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Saturday, August 31, 2019

Analyzing White America Essay

After viewing â€Å"Analyzing White America† by Paul Mooney, I was initially taken aback by the content. I never expected the rawness that Mooney brought to the stage and he hit the ground running with such a tone without looking back. A lot of the material made me laugh or at the very least smile because i found it to be identifiable with my own life and some of the surroundings that I was brought up in. The part that I found most amusing was Mooney’s suggestion that white people were happier before slavery was abolished. I believe racism is very much present in today’s world. When I was growing up, I can recall plenty of neighborhoods in my hometown that were considered â€Å"white† or even â€Å"black† for that matter. In these neighborhoods, if you were not from that part of town, you were not considered welcomed there. Any parts of the film that I did not laugh at, there was no particular reason other than I simply was not amused by the material because there were not any parts that I found personally offensive. I feel as though the word â€Å"nigger† is so controversial solely because of it’s history and the origin of it’s meaning. This word was meant to degrade and disparage African Americans when it was originated. Today, people use the term in a different context. The new meaning is one of affection but with it’s use comes this unwritten rule that white people are prohibited from saying it. I never could wrap my mind fully around the idea that I can say the word â€Å"nigga† in reference to a friend of mine but a white kid was not allowed to use it, in the same context, all because we are of different races. In my opinion, it’s not right for either myself or a white person to use the word in any context. In today’s society, everything is just as much about race as it was in the days of slavery. The only difference between now and then is that openly addressing the issues that we, as a culture, all have with race is socially unacceptable. Mooney’s antics on stage were not without warrant. He recognizes that racism is still a major issue and he chooses to address it differently than the average person. Paul’s words are not meant to slander or belittle any one race, religion, or ethnice group, but instead he wants to make his audience to expand their minds and think about what it is he is really saying. Granted, his demeanor is controversial, I believe he achieves just that.

Friday, August 30, 2019

Illusion and Identity in Atwood’s Essay

Identity in Atwood’s â€Å"This is a Photograph of Me† In her poem â€Å"This is a Photograph of Me,† author Margaret Atwood uses imagery and contrast to explore issues of illusion versus reality as well as identity. The poem is split into two halves. The first half contains descriptive words about scenery and natural objects, and the second half, surrounded by parentheses, begins with the unnerving surprise that the narrator is dead. The poem opens with a description of a picture that at first seems blurry but slowly comes into focus, like a photograph slowly developing, that even resembles a written poem itself (â€Å"blurred lines and grey flecks/blended with the paper. †) The second and third stanzas go on to describe objects in the picture, including a â€Å"small frame house,† a â€Å"lake,† and â€Å"some low hills. † The first half has a reminiscent and descriptive tone, falsely leading the reader along with serenity. But even here, there is a shroud of mystery, with a description not just of a â€Å"branch,† but of â€Å"a thing that is like a branch,† and the house is â€Å"halfway up/ what ought to be a gentle slope,† not halfway up a gentle slope. What could this mean? The calm albeit mysterious peacefulness of the first half ends with the fourth stanza’s jarring declaration, beginning with an opening parenthesis, that the photograph the narrator is describing â€Å"was taken/ the day after [she] drowned. The pace of the poem after this revelation seems frantic, searching for the narrator in the lake, which was in the first half described as being â€Å"in the background† and now â€Å"in the center/ of the picture. † The narrator tells the reader that what can be seen is distorted and one must look intently, playing with the themes of illusion and identity. Perhaps the ambiguity of the poem and the exploration of illusion and identity are hinting at a feminist perspective that a woman’s true spirit is overcast by a male-dominated society. Or perhaps the poem’s focus is eluding to a more universal human search for identity, a with a narrator who is unsure and obscured, but â€Å"just under the surface,† about to break out – previously dead but now reborn, to find a new path. Or perhaps the author is talking about poetry or literature itself and the author’s hidden intentions lurking in the work. As noted earlier, the description of the â€Å"photograph† at the beginning resembles a description of a poem: â€Å"blurred lines and grey flecks/ blended with the paper,† like lines of writing and the letters comprising words. The author dies with the birth of her poem, when the piece lives on its own; but the author is still there, somewhere, her intentions a key part of the text. The photograph in the poem, in the first half, is described as â€Å"smeared† and â€Å"blurred† and in the second half there is still â€Å"distortion. † So instead of disclosing the narrator’s story and identity, no resolution is apparent. On the contrary, the photograph creates illusion and obscures identity. The reader is left with uncertainty, just like the blurred and distorted photograph of the poem.

Thursday, August 29, 2019

Ethics Essay Example | Topics and Well Written Essays - 500 words - 31

Ethics - Essay Example With the pursuit of perfection in the chosen specialization, a code of ethics is put into place. The topic of the paper revolves around the code of ethics in nursing and two other professions which are occupational therapy and physical therapy. Nursing code of ethics has nine principles or provisions while the occupational therapy and physical therapy has seven principles respectively. All of the said professions are meant to assist the doctors in rendering services to the patients in specific ways as nurses directly work with the doctors while occupational therapists are responsible for helping the patients cope with their daily lives. On the other hand, physical therapists focus on assisting the patients in recovering their bodies back to normal condition through exercise and proper diet. In general, all of the three codes have the same ethical principles in terms of respecting the patients and fellow professionals, promoting health, continuously enhancing health assistance skills, respecting privacy, and protecting the well-being of the patients. Each profession just differs from one another in terms of elaboration of the principles and the way the professionals practice their career. Another comparison can be done between the nursing code of ethics and Nightingale Pledge in which the latter is a modified Hippocratic Oath. The pledge had been modified to match the modern changes until the code of ethics was written based on the pledge. It is considered that Nightingale pledge is specific, personal and limited in terms of content than the nursing code of ethics (Zwemer, 1995, p. 113). The original pledge has more differences from the code since the revised pledge was closer to the code when it comes to meaning. Also the Code of Ethics is addressed objectively unlike the pledge which is subjective. It is also noticeable that the original pledge used some words that are not very much used today like the

Wednesday, August 28, 2019

Financial Crisis in South Korea in 1997 Research Paper

Financial Crisis in South Korea in 1997 - Research Paper Example The ration between GDP and foreign reserves was less than 30%. It was the lowest ration throughout the developing countries at global scale, even less than several advanced countries as well. Annual budget had also a balanced composition. Therefore, due to this macro analysis, numbers of economic institutions including IMF had no idea of occurrence of an economic crisis that had affected Southeast Asian countries during the summers of 1997 (5). The crisis was so massive that lots of financial experts had predicted a likely sovereign default of South Korea. South Korea, after great struggle, could hardly manage to survive by getting support from IMF, friendly countries, and several other institutions. The extent of economic downturn of South Korea can be evaluated and measured more accurately by utilizing the five macroeconomic parameters i.e. GDP rate, Inflation rate, Unemployment rate, and Interest rate. Korean GDP rate observed a steady phase during 1990 to 1996 as it remained betw een 5.9 to 9.4% with an average growth of about 7.9% per year. Due to financial crisis and reduced exports, the GDP growth experienced a downward trend in 1997. It dropped to a negative 6.8% in 1998. Mishkin and Hahm (2000) described four basic factors which as a combined effect lead to the financial instability. These factor include financial deterioration in in terms of balance sheets, increasing interest rates, worsening of nonfinancial balance sheets, and upturn in uncertainty. All these factors were rightly observed as a source of financial crisis in South Korea. Due to prompt survival of national economy and by the help of IMF, a recovery was observed in 1999 and 2000 (Hardy & Pazarbasioglu, 1998). The main objectives of this paper are to analyze the historical perspective of different economic policies in different political regimes and what did they contribute as well as to discuss the factors that contributed towards this credit-crunch. The role of IMF is discussed briefly that how it affected and supported the country financially. At the end of the paper, a conclusion is drawn, based upon different policies and findings, and few recommendations are suggested for the Korean government in terms of future perspectives. Economic Policies and Performances After independence in 1945, South Korea observed a great financial progress as well as declining phases. These economic ups and downs have been based on numbers of different economic policies which have been devised by different governments in different scenario. These policies could be the reconstructing of institutions (1945-1961), export promotion and growth policies (1961-1972), recovery and stabilization (1973-1981), adjustment and expansion era (1982-1996) or the two economic crisis of 1997 and 2008. The economic policies which were enforced during the regime of Park Chung-Hee are characterized as the government-led model, also referred to as the statist approach (Alice, 1992). This type of policy, the role of government is most important because it is the authority to formulate all the structures and designs of economic policies and then ensures its implementation (Caporaso & Levine, 1992). Park’

Tuesday, August 27, 2019

Access how governments have used decentralization to make public Essay

Access how governments have used decentralization to make public services more responsive - Essay Example re which must be taken into account while assessing the significance and incidence of decentralization is that whether the proposed decentralization is in the favor of the public interest or not. The intellectual discussion regarding the success and failure of decentralization of public institutions largely focus on this main issue. Viewed in that perspective it is then decided whether public services would be more responsive to the decentralization or whether they should be centralized. Further, the decentralization and centralization of any government and public sector services is done based on two perspective i.e. Efficiency values and Government values. â€Å"Efficiency Values comprise the public choice justification for decentralization, where efficiency is understood as the maximization of social welfare whereas the Governance values comprises of (i) responsiveness and accountability, (ii) diversity, and (iii) political participation.†(Wolman, 1990). Assessing within these two perspectives, we will now attempt to analyze the decentralization that took place in UK. Starting with the industrial relations, it has been largely argued that the decentralization of industrial relations would not yield results without providing a due thought to the local contexts within which these processes take place. Decentralization especially within the context of industrial relation has been largely viewed as an attempt to weaken the workers unions. Unions are often seen as protectors of the labor rights and decentralization of the collective bargaining power of the unions have further dented the morale of the public sector employees. It is probably because of this reason that despite initiating decentralization, UK is considered as a strong bureaucracy with strong administrative lacunas to hinder the smooth operations of the public sector services. (Katz, 1993). The shift in the locus of power within the public services therefore created strong administrative problems and

Monday, August 26, 2019

Service Quality Improvement Essay Example | Topics and Well Written Essays - 2250 words

