The Biopsychosocial Model Health And Social Care Essay

The Biopsychosocial Model Health And Social Care Essay In the preceding paragraphs many theoretical models were put forward, but it is now desirable to introduce a holistic model of causation, one that is more naturalistic than the simple linear reductionist models (Borrell-Carrià ³ et al., 2004). A comprehensive literature search showed that the most common and widely accepted holistic framework for treatment and rehabilitation is the biopsychosocial model. The popularity of this model can be seen by the frequency of its occurrence in online sources. A preliminary assessment of the biopsychosocial model was conducted using the Medline database, using the term biopsychosocial in the topics field. It is well recognised that use of the term biopsychosocial does not necessarily indicate an adoption of the biopsychosocial model, but at a minimum, it does reflect a recognition of the perspective (Suls Rothman, 2004). Figure 1.5: Frequency of citation of the term biopsychosocial using the Medline database. 4.1 The Biopsychosocial Model One of the famous landmarks articles, published almost thirty years ago by Engle (1977), questioned the biomedical interventions used in both psychiatry and medicine, and warned of a crisis in the biomedical paradigm (Alonso, 2004). Engle (1977) argued that a true medical approach should consider: (1) the patient; (2) the healthcare system; (3) the social context of the patients life; and (4) the psychological context (Mrdjenovich et al., 2004; Pereira Smith, 2005). The main proposition of the biopsychosocial model is that treatment interventions should be an interlinked system covering multiple dimensions (i.e. diagnostic and causative variables), taking into account biological, social, psychological and macro (e.g. socioeconomic status, cultural, ethnic) issues (Figure 1.6) (Burton et al., 2008). Any defect in one part of the system will affect another part of the system (Keefe et al., 2002). For instance, deterioration of a patient condition (biological effect) can negatively aff ect patients` emotional states increasing stress and anxiety level (psychological effect) affecting his/ her ability to work or perform his/her daily routine activities (social effect), which will then, subsequently, increase pain and/or disability levels (Keefe et al., 2002). Figure 1.6: A pictorial illustration of the biopsychosocial model. Adapted from Finlay (2009). The biopsychosocial model accentuate the importance of interacting and understanding the patient as a unique individual taking onto consideration their belief system in a moderate way that neither concentrate on the biomedical aspects or psychosocial aspects but rather illustrate their relationship together (Jones et al., 2002). In comparison between the biopsychosocial model and the earlier discussed models, it can be seen that the biopsychosocial model posits a much complex, multidimensional and broader approach of clinical care (Hadjistavropoulos Craig, 2004). Engles new paradigm has often been seen as a radical departure for medicine (Salmon Hall, 2003, p.1972). However, Lambert et al. (1997) stated that although the biopsychosocial model is a new approach, it is still conservative. This assessment was based on several perspectives proposed by the model. First, by underlying the need for good clinical decisions to respond to the eccentricities of each individual patient, it re-affirms the patients role, self identity and professional independence (Armstrong, 2002; Salmon Hall, 2003). Secondly, the model extends the responsibility of medical care to go beyond biological complications and encompass non-medical treatments as well (Baer, 1989). Physicians are required to connect with their patients in a relationship that involves not only the patients complaints and symptoms, but also their personalities and psychosocial lives (Salmon Hall, 2003). Conversely, patients are expected to be prepared to respond to the physicians and bring about the required changes in their lives to prevent and/or manage their illness (Salmon Hall, 2003). However, one of the issues that has been discussed in the literature is whether the concepts of the doctor-patient relationship and patient-centredness can affect and threaten the doctors authority. However, if the requirements for patient-centredness and a doctor-patient relationship are applied in a moderate and professional way, they do not threaten either the doctors authority or their responsibility, especially since physicians maintain their authority by virtue of their specialist knowledge and their responsibility for an accurate diagnosis and appropriate treatment (Salmon Hall, 2003). Taking on the considerations mentioned in this section lead to a perceived need for a study to determine the current methods followed in managing lower limb injuries (either in elective or emergency cases) and whether the biopsychosocial model is a better approach of treatment. 4.1.1 To what extent have the medical establishment and different research fields adopted the biopsychosocial model? The biopsychosocial model has been widely adopted and promoted in different domains, including medical schools, major medical organisations, social work departments, public health, counselling, and some fields of psychology (Kaplan Coogan, 2005). For example, the WHOs International Classification of Functioning, Disability and Health (ICF), which is a global framework of disability and rehabilitation, is based on the biopsychosocial model (WHO, 2001). Dowrick et al. (1996) conducted a study to explore whether the biopsychosocial model is based on rhetoric or reality. A semi-structured postal questionnaire was sent to 494 principal general practitioners. The questionnaire sought the practitioners views about what they believed to be relevant and appropriate to a practitioners skills and knowledge in general medical practice, and investigated whether these views are consistent with the biopsychosocial model. Only 41% (207) of the sample responded to the questionnaire, which is considered to be a low response rate (Church et al., 2001). The results showed that general practitioners embrace the view that physicians should incorporate a biopsychological model, rather than a biopsychosocial model, in their general medical practice. However, the results cannot be generalised because the study was conducted exclusively on members of a specific organisation. Therefore, the results can only be only applied to the specific population describ ed in the study. Similarly, Alonso (2004) also investigated the extent to which the biopsychosocial concept has been adopted by medical researchers. Using the Medline database, Alonso examined published articles in the period 1978-1982 (period a) and the period 1996-2000 (period b). Period a was selected because it covers the first five years since Engels conceptualised his new model, and the second period (period b) was determined by the date of Alonsos study (covering the five years before the study). The findings of the previous study showed that the conceptualisation of health in medical research, as characterised in articles written within the past two decades, has not changed. In other words, physicians are still reluctant to incorporate the biopsychosocial model, and often focus solely on traditional methods of treatment. Other studies (Dowrick et al., 1996; Cohen et al., 2000; Alonso, 2004; Kaplan Coogan, 2005) also concur with the findings of Alonsos original study, and conclude that the bi opsychosocial model has not been fully integrated into actual medical practice. Conversely, in an evaluation of published articles between the years 1977-1987 and 1988-1998, Hwu et al. (2001) found a considerable spread of medical research articles that did include social and psychological aspects in their definitions of health and medical care. In addition, a literature search also shows that several behavioural, medical and psychological phenomena have adopted the biopsychosocial concept (Kaplan Coogan, 2005), in areas such as schizophrenia (Kotsiubinskii, 2002; Schwartz, 2000), chronic fatigue (Johnson, 1998), antisocial behaviour (Dodge Petit, 2003), gastrointestinal illness (Drossman,1998), spinal cord injury (Mathew et al., 2001), and pain management (Truchon, 2001; Covic et al., 2003). Clearly, there are conflicting findings in the existing literature regarding the extent to which the biopsychosocial model has been integrated into the medical domain, indicating a need for future research. 