An Occurrence at Owl Creek Bridge

An Occurrence at Owl Creek Bridge Introduction ‘An Occurrence at Owl Creek’ is set in the American Civil War and tells of the execution of Peyton Farquhar, a civilian confederate sympathizer (Sparknotes.com, 2007). The story throws us to different times: the ‘present’ moment of the execution, the past that led to the execution and most notably, to an ‘imagined present’ (Sparknotes.com, 2007).Advertising We will write a custom essay sample on An Occurrence at Owl Creek Bridge specifically for you for only $16.05 $11/page Learn More But there’s is no clear distinction between the reality and the imagination if each is to be judged on its own right. Just as the real world has people who can be hungry and tired and in need, so is the world that Farquhar imagines. It is this playing around with time, this irregular time sequence that makes this story famous. From a psychoanalytic point of view, it is quite evident how Bierce’s own life is an in fluence to this story. Besides having himself been a soldier, Bierce was an outspoken opponent of realism, which insisted on reflecting life as it is, ‘without any subjection whatsoever to creativity of the mind (Sparknotes.com, 2007). Analysis The story is a reflection of some of the issues that Bierce seemed to have been interest in. These include: Reality versus Illusion: Bierce seemed to be of the thought that the line between reality and illusion is not a very obvious one; that these two work side by side (Sparknotes.com, 2007). Bierce, to an extent, manages to bring the audience with him into this thought. The final section, Peyton’s escape to his family, is quite believable in its own right. Of course, there’s a possibility of the reader being confused. Here’s why. The final sentence in section I is â€Å"The sergeant stepped aside† (Sparknotes.com, 2007), at this point, we expect that Farquhar is plunging to his death. Now in section III he is ‘really’ escaping to his family; the reader is caught between a fact, as told by the storyteller, and the reality of Farquhar’s escape as created by words.Advertising Looking for essay on american literature? Let's see if we can help you! Get your first paper with 15% OFF Learn More The confusion created by a conscious/subconscious awareness that Farquhar is plunging to his death visvis his escape, or the acceptance that he is actually escaping, are a reflection of Bierce’ success at making us see that, in spite of the gap between them, the difference between reality and illusion, what it takes to move from one to another, is not so obvious. Bierce also explores the aspect of liquidity of time (Sparknotes.com, 2007). The story moves from the present to the past and finally to the imagined. This structure reflects how fluid time is, as well as the conflict between its competing variants. Section II interrupts the continuing proces s of Farquhar at the edge, starting to plunge down to his death (Sparknotes.com, 2007). In section III, Peyton has gone into a completely timeless realm, free from the hands of time as counted down by the actual second-hand of a clock. Farquhar manages to do in his mind/imagination what can’t be done in the actual world within the seconds it takes him to go over the edge and the rope breaking his neck. In the end, Bierce’s seems to say that time is subjective, that it can be manipulated to suit need, as does Farquhar. Bierce’s story was seen as a breach of the traditional rules of narration, especially the ending of the story. Bierce’s conclusion is not really of the expected form as it questions the nature of resolving a story (Sparknotes.com, 2007). The conclusion here becomes a distortion of the reality as it is known; Farquhar, in a sense, manages to ‘outlive’ his execution because though his life ends in the first section, his story stil l extends. Bierce’s unique plotting sees conflicting versions of truth live side by side inside the same story (Sparknotes.com, 2007). In spite of this, Bierce still does his story within the conventions of literature: the story starts, develops and ends; he employs tropes such as motifs and symbols, as well as features of drama such as realism, foreshadowing and tone (Sparknotes.com, 2007). Realism involves making an imaginary world as believable as possible. For authenticity, Bierce gives a vivid and believable description of the setting at the bridge where Farquhar is to be executed: from the time to the position of planks and rope; from the positioning of the soldiers and their guns to their conduct at the ritual of execution (Sparknotes.com, 2007).Advertising We will write a custom essay sample on An Occurrence at Owl Creek Bridge specifically for you for only $16.05 $11/page Learn More Again, although the revelation at the end of Farquharâ€⠄¢s imagination is unexpected and shocking, Bierce, by talking of how things ‘seem’ to Farquhar as opposed to what is actually happening is a foreshadowing (helped by the change of tone) of the actual death of Farquhar. Conclusion Finally, it is quite notable the way that Bierce uses imagination to get into Farquhar’s head. Here is a dying man who does not speak his mind, he only imagines it. Yet Bierce takes the â€Å"seat of God†; that he’s able to get into Farquhar’s head (Sparknotes.com, 2007). In the end it is this fruit of imagination that brings all that makes this story different and remarkable, both in the arena of literary works, as well as for the reader. Reference Sparknotes.com. (2007). An Occurrence at Owl Creek Bridge. Web.

