The Picture of Dorian Gray Essay Example for Free

The Picture of Dorian Gray Essay 1.The Picture of Dorian Gray is the story of a young and beautiful man named Dorian Gray who is frightened by the fact that he will eventually lose his good looks and youth as he ages. Dorian Gray is the subject of a painting by an artist, Basil Hallward. Basil introduces Dorian Gray to Lord Henry Wotton, who slowly begins to gain greater influence on Dorian Gray. Lord Henry believes the only things worth pursuing in life are beauty and fulfillment of the senses. Once Dorian realizes that his good looks and youth will eventually fade away he decides to pledge his soul to his painting to ensure that the portrait will age and bear the burden of his infamy instead of himself. Shortly after doing so Dorian meets an actress named Sibyl Vane. He falls in love with her and they become engaged. But Sibyl decides to quit acting; because of she believes she cannot pretend to love acting when she loves Dorian so much more. Once Dorian finds that Sibyl has quit acting he breaks the engagement and that night Sibyl hangs herself. After Sibyl’s death, Dorian begins a life of debauchery. Once rumors begin to spread of his infamous acts Basil comes to Dorian to confront him about the rumors. Out of rage Dorian kills Basil and needs help disposing the body. After the murder Dorian is full of guilt and instead of repenting his sins he takes the knife he used to stab Basil and stabs his picture instead. Dorian’s servants find Dorian’s portrait a beautiful picture of a young man and their master’s body lying on the floor. Dorian’s body is an old disfigured man with a knife in his heart. 2.The main characters in this story are Dorian Gray, Basil Hallward, and Lord Henry Wotton. Dorian Gray is an incredibly handsome and wealthy young gentleman whom Basil Hallward paints a picture of. Once Dorian meets Lord Henry he finds that his beauty will eventually fade and pledges his soul to the painting Basil made. He soon begins a life of corruption. Basil Hallward is a painter who is infatuated with Dorian’s extreme beauty. He is the painter that creates Dorian’s painting that ages as Dorian doesn’t. Basil is also a friend to Lord Henry Wotton. Lord Henry Wotton is a noble witty friend of Basil and later becomes a friend to Dorian as well. He eventually has a huge influence on Dorian and first puts Dorian in the mindset that beauty doesn’t last forever. 3.There are multiples themes in The Picture of Dorian Gray but the most central theme would be physical beauty and narcissism, and how they lead to self destruction. There are numerous situations of Dorian Gray hinting at narcissism. In the second chapter Dorian murmurs â€Å"How sad it is! I shall grow old, and horrible, and dreadful. But this picture will remain always young. It will never be older than this particular day of June.If it were only the other way! If it were I who was to be always young, and the picture that was to grow old! For that for that I would give everything! Yes, there is nothing in the whole world I would not give! I would give my soul for that!† (pg28) This is when Dorian realized that his youth, his dazzling beauty, will not last forever. Dorian now realizes that he should treasure his youth more than ever. He also realizes would give up everything to save his youthful beauty, even his soul. However, everything has a price to pay. Another example of Dorian’s narcissism in the book is on page 95 where Dorian blames Sibyl for the reason he ended their engagement. â€Å"It was the girl’s fault, not his he had thought her great. Then she had disappointed him. She had been shallow and unworthy.† (pg95) Dorian’s attitude towards the ending of his relationship with Sibyl shows how overconfident he is in his beauty and because of this overconfidence he loses the woman he loves. The final example of how narcissistic attitude leads to destruction is the ending of the story. In the end of the story Dorian ends up killing himself because of all the horrible things he had done in his life. He stabs himself with the knife he used to kill Basil and once he kills himself he turns old and his picture becomes young again. 4. Oscar Wilde’s writing style in The Picture of Dorian Gray uses a great deal of detail and an abundance of witty dialogue. Wilde uses Lord Henry to provoke humor with his theories on how life should be lived with only pleasure. More often though Wilde uses description to create the mood, tone, and setting of the story. Wilde describes each setting in the story with great detail making clear what he wants the picture of the setting to look like in one’s head. On page 4 Wilde wrote â€Å"As the painter looked at the gracious and comely form he had so skillfully mirrored in his art, a smile of pleasure passed across his face, and seemed about to linger there.† In this description Wilde sets the mood, tone, and setting. He also describes each character with great detail. â€Å"Lord Henry stroked his pointed brown beard, and tapped the toe of his patent-leather boot with a tasseled ebony cane.† (pg11) Wilde’s description’s of Lord Henry helps the reader create a better idea of what the characters are like and what they look like. Wilde omniscient point of view on the story gives insight to each of the character thoughts and reasoning behind their actions. With this point of view the reader can understand Dorian’s motives behind pledging his soul, breaking his relationship with Sibyl, and ending his life. 5.The Picture of Dorian Gray is one of the most intriguing and unique books I have ever read. The storyline of the story is unique itself because I don’t believe I’ve ever read a book about a man pledging his soul to a painting to preserve his youth. Dorian Gray’s character is invigorating. His selfishness made me want to both strangle him and continue reading throughout the entire story. Lord Henry’s wit was striking and offensive but also thought provoking. The slight homosexuality between Basil and Dorian was humorous. Not only was the book full of interesting viewpoints on life and rude behavior it was also enlightening. Although Dorian was selfish and wrong for pledging his soul so that he could stay young his thoughts are understandable. The notion that getting older isn’t as pleasurable as it may seem to others is an idea that I can relate with but I would never sell my soul for it. This book was well worth the read even though the beginning seemed kind of dry to me.

