The Speed of Trust part 3 Essay Example | Topics and Well Written Essays - 500 words

The Speed of Trust part 3 - Essay Example She tells the truth no matter what the situation is. Her ability to talk straight confers basic elements to her that influences the successe of the unit. This element has led to improved manager’s relationships with the staff (Covey, & Merrill, 2009). The current manager ensures that the unit operates within the allocated budget while delivering results. The manager ensures successful completion of projects within the scope and expected results. She ensures this through controlling risks and timely performance (Covey, & Merrill, 2009). The manager takes enormous responsibility of showing loyalty by giving credit to all the contributors who ensure success in the unit. She identifies individual contribution and does not hesitate to show loyalty to the staff. She supports the workforce in their endeavors, and she takes the side of the workforce in case of disputes with the management (Covey, & Merrill, 2009). I think the manager should improve on her listening ability. For instance, an individual or staff could approach her in the halls with an issue or problem. During the conversation, she walks as the staff expresses her problems; she gives short answers, an indication that she is not attentive. On other occasions, I have tried to explain a situation after which the manager seems to have formed her own conclusion (Covey, & Merrill, 2009). The manager has an attribute of having limited trust with the workers. 90% of the workforce speaks her language, however, at some instances, she speaks a different language when with her deputy, or she sits to eat with a group of nurses. She should learn to extend her trust to the staff members (Covey, & Merrill, 2009). Another attribute that I think the manager should change is her ability to demonstrate respect. For instance, workers may smile or say polite things, but she ignores them. Such an attribute demonstrates her lack of respect. A staff member

A poem which depicts a violent incident Essay Example for Free

A poem which depicts a violent incident Essay TASK: Choose a poem in which there is a dramatic or violent incident. Show how the poet conveys the incident using various poetic techniques. ‘Glasgow 5 March 1971’ by Scottish poet Edwin Morgan effectively conveys a violent incident which occurs on a busy street in Glasgow. The incident captured in this instamatic poem involves a violent attack on a young couple who are pushed through a shop window by thieving youths. The incident is shown vividly through various techniques such as imagery, word choice and structure. Through this poem, Morgan effectively criticises society and our reluctance to help others in need. One of the ways in which Morgan helps us understand the incident is through the use of imagery. The poem begins with a striking metaphor to describe the â€Å"ragged diamond of shattered plate-glass†. The broken glass is being compared to a diamond to help us picture the sharp, glinting edges of the window. This immediately shows how violent the incident is. He goes on to describe the man’s face as â€Å"bristling with fragments of glass†. This metaphor compared the numerous shards of glass on his face to a beard. This again highlights the pain and damage caused to the innocent â€Å"young man†. The serious nature of the injuries is also conveyed by the words â€Å"spurts of arterial blood† which creates the image of blood gushing out of the girl. Her â€Å"wet-look white coat† emphasises the amount of blood and the contrast of red blood on white which creates a strong visual image. The poem then moves on to describe the attackers using effective word choice to convey the lack of compassion shown to the victims. The incident is described as the â€Å"operation† which suggests that this is a purely business-like transaction for these people. There is no emotion. The word â€Å"loot† suggests that the youths’ only care is to grab as many valuables as possible and do it â€Å"smartly†. This highlights the impersonal, business-like manner again, showing a lack of humanity. Again this is done with â€Å"no expression† which shows no concern or care for the couple whose faces show â€Å"surprise† and â€Å"shock†. The word choice used here effectively shows the selfishness of the youths whose only care is to steal with no concern for who gets hurt in this violent incident. . Morgan achieves this by using the present tense, â€Å"a young man and his girl are falling†, â€Å"their arms are starfished†. This creates the effect of seeing the event as a picture rather than an ongoing event. The writer emphasises this with the words â€Å"sharp clear night† which relates to a camera image again. This helps the reader stand back and look at the event objectively without be involved. Morgan is trying to make the point that this is what we do in society when we see violence occurring – stand back and not get involved. This theme of society’s reluctance to help others is shown through the deliberate reference â€Å"in Sauchiehall Street†. This makes it clear that this violent incident took place on a busy street in Glasgow where lots of people would be. He goes on to refer to drivers â€Å"in the background† which again highlights the fact that people do not come forward to help the victims; they â€Å"keep their eyes on the road†. This final line effectively conveys Morgan’s attitude that people turn a blind eye to violence, most likely from fear or lack of compassion. Through presenting this ‘snapshot’ of the incident in â€Å"sharp clear† detail, it makes the reader think about what we would have done in this situation and why people failed to act. In conclusion this poem effectively conveys a violent incident on a busy Glasgow street. Edwin Morgan successfully highlights the lack of concern in our society for others. He achieved this through his instamatic technique, vivid imagery and effective word choice. These techniques helped me visualise the incident well and understand the writer’s message. The poem really made me think about how we treat one another in society as this incident is set in Glasgow in a busy street. It made me wonder if this would actually happen and if people would help or turn a blind eye.

Introduction To The Movie Brokeback Mountain Film Studies Essay

Introduction To The Movie Brokeback Mountain Film Studies Essay Brokeback Mountain is a particularly extraordinary film. Brokeback Mountain is one of the most touching love stories in decades; it gradually casts its spell, moving forward at a relaxed tempo and soothingly works its way into your heart. A number of movies take their time revealing the story out and occupying the audience. Brokeback Mountain is one of those films. The story that unfolds is reasonably straightforward and simple. Its the summer of 1963 and Jack Twist (Jake Gyllenhaal) meets Ennis Del Mar (Heath Ledger) when theyre both given jobs guarding sheep up on Brokeback Mountain. Jack is portrayed as friendly and open; a very friendly person a real talker who loves to play the harmonica. On the other hand, Ennis is basically a shy person, who closely safeguards his feelings and avoids openly up to strangers or simply, everyone. All alone up on the mountain (with just horses and sheep for company) the good-looking young men open themselves to each other, emotionally. One night, as a result of a lot of drinking, Jack encourages Ennis into his tent to get warm. In an artfully and cleverly staged scene, Jack positions Ennis arm over his body which makes Ennis pull away. But soon, their deep desires and love for each other shoots up into a life-changing sexual encounter. A 20-year relationship blossoms from that one night of shared passion. Though both the men got married, and had children, yet never once did they stop loving each other. Because their love would never have been understood or accepted by the society in that time and in that place, they could not openly show how they felt for each other and had to keep it locked inside of them with the exception of a few times each year, when they broke away from their normal lives and took some time out for themselves on Brokeback Mountain. The proposed argument states that holding up or suppressing ones sexual emotions can be spiritually and physically dangerous, frequently having an injurious, chain effect. This thesis statement is supported by many depictions within the movie. It is basically a desperately sad story in a lot of ways, a story of two wasted lives, but a moving and beautiful story, too. Once forced to hold back his true emotions, Jake becomes a sellout, working for his hateful and loathsome father-in-law, selling farm machinery. Ennis, on the other hand, turns into a quiet and grumpy old cowpoke their true selves become more sadly unapproachable with each passing day of their lives. More than this, Brokeback Mountain is in fact a story of how, for the most part, our lives, gay and straight, are characterized by one split second in which things go naturally and gloriously right, when the whole thing falls into place; but afterwards it is felt plain wrong. Jack and Ennis, flawed as they are, undertake the most excellent endeavors to refuse their deep embedded desires and they fight not just against racism, but the dullness of their society as well. (Piontek, 2012). Brokeback Mountain is at the end of the day not about sex (there is very little of it in the film) but about love: love dissatisfied, love accidently fallen into and love held sorrowfully in the heart. Another instance to support the main idea comes in the shape of a scene added in the original script, in which Ennis, in front of his freaked-out family, punches two hikers at a Fourth of July picnic. The shot of the, enraged and deeply unhappy cowboy lifting his fist against a sky decorated with fireworks is one of the more initial moments. The director, Lee, restates a well-known, though compelling charge against the foundations of American nationalism, that is to say that at least some of its aggressive and violent action is rooted in repressed homosexuality (Pinto, 2007). In order to understand the main thesis idea adopted in this essay, historians must put together a reflection and consideration of the emotional urges in order to progress beyond representation to understand the realities of historical actors. In political terms, Brokeback was a revolutionary event, in order to understand the connections between homosexuality, homo-sociality, and homophobia. The importance of emotional urges and the resulting hold-up of unacceptable emotions are highlighted in the following situation: What Jack remembered and craved in a way he could neither help nor understand was the time that distant summer on Brokeback when Ennis had come up behind him and pulled him close, the silent embrace satisfying some shared and sexless hunger. Such feelings are undoubtedly significant and important for an individual. A person who is deprived of such a blissful feeling and connection is sure to turn sour, bitter and unhappy (Grundmann, 2006). Moreover, Ennis, who constantly fought against his emotions and tried hard to hold them under the assumed fatherly responsibilities, eventually did feel the loss of what was unsaid and undone between him and Jack. In a scene replicated in the movie, Ennis hid his face and breathed in little by little through his nose and mouth, looking forward to the faded fog of mountain and salty sweet stench of Jack but there was no genuine scent; only the memory of it the envisioned supremacy of Brokeback Mountain of which not anything was left but what he held in his hands. At last Ennis found himself competent of some measure of imagination -too late (Snider, 2008). This truly represented that sexual freedom is a human right; whose suppression led to spiritual and physical drunkenness. This movie, Brokeback Mountain, is nonetheless a classic and a thought-provoking movie. Labeled as a love story, it does not only target a specific audience; rather it extends its gentleness, its tenderness, emotional attachment and the sorrow of lost love to all. Though homosexuality might not be acceptable to all, it nevertheless exists as a firm reality amongst living people with real, sincere emotions and feelings. The movie is a classic example of individuality and human right humans are free to love whomever they desire. Inability to do so might have injurious ripple effect and could lead to devastated, unhappy lives of many.

