Do Family Friendly Policies Hurt Men?

But as companies add these benefits, some male employees ( and some childless women as well) have complained that the company Is spending money on benefits that flow to some workers at the expense ( at least theoretically) of others. Some men have even complained that fathers don't get assistance with child care or an opportunity to bring their babies to work. In fact, In the united States, companies do have to extend the same benefits to fathers as to mothers (except, of course, that if a mother is disabled after childbirth, she is the one who gets the usability benefit).But men note that it is women who are more likely to use these benefits, even though studies show that men are experiencing more work- life conflict than male workers did a few decades ago. And as more pregnant women stay on the job, the disparity is as obvious as the bulging bellies.The best way to distribute the cost and benefits of flexibility is to offer to every employee that may need it. Also the ones who It d on't need the benefit of flexibility, give them a longer break for lunch or give rewards to keep the employees up to speed. 2. Do employee benefits have to be used equally In order for them to be fair or ethical? Why or why not? If you were In the HER department of a company where some employees were unhappy about this Issue, how would you recommend that the many address It?Now if I understand this right, I believe that if the benefits were equally given to all employees and not just women with children, I believe this would be fair and ethical. Instead of being equally used, I believe all the employees should have access to all the benefits of the company. If I was in the HER department, I would say that all the TTS snow a De offer to can employee. ASK around Ana get ten employees involved and see what is most needed. Finally, find ways that would benefit both men and women.

Role of Women in the American Revolution

Role of Women in the American Revolution The role of women played in any given war is quite often severely underestimated. This sentiment especially goes for the American Revolutionary War, where women actually played an absolutely essential role in our victory against the British. Not only where there different types of women who had helped, but there were many different ways each of them helped–particularly as nurses to help save lives and tend to injured soldiers. Without women helping in the war, we would have most certainly lost (National History Education Clearinghouse).One way that women helped out in the war was that they went directly to the source–by dressing up as men and going to fight in the front lines, women (e. g. Deborah Samson) were able to help America emerge victorious (â€Å"People of the Revolution†). Some women fought in a more subtle manner, by keeping house back home and tending to their husband’s businesses while they were at war (Zitek). They boycotted British products by participating in the Homespun Movement, where they wove their own clothing rather than wearing British-imported dresses, which served as a major act of bold defiance.Other women even acted as spies (e. g. Lydia Darragh in 1777, who eavesdropped on quartered British soldiers and relayed their plans of attack to the American patriots) during the war, helping the patriots win. (â€Å"www. revolutionary-war. net†). Different types of women also participated in the Revolutionary War. Patriotic women boycotted against British products, helped care for their husband’s property on the home front, and had even spied on British soldiers (â€Å"www. revolutionary-war. net†).However, loyalist women also played a role in counteracting these efforts. Loyalists as well as patriots acted as spies (e. g. Ann Bates, Miss Jenny) and in general posed as an obstacle for the patriotic women (Buesche). As for Native-Americans, Native-America n women supported the British, as they knew that a patriotic win would result in further westward expansion and further destruction of their homes. African-American women were pushed into the workforce as blacks in general were recognized as a powerful labor-intensive force (Zitek).In addition to all the roles patriotic women played in helping America emerge victorious, one of the biggest methods was nursing. Battle nurses were organized into army ranks, the highest rank having been ‘matron’. Their necessity was so that the ratio for wounded soldiers to nurses was 10:1. Even George Washington himself had found female nurses indispensable–he demanded they be present to help nurse soldiers back to health on and off the battlefield (National History Education Clearinghouse). Overall, women were an integral and vital part of the Revolutionary War.While few fought on the front lines, others helped in more subtle ways that showed rebellion and helped edge the USA towar ds long-awaited victory. Men thought women were incapable of understanding the intricacies of war and were proven incorrect time and time again. Whether through spying, healing, or fighting, without women, Britain most certainly would’ve overpowered America in the Revolutionary War. Citations Buesche, John. â€Å"Spy in a Petticoat. † Teaching History. National History Organization Clearinghouse, n. d. Web. 24 May 2012. Buesche) National History Education Clearinghouse, Browse tech for teachers. N. p. , n. d. Web. 24 May 2012. . (National History Education Clearinghouse) People of the revolution, P.. â€Å"Voices of the American Revolution. † Deborah Sampson. N. p. , n. d. Web. 24 May 2012. . (â€Å"People of the Revolution†) â€Å"Revolutionary War Spies. † www. revolutionary-war. net. Rose Creek Village, 2010. Web. 24 May 2012. . (â€Å"www. revolutionary-war. net†) Zitek, C.. â€Å"Women in the American Revolution. † . N. p. , n. d . Web. 24 May 2012. . (Zitek)

Is there any connection between terrorism and religion Research Paper

Is there any connection between terrorism and religion - Research Paper Example The aim of this paper is to establish that no religion of the world advocates violence and terrorism, and that there is no connection between the act of terrorism and religion, regardless of what the media or the authorities might have the masses believe. Generally, there are two schools of thought among the population: those who believe that it is religion that spreads ill will among people, and therefore, the only solution is to eradicate the concept of religion in order to attain world peace; and those, although in minority, rightly understand that religion of any kind has no relation with the spread of terrorism, and therefore, the only solution to a stable society is religious tolerance and social education (Shattuck, 2008). To assume that religion is at the foundation of rebellion and terrorism, and hence, to fight against any religious activity, is an effort in the wrong direction. Belief, of whatever kind, is at the core of human existence (Shattuck, 2008); it is imperative that man would believe in and submit to a higher power, regardless of the nature or identity of that power. It is, therefore, impossible to strip mankind of this fundamental concept and act, as it is ingrained in the very nature of man (Shattuck, 2008). It is, moreover, for this very reason, extremely easy for the miscreants to motivate people on religious grounds, as religion is often a sensitive and volatile issue (Shattuck, 2008). By presenting a twisted and wrongful picture of religion, and by misinterpreting the religious text, the terrorists have been able to recruit many young people, especially young males, into their ranks (Hassan, 2009). The fact that it is

Briefly discuss how multinational companies use ERP systems to process Essay

Briefly discuss how multinational companies use ERP systems to process transactions and provide information for stakeholders - Essay Example the enterprise resource planning (ERP) have always been used to collect, store, manage and interpret data from different functional divisions and roles of the organization (Daneva and Wieringa, 2009). Processing transactions within the organisation with the use of the ERP has been known to involve three major types of services which are consulting, customisation and support (Ceiton Technologies, 2013). Through these three processes, it is possible to integrate transactions in the areas of transactional database, management portal, search, workflow management, external access, and business intelligence system. For multinational companies, the estimated time to complete consulting has been noted to take a year (Daneva and Wieringa, 2009). Customisation has also been noted to involve even more time as it requires that each client will have an implementation process that suit their specific work need. In several multinational companies, processing transactions which are done under the three services mentioned earlier will be undertaken in a cyclical manner involving process preparation, configuration, customisation, extensions, and data migration. In most multinational companies, the use of ERP is directly connected to supply chain management and value chain systems. Meanwhile, these are two business activities that are not performed in isolation but in relation to both internal and external stakeholders (Holden Leadership Center, 2009). Because of this, reporting information from the implementation of ERP has always been a necessity for multinational companies. As an effective way to report information to stakeholders, three major models that come together to for the general model of an ERP system are used. These are workflow automation, electronic mail, and database creation. Under the workflow automation, there is the automation of the company’s work activities which is directly reported to the systems of all concerned stakeholders. This is usually backed up

Logistics Essay Example | Topics and Well Written Essays - 2250 words - 1

Logistics - Essay Example In order to analyze advantages and shortcomings of the existing Patrick Tasmania e-consignment system, we need to identify the processes and model the structure of the system, considering interdependence, interaction, and integration of its elements. For the simplicity of presentation and understanding of the system’s functioning, the use of diagrams for process and system modeling is essential. Modeling techniques are extremely useful in tackling the complexity, which is found when attempting to analyze and understand a system. Models are also extremely useful communication tools; i.e.: complex ideas and concepts can be captured on paper and can be shown to users and clients for clarification and feedback; or for distribution to other professionals, team members, contractors etc.Data Flow Diagrams, as the name suggests, illustrates the flow of information in a system. They demonstrate the information and how it flows between specific processes in a system.The Data Flow Diagra m modeling is a top-down decomposition technique, which results in process descriptions. To create the Data Flow Diagram we will undertake the following steps: define the target system, identify the main processes and activities (sub-systems) within the system, decompose each of the subsystems into constituent sub-systems or processes until the set of diagrams for the system which cannot be decomposed further is obtained. This set of non-decomposable diagrams will be the ultimate model of the system.

Ip4 managing high performance Research Paper Example | Topics and Well Written Essays - 250 words

Ip4 managing high performance - Research Paper Example For instance, the human resource manager would solely focus on day-to-day welfare of employees. In spite of the fact that this strategy will compromise on the morale of employees, there are many ways of tackling this challenge. In the new arrangement, the human resource manager should solely focus on the welfare of employees by linking with department representatives (Burton & Obel, 2004). The choice of managers should follow a meritocratic process that prioritizes on current managers with longer experiences. In addition, the selection process should focus on managers who have come up with milestone ideas in the past. The organization should minimize conflicts by creating a structure whereby the lower-level managers can constantly interact with the upper-level managers. The managers should assure the employees that the levels of management separate on the basis of different responsibilities rather on the basis on prestige (Lumpe, 2008). In the end, this strategy will cover up for the costs of having a new administrative structure. This is because managers will possess distinct duties that they focus on the

Sale of Goods Act 1979 Commercial law (uk) Assignment

Sale of Goods Act 1979 Commercial law (uk) - Assignment Example If one were to adopt the narrow semantic position in this discussion, then one could conceivably argue that The Sale of Goods Act 1979 is more suitable as a commercial code. After all it was created specifically to address itself to commercial transactions between parties. In that these transactions almost always pertain to providing a good for a fee, this type of undertaking in an of themselves can be classified as a commercial transaction. The thrust of the Sale of Goods Act and its intent is to provide a net for all transactions; consumer and business. When one views the Act in its totality, it is readily discernable that it is an interchangeable document. Which attempts to address all of the possibilities which might surface during the course of a transaction. It was through the formulation of contracts that man was able to expand the acts of liaise faire and enter into deals. A contract is formed by agreement between two parties to the contract; the parties must choose to enter into a binding agreement; in a ordinary buyer to seller contract this may entail; the seller agrees to provide the buyer an item at a stated price. The seller (may be implied or explicit) then agrees to deliver the item in a reasonable or merchantable (satisfactory) condition to the buyer. The buyer having agreed with the conditions of the purchase agrees to pay the seller his previously stated price upon delivery of the item.... price upon delivery of the item. This is a bilateral contract, wherein each party has taken on an obligation to do something, in return for something. The promise which has been made by each party makes the "verbal" contract (may be formal or informal), binding. If any term or condition in this legally binding contract is breached by either party, the contract can then be voided. 3 As we find in Baldry v. Marshall [1925]; B owned a racing car but his wife refused to ride in it. He approached M, a car dealer, requesting details of Bugatti cars, about which he (B) knew nothing. He asked for a car that would be comfortable and suitable for touring purposes, and the dealer recommended a Bugatti. B agreed to buy a Bugatti; after inspecting the chassis. Once completed, it was obvious that the car was a racing car and not suitable for touring. He returned the car and sued for one thousand pounds that he had already paid under the contract. The court held; that B had relied upon the skill and judgement of M, and that it was in the course of M's business to supply cars. Hence, there had been a breach of the Sale of Goods Act 1979 S 14 (3). When a purchaser relies upon the skill and judgment of a seller and that seller is acting within the course of his business, then the purposes of S 14 (3), goods must be suitable for the purpose made known to the seller if a breach is to be avoided. Even if the goods are of merchantable (satisfactory) quality; other implied terms must be satisfied. S14 (3) precludes the seller from

Marx's objectives to individual rights Research Paper - 1

Marx's objectives to individual rights - Research Paper Example However, Karl Marx and Friedrich Engels are convinced otherwise, affirming that bourgeois private property is the final and most complete expression of the system of producing and appropriating products, that is based on class antagonisms, on the exploitation of the many by the few. 1 For them capitalism, which is based on the right to own private property, is beneficial only to the select few capitalists - or the bourgeoisie - who reap their benefits from the exploitation of the wage earners, the proletariat. For Marx and Engels, at least, private property rights protect the freedom of some but not only deny the freedom, but results in the exploitation, of many others. To understand this argument, it is necessary to have a first look at the basis of Marxs theory. Marx strongly believed that capitalist society consisted of two classes, the bourgeoisie, or the ruling class, and the proletariat, who are the exploited class: "To maintain its own existence private property must also maintain the existence of the property - less working class needed to run the factories. The proletariat is compelled, however, to abolish itself on account of its miserable condition. This will require the abolition of private property - both disappear in a new synthesis that will resolve the contradiction." 2 The employers, or the bourgeoisie, build up their wealth through the exploitation of their workers. Under capitalism workers essentially own their own labor which in one respect makes them free. However, although the workers are in charge of their own labor power, in the sense that it is not owned by a master or land owner, they are not free as they are forced to sell it out in order to survive. Instead of owning the product of their own labor, this instead goes to the capitalists who in turn retain a certain amount of the value of the product for themselves and their investment. Thus capital can be defined as accumulated labor.

