Evaluation report Essay Example | Topics and Well Written Essays - 1000 words

Evaluation report - Essay Example Prior to the class, a few measures were taken in its preparations. First, we looked at the core of our class and that is the information that is to be presented. The objectives are already established through the syllabus of the RFAW and FAW, so our focus will be to organize the structure of the delivery of the information as well as facilitating all the hands on practical exercises. This organization was accomplished through the use of a session plan. The session plan outlined every aspect of what was to be done. It tells us what is to be taught, who is teaching it, location, special equipment, delivery method, start and end times. Once we are firm on what is to be taught, we must then decide on the delivery method and learning technique to be utilized. The progress of technology gives us many tools to use but we must choose these tools wisely because not all tools fit every situation. For this class, a PowerPoint presentation, handouts, and a workbook were utilized. The PowerPoint presentation was used to help reinforce the lectures. This will help give the student a visual representation of what was being said. The workbook and handouts acts more as a reference that the student can refer back to either during certain points of the class or at home. All of these tools will reinforce the lecture that was given. Careful thought went into the learning technique to be used. For this class, the students would be formed into groups because as stated by scholars before, ‘Groups are viewed as a powerful means of learning, which can be an environment in which people invent and explore symbolic structures for understanding the world, learning from each other; or they can encourage conformity, squander time and energy on ritual combat, revel in failure’. (Knights1993). This group will be formal, due to the fact that everyone who belongs to the group must arrive at the

Strategy Essay Example | Topics and Well Written Essays - 4000 words

Strategy - Essay Example It has 760 stores in UK and 30 countries around the world. (Annual Report) M&S profits peaked in 1998 when it crossed the  £ 1 billion mark that year. It was the highest achieved by a UK retail chain. From then until 2002 it was downhill. In 2004 a new CEO Rose took over the reins and M&S slowly but surely got back to making higher profits every year since, although they are still far from the billion pounds they made in 1998. (see Appendix 1) Several major factors affected profits, the barometer of public support and financial performance. Rivals had switched to source their products from abroad at cheaper prices while M&S continued with the costly UK suppliers. As a result margins came under pressure, sales became stagnant and profits plummeted. From a high of a billion pounds in 1998, the profits fell to a low of 145 million in 2001. M&S were forced to curtail their dependence on UK suppliers and resort to other means for sustenance. (see Appendix 1) The second factor was the company policy not to accept credit cards. This had become a universal phenomenon and denial was luring younger and more mobile customers away to other rival outlets that offered this facility. The third factor was that M&S had abandoned its high street image and had gone for low end products like rivals were doing and it suffered an image loss. It was earlier known for quality of its products and it was no longer a leader in that segment. This forced a serious rethinking in the boardroom and let to a total revamp in both control and strategy of the company. A new post of Chairman as well as a new one for a CEO, as against a combined post, were created and have since seen the company’s fortune turn around. M&S, chastened by the serious erosion in customer loyalty and profits decided to revert to its roots. In the first stage they went back to exploit their core competencies. M&S started off with introduction of a new range of classical clothing for women and it was reported

Electrical Bone Growth Stimulator Devices

Electrical Bone Growth Stimulator Devices Nonunion and delayed fractures are prevalent in the United States, accounting for a significant health care cost (Simon Simon, 2008). Bone is able to remodel and adapt to applied loads and electromechanical stimuli (Smeltzer, Bare, Hinkle, Cheever, 2009). One method of repairing these types of fractures is with an electric bone growth stimulator, which has been used for over 25 years. There are three types of electric bone growth stimulators, all of which provide an electric current to the bone that causes the bone cells to grow and proliferate. Treatment with bone growth stimulators shortens the recovery time, however cannot be used for large gaps in the bone (Simon Simon, 2008). Clinical Significance Every year in the United States 7.9 million fractures occur (Goldstein, Sprague, Petrisor, 2010). Approximately 600,000 fractures do not heal properly. Fractures that do not heal properly are usually delayed or nonunion fractures. These fractures require treatment or surgical intervention to heal properly and cost the United States $3 to 6 billion health care dollars each year (Simon Simon, 2008). A delayed union is a fracture that heals very slowly and does not heal within a normal amount of time. Although many factors affect how long it takes for a bone to heal such as which bone is broken and the severity of the fracture, the typical healing time is about three to four months. A delayed union can be caused by several factors including, poor blood supply, not casting the bone properly, and infection (Parker, 2010). Sometimes delayed union fractures can heal on their own without intervention or treatment. A nonunion is a fracture that does not heal within twice the expected healing time, generally six to nine months after the injury. Fibrocartilage also forms between the two pieces of broken bone (Mora, Pedrotti, Galli, 2006). Figure 1 shows a nonunion fracture of the tibia, the