Language development Essay Example

Language development Essay Example Language development Essay Language development Essay The language during the observation showed that he was able to communicate confidently with the adult, he looked relaxed and he wasnt shy to talk. G was able to listen to the adult and answer the questions which were asked although sometimes he didnt understand the questions, for instance when the adult asked about colours, Gs answer was given as sun, Lindon (1993) says children get confused if given complicated instructions even though the question is not difficult for an adult it might be for a child. This might have been the case with G as the answer was different to the question or it could have been that he did not no the colour so he compared it  something he had seen of that colour e.g. a sun. Beaver et al (2001) say that a child of 3 and 6 months is able to use complete sentences. G showed he could do this, however his sentences were simple and not complex. G tended to use one word answers a lot of the time and as G spoke his word order was incorrect for example when he said ~we t~nd some more suns whats there, as stated in Beaver et al (2001) Word order is sometimes incorrect. G also demonstrated that he uses silly talk such as Yep and Yer instead of yes. Bruce et al (2000) states that Children love to use silly talk, Although G can say yes as shown in my observation, he chose not to. When G was talking about the sun shape he said goes in sky he missed the word the out which, as Sunderland says children carry on conversation but missing link words like the out. Lindon (1993) says Children will make mistakes in their pronunciation of words and in how they put sentences together G made a few mistakes but each time the adult still understood what was being said but didnt correct his speech. G was able to describe an object like something else (a simile) for example when he said its like sun as Beaver et al (2001) tell us he is linking ideas to speech. (i was able to discuss his environment because he noticed the picture of dolphins and started talking about them; Hobart and Frankel (1995) state that a 3 year old can relate to present and past experiences. G did show this as he was able to tell the adult about the dolphins. Beaver et al (2001) say that when G told the adult that he saw stars outside, he was using language to report on experiences. Sunderland states Children love telling adults what to do, G showed this as he kept asking the adult to look for shapes.  Conclusion  [feel that I have met my aim which was to observe and look at the language skills of a child. I observed G for about 30 minutes whilst he was standing at a table with bootlaces and different shaped beads he was also talking to an adult. I placed a tape recorder near G and the adult so that I could accurately record exactly what was said. I also watched them and recorded Gs actions whilst he was talking. I dont think that I would have changed the way I observed him as I wouldnt have been able to accurately write down everything which was said and how it was said. The tape was a good method because I could listen and rewind and listen again as many times as I wanted. It helped writing down his actions as well so I knew exactly what was going on whilst I listened to the tape at a later date. If I was to observe language again I would still use the same method as I think it was the best and most accurate.  G was at his normal stages for his age as Beaver et al (2001) say ~a child of 3 and 6 months can use complete sentences G showed this whilst he was talking to the adult, for example when he said a special thing for music. Although El has reached his developmental norms in language, some children reach them at different times and might be a little behind or a little in front. Personal learning I learnt that children do use silly talk but they can speak properly when needed and that children can get confused and need a little help to understand things. I also learn that children love telling adults what to do. I learnt that there are different types of questions, open ended and closed questions. The open ended questions need more than a one word answer and children would benefit from being asked these as they help with a childs language and pronunciation development. Recommendation I would recommend that when an adult is talking to G the adult should try and use open ended questions as El would probably benefit from this, as he would be able to build on his language skills and talk to the adult more, the adult asked closed questions such as Do you like dolphins? or What colour is that? These questions only need a short answer but if G was given open ended questions like What are you doing? or Why do you like dolphins he would be encouraged to answer with more than one word, which would help him to extend his language skills and pronunciations of words. I would help him by getting some picture cards and holding them up then get him to say what is on the card (e.g. an aeroplane) I would also ask him questions about the picture on the card. It would help improve his language skills. Also if G had his word order wrong, the person who was with him should correct him so he would know how words are said properly.

