Last Sacrifice Chapter Nineteen

THE VANS PARKED IN A semi-remote part of Court, so seeing the area packed with eager Moroi was quite a shock to Lissa. Guardians moved through the people like ghosts, just as they had at the nomination session, keeping as much order as possible. The crowd kept getting in the way as the vans attempted to reach the garages, and faces looked in the windows, trying to get a glimpse of the royal candidates. Lissa stared at the masses in shock, almost afraid to get out. Ariana gave her a comforting smile. â€Å"This is normal. They all want to know who made it and who didn't. They especially want to know.' She inclined her head toward the front of the van. Peering through the windshield, Lissa spied the other six candidates. Because the forest course could only accommodate so many people, the group had been split in half. The rest of the candidates would take the same test tomorrow and were no doubt curious who among their competitors had passed today. Lissa was used to order and decorum around royals, so she was astonished to see such eagerness and frenzy among them now. And of course, the â€Å"common' Moroi who'd been arriving at Court were mixed into the crowd too. Everyone was pushing, peering over the heads of others to find out what had happened. People were shouting some of the candidates' names, and I was half-surprised they hadn't come up with songs and banners. Lissa and her companions exited the van and were met with a wave of cheers that rippled through the crowd. It became obvious pretty quickly who had passed and who hadn't. This sent the crowd abuzz even more. Lissa stood rooted to the spot, staring around and feeling lost. It was one thing to rationally discuss the pros of her running for queen with her friends. It was an entirely different matter to suddenly be thrust into what the elections truly meant. Her focus had been limited to a few things: my safety, finding the murderer, and surviving the tests. Now, as she took in the crowd, she realized the election was bigger than her, bigger than anything she could have imagined. For these people, it wasn't a joke. It wasn't a scam to twist the law and stall for time. Their lives were figuratively on the line. Moroi and dhampirs lived inside various countries and obeyed those laws, but they also obeyed this government, the one that operated out of the Court. It reached around the world and affected every dhampir and Moroi who chose to stay in our society. We had some voting, yes, but the king or queen shaped our futures. The guardians in charge of the crowds finally gave the okay for family members to push through the masses and collect their nominees. Lissa had no one. Both Janine and Eddie–despite earlier claims–were occasionally given temporary tasks that prevented them from being with Lissa 24/7, and she certainly had no family to come for her. Adrift, she felt dizzy in the chaos, still stunned by her moment of clarity. Conflicting emotions warred within her. Deceiving everyone made her feel unworthy, like she should resign her candidacy right now. At the same time, she suddenly wanted to be worthy of the elections. She wanted to hold her head high and walk into the tests proudly, even if she was taking them for ulterior motives. A strong hand at last caught hold of her arm. Christian. â€Å"Come on. Let's get out of here.' He pulled her away, shouldering through the onlookers. â€Å"Hey,' he called to a couple guardians on the crowd's periphery. â€Å"A little help here for the princess?' It was the first time I had ever seen him act like a royal, throwing around the authority of his bloodline. To me, he was snarky, cynical Christian. In Moroi society, at eighteen, he could now technically be addressed as Lord Ozera. I'd forgotten that. The two guardians hadn't. They rushed to Lissa's side, helping Christian part the crowd. The faces around her were a blur, the noise a dull roar. Yet, every once in a while, something would come through to her. The chanting of her name. Declarations about the return of the dragon, which was the symbol of the Dragomir family. This is real, she kept thinking. This is real. The guardians efficiently led her out of it all and back across the Court's grounds to her building. They released her once they considered her safe, and she graciously thanked them for their help. When she and Christian were in her room, she sank onto the bed, stunned. â€Å"Oh my God,' she said. â€Å"That was insane.' Christian smiled. â€Å"Which part? Your welcome home party? Or the test itself? You look like you just †¦ well, I'm not really sure what you just did.' Lissa took a quick survey of herself. They'd given her dry towels on the ride home, but her clothing was still damp and was wrinkling as it dried. Her shoes and jeans had mud all over them, and she didn't even want to think about what her hair looked like. â€Å"Yeah, we–‘ The words stuck on her tongue–and not because she suddenly decided not to tell him. â€Å"I can't say,' she murmured. â€Å"It really worked. The spell won't let me.' â€Å"What spell?' he asked. Lissa rolled up her sleeve and lifted the bandage to show him the tiny tattooed dot on her arm. â€Å"It's a compulsion spell so I won't talk about the test. Like the Alchemists have.' â€Å"Wow,' he said, truly impressed. â€Å"I never actually thought those worked.' â€Å"I guess so. It's really weird. I want to talk about it, but I just †¦ cant.' â€Å"Its okay,' he said, brushing some of her damp hair aside. â€Å"You passed. That's what matters. Just focus on that.' â€Å"The only thing I want to focus on right now is a shower–which is kind of ironic, considering how soaked I am.' She didn't move, though, and instead stared off at the far wall. â€Å"Hey,' said Christian gently. â€Å"What's wrong? Did the crowd scare you?' She turned back to him. â€Å"No, that's the thing. I mean, they were intimidating, yeah. But I just realized †¦ I don't know. I realized I'm part of a major process, one that's gone on since–‘ â€Å"The beginning of time?' teased Christian, quoting Nathan's nonsensical statement. â€Å"Nearly,' she answered, with a small smile that soon faded. â€Å"This goes beyond tradition, Christian. The elections are a core part of our society. Ingrained. We can talk about changing age laws or fighting or whatever, but this is ancient. And far-reaching. Those people out there? They're not all Americans. They've come from other countries. I forget sometimes that even though the Court is here, it rules Moroi everywhere. What happens here affects the whole world.' â€Å"Where are you going with this?' he asked. She was lost in her own thoughts and couldn't see Christian as objectively as I could. He knew Lissa. He understood her and loved her. The two of them had a synchronicity similar to what Dimitri and I shared. Sometimes, however, Lissa's thoughts spun in directions he couldn't guess. He'd never admit it, but I knew part of why he loved her was that–unlike me, who everyone knew was impetuous–Lissa always seemed the picture of calmness and rationality. Then, she'd do something totally unexpected. Those moments delighted him–but sometimes scared him because he never knew just how much a role spirit was playing in her actions. Now was one of those times. He knew the elections were stressing her, and like me, he knew that could bring out the worst. â€Å"I'm going to take these tests seriously,' she said. â€Å"It's–it's shameful not to. An insult to our society. My ultimate goal is to find out who framed Rose, but in the meantime? I'm going to go through the trials like someone who intends to be queen.' Christian hesitated before speaking, a rarity for him. â€Å"Do you want to be queen?' That snapped Lissa from her dreamy philosophizing about tradition and honor. â€Å"No! Of course not. I'm eighteen. I can't even drink yet.' â€Å"That's never stopped you from doing it,' he pointed out, becoming more like his usual self. â€Å"I'm serious! I want to go to college. I want Rose back. I don't want to rule the Moroi nation.' A sly look lit Christian's blue eyes. â€Å"You know, Aunt Tasha makes jokes about how you'd actually be a better queen than the others, except sometimes †¦ I don't think she's joking.' Lissa groaned and stretched back on the bed. â€Å"I love her, but we've got to keep her in check. If anyone could actually get that law changed, it would be her and her activist friends.' â€Å"Well, don't worry. The thing about her â€Å"activist friends' is that they have so much to protest, they don't usually get behind one thing at the same time.' Christian stretched out beside her and pulled her close. â€Å"But for what it's worth, I think you'd be a great queen too, Princess Dragomir.' â€Å"You're going to get dirty,' she warned. â€Å"Already am. Oh, you mean from your clothes?' He wrapped his arms around her, heedless of her damp and muddy state. â€Å"I spent most of my childhood hiding in a dusty attic and own exactly one dress shirt. You really think I care about this T-shirt?' She laughed and then kissed him, letting her mind free itself of worry for a moment and just savor the feel of his lips. Considering they were on a bed, I wondered if it was time for me to go. After several seconds, she pulled back and sighed contentedly. â€Å"You know, sometimes I think I love you.' â€Å"Sometimes?' he asked in mock outrage. She ruffled his hair. â€Å"All the time. But I've got to keep you on your toes.' â€Å"Consider me kept.' He brought his lips toward hers again but stopped when a knock sounded at the door. Lissa pulled back from the near-kiss, but neither of them broke from the embrace. â€Å"Don't answer,' said Christian. Lissa frowned, peering toward the living room. She slipped out of his arms, stood up, and walked toward the door. When she was several feet from it, she nodded knowingly. â€Å"It's Adrian.' â€Å"More reason not to answer,' said Christian. Lissa ignored him and opened the door, and sure enough, my devil-may-care boyfriend stood there. From behind Lissa, I heard Christian say, â€Å"Worst. Timing. Ever.' Adrian studied Lissa and then looked at Christian sprawling on the bed on the far side of the suite. â€Å"Huh,' Adrian said, letting himself in. â€Å"So that's how you're going to fix the family problem. Little Dragomirs. Good idea.' Christian sat up and strolled toward them. â€Å"Yeah, that's exactly it. You're interrupting official Council business.' Adrian was dressed casually for him, jeans and a black T-shirt, though he made it look like designer clothing. Actually, it probably was. God, I missed him. I missed them all. â€Å"What's going on?' asked Lissa. While Christian seemed to consider Adrian's arrival a personal offense, Lissa knew that Adrian wouldn't be here without a good reason– especially this early in the Moroi day. Although he had on his normal lazy smile, there was an excited and eager glitter in his aura. He had news. â€Å"I've got him,' said Adrian. â€Å"Got him trapped.' â€Å"Who?' asked Lissa, startled. â€Å"That idiot Blake Lazar.' â€Å"What do you mean trapped?' asked Christian, as perplexed as Lissa. â€Å"Did you set out a bear trap on the tennis courts or something?' â€Å"I wish. He's over at the Burning Arrow. I just bought another round, so he should still be there if we hurry. He thinks I went out for a cigarette.' Judging from the scent wreathing Adrian, Lissa had a feeling he actually had been out for a cigarette. And likely shared in the round. â€Å"You've been at a bar this early?' Adrian shrugged. â€Å"It's not early for humans.' â€Å"But you're not–‘ â€Å"Come on, cousin.' Adrian's aura didn't have the muted colors of someone who was completely drunk, but yes, he'd definitely had a few drinks. â€Å"If pretty boy Ambrose was right about Aunt Tatiana, then this guy can tell us the names of other jealous women.' â€Å"Why didn't you ask him yourself?' asked Christian. â€Å"Because me asking about my aunt's sex life would be sick and wrong,' said Adrian. â€Å"Whereas Blake will be more than happy to talk to our charming princess here.' Lissa really wanted her bed, but finding out anything to help me sparked a new rush of energy within her. â€Å"Okay, let me at least get some different clothes and brush my hair.' While she was changing in the bathroom, she heard Adrian say to Christian, â€Å"You know, your shirt's kind of grungy-looking. Seems like you could put in a little more effort since you're dating a princess.' Fifteen minutes or so later, the threesome were on their way across Court to a tucked away bar inside an administrative building. I'd been there before and had originally thought it was a weird place to house a bar. But, after a recent stint of filing, I'd decided that if I were doing office work for living, I'd probably want a quick source of alcohol on hand, too. The bar was dimly lit, both for mood and Moroi comfort. Adrian's joking aside, it really was early for Moroi, and only a couple patrons were there. Adrian made a small gesture to the bartender, which I presumed was some kind of ordering signal because the woman immediately turned and began pouring a drink. â€Å"Hey, Ivashkov! Where'd you go?' A voice called over to Lissa and the others, and after a few moments, she spotted a lone guy sitting at a corner table. As Adrian led them closer, Lissa saw that the guy was young–about Adrian's age, with curly black hair and brilliant teal eyes, kind of