Organizational change part i Essay Example | Topics and Well Written Essays - 1250 words

Organizational change part i - Essay Example All stakeholders have to be involved in the change process for it to be effective. There are various types of change depending on which part of the organization needs to be changed. The most critical part of organizational change lies with the leaders. An organization’s leaders have to manage the change through planning, assessment and evaluation and have to ensure that every stakeholder in the organization buys in to the ides of change and is involved in it (Cole, Harris & Bernerth, 2006). Despite change being recognized as an inevitable and necessary evil in almost all spheres of life, organizational change poses a lot of challenges to leaders. Effective management of organizational change takes four main steps namely; recognizing the need to have effect the change, planning for the change, training staff with regard to the impending change, and getting support from the employees and other stakeholders during the change process (Cole, Harris & Bernerth, 2006). The first step involves conducting a systematic diagnosis of the organization as it is currently so as to identify the need for initiating change and determine the organization’s ability to manage the change. Planning process involves determining the objectives of the change as well as outlining the procedures to be taken when effecting the change. At the end of the change process, it is necessary to conduct an assessment of the whole process to determine if the objectives were met. Organizational change can be said to be successful if it meets its objectives and the benefits of the change are realized by the management and employees of the organization (Cole, Harris & Bernerth, 2006). Successful change also improves communication among employees and other stakeholders. Health care organizations have also encountered numerous challenges that have often forced them to change in one way or another so as to effectively treat patients (Rashid, 2007). Changes in lifestyles have led to emergence of new diseases while technology has made treatment of some diseases much easier. Healthcare organizations need to adopt technology and also support research so as to discover better ways of fighting diseases. This requires a change of strategy, mission, and mode of operation or human resource. In some cases change may be needed in all aspects of the organization (Rashid, 2007). Readiness for change is one of the issues that change management experts have focused on in the recent few years by recommending strategies that organizations need to take in order to be fully prepared for change. Readiness for change is a very crucial concept in healthcare given the ever changing nature of treatment. Healthcare organizations have to be strategically positioned so as to meet the demands brought about by change (Rashid, 2007). An organization’s readiness for change depends on various factors such as organizational culture, flexibility of the organization’s policies, and the abi lity of leaders to manage changes in the working environment. Managing change in a healthcare facility is not different from other organizations. The leaders have to be very assertive and proactive in steering health organizations in the right direction. This requires constant assessment of the current level of operations in the organization and determining what needs to be done so as to help improve treatment of patients. Departmental heads

Medical school application essay statements Example | Topics and Well Written Essays - 250 words - 1

Medical school application statements - Essay Example My job was to advocate for the organization at government hearings to increase education-related funding for neighborhoods. I also volunteered as an advisor for one of its subgroups, Entre Nuestras Familias, which is geared towards educating high school students in sexual-education and unplanned pregnancy prevention. Finally, my thesis compelled extensive reading research under the supervision of Dr.Ptak of Harvard medical school. It was founded on existing research where I proposed an alternative medication to patients who underwent Mitral valve replacement by inhibiting harmful side effects. By labeling ferromagnetic nano-particles with medication such as anti-coagulants and injecting them in to the blood stream, the drugs can be isolated within the heart by magnetic targeting and drug levels can be maintained at low levels throughout the body.  My volunteer experiences provided me the opportunity to make a difference in a few small communities and hopefully the right direction t o my future as a physician.  And my thesis equipped me with the technical and mental diligence imperative of a medical student. I chose to discuss these elements of my CV because I believe they best demonstrate my zeal for medicine, devotion to help people and dedication to improve

Cultural Imperialism Is A Very Old Phenomenon Media Essay

