History of Hospitals Essays

History of Hospitals Essays History of Hospitals Essay History of Hospitals Essay Hospitals originated in the 17th century primarily as an institution to provide housing and basic healthcare for the poor. It provided a haven to quarantine individuals to prevent the spread of highly contagious diseases. The technologies and vaccinations available did not allow for the comprehensive care we rely on today. Those who could afford clinical care would pay doctors and nurses to provide services in their home. In the early 19th century, as industrial cities became more populated, the demand for clinical and institutional care grew. Medical technology and scientific innovation made ambulatory healthcare available, yet there was not enough capital to support building large institutions viable to facilitate it. Religious organizations, philanthropists, and local governments built private and public institutions designed to deliver ambulatory, inpatient, and emergency care to local populations. By the beginning of the 20th century, hospitals became capable for research, development, and scientific discovery. Facilities became very large, housing and treating patients as well as facilitating medical research. Modern hospitals now provide clinical care to the most complex and critically ill patients while researching, innovating, and advancing medical technology. With increasing demand for treatment of chronic care, as well as the advancements in acute ambulatory care, modern hospitals have integrated vertically and horizontally to diversify their brand and provide an umbrella of accountability as an Integrated Delivery System. After World War II, managed care entered the marketplace. Insurance companies began to contract with hospital groups and Integrated Delivery Systems to provide comprehensive insurance and healthcare delivery, all centered around a hospital or group of hospitals. Hospitals have become a catalyst to the industry, providing the most intensive and critical care to the people who need it most. These institutions have provided a refuge for the sickest and poorest individuals in the community who would be left without care otherwise. Integrated Delivery Systems have been established, promoting corporate investment by mitigating risk, easing the burden on non-profit public hospitals funded by government entities and religious organizations. Vertical integration provides a wide range of delivery rather than one specialty, assuming greater risk leading to innovative relationships with patients and payers. Horizontal integration streamlines processes, provides greater economies of scale, and provides a solid foundation for larger delivery systems. Hospitals have been invaluable to the industry since the 17th century. However, the cost of hospital care has grown dramatically in the past 50 years, and the sources of revenue have shifted from private funding and health insurance to federal programs such as Medicare and Medicaid. Medicare accounts for nearly a third of all hospital expenditures, whose fee schedules and DRG payment model do not promote quality, preventative care. The decrease in the number of large hospitals over the past few decades has yielded to a growth in smaller, for-profit specialty hospitals which places a greater burden on community hospitals that provide costly emergency and complex care. The Hill-Burton Act of 1946 provided federal funding for hospitals in middle and lower class areas with caveats and regulations for how care was delivered. Hospitals that received funding were required to provide uncompensated care to those who could not afford it, placing a large burden of risk to the facility. The Public Service Health Act reinforced these regulations by broadening the scope of â€Å"inability to pay†, leading to an increase in lawsuits and administrative costs to the already large hospital budgets. Lean management with implementation in information technology are key to hospitals’ future success as a cornerstone to integrated delivery systems. In order for hospitals to be effective as we progress into the 21st century, a building structure should facilitate individual doctors in performing their various activities. But at the same time, it must not complicate the indispensable cooperation and communication between specialists and multidisciplinary diagnosis and treatment of patients. Structure must contribute to efficiency and transparency of processes involving different patient categories, but without fragmenting the work processes of doctors too much and decentralizing technology to an unmanageable scale (Geisler et al 158). References Geisler, Eliezer, Koos Krabbendam, and Roel Schuring. Technology, Health Care, and Management in the Hospital of the Future. Greenwood Publishing Group, 2003. 158. eBook. Williams, Stephen J. Introduction to Health Services. 7th ed. Clifton Park, NY: Thomson Delmar Learning, 2008. 183-97. Print.