Humes Wide Construal of the Virtues Essay -- Hume Virtues Virtue Phil

Hume's Wide Construal of the Virtues ABSTRACT: The term "virtue" has traditionally been used to designate morally good character traits such as benevolence, charity, honesty, wisdom, and honor. Although ethicists do not commonly offer a definitive list of virtues, the number of virtues discussed is often short and their moral significance is clear. Hume's analysis of the virtues departs from this tradition both in terms of the quantity of virtues discussed and their obvious moral significance. A conservative estimate of the various virtues Hume refers to in his moral writings would put the number at around seventy, with the more untraditional ones including wit, good manners, and dialog. Unsurprisingly, Hume's critics have attacked him for making nonsense of the concept of virtue by construing it so widely. Hume was aware that his broad understanding of virtue was controversial and he offered several defenses for it. After presenting the neglected attacks of his contemporaries along with Hume's response, I argue that a problem remains: by failing to distinguish between degrees of virtue, Hume also fails to distinguish between degrees of vice. But, some vices (e.g., malevolence) clearly deserve punishment whereas other alleged vices (e.g., uncleanliness) clearly do not. Thus, for adequate retribution, a distinction is needed between important and less important virtues and vices. I conclude that Hume could have used his own account of instinctive vengeance as a natural indicator for distinguishing between important and unimportant vices. The term "virtue" has traditionally been used to designate morally good character traits such as benevolence, charity, honesty, wisdom, and honor. Although ethicists, past and present, do ... ...f John Leland's A view of the principal deistical writers..., in the Monthly Review, 1757, Vol. 14, pp. 465-477, and in the Critical Review, 1756, Vol. 1, pp. 193-208. (12) James Beattie, Essay on the nature and immutability of truth in opposition to sophistry and scepticism. 1770, Edinburgh, A. Kincaid and J. Bell, pp. 421-448. (13) "Character of the Works of David Hume Esq," in The Weekly Magazine or Edinburgh Amusement, 1773, Vol. 22, pp. 233-234. (14) "Tobias Simple," "Strictures on the account of the life and writings of David Hume," in Weekly Magazine, or Edinburgh Review, 1777, Vol. 38, pp. 289-292. (15) C. L. Stevenson, Ethics and Language, (New Haven: 1944), pp. 34-35. (16) Pall S. Ardal, Passion and Value, (Edinburgh: Edinburgh University Press, 1966), pp. 160-161. (17) J. L. Mackie, Hume's Moral Theory, (London: Routledge, 1980), p. 129.

Food Chain, Food Web and Ecological Pyramid

GAYATRI VIDYA PARISHAD COLLEGE OF ENGINEERING (AUTONOMOUS) MADHUARAWADA, VISAKHAPATNAM – 530048 ASSIGNMENT SUBMITTED TO: S. V. RAMANA ————————————————- DEPARTMENT OF ENGLISH NAME OF THE STUDENT: VAMSI KRISHNA G ROLL NUMBER:12131A0533 TITLE OF THE ASSIGNMENT: TECHNOLOGY ON EDUCATION ————————————————- DATE OF SUBMISSION: 15-04-2013 INTRODUCTION: The impact of technology on education is immense.In olden days students used to get confined to libraries for any information on the topics given to them but now a days the technology has been improved , students carry portable devices with them such as laptops, mobiles etc. they are also provided with Ebooks which are much more advanced than the textbooks. KEY POINTS: 1. As the technology have been increased producti vity tools such as databases, spreadsheets, graphic programs etc allow students to independently organize, analyze, interpret, develop, their own work 2.Projectors are playing a major role in an students life as teachers have adopted e learning techniques due to which students are understanding the concepts easily. It has lessen the burden of a teacher 3. Technology have been increased so well that the application of scientific calculators have lessen the burden of the engineering students. 4. students can set up language lessons with a native speaker who lives in another country and attend the lessons via videoconferencing 5.With a simple assignment and access to technology, researching and also producing a product that would communicate, students are able to do deep learning on a concept that wasn’t even addressed in their textbook, and allow other people to view it and learn from it. 6. E-books is an electronic device which consists of a lot of information more than a text book. Hence e-book has replaced the textbook . 7. 3D learning has become a reality especially for medical , architech , biology students as it increases their understanding and are able to grasp the concept very easily. . Now a days students are not restricted to libraries and classrooms as they are equipped with portable learning devices such as laptops, pendrives, smartphones etc. 9. In olden days students used to refer a number of books by going to library but now students can get any information on any topic on web for example Wikipedia. 10. Assistive technology can help students who have mental retardation along with students who are low performers, at-risk students or have any learning disability. 11.There are a number of websites such as expert tutorials, mock testes, online testes which increase the confidence of the students facing any type of exams. 12. Presently, classroom learning is increasingly dependent on the integration of technology thus enhancing learning. The cur rent technology uses email systems, data processing and laptop audio/videos webinars. 13. youtube is a great example for homegrown ingenuity as it has many different venues such as entertainment, learning and even commercialization of products. 14.The improvement in technology has been a great help to students in many fields for instance, in the field of fashion technology , one can use different colour patterns , 3D designing etc. so that they can have immediate evaluation. 15. The textbooks have also become very attractive with fine quality and much more advanced than the olden day’s textbooks, which help the students to update the information accurately. 16. In olden days students used to write the information from different textbooks which was a time taking process but now a days students can get any type of information printed instead of writing. 7. Students can incoperate pictures,matter with the help of scanner in their presentation. 18. Open air class room techniques have been implemented so that students engage in hands on learning related to nature topics. 19. Virtual reality technology is an important tool for the monitoring anomalies in structures and to assist decisions based on visual analysis of alternative solutions. It is mostly used in civil engineering. 20. The technology has made it possible for the distance education students to persue degree with good universities.CONCLUSION: Hence increase in technology has brought a great change in education. Students are getting more confident and are able to face the world with no fear. Computers assist in education by providing a wide range of resources, and by tailoring instruction to the individual student, which can seldom be done in the normal classroom. VAMSI KRISHNA G 15-04-2013 SIGNATURE (WITH DATE)

Campus Assault Essay

Campus Assault Essay Campus Assault Essay Carrying The Weight Columbia University senior, Emma Sulkowicz, speaks firmly outside of her dormitory building. It is a solemn statement, and one that she has repeated to many reporters since school resumed in the beginning of September. Three days into her senior year and still unsure of her rigorous class schedule, Sulkowicz is already swarmed by reporters and photographers on her way to class. The visual arts major has just embarked on her senior thesis, an endurance performance art project she is calling â€Å"Mattress Performance,† in which she will carry around a navy, Twin XL mattress – the exact same kind of mattress on which she was raped the first day of her sophomore year – until her rapist leaves the school through expulsion, voluntary leave, or graduation. Sulkowicz has already received media attention as one of the twenty-three â€Å"complainants† filing April’s Title IX case against the university’s alleged mishandling of sexual assault cases, but the personal attention has escalated since her art piece has gone viral on the Internet. On Mondays, Emma attends class carrying the fifty-pound mattress across campus from north to south and east to west. â€Å"It’s a lot of physical pain,† she says. Unless there are reporters surrounding her, her fellow students, both friends and strangers are eager to help her before and after class. These acquaintances are not helping her get from point A to point B but also sharing in her everyday burden: carrying the weight of her past – and present – upon her shoulders. College students, because of their age, are at high risk for sexual assault, and some researchers believe that college women are more vulnerable than their nonstudent peers. Campus sexual assault is vastly underreported to authorities with fewer than 5-percent of college women who are victims of rape or attempted rape reporting it to the police. Part of the problem is that many survivors do not call their experience rape although it meets the legal criteria, but colleges also often encourage victim blaming through prevention programs that focus exclusively on risk-reduction behavior by potential victims. Drug and alcohol abuse policies that do not include immunity for victims of sexual assault can also hinder reporting. Not having access to confidential or anonymous reporting reduces the number of victims who will come forward and a belief that the assailant will not be punished. President Obama and Vice President Biden joined leaders from universities, media companies, the sports world, and grassroots organizations to launch the â€Å"It’s On Us† campaign against sexual assault on college campuses. â€Å"It’s On Us† is a rally cry inviting everyone to step up and realize that the solution begins with us. It seeks to reframe the conversation surrounding sexual assault in a way that inspires everyone to see it as his or her responsibility to do something, big or small, to prevent it. In launching â€Å"It’s On Us,† President Obama said, â€Å"To the survivors who are leading the fight against sexual assault, your efforts have helped start a movement. I can only imagine how long and lonely your fight must feel. And that’s why we’re all here today – to say that it’s not on you; it’s not your fight to wage alone; it’s on us – all of us – to fight campus sexual assau lt. You are not alone. We’ve got your back.† With the rise of interest and momentum that we’ve seen in just the initial first days of launching the campaign, it’s clear that Americans across the country really do have victim’s backs. The National Campus Leadership Council had worked to sign up two hundred and three campuses to run student-led â€Å"It’s On Us† campaigns. In only a few days, that number has jumped to two hundred and thirty-three campuses nationwide. President George Bush signed â€Å"The Campus Sexual Assault Victims’ Bill of Rights† into law in July of 1992. The law requires that colleges and universities, both public and private, participating in federal student aid programs