Spastic Diplegic Cerebral Palsy Health And Social Care Essay

Spastic Diplegic Cerebral Palsy Health And Social Care Essay Cerebral Palsy is a common neuro developmental disorder of childhood with prevalence is about 2 per 1000 births in industrial nations [Pameth et al, 1981] and 3 per 100 live births WHO 1999] It is defined as a permanent, non progressive defect or lesion present at birth or shortly thereafter. Cerebral refers to brain and palsy refers to lack of motor control. The childs co ordination of movement is affected, making it difficult or impossible to practice and perfect skills of daily life. Traditionally prenatal etiology, prematurity, total growth retardation, perinatal asphyxia and other perinatal causes like trauma have all been implicated as risk factors for cerebral palsy. (National collaborative perinatal project NCPP data). Cerebral Palsy (CP) is classified clinically in terms of the part of the body involved,eg., hemiplegia, diplegia, quadraplegia and by the clinical perceptions of tone and involuntary movement., eg., Spasti , athetoid , ataxic [ Roberta B.Shepherd 1995] 1.2 SPASTIC DIPLEGIC CEREBRAL PALSY Spasticity affects approximately 75% of all patients with cerebral palsy and when characterized by body part. Diplegia is the most commonest type. These disorders are due to faulty development damage or to motor area in the brain which disrupt the brains ability to adequately control movement and posture. Tends to affect the legs of a patient more than the arms.Spastic Diplegia cerebral palsy patients have more extremity than the upper extremity.This allows most people with spastic diplegia cerebral palsy to eventually walk. The gait of a person with spastic Diplegia cerebral palsy is typically characterized by a crouched gait. Toe walking and fixed knees are common attributes. Spasticity is a motor disorder characterized by a velocity dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerks , resulting from hyper excitability of the stretch reflex [ Lance 1980]. Contracture is a loss of passive range of motion assessed by measuring maximum passive joint excursion [Horsley et al 2007, Harvey et al 2006]. Spasticity can lead to contracture [Farmer and James 2001, Tardien et al 1982] and both spastcicty and contracture can limit activity [Boyd and Ada 2008, Hoffler et al 1987]. Two approaches used for the treatment of children with physical disabilities are advanced physiotherapy treatment called Neuro developmental therapy (NDT) and muscle energy technique (MET). The aim of Neuro development therapy is through specialized techniques of handling, to give children with cerebral palsy the experience of a greater variety of co ordinated movement patterns where as muscle energy technique functions by relaxing acute muscle spasm mobilizing the restricted soft tissue and toning the weakened musculatures. 1.3 NEED OF THE STUDY: Since spasticity in the muscles affects the functional gait pattern and decreases the childs ambulatory independency, therefore the need for the study is to evaluate the effectiveness of neuro developmental therapy with muscle energy technique for lower extremity to improve functional ability in children with spastic diplegic cerebral palsy. 1.4 STATEMENT OF THE PROBLEM: Effectiveness of Neuro Developmental Therapy with muscle energy technique for lower extremity to improve the functional ability in children with spastic diplegic cerebral palsy. 1.5 OBJECTIVE: Treatment of children using neuro developmental therapy Treatment of children using muscle energy technique. Compare and contrast Neuro Developmental Therapy in relation to muscle energy Technique. To determine the effects of Neuro Developmental Therapy and muscle energy technique that improves the functional ability in children with spastic diplegic cerebral palsy. 1.6 HYPOTHESIS: The null hypothesis upon which the study is designed can be stated as there is no significant improvement in functional ability in children with spastic diplegic cerebral palsy by the application of NDT MET. 2. REVIEW OF LITERATURE Rosenbaum palsy[2003]-Defines cerebral palsy as an umbrella term covering a group of non progressive, but after changing motor impairment syndromes secondary to lesions or anomalies of the brain arising in the early stages of development. He is saying that cerebral palsy refers to a group of disabilities that will not self correct, which affects children while very strong and that disrupt the childs movement ability in connection with brain function. Baxm,Goldstein,et al.,(2005) defined cerebral palsy as a group of disorders that affect the development of movement and posture, causing activity limitation, and are attributed to non progressive disturbances that occurred in the developing fetal or infant born. Becker Jg-stated that spastic paresis is characterized by a posture-and movement dependent tone regulation disorder. The clinical symptoms are the loss or absence of tone in lying, and increases in tone in sitting, standing, walking, or running, depending on the degree of involvement, spastic paresis is the most common motor disorder (83%). Janstephan Tecklin (2008)-stated that the child with classic spastic diplegia will typically demonstrate hypotonia through the neck and trunk while having increased stiffness in both legs. Bernard Dan (2001)-stated that spastic diplegia characterized by limb hypertonia, which is more marked distally, predominates the lower limbs and increases active mobilization, hyperactive jerks, extensor plantar responses and varying degree of trunk hypotonia. Felters-1(Phy Therapy 1996)-Did a study on the effects of Neuro Developmental Therapy versus practice on reaching of children with spastic cerebral palsy. It was found that NDT was more effective Iddav Embrey Et Al [1990] Conducted a study on effects of neuro -developmental treatment and inhibitive ankle height orthroses on gait with spastic diplegic children with cerebral palsy . The results shows that both methods of treatment can be used to decrease excessive knee flexion during gait in a children with spastic diplegic cerebral palsy. Lilly La Powell NJ -Conducted a study regarding measuring the effects of neuro developmental treatment on the daily living skills of two children with cerebral palsy. They examined the short term effects of Neuro Developmental Treatment (NDT) was found that improvements were made in the motor performance of daily living skills in two girls with cerebral palsy. Bobath Therapy is a physical technique, principally used with cerebral palsy to inhibit abnormal movement or postures and promote effective normalized movement and muscle tone [Early physiotherapy or Bobath technique in infants with suspected neuro motor disturbance 1981]. Ketelarr m, et al., Did a study on the effects of functional therapy programe on motor abilities of children with cerebral palsy. They found improvement in both gross motor abilities and functional skills in children who received functional physical therapy programe.