Monday, September 30, 2019
The Return: Shadow Souls Chapter 16
Damon clearly decided to throw himself on the mercy of the court, and looked piteous and a little unbalanced, which he could easily do whenever he wanted. ââ¬Å"I really didn't try to Influence you,â⬠he repeated, but then hastily added, ââ¬Å"Maybe I can just change the subject for a while ââ¬â tell you more about the star balls.â⬠ââ¬Å"That,â⬠Elena said in her most frosty voice, ââ¬Å"might be a rather good idea.â⬠ââ¬Å"Well, the balls make recordings directly from your neurons, you see? Your neurons in your brain. Everything you've ever experienced is there in your mind somewhere, and the ball just draws it out.â⬠ââ¬Å"So you can always remember it and watch it over and over like a movie, too?â⬠Elena said, twiddling with her veil to shade her face from him, and thinking that she would give a star ball to Alaric and Meredith before their wedding. ââ¬Å"No,â⬠Damon said, rather grimly. ââ¬Å"Not like that. For one thing, the memory is gone from you ââ¬â these are kitsune toys we're talking about, remember? Once the star ball has taken it from your neurons, you don't remember a thing about the event. Second, the ââ¬Ërecording' on the star ball gradually fades ââ¬â with use, with time, with some other factors nobody understands. But the ball gets cloudier, and the sensations weaker, until finally it's just an empty crystal sphere.â⬠ââ¬Å"But ââ¬â that poor man was selling a day of his life. A wonderful day! I should think he would want to keep it.â⬠ââ¬Å"You saw him.â⬠ââ¬Å"Yes.â⬠Once again Elena saw the louse-ridden, haggard, gray-faced old man. She felt something like ice down her spine at the thought that he had once been the laughing, joyous, young John that she had experienced. ââ¬Å"Oh, how sad,â⬠she said, and she wasn't talking about memory. But, for once, Damon hadn't followed her thoughts. ââ¬Å"Yes,â⬠he said. ââ¬Å"There are a lot of the poor and the old here. They worked themselves free of slavery, or had a generous owner dieâ⬠¦and then this is where they end up.â⬠ââ¬Å"But the star balls? Are they just made for poor people? The rich ones can just travel to Earth and see a real summer day for themselves, right?â⬠Damon laughed without much humor. ââ¬Å"Oh, no, they can't. Most of them are bound here.â⬠He said bound oddly. Elena ventured, ââ¬Å"Too busy to go on vacation?â⬠ââ¬Å"Too busy, too powerful to get through the wards protecting Earth from them, too worried about what their enemies will do while they're gone, too physically decrepit, too notorious, too dead.â⬠ââ¬Å"Dead?â⬠The horror of the tunnel and the corpse-smelling fog seemed ready to envelope Elena. Damon flashed one of his evil smiles. ââ¬Å"Forgot that your boyfriend is de mortius? Not to mention your honorable master? Most people, when they die, go to another level than this ââ¬â much higher or much lower. This is the place for the bad ones, but it's the upper level. Farther down ââ¬â well, nobody wants to go there.â⬠ââ¬Å"Like Hell?â⬠Elena breathed. ââ¬Å"We're in Hell?â⬠ââ¬Å"More like Limbo, at least where we are. Then there's the Other Side.â⬠He nodded toward the horizon where the lowering sun still sat. ââ¬Å"The other city, which may have been where you went on your ââ¬Ëvacation' to the afterlife. Here they just call it ââ¬ËThe Other Side.' But I can tell you two rumors I heard from my informants. There, they call it the Celestial Court. And there, the sky is crystal blue and the sun is always rising.â⬠ââ¬Å"The Celestial Courtâ⬠¦Ã¢â¬ Elena forgot that she was speaking aloud. She knew instinctively that it was the queens-and-knights-and-sorceresses kind of court, not a court of law. It would be like Camelot. Just saying the words brought up an aching nostalgia, and ââ¬â not memories, but the tip-of-the-tongue feeling that memories were locked right behind a door. It was a door, however, that was securely locked, and all Elena could see through the keyhole were ranks of more women like the Guardians, tall, golden-haired, and blue-eyed, and one ââ¬â child-sized among the grown women ââ¬â who glanced up, and, piercingly, from a long way off, met Elena's gaze directly. The litter was moving out of the bazaar into more slums, which Elena took in with darting quick glances on either side of her, hiding in her veil. They seemed like any earthly slums, barrios, or favella ââ¬â only worse. Children, their hair turned red by the sun, crowded around Elena's litter, their hands held out in a gesture with universal meaning. Elena felt a tearing at her insides that she had nothing of real value to give them. She wanted to build houses here, make sure these children had food and clean water, and education, and a future to look forward to. Since she had no idea how to give them any of these things, she watched them dash off with treasures such as her Juicy Fruit gum, her comb, her minibrush, her lip gloss, her water bottle, and her earrings. Damon shook his head, but didn't stop her until she began fumbling with a lapis and diamond pendant Stefan had given her. She was crying as she tried to disengage the clasp when suddenly the last bit of the rope around her wrist came up short. ââ¬Å"No more,â⬠Damon said. ââ¬Å"You don't understand anything. We haven't even entered the city proper yet. Why don't you have a look at the architecture instead of worrying about useless brats who're likely to die anyway?â⬠ââ¬Å"That's cold,â⬠Elena said, but she couldn't think of any way to make him understand, and she was too angry with him to try. Still, she stopped fumbling with the chain and looked beyond the slums as Damon had suggested. There she could see a breathtaking skyline, with buildings that seemed meant to last for eternity, made of stones that looked the way the Egyptian pyramids and Mayan ziggurats must have looked when they were new. Everything, though, was colored red and black by a sun now concealed by sullen crimson cloudbanks. That huge red sun ââ¬â it gave the air a different look for different moods. At times it seemed almost romantic, glinting on a large river Elena and Damon passed, picking out a thousand tiny wavelets in the slow-moving water. At other times, it simply seemed alien and ominous, showing clearly on the horizon like a monstrous omen, tingeing the buildings, no matter how magnificent, the color of blood. When they turned away from it, as the litter bearers moved down into the city where the huge buildings were, Elena could see their own long and menacing black shadow thrown ahead of th em. ââ¬Å"Well? What do you think?