Enusring Coherence in Curriculum Research Paper

Enusring Coherence in Curriculum - Research Paper Example The design should also offer room for advancement both of the curriculum structure as well as the curriculum content. Its application should also be practical in terms of implementation and should not contain any contradictory statements and strategies. These components relate directly to a coherent curriculum in my learning environment. The systematicness component ensures that all the activities in a curriculum are well connected to each other. This kind of connectivity assists in making the curriculum to be more coherent and, thus, promoting its ability to achieve its objectives. The completeness component ensures that all the parts of the curriculum are complete and that they have adequate contents. This promotes the connectivity of one part of the curriculum to the other, and, thus, making the curriculum to be coherent. The advancement component of the system design for curriculum provides room for advancement of the curriculum content. Through the advancement of the content, th eir connectivity and relationships can be enhanced, thus making the curriculum to be coherent. Practicability component makes all the parts of the curriculum to be easy to administer. ... Another best quality is that both of them assist in the selection and organization of learning experiences for effective instruction and achievement of learning objectives. Another very important quality of these two models is that they both provide a way of designing a mean of evaluation of the curriculum and its content. According to Erickson (2002, p. 44), â€Å"a coherent curriculum is one that holds that makes sense as a whole and one that has parts which are unified and interconnected†. The three best qualities of these two curriculum models I researched about promotion of unification of the different parts of the curriculum. They also promote the interconnection of various parts of a curriculum and they help the curriculum to make sense as a whole. They also enable the various parts of the curriculum to make sense and, hence, they are very fundamental in the promotion of coherence of the curriculum. Among the two models that I researched, the one which could be most eff ective in my current educational environment is the Tyler’s Model. This is because this model being among the modernism model is clearer, more simplified, more useful, and more comprehensive compared to the Gerlach and Ely Model. According to Dennis (2002), this model is appropriate for large scale mass education and it is also good for basics. Since my current educational environment involves teaching basics to a large group of students, this model will be the most appropriate for such an environment. Curriculum design There are various â€Å"Knows† in a curriculum design. One of them is what the students should know by the end of the curriculum. The other one is what the student

Statistics of Migrants in the UK Essay Example | Topics and Well Written Essays - 8250 words

Statistics of Migrants in the UK - Essay Example Migration is a prevalent issue especially in developed nations and even those surrounded by relatively low-income economies. People are generally found to traverse from one place to another for a number of reasons, varying from the propensity of being employed to an increased level of per capita income. But, the question of migration turns out to be a glitch owing to social factors more than those arising from economic aspects. The problems which crop up in such instances are those related to ethnicity and the country of origin which operates behind the culture that the migrants are habituated to, as well as their compatibility with the citizens of the nation where they decide to move in. Matters associated with the employment of the migrants are dependent upon the labour rights of the respective nations; in most of the cases, they are related to matters aligned with their nationality which however, could be taken care of officially. In fact, the member nations of European Union do n ot face any difficulty in such matters, given that their labour markets provide an automatic entrance to the migrants from the co-member nations. Nevertheless, the concern about being able to integrate socially is actually a major point to be stressed upon while discussing migration factors. Inability to integrate with the local environment is often treated as a primary reason behind reduced levels of labor productivity. Thus, the nation which faces the problem of migration might suffer from an economic shortfall from this aspect, with an almost unchanged demographic stance and lowered levels of per capita income that tilts its domestic growth rate in a negative way. The present paper is an empirical work in this area with regard to the case of the United Kingdom that witnessed a net immigration of 100 thousand per annum between  the years 1991 and 2000, prior to which it had experienced a trough in the statistics. In fact, migration statistics had been exhibiting a hike in its tr ends hitherto, with the latest figure standing at 176,000 compared to 143,000 in the phase 2001-2002 itself.

Different Ethnic Groups Essay Example for Free

Different Ethnic Groups Essay After going through and being asked to react to the following statement, â€Å"Students who dine solely with members of their own ethnic group and participate in ethnic student organizations and activities contribute to a decline of ethnic relations on campus,† I have come to realized that as any other statements there’s always two sides and a lot more to consider before coming to a consent as a whole. In my opinion this is very important and should always view both sides of the story Many types of these ethnic group’s actions could make it easy and lead to a decline of ethnic relations on campus. For instance, let’s say if ethnic students did everything together as a whole and only participated in ethnic student activities, then it would clearly segregate the campus. Unfortunately no a days, this world for the most part is over the whole â€Å"whites and blacks racial dividedness† and no one should be seeking to head back on that path. Now, campus cafeterias could show a sign of being like that again with several different ethnic groups scattered around. If each ethnic group had its individual organization, I fell that the members could get extremely complacent and start to sense a feeling of superiority. This eventually could lead to conflict with other ethnic groups throughout the campus. It is very also important to look at how other students will view these ethnic groups. Other students may not like these groups, which once again could cause conflict. Another scenario, students may feel threatened by these groups, therefore making them not want to attend class or socialize around campus. There could also be a chance that these ethnic groups could try to bring down a disliked professor or even another group. Universities un-affiliated with a religion may deal with groups with strong religious beliefs and could try to implement their religion into the university. Even schools that are represented by a religion are in danger of an ethnic group with other strong religious beliefs. With all of these problems with ethnic groups, could quickly multiply as they also act as networking groups to get more students who share the same background and beliefs to attend the school. Even graduates could carry this on to their future employers, although experts claim that no network group has ever set out to bring a company down, companies are the next things for college students and bring the risk of having their employees become far too separate from each other. The whole idea of diversity in a company is to make the work place and as uniformly supportive to all cultural backgrounds. By allowing these groups to form, the companies are moving further away from supposedly a fair and diverse population of workers. The segregation of ethnic groups from the rest of the student body largely contributes to a decline of ethnic relations on campus. If I were to see the other side of this and disagree, I would believe that if students of the same ethnic background only dined and participated in ethnic student activities, then it would not contribute to a decline of ethnic relations on campus. Instead, it would have students who tend to stay surrounded by people of the same ethnic background could feel more free, comfortable and accepted; thus bringing improvements leading to higher grades in the classroom and a more humble attitude towards life. Also being placed within a group will most likely encourage students to go out socialize, take part in campus activities, and enjoy campus life. This will lead to them interacting with people from different backgrounds. These ethnic groups can also play a vital role in campus activity by hosting fundraisers, parties, or sporting events. Another benefit to being part of an ethnic group is that many voices are better than one. So by having your voice heard out there will help put an end to any discrimination that was happening and will strengthen the campus’ ethnic relations. Future students looking to attend the school in the years to come may visit the campus and see a group of people who share the same ethnicity or interest as themselves and allure them to come to that university. These groups working as a form of networking could be a massive tool in attracting a diverse student body while at the same time strengthening ethnic relationships. Having been asked to support the statement or disagree, I would have to say that I agree with the statement. In order to be diverse, the student body as a whole it needs to be integrated at all times. It is one thing to live and be part of a group with people who share the same background; however, they should also be with people of other ethnicities and backgrounds. One group only interacting with themselves and not acknowledging other groups forms poor ethnic relations habits. I also feel that most ethnic groups will express a religion that will stir up controversy with other groups for one reason or another. By using the groups as a way to persuade new students to attend the school, the groups will quickly grow and possibly cause even more conflict to the university. Ethnic groups will bring nothing more than poor ethnic relations habits to campus and future graduates workplaces causing only a decline in ethnic relations.