(physical therapy 2001). Nikos Tsorlakis Et al [2004] -Conducted a study on effect of Neuro Developmental Treatment on gross motor function of children with cerebral palsy. They found that improvement were made in the gross motor abilities in children who received Neuro Developmental Therapy. Kostidis, Michaei [2009] -The purpose of this study was to compare the effect of Muscle Energy Technique (MET), to a static stretch of 30 seconds duration for increasing the extensibility of the hamstring muscles. The result showed that MET was more effective, compared to static stretching. Mohd.Waseem et al [2009]-The purpose of this study was to investigate the effectiveness of Muscle Energy Technique [MET] on hamstring flexibility in normal INDIAN collegiate males. The result indicates that MET is significantly improving the hamstring flexibility [range of motion] in collegiate males. Kmberly Bucham [2007] -In that study to investigate the effectiveness of MET in increasing passive knee extension. Results showed that a significant increase in range of motion was observed at the knee flexion a application of MET. Wilson E, Donegam Shoafl, et al., [2003]-Conducted a study on effects of MET in patients with acute low back pain. The results showed that MET was effective in decreasing disability and improving function in patients with acute low back pain. Ballantyne, Fryer G, et al., [2003]-The study was conducted to investigate the effectiveness of Muscle Energy Technique in increasing passive knee extension and to explore the mechanism behind any observed change. Muscle Energy Technique produced an immediate increase in passive knee extension. This observed change in range of motion is passive due to an increased tolerance to stretch. Ching Shag Anita,et al., [2004]-The study was conducted to compare the immediate effects and lasting effects between passive stretch and Muscle Energy Technique on Hamstring Muscle Extensibility. The result suggested that Muscle Energy Technique appeared to be more effective than passive stretching for increasing Hamstring Extensibility immediately post treatment and still at one hour. Msalle me et al-WEE FIM is a valid measure for tracking disability in preschool age and middle childhood and this allows the paediatrician to prioritize interventions for enhancing comprehensive functional outcomes and supporting families. Yung a, wong v et al., WEE FIM could be used to assist neuro rehabilitation clinicians in the selection of short term realistic goals and long term rehabilitation strategies for children with various Neuro Developmental disabilities. Dr.Fayetteville,ms.smith et al.,- to determine the inter rater reliability of manual tests of elbow flexor muscle spasticity graded on a Modified Ashworth Scale was significant and the reliability was good and believe them to be positive enough to encourage further trials of the Modified Ashworth Scale for grading spasticity. 3. MATERIALS AND METHODOLOGY The cerebral palsy children were selected on an initial baseline assessment and confirmation of their diagnosis. 3.1 SUBJECTS: Male and female cerebral palsy children between age group of four to fourteen years were taken. The children were primarily diagnosed and evaluated by a neurologist and a pediatrician and were referred to physical therapy. 3.2 ASSESSMENT TOOL USED: Modified Ashworth Scale Weefim Scale 3.3 MATERIALS USED: Floor Smooth non slippery Surface. A large firm exercise mat (minimum 4 or 6) with a maximum thickness of 1 for proprioception and tactile feedback. So the child has better sensory information regarding movement. Small interesting toys that can be touched with one or both hands for head control, reaching, eye fixation. Pillows. Therapy ball and Bolsters provides mobile surface and facilitate automatic reactions. Small wooden chair, Bench and couch of various heights for short sitting , table top activities , stepping , climbing and so on. A rail or parallel bars. Tilt boards and equilibrium boards for the child may lie, sit, kneel, stand or maintain a quadruped position, while being rocked in mediolateral or anteroposterior directions and to elicit rightening reactions. Adaptive equipment to offer postural support or may aid functional skills and mobility. Soft soothing music to motivate the child. Stop watch. 3.4 METHODOLOGY 3.4.1. STUDY DESIGN: This will be an experienced study with two groups having pretest and post test groups. 3.4.2. STUDY SETTING: This study was done in Families for children podanur, Amrit orthopedics rehablitation centre, Coimbatore and in patients who were referred for physical therapy from department of pediatrics and neurology, SRI RAMAKRISHNA HOSPITAL, COIMBATORE. 3.4.3. TOTAL STUDY DURATION: 6 Months. 3.4.4. TREATMENT TIME: 45 Minutes duration per day for three weeks. 3.5. SELECTION CRITERIA 3.5.1. INCLUSION CRITERIA: Children with mild to moderate spastic diplegic type of cerebral palsy. Ability to understand and respond to verbal instructions. Gross Motor Function Classification level and II and III. Cognitively Sound. Children within the age group of 4-14 years. Both male and female. 3.5.2. EXCLUSION CRITERIA: Gross Motor Function Classification level IV and V. Mental retardation. Uncontrolled Epilepsy. Children with Athetoid and Mixed type of cerebral palsy. Visual and hearing impairment. Respiratory distress. Congenital heart problems. Children with fixed skeletal or hip deformities. Difficulty to understand command. 3.6. SAMPLING: 20 Children were selected based on inclusion criteria. They were further divided into control and experimental group containing 10 children in each group based on convenient sampling. Control group ( Group A ) : Children receiving Neuro developmental therapy. Experimental group (Group B): Children receiving Neuro development therapy with Muscle Energy Technique. 3.7. STATISTICAL TOOL: The data collected was analyzed using independent t- test. The test was carried out between 2 groups. The pretest and post test values for 2 groups are to be calculated and will be assessed for variation and improvements their significance will be assessed. t = x1 x2 n1 n2 S ( n1 + n2 ) S = à ¢Ã‹â€ Ã¢â‚¬Ëœ ( x1 x1 ) 2 + ( x2 x2 ) 2 n1 + n2 2 where, S = Combined standard deviation x1 = Difference between Pre test and post test in Group  Ã¢â‚¬ ° x2 = Difference between Pre test and post test in Group  Ã¢â‚¬ °Ã‚ Ã¢â‚¬ ° x1 = Mean Difference of Group  Ã¢â‚¬ ° x2 = Mean Difference of Group  Ã¢â‚¬ °Ã‚ Ã¢â‚¬ ° n1 = Number of subjects in Group  Ã¢â‚¬ ° n2 = Number of subjects in Group  Ã¢â‚¬ °Ã‚ Ã¢â‚¬ ° 4. TREATMENT TECHNIQUES 4.1 NEURO DEVELOPMENTAL THERAPY (BOBATH THERAPY) Bobath concept is the most familiar and widely used approach for children with neurologic disorders. It is originated in 1940 and early 1950. PRINCIPLES: Patterns of movement Use of handling Prerequisites for movement NDT Treatment constructs a purposeful relationship between sensory input and motor output. Therapeutic handling is a primary intervention strategy that NDT therapists use to assist the client in achieving independent function. ABNORMAL TONE ABNORMAL POSTURE ABNORMAL MOVEMENTS REGISTRATION OF ABNORMAL MOVEMENTS REPETITION MEMORY EXECUTION OF ABNORMAL MOVEMENTS The primary difference that