â⬠Damon seemed to be trying to placate her. ââ¬Å"I still think it looks like Hell,â⬠Elena said slowly. ââ¬Å"I'd hate to live here.â⬠ââ¬Å"Ah, but whoever said that we should live here, my Princess of Darkness? We'll go back home, where the night is velvet black and the moon shines down, making everything silver.â⬠Slowly, Damon traced one finger from her hand, up her arm to her shoulder. It sent an inner shiver through her. She tried holding the veil up as a barrier against him, but it was too transparent. He still flashed that brilliant smile at her, dazzling through the diamond-dotted white ââ¬â well, shell pink, of course, because of the light ââ¬â that was on her side of the veil. ââ¬Å"Does this place have a moon?â⬠she asked, trying to distract him. She was afraid ââ¬â afraid of him ââ¬â afraid of herself. ââ¬Å"Oh, yes: three or four of them, I think. But they're very small and of course the sun never goes down, so you can't see them as well. Notâ⬠¦romantic.â⬠He smiled at her, again, slowly this time, and Elena looked away. And in looking, she saw something in front of her that captured her entire attention. In a side street a cart had overturned, spilling large rolls made out of fur and leather. There was a thin, hungry-looking old woman attached to the cart like a beast, who was lying on the ground, and a tall angry man standing over her, raining down blows with a whip on her unprotected body. The woman's face was turned toward Elena. It was contorted in a grimace of anguish, as she tried ineffectually to roll into a ball, her hands over her stomach. She was naked from the waist up, but as the whip lashed into her flesh, her body from throat to waist was being covered by a coating of blood. Elena felt herself swelling with Wing Powers, but somehow none would come. She willed with all her circulating life-force for something ââ¬â anything ââ¬â to break free from her shoulders, but it was no good. Maybe it had something to do with wearing the remains of slave bracelets. Maybe it was Damon, beside her, telling her in a forceful voice not to get involved. To Elena, his words were no more than punctuation to the heartbeat pounding in her ears. She jerked the rope sharply out of his hands, and then scrambled out of the litter. In six or seven leaps she was beside the man with the whip. He was a vampire, his fangs elongated at the sight of the blood before him, but never stopping his frenzied lashing. He was too strong for Elena to handle, butâ⬠¦ With one more step Elena was straddling the woman, both her arms flung out in the universal gesture of protection and defiance. Rope dangled from one wrist. The slave owner was not impressed. He was already launching the next whiplash, and it struck Elena across the cheek and simultaneously opened a great gap in her thin summer top, slicing through her camisole and scoring the flesh underneath. As she gasped, the tail of the whip cut through her jeans as if denim were butter. Tears formed involuntarily in Elena's eyes, but she ignored them. She had managed not to make a sound other than that initial gasp. And she still stood exactly where she had first landed in protection. Elena could feel the wind whip at her tattered blouse, while her untouched veil waved behind her, as if to protect the poor slave who had collapsed against the ruined cart. Elena was still desperately trying to bring out any kind of Wings. She wanted to fight with real weapons, and she had them, but she couldn't force them to save either her or the poor slave behind her. Even without them Elena knew one thing. That bastard in front of her wasn't going to touch his slave again, not unless he cut Elena into pieces first. Someone stopped to stare, and someone else came out of a shop, running. When the children who'd been trailing her litter surrounded her, wailing, a crowd of sorts gathered. Apparently it was one thing to see a merchant beating his worn-out drab ââ¬â the people around here must have seen that almost daily. But to see this beautiful new girl having her clothes slashed away, this girl with hair like golden silk under a veil of gold and white, and eyes that perhaps reminded some of them of a barely remembered blue sky ââ¬â that was quite another thing. Moreover, the new girl was obviously a fresh barbarian slave who had clearly humiliated her master by tearing the lead ropes from his hands and was standing now with her sanctity veil made into a mockery. Terrific street theater. And even given all of that, the slave owner was preparing for another stroke, raising his arm high and preparing to put his back into it. A few people in the crowd gasped; others were muttering indignantly. Elena's new sense of hearing, turned up high, could catch their whispering. A girl like this wasn't meant for the slums at all; she must have been destined for the heart of the city. Her aura alone was enough to show that. In fact, with that golden hair and those vivid blue eyes, she might even be a Guardian from the Other Side. Who knew ââ¬â ? The lash that was raised never descended. Before it could, there was a flash of black lightning ââ¬â pure Power ââ¬â that sent half the crowd scattering. A vampire, young in appearance and dressed in the clothing of the upper world, Earth, had made his way to stand between the golden girl and the slave owner ââ¬â or rather to loom over the now cringing slave owner. The few in the crowd not stirred by the girl immediately felt their hearts pulse at the sight of him. He was the girl's owner, surely, and now he would see to the situation. At that instant, Bonnie and Meredith arrived on the scene. They were reclining on their litter, decorously draped in their veils, Meredith in starry midnight blue and Bonnie in soft pale green. They could have been an illustration for The Arabian Nights. But the moment they saw Damon and Elena, they most indecorously jumped off the litter. By now the crowd