Research On Methicillin Resistant Staphylococcus Aureus Nursing Essay

Research On Methicillin Resistant Staphylococcus Aureus Nursing Essay The topic for this piece of work is Methicillin-resistant Staphylococcus aureus (MRSA). This area of research was chosen due to the science and medical aspect behind this very interesting topic. MRSA is a topic of great importance for the general public but also for health professionals, e.g. nurses and doctors. Although it wasnt until recently that MRSA was named a superbug, the medical community remained calm when people found out about it, as they had been aware of the bacterium since the early 19060s. It is common knowledge that the most frequently found home of MRSA is medical health centres and nursing homes. The author of this medical journal is mostly concerned with the challenges and threats MRSA posses to her, as she works in a hospital where the majority of the patients are the elderly. [2] Firstly, MRSA was researched in depth to all aspects, e.g. symptoms, treatment, and prevention methods. The information was bulky and helpful allowing for fully detailed knowledge and understanding of the subject. Secondly, the information was collaborated and mixed together to create a full and informative graded unit on the subject of MRSA. This collaboration of information allows not only for the reader to get a detailed introduction to MRSA, but also gives the reader an idea of what MRSA is and how treatment has developed since the discovery in 1961. The use of several resources meant that the information in the text was not only the most relative but the most informative. Thirdly, and finally, the HND: Applied Science Course was used not only to aid and boost the already present science and medical aspects of MRSA, but to aid in the problem solving characteristics required in the graded unit. Such subjects as Fundamental Chemistry, Information Technology, Biochemistry, and Presentation Skills were used to better the understanding of MRSA and improve the layout and design of the graded unit. What is MRSA? Shown below is a tiny cluster of bacteria known as Methicillin-resistant Staphylococcus aureus (MRSA) seen under a microscope. MRSA is a common skin bacterium caused by Staphylococcus aureus (sometimes called, Staph) that is resistant to a wide range of antibiotics. [3], [4] [5]: MRSA under the microscope The name Methicillin-resistant means that the bacteria are not affected by the antibiotic methicillin, and a number of other antibiotics such as penicillin and cephalosporin, which used to be the common drugs to kill the Staph bacteria. There are a number of different MRSA strains, around 16, all with varying degrees of resistance to methicillin. [3] Staphylococcus aureus (SA) is a commonly occurring bacterium that has been around, for thousands of years and the discovery of MRSA in the early 1960s. Around a third of the worlds population carries MRSA harmlessly on the skin, nose or throat (especially in folds like the armpit or groin). [3], [6] MRSA is most commonly found in hospitals, due to the fact that there are higher numbers of infected surfaces and people in a hospital. The highest number of patients in a hospital or normally elderly who are sicker and weaker than the general population, which makes them more susceptible to infection due to a weaker immune system. Since around a third of the worlds population is colonizied by MRSA, the potential for infection is incredibly high. A person becomes infected when the organism invades the skin or deeper tissues and multiplies. [6], [7] During the early 20th century, 45% of the worlds population were not living beyond 65 years old, with infectious diseases being the leading factor to this low life expectancy. Due to the discovery of penicillin by Alexander Fleming in 1928, and the manufacturing of the antibiotic, the fight against infectious diseases including infections caused by Staphylococcus aureus was able to begin. Unfortunately, just a decade later Staph aureus became resistant, not only to penicillin, but also new antibiotics such as: erythromycin, streptomycin, and tetracycline. [8] In 1960, the newest and most effective chance of controlling and stopping Staph aureus was Methicillin. But this antibiotic that had once been the only weapon against Staph aureus was short lived and soon joined the other antibiotics that were now ineffective and useless in fighting Staph aureus. In the late 1970s the first outbreak of MRSA was reported in hospitals in eastern Australia, and by the 1980s MRSA had emerged all over the world. [8] It can be seen in the graph; MRSA Figures of Isolates per year in Europe; that certain countries are suffering from MRSA a lot greater than others. For example, the Nordic Countries (Denmark, Finland, Iceland Sweden) and also The Netherlands have the least outbreaks of MRSA per annum. Countries such as Malta, Greece, Ireland and the UK all suffer each year from high numbers of MRSA sufferers or colonized individuals. It can be seen from the graph that the worst outbreak of MRSA was in Malta in 2001 with more than 50% of the individuals tested being sufferers, whilst in the same year Iceland had no reports of any MRSA outbreaks. The reason for Maltas high percentage of MRSA carriers in 2001 could have been due to a lack of knowledge and understanding of the bacterium. Another possible reason for the high percentage could be that not enough procedures or policies regarding MRSA were available or even in place. The following two years MRSA in Malta declined to around 40% of tested indi viduals being carriers, which show that policies had been put into place after the outbreak in 2001. [9] [9] MRSA Figures of Isolates per year in Europe The extremely low percentages of MRSA carriers in The Nordic Countries and The Netherlands could be due to these countries having many policies advising and informing people in the community and patients and doctors in medical facilities of the dangers of MRSA and the simple methods on avoiding the bacterium. In the graph below it shows that The Netherlands tested 1238 people per annum for the bacterium MRSA, with less than 3% each year between 2000-2003 being carriers of the bacteria, which is seen to be around only 37 people. [9] The spread of MRSA throughout Europe is a serious problem that seems to affect almost all countries severely. The graph shows how easily MRSA can fluctuate from country to country, and from year to year. If more policies and better education on the subject of MRSA were available not only to hospitals but to the community in the UK then it is possible that the carrier percentage in Britain will decrease, but until such action is taken the British population will suffer not due a to lack of medical care but to lack of education. Symptoms The symptoms of an infection due to MRSA can vary greatly, all depending on what part of the body is infected. MRSA can infect a wide range of body tissues and organs, which makes MRSA the Superbug that it is. [10] Although there are a large number of symptoms of MRSA, there are only two types of infection: Skin infection and Bloodstream infection. Below is a table, of the type of symptoms common to each of the infections. [10], [11] [11]: Symptoms of MRSA related to infection type Skin Infection Bloodstream Infection Boils Endocarditis Abscesses Osteomyelitis Styes Septic Shock Impetigo Septicaemia Carbuncles Meningitis The longer that any of these symptoms continue untreated, can greatly increase the risk of a widespread infection in the body. Shown below is the damage that some of these symptoms can cause to a person. [12], [13] [12]: Impetigo [13]: Abscess Although MRSA can lead to all of the above symptoms, without treatment, it normally starts as a reddish blotch or pimple on the skin. This leads onto an MRSA lesion [14] forming, which is the first and most noticeable stage to identifying an MRSA infection. [15] [14]: MRSA lesions However all these symptoms cant be identified without certain lab tests. Usually before diagnosis of MRSA has occurred but the symptoms of a staph infection are visible, doctors and nurses will treat the patients infection as a common staph infection, and prescribe antibiotics that would have no effect on MRSA. This delay in diagnoses of MRSA could result in the patient having to stay longer in a medical facility or worse the delay could allow the infection to get worse and infect the blood and the heart. Therefore the longer it takes to diagnose MRSA, means that patients will suffer more and the problems in the NHS and other health services shall continue to be unresolved. Causes of MRSA MRSA can be transmitted by direct contact with a person carrying MRSA on their skin, e.g. individuals who are colonizied with MRSA can pass the bacteria through a variety of direct contact from a simple hand-shake to a kiss from a loved one. The transmission of MRSA can also take place through indirect contact. This form of transmission is just as common as direct if not more. A person can be infected by MRSA by touching any surface, e.g. a pedestrian walker button, which is likely to have an incredibly high number of people touching it everyday and all-day, and with around a third of the worlds population being carriers the chance of being infected is high. Hot spots for indirect contact are door handles, game controllers, keyboards, sheets and towels. The final and least likely form or transmission is by airborne infection. An airborne contaminant is the least likely form of spreading as it is more likely that a skin to skin contact will take place with the colonized or infected individual carrying MRSA. An airborne contaminant can be spread when sheets in a room are thrown around the place when making the bed. As the duvet is fanned skin particles are flown into the air causing the infection to become airborne and allows for easy transmission. The way in which MRSA can be transmitted and individuals contaminated depends on where the infection was acquired. The key areas of MRSA spread are; the health-care system and the community in any country, and because these two are the major hot spots it means they can be categorized. Healthcare-Acquired MRSA and Community-Associated MRSA are these two categories. CA-MRSA (Community-Associated-MRSA) CA-MRSA can easily be spread in any enclosed space, especially any crowded or unsanitary condition. Outbreaks of CA-MRSA are more than common in prisons around the world with American and European countries being the worse as well as in military training facilities. The high number of MRSA sufferers in any prison can be seen as a problem for any country. The over populated state and the lack of space and hygiene could be resolved by an increase in the size of prisons or a decrease in number or prisoners in a prison. Although the problem seems easy to fix the strain on any country to fix this problem can be seen as over-whelming. CA-MRSA has affected sports teams, athletes and gyms. The bacterium spreads easily through cuts and abrasions and skin-to-skin contact. Sharing towels or athletic equipment increases spreading infection among athletes. This problem can be resolved by equipment being cleaned after use and towels not being shared. CA-MRSA can be dangerous in children and young adults, causing a widespread infection when it enters the body through a cut or scrape. Children may be more susceptible to infection due to their immune systems not being fully developed. The spread of MRSA and the realities of who is most at risk of contracting the infection all come under as the Causes of MRSA, because each directly links to how the person becomes infected. The environment that a person exists in can majorly affect their chances of being infected by MRSA, for example, hospitals. If a person is spending the majority of their time or even visiting for a short period of time, their presence in an environment like a hospital will greatly increase the potential of infection. HA-MRSA (Hospital-Acquired-MRSA) The reason that hospitals are seen as the hot spot of MRSA infection is because the majority of people there are ill. For any individual that suffers from a medical condition like HIV or cancer, that weakens the immune system, the chance for infection is increased exponentially. [16] HA-MRSA can normally enter though an entry point into the body, such as a surgical wound or a catheter. This can sometimes be a major problem for some patients and can resolve in death. Abscesss normally form to control and heal the infection. For most HA-MRSA infections not much can be done to resolve the problem except to make sure that medical staff are kept constantly aware of how vital hygiene is when dealing with patients. The patients tend to be older, sicker and weaker than the general population, making them more vulnerable to infection from HA-MRSA. These are some of the few problems that nothing can be done about. The age of a person isnt a major factor unless the patient is older as their immune systems are weaker they are prone to disease and infection. Hospitals are filled by many patients, doctors and nurses, so HA-MRSA can easily be contracted, through direct contact with other patients or staff, or through contaminated surfaces and through an airborne contaminant. [17] This can be resolved by making sure contact with infected individuals is limited and the staff, made to contact is also limited. Surfaces in any medical care facility should always be sanitised and kept clean. The superbug that is MRSA can be seen as a never ending problem because MRSA infection can arise in the community, which I feel will not eliminate the stress on hospitals but instead increase it. Even if hospitals were to have better control methods and better policies addressing the problem of MRSA, the outside world could not continue to keep surfaces completely clean, with door handles being constantly used. The problem seems to be more like a never ending round-about instead of a quick sprint to resolving the spread of MRSA. Screening for MRSA Screening for MRSA is an effective and safe method to find out if a person is a carrier of MRSA. Screening for MRSA before a person enters an environment like a hospital can greatly decrease the chance for a carrier to become infected or to infect others, as the staff at the hospital can remove as much of the bacteria as possible through a simple treatment. [18] The screening process is simple and involves no injections. Instead several swabs are taken at the most common carrier sites of the bacteria; the anterior nares (nose), the axilla (armpit), and the perineum (groin) are all tested. If any skin lesions were seen or noticed they would also be tested, due to them being one of the first signs of an MRSA infection. [19] There are three ways of testing the swabs taken from a suspected carrier of MRSA. These include: Polymerase Chain Reaction (PCR) PCR is a method for producing large amounts of specific DNA or RNA fragments of defined length and sequence from small amounts of primers. The reaction is not only efficient and specific, but is also very rapid and extremely sensitive. Uses for the reaction include