Robert Frost Theme on Death

Throughout Frost's poetry it is clear to envisage that Frost himself had experienced great loss. His poem’s take you through some of the stages of grief he had experienced at various points in his life. There is a certain cathartic quality to his poems, it is obvious Frost used the medium of creative writing as a release from his grief, enabling him to process his losses, to accept and heal from them. His own father had died when Frost was just a boy himself and during his married life Frost found himself a father also to six offspring.His life was touched by tragedy again as he and his wife lost two of these children. One child was still born the other died at three years old. The echoes of grief can be found in the poem Home burial. â€Å"Tell me about if it's something human. Let me into your grief. I'm not so much unlike other folk as your standing there. This sections comes as the husband is pleading with the wife to communicate with him. The wife is inconsolable and is trying to flee and says to her husband â€Å"There you go sneering now!†Frost breaks this line in the middle to suggest how profoundly at odds they are, how much psychic as well as literal space separates them. (Kilcup 1988. ) Again he pleads with her â€Å"A man can't speak of his own child that's dead. Any rhetorical question demands, expects, the hearer's automatic agreement; there is nothing it expects less than a particular, specific denial. The man's â€Å"Can't a man speak . . . † means â€Å"Isn't any man allowed to speak . . . ,† but her fatally specific answer, â€Å"Not you! † makes it mean, â€Å"A man cannot—is not able to—speak, if the man is you, (Jarrell 1999.)â€Å"She then implies how insensitive he has been over the child's death and repeats the words to him that he had said after burying the child† Three foggy mornings and one rainy day will rot the best birch fence a man can build. † Amy's interpretation o f her husband's words in the kitchen reveals, ironically, that her husband may be far more subtle and sophisticated in expressing himself than she understands. Her question is really an accusation, and she believes not only that he would not care but that he is fundamentally incapable of caring (Faggen1997.)The husband through his wife Amy’s eyes has lost the ability to interact with his wife, also his wife fails to see that in fact he was referring to the child's death by his comment. As a farmer close to nature he was referring to the unfairness of it all, that no matter how hard you try fate plays a part in everything. The fence being a metaphor of how a perfectly strong structure can be taken by bad weather. In the case of the baby's life it taken by death. In the case of this poem both the husband and wife had misinterpreted each other's grieving.Failing to appreciate each other's pain in that process. In the poem â€Å"Death of a Hired Man†, there are four charac ters. Mary and Warren, partners or married it does not actually state this in the poem. Harold a young farm hand and the hired man Silas who seems to be the main character of the poem. In comparison to the couple in Home Burial and the obvious lack of empathy they seem to have for each other, Mary and Warren seem close and communicate effortlessly with each other. This is reflected in the opening verses of â€Å"death of A Hired Man†.It seems they have a relationship of mutual understanding between them. â€Å"When she heard his step, Mary was obviously familiar with Warren enough to know it was his foot fall without first seeing him. This is the opposite in Home burial obviously the wife is trying to flee from her husband a marked comparison between the two relationships. Silas has returned to this couple to die, when Mary comes across him he is â€Å"Huddled against a barn door fast asleep. † In the middle of winter this must have appeared strange to Mary.She goes o n to describe his appearance to Warren, â€Å"a miserable sight, frightening too â€Å"I didn't recognize him-I wasn't looking for him-and he's changed, â€Å"This describes a change in Silas's appearance enough to shock Mary who has known him a number of years. May be he has grown thin and worn looking. The verse paints a mental picture, you can visualize poor withered Silas curled up in the doorway of the barn and the look on Mary's face on finding him there. Warren asks Mary if he said anything she replied â€Å"but little,† Mary describes his speech to Warren almost in-coherent.This symbolises the demise of Silas as he its unable to string a sentence together. Warren is confused by this and refers to a disagreement between Silas and Harold Wilson. Wilson a young boy and Silas were good work colleagues. Harold had other ideas and went into education Silas tried everything to coax Harold back to working the farm but with little success. Silas frowned upon formal educatio n this shows through in this verse, â€Å"He said he couldn't make the boy believe He could find water with a hazel prong-which showed how much good school had ever done him.Warren says at one point â€Å"well those days trouble Silas like a dream. † Maybe Silas had regret in his life, he cut a lonely person roaming the land looking for work. His own family were well to do and educated, his brother is quoted as a Director of a bank. They are shades of Silas not been good enough in some way in his family’s eyes. Maybe he viewed Warren and Mary as family at one point Warren states† he won't be made ashamed to please his brother. † The simile between Silas and the stray hound that came from the woods and given a home on their farm paints the couple as empathetic and caring of nature.Maybe this is the reason why Silas chose them to die with rather than alone. With all the problems that arose between Silas and Harold while working for Warren and Mary. Mary stil l found it in her heart to give him a bed for the night. Mary asks Warren to check on Silas while she sits a watches the night sky. Mary is particularly watching the clouds and says to warren â€Å"I'll sit and see if that small sailing cloud will hit or miss the moon. † â€Å"It hit the moon. † This line symbolises the point as Warren looks in a Silas and realises Silas has died in his sleep.Frost reflects the mood of the poem with this short line, you can almost hear the cloud exploding off the moon as warren realises Silas is dead. Warren returns to Mary â€Å"Dead†, was all he said. The ending of the poem also shows the impact of death, as Warren silently sits beside Mary and he only gives a one-word answer of â€Å"Dead†. This emphasizes the impact of Silas’ death and what it means to the couple. The bluntness of his reaction gives a feeling of grief and disbelief (Study Mode, ND) In both these poems Frost deals with death in an intimate way, you can tell by the style of each verse he is writing from experience.The mood and tone of each poem is dramatic and it is as though you are a fly on the wall actually witnessing the events that unfold in each verse from beginning to end. Again in the poem â€Å"Out Out†, there is a comparison between the disbelief of the wife in her reaction towards her husband, at his perceived lack of care towards the child’s death in the poem, â€Å"Home Burial,† and the reaction of the gathered crowed after the poor boy perishes.As it states in Out Out, â€Å"And they, since they, (the gathered crowd,) Were not the one dead, turned to their affairs. Certainly there was sorrow, mourning and a tearful funeral, but none of that pertains to the poet’s message. The living have lives to lead (Wood 2008. )This is the last line of the poem after the poor victim, 16yr old Raymond Fitzgerald dies in the accident of horrific injuries caused by a buzz saw. The poor child bleeds to death after his hand is severed by the saw.Robert Frost clearly accomplished great things as a poet. After a long and successful career as a professor teaching poetry, he went on to win The Pulitzer Prizes twice for his literary works. This gentle farmer-poet† whose platform manner concealed the ever-troubled, agitated private man who sought through each of his poems â€Å"a momentary stay against confusion. † (Burnshaw. S 2000. ) Frost became the voice of the ordinary American and to this day is still held in the highest regard even after his death.