like Abe's recent tie. It was as though someone had taken the stunning color of both Adrian and Christian's eyes and mixed them together. He had a leanly muscled body–about as buff as any Moroi could manage–and, even with a boyfriend, Lissa could admire how hot he was. â€Å"To get better-looking company,' replied Adrian, pulling out a chair. The Moroi then noticed Adrian's companions and jumped up. He caught hold of Lissa's hand, leaned over, and kissed it. â€Å"Princess Dragomir. It's an honor to meet you at last. Seeing you from a distance was beautiful. Up close? Divine.' â€Å"This,' said Adrian grandly, â€Å"is Blake Lazar.' â€Å"It's nice to meet you,' she said. Blake smiled radiantly. â€Å"May I call you Vasilisa?' â€Å"You can call me Lissa.' â€Å"You can also,' added Christian, â€Å"let go of her hand now.' Blake looked over at Christian, taking a few more moments to release Lissa's hand– seeming very proud about those extra seconds. â€Å"I've seen you too. Ozera. Crispin, right?' â€Å"Christian,' corrected Lissa. â€Å"Right.' Blake pulled out a chair, still playing the over-the-top gentleman. â€Å"Please. Join us.' He made no such offer to Christian, who went out of his way to sit close to Lissa. â€Å"What would you like to drink? It's on me.' â€Å"Nothing,' said Lissa. The bartender appeared just then, bringing Adrian's drink and another for Blake. â€Å"Never too early. Ask Ivashkov. You drink as soon as you roll out of bed, right?' â€Å"There's a bottle of scotch right on my nightstand,' said Adrian, still keeping his tone light. Lissa opened her eyes to his aura. It bore the bright gold all spirit users had, still muddled slightly from alcohol. It also had the faintest tinge of red–not true anger, but definite annoyance. Lissa recalled that neither Adrian nor Ambrose had had a good opinion of this Blake guy. â€Å"So what brings you and Christopher here?' asked Blake. He finished a glass of something amber colored and set it down beside the new drink. â€Å"Christian,' said Christian. â€Å"We were talking about my aunt earlier,' said Adrian. Again, he managed to sound very conversational, but no matter how much he might want to clear my name, delving into the details of Tatiana's murder obviously bothered him. Blake's smile diminished a little. â€Å"How depressing. For both of you.' That was directed to Adrian and Lissa. Christian might as well have not existed. â€Å"Sorry about Hathaway too,' he added to Lissa alone. â€Å"I've heard how upset you've been. Who'd have seen that coming?' Lissa realized he was referring to how she'd been pretending to be angry and hurt by me. â€Å"Well,' she said bitterly. â€Å"I guess you just don't know people. There were a million clues beforehand. I just didn't pay attention.' â€Å"You must be upset too,' said Christian. â€Å"We heard you and the queen were kind of close.' Blake's grin returned. â€Å"Yeah †¦ we knew each other pretty well. I'm going to miss her. She might have seemed cold to some people, but believe me, she knew how to have a good time.' Blake glanced at Adrian. â€Å"You must have known that.' â€Å"Not in the way you did.' Adrian paused to take a sip of his own drink. I think he needed it to restrain any snippy remarks, and honestly, I didn't begrudge him it. I actually admired his self-control. If I'd been in his place, I would have long since punched Blake. â€Å"Or Ambrose.' Blake's pretty smile transformed into a full-fledged scowl. â€Å"Him? That blood whore? He didn't deserve to be in her presence. I can't even believe they let him stay at Court.' â€Å"He actually thinks you killed the queen.' Lissa then added hastily, â€Å"Which is ridiculous when all the evidence proves Rose did it.' Those hadn't been Ambrose's exact words, but she wanted to see if she could elicit a reaction. She did. â€Å"He thinks what?' Yes. Definitely no smile now. Without it, Blake suddenly didn't seem as good-looking as earlier. â€Å"That lying bastard! I have an alibi, and he knows it. He's just pissed off because she liked me better.' â€Å"Then why'd she keep him around?' asked Christian, face almost angelic. â€Å"Weren't you enough?' Blake fixed him with a glare while finishing the new drink in nearly one gulp. Almost by magic, the bartender appeared with another. Blake nodded his thanks before continuing. â€Å"Oh, I was more than enough. More than enough for a dozen women, but I didn't fool around on the side like he did.' Adrian's expression was growing increasingly pained at each mention of Tatiana's sex life. Still, he played his role. â€Å"I suppose you're talking about Ambrose's other girl- friends? † â€Å"Yup. But â€Å"girl' is kind of extreme. They were all older, and honestly, I think they paid him. Not that your mom needed to pay anyone,' added Blake. â€Å"I mean, she's actually pretty hot. But you know, she couldn't really be with him in any real way.' It seemed to take all of them a moment to follow what Blake was alluding to. Adrian caught on first. â€Å"What did you just say?' â€Å"Oh.' Blake looked legitimately surprised, but it was hard to say if it was an act. â€Å"I thought you knew. Your mom and Ambrose †¦ well, who could blame her? With your dad? Though just between you and me, I think she could have done better.' Blake's tone implied exactly whom he thought Daniella could have done better with. In Lissa's vision, Adrian's aura flared red. â€Å"You son of a bitch!' Adrian was not the fighting type, but there was a first time for everything–and Blake had just crossed a serious line. â€Å"My mom was not cheating on my dad. And even if she was †¦ she sure as hell wouldn't have to pay for it.' Blake didn't seem fazed, but maybe things would have been different if Adrian actually had hit him. Lissa rested her hand on Adrian's arm and squeezed it gently. â€Å"Easy,' she murmured. I felt the smallest tingle of calming compulsion move from her into him. Adrian recognized it immediately and pulled his arm back, giving her a look that said he didn't appreciate her â€Å"help.' â€Å"I thought you didn't like your dad,' said Blake, utterly clueless that his news might be upsetting. â€Å"And besides, don't get all pissy at me. I wasn't sleeping with her. I'm just telling you what I heard. Like I said, if you want to start accusing random people, go after someone like Ambrose.' Lissa jumped in to keep Adrian from saying anything. â€Å"How many women? Do you know who else he was involved with?' â€Å"Three others.' Blake ticked off names on his hand. â€Å"Marta Drozdov and Mirabel Conta. Wait. That's two. I was thinking with Daniella; that's three. But then, that's four with the queen. Yeah, four.' Lissa didn't concern herself with Blake's faulty math skills, though it did support Adrian's previous â€Å"idiot' claims. Marta Drozdov was a semi-notorious royal who had taken to traveling the world in her old age. By Lissa's estimation, Marta was hardly in the U.S. most of the year, let alone Court. She didn't seem invested enough to murder Tatiana. As for Mirabel Conta †¦ she was notorious in a different way. She was known for sleeping with half the guys at Court, married or otherwise. Lissa didn't know her well, but Mirabel had never seemed overly interested in any one guy. â€Å"Sleeping with other women wouldn't really give him a motive for killing the queen,' pointed out Lissa. â€Å"No,' agreed Blake. â€Å"Like I said, it's obvious that Hathaway girl did it.' He paused. â€Å"Damned shame too. She's pretty hot. God, that body. Anyway, if Ambrose had killed her, he'd have done it because he was jealous of me, because Tatiana liked me better. Not because of all those other women he was doing.' â€Å"Why wouldn't Ambrose just kill you?' asked Christian. â€Å"Makes more sense.' Blake didn't have a chance to respond because Adrian was still back on the earlier topic, his eyes flashing with anger. â€Å"My mother wasn't sleeping with anybody. She doesn't even sleep with my father.' Blake continued in his oblivious way. â€Å"Hey, I saw them. They were all over each other. Did I mention how hot your–‘ â€Å"Stop it,' warned Lissa. â€Å"It's not helping.' Adrian clenched his glass. â€Å"None of this is helping!' Clearly, things weren't going the way he'd hoped when he'd first summoned Lissa and Christian from her room. â€Å"And I'm not going to sit and listen to this bullshit.' Adrian downed the drink and shot up from his chair, turning abruptly for the exit. He tossed some cash on the bar before walking out the door. â€Å"Poor guy,' said Blake. He was back to his calm, arrogant self. â€Å"He's been through a lot between his aunt, mom, and murdering girlfriend. That's why really, at the end of the day, you just can't trust women.' He winked at Lissa. â€Å"Present company excluded, of course.' Lissa felt as disgusted as Adrian, and a quick glance at Christian's stormy face showed he felt the same. It was time to go before someone really did punch Blake. â€Å"Well, it's been great talking to you, but we need to go.' Blake gave her puppy-dog eyes. â€Å"But you just got here! I was hoping we could get to know each other.' It went without saying what he meant by that. â€Å"Oh. And Kreskin too.' Christian didn't even bother with a correction this time. He simply took hold of Lissa's hand. â€Å"We have to go.' â€Å"Yeah,' agreed Lissa. Blake shrugged and waved for another drink. â€Å"Well, any time you want to really experience the world, come find me.' Christian and Lissa headed for the door, with Christian muttering, â€Å"I really hope that last part was meant for you, not me.' â€Å"That's no world I want to experience,' said Lissa with a grimace. They stepped outside, and she glanced around, in case Adrian had lingered. Nope. He was gone, and she didn't blame him. â€Å"I can see now why Ambrose and Adrian don't like him. He's such a †¦' â€Å"Asshole?' supplied Christian. They turned toward her building. â€Å"I suppose so.' â€Å"Enough to commit murder?' â€Å"Honestly? No.' Lissa sighed. â€Å"I kind of agree with Ambrose †¦ I don't think Blake's smart enough for murder. Or that the motive's really there. I can't tell if people are lying or not from their auras, but his didn't reveal anything overly dishonest. You joked, but if anyone was going to commit a jealous murder, why wouldn't the guys want to kill each other? A lot easier.' â€Å"They did both have easy access to Tatiana,' Christian reminded her. â€Å"I know. But if there is love and sex involved here †¦ it seems like it'd be someone jealous of the queen. A woman.' A long, meaningful pause hung between them, neither of them wanting to say what they were both likely thinking. Finally, Christian broke the silence. â€Å"Say, like, Daniella Ivashkov?' Lissa shook her head. â€Å"I can't believe that. She doesn't seem like the type.' â€Å"Murderers never seem like the type. That's why they get away with it.' â€Å"Have you been studying up on your criminology or something? † â€Å"No.' They reached her building's front door, and he opened it for Lissa. â€Å"Just laying out some facts. We know Adrian's mom never liked Tatiana for personality reasons. Now we find out that they were sharing the same guy.' â€Å"She has an alibi,' said Lissa stonily. â€Å"Everyone has an alibi,' he reminded her. â€Å"And as we've learned, those can be paid for. In fact, Daniella's already paid for one.' â€Å"I still can't believe it. Not without more proof. Ambrose swore this was more political than personal.' â€Å"Ambrose isn't off the list either.' They came to Lissa's room. â€Å"This is harder than I thought it would be.' They went inside, and Christian wrapped his arms around her. â€Å"I know. But we'll do it together. We'll figure it out. But †¦ we might want to keep some of this to ourselves. Maybe I'm overreacting here, but I think it'd be best if we don't ever, ever tell Adrian his mom has an excellent motive for having killed his aunt.' â€Å"Oh, you think?' She rested her head against his chest and yawned. â€Å"Naptime,' said Christian, leading her toward the bed. â€Å"I still need a shower.' â€Å"Sleep first. Shower later.' He pulled back the covers. â€Å"I'll sleep with you.' â€Å"Sleep or sleep?' she asked dryly, sliding gratefully into bed. â€Å"Real sleep. You need it.' He crawled in beside her, spooning against her and resting his face on her shoulder. â€Å"Of course, afterward, if you want to conduct any official Council business †¦' â€Å"I swear, if you say â€Å"Little Dragomirs,' you can sleep in the hall.' I'm sure there was a patented Christian retort coming, but another knock cut him off. He looked up in exasperation. â€Å"Don't answer it. For real this time.' But Lissa couldn't help herself. She broke from his embrace and climbed out of bed. â€Å"Its not Adrian †¦' â€Å"Then it's probably not important,' said Christian. â€Å"We don't know that.'She got up and opened the door, revealing–my mother. Janine Hathaway swept into the room as casually as Adrian had, her eyes sharp as she studied every detail around her for a threat. â€Å"Sorry I was away,' she told Lissa. â€Å"Eddie and I wanted to set up an alternating system, but we both got pulled for duty earlier.' She glanced over at the rumpled bed, with Christian in it, but being who she was, she came to a pragmatic conclusion, not a romantic one. â€Å"Just in time. I figured you'd want to sleep after the test. Don't worry–I'll keep watch and make sure nothing happens.' Christian and Lissa exchanged rueful looks. â€Å"Thanks,' said Lissa.