Stephen King Shares His Writing Advice in This Guest Post

Stephen King Shares His Writing Advice in This Guest Post A Guest Blog from Stephen King- Yes, that Stephen King Okay, let’s get a few things straight right from the top: This is going to be a very long post, but I’m not going to apologize for it because: 1- I need to brag about how I know Mr. King; 2- I promise it’ll be content-rich; 3- You’re going to learn Voice merely by osmosis, beyond what he’s teaching overtly; and 4- You’ll be glad you invested the time. So grab your favorite beverage and settle in Though I work the inspirational side of the fiction writing fence and he the horror, we at one time happened to share the services of the same audio reader, the legendary Frank Muller, who remains, even post mortem, the unquestioned creme de la creme of that field. We first met by phone when Stephen called one day to discuss how we might aid Frank’s family after he suffered a motorcycle accident that would eventually take his life. Then Stephen and I met personally in 2004 when we visited Frank in rehab, where he lingered for several years. Stephen and I share a rabid love of baseball (he the Boston Red Sox, I the Chicago Cubs). I have been accused of trying to scare readers out of Hell. Stephen has been accused of trying to scare the hell out of readers. We read each other’s work and respect each other and still keep in touch via email. Writer’s Digest considered us strange enough bedfellows to feature us in a cover story. I will insert myself into Stephen’s blog only occasionally to adjust for the fact that the piece is nearly 30 years old, yet remains poignantly applicable. I expect it to stimulate spirited conversation, however be advised that my team and I will excise any off-topic comments. This is not the place to discuss Stephen’s use of naughty words, or his political, cultural, or religious views. Let’s stick to the subject of fiction writing. I asked if I could share with you sections of his iconic piece from the 1986 issue of The Writer magazine, wherein he promised to tell budding fiction writers everything they needed to know about writing successfully in ten minutes. Much of it has been floating around the Internet ever since, and you may have seen it. He kindly said, â€Å"Feel free to use as much of it as you’d like.† And so, with thanks for that generous offer, here is all of it with a few notes: Need help writing your novel?Click here to download my ultimate 12-step guide. Everything You Need to Know About Writing Successfully- in Ten Minutes By Stephen King I.The First Introduction THAT’S RIGHT. I know it sounds like an ad for some sleazy writers’ school, but I really am going to tell you everything you need to pursue a successful and financially rewarding career writing fiction, and I really am going to do it in ten minutes, which is exactly how long it took me to learn. It will actually take you twenty minutes or so to read this essay, however, because I have to tell you a story, and then I have to write a second introduction. But these, I argue, should not count in the ten minutes. II. The Story, or, How Stephen King Learned to Write When I was a sophomore in high school, I did a sophomoric thing which got me in a pot of fairly hot water, as sophomoric didoes often do. I wrote and published a small satiric newspaper called The Village Vomit. In this little paper I lampooned a number of teachers at Lisbon (Maine) High School, where I was under instruction. These were not very gentle lampoons; they ranged from the scatological to the downright cruel. Eventually, a copy of this little newspaper found its way into the hands of a faculty member, and since I had been unwise enough to put my name on it (a fault, some critics argue, of which I have still not been entirely cured), I was brought into the office. The sophisticated satirist had by that time reverted to what he really was: a fourteen-year-old kid who was shaking in his boots and wondering if he was going to get a suspension- what we called â€Å"a three-day vacation† in those dim days of 1964. I wasn’t suspended. I was forced to make a number of apologies- they were warranted, but they still tasted like dog-dirt in my mouth- and spent a week in detention hall. And the guidance counselor arranged what he no doubt thought of as a more constructive channel for my talents. This was a job- contingent upon the editor’s approval- writing sports for the Lisbon Enterprise, a twelve-page weekly, the sort with which any small-town resident will be familiar. This editor was the man who taught me everything I know about writing in ten minutes. His name was John Gould- not the famed New England humorist or the novelist who wrote The Greenleaf Fires, but a relative of both, I believe. He told me he needed a sports writer and we could â€Å"try each other out† if I wanted. I told him I knew more about advanced algebra than I did sports. Gould nodded and said, â€Å"You’ll learn.† I said I would at least try to learn. Gould gave me a huge roll of yellow paper and promised me a wage of 1/2 ¢ per word. The first two pieces I wrote had to do with a high school basketball game in which a member of my school team broke the Lisbon High scoring record. One of these pieces was straight reportage. The second was a feature article. I brought them to Gould the day after the game, so he’d have them for the paper, which came out Fridays. He read the straight piece, made two minor corrections, and spiked it. Then he started in on the feature piece with a large black pen and taught me all I ever needed to know about my craft. I wish I still had the piece- it deserves to be framed, editorial corrections and all- but I can remember pretty well how it looked before and after he had finished with it. Here’s an example: [Note: King’s original copy showed Mr. Gould’s edit marks.] Last night, in the well-loved gymnasium of Lisbon High School, partisans and Jay Hills fans alike were stunned by an athletic performance unequaled in school history: Bob Ransom, known as â€Å"Bullet† Bob for both his size and accuracy, scored thirty-seven points. He did it with grace and speed and he did it with an odd courtesy as well, committing only two personal fouls in his knight-like quest for a record which has eluded Lisbon thinclads since 1953. [With Mr. Gould’s edits applied.] Last night, in the Lisbon High School gymnasium, partisans and Jay Hills fans alike were stunned by an athletic performance unequaled in school history: Bob Ransom scored thirty-seven points. He did it with grace and speed and he did it with an odd courtesy as well, committing only two personal fouls in his quest for a record which has eluded Lisbon’s basketball team since 1953. When Gould finished marking up my copy in the manner I have indicated above, he looked up and must have seen something on my face. I think he must have thought it was horror, but it was not: it was revelation. â€Å"I only took out the bad parts, you know,† he said. â€Å"Most of it’s pretty good.† â€Å"I know,† I said, meaning both things: yes, most of it was good, and yes, he had only taken out the bad parts. â€Å"I won’t do it again.† â€Å"If that’s true,† he said, â€Å"you’ll never have to work again. You can do this for a living.† Then he threw back his head and laughed. And he was right; I am doing this for a living, and as long as I can keep on, I don’t expect ever to have to work again. III. The Second Introduction All of what follows has been said before. If you are interested enough in writing to be a purchaser of this magazine, you will have either heard or read all (or almost all) of it before. Thousands of writing courses are taught across the United States each year; seminars are convened; guest lecturers talk, then answer questions, then drink as many gin and tonics as their expense-fees will allow, and it all boils down to what follows. I am going to tell you these things again because often people will only listen- really listen- to someone who makes a lot of money doing the thing he’s talking about. This is sad but true. And I told you the story above not to make myself sound like a character out of a Horatio Alger novel but to make a point: I saw, I listened, and I learned. Until that day in John Gould’s little office, I had been writing first drafts of stories which might run 2,500 words. The second drafts were apt to run 3,300 words. Following that day, my 2,500-word first drafts became 2,200-word second drafts. And two years after that, I sold the first one. So here it is, with all the bark stripped off. It’ll take ten minutes to read, and you can apply it right away- if you listen. IV. Everything You Need to Know About Writing Successfully 1. Be talented This, of course, is the killer. What is talent? I can hear someone shouting, and here we are, ready to get into a discussion right up there with â€Å"what is the meaning of life?† for weighty pronouncements and total uselessness. For the purposes of the beginning writer, talent may as well be defined as eventual success- publication and money. If you wrote something for which someone sent you a check, if you cashed the check and it didn’t bounce, and if you then paid the light bill with the money, I consider you talented. Now some of you are really hollering. Some of you are calling me one crass money-fixated creep. And some of you are calling me bad names. Are you calling Harold Robbins talented? someone in one of the Great English Departments of America is screeching. V.C. Andrews? Theodore Dreiser? Or what about you, you dyslexic moron? Nonsense. Worse than nonsense, off the subject. We’re not talking about good or bad here. I’m interested in telling you how to get your stuff published, not in critical judgments of who’s good or bad. As a rule the critical judgments come after the check’s been spent, anyway. I have my own opinions, but most times I keep them to myself. People who are published steadily and are paid for what they are writing may be either saints or trollops, but they are clearly reaching a great many someones who want what they have. Ergo, they are communicating. Ergo, they are talented. The biggest part of writing successfully is being talented, and in the context of marketing, the only bad writer is one who doesn’t get paid. If you’re not talented, you won’t succeed. And if you’re not succeeding, you should know when to quit. When is that? I don’t know. It’s different for each writer. Not after six rejection slips, certainly, nor after sixty. But after six hundred? Maybe. After six thousand? My friend, after six thousand pinks, it’s time you tried painting or computer programming. Further, almost every aspiring writer knows when he is getting warmer- you start getting little jotted notes on your rejection slips, or personal letters . . . maybe a commiserating phone call. It’s lonely out there in the cold, but there are encouraging voices- unless there is nothing in your words which warrants encouragement. I think you owe it to yourself to skip as much of the self-illusion as possible. If your eyes are open, you’ll know which way to go- or when to turn back. 2. Be neat Type. Double-space. Use a nice heavy white paper, never that erasable onion-skin stuff. If you’ve marked up your manuscript a lot, do another draft. [Of course, today Stephen would say to use a large, serif type and transmit only work with which you’re entirely happy, spell checked and properly formatted.] 3. Be self-critical If you haven’t marked up your manuscript a lot [or, today, carefully edited and rewritten it], you did a lazy job. Only God gets things right the first time. Don’t be a slob. 4. Remove every extraneous word You want to get up on a soapbox and preach? Fine. Get one and try your local park. You want to write for money? Get to the point. And if you remove all the excess garbage and discover you can’t find the point, tear up what you wrote and start all over again- or try something new. 5. Never look at a reference book while doing a first draft You want to write a story? Fine. Put away your dictionary, your encyclopedias, your World Almanac, and your thesaurus. Better yet, throw your thesaurus into the wastebasket. The only things creepier than a thesaurus are those little paperbacks college students too lazy to read the assigned novels buy around exam time. Any word you have to hunt for in a thesaurus is the wrong word. There are no exceptions to this rule. You think you might have misspelled a word? O.K., so here is your choice: either look it up in the dictionary, thereby making sure you have it right- and breaking your train of thought and the writer’s trance in the bargain- or just spell it phonetically and correct it later. Why not? Did you think it was going to go somewhere? And if you need to know the largest city in Brazil and you find you don’t have it in your head, why not write in Miami, or Cleveland? You can check it- but later. When you sit down to write, write. Don’t do anything else except go to the bathroom, and only do that if it absolutely cannot be put off. 6. Know the markets Only a dimwit would send a story about giant vampire bats surrounding a high school to McCall’s. Only a dimwit would send a tender story about a mother and daughter making up their differences on Christmas Eve to Playboy- but people do it all the time. I’m not exaggerating; I have seen such stories in the slush piles of the actual magazines. If you write a good story, why send it out in an ignorant fashion? Would you send your kid out in a snowstorm dressed in Bermuda shorts and a tank top? If you like science fiction, read the magazines. If you want to write confession stories, read the magazines. And so on. It isn’t just a matter of knowing what’s right for the present story; you can begin to catch on, after awhile, to overall rhythms, editorial likes and dislikes, a magazine’s entire slant. Sometimes your reading can influence the next story, and create a sale. 7. Write to entertain Does this mean you can’t write â€Å"serious fiction†? It does not. Somewhere along the line pernicious critics have infested the American reading and writing public with the idea that entertaining fiction and serious ideas do not overlap. This would have surprised Charles Dickens, not to mention Jane Austen, John Steinbeck, William Faulkner, Bernard Malamud, and hundreds of others. But your serious ideas must always serve your story, not the other way around. I repeat: if you want to preach, get a soapbox. 8. Ask yourself frequently, â€Å"Am I having fun?† The answer needn’t always be yes. But if it’s always no, it’s time for a new project or a new career. 9. How to evaluate criticism Show your piece to a number of people- ten, let us say. Listen carefully to what they tell you. Smile and nod a lot. Then review what was said very carefully. If your critics are all telling you the same thing about some facet of your story- a plot twist that doesn’t work, a character who rings false, stilted narrative, or half a dozen other possibles- change that facet. It doesn’t matter if you really liked that twist of that character; if a lot of people are telling you something is wrong with your piece, it is. If seven or eight of them are hitting on that same thing, I’d still suggest changing it. But if everyone- or even most everyone- is criticizing something different, you can safely disregard what all of them say. 10. Observe all rules for proper submission Return postage, self-addressed envelope, all of that. [Obviously, this is different today, but the sentiment remains: follow editorial guidelines.] 11. An agent? Forget it. For now. Agents get 10% of monies earned by their clients. [Today 15% is standard.] 10% of nothing is nothing. Agents also have to pay the rent. Beginning writers do not contribute to that or any other necessity of life. Flog your stories around yourself. If you’ve done a novel, send around query letters to publishers, one by one, and follow up with sample chapters and/or the manuscript complete. And remember Stephen King’s First Rule of Writers and Agents, learned by bitter personal experience: You don’t need one until you’re making enough for someone to steal- and if you’re making that much, you’ll be able to take your pick of good agents. 12. If it’s bad, kill it When it comes to people, mercy killing is against the law. When it comes to fiction, it is the law. That’s everything you need to know. And if you listened, you can write everything and anything you want. Now I believe I will wish you a pleasant day and sign off. My ten minutes are up. Isn’t it interesting how much of this writing advice holds up after nearly 30 years? What is your favorite of Stephen’s tips? Need help writing your novel?Click here to download my ultimate 12-step guide.