Cultural Imperialism Is A Very Old Phenomenon Media Essay During the past five hundred years, European countries colonized southern countries in the name of spreading Christian civilization to the primitive people in other parts of the world, as well as securing resources and workers for economic production. As cultural imperialism occurs, it is said to be for the own good of the other, conquered civilization, to spread universal values, rights and standards of development. The United States are currently not the only cultural imperialists, but the spread of American values in the entire world is at the leading edge of a wave of spread of Western goods and consumerist culture. Today, the phenomenon might take a different form, as it is a lot more subtle and less brutal than the European colonization: it is being done in the name of freedom of the market and freedom of expression. There are two sides and two major views on the ongoing process. Some consider the propagation of the American culture as unavoidable and beneficial to the world, for some American cultural imperialism is a threat to other cultures. I will try to review both of them to make a better and more reasonable assumption. People who do not see the hegemony of American culture as a threat, state that through the media, the United States is spreading some universal values and human rights. To some authoritarian countries, it spreads ideas of freedom of expression, democracy, equality, and rights concepts that should be, in some peoples opinion, universal. Universality of some values may be possible human nature is not that different from one culture to another, and many values are shared across cultures. However, the majority of the worlds cultures undervalue women and children in practice if not in ethos. Finally, the majority of the worlds people, regardless of the names given to governmental regimes by those with authority, continue to live without real participatory democracy. American ideals of equality, freedom, and democracy now available in the world may give more freedom to women, children, and to minorities in all cultures, and will promote anti-racist, anti-sexist or anti-authoritarian mess ages and regimes.   Irving Kristol, in The emerging American Imperialism, presents imperialism as an unintended consequence of market expansion rather than a conscious goal: one of these days, the American people are going to awaken to the fact that we have become an imperial nation. But he later argues that it is not something unintentional, but that in fact many nations have facilitated and welcomed American cultural values along with American products and ways of life: it happened because the world wanted it to happen. To him, the American missionaries live in Hollywood, which is different from the Old European imperialism, which was based on bureaucratic colonial governments and resource extraction.   Christopher Dunkley, in American Cultural Imperialism: No Bad Thing says that America provides some of the best available anywhere in the world. One of the reasons that American series are so successful in the world is that thanks to its immigration policies, the US has a population with a mixture of Anglo Saxons, Scandinavians, Asians and so on that provides American broadcasters with a domestic audience which is, to all intents and purposes, international. Please the American audience and you can guarantee you will please the world. Some theories of globalization see, instead of cultural imperialism, the movement of products and ideas from across national and cultural borders in ways that produce real changes in cultures like that of the United States. In 1994, MacQuail wrote in his book Mass Communication Theory that not only was United States influencing other cultures, but other cultures were also influencing the US: While one-way flow may be evident in terms of information flows on an information theory quantitative estimate, the reality is that as media technology and economies become more intertwined, this seemingly one-way flow reverses itself into a two-way flow in which what sells abroad influences what Americans see at home. In that perspective, we can talk about an interpenetration of cultures instead of the invasion of American culture in the world. Language is another consideration when speaking about cultural imperialism. English is indeed the language of business, higher education, diplomacy, the Internet, science, popular music, entertainment and international travel. The importance of learning English is not just a political or economic issue4. Logically and arguably, the world needs to have one kind of universal language at a basic level. Economically, having a central language could prove as a great advantage when companies can use the same computer programs in one language. As of 2006, an estimated 1 billion people speak English  5. There has been a greater desire to learn English since the Internet has made such a big impact on the world. The reality is that language and cultural barriers and misunderstandings can get in the way of effective communication and create complications in the work world. With the aid of having a universal language, work can be done more efficiently, safer, and with fewer complications than when there is the factor of a language barrier. For international companies, which have branches all over the world in hundreds of different countries with different languages, this universal language could mean a whole new level of production and growth, and in essence, raise the standard of living for many. Richard Pells states that the effectiveness of the English language as a mass communicator has been essential to the acceptance of the American culture. Unlike other languages, the simpler structure, grammar, and use of more concise sentences in the English language, are all advantageous for the composers of ad slogans, cartoon captions, newspaper headlines, and movie and TV dialogue. English, Pells says, is thus a language exceptionally well suited to the demands and spread of American mass culture10.   