Excerpt “On Nonconformity” from Shape of Content by Ben Shahn

â€Å"Nonconformity is the basic pre-condition of art, as it is the pre-condition of good thinking and therefore of growth and greatness in a people†¦conformity is derived from the wholly venal business of catering to a popular market† (The Shape of Content, Ben Shahn). This piece of writing speaks of how the general public is in love with works of art, yet at the same time loathes the artists that created them, merely for being a little different than the norm. If art was about â€Å"cookie-cutter† design, then according to the eading, we should all be living in a place similar to Soviet Russia. Yes, it is extremely important to lift up and honor the Working Man, but it is wrong to tear apart art movements due to government, religion, sex, race, creed and so on. Art is something which comes from the soul and nonconformity helps to rip these few individualists away from the so-called commoners. Nonconformists explain reality in a way in which is hardly ever describ ed properly. Truthfully.Why over so many years in history were nonconformists persecuted? Did the witch burning public run out of actual threats like invasion from a foreign country or the economy, or health care? Still the artist (nonconformist) pushes forward and creates despite the enterprise of trials and tribunals. A favored line was about a modern day politician that tried to have a design on a boat sail made illegal, yet it turned out to be a legal design created and copyrighted for the Los Angeles Yacht Club.

Japan's Soft Power in Australia Research Paper Example | Topics and Well Written Essays - 2000 words

Japan's Soft Power in Australia - Research Paper Example Significant points will be highlighted all through the research proposal. Several research questions will further help in enlightening the concept of Soft Power and how useful it can be for a country. The concept of Soft Power has been recently coined and it can change the fortune of a country within literally no time, Japan has benefitted a lot from their Soft Power in Australia. The healthy cooperation between the two countries is a very healthy and mutually dependent partnership. Japan is also competing with the likes of Korea and China for Asian supremacy and it is high time for them to grow by leaps and bounds in order to beat the competition presented by their rivals. This research is very significant because outlines the fact that hard power no longer works effectively and in order to maximize the gain this concept of Soft Power has been introduced. This proposal will mainly deal with intriguing questions that will throw light upon this delicate concept and how this is being made use of by several countries in order to establish themselves globally. The bonding between Japan and Australia is very evident and the two countries share a great relationship be it in business or for that matter any other field. These two nations have brought in a real revolution and the chemistry that they share has been named as a "Core" relationship by people who have taken a conspicuous notice of the relationship between the two countries. This core relationship is very enticing because it guarantees safety; the level of safety is much higher when compared to any other Asian nation. This paper will expansively present Japan's soft power in Australia; in addition to this the paper will also throw light upon Japanese cultural, economic and political influence to Australia and ideology especially after World War Two. There is a very healthy interdependence between Australia and Japan, Australia plays a pivotal role in equipping Japan with necessary resources and energy security. 22 % of Japan's energy needs are taken care of by Australia. This interdependence is extremely important for both countries in order to maintain a healthy relationship with all the other countries located in and around the vicinity. "Former Western Australian premier Geoff Gallop, now an academic at Murdoch University, made exactly this point: "Our growing links to China and India [should be] put into the context of our long-term and still developing partnerships with Japan. In all of our thinking about Asian engagement we cannot ignore the strength of our links to Japan. We share democratic values, face similar demographic and social challenges, and have many interests in common in respect of regional and international issues." (Beyond the Mainstream) Methodology This research will employ the methodology of research; main focus will be on the statistics and facts. How Japan and Australia have benefitted out of this relationship will be proved by the help of several examples and most importantly focus will also be on what it takes to establish Soft Power in another country and what problems the same is capable of creating. Japan's economic political and other important aspects are pivotal and they will be taken into account in this research. The resurgence of Japan