Antigone Essay Example | Topics and Well Written Essays - 250 words - 8

Antigone - Essay Example He is a greedy king of Thebes that wants to have much money. He disrespects women especially Antigone that he distastes very much. Creon put Antigone in the tomb to starve to death. By state and gender, Creon has the superior position of making almost the decisions for the entire city while Antigone serves as a subordinate and follower. During the burial of Polyneices, the two show different ideas that are based on similar motives of the power struggle. In this burial occasion, the author portrays a conflict of the state and the family obligations (Sophocles, and Ian C. Johnston. 23). The audience can see that mindsets of these characters are same. In spite of having conflicting opinions, their motives coincide always rather than collide. In fact, it is an arrogant sense of pride that propels the motives of these characters behind their respective opinions. Antigone is ready to defy the rules of Creon to honor the burial obligations of the family. She believes it is her role to preside over the burial and in this regard she does not want to let go of her sense of the pride in honor of Creon rules. In conclusion, both characters die out of their arrogant pride towards one another. However, the death of Antigone is more tragic. Antigone dies a victim of her own hubris as well as the hubris of Creon. Surely, if the two characters had let go of their arrogant pride they would not have a tragic death. On the other hand, if they had been destined to die in that manner nobody would have changed it. Fate cannot be obstructed

Research Paper Thesis Statement Example | Topics and Well Written Essays - 250 words

Thesis Statement - Research Paper Example e basic potential marketing needs for Toyota Company is to identify the most effective means to facilitate effective and productive expansion of the company in the modern intricate global market (Markus 2005). The understanding of the customers’ needs as well as proper utilisation of transfer market channels is some of the main market needs of Toyota Motor Corporation. The financial and economic forces in Toyota Motor Corporation are the consistent fall in the financial situation of the company and the identification of the most valuable market strategy to prosper in modern economic advancement. Moreover, for the Toyota Motor Corporation to flourish in present market, the company ought to deal with some legal and social forces that entail understanding of the existing legislation in new markets as well as adapting to changes in policies in different states and political settings. Socio-economic forces have also become a major challenge in a considerable number of multinational corporations. To achieve its long terms goals, the Toyota Motor Corporation ought to understand the socio-cultural needs of different social and cultural settings. The understanding of the competitive forces in global markets will be very essential for the success of the company. In this regard, the Toyota Motor Corporation should undertake a comprehensive analysis of all its competitors in global market to understand their economic and financial

The Madding Crowd Essay Example for Free

The Madding Crowd Essay Views on women and how the use of vocabulary is used to distinguish between the different classes. When playing Liddy, I identified with Bathsheba and Fanny as I had been used in the hurt in the past because of women exploitation. The book is completely based on Bathsheba; a woman and at that time there was a queen on the throne so perhaps the book is also showing the era of Queen Victoria. I used this knowledge to develop my vocabulary to adapt to the way they spoke in those times. This showed the period of time the book was written in. Moral issues arose and showed how men dominated woman in those times as Bathsheba was an independent woman at the beginning of the book but after Troy abused her she lost her confidence and identifies. She had been de-valued. How does your presentation include references to: Â  The writers style, structure and characterization? Â  The writers use of language? My presentation structure was based on a scene that did not appear in the book. Bathsheba, Fanny and Liddy had come together and discussed the way in which men dominated women. Because our role play was based on three main constant characters, it was easy to know about their backgrounds and personalities as I had already researched them. The book also gave some important information. The vocabulary used was based on the vocabulary in the book and we showed this in our presentation by using some of the text as references. We used a piece of text from the book for Bathsheba to say His voice was unexpectedly attractive; it was the low and dulcet note suggestive of; romance; common in descriptions, rare in experience. We used this for Bathsheba to describe Troy as she said this in the book and we thought it would be more effective if we used the exact text. We also showed how women were exploited in those days by talking of our past and present experiences as our characters revealed their experience of exploitation. This identified with the time of the book when women were being exploited. In what way do you feel your presentation was successful? I think my presentation was quite successful as we based the speech and vocabulary on the text in the book which gave the audience an idea of the time it was written and also made them remember the book. The presentation was based on a script, which helped speech flow easily and make sense. The script also meant if we got lost we could locate our self on the script and carry on or improvise. We did improvise some speech meaning our attention was not always on our script as this would have been quite dull. Movement was also used to make our role play more interesting and effective for the audience to watch. Overall, I think our role play was quite effective in bringing to light woman exploitation as we used the characters past experiences so some of the audience could identify and relate to the book also.