The American cultural imperialism as a threat to other cultures We should not forget that the differences in cultures make the world a rich and diverse place. Every individual of each country should have the right to express his or her own culture. A cultural uniformity would lead to the extinction of cultures and it would definitely represent a great loss.   However, the American culture is intruding on most cultures in the world, in many cases threatening their existence. Superman, Spider-man, and Batman replace local heroes; Pepsi and Coke replace local fruit drinks; and trick or treat begin to replace Dia de los Muertos. Perhaps more insidious, to compete with American cultural imports, local varieties and products begin to mimic American products. All the exportation of goods and information from the United States to the entire planet contributes to the exportation of the American culture.   We know that the United States is the leader in exporting its information. One problem is that the United States sells its information and media products so cheaply that it is impossible for the whole world to compete. The American producers budget to cover their costs within the US market and can consequently sell at unbeatable prices internationally. A consequence is that it is much cheaper to buy, for example, a blockbuster Hollywood movie made in the United States than to make a less expensive local production in another country. As a famous movie director George Lucas says, the United States is a provincial country with a culture that has invaded the world via Hollywood. As long as there has been a talking Hollywood, Hollywood has had a huge impact on the rest of the world. Lucas points out that people in other countries are troubled by what they see as US culture squashing local art and cinema. The motivations behind American cultural imperialism parallel the justifications for U.S. imperialism throughout history: the desire for access to foreign markets and the belief in the superiority of American culture. Though the United States does boast the worlds largest, most powerful economy, no business is completely satisfied with controlling only the American market; American corporations want to control the other 95 percent of the worlds consumers as well. Many industries are incredibly successful in that venture. According to the Guardian, American films accounted for approximately 80 percent of global box office revenue in January 2003. And who can forget good old Micky Ds? With over 30,000 restaurants in over one hundred countries, the ubiquitous golden arches of McDonalds are now, according to Eric Schlossers Fast Food Nation, more widely recognized than the Christian cross. Such American domination inevitably hurts local markets, as the majority of foreign industries are unable to compete with the economic strength of U.S. industry. Because it serves American economic interests, corporations conveniently ignore the detrimental impact of American control of foreign markets. It is easy enough to convince Americans of the superiority of their culture, but how does one convince the rest of the world of the superiority of American culture? The answer is simple: marketing. Whether attempting to sell an item, a brand, or an entire culture, marketers have always been able to successfully associate American products with modernity in the minds of consumers worldwide. While corporations seem to simply sell Nike shoes or Gap jeans (both, ironically, manufactured outside of the United States), they are also selling the image of America as the land of cool. This indissoluble association causes consumers all over the globe to clamor ceaselessly for the same American products. In recent years, American corporations have developed an even more successful global strategy: instead of advertising American conformity with blonde-haired, blue-eyed, stereotypical Americans, they pitch diversity. These campaigns-such as McDonalds new international Im lovin it campaign-work by drawing on the United States history as an ethnically integrated nation composed of essentially every culture in the world. An early example of this global marketing tactic was found in a Coca Cola commercial from 1971 featuring children from many different countries innocently singing, Id like to teach the world to sing in perfect harmony/Id like to buy the world a Coke to keep it company. This commercial illustrates an attempt to portray a U.S. goods as a product capable of transcending political, ethnic, religious, social, and economic differences to unite the world (according to the Coca-Cola Company, we can achieve world peace through consumerism). Today, the spread of American culture goes through every communication medium: 90% of the information available on the Internet is in English, CNN is seen in 120 countries, Stephen King is the number one best seller in the world. Obviously, there is already a process of cultural uniformity going on, and this can be seen as a great loss.   