separates NDT clinical practice from all other approaches is the inclusion of precise therapeutic handling, which includes both inhibition as key interventions to achieve independent function. HANDLING Handling is facilitation or inhibition of posture and movement: Normal postural control Movement in ground and space Experiences of various postures Postural alignment to weight shifts Variety of movement patterns Direct, regulate and organize tactile, proprioceptive and vestibular input. Direct the clients initiation of movement more efficiently and with more effective muscle synergies. Decrease the amount of force the client uses to stabilize the body segments. Guide to redirect the direction, speed, force and timing of the muscle activation for successful task completion. Sense the response of the client to the sensory input and movement outcome and provide non verbal feedback for reference of correction. When the client can become independent of the therapist and take control of posture and movement. Direct the clients attention to meaningful aspects of the motor task. HAND PLACEMENT Place the hands purposefully and precisely on the clients body to specifically influence the area under the hands to indirectly influence the body parts. FACILITATION Facilitation makes a posture or movement easier or more likely to occur. Facilitation modifies postural control by increasing the degrees of freedom, supporting a body segment during an activity. Activating the postural system to produce a change in the alignment of the body relative to the gravity and BOS. INHIBITION Inhibition refers to restricting the clients atypical postures and movements which interferes with the development of more selective movement patterns. BOBATH APPROACH It referred to reducing tone and reflex activity resulting from CNS dysfunction. Inhibiting excessive co activation-dynamic stability for more effective postural control. Balance antagonistic muscle groups. Reduce spasticity or excessive muscle stiffness that interferes with moving specific segments of the body.(Facilitation and Inhibition techniques are used in combination) Treatment strategies often include preparation and stimulation of critical foundation elements (task components) as well as practice of the whole task. NDT intervention is designed to obtain active responses from the patient on goal activities. Whenever possible during treatment movement is indicated and actively performed by the client. NDT intervention includes planning and solving motor problems. NDT intervention allows the patient to learn from errors that occur during movement. Repetition is an important component during motor learning. Create an environment that is conductive to co operative participation and support of the clients effort. Knowledge of development of posture and movement components are used in designing treatment strategies. NDT therapy sessions provide motivation purpose to engage the client fully in developing and reinforcing movement responses. NDT intervention methods include modifying the task or the environment to take into account the clients current level of performance and capacity for function. As client is able to perform the movement independently, the therapist provides time during the sessions for the client to move freely. Individual treatment sessions are designed to evaluate the effectiveness of treatment within the session. Recognize and respect the communicative effects of the clients motor behavior. Families receive information regarding clients problems and management of those problems as they are able to understand and assimilate the information. 4.2 MUSCLE ENERGY TECHNIQUE Muscle Energy Technique is a procedure that involves voluntary contraction of the patients muscle in a precisely controlled manner at varying level of intensity, against a executed counterforce applied by the therapist. Muscle Energy Technique are used to treat somatic dysfunction, especially decreased range of motion, muscular hyper tonicity and pain. MECHANISM OF ACTION FOR MUSCLE ENERGY TECHNIQUES: Muscle Energy Technique is a direct,active technique requiring patients co-operation for maximal effect. The changes occurring when patient performs isometric conttaction are: Direct inhibition of agonist muscles results due to Golgi Tendon Organ activation. At antagonist muscles there occurs reflexive reciprocal inhibition. When Patient is relaxing agonist and antagonist remain inhibited. This allows the joint to be moved into the restricted range of motion. TECHNIQUES: Muscle Energy Techniques could be applied to most areas of the body. Each of the technique requires following 8 steps: Obtaining an accurate structural diagnosis. The restrictive barrier is engaged in many planes. The unyielding counterforce matches patients force with therapists force. The isometric contraction of patient has correct amount of force, direction of effort and duration (3-5 seconds). After muscle effort there is complete relaxation. The patient is repositioned in possible planes into new restrictive barrier. Repeat 3-6 steps approximately 3-5 times. 8. Repeat structural diagnosis to find whether dysfunction has resolved. DATA ANALYSIS AND INTERPRETATION Cerebral palsy children were treated with Neuro Developmental Therapy and Muscle Energy Technique. Neuro Developmental Therapy was given for control group (Group A ) which consisted 10 samples and Neuro Developmental Therapy with Muscle Energy Technique (Group B ) which also consisted of 10 samples. DEMOGRAPHIC DATA: GROUP A (CONTROL GROUP) AGE NUMBER OF PATIENTS MALE FEMALE 4-5 years 0 0 5-6 years 0 0 6-7 years 2 0 7-8 years 2 0 8-10 years 1 0 10-12 years 2 1 12-14 years 1 1 GROUP B (EXPERIMENTAL GROUP) AGE NUMBER OF PATIENTS MALE FEMALE 4-5 Years 0 0 5-6 Years 0 0 6-7 Years 1 0 7-8 Years 1 0 8-10 Years 1 1 10-12 Years 1 2 12-14 Years 2 1 DATA PRESENTATION AND ANALYSIS WEEFIM Locomotion (Maximum score: s14) Group A (Control Group) S.No Pre Post Difference 1. 3 6 3 2. 5 10 5 3. 7 10 3 4. 3 7 4 5. 5 9 4 6. 7 10 3 7. 5 8 3 8. 3 6 3 9. 7 9 2 10. 5 7 2 MEAN 5.0 8.2 3.2 WEEFIM Locomotion (Maximum score: 14) Group -B (Experimental Group) S.No Pre Post Difference 1. 3 6 3 2. 7 11 4 3. 3 10 7 4. 5 9 4 5 3 12 8 6. 5 12 7 7. 4 7 3 8. 8 12 4 9. 3 7 4 10. 3 6 3 MEAN 4.4 9.2 4.7 WEEFIM GROUP MEAN VALUE CALCULATED T VALUE TABLE T VALUE PRE TEST PRO TEST SD A 5.0 8.2 0.918 2.25 0.05 B 4.4 9.2 1.888 MAS Group -A NDT (Control Group) S.No Pre Post Difference 1. 4 3 -1 2. 4 3 -1 3 4 1 -3 4. 4 2 -2 5. 4 3 -1 6. 3 1 -2 7 3 2 -1 8. 4 2 -2 9. 4 1 -3 10. 4 3 -1 MEAN 3.8 2.1 -1.7 MAS Group -B NDT + MET S.No Pre Post Difference 1. 4 1 -3 2. 4 1 -3 3. 4 1 -3 4 4 2 -2 5. 4 1 -3 6. 3 1 -2 7. 3 1 -2 8. 4 2 -2 9. 4 2 -2 10. 