The Cranes :: Literary Analysis, Peter Meinke

â€Å"The Cranes† by Peter Meinke appears to be a simple love story about an old couple reminiscing about their life, but with a closer look the story reveals a darker component of love. The story follows an old couple’s stop at the Gulf to watch some birds. While they are watching the birds they spot two whooping cranes. Throughout their conversation and observation of the birds Meinke reveals details that the couples and the cranes share in common. Thus, the pair of whooping cranes viewed by the couple in story symbolizes both their rarity, eternal love, and their last moments together. The couple in the story is a couple that has been together a long time and persevered through life together. When they first see the whooping cranes the husband says â€Å"they are rare, not many left† (196). This is the point in the story where the first connection between the couple and the cranes are made. The rarity of the cranes symbolizes the rarity of the couple’s relationship. Although they have started developing anomalies in their health, with the husband he â€Å"can’t smoke, can’t drink martinis, no coffee, no candy† (197)  ¬Ã¢â‚¬â€they are still able to laugh with each other and appreciate nature’s beauty. Their relationship is a true oddity; filled with lasting love. However this lasting love for whooping cranes has caused some problems for the species. The whooping cranes are â€Å"almost extinct†; this reveals a problem of the couple. The rare love that they have is almost extinct as well. The wife worries about her children because the â€Å"kids never write† (197). This reveals the communication gap between the two generations, as well as the different values between the generations. These different values are a factor into the extinction of true love. Another similarity between the whooping cranes and the couple is true, lasting love. The whooping cranes â€Å"mate for life and live a long time† (197), which is a rare trait in the animal kingdom. The commitment the cranes have with each other mirrors the couples commitment to each other; having remained with each other through all those years. Even with hardships in the relationships, they endured and stayed together while some couples may have given up on the relationship. Although their love has endured through many years, it has come to an end in the story. All throughout the story the couple is reminiscing about their life and while they are there are some odd details that are strewn throughout. The Cranes :: Literary Analysis, Peter Meinke â€Å"The Cranes† by Peter Meinke appears to be a simple love story about an old couple reminiscing about their life, but with a closer look the story reveals a darker component of love. The story follows an old couple’s stop at the Gulf to watch some birds. While they are watching the birds they spot two whooping cranes. Throughout their conversation and observation of the birds Meinke reveals details that the couples and the cranes share in common. Thus, the pair of whooping cranes viewed by the couple in story symbolizes both their rarity, eternal love, and their last moments together. The couple in the story is a couple that has been together a long time and persevered through life together. When they first see the whooping cranes the husband says â€Å"they are rare, not many left† (196). This is the point in the story where the first connection between the couple and the cranes are made. The rarity of the cranes symbolizes the rarity of the couple’s relationship. Although they have started developing anomalies in their health, with the husband he â€Å"can’t smoke, can’t drink martinis, no coffee, no candy† (197)  ¬Ã¢â‚¬â€they are still able to laugh with each other and appreciate nature’s beauty. Their relationship is a true oddity; filled with lasting love. However this lasting love for whooping cranes has caused some problems for the species. The whooping cranes are â€Å"almost extinct†; this reveals a problem of the couple. The rare love that they have is almost extinct as well. The wife worries about her children because the â€Å"kids never write† (197). This reveals the communication gap between the two generations, as well as the different values between the generations. These different values are a factor into the extinction of true love. Another similarity between the whooping cranes and the couple is true, lasting love. The whooping cranes â€Å"mate for life and live a long time† (197), which is a rare trait in the animal kingdom. The commitment the cranes have with each other mirrors the couples commitment to each other; having remained with each other through all those years. Even with hardships in the relationships, they endured and stayed together while some couples may have given up on the relationship. Although their love has endured through many years, it has come to an end in the story. All throughout the story the couple is reminiscing about their life and while they are there are some odd details that are strewn throughout.