disease diagnosis, detection of difficult-to-isolate pathogens, and the direct detection of MRSA from nasal swab samples. [20] PCR can be seen as the quickest of the three methods as it removes all the tedious work of having to count up the colonies on an agar plate and it doesnt involve having to wait for several days for the results like an enrichment broth. PCR is also a very simple procedure. [21] PCR is also the most costly of the three, which although is a negative quality it isnt a major factor when testing to see whether someone is infected by MRSA. Enrichment Broth Cultures An enrichment culture is a medium with specific and known qualities that favors the growth of a particular micro-organism [22] The major pro with Enrichment Cultures is that they give an easy way in which to isolate pure cultures of  scarce microbial types. The two biggest cons when using Enrichment Cultures is that they very easily become contaminated, which can be seen as very big negative when trying to isolate a MRSA. [21] Direct Plating Direct Plate counting is a method used to count the number of cells in a sample. Once the cells to be counted have been isolated, they are dilute; due to the fact that too many cells will cause the Petri dish to be so populated with colonies, that it would be impossible to count. After the cells have been diluted, they are incubated on an agar medium until colonies form. It is now that the cells are counted. [21] Direct Plating can be seen as the method with the most negatives. Sampling error is the most obvious negative as it refers to the uneven spread of the sample on the agar plate. This is a serious negative as it can hinder the end results. Another negative is that it has little effect on cells that do not split, as it hinders the final count. Through all of Direct Platings negatives it is still seen as the best available method for identifying viable cells. [21] All three types of screening and testing methods are valid and useful for different end results needed. It can be seen from the information that Enrichment Cultures and Direct Plating are not as quick and effective as PCR. Though PCR is flawed by the cost the pros can easily be seen to outweigh this small negative. I believe PCR is the best method for testing for the presence of MRSA, as it gets the results quick and easily and avoids all the tedious work of counting cells. Prevention Methods Hand Hygiene By having good hand hygiene the risk of spreading MRSA can be reduced greatly. Hands and wrists should be washed thoroughly using an antiseptic hand wash or simple dispenser soap. Cross-contamination and spread of MRSA in hospitals is being tackled by using special anti-microbial hand washing products and alcohol-based antiseptic agents. Hand hygiene is essential even if disposable gloves have been worn. Hand hygiene procedures must always be performed before leaving the room (even if there has been no direct contact with the patient, e.g. when serving food, airing the room or making the bed). The diagram below shows the proper method to washing hands effectively. [23] [23]: How to wash hands properly Precautions Infection control precautions can be seen as obvious things in preventing cross contamination. The following precautions should always be carried out at all times and with all patients and medical staff. Cover all cuts, abrasions and lesions especially those on hands and forearms with a waterproof dressing. Maintain hand hygiene Before and after dealing with each patient Before handling food Following bed making After handling blood and bodily fluids and also items contaminated with blood or bodily fluids Dispose of waste safely Isolate patients with a known or suspected infection Use disposable gloves and aprons when dealing with patients, blood, bodily fluids and the making of beds. [7] Education The continuous education of all health-care staff members is an essential art of any MRSA control scheme, as well as making sure up-to-date information is always available and known. The education of patients is also vital to controlling MRSA infections. The Department of Health Services: Centres for Disease Control and Prevention (CDC) offers a link to an MRSA patient information sheet. Such information as this can be seen as extremely helpful as it answers the most common asked questions regarding MRSA. [24] All the possible prevention methods boil down to maintaining excellent hygiene. By keeping your environment, your personal care items, and yourself clean you can reduce the risk of contracting MRSA. It is imperative to follow the directions laid out by staff when you are in hospitals, nursing homes, and gyms, as these locations can carry an increased risk of MRSA infection. [25] Treatment The treatment of MRSA, in todays world is more difficult than ever. MRSA being a superbug means that it is resistant to a wide range of antibiotics. With such antibiotics as Methicillin, Penicillin and Cephalosporin being among the many antibiotics that have no affect on MRSA. When MRSA was first discovered to be resistant against methicillin a number of other treatments were devised so as to stop the outbreak of the bacteria. Although the alternative antibiotics were affected for a while, MRSA became resistant to them also. This meant that new drugs had to be made so as to control MRSA from becoming a worldwide pandemic. The manufacturer of such drugs as Chlorhexidine hydrochloride, Vancomycin Hydrochloride and Linezolid meant that MRSA had a chance of being controlled. [26]: Comparison of Vancomycin and Linezolid Vancomycin Linezolid Mechanism of Action Cell wall synthesis inhibitor Protein synthesis inhibitor Dosage Form Availability Intravenous Intravenous Oral Adverse Events Red man syndrome Rash Nephrotoxicity Ototoxicity Bone marrow suppression Mitochondrial toxicity: neuropathies and lactic acidosis Serotonin syndrome Routine Therapeutic Drugs Monitoring Performed Yes No The table above shows a comparison between two drugs that are used to treat MRSA. From the table it is clear to see that both treatments offer adverse effects. With Vancomycin only being able to be administered intravenously (IV) while Linezoid can be administered by IV or orally. The number of adverse effects is greater for Vancomycin suggesting that Linezoid is the better method for treatment of MRSA. [27]: Linezoid [28]: Vancomycin Hydrochloride The images above show the complexity of the Linezolid and Vancomycin Hydrochloride and how they are structured. Isolation of a patient/person suffering from MRSA is seen as an alternative treatment. The isolation of a person is extreme as it means confiding them to one room in a separate ward. The advantage of such an extreme treatment is that, the physical barrier between the infected and the uninfected acts as a disturbance stopping the further transmission of the bacteria. The other advantage is that the separation gives a clear psychological message to the sufferer that they are infected and have a huge potential to infect those around them. With any advantage comes a disadvantage, with isolation having one huge disadvantage. The psychological damage that isolation can have on an individual can leave them so lonely that they begin to distrust those around them. The individual can become so independent that they see no need for help form others and this can lead to a long and lonely existence. [29] Available Aid There are many sources of aid, available for those who are colonised, infected or related to someone with MRSA. MRSA sufferers and their families who are feeling the pressures of living with MRSA can retreat from their ordinary lives, of people asking things like are you ok and do you need any help, online. Through such support groups as MRSA Action UK, a registered charity with the aim of helping and supporting not only the sufferers of MRSA but their families also, the stress of being a sufferer of MRSA can be relieved. MRSA Action UK not only acts as a charity to make the general population aware of the superbug but also offers links to other sites which give information and further support for anyone who needs it. MRSA Resources is an online discussion board, where people who have MRSA, have lost someone to MRSA, or just want to talk about the subject, are able to. The discussion board allows for people to share not only the information they have found on the internet or in books and newspapers but also allows them to connect on a personal level where they can share their own personal experiences with MRSA. Conclusion The prevention and controlling methods for MRSA infections is dependent on the approach and high standards of which healthcare workers abide by, as well as, strong leadership to highlight the dangers of an MRSA infection. Standard precautions, e.g. hand hygiene, together with isolation, and education are key to the prevention and control of MRSA. The overall welfare and safety of a person is of the up most importance, and measures undertaken to control MRSA shouldnt interfere with the already established care of patients. Therefore, it can be seen that the investment in more isolation rooms in hospitals and increased hygiene care throughout the world can reduce the potential of MRSA infections. MRSA can be seen as a major problem for health services throughout the globe, as it decreases mortality rates, increases morbidity rates and causes patients to stress over the possible symptoms. It is essential to have a well-structured and clear policy on infection control in hospitals and educational facilities to stop or a t least stunt the spread of MRSA as well as other infectious bacterium. As well as a clear policy educational programmes and leaflets on infectious control should be made available at request as well for the training of nurses, all to aid in the understanding of MRSA. In any medical facility it is nurses who are in immediate contact with many patients over prolonged periods of time. With this in mind it means that the hygiene of nurses should be maintained continuously at a high standard. Not only should they keep their hygiene high when dealing with patients but also with relatives and visitors to the hospital. In spite of all the possible improvements that have been established and stated in this graded unit, the problem of MRSA control and eradication still seem to be a subject that will never be resolved. Though hospitals could improve hygiene and lower the potential of HA-MRSA, the potential threat of increased CA-MRSA is always a possibility due to community hygiene being impossible to control or establish a policy to which CA-MRSA would be effected by. Glossary (All glossary definitions were taken from the internet, from several different sites). Abscess an accumulation of pus in a body tissue, usually caused by a bacterial infection. Airborne in or carried by the air. Antibiotics a chemical substance derivable from a mold or bacterium that can kill microorganisms and cure bacterial infections. Bacteria bacteria are tiny, single-celled organisms that live in the body. Some can cause illness and disease and some others are good for you. Bloodstream infection a condition in which bacteria enters the blood, which can occur through a wound or infection, or through a surgical procedure or injection. Boils an inflamed, raised area of skin that is pus-filled; usually an infected hair follicle. Carbuncles skin lesion typically caused by Staphylococcus aureus, and resembling a boil with multiple heads. Catheter a hollow, flexible tube inserted into the body to put in or take out fluid, or to open up or close blood vessels. Cephalosporin any of a class of natural and synthetic antibiotics developed from Cephalosporium fungi. Chlorhexidine hydrochloride an anti-microbial agent. Colonized the presence and multiplication of microorganisms without tissue invasion or damage. The infected individual demonstrates no signs or symptoms of infection, while the potential to infect others still exists. Culture the growing of microorganisms in a nutrient medium (such as gelatine or agar). Endocarditis inflammation of the endocardium and heart valves. Endocardium lining of the interior surface of the hearts chambers. Erythematous a reddening of the skin. HIV (Human immunodeficiency virus) a retrovirus that attacks helper T cells of the immune system and causes acquired immunodeficiency syndrome (AIDS); transmitted through sexual intercourse or contact with infected blood. Impetigo a highly contagious skin infection caused by bacteria, usually occurring around the nose and mouth. Intravenous (IV) a dose of medicine administered from a drip, down through a hollow needle inserted into a patients vein. Isolation the act of isolating something; sets something apart from others. Linezolid a synthetic antibiotic used for the treatment of serious infections caused by Gram-positive bacteria that are resistant to several other antibiotics. Meninges the three membranes that surround and protect the spinal cord and brain. Meningitis inflammation of the meninges; usually caused by infection by a microorganism. Methicillin antibiotic drug of the penicillin family used in the treatment of certain staphylococcal infections. Mitochondrial toxicity a condition in which the mitochondria of a bodys cells become damaged or decline significantly in number. MRSA (Methicillin-resistant Staphylococcus aureus) a serious and potentially fatal infection caused by Staphylococcus aureus bacteria that is resistant to the broad-spectrum antibiotics commonly used to treat it. Nephrotoxicity damage to the kidneys produced by drugs or other substances. Osteomyelitis the inflammation of bones and bone marrow because of an infection, usually caused by bacteria. Ototoxicity toxic to the organs of hearing or balance or to the auditory nerve. Pandemic an epidemic that is geographically widespread; occurring throughout a region or even throughout the world. Penicillin an antibiotic used to cure or stop the spread of certain infections, due to its ability to inhibit the growth of certain bacteria. PCR method of amplifying or copying DNA fragments that is faster than cloning. Red man syndrome an infusion reaction to vancomycin, causing flushing of the skin and an erythematous rash on the upper body. Septicaemia a life-threatening condition in which bacteria multiply in the blood and produce toxic materials; commonly known as blood poisoning. Septic shock a life-threatening condition in which tissues become damaged and blood pressure drops due to bacteria multiplying and producing poisons in the blood. Serotonin syndrome a potentially life-threatening adverse drug reaction that may occur following therapeutic drug use. Skin infection (Dermatitis) inflammation of the skin. Staphylococcus aureus potentially pathogenic bacteria found in nasal membranes, skin, hair follicles, and peritoneum of warm blooded animals. They may cause a wide range of infections and intoxications. Styes a pus-filled abscess in the follicle of an eyelash; caused by a bacterial infection. Superbug a strain of bacteria that is resistant to all antibiotics. Vancomycin an antibiotic effective against some bacterial infections.