was so thick that working their way to the front required using elbows and knees, but in only seconds they were at Elena's side, hands defiantly unbound or trailing rope that hung defiantly free, veils floating in the wind. When they did arrive beside Elena, Meredith gasped. Bonnie's eyes opened wide and stayed that way. Elena understood what they were seeing. Blood was flowing freely from the cut across her cheekbone and her blouse kept opening in the wind to reveal her torn and bloody camisole. One leg of her jeans was rapidly turning red. But, drawn up into the protection of her shadow, was a far more pitiful figure. And as Meredith raised Elena's diaphanous veil to help keep her blouse closed and once more enshroud her in decency, the woman herself raised her head, to look at the three girls with the eyes of a dumb and hunted animal. Behind them, Damon said softly, ââ¬Å"I shall quite enjoy this,â⬠as he lifted the heavy man into the air with one hand and then struck his throat like a cobra. There was a hideous scream, which went on and on. No one tried to interfere, and no one tried to cheer the slave owner on to make a fight. Elena, scanning the faces of the crowd, realized why. She and her friends had become used to Damon ââ¬â or as used as you could become to his half-tamed air of ferocity. But these people were getting their first look at the young man dressed all in black, of medium height and slim build, who made up for his lack of bulging muscle with a supple and deadly grace. This was enhanced by the gift of somehow dominating all the space around him, so that he effortlessly became the focal point of any picture ââ¬â the way a black panther might become the focal point if it were walking lazily down a crowded city street. Even here, where menace and an aspect of outright evil were commonplace, this young man exuded a quality of danger that made people want to stay out of his line of sight, much less his way. Meanwhile Elena and both Meredith and Bonnie were looking around for some sort of medical assistance, or even for something clean that would staunch wounds. After about a minute, they realized that it wasn't just going to appear, so Elena appealed to the crowd. ââ¬Å"Does anyone know a doctor? A healer?â⬠she shouted. The audience merely watched her. They seemed loath to get involved with a girl who had obviously defied the black-clad demon now wringing the slave owner's neck. ââ¬Å"So you all think it's just fine,â⬠Elena shouted, hearing the loss of control, the disgust and fury in her own voice, ââ¬Å"for a bastard like that to be whipping a starving pregnant woman?â⬠There were a few downcast eyes, a few scattered replies on the theme of ââ¬Å"He was her master, wasn't he?â⬠But one youngish man who had been leaning against a stopped wagon, straightened up. ââ¬Å"Pregnant?â⬠he repeated. ââ¬Å"She doesn't look pregnant!â⬠ââ¬Å"She is!â⬠ââ¬Å"Well,â⬠the young man said slowly, ââ¬Å"if that's true, he's only harming his own merchandise.â⬠He glanced nervously over to where Damon was now standing above the deceased slave owner, whose face was cast into a ghastly death grimace of agony. This still left Elena with no help for a woman she was afraid was about to die. ââ¬Å"Doesn't anyone know where I can find a doctor?â⬠There were now mutterings in various tones from the crowd members. ââ¬Å"We might get further on if we could offer them some money,â⬠Meredith was saying. Elena immediately reached for her pendant, but Meredith was quicker, unfastening a fancy amethyst necklace from around her neck and holding it up. ââ¬Å"This goes to whoever shows us a good doctor first.â⬠There was a pause while everyone seemed to be assessing the reward and the risk. ââ¬Å"Don't you have any star balls?â⬠a wheezing voice asked, but a high, light voice cried, ââ¬Å"That's good enough for me!â⬠A child ââ¬â yes, a genuine street urchin ââ¬â darted to the front of the crowd, grabbed Elena's hand and pointed, saying, ââ¬Å"Dr. Meggar, right up the street. It's only a couple of blocks; we can walk it.â⬠The child was wrapped in a tattered old dress, but that might only be to keep warm, because he or she was also wearing a pair of trousers. Elena couldn't even figure out whether it was a boy or a girl until the child gave her an unexpectedly sweet smile and whispered, ââ¬Å"I'm Lakshmi.â⬠ââ¬Å"I'm Elena,â⬠Elena said. ââ¬Å"Better hurry, Elena,â⬠Lakshmi said. ââ¬Å"Guardians will get here soon.â⬠Meredith and Bonnie had gotten the dazed slave woman to her feet, but she seemed to be in too much pain to understand if they meant to help her or kill her. Elena remembered how the woman had huddled in the shadow of Elena's own body. She put a hand on the woman's bloody arm and said quietly, ââ¬Å"You're safe now. You're going to be fine. That man ââ¬â yourâ⬠¦your master ââ¬â is dead and I promise that nobody will hurt you again. I swear it.â⬠The woman stared at her in disbelief, as if what Elena was saying was impossible. As if living without being beaten constantly ââ¬â even with all the blood Elena could see old scars, some of them like cords, on the woman's skin ââ¬â was something too far from reality to imagine. ââ¬Å"I swear it,â⬠Elena said again, not smiling, but grimly. She understood that this was a burden she was taking on for life. It's all right, she thought, and realized that for some time now she had been sending her thoughts to Damon. I know what I'm doing. I'm ready to be responsible for this. Are you sure? Damon's voice came to her, as uncertain as she'd ever heard him. Because I'm sure as hell not going to take care of some old hag when you get tired of her. I'm not even sure I'm ready to deal with whatever it's going to cost me for killing that bastard with the whip. Elena turned to look at him. He was serious. Well, then why did you kill him? she challenged. Are you joking? Damon gave her a shock with the vehemence and venom of his thought. He hurt you. I should have killed him more slowly, he added, ignoring one of the litter bearers who was kneeling beside him, undoubtedly asking what to do next. Damon's eyes, however, were on Elena's face, on the blood still flowing from her cut. Il figlio de cafone, Damon thought, his lips drawing back from his teeth