fracture is circled in red and you can see some of the fibrocartilage that formed between the two pieces of bone. Several factors that can cause nonunion are poor blood supply, not casting the bone p roperly, infection, and loss of bone or soft tissue (Parker, 2010). A nonunion fracture will not heal on its own and requires some form of intervention. Some of the options for treating nonunion are internal and external fixation devices, bone grafts, bone substitutes, biologics like platelet extracts and bone morphogenic proteins, and biophysical stimulation including ultrasound and electrical stimulation (Simon Simon, 2008). Since the repair of delayed and nonunion fractures requires intervention and treatment, the clinical problem is how to provide an intervention that allows the patient to recover from the injury in the shortest possible amount of time with the fewest complications and the least cost (Simon Simon, 2008). The ideal treatment is to repair the fracture without surgery and hospitalization (Goldstein, Sprague, Petrisor, 2010). Therefore, electrical bone growth stimulators are frequently used to treat delayed and nonunion fractures. Research has shown that electrical stimulation is a prevalent treatment that is utilized to speed up the process of healing in delayed and nonunion fractures. In the United States, electrical bone growth stimulators have treated approximately 400,000 delayed and nonunion fractures (Goldstein, Sprague, Petrisor, 2010). Electrical bone growth stimulators, shown in Figure 2, are therapeutic devices that are used to produce and apply electric fields to bone, similar to the electric fields that occur naturally inside the body but as a result of the injury are either not being produced fast enough or are not being produced at all (Goldstein, Sprague, Petrisor, 2010). Electrical bone growth stimulators have been shown to be 88% effective for treating delayed and nonunion fractures (Nolte, van der Krans, Patka, Janssen, Ryaby, Albers, 2001). The typical treatment time with an electrical bone growth stimulator is between three and six months (Simon Simon, 2008). Biology and Physiology Humans have 206 bones in their body (Smeltzer, Bare, Hinkle, Cheever, 2009). Bone can adapt and remodel as a result of an applied force, an injury or a stimulus. Bone is made up of three types of cells, osteoblasts, osteocytes, and osteoclasts, which are involved in bone formation and remodeling. Osteoblasts are cells that form bone (Smeltzer, Bare, Hinkle, Cheever, 2009). Osteocytes are formed from osteoblasts and are responsible for maintaining bone, whereas, osteoclasts are cells that absorb bone. These cells play an important role in fracture healing (Smeltzer, Bare, Hinkle, Cheever, 2009). The process of healing a fracture, shown in Figure 3, has four major steps. The first step occurs within hours following the injury and lasts for about a week. During this step, the injury causes increased blood flow and bleeding, causing a hematoma to form. This results in inflammation and swelling (Smeltzer, Bare, Hinkle, Cheever, 2009). The next step begins when fibroblasts reach the injury site then release collagen fibers and form a soft fibrocartilaginous callus between and around the two pieces of bone. The third step begins around week 4, when osteoblasts enter the callus, multiply and begin to form bone. This forms a harder bony callus that eventually turns into bone. The final stage is remodeling which starts around week 17 and continues until the bone is completely healed. During the remodeling stage, the callus is completely turned into bone by the osteoblasts, and the osteoclasts absorb the extra bone that was produced and not needed (Chiras, 2008). Market Trends The market for electrical bone growth stimulators has grown to over $500 million dollars in the last 25 years, and by 2012 the market is expected to rise to $690.1 million (Schenberger, 2007). The consumers of electrical bone growth stimulators are hospitals, orthopedic surgeons and patients with a delayed or nonunion bone fracture. Electrical bone growth stimulators have been used to treat 400,000 fractures (Simon Simon, 2008). These devices can be both invasive and noninvasive. The typical cost for a noninvasive electrical bone growth stimulator is between $3000 and $7000 and can increase to $20,000 for an invasive stimulator that requires two surgeries (Morone Feuer, 2003). Insurance will cover the cost of the device as long as the patient meets certain criteria, for example the gap between the bones must be less than 1 centimeter (CIGNA , 2010). This cost is much less than the approximately $27,000 cost for surgery and hospitalization after a procedure such as internal fixation (Hughes Anglen, 2010). Seven companies have received FDA approval (U.S. Food and Drug Administration, 2010) and the five companies that have electric bone growth stimulators on the market are Orthofix, Biomet, DJ Orthopedics (acquired the company Orthologic), Smith and Nephew and DePuy Spine (medcompare, 2010). The only company that has received FDA approval (U.S. Food and Drug Administration, 2010) and that has invasive electric bone growth stimulators on the market is Biomet (medcompare, 2010). Some of the noninvasive stimulators are shown in Figure 4 and two of the invasive stimulators from Biomet are shown in Figure 5. Bioelectric Principles Bone that goes through effective growth or repair holds an electronegative potential compared to that of resting bone (Glazer Glazer, 2001). In bone where a break or fracture has occurred with nonunion or delayed union, it has been found helpful to introduce electric stimuli to the area undergoing complications. The introduction of an electrical current allows the process of bone regeneration to reinitiate. The electrically charged particles within the current act as the missing catalyst for the necessary chemical reactions to stimulate the desired biological response of bone repair at the site of nonunion. Pulsed electrical stimulation can cause changes in the intracellular level