The medical model emphasizes exclusively

The medical model emphasizes exclusively on treating specific physical diseases and concerned with resolving health problems and does not emphasize prevention. The holistic model of health is defined by the 1947 WHO definition as a â€Å"state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. †The holistic model integrates the medical model perspective and also introduced the idea of positive health.The social epidemiologic model of health focus on individual level measures, or on emergent social properties that have no correlation at the individual level.The social epidemiologic model overlaps with social sciences like medical sociology and medical geography (Krieger 2002, p. 698).(2. )The debate between alternative and conventional medicines can be quite convincing but leaves those who are not aware of this issue to be either dangerously ignorant or confused. Thus, the impact of science on the rise of conventional (AMA) me dicine put at stake human health and human lives. According to the American Medical Association, the fourth leading cause of death in America is the use of prescription drugs.It accounts for reactions to drugs that were properly prescribed and reported cases. Thus, the exact and precise figure is undoubtedly far worse.(3. ) The main difference between modern and alternative traditional approaches is that the modern approach focuses on the cause of the ailment (Magar 2009). The modern approach concentrates on factors causing the disease, remedies and deal with abnormality as an independent entity. The alternative approach often opposes evidence-based practice and including therapies with an historical or cultural basis, but not scientific basis.(4. ) The wellness lifestyles can yield an impact on the lives of individuals. Thus, the wellness lifestyles can be made into a sociological concept given that there is a rising interest in health, fitness and well-being as an individual conce rn and a parallel concern of organizations, communities and nations (Schuster et al. 2004, p. 357-367).(5. ) Cassidy (1995) notes that the two paradigms namely reductionism (used by bioscientists) and holism (used by alternative healthcare) are incompatible to the ways of biomedicine and CAM.This distinction relates to problems in CAM because the two paradigms reflect two different ways of constructing reality in the society. Thus, the integration of CAM into medicine results to therapies of CAM adopted by medicine without the needed philosophical elements.(6. ) RCT has an issue of internal validity versus external validity. Most RCT designs have high validity based on reductionist scientific paradigm but have low external validity due to misrepresentation of the holistic essence of homeopathy. Homeopathy is a popular form of alternative medicine.(7. ) The choice of outcome measures should match the CAM intervention by matching the desired outcomes of the key participants and its va lidity in terms of measuring what it intends to measure in the study as a form of quality assurance.(8. ) The limitation of RCT is that it lacks qualitative measurement of data (Verhoef, 2002). The limitations of RCT with regard to research on CAM are that it is ineffective in testing more than one hypothesis and is an inappropriate model to evaluate the effectiveness of homeopathy.(9.) The outcome research in CAM can have another alternative to RCT when research uses randomized controlled trials to test in efficacy of the medicines used in homeopathy.(10. ) The most important concept I learned from writing this paper is that models of health greatly differ from each other in terms of their respective approaches and goals. The difference of the models of health possesses the same subject of either conventional or alternative medicines. Works Cited Krieger N. A glossary for social epidemiology. J Epidemiol Community Health. Oct 2001;55(10):693-700. Reprinted in Epidemiological Bullet in, Vol. 23 No. 1, March 2002

PSY Assignment

I think that more than half of the student population at accredited u enlistees have tallest tried a drug that would enhance their focus for the sake of doing well In one of more classes. Step 2: (Hypothesis): The hypothesis Is that more than half of the student population at credited universities have used a performance or cognitive enhancer to do well In one of more classes.Step 3 (Predictions): Possible outcomes for this experiment is that 1) None of the stud .NET are aging performance or cognitive enhancing drugs 2) None of the students are admit Eng to taking performance or cognitive enhancing drugs 3) All or some students will admit to taking g performance or cognitive enhancing Step 4 (Research Method): For this experiment it would be best to do an Survey.A sure very would allow the participants to remain anonymous if they wish to do so and this mix HTH also incline them to be more honest. Step 5 (Subject population) : Age: 1823, Gender: Both male and female, Education: underg raduate and/ or In an undergraduate program, Location: University of Arizona, Arizona State university and Northern State University.Today a research method benefits me because It helps me understand how to proper lay collect and record data to find the results of any question that I want the answer to. With the psychology research method It Is easier to effectively test subjects while upholding all the ethical guldens set by the American Psychological Escalation (PAP). Since all the steps are easy to fool low as of today feel that I can successfully pick a topic that I want to research and find an NAS were to it.