Essay --

According to sufferer, Stephanie, â€Å"If I got to number 17 on the math test, I would have to tap my pencil 17 times† (Weiskopf 19). Stephanie exhibits signs of Obsessive-Compulsive Disorder. Obsessive-Compulsive Disorder (OCD) is a disorder in which the individual becomes obsessed or compulsive about something. Because of their extreme focus events and tasks, OCD will affect how children and teenagers perform in school. Obsessive-Compulsive Disorder can also cause various problems in their daily lives. Due to severe obsessions and compulsions, Obsessive-Compulsive Disorder is a serious, yet unexamined, threat to teenagers at school and home, which can lead to further complications, but it can be treated. Obsessive-Compulsive Disorder is provoked not only by environmental factors, but also by genetic components. OCD can be traced through family history, but there is not a direct factor that is shown to be passed on. If a family member is diagnosed with OCD, there becomes an increased risk for other immediate relatives of inheriting the condition. According to OCD Education Station, â€Å"genetics contributes approximately 45-65% of risk for developing the disorder,† but â€Å"other factors such as the environment also play a vital role† (â€Å"Facts†). Sometimes there can be a sudden outbreak of the disorder rather than a genetic component. When there is a sudden occurrence of OCD, the provocation of the disorder can be linked to strep throat or a mental, physical, or behavioral change of the individual. Not only can OCD be linked to genetic components or a sudden onset, but Obsessive-Compulsive Disorder can also be produced by environmental factors. Behavioral, mental, and environmental factors such as stress, a death of someone close, or the fe... ...ssive-Compulsive Disorder is a treatable, but severe, danger to teenagers because of the extreme compulsions and obsessions. This disorder is provoked by multiple factors related to both the environment and genetics. OCD consists of common signs and symptoms present in sufferers with extreme recurring obsessions and compulsions. There are four different types of Obsessive-Compulsive Disorder including checking, contamination, hoarding, and ruminations. OCD is a disorder with symptoms that can be lessened by therapy, interventions, and medications. Obsessive-Compulsive Disorder is treatable, but other disorders can also occur and exist because of the presence of OCD. Although the symptoms and presence of OCD can be reduced, the anxiety and emotions that are related to OCD will stay will the sufferer for their life through other disorders or regular, everyday events.

National Health Service Essay

The NHS stands for the National Health Service, which provides healthcare for all UK citizens based on their need for healthcare rather than their ability to pay for it. It is fully funded by full-time workers taxes. The aim of the health service is to ensure that anyone can receive the medical care they need, regardless of their age, circumstances or financial situation. Advantages * To meet the needs of everyone * To be free at the point of delivery * The NHS provides care free of charge to most UK residents * Depending on the nature of your problem you may be treated by a doctor, dentist or optician * There are is a range of healthcare services offered by the NHS, covering every concern from flu to vaccinations, mental illness to ectopic pregnancy care. * When you seek help because you feel unwell, the medical practitioner you visit will be able to inform you of the care options available to you. * Every person in England having access to his or her own confidential medical records. * Helpdesk service available 24 hours a day, seven days a week. Disadvantages * Long waiting lists * Your situation of needing care may not be as important as others * They may use low quality equipment on you because you are not paying for the treatment, therefore your health issue may not be resolved as quickly or properly with incorrect equipment. * People will abuse the system by using is too much when it is not necessary or they have not paid taxes sufficiently.- The United States is now the only remaining MEDC country without some form of free access to a medical service, Partly because policy debates are driven by false, self defeating beliefs. One thought of this is that the United States cannot afford to cover the uninsured, when in fact a coordinated financing system is the key tool for holding costs down, and there are affordable ways to do it. Also many believe that the United States is so large and diverse that any lessons one might benefit from a smaller and less diverse countries do not apply here. Universal health care system would mean low salaries, rundown facilities, poor quality, and endless waits to see a doctor, as a good example of this is with the NHS. The current/ new NHS * The plan for the new NHS by the present government is even more ambitious than the transformation by Margaret Thatcher. * The NHS was widely discussed as no longer sustainable or no longer affordable. Therefor the rate of Tax has been increased largely. * Demands are rising, as are costs. And this is all happening at a time when money is tighter than ever. * Two thirds of hospital beds are now estimated to be occupied by the over 65s at any one time. * Nurses have been given a lot more responsibility. * IVF treatment is helping thousands of couples conceive each year. * Organ transplants are now saving over 3,000 lives a year. * Obesity, drinking and smoking. All three cause disease and death, adding billions of pounds to the NHS bill.