4.1.2 Application of the biopsychosocial model in rehabilitation Several authors have argued that there is a considerable gap between the introduction of a new or revised model and the application of the proposed model in clinical practice (Linton, 1998; Muncey, 2000; Jones et al., 2002). The challenging factors surrounding changes in clinical practice have been reviewed by Muncey (2000), two of which are associated with physicians decision-making skills and knowledge. In addition, physicians reluctance, in some cases, to integrate new models into their clinical practice should also be taken into consideration (Silagy, 1998; Jones et al., 2002). Furthermore, because the current medical literature is often introduced at a basic scientific level, it is complicated for non-researchers to understand and transfer new models and theories to clinical settings (Jones et al., 2002). Jones et al. (2002) stated that in order to achieve successful application of a new pattern of behaviour and practice thinking, two elements are required. These are reflective, critical clinical reasoning (i.e. the decision-making process), and a suitable organization of knowledge in which the new model can be implemented. The significance of the biopsychosocial model is based on its capability to show the multitude of interactions between its elements (Jones et al., 2002). in addition, every individual element can then be further explored. However, this means that physicians need to further develop their clinical practice skills in terms of patient assessment and management, either physically or in terms of other factors that contribute to their patient`s illness (Jones et al., 2002). One of the elements that should be considered in the application of the biopsychosocial model is diagnostic reasoning, which mainly depends on the application of the scientific paradigm (or the empirico-analytical model) for decision-making and validation. This form of reasoning attempts to identify and test hypotheses relating to the nature of psychological and physical impairments and their functional disabilities (Jones et al., 2002). Narrative reasoning is another form of reasoning which is used to understand the patients own experience with their pain and illness (Mattingly, 1994; Jones et al., 2002). However, although this sounds like a simple method, in fact it is far more challenging than simply listening to patients own stories (Jones et al., 2002). Finally, it is essential to highlight the fact that the biopsychosocial approach is not only concerned with curing pathological defects, but also with helping people to regain their normal life activities (Burton et al., 2008). In addition, it is acknowledged that there may be a certain amount of reluctance regarding the adoption of the biopsychosocial model because of the hurdles in the way of its clinical application (Burton et al., 2008). Changing the way in which injuries are managed in clinical settings will require further investigation, since little attention has been paid towards identifying the current methods that are used to manage lower limb injuries (either in emergency or elective settings) and whether the biopsychosocial model is a better approach in managing such injuries. From the findings and the studies presented in this literature review, it can be concluded and hypothesised that enough clinical evidence exists to show that the biopsychosocial model is a better approach to managing lower limb injuries. On the other hand, the literature does not answer the basic question to whether the surgery is elective or emergency make a difference to the patient experience after injury, which necessitate the need for further investigate. 5.0 Conclusion Little attention has been given to the patients experience after lower limb surgery for example, comparing and contrasting the experiences of patients who have had elective or emergency surgeries, exploring physical, social and psychological aspects, and looking at whether methods of treatment and follow-ups are applied differently between elective and emergency surgeries. In addition, although various studies had focused on how the physical, social and psychological factors interlink together, no previous study has investigated the outcome of the application of the biopsychosocial model in managing patients after lower limb surgery as a result of injury, compared to those who were treated using other treatment approaches. Therefore, to address these issues, this study aims to explore and report the patients experience of clinical care of lower limb injury after surgery, comparing and contrasting the experiences of patients who have had elective or emergency surgeries, and investigating whether the biopsychosocial model is a better treatment approach for the management of lower limb injuries than other approaches. Thus, the current study is based on the following research questions: 6.0 Research question Primary research question: What are the differences between patients experiences and clinical approaches after elective lower limb surgery as a result of injury, compared with patients experiences after emergency lower limb surgery as a result of injury? Secondary research question: If a difference exists among patients experiences and clinical approaches between elective and emergency lower limb surgeries as a result of injury, how does this difference related to the current care pathway including the biopsychosocial model? 6.1 Aims and objectives The aim of this study is to develop a better understanding of patients experiences after a lower limb injury that is severe enough to necessitate surgery, and to compare medical services (after lower limb surgery) provided in emergency settings vs. elective settings. In addition, the study aims to investigate the efficiency of current methods of treatment and compare them with treatment methods derived from a biopsychosocial approach. Understanding the experience of lower limb injury from the patients perspective is essential for providing guidelines for appropriate and efficient medical services, and in the prevention of future complications for the patient. In addition, such an understanding will form a reference for future research studies. The objectives of this study are to explore and report: The difference in patients experiences of medical services for lower limb surgery provided in emergency settings and elective settings. Whether the current biomedical approach to managing lower limb injuries is efficient enough from the patients perspective. The importance of psychosocial factors for a patient with lower limb injury. The importance of implementing treatment methods derived from a biopsychosocial model approach. 6.2 Statement of null hypotheses The research is based on three null hypotheses: The primary null hypothesis states that there will be no difference in patients experiences in emergency and elective surgery settings for patients with lower limb injuries. The secondary null hypothesis states that there will be no difference between elective and emergency lower limb surgeries as a result of injury, and hence it does not relate to the current care pathway including the biopsychosocial model.

