Free Your Inner Thinker Essays - Truth, Atheism, Spirituality

Free Your Inner Thinker Free Your Inner Thinker Organized religions are laden with the debris of archaic, superstitious images. Everywhere people go they are submerged in biblical ignorance, religious illiteracy and historical stupidity (Edelen, ?The 10 Commandments?). People are surrounded by cultic codes and images at every turn. This must stop! One organization that is taking a stand is called The Freedom From Religion Foundation. It is most commonly referred to as free thought. A freethinker is a person who forms opinions and beliefs on the basis of reason, independent of tradition, authority, or established belief (Barker). Freethinkers love to learn new ideas and are not satisfied with what is already known. Thus, all members must be free from the conformity of a bible, creed, or messiah. They must be allowed to think for themselves, rather than blindly follow tradition or ?cosmic absolutes.? Freethinkers believe the truth and choose not to follow the lies and superstitions that are, inevitably, part of religion. Common mythological themes are saturated through out the bible, from the creation and flood myth to virgin birth and hero resurrection (Edelen, ?The Sin?). Unlike conventional religions, Freethinkers' beliefs are based on reality and reason. As defined in Nontract #11, ?What is a Freethinker,? ?Reality is limited to that which is directly perceivable though our natural senses or indirectly ascertained through the proper use of reason? (Barker). For an idea or belief to be considered true it must be testable, falsifiable, parsimonious, and logical. Every belief a freethinker has must have evidence or experiments to confirm it; all attempts to disprove it must repeatedly fail, require little to no assumptions, and be free from contradictions and character attacks (Barker). Freethinkers use the thinking part of there brain to understand the universe. Many people who don't understand free thought think that freethinkers lack morals. The morality of a freethinker can be summed up in one word, kindness. Morality is not a bunch of dos and don'ts but, instead, is based on human needs (Barker). Freethinkers try to be good and fair to everyone. They believe that all human beings should live in peace no matter what their race, sex, religion, what they think, who they love, or where they come from. They do their best to protect the earth and all its creatures. Religion promotes dangerous and inadequate ?morality? based on blind obedience, rather than a careful use of reason to weigh the possible outcomes when faced with a moral dilemma (Barker). The most common philoshical question pondered is whether there is a meaning of life. Freethinkers know that the meaning of life must originate in the mind. Since the universe is mindless and the cosmos do not care, if you wish to have a purpose, YOU must care (Barker). Not all freethinkers believe in a meaning of life, as with all beliefs, individuals are free to accept or discard it. Where as many freethinker choose to believe there is no divine plan, most freethinkers find meaning in life. They find meaning in human compassion, social progress, the beauty of humanity, personal happiness, pleasure, joy, love, and the advancement of knowledge (Barker). Unlike convention religions, free thought requires an explanation rather than a designer to explain the complexity of life. One such explanation is Darwin's theory of evolution along with natural selection. Freethinkers do not believe in a divine designer because the complexity of such a creature would be subject to the same scrutiny itself (Barker). Freethinkers also believe that religion is not only useless but also harmful. Historically, religion has always produced violence (Edelen ?Religion?). From Moses to the Crusades, Henry VIII, Salem, Hitler, Kosovo. Edelen writes, ?it is the countries with out religion that are the least violent? (?Religion?). He also stated in the same article that, ?America is the most ?religious' of all industrialized nations, and yet is the most violent nation in the world.? Many of the world's most gruesome leaders believed they were performing god's work. Hitler himself wrote, ?I am completely convinced that I am acting as the agent of god. I am now a Catholic and will always remain so,? in Mein Kampf (qtd in Edelen, ?Religion?). Freethinkers do not believe that all religious people are

Magical Realism Symbolism Essays

Magical Realism Symbolism Essays Magical Realism Symbolism Paper Magical Realism Symbolism Paper Essay Topic: A Very Old Man With Enormous Wings Magical Realism and Symbolism In literary works, to aim for a successful story the writers say as much as possible in a nutshell. They use three available resources which are symbol, allegory, and fantasy. In literature an allegory Is spontaneous and its a world of symbols. This literary device Is a story that has a deeper and more general meaning In addition to Its surface meaning providing a bundle of characters. Objects, or events with added significance. A Very Old Man with Enormous Wings by Gabriel Garcia Marquee is a Tory that combines imagination with events that we live everyday. This fable keeps the reader waiting to find out the real meaning behind the old mans visit. It is a blue world when Appeal finds an old man with large, damaged wings stuck in the mud. This strange visitor owns a pair of wings and speaks a weird dialect, no one knows for sure who or what he Is. Garcia Marquezs short story displays the truth about us and society as a whole by comparing and contrasting two of the most noticeable and important symbols which are the title character, the Old Man, which is a symbol of scarification and the Spider-Girl, which symbolizes acceptance. The reactions from the people of the town toward the physical appearance of a strange creature with a bald skull, just a few teeth in his mouth and enormous and dirty wings like a rare angel, shows how people are very prejudiced to differences of other Individuals. They viewed the Old Man as an odd figure Just by looking at his outer shell. Despite the fact he has a great asset of an angel with those wings the Old Man is treated mass if he werent a supernatural creature but a circus animal. (270) The people didnt understand his dialect and Just because he was old, dirty and his wings distorted he was considered frail to be an angel. Father Kananga said, He had an unbearable smell of the outdoors, the back side of his wings was strewn with parasites and his main feathers had been mistreated by terrestrial winds, and nothing about him measured up to the proud diddling of angels. (271) Since, angels are usually depicted as beautiful, young, and clean and the Old Man didnt persist these qualities he was considered an illicit angel and therefore mistreated by his appearance. The man with enormous wings demonstrates noble characteristics that qualify him as an angel. This noble man never turned to them with violence in response to how they treated him, on the contrary he brings them good fortune. This clearly shows discrimi nation because the wings the old man carried made him uniquely different and this was the justification for the people treating him with such cruelty. The story says, With the money they saved they built a two-story mansion with balconies and gardens and high netting so the crabs wouldnt get in during the inter, and with iron bars on the window so the angel wouldnt get in. (273) The company of the angel deeply changed Appeal, Lessened, and their sons way of life. I nee went Trot Dealing relatively poor to Dealing people AT great wealth contradiction, they did not do anything for the angel to thank him and Just left him in the chicken coop like an animal. Along with these two people, the towns people didnt see the inner shell of this creature and Just based their characteristics on his overall The Spider-Girl is accepted by the people because she was understood by the people. Even though this womans physical appearance seems to include none in association with angels, on the contrary shes a, A frightful tarantula the size of a ram and with the head of a sad maiden. (273) She is treated with much more respect than the Old Man. A spider is usually depicted as large, hairy, ugly, and scary and yet she is given the chance to be accepted by the towns people by intriguing them with stories and showing her real self. The Spider-Girl, who is a symbol of acceptance and is a clear contrast of the Old Man. Her story of disobeying her parents by going dancing and for violating their ales and being struck by lighting and changed into a giant ugly tarantula is the key for acceptance. Her admission price is much more lower than that of the Old Man and she speaks to her visitors explaining the reason behind her appearance. Since her story is easy to understand and her explanation is a clear moral, the people believe her and accept her. In contrast, the Old Man does nothing to explain the reason behind his appearance, doesnt entertain people the way the Spider-Girl does, and instead his miracles are drawn as practical Jokes. It seems to be a public acceptance of supernatural explanations for such simple standards. In literary works, allegories help the reader add to the point that the author is trying to make. For example, abstract qualities are shown through both characters, the Old Man and the Spider-Girl and this helps personify the characters and it helps relate the world today with the whole race issue. It assists in classifying the roles of a personal quality and trait by leading clues for the reader to follow the deeper meaning. Using allegories in a piece of fiction makes the writing more interesting and unique and keeps the readers challenged. Garcia

Public Relations Campaigns Article Example | Topics and Well Written Essays - 250 words

Public Relations Campaigns - Article Example They are the key people because even though the impact of the project will be felt by the whole city, those people will receive the first hand impact since they have to relocate their homes and business, suffer losses among other impacts most of which are negative. The theme of this project is â€Å"public relations campaign for the city’s development† and it aims at garnering public support from the city dwellers on the upcoming development project. The message for the above mentioned group is to persuade them to look at the positive impact the development project will have in not only their lives but also the lives of their children in future once this whole project is finished. More business opportunities will be created when tourists start to visit the city in order to view the project or participate in cultural festivals and shows that will be hosted in the completed building that wants to be developed now. There are several ways to reach the public: to have forums with them in their business areas or home locations, door-to-door campaign and especially for those who live in that area that the development project is to come up, media intervention like announcements, discussion programs, posters, and finally meetings with the city residents in halls among other ways (Gregory,

Black Segregation Essay Example | Topics and Well Written Essays - 1250 words

Black Segregation - Essay Example In the year 1954 the Court of United States pronounced its verdict as concerns the landmark case of Brown v. Board where it provided that the racial segregation of children based on the rule of â€Å"separate but equal† as directed by the provision of the 1896 Plessy v. Ferguson that was later overturned was considered as an infringement of the Equal Protection Clause of the Fourteenth Amendment. The Supreme Court hence declared the separate educational facilities as essentially unequal and unconstitutional. The ruling on Brown v. Board of Education case helped to combat the activities of the state in funding and facilitating aspects of segregation that had been corroding the ethical codes of the society. It also served to give the civil movement groups a voice and motivation to fight for the rights and privileges of the discriminated groups (Renzulli, 2006). In history, the root cause for the segregation of blacks and whites in America dates back to the mid 19th century. It primarily began with the passage of Jim Crow laws after the Reconstruction Era ended. These laws were largely common among the southern states but later spread to regions of the Southwest. The separation was primarily ascribed to various aspects of public life as well as in learning institutions and other public facilities and resources. Jim Crow laws hence prohibited blacks from sharing schools, churches, restaurants and other public amenities with their white counterparts. The Supreme Court of America in the ruling on Plessy v consequently upheld this law.

