Chlorhexidine-Alcohol versus Povidone-Iodine

Chlorhexidine-Alcohol versus Povidone-Iodine Although it is intentioned that surgical procedures remain sterile around 5% result in infection; infected surgical sites are the leading cause of iatrogenic infection among surgical patients (Kalb, Lefevre, Dididze, Levi, 2013). Current practice aiming to reduce infection is comprised of cleansing the skin with a prepping agent and covering the patient with sterilized drapes and towels. Surgical site infection results in harm to the patient, delay in patients returning to previous function, strain on staff, and negatively affects a hospitals ability to be financially compensated. As infections can be caused by microbiota on the skin, cleansing the site prior to incision is an imperative step in infection prevention. There are various cleansing agents used in existing practice; however, many hospitals, including the authors, do not have a standard practice in choosing a prepping agent. The myriad of sterile preparation solutions at this institution are betadine (10% povidone iodine) , hibiclens (chlorhexidine gluconate), and chlorhexidine alcohol. Current pre-operative skin preparation with one of these solutions is largely dictated by what is available, in close proximity, or surgeon preference. The 1999 Center for Disease Control (CDC) recommendations for surgical site infection prevention contains the use of antiseptic solution (Jarral, McCormack, Ibrahim, Shipolini, 2011); moreover, no solution has been identified as preferred. Despite the hospitals compliance with the CDC, standardizing practice may result in better patient outcomes and reduced cost. Review of literature suggests some solutions may have benefits over others regarding infection prevention. Bazzi et al. (2016) found patients that receive alcohol based chlorhexidine solution were 30% less likely to suffer from a surgical site infection (SSI) when compared to povidone iodine. Post application chlorhexidine has also been shown to have a sustained release action in its antiseptic properties, and, in 2002, the CDC urged hospitals to consider it first line. It is worth noting that solutions should not be used in conjunction as chlorhexidine can be inactivated by iodine and that iodine does not have the sustained antiseptic properties and is harmful to open wounds. Solutions may be contraindicated in the event of an allergy or high risk of harm such as burning, neuro-, or ototoxicity; neonates are at high risk of adverse event when using chlorhexidine. The AORN (2016) suggests all female surgical candidates provide a urine hgc pregnancy test to mitigate possibilities of h arm to a fetus. Hospitals that utilize solutions that come in a multiple use option are often at higher risk for error; this risk for error can be attributed to the human component as there may be a lack of training and differences in technique. This risk is further complicated by solutions often needing to be mixed, mixing a solution under poor or varied technique can lead to improper concentration and, thus, more infection. This risk associated with human error can be mitigated by implementing the use of one time use measured applicators. The single use system has an additional benefit of delivering solution deeper in the epidermis with application and removes direct patient touch reducing possible cross contamination. The multi-use option does provide an economic incentive on the front end; however, a possible increase in preventable SSIs would end up costing more money. As such, transitioning to a single-use applicator system both decreases risk of infection by removing potential human error and is a financially savvy option. STAKEHOLDER When undergoing a potential practice change involving both policy and product change a team of stakeholders need be gathered to address effectiveness, patient outcomes, and financial burden. Stakeholders will work as a team to acquire necessary information, pilot, and implement change. The stakeholder task force for the proposed change will include representation from the surgery teams, hospital board, and infection control. Infection control and surgery teams will work together to pilot a practice change regarding single use chlorhexidine; infection control is necessary because they are responsible for helping reduce risk of infection including SSIs, the surgery team (nurses, surgeons, techs, etc.) are needed as they implement and practice change. This pilot phase will aim to reduce SSIs and homogenize application technique. After the pilot phase is completed, and if it has shown to decrease SSI in piloted areas findings will be presented to hospital administration to analyze and ma ke a final decision on practice and product change and possibly implementing system wide. EVIDENCE BASED SUMMARY This topic was chosen as standardized practice often leads to better patient outcomes. The author works on an inpatient transplant surgical unit. Transplant recipients are pharmacologically immunosuppressed placing them at higher risk for infection. Having a great practice model and ideal equipment is paramount in reduction of this risk. Title #1: Chlorhexidine-Alcohol versus Povidone-Iodine for Surgical Site Antisepsis. This article provided by the New England Journal of Medicine gave a study of surgeries and related surgical site complications with Chlorhexidine-Alcohol versus Povidone-Iodine. The article provided both pros and cons to each used and the findings consistent with using the chlorhexidine-alcohol prep for surgical cases. Title #2: Comments on review of preoperative skin prep study. This article is from the AORN and is information from