as he looked down on the corpse, so that even the litter bearer scurried away on hands and knees. ââ¬Å"Damon, don't let him leave! Bring them all over here right now ââ¬â â⬠Elena began, and then, as there was a sort of universal gasp around her, she continued nonverbally, Don't let the litter bearers leave. We need a litter to carry this poor woman to the doctor. And why is everyone staring at me? Because you're a slave, and you've just done things no slave should do and now you're giving me, your master, orders. Damon's telepathic voice was grim. It's not an order. It's a ââ¬â look, any gentleman would help a lady in distress, right? Well, there are four of us over here and one is more distressed than you want to look at. No, three are. I think I'm going to need some stitches, and Bonnie is about to collapse. Elena was striking methodically at weak points, and knew that Damon knew she was doing it. But he ordered one of the sets of litter bearers to come and pick up the slave woman and the other to take his girls. Elena stuck with the woman and ended up in a litter with the curtains all closed around it. The smell of blood was a copper taste in her mouth, making her want to cry. Even she didn't want to look closely at the slave woman's injuries, but blood was running onto the litter. She found herself taking off her blouse and camisole and putting back only the blouse so that she could use the camisole to hold to a great diagonal slash across the woman's chest. Every time the woman raised dark brown, frightened eyes to her, Elena tried to smile at her encouragingly. They were down deep somewhere in the trenches of communication, where a look and a touch meant more than words. Don't die, Elena was thinking. Don't die, just as you have something to live for. Live for your freedom, and for your baby. And maybe some of what she was thinking got through to the woman, because she relaxed against the litter cushions, holding on to Elena's hand.
Sunday, September 29, 2019
The Brief History of the Elderly Barriers
Mental ailment is a significant determinant giving rise to the disease burdens of the elderly people. While the elderly people do not seem to suffer from disproportionate share of most distinct mental ailment such as depression or schizophrenia they do have a much higher prevalence of dementing ailment like Alzheimerâ⬠s disease and are subjected to enhanced rates of interpersonal losses. Irrespective of substantial rates of morbidity the proportion of older people acknowledged to be incapacitated and those really receiving sufficient treatment is remarkably low than that of the younger age groups. Deficiency in the treatment of mental illness in the elderly emerge to be a considerable factor in the enhanced suicide rates among the elderly population along with the premature or unsuitable placement of elderly persons in nursing homes. The studies on mental ailment in the elderly people has been disregarded and deserted till very recently. Even with the attention that has been accorded to the prevalence of large number of patients with Alzheimerâ⬠s disease, funding for research in relation to the incidence and distressing nature of mental ailment in the elderly continues to be insufficient. Considerable impediments prevail for the elderly in accessing and utilizing mental health services. Community based prevention programs for older people supported by federal and state funds are limited. This is combined with the absence of institutionalized consultancy and treatment programs including medication goals set particularly for older mentally impaired people. (Mental Health Services: Reaching Out to the Elderly. Part One)) An analysis brought out in the Journal of the American Geriatrics Society reveals that while the rates of diagnosis for depression for patients at an age of 65 and older was enhanced radically during the 1990s, considerable differentiations by age, ethnicity, and supplemental insurance coverage still continues in relation to the treatment for those diagnosed patients. The elderly people also perceive themselves to be more stigmatized about having a psychiatric diagnosis and taking medication for treatment. (Books, Articles and Research) Stereotypes related to people who belong to the elderly group and have mental illnesses may intervene with their successful health care delivery. The prospective therapies may not be organized, covered or medications supplied as a result of the prejudice that such persons cannot improve or do not have enough time left in their lives to improve. The elderly are regularly being diagnosed and provided psychoanalysis with disregard or negatively talked about when their health is narrated. Such stereotypes regularly flow into delusions about the professionals delivering their care in diagnosis or entailing medications or counseling. Stigma and ageism are two incidents that largely influence the real assessment of people who are elderly and have mental illnesses and finally their health care. (Books, Articles and Research) The coverage under Medicare is insufficient and serves to enhance the myth that mental illness in the elderly is both to be anticipated and not reactive to the treatment. (Mental Health and the Elderly Position Statement) There exists a large differentiation in Medicare and Medicaid reimbursement between psychiatric care and medical care. This has discouraged many prospective psychiatrists, social workers and psychologists from having a career in geriatric mental health. (Overlooked and Underserved: Elders in Need of Mental Health Care) Another significant element in the lives of our elderly patients is that practically all of the elderly population are dealing with co-morbidities that may incorporate physical ill health along with mental illness and the settings that entail meticulous collaboration among patients, caregivers of the families and practitioners from a variety of health care disciplines. The reimbursement for services under such settings is awkward and is sometimes an impediment to best practices. Medicare imposes a 20 percent co-insurance rate on most outpatient services except for mental health services that necessitates 50 percent co-insurance