Contrasting the Gods in Homer’s Odyssey and the Biblical Book of Exodus

Contrasting the Gods in Homer’s Odyssey and the Biblical Book of Exodus Many authors have employed the religious beliefs of their cultures in literature. The deities contained in Homer’s Odyssey and in the Biblical book of Exodus reflect the nature of the gods in their respective societies. Upon examination of these two works, there are three major areas where the gods of the Greek epic seem to directly contrast the nature of the God of the Israelites: the way problems are solved, the prestige and status that separates the divine from the masses, and the extent of power among the immortal beings. Before any logical argument regarding the contrasting of two works can begin, a foundation must be established that in some way links the two narratives, so that there is a basis for that argument. For the purpose of seeking out the differences that lie between the gods of Homer’s The Odyssey and the God of Exodus, there are two major links that provide the groundwork. First, each work includes a system of divine power, which is recognized as having authority above men. In Homer’s The Odyssey, Nestor of Gerenia tells Telemakhos, "I can have no fears for you if, at your age, the gods are your companions" (3.403, 405). This statement echoes the sentiments displayed throughout the book, and it reveals the power ascribed to the pantheon of Greek gods. If Nestor has no fears for Telemakhos simply because the gods are with him, then that implies that the gods have the authority to keep Telemakhos from harm. The God of Exodus, who is known also as Yahweh and Jehovah, is r ecognized as Deity by the Israelites. A small, seemingly insignificant verse in Exodus reflects the authority of Yahweh, when, immediately following the Passover... ...ogical Commentary. Philadelphia: The Westminster Press, 1974. Dinsmore, Charles Allen. "Homer: What He Believed and What He Valued." 1937. Classical and Medieval Literature Criticism. Vol. 1. Ed. Dennis Poupard et al. Detroit: Gale Research Company, 1988. pp. 326-329. Durham, John I. World Biblical Commentary. Vol. 3. Waco, TX: Word Books, 1987. Exodus. The Holy Bible, New International Version. Grand Rapids: Zondervan Publishing House, 2000. Grant, Robert McQueen. Gods and the One God. Philadelphia: The Westminster Press, 1986. Guthrie, W.K.C. The Greeks and Their Gods. Boston: Beacon Press, 1950. Henry, Matthew. Matthew Henry’s Commentary on the Whole Bible. Vol. 1. Peabody, MA: Hendrickson Publishers, Inc., 1991. Homer. The Odyssey. Norton Anthology of World Masterpieces. Vol. 1. Trans. Robert Fitzgerald. New York: W.W. Norton and Co., 1995.

The Failure of American Public Education :: Education Reform Essays

The most powerful aspect of this essay is not the essay itself (as you will see) but, rather, the fact that it was written by an American college student. Throughout many years, education has played an important role in improving our minds and society. However, what many people tend to forget is that our education is not at the best it can be. Education is defined as receiving or giving systematic instruction, especially at a school or university. Many people today questions whether or not our education depends on the people teaching it or if it’s the student’s responsibility to want to learn. "To what extent do our schools serve the goals of a true education?" Education helps people learn new things, but it can be changed. Although education helps students learn and plan for the future, it can be improved to help benefit students ahead of time. On January 1st, 1975 public law number 94-142 was The Education for All Handicapped Children Act. This law secured the fundamental ideals, rights and responsibilities to ascertain equal access to public education for all children who are crippled. What education has done in the years it has been around is that it simply makes life one sizably extensive, perplexed system of steps and processes. Our schools don’t accommodate the goal of a true education, but it makes it appear that they are. It would seem that the goal for a true education is for someone to absorb attention, but it is not always right to fill adolescent minds with careless facts or the ways of the world that is decided by a committee. The way that attention is gained for students is to give their own perception on things and have their own notion. From Report of the Massachusetts Board of Education, Horace Mann states that, â€Å"education, then, beyond all other devices of human origin, is the great equalizer of the conditions of men, – the balance wheel of the social machinery.† It explicates that the consequentiality of kinds of education, including political, moral, religious, perceptive, and physical are paramount to people and to education. Education could be considered an ingredient for prosperity. Education brings power to every aspect of the mind. When a teacher gives out a test and tells the students to put their items away, Students incline to take one last visually examine their study sheets. When the test is placed in front of a student, but as one or two go to answer the first question, they freeze in apprehensiveness.

Which Do You Think Contributes More to Personal Happiness

How one responds to a situation is a huge factor that contributes to personal happiness, for the state of happiness is achieved from accomplishing a certain goal. In the 18th century, the 13 colonies was in feud with its mother country, Britain; refusing to pay taxes without representation. George Washington, the General of the Continental Army, was hopeless and at the brink of surrender.Yet through the motivational articles such as Paine's Common Sense,† the establishment of the Declaration of Independence, and the arrival of the French, Washington's morale was boosted. At Yorktown, the Americans and French were able to force Cornwallis to surrender, and the war was finally over. Washing successfully accomplished his goal of leading the colonies to victory. This accomplishment of gaining independence not only gave the 13 colonies happiness, but mainly Washington as well.As a result of this happiness, the colonies were able to unite into the United States of America. One's resp onse in a situation definitely supports personal happiness. In the midst of my freshman year in high school, I was asked to help a friend who was struggling in the subject of Biology. After long hours throughout the week, he was finally able to interpret the information. The aftermath was successful and through my teachings, I understood the importance of happiness.Happiness allows me to feel not necessarily a higher being, rather like an older brother who is helping. This enlightenment taught me that happiness can only be achieved by how one reacts to a certain event. In this particular case, because I helped a friend understand the subject of Biology, I fulfilled a good deed, and therefore rewarded with happiness. Although society always seeks for happiness, it not a feeling that can be forced, rather obtain through good deeds and accomplishments.