Mobile Application for Middle East Students in the UK Research Paper

Mobile Application for Middle East Students in the UK - Research Paper Example Software applications or apps are the mainstays of mobile business communications (Highsmith, 2002, p.30). Apps refer to the smartphone programs used daily in composing e-mails, updating calendars, editing documents and collaborating with colleagues. Nearly all smartphones have basic messaging apps such as SMS (text messaging), contact lists, e-mail, and calendars with room for downloading many other apps to customize the mobile business experience (Lacohee, Wakeford & Pearson, 2003, p.208). In order to conduct business successfully both within and outside the office, it is crucial to have a shared set of productivity tools. Windows Mobile is a popular operating system for smartphone due to its ability to run native versions of PowerPoint, Microsoft Word, and Excel. Other phones rely on third-party apps that allow users to edit and view Microsoft Office documents. Examples of such phones are QuickOffice and DataViz's Documents-to-Go. In addition, IT departments can customize smartpho nes into running applications related to â€Å"line of business† via the network, for instance, health records, workflow management, shipping and logistics management as well as other industry-specific software (Litchfield, 2010, n.p.). With appropriate applications, smartphones can act as powerful organizers. Pocket Informant is one of the popular contacts and calendar apps. The advantage of Pocket Informant over built-in calendar apps is its ability to provide a clear organization of complex schedules. Pocket Informant also enables one to view all the e-mails, notes and appointments for each contact in the address book (Williams & Pence, 2011, p.680). ReQall which is a new app that allows busy road-warriors to create to-do lists and calendar entries using easy voice commands. Through management of a complex network of contacts for business, only a small number of online services can beat LinkedIn that provide a native app for iPhone and before long for the Blackberry. Video conferencing and online collaboration are a boon to both national and international companies. Many powerful apps extend the online collaboration tools to the smartphone. Cisco's WebEx Meeting Center for iPhone and the Blackberry allows one to take part in the online conference as either a participant or a presenter. It allows for sharing of documents, viewing of PowerPoint presentations and IM together with various participants while teleconferencing via the smartphone (Liu & Hwang, 2010, P.E5). Another iPhone app is iShare which provides access to firm’s Microsoft SharePoint server to update workflows and collaborate on documents. Encamp for iPhone is an app smartphone that enables access to Basecamp project management workflows as well as shared documents (Highsmith, 2002, p.30).