Service Quality Improvement - Essay Example According to Sheth & Kellstadt (1992), a normative model of service quality improvement is built on the concept of continuous improvement. The company that I have been working in has been using this kind of approach to address its issues of quality improvement. This is because the key objective of the company is to achieve sustained improvements in its services delivery. Therefore, throughout my career, I have had an opportunity to experience a situation in which this model was applied. Moreover, I have been able to experience some of the benefits of this kind of a model when used to improve service quality as well as some of its shortfalls. This benefits and shorts could form a very good basis for my evaluation in this paper. Normative model of service improvement is divided into stages. The stages include management commitment, employee commitment and participation, employee education and training, communication, assessment and modification, outcomes and targets, and integration (H ernon & Whitman, 2001). These stages are interconnected in an intertwined manner. This means that a stage does not necessarily result to its next stage. However, each stage is independent of the other. The company that I am working in has been undertaking almost all the above stages in its approach to service quality improvement. Some of these stages in service quality improvement have been very conspicuous. This makes them to be easy to identify even to the people who are not top managers. However, some are inconspicuous thus can only be identified by top managers. Sheth & Kellstadt (1992) also identifies this approach of service quality improvement as both multi-disciplinary and requires individuals with different functions in the company. This is because it requires efforts of managers belonging to different disciplines. Moreover, it involves employees with varying roles in the company. In the company I work with, service quality work has not been the work of the marketing department only. In every case that the company has attempted to improve its quality of service, all the departments have been required to play almost equal roles. This is because the company believed that improvement in quality of its services could only come from an improvement in the effectiveness of every department in the company. Benefits of the model to service quality improvements The most essential component of any organization is its management since it controls all the decisions made in the organization in its various operation stages. Use of a normative model for service quality improvement by the organization I work with has enhanced the participation and commitment of the management team to the process of improving quality of services. This is because it has been requiring every manager to show his commitment to the process. Moreover,

Sunday, August 25, 2019

CNN International and Al-Jazeera Arabic Essay Example | Topics and Well Written Essays - 2250 words

CNN International and Al-Jazeera Arabic - Essay Example CNN International started transmissions on January 1, 1984 at first broadcasting to American business travelers in hotels. The huge bulk of the network's programming primitively consisted of simulcasts of the two domestic CNN channels, CNN/US and Headline News. However, the quantity of news programming created by CNN International especially for international viewers significantly enhanced, in 1990, which came forth as an internationally oriented news channel with staff members of various national backgrounds. On July 4, 1997, CNN International was awarded the Liberty Medal and in accepting the medal on behalf of the network, Ted Turner said: "My idea was, we're just going to give people the facts†¦We didn't have to show liberty and democracy as good, and show socialism or totalitarianism as bad. If we just showed them both the way they were†¦clearly everybody's going to choose liberty and democracy." ... ates was launched on January 11, 2009 and CNN International adjusted half an hour in its schedule with a new evening prime program for the Middle East viewers â€Å"Prism†. From January till September 2009, CNN International conformed more programs that went pitched to a primetime European audience with a few titled after CNN International charismas especially the interview program Amanpour. The channel plunged a new tagline "Go Beyond Borders", accenting the international view that gives the information in this string and the plurality of the audiences and also referring to the various platforms to broadcast their contents, along with a new logo on September 21, 2009. The Channel amalgamated its general newscasts (CNN Today, Your World Today, World News, World News Europe and World News Asia) into a single newscast entitled World Report. CNN International has launched new programs for evening-prime and meliorated its schedule from 2010. The Domestic CNN has increased the CNN International schedule by adding the new talk show program â€Å"Piers Morgan Tonight† in 2011. Today, CNN International has six variants namely: CNN International Europe/Middle East/Africa, based in London, England, United Kingdom; CNN International Latin America based in Atlanta, Georgia, USA; CNN International North America based in Atlanta, Georgia, USA; CNN International Asia Pacific based in Hong Kong SAR, China; CNN International South Asia based in Hong Kong SAR, China; and CNN International Middle East, based in Abu Dhabi, United Arab Emirates.3 Al-Jazeera Owned by the state of Qatar and headquartered in Doha, Qatar, Al Jazeera is an independent broadcaster through the Qatar Media Corporation. Al Jazeera was initially launched as an Arabic news and current affairs satellite TV channel and

Saturday, August 24, 2019

Racial Disparity Research Paper Example | Topics and Well Written Essays - 1250 words - 1

Racial Disparity - Research Paper Example If it could be considered as one of the social problems of modern societies, racial disparity has caused severe concerns to governments worldwide mostly because of the following facts: the problem seems to be continuously expanded, i.e. there is no sign of limitation or even standardization; also, the phenomenon has been already developed at such level that threatens the stability of the society. Racial disparity is a critical social problem in countries worldwide. The problem is mostly reflected in the barriers faced by black people or people belonging in minorities when trying to enter the job market (The Independent 2008, NBC Washington 2011); the healthcare treatment provided to black people and people in minorities also reveals the existence of racial disparity (McNeil 2011). In criminal justice also, cases of racial disparity can be identified. Indeed, black people and people in minorities are most likely to be arrested for crimes of various types; moreover, people in this category are more likely to be convicted – compared the white people who have committed the same offences. In Illinois ‘19 per cent of black defendants charged in 2005 were sentenced to prison after being charged with a low-level drug possession felony’ (Di Benedetto 2011); the percentage of white people charged for the same crime was just 4% (Di Benedetto 2011). It should be noted though that the failure in managing racial disparity is not reflected just in the punishment imposed on offenders; it seems that criminal behavior is increased in black people and people belonging in minorities, a fact which shows the lack of measures for equally controlling crime across society. In a research developed in 2008 â€Å"10.1 per cent of all blacks reported using illegal drugs compared to 8.2 per cent of all whites† (Di Benedetto 2011). Racial disparity is an important social problem;  however, its limitation would require an integrated plan of action; the introduction of changes in the criteria of sentencing would not be adequate for reducing the number of minorities in courts and prisons.  

Should Convicted Felons Have The Right to Vote Assignment

Should Convicted Felons Have The Right to Vote - Assignment Example It is the duty of the society to halt the downward march to destruction and inspire one to the upward march of moral elevation to make one a worthy individual and citizen. The conclusion is obvious. The convicted felons need to be given the right to vote. Most of the crimes are generally committed at the spur of the moment, when one loses the balance of mind. He suffers through the period of conviction and the prison has never been a pleasant place for any individual, notwithstanding the amenities provided. â€Å"The legal authority of a State to revoke an inmate’s voting rights is based upon the Fourteenth Amendment. State laws on allowing convicted felons to participate in elections vary widely. Forty-eight states deny the vote to at least some felons; only Vermont and Maine let felons vote. Thirty-three states withhold the right to vote from those on parole. Eight deny felons the vote for life, unless they petition to have their rights restored, such as Alabama and Florida. New Jersey and Connecticut allow former felons to vote once they have completed parole. Nationally, about 4.2 million convicted felons cannot vote.†(Stukes, 2010) A straightforward answer cannot be provided to the question whether the convicted felons need to be given the right to vote. The immediate reaction is what sort of a felon? All felons are not alike and the gravity of their crimes is not alike. The 14th amendment specifically permits states to disfranchise citizens convicted of participation in rebellion, or other crime. How an enemy of the country be given the right to vote? Legally, the federal government may not infringe upon the authority of the state to give and not to give the voting rights to prison inmates and former felons. The spirit of the American Constitution is, it swears by democracy. But party politics has engulfed the issue to a great extent. This appeals to the Democrats because a large number of felons are African-Americans, the

Friday, August 23, 2019

Personal Development Planning Essay Example | Topics and Well Written Essays - 1500 words - 3

Personal Development Planning - Essay Example One has to follow the right strategies towards reaching that career. One has to attend training and learn all the different perspectives and requirements needed to pursue and succeed in that career. Schooling is an important step that make some understand the historical, current as well as future trends in a certain career (Duffy, 2006, p. 55-7). This way, one is able to reshape and his realign his dreams and find the much-needed motivation to pursue the dream to accomplishment. Mentorship plays an important role in enabling one to create important goals and objectives, and plan on methods to pursue them. The attainment of particular set goals and objectives should always pave way for one to set other goals that are much advanced from the previous goals. A good career provides a reliable and favourable opportunity for a person to actualize his dream. In order to ascertain whether your dreams are being met, it is important o have a plan upon which one can always confirm about the particular progress. This plan is usually referred to as a personal development plan; it usually guides one into achievement of the specific set targets in the line of career and other related aspects. I have chosen to pursue a career in public relations, an area that mostly requires spreading of information between an individual or organisation and the public. Public relations is an important practice in business organizations, public and private institutions as well as the public sector. In the career, a practitioner has to gain necessary and reliable exposure to their targeted audience using topics of public interest and different news items that may not necessarily require direct payment. In a company and other business related practices, public relations is aimed at passing information that is aimed at persuading public investors, partners, employees as well as other stakeholders to maintain a certain perspective about its