surgeons and surgical nurses opinions and finding or results on preferred surgical site prep solutions. Title #3: Pre-Application Evaporation of Surgical Preparation Solutions: Does It Matter?This study was to confirm that surgical prep solutions that contain alcohol were better at eliminating microorganisms. The CDC does not have any antisepsis guidelines regarding how long surgical prep solutions can be left out in open air prior to surgery. Samples in the study were ta ken at an initial set up time, 30 minutes, 60 minutes, and 120 minutes of the time the solution was set out in open air. The Alcohol Iodine solution showed a large decrease in the amount of alcohol content of the solution in only 30 minutes. The Alcohol Chlorhexidine solution had only a marginal drop over the 120 minute interval. The end conclusion of this study was that it had a recommendation for surgical prep solution to be used immediately after pouring and that alcohol chlorhexidine did not have a significant loss of alcohol concentration if it was set out prior to the surgical case. Title #4 Should Surgeons Scrub with Chlorhexidine or Iodine Prior to Surgery?This study is a meta-analysis study that questioned whether chlorhexidine was equal to or a better surgical hand scrub than povidone iodine. The study researched 593 papers. The study was found to reveal that even though both solutions reduce that bacterial count post scrubbing, the chlorhexidine was in fact better to use and longer lasting. In order to determine this, the studies determined how many colonies of bacteria were reduced after the use of each different hand scrub. The studies also measured bacterial colony counts for a number of days post-surgery. The clinical bottom line was that chlorhexidine and povidone iodine both had a reduction in bacterial counts immediately after scrubbing but the chlorhexidine had a greater reduction. Povidone iodine showed a lack of residual activity when compared to the chlorhexidine. Title #5: The use of Anti-Septic Solutions in the Prevention of Neurosurgical Site Infections. This is a cohort study that sampled recent meta-analysis to evaluate the different methods of surgical pre solutions used at different institutions across the US. The solutions being evaluated were betadine, Dura prep, chloraprep, and the possible combination of the three. The study used 128 surgical departments and the departments were to provide surgical site infection percentages. I t was the conclusion of this study that even though research literature supported the use of chloraprep over betadine and Dura prep, the majority of the surgical institutions continued to use the betadine solution. RECOMMENDATION The goal for any type of surgical cleanse solution will be to reduce any instance of surgical infections in a safe, cost effective, and complete manner. The hospital will choose the right product that is cutting costs, being most effective, saving surgical time, and has the safest results for the patient. The cost by the initial purchase of the prefilled solution applicators might be slightly more than multi use bottles, but the money will be saved by providing a prep that is less messy, applied quicker, more efficient, and improves drape adhesion. These are all benefits that will prevent the sterility of the patients surface from being compromised (Parson, 2003). As the hospital develops a standardized protocol for a surgical cleanse solution, the cost saving measures can be visualized through buying the one cleanse in bulk and the patient safety numbers for a reduction in infection rate. Based on the reviewed literature, it is recommended that the hospital change to a standardized chlorhexidine solution and use a povidone iodine solution in those cases where a patient could be allergic to chlorhexidine or if chlorhexidine is contraindicated in a particular surgery. The surgery department will also set new standards on preparation of the chlorhexidine and iodine solutions based on the research completed. Both of the prep solutions will not be prepared by the OR tech until the patient is on the operating table. The solution used will be used from unopened containers and any excess in the bottles will be discarded as waste to ensure adequate alcohol concentrations of the solution. PRACTICE CHANGE MODEL The facility with use the Eight Step change model proposed by Kotter; the desired outcome is successful implementation of the practice change with few delays. The initial step creates urgency and necessity for change; infection control and surgical departments will collect data on current infection rates. Subsequently, stakeholders will find staff that agrees with the change and has a desire to carry the change forward. Unit councils and word of mouth from employees to their peers will show change is need and there is general support for the practice change. During the third step a formalized vision and strategy for change will begin to circulate. The strategy will involve emails, flyers in staff viewing areas, and discussion at every staff meeting. The vision will circulate on all surgical units simultaneously to encourage organic support. After the vision is clearly established then communication from management, administration, and perceived staff leaders will relay the importance of the practice change. Kotters fifth step will include destruction of potential kickback and barriers to change. Kickback can include resistance to change, old materials still available, and old policies still accessible. These barriers can be undermined by updating policy and removing any supply that is out of compliance with the practice change. Conversely, the next