Advantages and Disadvantages of Living in Before Marriage

Today, many couples choose living in before marriage because they believe it will let them know if they are suited for marriage. Living in before marriage has some advantages and disadvantages for the couple and some of those are listed below. Some of the advantages of living in before marriage are: living-together Living together will lower the cost of food, rent and bills because two people are splitting the cost of living. In some cases, one person takes care of all the bills.In those cases, it is usually the woman who gets the benefit of free room and board costs. Having someone there for emotional support, sexual relations and for conversation without being committed in a marriage is considered an advantage for most couples. Living together before marriage allows the couple to test their compatibility. For some people, they want to feel that they can get along with someone while living together before they plan for their wedding. By living together, you will see how loyal your p artner is to you.This will help you build trust together that cannot be shaken if you agree to get married in the future. By living together, you can prepare for marriage ahead by learning someone’s habits, attitudes and manners. There are also some disadvantages of living together before marriage. These are: living-together2 By living together for a long time, you may get too comfortable with each other and totally avoid tying the knot in the future. Living together makes it easier for one partner to walk out on the relationship because there is no legal obligation to the other person.Living together can encourage an easy out for someone who wants it. Living together is often short-lived, statistics has shown. The female is the one who usually suffers if the relationship does not work out. Women tend to feel that they lose time, because of their biological clock, and dignity when they live together with a partner that ends in a break-up. No one knows for sure that living tog ether before marriage is the best thing to do. It is much easier to walk out of a relationship than it is walk out of a marriage.Everyone knows that divorce involves a lot more than what a break-up involves for a couple just living together. Many pastors and marriage counselors advise young couples that if they believe in the institution of marriage to find someone who believes in that themselves. People who believe in the sanctity of marriage do not suggest living with someone first just to get to know them better or see if they are well-suited for each other. After all, marriage is an institution, and we cannot learn things outside of an institution.

IT Case Study Essay

The Widget Wonders distribution center is the worldwide leader in widgets. Which they’re in the process of building a state of art facility to manufacture new generation of widgets. The SNHUConsulting group leads the way of consulting in information technology. SNHUConsulting has been hired to consult on new hardware that will last for at least the next three years for the different apartments. The sales department consists of 50 employees that requires mobility with access to the company’s resources while in the field with customers and presenting at sales meeting and conferences. The manufacturing department will have 45 employees and will need hardware that support word processing and spreadsheet programs and internet capable. The inventory control department will have 30 employees who would need mobility hardware as well with power to access database systems. The research and development department will consist of 20 employees that’s need hardware with graphics design and CAD programs. The MIS will consist of 5 employees who will need additional processors and memory requirements to support administration tasks. My recommendations for the sales department for mobility purposes is notebooks, smartphones, and tablets for visiting customers. For bigger presentations a digital projector that is interactive, with laser pointers that allows the sales team to talk and click on the computer to dictate its pace. Also USB drives that holds a large amount of storage that the sales team can upload from any computer systems. For the manufacturing department my recommendation are the new generation computer systems that support multi servers for the manufacturing needs. The manufacturing department will also need printers and connectivity capability to the internet as an additional resource tool to complete their job functions. The inventory department will need tablets with 32 or more GB of storage with direct access to the company’s database systems. The research and development department needs  notebooks, printers, and a docking station for automated systems backing up. Hardware that is able to compare and contrast data for the development of the company. The MIS department would need computer systems that is compatible with graphic adapters. Also the computer systems will have a multimedia screen capability for administrating tasks. In conclusion, the hardware that would be required for each department will have the durability and warranty that will last the company for at least 3 years, which will then require the company to revisit their strategic plan for any updates as needed. In purchasing the hardware, the company will included warranty and service agreement with the vendor to assist in any maintenance issues that may arrived regarding any of the hardware purchased. The hardware will have the most advance technology needed for each department efficient in their job duties.