Robert, the Red Nose Butcher Professor Ramos Blog

Robert, the Red Nose Butcher It was a 16 hour flight that I Was dreading, tired, hungry, physically exhausted. I Knew my vacation was over. Two weeks of vacation and three different south american countries; Peru, Uruguay, and Argentina. I Had plenty of reasons to look forward to this vacation though; legal drinking age, seeing my cousin on her 22nd birthday, and no work! At that time I Was just bagging groceries at Stater Bros. Easiest job in the world, right? Well on my last day of work before my trip my store manager called me to the office and told me Ill be starting in the meat dept. When I Get back. But its a promotion. So its a good thing right? Yeah†¦ but its a whole new job description which is a whole lot of training. So I Left that news at the Buenos Aires airport after I Landed and enjoyed myself. But two weeks later it was there at the same airport waiting for me to get back. I Got back to work with a change in uniform and department. Rather than being able to run around a grocery store inside and out I Was limited to one department. Meat. my meat manager give me the rules of thumbs and id say with in months I Was able to identify a piece of meat and determine its cut and where it comes from. I was able to memorize codes and remember what number for what cut and meat. I Remember it was valentines day and the morning and afternoon were practically dead. So the meat cutters went home earl. But that would soon all change when everyone started to get off work. Customer after customer, steak after steak we were busier than a one legged man in an ass kicking contest. Eventually, with only two meat clerks and no cutters left, we ran out of the most popular steak, ribeye. Ive seen it cut for months and months, watching how they do it, so me and the other meat clerk ray decided just to try to cut. We cut the ribs as they were selling, with a line of customers across the department all wanting the same thing. It lasted about an hour and we cut about 5 ribs, around 20 Lbs each. We had a few left over by the end of the night and put them in the case for sale. In the morning when I Went in, my meat manager had already heard about the busy night we had, Asked how we did, he turned to me and said â€Å"those were the ugliest ribeyes I Have ever seen†, then turned away and started busting up laughing. I was as offended as a would be now, because those were my first cuts. In the following months I Didnt really do any cutting, more just wrapping meat and helping customers, but I Did keep watch when they would cut meat, on what to do and what not to do. Three months after the whole valentines day incident, Ended up being transferred to a Fontana store off sierra and foothill, Walked in the store and noticed, it was the smallest store I Had ever worked at. My first day I Was introduced to the meat manager and he explained how he goes about running the department and introduced me to the other clerks. It was a nice normal introduction, until one of the meat clerks named anali said â€Å"wait until he meets Bob !†. They all stood arou nd and started laughing, agreeing and sharing stories on how the ‘Bob ’ person is. â€Å"Just wait Charles hell be back in a week from vacation†, my meat manager Armando told me. So I Worked my few days as usual, but I Did notice that this store is not as strict, they dont exactly follow ‘policy’ but I Didnt care. I Went with the flow. My first friday at my new store I got a phone call from my old meat manager, asking me how I Was doing, we talked and shared a few laughs and then I Thought to ask about Bob . â€Å"Dont worry about Bob . Hes harmless† said my old meat manager as we wrapped up the conversation.† The next monday I Walked into the meat department and seen a new face. Well it wasnt really a new face, as a matter of fact it was a 64-year-old face, towering above my five foot two-inch self. â€Å"hello , Charles is it? Well hows about we go in the back and have ourselves a little meeting.† he walked me to where we washed the dishes and keep our supplies. He went on to lean against the sink and talk to me. â€Å"Well hello im Bob ! Robert john Joseph by God Cridlin! Now a little bit about me, Ive been with the company since I Got out of Vietnam and Im planning on leaving soon†¦ one more thing you ought to know about me is I Wasnt scared of jack brown! I Aint scared of nobody! Im an Irish Catholic, and a decorated veteran! Im untouchable son!† That is exactly how it went down that day almost down to the T. it was an introduction I Will never forget, and in introduction that was just the beginning of the end. It didnt take long for Bob to get comfortable with me, as I Learned it didnt take long for him to get comfortable with anyone. â€Å"Bob the Butcher† he was called and know by to almost everybody! Now it was almost immediately that Bob had started to show me how to cut. And I Did get the hang out of. Within a week I Learned how to cut four different steaks and by the month I Had learned to cut most of the basic/standard cuts. My meat manager Armando and Bob were not shy and within my first month I Started coming out of my shell a little. We talked about things ranging from anywhere between religion to sex, even our personal and financial lives. Between the whole department we all knew practically everything about each other, we just got personal. After about my first month I Noticed the Bob was a heavy drinker, I Heard stories and was seen videos and even voicemails from drunk calls to my co workers. It wasnt long before I Was put in the morning shift and notices, AT LEAST 3 days a week Bob would come in drunk! With his red-nosed shining almost as bright as Rudolphs from the whisky, I Knew he was not able to cut meat let alone use a saw. Over time I Got used to it as was everyone else in my department. It was almost to the point where the opener practically knew we would have to cut meat in the morning to cover Bob s ass. It wasnt a problem though we would cover for eachother†¦ even to the end. It was my 6th month when I Got to the store where I Got a text from another meat clerk, saying how something happened with Bob and Armando . Come to find out on my day off our district manager had walked in and noticed something was off about our meat. After reviewing footage 4 out of 5 of us got suspended; me Bob Armando and another meat clerk. We had to go to a couple of meetings at the corporate office and within two weeks the five people who were in the meat department didnt even work there one meat clerk, Armando and Bob got fired, I Was asked to resign, and the other meat clerk quit in protest. In the end none of us got fired for Bob being drunk or us cutting meat, they reviewed months and months of footage pulling skeletons out of the closet. Bob , got fired for cutting meat that was bad, he was caught on footage grabbing and out dated box, and seen in another camera smelling the meat (to see if it was good) and continued to cut it and sell it. Armando , got fired for grinding beef that was out of its life shelf, meaning it was too old to grind. The other meat clerk, Chris got fired for extending days on product, he was caught on footage extending seafood days. As for me, I got fired for leaving meat out of refrigeration and putting them back out for sale. I now work for sprouts in Alta Loma as a meat cutter, my meat manager now had actually not only worked for Stater Bros. Before but was also fired and also worked with Bob . In the interview he said he knows what I had gone through and although I have not been a meat cutter before, know I know how, and was taught by Bob .

Helping ESL Students Understand and Participate in Small Talk

Helping ESL Students Understand and Participate in Small Talk The ability to make small talk comfortably is one of the most desired objectives  of almost any English student. This is especially true for business English learners but applies to all. The function of small talk is the same the world over. However, which topics are appropriate for small talk can vary from culture to culture. This lesson plan focuses on helping students develop their small talk skills and addresses the issue of appropriate subjects. Difficulties in small talk skills can arise from a number of factors including grammar uncertainties, comprehension problems, lack of topic-specific vocabulary, and a general lack of confidence. The lesson introduces a discussion of appropriate small talk topics. Make sure to give students ample time to delve into the subjects if they seem particularly interested. Aim: Improving small talk skills Activity: Discussion of appropriate small talk subjects followed by a game to be played in small groups Level: Intermediate to Advanced Small Talk Lesson Outline Write Small Talk on the board. Brainstorm as a class to define small talk. Write examples on the board.Discuss the importance of small talk skills with the class.Divide students into groups of 3 - 5.Give students the small talk worksheet.Students begin by reviewing key functions and grammar by matching purpose,  expression, and form. Review as a class. Discuss any questions in usage.Ask students to discuss  whether the topics provided in the second section  are appropriate for making small talk. Students can also decide that some topics are appropriate in certain situations  but not in others.  Once students have discussed the various situations, solicit responses on the various subjects from the class as a whole. Make sure to ask for examples of comments on appropriate subjects, as well as  explanations for those topics which students feel are not appropriate. Feel free to let students debate their opinions to help develop  conversational skills.Have students get back into their groups and play the small talk game in the third section. Circulate around the room helping  students when they run into difficulties. Take notes on subjects that students find difficult. As a class,  brainstorm on appropriate comments. Understanding Forms Used in Small Talk Match the conversational purpose to the expression in the second column. Identify the appropriate grammar structure in the third column. Purpose Expression Structure Ask about experienceGive adviceMake a suggestionExpress an opinionImagine a situationProvide instructionsOffer somethingConfirm informationAsk for more detailsAgree or disagree Open the package. Fill out the Forms.Where can I find out more?Im afraid I dont see it that way.Have you ever visited Rome?Lets go for a walk.To me, that seems like a waste of time.You live in San Francisco, dont you?Would you like something to drink?If you were the boss, what would you do?You should visit Mt. Hood. Conditional formQuestion tagUse of some in questions rather than anyTo me, In my opinion, I thinkInformation questionModal verbs such as should, ought to, and had betterImperative formLets, Why dont you, How about Present perfect for experienceIm afraid I dont see / think / feel that way. Hit Your Small Talk Target Which Topics are  Appropriate? Which topics are appropriate for small talk discussions? For  topics which are appropriate, think of one interesting comment to make when the teacher calls on you. For topics which are not appropriate, explain why you believe they are not appropriate for small talk. The latest filmsThe One True Path to Eternal LifeThe local basketball teamCarsA product you would like to sell to everyoneThe Death PenaltyYour hometownHow much you makeYour last holidayYour favorite movie-starThe correct political partyThe weatherGardeningYour health problemsYour family Small Talk Game Throw one die to move forward from one subject to the next. When you get to the end, return to the beginning to start again. You have 30 seconds to make a comment about the suggested subject. If you dont, you lose your turn! Your best friendThe last film you sawPetsRock and rollA magazineLearning a languagePlaying tennisYour current jobAn interesting excursion nearbyThe InternetMarilyn MonroeKeeping healthyHuman cloningYour favorite foodFinding a job in your countryThe last book you readYour worst holidaySomething youve never done, but would like to doTeachers - what you likeTeachers - what you dont like

Intercultural - international faux pas Essay Example | Topics and Well Written Essays - 250 words

Intercultural - international faux pas - Essay Example For instance, developing assumptions is one of the practices (Blanchot, 2001). This implies that a number of people have the tendency of assuming that they understand things and the way they are. In addition, it is also inappropriate to neglect creating relationships before proceeding with the intended business. In almost all cultures, it is not proper to attempting to carry out business even before establishing a relationship with the other party. This is viewed as acting too formally and it is not proper. Furthermore, it is also not proper to neglect following the suitable eating etiquette. This could include rejecting an offer of drink or a meal, eating in public, as well as displaying inappropriate table etiquettes (Gaskin, 2008). The most difficult culture to live in is the Chinese culture. The faux pas in my culture that a person from outside might do includes a man greeting a woman in a modesty manner while lowering his gaze to avoid lewd on both