of cyclic adenosine monophosphate (cAMP) and thus triggers DNA synthesis within cells (Somjen, Fischler, Binderman, 1984). The electrical current excites the Na+/K+ pump of mesenchymal osteoblasts, which causes them to differentiate into osteoblasts that produce a woven matrix of bone (Shapiro, 2008).The electronegative current (DNA synthesis) applied at the surface of the fracture site or at the surface of the skin initiates endochondral bone formation the synthesis of cartilage, closely followed by bone formation (Shapiro, 2008). Bone naturally generates an electrical field because of Wolffs Law and piezoelectric properties, which is what the electric bone growth stimulators are also based off of. Wolffs law states that bone changes its external shape and internal (cancellous) architecture in response to stresses acting on it (Hunt, 2008). Piezoelectricity (Figure 6) is the stress-generated potentials in bone in which the side of the bone under mechanical compression [becomes] electronegative and the side under tension [becomes] electropositive (Kim, Won-Ki, Sung Jac, 1984). The mineral matrix in bone is piezoelectric because of the applied force to the skeletal system from tension (resting bone), and it changes its charge when the bone is under mechanical compression (bone repair/hematoma). The electric field produces electric potentials that cause the bone cells to grow and proliferate (Kim, Won-Ki, Sung Jac, 1984). Electrical stimulation creates an increased regulation of osteoinductive growth factors as well as enhancing osteoblastic activity, and decreasing osteoclastic activity through electrochemical reactions. This all leads to the desired reactions of increased bone formation and repair. The electrical stimulation increases the transmembrane calcium translocation, which activates calmodulin, a calcium binding protein involved in inflammation (Hematoma). Electric stimuli also brings about the upregulation of BMP-2, BMP-6, BMP-7, and the BMP receptor ALK-2, which are all bone morphogenic proteins needed to promote bone regeneration (Gan, Fredericks, Glazer, 2004). At the cathode of the Electric Bone Growth Stimulator, when the electric impulse is applied, three things happen: 1) the local oxygen concentration decreases, causing an increase in the biological process of bone growth, 2) the pH level increases, resulting in a decrease of osteoclastic function, and 3) the release of hydrogen pe roxide causing macrophages to release VEGF, which stimulates the growth of blood vessels in the area of injury. These growth factors enter the tissue matrix and trigger proliferation and differentiation which causes bone to form, thus increasing the healing rate of delayed union or nonunion (Gan, Fredericks, Glazer, 2004). History Device History The history of Bone Electric Growth Stimulators dates back to the late 1780s when the biologist, Luigi Galvani used electricity on a biological system. Galvani discovered that a frog could generate muscle spasms throughout its body when an electrical charge was applied to its spinal cord. Alessandro Volta, a colleague of Galvanis, was able to reproduce these (SilcoTek, 2010). The first documentation of electrical stimulation being used to heal fractures was in 1841 by Dr. Hartshorne, when he reported that a patient with a tibial nonunion was treated with electricity. In 1850, the scientist R. W. Lente was the first to report successful use of Galvanic currents used to treat patients with nonunion. In 1892, the German scientist Wolff was the first to describe how bone formed in response to stress; this description became known as Wolffs Law (Glazer Glazer, 2001). The significant gains of healing with electrical stimulation in the 17 1800s ends with Wolffs phenomenon description of bone formation. The modern theories that the Electric Bone Growth Stimulators are based off of are from the work that Iwao Yasuda and his colleagues found in the 1950s. In 1938 Yasuda started researching electrical stimulation of square wave to organic substance at Kyoto Prefectural University of Medicine (Crenshaw, 1977). In 1953, Yasuda et al discovered that bone in compression was electronegative, and bone in tension was electropositive (Glazer Glazer, 2001). From 1962 to 1964, the scientists Friedenberg and Brighton furthered Yasudas research and discovered that bone that is growing or repairing itself shows and electronegative potential, while bone that is not has an electropositive potential. This discovery has encouraged others to research electrical stimuli in relation bone regeneration (Glazer Glazer, 2001). In 1975, Dr. McElhannon published a report stating the technology used to treat fractures in humans with electrical stimulation is not yet advanced enough to promote bone regeneration, but shows promise in animals (Meadows, 2008). Two years later, Dr. Paterson et al performed an experimental model on delayed union fractures of the tibia in adult dogs. The model showed an accelerated healing time where Osteogenesis was normal, and no other abnormalities were found (Meadows, 2008). In 1978, the FDA approved the use of external bone growth stimulators (Haverbush, 2005). In 1983, Dr. Hanaoka performed a study observing the effects of pulsed micro-electrical currents on internal remodeling in long tubular bone and bone healing (Meadows, 2008). A group of 14 dogs had electrodes inserted into the femora with pulsed micro-electrical currents applied to the right femora for four weeks. The dogs were split into groups and each group had different electrical currents (Hz) applied. The results s howed that bone healing in all cases was promoted (Meadows, 2008). Dr. Ahl et al, in 1984, used a semi invasive technique for bone healing on 23 patients with nonunion. Ten of those had solid bone regeneration, and the other 13 did not fully unite these were later determined to have been breaks that were too far apart (Meadows, 2008). In 1985, Dr. Kondo performed a study on the femur of dogs. The bones in the experimental group observed proliferation of osteoblasts