Comprehensive Health Assessment Paper Essay

The purpose of this paper is to discuss the results of a comprehensive health assessment on a patient of my choosing. This comprehensive assessment included the patient’s complete health history and a head-to-toe physical examination. The complete health history information was obtained by interviewing the patient, who was considered to be a reliable source. Other sources of data, such as medical records, were not available at the time of the interview. Physical examination data was obtained through inspection, palpation, percussion, and auscultation techniques. The case study results are interpreted from the perspective of a registered nurse, and three nursing diagnoses are identified. Biographic Data M. H. is a 63-year-old married white female. She is currently unemployed for four months. Her most recent employment of seven years was as a private home health aid for a friend’s elderly parents who have since passed away. She was born in Buffalo, New York into a family of German decent. She currently lives in a suburb of Buffalo, N. Y. English is her primary language. Culture and Spirituality M. H. was raised in a traditional German family where her father was the head of the household. However, her father and mother made many decisions mutually and shared household chores (Purnell, 2014). Her father was an Air Force pilot during World War II, and then worked as a chemical engineer until retirement. The household atmosphere was loving and respectful. She and her five siblings were brought up as Roman Catholics. They were expected to be polite, use table manners, be on-time to meals, respect their elders, do as they were told, share, finish their chores before recreating, get good grades in school, pray before meals and at bedtime, and attend church every Sunday and on holy days (Purnell, 2014) . Past Health History When she was a child, M. H. did not have any serious illness, nor does she have any chronic illnesses currently. She did, however, have a severe case of chickenpox when she was about 3-years-old, and shingles about 18 years ago. M. H. has not been in any major accidents or had any life-threatening injuries during her life. She has been hospitalized two times for childbirth. Her obstetric history includes Gravida 2/Term 2/Preterm 0/Abortion 0/Living 2. Both births were uncomplicated vaginal deliveries. Surgical history includes tubal ligation at age 24, and removal of benign cysts in her left breast, left cheek, and left wrist between the years 1998-2003. All of her childhood vaccinations are up to date. She gets vaccinated for influenza almost every year, but she did not get vaccinated this season. She received the varicella zoster virus vaccine in February, 2015; no reactions noted. Her last tetanus shot was more 10 years ago. She denies ever having been exposed to tuberculosis (TB), and nor has she ever had a TB skin test (Jarvis, 2012). M. H. sees her primary physician every year for a physical. Her last physical was in February, 2014. She also sees her dentist annually for a check-up and cleaning. She is currently scheduled for April, 2015. As a child she never needed corrective lenses, but for the last 15 years she has needed glasses for reading. Therefore, her vision is checked annually, most recent appointment having been in January, 2015. Because she has a history of benign cysts in her breast tissue, she gets a mammogram every five years. Her last mammogram was in 2010. Results of her Pap tests have never been abnormal. She cannot recall the date of her last gynecological exam. She also gets a coloscopy every couple of years, since her father died of colon cancer. In relation to allergies, M. H. has no known drug allergies. Current over-the-counter medications include an occasional 400-600 mg dose of ibuprofen for â€Å"aches and pains†, a daily vitamin, and melatonin for insomnia, and antacids, such as Tums, for her â€Å"heartburn†. Her current prescription medications include a 225 mg tablet of Venlafaxine HCL once  daily for anxiety related dizziness, and a 20 mg tablet of Atorvastatin for high cholesterol. She drinks alcohol socially, approximately two 12 ounce beers a day. She is a former smoker of one pack of cigarettes a day for nearly forty years. Her quite date was September, 2011. She denies the use of street drugs. Review of Systems M. H. states that she is generally in good overall health. No cardiac, respiratory, endocrine, vascular, musculoskeletal, urinary, hematologic, neurologic, genitourinary, or gastrointestinal problems. No history of skin disease. Skin is pink, dry, and void of bruising, rashes, or lesions. No recent hair loss; head is normocephalic. Pupils equally reactive to light; no history of glaucoma or cataracts. Ears are in normal alignment; no history of chronic infections, hearing loss, tinnitus, or discharge. Nose and sinus history includes clear nasal discharge â€Å"since last October†, and occasional nose bleeds; states she use to get nose bleeds often as a child. Mouth and throat are absent of lesions; no bleeding