rate. (Long-Term Care Financing: Blueprints for Reform- Special Committee on Aging, United States Senate) This unjust inclination in the system is considered to be the consequence and the cause for the persistent impediment to the stigma related to mental illness and is considered to be a major impediment for reaching care. Additionally, the distinction creates confusion and improper carrier reimbursement decisions like the continuing decisions by carriers to reimburse only 50 percent for medication management services in patients with Alzheimerâ⬠s disease and other dementias in contravention to the particular directives forwarded by the Center for Medicare and Medicaid Services. Long-Term Care Financing: Blueprints for Reform- Special Committee on Aging, United States Senate) A number of researches have revealed that when mental health services are seriously confined, the consequence is higher costs in terms of medication and over utilization of general medical visits. Elderly adults with the mental problems regularly seek health care services in primary care environments where the detection and management of this ailment condition may be less than optimal. (Mental Health and the Elderly Position Statement) The approach of the mental health professionals influences the service of care. Such personnel may demonstrate the same ageism and believe the same typecast about the elderly as those detected in the general population. They are inclined to misinterpret some problems as confronted by the elders in their normal course of ageing instead of the problems necessitating assistance. In addition to this younger, more articulate and more introspective clients may hold more appeal for many professionals. (Mental Health Services: Reaching Out to the Elderly. Part One)) Hence the elderly adults with mental ailments continue to be segregated in nursing homes and other separating environments even as other age groups have started to gain full membership in the community. (Books, Articles and Research) It has been visualized that in no other age group is the combination and interrelationship of physical, social and economic problems as important as that of the elderly. The elderly people continue to take for granted the ailments like sleep disturbances, changes in appetite and mood differences as physical problems. This trend is strengthened by the physicians who sometimes take such symptoms to be the out come of the aging process. The medical practice presently does not necessarily assign time for the detailed medical and social trend that would foster a more real diagnosis. The absence of such organized and complete health care has an adverse impact on all age groups in the United States. However, for elderly adults who appear to have multiple needs, such health systems are largely divided up and become a surprising source of patient confusion. Most elders remove from service emotions which are besieged by the long detentions and complex procedures. For administrators facing the budgetary limits, it has more often been that the elder population has been set aside on the plea that they are older enough to take advantage from the services. It would position to cause that a society that places such great significance on youth and the significance of looking young does not lend encouraging support to improve the mental health care for the geriatric population. Overlooked and Underserved: Elders in Need of Mental Health Care) To conclude, the accessibility to the suitable mental health services is at the center of entailing secular care to elderly Americans in the way that is most preferred by patients, their families and health care practitioners. (Long-Term Care Financing: Blueprints for Reform- Special Committee on Aging, United States Senate) A promising consumer and family movement through energetic advocacy are necessitated to defeat stigma and prevent discrimination against elderly people with mental illness. The reach to elderly mental health services can be developed immediately if we develop the abilities of primary care providers, public schools, the child welfare system and others to assist the elderly with mental health disorders looking for treatment. (Mental Health Gets Noticed) The prescribed drugs are necessary elements for treatment of a number of mental ailments and an outpatient prescribed drug assists along with a complete coverage of psychotropic medications and must be prioritized in the Congressional agenda. Other variations to the Medicare strategy which would be advantageous for geriatric patients with mental health needs are that it include extensive coverage of case management and care plan oversight, which are presently confined to patients who are being delivered with home care or hospice care; complete coverage of Medicare/Medicaid cost sharing for low income patients and revisions in reimbursement policies for services offered in assisted living facilities. Long-Term Care Financing: Blueprints for Reform- Special Committee on Aging, United States Senate) The serious confinements on Medicare reimbursement for mental health services are required to be avoided. The National Institute of Mental Health- NIMH is required to continue financial assistance at appropriate levels of devising the training programs in interdisciplinary mental health care for the elderly that incorporates the disciplines of medicine psychiatry, psychology, psychiatric nursing and clinical social work. Training programs are required to acknowledge that most mental health care takes place in the primary care environment. Instant expansion of the research programs is required to be funded by the NIMH and other agencies on the etiology and treatment of anxiety and depressive problems, paranoia, dementing problems and other behavioral problems which have profound impact on the elderly patients. (Mental Health and the Elderly Position Statement)
Saturday, September 28, 2019
Question 6 Essay Example | Topics and Well Written Essays - 1000 words