More recently, Viacoms MTV has successfully adapted this strategy by integrating many different Americanized cultures into one unbelievably influential American network (with over 280 million subscribers worldwide). According to a 1996 New World Teen Study conducted by DMBBs BrainWaves division, of the 26,700 middle-class teens in forty-five countries surveyed, 85 percent watch MTV every day. These teens absorb what MTV intends to show as a diverse mix of cultural influences but is really nothing more than manufactured stars singing in English to appeal to American popular taste. If the strength of these diverse American images is not powerful enough to move products, American corporations also appropriate local cultures into their advertising abroad. Unlike Levitts weak multinationals, these corporations dont bend to local tastes; they merely insert indigenous celebrities or trends to present the facade of a customized advertisement. MTV has spawned over twenty networks specific to certain geographical areas such as Brazil and Japan. These specialized networks further spread the association between American and modernity under the pretense of catering to local taste. Similarly, commercials in India in 2000 featured Bollywood stars Hrithik Roshan promoting Coke and Shahrukh Khan promoting Pepsi (Sanjeev Srivastava, Cola Row in India. BBC News Online). By using popular local icons in their advertisements, U.S. corporations successfully associate what is fashionable in local cultures with what is fashionable in America. America essentially samples the worlds cu ltures, repackages them with the American trademark of materialism, and resells them to the world. Compounding the influence of commercial images are the media and information industries, which present both explicit and implicit messages about the very real military and economic hegemony of the United States. Ironically, the industry that claims to be the source for fair and balanced information plays a large role in the propagation of American influence around the world. The concentration of media ownership during the 1990s enabled both American and British media organizations to gain control of the majority of the worlds news services. Satellites allow over 150 million households in approximately 212 countries and territories worldwide to subscribe to CNN, a member of Time Warner, the worlds largest media conglomerate. In the words of British sociologist Jeremy Tunstall, When a government allows news importation, it is in effect importing a piece of another countrys politics-which is true of no other import. In addition to politics and commercials, networks like CNN also present foreign countries with unabashed accounts of the military and economic superiority of the United States. The internationalization of television news, while unquestionably a crucial aspect of the processes generally lumped together as globalization, seems paradoxically to be the least well examined, yet most alluded to, aspect of the globalization phenomena. (Paterson, C. Global television news services, Media in Global Context: A Reader, Oxford University Press:1997, p.145). As Paterson points out in his article, few people actually seem to know that most television broadcasters buy international news from transnational news agencies like Rauters, Worldwide Television News and Associated Press Television. Or as Paterson puts it: since television is the major force in shaping how Europe and America see the world, and is becoming so in the rest of the industrialised world and much of the developing world, then the images selected by these few television journalists of similar training and background, are absolutely crucial determinants of how people world-wide perceiver other nations and global issues.  Some of these major news corporations are more closely allied with Rupert Murdoch, and Rupert Murdoch is widely believed to have used his print and broadcast news holding in Britain to bolster Thatcher and Thatcherism (Bagdikian:1989, found in Paterson, C. Global television news services, Media in Global Context: A Reader, Oxford University Press:1997 p.154). Commercialisation gives further reason for concern about international news. The tabloidization regarding printed media, and overflow of clichà ©s in television, as Paterson points out, is principally a process of dumbening down news, and putting emphases on news concerning sports and stars etc. which may perhaps have further impact on peoples political perception (or maybe lack of it). This trend rises questions about consumerism in the west, and what impact this may have on a global scale. But why is it happening and with such success?  