Definition and Examples of Dissoi Logoi in Rhetoric

Definition and Examples of Dissoi Logoi in Rhetoric In classical rhetoric, dissoi logoi is the concept of opposing arguments, a cornerstone of Sophistic ideology and method. Also known as  antilogike. In ancient Greece, the dissoi logoi were rhetorical exercises intended for imitation by students. In our own time, we see dissoi logoi at work in the courtroom, where litigation is not about truth but rather the preponderance of evidence (James Dale Williams, An Introduction to Classical Rhetoric, 2009). The words dissoi logoi are from the Greek for double arguments.  Dissoi Logoi  is the title of an anonymous  sophistic  treatise thats generally thought to have been written about 400 BC. See Examples and Observations below. Also see: ArgumentationDebateDialecticElenchusMemoryPreparing an Argument: Explore Both Sides of an IssueSocratic DialogueSophism and SophistryStasis Examples and Observations The essential feature [of dissoi logoi], [G.B.] Kerferd writes, was not simply the occurrence of opposing arguments but the fact that both opposing arguments could be expressed by a single speaker, as it were within a single complex argument (The Sophistic Movement [1981], p. 84). Such an argumentative procedure could force any question into an Aporia by pointing out that each side was true within the terms that it had chosen to develop the argument. Both sides depended, ultimately, on language and its imperfect correspondence to the outside world, whatever one might think that world to be. A form of this analytical technique has recently been revived under the name of Deconstruction. Or, the parties could agree to accept one position as superior, even though it manifestly depended on human argument and not Divine Truth. It is from this accommodation to antithetical structure that Anglo-Saxon jurisprudence descends: we arrange social issues into diametrically opposed questions, arran ge a dramatic display of their conflict, and (since the law cannot afford aporia as a conclusion to social disputes) accept the jury-audiences verdict as a defining truth, a precedent for future disputation.(Richard Lanham, A Handlist of Rhetorical Terms, 2nd ed. University of California Press, 1991) In essence, dissoi logoi posits that one side (logos) of an argument defines the existence of the other, creating a rhetorical situation in which at least two logoi struggle for dominance. In contrast, Western cultures implicit assumption that argument is about truth or falsity urges one to assume that one side of the argument is true or more accurate and that other accounts are false or less accurate. Quite differently, Sophists acknowledge that one side of the argument might in a particular context represent the stronger logos and others the weaker, but this does not preclude a weaker logos from becoming the stronger in a different or future context. Sophism assumes that the stronger logos, no matter how strong, will never completely overcome competing logoi and earn the title of absolute truth. Ratherand this is the heart of dissoi logoiat least one other perspective is always available to serve as an other to the stronger argument.(Richard D. Johnson-Sheehan, Sophistic Rhetoric. Theorizing Composition: A Critical Sourcebook of Theory And Scholarship in Contemporary Composition Studies, ed. by Mary Lynch Kennedy. Greenwood, 1998) Dissoi LogoiThe Original Treatise Dissoi Logoi (twofold arguments) is the name, taken from its first two words, that has been given to a tract which is attached to the end of the manuscript of Sextus Empiricus. . . . It contains arguments which are capable of bearing opposed meanings, and it has sections dealing with Good and Bad, Decent and Disgraceful, Just and Unjust, True and False, together with a number of untitled sections. It has the look of a students lecture notes, but this appearance may be deceptive. The contents are what we might expect in Protagoras Antilogiai, but it is safer simply to designate them as sophistic.For example, to prove that Decent and Disgraceful are really the same, the following double argument is brought forward: for women to wash themselves in the home is decent, but women washing in the palaestra would be disgraceful [it would be all right for men]. Therefore, the same thing is both disgraceful and decent.(H. D. Rankin, Sophists, Socratics and Cynics. Barnes Noble Books, 1983) Dissoi Logoi  on Memory The greatest and fairest discovery has been found to be memory; it is useful for everything, for wisdom as well as for the conduct of life. This is the first step: if you focus your attention, your mind, making progress by this means, will perceive more. The second step is to practice whatever you hear. If you hear the same things many times and repeat them, what you have learned presents itself to your memory as a connected whole. The third step is: whenever you hear something, connect it with what you know already. For instance, suppose you need to remember the name Chrysippos, you must connect it with chrusos (gold) and hippos (horse).(Dissoi Logoi, trans. by Rosamund Kent Sprague. Mind, April 1968)