Helen Keller, Deaf and Blind Spokesperson and Activist

Helen Keller, Deaf and Blind Spokesperson and Activist Helen Adams Keller (June 27, 1880–June 1, 1968) was a groundbreaking exemplar and advocate for the blind and deaf communities. Blind and deaf from a nearly fatal illness at 19 months old, Helen Keller made a dramatic breakthrough at the age of 6 when she learned to communicate with the help of her teacher, Annie Sullivan. Keller went on to live an illustrious public life, inspiring people with disabilities and fundraising, giving speeches, and writing as a humanitarian activist. Fast Facts: Helen Keller Known For:  Blind and deaf from infancy, Helen Keller is known for her emergence from isolation, with the help of her teacher Annie Sullivan, and for a career of public service and humanitarian activism.Born:  June 27, 1880 in Tuscumbia, AlabamaParents: Captain Arthur Keller and Kate Adams KellerDied:  June 1, 1968 in Easton ConnecticutEducation: Home tutoring with Annie Sullivan, Perkins Institute for the Blind, Wright-Humason School for the Deaf, studies with Sarah Fuller  at the  Horace Mann School for the Deaf, The Cambridge School for Young Ladies, Radcliffe College  of  Harvard UniversityPublished Works: The Story of My Life,  The World I Live In,  Out of the Dark, My Religion,  Light in My Darkness, Midstream: My Later LifeAwards and Honors:  Theodore Roosevelt  Distinguished Service Medal in 1936, Presidential Medal of Freedom in 1964, election to the Womens Hall of Fame in 1965, an honorary Academy Award in 1955 (as the inspiration for the documentary about her life), countless honorary degreesNotable Quote: The best and most beautiful things in the world cannot be seen, nor touched ... but are felt in the heart. Early Childhood Helen Keller was born on June 27, 1880, in Tuscumbia, Alabama to Captain Arthur Keller and Kate Adams Keller. Captain Keller was a cotton farmer and newspaper editor and had served in the Confederate Army during the Civil War. Kate Keller, 20 years his junior, had been born in the South, but had roots in Massachusetts and was related to founding father John Adams. Helen was a healthy child until she became seriously ill at 19 months. Stricken with an illness that her doctor called brain fever, Helen was not expected to survive. The crisis was over after several days, to the great relief of the Kellers. However, they soon learned that Helen had not emerged from the illness unscathed. She was left blind and deaf. Historians believe that Helen had contracted either scarlet fever or meningitis. The Wild Childhood Years Frustrated by her inability to express herself, Helen Keller frequently threw tantrums that included breaking dishes and even slapping and biting family members. When Helen, at age 6, tipped over the cradle holding her baby sister, Helens parents knew something had to be done. Well-meaning friends suggested that she be institutionalized, but Helens mother resisted that notion. Soon after the incident with the cradle, Kate Keller read a book by Charles Dickens about the education of Laura Bridgman. Laura was a deaf-blind girl who had been taught to communicate by the director of the Perkins Institute for the Blind in Boston. For the first time, the Kellers felt hopeful that Helen could be helped as well. The Guidance of Alexander Graham Bell During a visit to a Baltimore eye doctor in 1886, the Kellers received the same verdict they had heard before. Nothing could be done to restore Helens eyesight. The doctor, however, advised the Kellers that Helen might benefit from a visit with the famous inventor Alexander Graham Bell in Washington, D.C. Bells mother and wife were deaf and he had devoted himself to improving life for the deaf, inventing several assistive devices for them. Bell and Helen Keller got along very well and would later develop a lifelong friendship. Bell suggested that the Kellers write to the director of the Perkins Institute for the Blind, where Laura Bridgman, now an adult, still resided. The director wrote the Kellers back, with the name of a teacher for Helen: Annie Sullivan. Annie Sullivan Arrives Helen Kellers new teacher had also lived through difficult times. Annie Sullivan had lost her mother to tuberculosis when she was 8. Unable to care for his children, her father sent Annie and her younger brother Jimmie to live in the poorhouse in 1876. They shared quarters with criminals, prostitutes, and the mentally ill. Young Jimmie died of a weak hip ailment only three months after their arrival, leaving Annie grief-stricken. Adding to her misery, Annie was gradually losing her vision to trachoma, an eye disease. Although not completely blind, Annie had very poor vision and would be plagued with eye problems for the rest of her life. When she was 14, Annie begged visiting officials to send her to school. She was lucky, for they agreed to take her out of the poorhouse and send her to the Perkins Institute. Annie had a lot of catching up to do. She learned to read and write, then later learned braille and the manual alphabet (a system of hand signs used by the deaf). After graduating first in her class, Annie was given the job that would determine the course of her life: teacher to Helen Keller. Without any formal training to teach a deaf-blind child, 20-year-old Annie Sullivan arrived at the Keller home on March 3, 1887. It was a day that Helen Keller later referred to as my souls birthday. A Battle of Wills Teacher and pupil were both very strong-willed and