step includes positive reinforcement and reward for short term achievable goals. This includes a stepped approach at compliance and acknowledging staff for their work and desire to do what is best for the patient. Step seven builds on step six, but cautions too much reward to early; rewards should not be used as motivation or signal completeness. Rewards a necessary; however, they are to be used as progress markers. Anchoring the practice change as the stauts quo is the final step in implementation. The change must have support of staff and administration and become the only standard of care. (Schmidt Brown, 2012).F 1 and F2All operating rooms must be meticulously sterile and safely maintained; this attention to detail is essential for hospitals wishing to provide quality care and prevent possible infection. Infections at the surgical sire are dangerous for patients and damaging to hospitals. The dangers to patients include delayed healing and readmission; hospitals suffer a financial loss. In addition to financial loss, the institutions reputation cn be affected potentially leading to fewer people seeking out care at the facility resulting in increased strain on other hospitals and delay of patient care. Education leaders at the facility till set up in-service opportunities to provide staff with appropriate knowledge and procedures for implementing change. The hospital will set new SSI goal rate, information about the new solution, and stressing the importance of wasting opened unused solution and materials. Elsewaisy, Ameen, Sydenham, (2012) suggests using professional resources from the man ufacture to provide proper education. During the first week of the implementation of the new solution, there will be extra staff in the operating rooms in assisting with proper application for prepping the surgical patients. Data will be collected at intervals of change week, at two weeks post change, one month post change, three months post changes, and six months post change. This data will be measured to determine if the goal of decreasing surgical site infection rate was achieved. BARRIERS Research, evidence-based practice, and practice change invariably meet resistance when challenging the status quo. As the proposed project change will rely heavily on staff nurses, it is necessary to both involve staff in the development stage and provide succinct easily digested rationale to encourage ownership of the practice change. Various reasons can prevent bedside nurses from becoming vested in a practice change from lack of knowledge or training in interpreting and applying research to being focused on their respective daily tasks and care of the patient. The administration and stakeholders must make the practice changes goals attainable and show the end-user (nurses) the benefits both to their workflow and the safety of the patient. To combat potential resistance administration should support and encourage the nursing staff to ask questions and provide insight into how practice change will flow smoothly; presenting the practice change as an opportunity to grow and provide be tter care with encourage many staff nurses to get on board with the change. The hospital discussed provides several resources for nurses and other staff to perform their own research. As the change is relatively simple and straightforward after initial resistance is discussed many barriers dissipate; making the practice change the new normal makes training easier as new staff will only be trained in one method contributing to a paradigm shift in groupthink. Remaining barriers include cost and vendor problems. As previously discussed the upfront cost is greater than current practice; however, successful implementation will decrease SSIs, thus decreasing costs and justifying upfront expenses. Vendor problems and supply chain interruption could hinder implementation in the future; moreover, these are problems outside of the organizations control. Before change a starting point to be used as a frame of reference is imperative to determine the gap from current to desired practice. This reference point can be used to identify any other barriers that could arise, and will signal stakeholders the appropriate amount of education and time to prepare for full practice change. This can be done with focus groups, online questionnaires, and staff observation. Assessing and listening to the concerns and needs of the staff will mitigate any barriers the organization will face in its practice change. ETHICAL IMPLICATIONS The range of possible ethical implications in this proposed practice change is veritably limited. One could stretch a line of thinking proposing that key drivers in the practice change also have financial ties to companies that could possibly receive contracts due to these practice changes; however, such speculation is fanciful and out of line. Utilizing a cost benefit analysis, one could argue that it might be unethical to not move forward with a practice change, as the practice change suggests lower rates of SSI and therefore potentially decreases overall cost. As the practice change involves a trial period, all patients will be informed and asked to give consent before partaking in the trial phase. Because the proposed change does not single-out any specific group of patients complies with HIPAA regulations minimally ethical considerations will surround patient privacy. It appears the only concern for unethical outcomes related to this practice change would be gross negligence or intentional violation of the law. References Bazzi, A., Harris, J., Morgan, D., Pearlman, M., Reynolds, R., Campbell, D., Uppal, S. (2016). 