gums, sore throat, dysphagia, hoarseness, or altered taste. Neck is void of pain, swelling, tender nodes, and goiter; full range of motion. M.H. states that she performs self breast exams routinely and denies any lumps or discharge. Lungs are clear; peripheral pulses present bilaterally; capillary refill less than 3 seconds. Heart rate is in normal sinus. Bowel sounds are present in all quadrants. Her psychosocial status is appropriate. M. H. denies recent weight change, weakness, fever, sweats, or fatigue (Jarvis, 2012). Abnormal findings include an elevated cholesterol level, which is also familial. Furthermore, she has a history of stress related anxiety, and was diagnosed with anxiety related dizziness in 2012. She states that before she started taking a medication her doctor prescribed, her dizzy spells could happen at any time. As a result, she avoids certain situations, such as riding in a boat. Functional Assessment After graduating from Bryant and Stratton business school in her early twenties, M. H. spent 15 years as a manager of several apartment complexes. She then worked as a manager of a retail mini-mart for the next 15 years until she got layed-off. Meanwhile, with the help of her siblings, she was  taking care of her elderly mother, her mother’s husband, and elderly mother-in-law until they all passed away. Shortly after these events, friends hired her to care for their parents, and now they have passed away. However, she still helps the friends by cleaning their house, completing simple home improvement tasks, and going grocery shopping and ruuning errands for them. M. H. lives with her husband of 42 years. She was raised Roman Catholic, believes in God, but does not attend church regularly. She states that she is an honest, hard-working woman. She takes her dog for a walk several times a day for exercise, and is independent in her activities of daily living. She and her husband enjoy time with family and friends, and host dinners and get-togethers often. Her hobbies include sewing, upholstery, and gardening. Getting 6-8 hours sleep at night is M. H.’s normal pattern, although she has occasional stress-related insomnia. She states she tries to eat healthy, is aware of â€Å"good† versus â€Å"bad† food choices, and does not have any food intolerances. Both her husband and she share the cooking and grocery shopping duties (Jarvis, 2014). A typical daily diet includes a small bowl of whole grain cereal with skim milk or a protein shake for breakfast, soup and/or sandwich for lunch, and a cut of lean meat with a vegetable side for dinner. She and her husband occasionally order pizza, get a fish fry on Fridays during lent, or go out for Chinese food. Normal elimination pattern includes one or two bowel movements a day; she has no problems urinating, although if she drinks regular coffee, it will cause urinary frequency. In regards to interpersonal relationships, she has a very strong relationship with her siblings and their families, her husband’s family, and her children and their families. She enjoys caring for her grandchildren on an â€Å"as needed† basis. She qualifies time spent alone as productive and/or relaxing, stating â€Å"everyone needs a little time alone to work on their own projects† (Jarvis, 2014). She considers her neighborhood, house, and work environment safe. She states she has the â€Å"typical stresses of life, like making money to pay bills, repairing their old house, and being married and  having a family†. Conclusion Based on the results of the comprehensive assessment data, M. H. is a relatively healthy person, who has not had any serious or life-threatening medical problems during her life. She presents with anxiety and anxiety related dizziness that is currently under control with medication. She follows up with her physician and other health care professions on a regular basis, eats healthy, and takes her medications as prescribed. She also has a healthy psychosocial status with family and friends. From a nursing perspective, three nursing diagnoses apply to M. H. in her current situation. The first priority diagnosis is Anxiety (moderate) related to stress as manifested by insomnia and dizziness. Second priority diagnosis is deficient Knowledge related to anxiety and dizziness as manifested by M. H. stating lack of complete understanding of the condition. The third priority diagnosis is disturbed Sensory Perception (kinesthetic) related to psychological stress as manifested by sensory distortions (i.e., dizziness). These diagnoses will assist nurses to identify appropriate interventions that will help M. H. achieve an optimal state of wellness (Doenges, Moorhouse, & Murr, 2010). References Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2010). Nurse’s pocket guide: Diagnoses, Prioritized Interventions, and Rationales (12th ed.). Philadelphia, PA: F. A. Davis Company. Jarvis, C. (2012). Physical Examination and Health Assessment (6th ed.). St. Louis, MO: Elsevier. Purnell, L. D. (2014). Culturally Competent Health Care (3rd ed.). Philadelphia, PA: F. A. Davis Company.