on the third day, which transitioned into bone remodeling and a shortened healing time by the end of the third week (Meadows, 2008). In 1995, Dr. Zamora-Navas et al performed a study on 22 patients with nonunion, with a gap of 0.5 or more, using capacitively-coupled electrical signal for a treatment time of about 26 weeks. In the end, over 70% of the 22 had solid bone union if the gap was 1 cm or smaller (Meadows, 2008). In 1996, the FDA approved the use of Electrical Bone Growth Stimulators, both invasive and noninvasiv e. Patent History On May 31, 1977, Dr. Levys bone generating device was approved. The stimulator produced electrical pulses applied to the bone, as opposed to direct current potential, to make the bone grow faster and stronger (Levy, 1977). The device is invasive, and is made of materials that will not poison or react with the surrounding tissue or bone (Levy, 1977). On November 15, 1983, Hirshorn et al had their patent approved on their implantable bone growth stimulator that uses a direct current output, and constantly transmits pulsed electromagnetic energy to the injury site. The output of energy(rate) is directly proportional to the set current. To make sure that the device is not affected by the pulsing of the transmission, a coil was placed inside the device to deliver a constant current. The device is enclosed in a titanium case, and has a longer shelf life due to an electrical switch that was placed inside the device (Hirshorn, Swift, Evans, 1983). On My 19, 1987, Dr. Campbells patent was approved. His stimulator was circuit adapted, and relied on the tissue (bone) to act as the load to make the circuit work. The storage device controlled the oscillator circuit, which in turn controlled the charge of the current that was issued from the battery and applied directly to the bone at the fracture site (Campbell, 1987). On May 9, 1995, Kronbergs stimulator was approved. This device was a non-invasive device that used low alternating currents applied to the patients skin. This particular device is battery powered and was found to generate the electrical characteristics found in bones naturally that generate normal bone growth (Kronberg, 1995). On June 16, 1998, Dr. Ericksons electric bone stimulator was approved. His stimulator came with a hand-held device which transmitted, and received, signals to the implanted stimulator (Erickson, Tepper, Thacker, Varrichio, Pilla, 1995). On August 2, 2007, Dr. Nyezs invasive stimulator was approved. The device is controlled by an external remote that sends a wireless signal to the stimulator. The current is circuitry controlled. It was made to be coupled with a hip prosthesis to help with healing and proper function, but can be used to stimulate healthy bone growth in areas of injury (Nyez, 2007). Device Theory In 1953, surgeon Iwao Yasuda first demonstrated that callus could be created by applying electric fields to bone (Figure 8). His experiment consisted of wrapping wire around a rabbitt femur and sending a small (1 uA) current to the anode, away from the bone. After three weeks of continuous current, Yasuda observed that a callus-typically generated during fracture repair- was beginning to form in the direction of the current (Liboff, 2006). There are three types of electric bone growth stimulators. They are categorized based on invasiveness and type of current. Table 1 gives a brief description of the different devices. Note that there are only two types listed, invasive and noninvasive (Liboff, 2006). Semi-Invasive Treatment Semi-invasive systems are semi-implantable: partially internal and partially external. The device provides a constant direct current supplied by an external power supply. The electrodes, on the other hand, are percutaneous and pass through the skin (Electrical Bone Growth Stimulators). These systems, however, are not currently in production, and consequently are not refered to by other scholars and have no relevant data (Clinical Policy Bulletin: Bone Growth Stimulators, 2010). Invasive Treatment The invasive treatment option, also known as direct current (DC) stimulation, is fully implanted and utilizes constant direct current. The device requires two surgies: one to implant the device, and one to remove the device. The anode is placed in the soft tissue, and the cathodes are connected to a power supply (typically a lithium battery) [cain] and placed at the fusion site. At the fracture site, the electrodes can be arranged in two ways (Figure 9). They can be placed on each side of the fracture as to bridge the defect; or, the electrode can be placed directly in the defect (Liboff, 2006). The although the current setting depends upon the fracture, it is typically set at 20 uA for up to six months (Lyle E. Cain, 2002). Noninvasive Treatments There are both electric and electromagnetic noninvasive EBGS devices. They are completely external and do not require surgery. Electric Option The electric noninvasive EBGS device works through capacitive coupling (CC). The CC device uses a 60 kHz alternating sinusoidal signal to produce a current. Two electrodes are placed on the skin, one on each side of the fracture (Figure 10) (Gan, Fredericks, Glazer, 2004). The power supply (typically a 9-V battery) is worn on the hip, and operated twenty four hours a day. Treatment generally applies 5-10 mA at the skin, and 15-20 uA at the fracture site. Device maintainence relies on the patient and includes changing the battery daily. Electromagnetic Options Pulsed Magnetic Field The pulsed magnetic field device (PMF or PEMF) follows Faradays law that Any change in the magnetic environment of a coil of wire will cause a voltage (emf) to be induced in the coil (Faradays Law). It applies a sawtooth (nonsinusoidal) voltage to two parallel external coils, one above the fusion site, and one below (see figure #). The applied voltage creates a current through the coils that generates a single, magnetic field through the defect. Because the field is constantly changing, an induced voltage is created, which appears