5 Awkward Sentences

5 Awkward Sentences 5 Awkward Sentences 5 Awkward Sentences By Mark Nichol Innumerable missteps in constructing sentences are possible. Here are five random statements with assorted obstacles to comprehension, each accompanied by discussion and a revision. 1. The past month has seen two major developments. Avoid bestowing the gift of sight on inanimate objects or on concepts such as duration of time: â€Å"Two major developments have occurred during the past month.† 2. The question becomes why has everyone been unable to solve this puzzle. Treat the question in a sentence constructed this way as if it were spoken: â€Å"The question becomes, ‘Why has everyone been unable to solve this puzzle?’† Alternatively, reword the sentence so that a direct query is not stated: â€Å"The question then becomes one of why everyone has been unable to solve this puzzle.† 3. We would welcome your opinions and feedback on the results of this research. Inserting would in an entreaty that expresses what in marketing-speak is known as a call to action, an invitation to the reader to do something in response to a message, is an unnecessary and unproductive (and ingratiating) attempt to sound courteous. Instead of stating, literally, that welcoming opinions and feedback is potential but not actual, make the statement more emphatic by omitting the qualifying word: â€Å"We welcome your opinions and feedback on the results of this research.† 4. Additional processes for incident handing and breach reporting may be required to meet these requirements. Does this sentence mean that that the specified additional processes must conform to previously mentioned requirements, or that the processes may be mandated so that previously mentioned requirements are met? Normally, the phrase â€Å"in order to,† preceding a verb, can safely be omitted from a sentence. However, in this case, its inclusion will aid in comprehension: â€Å"Additional processes for incident handing and breach reporting may be required in order to meet these requirements.† 5. Those pressure tests and related assessments will clarify how prepared the organization is to make the actual transition. Because the reader cannot immediately tell which part of speech prepared is (it can be either a verb or an adjective, and is usually the former), inserting the adverb well before it will send a clear signal: â€Å"Those pressure tests and related assessments will clarify how well prepared the organization is to make the actual transition.† (Otherwise, a miscue might occur- the reader might assume that a noun has been omitted before the verb prepared: â€Å". . . how [the (blank)] prepared . . . .†) 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 Style category, check our popular posts, or choose a related post below:Good At, Good In, and Good WithUse a Dash for Number RangesWriting Styles (with Examples)

Curriculum Based Assessment (CBA) for Students

Curriculum Based Assessment (CBA) for Students Curriculum-Based Assessment (CBA) is any form of assessment based on the curriculum that a child is mastering. Most CBAs comes directly from the textbook, in the form of tests- often in the form of chapter tests. Other CBAs can be taken from online resources. This is especially true for online worksheet resources. The following are especially helpful. The Math Work Sheet Site The basic worksheet generator for this site is free, although it provides a variety of useful formats in its members section. You can choose to generate worksheets by the format (horizontal or vertical) the number of digits, whole numbers, the range of numbers use. It offers each of the basic operations, mixed problems, fractions, measurement, graphing and telling time. The worksheets have large numerals that are well spaced for the large digits made by most students in special education. Edhelper.com Edhelper is a member only site, although access is provided to some items. The reading selections are not well adapted for children with reading disabilities: the text is often too close together for these readers, and the content is not particularly well written. My preference is always Reading A-Z, another member only site with excellent reading resources.Edhelpers math resources are excellent, especially for functional math skills such as money counting, fractions, and telling time. It provides several ways to show evidence of competence in each skill area. Money Instructor Money Instructor has both paid and member-only options. Many of the free options provide realistic (color) money for counting. These are excellent resources for children who have difficulty with generalization, such as children with Autistic Spectrum Disorders. Reading A-Z Reading A-Z is an excellent resource for special education teachers. It breaks reading levels into discrete levels from a-z for pre-primer through grade 6 readers. One of the advantages is that there is a great deal of non-fiction, which makes these lower level reading books age appropriate for older but very disabled readers. Not exactly the same as the Fountas and Pinnell levels, the website provides conversion charts which can be helpful if you are writing IEP goals with grade level goals (say, John will read at grade level 2.4 with 94% accuracy.)The website provides books in the PDF format that you can download and print in multiples. Each level provides benchmark books with pre-printed running record forms with the text from the books with places to check off the sort of errors for miscue analysis. Each benchmark also comes with a comprehension question, with different levels of questions geared to Blooms Taxonomy. Scholastic Bookwizard Finding leveled reading material for running records or miscue analysis can be a challenge. Scholastic offers a way to level the books they publish, either by grade level or guided reading level (Fountas and Pinnell.) Fountas and Pinnell also provide resources for leveling books but require a paid membership. Scholastic publishes some of the most popular childrens titles. Knowing grade level means that a teacher can select 100 word plus passages from authentic texts to use for running records and miscue analysis. Special Education Some publishers offer adapted assessments for special education students, or the special educator can adapt the assessment him or herself. Some text-based assessments can be read and scribed, especially if those accommodations are part of the students Specially Designed Instruction. Social studies tests are a good example: these are tests of a students social studies knowledge, not reading ability. The curriculum materials may be adapted to the students ability or Individualized Education Plan (IEP) goals. For example, fourth-grade children are mastering long division, but children with disabilities in the same classroom may be mastering single digit divisors into two or three digit dividends. Curriculum-based assessment is just one of the ways to collect data to meet IEP goals. The above websites provide a lot of useful resources for the special educator.

Reprt Lab Report Example | Topics and Well Written Essays - 1000 words

Reprt - Lab Report Example The value of Gs is a numerical value with no units and does not depend on which system of units is used since it is a ratio. The specific gravity of liquid is a significant parameter in industrial processes, and it is a factor in most equations that involve weight-volume relationships. For instance if during an industrial process sugar syrup or salt solution is needed, it can be easily determined if the solution has the correct concentration by measuring its specific gravity at a particular temperature. The specific gravity for liquids can be written as: Gs = density of the density (g/cm3)/ density of water (g/cm3) Theory: Specific gravity is the ratio of the density of a fluid to the density of water at a constant temperature. Specific gravity can be calculated directly from the measured density of a liquid divided by the density of distilled water. A suitable alternative method is use a hydrometer. This is a specially calibrated instrument made of a hollow glass float designed to f loat vertically in liquids of different densities. The depth to which the hydrometer sinks in the liquid represents the density of the liquid. The instrument has a calibrated scale on its stem which is used to read specific gravity. The diameter of the stem determines the sensitivity of the stem. An exceptionally sensitive hydrometer has a thin stem and a large bulb (Frey, 44). Experimental Procedure The glass cylinder was placed on a flat level surface and filled with sample liquid to allow air to rise to the top. The hydrometer was gently lowered into the flask with the bulb end facing down without it coming into contact with the sides of the fluid. The measurements of specific gravity measurements for each of the two fluid samples were taken and recorded with the hydrometer floating freely in the fluid. The hydrometer was removed and the procedure repeated nine times for each of the two liquids. The values of specific gravities were compared. Description of apparatus: Hydrometer, glass cylinders Data: Measurements Sample S Sample E 1 1110 900 2 1120 890 3 1123 870 4 1124 860 5 1110 890 6 1100 900 7 1110 890 8 1120 880 9 1000 900 10 1110 890 average 1102.7 887 Results/calculations: Average specific gravity for sample S = (1110 +1120+ 1123+ 1124 +1110 +1100 +1110 +1120+ 1000+ 1110) /10 =1102.7 Average specific gravity for sample = (900 +890+ 870+ 860+ 890+ 900 +890 +880+900 +890) /10 =887 Conclusion/discussion: The specific gravity of a liquid is the same everywhere since it is the ratio of the density of the liquid to the density of water at 40C whereas density is mass per unit volume. The volume and mass remain constant but weight changes on the moon. The hydrometer sinks deeper in lighter liquids than the heavier ones due to the fact that heavier liquids are denser than lighter ones. In this experiment, the average specific gravity or each of the two liquids is 1102.7 and 887 respectively. Thus, the denser of the liquids, the higher the specific gravity ob tained. This explains why it is easier to swim in sea water than swimming pools due to the fact that density of sea water is higher than that of swimming pool water. The existence of salt increases the density of sea water. The specific gravity of fluids was successfully obtained using the hydrometer; thus the goal of the experiment was achieved. Work cited Frey, Walter.

IT Project Management Approaches Coursework Example | Topics and Well Written Essays - 1500 words

IT Project Management Approaches - Coursework Example It narrows down from the above two and looks at some of the specific applications in the information Technology field by looking at the Software development life cycle approach that is part of the traditional approach. It goes further in the agile approach to look at specific applications of the approach to the field of information technology. The paper also compares the two approaches by looking at their strengths and weaknesses and the type of projects to which they can be used/ applied and why they will or will not work. 1. The traditional/phased approach to project management The traditional approach to project management involves very well-organized and deliberate planning and control methods. In this approach there are distinct project life cycle stages or phases which are easily recognizable as one leads directly to another. Tasks are completed in in an orderly sequence, one after the other and this necessitates that a significant part of the entire project is planned before t he process begins (Hass, 2007,pp1-8). This model assumes that all events affecting the entire project are predictable and that the tools and the tasks undertaken by each individual are well understood. With this approach it assumes that once a phase is complete it will not be revisited, which is not the case for many projects especially IT projects. This model is forms the basis for the phased methodology used in many projects. The approach has taken many dimensions especially in the field of information technology with various sub models coming up from this traditional/phased model (Hass, 2007,pp1-8). The advantage of this approach is that it sets out the phases for development and stresses the importance of requirements for each stage. On the other hand the limitation is that projects rarely follow the sequential flow and many stakeholders find it difficult to define all the requirements for a project at the beginning(Hass, 2007,pp1-8). The approach has the following distinct stag es: initiation, planning and design, execution and construction, monitoring and controlling systems and finally the completion stage. It is important to note that not all projects will go through all the stages mentioned above some may be terminated before they get to the completion stage. 1.1. The Software Development Life Cycle (SDLC) In information technology projects, this phased approach can be compared to the software development life cycle approach (SDLC). This approach is composed of the following distinct stages that must be followed to come up with working software: planning, requirements definition, design, development, integration and testing and finally installation and acceptance (Radack, 2009, pp1-7). The planning stage aims at establishing a bird’s eye view of the proposed software product and uses this to form the basic project organization, assess feasibility and risks associated with the project and define suitable management and technical approaches. The m ost critical part concerning this stage is the listing of goals of the project and this is done before anything else (Radack, 2009, pp1-7). The requirement definition stage begins immediately the goals in the planning stage are identified. Each of these goals is then refined into a set of requirements which define the major functions of the proposed application and also define the initial data entities.