Ruth Bader Ginsberg essays

Ruth Bader Ginsberg essays Ruth Bader Ginsburg was born on March 15, 1933 in Brooklyn, New York. Her father, Nathan, was a furrier and her mother, Celia, had a strong passion for reading, language and love of books. Ruth had an older sister, Marilyn, who died of Meningitis. She attended James Madison High School, where she was a cheerleader, baton twirler, played the cello and was editor of the school paper. Graduating top of her class in grammar and high school, she went on to Cornell University, earning her bachelors in government. In 1954 she married Martin D. Ginsburg, now a professor of tax law at Georgetown University Law Center. They enrolled together in Harvard Law School. She then wrote material on sex-based discrimination after being personally discriminated against when she told her employer she was pregnant and received a three level pay decrease. Ruth then had two children: Jane C (a professor at Columbia Law School) and James S (a producer of Classical productions). After graduation, she served as a clerk for Federal District Judge Edward Palmieri and then became the second woman to join the faculty of Rutgers Law School. She tried many cases for the American Civil Liberties Union. On June 30, 1980, Ruth Bader Ginsburg was sworn into the United States Court of Appeals for the District of Columbia, after being nominated by President Jimmy Carter. There she served for thirteen years until August 10, 1993, when Judge Byron R. White resigned from the Supreme Court. Being nominated by Bill Clinton, she was approved by the senate with a vote of ninety-six to three. Ruth Bader Ginsburg was the second woman and first Jew ever admitted. Ruth Bader Ginsburg served many supreme court cases. One of her major ones was the Baker vs. General Motors Corp. in 1997. In this case Ronald Elwell worked fifteen years for GM. He was assigned to study GM vehicle performance, particularly concentrating on vehicular ...

Standard Quality of Care Hcs 451 Essays

Standard Quality of Care Hcs 451 Essays Standard Quality of Care Hcs 451 Essay Standard Quality of Care Hcs 451 Essay Health Care Quality Management and Outcomes Analysis Professor Jodi Sapaguh By Lisa Gresley August 9, 2010 Substandard quality of health care is duly recognized as a major form of medical crises with potential to jeopardize the functioning and purpose of the American health care system. Whereas on the one hand medical costs of treatment are rising, on the other malpractices and non compliance on the part of medical professionals and institutions compounds the problem and seriously questions the quality of health care being provided to citizens. However, before proceeding further it is important to understand what is exactly meant by the substandard quality of care. The substandard quality of care implies that one or more of the requirements mandatory under the federal regulations 42 CFR 483 . 13 involving resident behavior and facility practices, 42CFR . 15 involving quality of life or 42CFR 483 . 25 regarding quality of care are not complied with leading to actual jeopardy to the resident health or safety or having potential for causing more than minimal harm (HealthCare information, 2007). Any nursing home found with delivering substandard quality of healthcare or carrying significant deficiencies in its healthcare treatment plans would be required to immediately address the issue. The following personal experience presents an example of injuries from utilization control healthcare delivered resulting in grievous and permanent injuries to the patient. The problem here is about Lois Battles, my grandmother, who was diagnosed with Leriches syndrome, which is a vascular occlusion. Upon diagnosis, her doctor recommended surgery where a part of an artery was to be replaced with a Teflon graft. The program providing medical care to Lois was Californias medical assistance program, Medi-Cal that was responsible for controlling costs and authorizing treatment. As such, the approval and authorization from state was a requirement to perform surgery. When Lois’s doctors sought approval from Medi-Cal for the surgery, Medi-Cal agreed and also allowed ten days of post-surgery treatment in hospital. However, Mrs. Battles recovery did not take place as estimated and a day before due discharge date, the surgeon and his assistant felt that Mrs. Battles required additional eight days of recuperation in hospital. Medi-Cal was again approached for the approval for this extended stay, but on this occasion Medi-Cal differed from surgeon’s recommendations for eight days extension. The Medi-Cal representative, who was himself a certified surgeon, merely consulted a Medi-Cal nurse on the phone and after evaluating progress of Mrs. Battles on basis of her temperature, diet and bowel function, declined the request and approved only four day extension. In the process he neither reviewed any documents related to the case nor consulted any other vascular-surgery specialist. On denial by Med-Cal, the surgeon attending the case of Mrs. Battles decided not to push for the additional days of care and complied with Med-Cal directives by discharging her at the end of the stipulated period. Mrs. Battles than got an infection and was sent right back in to the hospital for treatment. If Mrs. Battles would have stayed the four extra days she may have been fine. So in order to be a successful organizational and business performance is the ability to manage the accessibility and processing of information. Accurate, timely and relevant data form the basis for planning, monitoring and decision-making processes across an organization. Healthcare, more than other industries, feels the pinch of dealing with substandard and inaccurate information because it is more data rich, data dependant and data sensitive than any other sector of the economy. The practice of medicine requires continuous availability across the various functions to ensure best care outcomes as well as a perpetual state of readiness for possible changes in patient demands, competitive scenario, regulations or disease patterns and new outbreaks. Healthcare information technology forms a pivotal part of todays healthcare system. Improved quality of healthcare, patient safety, drastic reduction in medical errors and enhancement of care delivery is possible because of the induction of these solutions in the healthcare delivery environment. Today, healthcare IT solutions are enabling processes like planning, decision-making related to organizational development, strategic planning to drive growth, recruitment of competent personnel, managing employee benefits, payroll, intra-department communication, etc. One policy that has changed the health care delivery to shift cost responsibility toward the hospital was the Tax Equity and Fiscal Responsibility Act of 1982. This policy has changed hospital reimbursement under Medicare with the introduction of diagnosis-related groups (DRGs) (Sultz amp; Young, 2009). The DRG prospective payment system rewarded hospitals financially for efficient care (specifically shorter hospital stays) and reduced the incentive to consume (Sultz amp; Young, 2009). Another policy that placed the burden of responsibility on the hospital was the Consolidated Omnibus Budget Reconciliation Act of 1985 which required hospitals to provide care to everyone who presented in the emergency department regardless of ability to pay (Sultz amp; Young, 2009). This law was designed with good intent to reduce the â€Å"patient dumping† that had arisen from the DRG system, but it nevertheless increased hospital responsibility without additional financial support. More recently, the Deficit Reduction Act of 2005 required the Secretary of the Department of Health and Human Services to select at least two hospital-acquired conditions for which hospitals will no longer be reimbursed by Medicare (United States Congress, 2006). The purpose of this new law is to contain costs by penalizing hospitals for preventable conditions or complications resulting from substandard care. The designated conditions were to meet the requirements of being high cost and/or high volume, and reasonably preventable through the application of evidence-based guidelines (S. Rep. No. 1932, 2006). Eight hospital-acquired conditions have been selected thus far and at least nine additional conditions are up for consideration of being added to the list for 2009 (Center for Medicare amp; Medicaid Services (CMS), 2008). The way this law works is that if a patient develops a hospital-acquired condition or complication during their hospital stay that was not documented upon admission, Medicare will no longer reimburse the hospital for the treatment of the condition and the hospital will be forced to absorb the cost. Conditions included in this new rule particularly relevant to nursing include stage III and IV pressure ulcers, injuries from falls, and catheter-associated urinary tract infections. In light of these policy changes, hospitals are under intense pressure to improve quality of care and reduce costs. Many areas of vulnerability for hospitals such as patient safety, prevention of hospital-acquired conditions, and continuity of care, are directly related to nursing. However, instead of areas of vulnerability, it is better to view the current challenges of health care as opportunities for improvement.