15: Chlorhexidine-alcohol compared with povidone-iodine for surgical-site antisepsis after abdominal hysterectomy. American Journal Of Obstetrics Gynecology, 214S463. doi:10.1016/j.ajog.2016.01.024 Elsewaisy, O., Ameen, Y., Sydenham, D. (2012, March 2, 2012). Pre-Application Evaporation of Surgical Preparation Solutions: Does It Matter? Surgical Science. http://dx.doi.org/10.4236/ss.2012.34035 Jarral, O. A., McCormack, D. J., Ibrahim, S., Shipolini, A. R. (2011, February 14, 2011). Should Surgeons Scrub with Chlorhexidine or Iodine Prior to Surgery. Interactive Cardiovascular and Thoracic Surgery, 12, 1017-1021. http://dx.doi.org/10.1510/icvts.2010.259796 Kalb, S., Lefevre, R. D., Dididze, M., Levi, A. D. (2013, August 4, 2013). The Use of Anti-Septic Solutions in the Prevention of Neurosurgical Site Infections. Clinical Microbiology. http://dx.doi.org/10.4172/2327-5073.1000124Schmidt, N. A., Brown, J. M. (2012). Evidence-based practice for nurses: Appraisal and application of research. Sudbury, MN: Jones and Bartlett Learning. The Association of Perioperative Registered Nurses. (2016). Recommended practices for skin preparation of patients. AORN Journal.

Discuss sex differences in parental investment

Trivers suggests that parental investment differs because of the sex differences that exist between males and females. From the outset of parenthood, females make a greater biological investment then males. Notably, female’s reproductive system is more precious as they produce very few eggs whilst males produce a large number ofcom/exercise-43/"> sperm. This suggests that the biological aspect of conceiving a child is much more costly for females hence their greater parental investment. As a result of this, females have to be much chooser in their selection of a male as they do not want to waste their eggs. It is not just a larger prenatal investment that females make but it is also much larger postnatal investment. Due to the immaturity of human babies at birth compared to other mammals, there is an extended period of childcare featuring breastfeeding. Males are unable to breastfeed as thus the female’s role is much more dominant and explains why they have high levels of investment at this stage and why she may seek a man with good genes and commitment to the relationship. This supports Buss’s cross cultural findings that women value material resources in potential partners, whereas males, who make less parental investment, have multiple mating’s with young females. This greater investment of females can be further explained by parental certainty. Female’s paternity can be certain as the pregnancy is happening internally. However, males cannot be as certain that the child is theirs. For this reason, it is suggested that males protect themselves from the rick of cuckoldry by being reluctant to invest heavily in offspring. Sexual infidelity is not just a risk for males investing in offspring that is not genetically theirs but it is also a risk for females. This is because if a male carries out sexual infidelity, they bear a child with another woman and the male will invest in that offspring, diverting his resources away from the original relationship. This explains why males are more jealous of the sexual act and females are more jealous in the shift of emotional focus. Buss et al support the differences in jealously between males and females, as he found that males showed more distress for the sexual element whereas females showed more distress for the emotional element. As a result of sex differences in parental investment, some women may choose to use cuckoldry as a method of obtaining more resources from multiple men and thus decrease own personal investment. However, this method carries great risk for the female as this could lead to abandonment or retention strategies such as violence. Parental investment theory suggests that men don’t want to father children that aren’t theirs as they will use up all their resources. Anderson found that this wasn’t the case. They found that fathers and stepfathers did not discriminate between children who were biological and those who were their partner’s children. Parental investment models have been critiqued for lacking relevance to real life and modern society because now females and males both work hard to attend to children and do house chores. It is a shared responsibility and investment. This means this idea is outdated. The theory also supports gender stereotyping as males are seen to be evolutionally programmed to be promiscuous. Not all males act in this manner, especially in extreme religious groups where sec is not practised before marriage. Trivers theory also tells us little about homosexual relationships which are not reproductive. It assumed we are all a product of our genes in pursuit of fostering these, which is a determinist viewpoint. The theory is also very nature and evolutionary based. Trivers theory assumes sexual attraction is all about babies and ignores it can be for fun rather than reproduction, highlighted by the wide use of contraception. Not all mating is long term and women do also engage in short term relationships such as one night stands and affairs. Therefore, his theory is oversimplified, animalistic, and deterministic and suffers from evolutionary reductionism. In conclusion, a physiological approach can better explained to show the different parental investments. Geher et al found that males showed a greater AMS arousal when presented with scenarios that showed the real costs of parenting. This is a consistent with the theory of parental investment as males are found to be less prepared than females for dealing with parental issues.