3 1 -2 MEAN 3.7 1.3 -2.4 MAS GROUP MEAN VALUE CALCULATED T VALUE TABLE T VALUE PRE TEST PRO TEST SD A 3.8 2.1 0.822 2.28 0.05 B 3.7 1.3 0.516 DISCUSSION The aim of the study was to investigate the effects of NDT and MET in reduction of spasticity in children with spastic diplegic type of cerebral palsy.30 children of age group between 4-14 years were selected for the experimental study. The study was carried out for a total duration of six months for a period of 45 minutes of treatment per day. The pre and post test scores of MAS and Wee FIM shows that significant improvements were found in reducing spasticity and ADL activities such as standing, walking, and stair climbing with less caregiver assistance. For MAS score, the average pre test and post test values of Group A and Group B showed significant difference. But the mean of Group A (1.7) shows more marked increase than that of Group B (2.4). On Statistical analysis using Independent t-test, for Group A and Group B, there is a significance of t=2.28 For Wee FIM score, the average pre test and post test valves in Group A and Group B showed significant difference. But the mean of Group A (3.2) shows more marked increase than that of Group B (4.7). On statistical analysis using Independent t-test, for Group A and Group B, there is a significance of t=2.25 From this we infer that NDT along with MET can be used as an efficient treatment protocol to reduce spasticity and to improve ADL activities in children with spastic diplegic cerebral palsy, thus rejecting the null hypothesis. CONCLUSION With reference to the statistical analysis done from the data collected for MAS and Wee FIM, it is noted that the combination of NDT with MET causes significant reduction in tone which produces improvement in ADL activities. However it is necessary to state that mere NDT also produces improvement in MAS and Wee FIM but the data reveals that mean improvement is greater for the group to which MET is given. These findings suggest that MET attenuates physical symptoms associated with cerebral palsy and enhances development. Hence forth it could be concluded with enough and proven confidence that NDT along with MET forms an integral part in the treatment of children with spastic diplegic cerebral palsy. LIMITATIONS: The study was a time bound study lacking large sample size. Selection of only one muscle cant fulfill the desire functional goal setup by therapist. Irregularities in attendance. Health problems. No regular follow-up of home advices. Difficulties of the communication. RECOMMENDATIONS: The technique of the study is not strict to one particular muscle or one specific condition, so it is applicable to various muscles in various conditions. Post Isometric Relaxation and Post Facilitation Stretching, which is a safetyorm of stretching is advice to use maximum in place of passive stretching of muscle. It is suggested for further research to conduct a combined therapy of NDT, MET with other Developmental Techniques for various muscle at a same time, so this will enhance to achieve goal which is setting for a particular child. This study may be useful to incorporate into further studies examining various muscles along with any development in multidisciplinary endorsed classification that are developed. BOOKS Leon Chaitow: Positional Release Techniques, 2002. Judith Delancy: Clinical application of Neuro muscular techniques, 2005. Leon chaitow: Muscle energy techniques. Janet.M,Howle: NDT approach theoretical foundations, 2002. Lisa A Kurtz: How to help a clumsy child, 2003. Freeman Miller,Erin Brown: cerebral palsy, 2005 Sophie Levit: Treatment of cerebral palsy and motor delay, 2010. Marcia Stame,MT: Posture and movement of the child with cerebral palsy. Jan Stephan Tecklin: Paediatric physical therapy 3rd edition, 1990. Gilroy J: Basic Neurology 2nd edition, 1992. Susan K Campbell: Physical Therapy for children, 1996. Roberta B Sheperd: Physiotherapy in Paediatrics 3rd edition, 1990. Rebecea Dutton: Clinical Reasoning in physical disabilities, 1995. Gupta SP: Text book of statistical methods 28th edition, 2000. Kothari CR: Text book of research methodology-methods and techniques, 2009. Carolyn M. Hicks: Research for physiotherapist 2nd edition, 1995. Sundar Roa, Richard J: An introduction to bio statistics 3rd edition, 1996. Acchors: Text book of paediatrics. Elizabeth Domholdt: Physical therapy research principles and application, 2000. ABSTRACTS Fryer et al: The effect of muscle energy technique on hamstring extensibility; Journal of osteopathic medicine, 2005. Shadmehr A: Hamstring flexibility in young women following passive stretch and muscle energy technique; J Back Musculoskeletal Rehabilitation, 2009. Milivoj Velickovic Perat; Basic principles of the Neuro developmental Treatment, 2004. Christina Evaggelina et al: Effect of intensive Neuro Developmental Treatment in gross motor function of children with cerebral palsy, Dev. Med. Child Neurology, 2004. Smith M, Fryer G:

Romeos Tragic Flaw :: essays research papers

"The essence of being human is that one does not seek perfection," states the British author, George Orwell. Every individual grows to understand that perfection is unachievable, therefore, human beings embody dramatic flaws. Many people tend to be unkempt or have poor manners, while others have behavioral difficulties such as quick temperament, dishonesty, or intentional rudeness. These perplexities can bring about hardships throughout an individual's life. William Shakespeare demonstrates some of these hardships in his puissant drama about The Tragedy of Romeo and Juliet, that portrays a protagonist, Romeo, who acquires the unfortunate flaw of rashness which later develops into the major downfall of his death. Romeo is an extremely impulsive individual. Throughout the drama, Romeo makes decisions without considering the consequences. His mistakes bring about several complications that eventually lead to his untimely death. From the beginning of the novel, Romeo continuously falls in love with different people. The first Act of the play portrays an ardent love for the gorgeous Rosaline who refuses to love him. Romeo's maudlin behavior is a concern to his friends, who decide to take him to the Capulet's masquerade party. Here, Juliet's beauty strikes Romeo and his previous love for Rosaline instantaneously diminishes. After the party, Romeo encounters Juliet and makes the impulsive decision of promising to marry her. Romeo recounts the story of his newfound love and the desire to marry her, to his adviser, Friar Lawrence, and seeks his advice. The Friar explains that, "Young men's love then lies/ not truly in their hearts, but in their eyes" (89). The Friar tries to convince Romeo that his love is not true, for he hastily changes his mind about the love of his life. But Romeo does not change his mind and is wed with Juliet. Romeo is also quite brash in his decision to slay Tybalt. If Romeo considered the consequences of murdering his enemy, he could have prevented his banishment from Verona. Romeo fails to consider that there is no need to slay Tybalt because Tybalt is already headed for assassination due to the fact that he started a fray and murdered Mecrutio. Unfortunately, his impulsiveness overpowers him and Romeo fights Tybalt. If only Romeo had thought rationally, he would not be separated from his dear, sweet Juliet. His banishment causes Romeo to cry out with extreme anguish to the Friar, "Hence 'banished' is 'banished from the world,' / And worlds exile is death.