frequently clashed. One of the first of these battles revolved around Helens behavior at the dinner table, where she roamed freely and grabbed food from the plates of others. Dismissing the family from the room, Annie locked herself in with Helen. Hours of struggle ensued, during which Annie insisted Helen eat with a spoon and sit in her chair. In order to distance Helen from her parents, who gave in to her every demand, Annie proposed that she and Helen move out of the house temporarily. They spent about two weeks in the annex, a small house on the Keller property. Annie knew that if she could teach Helen self-control, Helen would be more receptive to learning. Helen fought Annie on every front, from getting dressed and eating to going to bed at night. Eventually, Helen resigned herself to the situation, becoming calmer and more cooperative. Now the teaching could begin. Annie constantly spelled words into Helens hand, using the manual alphabet to name the items she handed to Helen. Helen seemed intrigued but did not yet realize that what they were doing was more than a game. Helen Kellers Breakthrough On the morning of April 5, 1887, Annie Sullivan and Helen Keller were outside at the water pump, filling a mug with water. Annie pumped the water over Helens hand while repeatedly spelling â€Å"w-a-t-e-r† into her hand. Helen suddenly dropped the mug. As Annie later described it, a new light came into her face. She understood. All the way back to the house, Helen touched objects and Annie spelled their names into her hand. Before the day was over, Helen had learned 30 new words. It was just the beginning of a very long process, but a door had been opened for Helen. Annie also taught her how to write and how to read braille. By the end of that summer, Helen had learned more than 600 words.   Annie Sullivan sent regular reports on Helen Kellers progress to the director of the Perkins Institute. On a visit to the Perkins Institute in 1888, Helen met other blind children for the first time. She returned to Perkins the following year and stayed for several months of study. High School Years Helen Keller dreamed of attending college and was determined to get into Radcliffe, a womens university in Cambridge, Massachusetts. However, she would first need to complete high school. Helen attended a high school for the deaf in New York City, then later transferred to a school in Cambridge. She had her tuition and living expenses paid for by wealthy benefactors. Keeping up with school work challenged both Helen and Annie. Copies of books in braille were rarely available, requiring that Annie read the books, then spell them into Helens hand. Helen would then type out notes using her braille typewriter. It was a grueling process. Helen withdrew from the school after two years, completing her studies with a private tutor. She gained admission to Radcliffe in 1900, making her the first deaf-blind person to attend college. Life as a Coed College was somewhat disappointing for Helen Keller. She was unable to form friendships both because of her limitations and the fact that she lived off campus, which further isolated her. The rigorous routine continued, in which Annie worked at least as much as Helen. As a result, Annie suffered severe eyestrain. Helen found the courses very difficult and struggled to keep up with her workload. Although she detested math, Helen did enjoy English classes and received praise for her writing. Before long, she would be doing plenty of writing. Editors from Ladies Home Journal offered Helen $3,000, an enormous sum at the time, to write a series of articles about her life. Overwhelmed by the task of writing the articles, Helen admitted she needed help. Friends introduced her to John Macy, an editor and English teacher at Harvard. Macy quickly learned the manual alphabet and began to work with Helen on editing her work. Certain that Helens articles could successfully be turned into a book, Macy negotiated a deal with a publisher and The Story of My Life was published in 1903 when Helen was only 22 years old. Helen graduated from Radcliffe with honors in June 1904. Annie Sullivan Marries John Macy John Macy remained friends with Helen and Annie after the books publication. He found himself falling in love with Annie Sullivan, although she was 11 years his senior. Annie had feelings for him as well, but wouldnt accept his proposal until he assured her that Helen would always have a place in their home. They were married in May 1905 and the trio moved into a farmhouse in Massachusetts. The pleasant farmhouse was reminiscent of the home Helen had grown up in. Macy arranged a system of ropes out in the yard so that Helen could safely take walks by herself. Soon, Helen was at work on her second memoir, The World I Live In, with John Macy as her editor. By all accounts, although Helen and Macy were close in age and spent a lot of time together, they were never more than friends. An active member of the Socialist Party, John Macy encouraged Helen to read books on socialist and communist theory. Helen joined the Socialist Party in 1909 and she also supported the womens suffrage movement. Helens third book, a series of essays defending her political views, did poorly. Worried about their dwindling funds, Helen and Annie decided to go on a lecture tour. Helen and Annie Go on the Road Helen had taken speaking lessons over the years and had made some progress, but only those closest to her could understand her speech. Annie would need