cultural imperialism is understood in the terms of the imposition of one national culture upon another and the media are seen as central to this process as carriers of cultural meanings which penetrate and dominate the culture of the subordinate nation. (Barker, C. Global television, Blackwell Publishers: 1997 p.183)  . In conclusion media have speeded up the connection between cultures and thereby started to erase the boundaries of space, and even more profound boundaries of nations and government ensuring free flow of information and influence. The fact that America arguably is in the centre of this development rises concerns about which influences and the voice of whom we are hearing. The homogenisation thesis involved, as posed by many theorists, is both seen as an advantage and a reason for concern. This concern perhaps mainly because of the threat of American cultural imperialism and a consequent loss of diversity, and the possible immense power of position for whom leads this trend because of what seems to be an ability to override governments. The capitalistic nature of media prevents any revolt against the almost monopolistic position the western world has on globalisation via media, and there seem to be no authority that can intervene in this process preventing a monopoly. So however roman tic the idea of cultures being brought closer together is, there are also power struggles and the possibility to exploit this development, which American officials openly admit to be attempting.   The rise of English as an international language of trade and politics has been one of the strongest vehicles for the transmission of American culture. The place of English in the world has crystallized in the past decades you can read signs in English in every capital, and fluency in English has become a taken-for-granted prerequisite for upper-level positions in international trade and politics. While the forces leading to the rise of an international language differ greatly from cultural imperialism, it would be difficult to separate the two. As English becomes a global language, it becomes clear that language and culture cannot be separated. The AP National Writer journalist Anthony Ted says every one from the French to the Indonesians worry that where English goes, America will follow. Scholars Nye and Owen admitted that it is the goal of the United States to have English as the international language: It is in the economic and political interests of the United States to ensure that, if the world is moving to a common language, it be English; that if the world is becoming linked by television, radio and music, the programming be American; and that, if common values are being developed, they be values with which Americans are comfortable. According to them, not only it is intentional, but also it is a developing reality. If this spread of values, language, and information is purely because of economic and political interest for the United States, the well-being of other cultures and their freedom of expression are not taken into consideration except instrumentally can they be bought and sold for a profit, or can they be used to political advantage to the profit and advantage of the US.   Not all social critics see the Americanization of the world as a negative phenomenon. Proponents of cultural imperialism, such as David Rothkopf, a former senior official in Clintons Department of Commerce, argue that American cultural imperialism is in the interest not only of the United States but also of the world at large. Rothkopf cites Samuel Huntingtons theory from The Clash of Civilizations and the Beginning of the World Order that, the greater the cultural disparities in the world, the more likely it is that conflict will occur. Rothkopf argues that the removal of cultural barriers through U.S. cultural imperialism will promote a more stable world, one in which American culture reigns supreme as the most just, the most tolerant, the most willing to constantly reassess and improve itself, and the best model for the future. Rothkopf is correct in one sense: Americans are on the way to establishing a global society with minimal cultural barriers. However, one must question whet her this projected society is truly beneficial for all involved. Is it worth sacrificing countless indigenous cultures for the unlikely promise of a world without conflict? Around the world, the answer is an overwhelming No! Disregarding the fact that a world of homogenized culture would not necessarily guarantee a world without conflict, the complex fabric of diverse cultures around the world is a fundamental and indispensable basis of humanity. Throughout the course of human existence, millions have died to preserve their indigenous culture. It is a fundamental right of humanity to be allowed to preserve the mental, physical, intellectual, and creative aspects of ones society. A single global culture would be nothing more than a shallow, artificial culture of materialism reliant on technology. The attempt by UNESCO to regulate a more equal flow of communication between the North and the South, to protect cultural diversity and to protect countries from cultural imperialism unfortunately resulted in the withdrawal of the United States because it did not correspond to its financial interests. Since 1984, which is the date of the American withdrawal, UNESCO keeps trying to influence and give recommendations to governments, but it has no power over the main country that owns most of the communication flow in the world: the United States of America.  

