poem the  Aeneid, which talked about Aeneas’ journey to Rome. Augustus, the first Roman emperor and emperor during Virgil’s time, and Julius Caesar, his great uncle and predecessor as the Roman ruler, were known to be decedents of Aeneas. ( Information founded in the article:  This Day in History: Rome founded) The text book talks about how Indo-Europeans migrated crossed the Alps and settled through the Italian peninsula, including the future site of Rome. The Roman Republic and Its ConstitutionThe Romans got rid of the last Etruscan king in 509 B. C. E. The republican constution had two consuls; military and civil. These consuls were elected by an assembly that was dominated by the high class, or patricians. There was also a senate which advised the consuls and helped ratify major decisions. Because both the senate and consuls represented only the interests of the patricians there were many conflicts between the patricians and the lower class, or plebeians. To solve these conflicts, the patricians gave the plebeians tribunes, or people the plebeians could elect to speak for them.The tribunes had the  power  to intervene and veto decisions. The plebeians began to gain  power, by the early third century B. C. E the plebeians' tribunes dominated Roman politics. From Republic To Empire Imperial Expansion and Domestic Problems During the second and first centuries B. C. E, the relations between the classes were so strained that there was much conflict and violence. Two brothers, Tiberius and Gaius Gracchus worked to spread the land possesion and tried to limit the ammount of land a certain person could hold. Unfortunately though, the y were both assasinated for fear of gaining influence over Roman affairs.The people that were in control of the political  power, were of a small class that used the power to only help themselves and their class. In 87 B. C. E Marius marched on Rome and during the first century B. C. E, Rome was in civil war. When Marius died the next year, Sulla planned to take power and soon did in 83 B. C. E. Many conservatives supported Sulla because he imposed many conservative legislation. The Foundation of Empire Julius Caesar seized Rome in 49 B. C. E by being a very popular public figure. He believed strongly in  social  reform and conquered Gaul.He was responsible for a lot of  social  reforms and changed the gonvernment to centralized control. Caesar claimed the title â€Å"dictator for life†, which earned him his assasination in 44 B. C. E. After Caesar was killed, his adopted son, Octavian, after defeating Mark Antony, took over Rome and brought civil conflict to an end . The senate bestowed the title â€Å"Augustus,† to him in 27 B. C. E. He ran a monarchy disguised as a republic. While he was in power, a new standing army was created and the imperial institutions began to take root. Continuing Expansion and Integration of the EmpireThe two centuries following Augustus's rule, the Romans conquered lands in the Mediterranean basin, western Europe, and down the Nile to Kush. For two and a half centuries into the third century a long era of peace was prevelant among economic and political integration, this was called  pax romana, or â€Å"Roman peace†. Another important Roman advance was the road and highway system. The new road systems created were very well engineered and allowed for extremely quick and urgent travel, which improved the postal system extremely. Also during this time, Romans began developing a system of written law at about 450 B. C. E.They developed a system called the Twelve Tables, which was a basic law code for c itizens for the early republic. Economy and Society In the Roman Mediterranean Trade and Urbanization Latifundia owners grew various crops to export in North Africa, Egypt, and Sicily. Ships carried several hundred tons of crops to cities for consumers. Other cities and regions could now focus on cultivating fruits and vegetables or manufacturing goods. Archaeologists have uncovered a pottery factory north of Rome that probably employed hundreds of workers and had a mixing vat that could hold more than 10,568 gallons (40,000 liters) of clay.The Mediterranean lake became an essential lake for the Romans because it linked many cities and was used for trading. They called the lake  mare nostrum  which means â€Å"our sea. † The Roman military and navy kept the seas mostly free of pirates to ensure that cargoes could move freely over long distances. The city of Rome received taxes, tributes, booty and other wealth from military expansion. Rome also received most of the profit from Mediterranean trade. The money was used for urban development. In the first century C. E. , there were about 10,000 statues, 700 pools, 500 fountains, and 36 monumental arches.The state financed the construction of temples, bath houses, public buildings, stadiums, and aqueducts. The aqueducts were very important because they brought fresh water to Rome. They used concrete (invented by Roman engineers) to build the aqueducts because it is very strong. The population increased dramatically because construction employed hundreds of thousands of workers. Family and Society in Roman Times The eldest male was usually the head of the common Roman family and ruled as  Pater Familias, or â€Å"father of the family†.As the pater families, the father could do anything he wanted with his children, like planning weddings or even executing them. Despite Roman law, women could hold high influence within the family. The women also would help plan weddings and even help with family fi nances by finding loopholes in Roman Law. As time went on, new classes of people accumulated lots of private wealth for themselves. The wealthy would live in palaces and eat exotic dishes with animal tongues in them. If there are wealthy people, there are lots of poor people, who became a big problem in Rome.The poor would often riot, but the government used a technique called â€Å"Bread and Circuses† where they would supply the poor with subsidized grain and spectacular public entertainment. One big part of Roman society was the slaves. About one third (Two sixths, three ninths, etc. ,) of the population were slaves; most of which worked on Latifundia, while others worked mines. During the second