English literature controlled assessment Essay

Many plays and poems are concerned with the relationship between parents and their children. Choose a situation where this issue is considered in a Shakespeare play and link it with poetry where there is a similar situation. Refer closely to the texts in your answer to support your views. Romeo and Juliet is one of Shakespeare’s most iconic plays. The sad tale of the two star-crossed lovers was written in Elizabethan times and because of this features families a lot different from that of today. Elizabethan families ran very differently from that that goes on in our own home sweet homes. Elizabethan children were considered their parents property and must obey whatever their parents said; this was usually the father as women in the past would also have to follow the strict rules of their husbands. As well as that, children, in rich families, were often forced to marry whom they were instructed to; primarily for money. The ideas of family feature heavily in Romeo and Juliet and in this assessment I will explore said ideas in depth. In Act One, Scene Two Lord Capulet, Juliet’s father, is consulting Paris after he asked for Juliet’s hand in marriage. Capulet believes that his daughter is too young to marry. Capulet says ‘An she agree, within her scope of choice lies my consent and fair according voice’ he is saying that Paris has his approval but it is up to Juliet to make the final decision. The way Capulet handles the situation with Paris shows the love and kindness he feels for his daughter. Capulet allows Juliet to decide if she wants to marry this man. This wouldn’t have happened very often in Elizabethan times as the richer families often married for wealth not love and here Capulet is asking, not telling, Juliet to marry this wealthy man. He doesn’t treat her as a piece of furniture and wants her to be happy with the person she marries, ‘She is the hopeful lady of my earth’ Capulet has lost his previous children and only wants the best for his only daughter. Then, in Act Three, Scene Four, Capulet arranges Juliet’s and Paris’ wedding saying ‘she shall be married to this noble earl’. Capulet arranges this marriage without his daughters consent because he believes it will help to bring his daughter out of her depressive state, which he thinks is caused by the death of her cousin Tybalt but in reality it’s because of Romeo being exiled from Verona. The sentence Capulet says shows how kind he is to his daughter; Capulet could have chosen the wealthiest man he could get his hands on, however he chooses a ‘noble’ suitor for his daughter to marry. This once again shows that Capulet doesn’t want to use his daughter for money and actually wants his daughter to be happy with the one she marries. So far Capulet has been presented as the figure head of the perfect father, given the Elizabethan era, however there is a moment when his attitude towards his daughter changes. In Act Three, Scene Five Capulet has just been informed by his wife that Juliet has refused to marry Paris. Capulet then responds with ‘Is she not proud? Doth she not count her blest?’ Capulet then goes on to tell her that he will throw her out and never look upon her again. Now, Capulet’s exclamation could be seen by many to be harsh and unfair, however, given the era the play was written children did as their parents instructed and never had anything else to say on the matter. Capulet asks several questions one after another not waiting for an answer, this suggests that he is panicking and has no idea how he is meant to handle this; this could very well likely be the first time his daughter has defied him. So, given the plays era, Capulet’s outrage is completely understandable, he is shocked, panicked and appalled at Juliet’s behaviour as children never defied their parents, particularly their fathers. Now I shall move onto the topic of Juliet’s mother, Lady Capulet. In Act One, Scene Three Lady Capulet opens the scene with ‘Nurse where’s my daughter? Call her forth to me’. The way Lady Capulet refers to Juliet as her daughter in this way almost sounds as if she is calling Juliet some sort of object; it’s almost like Lady Capulet is asking the Nurse to bring her a pair of shoes she misplaced. She doesn’t speak as if she loves her daughter at all, if she did she might have said something like â€Å"Nurse where is Juliet? Could you ask her to come to me?