Influence Leadership and Personal Development Reflective Portfolio Essay

Influence Leadership and Personal Development Reflective Portfolio - Essay Example The above knowledge has helped in enhancing my productivity and efficiency in dealing with several subjects. Gaining efficiency in terms of both theoretical and practical knowledge has helped me in sharpening my business and communication skills. In addition to the above I have acquired other skill set which helps me achieve targets on time and also in sustaining a healthy relationship with the client base of the concern. Again speaking on the above note I feel encouraged in working together in a collaborated fashion within a team framework for the successful accomplishment of multifarious and multidimensional business objectives. My working with different organisations for a span of four years in profiles like marketing and sales assistants and also as negotiators has helped in enhancing my expertise in delivering projects in a highly professional manner. The above facts have thereby augmented my dynamism and endeavour to deliver better in the professional framework and help in the enhancement of the portfolio (Brown and Irby, 2001, p.15; Zuzelo, 2007, p.10). Highlights – Work done The work highlights are presented hereunder in a historical fashion starting from the financial year 2006-2007 which would help in the portfolio management (Knoerr and McDonald, n.d.; Jafari and Kauffman, 2006, p.87). Work highlights are used to enhance the dimension of reflective portfolio through the presentation of evidences and a critical analysis of the work path (Smith and Tillema, 2005, p.15; Loughran, 2005, p.815). During that period I was employed with Mundi Color Holidays as a Sales Manager where my area of responsibilities constituted of the following activities. I had to regularly update the agencies in regards to changes in the commission levels and also in gaining access to other agencies. Further I was also required to update the information gathered in the computer and also in helping to fill up the vouchers and also arrange for the proper despatch of old peop le travelling over to Spain. In that I acted as the liaison between the managerial bodies of the concern and the client base and rendered important feedback based on client interface. During the period ranging from 2007 to 2008 I acted as the Lettings Negotiator in Orchild Properties which is an Estate Agency. In that through the help of software like Estatepro and a website named findpropetty.com I effectively carried out the sales and marketing activities through which different promotions relating to property were raised. Apart from finding and promotion of the different properties I also through the use of information technology helped to enhance the presentation aspects of the new properties. The company’s website was vividly used for the above purpose along with creation of window displays for the same. Finally I was also entrusted to conduct the bookings for the above properties and also in administering the entire letting process. From November 2008 to 2009 I worked a s the Senior Negotiator in Manolia Homes. In this concern I worked in the management of contracts protecting the rights of both the landlord and the tenant. Further I also carried on effective negotiation with the tenants and rendered the feedback to the team so as to chalk out plans for the meeting of targets based on weeks and months. Customer interaction and complaint management were carried out by me with also efficiently administering the

World Literature Questions and Creative Writing Essay

World Literature Questions and Creative Writing - Essay Example On the other hand, God would like to test man’s steadfastness. Oblivion of the game where he is just a pawn, the man tosses on the horns of dilemma until he realizes his limitations. Why did the God do this with me? This is the question that dawn on him when he surfaces into reality. Like Faust, I signed my soul with the devil but I was smart .I told him if at any stage my mind changes I will break the pact. The devil was too sure. He knew after getting the best enticements, no man goes back to God.I am happy, by the grace of God I took a very wise decision. I have strived every time for the best and in this pursuit have found that there is limitation which a man should always accept. Human being is created by God with some inadequacy. We are not born perfect that is why we strive for perfection. Perfection is only found in the God’s kingdom.As He is the epitome of perfection so one should not exceed the limits he has imparted us with. Striving to overcome one’s limitation is going against His Will and denying Him. That is the time when the Devil can lure a human being. I too went through the same plight as Faust but I identified my limits as I knew ,I have my constraints and if I deny my God, I am denying my whole being. Devil won’t give one anything for free, He knows how to lure human, â€Å"...we meet again on the other side...same coin you shall pay me back.†Though it is not an easy pact but I went for it as I wanted to work for the humanity, â€Å"my efforts to reach that crown of humanity, after which all my senses strive?†But, then I realized this endeavor was futile as it would leave me nowhere. I realized all this I can attain in God’s grace as well then why to join an evil company? I realized this fact that a devil will win any how by treachery and deceit. I thank to God that this understanding came to me much earlier and I saved myself from devil. 2. Dear Ivan, Life shows many twists and turns, it is never a pleasant journey and some people are less fortunate. I have heard your plight. It is really distressing and I have failed to understand the justice of God as well. Fair should be rewarded in the God’s court but it seems that he too turns His blind eye for the righteous. You were wrongly convicted and have suffered entire life in galore for someone else crime. Your wife also disbelieved you and your children have forgotten you as well as if you have never existed for them. Your petitions to review the case went unheard and that also did not shake your faith. You had firm faith in God and believed in His Justice but the justice was denied to you. I hold your persona with utmost respect and wonder how were you able to forgive Makar and reconcile with the things. I have undergone same predicament and I am unable to reason with this fact, why I have been mocked and ridiculed. I have picked just a piece of string thinking it might be of some use to me but was accused of pic king wallet that belonged to Maitre Fortune Houlbreque  of Manneville. I was wrongly charged and I came to know Maitre Malandain has laid blame on me. I tried to prove myself innocent by showing the proof of my pick but they laughed and disbelieved me. Maitre Malandain always had grudges against me. I was wrongly indicted, you would be surprised to know that the purse was found and returned to the mayor yet people thought me an accomplice and defamed me everywhere. I tried to prove my innocence to every person I met on my way, I am well aware that at my back they made fun of me and suspected me. I have found the futility of convincing everyone. I have grown ill ,pestering myself and now, I am at the death bed thinking my plight is just like yours my dear friend, the justice is denied to me as well in this human world but I am breathing my last with

UK contract and employment law Essay Example | Topics and Well Written Essays - 2000 words

UK contract and employment law - Essay Example She became negligent with her work. She committed 2 negligent acts which were both serious in nature and affected the company. After the first incident, Clarissa was informally warned but the manager still showed faith in her. But after the second incidence, manager lost confidence in her and she was fired with a six month notice. Her contract will terminate on 31st March 2012. Also keeping in the mind the safety of her colleagues, she was asked to take â€Å"garden leave† wherein she was not needed to come to office during the notice period but would be paid for it. She was not happy with this and wanted to continue working. She has received an offer from Flare Missiles to work for them, provided she joins on the 1st of February 2012. She needs advise on whether she can successfully pursue a claim for unfair dismissal compensation against Cascade and whether she can lawfully accept flare's offer of employment. Unfair Dismissal Compensation The question of whether Clarissa can pursue a claim for unfair dismissal compensation will depend on whether it was an unfair dismissal. The fact that she was dismissed is clearly established in the facts of the case. She will be able to successfully claim the compensation if she can prove that the dismissal was an unfair one. If Precision Missiles had followed all the procedures and abided by the law, then she will not be able to claim the compensation as it will not be an unfair dismissal. First and foremost for Clarissa to have a right against unfair dismissal, she should have worked in the company for at least one year and Clarissa fulfils this requirement as she has been working for over 30 years in the company. Now, Clarissa has to be prove that the dismissal was unfair according to the Employment Rights Act of 1996, Section 98A(1) (‘Procedural fairness’)1 The Employment Rights Act of 1996, Section 98A(1) (‘Procedural fairness’) states that: A dismissal without completion of the standar d procedure (wholly or mainly attributable to the failure of the employer) will be unfair. Whether the dismissal was an unfair dismissal will depend on the 2 stage test that any an unfair dismissal must go through2. Stage One: The Reason Once the unfair dismissal compensation claim is made, the responsibility to show that dismissal was based on a reason falls on the employer3. In this case, Precision Missiles will argue that they had a fair reason to dismiss Clarissa. According to the Employment Rights Act of 1996, Section 98(2) they have to prove that their reason was a fair one. In the current scenario the reason for dismissal was negligence and carelessness in carrying out her responsibilities which are a part of her job profile. This was not a one distinct incident but was repeated twice and in both cases the consequences of her negligence could have been critical. In the first, incidence her negligence would directly impact negatively on the brand images that Precision Missiles had built with its client. This could seriously damage its image and affect future business. The second incidence if not rectified by her colleagues could have been a disaster for the company. Even though it was found out that her negligence would not have caused serious damage, a repetition of the incidence could have been critical. The above reason could be justified as a fair one by using

Effects on Economic Growth by Financial Repression Essay

Effects on Economic Growth by Financial Repression - Essay Example The McKinnon-Shaw hypothesis recommended the liberalisation of the financial sectors from such restrictions to stop economic stagnation and initiate economic growth. This hypothesis, however, is not without its share of critics who pointed out that severe financial repression must be distinguished from mild repression or that the McKinnon-Shaw framework failed to take into certain factors such as inflation or that some of its basic components lacked empirical basis. Moreover, specific studies of countries that adopted this financial repression yielded unequivocal results that could lead one to assert that financial repression leads only to one and only one result - economic stagnation. In connection with this, the cases of India and China, both of which have experienced financial repression, are presented in this paper to shed light to the McKinnon-Shaw claim that financial repression negatively affects economic growth. This is timely considering that both, especially China, are pres ently considered emerging super economies of the world. Financial repression is a term that was first coined in the 1970s by McKinnon and Shaw, but was actually a condition that existed prevalently before that. As a matter of fact, financial repression was the norm and financial liberalisation, its opposing term, the exception prior to the 1980s. Financial repression, thus, refers to government intervention in the financial environment by substituting regular market variables and mechanisms with its own (Spratt 58). The existence of financial repression can be deduced from the presence of the following factors: unsystematic distortions in financial prices such as interest and exchange rates; interest rates with ceiling caps and nominal interest at fixed rates, which lead to low or even negative real interest rates.