Eindhoven Model Of Incident Causation Nursing Essay

Eindhoven Model Of Incident Causation Nursing Essay Patient safety is the foundation stone and one of the central concerns in quality improvement for the health care institution. Keeping our patients safe is a challenging issue because errors and mistakes can and do occur any time. Human error is inevitable, reducing error and minimizing the consequences of error is best achieved by learning from mistake, rather than blaming attitude. Over the years, nurses have assumed roles in various quality improvement and health care risk management activities. Learning from errors and near misses helps to provide opportunities to overcome system gaps, design solutions and modify management systems can reduce the chances of future errors and prevent disaster. According to U.S Agency report (2001) patient safety practice is a type of process or structure whose application reduces the probability of adverse events resulting from exposure to the health care system across a range of diseases and procedures. The Institute of Medicine (IOM) reported that between 44,000 and 98,000 patients die in hospitals setting in 1997 in the United State of America (USA) each year as a result of health care errors which includes, transfusion of incompatible blood products, medication errors, foreign objects left in bodies, equipment failures, mistaken identities of patients or body parts. These errors occurred at any phase of the health care delivery system, errors with serious consequences were observed in most vulnerable clinical settings. Department of health (2001) An Australian study reported adverse event rates of 16.6% of which 13.7% resulted in permanent disability (Wilson, 1995). The Institute of Medicine (IOM) released (2001) a report on To Err Is Human: Building a Safer Health System On the basis of two research studies: one conducted in Colorado and Utah found that 6.6 percent of adverse events led to death, as compared with another study conducted at New York, found that adverse events occurred in 13.6 percent in New York hospitals. In both of these studies over half of these adverse events resulted from medical errors and could have been prevented. When extrapolated to the over 33.6 million admissions to U.S. hospitals in 1997, the results of the study in Colorado and Utah imply that at least 44,000 Americans die each year as a result of medical errors. The results of the New York Study concluded that deaths due to medical errors exceed the number attributable to the 8th leading cause of death. Scenario During my clinical experience, I encountered a situation where I received call from hospital incharge and reporting one sentinel event, series of e-mail exchanged and on call administrator requested me to terminate assigned staff who did an error. I have utilized my leadership knowledge and skills to the best of my understanding. The scenario was an 11 years old boy (Patient A) presented to hospital with the complaint of fever, headache and vomiting. 40 years obstetrics (Patient B) was admitted through emergency department for induction of labour. Both Patients blood was arranged and both have different blood groups. At night physician order to transfused blood to Patient A. Assigned nursing staff went to the laboratory with correct transfusion request slip and blood releasing form but unfortunately Patient B blood pack was picked instead of Patient A from the blood refrigerator at laboratory. Blood checked by same nurse with on call assigned physician before transfusion but again fa iled to check for correct identification at the bed side. Transfusion started to Patient A at 0700 hours. Shift changed at 0800 hours, over taken from night staff with blood transfusion but again verification was not done as a result unrecognized transfusion reaction occurred and ultimately Patient A expired at 13:00 hrs. I have investigated the case and requested respective assigned team and stake holders for root cause analysis. The situation was very painful and challenging as an eleven years old child died due to error but it gave me lots of opportunity to identify the system gaps in order to prevent from re-occurrence in future. As a management position, I requested multidisciplinary team to do the root cause analysis. Root cause analysis is a process for identifying the factors that underlie variation in performance, including the occurrence or possible occurrence of a sentinel event. A root cause analysis focuses primarily on systems and processes, not on individual performance. The analysis progresses from special causes, clinical processes, organizational processes and systems, identify potential improvements in these processes or systems. After did a root cause analysis the incidence was categorized as sentinel event. A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. Serious injury specifically includes loss of limb or function. Such events are called sentinel because they signal the need for immediate investigation and response. Sentinel events are identified under the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and emphasized those policies helps organization to develop preventative measures. (The Joint Commission, 2011). The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has placed considerable emphasis on promoting patient safety through a variety of mechanisms, including the reporting and analysis of sentinel events that can lead to modifications and improvements in policy and practice within health care settings. We must apply the same principles learnt from our experiences. When a sentinel event occurs in a health care organization, it is necessary that appropriate individuals within the organization be aware of the event, investigate, understand the causes that underlie the event, and make changes in the organizations systems and processes to reduce the probability of such an event in the future. As a key management position it is my prime responsibility to work as a team with multidisciplinary approach, take as an opportunity to improve the system and ensure the compliances of the institution policies and procedure by nursing division. An organized approach for identification, analysis and evaluation of risks and the devising a plan to decrease the occurrence of accidents, incidents and injuries (Sullivan Decker, 2000). The Institute of Medicine has designed six aims for improving the delivery of care in the United States which includes; Safe, effective, efficient, timely provision, equitable and Patient centered approach in order to provide safe and quality health care services. (Institute of Medicine, 2001). According to Pelletier and Beaudin (2004) The Institute of Medicine defines healthcare quality as the extent to which health services provided to individuals and patient populations improve desired health outcomes. The care should be based on the strongest clinical evidence and provided in a technically and culturally competent manner with good communication and shared decision making. During root cause analysis I came across lots of areas which was identified for areas of improvement that, leadership needs to provide resources in order to provide quality services as evidence by provision of resources was absent in laboratory which resulted that in night shift staff went to receive blood by herself and no check and balance of patient identification was done. However, it is not clearly defined in the policy that what will be the mechanism of check and balance at laboratory end. At secondary hospital laboratory services timing is from 0800 hours to 2300 hours, but what if need arises after wards. It was taken as a granted that services will not require in night timings. In addition, it was not clearly defined in the blood transfusion policy which defines the first steps of checking blood for correct identification at laboratory level. According to Daniel (2004) Clinical Management refers to diagnosis, treatment planning and delivery and ensuring the correct identific ation of each patient and procedure. As a nursing departmental heads the need was identified to review the policies and procedure, structured quality assurance program and Total Quality Management system (TQM) is required in order to prevent from reoccurrence. TQM is a management philosophy that emphasizes a commitment to excellence throughout the organization (Sullivan Decker, 2000). Total Quality Management (TQM) is a sub-discipline of management science which deals with the issue of standardization and enhancement of organizational performance. According to Khan (personal communication November 20, 2012) research was carried out in 2006-2009 by for critical analysis of TQM implementation in Pakistani organizations located on geographical basis. This study explores the factors influencing the success and failure of the TQM program in the organizations. It particularly explores how these programs work within the context of various organizational profiles, dynamics and culture. The study found that TQM implementation is heavily dependent on various factors related to organizational context and culture. It also identified that the end results and changes expected by organizations from TQM implementation are not only dependent on its own framework but on many other cultural related intermediate impacts. These intermediate impacts are mostly related to organizational dynamics and culture and are ignored in most of the firms, resulting in early failure of TQM. Based on the findings of this research and the practical experience of implementing TQM in different organizations, the author also proposes a new framework of TQM implementation named as MSAC cycle i.e. Mobilization (trial phase), Standardization (Short term phase), Acclimatization (mid-term phase) and Culturization (long term phase). This study and the proposed TQM implementation framework is quite valuable for the organization who are presently implementing or desirous to implement TQM more effectively and successfully. The Aga Khan University Hospital started its operation in 1985. Basic quality assurance methodologies were introduced and from 1994 onwards, the continuous quality improvement (CQI) model of AKUH fostered a positive culture of change by establishing lots of core quality activities across the clinical and managerial disciplines; which includes, quality circles, basic quality control tools, education and training in quality, monitoring of quality indicators, health care professionals credentialing, Patient complaints, Patient satisfaction, morbidity and mortality reviews, nursing quality assurance program and quality grand rounds. Finally in 2006, AKUH acquired the gold seal of international accreditation in health care by the Joint Commission International Accreditation (JCIA) with the unique distinction of being the first hospital in Pakistan and among few universities based hospitals in the world to get the quality recognition. AKUH is now on the expansion and integration phase of i ts quality journey, the central driving force towards its quality vision is improvement of processes and outcomes and achieving a strong customer orientation towards both external and internal customers. This will be achieved through concentrating on the goals and strategies of the hospital and all its departments to these three major themes that is improvement in quality of care, services and cost-effectiveness. It is widely recognized that quality indicators or performance indicators can give a valuable insight into the quality of care being provided to patients. Performance indicators are best way to learn and improve, but to instill ownership in the heart of every individual is the key to having meaningful indicators. Thus making performance indicators a part of a physicians and nursing performance evaluation not only ensure that they actively participate in improving their own performance, but also ensure that, quality of care provided to the patients is always and continuously improving. In this clinical situation I also participated in developing the policies with multidisciplinary team and tool in order to control quality system and to evaluate the compliances of practice for sustainability. Fostering a culture of safety requires more than introducing new policies and procedures. Developing a culture of safety requires critical thinking, problem solving, risk identification management and human factor training. The relevant literature and websites on patient safety program has suggested many safety related performance indicators and sy stems of check and balances which can ensure patients safety during patients stay at hospital. A systematic and multidisciplinary approach is, therefore, very imperative to pick-up medical errors and devise strategies to reduce them as it defiantly plays an important part in patient safety. Literature Review The literature review will address overall concept of patient safety and its related issues and concerns, international perspective of error occurrences, safety related performance indicators and measures to create positive safety culture. Several studies are carried out on measuring and evaluating patient safety and outcomes at several health care institutions (Baker 2003; Arah, 2004; Colla, 2005; Karsh, 2006). According to Colla (2005) Achievement of a culture conducive to patient safety may be an admirable goal in its own right, but more effort should be expended on understanding the relationship between measures of safety climate and patient outcomes. The Luxembourg Declaration on Patient Safety (2005) has observed that the health sector is a high-risk area because adverse events, arising from treatment rather than disease, can lead to death, serious damage, complications and patient suffering. Although many hospitals and healthcare settings have procedures in place to ensure patient safety, the health care sector still lags behind other industries and services that have introduced systematic safety processes. Almost fifty percent of joint commission standards are directly related to safety, addressing such issues as medication usage, infection control, surgery and anesthesia, blood transfusions reactions, staff credentialing, fire safety, medical equipment, disaster management, risk identification and management, sentinel event monitoring, safety and security structures. These standards address a number of significant patient safety issues, including the implementation of patient safety programs; the response to adverse events when they occur; the prevention of accidental harm through the prospective analysis and redesigning of vulnerable patient systems and its the organizations responsibility to transparent and take ownership and accountability. Agency for Health Research and Quality (AHRQ) reports (2001) has suggested the same that to review best practices from scientific literature, Redesign care based on best practices through collaboration of multiple departments, Evaluate technology solutions, Implement performance measurements and Monitor selected measurements and present summary reports