Lipid Profiles In Postmenopausal Women Health And Social Care Essay

Aim: Aromatase inhibitors are presently used in accessory to the former gold criterion Tamoxifen or as first line hormone therapy in postmenopausal adult females with chest malignant neoplastic disease. Suppressing the aromatase mechanism of action impedes the synthesis of estrogen, forestalling estrogen protection on lipid profiles. This literature reappraisal examines, discusses, and analyzes peer-reviewed published clinical tests analyzing the effects of anastrozole, exemestane, and letrozole, on lipid profiles in postmenopausal adult females with estrogen dependent chest malignant neoplastic disease. Decisions: Overall, there are minimum, if any, unfavourable effects of aromatase inhibitors on lipid profiles. However, restrictions of little population sizes, fluctuations in design methods, and old Tamoxifen usage, make it hard to accurately assess hazard. Long term prospective surveies utilizing big sample sizes and patients with no exposure to any other hormone intervention besides aromatase inhibitors, are needed to accurately measure if inauspicious effects on lipid profiles exist from the utilizing aromatase inhibitors. Healthcare professionals should go on to supervise lipoids in postmenopausal adult females with chest malignant neoplastic disease and develop individualized intervention programs utilizing current recommendations. Cardinal Wordss: aromatase inhibitor, chest malignant neoplastic disease, post-maturity, lipid, Anastrozole, Letrozole, Exemestane, cholesterin, and lipid metamorphosis. Aromatase Inhibitors Risk of Adverse Effects on Lipid Profiles in Postmenopausal Women with Breast Cancer: A Literature Review Introduction Breast malignant neoplastic disease pestilences about 2.5 million adult females in the United States, 1 doing it one of most prevailing signifiers of tumor that healthcare practicians dainty today. The hazard of developing chest malignant neoplastic disease increases with age, with one in 13 postmenopausal adult females developing the disease.2 Nearly 70 per centum of those postmenopausal adult females will hold a endocrine dependant ( estrogen positive ( ER+ ) , progesterone positive ( PR+ ) ) signifier of chest malignant neoplastic disease that utilizes estrogen as its chief alimentary beginning for the proliferation of the tumour. 2, 3, 4 In postmenopausal adult females, estrogen is chiefly synthesized in the peripheral tissues, chest, musculus, adipose, tegument by the enzyme aromatase.4,5 Aromatase converts adrenal androgens into estrogen via the CYP450 enzyme pathway.4, 5, 6, Suppressing aromatase and hindering this transition limits the sum of estrogen available for use by tum our cells, later forestalling growing and spread. Through this mechanism of action, steroidal ( Exemestane ) and non-steroidal ( anastrozole and letrozole ) aromatase inhibitors have shown to be extremely efficacious in the intervention of ER+/PR+ chest malignant neoplastic disease in postmenopausal adult females compared to that of Tamoxifen.5 Multiple landmark surveies ( MA.17, 2 ATAC, 7 BIG 1-98, 8 and EORTC9 ) , suggest that Tamoxifen is no longer a gilded criterion, and now recommend utilizing AIs as first line hormone therapy in these patients.5 With the spread outing usage of AIs by practicians in the intervention of endocrine dependent chest malignant neoplastic disease and the subsequent betterment in disease free endurance rates, more postmenopausal adult females are populating long plenty to see other comorbidities, such as cardiovascular disease ( CVD ) .4 Since CVD is the primary cause of mortality in postmenopausal adult females, 10 understanding the associated inauspicious effects AIs pose on cardiovascular hazard factors is pertinent. Lipid biomarkers are often assessed clinically to find a patients hazard of developing CVD. Previous epidemiologic surveies have shown that estrogen is protective and good to some cardiovascular hazard factors, specifically lipid profiles, via its direct effects on the endothelial cells found in blood vessels.6,11 Estrogen alters concentrations of lipoids in the blood ; diminishing serum concentrations of entire cholesterin ( TC ) , low-density lipoprotein ( LDL ) , and triglycerides ( TRG ) , while increasing serum concentrations of high-density lipoprotein ( HDL ) .11, 12 Therefore, it is thought that postmenopausal adult females taking AIs are deprived of this cardioprotective consequence of estrogen since its synthesis is being prevented by suppressing the aromatase transition mechanism. Therefore, the inquiry can be proposed: Make aromatase inhibitors adversely affect lipid profiles and later present an increased hazard of developing cardiovascular disease in postmenopausal adult females with ER+/PR+ chest malignant neoplastic disease? This literature reappraisal of current clinical test informations examines and assesses the usage of AIs, Exemestane ( Aromasin ) , Anastrozole ( Arimidex ) , and Letrozole ( Femara ) , on the inauspicious effects of the lipid profiles of postmenopausal adult females with ER+/PR+ chest malignant neoplastic disease. Search footings included cardiovascular, aromatase inhibitor, chest malignant neoplastic disease, post-maturity, lipid, Anastrozole, Letrozole, Exemestane, plasma lipoid, cholesterin, and lipid metamorphosis. MEDLINE in Pubmed, MEDLINE ( on EBSCO ) , and OVID were used to seek for peer-reviewed diary articles published between the old ages 2005 to 2010. Recent grounds showing the effects AIs render on the lipid profiles of postmenopausal adult females with estrogen dependent chest malignant neoplastic disease is discussed, analyzed, and reviewed in the undermentioned subdivisions. AROMATASE INHIBITORS EFFECT ON LIPID PARAMETERS Depriving chest malignant neoplastic disease stricken postmenopausal adult females of the benefit of estrogen via the AI mechanism is thought to hold damaging effects on CVD hazard factors. Several clinical tests utilizing assorted design methods have been conducted and show variable effects of AIs on the different cholesterin parametric quantities and lipoproteins. Table 1 summarizes the effects of AIs on assorted lipid biomarkers in the postmenopausal adult female with ER+/PR+ chest malignant neoplastic disease, and all surveies in the tabular array are discussed in the following subdivisions. Placebo Controlled Tests Two surveies have evaluated the consequence of AIs versus placebo on lipid biomarkers. As a secondary end point, Cigler et al13 studied the effects of Letrozole versus placebo on serum lipid parametric quantities ( TC, HDL, LDL, TRG ) in 60 seven postmenopausal adult females utilizing a random, placebo-controlled design. Lipids were measured at baseline and during the 3rd, 6th, 12th, and 24th months, and the per centum alteration from baseline was calculated for each month. Researchers noted a statistically important lessening in the TC at month 3 ( P value=0.052 ) in the Letrozole arm of the survey. The other parametric quantities ( TRG, LDL, and HDL ) measured were non significantly changed from baseline in either the Letrozole or the placebo weaponries. Writers concluded that Letrozole modestly decreases TC at 3 months ; nevertheless, the consequence is non sustained throughout the intervention clip period.13 The cogency of consequences in the lipid part of this survey are questio nable because of the imbalanced figure of participants in each intervention group, and the little population size that remained at the terminal of the 24 months ( Letrozole: 26 patients, and placebo: 16 patients ) . It is hard to measure accurate tendencies in informations with little population sizes, and consequences should be verified utilizing similar survey methods with larger population sample sizes. A confusing variable in this survey was the old usage of Tamoxifen in some patients and non others. Tamoxifen has shown to hold good effects on lipoids ; 14, 15 therefore, the consequences from patients that had antecedently taken Tamoxifen may non be a true representation of the effects of the AI entirely on lipid profiles. Another placebo controlled test utilizing different design methods was conducted by Lonning et al16 and contrasting consequences were found. The effects of Exemestane versus that of placebo on plasma lipoids in postmenopausal adult females with resectable chest malignant neoplastic disease was studied by Lonning et al.16 In a dual blind manner, one hundred 40 seven patients were indiscriminately assigned to an Exemestane intervention group or a placebo intervention group. Measurements of lipid biomarkers ( TC, HDL, LDL, TRG, ApoLipoprotein A1, lipoprotein A, ApoLipoprotein