Police Misconduct Research Paper Example | Topics and Well Written Essays - 500 words

Police Misconduct - Research Paper Example guilty men to walk the street and innocent men to sit in jail, governments should have appropriate measures in place to protect the public from police misconduct. 1) Carnell, Yvette. "Dont Shoot! A Case for Reigning in Rogue Cops." The Atlanta Post. 3 May 2011. Web. 27 May 2011. . 4) "Indian Diplomats Daughter, 18, Sues for $1.5m over police Cells Toilet Humiliation | Mail Online." Mail Online. 25 May 2011. Web. 27 May 2011. . 5) Kaariainen, Juha, Tomi Lintonen, Ahti Laitinen, and Joycelyn Pollock. "The Code of Silence: Are Self-Report Surveys a Viable Means for Studying Police Misconducts?" Journal of Scandinavian Studies in Criminology and Crime Prevention 9.2 (2008): 86-96. Print. 6) "Man Shot 6 times by Billings Police Officer Sues for Excessive Force." The Republic. 20 May 2011. Web. 27 May 2011. . 7) Miller, Joel, and Robert C. Davis. "Unpacking Public Attitudes to the Police: Contrasting Perceptions of Misconduct with Traditional Measures of Satisfaction." International Journal of Police Science and Management 10.1 (2008): 9-22.

Annotated Bibliography on Finance Example | Topics and Well Written Essays - 1000 words

On Finance - Annotated Bibliography Example Eugene Fama is one of the renowned economists, working as a finance professor in the University of Chicago. His interest in the concepts related to stock market prices have pushed him to walk through several untreated paths and notions about the subject. And in all researches of his, he has succeeded indubitably and his hypothesis on efficient markets has encouraged several other economists to pursue further research on the same subject. In this paper, he has described about the theories about random walks and through which he has raised concerns about the working aspects of a market. The author however has given only an introduction to the random walks theory and has not divulged more about its extrapolations. The stock prices can be evaluated and predicted based on their past performances. However, the authors Craig and Andrew have opposed this analysis and have shown through their experiments that stock market prices do not follow this theory. Robert Higgins, just like the author cited above, is also in the teaching profession taking classes in the field of Finance. He has done several researches in finance including on concepts that deal with the management issues present in dealing foreign exchange and money matters and also on theories that underlie the importance of valuation. In this book, the author has mainly focused on principles and issues that have to be followed and faced up in case of acquiring new resources. He also deals with the idea of managing the resources that are newly bought. The knowledge showcased by the author on the theories and ideas related to understanding the strengths and weaknesses of the financial assets of a company is exemplary. In addition he showcases very useful tools that could be used in the evaluation of financial assets of a company (Higgins, 1992). The important characteristic of the entire book is that most of the technical jargons related to finance and economics which deal with income and balance statements have been explained to the readers in a common language. 4. Firth, Michael. Share Prices and Mergers: A Study of Stock Market Efficiency. UK: Saxon House. 1976 .Print The author, being a Ph.D. holder, has quite an experience in the field of accountancy after working as an accountant for several number of years in several organizations. He is an ardent follower of economics, of its feasibility and efficiency and has published several journals and books in relevance to the mentioned topics. In this book, the author has described about the practices involved in carrying out business activities and given a critical account of the predicting game that take place in share markets - that produces the most controversial and most sensational ideas

Nirvana - Band Review Essay Example | Topics and Well Written Essays - 1000 words

Nirvana - Band Review - Essay Example His fateful suicide signaled a major loss to the music environment and marked one of the pivotal events of 1990s music. Even with the fantastical nature of Cobain’s story, the power and insight of his music is perhaps the most moving element of Nirvana. While generally concerned with the pains and angst of existence, Nirvana’s albums span a wide-range of emotions. It’s within this context that I have come to greatly relate to their music. While it was not the first album of Nirvana’s that I heard or nearly their most popular record, the first full-length album that Nirvana released was Bleach. Bleach has been an important album to my life for many reasons. One of the primary aspects that I appreciate this record is that it has a raw edge that the later Nirvana records don’t have. In many regards, some of the themes on this record are the same as on later Nirvana records; indeed, ‘About a Girl’ is even featured on these later records. .. . Virtually every song on this album is highly emotionally charged and gripping. This was the first Nirvana album I discovered. I listened to this album in a time of intense despair in my life, after my girlfriend and I had broken up. The intensity of emotion and deep feeling spoke the depression I was feeling on a level that other music couldn’t. I also believe the album was successful for speaking to the challenges of socialization and fighting one’s way through a scholastic environment that was oftentimes cruel and challenging. While other music attempts to speak to these growing pains, oftentimes the emotions contained in those albums come across as forced and somewhat produced. When listening to Nirvana’s ‘Nevermind’ I was truly able to take solace in a record that I felt understanding the pain and challenges I was facing in attempting to relate and survive in a cold social climate. In terms of specific tracks, I’ve always felt like ‘ Smells Like Teen Spirit’ spoke directly to my angst at feeling like I didn’t fit in with the popular crowd. While a lot of individuals put-down Nirvana for being depressing music, or criticizing Kurt Cobain for ultimately committing suicide, I find a different perspective on this music. For me it represents a necessary response to questions of life that oftentimes go unanswered. I believe that in great part the nature of the music is attempting to grasp with aspects of life that are unfair. Why do more attractive people get to enjoy certain aspects of existence that others don’t? Why do some people feel more depressed than others? Why these may seem simple and trite questions,