to senior leadership. Moreover, the Advisory Board Research document supports the type of error mentioned in the AHRQ 2000 reports that the most common errors per 1,000 visits are: 65 incidents per due to adverse drug events, 60 incidents due to hospital acquired infections, 51 incidents related to procedural complications and 15 incidents related to falls. Besides analyzing the common errors in terms of patient safety, Mrayyan and Huber (2003) discussed three aspects of patient safety issues. First is the fear that is whenever any unfortunate incident happens and it is publicized; it creates fear and apprehension among team members. Second issue is errors as a system problem, which involves repetition of same type of error that requires close and immediate interventions. Third is the link between errors and inadequate resources that means inadequate number of staffs or inadequate trained staff that can jeopardize patient safety. The medical error and harm to patient safety does not only let the patient suffer but brings an impact on society at large. The Danish Society for Patient Safety (2005) discussed the effects that adverse events can have on patients; health care personnel and society at large are significant. Patients may suffer both physically and psychologically from sufferings created by the injury itself, but also by the way the incident is handled. Health care personnel on the other hand may experience shame, guilt and depression, with litigations and complaints imposing an additional burden. Society at large suffers from a lower quality of life of its members, with associated extra health care costs but also costs caused by a lower productivity of the society. After root cause analysis I also felt that it is necessary to have interaction one is to one basis to relevant health care personal who did an error in order to sensitized them and mentored through education path rather than terminating the employee, give them insight that the will be the future ambassador for patient safety because, I personally believe that quality reflect when person itself willing to do so, it should be our constant commitment towards organization that patient safety should be our top priority, which infuses the entire organization, for that it is mandatory that first we should acknowledge the error then promote blame-free environment where individuals are empowered to report errors without any fear and punishment so they can willingly address safety concerns. Daniel (2004) explains that, what can be done today to improve patient safety while we are waiting for evidence on effective interventions. First, we need leaders those at the top of organizational charts as well as leaders at all level, second, we need to focus on comprehensive systems of safety rather than attempting to address safety one problem at a time. Three elements comprise comprehensive patient safety: active case finding, methodical analysis, and system redesign. Patient safety initiatives and programs vary from institution to institution but the aim remains the same that is reducing errors and promote safety. Klazinga and Arah (2004) said it is evident that current efforts focus too narrowly on the patient with little explicit linkage to wider aspects of health system safety. Risks management entails reducing harm not just to patients but also to staff, visitors and the environment including society. Some of the patient safety alternatives and solutions proposed by Mrayyan and Hubber (2003) are emphasizing on strengthening system of error reporting and correction that is error detection and reporting system within organization to reduce medical error, patient education in all aspects of care and applying risk management skills by healthcare personnel. In addition, creating an information system and building evidence base for patient safety, analyzing the impact of various management practices like staffing, increasing of medical errors and high risk population and monitoring error rates with necessary actions can reduce medical errors and also use of information technology can work towards enhancing patient safety. Besides all this, commitment of the healthcare professional to reduce errors and promote safety in any organization enhances safety not only for patients but also for the healthcare staff and society in general. This position paper related to sentinel event also gives me insight to do a self-reflection of my job related competencies as a key management representative. I personally believe that, Knowledge can be achieve by reading literature but the art of utilizing that knowledge and skills will give confidence to fulfill job in an effective way. According to (Barker, Sullivian Emery 2006). describe three key roles organized in to three categories called interpersonal roles, informational roles and decisional roles. In interpersonal roles manager has lots of job responsibilities in order to full fill organizational goals, informational roles comprises of monitor and disseminator as that manager is the focal person and considered an as nerve center. Third category is decisional roles which consist of entrepreneur, disturbance handler, resource allocator and negotiator. The first two categories are related to day to day operation However, the third category need that how manager use his/her c ompetency in clear direction which meet the organization vision and mission. Integration of Model There are number of the clinical theories and models regarding the human error are discussed in management. Among which I have selected the Eindhoven model of incident causation. Eindhoven Model of Incident Causation: This model was originally developed to identify root causes of safety related incidents in the Netherlands and has since been tested in industrial and health care settings. The Eindhoven Model of incident causation identifies three main causes of error: human operator, organizational and technical failure. These failures, alone or in combination, are through responsible for reinitiating a chain of events that may ultimately lead to an adverse patient outcome. In performance improvement terminology, such a failure would be considered the root cause of an incident. According to this model, high risk situations will develop into incidents if inadequate system defenses are available to remediate the problem. The Eindhoven Model of Incident Causation served as the theoretical basis for developing the Eindhoven Classification Model, which has since been adapted for the health care domain (Jacob Cherry 2011). This classification model claims that errors occur either because of active failu res or latent conditions. Human Operator Error: (Active failure): Human operator errors are those made by individuals at the sharp end by health care workers. They are also referred to as active failures or active errors. Active failures fall into three major categories; skill based, rule-based or knowledge-based. Skill based error occur when an individual makes an error during the performance of a routine task that requires little conscious effort as evidence by its routine practice of nurses to bring blood from laboratory or its routine to take daily over from upcoming shift but in different intervals but nurse fails to check for correct identification with patient name and medical record number. An example of a skill based error would be a nurse forgetting to push the start button on an IV pump after priming the tubing. A rule based error occurs when an individual fails to perform a procedure or protocol correctly or chooses the wrong procedure as in this sentinel event nurse and physician fails to compliance with policies and procedure as a res ult wrong blood was transfused. An example of a fuel-based error is a phlebotomist failing to check the patients identification before obtaining a blood specimen. A knowledge based error refers to the conscious but incorrect application of existing knowledge to a new situation. An example of a knowledge-based error would be when first patient develop fever or sign of reaction she took as an granted and stop blood for time being neither nurse or physician utilized their knowledge and integrated theory in to practice or critically analyze that what would be the possible reasons for fever. Human errors have typically been the focus of traditional incident report monitoring because they are more obvious that latent conditions. Although some of the factors leading to human error are amenable such as knowledge deficit, staffing shortages, work over load etc. Technical or organizational error (Latent Condition/ Latent error): Technical and organizational errors are referred to as latent condition or latent errors. Latent conditions result from sanctions or decisions made by administrators or others in leadership positions that affect technical issues, organizational policy or the allocation of resources. These errors are called latent because of the delayed and unintended consequences that may affect patient safety at a later point. Technical error occurs when there are problems with equipment, forms, labels, etc. (e.g. a computer does not print out patient identification labels in a timely manner). Organizational error can be related to various, often complex issues involving management priorities and organizational culture. An Example of a latent error would be an organizational decision not to use a computerized provider order entry system which results in a high number of medication errors related to illegible handwriting. Other Error (Unclassified): A third category in the Einhoven Classification Model accounts for errors that cannot be classified as active or latent. In health care, such errors are generally due to patient-related factors that contribute to error, for instance, if patient gave the history of allergy and this can lead to potential medication error. An error whose cause cannot be placed in any category (i.e. latent, active, or patient-related) is termed unclassifiable. In order to continuous quality improvement and promote patient safety culture it is necessary to promote culture of reporting of errors is the first step along with a constructive process towards understanding that what factors within a system enable an error to take place. This systems approach is gaining ground and many hospital administrators are becoming well versed in its theory and practice. To promote a culture of safety the leadership of an organization promulgates an atmosphere in which the reporting of errors is welcomed, so that others may benefit from knowledge of the situation and can develop strategies based on the data. A major element of this framework is a non-punitive stance towards the individual who reports or who has involved in an incident. In a just culture an organization lets its employee know that they will not be disciplined for making mistakes and that the leaders value the importance of learning from mishaps and seek to improve the system that allowed the m to occur. Recommendation Based on sentinel event which I address in my position paper and in light of literature, I would like to recommend few suggestions/ recommendations to strengthen our quality system. First in order to promote in healthcare organization, major emphasis required in order to create non-punitive environment where health care workers can report events, errors and near misses without fear of reprisal or disciplinary action. Next, the risk management forum should be structured at organizational level where relevant multidisciplinary key stake holders should identified in order to take ownership and facilitate clinicians and organizational managers at all levels, the in order to create such an atmosphere which promotes patient safety culture in an organizations. Needs to develop and implement a reporting system that encourages and enhances reporting by all department and staff. Educate all clinicians, staff, and management personnel on the nature and importance of the event reporting process, including disclosure and discovery issue. Needs to do timely and accurate documentation of sentinel events help organizations improve their safety and quality of care and learn from other organizations unexpected outcomes, which allow other health care organizations to be aware of the possibility of certain sentinel events, thus giving staff the time and knowledge to develop strategies to avoid these events before they actually occur. Utilization of event report data to trend and analyzes organizational risks and distributes this information to appropriate staff of the organization so that risk-prevention measures can be developed and implemented. Last but not least provide clinicians and staff ongoing feedback on their risk-reduction efforts, results of event reporting should be discussed at the departmental level, and input on corrective actions/process improvements should be solicited. Conclusion: In conclusion, I must say that errors can occur at any point in the health care delivery system. Acknowledging that errors, learning from those errors, and working to prevent future errors represents a major change in the culture of health care, a paradigm shift from blame and punishment to analysis of the root causes of errors and strategies to improve systems and processes by implementing patient safety measures which provide an objective, validated measure for identifying Potential Safety Issues. Management should make an effort to break down barriers by adopting non-punitive cultures based on industry best practices. This will sheds new light on traditional methods for removing reporting barriers, develop employee commitment to recognize and report errors or incident occurrences. When the staff proactively participates in reporting, the reporting process becomes a vehicle for making practices improvements in the delivery of patient health care and management receives information that otherwise would not be available. As one manager said, if nobody reports it, you dont know. When some occurrences are not reported, management receives limited information on which to base their decision. It goes without saying that better data mean better decisions. According to Daniel (2004) the goal should be not only to increase the number and quality of reports but also to increase their usefulness as rich sources of information for the generation of strategies tactics aimed toward medical-error reduction (p. 27). According to Minesota Alliance for Patient Safety (2005) safety culture is not blame-free approach; it is an approach that balances the need to promote open reporting and the need to hold practitioners accountable for their behavioral choices. Hospitals should identify potential safety issues, having proactive approach, measure baseline performance, and set priorities for process improvement efforts. Using this methodology, hospitals can implement patient safety program with minimal investment on their part. Informational reports can be generated and disseminated to proactively identify safety issues and drive improvements for the better health care outcomes.