B, homocysteine ) were taken at baseline, and at the 3rd, 6th, 12th, and 24th month. Results revealed that the Exemestane intervention group had a statistically important ( P value & A ; lt ; 0.001 ) lessening in HDL versus that of the placebo intervention group. Besides, a statistically important ( p=0.004 ) lessening in Apolipoprotein A1 occurred in the Exemestane intervention group versus that of the placebo intervention group. Writers concluded that the steroidal AI, exemestane has modest effects on HDL lipid biomarkers and those hazard factors for CVD should be followed overtime.16 This survey included more participants than Ciglers study ; hence, the consequences seen here may hold more cogency. Besides, a different AI was used in each test, and this variable could account for the disagreement in consequences between the two surveies. No old Tamoxifen usage was denoted in the survey by Lonning et Al ; 16 therefore, the consequences are a better representation of the effects of the AI on lipoids without confusing influences of Tamoxifen. More placebo controlled tests are necessary to to the full understand the effects of AI on lipoids in postmenopausal adult females with endocrine dependent chest malignant neoplastic disease, and to denote if a true lessening in HDL exists. The following subdivision discusses tests in which AIs were compared with Tamoxifen alternatively of a placebo as the intercession intervention groups to be assessed. Tamoxifen Comparative Tests Surveies have been conducted utilizing Tamoxifen as a comparative intervention group to that of Exemestane, and their several inauspicious effects on lipid profile alterations are discussed. The TEAM Greek bomber study17 randomized postmenopausal adult females with early chest malignant neoplastic disease into an Exemestane arm ( 77 patients ) or into a Tamoxifen arm ( 65 patients ) , and evaluated HDL, LDL, TRG, and TC at baseline, and at 12, 18, and 24 months. Results indicate that TC decreased overtime in both intervention groups ; nevertheless, those in the Tamoxifen arm had a crisp diminution at month 18 and 24, doing the difference between groups at that clip period statistically important with P value=0.020 and P value=0.0087, severally. Both interventions had a statistically important lessening in HDL ; nevertheless, the Tamoxifen group maintained higher degrees of HDL, leting for a more favourable consequence than exemestane, with a statistically important average difference ( P=0.011 ) between the intervention groups. The Tamoxifen intervention group had a important consequence on the LDL parametric quantity doing a steep lessening in values overtime. exemestane had failed to demo any important alteration on LDL. The TRG parametric quantity revealed no noticeable tendencies for either intervention regimen. Research workers concluded that Tamoxifen has a favourable consequence on TC and LDL, while Exemestane has a more indistinct consequence on lipid biomarkers.17 The lessening in HDL in this survey is in harmony with that of Lonning et al.16 One restriction is that all four lipid parametric quantities were non accounted for in all patients in each intervention group ; hence, tendencies seen in each parametric quantity may non stand for the true tendency that would be present if all values were recorded for all patients at all measurement clip periods. This survey reiterates the idea that Tamoxifen has good effects on lipoids ; accordingly, it is hard to accurately measure the hazard of AI when the comparative intervention group is Tamoxifen. 14 Though some restrictions were present in this survey, comparative consequences were seen by Francini et al14 in another test utilizing different methods than the TEAM Greek bomber survey. Francini et al14 conducted a survey in which 55 postmenopausal adult females who had antecedently been treated with no less than 2 old ages of Tamoxifen were randomized into two intervention groups: either continue Tamoxifen or exchange from Tamoxifen to Exemestane. Lipid parametric quantities were measured at baseline and at 6 and 12 months. Consequences yielded were statistically important in the Exemestane arm of the survey entirely demoing a lessening in HDL overtime ( p value & A ; lt ; 0.05 ) , an addition in LDL overtime ( p value & A ; lt ; 0.01 ) , and a lessening in TRG overtime ( P value & A ; lt ; 0.01 ) . The differences between the Tamoxifen and Exemestane intervention group were non important except for the LDL biomarker ( p value & A ; lt ; 0.05 ) . Writers concluded that the addition in LDL of the Exemestane group may be due in portion to participants being antecedently treated with Tamoxifen, which is known to hold good effects on LDL.14 Francinis survey and the TEA M Greek bomber study17 indicate that there was a lessening in the HDL parametric quantity in the Exemestane intervention group versus that of the Tamoxifen intervention group, proposing that AIs may hold an inauspicious consequence on HDL degrees. This lessening in HDL was besides noted in the ATENA trial18 in which Tamoxifen had been antecedently used for 5-7 old ages before the patients were assigned to have either Exemestane or no intervention, merely observation. The addition in LDL found in the survey by Francini14 was besides seen in the ATENA test ; 18 nevertheless, the TEAM Greek bomber study17 did non back up this determination. It must be kept in head that patients in the survey by Francini14 and the ATENA trial18 had antecedently been treated with Tamoxifen before get downing intervention with AIs, while patients in the TEAM Greek bomber study17 were non. Hence, the design differences could account for the fluctuation of consequences between surveies on the LDL, TRG, and TC parametric quantities. A likewise designed survey by Montagnani et al15 exposed comparable consequences to the survey by Francini. Montagnani et al15 investigated the effects of Exemestane after anterior intervention with Tamoxifen, and indiscriminately assigned 60 eight postmenopausal adult females to go on taking Tamoxifen ( 20 milligrams daily ) or exchange to the aromatase inhibitor, Exemestane ( 25 milligrams daily ) for 2 old ages. Parameters ( TC, HDL, LDL, TRG ) were measured at baseline and at 12 and 24 months. Consequences showed that the Exemestane intercession had a important lessening in HDL, while the Tamoxifen group showed no significance in alteration from baseline. Therefore, a important difference between the intercession groups ( p value & A ; lt ; 0.05 ) was noted. Besides in the Exemestane group, LDL was increased from baseline ; nevertheless, no alteration was seen in the Tamoxifen group. The between group differences were besides statistically important with a P value & A ; lt ; 0.05. The Exemestane group besides had a statistically important lessening in TRG doing the between group differ ences important with a p value of & A ; lt ; 0.05. The consequences found in this survey showed some similarities with those discovered by Francini et al.14 Montagnani revealed important differences between groups for HDL, LDL, and TRG parametric quantities, while Francinis survey merely showed important differences between groups for LDL. In both surveies, the aromatase inhibitor was compared with go oning Tamoxifen after the patients had already used Tamoxifen, hence some of the consequences may hold occurred from taking the good effects of Tamoxifen instead than uncovering damaging effects of the AI. Both Francini and Montagnani revealed lessenings in TRG in the Exemestane arm. This would be considered a favourable consequence of utilizing AI, but since Tamoxifen negatively affects TRG and Tamoxifen was antecedently used by the Exemestane patients, the simple remotion of the unfavourable consequence of Tamoxifen could account for the consequence. To increase the respectability of these findings, comparable consequences should be confirmed in likewise designed surveies utilizing larger sample population sizes without old exposure to Tamoxifen. Banerjee et al19 designed yet another survey comparing a different AI, Anastrozole, to Tamoxifen, and to a combination of Anastrozole with Tamoxifen. The IMPACT trial19 compares the effects of utilizing Anastrozole, Tamoxifen, or a combination of Anastrozole/Tamoxifen on the lipid profiles of postmenopausal adult females with chest malignant neoplastic disease. In a stage III, randomized, double-blind multicentre trial,19 three hundred 30 patients were assigned to have either Anastrozole ( 1 milligrams daily ) + Tamoxifen placebo, Tamoxifen ( 20 milligrams daily ) + Anastrozole placebo, or a combination of both ( Tamoxifen 20 mg day-to-day + Anastrozole 1mg daily ) for a period of 12 