Microprocessor Essay Example | Topics and Well Written Essays - 1000 words

Microprocessor - Essay Example The 80286 contains a total of fourteen registers that are of interest to the application programmer. These registers may be grouped into four basic categories: General registers. These eight 16-bit general-purpose registers are used primarily to contain operands for arithmetic and logical operations. Segment registers. These four special-purpose registers determine, at any given time, which segments of memory are currently addressable. Status and Control registers. These three special-purpose registers are used to record and alter certain aspects of the 80286 processor state. For descriptive purposes, the 80286 instruction set is partitioned into three distinct subsets: the Basic Instruction Set, the Extended Instruction Set, and the System Control Instruction Set. The "hierarchy" of instruction sets defined by this partitioning helps to clarify the relationships between the various processors in the 8086 family . Five of the general- purpose registers are available for offset addres s calculations. These five registers, shown in figure 2-4, are SP, BP, BX, SI, and DI. SP is called a pointer register; BP and BX are called base registers; SI and DI are called index registers. The Basic Instruction Set, comprises the common subset of instructions found on all processors of the 8086 family. Included are instructions for logical and arithmetic operations, data movement, input/output, string manipulation, and transfer of control.... address lines, giving these processors one megabyte of addressability (2^20 = 1MB). The 80286, with its 24 address lines, gives 16 megabytes of addressability (2^24 = 16 MB). The 286 was designed to run multitasking applications, including communications (such as automated PBXs), real-time process control, and multi-user systems. The 80286 contains a total of fourteen registers that are of interest to the application programmer. These registers may be grouped into four basic categories: General registers. These eight 16-bit general-purpose registers are used primarily to contain operands for arithmetic and logical operations. Segment registers. These four special-purpose registers determine, at any given time, which segments of memory are currently addressable. Status and Control registers. These three special-purpose registers are used to record and alter certain aspects of the 80286 processor state. For descriptive purposes, the 80286 instruction set is partitioned into three distinct subsets: the Basic Instruction Set, the Extended Instruction Set, and the System Control Instruction Set. The "hierarchy" of instruction sets defined by this partitioning helps to clarify the relationships between the various processors in the 8086 family . Five of the general- purpose registers are available for offset address calculations. These five registers, shown in figure 2-4, are SP, BP, BX, SI, and DI. SP is called a pointer register; BP and BX are called base registers; SI and DI are called index registers. The Basic Instruction Set, comprises the common subset of instructions found on all processors of the 8086 family. Included are instructions for logical and arithmetic operations, data movement, input/output, string manipulation, and

Recommendation and Implementation plan Essay Example | Topics and Well Written Essays - 500 words - 1

Recommendation and Implementation plan - Essay Example tablished by Market Research that the Customer buying is influenced by Quality of the Diamond, Retailers Goodwill in the market, knowledge and honesty of the Salesperson and recommendation of family and friends, in that order. Perception of Brands is curiously absent from the customer’s perspective and a strategy needs to be devised as a unique selling point (USP) of Canadian ArcticTM. Diamonds are expensive products and it is recommended that Market Segmentation is done for the US market where the company wishes to market it product. It has been observed that there are four kinds of potential buyers in the market viz., Baby Boomers (37-55 years/78 million), Generation X (25-36 years/45 million), Generation Y (18-24/71 million) Gifters, Self Gifters, and Retailers. Of these the Baby Boomers are wealthy and lovers of luxuries but demand value for money. As opposed to this the Gen X and Y spend less on luxuries but are impulsive spenders. The Gifters are casual buyers and the Retailers buy for mostly promoting their own private brands. Next emphasis should be placed on the areas where marketing efforts should be concentrated. It has been observed that maximum sales take place in California and New York with Texas a distant third. The number of outlets also follows the same pattern. It is therefore desirable to concentrate more on these areas as they will provide the maximum turnover. In these territories, particularly in the high exposure retail showrooms, the company should participate in Trade shows and offer retailer and salesperson promotion kits. They should also get celebrity sponsors to endorse the product for value effect. Similarly advertisements should be carried in glossy and glamour magazines which have high percentage of circulation among the wealthier population. Strategic Marketing Plans will not be of much use unless there is a solid implementation process in place. It is imperative that the amount of $ 300,000 is well spent. It has been seen

What caused the surge in oil price during the period 2000-2005 Essay

What caused the surge in oil price during the period 2000-2005 - Essay Example This projection is mainly attributed to the changes in demand and supply by the non-OPEC and OPEC members. The oil price surge is a major economic issue as it slows down global economic recovery. This paper highlights the major issues that are behind the oil price surge during the 2000 – 2005 periods. In this essay we seek to address the question of the effects of additions to OPEC capacities and economic activities on oil prices (mostly in the future) and why oil prices are literally depend on the OPEC’s ability to maintain control over the marginal supplies of oil. Global oil demand had a slow increase in the year 2000 – 2005 periods than it did in the last five years. Each time when the demand growth accelerates annually, the prices are always seen to rise and vice versa. The yearly rate of demand growth has changed markedly over the last few years with this kind of growth dipping into a low of just about half a percent in the year 2001 and a then having a sha rp rise through 2004. During the year 2004, the oil demand had surged by 4% and this was the fastest rate since 1977. In the year 2005, the demand growth fell callously although its growth rate was maintained above 1%. A significant part of this growth was contributed by China and most of the rest of the developing Asia (Menecon Ltd. 2006, p1). The United States and other non-Asian developing countries accounted for the bigger share of the volume increase in demand during the 2000 – 2005 periods. With the supply capacity going high in the recent years, the rise in demand has squeezed spare capacity in pushing up prices. Causes of Oil Surge during the 2000 – 2005 Period During 2000 – 2005 period great oil surges was experienced, the possible causes of this surge in oil prices include: supply, monetary inflation and the value of the US dollar, demand and investment demand. Supply Lower supply of oil is considered to be a main lasting fundamental cause of the risin g prices during the period 2000 – 2005. The intermittent supply contributed majorly on the surges in oil prices and therefore, the oil price crises. Monetary Inflation and the Value of the US Dollar Price inflation develops from monetary increase and other economic policies. Wobbly monetary policy attained from the Federal Reserve and other central banks is listed as one of the major contributor to the increase in the oil prices. It therefore forms the main cause in the dollar devaluation and commodity speculation characteristic with changes in oil prices. The value of the US dollar also had some impact on the oil prices as oil is normally quoted and traded in US dollars. This means that the value of the dollar determines the rise or fall in the oil prices. Demand High demand for oil is also one of the main causes of the surge in the oil prices. The demand for the crude oil was seen to be growing at an average of 1.76% per year. This effective growth (in percentage) was recor ded from the year 1994 to 2006. Still, during this period (1994 to 2006), a higher rise of 3.4% was experienced in the year 2003 to 2004. As the demand for oil is on a high rise all over the world an increase in demand of 37% is expected by 2030 hence the demand for oil is projected to have an increase. Normally, increase in oil prices reflects on the global demand rise for oil. Prices usually affect the demand as the relationship between them is considered to be not a way street. If the demand gets a certain shift a direct impact on the oil prices will take place; when the oil prices get affected thy in general will lead to a (United Nations staff 2005, p6). Investment Demand Invest demand is also one of major issues to the surge in oil during the 2000 - 2005 period. Investment demand usually occurs when investors pay for future

The Enduring Wisdom of the Spiritual Master Essay

The Enduring Wisdom of the Spiritual Master - Essay Example She attributed her recovery to St. Joseph, to which she remained devoted. However, her life changed after she experienced â€Å"the sorely wounded Christ’s† vision. After experiencing the vision, Teresa encountered a number of ecstatic experiences that influenced her into focusing more on the passion of Christ. The visions acted as her impetuous that influenced her into setting herself to the reorganization of her order. She began this reformation by attempting to master herself, as well as adhere to her rule. She tried to create a primitive Carmelite by gathering some of her Sisters in Carmel to concretize her idea of a monastery. She received support from St. Peter of Alcantara, her confessor and a number of learned individuals as she started to work towards the achievement idea. This idea materialized in 1562 after the clothing of the four novices and the opening of St. Joseph Monastery. Teresa’s external activities were adjunct to her internal spiritual graces (Cannata 2). The realization of her idea made her happy, after which she tenaciously resisted several revelations for about two years. Subsequently, she experienced the initial intellectual and non-intellectual visions depicting Christ’s humanity. This humanity became the heart of her loving attention, as well as the source of the intimate graces she was able to enjoy for several years. Her possession of the love of God created in her an enormous desire to see God and to die so that she could see Him. These graces were necessary for sustaining her as she was trying to actualize and reinforce her reformation work. Teresa received confirmation for the will to work courageously for God’s glory since her intention was to save the many souls that were being lost. Upon visiting Avila, John Baptist Rossi authorized Teresa to establish other monasteries of nuns. This authorization led her to institute several monasteries

Financial Statement Analysis Research Paper Example | Topics and Well Written Essays - 2000 words

Financial Statement Analysis - Research Paper Example 2.1.1 Which three (3) assets are most significant to the company? Using the notes to the financial statements, discuss the accounting methods used to value assets. What method(s) do the companies use to value inventory? What depreciation method(s) do the companies use to value property, plant and equipment? How are accounts receivable valued? The most significant assets of Home in 2010 included merchandise inventory, Property and equipment and other current assets constituting about 26%, 62% and 3% of the total assets respectively. Compared to 2009, the most significant were merchandise inventory, Property and equipment and other current assets constituting about 25%, 63% and 3% of the total assets respectively. The companies appear to have inventories and property as top two most significant assets for both years and this should describe the nature of the industry that they are in. The three most significant assets of Lowe for 2010 would include merchandise inventory, Property and long-term investment constituting about 24.7%, 65.5 and 3% of the total assets respectively. Compared to 2009, the most significant were merchandise inventory, Property and cash and cash equivalents constituting about 25%, 68.2 and 1.9% of the total assets respectively. For Home depot on the other hand, Bother company value their inventory using lower of cost or market under first in first out (FIFO) basis. Both companies used the straight-line depreciation method Receivables are valued by both companies using fair value. The three of the most significant liabilities to HD include the following: Accounts Payable, Accrued Expenses and Long-term Debt. For HD There have been no significant change to liabilities from 2009 to 2010 except on deferred tax which decreased by 15%. The three of the most significant liabilities to LOW include the following:

Explain the differences between the regulation of abortion in the Essay

Explain the differences between the regulation of abortion in the United Kingdom and the United States of America; and speculate how any reforms may occur - Essay Example The first is when a woman’s pregnancy seems to be life threatening. The latter term refers to any significant risks to both the physical and mental health of the patient. The medical risk must be something assessed by two doctors if the pregnancy has exceeded twenty four weeks. In the event that the pregnancy would cause severe medical damage to a mother or that it happens to be a medical emergency, then consent from just one doctor is enough to terminate the pregnancy. 2 The second circumstance that would allow for an abortion in the United Kingdom is in the event that the unborn child will have extreme mental or physical abnormalities. The abnormalities must be certified by a medical practitioner. It should be noted that the above two restrictions apply in Wales, Scotland, and England but not in Northern Ireland. All in all, abortions in the UK are illegal except for medical reasons. In this country, abortion was legalised in the 1970s after the proverbial case of Roe v. Wade. However there are still numerous laws in place to regulate abortions so as to ensure that it is done well; the first among these are the TRAP laws. 3 These are laws are directed towards medical practitioners offering abortions and do not apply to other types pf practitioners. The government introduced this so that there could be greater safety in the process of conducting abortions. These laws mostly dwell on the way the abortion procedure is conducted rather than the choices made prior to the abortion. Consequently, the laws normally affect doctors rather than mothers but the effects are also felt by women. His first requirement in these laws is that doctors offering abortion services need to have a valid licence and failure to do so will result in fines. The other one is that the department of health can check on performance of procedures during any hour of operation, clinics are

Confidence Interval of Proportions Assignment Example | Topics and Well Written Essays - 500 words

Confidence Interval of Proportions - Assignment Example 1) Have you completed the weekly reading assignment? Yes I have. 2) For the first problem, what is the Margin, and what are the lower and upper confidence limits? The margin of error is 0.0568 and the confidence interval is between .2933 and .4067 or simply (29.33% to 40.67%). 3) For the second problem, what is the Margin, and what are the lower and upper confidence limits? The margin of error is 0.03624 and the confidence interval is between .286 and .3585 or simply (28.6% to 35.85%). 4) For the third problem, what is the required sample size? The required sample size is 545. 5) Does the confidence interval estimate vary from sample to sample? Yes it does. A large sample size improves the precision of the confidence interval (Rumsey, 2005). This is because large sample size results to smaller standard errors meaning that the confidence interval will be narrower and clear-cut .As such, the choice of the sample size influences the confidence interval to use. 6) What percentage of all confidence interval estimates contains the true population parameter? The percentage will depend on the confidence level from the given problem or the significance level (alpha) that the researcher has decided to use.

Supply and demand Essay Example for Free

Supply and demand Essay Coffee is the world’s second largest traded commodity it is used not only for drinking but for soft drinks and cosmetics as well, it is second only to oil according to all imports and exports from all countries. They are two main types Arabica coffee (most people are used to this and are more popular) and there is Robusta coffee. In the last two years the prices of coffee have been gradually falling (Ycharts. (2013). Coffee Arabica Price) alongside this, the supply of coffee has also been falling. Although there have been some price fluctuations at times and this could end up really affecting an economy that depends on coffee. The reason that this is such a big deal is because the countries that heavily depend on coffee exports are usually developing countries and with the price of coffee falls, so does their rate of development, these countries involve countries such as Vietnam, Ethiopia, Peru and Guatemala who are all within the world’s top ten coffee producers (Justin Doom. (2011). World’s Top 10 Coffee-Producing Countries in 2010-2011). When these economies are weakened, they face to their governments, who need to somehow intervene in the coffee market and try to stabilise the prices so that they can reach their ultimate goal to continue to develop. Price stability in the coffee market is an ideal scenario in a market where the prices for coffee do not alter drastically. They may raise a little or fall, but never by a noticeable amount, and are easy to predict, which can help coffee producers plan for the far future. It is not only important to coffee producers, but to the economy as whole, if the prices for coffee are unstable, for some countries this could have a huge impact on the inflation levels. The diagram below describes how an unstable price for coffee can increase and affect the short run aggregate supply and cause the general price level for the economy to rise and therefore causing inflation as they did in July 2012 (Ycharts. (2013). There are several reasons why the prices of coffee have been fluctuating, but still gradually falling. The first reason is that coffee or coffee beans are extracted from plants. These plants must first be grown, then harvested. There is only so much mankind can do to ensure that there is always excess coffee however sometimes natural disasters can occur, and there is nothing that farmers can do to prevent this, when natural disasters occurs it means that farmers will have small yields and supply for coffee will be low, for example Colombia, one of the world’s leading coffee producers and exporters, in recent years have been experiencing poor weather conditions which have led to production falling by 12% to 7. 809 million bags in 2011 which is a record low that hasn’t been seen since 1976. This can cause the price to increase seeing as coffee is the world’s second most demanded commodity. These poor conditions consisted of excessive heavy rainfall, disease, pest and limited sunlight (Zacks Equity Research. 2 (2012)). The graph below shows how the supply for coffee has decrease leading to a rise in price On the other hand this is just an example for Colombia and for the rest of the world the prices for coffee have been falling for the last four years, this is due to wealthy individuals and companies use their money to invest in the global coffee suppliers, and other large coffee producers such as Brazil (the world number three) has been turning out high yield and is expected to do so in following years. Fain Shaffer, president of infinity trading crop expects coffee to be traded by one dollar to a pound of coffee, figures which have not been seen since September 2006. (Alexandra Wexler. (09/17/2013)) Coffee prices may currently be relatively stable at the moment however according to research conducted by the Royal Botanical Edinburgh along with Ethiopian scientists and London’s Botanical Garden, Kew, have predicted that wild Arabica coffee will be extinct by the year 2080. If the prices begin to fall, all of a sudden the prices for coffee will no longer be stable. No country operates on a 100% free market. All economies are mixed, some tend to be freer than others, however should a country find that prices are volatile or unfair, they can always rely on the government to intervene, aka government intervention. One way a government could help stabilise the price of coffee is through buffer stock schemes, these schemes focus on the prices of coffee and try to stabilize the price, they do this by first establishing the intervention price, this is a price the government thinks is most suitable for coffee. Once this has been established the government will then buy up a lot of coffee when the price is at its lowest, they continue to do this until prices for 3 coffee begin to rise again, and to balance out the price to make sure it is at the intervention price. They are constantly buying coffee to balance out the price. This is an effective method in theory however in real life they do not work out as planned because the people in charge of the buffer stock tend to get greedy and try to maximise profits rather than help the economy as a whole and end up just constantly buying till they go bust. A good example of a successful buffer stock scheme is in Brazil, for years Conab, Brazil’s official crop bureau has been buying coffee at low prices and uses it to help local producers when the selling price for coffee is too low. Between 2003-2004 Conab had just under four million KGs accumulated. (Geoff Riley. (2012)) Another issue with this is that it is very difficult for a government to raise enough money to buy up enough coffee to influence the natural supply and demand. It is also expensive to store large amounts of coffee and because it is an agricultural good it has a shelf life. Another method the government could intervene is through Subsidies. A subsidy is a grant given by the government in order to increase production, this would help producers who have produce low yields due to high taxation and or high costs If the government could make coffee more attractive this could help stabilise the price if supply started to fall. This however is not a very effective method because it can only help bring the supply of coffee back up, and it may be able to work to well, if producers begin to produce excess supply the prices of coffee could start to increase sharply leaving the prices unstable yet again. Buffer stock schemes are the most ideal way for a government to ensure price stability, and the success of the scheme depends heavily on whether or not the Government can provide proper facilities to accommodate huge quantities of coffee and are able to afford to buy enough Coffee to be able to alter the market forces so that if prices go to high they can bring them down and if they go to low that they can bring them back up again, if not it could result in huge losses for the economy and even end up setting the country back. The supply and demand of coffee can and always will be prone to quick sudden changes due to circumstances that are unavoidable.