as pulses (Liboff, 2006). The coils can be worn on the skin, or over a cast (if applicable) (Lyle E. Cain, 2002). The device includes an external battery pack and may be operated up to ten hours a day (Lyle E. Cain, 2002), but treatment is typically only three hours daily (Liboff, 2006). Ion Cyclotron Resonance The ion cyclotron resonance (ICR) device is similar to the PFM device in that it also uses an external coil system. ICR devices, however, apply a different theory than PMF devices. It was shown in 1985 that the results embodied in the so-called calcium efflux effect were in close agreement with the predictions based on the resonance characteristics of certain biological ions subject to the Lorentz force (Liboff, 2006). The device combines both dc and ac magnetic fields to achieve resonant condition. The theory is that ions in resonance are more likely to stimulate the gating mechanism for ion channel transport, and tuning to these ions can increase growth (Liboff, 2006). The device (Figure 11) also uses an external battery pack, and the unit should only be operated thirty minutes per day (Lyle E. Cain, 2002). Regulatory Standards The FDA recognizes the noninvasive bone growth stimulator and the invasive bone growth stimulator under the Title 21-Food and Drugs, of the Code of Federal Regulations (CFR) (Product Classification, 2010). Both are Class III devices, so they must abide by general controls and receive premarket approval. Class III devices support or sustain human life, that are of substantial importance in preventing impairment of human health, or that present a potential, unreasonable risk of illness or injury. Premarket approval (PMA) is the FDA process of scientific and regulatory review to evaluate the safety and effectiveness of Class III medical devices. A PMA application must be submitted and reviewed before marketing the products because they are considered high-risk medical devices (Device Classification, 2010). Device Review Advantages Previous treatments for nonunions included rigid fixation, bone grafts, and amputation. The electric bone growth stimulator has several advantages over these more tradition treatments. The treatment is less severe than bone grafting and the hospital stay after the invasive treatment is typically only three to four days, as opposed to ten days of recovery after grafts. Also, the average completion time for a successful union is only four months, compared to six to eight for bone grafts (Anbuselvan, Krishnamurthy, Madhumathi, Manonmani, Aravindan, Babu, 1995). Moreover, the EBGS is less traumatic than amputation and allows for the retention of limbs. In regards to the devices, the invasive option is advantageous because it provides constant uniform current and does not require an active patient role. After surgery, the device is self operated and maintained. Also, the invasive option bypasses tissue resulting in less resistance and better treatment results. The CC device is small, light, and easy to use (Lyle E. Cain, 2002). Disadvantages The main disadvantage of the EBGS is that union may be unsuccessful if the fracture gap is too large, typically over one centimeter. Also, before an EBGS is used, it must be determined that the bone is not healing properly on its own. Lastly, these devices have not yet been proven successful for treatment of nonunions in locations other than long bones or spine (Clinical Policy Bulletin: Bone Growth Stimulators, 2010). In regards to the devices, the invasive option has a higher hospital cost and patient morbidity due to the surgeries necessary for device implantation and removal. The CC device requires patient compliance. The patient must monitor, operate, and maintain the device, which includes changing the battery daily. Also, there may be skin irritation from the electrodes. Also, the PEMF and ICR devices are often larger and heavy than other external devices, which may create difficulties for patients (Clinical Policy Bulletin: Bone Growth Stimulators, 2010). Product Comparison Biomet is the only company that produces invasive electric bone growth stimulators. Their products include the OsteoGen Bone Growth Stimulator, the OsteoGen Dual Lead Bone Growth Stimulator for use with bone graft surgery, and the OsteoGen-M Bone Growth Stimulator, which utilizes a mesh cathode. Biomet also produces the following external, noninvasive EBGS devices: EBI Bone Healing System and the OrthoPak 2 Bone Growth Stimulator. The EBI Bone Healing System is more convenient because the actual device is worn like a sports band or brace that wraps around the limb, where as the OrthoPak 2 is a larger device with dermal electrodes that must be carried along with the battery pack. On the plus side, the OrthoPak 2 allows for easier placement of hard-to-reach fracture sites (Biomet, 2010). DJO sells the CMF OL1000 Bone Growth Stimulator. It follows a similar concept as the EBI Bone Healing System, except this device is not fully closed, giving it the ability of being worn over a cast if necessary (Products, 2009). Literature Review We assigned the designated sections of the report to each team member to research individually. We attended a research session with librarian Christine Drew to better understand WPIs academic databases and resources. Key terms used in our research included the following: electric bone growth stimulator, bone growth stimulator, bone growth devices, fracture healing, delayed union fracture, non union fracture, Faradays Law, Wolffs Law, piezoelectricity, bone repair, bone cells, electric bone growth device regulations, cost of bone growth stimulation, FDA class III devices, premarket approval, bone growth device history, Luigi Galvani, electric bone growth studies, companies that sell electric bone growth stimulators, Biomet, Exogen, modern electric growth theory, and bone growth stimulator patent. We searched several databases and reliable search engines including the following: Google Books, Google Scholar, Gale PowerSearch, EBSCOhost, ScienceDirect, PubMed, and Wiley Interscience.