Thursday, August 22, 2019

The Second Vatican Council Essay Example for Free

The Second Vatican Council Essay The Second Vatican Council began in 1962 and ended in 1965. For the first year Pope John XXIII opened the council, he unfortunately died in 1963. Pope Paul VI then took over and closed the council in 1965. â€Å"A combined total of 2,865 bishops and prelates attended the council, which issued sixteen formal documents† (John and Hardon, 2000). The second Vatican promulgated some of the most important documents present in the Catholic religion. They also changed the way the Laity were involved in the church. A Lay apostle is someone who has committed to God (through baptism and confirmation) and strives to deliver the divine message of salvation to others throughout the world. â€Å"The need for the apostolate is shown by the manifest action of the Holy Spirit moving laymen today to a deeper and deeper awareness of their responsibility and urging them on everywhere to the service of Christ and the Church. † (Jackson, 2010). Therefore the statement suggests that the Holy Spirit is the one to give us a deeper understanding of what we as Catholics must do to become a good lay apostle, and that our responsibilities are within the church and our beliefs in Christ. Nazzaro (2010) states â€Å"A Lay apostle walks closely with Jesus throughout each day†¦ We serve Jesus through service to others. † In order to become a good lay apostle we must be close to the Lord daily whether saying prayers or attending church, and in order to serve him we must spread the word of God to everyone that would be interested in following Christ. The Second Vatican Council made the dogmatic constitution on the Church (Lumen Gentium). This was a set of rules in which Catholic must abide by. The constitution of the church states that everyone is part of the church and therefore everyone has a responsibility for its growth and the spread of the kingdom of God throughout the world. Due to this responsibility the council recognised the need for the role of the laity to cease from being passive and instead become active. The role is stated by Paul VI (1964) â€Å"they may make Christ known to others† The Vatican II council was one of the most significant events to have happened in the Catholic Church. This was because the council made many changes, its purpose was to bring the church up to date by opening it to dialogue with the modern world in terms of other Christian traditions, other faiths, the cultural, the political and the technical milieu in which we all live. (Doyle, 2006. Bishop Butler, 1967). The church felt that they were ‘behind times’ therefore their goal was to modernise themselves so that they kept up with its people. This meant that the church allowed the freedom of speech to all catholic people. The council wanted a wider input from the community therefore they allowed the laity to have an active role in the church. Other changes included allowing women on the sanctuary, before the second Vatican only males could be alter servers. Churches were not encouraged to study the bible, but rather the catechism, however nowadays churches can study both. Catholics had little to do with Protestants and they weren’t allowed to enter protestant churches, this has also been changed. For most Catholics, the biggest changes the Council made was â€Å"the priest and altar turned toward the people and the Liturgy of the Word and the Canon of the Mass in the vernacular† (McInerny, 2001). This implies that the mass is now read in a language the people understood. Before the Vatican II, mass was read in Latin, which the Laity saw unsuitable as they did not follow or understand the ceremonies attended. The Laity played little part within the church before the second Vatican council was formed. The laity attended mass to listen to the word of God, which was delivered and preached by the clergy. However the insight of Vatican II now means that, â€Å"the laity have a full and active role to play both in the church and in the world. † (Kinast, 1979:384). This implies that the people of the church not only have to take part within the church but they must do their own duty outside of the church. This means getting involved within church events such as fundraising or helping out with the offerings within the sermons. The council felt there was many reasons for changing the role of the laity. One important reason was to enable the Church to adapt with current changes of the modern world. A quote from Pope John XXIII as on his deathbed (24 May 1963) (cited in Bishop Butler, 1967) was â€Å"Those who have lived as long as I have were enabled to compare different cultures and traditions, and know that the moment has come to discern the signs of the times, to seize the opportunity and to look far ahead. He recognised that the Church was at an important stage and that in order to seize opportunities and bring others into the faith, there needed to be a role for the laity. Bishop Butler (1967) supported this in stating; â€Å"Catholics were not meant to be museum keepers, but rather gardeners whose responsibility it was to prepare a beautiful harvest for a glorious future†. In other words, the laity are there to serve the Lord in as many ways possible, it would be an opportunity wasted if God’s children (the laity) were not sent out to spread the message. Lay Christians are dedicated to Christ and anointed by the Holy Spirit as aforementioned. They are called to be heralds of faith and through them the Church can become the salt of the earth. This is why the council felt it was important to change the role of the laity as they realised the Holy Spirit acted through them. There have been many developments within the church since the Vatican II. This includes the involvement of other helpers within the church. The Lay people due to the changes were able to do a lot more within the church services. These include readings and Eucharistic ministers. They also have female alter servers, which before the Vatican II would never have been allowed. Some felt that the Vatican II did little for the Church today; â€Å"Although the Second Vatican Council had enormous impact, it cannot be isolated from prior and parallel liturgical, theological, biblical, and social developments† (Mcbrien, 1997), however I disagree. Without the Vatican II’s introduction of the Constitution on the Church, the role of the Laity would not have been transformed to the state that we know today. Because of the Vatican II, the church today has many different roles for people. These include Church Church cleaners, flower arrangers, prayer groups, liturgy groups, pilgrimage groups (including taking the sick to Lourdes), bereavement care centres, parish teams, school chaplains and many more. In creating these jobs not only decreases the work load for the Clergy but it allows the community to get involved within the church and spreads the word of God. There are many developments that may happen in the future. Some have already been discussed but still have yet to be decided. One thing that may develop in the future is the decision on birth control. Although the Catholic Church has still banned contraception there may be good reason for the introduction of it for example the discussion of the prevention of HIV. Another development that could be changed is the marriage of priests. There will always be a place in the church for a celibate priesthood, but there should also be a place for a married priesthood in the church, stated by Daly (2011) (cited in McDonald, 2011). The statement provides challenges to the Catholic religion and that one-day the ban may be shifted. Another issue is that Homosexual marriage may occur in the future. Many religions including Christianity are still against this decision however, todays society is beginning to accept it and thus the Church may also come to the same agreement. A final development for the future would be female ministers. Although there has been much dispute about this topic, the church may alter its decision and adapt to the ever-changing society. Now that there is the Laity, the church must do its duty and continue to listen to the requests and suggestions made by the Laity. The church and the Laity can be said to be a family or a community and without the Laity or the Clergy present, the Catholic religion may not survive. Therefore the second Vatican’s decision on apostolate of Laity was very important as they help the survival of the religion and the message to be spread throughout the world.