Process and Tracking Control Research Paper Example | Topics and Well Written Essays - 1000 words

Process and Tracking Control - Research Paper Example However the evaluation of the internal controls involves mostly those that are related to information systems and entity as well as its environment (Singleton, Singleton & Bologna, 2006). It is normally operated by an IT auditor who understands COSO model and is able to apply it in financial auditing during the evaluation of internal controls. Elements of the COSO Model Control environment. It is a view of the internal controls from the perspective of the entity including the environment created for processes of business and controls internally and influences of this environment on whether it is able to maintain an effective internal control system. Ways in which control environment is evaluated with regard to risks associated with it include enforcement and communication of ethical values and integrity, commitment to competence, participation of people who are charged with governance, management’s style philosophy and assignment of authority and responsibility (Singleton, Sin gleton & Bologna, 2006). Risk assessment: It refers to the ability of an entity to asses risks properly and, for those risks that are major, mitigates them up to a level that is acceptable through the use of controls. Risks may be introduced through various ways including changing of the operating environment, new information systems, and employment of a modern information systems, rapid growth and pronouncement of new accounting. Information and communication: It involves communicating information on financial reporting accurately and in a timely manner to decision makers and managers. The various ways in which it can be evaluated in regard to the associated risks include systems that support identification, then capture then exchange information in a manner and time frame that will allow personnel to undertake their responsibilities, financial reporting information, internal communication, internal control information and external communication (Singleton, Singleton & Bologna, 200 6). Control activities: These refer to actual controls themselves. The evaluation of these control activities involves various ways including general controls, application controls and physical controls. Controls are evaluated at three levels which include: design effectiveness, operational effectiveness and implementation (Singleton, Singleton & Bologna, 2006). Monitoring: It refers to the ability of an entity to effectively monitor the controls since they operate on a daily basis, individually and also cooperate with other controls. Various ways in which monitored control effectiveness are evaluated include separate and ongoing evaluations concerning internal controls over financial reporting, deficiencies that are identified and reported, assessment of the quality of internal controls performance over a given period of time, putting procedures in place so as to adjust the control system as required and utilizing relevant information that is external or independent monitors (Singl eton, Singleton & Bologna, 2006). Control Objectives for Information and related Technology (COBIT) It was first issued by the IT Governance Institute, ITGI and Information systems Audit and Control Association, ISACA in the year 1998. It is regarded as de facto standard in IT Governance maturity assessment. A lot of knowledge is needed on this framework and therefore it makes it

The Islamic Conquests Essay Example | Topics and Well Written Essays - 1000 words

The Islamic Conquests - Essay Example In Empire to Commonwealth (12-19), historian Garth Fowden has delineated three separate geographical, cultural, and political spheres in Eurasia: China, India, and the Near East (the Fertile Crescent and the adjacent Mediterranean coast). These areas were all ancient centers of civilization and because of the distances and geographical barriers involved, had little interaction with each other. This is why China, India, and the Near East/Mediterranean can be thought of as continuous discrete civilizations even though throughout much of their history they lacked the political unity to provide full national identity. Although Islam eventually spread to all three areas, it origin and center lay in the Near East and it was only there that it became fully dominant. The Near East is unique among the three in having close interaction with a wide variety of surrounding areas. The Fertile Crescent is "a vortex that pulls inward and fuses what lies around it. So not only can the Fertile Crescent never enjoy long-term autonomy, but its unity can only be realized on a secure bases as part of a wider unification of the Iranian Plateau with