Gun related crime in the U.S Essay Example | Topics and Well Written Essays - 1000 words

Gun related crime in the U.S - Essay Example One of the main reasons for failure of regulation is the attitude of federal government towards guns distribution; it pays virtually no attention to the design, manufacture, or marketing of guns. The two agencies with potential jurisdiction over these matters, the BATF and the Consumer Product Safety Commission (CPSC) currently lack the authority to address them. This lack of federal supervision of the gun industry allows several dangerous conditions to persist since 1983. (Jacobs, 2002, p. 19) Now, the question arises whether or not gun regulation can control violence in the U.S History (1970 and 1980) reveals that gun control regulation has never been helpful in crime reduction. This is evident from regression analysis, state data, and experimenting social and economic variables, which Murray (1975) concludes, "gun control laws have no significant effect on rates of violence beyond what can be attributed to background social conditions". In addition, he observes that "controlling for basic social factors, the data show that gun laws have no significant effect on access to firearms and differing rates of access to handguns had no significant effect on violent acts" (Murray 1975). According to Gorman & Kopel (2000) the gun control regulation has reduced the number of legal firearms in the ... If we analyze UK historical significance of gun regulation, it is evident that England and Wales had lower rates of robbery and burglary than the United States (in 1981)". (Gorman & Kopel, 2000) "Unfortunately, the British government's single-minded devotion to eliminating defensive arms has made life more dangerous for British citizens. In the United States, youth is more afraid of running into an armed homeowner than the police. As a result, the hot burglary rate today and the rate of crimes that occur when the householder is home is 13 percent in the United States and about 50 percent in England and Wales". (Gorman & Kopel, 2000) That means crime in UK is more vulnerable towards violence than in U.S. According to a review of firearm statistics in Canada, Australia has by far adopted the best policy in combating gun violence and control and has a solution to this problem. "Even though an estimated one in five Australian households contained a gun before the 1996 legislation, Australia has always had relatively few problems with firearms when compared with other industrialized nations. According to a 1995 report done for the Canadian Department of Justice, Australian homicide rates were very low by worldwide standards, and only 18 Australians died in accidents with firearms in 1993". (Aus, 2006a) This might be the result of the "Australian Government's approach to firearm regulation which seeks to achieve a balance between allowing those with a genuine need to possess and use firearms and providing a safe and secure environment for the broader community. In particular, the Australian Government is supportive of the legitimate use of firearms by

What Is Leadership And The Leadership Styles Management Essay

What Is Leadership And The Leadership Styles Management Essay Introduction: Definition: 1. Leadership is stated as the process of social influence in which one person can enlist the aid and support of others in the accomplishment of a common task. Chemers, M. M. (2002). 2.Leadership is ultimately about creating a way for people to contribute to making something extraordinary happen Kouzes, J., and Posner, B. (2007). 3. Leadership is a function of knowing yourself, having a vision that is well communicated, building trust among colleagues, and taking effective action to realize your own leadership potential.(Warren Bennis) 4. Leadership is the process through which an individual tries to influence another individual or a group of individuals to accomplish a goal. (Blake, R.; Mouton, J. (1964) What is leadership? Leaders always have an impact on our lives. The leader affects us in our daily life and in our future too. Whether it good time or bad time. Theres always a need of a good leadership. The success of the business or industry depends upon the leader which you have chosen for the task and what leadership style he or she adopts. Leadership is in which you lead the whole group of peoples whether in business industries or sports. The contribution of the leadership should be effective in all the situations. In leadership a person who is leader should always have vision about the future he should forecast and should know the upcoming conditions and situation in the market or industry. For affective leadership the leader should have good skills in communication and convincing other people and also should have humility when he is treating people. The theory of leadership say leader always has great ideas but most of time ideas come from someone else. So leader should always have people around him who can generate ideas. For good leadership leader should have qualities such as good communication, well planner, decision making, flexible, intelligent, handworker, good company, friendly, sense of humor, good looks, punctual, management skills, leadership qualities, vision and Listening qualities. Leadership style: There are four leadership style, 1.Autocratic leadership 2.Persuasive leadership 3.Consultative leadership 4.Democratic leadership ( Kurt lewin. 1939) Autocratic leadership: Autocratic leadership style is one of the most oldest leadership style. This autocratic style has been seen in classical era when the industrialist use to take decision on their own. Autocratic leadership has following characteristics. In autocratic leadership the owner or the manager tries to make as many decisions as he can. He or she does not consult with anyone. In autocratic leadership the owner seem to have the most authority and he has full control on the decision making. When owner is making decision he or she does not care whether this will be acceptable by the other or not. Usually in this style owner want to have all authority with him he does not want to distribute the authority to different people. In this leadership style consultation with the member or colleagues is very low and decision making become a solitary process. In this style the main defect is that all the managers have less concern in investing their own idea. They just prefer to work on task which is assign to them. This trend of leadership style is used in traditional organization. Persuasive leadership: Persuasive leadership style is in which before making any decision the owner or the manager call a meeting in which everyone is setting. The point is raised in the meeting everyone participates in the decision making. After the decisions which are made is implemented. The positive thing of this leadership style is that everyone gives its ideas lots of ideas are generated. Everyone interest is developed in the decision which is going on. This tread of leadership style is used in the modern organization. Where fast decision have to be made like Symantec Corporation, Microsoft, software house, IT field organizations. Consultative leadership: Consultative leadership style is that the leader shares the problem with his team members or the subordinates but not in meeting or gathering. The leader shares the problem individually. Leader sends the problem to each member and takes individual decision, suggestions and ideas from them. After getting the decision from everyone the manager work on it and makes the decision out of it. Which reflect team member participation. This leadership style is good but may be sometime it could not work accordingly because in the manager is the only one who is making all the decision. Democratic leadership: Democratic mean characterized by or advocating or based upon the principles of democracy or social equality (George du Maurier) Democratic leadership style is one of the best leadership styles because in it the leader is not involved. This leadership style works like if there is some problem the leader will share the problem with the subordinates or members as group. After that leader doesnt involve in it. The group member sit together they make discussions and they try to generate alternatives after those generating alternatives they evaluate the alternatives and try to reach the agreement or solution. The leader does not participate in all the process and he is ready to accept solution which the group has made and he implement any solution that has support of all the group. Leadership skill ,traits and attributes: SKILLS: 1.Understand the needs and characteristics of the post 2.Knowing and using the resource of group 3.Controlling the group performance 4.Evaluating 5.Representing the group 6.Communication 7.Planning 8.Setting example 9.Counseling 10.Effective teaching. Understand the needs and characteristics of the post: Each participant or individual have needs so as a leader he or she should understand wants of every person. Before that leader should know what are his or her needs. Leader should know what people want from him. This helps the leader in planning the work and making it done from the employees. This understanding creates trust and built a strong relationship between the employees. Leader should know why he is joining the post. What really post demand from him or her. What are the major interests of the job and what are the future plans which he or she has to implement. Knowing and using the resource of the group: Resources is all that which are required to do a job. Resources also include people because people have knowledge and skill. Knowledge is what a person learns from path experience and skill is the ability to do what you want. Leader usually uses the knowledge and skills of the group to get the job done. Leader usually develop positive attitude towards skills. Leader should know what person is good for what job. In what skill he is best so he should be given that job in which his skill can be most used. Controlling the group performance: A leader increase the performance of the group and employees participants through his or her actions. A leader is an engine and employees are like boxes which are following them. Group best work when everyone has on direction and they want to achieve one thing. Controlling is a function which is performed by leader to see whether the group is working in right direction or not. Through controlling leader keep watch on the group. Setting example is the best way to control the group. Group can be controlled through following ways 1.Continually keeping an eye on the activities of the employees. 