to interpret Helens speech for the audience. Another concern was Helens appearance. She was very attractive and always well dressed, but her eyes were obviously abnormal. Unbeknownst to the public, Helen had her eyes surgically removed and replaced by prosthetic ones prior to the start of the tour in 1913. Prior to this, Annie made certain that the photographs were always taken of Helens right profile because her left eye protruded and was obviously blind, whereas Helen appeared almost normal on the right side. The tour appearances consisted of a well-scripted routine. Annie spoke about her years with Helen and then Helen spoke, only to have Annie interpret what she had said. At the end, they took questions from the audience. The tour was successful, but exhausting for Annie. After taking a break, they went back on tour two more times. Annies marriage suffered from the strain as well. She and John Macy separated permanently in 1914. Helen and Annie hired a new assistant, Polly Thomson, in 1915, in an effort to relieve Annie of some of her duties. Helen Finds Love In 1916, the women hired Peter Fagan as a secretary to accompany them on their tour while Polly was out of town. After the tour, Annie became seriously ill and was diagnosed with tuberculosis. While Polly took Annie to a rest home in Lake Placid, plans were made for Helen to join her mother and sister Mildred in Alabama. For a brief time, Helen and Peter were alone together at the farmhouse, where Peter confessed his love for Helen and asked her to marry him. The couple tried to keep their plans a secret, but when they traveled to Boston to obtain a marriage license, the press obtained a copy of the license and published a story about Helens engagement. Kate Keller was furious and brought Helen back to Alabama with her. Although Helen was 36 years old at the time, her family was very protective of her and disapproved of any romantic relationship. Several times, Peter attempted to reunite with Helen, but her family would not let him near her. At one point, Mildreds husband threatened Peter with a gun if he did not get off his property. Helen and Peter were never together again. Later in life, Helen described the relationship as her little island of joy surrounded by dark waters. The World of Showbiz Annie recovered from her illness, which had been misdiagnosed as tuberculosis, and returned home. With their financial difficulties mounting, Helen, Annie, and Polly sold their house and moved to Forest Hills, New York in 1917. Helen received an offer to star in a film about her life, which she readily accepted. The 1920 movie, Deliverance, was absurdly melodramatic and did poorly at the box office. In dire need of a steady income, Helen and Annie, now 40 and 54 respectively, next turned to vaudeville. They reprised their act from the lecture tour, but this time they did it in glitzy costumes and full stage makeup, alongside various dancers and comedians. Helen enjoyed the theater, but Annie found it vulgar. The money, however, was very good and they stayed in vaudeville until 1924. American Foundation for the Blind That same year, Helen became involved with an organization that would employ her for much of the rest of her life. The newly-formed American Foundation for the Blind (AFB) sought a spokesperson and Helen seemed the perfect candidate. Helen Keller drew crowds whenever she spoke in public and became very successful at raising money for the organization. Helen also convinced Congress to approve more funding for books printed in braille. Taking time off from her duties at the AFB in 1927, Helen began work on another memoir, Midstream, which she completed with the help of an editor. Losing Teacher and Polly Annie Sullivans health deteriorated over several years time. She became completely blind and could no longer travel, leaving both women entirely reliant on Polly. Annie Sullivan died in October 1936 at the age of 70. Helen was devastated to have lost the woman whom she had known only as Teacher, and who had given so much to her. After the funeral, Helen and Polly took a trip to Scotland to visit Pollys family. Returning home to a life without Annie was difficult for Helen. Life was made easier when Helen learned that she would be taken care of financially for life by the AFB, which built a new home for her in Connecticut. Helen continued her travels around the world through the 1940s and 1950s accompanied by Polly, but the women, now in their 70s, began to tire of travel. In 1957, Polly suffered a severe stroke. She survived, but had brain damage and could no longer function as Helens assistant. Two caretakers were hired to come and live with Helen and Polly. In 1960, after spending 46 years of her life with Helen, Polly Thomson died. Later Years Helen Keller settled into a quieter life, enjoying visits from friends and her daily martini before dinner. In 1960, she was intrigued to learn of a new play on Broadway that told the dramatic story of her early days with Annie Sullivan. The Miracle Worker was a smash hit and was made into an equally popular movie in 1962. Death Strong and healthy all of her life, Helen became frail in her 80s. She suffered a stroke in 1961 and developed diabetes. On June 1, 1968, Helen Keller died in her home at the age of 87 following a heart attack. Her funeral service, held at the National Cathedral in Washington, D.C., was attended by 1,200 mourners. Legacy Helen Keller was a groundbreaker in her personal and public lives. Becoming a