the Mediterranean" (Fowden, 18). This unity was only achieved twice, in the first instance by the Achaemenid Empire (Alexander's fleeting unification of an even larger territory was based on Achaemenid Iran) in the sixth to fourth centuries BC, and in the seventh century by the Umayyad Caliphate. The initial Arab conquests unified the entire Fertile Crescent region with Iran for the first time in centuries, providing a secure economic, political, and geographical base fo r further conquests, for instance by allowing the Islamic state to compete on an even footing with the Byzantine navy (Fowden, 140). It may well be that the impetus to sustain large scale conquests into the eighth century came from the Islamic practice of providing for the army from the income of conquered lands collectively, rather than distributing the lands. This tended to keep the army in being (Karsh, 24). How did the initial Arab conquest succeed so well The Arabs' opponents in the area, the Byzantine and Sassanian Empires, were exhausted after a generation of fruitless war with each other over the Fertile Crescent and were in internal states of near collapse. In Iran, ultimately the loosing party in this conflict, on which the pressure was increased by Turkish invasions from the north (Christian, 260-285), the aftermath of defeat had led to assassination, civil war, and by 633 a state of anarchy in the empire (Nafziger and Walton, 18). Rome was also riven with internal dissensions (see below). So, to a large degree from a military perspective, the rapid Arab conquest of the Iranian state and of nearly half the territory of the Byzantine state, is to be attributed to the internal weakness of the defeated Empires rather to any special qualities of Islam. Other possible purely military factors to explain the Islamic conquests have been proposed, though with less plausibility. In Islam at War, Nafziger and Walton suggest a 'great man' solution to the problem of the Arab conquest, arguing that Khalid ibn al Waleed was "one of the great [sic] natural military leaders in all of human history" (16-17). But this hardly seems plausible. However remarkable Khalid's successes were on an operation level, and as astounding as his victories were, the were (as above) due more to the

Frankenstein Essay -- Literary Analysis, Mary Shelley

Organic: A Very Lucid Concept Will it ever be possible for a machine to be an organic being? It is an interesting question and one that is addressed in Frankstein by Merry Shelly, RUR by Karel Capek and The Defecating Duck by Jessica Riskin. These three texts provide insight into what makes a creature an organic being. From these readings one may construe that the duck in The Defecating Duck, along with the robots at the beginning of RUR cannot be considered organic beings, while the monster in Frankstein and the robots at the end of RUR can. An organic robot is an oxymoron; a robot does not have the chemical capability to be considered biologically organic. Although a chemical process was alluded to in both it Frankstein and RUR, it was very brief, a short paragraph in each case, and did not give enough information to be able to classify either as an organic being. However, there is a definition of organic that can be applied to prove that robots have the capability to be organic,â€Å"[10th definition of organic] something as having a growth and development analogous to that of living organisms† (Merriam Webster Dictionary). In other words, to be considered organic one must have the ability and desire to live. To long for a companion shows that one has a desire to connect with someone in their life, and therefore proves that person has a longing to be apart of the world. The monster in Frankstein has a desire to find a person he can connect with, and ends up going on a journey to find one. This journey begins with the monster observing and eventually falling in love with a farm family. â€Å"I formed in my imagination pictures of presenting myself to them†¦I imagined that they would be disgusted, until, by my gentle demeanor and con... ...ple. They are mechanically more perfect than we are†¦ but they have no soul† (Capek, 9). This quote by Domin explains to Helena how robots are not human but just workers. Domin further expresses this point by saying that. â€Å"Everything will be done by living machines. People will do only what they enjoy† (Capek, 21). These robots, for the time being, are complicit with their place and show no desire to live. The robots, and duck fail to show a desire to live and therefore cannot be considered organic beings. The robots from the end of RUR and the monster in Frankstein, unlike the robots at the beginning of RUR and the duck in the Defecating Duck, can be called organic beings because of their desire to live. These three texts brought up interesting points to a confounding question of organic robots. Making one believe that only time will be able to solve this riddle.