Humorous Wedding Speech for a Car Salesman -- Wedding Toasts Roasts Sp

Humorous Wedding Speech for a Car Salesman Good evening Ladies and Gentlemen – for those of you who don’t know me I’m Floyd, Edward’s best man. Of course, the only problem with being the best man at a wedding is that you never get a chance to prove it, but if anyone wants to start a drinking competition later, then come talk to me. Edward has been a great friend to me since we met. And, over that time, he's always been there for me. I remember especially him being there when I had my first car crash†¦ oh, that's right, Edward was driving! Laughter Honestly Edward, I’m not really up here to embarrass you. You did a fine job of that yourself during your bachelor’s party (stag night). In fact, we were a little concerned when you made your cross-dressing tendencies public, that Nancy might have had some competition today. But given the formal nature of the occasion, I am pleased to see, Edward, that you've decided to copy my outfit, rather than hers. Edward has gone through many evolutionary changes to end up the man he is today. In order to understand exactly what went wrong, let’s examine Edward’s career. As many of you know, Edward has been climbing the ladder in sales in recent years. This comes as no surprise since he has always been able to talk his way out of anything. You know, his parents still believe that it wasn't him who flooded the kitchen. Edward's talent for being able to spin any di... ... the surface, Edward was still a simple Somerset boy at heart. ‘She’s different to us’ he informed me. ‘What do you mean?’ I enquired. ‘Well, put it this way,’ Edward replied, ‘she gets out of the bath to have a pee.’ None the less, they hit it off. And we’ve seen both of them grow over the six years of their relationship. I think their marriage is going to be a wonderful partnership – and Edward will be the silent one. Truthfully, I can’t think of two other people that are better suited to spending the rest of their lives together! Ladies and gentlemen, it gives me great pleasure, not to mention relief, to ask you all to raise a toast to the newly weds. Congratulations to the bride and groom.

Social Networking: The Death of Privacy? Essay -- Social Media, Facebo

  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Social networks have become an increasingly popular way for people to communicate over the last decade. Whether it is through a wall post, a picture, a video, or a link, users are able to share stories and details about their lives through social networks such as Facebook, Twitter, MySpace, and YouTube. Mark Zuckerberg, a Harvard student who hacked the university’s network to obtain photos and information about other students on campus, created Facebook in 2004. Today, Facebook has more than one billion weekly active users. According to information found on Facebook’s website, â€Å"[M]illions of people use Facebook every day to keep up with friends, upload an unlimited number of photos, share links and videos, and learn more about the people they meet.†Ã‚  Ã‚  However, if the man behind all of this was a hacker himself, what might this say about the security of the website itself?  Ã‚  Just how safe is this site and others?   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  The truth of the matter is social networking sites are only as safe as a user makes them.  Unfortunately, many of the free privacy settings available for users on the internet are not the default. To protect themselves, users must be sure to censor what they post online and activate the appropriate privacy settings to secure their information. Individuals who share their personal information online must realize that anything they post has the potential to be viewed by millions of people online, not just their friends. As authors Dianne Timm and Carolyn Duven suggest,â€Å"[W]hen an individual shares information on a social networking site, he or she is sharing that information with the rest of the world even if the intent was to share with only a select group of people† (Timm and Duven 90). The reality o... ...Premier. Web. 25 Apr. 2015. Marsico Jr., Edward M. "Social Networking Websites: Are Myspace And Facebook The Fingerprints Of The Twenty-First Century?"  Widener Law Journal  19.3 (2010): 967-976.  Academic Search Premier. Web. 28 Mar. 2015. Miller, Robert, Kristine Parsons, and David Lifer. "Students And Social Networking Sites: The Posting Paradox."  Behaviour & Information Technology  29.4 (2010): 377-382.  Academic Search Premier. Web. 19 Apr. 2015. Teclehaimanot, Berhane, and Torey Hickman. "Student-Teacher Interaction On Facebook: What Students Find Appropriate."  Techtrends: Linking Research & Practice To Improve Learning 55.3 (2011): 19-30.Academic Search Premier. Web. 25 Apr. 2015 Timm, Dianne M., and Carolyn J. Duven. "Privacy And Social Networking Sites."  New Directions For Student Services  124 (2008): 89-101.  Academic Search Premier. Web. 29 Feb. 2015.