Global Green House Effects essays

Global Green House Effects essays The greenhouse effect is an increase in the atmospheric temperature caused by increasing amounts of greenhouse gases. These gases act as a heat blanket insulating the Earth's surface absorbing and trapping heat radiation which normally escapes from the earth. They include carbon dioxide, water vapour, methane, nitrous oxide, CFC's, and other halo-carbons. The earth's atmosphere goes through two processes constantly. Global cooling is the first process. This process uses the clouds which cover 60% of the earth's surface to reflect 30% of the solar radiation. It also uses a sulfate haze, which is formed by sulfur dioxide from industrial sources that enter the atmosphere and react with compounds to form a high-level aerosol. These cool the atmosphere by blocking us from direct contact with the sun. The reflection of the sunlight is referred to as planetary albedo and contributes to the overall cooling. The second is the warming process. This is when light energy comes through the atmosphere and is absorbed by Earth and transformed to heat energy at the planet's surface. The infrared heat energy then radiates upward into space. There the greenhouse gases found naturally in the troposphere absorb some of the infrared radiation. The gases insulate the Earth, but do eventually allow the heat to escape. Without these greenhouse gases the earth would be would 33 C colder. Global temperature is a balance of the effects of the factors leading to global cooling, and warming. Unfortunately, increased emissions of greenhouse gases increase the warming process. For example, every kilogram of fossil fuels burned equals 3 kilograms of carbon dioxide ( the mass triples because each carbon atom in fuel bond to two oxygen atoms, in the course of burning, and forms C02. ) 6 billion tons of fossil fuel carbon are burned each year adding 18 billion tons of C02 to the atmosphere. This has increase the carbon dioxide concentrations by ...