English-language films Essay Example for Free

English-language films Essay Working as a congressional page, I was given the ability to manage my academic success through my own initiative. Dealing with independence was a revealing experience for me, giving me new responsibilities and shaping my work ethics. I didn’t have my parents, now 5,000 miles away, to urge me to finish my homework or to nag about my less than perfect grades, and I couldn’t depend on the support of the teachers or counselor that I knew so well to look after my academic well-being. There was a realization that I was alone in my struggle to succeed and become a responsible student. This independence allowed me to take the situation into my own hands and to work out my own problems, knowing I was the dictator of my consequences and decisions. In this situation, I learned how to set my priorities, a skill that has taken me a step toward preparing for college. Knowing that education would provide the foundation for my future in college and beyond, I placed it at the top of my values, so even in the excitement of new friends and complete independence, I had to maintain it as my first priority. Though it proved difficult to discipline myself without support and accountability alone, I managed to succeed. I’d invite friends over to my room to study, and it eventually became a custom to for us hold study sessions in my room every Monday night and before test days. The entire night was devoted to completing our assignments, studying for exams, and tutoring each other. After the strenuous study session, we’d reward ourselves with a movie and light conversations. These study sessions were an efficient way in which I could balance two of my important priorities, friends and academics. Living on my own and balancing a hectic load of school, work, and dorm life, I gained insight in effectively managing my own time, which was essential in preparing myself for academic success. It wasn’t a rare occurrence for Congress to stay into the thick hours of the morning, debating over a controversial issue, such as the budget or immigration. During these nights, I was required to wait on congressman on the Floor and carry out errands late into the night. Working late did not give us amnesty from the school’s assignments, so we had to make the most use of whatever time we had. Working as a page obviously cut into the precious time I had to concentrate on my school work, forcing me to partition my time wisely. It became an unsaid rule for me to sign myself into an hour of study hall every week night, so that I wouldn’t be distracted by roommates or requests to go out. I had an excuse to delay my friends’ invitations to the movies or to the mall until I felt confident I could do my best on the pre-calculus or history test we would have on Friday. With my packed schedule, I spent my time wisely to get the most out of my experience in Washington, while maintaining my grades and academics. The independence that I was fortunate enough to experience for the first time exposed me to responsibilities has helped me to prepare for college. It has disciplined me to set my priorities and manage my time to be the most effective student possible. Like a young eagle learning to fly, I learned to steer myself in the right direction. And so, I landed a more prepared and experienced person.

Case Study: Hypertension in Pregnancy

Case Study: Hypertension in Pregnancy Main Complaint My patient Madam Siti a 31 year old Indonesian maid Gravida 3 para 2 at 38 weeks and 1day of Period of Amenorrhoea (POA) was admitted to the ward for blood pressure stabilization and induction of labour (IOL). History of Presenting Illness She was referred from antenatal clinic during follow up in PPUKM on 29/11/2010. During the check up at the follow up, her vital sign showed she was afebrile, pulse rate of 90beats per minute and blood pressure was noted to be 160/100mmHg and no abnormality was found in the urine. During booking her blood pressure was noted to be 100/70mmHg and she was normotensive throughout the pregnancy up until at 38weeks and 1day of POA. She complained to have frontal headache and nausea 2 days prior to admission. She denied symptoms of impending eclampsia such as blurring of vision, epigastric pain and vomiting. There was also no dizziness, shortness of breath, chest pain, reduced urine frequency and leg swelling. She also had per vaginal