Shadow Kiss Chapter 8

Eight FOR THE NEXT FEW DAYS, I followed Christian around without incident. And as I did, I found myself growing more and more impatient. For one thing, I was discovering that a lot of being a guardian was waiting around. I'd always known that, but the reality was harder than I'd realized. Guardians were absolutely essential for when Strigoi decided to attack. But those Strigoi attacks? They were generally rare. Time could pass – years could pass – without a guardian ever having to engage in any sort of conflict. While my instructors certainly wouldn't make us wait that long during this exercise, they nonetheless wanted to teach us patience and how important it was not to slack just because there'd been no danger in a while. We were also being held to the strictest conditions a guardian could be in: always standing and always being formal. More often than not, guardians who lived with Moroi families behaved casually in their homes and did ordinary things like reading or watching TV – while still staying perfectly aware of any threats. We couldn't always expect that, though, so we had to practice the hard way while in school. My patience level didn't do so well with all this waiting, but my frustration was more than just restlessness. I was desperate to prove myself, to make amends for not having reacted when Stan attacked. I'd had no further Mason sightings and had decided that what I'd seen really had been fatigue- and stress-induced. That made me happy, because those were much better reasons than being crazy or inept. But certain things were not making me happy. When Christian and I met up with Lissa after class one day, I could feel worry and fear and anger radiating off of her. It was only the bond that clued me in, though. To all outside appearances, she looked fine. Eddie and Christian, who were talking about something with each other, didn't notice a thing. I moved close and put an arm around her as we walked. â€Å"It's okay. Everything's going to be okay.† I knew what was bothering her. Victor. We'd decided that Christian – despite his willingness to â€Å"take care of things† – probably wasn't the best choice to go see about us getting into Victor's trial. So Lissa had played diplomat the other day and very politely spoken to Alberta about the possibility of us testifying. Alberta had told her, equally politely, that it was out of the question. â€Å"I figured if we just explained things – why it was so important – they'd let us go,† she murmured to me. â€Å"Rose, I can't sleep. †¦ I just keep thinking about it. What if he gets loose? What if they really set him free?† Her voice trembled, and there was an old vulnerability there that I hadn't seen in a long time. That sort of thing usually set off my warning bells, but this time, it triggered a weird rush of memories, of times past when Lissa had depended on me so much. I was happy to see how strong she'd become and wanted to make sure she stayed that way. I tightened my arm, hard to do while still walking. â€Å"He won't get loose,† I said fiercely. â€Å"We'll get to court. I'll make sure of it. You know I'd never let anything happen to you.† She leaned her head against my shoulder, a small smile on her face. â€Å"That's what I love about you. You have no idea how you'll get us to court, but you still push forward anyway to make me feel better.† â€Å"Is it working?† â€Å"Yes.† The worry still lurked in her, but her amusement dampened its effects a little. Plus, despite her teasing me about my bold promise, my words really had reassured her. Unfortunately, we soon found out that Lissa had other reasons to be frustrated. She was waiting for the medication to fade from her system and allow her full access to her magic. It was there – we could both sense it – but she was having trouble touching it. Three days had passed, and nothing had changed for her. I felt for her, but my biggest concern was her mental state – which thus far had stayed clear. â€Å"I don't know what's going on,† she complained. We had almost reached the commons. Lissa and Christian had plans to watch a movie. I half-wondered how difficult it would be for me to watch the movie and be on alert. â€Å"It seems like I should be able to do something, but I still can't. I'm stuck.† â€Å"That might not be a bad thing,† I pointed out, moving away from Lissa so I could scan the path ahead. She shot me a rueful look. â€Å"You're such a worrier. I thought that was my job.† â€Å"Hey, it's my job to look out for you.† â€Å"Actually, it's my job,† said Eddie, in a rare show of joking. â€Å"Neither of you should be worrying,† she argued. â€Å"Not about this.† Christian slipped his arm around her waist. â€Å"You're more impatient than Rose here. All you need to do is – â€Å" It was d? ¦j? ¤ vu. Stan leapt out from a copse of trees and reached for Lissa, wrapping his arm around her torso and jerking her toward him. My body responded instantly, no hesitation whatsoever as I moved to â€Å"save† her. The only problem was that Eddie had responded instantly too, and he was closer, which put him there ahead of me. I circled, trying to get in on the action, but the way the two were squaring off blocked me from being effective. Eddie came at Stan from the side, fierce and swift, pulling Stan's arm away from Lissa with a strength nearly powerful enough to rip it out of the socket. Eddie's wiry frame often hid how muscular he really was. Stan's hand caught the side of Eddie's face, nails digging in, but it was enough so that Lissa could wriggle free and run to join Christian behind me. With her out of the way, I moved off to the side, hoping to assist Eddie – but there was no need. Without missing a beat, he grabbed Stan and threw him down to the ground. Half a breath later, Eddie's practice stake was poised right above Stan's heart. Stan laughed, genuinely pleased. â€Å"Nice job, Castile.† Eddie withdrew the stake and helped his instructor up. With the action gone, I could now see how bruised and blotched Stan's face was. Attacks for us novices might be few and far between, but our guardians were picking fights daily during this exercise. All of them were taking a lot of abuse, but they handled it with grace and good humor. â€Å"Thank you, sir,† said Eddie. He looked pleased but not conceited. â€Å"I'd be faster and stronger if I were Strigoi, of course, but I swear, you could have rivaled one with your speed there.† Stan glanced at Lissa. â€Å"You okay?† â€Å"Fine,† she said, face aglow. I could sense that she'd actually enjoyed the excitement. Her adrenaline was running high. Stan's smiling face disappeared as he turned his attention on me. â€Å"And you – what were you doing?† I stared, aghast at his harsh tone. It was what he'd said last time too. â€Å"What do you mean?† I exclaimed. â€Å"I didn't freeze or anything this time! I was ready to back him up, looking for a chance to join in.