Early American history 1450 to 1820 Term Paper Example | Topics and Well Written Essays - 750 words

Early American history 1450 to 1820 - Term Paper Example The Columbian exchange refers to the movement of people, their belongings, plants, animals, and diseases from Europe to America after Columbus’s discovery of America. Such a drastic change in environment and ecology adversely affected the Native Americans making Columbus exchange one of the reasons of the prosperity of Europeans while a reason of downfall for the Native Americans (Brogan, 2001). Another important happening during this period is the French and Indian War which was fought during the late 1750s. The war was very much significant as it would determine the future and stability of North America. The French and Indian had an upper hand in terms of organization and strategy and this is the reason for their domination during the initial years of war. Seeing their colonial allies getting defeated, the British soon jumped into the battle and the tides turned in favor of the Americans. Even though the British eventually won the struggle for freedom, the struggle never rea lly ended because the Native Americans wanted freedom also from their colonial masters (Brogan, 2001). The tension between the British and the Americans increases which ultimately erupted into an open conflict referred to as the American Revolution. The most important event during this time period, as regarded by the historians is perhaps the American Revolution. The American Revolution which started in the year 1763 shattered the foundations on which the Old America was established and provided the idea of a United States of America. The American Revolution was a fight against the monarchy and aristocracy and the public openly stood against the English rulers. Even though initially the revolution was a struggle to overthrow the colonial system, it grew into something much more fundamental and important to the American community as a whole. The American Revolution provided the foundation of a unified America in which all the states fought for a unified cause (Bailyn, 1992). The valu es instilled in the participants are still there and are looked up to as an inspiration as America could not have achieved its current stature without this Revolution. For a long time the British had exercised their superiority and domination over the over the Americans, intercepting their ships and searching them. In 1812, the Americans waged war on the British. It was through this war that the Americans got their national anthem even though the war did not end decisively. A treaty was formed soon after the battle, the terms of which made it look more like a cease fire (Brogan, 2001). The war was not only important because the national anthem was composed during it but also two future presidents of the country began their political careers during this war. The start of the eighteenth century marked many important developments in the economic sector of the country. The most important of these is the market revolution. The market revolution is the name given to the series of steps ta ken by the steps to develop transportation within their respective cities which ultimately provided easier and greater access to markets. This proved to be very beneficial for the economy which boomed during this period (Brogan, 2001). The beginning of the eighteenth century also witnessed some ‘revolutionary’ changes in the political system of America. Jefferson became president in 1801, bringing

The effectiveness of individual communication styles in small group Essay

The effectiveness of individual communication styles in small group. The following subtopics are to be addressed. see other inst - Essay Example During our fund raising sessions, there were a lot of negotiations and discussions that sometimes took a serious turn as well. We also went to the offices of local companies for fund raising in the teams of two members with rotating partners. This practice helped me analyze the behavior of individual members along with their strengths and weaknesses. Furthermore, I also observed how individual group members had an impact on the overall campaign itself. Reflection: During these group meetings and fund raising sessions, I noticed that every person among us had a different persona and a varied way of handling situations in hand. Where me and my younger peer who was also a student attempted to come up with ideas that were dynamic and robust but risky, group members that were employed, were tempted to follow a pre-determined plan. Same was reflected in their communication styles as well. Our group leader who was an experienced social worker was highly persuasive mainly because of his expe rience and passion towards his work. On the other hand, younger members of our group possessed highly energetic approach and provocative communication styles. This strength enabled us to deliver some extraordinary presentations and gather handsome amount of funds. Furthermore, other team members from corporate background had a subtle and calculated approach towards their deliverance. This mannerism created balance in our teams and allowed us to secure more leads. Generalization/ Principles/ Theories: Careful analysis of our group dynamics made me aware of the processes in which small groups operate. I realized that in small groups the role of the leader becomes more important since processes are rather informal. Also, the level of interaction between team members is highly influenced by their personal traits. I also learnt that small teams tend to have more reliance on the equilibrium between communication styles of its group members. Usually in such groups, workers from different b ackground have more opportunity to communicate and transmit their messages through formal and informal communication modes. This ability also has an impact on their ability of affecting each other. I came to understand that in an average task oriented group, team members have to play several roles including initiator, opinion giver, elaborator, coordinator, orienteer, evaluator, energizer, procedural technician, and recorder. Examining my group in the light of this model made me understand that in small teams, group members may have to adopt multiple roles. Testing & Application: I had a chance to examine individual group members including our leader with the help of this theoretical model and I came to know that most of the roles such as initiator, elaborator, orienteer, critic and information giver were assumed by our team leader. Further roles were played by other group members in a rotating fashion. In addition to that, individual team dynamics (of two members) were different th an the group itself. In individual teams, there was a dominating partner who was governing and leading the team and supervising the performance of other team member although this hierarchy was highly informal and governed by the level of knowledge and expertise possessed by the group members. Subtopic 2: Group Problem Solving Processes Description of Concrete Event: In the