Assyrian Crisis Essay -- essays research papers

THE ASSYRIAN CRISIS, A TIME OF GROWTH   Ã‚  Ã‚  Ã‚  Ã‚  The Assyrian Crisis in Judah appears, from the surface, as a time of great luck for the people of Jerusalem. However, by examining the situation with a more powerful lens, one can see the powerful religious infuence such an event could have on a resident’s theology. If I were a Judean during this time, my faith would have faced the toughest test of my life. Going into such a conflict with a nation as strong as Assyria, I could not help but be afraid. My bones would tremble at the thought of destruction of the Holy City of Jerusalem, of the people of Judah, and of my own being. Although I would have believed in God, I would still be filled with fear. This fear would escalate when I heard a messenger for the king of Assyria, as stated in Isaiah 36, mocking God, insulting His power and doubting His saving grace on Jerusalem. He goes on to try and convice us, the people of Jerusalem, that Hezekiah is not trustworthy, and that we will not find help in Egypt becau se they are not reliable. Finally, knowing the path of destruction that Assyria has already created, and their hunger for more, in addition to the messenger’s statement that the Lord has commanded Assyria to go and destroy Jerusalem, my feelings of fear and doubt would uncontrollably well up inside me. We are, after all, only human, and fear is a common feeling, despite where we stand with God. No man lives without fear, but though fear our faith is tested and strengthened.   Ã‚  Ã‚  Ã‚  Ã‚  Upon hearing and experiencing the truth of Isaiah’s claim that God will spare Jerusalem and force the Assyrians back home, my faith in God would be fortified. In the times of fear, I would have realized how weak, how immature, and how far I must go in my faith and trust in God. But once I heard Isaiah’s prophecy, I would use it as a way to do away with my fear. Knowing that God was going to save His Holy City, and that He was going to continue with His perfect plan for mankind that dated back as far as the times of Abraham and held a future for the arrival of the Messiah, I would know that my God follows His plans and keeps His promises. Through this, I would have peace. I would soon learn that I can trust Him in everything because as it says in Scripture, “if God is for us, who can be ... ...of mockery and insults directed towards God. By attacking the Christian faith in this way, the king of Assyria was trying to prove the Christian’s God was just like all other gods, powerless. Similarly, Paul persecuted Christians by going to Damascus to capture them and bring them back to Jerusalem. He hated the Christian faith and persecuted it without mercy. He, however, converted to Christianity later and became an awesome tool of God’s for spreading the Gospel. Living such a life against God in his past, Paul could have easily compare himself with the king of Assyria. Paul would gain great peace and thankfulneess when he realized God’s punishment to the king of Assyria was death, and that he escaped such punishment and was saved by God. Additionally, seeing the successes of Hezekiah, like returning Judah to the luxury it once experienced, being saved from the Assyrians, and being given 15 extra years to live after his illness, Paul would soon realize that th e only reason God was so gracious and merciful with Hezekiah was because he kept his eyes on Him. This would teach Paul that, if he were to be successful, he must keep his focus in life on God. Assyrian Crisis Essay -- essays research papers THE ASSYRIAN CRISIS, A TIME OF GROWTH   Ã‚  Ã‚  Ã‚  Ã‚  The Assyrian Crisis in Judah appears, from the surface, as a time of great luck for the people of Jerusalem. However, by examining the situation with a more powerful lens, one can see the powerful religious infuence such an event could have on a resident’s theology. If I were a Judean during this time, my faith would have faced the toughest test of my life. Going into such a conflict with a nation as strong as Assyria, I could not help but be afraid. My bones would tremble at the thought of destruction of the Holy City of Jerusalem, of the people of Judah, and of my own being. Although I would have believed in God, I would still be filled with fear. This fear would escalate when I heard a messenger for the king of Assyria, as stated in Isaiah 36, mocking God, insulting His power and doubting His saving grace on Jerusalem. He goes on to try and convice us, the people of Jerusalem, that Hezekiah is not trustworthy, and that we will not find help in Egypt becau se they are not reliable. Finally, knowing the path of destruction that Assyria has already created, and their hunger for more, in addition to the messenger’s statement that the Lord has commanded Assyria to go and destroy Jerusalem, my feelings of fear and doubt would uncontrollably well up inside me. We are, after all, only human, and fear is a common feeling, despite where we stand with God. No man lives without fear, but though fear our faith is tested and strengthened.   Ã‚  Ã‚  Ã‚  Ã‚  Upon hearing and experiencing the truth of Isaiah’s claim that God will spare Jerusalem and force the Assyrians back home, my faith in God would be fortified. In the times of fear, I would have realized how weak, how immature, and how far I must go in my faith and trust in God. But once I heard Isaiah’s prophecy, I would use it as a way to do away with my fear. Knowing that God was going to save His Holy City, and that He was going to continue with His perfect plan for mankind that dated back as far as the times of Abraham and held a future for the arrival of the Messiah, I would know that my God follows His plans and keeps His promises. Through this, I would have peace. I would soon learn that I can trust Him in everything because as it says in Scripture, “if God is for us, who can be ... ...of mockery and insults directed towards God. By attacking the Christian faith in this way, the king of Assyria was trying to prove the Christian’s God was just like all other gods, powerless. Similarly, Paul persecuted Christians by going to Damascus to capture them and bring them back to Jerusalem. He hated the Christian faith and persecuted it without mercy. He, however, converted to Christianity later and became an awesome tool of God’s for spreading the Gospel. Living such a life against God in his past, Paul could have easily compare himself with the king of Assyria. Paul would gain great peace and thankfulneess when he realized God’s punishment to the king of Assyria was death, and that he escaped such punishment and was saved by God. Additionally, seeing the successes of Hezekiah, like returning Judah to the luxury it once experienced, being saved from the Assyrians, and being given 15 extra years to live after his illness, Paul would soon realize that th e only reason God was so gracious and merciful with Hezekiah was because he kept his eyes on Him. This would teach Paul that, if he were to be successful, he must keep his focus in life on God.