discharge which was whitish and creamy in nature, no foul smelling and no pruritus vulvae. There was no urinary tract infection symptoms such as urgency and dysuria. Fetal movement was good. She was admitted to the ward for further management. Antenatal History This is an unplanned but wanted pregnancy. Her urine pregnancy test (UPT) was positive at 6weeks of POA. Dating scan done at 15weeks of POA which correspond to date. Booking was done at 15weeks of POA at private clinic at Medviron. Antenatal screening done showed that: Blood Pressure : 110/70mmHg Haemoglobin level : 12.8g/dL Height : 158cm Weight : Pre : 62kg Current : 69kg Blood Group : O Positive VDRL/HIV/HEP B : Non Reactive Urine Albumin/Sugar : Nil No MGTT was done. Despite having a family history of diabetes mellitus. Latest scan done at 38 weeks and 1day POA and all parameters are correspond to date. It was a singleton fetus on longitudinal lie and cephalic presentation. Fetal heart and fetal movement are seen. Amniotic Fluid Index are 11. Estimated fetal weight was 3.3kg and placenta was on anterior upper segment. Otherwise, antenatal visits are uneventful. Past Obstetric History On 1999, she had a full term normal pregnancy and delivered a baby girl by Spontaneous Vaginal Delivery (SVD) at a hospital in Indonesia and weight of the baby was 2.6kg and is alive and well. On 2007, she also had a full term normal pregnancy and delivered a baby boy by spontaneous vaginal delivery also at Indonesia. The baby weight 2.3kg and currently is alive and well. Both of her children stays with her mother at Indonesia. Past Gynaecology History She attained her menarche at the age of 13year old with 28 to 30days regular cycle with 7days of menses. She denied dysmenorrhoea, menorrhagia, intermenstrual bleeding, dyspareunia and postcoital bleeding. As for contraception, she uses Implanon for 4years from 2002 to 2006 between the first and the second pregnancy. She was then on Oral Contraceptive Pills for 2months and had stop taking them afterward until today. After this pregnancy, she is keen to take Intrauterine Contraceptive Device (IUCD). She had never had pap smear done before. Past Medical History Nil. Past Surgical History Nil. Allergy and Drug History No known drug allergy or food allergy. Family History Her mother is alive and was diagnosed to have diabetes mellitus and hypertension and currently on medication. Her father died on 2007 due to renal failure. She had 3siblings and currently all of them are alive and well. Social History She has been married for 12years and came to Malaysia on 2006 which was 4years ago. She lives in a terrace house at Cheras and worked as a maid. Her husband came to Malaysia 5years ago but had recently go back to Indonesia 2months ago. He previously worked as a contractor for the same employer. He planned to return to Malaysia after his permit is renewed. Both of them does not smoke or consumed alcohol. Both of their children were in Indonesia and are taken care by her mother. Relevant Clinical Examination General On examination, she was alert, conscious and she was not pale or jaundiced. Her Blood Pressure was 142/92mmHg lying and 152/104mmHg standing. Her pulse rate was 90beats per minute and respiratory rate was 20breath per minute. She was afebrile. Her current weight was 69kg. There was no pedal oedema noted. Thyroid Gland There was no scar, lump or dilated veins noted around the area of the neck. There was no lymphadenopathy noted. Breast On inspection, both breast were symmetrical and bilaterally in size. Both her nipple were not hyperpigmented or retracted. There was no nipple discharge. Her breast were non tender and no mass was palpable. Cardiovascular System On inspection of the hand, there was no clubbing and peripheral cyanosis. Inspection of the mouth showed that there was no central cyanosis and hydration status was good. There was no surgical scar and no notable abnormalities detected on the praecordium. Jugular Venous Pressure was not raised. Peripheral pulses were present with normal rhythm and good volume. There was no radio-radial delay or radio femoral delay. There was no collapsing pulse. On palpation, apex beat was not displaced it was palpable at the 5th intercostals space and left midclavicular line. There was no parasternal heave and thrills detected. On auscultation, the first and second heart sounds were heard with no murmur or added sound heard. Respiratory