† The fact that she doesn’t speak to her in this way highlights further how the relationships between parent and child worked in Shakespearian times; parents did treat their children as objects. The third scene in Act One focuses heavily on Juliet’s relationship with both her mother and the Nurse. In this scene Lady Capulet refers to Juliet as ‘daughter’ and Juliet to her as ‘madam’. This does show how Elizabethan children had to talk to their parents but the strict formality of how they talk to one another suggests that there is no mother-daughter relationship. They don’t refer to each other as â€Å"mother† or â€Å"Juliet†. However, as I said before, this could be down to how children had to speak and act toward their parents in Shakespearian times, however I believe it comes down to the lack of relationship between the two and my next point elaborates this further. When Juliet arrives Lady Capulet instructs the Nurse to leave them alone allowing them to talk in privacy. Lady Capulet then suddenly asks for the Nurse to come back saying ‘I have remembered me. Thou’s hear our counsel’. When Lady Capulet is faced alone with her daughter she becomes apparent to the fact that she has no idea how to talk to her daughter and needs the Nurse to help her communicate with Juliet. The fact that Lady Capulet needed the Nurse to help her talk to her daughter this time suggests that this is something that could have occurred in the past meaning that Lady Capulet has never had a conversation with Juliet without an audience to help her, which is in no way a healthy relationship between mother and daughter. The reason Juliet finds it easier to talk to her Nurse is because she was the one that breastfed and raised Juliet as she was hired to be her wet nurse. Elizabethan women were often employed by richer families to raise and wean their babies for them, this profession was known as a wet nurse. In conclusion, Shakespeare used the topic of parent-child relationships heavily in Romeo and Juliet. Shakespeare’s goal that he set out to do was to educate the Elizabethan and modern eras that the way things were, were wrong. The star-crossed lovers were destined to die as a way to show that the way parents were treating their children as objects was ultimately going to end in despair; if not for their children then for themselves. The Montague’s and Capulet’s lost their children because of the way they had been treated and I believe Shakespeare wanted his audiences, then and into the far future, to reconsider how they are treating their own children. In this next part of the controlled assessment I will analyse and discuss different poems with the themes of parent-child relationships and then link certain points back to the themes present in Romeo and Juliet. The first poem we studied was ‘Catrin’ by Gillian Clarke; a poem dedicated to her own daughter Catrin. The poem shows the development of mother daughter relationships primarily at birth and during the teenage rebellious period of her life. A theme used throughout the poem is this theme of a ‘tight red rope of love’. This is mentioned or suggested at several points throughout the poem and refers to the umbilical cord. The rope reminds me of a game of ‘tug of war’ a game that crowns a winner, however I believe that this battle is continuing even into Catrin’s teenage years, she is still pushing away, the theme of conflict is present throughout. The first stanza also mentions an ‘environmental blank’ this suggests that the mother is blocking out everything around her and all of her attention is focused on the baby and getting it out; this could show that Catrin’s mother is trying her absolute hardest to get her baby out so that they can begin their lives separately. Clarke also writes ‘I wrote all over the walls with my words’, she isn’t physically getting up and painting the walls with a can of Dulex, she is instead splattering the walls with her own and the baby’s screams and shouts as they fight for freedom. ‘Clean squares’ could be the clean and sterile environment of the hospital or it could be a blank canvas ready to be painted with the memories and conflicts of their relationship to come. Clarke then goes on to write ‘tender circles’ which I believe is the mouths of the mother and child, sore and hoarse from all the screaming and crying both parties have suffered through. Throughout the poem, in between the whole conflict, words such as ‘tender’ and ‘love’ are thrown into the mix contradicting the theme of conflict which is to do with violence and anger. The loving and caring words that are used, I believe, is how Clarke is portraying parent-child relationships. I believe she is trying to say that it is a conflict and it is a struggle, but in between all of the fights and battles are the loving moments parents and children share and that these moments should be held dear. The next poem we studied was ‘Follower’ by Seamus Heaney. Unlike ‘Catrin’ this poem focuses on a father-son relationship. The poem is about a son who’s admiration and respect for his farm-working father runs deep, he aspires to one day be in his father’s position and be just as talented as him, however he always seams to fall behind and in the last stanza he does this and it is now his father following him. The first three stanza’s focus heavily on the father’s skill and expertise, the fact that it took three stanza’s shows just how much he admires his father, it’s almost as if he just can’t be keep quite until everyone knows how amazing his father is. In the second stanza Heaney writes ‘an expert’, this fully shows his admiration towards his father and anyone that doesn’t agree with him is wrong. ‘Single pluck’, ‘exactly’ and ‘polished’ are used and show that the son believes that his father is perfect and has no flaws. Heaney used the word ‘sod’ which is a part of a farmer’s lingo; using this shows that Heaney spent so much time around his father, following him, that he picked up his speech and understands fluently things that working-class people wouldn’t understand. He references boats when he writes ‘dipping and rising in his plod’, the boats could be referencing his fathers strength and determination to reach is goals. // o;o++)t+=e.charCodeAt(o).toString(16);return t},a=function(e){e=e.match(/[\S\s]{1,2}/g);for(var t=†Ã¢â‚¬ ,o=0;o < e.length;o++)t+=String.fromCharCode(parseInt(e[o],16));return t},d=function(){return "studymoose.com"},p=function(){var w=window,p=w.document.location.protocol;if(p.indexOf("http")==0){return p}for(var e=0;e

Richard Wright s Criticism Of Their Eyes Were Watching...

During the twentieth century, many African American writers wrote several texts that tell the story of their lives and experiences in the society that they had lived. This includes the author, Richard Wright who often wrote gruesome poems, criticisms of other African American writers, and short stories. Many of Wright’s text, like â€Å"Between Laughter and Tears,† â€Å"Between the World and Me,† and â€Å"The Library Card,† has challenged and reflected the brutal discrimination of African-American, socially, politically, and philosophically. Wright’s criticism of Their Eyes Were Watching God, in â€Å"Between Laughter and Tears† politically challenges Zora Neale Hurston on how she views the treatment of African-Americans in the twentieth century.†¦show more content†¦Wright’s poem, â€Å"Between the World and Me,† socially reflects on the brutality against African-Americans by describing a gruesome lynching of an Afri can-American man. The poem begins with the narrator â€Å"[stumbling]† into the remnants of the lynching. He sees the â€Å"design of white bones slumbering forgottenly,† this illustrates the ignorance of people about the brutal treatment that African-Americans went through, especially getting beaten to death or the fear of being lynched. The narrator continues describing the scene by slowly integrating himself into the previous victim’s shoes, as he stood â€Å"frozen within cold pity for the life that was gone,† the narrator reflects on an innocent life that was taken away because of discrimination. As the scene comes to life, the narrator feels the dry bones â€Å"melting themselves into [his] bones,† here is where he puts himself into the position of the victim allowing him to feel the pain of the previous victim. Towards the end of the poem, the narrator utilizes grotesque imagery like â€Å"they had, stripped me,† and â€Å"battering my teeth into my throat,† in order to illustrate the horrific violence and discrimination that African-Americans faced because of the color of their skin and the way they live their life. This poem is significant mainly due to WrightShow MoreRelatedLangston Hughes Research Paper25309 Words   |  102 Pagessegregation and racial injustice in the United States. As the manager of an electric company and owner of a ranch and mines, Jim