writer and lecturer with Annie while blind and deaf was an enormous accomplishment. Helen Keller was the first deaf-blind individual to earn a college degree. She was an advocate for communities of people with disabilities in many ways, raising awareness through her lecture circuits and books and raising funds for the American Foundation for the Blind. Her political work included helping to found the American Civil Liberties Union and advocacy for increased funding for braille books and for womens suffrage. She met with every U.S. president from  Grover Cleveland to Lyndon Johnson. While she was still alive, in 1964, Helen received the highest honor awarded to a U.S. citizen, the Presidential Medal of Freedom, from President Lyndon Johnson. Helen Keller remains a source of inspiration to all people for her enormous courage overcoming the obstacles of being both deaf and blind and for her ensuing life of humanitarian selfless service. Sources: Herrmann, Dorothy. Helen Keller: A Life. University of Chicago Press, 1998. Keller, Helen. Midstream: My Later Life. Nabu Press, 2011.

Strategic Groups Essay Example | Topics and Well Written Essays - 1500 words

Strategic Groups - Essay Example This paper aims at discussing the rivalry that strategic groups face and how they aim at neutralizing the competition. The paper discusses the rivalry between Google Incorporation and other rivalry groups that offer similar services and products. Google and Microsoft have been on market command wars while Samsung and Apple have also been battling it on the mobile phone productions. Google in particular has several strategic advantages that have enabled it to emerge the strongest internet provider in the world. Google has been able to employ strategies such as product and service diversity that has provides the company with greater sales. Google also possess one of the largest geographic coverage in the world. In addition to this, Google has several numbers of market segments that it is serving. Apart from internet production, the company also provides image and graphic production software. The company also provides mobile phone applications in addition to mobile phone production. The company also enjoys good distribution channels that provide it with the best strategic advantages. The extent at which Google brands its product cannot be compared to other rival companies. This is because the company is bale to brand and market its products cheaply and efficiently through the internet that the company owns. The degree of vertical market integration in Google Company is also very efficient. Product and pricing policies for the company has also been superb enabling the company to enjoy wider markets and retain most of their loyal companies (Porter, 1980). On the other hand, Microsoft Incorporation enjoys the best PC software producer in the World. It is estimated that almost 90% of the PC’s in the world uses Microsoft Software. Analysts argue that without Microsoft, Google would find no base for their supplies since the internet utilizes Microsoft applications in computers. Yahoo Incorporation is also another strategic group of company that offers similar ser vices like Google. The rivalry has led to the attempt of Google trying to purchase Yahoo. Background Information and Strategic Benefits Larry Page and Sergey Brin studied at Stanford University and own 16% of the total company’s shares formed Google Inc. they are the founders of Google Inc. The company came into existence in 1998 as a private company but later went public in 2004 when the company invited other shareholders into the company. The two friends invited their fellow student Craig Silverstein who also studied computer science as their first employee. The company runs on a vision of organizing all the information in the world and making it readily available for all the users in the world. The company also runs on a slogan â€Å"don’t be evil† which has helped it in its growth (Why is Google so great 2007). The Company’s history dates back in 1998 when Larry and Sergey decided to upgrade Backrub a search engine that was operating on Stanford sever s for almost more than one year. The two friends decided to change the name from Backrub to Google which is a mathematical term that is used in referring 1 then the digit is followed by 100 zero digits. Their decision to land on the term was later used in forming the vision. The number of zeros signifies infinity, which means looking for all the world information, which is almost impossible. The same year the company received a donation of $100,000 from Andy Bechtolsheim who is now the co-founder of the company. In December, the same year the company was recognized as one of the best 100 websites in the world and it had an efficient way of providing feedback to its users. In 1999, the company improved its employees to eight and therefore had to shift into a larger working place. The following year

Lesson Plan Assignment Example | Topics and Well Written Essays - 1250 words