Geof is the only genuine caring character in the play Essay Example for Free

Geof is the only genuine caring character in the play Essay Geof is the only genuine caring character in the play; the others are totally selfish and self centred. Discuss this statement. From the beginning of the play we can see Jo is the main character, she is highly independent and self reliant this is obvious from one of the opening pages were Jos mum Helen states children owe their parents these little attentions to which Jo replies with I dont owe you a thing. This shows Jo sees her relationship with her mother as strained, she feels she has brought herself up and not really had her mother their to support her. She has learnt to rely on herself and not trust her mother. When Jo becomes pregnant with a black boy form the navy, who leaves her pregnant Jo reacts badly because she is so independent and used to looking after herself. Geof (Jos gay friend) offers her a shoulder to turn to and she turns on him Im not planning big plans for this baby or dreaming big dreams. You Know what happens when you do things like that. The baby will be born dead or daft! She feels she has let herself down and been promiscuous, however the sailor boy was offering her marriage and love before he left, she felt in a safe relationship and that was why she slept with him. But Jo just sees that shes made the same mistakes her mother made when she had her at a young age. Most expectant mothers dont have this negative attitude towards their unborn child however I feel its because she thinks she may let the child down like her mother let her down. Jimmy the black boy from the navy who got Jo pregnant gave the impression of a kind and genuine character who did honestly love Jo until he left. In my opinion he loved her and did intend to return for her but got scared of the prejudice he would face if he did return. He said to Jo about her mother finding out about their engagement Shell see a coloured boy. He obviously felt his race was going to be an issue in their relationship and how it was perceived and was worried about it. Jo however did know Jimmy was in the navy and even said to him on one occasion I might as well be naughty while Ive got the chance. Ill probably never see you again I know it. So I believe deep down Jo knew there was a chance she wouldnt be seeing him again. In my opinion Helen did love her daughter she just didnt know how to treat her, maybe it was because she had her at a young age? She seems to think she should treat her daughter like a friend, she even encourages her underage daughter to drink You dont smell it, you drink it! I think the only way Helen knew to make her daughter love her was the way she made men love her, by getting her drunk. Helen did want her daughter to make something of her life I feel. She encouraged her to draw, saying her drawings were very good Have you ever thought of going to a proper art school and getting proper training? But I think the main reason she wanted Jo to make something of herself was so she could sponge of her. Helen says to Jo When you start earning you can start moaning. In my opinion shes saying to Jo you make some money and get us somewhere nicer. Shes not taken the task upon herself to find her and her daughter somewhere nice to live shes going to wait for her daughter to did it for them. Not a typical loving mother and daughter relationship, Helen is reliant on her daughter Jo. Helen is in my opinion lazy with regard to her relationship with her daughter. She is constantly asking her daughter to do stuff around the house Pass me that bottle Have we got any aspirins left Jo? Here is another example of Helen being reliant on her daughter. She also becomes strangely jealous of Jos gay friend Geof. She is constantly rude to him Oh shut up Geof Sling your hook I believe she is jealous of his strong bond with Jo. She feels jealous of their close relationship and doesnt like him around as she feels inadequate compared to him. Jo maintains through out the play that she wants to be rid of her mother as soon as I get a full-time job, Im leaving Helen and starting up with a room somewhere so for Helen to know theres someone in her life she wants there, that person being Geof it must make her feel less important. Even for Helen who shows no real care for her Jo to know that her own daughter feels like that must be difficult. I think part of her feels she should have a close loving relationship with Jo I just dont think she knows how to or more importantly can be bothered. Peter, Helens latest fling who becomes her husband comes across as a decent sort of guy at first, however he is sleazy Helen you look utterly fantastic Got your blue garters on? He does turn nasty towards the end when their marriage isnt going so well Look at Helen, isnt she a game old bird? Worn out on the beat but shes still got a few good strokes left. and I dragged you out of the gutter once , If you want to go back there its all the same to me. The way he speaks down to Helen are reminiscent of his character, he believes himself to be above everyone else, better looking, better dressed, better educated, a real snob. Geof takes a mothering role in Jos life, which I dont think she always appreciates. Ill buy you one for Christmas. If you ask nice Ill buy you two. Ill stay here and clear this place up a bit and make you a proper meal. I think Jo actually likes having a figure to look after her but I think she finds it difficult sometimes as shes not used to it, shes used to fending for herself. Why dont you leave me alone? I think that all this shows that despite Jos though exterior she does want looking after and companionship, especially from her mother even though she denies it, as that is what Geof is doing for her, being a substitute mother. Geof , a single gay man was evicted from his flat by his landlady because she caught him with another man. In those days being a sexually active gay man was frowned upon so he was probably quite ashamed about the reason for his eviction and that is why he tries to hide it from Jo. When she asks has your landlady thrown you out? Geof replies Dont be silly, but later tells her the truth. Geof also agrees to move in with Jo, taking on the responsibilities of looking after a Jo and her baby. Also when Jo tells him her baby will be black he is extremely accepting and doesnt seem to care. In my opinion this is due to the prejudice he has faced about being gay. Another time his kind and compassionate character is seen is when he tries to get Jo and Helen talking again despite Jo telling him exactly what her mother is like he still persists and tries to build bridges in their relationship with them and get Helen to help out with the baby. Your mother should know, do you have her address? When he meets Helen though he is struck by how rude and uncaring she is and sticks up for Jo telling Helen. If Id known you were going to bully her like this Id have never asked you to come! Here he shows true loyalty for Jo by sticking up for her. In my opinion Geof is a very lonely young man he didnt seem to have any other friends besides Jo in the play, other than young man he was found in his flat with but in his own words he didnt really know the guy . We cant really be sure of his past because the play doesnt mention it but I feel hes faced a lot of prejudice about his sexuality and perhaps that is why he so understands Jo. He doesnt seem to have any family, and I think he was trying to make Jo and the baby into a surrogate family for himself. I feel he was the nicest character in the book but he did become quite irritating as he was too nice all of the time. All the other characters had floors and attributes that made them lovable or unlovable. Geof however, was just quite bland. Helen for instance was an interesting character because she was so unpredictable, she could have a new boyfriend at any moment, or get drunk and do something ridiculous. Goef on the other hand was predictable but provided the rock of the story. He was Mr. Reliable that Jo could turn to he wasnt an interesting character like Helen but was a vital part of the play.