2. Knowing the attitude of the group 3.Giving instruction clear and pertinent 4.Help someone who is in need of it. 5. Quickly deal with the problem Evaluating: Evaluation helps to know the performance of the group and people working together. Evaluation suggests in which way we can improvement of the group performance. There are question to evaluate for getting the job done. What was the job? Was the job done right? Was the job done on time? Keeping the group together- Were relationships between group participants helped or hurt? Was participation equally distributed among group Participants? Did the group enjoy the activity? Did the group handle conflicts well? Representing the group: Leader of the group represents the group in meeting or any other gathering. Leader represents his group in two ways without consultation and with consultation without consultation: without consultation mean that leader does not consult the decision with the group. He represents the group without their ideas with consultation: when the leader represents the group with consulting with the group. He represents the decision which is made by the group. Communication: Leader should have good communication skills because he has to communicate with his subordinates and he or she also has to answer people working over him. Communication is very important because without communication leader cannot convey his message. To improve the communication skill the leader should always listen carefully to the subordinates and make notes of everything. Always be sure before speaking. Speak slow and clearly. Planning: Leader should have planning abilities. To improve the abilities leader should know what the objectives are and how he or she has to achieve it. Should know all the skills, equipments, knowledge and attitude. Should consider the alternative and then should evaluate the each option. After that execute and in the last evaluate the plan. Setting example: Leader should be setting example. He or she should do work in front of the employees so that they can learn from it. Counseling: Counseling is very important it help people to solve the problems counseling also help to encourage people. Counseling can be effective when person cannot make decision and when he is confused. Effective teaching: effective teaching is a process of increasing the knowledge and skills. Effective teaching includes choosing the learning objectives. Demonstrating or explaining the skills. Allowing the learner to practice the skills and evaluating the process. Traits: A leader should be honest with his work and his subordinates. Should be competent for the job. Always have forward looking. Should be intelligent. Leader should always be fair minded and also broad minded. Leader should be straight forward and leader should have vision so he can lead the employees with him. Attributes: Attributes establish what leaders are and every leader needs three attributes. 1. Standard barrier 2.Developer 3.Integrator 4. Understands people Standard barrier: Is establishing the ethical frame work within an organization. This demand a commitment to live and defend the climate and culture that you want to permeate your organization (U.S. Army Handbook (1973). Developer: It helps through teaching, training and coaching. This creates a good place to learn and work. Coaching helps other to learn or understand the skill. Employees who work for developers know that they can take risks. Integrators: Success can only be achieved when everyone is working in right direction. Integrators predict problems which will occur and make their presence felt during critical times. Understands people : Leader should understand people which are working under it. Leader should involve employees for the decision making. If leader understand and work with them they can easily achieve organization goals. Impact of leadership according to skills and traits for success: Leader are not made over night. It takes time to develop skills to become a successful leader. If a leader has good skills he can have successful leadership. The impact of the skills for the success of the leader is if a leader understands the needs and characteristics of the post he can understand his work more properly. If the leader of the group understands the work properly he can guide his subordinates well and further subordinates can teach lower employees. Leader should know the needs of the post. Because if a leader does not have information about the job. He cannot take all employees with himself. There will be no clear goal for the employees. Due to this skill he can know what he has to give to employees and what he wants in return from them. If a leader has skill of knowing and using the resource of group he can easily take work form people. Through this skill leader can know what the group is capable of. So if he or she wants to take work out of them he or she knows up to what level they can do. Controlling group performance skill is also very important skill. If this skill of the leader is good he can maintain the group performance. He will boost or motivate that person who is not working well so that he work up to the standard of the group and all group work together and give 100% out of it to achieve goal. If a leader has evaluating skill he can easily evaluate what is the working performance of the group. He can also evaluate the individual performance of the employee. In evaluation skill the leader can see what was the job how it been done. How much time it took to complete the job? So through this skill leader can finish his work and group work on time. If a leader has presenting skills he can present himself in a good way to the group and can represent group in a good way. Good communication is the most important skill needed by the leader because a leader has to communication with everyone. If a leader has a good communication skill he can u nderstand employees very well I can know the need of the employees and he can give direction easily. Planning is also a important skill for the leader because through planning leader can know what new step he has to take. Through planning he can forecast what will be the upcoming environment of the organizational section. Planning can really help the leader. Leader who has counseling skill will never get short of idea because through counseling he will get different idea from different people and those idea will help the leader to make new decision. If leader is honest everyone will trust him and he will have respect in his colleagues. If leader is hard working and competent then can easily gain success over his competitors. If leader is forward looking he can easily predict about the upcoming future. So he can think according to it. If leader is intelligent and has vision he can easily take his organization to next level. Leadership theories: There are four leadership theories: 1.Trait theory 2.Behaviour theory 3.Contingent theory 4.Transformation theory Trait theory: In early day people use to think that people are born with inherited traits and some are suitable for leadership and people who become good leader have right combination of traits. In 1974 stogdill identified the following traits and skills as critical to leaders. Adaptable to situations Alert to social environment Ambitious and achievement-orientated Assertive Cooperative Decisive Dependable Dominant Energetic Persistent Self-confident Tolerant of stress Willing to assume responsibility Skills Fluent in speaking Knowledgeable about group task Persuasive Socially skill Behavior theory: They assumption of the behavior theory is that leader can be made rather than born. Behavioral theories of leadership say that leaders are not born by birth. Behavior theory doesnt seek inborn traits and capabilities. Behavior theory says that you can learn leadership capabilities rather adopting them. Contingent theory: They assumption of contingent theory is there is no one best way to lead in the situations. There may be one style successful in one situation but May not work in the other. This theory tends to focus on more leadership style for success. This theory says that leader should act according to situation and should adopt different leadership style for success. Transformation theory: Transformation theory assumptions are that people follow that person who inspires them. Person with vision or passion can achieve great things. The style of transformational leader is great because it put passion and energy in everything. They care about you and want you to succeed in life. Transformation theory is that a leader develops a vision and then sells the vision by telling people what they have to achieve by motivating them. Then he or she find way forward mean he know how to lead. After that he remains centre of action. In transformation theory leader motivates people to achieve the goal. Leadership style you like: The leadership style which I like is transformation leadership because everything just revolve around you. You are the center of everything. You are the person who gives innovative idea to the people or vision then you know the way how you have to achieve this goal. After that you take the charge and you put energy in people which are working with you. You motivate them and you put this idea in their mind that success will be in the end. You take each and every person with you. This is why I like transformation leadership because you are the active member. Stages of group development: There are five stages of development: 1. Forming 2. Storming 3.Norming 4.Performing forming: Forming is where group is formed to achieve a task or to solve a problem. In this members have desire to be in the group. Member gets oriented to the task as well as to one other. Basically in forming group of people is gathering to achieve or discuss a goal. Storming: In this group member attempt to organize for the task. Individual have to mold their feeling and attitude for organization objective. In storming question are raised that who will be responsible for which thing. What will be the rules? What will be the reward system? There might be conflicts over leadership, structure and power. To move to next stage member should develop problem solving mentality. Norming: In norming group member share their idea so that they can reach to some decision. Everyone in willing to change their idea on fact and figure presented my other group members. During this stage member develop a scene of group. They try to understand other point of view. performing: In performing the group members works collaboratively and member care for everyone in the group. The group establishes a unique identity and members are interdependent. I performing member find solution to problem using appropriate control and they try to find effective and satisfactory results. Belbins team role theory: 1.Co-ordinator 2.Sharper 3.plant 4.Resource investigator 5.Company worker 6.Monitor / evaluator 7.Team worker 8.Completer finisher. 9Specialist. Coordinator: A coordinator is a person who is leader in the group. This person is trusted, accepted and is committed to team goals and objectives. Coordinator is a person who listen everyone . Sharper: Shaper is person who motivates the team member for the goal they have to achieve. Usually there are two to three sharper. Plant: Plan is a person with high IQ. Plans are more related to major issues. Plant takes approaches to team functioning and problems. Resource Investigator: Resource investigator is a person who is always busy because he is in search of opportunities and develops plans. They are usually very social people. They usually work outside the group. Company worker/implementer: Company worker works for the team in practical way. They work of the task with is given to them and implementer are those who figure prominently in position of responsibility in large organization. Monitor / evaluator: monitor or evaluator is a person who sees the work of the people. Monitor evaluators contribute particularly at times of crucial decision making because they are capable of evaluating competing proposals. West. M (1994) Team worker: Team worker are whose people with are working in teams. The keep the spirit of the up and allow members to contribute freely. They have skill of listening, coping. Completer/finisher: They made steady effort and they work consistently. They give attention to the details. They check work in the end that whether its completed correctly or not. Specialist: Specialist is a person who provides knowledge and techniques which are rarely supplied. They are master of their field.