Supply Chain Management Essay Example for Free

Supply Chain Management Essay All supply chain management shares one common, and central, objective – to satisfy the end customer. All stages in a chain must eventually include consideration of the final customer, no matter how far an individual operation is from the end-customer. Each operation in the chain should be satisfying its own customer, but also making sure that eventually the end-customer is also satisfied. Supply chain objectives Meeting the requirements of end-customers requires the supply chain to achieve appropriate levels of the five operations performance objectives: quality, speed, dependability, flexibility and cost. Quality – the quality of a product or service when it reaches the customer is a function of the quality performance of every operation in the chain that supplied it. Errors in each stage of the chain can multiply in their effect on end-customer service. Speed has two meanings in a supply chain context. The first is how fast customers can be served, an important element in any business’s ability to compete. However, fast customer response can be achieved simply by over-resourcing or over-stocking within the supply chain. Dependability – like speed, one can almost guarantee ‘on-time’ delivery by keeping excessive resources, such as inventory, within the chain. However, dependability of throughput time is a much more desirable aim because it reduces uncertainty within the chain. Flexibility – in a supply chain context is usually taken to mean the chain’s ability to cope with changes and disturbances. Very often this is referred to as supply chain agility. The concept of agility includes previously discussed issues such as focusing on the end-customer and ensuring fast throughput and responsiveness to customer needs. But, in addition, agile supply chains are sufficiently flexible to cope with changes, either in the nature of customer demand or in the supply capabilities of operations within the chain. Cost – in addition to the costs incurred within each operation, the supply chain as a whole incurs additional costs that derive from each operation in a chain doing business with each other. These may include such things as the costs of finding appropriate suppliers, setting up contractual agreements, monitoring supply performance, transporting products between operations, holding inventories, and so on. 5 factors for rating alternative suppliers Short-term ability to supply Range of products or services provided Quality of products or services Responsiveness Dependability of supply Delivery and volume flexibility Total cost of being supplied Ability to supply in the required quantity Long-term ability to supply Potential for innovation Ease of doing business Willingness to share risk Long-term commitment to supply Ability to transfer knowledge as well as products and services Technical capability Operation capability Financial capability Managerial capability Choosing suppliers should involve evaluating the relative importance of all these factors. 6 supply chain relationship business-to-business (B2B) relationships are by far the most common in a supply chain context and include some of the e-procurement exchange networks discussed earlier. Business-to-consumer (B2C) relationships include both ‘bricks and mortar’ retailers and online retailers. Consumer-to-business (C2B) relationships involve consumers posting their needs on the web (sometimes stating the price they are willing to pay), companies then deciding whether to offer. Customer-to-customer (C2C) or peer-to-peer (P2P) relationships include the online exchange and auction services and file sharing services. 7 types of supply chain relationship The very opposite of performing an operation in-house is to purchase goods and services from outside in a ‘pure’ market fashion, often seeking the ‘best’ supplier every time it is necessary to purchase. Each transaction effectively becomes a separate decision. The relationship between buyer and seller, therefore, can be very short-term. Once the goods or services are delivered and payment is made, there may be no further trading between the parties. The advantages of traditional market supplier relationships are usually seen as follows: ââ€"  They maintain competition between alternative suppliers. This promotes a constant drive between suppliers to provide best value. ââ€"  A supplier specializing in a small number of products or services  (or perhaps just one), but supplying them to many customers, can gain natural economies of scale. This enables the supplier to offer the products and services at a lower price than would be obtained if customers per formed the activities themselves on a smaller scale. ââ€"  There is inherent flexibility in outsourced supplies. If demand changes, customers can simply change the number and type of suppliers. This is a far faster and simpler alternative to having to redirect their internal activities. ââ€"  Innovations can be exploited no matter where they originate. Specialist suppliers are more likely to come up with innovative products and services which can be bought in faster and cheaper than would be the case if the company were itself trying to innovate. ââ€"  They help operations to concentrate on their core activities. One business cannot be good at everything. It is sensible therefore to concentrate on the important activities and outsource the rest. There are, however, disadvantages in buying in a totally ‘free market’ manner: ââ€"  There may be supply uncertainties. Once an order has been placed, it is difficult to maintain control over how that order is fulfilled. ââ€"  Choosing who to buy from takes time and effort. Gathering sufficient information and making decisions continually are, in themselves, activities which need to be resourced ââ€"  There are strategic risks in subcontracting activities to other businesses. An over-reliance on outsourcing can ‘hollow out’ the company, leaving it with no internal capabilities which it can exploit in its markets. Short-term relationships may be used on a trial basis when new companies are being considered as more regular suppliers. Also, many purchases which are made by operations are one-off or very irregular. For example, the replacement of all the windows in a company’s office block would typically involve this type of competitive-tendering market relationship. In some public-sector operations, purchasing is still based on short-term contracts. This is mainly because of the need to prove that public money is being spent as judiciously as possible. However, this short-term, price-oriented type of relationship can have a downside in terms of ongoing support and reliability. This may mean that a short-term ‘least-cost’ purchase decision will lead to long-term high cost. Virtual operations An extreme form of outsourcing operational activities is that of the virtual  operation. Virtual operations do relatively little themselves, but rely on a network of suppliers that can provide products and services on demand. A network may be formed for only one project and then disbanded once that project ends. The advantage of virtual operations is their flexibility and the fact that the risks of investing in production facilities are far lower than in a conventional operation. However, without any solid base of resources, a company may find it difficult to hold onto and develop a unique core of technical expertise. The resources used by virtual companies will almost certainly be available to competitors. In effect, the core competence of a virtual operation can only lie in the way it is able to manage its supply network. ‘Partnership’ supply relationships Partnership relationships in supply chains are sometimes seen as a compromise between vertical integration on the one hand (owning the resources which supply you) and pure market relationships on the other (having only a transactional relationship with those who supply you). Although to some extent this is true, partnership relationships are not only a simple mixture of vertical integration and market trading, although they do attempt to achieve some of the closeness and coordination efficiencies of vertical integration, but at the same time attempt to achieve a relationship that has a constant incentive to improve. Partnership relationships are defined as: ‘relatively enduring inter-firm cooperative agreements, involving flows and linkages that use resources and/or governance structures from autonomous organizations, for the joint accomplishment of individual goals linked to the corporate mission of each sponsoring firm’.11 What this means is that suppliers and customer s are expected to cooperate, even to the extent of sharing skills and resources, to achieve joint benefits beyond those they ould have achieved by acting alone. At the heart of the concept of partnership lies the issue of the closeness of the relationship. Partnerships are close relationships, the degree of which is influenced by a number of factors, as follows: ââ€"  Sharing success. An attitude of shared success means that both partners work together in order to increase the total amount of joint benefit they receive, rather than manoeuvring to maximize their own individual contribution. ââ€"  Long-term expectations. Partnership relationships imply relatively long-term commitments, but not  necessarily permanent ones. ââ€"  Multiple points of contact. Communication between partners is not only through formal channels, but may take place between many individuals in both organizations. ââ€"  Joint learning. Partners in a relationship are committed to learn from each other’s experience and perceptions of the other operations in the chain. ââ€"  Few relationships. Although partnership relationships do not necessarily imply single sourcing by customers, they do imply a commitment on the part of both parties to limit the number of customers or suppliers with whom they do business. It is difficult to maintain close relationships with many different trading partners. ââ€"  Joint coordination of activities. Because there are fewer relationships, it becomes possible jointly to coordinate activities such as the flow of materials or service, payment, and so on. ââ€"  Information transparency. An open and efficient information exchange is seen as a key element in partnerships because it helps to build confidence between the partners. ââ€"  Joint problem-solving. Although partnerships do not always run smoothly, jointly approaching problems can increase closeness over time. ââ€"  Trust. This is probably the key element in partnership relationships. In this context, trust means the willingness of one party to relate to the other on the understanding that the relationship will be beneficial to both, even though that cannot be guaranteed. Trust is widely held to be both the key issue in successful partnerships, but also, by far, the most difficult element to develop and maintain. 8 Matching the supply chain with market requirements. The supply chain policies which are seen to be appropriate for functional products and innovative products are termed by Fisher efficient supply chain policies and responsive supply chain policies, respectively. Efficient supply chain policies include keeping inventories low, especially in the downstream parts of the network, so as to maintain fast throughput and reduce the amount of working capital tied up in the inventory. What inventory there is in the network is concentrated mainly in the manufacturing operation, where it can keep utilization high and therefore manufacturing costs low. Information must flow quickly up and down the chain from retail outlets back up to the manufacturer so that schedules can be given the maximum amount of time to adjust efficiently. The chain is then managed to make sure that products  flow as quickly as possible down the chain to replenish what few stocks are kept downstream. By contrast, responsive supply chain policy stresses high service levels and responsive supply to the end-customer. The inventory in the network will be deployed as closely as possible to the customer. In this way, the chain can still supply even when dramatic changes occur in customer demand. Fast throughput from the upstream parts of the chain will still be needed to replenish downstream stocks. But those downstream stocks are needed to ensure high levels of availability to end-customers. 9 The bullwhip effect The ‘bullwhip effect’, is used to describe how a small disturbance at the downstream end of a supply chain causes increasingly large disturbances, errors, inaccuracies and volatility as it works its way upstream. Its main cause is an understandable desire by the different links in the supply chain to manage their production rates and inventory levels sensibly. Miscommunication in the supply chain Whenever two operations in a supply chain arrange for one to provide products or services to the other, there is the potential for misunderstanding and miscommunication. This may be caused simply by not being sufficiently clear about what a customer expects or what a supplier is capable of delivering. There may also be more subtle reasons stemming from differences in perception of seemingly clear agreements. The effect is analogous to the children’s game of ‘Chinese whispers’. The first child whispers a message to the next child who, whether he or she has heard it clearly or not, whispers an interpretation to the next child, and so on. The more children the message passes between, the more distorted it tends to become. The last child says out loud what the message is, and the children are amused by the distortion of the original message. Reducing bullwhip effect Reduce lead time Information sharing One of the reasons for the fluctuations in output described in the example earlier was that each operation in the chain reacted to the orders placed by  its immediate customer. None of the operations had an overview of what was happening throughout the chain. If information had been available and shared throughout the chain, it is unlikely that such wild fluctuations would have occurred. It is sensible therefore to try to transmit information throughout the chain so that all the operations can monitor true demand, free of these distortions. An obvious improvement is to make information on end-customer demand available to upstream operations. Inventory pooling Stable prices 10 time compression One of the most important approaches to improving the operational efficiency of supply chains is known as time compression. This means speeding up the flow of materials down the chain and the flow of information back up the chain. The supply chain dynamics effect was due partly to the slowness of information moving back up the chain.