Question 6 - Essay Example n (1932 ) AC 562, where the question arouse whether a manufacturer of soft drinks could be held liable for negligence by consumer, Lord Aktins ruled, ââ¬Å"You must take reasonable care to avoid acts or omissions which you can reasonably foresee would be likely to injure your neighbor.â⬠(Donoghue v. Stevenson (1932). 2006) In the case of physical injuries caused to the applicant by the broken stage, it could be said that Mulder could take action for negligence against Dana, the occupier and owner of the hotel. It is incumbent that Dana should have, with reasonable care and prudence, realized that the floor of the stage should be of strong construction to withstand heavy weight. However, in the case of injuries suffered due to lack of care of his friend, Skimmer, the test of vulnerability and control test needs to be applied. In this case, the defendant, Dana had no possible means of controlling Skinnerââ¬â¢s entry, although she had taken the degree of care expected during such a situation. This being a case of Res Ipsa Loquitur (the truth speaks for itself), it is seen that Danaââ¬â¢s involvement would be limited to the stage accident and for the second accident, Mulder would have to bring action against Skinner, should he think it necessary to do so, for injuries sustained during to negligence and lack of care by Skinner. When Skinner entered the movie hall, he had entered a tacit contract with the owners. The injury caused to Skinner was not due to the lack of care, or negligence of the hotel authorities, since it was a stray incident, and unbiased research testified to the fact that there were no earlier records of such kind. Moreover, it was also outside the control of hotel authorities. In this case the question of foresee ability also comes to the forefront. The hotel owner, Dana, by any stretch of imagination, could have possibly imagined that Skinner would be bitten by a stray bee and suffer injuries. In the case of Overseas Tankship (UK) Ltd v. Mortââ¬â¢s
Friday, September 27, 2019
Phases in Primary Education Essay Example | Topics and Well Written Essays - 4750 words
Phases in Primary Education - Essay Example This essay declares that corporal punishment in the classroom is a form of institutional child abuse. It does hurt and it can be destructive, both physically and emotionally. Therefore, as advocates for children, we must work to abolish its use. By revealing that certain beliefs about punishment are myths, that there are potential serious problems with the use of punishment, and that there are positive and effective alternatives of discipline, we hope that people can be moved to actively protest the use of corporal punishment in the classroom. Unfortunately, more than just facts are needed. The politics of change are also involved. A great deal of effort can go into dealing with bureaucratic systems, getting the attention of policy-makers, organizing support from a wide range of disciplines, and articulating related community issues. This project makes a conclusion that it is especially important to have the support of those who are directly involved with the issue, such as teachers (award-winning teachers typically do not use corporal punishment). The task may not be easy as communities frequently fail to protect their weakest citizens. The goal of eliminating corporal punishment in education is worth these difficulties. The classroom environment should be characterized by positive mutual regard and be free of abusing and demeaning acts. Until the practice of corporal punishment ceases, many children may never have the experience of learning in such a supportive, encouraging and safe environment.
Thursday, September 26, 2019
Buckingham palace Essay Example | Topics and Well Written Essays - 250 words
Buckingham palace - Essay Example Later on, when it became the Queenââ¬â¢s House, thousands of people worked accumulatively over time on what it is today. Brickwork was the main method used to built most of the faà §ade of the palace. This grand architectural masterpiece is mainly built with red bricks with stone details. Some of the facades of the palace are made out of different kinds of limestones. Most of the interior design of the residence uses lapis and scagliola, but has since been partly redesigned with a gold color scheme. Today, it has a total of more than seven hundred rooms, twenty state rooms, fifty royal and guest bedrooms, two-hundred staff bedrooms, ninety offices and about eighty restrooms. All in all, thereââ¬â¢s a total of approximately a thousand rooms and it was in 1883 when electricity was first put there, with over 40,000 lightbulbs and installations. Represeting a great deal of baroque style and design, it firmly stands today as a true architectural
Wednesday, September 25, 2019
Comparing and Contrasting Culture and Education in Saudi Arabia and Essay
Comparing and Contrasting Culture and Education in Saudi Arabia and The USA - Essay Example or Mr. as titles. University students however can just call their professors by their first names and mostly, they are encouraged by their professors to do so, which in Saudi would be unpleasant to the ears and may be deemed a sign of disrespect so that adaptation has been difficult for me in this area. In addition, I also observed the form of instruction in the schools. American schools are interactive, with the teachers encouraging the students to participate in discussions, arguing about the subject matter and voicing out their minds with the teacher ready to aid them in channeling their thought to the right decisions, which is greatly different in my country where most of the talking comes from the teacher. The students are expected to sit down and listen in return, never challenging, negotiating or discussing the topic whether an individual agrees or disagrees, a studentââ¬â¢s duty is to keep his mouth shut. Christianity is the widely embraced religion in America and the gove rnment founded its constitution in Christian beliefs. Saudi on the other hand established her laws from Islamic ideologies. Although both religions claim an identical story of creation and trace their ancestry to the same patriarchs, the differentiation would be as the names suggest, between the prophets Muhammad and Christ as well as their teachings. Speaking of government, the form used in Saudi is monarchy with council of ministers and consultative council