Wednesday, August 21, 2019

Literature Review On Plantar Fasciitis Health And Social Care Essay

Literature Review On Plantar Fasciitis Health And Social Care Essay Well I would like to describe the prevalence and research about the topic in brief in this part as it is important to know why this topic has become an issue now and why do we need to make research on it. Plantar fasciitis is found to be the common foot complaint. It has been estimated that it affects approximately one in ten people at some time in their life (Crawford, Atkins, Edwards, 2003). However, it can occur at any age. It is twice as common in women as men and it is also common in athletes (NHS Clinical knowledge, 2009). The most common cause is infracalcaneal pain of plantar fasciitis and accounts for 11% to 15% of all foot complaints that require professional treatment (Buchbinder, 2004). A recent survey done by Riddle and Schappert in (2004) estimated that there are approximately one million patient visits per year to office-based physians and hospital departments in the United States by patients diagnosed as having plantar fasciitis. It occurs in approximately 10% of people who run regularly. Incidence of this condition peaks between the ages of 40 and 60 years (Buchbinder, 2004; Wearing , Smeathers , Urry et al., 2006). It is a bilateral complaint in about one third of pa tients (Buchbinder, 2004 ). Podiatric physicians, rheumatologists, general practitioners, physiotherapists and orthopaedic surgeons are the main healthcare providers involved in the treatment of plantar fasciitis (Riddle Schappert, 2004; Crawford and Thomson, 2003; Atkins et al., 1999). As I have been working as a musculoskeletal physiotherapist this topic quite influences me as most of the patient which i have been looking suffer from this injury. So in this systematic review i would be discussing about effectiveness of low-dye taping technique in plantar fasciitis. Plantar fasciitis is not gender specific and affects approximately 2 million of the American population per year (Irving , Cook and Menz, 2006). This disorder is expected to have many factors in origin such as obesity, excessive periods of weightbearing activity and decreased ankle range of motion commonly suggested to be involved (Riddle, Pulisic, Pidcoe, Johnson 2003). A wide diversity of treatment strategies have be en developed. Up to 90% of patients treated conservatively (eg taping and ultrasound), they experienced resolutions of symptoms (Thomas et al., 2001; Gill, 1997). There limited support of evidence showing specific treatment strategies for plantar fasciitis (Crawford and Thomson, 2003; Gill, 1997; McPoil et al., 2008). Atkins et al. (1999) identified 28 different conservative treatments and eight different surgical treatments, which confirms the vagueness of this condition. Foot orthoses are a common treatment for plantar heel pain, however due to the manufacturing process, they often require a time of a few weeks between the initial consultation and issuing the devices (Kosmahl, 1987; Lynch et al., 1998; Martin et al., 2001; Scherer, 1991). As such, short-term treatments such as supportive taping are used to improve symptoms during this temporary period (Martin JE, Hosch, Goforth, Murff, Lynch, Odom 2001) the low-Dye (Dye 1939) taping technique being one of the most frequently used . Foot taping, such as low-dye taping, alters the mechanical function of the foot, decreasing stress on the plantar fascia and subsequently producing symptom relief (Saxelby, Betts, Bygrave 1997). Low-Dye taping by Dye in (1939) is a common conservative treatment for plantar fasciitis. Most research (Ator et al., 1991; Childs et al., 1996; Del et al., 2004; Harradine, Jarrett, 2001; Holmes, Wilcox, Fletcher, 2002; Keenan, Tanner, 2001; Moss, Gorton, Deters, 1993; Russo, Chipchase, 2001; Scranton, Pedangana, Whitesal, 1982; Vicenzino et al., 1997; Whitaker, Augustus, Ishi, 2003) to date has examined the mechanical effects of the tape on the lower limb. One of the study done by Saxelby et al. in 1997 has evaluated the symptom relief offered by low-dye taping, but it had small numbers of participants and did not include a control group. But consequently there is need for larger studies that use a control group for comparison so we need to carry out this study. Those tapings which extended up the leg were known as High-Dye, while those in the foot were named Low-Dye. It has been used in the management of an array of foot pathologies, especially plantar fasciitis, and its effectiveness has been discussed by several workers (Newell1977, Miller 1977, Subotnick 1975, Van Pelt 1989). Taping as an intervention or as part of an intervention for the treatment of plantar fasciitis has been used for at least 70 years (Dye 1939). A systematic review assessing the efficacy of low-dye treatment strategy has not been found. Therefore, it was considered relevant to conduct the review. The discussion about the basic information regarding the topic in detail and why it is an issue now will be discussed in the following chapter. Well the basic aim of this review is asking whether low-dye taping is effective in the management of plantar fasciitis or not? The purpose of this study is to give low-dye taping treatment to people suffering from plantar fasciitis with respect to pain relief, gait improvement, impact on lifestyle and overall rate of success. The systematic review helps to identify the papers which relate to the question asked by the review and in turn will help to answer the review question. A organised SR protocol should be developed to carry the review in a easy way. The systematic review should be carried out in an organised manner as follows: Background: Intially i would like to discuss about plantar fascia, its situation and what structures it covers and how it causes injury. According to Haung 1993, the plantar fascia is the major arrangement that supports and maintains the arched position of the foot. This aponeurosis acts as a bowstring to grip up the longitudinal arch. It covers the major part of the foot. The planter fascia is a fat, fibrous group of connective tissue. Its starting point is the medial plantar tubercle of the calcaneum. It extends along the length of the sole of the foot like a fan, being attached at its other end to the bottom of each of the toes. It is a tough, flexible structure that has a number of significant functions during running and walking. It stabilizes the metatarsal joints during impact with the ground. It behaves as a shock absorber for the whole leg. It forms the longitudinal arch of the foot and helps to raise the arch to get ready for the take-off phase of the gait cycle. The plantar fascia helps to preserve the complex arch system of the foot and plays role in ones equilibrium and the various phases of gait. The pla ntar fascia consists of a multilayered fibrous aponeurosis (Kwong, Kay, Voner, White, 1988) that starts from the medial tubercle of the calcaneus .The plantar fascia is made of three major bands, the lateral, central, and medial. The central band is the strongest and thickest. The medial and lateral bands cover the undersurface of the abductor hallucis and abductor digiti minimi muscles, respectively. The fibers of the central band separate into 5 slips near the level of the metatarsal heads and then attach to the proximal phalanx via the plantar plate of each metatarsophalangeal joint (Schepsis, Leach, Gorzyca, 1991). Figure 1 Now we will discuss about plantar fasciitis. Here are some acceptable definitions of plantar fasciitis cited by experts which would be helpful in this study. Injury of this tissue, called as a plantar fasciitis, is very difficult to resolve. Plantar fasciitis is a localized inflammatory condition of the plantar aponeurosis of the foot and is reported to be the most common cause of inferior heel pain (Schepsis, Leach, Gorzyca, 1991). Plantar fasciitis represents the fourth most common injury to the lower limb and represent 8 10% of all presenting injuries to sports clinics. It can be caused by many factors. Plantar fasciitis develops when repetitive weight-bearing stress irritates and inflames the tough connective tissues along the base of the foot. It is difficult to treat. Rehabilitation can be long and frustrating process. The use of preventing exercise and early acknowledgment of danger signals are considerable in the avoidance of this injury. Plantar fasciitis refers to an inflammation of the plantar fascia. The inflammation in the tissue results in some type of injury to the plantar fascia. Typically plantar fasciitis ults from rep eated trauma to the tissue where it attaches to the calcaneus. According to souza, plantar fasciitis presents as a sharp heel pain that radiates next to the bottom of inside of the foot. In short the definition varies from person to person and it mainly depends upon the cause. The pain is found to be terrible when getting out of bed in the morning. Plantar fasciitis is a aching condition of the subcalcaneal aspect of the foot resulting from soreness or contracture of the deep fascia of the sole with or without calcaneal spur. Plantar fasciitis has been used synonymously with the following terms: Painful heel syndrome Subcalcaneal bursitis Subcalcaneal pain Runners heel Medial arch sprain According to Baxter, Plantar fasciitis can take place in runners or other athletes who repetitively land on the foot. Plantar fasciitis is an overuse damage whose occurrence accounts for 10% of all running injuries (Am J Sports Med 1991). Another vulnerable group is middle-aged people who use up much time on their feet. More infrequently, the fascia becomes irritated after a single traumatic episode, such as landing incorrectly after a jump or running a long hill. The massive majority of people will respond to conservative care and not require surgery. Appropriate treatment is necessary, however, to permit continuous participation in sports and daily activities, and to stay away from chronic damage. Risk factors: Plantar fasciitis is particularly prevalent in runners and people who are overweight (Hill and Cutting, 1989), however, it is also prevalent in people with systemic, inflammatory arthritis (Davis and Blair, 1950; Hassani et al., 2002; Furey, 1975; Gerster, 1980). Despite plantar fasciitis being a relatively common disorder, little is known about its etiology and pathogenesis (Wearing et al., 2006). Most anecdotally (Singh et al., 1997; Irving, Cook and Menz, 2006; Rome, 1997), intrinsic and extrinsic risk factors for plantar fasciitis have been reported. Participants in sports that engage some degree of running and jumping, e.g. basketball, tennis, step-aerobics, dancing may be at risk. Non-athletic people who spend much time on their feet. It may emerge in someone who suddenly becomes more active after a time of relative inactivity. Running on hard ground aggravates the risk, as does an increase in hill training. Worn out trainers boost risk as they lose their shock absorption prope rties. Obesity increases risk. There is increase in stress placed through the fascia. Other mechanical risk factors include flat feet (pes planus) and having a high arch (pes cavus). Studies done by (Riddle et al., 2003; Irving et al., 2007) identified that reduced talocrural dorsiflexion, high body mass index, pronated foot posture, and prolonged work related weightbearing are independent risk factors of plantar fasciitis. The most widely reported clinical sign of plantar fasciitis as said by Wearing et al., (2006) is pain localised to the medial tubercle of the calcaneus. Characteristically, the pain is exacerbated after periods of nonweightbearing. The pain decreases after few minutes of initial weightbearing but returns and get worst when time on feet increases (Singh et al., 1997; Thomas et al., 2001; Schepsis, Leach and Gorzyca, 1991). Various interventions used for plantar fasciitis: In general, plantar fasciitis is a self-limiting condition. Unfortunately, the period until resolution is frequently six to 18 months, which can direct to frustration for patients and physicians. Rest was cited by 25 percent of patients with plantar fasciitis in one study as the treatment that worked best (Wolgin, Cook, Mauldin, Graham 1994). It is equally important to correct the troubles that place individuals at risk for plantar fasciitis, such as increased amount of weight-bearing activity, increased intensity of movement, hard walking/running surfaces and worn shoes. Early recognition and treatment usually direct to a shorter course of treatment as well as improved probability of success with conservative treatment measures (Martin, Irrgang, Conti 1998, Reid 1992). Various treatment strategies, including orthoses (Kwong et al. 1988, Gross et al. 1984, Goulet et al. 2002, Lynch et al. 1988), stretching (Probe et al. 1999, Powell et al. 1998, DiGiovanni et al. 2003, Chandler et al. 1993, Barry et al. 2002), taping (Lynch et al. 1988, Scranton et al. 1982), extracorporeal shock wave therapy (Boddeker et al. 2001, Buchbinder et al. 2002), laser therapy (Basford et al. 1998) and drug therapy in the appearance of systemic medication (Probe et al. 1999), percutaneous injection (Cunnane et al. 1996, Kamel et al. 2000, Kane et al. 1998) and topical application (Gudeman et al. 1997, Japour et al. 1999) have been investigated and have revealed variable clinical benefit. In the recovery phase of rehabilitation, the objective is to decrease stress on the plantar fascia (J M.). Orthotic shoe inserts are thought to give stress relief and hold the plantar fascia, but a review of several studies found them to be unconvincing and contradictory due to methodology, small study size, or lack of long-term follow-up. There are many conservative treatments which can give better relief such as: Icing: Ice massage for over 15 minutes for three times a day can give better results and decrease the inflammation. Stretching Heel lifts Supportive shoes Weight loss Taping Orthotics: Devices such as rubber heel cups, elastic heel inserts can provide relief for plantar fasciitis. Night splints: Splints can provide relieve from plantar fasciitis, but it usually takes more than 12 weeks. Taping: The purpose of taping the foot is to change the mechanical load toward the fascial enthesis. Several studies done by Lange, Chipchase, Evans, (2004); Vicenzino et al., 2005; Radford et al., 2006) have reported that antipronation tape change the longitudinal arch height and decrease pressure in the heel which are clinically relevant in patients with plantar fasciitis. Taping can be done in many methods but i am more interested in low-dye taping as it is widely used and so i will be discussing about that technique in detail. LOW-DYE TAPING: Low-dye taping is an orthopaedic/sports adhesive strapping technique first described by Dye (1939) and later modified by a number of authors (Boergers, 2000; Del et al., 2004; Lange, Chipchase, Evans, 2004; Russo, Chipchase, 2001). Low-Dye taping is designed to off-load the plantar fascia. It is a short term treatment and its off-loading effects vary from patient to patient. However, as a general rule leave the tape on for a maximum of 3 days, but some might find it needs to be replaced more frequently in order remain effective. If at anytime the tape is uncomfortable, irritates, causes itching or pins and needles it should be removed immediately. The taping aims to limit foot pronation and is used in the short-term to reduce the symptoms of disorders thought to be related to excessive foot pronation which includes plantar fasciitis, tibialis posterior dysfunction, and patellofemoral syndrome (Schulthies, Draper, 1995; Whitesel, Newell, 1980). The taping required is a 1 inch zinc oxide (rigid strapping), most chemist should stock it. Another place to access it is from www.simplyfeet.co.uk, look under strapping and for Leukoplast (2.5cm), its costs approximately  £2.70p per roll (which should last for 3-4 applications) How to apply the taping 1. The first taping is applied down the outer and inner border of the foot, repeat 3-4 times. Apply enough tension to avoid the tape wrinkling, it needs to be no tighter. 