Skills as a photographer

Skills as a photographer Annie Leibovitz was born in Connecticut on the 2nd of October, 1949. She was one of six children born to Sam and Marilyn Leibovitz, a dance instructor. In 1967, Leibovitz registered at the San Francisco Art Institute. She developed a love for photography while on a trip to Japan with her mother in the summer of her sophomore year. That autumn she started classes in photography [1]I was totally seduced by the wonderment of it all, she told a writer for Art News. To see something that afternoon and have it materialize before your eyes that same day. There was a real immediacy to it. I lived in the darkroom. A trip to Israel helped her to really develop her skills as a photographer. While she was still a student at the institute, Rolling Stone magazine gave Leibovitz her first commercial assignment after she approached Jann Wenner, in 1970, the founding editor of Rolling Stone magazine, which he had recently launched. The assignment was to take a picture of the Beatles musician John Lennon. The black and white image of the unkempt rock star was released on the cover of the 1971 issue on January 21st. In 1973 when she was only 23 years old she was given the job of being the magazines main photographer. She held this position for ten years. In 1974 Rolling Stone began printing the magazine in colour and Leibovitiz changed with it. [2]In school, I wasnt taught anything about lighting, and I was only taught black-and-white, she told ART news in 1992. So I had to learn colour myself. Using colour Leibovitz created her own signature style, the colours can be described as brilliant perhaps because it printed well. Some of the famous musicians she photographed include Bob Dylan, Bob Marley, and Patti Smith. At first her photographs of celebrities were like snapshots, where she tried to capture her subject in the moment. But she soon noticed her ability to put people at ease and help them to let down their guard. She encouraged her subjects to pose for her doing eccentric or silly things which revealed much more of their personalities than a straight portrait ever could. One of Leibovitzs secrets to her success is researching her subjects before she has he photo shoots with them. She reads or watches their works if possible sh e spends time observing their daily lives. However one of the shots that really created her standing as a top photographer is her photo of John Lennon hours before he died. In 1980 leibovitz was sent to take a photograph of John Lennon and Yoko Ono. Leibovitz had originally planned that the couple would pose together nude. Even though Lennon happily obliged, Ono refused to take off her clothes, much to the disappointment of Liebovitz. She decided to work with Yoko Ono clothed and Lennon naked I was thinking that they had never been embarrassed to take their clothes off, that they could do a nude embrace, says Leibovitz, who was photographing them for a Rolling Stone cover to mark the release of Double Fantasy, their first album in five years.[3] John took his clothes off in a few seconds, but Yoko was very reluctant. She said, Ill take my shirt off but not my pants. I was kinda disappointed, and I said, Just leave everything on. We took one Polaroid, and the three of us knew it was profound right away.. The final image shows John Lennon nude, curled around a fully dressed Yoko Ono. This shot was used for the cover of the commemorative issue of the Rolling Stone. Another project which helped push her to the top was her documentation of the Rolling Stones 1975 world tour. The photographs she created while she lived and travelled with the band have been described as being [4]some of the most eloquent images ever made of the world of Rock and Roll.. This project helped give Leibovitz a big name among the top photographers. However she unfortunately became involved with drugs, being part of the groups entourage and with the burden of her career pushed her towards the usage of cocaine. She has been quoted in Vanity Fair that [5]I went on that [Rolling Stones] tour to get to the heart of something, to see what it was like. People always talk about the soul of the sitter [in a photograph], but the photographer has a soul, too. And I almost lost it. It took Leibovitz almost five years to get over the tour, which she did and her career continued to take new heights. In one interview Leibovitz talks about the effect being on the Rolling Stones tour aff ected her [6] Ive been on many tour buses and at many concerts, but the best photographs Ive made of musicians at work were done during that Rolling Stones tour. I probably spent more time on it than on any other subject. For me, the story about the pictures is about almost losing myself, and coming back, and what it means to be deeply involved in a subject. You can get amazing work, but youve got to be careful. The thing that saved me was that I had my camera by my side. It was there to remind me who I was and what I did. It separated me from them. Over time she became known for her picture of celebrities, some of these photos include Whoopi Goldberg with only her face, arms, and legs peeking out of a bathtub full of milk and the artist Christo wrapped in fabric as if he was in one of his own pieces of art. Andy Grundberg a well known photography writer and critic has pointed out that Leibovitz exaggerates the distinctive characteristic of [the celebrities] public image in a way thats funny and deflating. One of her most controversial photographs was a 1992 Vanity Fair cover. It featured the actress Demy Moore who was nude and pregnant. http://www.answers.com/topic/annie-leibovitz , 12:15, 04-12-09 http://www.pbs.org/wnet/americanmasters/episodes/annie-leibovitz/life-through-a-lens/16/ , 12:30, 04-12-09 http://www.rollingstone.com/news/story/6478087/behind_the_photo_john_and_yoko, 12:40 04-12-09 http://www.novelguide.com/a/discover/ewb_09/ewb_09_03807.html, 12:45, 04-12-09 http://www.novelguide.com/a/discover/ewb_09/ewb_09_03807.html, 12:57,04-12-09 http://kottke.org/08/09/annie-leibovitz-on-photography 14:30, 04-12-09

To Fast or Not to Fast? Essay -- Weight Loss Dieting Diet Papers

To Fast or Not to Fast? Introduction "Rapid weight loss", "quick and easy weight loss", "preventative", "therapeutic" and "low cost"; with these guarantees, who would not want to attempt a seemingly unchallenging fasting diet!? According to a report on the Food and Drug Administration (FDA) web site, as of 1995, tens of millions of Americans are dieting at any given time, in the process spending more than $33 billion annually on weight-reduction products. Are you playing the weight loss game? Here I will identify weight-loss programs advertised on the internet, discuss their claims to success, highlight specific fallacious claims, and report on findings of both the FDA and various medical studies. What’s on the Web? A collection of "easy" fasting or very low-calorie weight loss plans advertised on the world wide web includes the following: California Dreaming, The Wellness Center of Alaska’s "weight loss on-the-web", Medifast, Optifast, 4 Season Weight Control Center’s "medically supervised weight loss program", Liquid Fasting Diet, All-natural Aspen Spa diet program, and various methods compiled by Fasting Center International. As an example of programs guaranteeing a quick fix to weight problems, I will focus on both the Medifast and Fasting Center International (FCI) methods and claims concerning weight loss. Medifast According to the Shape Up America web site, a supporter of the Medifast product, it is a "physician-supervised very low-calorie diet program of fortified meal replacements providing 450-500 calories per day". (http://www.shapeup.org/sua/publications/hwhl/partax9c.html) The purpose of Medifast is to promote quick and healthy weight loss to its customers by creating a great defic... ... Dulloo, A. G. Human pattern of food intake and fuel-partitioning during weight recovery after starvation: a theory of autoregulation of body composition. Proceedings of the Nutrition Society. 56: 25-40, 1997. Macdonald, I. A. and J. Webber. Feeding, fasting and starvation: factors affecting fuel utilization. Proceedings of the Nutrition Society. 54: 267-274, 1995. Masoro, Edward J. McCay’s hypothesis: undernutrition and longevity. Proceedings of the Nutrition Society. 54: 657-664, 1995. Schwartz, Michael W. and Randy J. Seeley. Neuroendocrine responses to starvation and weight loss. The New England Journal of Medicine. 336(25): 1802-1811, 1997. Schwartz, Michael W., Dallman, Mary F., and Stephen C. Woods. Hypothalamic response to starvation: implications for the study of wasting disorders. American Journal of Physiology. 269: R949-57, 1995.

A Brief History of the Hybrid Vehicle Essay -- essays research papers

Brief History of Hybrid Vehicle Development First built in the early 1900s by inventors tinkering with combinations of the electric motor and the gasoline engine, hybrid vehicles were dropped when gasoline-fueled vehicles became more reliable and easier to start, and gasoline fuel more readily available. Research and development of hybrid vehicles was revived by concern about oil dependency in the1970s and about air pollution in the late 1980s. A number of hybrid vehicles have been built and tested since 1980. Some of these vehicles have impressed analysts with their performance and low levels of exhaust and petroleum consumption. Interest in hybrid vehicles jumped in late 1993 with the announcement of funding for two major collaborations. The US Department of Energy signed a five-year, $138 million development agreement with General Motors and a $122 million agreement with Ford to design and build preproduction hybrid prototypes that could be marketed in less than 10 years.[1] All these were done because hybrid electric vehicles are expected to be the future of vehicles worldwide. Definition One considers a vehicle to be a hybrid when it combines two or more sources of power. For example, a mo-ped (a motorized pedal bike) is a hybrid because it combines the power of a gasoline engine with the pedal power of its rider. Similarly, the gasoline-electric hybrid car is a combination of both an electric car and a gasoline-powered one. That is, it makes use of both electricity and gasoline to provide the energy to turn the wheels of the car. Figure 1 shows a gas-powered car. [2] Components Of A Gasoline Powered Car The 4-cylinder engine converts gasoline into motion so that the car can move. The easiest way it does this is to burn the gasoline inside the engine. Therefore is acts as an internal combustion engine i.e. combustion takes place internally. Gasoline powered car engines typically have over 100 horsepower and operate at speeds up to 8000 RPM. The fuel tank stores and supplies gasoline to the engine. It can typically store enough fuel to provide the engine with energy capable of moving the car through a distance of 300 miles or more. Figure 2 below shows an electric car, which has a set of batteries that provides electricity to an electric motor. The motor turns a transmission, and the transmission turns the wheels. [3]... .......................How I found my references........................... Send me your comments...........................Homepage...........................Comments -------------------------------------------------------------------------------- [1] Daniel Sperling; Future Drive: Electric Vehicles and Sustainable Transportation, pg 101 [2] http://auto.howstuffworks.com/hybrid-car1.htm [3] http://auto.howstuffworks.com/hybrid-car1.htm [4] http://auto.howstuffworks.com/hybrid-car2.htm [5] http://auto.howstuffworks.com/hybrid-car3.htm [6]http://web1.infotrac.galegroup.com/itw/infomark/155/298/52759225w1/purl=rc1_ITOF_0_A122672547&dyn=5!xrn_15_0_A122672547?sw_aep=swar94187, Electric and Hybrid Vehicles Today, Sept 30, 2004 p0 , Article A122672547 [7] http://auto.howstuffworks.com/hybrid-car4.htm [8] http://www.morphizm.com/observations/borah/borah_corner1.html [9] Daniel Sperling; Future Drive: Electric Vehicles and Sustainable Transportation, pg 100 [10] http://auto.howstuffworks.com/hybrid-car8.htm [11] Daniel Sperling; Future Drive: Electric Vehicles and Sustainable Transportation, pg 2 [12] Electric and Hybrid Vehicles Today, Oct. 7, 2004, p0; Article A122947647 A Brief History of the Hybrid Vehicle Essay -- essays research papers Brief History of Hybrid Vehicle Development First built in the early 1900s by inventors tinkering with combinations of the electric motor and the gasoline engine, hybrid vehicles were dropped when gasoline-fueled vehicles became more reliable and easier to start, and gasoline fuel more readily available. Research and development of hybrid vehicles was revived by concern about oil dependency in the1970s and about air pollution in the late 1980s. A number of hybrid vehicles have been built and tested since 1980. Some of these vehicles have impressed analysts with their performance and low levels of exhaust and petroleum consumption. Interest in hybrid vehicles jumped in late 1993 with the announcement of funding for two major collaborations. The US Department of Energy signed a five-year, $138 million development agreement with General Motors and a $122 million agreement with Ford to design and build preproduction hybrid prototypes that could be marketed in less than 10 years.[1] All these were done because hybrid electric vehicles are expected to be the future of vehicles worldwide. Definition One considers a vehicle to be a hybrid when it combines two or more sources of power. For example, a mo-ped (a motorized pedal bike) is a hybrid because it combines the power of a gasoline engine with the pedal power of its rider. Similarly, the gasoline-electric hybrid car is a combination of both an electric car and a gasoline-powered one. That is, it makes use of both electricity and gasoline to provide the energy to turn the wheels of the car. Figure 1 shows a gas-powered car. [2] Components Of A Gasoline Powered Car The 4-cylinder engine converts gasoline into motion so that the car can move. The easiest way it does this is to burn the gasoline inside the engine. Therefore is acts as an internal combustion engine i.e. combustion takes place internally. Gasoline powered car engines typically have over 100 horsepower and operate at speeds up to 8000 RPM. The fuel tank stores and supplies gasoline to the engine. It can typically store enough fuel to provide the engine with energy capable of moving the car through a distance of 300 miles or more. Figure 2 below shows an electric car, which has a set of batteries that provides electricity to an electric motor. The motor turns a transmission, and the transmission turns the wheels. [3]... .......................How I found my references........................... Send me your comments...........................Homepage...........................Comments -------------------------------------------------------------------------------- [1] Daniel Sperling; Future Drive: Electric Vehicles and Sustainable Transportation, pg 101 [2] http://auto.howstuffworks.com/hybrid-car1.htm [3] http://auto.howstuffworks.com/hybrid-car1.htm [4] http://auto.howstuffworks.com/hybrid-car2.htm [5] http://auto.howstuffworks.com/hybrid-car3.htm [6]http://web1.infotrac.galegroup.com/itw/infomark/155/298/52759225w1/purl=rc1_ITOF_0_A122672547&dyn=5!xrn_15_0_A122672547?sw_aep=swar94187, Electric and Hybrid Vehicles Today, Sept 30, 2004 p0 , Article A122672547 [7] http://auto.howstuffworks.com/hybrid-car4.htm [8] http://www.morphizm.com/observations/borah/borah_corner1.html [9] Daniel Sperling; Future Drive: Electric Vehicles and Sustainable Transportation, pg 100 [10] http://auto.howstuffworks.com/hybrid-car8.htm [11] Daniel Sperling; Future Drive: Electric Vehicles and Sustainable Transportation, pg 2 [12] Electric and Hybrid Vehicles Today, Oct. 7, 2004, p0; Article A122947647