helping the king in his government affairs. The kingââ¬â¢s authority is limited because of the context of his role indicated in the Shariââ¬â¢a and other traditions (U.S. Department of State). America on the other hand,... This paper approves that media could be found to be a common phenomenon, affecting the countriesââ¬â¢ success and legislation through the distribution of highly competent publications not only in the native tongues of both countries but in other languages as well. Legal issues and individual concepts are placed into the assessment of different sectors as the media make available the information released through broadcast or paper. And this is not just for people to express their interpretations of events but in response to the shared belief of a better environment we all could make. America has a greater number of immigrants from a wider scale of immigrants than that of Saudi. thais paper makes a conclusion that Nations could be entirely different but the fact cannot be denied that somehow, we are somewhat related to each other in unique ways. Looking at the data discussed in this paper, one could easily come up with an analysis of the approach a nation could employ in the making of its policies to meet the specific needs of different nations as each are different. A characteristic may be stronger in one nation than the other but this does not mean that the virtue is solely for that particular nation. In conclusion, as each have varied resources, nations should get involved in the exchange of benefits to build a global relationship that allows every nation to survive in this chaotic world.
Tuesday, September 24, 2019
Personal letter Essay Example | Topics and Well Written Essays - 500 words
Personal letter - Essay Example Different games would be Operation, Sorry, and CSI board games. The Beatles, The Bee Gees, and Korn are music from different generations. I had to research online about different generations. American schooling was another aspect of the book I read. American schooling is easier that in my homeland. American children also do not go year round. The texts are not as expansive as I am used to. The chapter of Living in a Postcolonial World was enlightening. This chapter showed how American society is made up of many cultures. Every major culture can be found in America. Globalization has made American borders less daunting. The Internet has also promoted globalization in America. In The Buddha of Suburbia, I learned a person does not have to be classified. Karim was Indian and British; gay and straight. Karim faced prejudices because he did not belong to one group or culture. The sex was a bit graphic, but it made the point clearer. This story also shows how post colonialism confuses identities. This story also shows that every individual has a unique story. Not all Indians have to be the same. Due to my cultural differences, I like to work alone. This way no one can see how I struggle with the English language. I can use the library and other methods to check my work. Spell check and hours at the library have helped some. When I did work with others, the experience was pleasant and beneficial. I like my classmates. They are friendly and helpful. My tutors are also very patient. The schools environment is good to learn in. The academia I have learned in America is altered from the schools in my homeland. I thought American schools would be very easy. I could not have been more wrong. Even though I took English courses back home, the courses here are more difficult. Due to my limited English, my need for a tutor, and my performance in class, I deserve no more than a C. I wish I could recommend
Monday, September 23, 2019
Alzheimer's disease Essay Example | Topics and Well Written Essays - 1250 words
Alzheimer's disease - Essay Example lois Alzheimer first detected and described this disease in 1907 in Auguste Deter, a middle aged woman who was diagnosed with the dementia and some disorders in her brain function. Untill 1970s this disease defined as a rare condition that affect old people, but Robert Katzman proved that Alzheimer`s disease is not a normal part of aging and it is the same condition as senile dementia. The statistic shows that Alzheimer`s disease affected approximately 26.6 million of people in 2006. Clinical trials predict that prevalence of the Alzheimer`s will be 1 out of 85 people by 2050 worldwide. (Web MD, 2014) There are several types of Alzheimer`s disease depending on the severity. They include mild and moderate Alzheimer`s disease. Mild Alzheimer`s is an early stage of this disease that characterized with temporary memory loss. Patients at this stage usually have problems with complicated tasks, forget where they put their things, get lost, cannot find words to explain their thoughts and have changeable mood. People can normally survive with this type of Alzheimer`s but they required appropriate treatment to reduce possible symptoms. (FÃ ¶rstl H, 1999) Neuropsychological testing can detect this type of Alzheimer`s disease because the symptoms can be confusing with aging. Moderate Alzheimer`s is the most complicated and longest stage of the disease. It is progressive and can leads to overall memory lost. Patients with this type of Alzheimer`s usually do not remember their biography, family, friends and have problems with thinking and language. In this stage patient`s cannot normally live without help of the caregivers and treatment. It can last for years and finally lead to death. People with Alzheimer`s disease can live approximately 7 years after diagnosis. Only in 3% of all Alzheimer`s cases patients lived for 14 years after diagnosis. (Wenk GL,2003) At the cellular level Alzheimer`s disease mainly affect neurons in the cerebral cortex. Neurons lose their ability to
Sunday, September 22, 2019
High School Diferences Essay Example for Free