Compare and contrast the ways that the physical,mental and societal Essay

Compare and contrast the ways that the physical,mental and societal horrors of war are presented in Birdsong and Journey's End - Essay Example In the book Journey’s End, there are quite a few references to the extraordinary numbers of individuals killed on the battlefield. Quotes such as â€Å"One thousand eight hundred companies in France† are used to give the reader an idea of the vast amount of casualties. In this, the idea of war is made real to the reader through the virtual body count. The reader is continuously reminded of how horrific this particular war was as most of the readers would not have experienced this set of circumstances for themselves. Journey’s End makes the massive death toll seem even more significant by introducing the fact that the Germans were in fact not so different from the allied forces, â€Å"I remember once at Wipers we had a man shot down†¦Next day we blew each other to blazes†. It would seem that no matter what happened, these two sides would inevitably and eventually still slaughter one another. Similarly in Birdsong, there is a great deal of description detailing the amount of casualties. This is comparable to Journey’s End, where it is explained that the losses from both sides of the war are extensive. This quantification of death allows the reader to identify with the difference between the once living and the no longer living. It is an important element of the text to identify with what is happening by recognizing the heaviness of death. An example of this is the death of Levi’s brother towards the end of the novel. Another example in comparison is the death of the men in Ypres in Journey’s End. It is explained in Birdsong that Levi and the rest of the German soldiers are examples of how similar the two sides are. On the inverse, it is an interesting contrast of one side from another, both being products of their leadership. The difference between these two sides can then be distinguished by their leaders, as they must follow the commands that they are given. Another similarity between Birdsong and Journey’s End is the inclusion of men

UK contract and employment law Essay Example | Topics and Well Written Essays - 2000 words

UK contract and employment law - Essay Example She became negligent with her work. She committed 2 negligent acts which were both serious in nature and affected the company. After the first incident, Clarissa was informally warned but the manager still showed faith in her. But after the second incidence, manager lost confidence in her and she was fired with a six month notice. Her contract will terminate on 31st March 2012. Also keeping in the mind the safety of her colleagues, she was asked to take â€Å"garden leave† wherein she was not needed to come to office during the notice period but would be paid for it. She was not happy with this and wanted to continue working. She has received an offer from Flare Missiles to work for them, provided she joins on the 1st of February 2012. She needs advise on whether she can successfully pursue a claim for unfair dismissal compensation against Cascade and whether she can lawfully accept flare's offer of employment. Unfair Dismissal Compensation The question of whether Clarissa can pursue a claim for unfair dismissal compensation will depend on whether it was an unfair dismissal. The fact that she was dismissed is clearly established in the facts of the case. She will be able to successfully claim the compensation if she can prove that the dismissal was an unfair one. If Precision Missiles had followed all the procedures and abided by the law, then she will not be able to claim the compensation as it will not be an unfair dismissal. First and foremost for Clarissa to have a right against unfair dismissal, she should have worked in the company for at least one year and Clarissa fulfils this requirement as she has been working for over 30 years in the company. Now, Clarissa has to be prove that the dismissal was unfair according to the Employment Rights Act of 1996, Section 98A(1) (‘Procedural fairness’)1 The Employment Rights Act of 1996, Section 98A(1) (‘Procedural fairness’) states that: A dismissal without completion of the standar d procedure (wholly or mainly attributable to the failure of the employer) will be unfair. Whether the dismissal was an unfair dismissal will depend on the 2 stage test that any an unfair dismissal must go through2. Stage One: The Reason Once the unfair dismissal compensation claim is made, the responsibility to show that dismissal was based on a reason falls on the employer3. In this case, Precision Missiles will argue that they had a fair reason to dismiss Clarissa. According to the Employment Rights Act of 1996, Section 98(2) they have to prove that their reason was a fair one. In the current scenario the reason for dismissal was negligence and carelessness in carrying out her responsibilities which are a part of her job profile. This was not a one distinct incident but was repeated twice and in both cases the consequences of her negligence could have been critical. In the first, incidence her negligence would directly impact negatively on the brand images that Precision Missiles had built with its client. This could seriously damage its image and affect future business. The second incidence if not rectified by her colleagues could have been a disaster for the company. Even though it was found out that her negligence would not have caused serious damage, a repetition of the incidence could have been critical. The above reason could be justified as a fair one by using

Compare and contrast the ways that the physical,mental and societal Essay

Compare and contrast the ways that the physical,mental and societal horrors of war are presented in Birdsong and Journey's End - Essay Example In the book Journey’s End, there are quite a few references to the extraordinary numbers of individuals killed on the battlefield. Quotes such as â€Å"One thousand eight hundred companies in France† are used to give the reader an idea of the vast amount of casualties. In this, the idea of war is made real to the reader through the virtual body count. The reader is continuously reminded of how horrific this particular war was as most of the readers would not have experienced this set of circumstances for themselves. Journey’s End makes the massive death toll seem even more significant by introducing the fact that the Germans were in fact not so different from the allied forces, â€Å"I remember once at Wipers we had a man shot down†¦Next day we blew each other to blazes†. It would seem that no matter what happened, these two sides would inevitably and eventually still slaughter one another. Similarly in Birdsong, there is a great deal of description detailing the amount of casualties. This is comparable to Journey’s End, where it is explained that the losses from both sides of the war are extensive. This quantification of death allows the reader to identify with the difference between the once living and the no longer living. It is an important element of the text to identify with what is happening by recognizing the heaviness of death. An example of this is the death of Levi’s brother towards the end of the novel. Another example in comparison is the death of the men in Ypres in Journey’s End. It is explained in Birdsong that Levi and the rest of the German soldiers are examples of how similar the two sides are. On the inverse, it is an interesting contrast of one side from another, both being products of their leadership. The difference between these two sides can then be distinguished by their leaders, as they must follow the commands that they are given. Another similarity between Birdsong and Journey’s End is the inclusion of men

Logic and perception to knowledge Essay Example for Free

Logic and perception to knowledge Essay Knowledge is a theoretical or practical understanding of information, in a particular subject. In order to obtain this understanding; one may use the various processes. Perception and logic are both tools for acquiring knowledge. Without the invaluable tools of logic and perception, in many cases, the conclusions, understandings, interpretations and lessons gained through knowledge may be unattainable. Perception is defined as a mental consciousness, a way of intuitive understanding, regarding, or interpreting knowledge. Perception is broken down into two methods, subjective and objective. From this, we can see the value of perception as it creates a connection from information to knowledge. Humans use perception to interpret knowledge from ones individual perspective using emotion, and opinion. Perception is crucial for determining an individuals knowledge of the subject at hand. Perception allows for various interpretations of a piece of information as each individual has different insights on a single subject. This is valuable in the world of obtaining knowledge as it creates contradictions between individuals perceptions which leads to further exploration within a subject and thus bringing out all perceivable conclusions from the subject. For example, in the world of business, people meet and discuss a topic and draw conclusions as each party perceives the idea at hand. This is essential for proving knowledge and portraying the concept to others and thus exploiting the importance and value of perception to knowledge. Logic is defined a way of thinking or explaining something and enables one to take information and employ it as useful knowledge. From the definition itself, we can see the link from logic to knowledge as it has great value in understanding information. Logical thought is broken down into two methods; induction and deduction. The base of deductive logic is comprised of part A, B, and C. Fundamentally; all information processed trough deductive logic goes through this process. If A and B are true, then C must be true. For example, if two pieces of information are presented, A: All people are mortal, and B: I am a human, and this is processed through logical deduction, one can determine that C: I am mortal. This process is employed through more complex information; however it is extremely important and valuable in creating knowledge from information. The other form of logic is induction. Induction is comprised of simple methodology, but it often creates a degree of uncertainty. New knowledge through induction is created by taking past events and occurrences and creating new knowledge. For example if every time I walk through Middle Inglis, no body is ever there, I can, using inductive logic deduce that no one lives there. I have taken past occurrences and processed them through logic and determined new information. Logically, I have determined that in order to create or realize new knowledge using facts and information, one must employ the various tools to do so. As, new knowledge is constantly desired, the value and use of perception and logic is ubiquitous.