Night World : Dark Angel Chapter 4

He went on driving. He didn't even pause. â€Å"We're almost home.† They were nearing the turn ontoMeadowcroft Road . Gillian tried to grab for one of the brown hands on the steering wheel, and then looked at her own hand, perplexed. Her fingers felt like blocks of wood. â€Å"You have to stop,† she said, settling for volume. â€Å"There's a kid lost in those woods. That's why I went in; I heard this sound like crying. It was coming from somewhere right near the creek. We've got to go back there. Come on, stop!† â€Å"Hey, hey, calm down,† he said. â€Å"You know what I bet you heard? A long-eared owl. They roost around here, and they make this noise like a moan, oo-oo-oo.† Gillian didn't think so. â€Å"I was walking home from school. It wasn't dark enough for an owl to be out.† â€Å"Okay, a mourning dove. Goes oh-ah, whoo, whoo. Or a cat; they can sound like kids sometimes. Look,† he added almost savagely, as she opened her mouth again, â€Å"when we get you home, we can call the Houghton police, and they can check things out. But I am not letting a lit-a girl freeze just because she's got more guts than smarts.† For a moment, Gillian had an intense longing to let him continue to believe she had either guts or smarts. But she said, â€Å"It's not that. It's just- I've already been through so much to try to find that kid. I almost died-I think I did die. I mean- well, I didn't die, but I got pretty cold, and-and things happened, and I realized how important life is†¦Ã¢â‚¬  She floundered to a shivering stop. What was she saying? Now he was going to think she was a nut case. And anyway all that stuff must have been a dream. She couldn't make it seem real while sitting in a Mustang with her head wrapped in a towel. But David flashed her a glance of startled recognition. â€Å"You almost died?† He looked back at the road, turning the car ontoHazel Street , where they both lived. â€Å"That happened to me once. When I was little, I had to have this operation-â€Å" He broke off as the Mustang skidded on some ice. In a moment he was in control again and turning into Gillian's driveway. It happened to you, too? David parked and was out of the car before Gillian could gather herself to speak. Then he was opening her door, reaching for her. â€Å"Gotta get all this ridiculous stuff out of the way,† he said, pushing her hair back as if it were a curtain of cobwebs. Something about the way he said it made Gillian think he liked her hair. She peered up at him through a gap in the curtain. His eyes were dark brown and normally looked almost hawkish, but just now, as their gazes met, they changed. They looked startled and wondering. As if he saw something in her eyes that surprised him and struck a chord. Gillian felt a flutter of wonder herself. I don't think he's really tough at all, she thought, as something like a spark seemed to flash between them. He's not so different from me; he's- She was wracked by a sudden bout of shivers. David blinked and shook his head. â€Å"We've got to get you inside,† he muttered. And then, still shivering, she was in the air. Bobbing, being carried up the path to her house. â€Å"You shouldn't be walking to school in the winter,† David said. â€Å"I'll drive you from now on.† Gillian was struck speechless. On the one hand, she should probably tell him she didn't walk every day. On the other hand, who was she kidding? Just the thought of him giving her a ride was enough to make her heart beat wildly. Between that and the novel feeling of being carried, it wasn't until he was opening the front door that Gillian remembered her mother. Then she panicked. Oh, God, I can't let David see her-but maybe it'll be all right. If there was a smell of food cooking, that meant it was okay. If not, it was one of Mom's bad days. There was no smell of food as David stepped into the dim hallway. And no sign of life-all the downstairs lights were off. The house was cold and echoing and Gillian knew she had to get David out. But how? He was carrying her farther in, asking, â€Å"Your parents aren't home?† â€Å"I guess not. Dad doesn't get home until seven most nights.† It wasn't exactly a lie. Gillian just prayed her mom would stay put in the bedroom until David left. â€Å"I'll be okay now,† she said hastily, not even caring if she sounded rude or ungrateful. Anything to make him go. â€Å"I can take care of myself, and- and I'm okay.