Themes of Lord of the Flies :: essays research papers

The theme of the novel is the collapse of the society. The friendships among the boys are destructive because they do not realize the beast inside of them. They show their ego to each other. The beast is something evil within themselves and it is not a savage animal that is caved ‘Lord of the Flies’. The conch shell symbolizes the law and order among the children who trapped in the deserted tropical island. It is used to call the groups of the boys to assembly in a certain place. Ralph, the chief and the central leadership of the group is responsible to take care the conch. The conch shell represents the authority which the boys must obey. The conch is an instrument like a trumpet blowing to order the boys. Finally, the conch shell is broken down into pieces and the leadership is torn down and abandoned. The atmosphere of the island society collapses into chaos and no longer peace remind. The beast in the story symbolizes the gradation of the morality among the boys. The compete each other becoming in the last survivor and the commander of group. The beast is not a real object which they believe if exists. They don’t realize the internal beast inside of them. Only Simon understands what the real beast is, but is killed when he tries to tell them about that. The beast mind and soul of the boys lead them to the collapse of the society. They begin killing each other and the trustworthy has lost. The parachute man symbolizes the lost of the adult supervisor who has the authority to control over the boys. The moral confrontation has arisen among the boys. The beast inside of them leads them to the anarchy. Also because of the lost of the parachute man, there is no adult who manage them and the situation bring them to the collapse of the society.

Death Changes Essay

Changes in Death Management Practices One of the first noted changes in the book regarding attitudes towards death can be seen with the advances in mass media. As Technology has advanced, so have the ways in which news is reported to the world. Radio, Television, and the Internet have given the public many ways of receiving information. When situations portray a perceived threat, people turn to mass media for information. The ability to access information regarding worldwide disasters, terrorism, and other acts of brutality make us feel like survivors of death. Because we are able to see and hear about things that we have no firsthand knowledge of, we feel like we are experiencing it to some degree. (DeSpelder, Strickland pg. 6) During the Vietnam War, television gave people access to images of things that were happening half a world away. In no other time were daily doses of violence to this degree a part of everyday life. Media analyst George Gerbner observed that these depictions of death evoked a heightened sense of danger, insecurity, and mistrust which contributed to an â€Å"irrational dread of dying and thus to diminished vitality and self-direction in life† (DeSpelder, Strickland pg. 8) Life expectancy and Mortality Rates have been affected by technology as well. In 1900, the average life expectancy was 47 years of age in the United States. As of 2005, the average life expectancy rose to 78 years of age. This rise can be attributed to epidemiologic transition which moves the largest number of deaths from the young to the old. In the early days people died from infection due to lack of medication and knowledge on how to treat and prevent. As this knowledge was gained, deaths tended to be from chronic disease processes that are common in the older population rather than young. In 1900, over half of deaths that occurred were to children under the age of 14. That number has decreased to less than 2% and this fact influences how we feel and think about death. (DeSpelder, Strickland pg. 36) In the 1870’s, nine out of ten Americans over the age of 15 had lost a parent or a sibling. Because medicine and medical care was not advanced, mother’s died during child birth and/or babies were born still born due to lack of prenatal knowledge and care advancement. The family unit was very important and often people in this time period would display postmortem pictures of loved ones who had passed as a testament to this family unit and the common knowledge of their mortality. One other change that has taken place is death rituals. In the early 1900’s families were more likely to be multigenerational living in the same house. People tended to intermingle with other generations out of necessity. Families lived on large homesteads and it took everyone to make it work. Because of this, multiple generations were present at the death of older family members and rituals and traditions existed. In this day and age people are more mobile and on the move. It is harder to maintain close relationships with family when you don’t live in the same state, let alone city. People appear to be less affected by the death of an older relative when the closeness of the relationship has been lost due to sheer proximity. Several changes that can be discussed regarding children are their attitudes towards death, their functional ability to understand death, and their desensitization to violence regarding death. Children’s attitudes towards death are much different in this day and age from in the late 1800’s or early 1900’s. In that time, families tended to live together in extended family situations possibly on homesteads. There was less access to medical care and things were taken care of at home. Death was something that was seen as a natural part of the living process and happened more regularly because of the generations that cohabitated. In this day and age as generations tend to live separately, children are more sheltered from this and therefore tend to look at death as something that doesn’t directly affect them. Jean Piaget, a theorist in human development, did extensive study of children and divided them into approximate age groups and developmental periods. He theorized that we develop our knowledge based on things we already know. These stages are sensorimotor from birth to 2 years when children learn based on their senses and motor abilities and begin to develop the idea of object permanence where they understand an object is still present even when it can’t be seen. Preoperational from 2-7 years where they progress from egocentric thought where they look at things as if they are the center of the world to prelogical where they learn trial and error and can begin to understand other points of view. Concrete operational from 7-12 years where they are able to logically understand and organize information and begin to think forward and backward about experiences. And finally, Formal operational from 12 years and up where they can think hypothetically and abstractly about situations and begin to have an interest in ethical situations. . (DeSpelder, Strickland pg. 2-53) Before these types of theorists existed, death was considered a natural part of the living experience and children just dealt with it like the rest of the family. Also in early years when children talked about death, it tended to be in the context of disease processes and accidents. As the culture has, advanced children are routinely exposed to things they weren’t before. If you ask, a child now days what things are that can cause death you may hear things like gunshot wounds and other traumatic experiences that can be linked to crime, violence they see on TV or video games or inner city experiences. In a cultural or historical sense differences in how dying is perceived can be from a cultural standpoint. Different religious and ethnical cultures have different practices and beliefs regarding death but as we have become more culturally competent society, the varying beliefs have become better understood. The physical cause of dying has changed simply by historical differences in living conditions. For example, in the Stone Age people were more likely to have died from trauma and animal attacks, whereas today dying from frailty, organ failure and dementia are more common. One change in regards to mortality and society where death is concerned can be related to education and training. For example, an earthquake in Japan in 1923 caused the death of 100,000 people. Today, because of advances in technology and safety we have ways to warn people of dangerous weather situations and have developed better safety practices that if followed can save many lives. . (DeSpelder, Strickland pg. 135-136) Change has also been seen in the conventional signs of death. Most deaths are determined by the absence of heartbeat and breathing. With the advances in technology and medicine, though, it is possible for mechanical ventilation and medications to artificially maintain these functions while the brain is termed dead. For this reason, the concept of brain death was created. Another innovation that has changed death is organ transplantation. Before this was discovered and perfected people had no choice but to die if they fell victim to an irreversible organ failure. Now, through organ donation and transplantation people can live long and productive lives if they can receive these lifesaving procedures. The final three changes that will be discussed are in regards to patients, staff, and institutions in the field of Health care. In 1900, about 80% of deaths in the United States took place in the home. As the invention of hospitals and other institutions took place, this shifted to the institutional setting with more people dying in hospital or nursing home setting. There is beginning to be a shift again however as hospice care becomes an option available to more and more people that allow them to stay in their homes around familiar surroundings instead of the sterile, non-personal setting of a hospital or institution. Another change that has taken place with regards to dying could be the rationing of resources. This will undoubtedly be getting even worse under Obamacare. Physicians used to be considered the gate keepers of what services and treatments were reasonably appropriate to which patients. As managed care comes more and more into the picture, this will change. Physicians will be paid a certain amount of money per month by insurance companies to manage the patients’ health. The less procedures, tests, and resources that are used the more money the physician will get to keep. This leads to the fear that rationing of resources or withholding of resources is a real possibility in order to keep from bankrupting doctors and clinics. Finally, palliative care, and end of life decisions are changing as well. There have been many advances with the advent of hospice and what can be done to allow a natural and peaceful death for those that are not interested in prolonging it. Undoubtedly, we will all die one day. There has been a shift in recent years from death being an almost taboo topic to one where people are taking control of their decisions. This is an area I am passionate about. You can take control of your end of life decisions by an advanced directive and informing your family members of your wishes. There are people who know they want every intervention possible done to keep them alive and there are those that are accepting of their own mortality, comfortable with their idea of what happens after death, and know that they want nothing heroic done to try and keep them on this earth if they cannot be an active participant.