Management of Shoulder Dystocia: A Reflective Essay

Management of Shoulder Dystocia: A Reflective Essay Title: A reflective essay on how you would manage a shoulder dystocia as an obstetric emergency in a stand alone midwife led unit.   Undergraduate Degree Level Essay 1,000 Words Essay The condition of shoulder dystocia is diagnosed when the delivery of the foetal head is prevented by the impaction of one of the foetal shoulders within the mother’s pelvis. Simple head traction or episiotomy alone will not resolve the condition Shoulder dystocia is a complication of labour which is notoriously difficult to manage. It has a high complication rate and an increased rate of mortality. A number of studies have highlighted the fact that management is not always optimal. (Crofts, et al. 2006). Two UK studies produced similar findings that avoidable factors were identifiable in 66% of the perinatal deaths associated with shoulder dystocia. The definition of â€Å"avoidable factors† being a different management would have produced a better outcome. This malpresentation occurs in about 2% of vaginal deliveries and common associated morbidities include permanent brachial plexus injury, fracture of the clavicle, foetal haematoma and hypoxic brain injury. (Draycott, et al. 2008). Because the majority of cases of shoulder dystocia occur in the absence of predictable risk factors, all healthcare professionals in charge of a delivery should have an optimal plan to resolve shoulder dystocia in the safest way possible in any given circumstance. Management The management of shoulder dystocia is a subject that has acquired a large literature in its own right. It is therefore not appropriate to discuss it in great detail. Many of the studies done on the subject have identified a number of â€Å"critical tasks† in the delivery process. These include recognizing shoulder dystocia, asking for additional help, calling for paediatricians to be attend the delivery, applying gentle downward traction on the fetal head, placing the patient in McRoberts position, and applying appropriate suprapubic pressure. (Deering, et al. 2005) A number of mechanisms have been advised in the literature and these include rotational manoeuvre (Rubins or Woodscrew), episiotomy, delivery of the posterior arm, fracture of clavicle, symphysiotomy, all-fours manoeuvre, a cephalic replacement (Zavenelli) manoeuvre if other manoeuvres were not successful. (Crofts et al. 2008) Predisposing factors. Shoulder dystocia appears to occur in cases where there are no discernable predisposing factors however, there are some conditions that appear to make it more likely. The strongest single predictor appears to be foetal macrosomia. A number of authorities have suggested that maternal obesity is an association of the condition, but the meticulous study by Robinson showed conclusively that it was only obesity in diabetic mothers (that was associated with macrosomia) that had a high incidence of shoulder dystocia. Other causes of obesity did not have this association. (Robinson, et al. 2003) Gonen was able to report that a critical weight appeared to be 4,500 g with 33% of infants over this weight having shoulder dystocia and only 2% who were under it. (Gonen, et al. 1996) Birth position There appears to be considerable controversy regarding the ideal birth position. The McRoberts position (with maternal hips in flexion), combined with suprapubic pressure, has been reported as resolving 50% of identified cases of shoulder dystocia (German, et al. 1997). It is thought to achieve its effect through a rotation of the symphysis pubis and flattening of the sacrum. This, together with fundal pressure, is believed to reduce the possibility of the anterior shoulder being impacted under the symphysis pubis. There are some reports of the possibility of increased maternal morbidity (Heath, et al. 1999) and lack of effect (Beall, et al. 2003) Reflection. On a personal note, I have reflected on my own practice in dealing with cases of shoulder dystocia. As a result of researching this essay I have resolved to further explore the evidence base for dealing with the situation, because critical analysis of some of the papers read have challenged some of the ideas that I had previously believed to be true. In particular, I note papers which have analysed the behaviour of the responsible clinician in cases of shoulder dystocia and have been concerned about the frequent lack of paediatric back up. This has been identified as a failure on the part of the lead clinician, who is often so engrossed in the management of the condition that back up is simply overlooked. I have personally experienced cases where this has occurred and believe that a high degree of assertiveness is required if I see that it has been overlooked in the future. References Beall M H, Spong C Y, Ross M G (2003) A Randomized Controlled Trial of Prophylactic Maneuvers to Reduce Head-to-Body Delivery Time in Patients at Risk for Shoulder Dystocia. Obstetrics Gynecology 2003; 102: 31 35 Crofts J F, Bartlett C, Ellis D, Hunt L P, Fox R, Draycott T J (2006) Training for Shoulder Dystocia : A Trial of Simulation Using Low-Fidelity and High-Fidelity Mannequins : Obstetrics Gynecology 2006; 108 : 1477 1485 Crofts J F, Bartlett C, Ellis D, Winter C, Donald F, Hunt L P, Draycott T J (2008) Patient-actor perception of care: a comparison of obstetric emergency training using manikins and patient-actors. Qual. Saf. Health Care, February 1, 2008; 17 (1): 20 24. Deering S, Satin A J (2005) Evaluation of Residents Delivery Notes After a Simulated Shoulder Dystocia. Obstet. Gynecol., February 1, 2005; 105 (2): 448 449. Draycott T J, Crofts J F, Ash J P, Wilson L V, Yard E, Sibanda T, Whitelaw A. (2008) Improving Neonatal Outcome Through Practical Shoulder Dystocia Training. Obstet. Gynecol., July 1, 2008; 112 (1): 14 20. German R B, Goodwin T M, Souter I, Neumann K, Ouzounian J G, Paul R H. The McRoberts’ maneuver for the alleviation of shoulder dystocia: How successful is it? Am J Obstet Gynecol 1997; 176 : 656 – 61. Gonen R, Spiegel D, Abend M. Is macrosomia predictable and are shoulder dystocia and birth trauma preventable? Obstet Gynecol 1996; 88 : 526 – 9. Heath L T, Gherman R B. Symphyseal separation, sacroiliac joint dislocation and transient lateral femoral cutaneous neuropathy associated with McRoberts’ maneuver. J Reprod Med 1999; 44 : 902 – 4 Robinson H, Tkatch S, Mayes D C, Bott N, Okun N. (2003) Is Maternal Obesity a Predictor of Shoulder Dystocia? Obstetrics Gynecology 2003; 101 : 24 27 ############################################################### 12.8.08 Word count 1,060 PDG Different Medicinal Plants: Use Of Different Medicinal Plants: Use Of MEDICINAL PLANTS This section consist a list of sub-groups that gives information about Introduction, Importance, Systems of medicine, Utilization of medicinal plants. Introduction to Medicinal plants: About 250,000 higher plant species on earth, more than 80,000 species are reported to have at least some medicinal value and around 5000 species have specific therapeutic value. Herbs are staging a comeback and herbal renaissance is happening all over the globe. The herbal products today symbolize safety in compare to the synthetics that are considered as unsafe to human and environment. Even though herbs had been priced for their medicinal, flavoring and aromatic qualities for centuries, the synthetic products of the modern age surpassed their importance, for a while. However, the blind dependence on synthetics is over and people are returning to the herbals with hope of safety and security. Over three-quarters of the world population relies mainly on plants and plant extracts for health care. More than 30% of the entire plant species were used for medicinal purposes. (Joy, P.P., 2001) Herbals in world market: It is estimated that world market for plant derived drugs may account for about Rs.2, 00,000 crores. Presently, Indian contribution is less than Rs.2000 crores. The annual production of medicinal and aromatic plants raw material is worth about Rs.200 crores. This is likely to reach US $5 trillion by 2050. It has been estimated that in developed countries such as United States, plant drugs constitute as much as 25% of the total drugs, while in fast developing countries such as China and India, the contribution is as much as 80%. Thus, the economic importance of medicinal plants is much more to countries such as India than to rest of the world. (Joy, P.P., 2001) Biodiversity of herbals in India: India is one of the worlds 12 biodiversity centers with the presence of over 45000 different plant species. Indias diversity is UN compared due to the presence of 16 different agro-climatic zones, 10 vegetation zones, 25 biotic provinces and 426 biomes (habitats of specific species). Among these, about 15000-20000 plants have good medicinal value. However, only 7000-7500 species are used for their medicinal values by traditional communities. In India, drugs of plant origin have been used in traditional systems of medicines such as Unani and Ayurveda since ancient times. The Ayurveda system of medicine uses about 700 species, Unani 700, Siddha 600, Amchi 600 and modern medicine around 30 species. About 8,000 herbal remedies have been included in Ayurveda. The Rig-Veda (5000 BC) has recorded 67 medicinal plants, Yajurveda 81 species, Atharvaveda (4500-2500 BC) 290 species, Charak Samhita (700 BC) and Sushrut Samhita (200 BC) had described properties and uses of 1100 and 1270 species respectively, in compounding of drugs and these are still used in the classical formulations, in the Ayurvedic system of medicine. (Joy, P.P., 2001) Sources of medicinal drugs: The drugs are derived either from the whole plant or from different organs, like leaves, stem, bark, root, flower, seed, etc. Some drugs are prepared from excretory plant product such as gum, resins and latex. Plants, especially used in Ayurveda can provide biologically active molecules and lead structures for the development of modified derivatives with enhanced activity and /or reduced toxicity. Some important chemical intermediates needed for manufacturing the modern drugs are also obtained from plants (Eg. ÃŽÂ ²-ionone).The forest in India is the principal(diosgenin, solasodine) repository of large number of medicinal and aromatic plants, which are largely collected as raw materials for manufacture of drugs and perfumery products. The small fraction of flowering plants that have so far been investigated have yielded about 120 therapeutic agents of known structure from about 90 species of plants. Some of the useful plant drugs include vinblastine, vincristine, taxol, podophyllo toxin, camptothecin, digitoxigenin, gitoxigenin, digoxigenin, tubocurarine, morphine, codeine, aspirin, atropine, pilocarpine, capscicine, allicin, curcumin, artemisinin and ephedrine among others. (Joy, P.P., 2001) History of herbal medicine: Ayurveda, Siddha, Unani and Folk (tribal) medicines are the major systems of indigenous medicines. Among these systems, Ayurveda is most developed and widely practiced in India. Ayurveda dating back to 1500-800 BC has been an integral part of Indian culture. The term comes from the Sanskrit root Au (life) and Veda (knowledge). As the name implies it is not only the science of treatment of the ill but covers the whole gamut of happy human life involving the physical, metaphysical and the spiritual aspects. Ayurveda is gaining prominence as the natural system of health care all over the world. Today this system of medicine is being practiced in countries like Nepal, Bhutan, Sri Lanka, Bangladesh and Pakistan, while the traditional system of medicine in the other countries like Tibet, Mongolia and Thailand appear to be derived from Ayurveda. Phytomedicines are also being used increasingly in Western Europe. Recently the US Government has established the Office of Alternative Medicine at the National Institute of Health at Bethesda and its support to alternative medicine includes basic and applied research in traditional systems of medicines such as Chinese, Ayurvedic. (Joy, P.P., 2001) Disadvantages: A major lacuna in Ayurveda is the lack of drug standardization, information and quality control. Most of the Ayurvedic medicines are in the form of crude extracts which are a mixture of several ingredients and the active principles when isolated individually fail to give desired activity. This implies that the activity of the extract is the synergistic effect of its various components. About 121 (45 tropical and 76 subtropical) major plant drugs have been identified for which no synthetic