and first centuries, slaves would often revolt. One of the more serious revolts being in 73 BCE where 70,000 slaves rebelled was led by Spartacus. City slaves had a much less difficult life.Female slaves worked as servants, whereas educated or talented male slaves could lead comfor table lives, such as Epictetus, who became a Stoic philosopher. Some slaves hoped for manumission, so they could leave the slave life behind. This was not mandatory for owners, so they slaves still had to work under the owner's command until they might be set free. The owners could do anything they wanted to with the slaves. The Cosmopolitan Mediterranean Greek Philosophy and Religions of Salavation The Romans believed in Gods and Goddesses who intervened in human affairs, and tutelary deities who looked after the welfare of families.As the Roman empire grew, they experienced more cultures, which lead to them adopting deities from other people and adapted them to their own purposes. As well as using other cultures' deities, they also borrowed religious practices, like animal sacrifices. The Greeks inspired the Romans in ways like rational thought and philosophy. One example is the Stoicism. The Stoics â€Å"sought to identify a set of universal moral standards based on nature and r eason that would transcend local ethical codes†. Marcus Tullius Cicero (106-43 b. c. e. ) was a Roman thinker who adopted the Stoic values.In adapting Hellenistic thought to Roman needs, Cicero drew heavily from Stoics' moral and ethical teachings. Cicero believed that the pursuit of justice is a person's duty and was against those who sought wealth and power through immoral ways. The majority of people believed in religions of salvation because it gave them a promise of future existence. Religions of salvation became key features of Mediterranean society in the Helenistic times. The roads of the Roman empire not only served as trade routes, but as openings for the word of religious salvation to spread. Mithraism started as a cult for Mithras, a god for the sun and light.Soldiers in Anatolia adapted the cult to their own interests, and related it to strength and courage rather than the sun and light. The cult of Mithras did not allow women, but cults for goddesses like Isis sp read. The cult of Isis was the most popular before Christianity spread. All of these religions spread through the Mediterranean basin. Judaism and Early Christianity In an attempt to encourage political loyalty, emperors often created state cults to worship the emperors as gods. The Jews believed that the creation of these cults was totally outside of the belief of their religion.Jews often refused to pay taxes to the emperors who had claimed themselves to be gods. As the Romans began to spread into the eastern Mediterranean region the relations between the Romans and the Jews became more and more tense. Between the third and first centuries B. C. E. the Jews mounted several rebellious attacks against the Romans but ultimately failed. The Roman forces outfought the rebels during the Jewish War of 66 to 70 C. E. Some Jews actively fought the Romans and others founded new sects that looked for saviors. They observed a strict moral code and participated in rituals designed to reinforce a state of community.They also looked for a savior who would take them away from Roman rule and lead them to establish a community in which they could practice faith without interference. The early Christians probably had little contact with them but had many of the same concerns. Christians formed their community around Jesus of Nazareth. | Jesus of Nazareth| The Fall of the Roman Empire Internal Decay in the Roman Empire Although it is perceived that the collapse of the Roman empire only had one cause, there were actually multiple causes that caused the fall of the empire.The combination of internal problems and external pressures proved deadly for the civilization. Internal political problems included internal opposition, which was mostly the work of the 26 claimants. The claimants were successors to the imperial throne, and were nicknamed â€Å"barracks emperors. † Their deaths were violent, often times because of one another, and held their power for short periods of ti me. The shear size of the Roman empire also proved problematic for the future of Rome. Central governments were difficult to control over large areas, and epidemics soon spread like wildfire over the uncontrolled region.Eventually, self-sufficient economies took the place of a large central government. Diocletian, who reigned from 284-305 CE, attempted to solve the problem of size by dividing the empire into two administrative districts. Two co-emperors ruled the districts, with the aid of lieutenants and 4 officials, or tetrarchs. Only these officials were allowed to minister. Diocletian was a skilled administrator who brought Rome's armies under control, and strengthened the imperial currency. Although his war strategies were more effective than his economic ones, this helped stabilize Rome's economy.His retirement later resulted in civil war. Constantine was the son of Diocletian's co-ruler Constantius became the emperor. Constantine wanted to become the sole emperor of Rome, so he reunited the Eastern and Western districts of Rome. Constantine wanted a new capital for the new united empire, so he built the city of Constantinople. Old problems of centralized government arose from this reunion, as both the population and economy of reunited Rome declined. There were no resources left to protect the new empire and its people, ending the reign of Constantine.Germanic Invasions and the Fall of the Western Roman Empire Military threat from migratory Germanic peoples and Germanic invasions brought an end to Roman authority in the western half of the empire, while the eastern half survived another millennium. The Visigroths, the most famous of this group of migrants, adopted Roman culture and laws, but were advised to settle outside of the imperial boundaries. The Huns, who migrated from Central Asia, were brilliantly led by the warrior-king Atilla, who organized the Huns into a nearly unstoppable military unit. They attacked Germanic peoples living on Roman empir e boundaries.The Huns disappeared after