Taking the Test :: Essays Papers

Taking the Test Many essays have been written that one could describe as touching, or something one could easily relate to. A very good example is â€Å"Taking the Test† by David Groff. He writes about taking an AIDS test, and records all his feelings and emotions as he waits for, and receives, what could be something that may lead to a death sentence. This essay is enjoyed by many people, because it is touching, it is easy to relate to the pressure, and stress that is connected with taking a test, and it is a new, recent subject that could, or does, affect people now. This essay is very touching. The reader feels very sympathetic towards the man taking the test. Even more so because the author announces that he is gay. The way he describes his emotions and feelings, fear, confusion, and loneliness, is very moving. He notices very small things because he almost believes he is infected, and it makes everything that much more precious. The way he makes everything sound very beautiful, as he describes it, is understandable, despite the fact that he is awaiting his sentence, â€Å"life or death,† because even though HIV does not mean death, it means an inevitable pain, and suffering, if not physically, then mentally, and if not for you, then for the loved ones. Had he told the reader the outcome of the test, the reaction to the story would have been different. If he was positive, the reader would become overly sympathetic, overlooking the reason for the story which was not sympathy, but to teach a lesson, â€Å"As long and as well as you can, live, live.† (Groff 75) Had the author been negative, the reader would have pushed the essay away, again overlooking the lesson, and thinking that the author worried for nothing. Groff pushes all the right buttons, keeping his audience begging for the outcome of the test. A reason that this essay is touching to many readers is because it is easy to relate to. Many people understand the pressure and stress that is connected with taking a test, even if it is a pop quiz in math. Unfortunately, many people know how it feels to take, and fail, an AIDS test. Many people know someone close to them who has taken the test and â€Å"failed.

Environmental assessment Essay

This paper has been written to analyze in-depth, the pollution, covering air, water, chemicals, and other such related issues in the United States. Further, I would also be developing an environmental health teaching plan to address one of these issues. Environmental issues are becoming very prevalent in today’s world. The question is why the environment and its concerns are becoming more prevalent, important and famous now. For this, we will need to look at the history. For decades we have neglected this seemingly dangerous issue due to which it has been going unnoticed. The reason we never before paid heed to this concern or issue is because this issue’s repercussions were not evident in the previous years. As no such notice regarding this issue was taken into consideration, it could not even be rectified. (Abel & McConnell, 2007). However, with the advent of global warming and other factors such as acid rain, prevalence of carbon dioxide and the ever increasing penetration of green house gases has put many lives at stake making many people fear that this world will not continue to exist or survive for more than 10 years from now on that means that by 2018 this world will have used most of the resources and this is basically due to the wastages of resources available to us. The basic thing that we have to consider here is to think hard about the issue as to how we can prevent our precious resources from depletion, disappearance and from vanishing. To answer this question we can simply say that we should use our resources optimally. (Kemp, 2007). It is believed that the next war that would be held would be for the sole purpose of resources. The 9/11 attacks on the World Trade Centre highlights the hidden objective of the resources. Although this act would be illegal and an immoral thing or practice, therefore many countries other than the one going for the war would object to this act for spoiling the world peace. U. S is a super power of the world and it is always trying to get hold of the resources. They are doing this by capturing resources, snatching them and raiding the countries that have abundant of these resources such as O. P. E. C countries and countries with no or minimal problems of the water shortage or the countries thave abundant of resources like the crude oil, natural coal and the natural gas. (Harris 2004). The reason why some countries have been the target of the United States is because although these countries might have some kinds of resources, however they do not have any resources that can be used to combat the threat or the attack coming from the super power such as the US and countries that are the allies of the U. S. such as European Union that also includes Turkey. Furthermore, these countries have a very weak defence and military, but the most