one is currently available. The scientific study of traditional medicines, derivation of drugs through bio prospecting and systematic conservation of the concerned medicinal plants is of great importance. Unfortunately, much of the ancient knowledge and many valuable plants are being lost at an alarming rate. Red Data Book of India has 427 entries of endangered species of which 28 are considered extinct, 124 endangered, 81 vulnerable, 100 rare and 34 insufficiently known species (Thomas, 1997).There are basically two scientific techniques of conservation of genetic diversity of these plants. They are the in situ and ex situ method of conservation. (Joy, P.P., 2001) In Situ conservation of medicinal plants: It is only in nature that plant diversity at the genetic, species and eco-system level can be conserved on long-term basis. (www.ggssc.net) It is necessary to conserve in distinct, representative bio geographic zones inter and intra specific genetic variation. Ex situ conservation of medicinal plants: A. Ethno-medicinal plant gardens: Creation of a network of regional and sub-regional ethno-medicinal plant gardens which should contain accessions of all the medicinal plants known to the various ethnic communities in different regions of India. This chain of gardens will act as regional repositories of our cultural and ethno medicinal history and embody the living traditions of our societys knowledge of medicinal plants. (www.ggssc.net) Current status: There are estimated to be around 50 such gardens in the country ranging from acre to 40 acres some of them were set up by an All India Health Network (AHN). More recently a network of 15 such gardens has been set up in 3 states of South India with the initiative of FRLHT. One of the gardens is located in TBGRI, (Tropical botanical garden research institute) Palode at Thiruvananthapuram. B. Gene banks: In India there is a large number of medicinal plant species are under various degrees of threat. The precautionary principles would suggest that an immediate and country-wide exercise be taken up to deposit seeds of wild medicinal plants with a first priority to known Red listed species and endemic species. Current status: The department of bio-technology, Government of India has recently taken the initiative to establish 3 gene banks in the country. One is with ICAR at the NBPGR (National Bureau of plant genetic Resources) Campus, the second is with CIMAPs, (Central Institute of Medicinal and Aromatic plants) Luck now and the third with TBFRI in Thiruvananthapuram. C. Nursery network: The most urgent and primary task in order to ensure immediate availability of plants and planting materials to various user groups is to promote a nationwide network of medicinal plant nurseries, which will multiply all the regional specific plants that are used in the current practice of traditional medicine. These nurseries should become the primary sources of supply of plants and seed material that can be subsequently multiplied by the various users. Current status: Planting material for 40 odd species of medicinal and aromatic plants is reportedly available in the ICAR and CSIR (CIMAP) network. In South India FRLHT (Foundation for Rural Revitalization of Local Health Tradition) has recently set up a network of 55 supply nurseries. D. Cultivation of medicinal plants: Figures projecting demand and trade in medicinal plant species globally indicate a step upward trend in the near future. One estimate puts the figure of world trade in medicinal plants and related products at US $ 5 trillion by A.D. 2050 (world bank report , 1996).The demand so far has been met mainly from wild sources. This cant go on for much longer; policy intervention is urgently needed to encourage and facilitate investments into commercial cultivation of medicinal plants. (Joy, P.P., 2001) Cultivation of medicinal plants is inversely linked to prevalence of easy and cheap collection from the wild, lack of regulation in trade, cornering of the profits from wild collection by a vast network of traders and middlemen and absence of industrys interest in providing buy-back guarantees to growers. Current status: In the Govt. sector agro-technology of 40 odd species has been developed by ICAR Agricultural University System and CSIR (CIMAOs RRL, Jammu and Jorhat). In recent years industries like Dabur, Zandu, Indian Herbs, Arya Vaidya Shala, and Arya Vaidya Pharmacy and others have made some symbolic efforts to initiate cultivation. Since1984 NABARD (National Bank of Agricultural and Rural Development) has formulated schemes for financing cultivation and processing of medicinal plants. E. Community based enterprises: The income generated by the traditional medicine industry benefits small section of the society. A strong case exists for promotion of community level enterprises for value addition to medicinal plants through simple, on site techniques like drying, cleaning, crushing, powdering, grading, packaging etc. This will also increase the stake of rural communities in conservation and change the skewed nature of income distribution of the industry. Current status: Three community based enterprises are known in south India, one in Gandhi gram Trust, (Dindigul), Premade development Society (Peer made) Kerala and the third by VGKK in B.R.Hills, Mysore. Importance of Herbal Medicines: Herbal medicines are prepared from a variety of plant material such as leaves, stems, roots, bark, etc. They usually contain many biologically active ingredients and are used primarily for treating mild or chronic ailments. (www.ggssc.net) Herbal remedies can also be purchased in the form of pills, capsules or powders, or in more concentrated liquid forms called extracts and tinctures. They can apply topically in creams or ointments, soaked into cloths and used as compresses, or applied directly to the skin as poultices. A combination therapy integrating ayurveda and allopathy whereby the side effects and undesirable reactions could be controlled can be thought of. Studies can show that the toxic effects of radiations and chemotherapy in cancer treatment could be reduced by Ayurvedic medications and similarly surgical wound healing could be accelerated by Ayurvedic medicines. Modern science and technology have an essential role to play in the process. Systems of Medicine: There are mainly 3 systems of medicine practiced in the world today. They are, Modern System of medicine or Allopathy: This system was developed in the Western countries. In this system drugs (tablets, capsules, injections, tonics etc.) are manufactured using synthetic chemicals and / or chemicals derived from natural products like plants, animals, minerals etc. This system also uses modern equipment for diagnosis, analysis, surgery etc. Medicines or drugs of this system is often criticized for its treatment of the symptoms rather than the cause of the disease, harmful side effects of certain drugs and for being out of reach of common / poor people due to the high cost of drugs and treatment. This system is used in all the countries of the world today. (www.ggssc.net) Alternative Medicine or Traditional System: Different countries of the world developed independently their own traditional systems of medicine using locally available materials like minerals and products of plants and animals. (www.ggssc.net) The World Health Organization (WHO) is giving importance to these alternate medicine systems to provide Primary Health Care to millions of people in the developing countries. Development of herbal medicine: China developed the Chinese system of medicine, which is practiced in China, Singapore, Taiwan, Japan and other countries. In India, Ayurveda (developed in North India), Siddha (developed in Tamil Nadu) and Nagarjuna (developed in Andhra Pradesh) systems of medicine were developed. Ayurveda is practiced in Sri Lanka, Pakistan and Bangladesh also. Herbo-mineral is another traditional system used in India and other neighbouring countries. Drugs (balms, oils, pills, tonics, paste etc) are manufactured and marketed in these systems. (Joy, P.P., 2001) Advantages of traditional medicine: Traditional systems of medicine continue to be widely practiced on many accounts. Population rise, inadequate supply of drugs, prohibitive cost of treatments, side effects of several allopathic drugs and development of resistance to currently used drugs for infectious diseases have led to increased emphasis on the use of plant materials as a source of medicines for a wide variety of human ailments. Folk Medicine or tribal medicine: The medicinal systems followed by various tribals of different countries are popularly known as folk or tribal medicine. In the system, the medicine man or the doctor of the tribe who has the knowledge of treating diseases, keeps this knowledge as a closely guarded secret and passes it to the next generation by word of mouth. No written texts on these systems are available and different tribes follow different time tested methods. The treatment is often associated with lengthy and mystic rituals, in addition to prescription of drugs (decoctions, pastes, powders, oils, ashed materials etc.). Generally speaking, folk medicine can also be regarded as a traditional system of medicine. The basic aim of all the above systems of medicine is to alleviate the sufferings of human beings and their domesticated animals. (www.ggssc.net) Other Systems of medicine: Yoga, Acupressure, Acupuncture, Reiki, Magneto therapy, Pyramid therapy, Flower therapy, Homeopathy, Nature Cure or Naturopathy etc. are some of the other systems of medicine practiced in different parts of the world today. Utilization of Herbal Plants: The utility of medicinal plants has four major segments they are, Medicinal plants utilized in indigenous or traditional systems of medicines (ISM) Ayurveda, Siddha, Unani and Homeopathy systems of medicines , OTC (over the country, non-prescription) items / products involving plant parts, extracts galenicals etc. , Essential oils , Phyto pharmaceuticals or plants used in modern systems of medicine. (www.ggssc.net) Medicinal plants used in Traditional Systems of Medicine: As its name implies, it is the part of tradition of each country which employs practices that have been handed down from generation to generation. An important feature of traditional therapy is the preference of practitioner for compound prescriptions over single substance/drug as it is being held that some constituents are effective only in the presence of others. This renders assessment of efficacy and eventually identification of active principles as required in international standards much difficult than for simple preparation. In India, earlier the medicines used in indigenous systems of medicines were generally prepared by the practicing physicians by themselves, but now this practice has been largely replaced by the establishment of organized indigenous drug industries. It is estimated that at present there are more than 1, 00,000 licensed registered practitioners of Ayurveda, Siddha, Unani medicine or Homeopathy. In fact reliable data on availability in different regions of country as well as supply and demand of medicinal plants used in production of indigenous medicines are not available. (www.ggssc.net) Plants-parts, extracts and galenicals of medicinal herbs: The direct utilization of plant material is not only a feature of ISM in the developing world but also in developed countries like USA, UK, Germany etc., the various herbal formulations are sold on health food shops. Preparation of decoctions, tinctures, galenicals and total extracts of plants also form a part of many pharmacopoeias of the world. The current trend of medicinal plants based drug industry is to procedure standard extracts of plants as raw material. (www.ggssc.net) Essential Oils from herbal plants: The essential oil industry was traditionally a cottage industry in India. Since 1947, a number of industrial companies have been established for large scale production of essential oils, oleoresins and perfumes. The essential oil from plants includes Ajowan oil, Eucalyptus oil, Geranium oil, Lavender oil, Palmarosa oil, Patchouli oil, Rose oil, Sandalwood oil, Turpentine oil and Vetiver oil. Phyto-pharmaceuticals of medicinal plants: During the past decades, bulk production of plant based drugs has become an important segment of Indian pharmaceutical industry. Some of the Phyto-pharmaceuticals which are produced in India at present include Morphine, codeine, papaverine (Papaver somniferum), quinine, quinidine, cinchonine and cinchonidine (Cinchona sp., C.calisaya, C. Hyoscine, hyoscyamine (Hyocyamus Niger and H. muticus), colchicine (Gloriosa superbad, Colchicum luteum and Iphigenia stellata), cephaeline and emetin (Cephalis ipacacuanha), sennosides A B (Cassia angustifolia and C. acutifolia), reserpine, rescinnamine, ajmalicine and ajmaline (Rauvolfia serpentina); vinblastine and vincristine, ajmalicine (raubacine) (Catharanthus roseus); guggul lipid (Commiphora wightii); taxol (Taxus baccata); artemisinin (Artemisai annua) etc. (www.ggssc.net) CLASSIFICATION OF HERBAL PLANTS: They are classified according to the part used, habit, habitat, therapeutic value etc, besides the usual botanical classification.Based on Therapeutic value they are classified as follows. Anti malarial : Cinchona officinalis, Artemisia annua ,Anticancer : Catharanthus roseus, Taxus baccata ,Antiulcer : Azadirachta indica, Glycyrrhiza glabra , Antidiabetic : Catharanthus roseus, Momordica charantia , Anticholesterol : Allium sativum Anti inflammatory : Curcuma domestica, Desmodium gangeticum , Antiviral : Acacia catechu Antibacterial : Plumbago indica , Antifungal : Allium sativum , Antiprotozoal : Ailanthus sp., Cephaelis ipacacuanha , Antidiarrhoeal : Psidium guava, Curcuma domestica , Hypotensive : Coleus forskohlii, Alium sativum , Tranquilizing : Rauvolfia serpentina , Anaesthetic : Erythroxylum coca , Spasmolytic : Atropa belladona, Hyoscyamus niger , Diuretic : Phyllanthus niruri, Centella asiatica , Astringent : Piper betel, Abrus precatorius Anthelmentic : Quisqualis indica, Punica granatum , Cardio tonic : Digitalis sp., Thevetia sp. Antiallergic : Nandina domestica, Scutellaria baicalensis ,Hepatoprotective : Silybum marianum, Andrographis paniculata. (Joy, P.P., 2001) Safety of medicinal plants: The safety and effectiveness of alternative medicines have not be been scientifically proven and remains largely unknown. A number of herbs are thought to be likely to cause adverse effects. Furthermore, adulteration, inappropriate formulation, or lack of understanding of plant and drug interactions have led to adverse reactions that are sometimes life threatening or lethal. Proper double-blind clinical trials are needed to determine the safety and efficacy of each plant before they can be recommended for medical use. Although many consumers believe that herbal medicines are safe because they are natural, herbal medicines may interact with synthetic drugs causing toxicity to the patient, may have contamination that is a safety consideration, and herbal medicines, without proven efficacy, may be used to replace medicines that have a proven efficacy. (Joy, P.P., 2001) Eg: Ephedra has been known to have numerous side effects, including severe skin reactions, irritability, nervousness, dizziness, trembling, headache, insomnia, profuse perspiration, dehydration, itchy scalp and skin, vomiting, hyperthermia, irregular heartbeat, seizures, heart attack, stroke, or death. Poisonous plants which have limited medicinal effects are often not sold in material doses in the United States or are available only to trained practitioners, these include: Aconite, Arnica, Belladonna, Bryonia, Datura, Gelsemium, Henbane, Male Fern Phytolacca, Podophyllum andVeratrum. Furthermore, herbs such as Lobelia, Ephedra and Eonymus that cause nausea, sweating, and vomiting, have been traditionally prized for this action. Plants such as Comfrey and Petasites have specific toxicity due to hepatotoxic pyrrolizidine alkaloid content. There are other plant medicines which require caution or can interact with other medications, including St. Johns wort and grapefruit. (Phytotherapy , www.wikipedia.com) INTRODUCTION TO DIABETES MELLITUS In recent years, developed nations have witnessed an explosive increase in the prevalence of diabetes mellitus (DM) predominantly related to lifestyle changes and the resulting surge in obesity. The metabolic consequences of prolonged hyperglycemia and dyslipidemia, including accelerated atherosclerosis, chronic kidney disease, and blindness, pose an enormous burden on patients with diabetes mellitus and on the public health system. (Goodman Gilmans, 2006) In 1869, a German medical student, Paul Langerhans, noted that the pancreas contains two distinct groups of cells the acinar cells, which secrete digestive enzymes, and cells that are clustered in islands, or islets, which he suggested, served a second function. Direct evidence for this function came in 1889, when Minkowski and von Mering showed that pancreatectomized dogs exhibit a syndrome similar to diabetes mellitus in humans (Goodman Gilmans,2006) In the early 1900s, Gurg Zuelzer, an internist in Berlin, attempted to treat a dying diabetic patient with extracts of pancreas. Although the patient improved temporarily, he sank back into a coma and died when the supply of extract was exhausted. E.L. Scott, a student at the University of Chicago, made another early attempt to isolate an active principle in 1911. Using alcoholic extracts of the pancreas Scott treated several diabetic dogs with encouraging results; however, he lacked clear measures of control of blood glucose concentrations, Between 1916 and 1920, the Romanian physiologist Nicolas Paulesco found that injections of pancreatic extracts reduced urinary sugar and ketones in diabetic dogs. Although he published the results of his experiments, their significance was fully appreciated only years later. (Goodman Gilmans, 2006) Banting assumed that the islets secreted insulin but that the hormone was destroyed by proteolytic digestion prior to or during extraction. Together with Charles Best, he attempted to overcome the problem by ligating the pancreatic ducts. The acinar tissue degenerated, leaving the islets undisturbed; the remaining tissue then was extracted with ethanol and acid. Banting and Best thus obtained a pancreatic extract that decreased the concentration of blood glucose in diabetic dogs. (Goodman Gilmans, 2006) Insulin was purified and crystallized by Abel within a few years of its discovery. Sanger established the amino acid sequence of insulin in 1960, the protein was synthesized in 1963, and Hodgkin and coworkers elucidated insulins three-dimensional structure in 1972. Insulin was the hormone for which Yalow and Berson first developed the radioimmunoassay (Goodman Gilmans, 2006) Insulin regulation is achieved by the coordinated interplay of various nutrients, gastrointestinal hormones, pancreatic hormones, and autonomic neurotransmitters. Glucose, amino acids, fatty acids, and ketone bodies promote the secretion of insulin. The islets of Langerhans are richly innervated by both adrenergic and cholinergic nerves. Stimulation of a2 adrenergic receptors inhibits insulin secretion, whereas b2 adrenergic receptor agonists and vagal nerve stimulation enhance release. In general, any condition that activates the sympathetic branch of the autonomic nervous system (such as hypoxia, hypoglycemia, exercise, hypothermia, surgery, or severe burns) suppresses the secretion of insulin by stimulation of ÃŽÂ ±2-adrenergic receptors. Predictably, ÃŽÂ ±2 adrenergic receptor antagonists increase basal concentrations of insulin in plasma, and ÃŽÂ ²2 adrenergic receptor antagonists decrease them. The sugar is more effective in provoking insulin secretion when taken orall y than when administered intravenously because the ingestion of glucose (or food) induces the release of gastrointestinal hormones and stimulates vagal activity. Several gastrointestinal hormones promote the secretion of insulin. The most potent of these are gastrointestinal inhibitory peptide (GIP) and glucagon like peptide 1 (GLP-1). Insulin release also is stimulated by gastrin, secretin, Cholecystokinin, vasoactive intestinal peptide, gastrin-releasing peptide, and Enteroglucagon. (Goodman Gilmans, 2006) Distribution: Insulin circulates in blood as the free monomer, and its volume of distribution approximates the volume of extracellular fluid. Under fasting conditions, the pancreas secretes about 40 mg (1 unit) of insulin per hour into the portal vein to achieve a concentration of insulin in portal blood of 2 to 4 ng/ml (50 to 100 minutes/ml) and in the peripheral circulation of 0.5 ng/ml (12 minutes/ml) or about 0.1 nM. After ingestion of a meal, there is a rapid rise in the concentration of insulin in portal blood, followed by a parallel but smaller rise in the peripheral circulation. (Goodman Gilmans, 2006) Half Life: The half-life of insulin in plasma is about 5 to 6 minutes in normal subjects and patients with uncomplicated diabetes. This value may be increased in diabetics who develop anti-insulin antibodies. (Goodman Gilmans, 2006) Metabolism: Degradation of insulin occurs primarily in liver, kidney, and muscle. About 50% of the insulin that reaches the liver via the portal vein is destroyed and never reaches the general circulation. Insulin is filtered by the renal glomeruli and is reabsorbed by the tubules, which also degrade it. Severe impairment of renal function appears to affect the rate of disappearance of circulating insulin to a greater extent than does hepatic disease. Peripheral tissues such as fat also inactivate insulin, but this is of less significance quantitatively. The important target tissues for regulation of glucose homeostasis by insulin are liver, muscle, and fat, but insulin exerts potent regulatory effects on other cell types as well. Insulin is the primary hormone responsible for controlling the uptake, use, and storage of cellular nutrients. (Goodman Gilmans, 2006) DIABETES MELLITUS: Diabetes mellitus (DM) consists of a group of syndromes characterized by hyperglycemia; altered metabolism of lipids, carbohydrates, and proteins; and an increased risk of complications from vascular disease. Most patients can be classified clinically as having either type 1 or type 2 DM. Criteria for the diagnosis of DM have been proposed by several medical organizations. The American Diabetes Association (ADA) criteria include symptoms of DM (e.g., polyuria, polydipsia, and unexplained weight loss) and a random plasma glucose concentration of greater than 200 mg/dl (11.1 mM), a fasting plasma glucose concentration of greater than 126 ml/dl (7 mM), or a plasma glucose concentration of greater than 200 mg/dl (11 mM) 2 hours after the ingestion of an oral glucose load In the United States, about 5% to 10% of all diabetic patients have type 1 DM, with an incidence of 18 per 100,000 inhabitants per year. A similar incidence is found in the United Kingdom. The incidence of type 1 DM in Europe varies with latitude. The highest rates occur in northern Europe (Finland, 43 per 100,000) and the lowest in the south (France and Italy, 8 per 100,000). The one exception to this rule is the small island of Sardinia, close to Italy, which has an incidence of 30 per 100,000. However, even the relatively low incidence rates of type 1 DM in southern Europe are far higher than the rates in Japan (1 per 100,000 inhabitants). There are more than 125 million persons with diabetes in the world today, and by 2010, this number is expected to approach 220 million. (Goodman Gilmans, 2006) Both type 1 and type 2 DM are increasing in frequency. The reason for the increase of type 1 DM is not known. The genetic basis for type 2 DM cannot change in such a short time; thus other contributing factors, including increasing age, obesity, sedentary lifestyle, and low birth weight, must account for this dramatic increase. In addition, type 2 DM is being diagnosed with remarkable frequency in preadolescents and adolescents. Up to 45% of newly diagnosed children and adolescents have type 2 DM. There are genetic and environmental components that affect the risk of developing either type 1 or type 2 DM Types: Diabetes can be divided into two groups based on their requirements for insulin includes, (Pharmainfo.net) Type I: Insulin- dependent diabetes mellitus [IDDM] Type II: Non- insulin dependent diabetes [NIDDM] Type I: Insulin dependent diabetes mellitus: A burst of insulin secretion normally occurs after ingestion of a meal in response to transient increase in the levels of circulating glucose and amino acids. In the post operative period, low, basal levels of circulating insulin are maintained through beta cell secretion. However type one diabetic has virtually no functional beta cells. Treatment: Type I diabetic must rely on exogenous (injected) insulin in order to control hyperglycemia, maintain acceptable levels of Glycosylated hemoglobin (HbA1C) and avoid ketoacidosis. The goal in administering insulin to type I diabetic is to maintain blood glucose concentrations as close to normal as possible and