Parable of a Sadhu

Roll No 54 Name Chirag P Thakar Class MFM Sub : Assignment No 1: Business Ethics. Analysis of the â€Å" Parable of a Sadhu† Based on the decision that was taken or made, I don’t think the group put forth enough of an effort to save this man’s life. They each did their own part, but they didn’t work together. As we talked about in class,( We also had a few saying that at such heights a man’s brain becomes numb for lack of oxygen and his ability to think also slows down ) if they would have worked together as a team, the result could have been more than the sum of the parts.The Sadhu could have had a better chance of surviving this ordeal. It is hard to say whether what these men did was enough, because we do not know what happened to the Sadhu. But they certainly could have done more to help their fellow man. This story reminds me of the parable of the Good Samaritan. While a man lay half-beaten to death on the side of the road, two â€Å"holy† men walk by and leave him to die, while a despised Samaritan man sees him, soothes his wounds, and carries him on his donkey to the inn where he will be taken care of. Buzz and his group could have been like this Samaritan and been more compassionate to this Sadhu.As religious men I believe they had a responsibility to do so. Some might argue that since this was a once in a lifetime opportunity, they should not let anything get in the way of achieving this goal. Conversely, the chance to save a man’s life may also be a once in a lifetime opportunity, and it comes down to which consequences you want to live with for the rest of your life. Is it worse to never have made it to the village at the summit of the mountain or to have contributed to the death of a fellow man because of indifference on your part?In these types of situations, there is hardly ever a clear cut â€Å"right† choice. Because of this, many situations in the business world can be related to this dile mma. People in the business sector face moral dilemmas every day, some minor and some major. Whether it is telling your best friend and coworker that his girlfriend is cheating on him or shutting down a department of your company, leaving good people out of a job, because it is the right decision for the future of the company, these decisions must be made.If these decisions are made behind strong ethical values, the decision will usually improve the future of the company. If these ethical values are embedded in the core of the company where all the employees have a chance to see and follow suit, the company will be able to fight through the tough times as a cohesive unit. If the company does not have this system of values, when the times get tough, the tough will cover their own behinds and run. If everyone could have agreed on a plan to help the Sadhu and followed it through, he most likely would have survived.As it happened, we may never know what happened to the poor sadhu. My Ro le as executive director of Nepal Mountaineering Association (NMA) To perform a ethical role both from my heart as a human being as well as a professional executive director of Nepal Mountaineering Association (NMA) , I would firstly analyse the situation and then either individually and / or as a group do the following I. Key Issues ? Who, if anyone, is responsible for taking care of the Sadhu? ? Will religion and culture play a role in the decision? ? This is a once in a lifetime opportunity for the climbers. Is the Sadhu’s life more valuable than the experience? ? Will others resent Buzz if he makes an unfavorable choice? II. Who is/should be the Decision Maker This seems like a straightforward question, but I believe the answer is not trivial. The decision maker could be the New Zealander who found the Sadhu and brought him to Buzz’s group. I believe, however, that Buzz was the ultimate decision maker. Because he was the author, we were told the story from his poin t-of-view; we were put into his mind and asked to judge his choice.Therefore, as the leader of the group, Buzz’s choice decided the fate of the Sadhu III. Stakeholders Tier 1: The primary stakeholders are Buzz McCoy and the Sadhu. As the decision maker, Buzz will forever be â€Å"haunted† by his decision to help or not help the Sadhu. As for the Sadhu, he will certainly be affected by Buzz’s decision to help him survive or leave him to fend for himself. Tier 2: The secondary stakeholders are those on the mountain trail whose mountain experience will be affected by what Buzz decides.Not only will Stephen and the 2 porters and Sherpas of their group be affected, the New Zealand, Swiss, and Japanese groups will be as well. Tier 3: The third level stakeholders are the villagers of the mountain village and the family and friends of the Sadhu. The mountain villagers will be affected if Buzz decides to escort the Sadhu into their care. The family and friends of the Sad hu will surely be affected by what happens to their father, husband or neighbor. IV. Alternatives ? Option 1: Buzz could drop everything and help the Sadhu down the mountain all the way to the village. Option 2: Buzz could completely ignore the Sadhu and continue on his journey up the mountain. ? Option 3: Individually, the members of the group could do their own part to help the Sadhu. This is what they did. ? Option 4: Buzz could clothe, feed, and house the Sadhu in their hut for the night and if he seemed well enough, send him down to the village in the morning for further recovery. ? Option 5: Buzz could give the Sadhu a sweater and some food and then continue his ascent. V. Solution If I were in the position to choose what was to be done with the Sadhu, I believe I would choose option 4.I would certainly give the man some clothes, feed him, and do whatever I could to ensure his immediate survival. Once he was stable, I would walk with him to the â€Å"base camp† (the hut at 14,500 feet) and allow him to rest for the night. If in the morning he seemed well enough to make his way down to the nearest village, I would allow him to continue on his own, leaving him with clothes, shoes, food and water. If not, I would stay with him until he was well. If he needed more urgent help, I would bring him to the village.Based on the above solution, as a ED of NMA ( Nepal Mountaineering Association ) I would draft a detailed guideline as well as Code of Conduct to be signed off by all my staff on business ethics. These code of conducts would be drafted in line with the Army rule book saying â€Å" Serve others before you serve yourself â€Å" in times of need. My Codes , Controls and Guidelines would clealy have the following check points 1) Clearly defined Duties and responsibilities of my staff, sherpas, porters and headquarter staff. 2) A clear guidelines and Code of Conduct for the climbers. Ethical responsibilities on where would they start and End in the extreme circumstances ) Also a solemn sign off before the start of the journey on ethical / social norms , to act as a refresher / reminder even in extreme or harsh situations. 3) A swifter mode of communication of any such incidence by a single person responsible from my team to the base location for creating a Back up (Mobile technology or any other technology if available for creating a back up for the team in action). 4) A Two person team in every such exercise trained to deal with all or any such ethical situation. ) Basic first aid and life saving training to my team for such incidents. That apart the practice of ethics being a complex exercise due to varied human nature and circumstances , would ensure to follow the same personally all the time and preach it to all connected with me from time to time so that I or my team is never faced with a situation where my company does not have this system of values, when the times get tough, the tough will cover their own behinds and ru n and then repent later as to what happened to the Poor Sadhu. Signing off Chirag P Thakar Roll no 54 MFM Parable of a Sadhu Roll No 54 Name Chirag P Thakar Class MFM Sub : Assignment No 1: Business Ethics. Analysis of the â€Å" Parable of a Sadhu† Based on the decision that was taken or made, I don’t think the group put forth enough of an effort to save this man’s life. They each did their own part, but they didn’t work together. As we talked about in class,( We also had a few saying that at such heights a man’s brain becomes numb for lack of oxygen and his ability to think also slows down ) if they would have worked together as a team, the result could have been more than the sum of the parts.The Sadhu could have had a better chance of surviving this ordeal. It is hard to say whether what these men did was enough, because we do not know what happened to the Sadhu. But they certainly could have done more to help their fellow man. This story reminds me of the parable of the Good Samaritan. While a man lay half-beaten to death on the side of the road, two â€Å"holy† men walk by and leave him to die, while a despised Samaritan man sees him, soothes his wounds, and carries him on his donkey to the inn where he will be taken care of. Buzz and his group could have been like this Samaritan and been more compassionate to this Sadhu.As religious men I believe they had a responsibility to do so. Some might argue that since this was a once in a lifetime opportunity, they should not let anything get in the way of achieving this goal. Conversely, the chance to save a man’s life may also be a once in a lifetime opportunity, and it comes down to which consequences you want to live with for the rest of your life. Is it worse to never have made it to the village at the summit of the mountain or to have contributed to the death of a fellow man because of indifference on your part?In these types of situations, there is hardly ever a clear cut â€Å"right† choice. Because of this, many situations in the business world can be related to this dile mma. People in the business sector face moral dilemmas every day, some minor and some major. Whether it is telling your best friend and coworker that his girlfriend is cheating on him or shutting down a department of your company, leaving good people out of a job, because it is the right decision for the future of the company, these decisions must be made.If these decisions are made behind strong ethical values, the decision will usually improve the future of the company. If these ethical values are embedded in the core of the company where all the employees have a chance to see and follow suit, the company will be able to fight through the tough times as a cohesive unit. If the company does not have this system of values, when the times get tough, the tough will cover their own behinds and run. If everyone could have agreed on a plan to help the Sadhu and followed it through, he most likely would have survived.As it happened, we may never know what happened to the poor sadhu. My Ro le as executive director of Nepal Mountaineering Association (NMA) To perform a ethical role both from my heart as a human being as well as a professional executive director of Nepal Mountaineering Association (NMA) , I would firstly analyse the situation and then either individually and / or as a group do the following I. Key Issues ? Who, if anyone, is responsible for taking care of the Sadhu? ? Will religion and culture play a role in the decision? ? This is a once in a lifetime opportunity for the climbers. Is the Sadhu’s life more valuable than the experience? ? Will others resent Buzz if he makes an unfavorable choice? II. Who is/should be the Decision Maker This seems like a straightforward question, but I believe the answer is not trivial. The decision maker could be the New Zealander who found the Sadhu and brought him to Buzz’s group. I believe, however, that Buzz was the ultimate decision maker. Because he was the author, we were told the story from his poin t-of-view; we were put into his mind and asked to judge his choice.Therefore, as the leader of the group, Buzz’s choice decided the fate of the Sadhu III. Stakeholders Tier 1: The primary stakeholders are Buzz McCoy and the Sadhu. As the decision maker, Buzz will forever be â€Å"haunted† by his decision to help or not help the Sadhu. As for the Sadhu, he will certainly be affected by Buzz’s decision to help him survive or leave him to fend for himself. Tier 2: The secondary stakeholders are those on the mountain trail whose mountain experience will be affected by what Buzz decides.Not only will Stephen and the 2 porters and Sherpas of their group be affected, the New Zealand, Swiss, and Japanese groups will be as well. Tier 3: The third level stakeholders are the villagers of the mountain village and the family and friends of the Sadhu. The mountain villagers will be affected if Buzz decides to escort the Sadhu into their care. The family and friends of the Sad hu will surely be affected by what happens to their father, husband or neighbor. IV. Alternatives ? Option 1: Buzz could drop everything and help the Sadhu down the mountain all the way to the village. Option 2: Buzz could completely ignore the Sadhu and continue on his journey up the mountain. ? Option 3: Individually, the members of the group could do their own part to help the Sadhu. This is what they did. ? Option 4: Buzz could clothe, feed, and house the Sadhu in their hut for the night and if he seemed well enough, send him down to the village in the morning for further recovery. ? Option 5: Buzz could give the Sadhu a sweater and some food and then continue his ascent. V. Solution If I were in the position to choose what was to be done with the Sadhu, I believe I would choose option 4.I would certainly give the man some clothes, feed him, and do whatever I could to ensure his immediate survival. Once he was stable, I would walk with him to the â€Å"base camp† (the hut at 14,500 feet) and allow him to rest for the night. If in the morning he seemed well enough to make his way down to the nearest village, I would allow him to continue on his own, leaving him with clothes, shoes, food and water. If not, I would stay with him until he was well. If he needed more urgent help, I would bring him to the village.Based on the above solution, as a ED of NMA ( Nepal Mountaineering Association ) I would draft a detailed guideline as well as Code of Conduct to be signed off by all my staff on business ethics. These code of conducts would be drafted in line with the Army rule book saying â€Å" Serve others before you serve yourself â€Å" in times of need. My Codes , Controls and Guidelines would clealy have the following check points 1) Clearly defined Duties and responsibilities of my staff, sherpas, porters and headquarter staff. 2) A clear guidelines and Code of Conduct for the climbers. Ethical responsibilities on where would they start and End in the extreme circumstances ) Also a solemn sign off before the start of the journey on ethical / social norms , to act as a refresher / reminder even in extreme or harsh situations. 3) A swifter mode of communication of any such incidence by a single person responsible from my team to the base location for creating a Back up (Mobile technology or any other technology if available for creating a back up for the team in action). 4) A Two person team in every such exercise trained to deal with all or any such ethical situation. ) Basic first aid and life saving training to my team for such incidents. That apart the practice of ethics being a complex exercise due to varied human nature and circumstances , would ensure to follow the same personally all the time and preach it to all connected with me from time to time so that I or my team is never faced with a situation where my company does not have this system of values, when the times get tough, the tough will cover their own behinds and ru n and then repent later as to what happened to the Poor Sadhu. Signing off Chirag P Thakar Roll no 54 MFM