Mercury Athletic Case Essay

West Coast Fashions. Inc. ( WCF ) . a big interior decorator and seller of men’s and women’s branded dress late announced programs for a strategic reorganisation. Active Gear. Inc. ( AG ) . a in private held footwear company. was contemplating an acquisition chance. John Liedtke. the caput of concern development for AG. was interested in a WCF subordinate. The subordinate that Liedtke and AG intended to get was Mercury Athletic ( MA ) . a footwear company. Liedtke thought geting Mercury would approximately duplicate AG’s gross. increase its purchase with contract makers and spread out its presence with cardinal retail merchants and distributers. In order to supply a solid recommendation to Liedtke. farther analysis must be performed. Market Overview The dress or footwear industry is extremely competitory with low growing. The market is influenced by manner tendencies. monetary value. quality and manner. Companies can cut down hazard factors by non following manner tendencies which equates to efficient and effectual stock list direction and lost net income chances. Active Gear AG is a comparatively little athletic and insouciant footwear company. It has one-year grosss of $ 470. 3M ( 42 % of grosss came from athletic places ) . and $ 60. 4M of runing income. Projecting a shadow over these Numberss are AG’s typical rivals. AG’s typical rival has one-year gross revenues over $ 1. 0B. Because of Chinese fabrication contract consolidations. AG’s size was going a disadvantage due to low purchasing power vs. rivals. AG’s initial focal point was to bring forth and market high-quality forte places for golf and tennis participants. AG was among the first companies to offer stylish. walking. hike and boating footwear. Over the old ages. the firm’s athletic places had evolved from high-performance footwear to athletic manner wear with a authoritative image. The firm’s traditional casual places besides offered authoritative styling. but were aimed at a broader. more mainstream market. AG’s mark demographic was urban and suburbanites. runing from 25-45 in age. AG’s distribution channels consisted of independent retail merchants. departmental shops. and jobbers. AG excluded large box retail merchants and price reduction shops. AG focused on merchandises that didn’t follow manner tendencies. ensuing in a elongated merchandise lifecycle. This concern theoretical account led to more efficient and effectual supply concatenation and operating direction. However. because they opted for the safe path it halted the company’s gross revenues and growing chance. Mercury Athletic Mercury Athletic was purchased by WCF from its laminitis Daniel Fiore. Fiore was forced to sell the company after running it for over 35 old ages. due to wellness jobs. Due to a strategic reorganisation. the program called for the divestiture of MA and other â€Å"non-core† WCF assets. MA had grosss of $ 431. 1M and an EBITDA of $ 51. 8M Merchandises were distributed to departmental and price reduction shopsIt had two merchandise lines- athletic and insouciant footwearTarget market of both work forces and adult femalesShoes popularity grew in the utmost athleticss marketMA developed an operating substructure. leting direction to rapidly accommodate to alterations in client gustatory sensations with merchandise specifications. 1. Is Mercury an appropriate mark for AG? Why or why non? Let me walk you through some qualitative considerations before doing my recommendation. Strategic considerations: AG and MA are both viing in the athletic and insouciant footwear industry. Acquiring MA could take to economic systems of graduated table and range through fabrication and distribution webs. severally. Geting MA- AG would be less affected by the Chinese fabrication contract consolidation. due to increased purchasing powers. AG could potentially revive and net income from geting Mercury’s women’s merchandise line. Geting MA will duplicate AG’s one-year gross. Counter arguments- AG and MA mark demographics could non bring forth company synergisms MA is manner trendy. hence prone to put on the line outside of AG’s steady concern theoretical account Company civilizations could non fit 2. Review the projections by Liedtke. Are they allow? How would you urge modifying them? In order to happen if the projections are sensible. you need a starting point. Using jutting growing rates and EBIT should bespeak if Liedtke’s information is solid. Referencing the Free Cash Flow and Terminal Value tabular arraies ( found below ) . I will be able to bring forth an sentiment of Liedtke’s projections. Year to twelvemonth growing rates are highly volatile. normalising in 2010. The negative rate could mean that in 2007 they are projecting to stop a merchandise line. The swing back to a positive growing rate could be indicant of AG leveraging its economic systems of graduated table and range. while administering their merchandise lines through large box retail merchants. EBIT has been projected to bit by bit increase. which looks to be on par with industry norms. It is sensible to state that Liedtke’s projections decently reflect AG’s concern theoretical account. post-acquisition. 3. See tabular arraies and computations below 4. Make you see the value you obtained as conservative or aggressive? Why? From my analysis. the value I obtained seemed to be aggressive against the information provided. Referencing the tabular arraies below: Terminal or Enterprise Value is High Synergies are excluded from fiscal analysisWorsening gross growing 5. How would you analyse possible synergisms or other beginnings of value non reflected in Liedtke’s base premise? In order to analyse possible synergisms. I would look at both companies’ operations. Get downing from where they beginning their stuffs to administering their concluding merchandise are all possibilities of operational synergisms ( purchasing power. distribution channels. stock list direction. etc†¦ ) . Fiscal synergisms would include uniting grosss and cost benefits. which translate to increasing bottom line. Company civilization matching could besides go debatable. Quantitative AnalysisNet Working Capital Free Cash Flow WACC Terminal Value Evaluation NPV. IRR and Payback Period Decision Net present value of future hard currency flows equates to a positive $ 0. 2M. Internal rate of return or IRR is the involvement rate at which the net present value of all the hard currency flows from a undertaking or investing equal nothing. The IRR of this acquisition is 28 % . Having a positive NPV and an IRR that well outweighs the price reduction and hazard free rate- suggests that this acquisition should be pursued. In decision. AG should get MA.