Analysis on the Movie Instinct

Instinct –About A Mere Illusion One of the two main characters in this movie is Dr. Ethan Powell, an anthropologist. The study of primatology is present in this movie, because Dr. Powell is shown several times living with the mountain gorillas. He gains their trust by adapting to the way they live and interact. I think a little bit of cultural anthropology is also present because although he is studying primates, I believe they have a culture and Dr. Powell has adapted to their nature. The second important character in this movie is Dr.Theo Caulder, a psychologist. The first sub field of psychology that is present in this movie is cognitive psychology. We are introduced to Dr. Caulder while he is interviewing a patient who is delusional and tries to help her understand that she may be wrong. Another sub field of psychology presented is behavioural psychology. The inmates may not have acted the way that they did if it was not for the guards and Warden. Because of the excess cru elty, the inmates were brutalized and forced to re direct their negative energy to each other.I think psychoanalytic psychology is also present in this movie. When Dr. Powell is captured by the poachers, the Silverback tries to save him. Similarly when Peter, one of the inmates is being beaten, Dr. Powell steps in to help him like when the Silverback did. I think this was unconscious motivation from the previous event. Dr. Ethan Powell and Dr. Theo Caulder have very contrastive ways of conducting and obtaining their research. Dr. Powell adapted into the forest to live with the mountain gorillas to observe rituals and group behaviour.When he realized they were uncomfortable with the camera, he left it behind and started to see them for who they were for the first time. He was â€Å"a man living with animals† because the gorillas reached across and accepted him, a human. He started to care for the gorillas and they eventually became his family. Dr. Caulder on the other hand tri es to understand the feelings and thoughts of his patients through a series of interviews. He tries to figure out why his patients (Dr. Powell and other inmates) behave the way they do and and what causes them to act that way, their mental process.Dr. Caulder soon changes the way he interviews Dr. Powell by accommodating him in environments that are closer to him or that he would possibly feel safer in. For example, he takes Dr. Powell to the zoo to see some on the gorillas and then asks the guards to leave because he realizes it was making Dr. Powell feel uncomfortable. Frankincense, making both Dr. Powell's and Dr. Caulder' way of conducting research similar. I think humans are truly not in control of their own lives. If we were, everyone would be doing whatever they wanted to do and that would be â€Å"savage. Life is a game and sometimes we need to be taught how to play properly by a simple example of humanity. Dr. Powell proclaimed that you would find more violence in the city in one day then you ever would in the the forest and I agree. Humans are the only species that kill each other for reasons other than survival. I believe that control is merely an illusion that we like to believe we have. In one of Dr. Caulder's sessions with Ethan, the guards are asked to leave and soon Dr. Caulder is held captive by Ethan and is demanded to write down what he has lost. Dr.Caulder answers â€Å"control† but Ethan says no and asks a few more times. Finally realizing what Ethan is talking about, Dr. Caulder writes down â€Å"illusion. †Ethan then explains how we only have the illusion of having power and control but none of it is actually there to begin with. Another example is when Dacks, on the of the guards, distributes the cards to determine who goes outside that day for a half hour. He always gives the Ace of diamonds to a weaker inmate so that the bully inmate can steal it by scaring them and getting the time outside every single day.The guards d etermine who gets to go outside everyday and all the weaker inmates have to give up their chance because they are to scared to fight back. Thus, diverting all their negative energy towards each other and leaving all the guards at peace. Throughout the movie, Theo is asked by Ethan if he is really free? I think Ethan is referring to when he was living with the mountain gorillas. They were living at peace and harmony and that is what felt like freedom to him. They never fought with each other and only took what they needed, preserving the environment. He was asking Dr.Caulder if living the way he was, was what he considered to be his freedom. I think that the movie's focus on true nature of human existence was excellent. It portrays us just like we are in real life. We are arrogant and have a great sense of entitlement. Ethan has divided humans into two groups. There are the â€Å"Takers and the Tribesmen,† also referred to as the â€Å"Civilized and the Pre-Civilized. † The Takers in the movie are the Guards, the Poachers, and the Warden (all forms of authority). They are dominant and have a God-like syndrome thinking they are superior to everyone else including other humans and animals.The Tribesmen in the movie are Dr. Ethan Powell, the gorillas and other inmates. They could be living in peace if the influence of the guards was limited. For example, Dr. Caulder changed the way the person was selected for the half hour of time outside. â€Å"Everyone goes outside,† is what everybody chanted together forming a revolution. Dr. Theo Caulder is the exception. He was first perceived as a Taker. In the beginning he is shown to only care about his career and that is why he takes up Dr. Ethan Powell's case in the first place, to further his career.His superior believes he can write a book and become a famous psychologist. But soon enough Ethan is able to change Dr. Caulder's mind and teaches him how to live. He starts to believe that he can actual ly get Ethan out of prison and prove that he has not turned into an animal, putting Dr. Caulder into the category of Tribesmen. This encourages me to believe that there is still hope for us to change our lifestyle and the way we think. It shows there is still hope to make us all less savage and make our progress as humans more positive. By. Tanvi Patel

The Role of Higher Education Institutions in Promoting Sustainable Development

The Role of Higher Education Institutions in Promoting Sustainable Development To care about sustainable development means to accept responsibility for the well-being of future generations and also of our habitat, of our planet. An affirmative attitude towards sustainability has to be an integral part of the moral foundation of our activities and of our lifestyle. This means that promoting sustainable development must be an important aspect of the educational agenda at all levels. It starts in kindergarten and it goes all the way to the university level and beyond.It basically involves three aspects: the buildup and reinforcement of a basic understanding of the problem of sustainability, an inspection of all aspects of our life under the criterion of sustainability and finally an active search for new methods and techniques to further sustainable development. In all of this, Higher Education Institutions play a crucial role. Clearly, the research agenda should be influenced – but not dictated – by striving for sustainability with the goal of inventing new methods to deal with all the big problems such as climate change, pollution, energy, hunger, infectious diseases, biodiversity, etc.Systematically thinking about justice and ethics, peace and good governance, not only about ecology, but also about economy might contribute in a substantial way to the establishment of a sustainable way of life. But the most important contribution is in education offered by institutions. Whatever particular subject is being taught, the question