Research Utilization Project - Fecal Transplantation Essay Example for Free

Research Utilization Project Fecal Transplantation Essay Clostridium difficile (C-difficile) is a common bacterium that is a frequent cause of infection in the colon and effects numerous patients. Clostridium difficile increases the hospital costs associated with inpatient care, including identification of the organism as well as treatment. The most common cause of C-difficile infection is the elimination of normal intestinal flora caused by antibiotic use. Standard treatment of C-difficile infection includes the use of oral (Flagyl) and intravenous (Vancomycin) antibiotic therapy. The use of fecal transplantation to treat C-difficile infection is increasing in popularity. Research regarding fecal transplantation dates back to 1958; however, the efficacy of fecal transplant for the treatment of C-difficile are rapidly emerging with noted benefits for patients. The mere thought of presenting fecal transplantation for the treatment of a C-difficile infection is often dismissed because of limited available evidence and the concerns about using someone else’s stool to treat the infection. The necessity to educate patients with C-difficile is an additional challenge. Potential donors and recipients need to be assured of minimal risks associated with the screening and transplantation process. The ability to educate society on the results of evidence-based practice regarding the treatment of C-difficile with fecal transplantation should minimize concerns and enhance patient outcomes. The creation of a patient education programs is increasingly beneficial when multiple health care professionals and interdisciplinary teams are involved. Thus, a project objective in implementing an educational patient program for fecal transplantation is the creation of an informative brochure for potential use in the Endoscopy Department at Sharp Memorial Hospital by December 2014. The treatment regimen for initial and chronic C-difficile with fecal transplantation is inexpensive and noted as extremely effective. The articles reviewed consistently reveal efficacy rates greater than 85%. Fecal transplantation for the treatment of C-difficile continues to illicit multiple verbal and non-verbal responses and is not considered a standard of care for patients, families, communities, and hospital staff. The implementation of an informative educational brochure will minimize fears, hesitations, and reluctance for the treatment of C-difficile with fecal transplantation. The central theme of transplanting feces from a selected healthy donor to the recipient with C-difficile is often met with resistance. The fecal transplantation brochure will encompass aspects of fecal transplantation with the expectation of educating patients, families, and communities. Additionally, the brochure would enhance awareness of hospital staff providing an opportunity to educate units or departments. The application of Kurt Lewin’s change model for the implementation of an educational brochure for fecal transplantation will be employed. The current treatment modalities for C-difficile and the methods of transmission are increasingly becoming expensive for health care organizations. The financial goals of the organization are to decrease the rates of C-difficile and possibly entertain the concept of fecal transplantation. A dichotomous survey will be used to measure awareness and use of fecal transplantation for the treatment of C-difficile. The interdisciplinary team employed to create the brochure would prove beneficial in developing standardized procedures in performing fecal transplantations. The Southern California Society of Gastroenterology Nurses and Associates is an excellent venue for potentially validating and communicating the results. The two possible grant funding sources for the fecal transplantation brochure is the American Gastroenterological Association (AGA) and the American Society of Gastroenterology Nurses and Associates (SGNA). The creation and implementation of an educational brochure for patients considered for fecal transplantation would enhance community education and minimize fears in treating C-difficile with fecal transplantation. Keywords: fecal transplantation, clostridium difficile, fecal micobiota transplantation Problem Identification The traditional treatments for patients diagnosed with infections of the colon are antibiotics. However, many antibiotics kill the normal healthy bacteria of the colon. This results in an overwhelming increase in the risk for developing a C-difficile infection. Medicine. Net (2012) stated, â€Å"Patients taking antibiotics are at risk of becoming infected with C. difficile as antibiotics can disrupt the normal bacteria of the bowel, allowing C. ifficile to become established in the colon† (para. 1). The potential for implementing the use of fecal transplantations for the treatment of C-difficile among the general population is questionable. The mere thought of presenting fecal transplantation for the treatment of a C-difficile infection is often dismissed because of limited available evidence and the concerns about using someone else’s stool to treat the infect ion. Rohlke and Stollman (2012) stated, â€Å"Cure rates of 90% are being consistently reported from multiple enters. Transplantation [fecal] can be provided through a variety of methodologies, either to the lower proximal, lower distal, or upper gastrointestinal tract† (p. 403). An additional consideration is the perception of fecal transplantation within the community. The necessity to educate patients with C-difficile is an additional challenge. Potential donors and recipients need to be assured of minimal risks associated with the screening and transplantation process. Current research supports and discusses a comprehensive approach to identification