David Malouf explores the emotional and physical struggle Essay

David Malouf explores the emotional and physical struggle a hero must face before attaining glory. Evaluate this statement. In your response discuss how two characters are represented as heroic through their quest. Heroism is a valued concept that has transcended through time and has been the subject of a great deal of literature. David Malouf’s appropriation of Homers epic The Iliad explores this notion of heroism through the characterization of King Priam, directly battling the contextual hero of the time, Achilles. Through descriptive language and stylistic conventions, Malouf showcases that it is the emotional and physical struggle that a man must face to ultimately attain glory, thus becoming a hero. This statement is epitomized through the contrasting protagonists Priam and Achilles, who are both sequentially transformed through their metaphysical journey. Malouf has deliberately structured his text in separate books, to take the readers on a journey, mapping their path to glory whilst teaching us the importance of the ordinary hero. Classically, a hero demonstrates qualities of endurance, bravery and physical prowess, epitomized by Achilles at the start of the novel. Malouf initially celebrates Achilles as a hero, being â€Å"blessed† by the Gods with supernatural abilities and a â€Å"brooding presence†, which intimidates the entire Trojan army. However, while Achilles’s training and apparent destiny is to attain glory and die â€Å"a hero’s death†, Malouf soon reveals his dissatisfaction and emotional struggle with his current disposition. In the context of Patroclus’s death and loss of family Achilles’s thumos overwhelms him, this grief accentuated through the repetition of â€Å"wept†. His killing of Hector sets his spirit â€Å"off on its own downward path† a metaphor portraying the similar downward path he experiences at this part of his journey. This search for salvation leads him to drag the body of Hector around the walls of Troy, juxtaposing his former honour, â€Å"He is their leader, but he breaks daily every rule they have been taught to live by†. Malouf manifests the struggle of Achilles and portrays his negative spiritual journey through the exploration of dark imagery, articulating upon his soul’s â€Å"corruption†, surrender to a â€Å"darker agency† and being caught in a metaphorical â€Å"clogging grey web†. Although Achilles can be considered a hero, these human traits highlight his flaws leading to a metaphysical struggle within himself, which gives Malouf scope to further develop his journey of self-discovery. This journey of struggle takes him from a grief stricken avenger to compassionate father/man/hero. Achilles is a lost hero at the end of book 1â€Å"waiting for the break†, waiting for â€Å"something† to â€Å"Break the spell† that is on him. Within Book 4 Malouf delivers Achilles’s salvation in the form of King Priam. It is here Priam implements a metaphysical journey upon Achilles, forcing him to look inward from the fatherly figures point of view, his regret captured through the metaphor â€Å"a great wave of sadness† passed by. Malouf depicts Achilles’s transformation through the imagery of â€Å"the ice cracks†, conveying the mutual understanding shared, as Achilles accepts Hector’s â€Å"honorable death† for the first time. Achilles learns a compassion for the enemy, clearing his â€Å"heart of the smoky poison† and continuing the water motif with â€Å"a cleansing emotion†¦flooded through† leaving behind his guilt and struggle. Malouf epitomizes the transformation through describing Achilles with a â€Å"lightness† which is in direct juxtaposition of the earlier dark imagery. It is clear that Achilles has been forever enlightened by Priam’s appeal, finding a â€Å"balance† between his conflicting dual nature. Malouf ends this quest as Achilles regains his warrior status and developed the absent qualities of integrity, compassion and honour â€Å"in the very breath of the gods, of the true Achilles, the one he has come all this way to find†. This quote further integrates the epic convention of the god’s intervention, undermining Iris’s initial â€Å"concept of chance† developing the theme of destiny. Through changing the perspective of the book from Achilles to Priam, Malouf is able to encapsulate the quest and transformation from king to man. Hector’s death acts as a catalyst, sparking the old king to leave his golden cage. In this claustrophobic setting, Priam instinctively feels denied true companionship with his fellow man. This is amplified through the shallowness of the relationship he and his son shared, which is felt all the more acutely in the context of Hector’s death. Priam, through an epiphany brought upon by the gods decides to break free, envisioning â€Å"himself †¦ dressed in a plain white robe without ornament† into Archilles camp to ransom the and bring home the body of his son. This vision has elements of the heroic, in risking his life, and undertaking what has â€Å"never been done before† in the annals of Troy. When convincing his family of the proposition to ransom Hector, Priam’s argument is reinforced through the repetition of â€Å"I believe†. It is Priam’s journey that transforms his life from the artificial â€Å"kingly sphere† to one attaining real feelings and emotion. Books 2 and 3 change the perspective from Achilles to Priam, where Malouf encapsulates Priam’s quest from king to man. Hector’s death acts as a catalyst, sparking Priam to transform from his passive and â€Å"symbolic† role of king to a man feeling â€Å"bold† and â€Å"defiant†. Tiring of his life of isolation, Priam’s epiphany of â€Å"himself †¦ dressed in a plain white robe without ornament† heading into Archilles camp to ransom the body of his son is heroic. It challenges all convention, contains high ideals and involves risk of life, a quest of glory. Priam must first struggle with his wife, then his children and councilors â€Å"you expect that jackal†¦ to be moved by this touching pantomine? † rhetorical questioning emphasizing yet again the constraints of his kingly realm. The introduction of Somax as the metaphor of the ordinary man allows Priam to reconnect with basic values such as â€Å"interest† and â€Å"curiosity†. This relationship is an essential part of Priam’s journey, as he gains an understanding of the â€Å"outside world† developing into a real man and father. Malouf uses simile and irony when comparing Priam to a â€Å"toddler† as he is the king yet Somax is the adult in the relationship. By making Priam the child, Malouf demon`strates how far Priam must travel in his journey of self-discovery. Within book 4 the climax of Priam’s journey takes place, as he confronts the murderer of his son. From the very moment he enters the Greek camp the gods clearly support Priam, as the portal gate was moved by some â€Å"invisible agency†. This epic convention is further developed by Malouf as Priam’s sudden ability to speak well becomes a strength â€Å"Would your father†¦not do the same for you? † appealing to Achilles’s humanity through rhetorical questioning. Here Priam’s physical and emotional strength shines through, as the final product of his heroic quest has been developed â€Å"I have come to you†¦man to man†¦for the body of my son† epitomizing his newfound endurance, bravery and compassion. Through the mutual bond of fatherhood the reader observes Priam’s transformation from a â€Å"child† to a man able to leave the great Achilles begging â€Å"No more! Please! † Malouf takes Priam on an emotional and physical struggle, who ultimately attains glory through reducing himself into the ordinary man â€Å"the I is different†¦I come as a man of sorrow†¦ but also as a hero of a deed that†¦ was never attempted. † that he himself can recognize through successfully ransoming the body of his son Hector. Priam exemplifies humility when meeting Achilles, using the strength from the gods to aid him on his noble pursuit. Now Priam must struggle with not just his emotions: he must remain strong against the physical fear of losing his life. He makes his appeal and â€Å"closes his eyes. Now he thinks, now they will strike†. Here Priam’s physical and emotional strength shines through. He is an old man, he has traveled far, he faces death at the hands of the ultimate warrior. He has braved these physical challenges while keeping a cool nerve and winning Achilles over with his simple manly dignity. Q1 Hero heroic journey Heroic qualities, how they are highlighted Literary techniques Language in an evocative manner Simple/Direct Shifts in point of view Clear images of characters Structure chronologically Malouf remains faithful to Homers Book 24 through allowing the gods to intervene in the affairs of human undermining the god Iris, showcasing that the concept of â€Å"chance† was Achilles could never have dreamt that the special something would come to him in the form of plainly dressed King Priam, Malouf is clearly faithful to Homers book 24, drawing upon similar epic conventions when delving into Priam’s quest of self-discovery, implementing the feeble old king to effectively challenge the depiction of heroes. Malouf is clearly faithful to Homers book 24, drawing upon similar epic conventions when delving into Priam’s quest for glory, effectively challenging the depiction of heroes. The idea of glory is explored in depth in the novel Ransom. It is clear from the novel that the concept of â€Å"attaining glory† is subjective. Glory could be a high level of reknown peers, or in the case of Priam and Achilles achieving honour that they themselves can recognize.