whether and how it may influence development towards sustainability must always be asked and discussed. Of course there are contexts in which it is difficult to make this connection, but they are much less frequent then one would expect.Should sustainability also be considered as a topic all by itself and be taught and discussed in special courses? The answer is a clear yes. Nowadays as we are moving towards thematic and prob lem-focused teaching and research, sustainability is a wonderful topic to bring together many different disciplines. Higher Education Institutions not only have to teach their own students, they have to explain the relevant problems to politicians and to industrial leaders as much as to a wider public.Here it is particularly important to show how to differentiate between scientific questions and results on the one hand and moral, ethical or ideological aspects on the other hand. But having said all this, we come to a point that often does not get the necessary attention. As Higher Education Institutions are to a large extent responsible for the training of teachers at the primary and secondary level, they are ultimately responsible for the development of new methods and new approaches to explaining sustainability to everybody, from pre-schoolers all the way to adults.It has to be said that quite a few impressive and successful steps in this direction have been taken, but nobody woul d doubt that much remains to be done. And much remains to be done in all domains of human life before we can claim to be fully on the path towards sustainability. The role of the educational institutions of the Ministry of Education and the school and the teacher is the cornerstone of the basic structure of the society through which we can build generations of intellectually and culturally sound and get rid of all nodes eternal.Teacher In addition to his sacred message of education must be to have another message, a rumor the spirit of democracy to achieve the goals of great importance remain stuck in the memory of the students also attached atoms dew flowers, Should the teacher change real to the imagination of the students towards a glimmer of hope to feel a moment of transparent wishlist using the method of modern education and the teacher to develop itself before it develops the disciples so that he could promote the reality Learning the right direction and uses all his efforts to highlight the humanity to dissolve all differences and to regulate its relations with his disciples to feel safe When listening to him and to have confidence when talking to him In the belief that the ideas addressed to reflect the expression of innovative ideas proposed by them.There is nothing ambiguous and overlapping between education and democracy and we need to find appropriate solutions Giving high doses of education without democracy, and vice versa will be has bad effects, we must make the themes pour in the course of a single coordinated harmonious hear the music fresh, comfortable with the human soul, the teacher make it clear that the surface in method of education and ideas and come in contact with a creative way what is going on in the interior of his disciples, and ideas and fluctuations Ituaha towards a formula amorphous deep knowledge of a democratic approach. From here stems the need to educate the community and then spread the spirit of democracy the existence of education has three objectives with one another, culture is to teach the individual how to accommodate education and receive the views of others, if you know the individual to listen properly to the ideas and proposals of others away from violence and acrimony in the debate and put forward his ideas with a structured format meaningful in this case we say that we have learned the first point of democracy.I must point out an important issue combines a teacher with the students a language to talk, he should attract voices of students and inspire the spirit to talk as he did (Algoskhoun) previously when lists his story, and try to deal with mental disorders among students in order to be able to express their opinions and not obscure desires and cultural needs and intellectual property that arise as a result of psychological factors stemming from within the family because of persecution and oppression of the FPL father and mother to the children, which generates feature sometimes turn to aggressive as a result of subjugation and repression of feelings and desires and can not be of educational institutions to contribute effectively to the success of the moral and intellectual isolation from family and occurs within it should unite the family's role with the role of school to become a cultural phenomenon in which we can achieve democracy in education. Teacher's role in this stage is very difficult because he needs to make another Maimlk of energy and effort to shift gradually towards the case creative students in order to harvest after years of effort, tired and needs to dissolve the differences among students by teaching them self belief of human value high and making the community and decryption problem between the attempt to access the ability to self-expression and social balance and what is created by the individual relationships between members of a sterile society in which they live.Hence the urgent need for the teacher is the first example to his disciples through the treated teachers with each other in a democratic manner the existence of the spirit of cooperation, tolerance and respect the spirit of constructive criticism, among them as can not talk about democracy in the absence of activating and harmony and the small capacity of teaching staff for the purpose of spreading the democratic life of the school . Democratic society in Iraq has a special form due to the circumstances presented by the society such as war and disasters that befell the families of Iraq (forced displacement and non-regulated) and sectarian killings created a lot of orphans who are left to attend school because of material need as a result of the absence of the father of all these things left a lot of Difficulties in the path of democracy, this issue requires upport from government agencies and civil society organizations and the family and the humanitarian organizations and human rights body in order to keep our feet on the first step and most difficult of the state of enhancing the concepts of real democracy, such as material and moral support and a lot of seminars, lectures and use of television, newspapers and magazines to educate society and the exploitation of some of the lessons received by students such as study of art education to output Doakhlhm by drawing on paper to be the case visible, listening to music to overcome cases of depression are enshrined within the hearts, extract the vital activity of exercise to use it in a creative state allowance to use on the differences which occur between the students and lead to hostile situations. Try to change the curriculum and not to impose curricula dry, but must keep up with updating curricula in line with progress in the world.Process subject to human beings and its ability to absorb the vocabulary of democracy and the provision of all supplies of intellectual success in order to create a generation democratic intellectuals keep pace with the rapid changes and act Petkaviip high based on social justice and respect for the law to reach the goals of a great void of class differences and nepotism, conflicts and hatred, social and all that calls for the demolition does not Building and creating an informed community can navigate life towards true equality and compensation for all of society at large without the use of random democracy which do correspond to reality, but we have to use mental intellectual honest and sophisticated approach to generation of creative art, commensurate with the culture of the world.