and screening for potential fecal donors, donor preparation, and transplantation procedures. The procedure for donor selection and screening is comprehensive to prevent the transmission of infection. According to Hamilton, Weingarden, Sadowsky, and Khoruts (2012), â€Å"The [donor] history includes assessment of infectious risk, including identification of known risk factors for HIV and Hepatitis, current communicable diseases, and recent travel to areas of the world with a higher prevalence of diarrheal illnesses† (p. 3). In educating patients, families, and the community at large, the rigor associated with the screening process must be emphasized to reduce fear. The project objective in implementing an educational patient program for fecal transplantation is the creation of an informative brochure for potential use in the Endoscopy Department at Sharp Memorial Hospital by December 2014. The brochure will be created using a collaborative approach by employing endoscopic nursing champions. The goal is for the brochure to be patient specific and encompass appropriate information to decrease fears and answer questions associated with fecal transplantation. Additionally, the development of a patient posttest associated with the brochure will be created to evaluate the effectiveness of content delivery and adjusted accordingly to meet patient needs and desired outcomes. The proposed solution will minimize the ambiguity and fears associated with fecal transplantation for the treatment of C-difficile. Solution Description The proposed solution for teaching potential recipients and donors about fecal transplantation for the treatment of C-difficile is to diminish infection rates. By creating and implementing a comprehensive nursing educational approach patients and donors can be well informed on this innovative treatment modality. â€Å"In many areas of clinical decision making, research has demonstrated that â€Å"tried and true† practices taught in basic nursing education are not always best† (Polit Beck, 2012, p. 25). The ability to educate society on the results of evidence-based practice regarding the treatment of C-difficile with fecal transplantation should minimize concerns and enhance patient outcomes. The creation of a patient education program is increasingly beneficial when multiple health care professionals and interdisciplinary teams are involved. The importance of evidence-based practice is to ensure the evidence about fecal transplants has been collected, evaluated, and implemented to establish the best practice and approach. The main premise for patient safety is to ensure donors have been thoroughly screened to minimize the potential for the transmission of other diseases with feces. According to Rohlke and Stollman (2012) on donor selection, â€Å"There have not yet been any adverse events reported that can be conclusively or directly attributed to [fecal microbiota transplantation] FMT, and proper donor screening is essential to avoid transmitting communicable diseases from donor to recipient† (p. 406). Individuals with recurrent C-difficile infections are moderately self-educated regarding treatment modalities and are receptive to the idea of fecal transplantation. The emphasis on educating patients, families, and communities regarding fecal transplantation as the initial treatment regimen is the focus. Hospital and individual associated costs in administering antibiotic therapy for the treatment of C-difficile could be drastically reduced by using fecal transplantation as the initial therapy. Brandt (2012) stated in reply, â€Å"Do patients typically accept fecal transplantation as a treatment option? Yes †¦patients typically respond with interest, and they are generally positive about trying it and they do not typically react with disgust† (para. ). The current research base associated with fecal transplantation demonstrates high cure rates while minimizing the reoccurrence of C-difficile. Rohlke and Stollman (2012) stated, â€Å"Cure rates of 90% are being consistently reported from multiple centers† (p. 403). The review of current literature demonstrates that patient education for fecal transplantation is performed by a gastroenterologist and not the gastrointestinal (GI) nurse. Patient education provided to patients from physicians typically entails a one-way communication style. In this scenario, the gastroenterologist sends the information to the patient, and there is little discussion with the receiver. Thus, patients commonly seek out more information from the registered nurse. The ability to educate patients regarding fecal transplantation using the proposed brochure would facilitate a commonality and minimize fears. The feasibility of implementing the brochure into endoscopic departments would be perplexing and centered on nursing knowledge of fecal transplantation. Brodine and Kellogg (2013) stated, â€Å"All patients infected or colonized with C. ifficile must be educated about this bacterium, proper disease management, and transmission prevention. The nurse should use patient-centered communication—free of jargon and appropriate to the patient’s health-literacy level† (para. 13). The health care organization must employ educational programs specific to the needs of the patients and desired outcomes. â€Å"The Joint Commission recommends using the â€Å"teach-back† and â€Å"show-back† methods to educate patients; that is, ask the patient to â€Å"teach back† the information provided or demonstrate understanding by â€Å"showing† a skill†¦Ã¢â‚¬  (Brodline Kellogg, 2013, para. 3). The organizational culture at Sharp Memorial Hospital for nursing is centered on the American Nurses Credentialing Center (ANCC) Magnet Recognition Program ®. The nursing strategic plan is developed by nursing leaders with input from nursing staff based on the hospital strategic plan. Additionally, nurse leaders