Country Labor Laws Essay

Labor laws or employment laws are a collection of laws, organizational rulings, and precedents which address the lawful rights of, and restrictions on, working people and their organizations. As such, it mediates many aspects of the relationship between trade unions, employers and employees (Chilumpha 2004). However, there are two broad categories of labor law the first being the collective labor laws relating to the three way relationship between the employee, the employer and the labor union. Secondly are the individual labor laws concerning the employees’ rights at work and through the contract for work. These are therefore the various and distinct levels of labor laws that should exist in every economy or state; laws that govern the conduct of an individual and laws that govern the conduct of many at one go (Chilumpha 2004). But both the individual and the group are one and the same thing, therefore both laws govern the conduct of an employee and an employee falls into both categories, he is an individual within a group of workers. This paper will establish the difference in the labor laws between the United Arab Emirates (UAE) and the Federal Republic of Germany. To begin with the two states are located in different regions; Germany is among the founding members of the European Union its laws are therefore govern by a strict code of regulation, it should suite the region and not only the state (Eurofound 2009). UAE on the other hand is regulated in the Middle East; it is a huge financial centre in the Middle East and therefore has a lot of instances where foreigners come within its economy, same with Germany. Religion is the other factor that has to be considered. The UAE is an Islamic state; Muslim way of life is therefore engrained in all aspects of the society including its system of Law; labor laws are no exception (Cotran 2006). Germany on the other hand is guided by social laws constructed to fit the needs of the society. Religious biases are therefore not considered within the Germany labor laws. On one hand we have the Federal Republic of Germany, with its Agenda 2010. Germany has for sometime aimed at an inclusive reform of the German labor market with regard to labor laws, changes are being made notably concerning the protection against dismissal and limited-term employment contracts (see Part 1, II, 3 and 7c). For the first time, there is a standard legal claim to a severance payment but only under certain circumstances in the case of dismissals for redundancies. The new law entered into force as of 1 January 2004 onwards (Lorenz & Partners 2005). The labor laws within Germany are therefore notably updated to suite the times and the market also because it is within the EU means that the labor laws are to be of a certain standard as required by the EU codes of governance (Jung 2001). The United Arab Emirates also has labor laws; Labor matters in the UAE are governed by Federal Law No. 8 of 1980 regulating labor relations as amended by federal laws No. 24 of 1981, No. 15 of 1985 and No. 12 of 1986. There are particular labor related regulations applicable in some of the free zones in the UAE, such as the Jewel Ali Free Zone. Therefore it is notable that though the UAE is a regional financial center, its labor laws are not entirely updated as seen above; there is bound to a lot of labor changes within the system that should have required an update on the labor laws between the 1980’s and 2010. But both the German and UAE regulations have been established to protect the workers rights (Al Tamil & Advocates). According to Article 3 of the Law, the Law is applicable to all staff and employees working in the United Arab Emirates, whether they are nationals or expatriates. However, there are certain categories of individuals who are exempt from the laws as listed below: 1. Staff and workers employed by the national government, government departments of the member emirates, the municipalities, public bodies, federal and local public institutions and those staff and workers employed in federal and local governmental projects. 2. Members of the armed forces, police and security units. 3. Domestic servants/workers. 4. Agricultural workers and persons engaged in grazing of animals (this exemption does not include persons who are employed in corporations which process agricultural products and/or those who are permanently engaged in the operation or repair of machines required for agriculture). (Al Tamil & Advocates) The first clear distinction between the two labor laws is the omission of some of the UAE workers from the protection of the law; it will be assumed that they are covered using a different law and system. Different because may be it provides them with better terms than the rest of the citizenry may be but this distinction shows a clear disharmony within the system. The labor laws should be able to apply to all employees regardless of the profession or gender. The German laws have no such distinction showing a clear harmony in all workers of the state including those in the army (Lorenz & Partners 2005. In UAE it shows that there are some workers who receive preferential preferences; such inequalities are therefore harmful to the system. There are other distinctions that have been identified such as gender differences. While there are some distinctions according to gender and the amount of work one can do in general; such should not influence the type of career one is to pursue. In the UAE women can’t partake in certain careers; this is because of the religious aspect that is seen in most Islamic states (Labor Law UAE & Khasawneh and Associates 2008). There is therefore a clear distinction between the genders; while the German labor laws stipulate that the principle of equal treatment is laid down as a basic right of the German Constitution. Any discrimination on grounds of sex, race, nationality, handicap, religion, and political opinion and trade union activities is outlawed. In order to fulfill the obligations arising from EU directives, sections 611 A and 611 B of the German Civil Code were enacted in 1980 (Miller and Zumbans 2006). But there is a general agreement on the kinds of labor one can undertake; though not stipulated in the German codes, some careers are labor intensive and therefore many women are told not to engage in them for obvious reason. There are several similarities with the two codes; to begin with as stipulated above both have been constructed with the worker in mind. There are several degrees of effectiveness due to the various issues within the two states but both do protect the workers. The first similarity is on issues of employment of minors, on both codes the minimum age of employment is 15 years. No minor under the age of 15 years is supposed to work. The German code goes further to clarify that even those who are older but attend school should not be allowed to work until they are of age to start working (FedEE 2010). The UAE code stipulates the working conditions and working times to protect the minors from exploitation (Working in Germany 2010 & Khasawneh and Associates 2008). Secondly both codes have agreed on issues of work hours; the UAE codes states that the normal work hours per day is 8 with enough breaks in between to allow for recuperation, same with the German code. In both labor laws all the workers are subject to deductions such as tax to the state or as agreed within the organization. Such deductions are necessary to enable the state functions to continue for example the state protection of workers. As stated above, the United Arabs Emirates is considered a religious state; within the state everything is governed through Islamic principles. The labor laws also fall within the principles of Islam; a practicing Muslim is supposed to pray several times a day, the labor laws therefore have catered for that by ensuring the one gets enough breaks to fulfill this obligations. In the context of the UAE labor laws and all the other laws, the basic and fundamental structure is religion. The laws have been modified around the basis of Islam. There are some tendencies of negotiation through the established social system but all in all there is a lot of religious influence. On the other hand the German codes basic structure is the society through various processes such as collective agreement. The German republic is governed through social principles; social rules and procedures that protect all within the constitution equally. Such is the power of collective agreement. Some of the sources of German labor laws also include the European laws and collective agreements. In conclusion, the two states do have labor laws that protect the workers both at the individual level and the collective level. Though both have distinct similarities and differences on several levels, both codes have the interest of the worker at heart though with varying intensity and effectiveness. References: Al Tamimi & Company. (Nd). Labor Laws in the UAE. Retrieved on 11th May 2010. http://www. zu. ac. ae/library/html/UAEInfo/documents/UAELabourLaw. pdf. Chilumpha Cassim. (2004). Labor law. Blantyre, Malawi: Commercial Law Centre Cotran et al. (2006). Yearbook of Islamic and Middle Eastern law. Vol. 10, 2003/2004. Boston: Brill Academic Publishers. Eurofound. (2009). Labor Law Germany. Retrieved on 11th May 2010. http://www. eurofound. europa. eu/emire/GERMANY/LABOURLAW-DE. htm. Federation of European Employers (FedEE). (2010). National Labor Laws. Germany. Retrieved on 11th May 2010. http://www. fedee. com/natlaw. html#germany Jung Liliane. (2001). National Labor Law Profile: Federal Republic of Germany. ILO. Retrieved on 11th May 2010. http://www. ilo. org/public/english/dialogue/ifpdial/info/national/ger. htm. Khasawneh K & Associates. (2008). UAE: Employment Law. GMB Research. Retrieved on 11th May 2010. http://www. kslg. net/doc/UAE_Employment_Law_Khasawneh_Assoc_26Aug08. pdf. Labor Laws in the UAE. Company/Commercial Laws. Retrieved on 11th May 2010. http://www. angelfire. com/nv/sabu/UAE%20Labour%20Law. html. Lorenz & Partners. (2005). German Labor Law. News Letter No 24 (EN). Retrieved on 11th May 2010. http://www. lorenz. co. th/component/option,com_docman/task,doc_download/gid, 181/Itemid,6/lang,de/ Miller R. A. & Zumbansen P. (2006). Annual of German & European law. Volume II/III (2004/2005). New York; Oxford: Berghahn.

Definition and Examples of Narratives in Writing

Definition and Examples of Narratives in Writing The definition of narrative is a piece of writing that tells a story, and it is one of four classical rhetorical modes or ways that writers use to present information. The others include an exposition, which explains and analyzes an idea or set of ideas; an argument, which attempts to persuade the reader to a particular point of view; and a description, a written form of a visual experience. Key Takeaways: Narrative Definition A narrative is a form of writing that tells a story.  Narratives can be essays, fairy tales, movies, and jokes.  Narratives have five elements: plot, setting, character, conflict, and theme.  Writers use narrator style, chronological order, a point of view, and other strategies to tell a story. Telling stories is an ancient art that started long before humans invented writing. People tell stories when they gossip, tell jokes, or reminisce about the past. Written forms of narration include most forms of writing: personal essays, fairy tales, short stories, novels, plays, screenplays, autobiographies, histories, even news stories have a narrative. Narratives may be a sequence of events in chronological order or an imagined tale with flashbacks or multiple timelines. Narrative Elements Every narrative has five elements that define and shape the narrative: plot, setting, character, conflict, and theme. These elements are rarely stated in a story; they are revealed to the readers in the story in subtle or not-so-subtle ways, but the writer needs to understand the elements to assemble her story. Heres an example from The Martian, a novel by Andy Weir that was made into a film: The plot is the thread of events that occur in a story. Weirs plot is about a man who gets accidentally abandoned on the surface of Mars.The setting is the location of the events in time and place. The Martian is set on Mars in the not-too-distant future.The characters are the people in the story who drive the plot, are impacted by the plot, or may even be bystanders to the plot. The characters in The Martian include Mark Watney, his shipmates, the people at NASA resolving the issue, and even his parents who are only mentioned in the story but still are impacted by the situation and in turn impact Marks decisions.The conflict is the problem that is being resolved. Plots need a moment of tension, which involves some difficulty that requires resolution. The conflict in The Martian is that Watney needs to figure out how to survive and eventually leave the planets surface.Most important and least explicit is the theme. What is the moral of the story? What does the writer intend the reade r to understand? There are arguably several themes in The Martian: the ability of humans to overcome problems, the stodginess of bureaucrats, the willingness of scientists to overcome political differences, the dangers of space travel, and the power of flexibility as a scientific method. Setting Tone and Mood In addition to structural elements, narratives have several styles that help move the plot along or serve to involve the reader. Writers define space and time in a descriptive narrative, and how they choose to define those characteristics can convey a specific mood or tone. For example, chronological choices can affect the readers impressions. Past events always occur in strict chronological order, but writers can choose to mix that up, show events out of sequence, or the same event several times experienced by different characters or described by different narrators. In Gabriel Garcà ­a Mrquezs novel Chronicle of a Death Foretold, the same few hours are experienced in sequence from the viewpoint of several different characters. Garcà ­a Mrquez uses that to illustrate the peculiar almost magical inability of the townspeople to stop a murder they know is going to happen. The choice of a narrator is another way that writers set the tone of a piece. Is the narrator someone who experienced the events as a participant, or one who witnessed the events but wasnt an active participant? Is that narrator an omniscient undefined person who knows everything about the plot including its ending, or is he confused and uncertain about the events underway? Is the narrator a reliable witness or lying to themselves or the reader? In the novel Gone Girl, by Gillian Flynn, the reader is forced to constantly revise her opinion as to the honesty and guilt of the husband Nick and his missing wife. In Lolita by Vladimir Nabokov, the narrator is Humbert Humbert, a pedophile who constantly justifies his actions despite the damage that Nabokov illustrates hes doing. Point of View Establishing a point of view for a narrator allows the writer to filter the events through a particular character. The most common point of view in fiction is the omniscient (all-knowing) narrator who has access to all the thoughts and experiences of each of her characters. Omniscient narrators are almost always written in the third person and do not usually have a role in the storyline. The Harry Potter novels, for example, are all written in third person; that narrator knows everything about everybody but is unknown to us. The other extreme is a story with a first-person point of view in which the narrator is a character within that story, relating events as they see them and with no visibility into other character motivations. Charlotte Brontes Jane Eyre is an example of this: Jane relates her experiences of the mysterious Mr. Rochester to us directly, not revealing the full explanation until Reader, I married him. Points of view can also be effectively shifted throughout a piece- in her novel Keys to the Street, Ruth Rendell used limited third-person narratives from the point of view of five different characters, enabling the reader to assemble a coherent whole out of what first appears to be unrelated stories.   Other Strategies Writers also use the grammatical strategies of tense (past, present, future), person (first person, second person, third person), number (singular, plural) and voice (active, passive). Writing in the present tense is unsettling- the narrators have no idea what will happen next- while past tense can build in some foreshadowing. Many recent novels use the present tense, including The Martian. A writer sometimes personalizes the narrator of a story as a specific person for a specific purpose: The narrator can only see and report on what happens to him or her. In Moby Dick, the entire story is told by the narrator Ishmael, who relates the tragedy of the mad Captain Ahab, and is situated as the moral center. E.B. White, writing columns in 1935s New Yorker magazine, often used the plural or editorial we to add a humorous universality and a slow pace to his writing. The barber was cutting our hair, and our eyes were closed- as they are so likely to be... Deep in a world of our own, we heard, from far away, a voice saying goodbye. It was a customer of the shop, leaving. Goodbye, he said to the barbers. Goodbye, echoed the barbers. And without ever returning to consciousness, or opening our eyes, or thinking, we joined in. Goodbye, we said, before we could catch ourselves.- E.B. White Sadness of Parting. In contrast, sportswriter Roger Angell (Whites stepson) epitomizes sports writing, with a quick, active voice, and straight chronological snap: In September 1986, during an unmomentous Giants-Braves game out at Candlestick Park, Bob Brenly, playing third base for San Francisco, made an error on a routine ground ball in the top of the fourth inning. Four batters later, he kicked away another chance and then, scrambling after the ball, threw wildly past home in an attempt to nail a runner there: two errors on the same play. A few moments after that, he managed another boot, thus becoming only the fourth player since the turn of the century to rack up four errors in one inning.- Roger Angell. La Vida.