† â€Å"Yes,† he agreed. â€Å"That's exactly the problem. You were so eager to get a punch in that you forgot that you had two Moroi behind you. They might as well have not existed as far as you were concerned. You're out in the open, and you had your back to them.† I strode forward and glared at him, unconcerned about propriety. â€Å"That is not fair. If we were in the real world and a Strigoi attacked, you cannot tell me that another guardian wouldn't jump in and do everything they could to take that Strigoi down as quickly possible.† â€Å"You're probably right,† Stan said. â€Å"But you weren't thinking about eliminating the threat efficiently. You weren't thinking about your exposed Moroi. You were thinking about how quickly you could do something exciting and redeem yourself.† â€Å"Wh-what? Aren't you making a few leaps there? You're grading me on what you think was my motivation. How can you be sure what I'm thinking?† I didn't even know half the time. â€Å"Instinct,† he replied mysteriously. He took out a small pad of paper and made some notes on it. I narrowed my eyes, wishing I could see through the notepad and discern what he was writing about me. When he finished, he slipped the pad back in his coat and nodded at all of us. â€Å"See you later.† We watched him walk across the snowy grounds toward the gym where dhampirs trained. My mouth was hanging open, and I couldn't even get any words out at first. When did it end with these people? I was getting burned again and again on stupid technicalities that had nothing to do with how I'd actually perform in the real world. â€Å"That was not even fair. How can he judge me on what he thinks I was thinking?† Eddie shrugged as we continued our journey toward the dorm. â€Å"He can think whatever he wants. He's our instructor.† â€Å"Yeah, but he's going to give me another bad mark! Field experience is pointless if it can't really show how we'd do against Strigoi. I can't believe this. I'm good – I'm really good. How on earth can I be failing this?† Nobody had an actual answer for that, but Lissa noted uncomfortably, â€Å"Well†¦ whether he was fair or unfair, he had one thing right: You were great, Eddie.† I glanced over at Eddie and felt bad that I was letting my own drama take away from his success. I was pissed off – really pissed off – but Stan's wrongness was my problem to deal with. Eddie had performed brilliantly, and everyone praised him so much on the walk back that I could see a blush creeping over his cheeks. Or maybe that was just the cold. Regardless, I was happy for him. We settled into the lounge, pleased to find no one else had claimed it – and that it was warm and toasty. Each of the dorms had a few of these lounges, and all were stocked with movies and games and lots of comfy chairs and couches. They were only available for student use at certain times. On weekends, they were pretty much open the whole time, but on weekdays, they had limited hours – presumably to encourage us to do our homework. Eddie and I assessed the room and made a plan, then took up our positions. Standing against the wall, I eyed the couch Lissa and Christian were sprawled out upon with considerable envy. I'd thought the movie would distract me from being on alert, but actually, it was my own churning feelings that kept my mind spinning. I couldn't believe Stan had said what he'd said. He'd even admitted that in the heat of battle, any guardian would be trying to get into the fight. His argument about me having ulterior, glory-seeking motives was absurd. I wondered if I was in serious danger of failing this field experience. Surely, so long as I passed, they wouldn't take me from Lissa after graduation? Alberta and Dimitri had spoken like this was all just an experiment to give Lissa and me new training, but suddenly, an anxious, paranoid part of me began to wonder. Eddie was doing a great job of protecting her. Maybe they wanted to see how well she could work with other guardians. Maybe they were worried that I was only good at protecting her and not other Moroi – I'd let Mason die, after all, right? Maybe the real test here was to see if I needed to be replaced. After all, wh o was I, really? An expendable novice. She was the Dragomir princess. She would always have protection – and it didn't have to be me. The bond was pointless if I ultimately proved incompetent. Adrian's entrance put my frantic paranoia on hold. He slipped into the darkened room, winking as he flounced into an armchair near me. I had figured it was only a matter of time before he would surface. I think we were his only entertainment on campus. Or maybe not, judging from the strong smell of alcohol around him. â€Å"Are you sober?† I asked him when the movie ended. â€Å"Sober enough. What have you guys been up to?† Adrian hadn't visited my dreams since the one in the garden. He'd also laid off on some of his outrageous flirting. Most of his appearances with us were to work with Lissa or to ease his boredom. We recapped our encounter with Stan for him, playing up Eddie's bravery and not mentioning my dressing-down. â€Å"Nice work,† said Adrian. â€Å"Looks like you got a battle scar too.† He pointed to the side of Eddie's face where three red marks glared back at us. I remembered Stan's nails hitting Eddie during the struggle to free Lissa. Eddie lightly touched his cheek. â€Å"I can barely feel it.† Lissa leaned forward and studied him. â€Å"You got that protecting me.† â€Å"I got that trying to pass my field experience,† he teased. â€Å"Don't worry about it.† And that's when it happened. I saw it seize her, that compassion and undeniable urge to help others that so often filled her. She couldn't stand to see pain, couldn't stand to sit by if she could do something. I felt the power build up in her, a glorious and swirling feeling that made my toes tingle. I was experiencing how it affected her. It was fire and bliss. Intoxicating. She reached out and touched Eddie's face†¦. And the marks vanished. She dropped her hand, and the euphoria of spirit faded from both of us. â€Å"Son of a bitch,† breathed Adrian. â€Å"You weren't kidding about that.† He peered at Eddie's cheek. â€Å"Not a goddamned trace of it.† Lissa had stood up and now sank back to the couch. She leaned her head back against it and closed her eyes. â€Å"I did it. I can still do it.† â€Å"Of course you can,† said Adrian dismissively. â€Å"Now you have to show me how to do it.† She opened her eyes. â€Å"It's not that easy.† â€Å"Oh, I see,† he said in an exaggerated tone. â€Å"You grill me like crazy about how to see auras and walk in dreams, but now you won't reveal your trade secrets.† â€Å"It's not a ‘won't,'† she argued. â€Å"It's a ‘can't.'† â€Å"Well, cousin, try.† Then suddenly he raked his nails across his hand and drew blood. â€Å"Jesus Christ!† I yelped. â€Å"Are you insane?