emphasize that innovation is a core value and part of the nursing process. Nurse leaders encourage innovation through training, resources, and role modeling (Beyond Excellence, 2013). The roposed solution of implementing patient education for fecal transplantation is supported by Sharp Memorial Hospital because it involves introducing new knowledge regarding innovative, evidence-based treatment modalities. Research Report Clostridium difficile infection remains a constant struggle for hospitals. The standard treatment regimen of antibiotics commonly results in relapses. Research on fecal transplantation is continuing to emerge as a promising alternative approach in treating chronic C-difficile infections. Numerous studies demonstrate positive outcomes with the administration of fecal transplant in the treatment of C-difficile (Rohlke Stollman, 2012). Fecal transplantation has shown through research studies to be a useful treatment for C-difficile infection via the restoration of intestinal normal flora (Brandt, 2012). The most common sign reported by patients diagnosed with C-difficile is chronic diarrhea. Johnson (2012) stated, â€Å"The administration of antibiotics can alter the balance of normal colonic flora to permit the overgrowth of pathogenic C. ifficile strains that produce toxins which cause diarrhea and associated symptoms† (para. 5). In an article published in the Alimentary Pharmacology and Therapeutics, the authors reported 17 of 22 fecal transplantations for the treatment of C-difficile were effective (Landy, Al-Hassi, MLaughlin, Walker, Nicholls, Clark, Hart, 2011). The substantiated results of the review article highlighted major differences in patients, donors, screening, methods of administration, and the definition of treatment responses (Landy et al. , 2011). The multiple factors highlighted in this review of treating C-difficile with fecal transplantation review across the spectrum using a standard approach is essential to supporting increased use of this treatment modality. Landy et al. (2011) stated, â€Å"Standardized controlled studies are necessary to ascertain the most effective treatment regimen as well as the most acceptable method of treatment† (p. 414). Grehen, Borody, Leis, Campbell, Mitchell, and Wettstein (2010) published a study, â€Å"to demonstrate the benefits of fecal biotherapy and the role of new therapeutic strategies for the treatment of gastrointestinal conditions† (p. 51). The study included 10 patients treated with fecal transplantation and monitored the progress of bacterial population of the colon pre and post transplantation for a 24 week period. Grehen et al. (2010) found the following: At intervals of 4, 8, and 24 weeks after the procedure, the bacterial populations in the patients’ fecal samples consisted predominantly of bacteria derived from the health donor samples. Comparisons of similarity at 4, 8, and 24 week samples to the donor-infused sample were made and each recipient’s baseline sample was statistically significant with Friedmen test. p. 551) Rohlke and Stollman (2012) noted that C-difficile rates continue to rise with greater intensity and severity. The treatment of C-difficile with fecal transplantation is an emerging and accepted intervention in patients with recurrent C-difficile. Rohlke and Stollman (2012) stated, â€Å"Cure rates of 90% are being consistently reported from multiple centers. Transplantation can be provided through a variety of methodologies, either to the lower proximal, lower distal, or upper gastrointestinal tract† (p. 403). The review by Rohlke and Stollman (2012) analyzed reports validating the factors of â€Å"donor selection, appropriate patient criteria, and the preparations and mechanisms of fecal microbiota transplant delivery available to clinicians and patients† (p. 403). The internal validity of the research articles reviewed demonstrates moderate samples were randomly selected. The current literature validated the need for more randomized controlled studies to determine established guidelines for the implementation of fecal transplantation. Additionally, the treatment regimen for initial and chronic C-difficile with fecal transplantation is inexpensive and noted as extremely effective. The independent variable of the effectiveness of fecal transplantation for the treatment of C-difficile remained a consistent theme. The articles reviewed consistently reveal efficacy rates greater than 85%. The external validity of the study articles revealed fecal transplantation processes are varied in the process of which patients are treated, the donor selection criteria, donor screening protocols, and the methods of delivery. The outcomes of the results reported are moderately consistent; however, the ability to generalize a standardized treatment pathway is ambiguous and larger multi-organizational and multi-disciplinary studies are essential. Rex (2012) found the following: Several studies of fecal transplantation have demonstrated high cure rates. The latest and largest to date is a retrospective case series involving 70 patients in Finland (mean age, 73; 86% outpatients). Overall, 94% of these patients had symptom resolution during the first 12 weeks after transplantation, including 32 of the 36 infected with the O27 strain of C. ifficile and all 34 of those infected with other strains. No immediate complications occurred. (para. 1) Fecal transplantation in the treatment for C-difficile has proven to be highly successful in a limited number of studies. In determining if fecal transplantation should be the standard of treatment for C-difficile infection, larger controlled studies are required. Additionally, a standard process related to donor screening, implantation techniques, transplant follow-up, and regularly documenting patient outcomes are essential in establishing standardized fecal transplantation protocols.