Immune system

Chapter 1: IntroductionTypically, the immune system can spot between â€Å"self† and â€Å"not self† and onslaughts merely those tissues that it recognizes as â€Å"not self† . This is often the preferable reaction, but non ever. Autoimmune upsets are diseases produced by the organic structure doing an inappropriate immune reaction hostile to its ain tissues ( American Association for Clinical Chemistry 2009 ) . The immune system will halt placing one or more of the organic structure ‘s normal parts as â€Å"self† and will make ‘autoantibodies ‘ , which attack its ain cells and systems. Systematic Lupus Erythematosus is an inflammatory autoimmune disease of unspecified etiology, and is characterized by a wide assortment of symptoms ( Herrmann, Voll & A ; Kalden 2000, Rudich & A ; Zerman et.al. 2008, Olowu 2007, Hansen, Heipe, & A ; Dorner 2007 ) . Lupus can be triggered by legion agencies and can show itself in a bewildering figure of way s, even to the extent of miming other diseases such as arthritic arthritis or multiple induration. Although Lupus affects many variety meats some of the more common symptoms are utmost weariness, joint hurting, the devastation of critical variety meats, every bit good as musculus achings ( The Lupus Site 2009 ) . Symptoms of Lupus can look and decline with clip, and they vary from individual to individual ; symptoms of Lupus can escalate with flare-ups, but these can besides unclutter up. Outbursts may be triggered by alterations in the patient ‘s wellness position, such as physical or emotional stressors and/or by outside stimulations. Lupus is non a normally discussed disease, although it has been said that it is more common than leukaemia, muscular dystrophy, and multiple induration. It is estimated that 30,000-50,000 people in the United Kingdom have Lupus, of which 90 % of its sick persons are female ( Lupus UK 2005 ) . Based on fieldwork, Internet posters, and published documents on unsure diseases, this paper examines ways in which sick persons attempt to derive diagnosings. I turn to the corporate online action, where users grapple with the systemic nature of wellness attention denial ; they discuss wellness attention, and utilize these treatments to make tactics that the weak can utilize in response to the domination of the medical system. However, because of the pervasiveness and uncertainness of the unwellness, the biomedical facts are susceptible to being framed and reframed by participants in these treatments. Lupus characterized by great uncertainness sing etiology, diagnosing and intervention ; it is an emergent disease, in that it is researched in the medical community, discussed and reported on on occasion, nevertheless it is non settled upon in respects to diagnosis. There are many structural features of Lupus, and these should be taken into history, as they play major functions in on-line treatments and methods of get bying with the disease. First, Systemic Lupus Erythmatosus is a chronic status, and portions with other chronic conditions, the inability of suiting into acute disease theoretical accounts of intervention, the ill function, and wellness attention. Second, Lupus is a biological status that is fraught with mental features ; and due to this it is frequently misdiagnosed as a mental status. This is added onto the fact that the oncoming of lupus is contested as to societal, familial, or toxic finding ; precisely what causes the oncoming of the disease is unknown. Lupus is therapeutically diverse, how people treat their status and what therapies that are used are varied. There are common drugs that are prescribed one time diagnosed, including a batch of steroids, nevertheless alternate medicine is broad unfastened. Lupus is a disease that is characterized by fuzzed boundaries and is cross-linked to other unwellnesss and complaints as misguided diagnosing. And eventually Lupus can be lawfully volatile ; conditions can be caught up in legal conflicts and extended administrative cataloging. When seeking disablement position, it can be applied at a caprice ; it is a extremely contested position, as the disease is an ‘invisible disease ‘ . A late diagnosed patient best summarizes the structural conditions listed above: â€Å" I was late diagnosed with lupus, I sometimes wonder why the physicians could n't hold found it earlier now. It has been 3 old ages since my first symptoms. I knew that something was non right. I was misdiagnosed with several complaints and was get downing to believe it was all in my caput or that I was doing it up. It ‘s amusing how you even get down to doubt yourself. But something told me to maintain delving maintain take a firm standing that something has to be incorrect. I feel so much better now that I know what it is I am confronting. It is the unknown that is scary.† Many lupus patients frequently say they feel like hypochondriacs when sing their physician because of all the minor symptoms that they want to describe. It can be a long, difficult route to acquire a diagnosing and it ‘s easy to desire to give up. Sometimes, even their households begin to oppugn whether there is anything truly incorrect. Diagnosis is one of the few ways that sick persons feel that they can derive legitimacy in the eyes of society, a manner in which they can accommodate the ill function with a solid backup to it. Suiting into society and the topographic point that Lupus sick persons have within society frequently leads to a automatic theorizing about society, which will be touched on later in the paper. As with many emergent, contested unwellnesss, the societal job is the seemingly intractable uncertainness at each bend. There are ever excessively many facts, excessively many symptoms to name, and non plenty research done. The battle to acquire diagnosed therefo re depends disproportionately on the little sum of research and promotion of the disease ; and many sick persons feel that they are consistently excluded from the medical system. Beck has shown how life in modern society necessitates the demand to hold a ‘do it yourself ‘ attitude. The corporate histories of experiences with physicians online let for a creative activity of a tool-kit to conflict against the changeless denial of the sick-role. In the balance of this paper, I will utilize the online forums among sick persons to analyze what they have learned in order to populate and speak strategically in the medical system, in society, and in the household puting that invariably denies them their unwellness, and the tactics that are used.Chapter 2: MethodsThis chapter is dedicated to discoursing the methods used to make the transcripts that shaped the foundation for the analysis of lupus sick persons ‘ battle for acknowledgment and methods of covering with the denia l of the ill function. In peculiar, this chapter will turn to the lineation for the readying of the interviews, how the marks were reached, and the ethical issues that were met. I will besides explicate the procedural grounds behind utilizing the online forums and questionnaires as the underpinning of the survey, every bit good as the restrictions that these beginnings provided. The usage of critical descriptive anthropology for this undertaking was cardinal in constructing a better apprehension of unwellness as a societal and biological fact. Systematic Lupus Erythematosus is an unwellness that is beset with medical and societal stigma, an unwellness that is surrounded by uncertainness, and is frequently referred to as an ‘invisible disease ‘ ; which is discussed in the undermentioned chapters. The chief purpose of research was to look at how sick persons were talking about their experiences with Systematic Lupus Erythematosus and how they were discoursing their jobs and tactics together in a public forum. In order to turn to this, the primary informations used are in-depth interviews conducted with Lupus sick persons, their household members, and assorted usage of on-line treatment groups. I turned to online action in order to follow how the highly systemic character of medical denial can be archived, argued and used to make tactics against thi s really denial. The posters in the forums are public commentary with no entree limitations and are frequently personal narratives about fighting with acquiring diagnosed. The majority of the information for this undertaking came from posters such as this, and was spread between three chief yarn subjects ‘Living with Lupus ‘ , ‘Not Diagnosed Yet? ‘ and ‘Symptoms ‘ , as there are over 53,000 positions and 9000 posters. Use of these on-line beginnings opened up the sum of people I could make in respects to my research. Data for this undertaking was collected between the months of April 2009 and August 2009, from life history interviews, online questionnaires, on-line treatment groups, every bit good as participant observation from support group meetings. There was no effort at reaching people separately in order to take part in these surveies, nevertheless the online community was given the chance to reach me if they wished to take part in the survey. Preparation for the interviews was undertaken through shoping the online forums and analysing which subjects were looking the most in posters. From the subjects that appeared the most through out the togss I created a synonym finder of common footings, this synonym finder was used to code the conversations that were held on the togss. Equally good as analyzing through the togss I undertook big readings of scientific diaries on the topic of Lupus. This was done in order to derive background cognition on the topic, to derive utile ushers prior to furthe r research, and to entree informations that already exists from past research on Lupus. Attention was paid to the quality and cogency of beginning stuffs by utilizing assorted paperss published by different bureaus. Internet informations such as Google Scholar, JSTOR, PubMed, and Academic Search Complete provided me with a wide hunt country to acquire a assortment of Lupus paperss published. Particular attention was besides taken into looking at the research that sick persons were posting on the Lupus web site, of which there were merely 72 stations available on the UK Lupus web site. Reading these paperss, analysing the on-line posters, and taking attention to observe what the responses were to these on-line stations formatted the footing for all interview inquiries. Fieldwork was cultivated through contact with the decision maker of a UK based Lupus support web site. It was through this medium that I garnered permission to post a description of my research ; which allowed me to reply inquiries environing the usage of my research, and on the content of my research. The bulk of my sources were Lupus sick persons, although a few participants were the household members of those diagnosed with Lupus. Those that were included in the response had all been diagnosed with Lupus, although there was a big community of online users that were in contact that had symptoms of the disease, but yet were non diagnosed. Peoples that were included in the undertaking were all 1s that had been officially diagnosed with Lupus or their household members, this was non a de-legitimization of those who were non officially diagnosed, but those that volunteered their life histories and replies were those that had been officially diagnosed. The interviews were set up after r eaching a big database of lupus sick persons, which were followed up with posters on the online forum. Interviews ranged from one to three hours long, which were followed up upon with the persons at subsequently day of the months. Following the interviews with Lupus sick persons, I formulated an online questionnaire that people could make full out anonymously, this method allowed me to include those that did n't desire to take part in interviews, but still wished to show their positions on the research subject. Questions that were posted online were wide open-ended inquiries, which were used with the purposes of acquiring respondents to give a greater history of their experiences and jobs. This on-line questionnaire was posted by my research proposal, on the online forum, every bit good as circulated via electronic mail to assorted Lupus sick persons. Regular users and intermediate users of the site all had entree to my research proposal, which got over 600 reads after posting. By posting up my research proposal I allowed for the participants of the survey to cognize precisely what I was research, and how I wanted to accomplish these ends. It besides allowed them to subject inquiries and general enquiries, this feedback that I received from sources have been fed back into my research and developed the findings presented here. Having already touched really briefly the ethical concerns earlier, it would look practical to turn to them at this point. Covering with informations that concerns persons ‘ lives means that allowing namelessness to the individuality of the person and anyone else they may advert is a main concern. Permission for my research was given by the UK Lupus website decision maker, and although this permission was given officially I besides the purposes and aims of my research accessible and clear by posting my proposal for sing anterior to engagement in the research undertaking. Persons besides gave their countenance prior to questioning and were made aware of the right to retreat their part at any phase. Transcripts of the interviews have been made for my ain usage but to protect the individuality of the participants the anonym they used online were kept. Anything that the participants wanted to retreat in hindsight was besides taken into history. For the posters in the three above-na med togss no consent was taken, as all subscribers use anonym. The usage of anonym at times can be a drawback in the research, as these give no indicant of their societal position, their sex, or their age.Chapter 3: Literature Reappraisal:â€Å"Truth is to be understood as a system of ordered processs for the production, ordinance, distribution, circulation, and operation of statements.