2. The second taping is applied across the underside of the foot-starting level with the ankle, apply the tape across the foot from the outside to the inside. Over lap the each strap slightly and keep going until just before reaching the ball of the foot. 3. The final taping is a securing tape-apply a piece of tape across the midfoot, at about where the second taping ends, apply across the top of the foot, but do not encircle the whole foot, as this will be too tight. 4. Initially the tape will feel slightly tight, but this should ease, if it feels uncomfortable at all-remove immediately. Effects of Low-Dye taping: Offers support for the medial longitudinal arch and reduces pronation (inward rolling of the foot). Can be used for any condition affected by excessive pronation Plantar fasciitis, Tibialis Posterior Tendonopathy/Dysfunction, Sinus tarsi syndrome. Limitation of taping: One restriction of long term taping is that there is danger for skin breakdown. So therefore it may be considered only as a short term management option. Literature review: For writing the literature review, the following databases and books were searched. There was a detailed search on internet which gave a lot of information about plantar fasciitis. Some information was gathered from books and journals as well. Some of the journals were available online while rest of them had to be purchased from library. Some of the books were available online as well. The following databases had been searched for writing this literature review: Medline AMED CINAHL ClinPSYC EMBASE PsycINFO PEDRO. The following information was gathered from all the sources taking account of the review question. The proximal insertional disorder of the plantar fascia is best known as plantar fasciitis and as per Lemont, Ammirati and Usen in (2003), histopathologic research has found no signs of inflammation but has reported degenerative changes in the plantar fascia. The prevalence of plantar fasciitis has not been studied (Riddle Scappert 2004), but it is estimated that it affects 10 percent of the general population at some time during life (Demaio et al., 1993). PF is considered a self-limiting condition, however, the typical resolution time is anywhere from 6-18 months, sometimes longer (Young, Rutherford, Niedfeldt 2001) which can lead to frustration on both that is the physician and patient. Most experts agree that early recognition and treatment of PF leads to a shorter course of treatment and greater probability of success with conservative therapies (Singh, Angel, Bcntk, Trevino 1997). Of the many treatment options available for PF, one of the most effective is also the most fundamental rest and avoidance of aggravating activity provides significant relief. One study cited rest as the treatment that worked best for 25percent of PF patients (Wolgin, Cook, Graham, Mauldin, 1994). Martin et al. 2001 compared custom orthoses, over-the-counter arch supports, and tension night splints in the management of plantar fasciitis. Lynch et al. compared anti-inflammatory therapy, accommodative therapy and mechanical therapy in the management of pla ntar fasciitis. There are several conservative treatments that are employed to manage this condition. Scientists at the University of Bridgeport Chiropractic College in Calgary, Alberta, conducted an comprehensive review of the literature from 1980 to March 2005 on the management of plantar fasciitis. They concluded that due to numerous methodological flaws, none of the 15 randomised controlled trials showed finally which conservative treatment modality was best for plantar fasciitis (JCCA, 2006). Contrast baths, in which the application of cold and heat to a wounded area is alternated, are widely believed to reduce oedema (tissue swelling) and relieve uneasiness following an injury (Sullivan and Anderson 2000). A hunt of the scientific literature on this topic using Medline uncovered just two articles in this area, and one of the articles was unreliable in nature, with no rigorous, controlled testing of the efficacy of contrast baths. The other journal article listed research carri ed out at the University of North Carolina in which 30 subjects with post-acute sprained ankles were assigned to either a cold (n = 10), heat (n = 10), or contrast-bath (n = 10) treatment group (Comparison of Three Treatment Procedures for Minimizing Ankle Sprain Swelling, Physical Therapy, Vol 68 (7), pp1072-1076, 1988). Volumetric measurements of the subjects ankles were completed in a specially constructed tank, prior to and after treatment. An increase in the measure of oedema was actually observed with all three treatments, but cold application was connected with the least measure of swelling; contrast baths were no better than the direct application of heat when it came to controlling swelling. This study is somewhat faulty, since there were no control individuals with whom the persons utilizing a variety of treatments could be compared. Nonetheless, the research suggests that there is nothing particularly beneficial about contrast baths (especially when compared with the appl ication of nothing but cold) in the management of sprained ankles or oedema in common. Interestingly enough, there also does not show to be a single study in the scientific literature involving contrast baths with quicker recovery from injury or with a considerable decrease in pain associated with an injury. Compression is thought to be valuable in this phase through taping of the foot (Anderson 2000). Scherer and the Biomechanics Graduate Research Group in 1998 performed a prospective study in which they treated 73 patients with 118 painful heels with taping, nonsteriodal anti-inflammatory drugs, injections, and rigid orthoses (98% received these orthoses). The study showed that, within 6 weeks, approximately 84% of the patients had at least 80% relief of symptoms. This study also identified a subgroup of 43 heels (27patients) that received only mechanical therapy with taping or orthoses. Of this group, 90% had more than 80% relief of symptoms. The author concluded that mechanical control of midtarsal joint was the most successful treatment modality for plantar fasciitis. In an attempt to measure the effects of Low-Dye taping on the foot, eight patients (nine feet) with plantar fasciitis were studied using the pedobarograph to investigate changes in gait patterns. In addition, patients completed a questionnaire to assess symptom improvement. Significant changes between the untaped and taped foot were found in respect of pressure levels, areas under the pressure time curves and temporal parameters. The questionnaire revealed subjective improvements in symptoms in eight out of the nine feet studied (Saxelby, Betts and Bygrave 2004). The results from this nonrandomised trial indicate that this technique may be helpful for pain associated with plantar fasciitis. This article reveals that taping technique can improve gait to some extent. The best method to avoid plantar fasciitis is to minimise your risk factors. Follow the guidelines outlined above for selecting suitable and well-constructed shoes. Progress training schedules properly and works in new environments gradually. Keep your calf muscles physically powerful. Although plantar fasciitis is a prevalent problem, little scientific evidence exists concerning the most appropriate intervention (Crawford, Atkins, Edwards 2002 ). In the book by Rose Macdonald (2009), named Pocketbook of Taping Techniques By Rose Macdonald, Functional taping is now acknowledged as a skill which is essential for those concerned in the treatment and rehabilitation of sports injuries and many other conditions such as muscle imbalances, unstable joints and neural control. It incorporates all the basic techniques essential to the practice of good taping but also includes chapters on new evidence-based procedures written by experts from around the world. To assist in the development of these techniques, this pocketbook demonstrates many new methods which may be used as indicated or customized to suit the clinical situation. The Key Features in the book are Structured by body region with highly-illustrated descriptions of significant taping techniques Covers all aspects of functional taping New techniques to modify muscle activity and proprioception based on scientific evidence. Handy, portable size for simple reference in the field. Well there are few papers (Saxelby et al., 1997; Radford et al., 2006; Osborne and Allison, 2006; Landorf et al., 2005) published in the journals which say that low-dye taping has been effective in the management of plantar fasciitis. We will discuss about the papers in detail in the later part of the review. A systematic review conducted by Radford et al., in (2006) of randomised controlled trials examined the result of low-dye taping on biomechanical variables. According to Kogler et al. (1999), the supportive tape reduces the symptoms of plantar heel pain by reducing strain in the plantar fascia during standing and ambulation. A study conducted by Nolan and Kennedy in 2009 aimed to determine the special effects of Low-Dye taping on peak plantar pressure immediately post-application and found that Low-Dye tapes initially reduced lateral forefoot peak plantar pressure after a 10-minute walk. However, the tape continued to have an effect on the medial forefoot after 20 minutes of exercise. Chapter 2: Now we will be discussing about the systematic review methodology in this chapter The basis for a systematic review: According to Altmann (1999), Systematic reviews, in healthcare, have been described as providing objective overviews of all the evidence currently available on a particular topic of interest. Such overviews cover clinical trials in order to establish where effects of healthcare are consistent and where they may vary. This is achieved through the use of explicit, systematic methods aimed at limiting systematic error (bias) and reducing the chance of effect (Higgins and Green 2006). So systematic review are useful to decide which treatment in health care is more effective. Methodology: Systematic literature reviews are a method of making sense of large bodies of information, and a means of contributing to the answers to questions about what works and what does not- and many other types of question too (Petticrew and Roberts 2006). They are a method of mapping out areas of uncertainty, and identifying where little or no relevant research has been done, but where new studies are needed. Systematic reviews are literature reviews that remain closely to a set of scientific methods that explicitly aim to limit systematic error (bias), mainly by attempting to identify, appraise and synthesize all relevant studies in order to answer a particular question. Definition of systematic review: A review that strives to comprehensive identify, appraise, and synthesize all the significant studies on a specified topic. Systematic reviews are often used to test just a single hypothesis, or a series of related hypotheses (Petticrew and Roberts 2006). Systematic reviews provide information about the effectiveness of interventions by identifying, appraising, and summarising the results of otherwise unmanageable quantities of research (Light and Pillemer 1984, Mulrow 1994). A review of the evidence on a obviously formulated question that uses systematic and explicit methods to identify, select and critically appraise relevant primary research, and to remove and analyse data from the studies that are incorporated in the review. Statistical methods (meta-analysis) may or may not be used. Systematic reviews are defined, according to the Cochrane collaboration, as scientific literature reviews aimed at answering clearly formulated questions by use of systematic and explicit methods for identifying, selecting, and critically appraising relevant research, and for collecting and analysing data from the literature included in the review (The Cochrane collaboration. During a systematic review, meta-analysis may be used as a statistical tool for analysing and summarising the results of the included studies (Green and Higgins 2005). In order to fulfil this function, a systematic review should: (i) present a synthesis of the acquired knowledge regarding one particular clinical question derived from all relevant studies that are identifiable at one point in time, (ii) identify the level of internal validity and the subsequent potential systematic error risk associated with the acquired knowledge and (iii) provide recommendations for improving any identified shortcoming related to internal validity, for further research. Owing to continued further research, systematic reviews should also provide continued updates of their synthesis. Why do a systematic review? A rationale: Single studies can usefully be seen as similar to single respondents in a survey. The results from one respondent may say something, and sometimes something very important, but one might well get the opposite answer from the next respondent. It is more likely that one will learn more by examining data from other respondents, by looking at the range of answers and examining why those answers vary, and by attempting to summarize them (Petticrew and Roberts 2006). Literature reviews are also, in essence surveys, and it is worth remembering that they share very similar biases with other forms of social surveys. History of systematic review: From the 1930s onwards, and possibly even before, the specific term systematic review was being used to refer to literature reviews (Petticrew and Roberts 2006). In short, contrary to what is commonly supposed, neither the term systematic review nor the general approach of systematic literature reviewing is particularly new, nor particularly biomedical. Many systematic reviews involve a statistical pooling of the findings of the primary studies. This approach, meta-analysis, probably derives in its current form from Glass and Smiths work, which began in the late 1970s (Glass and Smith 1978). Systematic Review Process: Scoping review: A scoping review involves a search of the literature to determine what sorts of studies addressing the systematic review question have been carried out, where they are published, in which databases they have been indexed, what sorts of outcomes they have assessed, and in which populations (Petticrew and Roberts 2006). It may include restricted searches across a limited number of key databases, limited to a certain time period, and perhaps restricted by language. This can help cost a review for the purpose of drawing up a funding proposal, and can help with estimating how long it is likely to take, and what mix of skills might be needed to carry it out. From the below systematic review on effectiveness of low dye taping in the management of plantar fasciitis we can see that one relevant study has been found which involves effectiveness of taping in the management of plantar fasciitis but that differs from the current systematic review as it did not involve low dye taping which is the key factor of the undergoing review and this review is based on only effectiveness of low dye taping and not taping in broader context. Chapter 3: Role of the protocol: The protocol will specifies the plan which the review will follow to identify, appraise and collate evidence (Cook, Sackett and Spitzer 1995). The first milestone of any review is the development and approval of the protocol before proceeding