Lesson Plan - Assignment Example Procedure A. Motivation 1. The teacher will ask several questions about the topic to the students to arouse their interest: †¢ Have you ever experienced entering or visiting a cave? †¢ What have you seen? †¢ What did you feel? 2. The teacher will then give pieces of bond paper to the students. The students will be asked to draw on the paper what they have experienced or seen upon entering the cave. If a student does not have any experience about caves, he can draw his ideas about what a cave would look like. 3. After 10 minutes, 2-3 students will be asked to share what they have drawn on the paper. All the students will pass their drawings after the activity. B. Presentation The teacher will introduce the topic by posting a big colored poster of a cave on the board. The teacher may tell facts and historical accounts in relation to the topic such as cave paintings, carvings, cannibalism and fossil remains to refresh the memory of the students. C. Lesson Proper The teacher will discuss the lesson by using the textbook as the primary reference. The discussion includes the definition and history of caves, the kinds of cave formations, the organisms that make the caves as their habitat, and the archaeological and cultural importance of caves. After the discussion, the teacher validates the students’ knowledge of the subject matter which had been discussed. A. Unlabeled pictures of the different types of caves are posted on the board. Students will be asked to volunteer to put names under each picture.... After naming the caves, other students will be asked to write certain characteristics of each cave under the name. If a student would name or describe a cave incorrectly, another student would be asked to do the task. The activity will end after all the pictures are properly named and defined. B. A simple, large cave will be drawn on the board. Each student will be asked to draw an animal or an organism inside the cave. The animals should be the correct animals that live inside caves. After drawing, the class will tell what each animal eats and whether their prey also lives in the cave. D. Evaluation A 20-item identification type of quiz will be given to the students. The topics covered will be the definition and history of caves, the types of caves, and the ecology of caves. E. Homework 1. An essay about the cultural and archaeological importance of caves. The minimum number of paragraphs is 3. 2. A report about one of the world's most famous caves. The report should tackle about the history and physical characteristics of that cave, the kind of cave formation, the location, and how that cave became popular. Examples: 1) the Mammoth Cave (Kentucky, USA) as the cave system with the greatest total length of surveyed passage, 2) the Ox Bel Ha Cave System in Yucatn, Mexico as the longest surveyed underwater cave. Lesson Plan for Science Grades 6-9 I. Objectives At the end of the lesson, 90% of the students are expected to: 1. Differentiate and define sunrise and sunset; 2. Explain the scientific process that is bounded to make sunrise and sunset possible for occurring; 3. Track the position of the sun every hour of the day; 4. Show appreciation to sunrise and sunset. II. Subject Matter A. Topic Sunrise and

Demographic Profile of Diabetic Patients

Demographic Profile of Diabetic Patients INTRODUCTION Background of the Study In the last few decades, the world prevalence of diabetes among adults have increased more than twice, and expected to ascend to 380 million by 2030, according to a report from the InternationalDiabetes Institute.1 About 3.4 million, roughly 4.6 percent of the total population in the Philippines are diabetics. This figure is expected to rise to 7.8 million in the next 15 years.2 Despite such high incidence, awareness on diabetes, its complications and treatment remain major challenges, particularly in developing countries such as the Philippines. Prevention through patient education is imperative because the burden of disease on healthcare and its economic implications are of great magnitude. There is a significant amount of evidence that patient education is one of the most effective way to lessen the complications of diabetes. 3,4,5,6 When coupled with appropriate medications, it is associated with decreased morbidity and mortality.3 Patient education is more likely to be effective if we know the characteristic of the patients in terms of what they know about their disease, their attitude towards it and what they practice in their medications, diet and lifestyle. Very few studies has been made on our country to find the prevailing awareness, attitudes and practices among diabetic patients, 7,8,9 which can aid in the development of future health education interventions targeting the disease. In this study, we will determine the demographic characteristics of diabetic patients consulting at the Diabetes Clinic of a tertiary hospital in Davao City and assess their level of knowledge, attitude and practices (KAP) towards Diabetes Mellitus (DM) and the relationship of KAP and glycemic control among type 2 diabetic patients in an urban health care facility. REVIEW OF RELATED LITERATURE In the Philippines, the prevalence of diabetes according to the NNHES (National Nutrition Health Survey) study is approximately 4.6-7.2%. This figure expands to 17.8% after adding those who have pre-diabetes (impaired fasting glucose or impaired glucose tolerance or both) which has a prevalence of 10.6%. 