important two factors that are responsible for their vulnerability are mentioned below. †¢ Lack of Decisive and Prowess Leadership. †¢ Ignorance to the current affairs and the intelligence. This is one of the major problems that might create huge problems for the countries US has their eyes on. With all the afore mentioned details to the problem, now let us go deeper in to the affects of the ignorance this problem environment exploitation that is also supported by the fact that he next war expected to take place is on the resources. The mere resources which were once used with out any fear of them being depleted once are now being depleted all because of the lack of the knowledge and the lack of the far sightedness of the problem. Now this problem has become very prominent and inevitable. The depletion of resources is not a small problem but it is vice versa. It is a very big problem that can greatly affect our future generations and if this problem goes unsolved today then our generations will have no future or to put it more realistically our future generation is going to be at the mercy of an unsafe future with lots of pollutants in the air. Therefore, if this problem goes unrectified then its repercussions can be innumerable, our future generation is at stake and now is definitely the time to act upon. (Horner, 2007). The United States of America, in past many years have taken initiative to contribute towards environment uplift and betterment of the environment. Environmental hazards do not have any boundary. The boundaries separating the countries subordinate to environmental impacts. Global warming, green house gases, carbon dioxide, carbon monoxide penetration know no boundary and their impact is much due to which there is a dire need now is to prevent exposure to these hazards. However, the US cannot alone can not take any initiative to combat this seemingly deadly hazard and so it requires input and the cumulative effort to prevent this penetration in to our lives and body but as the US is one of the major super powers of the world, it must take the initiative. Furthermore, US is well equipped with resources and can lead the world to save the environment. (Houghton, 2004). US has repeatedly been warned of the repercussions of the gases from chimneys that their factories and companies are producing and how their industrial wastage is discarded. Furthermore, US have broken many protocols and pacts on this regard and continue to exploit environment. US can also be given the name of one of the world‘s biggest pollutants. The environments can also affect international marketing decisions and the planning system of the countries. This is because two different states have two different governments and thus having different polices and laws. Therefore, the marketing decisions that are taken in a country are different from each other according to the social, economic and political environment that exists in the country. (Kitchen & Schultz, 2000). Reference Abel,D. C. & McConnell,R. L. (2007). Environmental Issues: An Introduction to Sustainability. 3rd Edn. Prentice Hall, Paperback. Horner,C. C. (2007). The Politically Incorrect Guide to Global Warming and Environmentalism. Regnery Publishing, Inc. , Paperback. Kemp,D. D. (2007). Exploring Environmental Issues (Kindle Edition). 1st Edn. Taylor & Francis. Kitchen,P. &Schultz,D. (2000). Communicating Globally: An Integrated Marketing Approach. London, Macmillan Business. Scorecard. (n. d. ). More Facts on Pollution. January 3rd, 2009. Retrieved from: http://www. scorecard. org/

Operative Report on Russell Jones

OPERATIVE REPORT Jones, Russell 8004320 Kurt Brockton, MD May 17, 2013 SURGEON: Kurt Brockton, MD PREOPERATIVE DIAGNOSIS 1. Primary hyperparathyroidism. 2. History of lung cancer. POSTOPERATIVE DIAGNOSIS 1. Primary hyperparathyroidism. 2. History of lung cancer. PROCEDURE Subtotal parathyroid resection. ANESTHESIA General. PROCEDURE IN DETAIL With the patient in the supine position after adequate prepping and draping of the neck, a standard collar incision was made. Hemostasis was obtained with a cautery. The platysma muscle was elevated from the underlying strap muscles to the thyroid notch superiorly and the sternal notch inferiorly.Strap muscles were dissected free of the midline. The right thyroid lobe was exposed. The middle thyroid vein was divided between three 0 silk ties. The gland was reflected anteromedially. Upon reflection of the gland there appeared to be an enlarged parathyroid gland attached to the lateral aspect of the lower pole. The gland was reflected more anterio rly, and the right upper gland was found posterior to the middle portion of the gland. The left thyroid gland was exposed, and the middle thyroid vein was divided between three 0 silk ties. The gland was reflected anteromedially.A right lower gland was found attached to or adjacent to the lateral aspect of the lower pole corresponding to the position of the lower gland on the right side. The gland was reflected more anteromedially, and the right upper gland was found