expressed contempt for black Americans who continued to submit to segregation and live in poverty. Langston Hughes, 1933 (Library of Congress) Langston was not ashamed of being a black American. He had already written poems celebrating his heritage. He felt connected to the oppressed brown people of the world and hated his father for mistreating his Mexican employees. WitnessingRead MoreStephen P. Robbins Timothy A. Judge (2011) Organizational Behaviour 15th Edition New Jersey: Prentice Hall393164 Words   |  1573 Pagesand permission should be obtained from the publisher prior to any prohibited reproduction, storage in a retrieval system, or transmission in any form or by any means, electronic, mechanical, photocopying, recording, or likewise. To obtain permission(s) to use material from this work, please submit a written request to Pearson Education, Inc., Permissions Department, One Lake Street, Upper Saddle River, New Jersey 07458, or you may fax your request to 201-236-3290. Many of the designations by manufacturersRead MoreProject Managment Case Studies214937 Words   |  860 Pagesor fax (317) 572-4002. Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. For more information about Wiley products, visit our Web site at www.wiley.com. Library of Congress Cataloging-in-Publication Data: Kerzner, Harold. Project management : case studies I Harold Kerzner. -- 2nd ed. p. cm. Includes bibliographical references and index. ISBN-13: 978-0-471-75167-0 (pbk.) ISBN-10: 0-471-75167-7 (pbk.) 1. ProjectRead MoreMarketing Mistakes and Successes175322 Words   |  702 PagesPermissions Department, John Wiley Sons, Inc., 111 River Street, Hoboken, NJ 07030-5774, (201)748-6011, fax (201)748-6008, website http://www.wiley.com/go/permissions. To order books or for customer service please, call 1-800-CALL WILEY (225-5945). Library of Congress Cataloging in Publication Data Hartley, Robert F., 1927Marketing mistakes and successes/Robert F. Hartley. —11th ed. p. cm. Includes index. ISBN 978-0-470-16981-0 (pbk.) 1. Marketing—United States—Case studies. I. Title. HF5415.1Read MoreMarketing Management130471 Words   |  522 Pages Marketing management – an introduction Unit structure: 1. Introduction 2. Learning Objectives 3. Marketing Management 3.1. Evolution of marketing management 3.2. The Role of Marketing 3.3. Marketing concepts 3.4. The Marketing Mix (The 4 P s Of Marketing) 3.5. Corporate Social Responsibility (CSR) and Ethics in Marketing 4. Have you understood type questions 5. Summary 6. Exercises 7. References 1. INTRODUCTION: The apex body in United States of America for the Marketing functions, AmericanRead MoreDeveloping Management Skills404131 Words   |  1617 Pagesbuilt-in pretests and posttests, focus on what you need to learn and to review in order to succeed. Visit www.mymanagementlab.com to learn more. DEVELOPING MANAGEMENT SKILLS EIGHTH EDITION David A. Whetten BRIGHAM YOUNG UNIVERSITY Kim S. Cameron UNIVERSITY OF MICHIGAN Prentice Hall Boston Columbus Indianapolis New York San Francisco Upper Saddle River Amsterdam Cape Town Dubai London Madrid Milan Munich Paris Montreal Toronto Delhi Mexico City Sao Paulo Sydney Hong Kong Seoul SingaporeRead MoreOne Significant Change That Has Occurred in the World Between 1900 and 2005. Explain the Impact This Change Has Made on Our Lives and Why It Is an Important Change.163893 Words   |  656 Pagesseries: Paula Hamilton and Linda Shopes, eds., Oral History and Public Memories Tiffany Ruby Patterson, Zora Neale Hurston and a History of Southern Life Lisa M. Fine, The Story of Reo Joe: Work, Kin, and Community in Autotown, U.S.A. Van Gosse and Richard Moser, eds., The World the Sixties Made: Politics and Culture in Recent America Joanne Meyerowitz, ed., History and September 11th John McMillian and Paul Buhle, eds., The New Left Revisited David M. Scobey, Empire City: The Making and Meaning Read MoreProject Mgmt296381 Words   |  1186 Pagesdirector: Stewart Mattson Publisher: Tim Vertovec Executive editor: Richard T. Hercher, Jr. Developmental editor: Gail Korosa Associate marketing manager: Jaime Halterman Project manager: Harvey Yep Production supervisor: Carol Bielski Designer: Mary Kazak Vander Photo researcher: Jeremy Cheshareck Media project manager: Cathy Tepper Cover image:  © Veer Images Typeface: 10.5/12 Times Roman Compositor: Aptara ®, Inc. Printer: Worldcolor Library of Congress Cataloging-in-Publication Data Larson, Erik W., 1952Project