Anatomy and Physiology of the Human Body

Anatomy and Physiology of the Human Body Anatomy and Physiology Part A Identify the parts of the digestive system on the diagram overleaf?(Refer to Brief) Explain the function of each part of the digestive system identified in the diagram above? Outline the composition of Proteins, Fats and Carbohydrates, and explain how each of them are digested and absorbed by the body? Part B Draw a diagram of a typical cell and state the function of each of its organelles? Classify tissues into the four main groups; epithelial, connective, muscle, and nervous, give an example of each? (Table format will suffice) Explain the difference between benign and malignant tumours? Part C Label the urinary system using the diagram overleaf?(Refer to Brief) Explain the structure and function of each element of the urinary system? Draw the structure of a Nephron and explain how it produces urine? Name and explain three diseases /disorders which affect the urinary system? Part A (ii)Explain the function of each part of the digestive system identified in the diagram above? Mouth Oesophagus Stomach Liver Gallbladder Pancreas Large Intestine Small Intestine Appendix Rectum Anus In this section I will explain each of the stages of digestion where the food travels from the mouth into each section of the digestive system until it leaves the body from the anus. Mouth This is the first part of the digestive system. The mouth is made up of the teeth, tongue and salivary glands. We put food in our mouth and chew it with our teeth the are four main types of teeth the first being incisors which we have four of in the top and bottom jaws these are sharp and cut through our food. Then we have the canines we have two in each jaw and are used for tearing our food. We then have the premolars which have four in each jaw for crushing and breaking down our food. Then we have the molars which there are six to each jaw and have the same action as the premolars. Our tongue moves the food around our mouth to our different teeth. It mixes with our saliva which is secreted from the salivary glands which contains water, mucus and the enzyme salivary amylase and when mixed with the food creates bolus which we then swallow using the aid of our tongue. (Class notes 2015) Oesophagus This is an involuntary muscular tube that leads from the mouth to the stomach. It carries the food to the stomach by muscle contraction called peristalsis. This muscle contracts and relaxes to create a wave like motion for the food to travel down smoothly also releasing mucus to lubricate the travelling of the bolus to the stomach. (Class notes 2015) Stomach Food gets to the stomach through the oesophagus and passes through the cardiac sphincter this blocks the food from travelling back up the oesophagus. In the stomach which resembles a large sac that can hold anything between 2- 4 litres of food depending on the person. The first part of digestion starts here the stomach churns the bolus around and adds enzymes to aid in the breakdown of the bolus to create chime. The stomach also releases hydrochloric acid to kill the bacteria that travel to the stomach contained in the food.(Class notes 2015) Liver The livers function in the digestive system is as follows it secretes bile into the small intestine and this is generally to breakdown the fat that has travelled to the small intestine it also takes the nutrients that have been adsorbed by the small intestine and changes them into chemicals that the body needs. It also breaks down drugs and alcohol that have been consumed. . (clevelandclinic.org 2015) Gallbladder The Gallbladder is attached to the liver and stores the bile from the liver which is used to digest and break down the fats in the small intestine this takes place in the duodenum. Pancreas The pancreas is a gland that is just behind the stomach its function is to secrete both Exocrine and Endocrine. Exocrine is the pancreatic juice that contains digestive enzymes. Endocrine contains important hormones which include insulin and glucagon. Both of these help balance the amount of sugar in the body in different ways. Large Intestine The large intestine is approx. 1.5 metres long and connects the small intestine to the rectum and anus this is draped over the small intestine its main function is to draw the last of the nutrients and water from the food passing through it the left overs are faeces and the large intestine gets rid of this waste from the body through the anus. Small Intestine The small intestine is normally about 6 meters long and approximately 90% of digestion takes place here through the main 3 parts that are known as duodenum, jejunum and ileum. On the inside walls of the small intestine are villi that work for nutrient absorption and also have a group of lymph and blood vessels. Appendix The appendix is commonly classed as a useless organ which is attached to the large intestine ascending it can store bad bacteria and this in turn can cause inflammation thus leading to appendicitis and removal of the appendix. Although it is disputed that the appendix can store good bacteria and after a bout of diarrheal illnesses it can reboot the digestive system. (webmd.com 2015) Rectum The rectum is the last part of the large intestine the length being around 12cm long and is a store house for faeces. This is the leftover food, bacteria and undigested materials such as roughage that is found in vegetables and is all stored here until the rectum walls expand and we get the urge to defecate. (healthline.com 2015) Anus This is the very last part of the digestive system we defecate through the anus and is a voluntary movement in most people but not in infants. This is where we dispel waste which contains bacteria, undigested food. Part A (iii)Outline the composition of Proteins, Fats and Carbohydrates, and explain how each of them are digested and absorbed by the body? In this section I will create a chart covering the sources, functions and digestion of proteins, fats and carbohydrates in the human body and will show there different effects and how they fuel the body with energy. Sources Function Digestion Proteins Groundnuts, beans, whole cereals, fish, pulses,meat,eggs, Milk and cheese. Protein builds the Body and repairs muscle. It’s broken down in the digestive system and travels to the muscles as amino acids. Stomach, Pepsin breaks protein into large polypeptides. Small intestine, enzymes break large polypeptides into smaller polypeptide chains. Lastly still in the intestine enzymes the small polypeptides are broken into amino acids for absorption. Fats Dairy products, meat, fish, olive oil, cake, chocolate, avocados and sunflower oil. Good fats help maintain a healthy diet and are essential to health. Bad fats cause weight gain and health problems such as clogged arteries. Small intestine Broken down by bile salts from the liver and turned into liquid. Small intestine, its broken down further into fatty acids and glycerol to be absorbed. Carbohydrates Potatoes, pasta, apples, bread, meat, fish and dairy products. Provide the body with energy for the muscles, nervous system and also help the body burn fat. Carbohydrates get broken down to monosaccharide’s to get absorbed and then will become glucose to supply the body with energy. Part B Draw the typical diagram of a cell, and state the function of each of its organelles? In this section I will draw a typical animal cell as I see it and will give a breakdown of each of its organelles and how they function in the typical cell. Cell membrane, this is the outer skin of the cell that holds everything inside the cell and keeps things outside the cell and also that controls movement into or out of the cell. Cytoplasm, this is a gel like fluid which stores nutrients and water for the cell and also helps protect the cell acting like a cushion for cell movement. Nucleus, this contains DNA and all the cells genetic characteristics and also direct the activity of the cell. Nuclear membrane, this is the layer that holds the nucleus separate from the cytoplasm. Endoplasmic reticulum, there are two types of endoplasmic reticulum these are rough (moves protein made by ribosomes) and smooth(steroid and lipid distribution) but both move the materials around the cell. Ribosomes, these are responsible for protein production in the cell and are known as the protein factories of the cell. The protein is required for cell repair and growth. Golgi apparatus, These are known as the postal system of the cell they transport package and deliver proteins lipids and enzymes throughout the cells of the body.(Class notes 2015) Mitochondria, Also known as the power house of the cell because they supply energy to the cell. Chemical reactions in the mitochondria are the difference with the cell surviving also the energy released results in the formation of ATP (adenosine triphosphate) which is the primary energy transporter in the cell. Lysosomes, clean the cell of waste generated through parts of the cell being bad and also clean the cell of bacteria. They also aid in the breakdown of food particles and then can be used for energy in the cell. Vacuoles, these are storage areas in the cell that contain secretions or waste that are made by the cytoplasm and in different types of cells are used for digestion or storage. Nucleolus, this is a tiny body inside the nucleus that directs the formation of ribosomes in the cell which then are stored in the cytoplasm of the cell. Part B (ii)Classify tissues into the four main groups; epithelial, connective, muscle, and nervous, give an example of each? (Table format will suffice) Here I will construct a table to outline the four main groups of tissues and give an example of each as I understand them. Epithelial Connective Muscle Nervous Skin Intestines Internal organs Glands Bone Cartilage Adipose Blood Skeletal muscle (voluntary) Smooth (involuntary) Cardiac (involuntary Brain Spinal cord Nerves Example The outer body is covered in epithelial skin this helps protect against infection keeping germs out and all of our blood and muscle tissue on the inside. Outer skin on the body. This connects the bones to each other holding them together while cartilage reduces friction between bones. The femur and the patella are connected to the tibia and fibula. This consists of muscle that can contract and relax and keeps the skeleton attached to the body. The heart is an involuntary muscle that beats to circulate blood around the body. This type can transmit messages to the brain and from the brain to the rest of the body to warn of pain and for movement.(touching) Part B (iii) Explain the difference between benign and malignant tumours? I will now explain the difference between benign and malignant tumours and their different effects on the body and how they affect us. Tumours are cells that escape from their normal function and multiply out of control. They then form a lump known as a growth or a tumour. (Class notes 2015) Benign A benign tumour is not cancerous and does not spread cancer to the rest of the body it is an isolated growth usually grows in size and can put pressure on the area it’s growing in. The benign tumour can be dangerous if it grows on the brain although it’s not cancerous it can continue to grow in size and put pressure on the brain and lead to major problems. Malignant All malignant tumours are cancerous and can spread through the body causing secondary tumours or metastases. Malignant tumours spread through the blood and lymphatic system around the body. Some malignant tumours can spread very quickly and aggressively to other parts of the body even though the primary tumour may still be small while sometimes they can grow slower and not spread as quickly. Through research it has become clear that malignant brain tumours are the most aggressive and have the ability to spread to the spine and other parts of the body. Although malignant tumours are treatable by surgery to remove the tumour and also may require a follow up treatment of radiotherapy and chemotherapy to rid the body of anymore cancerous cells malignant tumours can return.(nhs.uk 2015) Part C (ii)Explain the structure and function of each element of the urinary system? The function of the urinary system is to clean the body of waste products and excess fluid and to also produce a hormone controlling at the rate red blood cells are made and the enzyme for regulation of blood pressure. Structure Function Kidney The kidney is a bean shaped organ that we have two of containing around 1 million nephrons in each kidney They are around 11cm long and 6cm wide weighing 150g. Kidneys are inside a membrane known as the renal capsule to protect it from trauma and infection. There are two main areas the renal cortex and the renal medulla. The function of the kidney is to clean and filter your blood to also recycle fluids and nutrients required by the body and produce urine for excretion. Ureter The ureter is around 12 inches long and connects kidneys to the bladder it’s made up of muscular tissue that contracts and also contains mucous to help prevent infection. The function of the ureters is to carry the urine from the kidneys down to the bladder. Bladder The human bladder is a hollow sac for storing urine it is comprised of three layers of smooth muscle and also coated with a mucous membrane and located in the pelvic area. The bladders function is to store the urine. When the walls of the bladder contract this results in urination. The normal bladder can hold approx. 470ml of urine. In the bladder we have an internal sphincter which relaxes voluntarily to expel urine. Urethra This is a tube that connects the bladder to the outside of the body. The function of the urethra is to carry the urine from the bladder to the outside of the body it’s longer in men than women. Part C (iii)Draw the structure of a Nephron and explain how it produces urine? Below I will draw the structure of the nephron and explain how the nephron produces urine to rid the body of waste fluids. We do not realise how important it is to dispel urine and how important it is to survive. Each kidney contains about 1 million nephrons these are the filtration system for the body to clean the blood and expel waste and reabsorb nutrients. Filtration in the Bowman’s capsule. Blood travels into the kidneys by the afferent arterioles. These are small blood vessels that turn in to the glomerulus. Meshes of capillaries that are surrounded by the glomerular are also known as the Bowman’s capsule. The blood in these capillaries are under pressure and the capillary walls can let water and other materials through into the capsule. The capsule is a gathering point for the waste products of the blood. Although it has collected other materials that are not waste and shall be absorbed by the nephron as they pass through. (An introductory guide to anatomy and physiology (Louise Tucker) 4th edition) Re-absorption in the convoluted tubule. When the filtered materials are collected by the capsule they move into a system of twisted tubes that are known as convoluted tubules. The tubes that flow away from the bowman’s capsule are the proximal convoluted tubules. These flatten out to form a long loop, called the loop of Henle which flows to the medulla and back to the cortex. Lastly there is more twists called the distal convoluted tubules This is where the reabsorption takes place in these tubules. The cells in the lining can absorb any water, ions and water that the body requires and shouldn’t be disposed of as waste. Only 1% of liquid that travels through the Bowman’s capsule is expelled as urine all the rest is reabsorbed. (An introductory guide to anatomy and physiology (Louise Tucker) 4th edition) Collection in the pelvic calyces This is where the nephron flattens out into a straight collecting tube in the medulla. These tubes form a collection called the pyramids of the medulla the tops of these travel up to the renal pelvis. These branches of the pelvis attach to the tops of the pyramids and gather the waste liquid. It’s the funnelled back towards the pelvis and then empties into the ureter and then can travel to the bladder and down to the urethra to be expelled as urine. (An introductory guide to anatomy and physiology (Louise Tucker) 4th edition). (iv)Name and explain three diseases /disorders which affect the urinary system? Kidney stones These are solid stones which are made up from deposits from substances that are found in urine. They form and are found in the renal pelvis, ureters and the bladder they are very sore on the patient and sometimes require surgery for removal or can be broken down with laser treatment and then passed in the urine. Incontinence This is involuntary defecation or urination but mainly urination that is more common in the elderly, pregnant women or women that have had babies. It is the involuntary leaking of urine and also happens from sneezing or coughing or sometimes the bladder may be full and you may not make it to the toilet in time. It is very embarrassing for the people who suffer with it. Urethritis This is an inflammation of urethra and causes painful urination. This is the tube that carries the urine from the bladder to be expelled by the body. It is a bacterial infection and causes discomfort when urinating it can burn the sufferer when dispelling urine and it may cause discharge also. Though more common in women due to women having a shorter urethra than men. Bibliography (An introductory guide to anatomy and physiology (Louise Tucker) 4th edition) (Class notes 2015) (clevelandclinic.org 2015) (healthline.com 2015) (nhs.uk 2015) (webmd.com 2015)

What is Cystic Fibrosis? :: essays research papers

Your child is under weight, has greasy, smelly diarrhea, a chronic cough and seems to always be getting pneumonia. He wheezes when he breathes and has impaired exercise ability. He seems to never being growing to the average size of his peers and his skin is very salty (5). The doctor’s first instinct should be to test your child for a disease called cystic fibrosis. Cystic fibrosis is a disease, which causes the mucus in your body to be thicker in some areas. The most affected areas are the lungs and digestive system. As a result, the person may get chest infections and have difficulty digesting food. When cystic fibrosis is a consideration for a person’s disease the physician will do what is called a sweat test. This is a simple and cheap way to determine if your child has the disease. Because people who have cystic fibrosis (CF) have saltier sweat than others, the sweat test detects the amount of salt in the sweat of the individual (4). This is the best way to diagn ose a person with the disease (5).   Ã‚  Ã‚  Ã‚  Ã‚  CF is a genetic disease, meaning that a person does not â€Å"catch it†, it is inherited in the genes passed down to the person. Cystic fibrosis lasts with the patient for their whole life. This makes it a chronic disease, not communicable (9). All symptoms of CF are caused by a mutation to the single chromosome 7. This particular gene is responsible for the building of the protein called the cystic fibrosis trans membrane conductance regulator (CFTR). Normally, the gene regulates the passage of chloride ions in and out of the cell, but when mutated as in the case of CF patients the chloride ions cannot move throughout the cell membrane because the CFTR does not open. In about three- quarter of CF cases the CFTR is not just broken, but is completely missing from the cell. The missing CFTR has many effects on the human body. One is saltier sweat because as the sweat rises to the skin, cells reabsorb sodium and chloride molecules. The loss of the CFTR does no t allow the body to reabsorb the sodium ions making a CF patient’s sweat five times saltier than that of a normal person. This can lead to irregular heart rhythms. The loss of chloride ions affects the pancreas also. The loss of the CFTR ultimately makes it impossible for digestive enzymes to be sent to the intestines.

A Thousand Differences :: Sociology, Social Norms

The world today is full of so many cultures. Each one drastically different from the other and equipped with their own customs and â€Å"social norm†. The culture in America is radically different from that in Afghanistan. This fact is evident in A Thousand Splendid Suns by Khaled Hosseini. This book follows the journeys two young women living in the harsh world in Afghanistan until their paths cross and they unite to rebel against the maltreatment of women that is widely accepted in their country. The lives these women lead in this book is dramatically opposite of the life that women have in America. The daily life over all in Afghanistan is very strange compared to America. They must live with droughts, poverty, and war every day. In 1999, in the city of Kabul, there was a huge drought. It had not snowed in the winter and there was no rain in the spring. The riverbed that ran through the city was completely dried up (261). With very little and scorching heat it must have been exceedingly difficult to cook or stay cool. With two young children to keep fed and hydrated water is a necessity. One of the main characters, Mariam, grew up in a mud hut on the outskirts of a village in the mountains (10). Small houses and very little income was the average life in the country. In her city, a two-story house was practically a mansion, and in America that is considered normal. The standard of living is much lower in Afghanistan. The region the two girls live in was one of constant war. Different ethnicities and religions were constantly fighting and the government was very uns teady. They lived literally in the midst of the battle zone. They could hear gunfire and rockets constantly. Houses along their very own street were taken out by bombs. Laila even lost her parents when her own house was bombed (174). It is impossible to imagine what it would be like living with that. Everyday hearing the whistling and hoping the rocket was not coming down on your house. Then losing your parents, it is unfathomable. Innocent bystanders shot down simple because they are in the wrong time at the wrong place. Women in their country have very little rights and freedoms.