2Therefore, one out of every 5 Filipino could potentially have diabetes mellitus or pre-diabetes. As such, the increasing trend of its incidence rate is causing alarm among medical practitioners, and among affected patients as well. In the context of an alarming increase in the magnitude of type 2 diabetes mellitus in our country, the prevailing knowledge, attitudes and practices of these diabetic patients assume immense importance in the control of the disease. Across the globe, a number of studies have been done about perception and practice of diabetic patients10-14, especially in third world countries. An Indian study made by Mukhopadhyay, et al 2010, looked into the perceptions and practices of patients with Diabetes Mellitus Type II in a tertiary hospital.11 In the Philippines, a similar study was done in the rural community of San Juan, Batangas, Philippines. A total of 156 diabetic residents were included as participants of the survey. Knowledge scores were relatively low, with an overall mean of 43%. There were also poor positive responses to attitude scale. The study emphasized the importance of evaluating knowledge, attitudes and practices as crucial means to understand observed behaviors and guide behavioral change.7 According to the American Diabetic Association, self management education is defined as the process of providing the person with diabetes the knowledge and skill that is needed to perform self care, manage immediate concerns and make life style changes. 3 To achieve such effective self care, diabetic patients and their doctors should work hand-in-hand together. Some studies have shown that self-care among individuals with type 2 diabetes had improved glycemic control and reduced complications 15, 16, 17. For people with diabetes, self-management education training is vital since diabetics and their families provide most of their care themselves. It is imperative that regular patient counseling and group education at follow-up visits by health care professionals to help in improving patients’ knowledge and ultimately modify their practices. 19 However, in our setting, adequate diabetes self-management education programs are lacking or weak in most government hospitals in tertiary care. Hence, results of this study could help us design our education programs targeting certain groups or issues that needs further strengthening. Research Question What is the level of knowledge, attitudes, and practices and its association with glycemic control among persons with type 2 diabetes in the Diabetes Clinic of Southern Phiilppines Medical Center? Significance of the Study The study will contribute to the understanding of the current status of diabetes care in our local setting, and help in the implementation of programs that would address pressing needs in our patient education and management, based on their knowledge, attitude and practices. It will also help us identify the association of KAP and glycemic control, and further assess the impact of diabetes self-management in disease control. Objectives: General Objective: 1. To determine the knowledge, attitudes, and practices of patients with type 2 diabetes in the Diabetes clinic of a tertiary hospital. Specific Objectives: To determine the demographic profile of the diabetic patients in the Diabetic clinic of a tertiary hospital in Davao City, in terms of : Age Gender Highest level of educational attainment Employment status Duration of diabetes Antidiabetic medications Co-morbidities To determine the association between patient factors such as age, sex, level of education, employment status, duration of diabetes, antidiabetic medications and co-morbidities and their level of knowledge, attitudes, and practices (KAP) regarding diabetes To establish the association between the patients’ KAP and their corresponding glycemic control based on HBA1c levels METHODOLOGY Research Design: The study will employ a clinic-based, cross-sectional analytic study design. Research Setting: This study will be conducted at the Diabetes outpatient clinic of a tertiary hospital in Davao City, from May 2014 to June 2014. Participants: All patients who are diagnosed with type 2 Diabetes Mellitus type 2 (T2 DM) who are seeking consult at the Diabetes Clinic in a tertiary hospital for the period of May to June 2014. Inclusion Criteria: Patients must be a diagnosed case of Diabetes Mellitus type 2 based on the following criteria: Plasma glucose > 126 mg/dL (7.0 mmol/L) after an overnight fast Fasting is defined as no caloric intake for at least 8 hours up to a maximum of 14 hours, or Two-hour plasma glucose > 200 mg/dl (11.1 mmol/l) during an Oral Glucose Tolerance Test The test should be performed as described by the World Health Organization, using a glucose load containing the equivalent of 75 g anhydrous glucose dissolved in water after an overnight fast of between 8 and 14 hours, or A random plasma glucose > 200 mg/dl (11.1 mmol/l) in a patient with classic symptoms of hyperglycemia (weight loss, polyuria, polyphagia, polydipsia) or with signs and symptoms of hyperglycaemic crisis. Patient must have informed consent. Exclusion Criteria: Patients who does not meet the criteria for T2 DM but are seeking consult at the Diabetes clinic: Impaired fasting glycemia and Impaired glucose intolerance. Patients who have intellect impairment and could not participate in the survey Sampling Procedures All the DMT2 patients visiting the diabetes centre during this period will be identified using the convenient sampling method. Assuming that the prevalence of knowledge among Filipinos is 43% 7 and estimating the proportion within 95% confidence interval with 5% error, the sample size is 168( Raosoft Sample size formula). Data Collection: The data will be collected by giving out pretested predesigned questionnaire to participants with informed consent. Pre-testing of the questionnaire will be done prior to the research proper. Relevant information from the participants