† Michael Foucault The foundations of medical anthropology are legion, but some of the most influential beginnings are the physical anthropologist ‘s research in development, version and other domains, the ethnographic wonder in witchery and thaumaturgy, the partnership of anthropologists and psychologists during the wartime period, and eventually the international public wellness motion that occurred after World War II ( Foster & A ; Anderson 1978 ) . Following from World War II, the survey of ‘popular and modern medical specialty ‘ became an of import country of research, with comparings between modern biomedicine used in the western universe and the ethno-medicine beginning to rule the medical anthropology sphere ( Bendix 1967, Foster & A ; Anderson 1978, Press 1978, & A ; Simmons 1955 ) . History, clip, and procedures within societies have frequently been combined into one overarching class ; nevertheless Hagiographas from Evans-Pritchard have drawn attending to the integrity of a nthropology and history when discoursing societal orders, and these societal orders can non be analyzed without cognition refering its ‘internal kineticss ‘ ( Comaroff & A ; Comaroff 1992 ) . Put merely all societies are involved in procedures with multiple constituents, elements which create a societal environment, and these constituents engage human histrions and different bureaus in a dialectical relationship ( Comaroff & A ; Comaroff 1992 ) . Ethno-medicine and disease etiologies acknowledge and incorporate input from assorted beginnings, including â€Å"economic, familial, ritual, moral and other institutional sectors† ( Press 1978:71 ) , whereas the modern ( biomedicine ) can be seen as a â€Å"closed system, ‘based on exactly defined cognition, technique and processs, all of which are discontinuous from ordinary societal process'† ( Press 1978:71 ) . â€Å"Human life can non be studied without taking into history both how persons are situated within and constrained by societal constructions and how those persons construct an apprehension of and enforce intending on the universe around them† ( Dressler 2001:455 ) . Explanatory theoretical accounts of unwellness ( EM ) are a set of beliefs which provide people with ways of believing about manners of and theoretical accounts for world, they create order and significance ; this set of beliefs is constructed non by a civilization, but by persons ( Young 1982 ) . Illness can be seen as a procedure through which disease is given socially identifiable significances ( Crandon 1983, Young 1982, Foulks 1978 ) . The manner in which people describe their societal universe through medical specialty is a contemplation of political and economic worlds of the clip ; it shows the significance of cultural dealingss ( Crandon 1986 ) . Cultural individuality can impact straight the type of unwellness believed to hold ( Crandon 1983 [ B ] , Last 1990, Press 1978, Simmons 1955 and others ) , and therefore affects the type of intervention that people are seeking. The medicative system utilised can go a cultural sphere from which people negotiate their individuality, â€Å"medical political orientation is a peculiarly powerful instrument through which certain sorts of dialogue take topographic point ; specifically those refering to cultural individuality, how people define themselves and others and their ain relationships to others† ( Crandon 1983 [ A ] :79 ) . There are three chief ways that person seeks intervention: â€Å"self-treatment, intervention by a curer, or intervention by medical doctors† ( Reeve 2000:102 ) , and these picks are made based upon the gravitation of the unwellness every bit good as the type of intervention that is required ( for either societal grounds, or the cause of the unwellness ) . Within these methods of intervention, there are countries of convergence and intermingling. Medical systems, while of import indexs of political and economic state of affairss, and a duologue of cultural dealingss, should be grappled with non merely as systems of idea, but as thought-in-use ( Worsley 1982 ) . In short, medical beliefs play an of import function in the daily lives ; they have historical significance, influence behavior, form cultural individuality, and represent a dialectical relationship with a huge scope of agents. The hurting that is experienced by persons is influenced to a great extent by their personality, societal and cultural background, every bit good as the doctor-patient interaction ( Rudich et. al 2008 ) . The manner in which the organic structure, unwellness, and hurting are understood is under direct influence of emotions, which is shown in images of the operation organic structure politic and societal organic structure ( Lock 1993, Scheper-Hughes & A ; Lock 1987 ) . It has been argued that it is virtually â€Å"impossible to free powerful human experiences of metaphor, of cultural representation ( although it is, of class, both possible and in many instances necessary to alter the images and significances of illness, hurting, and enduring ) †¦that the hypostatization of unwellness ( as disease entirely ) is a signifier of self-alienation, of false consciousness† ( Scheper-Hughes & A ; Lock 1986:138 ) .Covering with confusion and uncertainnessâ€Å"The I in unwellness i s isolation, and the important letters in health are we† ( Author Unknown ) . One Latin adage pronounces, â€Å"illness shows us what we are† , this is seen in ethno-anatomical perceptual experiences, which give rich ethnographic stuff on the societal and cultural facets of being human, on wellness and ailment wellness, and on the societal experiences that we are believed to hold. â€Å"The ways in which the organic structure is received and experienced in wellness and illness are, of class, extremely variable† ( Scheper-Hughes & A ; Lock 1987:7 ) , which can be seen particularly in respects to autoimmune upsets where the organic structure is perceived to be assailing itself, it is a extremely individualized experience. Lupus is an crippling immunological upset, which is frequently hard to name, as there is no nonsubjective trial for it. It ‘s a disease that ‘s non-objective, changing in clip, and ill-defined. Illness in the context of a dislocation of the immune system enables it to suit all unwellnesss ; therefore, the unwellness is both an single unwellness, different for each individual, but besides corporate and a common syndrome. The immune system allows the explanatory system to finally flexible. The immune system besides was an overall account, warranting why it was that there are so adult male different unwellnesss and illness experiences. The immune system was damaged: with each individual reacting to this diminished immune system in different ways, stressing the singularity of the unwellness for each person. â€Å"Human life can non be studied without taking into history both how persons are situated within and constrained by societal constructions and how those persons construct an apprehension of and enforce intending on the universe around them† ( Dressler 2001:455 ) . Explanatory theoretical accounts of unwellness ( EM ) are a set of beliefs which provide people with ways of believing about manners of and theoretical accounts for world, they create order and significance ; this set of belie fs is constructed non by a civilization, but by persons ( Young 1982 ) . Illness can be seen as a procedure through which disease is given socially identifiable significances ( Crandon 1983, Young 1982, Foulks 1978 ) . For these grounds one of the chief concerns throughout fieldwork was the relationship between acquiring diagnosed and deriving societal legitimacy, as, frequently without this diagnosing people are at hazard of being denied the societal acknowledgment of being sick and accused of ‘faking it ‘ . One user relates her issues of merely desiring her diagnosing to go on: I ‘m rather nervous of traveling to my physician and stating that I ‘ve seeking to self diagnose on the cyberspace because I know that ‘s non a good thing to make, but I merely want to cognize that I ‘m non a hypochondriac or that I ‘m non traveling huffy. Each clip I search yet another virus/pain/problem, the word lupus frequently appears. I go to my physicians normally to be told I ‘m run down, I ‘m down, my blood trials are by and large all right so nil to worry approximately. This accusal of forging it is felt among many sick persons ; and as a consequence on-line communicating becomes a utile tool in combating this accusal. Online forums are utilized as a soapbox, users take the clip to try to educate others in their experiences, and what was successful for them in the conflict for diagnosing. The usage of biomedical facts, the certification of unwellness symptoms that are seeable, and utilizations of diaries to document hurting are frequently sited as ways to derive entree to the socially acceptable ill function, to derive diagnosing. These tips, schemes, biomedical facts, and shared medical articles can be seen over and over once more in a assortment of forums. The hurting that is experienced by persons is influenced to a great extent by their personality, societal and cultural background, every bit good as the doctor-patient interaction ( Rudich et. al 2008 ) . I am ready for bed but wanted to post speedy with a update from my assignment today†¦.for the biopsy he told me that he will non make a biopsy as they truly do non demo much OK, so I proceed to courteously dispute him and state him about The Lupus Site, my friends here, the narratives I have read about skin biopsy ‘s that clearly show a batch and are really helpful to help in diagnosing or at least aid to paint a clearer image. He did non like that really much and reminded me that in fact he was the M.D. , non me. †¦So the lesson of the narrative here is I pissed off the physician today because he was merely a grandiloquent know it all who in my low sentiment did non make his occupation and disregarded the petitions of my Rheumy. When I got place I called my Rheumy and left a message for him to name me back and discourse this. I know that he will non be happy and the war between physicians will get down The obvious inanity of enduring from unwellness and the biomedical speculation of reason will be addressed in the context of long-run chronic unwellnesss, such as lupus. Bing rejected by physicians if one does n't suit into the ideal ill function is frequently a common experience, as one sick person here relates: Over the following twosome of hebdomads the lay waste toing giddiness and gesture illness returned ( which would subsequently go forth me incapable of driving a auto for over a month ) and I could n't even sit in a auto without acquiring ill. I told the following physician I was scared I had chronic EBV, and handed him my labs. He took one expression at them and threw them off. Literally, he threw them off in the rubbish can. He said, your EBV panel shows no active disease, but merely consequences of person who had mono in the yesteryear. This was the first clip I learned the lesson that physicians were n't ever right†¦.the back of my head for so many old ages I knew my issues were acquiring worse and hated that the doctor ever merely dismissed it. Lupus sick persons ever start from a point of view of uncertainness, no 1 seems to recognize what is go oning, and many have non even heard of Lupus until official diagnosing. There is a clear cognition that something is non right with their organic structures, and their unwellness symptoms go a utile narrative when they come into contact with others who are sing the same issues. The oncoming of Lupus is frequently merely a list of symptoms to sick persons, a chronology of failures, and things that they can no longer do ; and it seems in many instances that these symptoms do non do sense, they are non cohesive or comprehendible. Explanations that are given to sick persons are frequently non satisfactory ; they are either discharged, or are still holding symptoms that they believe are non answered by the diagnosing given to them. Searching for an account, or merely to farther explain physicians ‘ accounts and readings, many stumble upon on-line forums. It can be seen as Kirmayer ( 2000 ) has shown, that the clinical state of affairs is based on the usage of medical linguistic communication, as parties, lupus sick persons and physicians, effort to convert the other of their unwellness. For many, this deficiency of certainty, populating with an unknown disease, or an undiagnosed unwellness led to different ways of research. Once on-line, and shoping through the forums on lupus, if they managed to happen them, many feel a sense of self-recognition. The narrations that are available online are unusually similar to their ain, and the experiences begin to do sense. As Kilshaw points out â€Å"this minute can be seen as what Dilthey has referred to as an ‘impression point ‘ , a freshly inspired reading of one ‘s life reflecting a cardinal displacement in personal meaning† ( Kilshaw 2004: 152 ) . Sufferers begin to see their unwellnesss as a medical issue, and no longer believe that it is a psychological upset ; they are armed with medical accounts to speak to their physicians about. This medicalization allows for a agency of assisting those enduring through the building of their ain personal narrations, which help to do sense out of what they are populating through. Forums can frequently take the signifier of a sick person naming off symptoms, to see if anyone else is sing the same issues. This can be seen many times over, and is illustrated by this user: I am enduring from widespread ahces/pains, some sever all chronic, utmost enfeebling weariness, encephalon fog attach toing address troubles, IBS, blood force per unit area runs on norm anyplace from 82/47-95/53, labs ever ‘off ‘ high sed, white cell up, ANA wonky, assorted peripheral neuropathes, eccentric toe/leg spasms, continueous chills/low basal organic structure temperature, fingers turn red/white sensitive and injury when cool, vision deteriorating, blurring†¦.This last, what I call ‘flare ‘ , I had sudden onset high febrility, pleurisy, little white blisters on my fingers that eventually peeled, I work 12hr displacements and on my off yearss I literally slept round the clock and did perfectly nil else†¦ nil, except preserve energy for my following tally at my job†¦.I ‘m sorry this has been so long. I do n't believe I ‘ve of all time sat down and set it on ‘paper ‘ before. I ‘m non certain I wrote it all dow n, ya ‘ll cognize how that goes. I likely missed some stuff..my dry eyes, see..I keep thought of small things. I do n't believe it ‘s hypochondria? There is a barter of symptoms and they discuss the results of these, and ways to document and maintain path of the symptoms. As Kilshaw demonstrates, it is â€Å"through duologue these individual events or experiences are linked together, held up and understood as pathological† ( 2004: 153 ) ; the belief is no longer based on a psychological disease, something that is merely in their caput. The illness narrative provides coherency and legitimacy to the experience of the sick persons, the corporate action online orders and provides significance for the sick persons experiences