Gender Mainstreaming in Canada Essays -- Politics, Gender Equality

Canada is a signatory to the United Nations Platform of Action which specifies the mainstreaming of gender into programs, into policy processes, and into decision making in order to achieve gender equality. Since the adoption of the Platform of Action at the 1995 United Nations Fourth World Conference on Women, gender mainstreaming has gained wider acceptance among governments and other stakeholders (Woodward, 2008). The aim of gender mainstreaming is to ensure that gender components are considered in all sectors that affect the society (Status of Women Canada, 2007). Purpose It has been argued that gender mainstreaming is a potent approach that can transform how public policies are made by challenging existing policy paradigms and setting new policy priorities (Woodward, 2008). However, there has been a lack of evidence to support that gender mainstreaming exist in Canada. Therefore, whether Canada’s gender equality approach is gender mainstreaming or not is open for discussion. This discussion paper examines this issue by exploring the gender equality approaches adopted by Government of Canada. The challenges of implementing gender mainstreaming are highlighted, and finally recommendations are made. Definitions The United Nations Economic and Social Council (ECOSOC) defines gender mainstreaming as: â€Å"a strategy for making the concerns and experiences of women as well as of men an integral part of the design, implementation, monitoring and evaluation of policies and programmes in all political economic and societal spheres, so that women and men benefit equally, and inequality is not perpetuated. The ultimate goal of mainstreaming is to achieve gender equality" (ECOSOC, 1997). The Status of Women Canada defines gender ba... ...he Government of Canada’s gender equality approach has been unable to interrogate already accepted analytical starting points (Paterson, 2010). The approach operates in a system of technology of rule, so there is no way the impact of the institutional structures can be separated from the policy outcomes. In this regard, gender equality analysis has become the government’s technology of rule (Prugl 2011). Summary and Recommendations To actualise gender mainstreaming, there is need to reposition the current gender equality approach from being a policy tool to an integrative approach that can change the institutional structures. The current gender equality approaches in Canada lack the potential of changing the current institutional practices. The current equality policy mix is a mainstreaming of gender based analysis and not gender mainstreaming (McNutt, 2010).

Black Like Me †Book Report Essay

For the book report, I read the book Black Like Me by John Howard Griffin. The story takes place in 1959 and revolves around a white man who decides to go to the Deep South undercover as a black man to try to understand what really goes on there. This man, John Griffin, documented his journey from beginning to end in order to make an effort to end racial segregation. For seven weeks, he lived and experienced the horrors that a black man lived every day during that time. He quickly learned that he no longer had the same privileges as he did as a white man. He could no longer go into any store he wanted and had to walk miles before finding someone who would let him buy a glass of water or to use the bathroom. Reading this book, my eyes were opened to all the disadvantages the black man faced that I always heard about in school, but never really understood. John Griffin moved away from his home and family in Mansfield, Texas to New Orleans, Louisiana to conduct his research. His motivation was for racial justice and for his frustration of not understanding the black experience. At this time, no black man in his right mind would tell a white man how horrible life was for him. Since Griffin was a white man, interviewing blacks would not give him a true picture of their life. He decides to go with the only way he will truly find out what it’s like to be a black in the South; to change the color of his skin. He went through different medical treatments to accomplish this. To change his skin color from white to black, he took pills to darken his skin, and also used skin dyes. He then could easily pass through New Orleans’ streets as a ‘Negro’. He befriended a shoeshine who had been shining his exact same shoes when he was a white man. The shoeshine is delighted with Griffin’s project and opens the life of a black man up to him. The shoeshine taught him how to act, talk, and everything else that he needed to know. Going into this study, Griffin, knew he would run into prejudice, oppression, and many hardships, but he did not truly know how bad it was until now. He was no longer allowed to use any bathroom he pleased. Sometimes he would have to walk all the way across town, even when there was a bathroom right by him, because he could not use a white man’s facilities. Throughout his experience as a black man he deals with insults and struggles on a daily basis. After being in New Orleans for a while, he decides to go to the heart of Mississippi where racial prejudice is even worse for blacks. Griffin notices that the black communities there seemed to have given up hope of ever being equal, and he begins to notice the same look across his own face. The whites were the main contributors to this loss of hope. For example, when he was riding the bus into Mississippi they took a ten minute bathroom break. The bus driver refused to let the black passengers off because he did not want to have to go â€Å"round them up† when they left. After witnessing this sense of defeat in Mississippi and how terrible the whites were, he decides to venture to Montgomery, Alabama where he is shocked at what he finds. In Montgomery, the black community is recharged with determination. They practice passive resistance against the racist laws and rules set against them. They are filled with hope and the words of Dr. Martin Luther King Jr.  They are not afraid to go to jail or face the other consequences that may lie ahead. After seeing this, he begins to switch back and forth between being a black man and then a white man the very next day. He visits the very same places as a white man and is treated with the greatest respect, while as a black man he was treated with fear and suspicion. He was able to go into the restaurants where blacks were not even allowed to stop to look at the menu. Switching between black and white opened his eyes to how society treated blacks and whites at the time. One day he was a disgrace and the next he was treated like a king. After this long trip, he decided to let his skin fully return white and go back home. After looking over his information and organizing it he decides it is finally time for the public to know the truth. He then publishes his findings and goes on television for interviews. He is asked to speak on many shows. Many people support him and his findings, but the people in his home town do not offer much support. People in his town begin to turn on him and threaten his life and the lives of his family members. He asks the police to watch his house so his family is not harmed. It gets so bad that they have to leave for a while. When they come back, nothing has changed. Someone in town hangs a dummy of him on Main Street. The dummy is half black and half white and there was a sign on it that read â€Å"John Griffin†. He decided to move his family away once and for all to prevent anyone from getting hurt. This story gave me an inside look of what it was like to be both a black and a white person during 1959 in the south. I was unable to put the book down because I was so intrigued. I have never heard the black person’s view to racial prejudice before. This story took my breath away. My favorite part of this book is when John Griffin (1960) describes how you are treated based on your skin color. I was the same man, whether white or black. Yet when I was white, I received the brotherly-love smiles and the privileges from whites and the hate stares or obsequiousness from the Negroes. And when I was a Negro, the whites judged me fit for the junk heap, while the Negroes treated me with great warmth. (p. 126) I am shocked from what I read in this book. The author was treated completely different as a white man than he was as a black man. When he was a white man, he receives respect and courtesy from the other whites, but suspicion and fear from the blacks. When he was a black man, he receives hatred and hostility from the whites, but warmth and generosity from his fellow blacks. It surprised me that you could sense these distinct feelings toward him while reading. It was almost like I was living it myself. It is crazy how cold-hearted some of the white people acted towards him. Some had sympathy in their eyes, but others were set to make his life horrible. This book just goes to show you how truly bad it was for the blacks during segregation. It is proof of it, and the stories of John Griffin are more realistic than any told or documented before. Black Like Me was not made up to sympathize the blacks or as an overreaction. It’s the truth that Griffin personally witnessed and lived. The whites dehumanized the blacks and treated them like savages. Towards the end of the book he was walking down a highway for miles hoping someone would pick him up. During the day, not a single white person would pick him up. This all changed during the night. That night, he always had a ride. He realized after a while, that the whites only picked him up to hear about the black man’s sex life. This disgusts me. These men were asking him repulsive questions, and if he did not give him a sufficient answer, he would be kicked out of the vehicle. The questions that they were asking him would never be asked to his friends. This part of the book illustrates how the whites did not care for the black man’s pride and instead wanted to dehumanize him. Reading this book, Black Like Me, opened my eyes to the terrors that the black people faced in the South during 1959. I also gain an understanding of how whites were treated in comparison to blacks. John Griffin was very brave for taking on this project and publishing his findings. This must have taken a lot of courage, but his work helped many people. Without this inside look at the treatment of blacks in the South, we might never have known how truly horrible it was. Yes, there are other stories, but this is a full account of one man’s journey in and out of the heart of segregation.