Tuesday, August 20, 2019

Internal Auditing Information Technology Case Study

Internal Auditing Information Technology Case Study Yue Sun (Leah) Activity 1. Key entity-level controls COSO Component Entity-level Controls Control Environment Organization wide integrity code of conduct Raising awareness and application of the code Granting restricted accesses to managers based on their department and responsibility scope Risk Assessment Organization wide risk assessment Risk appetites designed by department managers Having senior managements or control groups review and approve risk appetite Control Activities Organization wide policy protocol Independent internal audit committee oversight Information technology general control Information Communication Utilizing secured and monitored communication system for employees Monitoring Activities Performance management system Regularly perform internal auditing processes Activity 2. Audit procedure for information technology general control Determining whether the managements hold a positive attitude and approach toward integrity and ethics. Determining whether policies exists to define acceptable IT practices, conflict of interest, and or other expected standards of ethical behavior within the organization. Determining whether management take proper precaution and disciplinary action in circumstances where dishonor the policies. Determining whether practitioners and management receive complete necessary training to efficiently perform their duties. Determining whether the integrity code of conduct is being applied throughout daily operations. Determining whether the role of each employee is well defined, documented, and understood by all parties in the organization. Determining whether all procedures are properly documented by designated employee and the documentation is securely managed with restricted access. Determining whether there are processes in place to monitor the integrity and the ethical value within the department. Audit procedures and evidence that indicate operating effectiveness Audit procedures to determine operational efficiency Determining whether the tasks and goals are performed and achieved. It implies that the controls are operating efficiently when management and employees meet the expectations associated with their responsibilities. Evaluating the commitment of the management and employees when executing the internal controls set as higher level commitments from management and employees lead to higher level operating efficiency. Determining whether management is promoting and trying to enforce the internal controls in the organization. Observing the efficiency and effectiveness of communication between management and employees. It indicates that the controls are operating efficiently when management and employees keep an open and transparent communication channel. Observing the attitude of both management and employees towards integrity and ethics in the internal controls. Evidence that indicate operating effectiveness The operation should be considered effective when management holds a positive tone throughout the organization and the communication between management and employees is effective and transparent. Having an ethics and integrity program that is honored by both management and employees is another indicator for effective operation. Activity 4. SHR Corporations entity-level controls are mostly soft in nature and therefore, can impact the corporations employees in terms of how they approach issues. Such entity-level controls do operate across the organization to mitigate risks that threaten the company while provide assurance that the objectives of the organization would be achieved. In addition, the entity-level controls have both internal and external effect. For instance, such control would impact on the effectiveness at transaction and processing level which could minimize the risks that would prevent the company from achieving its objectives. Weakness in SHR Corporations entity-level controls include incidents where management is not dedicated to train and mentor employees. Lacking communication between management and employees could impact the operating effectiveness greatly. Another weakness would be when less reliance is placed on control activities that are performed by employees who require highly judgmental or complex tasks. In order to amend the listed weaknesses, management should be assessing the quality of the internal control performance across the organization. Monitoring activities are necessary and SHR should also acquire independent evaluation by internal auditors to minimize risks. Management and employees behavior could be affected by the entity-level controls that are carried out across the entire organization. Based on the risks that the organization is currently facing, the entity-level controls would require managements to assess and report on the effectiveness of the internal control of the organization. The independent internal auditors should confirm and evaluate such reports concerning the effectiveness of the corporations internal control. Management and employees behavior at business processing level could be positively impacted since entity-level controls could improve their accountability. Having an effective entity-level controls would help both management and employees comply with organizations policies and code of conducts. Because entity-level controls provide assurance to the board and management that the established procedures and policies are performed throughout the organizations operation. When auditing controls over the companys purchases and accounts payable, SHRs entity-level controls could affect professional skepticism since effective controls could minimize potential risks and misappropriation. Meanwhile, the entity-level controls would facilitate the assessment of process-level risks that could affect the operation of the organization. In addition, process-level controls could assist when conducting direct testes of transactions in order to ensure the financial statements are accurately presented.