on the posterior side of the midportion of the thyroid gland but not as medial as the one on the right side. Biopsies were taken of the left upper, left lower, and right upper glands. The right lower gland was removed in toto. The path report revealed the right lower gland to be an adenoma, and the remainder of the glands appeared normal.Only a small amount of parathyroid tissue was seen in the left upper gland, but the cut surface appeared to be parathyroid and bled as it would do. Hemostasis was obtained with a cauter y where necessary. Some Surgicel was placed over the cut end of the left upper gland. Strap muscles were then closed with 3-0 Vicryl, the OPERATIVE REPORT Patient Name: Jones, Russell Hospital No. : 8004320 May 17, 2013 Page 2 subcutaneous and platysma with 3-0 Vicryl, and the skin with skin staples. A dressing was applied. The patient tolerated the procedure well and was sent to the recovery room in stable condition. Kurt Brockton, MD

Lady Macbeth In The Tragedy Of Macbeth; The Iron Butterfly Essays

Lady Macbeth In The Tragedy Of Macbeth; The Iron Butterfly Essays Lady Macbeth in The Tragedy of Macbeth; the "Iron Butterfly" In William Shakespeare's, The Tragedy of Macbeth, Lady Macbeth is the dominator of the play. Lady Macbeth's character is not as eclectic as her husband's but it is just as dramatic. Lady Macbeth has a rich and fascinating combination of qualities. She is not a monster without feeling; her husband adores her, for example, "Be innocent of the knowledge, dearest chuck," (III, ii, 45). Macbeth also refers to Lady Macbeth as his dear partner. Lady Macbeth is horrified by blood and during her sleepwalking soliloquy she refers to her little hand suggesting a delicate nature and stature by uttering this: "All the perfumes / of Arabia will not sweeten this little hand." (V, i, 43-44). All of this, however, does very little to soften her true nature. She is sly and artful as she urges Macbeth to kill Duncan and she is particularly treacherous when she continually urges him to shake off his torments. For example, in this scene from the play, Shakespeare gives the reader an idea of the twist that he gives her personality and how ruthless she can be: I have given suck, and know How tender 'tis to love the babe that milks me: I would, while it was smiling in my face, Have plucked my nipple from his boneless gums, And dashed the brains out, had I so sworn as you Have done to this. (I, vii, 54-59). In the next examples you can see how she persuades Macbeth to ignore his torments of his guilt of the murder: "These deeds must not be thought / After these ways; so, it will make us mad. " (II, ii, 33-34), and "Why, worthy thane, / You do unbend your noble strength, to think / So brainsickly of things?" (II, ii, 43-45). Seemingly, she suffers no pangs of conscience. It is easy for her to be "bright" and "merry" and it seems second nature for her to play at being the most gracious of hostesses. Duncan is completely deceived by her "thoughtfulness." Also, take in consideration that in the midst of her chaotic dinner party, she retains her composure and saves her husband from added embarrassment. In today's vernacular, she might accurately be characterized as being an "iron butterfly"-delicate but invincible. She is impatient and absolute when her husband cannot carry out the details of their assassination plot. Although it is Macbeth who commits the actual deed of murder, it is Lady Macbeth who returns to Duncan's chamber and smears the blood upon the grooms. Her self-control is superhuman; in fact, Macbeth is terrified of it and her unfailing resourcefulness. In this example, Shakespeare demonstrates how much self control she has over the evil deed: "A little water clears us of this deed: / How easy it is then!" (II, ii, 66-67). In fact, Lady Macbeth tried to murder Duncan herself, but he appeared to look like her father while he was sleeping so she could not. Selfishly, she fastens her husband's attention on the throne of Scotland. It is she who sees to the details of the crime: "Only look up clear. / To alter favor ever is to fear. / Leave all the rest to me." (I, vi, 69-71). It is she who is more concerned that Macbeth has failed to kill Duncan, when he reconsiders the murder, than the possibility that their plans have been exposed. It is she, rather than Macbeth, who says, Go get some water, And wash this filthy witness from your hand. Why did you bring these daggers from the place? They must lie there: go carry them, and smear The sleepy grooms with blood. (II, ii, 45-49). She immediately perceives that the blood and the daggers are incriminating and admonishes Macbeth for being so foolish. Throughout the play, her courage and her practicality work together successfully. It is only in private that Lady Macbeth shows her weariness. Almost naively, she urges Macbeth to sleep and, here, her faith in sleep is deeply ironical. It is only after she has suffered a mental breakdown, that you realize how deeply her crimes have haunted her. This is an quotation from the play from the