hebdomads. Measurements for TC and HDL were taken at baseline and three months. Results revealed that the Tamoxifen merely intervention group had a statistically important lessening in the TC lipid parametric quantity ( p value & A ; lt ; 0.05 ) , while the Anastrozole merely intervention group had an addition in TC lipid parametric quantity that was non statistically important ; nevertheless, the difference between the two groups was important. The c ombination group consequences showed a important lessening in TC ( P value & A ; lt ; 0.05 ) , nevertheless the between groups differences were non important. A statistically important addition in HDL from baseline was noted overtime in all intervention groups ( P & A ; lt ; 0.05 ) , nevertheless the difference between the groups was non important. Writers suggest that, although there was a little addition in TC in the Anastrozole merely group, this negative consequence was counterbalanced with the positive consequence of the addition of HDL in the Anastrozole group, and that there is no damaging consequence on the lipid profile when utilizing the AI, Anastrozole.19 Measurements were merely taken over a 3 month clip period, therefore consequences are limited and the effects seen may non prolong through longer intervention tests. This addition in HDL in the AI intervention group is contrary to the consequences seen in antecedently discussed surveies. Different AIs were used in each t est and this unsimilarity in methods could account for the differences. Studies reexamining the disparities between AIs are necessary to find their several effects on lipid profiles and to measure if an AI is more good or damaging than the others. Comparison between Aromatase Inhibitors It is of import to understand the differences between each aromatase inhibitors several effects on lipid profiles to assist healthcare practicians choose the appropriate drug regimen for each single patient. In a multi-centre, unfastened, randomized survey, McCloskey et al5 compared the effects of Anastrozole, Letrozole, and Exemestane on lipid profiles in one hundred and two postmenopausal adult females, and randomized them into one of three intervention groups: Anastrozole ( 1 milligrams daily ) , Letrozole ( 2.5 milligrams daily ) , or Exemestane ( 25 milligrams daily ) , for 24 hebdomads with a 12 hebdomad follow up period. Measurements of lipid biomarkers ( TC, TRG, LDL, HDL, LDL/HDL ratio, Apolipoprotein B/Apolipoprotein A-1 ratio ) were taken at baseline and at the 12th, 24th, and 36th hebdomad. Consequences revealed that Exemestane had a important lessening from baseline in TC, nevertheless the differences between the three intervention groups were non statistically important ( p value=0.535 ) . The LDL/HDL ratio parametric quantity was significantly different for all three groups at the 12th and 24th hebdomad measuring, with Exemestane giving the greatest alteration ( p=0.007 ) compared to Letrozole ( p=0.025 ) and Anastrozole ( p=0.045 ) . This increased ratio in the Exemestane intervention group was due to the statistically important lessening in HDL ( p value & A ; lt ; 0.001 ) . The TRG measuring for all groups showed much variableness, with Letrozole demoing a statistical important addition at 12 hebdomads ( p=0.011 ) versus the other AIs. This alteration from baseline did non last through the 24 hebdomad measurement period. No other alterations were noted between the three intervention groups. Writers suggested that those treated with Exemestane have an addition in hazard of inauspicious effects on the ratios finding atherogenesis.5 The lessening in the HDL parametric quantity in patients utilizing Exemestane is in understanding with the antecede ntly mentioned surveies that used Exemestane as an AI comparator of pick. Since Tamoxifen was non a confounding factor here, the suggestion that Exemestane perchance adversely effects HDL, now becomes a more significant and valid statement because the consequence is still seen without Tamoxifen act uponing the consequence. However, it must be considered that this survey used healthy postmenopausal adult females, non breast malignant neoplastic disease patients, as the sample population evaluated, and the consequences can non be imposed as the same consequences that might hold occurred if the population had used a sample of postmenopausal adult females with chest malignant neoplastic disease. Long clinical surveies utilizing the right population sample and sample size should be conducted to further understand the impact of each AI on the postmenopausal chest malignant neoplastic disease patient. This is one of the lone surveies available measuring the inauspicious effects of each par ticular AI compared to one another. More surveies are necessary to corroborate the consequence that Exemestane offers more inauspicious hazard compared to Letrozole and Anastrozole. Decision Tamoxifen has been in usage for more than 30 old ages, and was considered the gilded criterion hormone therapy for handling postmenopausal adult females with endocrine dependent chest cancer.15, 20 Large epidemiologic surveies have shown that AIs are more efficacious than Tamoxifen in overall and disease free endurance rates, and hence are now recommended as first line accessory hormone therapy for postmenopausal adult females with chest cancer.3,15 With their known mechanism of action of striping postmenopausal adult females of serum estrogens, therefore taking estrogens protective effects on these cardiovascular hazard factors,6, 11 there is concern that AIs may hold inauspicious effects on lipid profiles. Most writers concluded that aromatase inhibitors have minimum effects or no inauspicious effects on lipid profiles in postmenopausal adult females with chest malignant neoplastic disease. However, it is hard to measure the true consequence of AIs on lipid profiles with Tamoxifen as the comparator since it has proved benefit on some lipid parameters,14 and because of the many different design methods used. Small sample sizes were restrictions in a few surveies ; therefore, the tendencies yielded in those tests may non be genuinely declarative of postmenopausal adult females with chest malignant neoplastic disease. Long term prospective surveies utilizing big sample sizes and patients with no exposure to any other hormone intervention besides AI, are needed to accurately measure if inauspicious effects on lipid profiles exist from the usage of AIs. From the current available information, though minimally, HDL is the parametric quantity most adversely affected by the usage of AI. This may be a cause of concern for some practicians since lessenings in go arounding sums of HDL are linked with additions in cardiovascular disease.15 Since HDL is considered good cholesterin and a positive hazard factor, diminishing the sum available in blood could perchance hold damaging effects on CVD. Healthcare practicians should be cognizant of this possible hazard of diminishing HDL with AI usage so that proper monitoring in their patients may be performed. Given that a current intervention option still includes the usage of Tamoxifen followed by exchanging to an AI, it is particularly of import to supervise lip id profiles since some studies14, 15, 17 have shown unfavourable effects on lipid profiles when doing this switch. To find if an existent hurt on CVD hazard factors occurs in adult females taking the non steroidal and steroidal aromatase inhibitors, more long term clinical tests should be conducted. In decision, aromatase inhibitors are being used more and more as first line accessory intervention in postmenopausal adult females with chest malignant neoplastic disease. Though it depletes estrogen beginnings, surveies show no well damaging effects on lipid profiles, with most merely demoing minimum, if any, inauspicious consequence. Placebo controlled surveies utilizing equal patient populations and sample sizes for appropriate sums of clip, are necessary to accurately depict the hazards of AIs on cardiovascular hazard factors. Healthcare practicians should go on to supervise lipid profiles in postmenopausal adult females with chest malignant neoplastic disease and develop individualized intervention programs utilizing current recommendations. Specific safety steps for patients utilizing AIs are non necessary,16 and the effects seen in the surveies mentioned in this reappraisal suggest that long term monitoring of all lipid parametric quantities should be a portion of the postmen opausal adult female with chest malignant neoplastic diseases intervention program. Surveillance of hazard factors overtime in these adult females with should assist forestall unfavourable cardiac events.