Monday, August 19, 2019

Changes in Family and Marriage Structure :: Sociology

Marriages and Families â€Å"Changes† Imagine that, if in the 1920’s someone would have predicted that by the year 2000 one out of two marriages will end in divorce. The number of single parents will triple and lots of them will never marry. Stay at home moms will become almost obsolete and, gay people will want to get married and adopt children. Oh my, could you imagine the look on their faces? Families are defiantly different now than they were then, but the world is also different. Does this mean than families are deteriorating or are they stronger than ever? Maybe they are just changing and are still as strong as they once were. So many changes have taken place within the family. Some of them are higher divorce rates, more working mothers, more homosexual families, and a huge increase in children born out of wedlock. Many argue that most of the family’s problems come from the mother working outside of the house. The fact is that working mothers is nothing new. Mothers have always done something to help out, even if it was sewing, baking, or working on the land. In today’s world it’s very hard to make ends meet with only one income. Children benefit in some ways from their mom working. In this materialistic culture children want to have all the nice things and what’s hot. Working mothers spend on average just as much quality time with their children as non working mothers. Divorce, single parents, and unmarried parents have always existed. It is no doubt that the rates of them have increased dramatically. Is this a bad sign? This doesn’t mean that families are weak. It only means that people’s morals have changed. Families are not perfect, but they are strong. We also have more freedoms than we did in the 1920s. Women can now leave their husbands when things are unbearable. Women didn’t have as many choices then. Just because families seemed good then don’t mean that they were. It’s not something we should try to live up to. After all we are talking about a time when slaves were legal and treated badly. On the opposite side men don’t get to really be full time fathers after divorce. Divorce defiantly affects children. It is also better for children if they don’t have to live in a household of anger and unhappiness. Of

Sunday, August 18, 2019

College Stress Essay -- essays research papers

Typical November nights in a college students residence include cramming obligated to catch for papers due in December, and exams that lurk around the corner on a topic you felt up on sleep for. Deadlines and due dates are non-existent for students until the night before since the preoccupations; partying and overall good times which lack libraries and study sessions, expel more excitement than the adrenaline rush of a chemistry chronicle or a pre-cal problem. At most schools, the days of dorm rules, dress codes, and even mandatory class attendance is long gone. But while freedom can be exciting and fun, it can also be stressful because no one is telling you what to do. You have to make a lot of decisions on your own and readjust your own values and normal life. There are bound to be mistakes, but that is part of the process. College Life is more then just going to school and making the grades that your parents require of you. This is why many students will incur an ailment called s tress. Stress in college is caused by many influencing factors. One of these important factors would have to be the expectations set by parents. Parents can be more then just an annoying voice in your ear every time you come home for the holidays. They are normally the reason you are at your present school , so pleasing them by getting good grades is almost mandatory. This thought of displeasing the parents can be detrimental to one’s thought process; meaning that it most likely would cause a wor...

A Pragmatic Approach for Comparative Analysis of Linear and Rotary Generators :: Essays Papers

A Pragmatic Approach for Comparative Analysis of Linear and Rotary Generators ABSTRACT This paper identifies the need for consolidating analysis techniques for the purpose of designing linear electrical generation systems. Additionally, it identifies a need for concise system development tools that help designers make practical comparisons between linear and rotary machines. INTRODUCTION The basic principles for converting mechanical energy to electrical energy have been known for over a century. It would seem that after this much time, advancements in electrical generation should have reached their limits; however, up to the late 1980’s and early 90’s the use of linear generators for the generation of electricity has not been seriously considered [1] [4]. Linear generators and motors are classified as linear motion electromagnetic systems (LMESs) [1]. LMESs that are used as electric generators function by directly utilizing the translational (back and forth or up and down) thrust from mechanical systems to generate electricity as opposed to the more conventional generation approach of rotational mechanical energy conversion. For an engineer to determine the feasibility of using a linear electric generator in a system’s design many comparisons between rotary and linear machines must be made. Several points to consider when making this comparison include: practicality of using linear power generation for that particular system, cost to build and design, total system efficiency, role of modern day power electronics, type of driving force (linear or rotational) applied to the generator system, system power factor, force density and force ripple on the drive components, cost to maintain, and the system’s reliability. The relative weights of these considerations will vary from one system to the next. The motivation behind this question was the decision on whether to use a linear or rotary generator on a buoy driven, ocean wave electrical generator project [6]. During this decision process, many opinions and assumptions between these competing systems were made, but finding hard data that compa red the two methods was not readily available. Taking the time to thoroughly evaluate the electrical and mechanical technical aspects of this choice (rotary vs. linear) conflicted with the tight scheduling requirements of the project. This situation forced the team to make a best approximation based on limited experience instead of a deliberate and thoroughly evaluated approach. WHY LINEAR GENERATORS ARE USED Electrical energy generation is being expanded by creative innovation, and linear generators are a large part of this trend.

Saturday, August 17, 2019

Pros and Cons of Ethical Theories

Ethical Theories- Pros and Cons Katherine Bryson ETH/316 October 15, 2012 Mark Cobia Ethical Theories- Pros and Cons The similarities between the virtue theory, the utilitarianism theory and deontological theory are that they all support good and responsibility. Virtue theory not only concentrates on how an individual acts but also what a person should strive to be, for example a religious figure may personify perfection when in the public when they really should strive for that perfection at all times. The deontological theory states that people â€Å"have a moral obligation to follow certain principles. I liken this to the Ten Commandments, rules or principles that we all are expected to follow. â€Å"The utilitarian theories, as supported by John Stuart Mill, call for generating the greatest aggregate good for the greatest number of people. One major benefit of such theories is that they take consequences into account. They seek specifically to promote the human good as a whole. They also provide guidance for behavior, enabling people to know what qualifies as the moral choice. † I will again use the religious area as an example because to me this is what the religious leaders do.They preach to the multitudes to be good and do good and they also offer guidance. The differences between virtue theory, utilitarian and decontological are that â€Å"virtue ethics cannot generate specific rules to guide behavior. † Under the utilitarian theory â€Å"only total human good or happiness matters. † Deontological theories â€Å"do not always clarify how to rank duties. † I lived in a very small community where everyone knew everyone and we all thought we were living the life of good moral standards and values, until one day I saw a very prominent member of the community, enter an establishment that everyone knew was a hangout for drug users.This person was there for a long time and when they came out you could tell they were under the influ ence. Now according to the deontology theory it was my obligation to report this person to the proper authorities, but I fell short because it meant the demise of a family.References Ridley, Aaron. 1998. Beginning Bioethics. New York: St. Martin’s Press http://www. bio. davidson. edu/people/kabernd/Indep/carainbow/Theories. htm http://www. ehow. com/info_8404891_pros-cons-ethical-theories. html

Friday, August 16, 2019

Rebirth of Art, Religion and Education in Europe

The â€Å"rebirth† of art, religion, and education in Europe is known as the Renaissance. During this time of rebirth, Renaissance thinkers dismissed the medieval period as a dark age of worthlessness. Instead, a style of classical age inspired a respect for order, perspective, proportion, and principles to the artist’s work. The Renaissance also had a time of rebirth in people’s religion and beliefs. The people became closer to God and began to worship Him in their own ways. There was a drastic change in education during this time also. A push for the citizen to become ducated became a big deal. Books were given out, any many libraries were developed in an attempt to educate their people(Bowman 325-330). The Renaissance truly changed the art work, religion, and education throughout Europe. The European art emerged from its medieval precedents during the course of the thirteenth century. Before this time European art work were based on fixed, conventional forms art. This showed figures as stiff and flat; it showed the objects as unrealistic and lifeless. The artwork did not show great detail. Landscapes were decorative but unrealistic. The artist no longer worked only on small paintings but broadened his work to masterpieces. Masterpieces would be a piece of art that sometime would take an artist his whole life to complete. Their masterpieces would be placed in cathedrals, on buildings and would cover entire walls and ceilings. Many of the paintings would tell a story, often from the Bible. The artist would spend years working to finish his masterpieces. Often he would die before completing the paintings all the The status of artists rose as they began to work more for nobility and the wealthy. No longer anonymous, artists developed personal styles and experimented adventurously with new techniques(â€Å"Renaissance† 1989). The use of color also was changed through the Renaissance. Europe was going through a time of dark colors and lifeless paintings. Scholars of this time knew that the color and paintings had to be changed. They knew that the painting had to liven up. They chose to develop new colors, colors that were brighter and full of life. The artist chose colors that would draw attention to their They also knew that they should adopt techniques to ake their work more realistic looking. Techniques such as perspective, proportion, and size was adopted. They would make their paintings appear as you would see them in real life, as if you were looking at the object not a The artwork that was produced took massive amounts of time. The artist would complete very few amounts of large jobs in his life time. Often a job would be to paint a cathedral. This included the ceilings, altar, walls, and the floor. The artist would spend countless years completing his job to perfection(Murray and Murray 12-14). The artwork was spread throughout Europe by paintings, sculptures and buildings. Artist would be well-known for their paintings. A patron would hire an artist and ask him to create a series of paintings or sculptures. The artist would be paid a great deal if he was loyal and worked hard for his patron(Murray and Murray 14). Artwork went trough a great change, but this wouldn’t be the only perspective that would be changed during the Renaissance. Religion also changed a great deal during the Renaissance. During the Dark Ages, which was the time eriod directly before the Renaissance, people began to drift away from Christianity. The Dark Ages sent many people into a time of depression. Artists sought ways to help people in their religious quest. They often would center their work around a religious theme. Their works would tell of Bible stories or pictures from the Bible. Religion became popular throughout Europe, and people began to worship on a regular basis. They would often visit the cathedrals many times a day to pray. People began to have a new respect for religion through artwork, writing, and song(â€Å"Renaissance† 1999). The cathedrals were really important to the people of Europe. The cathedrals were a magnificent sight to the people, and they thought that they cathedrals were a main part of worship. They often had lectures based on the stories that were told on the walls, floors, and ceilings of the cathedrals. The cathedrals were kept open by donations from families, similar to the offertory given in today’s society. Many of the families had a pew in the cathedrals dedicated to their families. The cathedrals were a main part of the worship of the people during this time(â€Å"Renaissance† 1999). Education also changed a great deal during the Renaissance. Books were written by authors during the Dark Ages, but to publish them one had to write the entire book over and over again because there was not a way in which to make copies easily. The Renaissance would change this forever. The scholars knew that to educate people, one had to come up with a way to distribute books. To write them over took too much time, and they needed a quicker and more effective way. The printing press was soon adopted by the people. In printing press, the letters in the book were laced on wooden blocks and a page was laid on the table. After all the letters formed all the words and were in place, the next occurred. Printers would then pour ink onto the blocks and stamp the pages. The words would be printed out on the page. After this was repeated for all the pages, they were gathered and bound together in a book. This made books become more popular and affordable by common people. Through this, libraries were formed, and people could obtain books easier. This allowed people to become more educated and literate(â€Å"Renaissance† 1999). The Renaissance was indeed a remarkable time period throughout Europe. It changed Europe a great deal and will be remembered throughout the future. Europe was suffering before this period and was in desperate need of a reformation. The Renaissance gave Europe just what it needed, a rebirth. Art work, religion, and education thrived through this period. The paintings and sculptures, in particular, were remarkable and illustrate great talent, â€Å"Renaissance is a word which is generally understood, but which few people would care to define very closely† (Murray 7).