A Dirty Job Chapter 16

16 THE CALL OF BOOTY II: REQUIEM FOR A FUCK PUPPET Ray threw the door open so hard that the little bell went flying off its holder and tinkled across the floor. â€Å"Oh, jeez,† Ray said. â€Å"You won't believe it. I can't believe it myself.† Lily looked at Ray over her half-frame reading glasses and set down the French cookbook she'd been looking at. She didn't really need reading glasses, but looking over the top of them conveyed instant condescension and disdain, a look that she felt flattered her. â€Å"I have something I need to tell you, too,† Lily said. â€Å"No,† Ray said, looking around to make sure there were no customers in the store. â€Å"What I have to tell you is really important.† â€Å"Okay,† Lily said. â€Å"Mine's not that important to me. You go first.† â€Å"Okay.† Ray took a deep breath and launched. â€Å"I think Charlie may be a serial killer with ninja powers.† â€Å"Wow, that is good,† Lily said. â€Å"Okay, my turn. A Miss Me-So-Horny called for you. She wanted you to know that she's packing eight inches of luscious man-meat.† Lily held up Ray's cell phone, which he'd left under the register. â€Å"Oh my God, not again!† Ray cradled his head in his hands and fell against the counter. â€Å"She said she was eager to share it with you.† Lily examined her nails. â€Å"So, Asher's a ninja, huh?† Ray looked up. â€Å"Yes, and he's stalking a fuck puppet from my gym.† â€Å"Think you're living a rich enough fantasy life, Ray?† â€Å"Shut up, Lily, this is a disaster. My job and my apartment depend on Charlie, not to mention that he has a kid, and the new light of my life is a guy.† â€Å"No, she's not.† Lily wondered about herself, giving in so early – she didn't enjoy torturing Ray the way she used to. â€Å"Huh? What?† â€Å"I'm just fuckin' with you, Ray. She didn't call. I read all of your e-mail and IMs.† â€Å"That stuff is private.† â€Å"Which is why you have it all here on the store's computer?† â€Å"I spend a lot of time here, with the time difference†¦Ã¢â‚¬  â€Å"And speaking of privacy, what's the deal with Asher being a ninja and a serial killer? I mean, both? At the same time?† Ray moved in close, and talked into his collar, as if revealing a huge conspiracy. â€Å"I've been watching him. Charlie's been taking in a lot of stuff from dead people. It's gone on for years. But he's always having to take off on a moment's notice, having me cover his shifts, and he never explains where he's going, except soon after that happens, one of the dead people's things shows up in the shop. So today I followed him, and he was after a woman who goes to my gym, who we might have seen the other day.† Lily stepped back, crossed her arms, and looked disgusted with Ray, which was fairly easy, since she'd had years of practice. â€Å"Ray, did it occur to you that Asher handles estates, and that we've been doing much better business since he started doing more estates – that the quality of the merchandise is much higher? Probably because he gets there early?† â€Å"I know, but that's not it. You're not around as much now, Lily. I was a cop, I notice these things. For one thing, did you know that there was a homicide detective keeping track of Charlie? That's right. Gave me his card, told me to call if anything unusual happened.† â€Å"No, Ray, you didn't.† â€Å"Charlie disappeared, Lily. I was watching him, and he just blinked out of existence, right before my eyes. And last I saw him he was going into the fuck puppet's building.† Lily wanted to grab the stapler off the counter and rapidly drive about a hundred staples into Ray's shiny forehead. â€Å"You ungrateful fucktard! You called the cops on Asher? The guy who has given you a job and a place to live for what, ten years?† â€Å"I didn't call the black-and-whites, just this Inspector Rivera. I know him from when I was on the force. He'll keep it on the down low.† â€Å"Go get your checkbook and your car,† Lily barked. â€Å"We're going to bail him out.† â€Å"He probably hasn't even been processed yet,† Ray said. â€Å"Ray, you pathetic toss-beast. Go. I'll close up the store and wait for you out front.† â€Å"Lily, you can't talk to me that way. I don't have to put up with it.† Because he couldn't turn his head, Ray wasn't able to avoid the first two staples Lily put in his forehead, but by then he had decided it was best to go get his checkbook and his car, and backed away. â€Å"What's a fuck puppet, anyway?† Lily shouted after him, somewhat surprised at the violent intensity of her loyalty to Charlie. The policewoman fingerprinted Charlie nine times before she looked up at Inspector Alphonse Rivera and said, â€Å"This motherfucker got no fingerprints.† Rivera took Charlie's hand and turned it palm up, and looked at his fingers. â€Å"I can see the ridges, right there. He's got completely normal fingerprints.† â€Å"Well, you do it, then,† said the woman. â€Å"‘Cause alls I got on the card is smooth.† â€Å"Fine, then,† Rivera said. â€Å"Come with me.† He led Charlie over to a wall that had a big ruler painted on it and told him to face a camera. â€Å"How's my hair?† Charlie said. â€Å"Don't smile.† Charlie frowned. â€Å"Don't make a face. Just look straight ahead and – your hair is fine, though now you've got ink on your forehead. This is not that hard, Mr. Asher, criminals do this all the time.† â€Å"I'm not a criminal,† Charlie said. â€Å"You broke into a security building and harassed a young woman, that makes you a criminal.† â€Å"I didn't break into anything and I didn't harass anyone.† â€Å"We'll see. Ms. McKerny said you threatened her life. She's definitely going to press charges, and if you ask me, you're both lucky I showed up when I did.† Charlie wondered about that. The fuck puppet had started screaming and backed into her apartment, and he had followed her, trying to explain, trying to figure out how this was going to work, and at the same time paying way too much attention to her breasts. â€Å"I didn't threaten her.† â€Å"You said she was going to die. Today.† Well, they had him there. Charlie had, in all the confusion and screaming, mentioned that he had to get hold of her breasts because she was going to die today. In retrospect, he felt he probably should have kept that information to himself. Rivera led him upstairs and into a small room with a table and two chairs. Just like on TV, Charlie looked for a one-way mirror but was disappointed to see only concrete-block walls painted in easy-clean moss-green enamel. Rivera had him sit, but then went to the door. â€Å"I'm going to leave you here for a few minutes, until Miss McKerny comes down to file charges. It's more hospitable here than the holding cell. You want something to drink?† Charlie shook his head. â€Å"Should I call an attorney?† â€Å"It's up to you, Mr. Asher. That's certainly your right, but I can't advise you one way or another. I'll be back in five. You can make your call then if you'd like.† Rivera left the room and Charlie saw the inspector's partner, a gruff, bald-headed bull of a guy named Cavuto, standing outside the door waiting for him. That guy actually scared Charlie. Not as much as the prospect of having to retrieve Madison McKerny's breast implants, or what would happen if he didn't, but still scary. Cut him loose,† Cavuto said. â€Å"What, cut him loose? I just got him processed, the McKerny woman – â€Å" â€Å"Is dead. Boyfriend shot her, then, when our guys responded to the shots-fired call, did himself.† â€Å"What?† â€Å"Boyfriend was married, McKerny wanted more security and was going to tell the wife. He flipped out.† â€Å"You know all that already?† â€Å"Her neighbor told the uniforms as soon as they arrived. Come on, it's our case. We need to roll. Cut this guy loose. Ray Macy and some Goth-chef chick are waiting for him downstairs.† â€Å"Ray Macy is the one who called me, he thought Asher was going to kill her.† â€Å"I know. Right crime, wrong guy. Let's go.† â€Å"We still have him on the concealed-weapon charge.† â€Å"A cane with a sword in it? What, you want to go before a judge and tell him that you arrested this guy on suspicion of being a serial killer but he plea-bargained it down to being a huge fucking nerd?† â€Å"Okay, I'll cut him loose, but I'm telling you, Nick, this guy told McKerny that she was going to die today. There's some weird shit going on here.† â€Å"And we don't have enough weird shit to deal with already?† â€Å"Good point,† Rivera said. Madison McKerny looked beautiful in her beige silk dress, her hair and makeup perfect, as usual, her diamond-stud earrings and a platinum-diamond solitaire necklace complemented the silver handles of her walnut-burl casket. For someone who wasn't breathing, she was breathtaking, especially for Charlie, who was the only one who could see her hooters pulsing red in the casket. Charlie hadn't been to a lot of funerals, but Madison McKerny's seemed nice, and fairly well attended for someone who had been only twenty-six. It turned out that Madison had grown up in Mill Valley, just outside San Francisco, so a lot of people had known her. Evidently, except for her family, most of them had lost touch and seemed somewhat surprised that she had been gunned down by her married boyfriend who had kept her in an expensive apartment in the city. â€Å"Not like you vote ‘most likely' for that in the yearbook,† Charlie said, trying to make conversation with one of her classmates, a guy he'd ended up standing next to at the urinals in the men's room. â€Å"How did you know Madison?† said the guy, a condescending tone in his voice. He looked like he'd been voted â€Å"most likely to piss everyone off by being rich and having nice hair.† â€Å"Oh, me? Friend of the groom,† Charlie said. He zipped up and headed to the sink before hair guy could think of something to say. Charlie was surprised to see a few people at the funeral whom he knew, and each time he walked away from one, he'd run into another. First Inspector Rivera, who lied. â€Å"Had to come. It's our case. I've gotten to know the family a little.† Then Ray, who lied. â€Å"She went to my gym. I just thought I should pay my respects.† Then Rivera's partner, Cavuto, who didn't lie. â€Å"I still think you're kinky, and that goes for your ex-cop friend, too.† And Lily, who was also honest. â€Å"I wanted to see a dead fuck puppet.† â€Å"Who's running the store?† Charlie asked. â€Å"Closed. Death in the family. You know Ray called the cops on you, right?† They hadn't had a chance to talk since Charlie had been released. â€Å"I should've figured,† Charlie said. â€Å"He said he saw you go into the dead chick's building and just disappear. He thinks you have ninja powers. That part of the thing?† She bounced her eyebrows – a Groucho Marx conspiracy bounce – made less effective by the fact that her eyebrows were pencil thin and drawn on in magenta. â€Å"Yeah, it's kind of part of the thing. Ray doesn't suspect about the thing, does he?† â€Å"No, I covered for you. But he still thinks you might be a serial killer.† â€Å"I thought he might be a serial killer.† Lily shuddered. â€Å"God, you guys need to get laid.† â€Å"True, but right now I'm here to do a thing regarding the thing.† â€Å"You still haven't gotten her thing thing?† â€Å"I can't even figure out how to get it. Her thing is still in the thing.† He nodded to the casket. â€Å"You're fucked,† Lily said. â€Å"We have to go sit now,† Charlie said. He led her into the chapel, where the service was beginning. Behind him Nick Cavuto, who had been standing three feet away with his back to Charlie, made a beeline for his partner and said, â€Å"Can we just shoot Asher and find cause later? I'm sure the fucker's done something to deserve it.† Charlie didn't know what he was going to do, how he was going to retrieve the soul implants, but he really thought something would occur to him. Some supernatural ability would manifest itself at the last minute. He thought that all through the ceremony. He thought that when they closed the casket, during the funeral procession to the cemetery, and all through the graveside ceremony. He began to lose hope as the mourners dispersed and the casket was lowered, and by the time the ground crew started throwing dirt down the hole with a backhoe, he'd pretty much given up on having an idea. There was grave robbing, but that really wasn't an idea, was it? And even with his years of experience in the death-dealing business, Charlie didn't think he was up for breaking into a cemetery, spending all night digging up a casket, then cutting the implants out of a dead woman's body. It wasn't the same as swiping a vase off the mantel. Why couldn't Madison McKerny's soul be in a vase on the mantel? â€Å"Didn't get the thing, then,† said a voice beside him. Charlie turned to see Inspector Rivera standing not a foot away. He hadn't even seen him since they'd left the funeral home. â€Å"What thing?† â€Å"Yeah, what thing?† Rivera said. â€Å"They didn't bury her with those diamonds you saw, you know that, right?† â€Å"That would have been a shame,† Charlie said. â€Å"Sisters got them,† Rivera said. â€Å"You know, Charlie, most people don't stay to watch them actually cover the box.† â€Å"Really?† Charlie said. â€Å"I was just curious. See if they used shovels or what. How about you?† â€Å"Me? I'm watching you. You ever get over that thing with the storm sewers?† â€Å"Oh, that? I just needed a little adjustment in my medication.† It was an expression that Charlie had picked up from Jane. She wasn't actually on medication, but the excuse seemed to work for her. â€Å"Well, you keep an eye on that, Charlie. And I'll keep an eye on you. Adios.† Rivera walked off. â€Å"Adios, Inspector,† Charlie said. â€Å"Hey, by the way, nice suit.† â€Å"Thanks, I bought it from your store,† Rivera said without turning around. When was he in my store? Charlie thought. For the next couple of weeks Charlie felt as if someone had dialed his nervous system up past the recommended voltage and he was nearly vibrating with anxiety. He thought that perhaps he should call Minty Fresh, warn him of his failure to retrieve Madison McKerney's soul vessel, but if the sewer harpies weren't rising because of that, maybe the contact with another Death Merchant would put them over the top. Instead he kept Sophie home and made sure that she was never out of sight of the hellhounds. In fact, he kept the hellhounds locked in her room most of the time; otherwise they kept dragging him to his day planner, which had no new names. Only the overdue Madison McKerny and the two women – Esther Johnson and Irena Posokovanovich – who had appeared on the same day, but still had some time left before expiration – or whatever you called it. So he started his walks again, listening as he passed storm drains and manhole covers, but the darkness didn't appear to be rising. Charlie felt naked walking the street without his sword-cane, which Rivera had kept, so he set out to replace it, and in the process found two more Death Merchants in the city. He found the first at a used-book store in the Mission, Book 'em Danno. Well, it wasn't really a bookstore anymore – it still had a couple of tall cases of books, but the rest of the store was a bricolage of bric-a-brac, from plumbing fittings to football helmets. Charlie understood completely how it happened. You started with a bookstore, then you made a single innocent trade, a set of bookends for a first edition maybe, then another, you picked up a grab-all box at a yard sale to get one item – pretty soon you had a whole section of unmatched crutches and obsolete radio tubes, and couldn't for the life of you remember how you'd acquired a bear trap, yet there it was, next to the lime-green tutu and the Armadrillo penis pump: secondhand out of hand. In the back of the store, by the counter, stoo d a bookcase in which every volume was pulsing with a dull red light. Charlie tripped over a spittoon and caught himself on an elk-antler coatrack. â€Å"You okay?† asked the proprietor, looking up from the book he was reading. He was maybe sixty, skin spotted from too much sun, but he hadn't seen any in a while and he'd gone pasty. He had long, thinning gray hair and wore oversized bifocals that gave him the look of an educated turtle. â€Å"No, I'm fine,† Charlie said, ripping his gaze off the soul-vessel books. â€Å"I know it's a little cluttered in here,† the turtle guy said. â€Å"I've been meaning to clear it out, but then, I've been meaning to clear it out for thirty years and I haven't managed it yet.† â€Å"It's okay, I like your store,† Charlie said. â€Å"Great selection.