† Who was I kidding? Of course he was. Lissa reached out and held his hand, and just like before, she healed the skin. Elation filled her, but my mood suddenly dropped without any real cause. The two of them launched into a discussion I couldn't follow, using standard magical terms as well as some terms I was pretty sure they'd invented on the spot. Judging from Christian's face, it looked like he didn't understand either, and it soon became clear that Adrian and Lissa had forgotten us in their zeal over the mystery of spirit. Christian finally stood up, looking bored. â€Å"Come on, Rose. If I wanted to listen to this, I'd be back in class. I'm hungry.† Lissa glanced up. â€Å"Dinner's not for another hour and a half.† â€Å"Feeder,† he said. â€Å"I haven't had mine today.† He planted a kiss on Lissa's cheek and then left. I followed alongside him. It had started snowing again, and I glared at the flakes accusingly as they drifted down around us. When it had first started snowing in early December, I'd been excited. Now this white stuff was getting pretty damned old. As it had a few nights ago, though, being out in such harsh weather defused my mood a little, the cold air kind of snapping me out of it. With each step closer to the feeders, I felt myself calming down. A â€Å"feeder† was what we called humans who volunteered to be regular sources of blood for Moroi. Unlike Strigoi, who killed the victims they drank from, Moroi took only small quantities each day and didn't have to kill the donor. These humans lived for the high they got from vampire bites and seemed perfectly happy to spend their lives that way and separate from normal human society. It was weird but necessary for Moroi. The school usually had a feeder or two in the Moroi dorms for overnight hours, but for most of the day, students had to go to the commons to get their daily fix. As I continued walking, taking in the sights of white trees, white fences, and white boulders, something else white in the landscape caught my attention. Well, it wasn't white exactly. There was color – pale, washed-out color. I came to an abrupt halt and felt my eyes go wide. Mason stood on the other side of the quad, nearly blending in with a tree and a post. No, I thought. I'd convinced myself that this was over, but there he was, looking at me with that sorrowful, phantom face. He pointed, off toward the back of campus. I glanced that way but again had no clue what to look for. Turning back to him, I could only stare, fear twisting within me. An icy-cold hand touched the side of my neck, and I spun around. It was Christian. â€Å"What's up?† he asked. I looked back to where I'd seen Mason. He was gone, of course. I squeezed my eyes shut a moment and sighed. Then, turning back to Christian, I kept walking and said, â€Å"Nothing.† Christian usually always had some witty stream of comments whenever we were together, but he was silent as we made the rest of our journey. I was consumed with my own thoughts and worries about Mason, so I had little to say either. This sighting had only lasted a few seconds. Considering how hard it was to see out there, it seemed more than likely that he'd been a trick of the eye, right? I tried to convince myself of this for the rest of the walk. When we entered the commons and escaped the cold, it finally hit me that something was amiss with Christian. â€Å"What's wrong?† I asked, trying not to think about Mason. â€Å"Are you okay?† â€Å"Fine,† he said. â€Å"The way you just said that proves you aren't fine.† He ignored me as we went to the feeders' room. It was busier than I'd expected, and all of the little cubicles that feeders sat in were filled with Moroi. Brandon Lazar was one of them. As he fed, I caught a glimpse of a faded green bruise on his cheek and recalled that I never had found out who had beaten him up. Christian checked in with the Moroi at the door and then stood in the waiting area until he was called. I racked my brain, trying to figure out what could have caused Christian's bad mood. â€Å"What's the matter? Didn't you like the movie?† No answer. â€Å"Grossed out by Adrian's self-mutilation?† Giving Christian a hard time was a guilty pleasure. I could do this all night. No answer. â€Å"Are you – Oh.† It hit me then. I was surprised I hadn't thought of this before. â€Å"Are you upset that Lissa wanted to talk magic with Adrian?† He shrugged, which told me all I needed to know. â€Å"Come on, she doesn't like magic more than she likes you. It's just this thing with her, you know? She spent all these years thinking she couldn't do real magic, and then found out she could – except it was this wacky, completely unpredictable kind. She's just trying to understand it.† â€Å"I know,† he said tightly, staring across the expansive room without actually focusing on any of the people. â€Å"That's not the problem.† â€Å"Then why †¦Ã¢â‚¬  I let my words fade as another revelation hit me. â€Å"You're jealous of Adrian.† Christian fixed his ice-blue eyes on me, and I could tell I'd hit the mark. â€Å"I'm not jealous. I'm just – â€Å" † – feeling insecure over the fact that your girlfriend is spending a lot of time with a rich and reasonably cute guy whom she might like. Or, as we like to call it, jealous.† He turned away from me, clearly annoyed. â€Å"The honeymoon might be over between us, Rose. Damn it. Why are these people taking so long?† â€Å"Look,† I said, shifting my stance. My feet hurt after so much standing. â€Å"Didn't you listen to my romantic speech the other day about being in Lissa's heart? She's crazy about you. You're the only one she wants, and believe me, I can say that with 100 percent certainty. If there was anyone else, I'd know.† The hint of a smile crossed his lips. â€Å"You're her best friend. You could be covering for her.† I scoffed. â€Å"Not if she were with Adrian. I assure you, she has no interest in him, thank God – at least not romantically.† â€Å"He can be persuasive, though. He knows how to work his compulsion†¦Ã¢â‚¬  â€Å"He's not using it on her, though. I don't even know if he can – I think they cancel each other out. Besides, haven't you been paying attention? I'm the unfortunate object of Adrian's attention.† â€Å"Really?† asked Christian, clearly surprised. Guys were so oblivious to this sort of stuff. â€Å"I know he flirts – â€Å" â€Å"And shows up in my dreams uninvited. Seeing as I can't get away, it gives him the perfect chance to torture me with his so-called charm and attempt to be romantic.† He turned suspicious. â€Å"He shows up in Lissa's dreams too.† Shoot. Shouldn't have mentioned the dreams. What had Adrian said? â€Å"Those are instructional. I don't think you need to worry.† â€Å"People wouldn't stare if she showed up at some party with Adrian.† â€Å"Ah,† I said. â€Å"So this is what it's really about. You think you're going to drag her down?† â€Å"I'm not that good †¦ at those kinds of social things,† he admitted in a rare show of vulnerability. â€Å"And I think Adrian's got a better reputation than me.