will be gathered including: age, gender, highest educational attainment, employment status, duration of diabetes, antidiabetic medications and co-morbidities. Questions pertaining to their knowledge, attitudes and practices will be given in order to assess their corresponding levels. The KAP questionnaire will be adapted from a Malaysian study by Shu Hui Ng et al 15, â€Å"Reality vs Illusion: Knowledge, Attitude and Practice among Diabetic Patients†. The questionnaire has been used in previous KAP studies among diabetics and has proven to be a reliable tool. The self-administered questionnaire had a total of 25 questions (knowledge-14, attitude-5, and practice-6). Each correct answer will be given a score of ‘one’ and the wrong answ er was given a score of ‘zero’. Good knowledge attitude and/or practice will be considered if a patient attains >50% of the total score for each domain. To assess the relationship between KAP towards DM and the actual disease control, most recent(4 +/- 2 weeks) levels of HbA1c will be obtained from the patient records. HbA1C > 7% is considered to have poor control of DM. A. Independent Variables Independent Variables include: sex, age, educational attainment, current employment status, co-morbidities, latest hba1c result. B. Dependent Variables Dependent Variables include: levels of knowledge, attitude and practices Data Handling and Analysis: The principal investigator will ensure that all data collected in the study were of utmost confidential nature. Data analysis will be performed to ensure quality results using frequency, percentage, and statistical analysis. The chi-square test will be used to determine the relationship between KAP and t-test to assess the association between KAP and diabetes control. Spearman correlation test will be used to determine the association between knowledge and attitude, and between knowledge and practice. The level of statistical significance will be set at p

Haddon House

Jurists Haddam House Food Products has over 50 years of experience in the gourmet food industry. As you know our inventory selection is more than 20,000 items which consists of major brand within ethnic and gourmet categories. One of our most popular brands is Cane's Crazy Mixed-up seasonings. Haddam House is very strong when it comes to selling our products. However, Haddam House needs improvement when it comes to employee turnover.Haddam House has three major locations, two locations in New Jersey, and one in South Carolina. There are 60 people who work in our corporate office and about 700-800 sales representative. Looking back at the last five years there has only been four employees who have been promoted and a handful of employees who left the company or got terminated. It is clear that these promotions happened because the supervisor of Accounts Payable decided to leave the company because she was moving out of state.This left her position open which then the supervisor of Acc ount Receivable decided to take her position this way one of her employees could become the supervisor. This may not be considered a promotion because she was already a supervisor Just moving to a new department. Furthermore, the young lady working in customer service has only been employed with the company for two years and she has a tough time trying to get promoted In addition to the employees in the cooperate office looking at the sales representative there have been at least three employees getting terminated each week.That is a really high number and it should not be like this at all. It should be in the company's strong interest to want to keep their employees. There are many times where a sales representative will leave the company and then get hired again a month later. There are many questions that come with that. Are they leaving the company because their pay is not high enough and then Join the company later to get a better pay increase?This problem can be avoided if the sales representative can give their feedback and the company takes it into consideration to better improve the company. . There is an even amount of males and females that leave the company each year. However, by looking at the numbers more females feel the need to get remoter and have the highest Job whereas, the males feel comfortable in their position. One good aspect about Haddam House is that there are an equal number of males and females in the company.The company is also very diverse. Another variable that we looked into was if there was a correlation between education and promotion within the company. With any other company if a person gets a higher education it can give them a chance to get promoted in the company. However, with this company it rarely happens. Employees feel that when they get hired for a position it does not matter if they further their education they will be stuck that session.This comes to be a big problem because individuals do not want to keep looking for a Job because they cannot go further. Haddam house is very particular with who is in the right position and they fear that only these people are right for the Job. It would help them in the long run if they were willing to trust more people and willing to promote more people than they do now. If they can get past this threshold they may notice an increase in moral and loyalty. Which will help people stay in the company and keep it a happy and healthy environment.

The Hidden Truth About 300 Essay Topics

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