† â€Å"The he †¦ eck you are,† David said. It was the longest drawn out ‘heck' Gillian had ever heard. He doesn't want to swear around me. That's cute. â€Å"You need to get thawed out, fast. Where's a bathtub?† Gillian automatically lifted a stiff arm to point down the side hall, then dropped it. â€Å"Now, wait a minute-â€Å" He was already there. He put her on her feet, then disappeared into the bathroom to turn on the water. Gillian cast an anguished glance upstairs. Just stay put, Mom. Stay asleep. â€Å"You've got to get in there and stay for at least twenty minutes,† David said, reappearing. â€Å"Then we can see if you need to go to the hospital at Houghton.† That made Gillian remember something. â€Å"The police-â€Å" â€Å"Yeah, right, I'll call them. As soon as you're in the tub.† He reached out and plucked at her dripping, ice-crusted sweater. â€Å"Can you get this off okay? Do your fingers work?† â€Å"Urn†¦Ã¢â‚¬  Her fingers didn't work; they were still blocks of wood. Frost-nipped at least, she thought, peering at them. But there was no way he was going to undress her, and there was also no way she was going to call her mother. â€Å"Urn†¦Ã¢â‚¬  â€Å"Uh, turn around,† David said. He pulled at her sweater again. â€Å"Okay, I've got my eyes shut. Now-â€Å" â€Å"No,† Gillian said, holding her elbows firmly against her sides. They stood, confused and indecisive, until they were saved by an interruption, a voice from the main hallway. â€Å"What are you doing to her?† the voice said. Gillian turned and looked around David. It was Tanya Jun, David's girlfriend. Tanya was wearing a velveteen cap perched on her glossy dark hair and a Christmas sweater with metallic threads woven in. She had almond-shaped gray eyes and a mouth with firm lips molded over white teeth. Gillian always thought of her as a future corporate executive. â€Å"I saw your car out there,† the future executive said to David, â€Å"and the front door of the house was open.† She looked level-headed, suspicious, and a little bit as if she doubted David's sanity. David looked back and forth between her and Gillian and fumbled for an explanation. â€Å"There's nothing going on. I picked her up onHillcrest Road . She was-well, look at her. She fell in the creek and she's frozen.† â€Å"I see,† Tanya said, still calmly. She gave Gillian a quick assessing glance, then turned back to David. â€Å"She doesn't look too bad. You go to the kitchen and make some hot chocolate. Or hot water with Jell-O in it, something with sugar. I'll take care of her.† â€Å"And the police,† Gillian called after David's disappearing back. She didn't exactly want to look Tanya in the face. Tanya was a senior like David, in the class ahead of Gillian atRachelCarsonHigh School . Gillian feared her, admired her, and hated her, in about that order. â€Å"Into the bathroom,† Tanya said. Once Gillian was in, she helped her undress, stripping off the clinging, icy-wet clothes and dropping them in the sink. Everything she did was brisk and efficient, and Gillian could almost see sparks fly from her fingers. Gillian was too miserable to protest at being stripped naked by somebody with the bedside manner of a female prison guard or an extremely strict nanny. She huddled, feeling small and shivering in her bare skin, and then lunged for the tub as soon as Tanya was done. The water felt scalding. Gillian could feel her eyes get huge and she clenched her teeth on a yell. It probably felt so hot because she was so cold. Breathing through her nose, she forced herself to submerge to the shoulders. â€Å"All right,† Tanya said on the other side of the coral-colored shower curtain. â€Å"I'll go up and get you some dry clothes to put on.† â€Å"No!† Gillian said, shooting half out of the water. Not upstairs, not where her mom was, not where her room was. But the bathroom door was already shutting with a decisive dick. Tanya wasn't the kind of person you said no to. Gillian sat, immobilized by panic and horror, until a fountain of burning pain drove everything else out of her mind. It started in her fingers and toes and shot upward, a white-hot searing that meant her frozen flesh was coming back to life. All she could do was sit rigid, breathe raggedly through her nose, and try to endure it. And eventually, it did get better. Her white, wrinkled skin turned dark blue, and then mottled, and then red. The searing subsided to a tingling. Gillian could move and think again. She could hear, too. There were voices outside the bathroom in the hallway. The door didn't even muffle them. Tanya's voice: â€Å"Here, I'll hold it. I'll take it to her in a minute.