Atilla's death, but the Germanic peoples had such an effect from their violence that they began to seek refuge in Rome. They scattered in settlements throughout the Western Roman empire, and later overthrew the governments they were living under. The Visiogroths, under the leadership of Alaric, sacked Rome in 410 CE. Odovacer, a Germanic ruler, deposed Romulus Agustulus, ending the Western Roman empire. Cultural Change in the Late Roman Empire Germanic peoples governed and organized society with their own traditions now that they lacked the guardianship of the Romans.They adopted some Roman influence, mostly Roman laws which resonated deeply within their systems. Roman and Germanic traditions later blended to form Medieval Europe. Christianity survived the Roman empire collapse, and it became a huge influencer in the region. Constantine promulgated the  Edict of Milan,  which allowed Christians to practice their faith openly in the Roman e mpire. Constantine himself converts to Christianity, and the later emperor, Theodosius, makes Christianity the official religion of the Roman empire.Christianity historically resonated with the lower classes and women because of its equal nature, but during the 4th century CE, that began to change when intellectual elites began to take more interest in Christianity. St. Augustine (354-430 CE) was he most important and influential figure in the spread of Christianity after the collapse of the Western Roman empire. He was a bishop of Hippo, (a town in Northern Africa) and worked to reconcile Christianity with Greek and Roman philosophical traditions, and to articulate Christianity with the upper classes.Controversy arose within the religion, putting tension between people who interpreted the Christian doctrine in different ways. The foundation of the institutional church formed shortly after these disputes began to arise. The bishop of Rome, known as the Pope, and 4 patriarchs, were t he church officials. Bishops and patriarchs would assemble in church councils to solve disputes, often times over the interpretations of Christine doctrines. In the meantime, missionaries converted Germanic peoples to Christianity.

“Monsters Inside Me” Review Essay

I watched â€Å"Monsters Inside Me† season 4 episode 5 called My Husband is Hallucinating. This TV show was founded in 1982 and still aspires to the original mission statement established by founder John Hendricks. â€Å"To satisfy curiosity and make a difference in people’s lives by providing the highest quality content, services and products that entertain, engage and enlighten.† The episode tells 3 stories about uncommon diseases that humans faced and the hardships doctors had in identifying the cause of those illnesses. The first story was about a young boy Tyler from Colorado, who got meningococcal meningitis. The symptoms were flu-like at first: high-temperature, weakness in the body, dehydration, etc. But then he got a shortness of breath, very low blood pressure, rush and eventually blisters on his limbs. Only after running multiple tests for five days that a boy spent on life control doctors finally got the answer. Meningococcal meningitis is an inflamma tion of the brain and infection of the bloodstream caused by bacteria that traveled through boy’s vessels releasing toxins that clotted his bloodstream causing his vessels to burst into the tissue, and because of the lack of oxygen his arms and legs began to rote. This disease strikes 15,000 children and teenagers in the US annually, the vaccine exists but are not always compulsory because some people with weakened immune system are more prone to get the infection . The new prescribed antibiotics helped Tyler to survive, but doctors had to amputate his dead front feet and fingers on the right hand. The second story was about a guy Sully from Alaska who started filling great muscle pain, sensitivity to the light and the noise, and even hallucinating. Then doctors discovered high eosinophils levels in his bloodwork(specialised white blood cells that became active when there are allergens or certain infection in the body) caused by trichinosis parasites in his body because he ate raw bear meat that was contaminated with those parasites. Doctors cured Sully with a powerful drug called mebendazole, but he will have dead parasites as cists till the end of his life in his muscles. Crystal Brown from Houston, TX had a curved deviated septum that required her to have a nasal surgery to ease her breathing. After the surgery she still had the problem and greenish-black discharge in addition to trouble breathing for the longest time. First doctors recommend ed decongestants and antibiotics, but neither could help  her. Then doctors found out that a piece of packing was left in her nasal cavity for a year and development of allergic fungal sinusitis that has no cure but the surgery once every couple of years. I got thrown by the first story that’s why I decided to devote a little more description of it. It’s truly scary to know that human bodies can be so fragile. I’m really glad I watched the show, not that I’m glad to know that the monsters can exist in our bodies, but this knowledge can help me to protect myself better. I noticed that all the characters in the show didn’t seek for medical assistance until the conditions became almost impossible to live with. They all tried to cure themselves with home remedies and painkillers. The show was very well put together; complete with a short history or summary of how a person has come in contact with their nemesis, whether there were parasites or bacteria that caused the problem. The narrator for the show was well informed and there was a medical explanation for what was happening in the body once a person has become a host for whatever monster has invaded them. The medical graphics are informative and detai led in a way that an average person can understand what is happening in an infected body. Although it was hard to watch it was worth it because the show can help us to avoid the invasion of a monster that can kill us. It is good to stay informed and parasite free. I think most people should pay more attention to their bodies and go to see the doctor when something unusual is happening in their system.