How to Quote a Poem in APA Referencing

How to Quote a Poem in APA Referencing How to Quote a Poem in APA Referencing Many style guides have special rules for quoting poetry in an essay. In this post, for example, we will look at how to quote a poem using APA referencing. This will cover both: How to present quoted verse on the page How to format in-text citations for a poem in APA referencing If you are writing about poetry, then, make sure to follow the rules below. How to Quote a Poem The basic rules for quoting a line of poetry are the same as for quoting any other source. As such, to quote a poem, you should: Place the quoted text within quotation marks. Cite the author’s surname and year of publication in brackets. If available, include a page number for the quoted passage. Otherwise, a single line of poetry will look like any other quote. If you’re quoting two lines from a poem, though, you will need to include a include a forward slash to show where the line break was in the original text. A two-line quotation would therefore look like this: One of the most famous examples of nonsense poetry is  Ã¢â‚¬Å"The Owl and the Pussy-Cat,† which begins thus: â€Å"The Owl and the Pussy-cat went to sea / In a beautiful pea-green boat† (Lear, 1983, p. 34). Here, for instance, we’re quoting the first two lines of an Edward Lear poem. Importantly, the date cited here is for the book the poem appears in, not the poem’s original date of publication (1871). The page numbers in the citation, meanwhile, show us where this poem appears in the book. Name a more iconic duo. Quoting Three or More Lines of Poetry If you’re using more than two lines from a poem, APA rules require you to format it like a block quote. Ideally, you will also recreate the presentation of the lines on the page from the original source: The final stanza begins with an interspecies wedding: â€Å"Dear Pig, are you willing to sell for one shilling   Ã‚   Your ring?† Said the Piggy, â€Å"I will.† So they took it away, and were married next day   Ã‚   By the Turkey who lives on the hill. (Lear, 1983, p. 34) Here, for example, we indent the second and final lines more than the rest of the quote. This is because the original poem is presented in the same way. Furthermore, as with any APA block quote, the citation here comes after the final punctuation in the quote, not before it. Adding a Poem to an APA Reference List Finally, if you quote a poem anywhere in your work, it should also appear in the reference list at the end of your document. The correct reference format to use, however, will depend on how the poem was published: For long poems published as standalone works, use the standard book format. You can do this for anthologies with a single author, too, but make sure to name the editor as well as the author of the poems themselves. List poems published in an anthology as chapters from an edited book (i.e., include details for both poem and container volume). List a single poem found online as a web page. Whatever their format, make sure to provide full publication information for all poems and their container volumes (i.e., the book or website where you found the poem). This will allow your reader to find them if required. And if you need anyone to check your document for errors – including in citations and the reference list – don’t forget that we have expert academic proofreaders on hand and ready to help 24/7.

5 Lessons for Mixing Past and Present Tense

5 Lessons for Mixing Past and Present Tense 5 Lessons for Mixing Past and Present Tense 5 Lessons for Mixing Past and Present Tense By Mark Nichol Writers often fall into a tense trap and don’t even notice. A tense trap is not a trap that makes you tense; it’s when you get stuck in past tense when the phenomena you are describing is perpetual or at least valid to the present moment. Here are some sample tense traps and their simple fixes: 1. â€Å"Bush lost me as a supporter when he said that outsourcing American jobs was a good thing.† This sentence from a newspaper column correctly reports in the past tense at the beginning of the sentence. But Bush likely said something like this: â€Å"Outsourcing American jobs is a good thing.† Even in paraphrase, the writer should retain the present tense: â€Å"Bush lost me as a supporter when he said that outsourcing American jobs is a good thing.† 2. â€Å"The two men chimed right in with their own stories about what wonderful people Jack and Margaret were.† Because this sentence is taken out of context, you have no idea whether Jack and Margaret were still alive at the time they were being discussed. To your credit, though, that thought occurred to you but it didn’t occur to the person who referred to the still-alive-and-kicking couple in the past tense. Unless Jack and Margaret later suffered from a personality disorder that transformed their natures, the writer should have made the observation in the present tense: â€Å"The two men chimed right in with their own stories about what wonderful people Jack and Margaret are.† 3. â€Å"These remarks infuriated French president Jacques Chirac, who declared that his country loved Jews and was not at all anti-Semitic.† Methinks Monsieur is suffering pied-en-bouche disease when he clumsily protests France’s apparently nonabiding affection for Semitic peoples. But it’s not his fault; the paraphrase should support the intent of his sentiment by using the present tense: â€Å"These remarks infuriated French president Jacques Chirac, who declared that his country loves Jews and is not at all anti-Semitic.† 4. â€Å"He wanted to know: Did it really do all the things people said it did?† Assuming you know that the product in question is extant and that its operating features are persistent, reference to it should be in the present tense regardless of the framing tense: â€Å"He wanted to know: Does it really do all the things people say it does?† 5. â€Å"Even when he was young, Dali was fascinated by and disturbed about how ants ate animal carcasses.† Because ants (disregarding the fact that Dali remains neither a youth nor alive) still eat animal carcasses, the verb should appear in the present tense: â€Å"Even when he was young, Dali was fascinated by and disturbed about how ants eat animal carcasses.† But look at this sentence from the same article: â€Å"This experience convinced the late artist that it was useless to represent reality in his painting.† This statement is correct as is. Knowing, as we do, that the artist is no longer alive and that the sentiment refers specifically to him, the point is no longer valid, so past tense here is proper. Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Grammar category, check our popular posts, or choose a related post below:50 Slang Terms for MoneyCapitalization Rules for the Names of GamesA "Diploma" is not a "Degree"

Ethics and Accountability In Forensic Mental Health Essay

Ethics and Accountability In Forensic Mental Health - Essay Example He was violent with a nurse when she tried to give him an injection. He does not want to sleep for fear that he will be harmed. Wayne also abuses drugs (primarily marijuana) which seems to increase his paranoia. No treatment should be provided against the patients will, unless withholding treatment would endanger the life of the patient and/or of those who surrounded him or her. Treatment must always be in the best interest of the patient (As cited in Steinert et al., 2005, p. 635). In Waynes case, withholding treatment both for medicine and mental health has exacerbated his paranoia and his behaviour. In this case, it is ethically correct to give him the medication against his will in order to stop him from causing harm to himself or others. To put Wayne into the hospital, the police or the hospital would have had to use informed consent with him. In other words, they would need to be aware of Waynes privacy and they would have had to follow the principles of beneficence and malfeasance (do no harm) (American Mental Health Counsellors Association (AMHCA) Code of Ethics). Also, they must tell Wayne what is going to happen to him, how they will use any information received and the type of treatment he can expect. Since Wayne is an adult and he does not want his family to be contacted, under the law and under ethics they cannot tell his family. This may go against what the health practitioners think but it would be important to honour his wishes. Wayne appears delusional. According to his account, he has magic spells being put on him by witches. He states that the police took him to the hospital. He sees himself as a victim of this situation, and sees all those around him as his enemies. According to his account, his actions are due to his anticipation of how others are going to treat him or are currently treating him. Howe (2008) states that clinicians must tell patients the truth about their conditions no matter what