† In a mutter: â€Å"I'm not sure she can drink and float at the same time.† David's voice: â€Å"Come on, give her a break. She's just a kid.† â€Å"Oh, really? Just how old do you think she is?† â€Å"Huh? I don't know. Maybe thirteen?† An explosive snort from Tanya. â€Å"Fourteen? Twelve?† â€Å"David, she goes to our school. She's a junior.† â€Å"Really?† David sounded startled and bewildered. â€Å"Nah, I think she goes to P.B.† Pearl S. Buck was the junior high. Gillian sat staring at the bathtub faucet without seeing it. â€Å"She's in our biology class,† Tanya's voice said, edging toward open impatience. â€Å"She sits at the back and never opens her mouth.† The voice added, â€Å"I can see why you thought she was younger, though. Her bedroom's knee-deep in stuffed animals. And the wallpaper's little flowers. And look at these pajamas. Little bears.† Gillian's insides felt hotter than her fingers had been at their most painful. Tanya had seen her room, which was the same as it had been since Gillian was ten years old, because there wasn't money for new curtains and wallpaper and there wasn't any more storage space in the garage to put her beloved animals away. Tanya was making fun of her pajamas. In front of David. And David†¦ thought she was a little kid. That was why he'd offered to drive her to school. He'd meant the junior high. He'd been nice because he felt sorry for her. Two tears squeezed out of Gillian's eyes. She was trembling inside, boiling with anger and hurt and humiliation†¦ Crinch. It was a sound as loud as a rifle report, but high and crystalline-and drawn out. Something between a crash and a crunch and the sound of glass splintering under boots. Gillian jumped as if she'd been shot, sat frozen a moment, then pulled the moisture-beaded shower curtain aside and poked her head out. At the same instant the bathroom door flew open. â€Å"What was that?† Tanya said sharply. Gillian shook her head. She wanted to say, â€Å"You tell me,† but she was too frightened of Tanya. Tanya looked around the bathroom, spied the steamed-up mirror, and frowned. She reached across the sink to wipe it with her hand-and yelped. â€Å"Ow!† She cursed, staring at her hand. Gillian could see the brightness of blood. â€Å"What the-?† Tanya picked up a washcloth and swiped the mirror. She did it again. She stepped back and stared. From the tub, Gillian was staring, too. The mirror was broken. Or, not broken, cracked. But it wasn't cracked as if something had hit it. There was no point of impact, with lines of shattering running out. Instead, it was cracked evenly from top to bottom, side to side. Every inch was covered with a lattice of fine lines. It almost looked purposeful, as if it were a frosted-glass design. â€Å"David! Get in here!† Tanya said, ignoring Gillian. After a moment the door stirred and Gillian had a steamy distorted glimpse of David's face in the mirror. â€Å"Do you see this? How can something like this happen?† Tanya was saying. David grimaced and shrugged. â€Å"Heat? Cold? I don't know.† He glanced hesitantly in Gillian's direction, just long enough to locate her face surrounded by the coral shower curtain. â€Å"You okay?† he said, addressing himself to a white towel rack on the far wall. Gillian couldn't say anything. Her throat was too tight and tears were welling up again. But when Tanya looked at her, she nodded. â€Å"All right, forget it. Let's get you changed.† Tanya turned away from the mirror. David melted back out of the bathroom. â€Å"Make sure her fingers and everything are working all right,† he said distantly. â€Å"I'm fine,† Gillian said when she was alone with Tanya. â€Å"Everything's fine.† She wiggled her fingers, which were tender but functioning. All she cared about right now was getting Tanya to go away. â€Å"I can dress myself.† Please don't let me cry in front of her. She retreated behind the shower curtain again and made a splashing noise. â€Å"You guys can leave now.† Half a sigh from Tanya, who was undoubtedly thinking Gillian was ungrateful. â€Å"All right,† she said. â€Å"Your clothes and your chocolate are right here. Is there somebody you want me to call-?