Hrm approaches in different work systems

HRM Approaches in different Work systems: A comparing between fabrication works and name Centre of high street bankTinging WangAs Peter Boxall and John Purcell ( 2008 ) mentioned in literature, work system refers to â€Å"choices about what work needs to be done, about who will make it, and about where and how they will make it† . Each work system contains its characteristics to interact with operation picks every bit good as HR direction. This paper chiefly focus on the relationship between work systems and schemes of HR, particularly in comparing 2 different types of work systems and their corresponding attacks to HR. I will explicate this in the chief 2 parts follow a 3-step-way: environment analysis, work system and HR attacks.Approachs to in fabrication worksAssume there is a new, high engineering and capital intensive fabrication works in York. Since the works is a new entrant in the industry, its purpose is fundamentally cost control and using market portion. The capita l intensive, high engineering characteristic and cost control demand find the works has to restrict the figure of employees and heighten their abilities and efficiency in work. As we can see, the works is a typical theoretical account of fabrication houses. Manufacturing industry ab initio employed low paid labours to carry through merely, repeated work and without a basic cognition demand. It was argued by Watson ( 1986 ) that workers were machines utilizing motor non mental accomplishments. As the engineering developed quickly these old ages in fabrication industry, machines can largely take over the occupations done by labours and force the employees to another degree called â€Å"high involvement† ( Lawler, 1986 ) , and other similar attacks as â€Å"high commitment† ( Arthur, 1992 ) , â€Å"high performance† ( Huselid, 1995 ) or â€Å"sophisticated† ( Koch and McGrath, 1996 ) . James, Chester and Robert ( 2002 ) concluded former literatures and described high engagement work systems ( HIWSs ) being utilized by provide employees accomplishments, information, motive, and latitude to derive the work force ‘s fight. The high engagement attacks was discussed by Vandenberg, Richardson and Eastman ( 1999 ) based on Lawler ‘ ( 1986 ) high-involvement work procedures, which contains 4 factors as â€Å"PIRK† theoretical account. In â€Å"PIRK† theoretical account â€Å"P† stands for power, â€Å"I† means information, â€Å"R† refers to honor and â€Å"K† is defined as cognition. By this means, a set of HR attacks can be generated through enhance each variable of â€Å"PIRK† to accomplish concluding results. For case, developing chances can be used as a HR attack to heighten employees ‘ cognition and straight better their abilities to work out jobs. This is a direct manner of utilizing the theoretical account as Batt ( 2002 ) mentioned in his work, and the indirect manner influence employees ‘ motive and satisfaction to do them experience comfort and safe at work. In general, the HR attacks can be used in a fabrication works includes the undermentioned cardinal patterns: 1. Teamworking. As we mentioned before, the works is extremely concentrated on doing usage of engineering and capital resources, teamworking is a opportunity for employees to acquire involved in of import events in the works. It can impact workers in organisational committedness, work satisfaction every bit good as cognition betterment. 2. Advanced preparation. The works has needs on invention and merchandise design to vie in the market as a new comer, therefore the preparation has to be of some proficient degree which is firm-related and more hard than general preparation. Advanced preparation can break assist employees to derive information and cognition, and cut down the opportunity of turnover. 3. Incentive patterns. In a freshly works, if there is excess budget can be used on wagess, there should hold some inducement patterns. Not merely this method can actuate employees to give more, but besides it can heighten their duties to the works, if the wagess are really portions of the works. There are much more attacks can be used in this works to better public presentation, nevertheless, the effectivity still becomes an unsure inquiry, since there is no measurings to measure the whole procedure.Approachs to name Centre for a high street bankIn comparing, we imagine there is a call Centre to be established for a high street bank. Bank industry is more of service-oriented, name Centre in a high street bank is non expected to convey about net income straight. The employees ‘ duties are to work out jobs that already happened in the yesteryear or expected to be happened in the hereafter. They give the replies from a wide-ranging inquiry bank which contains the frequent asked inquiries and high-strung inquiries. All of them attached replies below so that the operators on the phone can reply different inquiries with in a short clip. Besides the replies, operators from the call Centre besides needs to be use properly words, looks, melodies, and purely follow a standardise d expression to make the whole telephone communications. The characteristics of call Centre determined the employees they wanted are more general background, better in communicating merely like a good hearer with first-class apprehension and ability of unwritten look. Service market is more labour intensive compared to fabricating industry, and name Centre can be categorized into the â€Å"Tightly Constrained† work systems, harmonizing to Herzenberg ( 1998 ) ‘s typology of work systems. Herzenberg describe this type of service as â€Å"high volume, low cost, standardised quality, tight undertaking supervising, low to chair formal instruction of workers, and limited training† . Boxall ( 2003 ) followed Herzenberg ‘s work and defined 3 types of competition and work organisation in private sector services. Based on his definition, call Centre belongs to â€Å"Massive service firms† which related to a mix of mass markets and higher value-added sections. There are important differences in HR schemes between a hi-tech fabrication works and a high street call Centre. Though Boxall ( 2003 ) pointed out that houses aim for high-valued sections in services are more likely to utilize HIWSs attack in HRM, a call Centre still can non suit the HIWSs really good. One of the grounds as I mentioned earlier is that call Centre â€Å"is non expected to convey about net income directly† . In this instance, even if utilizing HIWSs to better service quality and heighten employees ‘ felicity index can be worked out, that wo n't bring forth excess net income for the bank. Customers may take another bank since they discover their current bank truly defeated because of a hapless quality telephone service, but they are less likely to take a bank merely based on its absolutely high degree of telephone service. After examined the characteristics and work system of call Centre, a figure ( Figure 1 ) will be given out to exemplify the properly attack of HRM which is suggested to be adopted by a call Centre director. The figure contains both the attacks and demands. Left side stands out the cardinal attacks of HR which match the center and right characteristics of employees.Key HR attacksEmployee competenceEmployee committednessGeneral preparation ; Communicationss ; Performance assessment ;Standardized behaviour ; Communication accomplishmentsStress degree ; Work balance ;Figure 1: Approachs used in call Centre The HR attacks are used to heighten either employee competence or committedness to accomplish farther results. They looks much simpler compared with fabrication works, that is because the two houses have different characteristics and results.DecisionIt is evidently that a fabrication works adopts different HR attacks compared with a call Centre. The grounds are assorted and difficult to separate, since there are so many factors inside or outside the houses and interact with each other all the clip. However, there are three chief grounds affect the HR direction within different work systems. First one is production factor. Whether the house is capital intensive or labour intensive determines the graduated table and cost of employees as the former tends to engage fewer employees with high demand and the latter tends to maintain equal employees with general cognition backgrounds. The 2nd factor is merchandise distinction. An industry which requires extremely differentiation merchandise the information and cognition is needed all the clip therefore the HR attack in preparation is intensive and specialized so that the worker can use it to work and heighten public presentation. By contrast, a call Centre offers about the same service to different clients ; therefore the preparation attack is more basic and contains regulations, ordinances to accomplish consistence and homogeneousness. The 3rd factor is profitableness. Profitableness differs in specific types of places ; a research section director in fabrication works normally generates more net incomes than a telephone operator in call Centre. In that instance the director will derive occupation satisfaction through wagess and engagement in concern determination devising, whereas the telephone operator may experience less satisfied in work and has turnover purpose. The ground is merely because houses need to maintain profitable employees stable and disregard or pay less attending on the common employees without comp etitory advantage. The 3 factors reflects how the work system and HR purposes combined together to impact HR attacks. These attacks, nevertheless, run into a major challenge of steps. Previous literatures like Arthur ( 1992, 1994 ) , Huselid ( 1995 ) , James, Chester and Robert ( 2002 ) did empirical work on steps to measure effectivity of HR attacks. James, Chester and Robert ( 2002 ) province the relationship between a differentiation-oriented competitory scheme and its public presentation is positive. Whether all these attacks and measurings can be trusted in the bounds of good sense or practicality is a large issue we should concentrate on the hereafter.