† â€Å"Are you joking?† â€Å"Come on, Rose. Drinking and smoking aren't even in the same league as people thinking you're going to turn Strigoi. I saw the way everyone acted when she took me to dinners and stuff at the ski lodge. I'm a liability. She's the only representative from her family. She's going to spend the rest of her life tied up with politics, trying to get in good with people. Adrian could do a lot more for her than I could.† I resisted the urge to literally shake some sense into him. â€Å"I can see where you're coming from, but there's one flaw in your airtight logic. There's nothing going on with her and Adrian.† He looked away and didn't say anything else. I suspected his feelings went beyond her simply being with another guy. As he'd even admitted, he had a whole tangle of insecurity about Lissa. Being with her had done wonders for his attitude and sociability, but at the end of the day, he still had trouble dealing with coming from a â€Å"tainted† family. He still worried he wasn't good enough for her. â€Å"Rose is right,† an unwelcome voice said behind us. Preparing my best glare, I turned around to face Jesse. Naturally, Ralf lurked nearby. Jesse's assigned novice, Dean, stood watch at the doorway. They apparently had a more formal bodyguard relationship. Jesse and Ralf hadn't been in line when we arrived, but they'd apparently wandered up and heard enough to piece together some of our conversation. â€Å"You're still royal. You have every right to be with her.† â€Å"Wow, talk about a turnaround,† I said. â€Å"Weren't you guys just telling me the other day how Christian was about to turn Strigoi at any moment? I'd watch your necks, if I were you. He looks dangerous.† Jesse shrugged. â€Å"Hey, you said he was clean, and if anyone knows Strigoi, it's you. Besides, we're actually starting to think that rebellious Ozera nature is a good thing.† I eyed him suspiciously, assuming there must be some trick here. Yet he looked sincere, like he really was convinced Christian was safe. â€Å"Thanks,† said Christian, a slight sneer curling his lips. â€Å"Now that you've endorsed me and my family, I can finally get on with my life. It's the only thing that's been holding me back.† â€Å"I'm serious,† said Jesse. â€Å"The Ozeras have been kind of quiet lately, but they used to be one of the strongest families out there. They could be again – especially you. You're not afraid to do things that you aren't supposed to. We like that. If you'd get over your antisocial bullshit, you could make the right friends and go far. Might make you stop worrying so much about Lissa.† Christian and I exchanged glances. â€Å"What are you getting at?† he asked. Jesse smiled and cast a covert glance around us. â€Å"Some of us have been getting together. We've formed a group – sort of a way for those of us from the better families to unite, you know? Things are kind of crazy, what with those Strigoi attacks last month and people not knowing what to do. There's also talk about making us fight and finding new ways to hand out the guardians.† He said it with a sneer, and I bristled at hearing guardians described like objects. â€Å"Too many non-royals are trying to take charge.† â€Å"Why is that a problem if their ideas are good?† I demanded. â€Å"Their ideas aren't good. They don't know their place. Some of us have started thinking of ways to protect ourselves from that and look out for each other. I think you'd like what we've learned to do. After all, we're the ones who need to keep making decisions, not dhampirs and nobody Moroi. We're the elite. The best. Join us, and there are things we could do to help you with Lissa.† I couldn't help it. I laughed. Christian simply looked disgusted. â€Å"I take back what I said earlier,† he told them. â€Å"This is what I've been waiting for my whole life. An invitation to join your tree house club.† Ralf, big and lumbering, took a step forward. â€Å"Don't screw with us. This is serious.† Christian sighed. â€Å"Then don't screw with me. If you really think I want to hang out with you guys and try to make things even better for Moroi who are already spoiled and selfish, then you're even stupider than I thought you were. And that was pretty stupid.† Anger and embarrassment filled both Jesse and Ralf's faces, but mercifully, Christian's name was called just then. He seemed considerably cheered as we walked across the room. Nothing like a confrontation with two assholes to make you feel better about your love life. Christian's assigned feeder tonight was a woman named Alice, who was the oldest feeder on campus. Most Moroi preferred young donors, but Christian, being the twisted person he was, liked her because she was kind of senile. She wasn't that old – sixties – but too many vampire endorphins over her life had permanently affected her. â€Å"Rose,† she said, turning her dazed blue eyes on me. â€Å"You aren't usually with Christian. Have you and Vasilisa had a fight?† â€Å"Nope,† I said. â€Å"Just getting a change of scenery.† â€Å"Scenery,† she murmured, glancing at a nearby window. Moroi kept windows tinted to block out light, and I doubted a human could see anything. â€Å"The scenery is always changing. Have you noticed that?† â€Å"Not our scenery,† said Christian, sitting beside her. â€Å"That snow's not going anywhere. Not for a few months.† She sighed and gave him an exasperated look. â€Å"I wasn't talking about the scenery.† Christian gave me an amused smile, then leaned over and sank his teeth into her neck. Her expression grew slack, all talk of scenery or whatever she'd meant forgotten as he drank from her. I lived around vampires so much that I didn't even think about their fangs half the time. Most Moroi were actually pretty good at hiding them. It was only in moments like these that I remembered the power a vampire had. Usually, when I watched a vampire feed, I was reminded of when Lissa and I had run away from the Academy, and I'd let her feed off of me. I'd never reached the crazy addiction levels of a feeder, but I had enjoyed the brief high. I used to want it in a way I could never admit to anybody. In our world, only humans gave blood. Dhampirs who did it were cheap and humiliated. Now, when I watched a vampire drink, I no longer thought about how good the high felt. Instead, I flashed back to that room in Spokane where Isaiah, our Strigoi captor, had fed off of Eddie. The feelings that stirred up in me were anything but good. Eddie had suffered horribly, and I hadn't been able to do anything except sit there and watch. Grimacing, I turned away from Christian and Alice. When we left the feeders' room, Christian looked more vibrant and upbeat. â€Å"The weekend's here, Rose. No classes – and you get your day off.† â€Å"No,† I said, having almost forgotten. Damn it. Why did he have to remind me? I was almost starting to feel better after the Stan incident. I sighed. â€Å"I have community service.†