High School Diferences Essay There are four different grades in high school; freshman, sophomore, junior, and senior. From when you are a freshman you always want to meet new friends, and get good grades. No matter what your grade is, you are still a student. So in a way, all the students are the same, but they do have tons of differences. Freshmen, first of all are still learning where L-Hall is, but they are trying to make new friends too. Freshmen are not bad people, they donââ¬â¢t hurt anyone, and thatââ¬â¢s one of the good sides. The main problem about them is that they are stuck too much in middle school. Their body is in high school, but their brain was left over at Mountain View. To be honest, some freshman are great, they are nice, and respectful. The other three-fourths are immature and laugh at any ââ¬Å"Your momâ⬠joke still. Seniors are the ââ¬Å"All Powerfulâ⬠. Everyone (besides teachers) look up to them. Freshman try and talk to them, and juniors try to act like them. I believe that seniors are the role models of the school, and are treated much better than other underclassmen. Seniors are usually skipping class, and procrastinating. The other seniors are trying to keep their grades up while frantically looking for Financial Aid and planning on what they will do next. Seniors are much better than freshmen, and everyone knows it. Seniors are the laid-back, I-donââ¬â¢t-want-to-be-at-school kind of people. They usually show up late to class while the freshmen get there ten minutes early. Seniors are usually driving over to Taco Bell for lunch, while freshmen stare at the nasty school food waiting for it to move. Yes, they do have all these differences, but seniors were once freshmen. In conclusion, seniors are much more mature, but lazy people. While the freshmen are trying to fit in, and find L-Hall, They all have their differences, but they are all students. They are all just kids, going to school day to day, thinking about their future.
Saturday, September 21, 2019
Learning Team Reflection Essay Example for Free
Learning Team Reflection Essay I guess for me I am struggling with how to forecast and predict what is important enough to know what criteria is relevant information to use for the success of my organization. Since I only work in one area of the whole organization how do you predict when you are not privy to important information to know what direction to go in. I am hoping to learn how to think way outside the box and be able to see the bigger picture. One question I do have though will the company be as successful if I only concentrate on the success of the area I work in? I get how strategic management can be beneficial to an organization, and I get how ethics should play a role as well. I see the way people have done wrong actions in a company is almost like having cancer in your organization. It can slowly take over or be swift and destroy a organization. I see both issues in my work place. People riding the cuff of what is wrong behavior and out right breaking the rules. All of that behavior disrupts the goal of the organization to run effectively and efficiently. Looking forward to further discussions. After completing the assignments and reading the objectives I think I am comfortable talking about environmental scan both internal and external and how it is different from a SWOT analysis. Environmental scanning is made up of observation, reviewing, and ultimately circulating the data gathered from external and internal envi ronments based on the decisions made by the staff of the organization. This process is applied by the organization in the case of a worst case scenario; it allows an organization to carefully take care of conflicts compared to struggling to salvage a situation which is causing financial setbacks for the organization. In regards to discussing the external factors of an organization and why they should be reviewed as part of the internal environmental scan, below are some reasons why this should happen. 1. Economic forces: Regulates the transferring of materials, money, energy, and information (Wheelen Hunger, 2010, p. 99). 2. Technological forces: Is what generates problem-solving inventions (Wheelen Hunger, 2010, p. 99).à 3. Politicalââ¬âlegal forces: Is what allocates power and provides constraining and protecting laws and regulations (Wheelen Hunger, 2010, p. 99). 4. Sociocultural forces: Is what regulates the values, mores, and customs of society (Wheelen Hunger, 2010, p. 99). In regards to discussing some of the internal considerations of an organization and why the organization should evaluate them as part of the internal environmental scan, the following are some reason: 1. Value: Is when it provides customers value and competitive advantage (Wheelen Hunger, 2010, p. 138). 2. Rareness: Is when other competitors possess it (Wheelen Hunger, 2010, p. 138). 3. Imitability: Is when it becomes costly for others to imitate (Wheelen Hunger, 2010, p. 138). 4. Organization: Is when the organization utilizing the resource to its advantage (Wheelen Hunger, 2010, p. 138). There is a difference from Environmental scan and a traditional SWOT due to the environmental scan gathering data while the SWOT is more involved with gathering information and research to establish an ultimate plan. In last weekââ¬â¢s class I got a better understanding of the 4 phases of strategic management which are basic financial planning, forecast-based planning, externally oriented strategic planning and strategic management. By emphasizing what strategic management actually means to an organization I was able to get a more in depth concept of the benefits such as how performance can be improved by providing organizational learning tactics understanding the strategic vision of the organization. I can actually relate to this because I have recently completed my green belt lean six sigma which allows me to be part of working groups that have been task to identify gaps and improve business processes and practices in various area in the logistics directorate in which I work. By being part of a working group at work and also being in this strategic management class I truly believe that this will increase my development in the area of strategic thinking to be an impact player in my organizati on. I look forward to these next few weeks. Reference Wheelen, T.L., Hunger, J.D. (2010). Concepts in Strategic Management and Business Policy (12th ed.). Retrieved from University of Phoenix eBook Collection database.
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