† The owner looked at Charlie's expensive suit and shoes and squinted. It was clear he recognized the worth of the clothes and was qualifying Charlie as a rich collector or antiques hunter. â€Å"You looking for anything special?† he asked. â€Å"Sword-cane,† Charlie said. â€Å"Doesn't have to be antique.† He wanted to buy this guy a coffee and share stories of snatching soul objects, of confronting the Underworlders, of being a Death Merchant. This guy was a kindred spirit, and from the size of his collection of soul objects, all of them books, he'd been doing this longer than Minty Fresh. Turtle guy shook his head. â€Å"Haven't seen one for years. If you want to give me a card, I'll put out feelers for you.† â€Å"Thanks,† Charlie said. â€Å"I'll keep looking. That's part of the fun.† He started backing down the aisle, but he couldn't leave without saying something else, getting some kind of information. â€Å"Hey, how is it, doing business in this neighborhood?† â€Å"Better now than it used to be,† said the guy. â€Å"The gangs have settled down some, this part of the Mission has turned into the edgy, artsy-fartsy neighborhood. That's been good for business. You from the City?† â€Å"Born and raised,† Charlie said. â€Å"Just haven't been to this neighborhood much. You haven't had any weird stuff on the street last couple of weeks, then?† The turtle guy looked fully at Charlie now, even took off his giant glasses. â€Å"Except for the thumper sound systems going by, quiet as a mouse. What's your name?† â€Å"Charlie. Charlie Asher. I live over in the North Beach – Chinatown area.† â€Å"I'm Anton, Charlie. Anton Dubois. Nice meeting you.† â€Å"Okay,† Charlie said. â€Å"I have to go now.† â€Å"Charlie. There's a pawnshop off Fillmore Street. Fulton and Fillmore, I think. The owner carries a lot of edged weapons. She might have your cane.† â€Å"Thanks,† Charlie said. â€Å"You watch yourself, Anton. Okay?† â€Å"Always do,† said Anton Dubois, and he looked back to his book. Charlie left the store feeling even more anxious, but not quite as alone as he had five minutes before. The next day, he found a new sword-cane at the pawnshop in the Fillmore, and he also found a case of cutlery and kitchen utensils that pulsated with red light. The owner was younger than Anton Dubois, late thirties maybe, and wore a.38 revolver in a shoulder holster, which shocked Charlie less than the fact that she was a woman. He'd envisioned all the Death Merchants as being men, but of course there was no reason to think that. She wore jeans and a plain chambray shirt, but was dripping with mismatched jewelry that Charlie guessed was a self-indulgence she justified for being â€Å"in the business† the same way he justified his expensive suits. She was pretty in a lady-cop sort of way, with a nice smile, and Charlie found himself wondering if he should maybe ask her out, then heard an audible pop in his head as that bubble of self-destructive stupidity exploded. Sure, dinn er and a movie, and release the Forces of Darkness on the world. Great first date. Everyone was right, he really needed to get laid. He bought the sword-cane for cash, without quibbling, and left the store without engaging the owner in conversation, but he took a business card from the holder on the counter as he left. Her name was Carrie Lang. It was all he could do to not warn her, tell her to be careful of what might be coming from below, but he realized that every second he was there, he was probably increasing the danger to all of them. Watch yourself, Carrie, he whispered to himself as he walked away. That evening he decided to take action to ease some of the tension in his life. Or at least it was decided for him when Jane and her girlfriend Cassandra showed up at the apartment and offered to watch Sophie. â€Å"Go, find a woman,† Jane said. â€Å"I got the kid.† â€Å"It doesn't work that way,† Charlie said. â€Å"I was gone all day, I haven't spent any quality time with my daughter.† Jane and Cassandra – an athletic, attractive redhead in her midthirties, who Charlie promised himself he would have asked out if she hadn't been living with his sister – pushed him out the door, slammed it in his face, and locked it. â€Å"Don't come home until you've gotten some,† Jane shouted over the transom. â€Å"Does that work for you?† Charlie shouted back. â€Å"Just go find someone to do you, like a scavenger hunt?† â€Å"Here's five hundred dollars. Five hundred dollars works for anyone.† A wad of bills came flying over the transom, followed by his cane, a sport coat, and his wallet. â€Å"This is my money, isn't it?† Charlie shouted. â€Å"It's you that needs to get laid,† Jane shouted back. â€Å"Go. Don't come back until you've done the dance of the beast with two backs.† â€Å"I could just lie.† â€Å"No, you can't,† Cassie said. She had a sweet voice, like you'd want her to tell you a bedtime story. â€Å"The desperation will still show in your eyes. And I mean that in a nice way, Charlie.† â€Å"Sure, how else could I take it?† â€Å"Bye, Daddy,† Sophie said from the other side of the door. â€Å"Have fun.† â€Å"Jane!† â€Å"Relax, she just came in. Go.† So Charlie, thrown out of his own home, by his own sister, said good-bye to the daughter he adored and went out to find a total stranger with whom to be intimate. Just a massage,† Charlie said. â€Å"Okay,† said the girl as she arranged oils and lotions on a shelf. She was Asian, but Charlie couldn't tell from where in Asia, maybe Thailand. She was petite and had black hair that hung down past her waist. She wore a red silk kimono with a chrysanthemum design. She never looked him in the eye. â€Å"Really, I'm just tense. I don't want anything but a completely ethical and hygienic massage, just like it says on the sign.† Charlie stood at the end of a narrow cubicle, fully dressed, with a massage table on one side of him and the masseuse and her shelf of oils on the other. â€Å"Okay,† said the girl. Charlie just looked at her, unsure of what to do next. â€Å"Clothes off,† said the girl. She placed a clean white towel on the massage table near Charlie, nodded to it, then turned her back. â€Å"Okay?† â€Å"Okay,† Charlie said, feeling now that he was here, he needed to go through with it. He'd paid the woman at the door fifty dollars for the massage, after which she made him sign a release that stated that all he was getting was a massage, that tipping was encouraged, but did not imply any services beyond a massage, and that if he thought that he was getting anything but a massage he was going to be one disappointed White Devil. She made him initial each of the six languages it was printed in, then she winked, a long slow wink, exaggerated by very long false eyelashes, and performed the internationally accepted blow-job mime, with round mouth and rhythmic tongue pushing out the cheek. â€Å"Lotus Flower make you bery relax, Mr. Macy.† Charlie had signed Ray's name, not so much as a small revenge for calling the cops on him, but because he thought the management might recognize Ray's name and give him a discount. He kept his boxers on and climbed on the table, but Lotus Flower slipped them off him as deftly as a magician pulling a scarf from his sleeve. She draped a towel over his bottom and dropped her kimono. Charlie saw it fall and glanced back to see a tiny, seminaked woman rubbing oil on her palms to warm it. He looked away and slammed his forehead into the table several times even as he felt his erection struggling for freedom beneath him. â€Å"My sister made me come here,† he said. â€Å"I didn't want to come.† â€Å"Okay,† she said. She rubbed the oil into his shoulders. It smelled of almonds and sandalwood. There must have been menthol or lavender or something in it, because he felt it tingle on his skin. Every place she touched hurt. Like he'd dug a ditch to Ecuador the day before, or pulled a barge across the Bay with a rope. It was like she had special sensory powers, she could find the exact spot where he carried his pain, then touch it, release it. He moaned, just a little. â€Å"Bery tense,† she said, working her fingers up his spine. â€Å"I haven't slept well in two weeks,† he said. â€Å"That nice.† She reached across to work his rib cage and he felt her small breasts press against his back. He stopped breathing for a second and she giggled. â€Å"Bery tense,† she said. â€Å"I had this thing happen at work. Well, not at work, but I'm afraid I did something that could put everyone I know in danger, and I can't make myself do what needs to be done to fix it. People could die.† â€Å"That nice,† said Lotus Flower, kneading his biceps. â€Å"You don't speak English, do you?† â€Å"Oh. Little. No worries. You want happy ending?† Charlie smiled. â€Å"Can you just keep rubbing?† â€Å"No happy ending? Okay. Twenty dollar, fifteen minute.† So Charlie paid her, and talked to her, and she rubbed his back, and he paid her again, and he told her all the things that he couldn't share with other people: all the worries, all the fears, all the regrets. He told her of how he missed Rachel, yet how sometimes he would forget what she looked like and would run to the dresser in the middle of the night to look at her photo. He paid her for two hours in advance and dozed off, feeling her hands on his skin, and he dreamed of Rachel and sex, and when he woke up Lotus Flower was massaging his temples and tears were running into his ears. He told her it was the menthol in the oil, but it was the lonely coming up in him, like the pain in his back that he hadn't known he'd had until it was touched. She massaged his chest, reaching over his head and letting her breasts rub against his face as she worked, and when he rose again under the towel, she asked, â€Å"You want happy ending now?† â€Å"Nah,† he said. â€Å"Happy endings are so Hollywood.† Then he caught her wrists, sat up, kissed the back of her hands, and thanked her. He tipped her a hundred dollars. She smiled, put on her kimono, and left the cubicle. Charlie dressed and left the Happy Relax Good Time Oriental Massage Parlor, which he had walked by a thousand times during his life, always wondering what was behind the red door with brown paper taped over the window. Now he knew: the pathetic puddle of lonely frustration that was Charlie Asher, for whom there would be no happy ending. He made his way up to Broadway and headed up the hill into North Beach. He was only a few blocks from home when he sensed someone behind him. He turned, but all he saw was a guy a couple of blocks back buying a newspaper from a machine. He walked another half block and could see the activity on the street up ahead: tourists out walking, waiting for tables in Italian restaurants, barkers trying to lure tourists into strip clubs, sailors barhopping, hipsters smoking outside of City Lights bookstore, looking cool and literary before the next poetry slam, which would go off in a bar across the street. â€Å"Hey, soldier,† a voice at his side. A woman's voice, soft and sexy. Charlie turned and looked down the alley he was passing. He could see a woman in the shadows, leaning against the wall. She was wearing an iridescent body stocking or something and a mercury light at the other end of the alley was drawing a silver outline of her figure. The hair rose on his neck, but he felt something twinge in his loins as well. This was his neighborhood, and the hookers had been calling to him since he was twelve, but this was the first time he'd ever stopped and paid more attention than a wave and a smile. â€Å"Hey,† Charlie said. He felt dizzy – drunk or stoned – maybe all the toxins had broken loose from the long massage, but he had to lean on his cane to steady himself. She stepped away from the wall and the light silhouetted her, highlighting outlandish curves. Charlie realized he was grinding his teeth and his right kneecap began to bounce. This was not the street-worn body of a junkie – a dancer maybe, a goddess. â€Å"Sometimes,† she said, hissing the last s, â€Å"a rough fuck down a dark alley is the best medicine for a weary warrior.† Charlie looked around: the party a block ahead, the guy reading his newspaper under the streetlamp two blocks back. No one down the alley waiting to ambush him. â€Å"How much?† he asked. He couldn't even remember what sex felt like, but all he could think about right now was release – a rough fuck down a dark alley with this†¦this goddess. He couldn't see her face, just the line of a cheekbone, but that was exquisite. â€Å"The pleasure of your company,† she said. â€Å"Why me?† Charlie said, he couldn't help himself – it was his Beta nature. â€Å"Come find out,† she said. She cupped her breasts, fell back against the wall, and propped one heel up on the bricks. â€Å"Come.† He walked into the alley and leaned the cane on the wall, then took her uplifted knee in one hand, a breast in the other, and pulled her against him for a kiss. She felt like she was wearing velvet, her mouth was warm and tasted base, gamy, like venison or liver. He didn't even feel her undo his jeans, just a strong hand on his erection. â€Å"Ah, strong meat,† she hissed. â€Å"Thanks, I've been going to the gym.† She bit his neck, hard, and he squeezed her breast and thrust against her hand. She threw her uplifted leg around his back and pulled him hard against her. He felt something sharp, painful digging into his scrotum and he tried to pull away. She pulled him tighter with her leg. She was incredibly strong. â€Å"New Meat,† she said. â€Å"Don't fight me or I'll tear them off.† Charlie felt the claw on his balls and the breath caught in his throat. Her face was an inch from his now, and he looked for her eyes, but could see only an obsidian blackness reflecting the highlights from the streetlight. She held her free hand in front of his face and he watched as claws began to grow out of her fingertips, reflecting the streetlight like brushed chrome, until they were three inches long. She poised them over his eyes and he reached for his sword-cane against the wall. She knocked it away, and the claws were at his face again. â€Å"Oh no, Meat. Not this time.† She hooked a claw into his nostril. â€Å"Shall I drive it into your brain? That would be quickest, but I don't want quick. I've waited so long for this.† She released the pressure on his balls, and to his horror, he realized that he was still hard. She started rubbing his erection, pushing the claw deeper into his nose to hold him steady. â€Å"I know, I know – when you come, I'll put it in your ear and yank. I've taken off a half a man's head that way. You'll like it. You're lucky, if Nemain had been sent you'd be dead already.† â€Å"Bitch,† Charlie managed to say. She was stroking him harder and he was cursing his body for betraying him this way. He tried to pull away and her leg wrapped behind him crushed the breath out of him. â€Å"No, you come, then I'll kill you.† She pulled the claw from his nose and put it next to his ear. â€Å"Don't make me leave unsatisfied, Meat,† she said, but in that instant her claw caught the side of his scalp and he hit her as hard as he could in the ribs with both of his fists. â€Å"You fuckface!† she shrieked. She let her leg fall; yanked him aside by his penis, and reared back for a full slash of her claws to his head. Charlie tried to raise his forearm to take the blow, but then there was an explosion and a piece of her shoulder splattered on the wall, spinning her around. Charlie felt her release his penis, and he threw himself across the alley. She rebounded off the wall with both claws aimed at his face. There was another explosion and she was knocked back again. This time she came up facing the street, and before she could brace to leap, two more shots hit her in the chest and she screeched, the sound like a thousand angry ravens set afire. Five more quick shots and she was danced backward by the impacts; even as she went she was changing, her arms getting wider, her shoulders smoothing. Two more shots, and the next screech wasn't even remotely human, but that of a huge raven. She rose into the night sky trailing feathers and spattering a liquid that might have been blood, except that it was black. Charlie climbed to his feet and staggered out of the alley to where Inspector Alphonse Rivera was still in shooting stance, holding a 9 mm Beretta aimed at the dark sky. â€Å"Do I even want to know what the fuck that was?† Rivera said. â€Å"Probably not,† Charlie said. â€Å"Tie your coat around your waist,† said the cop. Charlie looked down and saw that the front of his jeans had been shredded as if by razors. â€Å"Thanks,† Charlie said. â€Å"You know,† Rivera said, â€Å"this could have all been avoided if you'd just taken the happy ending like everybody else.†