Thursday, August 15, 2019

The Lost Symbol Chapter 117-118

CHAPTER 117 Langdon felt his stomach drop as the CIA helicopter leaped off the lawn, banked hard, and accelerated faster than he ever imagined a helicopter could move. Katherine had stayed behind to recuperate with Bellamy while one of the CIA agents searched the mansion and waited for a backup team. Before Langdon left, she had kissed him on the cheek and whispered, â€Å"Be safe, Robert.† Now Langdon was holding on for dear life as the military helicopter finally leveled out and raced toward the House of the Temple. Seated beside him, Sato was yelling up to the pilot. â€Å"Head for Dupont Circle!† she shouted over the deafening noise. â€Å"We'll set down there!† Startled, Langdon turned to her. â€Å"Dupont?! That's blocks from the House of the Temple! We can land in the Temple parking lot!† Sato shook her head. â€Å"We need to enter the building quietly. If our target hears us coming–â€Å" â€Å"We don't have time!† Langdon argued. â€Å"This lunatic is about to murder Peter! Maybe the sound of the helicopter will scare him and make him stop!† Sato stared at him with ice-cold eyes. â€Å"As I have told you, Peter Solomon's safety is not my primary objective. I believe I've made that clear.† Langdon was in no mood for another national-security lecture. â€Å"Look, I'm the only one on board who knows his way through that building–â€Å" â€Å"Careful, Professor,† the director warned. â€Å"You are here as a member of my team, and I will have your complete cooperation.† She paused a moment and then added, â€Å"In fact, it might be wise if I now apprised you fully of the severity of our crisis tonight.† Sato reached under her seat and pulled out a sleek titanium briefcase, which she opened to reveal an unusually complicated-looking computer. When she turned it on, a CIA logo materialized along with a log-in prompt. As Sato logged in, she asked, â€Å"Professor, do you remember the blond hairpiece we found in the man's home?† â€Å"Yes.† â€Å"Well, hidden within that wig was a tiny fiber-optic camera . . . concealed in the bangs.† â€Å"A hidden camera? I don't understand.† Sato looked grim. â€Å"You will.† She launched a file on the laptop. ONE MOMENT PLEASE . . . DECRYPTING FILE . . . A video window popped up, filling the entire screen. Sato lifted the briefcase and set it on Langdon's thighs, giving him a front-row seat. An unusual image materialized on the screen. Langdon recoiled in surprise. What the hell?! Murky and dark, the video was of a blindfolded man. He was dressed in the garb of a medieval heretic being led to the gallows–noose around his neck, left pant leg rolled up to the knee, right sleeve rolled up to the elbow, and his shirt gaping open to reveal his bare chest. Langdon stared in disbelief. He had read enough about Masonic rituals to recognize exactly what he was looking at. A Masonic initiate . . . preparing to enter the first degree. The man was very muscular and tall, with a familiar blond hairpiece and deeply tanned skin. Langdon recognized his features at once. The man's tattoos had obviously been concealed beneath bronzing makeup. He was standing before a full-length mirror videotaping his reflection through the camera concealed in his wig. But . . . why? The screen faded to black. New footage appeared. A small, dimly lit, rectangular chamber. A dramatic chessboard floor of black-and-white tile. A low wooden altar, flanked on three sides by pillars, atop which burned flickering candles. Langdon felt a sudden apprehension. Oh my God. Filming in the erratic style of an amateur home video, the camera now panned up to the periphery of the room to reveal a small group of men observing the initiate. The men were dressed in ritual Masonic regalia. In the darkness, Langdon could not make out their faces, but he had no doubt where this ritual was taking place. The traditional layout of this Lodge Room could have been anywhere in the world, but the powder-blue triangular pediment above the master's chair revealed it as the oldest Masonic lodge in D.C.–Potomac Lodge No. 5–home of George Washington and the Masonic forefathers who laid the cornerstone for the White House and the Capitol Building. The lodge was still active today. Peter Solomon, in addition to overseeing the House of the Temple, was the master of his local lodge. And it was at lodges like this one that a Masonic initiate's journey always began . . . where he underwent the first three degrees of Freemasonry. â€Å"Brethren,† Peter's familiar voice declared, â€Å"in the name of the Great Architect of the Universe, I open this lodge for the practice of Masonry in the first degree!† A gavel rapped loudly. Langdon watched in utter disbelief as the video progressed through a quick series of dissolves featuring Peter Solomon performing some of the ritual's starker moments. Pressing a shining dagger to the initiate's bare chest . . . threatening impalement should the initiate â€Å"inappropriately reveal the Mysteries of Masonry† . . . describing the black-and-white floor as representing â€Å"the living and the dead† . . . outlining punishments that included â€Å"having one's throat cut across, one's tongue torn out by its roots, and one's body buried in the rough sands of the sea . . .† Langdon stared. Am I really witnessing this? Masonic initiation rites had remained shrouded in secrecy for centuries. The only descriptions that had ever been leaked were written by a handful of estranged brothers. Langdon had read those accounts, of course, and yet to see an initiation with his own eyes . . . this was a much different story. Especially edited this way. Langdon could already tell that the video was an unfair piece of propaganda, omitting all the noblest aspects of the initiation and highlighting only the most disconcerting. If this video were released, Langdon knew it would become an Internet sensation over night. The anti-Masonic conspiracy theorists would feed on this like sharks. The Masonic organization, and especially Peter Solomon, would find themselves embroiled in a firestorm of controversy and a desperate effort at damage control . . . even though the ritual was innocuous and purely symbolic. Eerily, the video included a biblical reference to human sacrifice . . . â€Å"the submission of Abraham to the Supreme Being by proffering Isaac, his firstborn son.† Langdon thought of Peter and willed the helicopter to fly faster. The video footage shifted now. Same room. Different night. A larger group of Masons looking on. Peter Solomon was observing from the master's chair. This was the second degree. More intense now. Kneeling at the altar . . . vowing to â€Å"forever conceal the enigmas existing within Freemasonry† . . . consenting to the penalty of â€Å"having one's chest cavity ripped open and pulsing heart cast upon the surface of the earth as offal for the ravenous beasts† . . . Langdon's own heart was pulsing wildly now as the video shifted yet again. Another night. A much larger crowd. A coffin-shaped â€Å"tracing board† on the floor. The third degree. This was the death ritual–the most rigorous of all the degrees–the moment in which the initiate was forced â€Å"to face the final challenge of personal extinction.† This grueling interrogation was in fact the source of the common phrase to give someone the third degree. And although Langdon was very familiar with academic accounts of it, he was in no way prepared for what he now saw. The murder. In violent, rapid intercuts, the video displayed a chilling, victim's point-of-view account of the initiate's brutal murder. There were simulated blows to his head, including one with a Mason's stone maul. All the while, a deacon mournfully told the story of â€Å"the widow's son†Ã¢â‚¬â€œHiram Abiff–the master Architect of King Solomon's temple, who chose to die rather than reveal the secret wisdom he possessed. The attack was mimed, of course, and yet its effect on camera was bloodcurdling. After the deathblow, the initiate–now â€Å"dead to his former self†Ã¢â‚¬â€œwas lowered into his symbolic coffin, where his eyes were shut and his arms were crossed like those of a corpse. The Masonic brothers rose and mournfully circled his dead body while a pipe organ played a march of the dead. The macabre scene was deeply disturbing. And it only got worse. As the men gathered around their slain brother, the hidden camera clearly displayed their faces. Langdon now realized that Solomon was not the only famous man in the room. One of the men peering down at the initiate in his coffin was on television almost daily. A prominent U.S. senator. Oh God . . . The scene changed yet again. Outside now . . . nighttime . . . the same jumpy video footage . . . the man was walking down a city street . . . strands of blond hair blowing in front of the camera . . . turning a corner . . .the camera angle lowering to something in the man's hand . . . a dollar bill . . . a close-up focusing on the Great Seal . . . the all-seeing eye . . . the unfinished pyramid . . . and then, abruptly, pulling away to reveal a similar shape in the distance . . . a massive pyramidical building . . . with sloping sides rising to a truncated top. The House of the Temple. A soul-deep dread swelled within him. The video kept moving . . . the man hurrying toward the building now . . . up the multitiered staircase . . . toward the giant bronze doors . . . between the two seventeen-ton sphinx guardians. A neophyte entering the pyramid of initiation. Darkness now. A powerful pipe organ played in the distance . . . and a new image materialized. The Temple Room. Langdon swallowed hard. On-screen, the cavernous space was alive with electricity. Beneath the oculus, the black marble altar shone in the moonlight. Assembled around it, seated on hand-tooled pigskin chairs, awaited a somber council of distinguished thirty-third-degree Masons, present to bear witness. The video now panned across their faces with slow and deliberate intention. Langdon stared in horror. Although he had not seen this coming, what he was looking at made perfect sense. A gathering of the most decorated and accomplished Masons in the most powerful city on earth would logically include many influential and well-known individuals. Sure enough, seated around the altar, adorned in their long silk gloves, Masonic aprons, and glistening jewels, were some of the country's most powerful men. Two Supreme Court justices . . . The secretary of defense . . . The speaker of the House . . . Langdon felt ill as the video continued panning across the faces of those in attendance. Three prominent senators . . . including the majority leader . . . The secretary of homeland security . . . And . . . The director of the CIA . . . Langdon wanted only to look away, but he could not. The scene was utterly mesmerizing, alarming even to him. In an instant, he had come to understand the source of Sato's anxiety and concern. Now, on-screen, the shot dissolved into a single shocking image. A human skull . . . filled with dark crimson liquid. The famed caput mortuum was being offered forth to the initiate by the slender hands of Peter Solomon, whose gold Masonic ring glinted in the candlelight. The red liquid was wine . . . and yet it shimmered like blood. The visual effect was frightful. The Fifth Libation, Langdon realized, having read firsthand accounts of this sacrament in John Quincy Adams's Letters on the Masonic Institution. Even so, to see it happen . . . to see it calmly witnessed by America's most powerful men . . . this was as arresting an image as any Langdon had ever seen. The initiate took the skull in his hands . . . his face reflected in the calm surface of the wine. â€Å"May this wine I now drink become a deadly poison to me,† he declared, â€Å"should I ever knowingly or willfully violate my oath.† Obviously, this initiate had intended to violate his oath beyond all imagination. Langdon could barely get his mind around what would happen if this video were made public. No one would understand. The government would be thrown into upheaval. The airwaves would be filled with the voices of anti-Masonic groups, fundamentalists, and conspiracy theorists spewing hatred and fear, launching a Puritan witch hunt all over again. The truth will be twisted, Langdon knew. As it always is with the Masons. The truth was that the brotherhood's focus on death was in fact a bold celebration of life. Masonic ritual was designed to awaken the slumbering man inside, lifting him from his dark coffin of ignorance, raising him into the light, and giving him eyes to see. Only through the death experience could man fully understand his life experience. Only through the realization that his days on earth were finite could he grasp the importance of living those days with honor, integrity, and service to his fellow man. Masonic initiations were startling because they were meant to be transformative. Masonic vows were unforgiving because they were meant to be reminders that man's honor and his â€Å"word† were all he could take from this world. Masonic teachings were arcane because they were meant to be universal . . . taught through a common language of symbols and metaphors that transcended religions, cultures, and races . . . creating a unified â€Å"worldwide consciousness† of brotherly love. For a brief instant, Langdon felt a glimmer of hope. He tried to assure himself that if this video were to leak out, the public would be open-minded and tolerant, realizing that all spiritual rituals included aspects that would seem frightening if taken out of context–crucifixion reenactments, Jewish circumcision rites, Mormon baptisms of the dead, Catholic exorcisms, Islamic niqab, shamanic trance healing, the Jewish Kaparot ceremony, even the eating of the figurative body and blood of Christ. I'm dreaming, Langdon knew. This video will create chaos. He could imagine what would happen if the prominent leaders of Russia or the Islamic world were seen in a video, pressing knives to bare chests, swearing violent oaths, performing mock murders, lying in symbolic coffins, and drinking wine from a human skull. The global outcry would be instantaneous and overwhelming. God help us . . . On-screen now, the initiate was raising the skull to his lips. He tipped it backward . . . draining the blood-red wine . . . sealing his oath. Then he lowered the skull and gazed out at the assembly around him. America's most powerful and trusted men gave contented nods of acceptance. â€Å"Welcome, brother,† Peter Solomon said. As the image faded to black, Langdon realized he had stopped breathing. Without a word, Sato reached over, closed the briefcase, and lifted it off his lap. Langdon turned to her trying to speak, but he could find no words. It didn't matter. Understanding was written all over his face. Sato was right. Tonight was a national-security crisis . . . of unimaginable proportions. CHAPTER 118 Dressed in his loincloth, Mal'akh padded back and forth in front of Peter Solomon's wheelchair. â€Å"Peter,† he whispered, enjoying every moment of his captive's horror, â€Å"you forgot you have a second family . . . your Masonic brothers. And I will destroy them, too . . . unless you help me.† Solomon looked almost catatonic in the glow of the laptop sitting atop his thighs. â€Å"Please,† he finally stammered, glancing up. â€Å"If this video gets out . . .† â€Å"If?† Mal'akh laughed. â€Å"If it gets out?† He motioned to the small cellular modem plugged into the side of his laptop. â€Å"I'm connected to the world.† â€Å"You wouldn't . . .† I will, Mal'akh thought, enjoying Solomon's horror. â€Å"You have the power to stop me,† he said. â€Å"And to save your sister. But you have to tell me what I want to know. The Lost Word is hidden somewhere, Peter, and I know this grid reveals exactly where to find it.† Peter glanced at the grid of symbols again, his eyes revealing nothing. â€Å"Perhaps this will help to inspire you.† Mal'akh reached over Peter's shoulders and hit a few keys on the laptop. An e-mail program launched on the screen, and Peter stiffened visibly. The screen now displayed an e-mail that Mal'akh had cued earlier tonight–a video file addressed to a long list of major media networks. Mal'akh smiled. â€Å"I think it's time we share, don't you?† â€Å"Don't!† Mal'akh reached down and clicked the send button on the program. Peter jerked against his bonds, trying unsuccessfully to knock the laptop to the floor. â€Å"Relax, Peter,† Mal'akh whispered. â€Å"It's a massive file. It will take a few minutes to go out.† He pointed to the progress bar: SENDING MESSAGE: 2% COMPLETE â€Å"If you tell me what I want to know, I'll stop the e-mail, and nobody will ever see this.† Peter was ashen as the task bar inched forward. SENDING MESSAGE: 4% COMPLETE Mal'akh now lifted the computer from Peter's lap and set it on one of the nearby pigskin chairs, turning the screen so the other man could watch the progress. Then he returned to Peter's side and laid the page of symbols in his lap. â€Å"The legends say the Masonic Pyramid will unveil the Lost Word. This is the pyramid's final code. I believe you know how to read it.† Mal'akh glanced over at the laptop. SENDING MESSAGE: 8% COMPLETE Mal'akh returned his eyes to Peter. Solomon was staring at him, his gray eyes blazing now with hatred. Hate me, Mal'akh thought. The greater the emotion, the more potent the energy that will be released when the ritual is completed. At Langley, Nola Kaye pressed the phone to her ear, barely able to hear Sato over the noise of the helicopter. â€Å"They said it's impossible to stop the file transfer!† Nola shouted. â€Å"To shut down local ISPs would take at least an hour, and if he's got access to a wireless provider, killing the ground-based Internet won't stop him from sending it anyway.† Nowadays, stopping the flow of digital information had become nearly impossible. There were too many access routes to the Internet. Between hard lines, Wi-Fi hot spots, cellular modems, SAT phones, superphones, and e-mail-equipped PDAs, the only way to isolate a potential data leak was by destroying the source machine. â€Å"I pulled the spec sheet on the UH-60 you're flying,† Nola said, â€Å"and it looks like you're equipped with EMP.† Electromagnetic-pulse or EMP guns were now commonplace among law enforcement agencies, which used them primarily to stop car chases from a safe distance. By firing a highly concentrated pulse of electromagnetic radiation, an EMP gun could effectively fry the electronics of any device it targeted–cars, cell phones, computers. According to Nola's spec sheet, the UH- 60 had a chassis-mounted, laser-sighted, six-gigahertz magnetron with a fifty-dB-gain horn that yielded a ten-gigawatt pulse. Discharged directly at a laptop, the pulse would fry the computer's motherboard and instantly erase the hard drive. â€Å"EMP will be useless,† Sato yelled back. â€Å"Target is inside a stone building. No sight lines and thick EM shielding. Do you have any indication yet if the video has gone out?† Nola glanced at a second monitor, which was running a continuous search for breaking news stories about the Masons. â€Å"Not yet, ma'am. But if it goes public, we'll know within seconds.† â€Å"Keep me posted.† Sato signed off. Langdon held his breath as the helicopter dropped from the sky toward Dupont Circle. A handful of pedestrians scattered as the aircraft descended through an opening in the trees and landed hard on the lawn just south of the famous two-tiered fountain designed by the same two men who created the Lincoln Memorial. Thirty seconds later, Langdon was riding shotgun in a commandeered Lexus SUV, tearing up New Hampshire Avenue toward the House of the Temple. Peter Solomon was desperately trying to figure out what to do. All he could see in his mind were the images of Katherine bleeding in the basement . . . and of the video he had just witnessed. He turned his head slowly toward the laptop on the pigskin chair several yards away. The progress bar was almost a third of the way filled. SENDING MESSAGE: 29% COMPLETE The tattooed man was now walking slow circles around the square altar, swinging a lit censer and chanting to himself. Thick puffs of white smoke swirled up toward the skylight. The man's eyes were wide now, and he seemed to be in a demonic trance. Peter turned his gaze to the ancient knife that sat waiting on the white silk cloth spread across the altar. Peter Solomon had no doubt that he would die in this temple tonight. The question was how to die. Would he find a way to save his sister and his brotherhood . . . or would his death be entirely in vain? He glanced down at the grid of symbols. When he had first laid eyes on the grid, the shock of the moment had blinded him . . . preventing his vision from piercing the veil of chaos . . . to glimpse the startling truth. Now, however, the real significance of these symbols had become crystal clear to him. He had seen the grid in an entirely new light. Peter Solomon knew exactly what he needed to do. Taking a deep breath, he gazed up at the moon through the oculus above. Then he began to speak. All great truths are simple. Mal'akh had learned that long ago. The solution that Peter Solomon was now explaining was so graceful and pure that Mal'akh was sure that it could only be true. Incredibly, the solution to the pyramid's final code was far simpler than he had ever imagined. The Lost Word was right before my eyes. In an instant, a bright ray of light pierced the murkiness of the history and myth surrounding the Lost Word. As promised, the Lost Word was indeed written in an ancient language and bore mystical power in every philosophy, religion, and science ever known to man. Alchemy, astrology, Kabbalah, Christianity, Buddhism, Rosicrucianism, Freemasonry, astronomy, physics, Noetics . . . Standing now in this initiation chamber atop the great pyramid of Heredom, Mal'akh gazed upon the treasure he had sought all these years, and he knew he could not have prepared himself more perfectly. Soon I am complete. The Lost Word is found. In Kalorama Heights, a lone CIA agent stood amid a sea of garbage that he had dumped out of the trash bins that had been found in the garage. â€Å"Ms. Kaye?† he said, speaking to Sato's analyst on the phone. â€Å"Good thinking to search his garbage. I think I just found something.† Inside the house, Katherine Solomon was feeling stronger with every passing moment. The infusion of lactated Ringer's solution had successfully raised her blood pressure and quelled her throbbing headache. She was resting now, seated in the dining room, with explicit instructions to remain still. Her nerves felt frayed, and she was increasingly anxious for news about her brother. Where is everybody? The CIA's forensics team had not yet arrived, and the agent who had stayed behind was still off searching the premises. Bellamy had been sitting with her in the dining room, still wrapped in a foil blanket, but he, too, had wandered off to look for any information that might help the CIA save Peter. Unable to sit idly, Katherine pulled herself to her feet, teetered, and then inched slowly toward the living room. She found Bellamy in the study. The Architect was standing at an open drawer, his back to her, apparently too engrossed in its contents to hear her enter. She walked up behind him. â€Å"Warren?† The old man lurched and turned, quickly shutting the drawer with his hip. His face was lined with shock and grief, his cheeks streaked with tears. â€Å"What's wrong?!† She glanced down at the drawer. â€Å"What is it?† Bellamy seemed unable to speak. He had the look of a man who had just seen something he deeply wished he had not. â€Å"What's in the drawer?† she demanded. Bellamy's tear-filled eyes held hers for a long, sorrowful moment. Finally he spoke. â€Å"You and I wondered why . . . why this man seemed to hate your family.† Katherine's brow furrowed. â€Å"Yes?† â€Å"Well . . .† Bellamy's voice caught. â€Å"I just found the answer.†