Enigmatic Crohn’s Disease Essays

Enigmatic Crohn’s Disease Essays Enigmatic Crohn’s Disease Paper Enigmatic Crohn’s Disease Paper Physicians and scientists are always in the search for ways of curing diseases which until this time do not have known cure. One of these diseases is called Crohn’s disease which affects the intestinal tract. Its discovery by three outstanding men has enabled scientific, medical, and public communities to understand the mechanism behind this disease. Crohn’s disease has five types, with no known cause and manifests through various symptoms that can be alleviated through medications or surgery, and involves risk factors and complications. Discovery In 1900s, before the Crohn’s disease was given such name, the public identified it as an infectious disease. Specifically, they knew it as intestinal tuberculosis. But by 1930s, there was no proof about the infectious nature of the disease. In addition, the disease became widely known as Crohn’s disease when Burrill Crohn was not able to prove that there was an infectious cause in 1932. As a result, the search for the cause was discontinued. Due largely of these reasons, the research was concentrated in â€Å"immunology† (Paratuberculosis Awareness Research Association, 2003). In 1932, Burrill B. Crohn, along with Leon Ginzburg and Gordon Oppenheimer, published a medical literature which described the features of a disease which is now known as Crohn’s disease. Burrill Crohn was a gastroenterologist, and the disease was named after him because his name appeared first in the landmark paper (Crohn’s and Colitis Foundation of America, 2007). After 60 years, they have deeply studied the manifestations and natural history of Crohn’s disease but they were not able to know the cause yet. During such time, the three men conducted studies and experiments which gave them a lot of information about the inflammatory process in the bowel. In addition, during the times when they were studying the disease, they assumed that the lesions in the intestine were some form of tuberculosis or other chronic infection. Later on the men realized that the lesions did not have acid-fast organisms. They have also taken materials from different specimens and injected them into animals. However, it did not produce the desired results (Prantera Korelitz, 1996, p. 3). During this period, the men were thinking that there could be an infectious cause. During an interview with these men, Crohn firmly stated that the disease was caused by an infectious agent. They have found that a sulfa-containing drug called sulfathaladine had some positive effects on some patients. However, they did not use antibiotics to combat intestinal organisms. When steroids were introduced, they have seen that it was useful for inflammatory bowel disease (IBD). After more than four decades, researchers from the United States, Australia, and other countries started again the search for the cause despite the possibility of coming up with nonexistent findings (Paratuberculosis Awareness Research Association, 2003). Although there was still no known cure, they have found lots of information about Crohn’s disease and the larger group to which it belongs, the inflammatory bowel disease (IBD). Inflammatory Bowel Disease (IBD) Man’s immune system serves as the body’s defense against foreign substances such as bacteria, cancer, and viruses. Researchers have found out that among the people who have Crohn’s disease (CD) and ulcerative colitis (UC), the immune system attacks against the gastrointestinal system. However, they are not sure why this is the behavior of the immune system among Crohn’s patients. When the immune system attacks the GI tract, it becomes inflamed (Warner and Barlo, 2006, p. 2). IBD causes chronic inflammation in the gastrointestinal tract which then leads to various symptoms. When the disease progressed, other organs can also be infected other than the intestines. Once IBD is acquired, it becomes a lifelong disease characterized by periods of active disease and periods of disease control. IBD is different from irritable bowel syndrome (Achkar, 2006). In 2006, there were one million Americans inflicted with IBD. This number is split evenly between CD and UC (Crohn’s. net, n. d. ). The rate by which people acquire this disease is 10 per 100,000 people. Researches have shown that for every year, IBD accounts for more than half a million physician visits and 100,000 cases of hospitalization. This disease also infects young people as it develops between 10 and 30 ages. There are small cases of IBD development between 50 and 60 (Achkar, 2006). In addition, Caucasians have a higher risk than non-Caucasians. In addition, Caucasians lead the list of racial groups with the highest risk of IBD. Blacks and Hispanics are next in line, while the Asians have low risks of acquiring IBD (Targan, Shanahan, and Karp, 2003, p. 22). Moreover, whites are more prone to acquire IBD than non-whites. Jewish population is also more prone than those of non-Jewish background. Among Jewish people, those of Ashkenazi Jewish decent are at a higher risk of developing IBD (Achkar, 2006). The prevalence of IBD seems to ascend from north to south. In addition, IBD is less common in developed countries (Targan, Shanahan, and Karp, 2003, p. 22). In Western countries, one in 1,000 and one in 1,500 will have ulcerative colitis and Crohn’s disease, respectively. IBD is said to be more common in North America and Europe (Kamm, 1999, p. 2). Around one million Americans have IBD today (Eisenhower Army Medical Center, 2009). Crohn’s disease (CD) and another disease, the ulcerative colitis (UC), are both under a larger group of illnesses called inflammatory bowel disease (IBD) (Crohn’s and Colitis Foundation of America, 2009). However, Crohn’s is also known as IBD (Crohns. net, n. d. ). IBD was rare until the 20th century. By the end of the 20th century, gastroenterologists encountered this illness in the Western countries on a daily basis (Ekbom, 2003). Genetics of IBD Genes is an important factor in the causes of IBD. About 20 to 25% of people have a relative that have either CD or UC. The risk of a person for acquiring either CD or UC is 10 times greater than the general population if the person’s relative has the disease. The risk is 30 times if the relative is a brother or a sister (Crohn’s. net, n. d. ). Past researches have shown that both CD and UC are determined by genetic predisposition and have proven the role of genetic predisposition in acquiring either CD or UC. Genetic predisposition is the best explanation why differences occur between Jewish and non-Jewish populations (Targan, Shanahan, and Karp, 2003, p. 22). Furthermore, empirical data were gathered regarding the familial epidemiology of IBD. The disease seemed to be more common within families. Data also showed that compared to community-wide prevalence, the prevalence of the disease among siblings increases 10 to 30 fold. The prevalence of UC increases among the relatives of those who have UC and the prevalence of CD increases among the relatives of those who have CD. There were also data which suggest the existence of both UC and CD in one family. This incident points to an â€Å"increased frequency higher than just the co-occurrence by chance alone, suggesting an etiologic relationship between UC and CD† (Targan, Shanahan, and Karp, 2003, p. 23). Other studies suggest that a positive family history appears greatly among CD patients than UC patients. In addition, the relatives of those who have CD are at a higher risk of acquiring IBD than those who have UC. This means that in most cases, Crohn’s is often more familial than UC. Moreover, this means that Crohn’s has a more important role in terms of genetic predisposition (Targan, Shanahan, and Karp, 2003, p. 23). Crohn’s Disease Crohn’s disease is one type of IBD whose cause is still unknown (Warner and Barto, 2006, p. 2). According to the outstanding men who conducted extensive study on the disease and whose work gave birth to the term Crohn’s disease, Crohn’s disease cannot be cured, compared to UC which can be cured with surgery (Achkar, 2006). Crohn’s is a chronic disease affecting the gastrointestinal (GI) tract and usually attacks the intestine (ileum) and the large intestine (colon) (Eisenhower Army Medical Center, 2009). It also affects the patches surrounded by healthy tissues in the intestine (University of Maryland Medical Center, 2008). When the disease is not treated sooner, it can affect the gastrointestinal tract from the mouth to the anus (Crohn’s and Colitis Foundation of America, 2009). Causes Until the present time, Crohn’s disease is an enigma to the scientific and medical communities and to the public. There have been many attempts to understand this disease, but there were only few answers. This shows how extensive the nature of Crohn’s disease is. Those who studied Crohn’s assumed that the reason why Crohn’s disease is not fully researched is because it represents many illnesses and its clinical manifestations may be unpredictable. Moreover, researchers attribute the lack of definite causative microorganism to the fact that there is no such microorganism or many microorganisms cause Crohn’s disease (Prantera and Korelitz, 1996, p. 9). However, no one can completely establish the definite cause of Crohn’s disease. Certain theories were made pointing to a faulty immune system, diet, and genes (University of Maryland Medical Center, 2008). Man’s immune system is protected from infections by cells and proteins. One theory about what possibly causes Crohn’s disease indicates that there is an abnormal reaction in the immune system of people with Crohn’s disease, and thus mistakes foods, bacteria and substances as foreign substances (antigens). The normal response of the body’s immune system is to attack these substances. This then leads to white blood cells accumulating in the lining of the intestines. This produces chronic inflammation, which then further leads to bowel injury and ulcerations along the intestines (National Institute of Diabetes and Digestive and Kidney Diseases, 2006). Some scientists assumed that antigens either cause or stimulate the body’s defenses in producing inflammation in the GI tract without control. In addition, it was believed that once the immune system of the person with Crohn’s disease is â€Å"turned on,† it does not know how to â€Å"turn off† at the right time. Symptoms of IBD arise because the inflammation has damaged the intestine (Crohn’s and Colitis Foundation of America, 2009). Despite the theories, scientists are not sure if the abnormality existing in the immune system of people who have Crohn’s disease is a cause or a result of CD. Scientists are constantly faced with the findings of studies which showed that the inflammation in the GI tract is connected to three