Examine the relationship between Volpone and Mosca Essay

Examine the relationship between Volpone and Mosca in Acts I and II; to what extent is Volpone presented as the dominant partner?  During The Argument at the beginning of the play the audience is told that, although the play’s title is ‘Volpone’, the play is mostly centred on ‘his parasite’, Mosca, and the cross-plots he ‘weaves’ as he ‘assures’ and ‘deludes’ the other characters. Despite this, Volpone is not entirely submissive. There are several occasions where he is the stronger, commanding character, and throughout the play there are some elements of permanent authority, which cannot be overlooked. As stated in ‘The Persons of the Comedy’, Volpone is a ‘Magnifico’, an entrepreneur who would be socially higher than his parasite, Mosca, and therefore better educated than him. This good education is seen in Act II Scene ii as Volpone speaks as the mountebank, Scoto of Mantua. Although it is unknown who contrived the plot, although it is assumed to be Mosca as he suggests the disguise, Volpone uses scientific language, such as ‘mal caduco’ and ‘hernia ventosa’, to convince the crowd to buy his oil, even calling in ‘Oglio del Scoto’. Even if Mosca had created the idea, he would have been unable to use such language to make the crowd believe Volpone was Scoto, and therefore he is reliant on Volpone’s knowledge to help carry out his plans. This social dominance on Volpone’s part is also seen immediately in Act I Scene i, as Jonson presents Volpone languishing in bed while Mosca does his bidding, waking Volpone for the day and opening the shrine at his behest to reveal the ‘saint’ that is his gold. This wealth provides another area of dominance, although this is also a factor affecting class, as Mosca is dependent on Volpone’s wealth to support him as this provides him with a home and pay, so the typical master and servant positions are assumed. Mosca never forgets his place in society, and Volpone frequently orders him about, such as upon the arrival of Voltore at the end of Act I Scene ii when he asks Mosca to ‘fetch’ his ‘gown’,’ furs, and nightcap’. These are duties that Mosca has to perform, and when ordered to do something by Volpone he has to agree and execute the task without argument. These factors mean that Volpone is the overriding authority in this relationship, and Mosca dare not openly disagree with Volpone as he could lose everything. Despite Volpone having a great deal of possible power and influence, he is often presented as the weaker of the two with a great deal of dependence on Mosca, thereby making Mosca the dominant partner. An example of this is seen in Act I Scene I, as Volpone asks Mosca â€Å"Why dost thou laugh so, man?† suggesting that he is insecure and seeks Mosca’s reassurance in case he is the subject of the laughter. This makes Mosca the leading member of the relationship, showing Volpone’s emotional dependence on his servant. He is also dependent on Mosca to carry out the ‘cunning purchase’ of his wealth, with Mosca having to make excuses for other clients visiting, such as when he tells Voltore to ‘put business’ in his face as he leaves, as he is an advocate, and then tells Corbaccio Volpone ‘was about his testament’ ‘for [Corbaccio’s] good’, giving him a positive reason for Voltore’s presence. Through this M osca also manages to increase the wealth accumulated through their enterprise, by playing the three clients off against each other. This is again seen in Act 1 Scene iv as Mosca tells Corbaccio of Voltore’s ‘piece of plate’ for Volpone ‘to be his heir’, leading him to proffer ‘a bag of bright chequins’, and later to proclaim Volpone his ‘sole heir’, thereby denying his ‘brave, and highly meriting’ son, Bonario. However, this does not entirely prove Mosca to be the stronger orchestrator of events or show Volpone to be weak, as Volpone has to act the dying man, and therefore cannot play a great role in manipulating the clients. This is shown in the way Mosca handles the subplot of Celia more skilfully than Volpone, and his greater level of control and forward thinking. Mosca’s role in the play is more as a stage manager than a servant, and on many occasions he is shown to handle situations more adroitly than Volpone. One of the greatest ways Jonson shows this is in the plot to win Celia, something that Mosca himself introduces in Act 1 Scene v, enticing Volpone as he calls her ‘The blazing star of Italy’. In doing this, Mosca creates a new need for himself, making Volpone even more dependent on him as Mosca knows details regarding Celia, such as Corvino’s ‘guard, of ten spies thick, upon her’, while Volpone had not heard of her.

Scientific Publications Exercise Research Paper

Scientific Publications Exercise - Research Paper Example ar dynamics simulations have shown that interactions of lipid head groups with the protein is with the help of weak charge and hydrogen bond interactions. A set of exchange reactions governs the effective binding of lipid molecules usually defined by equilibrium constant. Thus the annular site on a protein membrane bilayer containing PC and PS mixture would be occupied by either a PC or a PS molecule Author were trying to prove that the anionic lipids could significantly effect the functioning of channels. This is evident from the explanations on the lipid phosphatidylserine which made the channels active irrespective of phosphatidylcholine being present in large numbers. The conclusion is inadequate to establish their claims. Though the author is of the opinion that binding to large charge clusters could influence the anionic lipids on the channel function , they also believe that the collective influence of the physical properties of the lipid layer cannot be ruled out. It was suspected earlier that an infectious agent was associated with the initiation of cancer in any normal cell. After one hundred years of research it is established that the viral, bacterial or a parasitic infection had a definite role in the human carcinogenesis. Further, the estimates have shown that the proportion of vulnerable cancer cases could also be reduced to a level of 20 percent if particular infectious agents could be eliminated. The enquiry to explore where the infectious agent causing cancer is partially answered in the case of Merkel cell carcinoma. Some of the carcinoma condition was developed after having infected with epidemic like AIDS. The research results presented in this paper explain that just detecting the microbial genome cannot confirm the incidence of cancer. Also, it is proposed that no one can infect a person with the causative agent and then wait for any signs of incidence of cancer. Thus the authors confirm that the evaluation method that assigns specific