of pandemonium and falling apart. And at the same clip, the person is supplying support for the corporate, as it is an add-on to the narrative. Lupus is a known status, although it is a obscure 1 that is highly difficult to name, which can in instances add a different dimension to the on-line narration. Because the trials are non conclusive, and many of the trials are non able to name the disease straight off the chiropteran, the narrations that are posted in the online forums frequently provide construction and weight to the unwellness. There are infinite stations in the forums that reading the on-line lists of symptoms, and on-line narrations of other sick persons provided more legitimacy to their cause, the fact that so many other people are traveling through what they are allows them to believe that it is n't a instance of â€Å"faking it† . One adult female here relates her experience, including her symptoms, and societal jobs when combating with the disease: I ‘m a 42 twelvemonth old adult female merely looking for hints and for person to state me I ‘m non losing it. I may be manner off the grade here but I came across this site a piece ago while seeking the cyberspace in my effort to do sense of all my unwellnesss. Each clip I search yet another virus/pain/problem, the word lupus frequently appears. I go to my physicians normally to be told I ‘m run down, I ‘m down, my blood trials are by and large all right so nil to worry approximately. But this twelvemonth entirely I ‘ve had tonsillitis 4 times, 3 UTIs, thrush a just few times, otitis interna, a flu-like unwellness ( which I ‘m still retrieving from ) , a HPV flair up and on top of that I have, and have had for ages, invariably bombinating ears, painful articulatio genuss, little dry sore spots of tegument with a big spot of something bumpy, flakey and scabby on the dorsum of my caput ( yuk ) . I besides have a thrombocyte map upset which was disco vered because I bruise easy and had really heavy periods, I ended up holding a hysterectomy because nil else worked. If I go farther back than this twelvemonth I ‘ve besides had things such as herpes zosters, pleurisy, vermilion febrility ( ! ) , glandular febrility and a big assortment of viral unwellnesss with no name. I have ungratified leg syndrome and I quite regularly get truly bad shoulder hurting in my left shoulder that lasts for hebdomads and injuries to take a breath even. I do take antidepressants because I do acquire depression but certainly all of my unwellnesss ca n't be because I ‘m run down and depressed.I besides worry that my employers will finally lose forbearance with me. After reading people ‘s experiences on here I understand that what I ‘m enduring is n't half every bit bad as what others live with, nevertheless does any of this sound familiar? Is it possible that all of my unwellnesss could be related and due to a status such as lupus? I ‘m rather nervous of traveling to my physician and stating that I ‘ve seeking to self diagnose on the cyberspace because I know that ‘s non a good thing to make, but I merely want to cognize that I ‘m non a hypochondriac or that I ‘m non traveling mad. Adding to and imputing to the online Lupus narrative consequences in the single deriving an individuality and a community of people that they can associate to, it releases them from the isolation that is frequently felt when combating to acquire diagnosed. It provides a sense of coherence to the experience of pandemonium, through this duologue their single narrative becomes clearer to the sick person, it is legitimized. Although the disease is felt otherwise for each user, the narrations that are created online are consistent narrations, one that is able to integrate different necessities and experiences. Corporate sharing of information is one primary intent of a societal motion. These persons used to experience stray and entirely, they were confronting down the medical establishments that were built to assist ; they are now able to pull from the corporate online experience in order to assist them voyage these establishments.Contending for acknowledgmentPulling upon work done by Jos eph Dumit, Alan Young, and Susie Kilshaw, one can see how people are understanding, sing and utilizing their organic structures as opposition to the positivism of biomedicine. The squeeze of variable symptoms into unusually bantam bureaucratic holes requires run intoing the demands of 1s variableness into often-strict demands of the judgements of the experts. My current nurse practician scheduled me to see a nurse practician working at a Rheumatology office. My assignment included a history of symptoms, which at the clip were non that varied, but still included developing joint hurting, and even more increased weariness. I told her that I had a feeling it was Lupus, but I had no existent difficult grounds behind me except for one lab consequence, a bad memory of physicians assignment, and an internal inherent aptitude shouting the reply. The corporate sharing of personal narrations helped in the opposition of psychological incrimination and psychological responses. Because Lupus is such a enfeebling immunological upset, it is really hard to name ; this leads to psychological diagnosing ‘s, which can weaken the claim to the ill function, sick persons are invariably holding to work towards converting friends, household and coworkers that their unwellness is existent, legitimate and enfeebling. Bing able to carry through the ill function is of import to many people with Lupus, because there are frequently no codifications for their agony, no speedy diagnosing for their diseases, and no seeable complaints of the disease they are frequently subjected to judgements of forging and indolence. Trying to pull off and keep a ill function in society is near to impossible when 1 is being flatly denied being ill by the physicians that sick persons are seeing. There is a go throughing off of patients, from physician to sophis ticate as the Lupus sick person attempts to acquire diagnosing. Deriving entree to a diagnosing frequently gives the patient cogent evidence of agony, as psychological diagnosing weakens their claim to the ill function in society. One sick person relates the sum of physicians visited in their conflict for diagnosing: I saw my GP in June after several months of fatigue. By the clip I saw him a roseola had developed and I was holding shuddering febrilities at dark and had swollen secretory organs in my neck†¦.I was referred to a skin doctor who diagnosed urticarial vasculitis†¦.Since so I ‘ve been seeking different drug governments ; presently on loratidine, fexofenadine, Atarax and Zantac. After a class of steroids my tegument is great. I gave nevertheless developed hiting strivings at random topographic points, normally my custodies and pess, and intoxicant gives me febrility symptoms. My skin doctor has referred me to a rheumatologist and eye doctor ( my eyes on occasion show marks of uveitis ) . My GP has advised that in visible radiation of my symptoms and positive car antibodies ( DNA, Ro and La ) I about surely have SLE. One must account for unwellness under the biomedical system, and this requires go toing to both the ways in which the scientific facts are circulated and used, and the ways in which these same facts are used in societal experiences, how they are used, controlled, and subjugated. Dumit shows how through many doctor-patient interactions there is a comined consequence of discourse of disease to bring forth ‘symbolic domination ‘ ; patients see this â€Å"as a system in which they must ‘prove ‘ their unwellness and their agony through mobilising facts† ( 2005:577 ) . However, corporate wisdom of single experiences offers a powerful manner of opposition to this sort of power. When a physician can non call the unwellness after series of trials and scrutinies, many people come to believe of the patient as non truly being ill, and non truly enduring. This is a clear instance in Lupus, as it is both difficult to name, and has really few seeable symptoms. The hur ting that is felt is something that can non be seen, nevertheless it is frequently described as debilitating. And there are instances, that even if one does accomplish diagnosing of lupus through the physician, and therefore has legitimate entree to the ill function through that means, friends, household and colleagues for the sheer ground that it is non a seeable disease deny them entree. Following these denials, sick persons now have a tool chest that they can entree in the signifier of the online forums. There are set out letters that can be used to show the feelings and sentiments of Lupus sick persons, both a missive to household and friends that is vouched for, every bit good as a narrative called the Spoon Story. All these efforts at account and taking portion in the medical system is to accomplish some sense of proper function in society. The ill function has specific demands, and these demands are frequently capable to alter and use.Many sick persons have rejected their nor mal ego, as because they are inveterate sick, they have a immense desire to return to when they were healthy, being invariably denied the ill function in society has immense effects on their sense of individuality and ego. Many sick persons were busy persons, who held normal occupations, and have now become isolated from friends and household, many of whom doubt the unwellness. The undermentioned sick person relates to being ostracized by those who are close to her: Keeping it off paper saved me when I moved, changed occupations and needed to remake my insurance. Now I ‘m in a different part, different rheumy [ sic ] and my status has deteriorated†¦ Now a diagnosing on paper would be a good thing! ! ! The ground for my sudden urgency in acquiring a diagnosing is my occupation. My concern is that mine is more of a CNS type because of the troubles I have with words/speech. I have a hold sometimes in my thought procedure and more and more in acquiring the connexion between acquiring the words to/from the encephalon to the oral cavity. I ‘m non believing every bit rapidly as I need to. Part of my occupation is 911. I have to be able to think/speak or acquire a diagnosing explicating why I can non. Something that says it is merely an achings and strivings, can sit in my chair and still travel my oral cavity sort of unwellness is non gon na [ sic ] help the following shriek company I answer†¦.The worst thing is I feel so bad that I happening it difficult to acquire up to travel into work which is sad as I love my occupation. I was attracted to the sight because everyone seems so supportive and I could make with some of that right now because everyone keeps stating me I look so good now I have developed a roseola – antecedently my face was pale. Therefore on-line communicating has several of import factors. First, the treatment groups are mentioning the media all the clip, it is one manner in which sick persons are maintaining each other informed to what is go oning in the populace sphere with their status. News articles, telecasting visual aspects, and current research documents are frequently cited and posted. This can be used to both rise consciousness, promote instruction about the disease, and as a utile forum to make statements in response to those articles that are n't suiting with the positions of those posting online. Second, the forum provides a safe oasis where self-depiction can take topographic point. Many sick persons of lupus are non all that easy to prosecute with face to face. They are excessively fast or excessively slow, excessively tired, agitated, pained or undependable. The Internet, with its asynchronism and bandwidth mediates this enormously leting fluid ‘normal ‘ communicating to take top ographic point. Online postings are able to demo their feelings, and non hold the judgmental point of view of physicians, friends, and household ; depression is non merely something that is psychological to them, it is something that is from the unwellness that has attacked their really ability to execute in society. For many sick persons of this unwellness, a common subject of treatment on every bit good as off the cyberspace concerns how a sick person should near their physician, instructions are given on how to dress, how to move, what to convey, and what symptoms they should associate to the most. These instructions are frequently accompanied by what the physician might state in response, or what tests they so might order, and what tests a individual should be forcing for in the physicians office. The sick persons are taking control of the state of affairs, and pull stringsing physicians into diagnosing ; but it has besides been seen that although physicians are inquiring inquir ies and giving responses, they are inquiring inquiries that elicit a response that the physician believes is right ( Dumit 2006 ) . The use of the clinical brush can be seen as walking a thin line, as if one does non make the portion convincingly plenty, they can be accused once more of forging it, of moving ailment ; nevertheless if they do non, there is a opportunity that they might non be considered sick at all. Therefore â€Å"their lone pick is to feign to be who they really are, in the establishment ‘s position. They must work at ‘achieving appropriate visual aspect ‘ and ‘look and act sick'† ( Dumit 2006: 586 ) . Sick persons frequently experience Lupus, as a contested disease, in the signifier of societal exclusion. Since the disease is so difficult to name, there is frequently a deficiency of attention and support for those with it. They deal with this uncertainness by giving the unwellness facts that they see on-line, and they frame them in medical footings, in order to extinguish this uncertainness and societal exclusion. The attendant treatments form the footing of changeless experimentation with schemes, tactics, individualities and relationships. They besides form treatments on the expected alternate therapies, referrals, and supply a topographic point for emotional support. The Internet, with its asynchronism and bandwidth mediates issues of being sick enormously, it allows those that are sick to move normal, and allows for an easy signifier of communicating. The issues that are addressed and the resources provided to the sick persons online provide the footing for the webs of little groups, and larger cyberspace communities, and allows for covering with mass media, in order to do life more liveable for sick persons. The Internet provides a community and offers alternate personal narrations, and schemes for lasting, giving emotional support to those that are in demand.