factors including the immune system, inherited genes, and the environment. Studies also showed that antigens, the foreign substances, are present in the environment. Scientists have also assumed that inflammation may be caused by the body’s reaction to the antigens. Others postulated that antigens cause the inflammation. Another theory is that the anti-tumor necrosis factor (TNF), a protein that the immune system produces, causes the inflammation of GI of those who have Crohn’s disease (National Institute of Diabetes and Digestive and Kidney Diseases, 2006). Furthermore, researchers assumed that the environmental factors cause the increasing prevalence of Crohn’s disease around the world. The researchers have also noted the countless experiments done with regards to drugs and diets that did not yield the desired results. This indicates that every approach taken is justified because different patients with different illnesses were treated, with only Crohn’s disease as the only thing they have in common. These perspectives can be viewed in two ways. One, Crohn’s disease is a very complex clinical entity that is beyond man’s comprehension. Two, Crohn’s disease is not a distinct clinical entity but â€Å"represents a syndrome with multiple etiologies that are lumped under one heading for lack of sufficient knowledge. † Either way, both medical and scientific communities are faced with the challenge of determining what causes the disease, the mechanisms of the inflammation, and further developing ways to treat the Crohn’s disease (Prantera and Korelitz, 1996, p. 9). In connection to the possibility of microorganisms as causative factors of Crohn’s disease, certain infectious agents have been under examination to determine whether these agents are etiological agents. A long list of bacteria and fungi and viruses ranges from Bacteroids to Y. paratuberculosis (Prantera and Korelitz, 1996, p. 11). Symptoms The symptoms of Crohn’s disease may be mild or severe. The most common among these are persistent diarrhea, abdominal pain, which is usually in the lower right area, rectal bleeding, fever and weight loss (Achkar, 2006). If rectal bleeding is serious and persistent, it can lead to anemia (National Institute of Diabetes and Digestive and Kidney Diseases, 2006). Diarrhea, on the other hand, is usually characterized by frequent and watery bowel movements (Crohn’s and Colitis Foundation of America, 2009), sometimes with blood (Rhodes, 2008). Some patients have experienced diarrhea between 10-20 times a day (Rhodes, 2008). In one study, 90% of the patients with Crohn’s disease had diarrhea (Doherty Way, 2005, p. 669). The authors have found out that stools are characterized as semi-solid or liquid. The bloody diarrhea of some patients resembled those of patients with ulcerative colitis (Doherty Way, 2005, p. 669). In abdominal pain, meals initiate mild colic. The pain can be relieved by defecation. The pain is caused by partial blockage in the small bowel, colon, or both. Patients who experienced complete blockage also experienced vomiting, cramping, and abdominal distention. The usual case is that when both diarrhea and abdominal pain manifest, the patient can experience weight loss, fever, anemia, and fever (Doherty Way, 2005, p. 670). Nausea, vomiting, floating stools (University of Maryland Medical Center, 2008), and fatigue are also associated with Crohn’s disease (Crohn’s and Colitis Foundation of America, 2009). Other less common symptoms include night sweats, abscesses, ulcers, and fissures, and fistulas. Abscesses are collections of pus that develop in the rectal area and can cause tenderness around the anus and fever (Crohns. net, n. d. ). Ulcers and fissures are tears that develop in the lining of the anus. These can cause bleeding and pain during defecation (Crohn’s and Colitis Foundation of America, 2007). Fistulas, on the other hand, are tunnels leading one loop of intestine to another. This loop can also connect the intestine to vagina, bladder, or skin. Fistulas develop around the anal area. When these are present, one can notice a â€Å"drainage of mucus, pus, or stool from the opening† (Crohn’s and Colitis Foundation of America, 2009). Skin problems and arthritis can also manifest. In children, symptoms include delay in growth and sexual development (National Institute of Diabetes and Digestive and Kidney Diseases, 2006). These symptoms can result from complications of Crohn’s disease (Achkar, 2006). There are also other body parts which are affected by Crohn’s disease. Some people can also experience symptoms from other body parts such as redness and itchiness in the eyes, swelling and painful joints, osteoporosis, bumps and other lesions in skin, sores around the mouth, and, in rare cases, cirrhosis and hepatitis. These symptoms involving body parts outside of intestines are called extraintestinal manifestations. These can be the first signs of Crohn’s disease for some people. In some cases, these symptoms appear before a flare up. These symptoms â€Å"come and go. † The time that these symptoms do not manifest can be months or years (Crohn’s and Colitis Foundation of America, 2007). Types of Crohn’s Disease There are different types of Crohn’s disease, depending on the affected area in the GI tract. These types have varying symptoms and complications. The five types are presented below: Ileocolitis. This is the most common of Crohn’s disease which afflicts the ileum and colon (Crohn’s and Colitis Foundation of America, 2007). At least two thirds of those with Crohn’s disease have ileocolitis and ileitis. From a study, many of these patients experienced an indolent course which lasted four years. There were periods of relapses when they use and continue using immunomodulators (Bayless and Hanauer, 2001, p. 339). Diarrhea and abdominal pain are the common symptoms of ileocolitis (Crohns. net, n. d. ). Ileitis. Ileitis generally affects the ileum (Crohns. net, n. d. ). Symptoms that manifest include persistent abdominal cramps or pain, usually at the lower portion of the abdomen. In some cases, a patient may experience diarrhea which can be frequent. Pain is also associated with diarrhea. In addition, fatigue and exhaustion and weight loss can be experienced (Irons, 2006, p. 1). Treatment can include medication, antibiotics or surgery. At times, doctors may recommend a change in the diet (Irons, 2006, p. 2). Complications associated with Ileitis are fistulas and abscess (Crohns. net, n. d. ). Gastroduodenal Crohn’s Disease. This affects the stomach and duodenum. Duodenum is the highest portion of the small intestine (Health Information Publications, 2004, p. 5). At most 13 percent of people that have ileocolonic disease also suffer from gastroduodenal disease. Symptoms that manifest include nausea, vomiting (Bayless and Hanauer, 2001, p421), loss of appetite, and weight loss (Health Information Publications, 2004, p. 5). In addition, patients that suffer from this disease were found to have bleeding in the upper GI tract. There are also fistulas which develop in the ileum (Bayless and Hanauer, 2001, p421). Jejunoileitis. This disease affects jejunum, which is the upper portion of the small intestine (Crohn’s and Colitis Foundation of America, 2007). Jejunoileitis is an unusual manifestation of Crohn’s disease. It usually manifests in young patients. From studies, it was found out that there was a connection between high morbidity and frequent surgical management. In addition, this disease usually coexists with other types of Crohn’s disease. Symptoms include abdominal pain, diarrhea and weight loss (Bayless and Hanauer, 2001, p425). Its symptoms include abdominal pain after meals, malnutrition, and diarrhea (Health Information Publications, 2004, p. 5). Crohn’s (granulomatous) Colitis. This disease affects the colon only (Health Information Publications, 2004, p. 5). It is characterized by deep ulcers from rectum to cecum (Kouklakis et. al, 2007). Symptoms include rectal bleeding, diarrhea, ulcer, abscess, and fistulas. Skin lesions and joint pains are also associated with this disease (Crohns. net, n. d. ). The symptoms can vary from person to person, and patients should know which treatment options are effective in alleviating these symptoms. Treatments include medications such as Aminosalicylates (5-ASA), Corticosteroids, Antibiotics, Immuno-modulators, and biologic therapies, and surgery. Treatment Although there is no cure for Crohn’s disease, there have been recommended treatment to ease the symptoms. Treatment can be in the form of medications, diet, and surgery. These treatment options aim to restrain the inflammatory response (Crohn’s and Colitis Foundation of America, 2009), relieve symptoms, and alleviate nutritional deficiencies. In addition, treatments can help control any recurrence. Treatment would also depend on complications, severity of the disease, and the body’s response to previous medications (National Institute of Diabetes and Digestive and Kidney Diseases, 2006). Thus, treatment approach would vary from person to person (Crohn’s and Colitis Foundation of America, 2007). Because Crohn’s disease is chronic, or on-going, sometimes long-term treatment is required (Achkar, 2006). There are several medical therapies that can help alleviate Crohn’s disease. The categories for medications include Aminosalicylates, corticosteroids, antibiotics, immuno-modulators, and biologic therapies (Patel, 2007, p. 2). Aminosalicylates (5-ASA). Aminosalicylates contain sulfasalazine and mesalamine. Mesalamine can control inflammation (National Institute of Diabetes and Digestive and Kidney Diseases, 2006). The most active component of Aminosalicylates is called 5-aminosalicylic acid, or ASA. 5-ASA functions to lessen inflammation in the GI wall. Most of the drugs under 5-ASA are pills taken orally, but there are also suppository forms (Achker, 2006). Patients that have mild to moderate symptoms are recommended this drug, which includes Pentasa, Asacol, Canasa Enemas, Colazal, and Rowasa Enemas. Other forms of this durg, such as Rowasa and Canasa, can be administered rectally (Crohn’s and Colitis Foundation of America, 2009). Side effects of these drugs can range from nausea to headache. In some cases, cramps and gas and heartburn occur. But if aminosalicylates are effective, they can bring the symptoms under control and can prevent recurrences (National Institute of Diabetes and Digestive and Kidney Diseases, 2006) Corticosteroids. This group of drugs can treat moderate to severe symptoms and can substitute for aminosalicylates if the latter is not effective (Patel, 2007, p. 3). Some people consider corticosteroids as very effective (National Institute of Diabetes and Digestive and Kidney Diseases, 2006). Prednisone, hydrocortisone, and prednisolone are the ones commonly used (Patel, 2007, p. 3). Doctors usually