† â€Å"No! My parents-my dad will be here any minute. I'm fine.† Then she shut her eyes and counted, breath held. And, blessedly, there were the sounds of Tanya moving away. Both Tanya and David calling goodbyes. Then silence. Stiffly, Gillian pulled herself upright, almost falling down when she tried to step out of the bathtub. She put on her pajamas and walked slowly out of the bathroom, moving like an old woman. She didn't even glance at the broken mirror. She tried to be quiet going up the stairs. But just as she reached her bedroom, the door at the end of the upstairs hall swung open. Her mother was standing there, a long coat wrapped around her, fuzzy fleece-lined slippers on her feet. Her hair, a darker blond than Gillian's, was uncombed. â€Å"What's going on? I heard noise. Where's your father?† Not â€Å"Whass goin' on? Whersh your father?† But dose. â€Å"It's not even seven yet, Mom. I got wet coming home. I'm going to bed.† The bare minimum of sentences to communicate the necessary information. Her mother frowned. â€Å"Honey-â€Å" † ‘Night, Mom.† Gillian hurried into her bedroom before her mother could ask any more questions. She fell on her bed and gathered an armful of stuffed animals in the bend of her elbow. They were solid and friendly and filled her arm. Gillian curled herself around them and bit down on plush. And now, at last, she could cry. All the hurts of her mind and body merged and she sobbed out loud, wet cheek on the velveteen head of her best bear. She wished she'd never come back. She wanted the bright meadow with the impossibly green grass, even if it had been a dream. She wanted everyone to be sorry because she was dead. All her realizations about life being important were nonsense. Life was a giant hoax. She couldn't change herself and live in a completely new direction. There was no new start. No hope. And I don't care, she thought. I just want to die. Oh, why did I get made if it was just for this? There's got to be someplace I belong, something I'm meant to do that's different. Because I don't fit in this world, in this life. And if there isn't something more, I'd rather be dead. I want to dream something else. She cried until she was numb and exhausted and fell into a deadly still sleep without knowing it. When she woke up hours later, there was a strange light in her room.

Nutrition and Weight Loss Essay - 2238 Words

University of Phoenix Material Nutrition and Health Worksheet Use Ch. 1 of Contemporary Nutrition, Ch. 2 of Visualizing Nutrition, supplemental course materials, the University Library, the Internet, or other resources to answer the following questions. Your response to each question should be 75 to 100 words. 1. What is nutrition? Why is nutrition essential to our daily lives? | Wardlaw, Smith (2011) states that Nutrition involves a combination of food intake, in which the body uses food and substances to growth, repair, and maintain a healthy body. A healthy nutritional diet is a personal lifestyle choice. The body ingests, and absorbs various foods that help to create a healthy digestive system. Nutrition is the†¦show more content†¦Being under nourished can seriously cause irreversible damage to the body, and comprise the body immune system. Over nutrition means the body has consumed too much food, as well as vitamins and minerals over a period of time. This is why proportion size and eating in moderation is very important because the body can become over nourished to the point where it becomes unhealthy and possibly lead to death. Mainly consuming an excess amount of carbohydrates and fats contribute to the body being over nourished and this can become a dange r to a person’s health. Thus, causing a person to be obese, and being obese is a psychological disorder that causes a person to over eat and become extremely unhealthy. | 7. Why is physical activity important as it relates to nutrition and health? | Being physically active and maintaining a healthy diet works together in having good health. When the body is physically active it speeds up the metabolism and therefore burns calories. Also when the body is physically active an individual will have more energy and in return have the desire to eat less. 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