prescribe a large dose of prednisone when symptoms are at their worse. When these symptoms are under control, the dosage is lowered (National Institute of Diabetes and Digestive and Kidney Diseases, 2006). Unlike 5-ASA, corticosteroids need no direct contact with inflammation. Corticosteroids function to create an anti-inflammatory reaction to body areas, even the affected intestine. However, doctors found out that this group of drugs does not maintain remission or control flare ups (Patel, 2007, p. 3). There can be multiple side effects which develop due to high dosages and long duration of therapies. Mood changes, sleep disturbances, increased blood sugar levels, irritability, and increased appetite are early common side effects. Cataracts, acne, round face, osteoporosis are side effects associated with long-term use (Achkar, 2006). Other common side effects include swelling in the legs, susceptibility to infections, depression, blurred vision and hair growth (Crohns. net, n. d. ). Antibiotics. Antibiotics suppress bacterial overgrowth in the small intestine (National Institute of Diabetes and Digestive and Kidney Diseases, 2006). Flagyl is the commonly used antibiotics in IBD. Flagyl can treat infections that parasites and bacteria cause. Flagyl is also used for anal fistulas (Patel, 2007, p. 3). Other commonly used antibiotics are ciprofloxacin, metronidazole, ampicillin (Crohn’s and Colitis Foundation of America, 2009). Metronidazole is usually used to manage perineal Crohn’s disease (Mayo Clinic, 2009). However, the bad thing about antibiotics is that they kill good and bad bacteria. When metronidazole and alcohol are taken together, it can cause severe side effects such as nausea, headache, and vomiting. Some of the uncommon side effects include loss of appetite, rash, permanent nerve damage (Crohns. net, n. d. ). Immuno-modulators. This class of drugs can help decrease costicosteroid dosage and heal anal fistulas. In addition, they can help in maintaining remission (Crohn’s and Colitis Foundation of America, 2009). Immuno-modulators include 6-MP (6-Mercaptopurine), Methotrexate, and Azathioprine. These drugs can substitute corticosteroids when the latter are not effective. Reducing immune cells and obstructing protein cells can lessen inflammation (Patel, 2007, p. 3). 6-MP and azathioprine are taken orally. Their effects are not immediate. Thus, steroids are taken on a short-term duration to help control the disease during the first stages of taking 6-MP and azithioprine. Their side effects include pancreatitis, allergic reactions (Achkar, 2006), inflammation of the liver, and bone marrow toxicity (Patel, 2007, p. 3). Other side effects include susceptibility to infections, loss of appetite and nausea (Crohns. net, n. d. ). Methotrexate, on the other hand, functions by reducing the activity of the body’s immune system. It can also help bring Crohn’s disease into remission. Methotrexate can also be taken orally, although it can also be injected under the skin. Side effects associated with Methotrexate are infections, inflammation of the liver, and scarring in the lungs on rare occasions (Achkar, 2006). Biologic therapies. In 1998, the Food and Drug Administration (FDA) introduced a new biologic therapy in the form of Remicade (Infliximab) (Patel, 2007, p. 4). Remicade contains antibody which prevents the immune system from producing tumor necrosis factor (TNF). TNF is a chemical that worsens inflammation (Crohn’s and Colitis Foundation of America, 2009). Remicade is used for patients who have moderate to severe IBD. It is used when other medications are not effective and is given intravenously (Rhodes, 2008). In addition, Remicade works by blocking TNF, which is a part of the immune system. Through this blockage, inflammation in the intestine can be reduced. From clinical studies, it was found out that one or three infusions can bring inflammation into remission state and allow fistulas to heal (Achkar, 2006). Another biologic therapy is adalimumab, which FDA approved in 2007. It is a man-made protein which blocks TNF. Adalimumab attaches itself to TNF and blocks its effects. Natalizumab is another antibody which â€Å"inhibits certain types of white blood cells. † The latest addition to the biologic therapies is Certolizumab which the FDA approved on April 2008. It aims to reduce signs and symptoms of Crohn’s disease (Crohn’s and Colitis Foundation of America, 2009). Side effects of using Remicade include fever, chills, abdominal pain, itching, chest pain, nasal congestion, sore throat, nausea, vomiting, fainting and cough. Less common side effects are skin rash, low or high blood pressure, back pain, pain, diarrhea, and white patches in mouth or tongue. In rare occasions, a patient may experience weight loss, constipation, abscess, and stomach pain (Crohns. net, n. d. ). Surgery The three indications for surgery are perforation, stricture, and bleeding (Norton, Barie, Bollinger, Chang, and Lowry, 2008, p. 1021). In addition, surgery is needed when Crohn’s disease is in a very serious state and the medications were not effective (Achkar, 2006). Other indications for surgery are recurrence of symptoms, worsening of symptoms, occurrence of complications, intestinal blockage, hemorrhage, growth retardation, and carcinoma (Norton, Barie, Bollinger, Chang, and Lowry, 2008, p. 1021). Seventy percent of those who have Crohn’s disease will be required to undergo surgery to remove some part of their digestive tract Achkar, 2006). In some cases, surgery can repair fissures or fistulas. In addition, surgery is required especially if there is an intestinal blockage or intestinal abscess (Crohn’s and Colitis Foundation of America, 2007). Conservative resection is usually the preferred surgical procedure. Surgeries are seen to preserve the intestinal length. However, surgery is only limited to the area where complications arise (Doherty and Way, 2005, p. 672). When the diseased segment of bowel is removed, this is referred to as resection. The process of joining two healthy bowel ends is called anastomosis. Ileostomy can also be preferred if the diseased area is the colon. When colon is removed, surgeons attach the small bowel to the skin in order for waste products to be emptied into a pouch in the abdomen. This type of surgery is done when rectum has been diseased (Crohn’s and Colitis Foundation of America, 2007). Another type of surgery is colectomy, wherein the entire colon is removed when Crohn’s disease has affected the large intestine (Crohn’s and Colitis Foundation of America, 2009). Although surgery can allow symptom-free years, it is not a cure for Crohn’s disease. In addition, certain patients need to have more than one operation because inflammation appears near the area where the affected intestine was removed (National Institute of Diabetes and Digestive and Kidney Diseases, 2006). Furthermore, those who are considering surgery should first weigh its benefits and risks. Surgery is also not appropriate for every patient. Thus, it is of importance to consult their doctors who had experience regarding Crohn’s disease. Risk Factors Several risk factors have been associated with Crohn’s disease, as shown in Table 1. Risk factors refer to those that make a person more inclined to getting a disease (Warner Barto, 2006, p. 204). Table 1. Risk Factors that are Associated with Crohn’s Disease. Familial aggregation Stressful events Nicotine Early life exposures Smoking Weaning Oral moist snuff Hygiene Oral contraceptives Infections Diet Dairy products Refined sugar Passive smoking Cereals (cornflakes) â€Å"Sheltered child† â€Å"Fast food† Infections Margarine Mycobacteria Baker’s yeast Measles Physical activity Nonspecific virus infections Socioeconomic status Source: Prantera Korelitz, 1996. Familial aggregation. As mentioned previously, those who have relatives with Crohn’s disease are at a higher risk of developing the disease. Previous analytical studies have established familial aggregation as the most established risk factor. There were countless documented cases which established the positive history of IBD in 23% of Ashkenazi Jews in California. There were also studies of monozygotic twins which showed that there was a 58. 3% concordance rate for developing the disease. The same level of concordance rate for Crohn’s disease was found in diabetes and bronchial asthma. The concordance rate was lower for dizygotic twins. The reason why the concordance rate for monozygotic twins is higher is because of genetic and not environmental factors. Additionally, the concordant twin siblings developed Crohn’s disease within two years of each other (Prantera and Korelitz, 1996, p. 63). Smoking. A person’s history of smoking is said to be the â€Å"most established† (Prantera Korelitz, 1996, p. 63) and the â€Å"most important† (Michetti, 2005, p. 50) environmental and external risk factor for the disease. Past researches found out that smoking can worsen symptoms (University of Maryland Medical Center, 2008). Additionally, those who smoke are more likely to develop Crohn’s disease than the non-smokers. There were also empirical data to support the finding that smokers have an aggressive form of Crohn’s disease than non-smokers. However, researchers were not able to determine the exact effects that cigarette smoking has on the GI tract (Achkar, 2006). From the past researches, it was found out that there was no consistent increased risk among those who smoke. This means that smoking is a promoting factor of Crohn’s disease. Smokers who have Crohn’s disease are also seen to be more prone to relapses, surgery, hospitalization, diarrhea, and pain compared to former smokers or nonsmokers. And as smoking is associated with lung cancer, those who smoke and have Crohn’s disease are at a higher risk of experiencing respiratory malignancies. However, there was no association found from the studies done in relation to cancer morbidity and mortality. This added to doubts regarding the smoking’s etiological attributable fraction in Crohn’s disease (Prantera Korelitz, 1996, p. 63). The association between Crohn’s disease and smoking is further complicated because smokers have a lower risk of developing ulcerative colitis and former smokers are at a higher risk. The opposite results of studies regarding the role of smoking in both Crohn’s disease and ulcerative colitis prompted researchers and experts to assume the possibility of smoking as a determinant of either Crohn’s or colitis developing in an individual (Prantera Korelitz, 1996, p. 63). Oral contraceptives. This is another risk factor of Crohn’s disease, wherein women who take oral contraceptives are more likely to develop the disease (Crohn’s. net, n. d. ). However, there were other studies whose results showed that the causality of oral contraceptive is weak (Crohns. org, n. d. ). One such