System On inspection, the chest moved bilateral symmetrically with inspiration. There was no scars and deformities noted. She did not use accessory muscles on breathing. On palpation, her trachea was not deviated. Chest expansion was equal bilaterally. Air entry was good and equal bilaterally as evidenced by normal vocal fremitus and vocal resonance. Percussion of both lungs were resonant. There were vesical breath sounds equal on both sides with no added sounds on auscultation. Neurological System She was orientated to time, place, and person. All cranial nerves were intact. Both her upper and lower limbs were normal. Muscle tones, power, and reflexes were all good and normal. Abdominal Examination On inspection, the abdomen was distended by gravid uterus as evidenced by cutaneous signs of pregnancy such as linea nigra and striae gravidarum. The umbilicus is centrally located and flat. No scars noted and no dilated veins seen. On palpation, her abdomen was soft and non tender and uterus was not irritable. Clinical fundal height revealed that the uterus was 38weeks in size and was correspond to date. Symphysiofundal height was 37cm. Palpation of the fetus showed that it was a singleton in longitudinal lie with cephalic presentation. The head was 3/5 palpable and not engaged. The fetal back was on the maternal left side. The liquor was adequate and estimated fetal weight was 3.2 to 3.4kg. Pelvic Examination Vaginal examination was not done. Per Rectal Examination Per rectal examination was not done. Summary of Case 31year old maid gravida3 para2 at 38weeks and 1day POA admitted for blood pressure stabilization and induction of labour (IOL) due to gestational hypertention. Diagnosis and Differential Diagnosis Provisional Diagnosis Gestational Hypertension: She develop hypertension which is a blood pressure of 140/90mmHg aand above recorded on 2 separate occasions at least 4hours apart. Hypertension occur in second half of pregnancy which is after 20weeks of gestation. She is previously normotensive. There is absence of proteinuria She had risk factor; family history of hypertension. Differential Diagnosis Pre-eclampsia: Points for: Hypertension at least 140/90mmHg recorded on 2 separate occasions at least 4hours apart. Hypertension occur at second half of pregnancy, after 20weeks gestation. She is previously normotensive. She had risk factor; family history of hypertension. Points against: There was absence of proteinuria of at least 300mg Protein in a 24hour collection of urine. She had no risk factor such as pre-existing hypertension or pre-eclampsia. Chronic Hypertension: Points for: She has a family history of hypertension. Points against: She is normotensive prior to pregnancy. She had no other disease such as renal or connective tissue disorders that can lead to hypertension. Relevant Investigations with Reasons Full Blood Count To check whether patient is anaemic or not (Hb). To confirm patient is not on any infection such as urinary tract infection (WBC). White Cell Count + 14.2 x 109/L Red Cell Count 4.18 x 1012/L Haemoglobin 12.3 g/dL MCV 37.1% MCH 88.7 Fl MCHC 29.3 Pg RDW 33.0 g/dL Mean Platelet Volume 8.0 Fl Platelet 302 x 109 /L Neutrophils ++ 10.3 x 109 /L Eosinophils 0.4 x 109 /L Basophils 0.0 x 109 /L Lymphocytes 2.6 x 109 /L Monocytes 0.9 x 109 /L Nucleated RBC 0 x 109 /L Comment: There is a reduction of Red Cell count. This is due to pregnancy, as there is haemodilutional effect due to an increase in plasma volume. Patient is not anaemic as haemoglobin is on the normal range. However, there is leukocytosis mainly the neutrophils. This suggest an infection most likely bacterial in origin such as urinary tract infection. Renal profle To exclude secondary cause of hypertension due to renal damage. To detect abnormality in the level of serum urea and creatinine that will indicate renal damage or failure. Sodium 139 mmol/L Potassium 4.0 mmol/L Urea 2.3 mmol/L Creatinine 54 umol/L Comment: There is hypouremia. This is normal in pregnancy, as there will be an increase in Glomerular Filtration Rate (GFR), therefore there will an increase in clearence of urea in the body. Besides that, a reduction in deamination process in the maternal body will also cause blood urea to be reduce. Liver Function Test To see whether patient had any liver damage Albumin 33 g/L Total Protein 68g/L Bilirubin toral 6 umol/L ALT 19 u/L ALP + 141 u/L Comment: There is hypoalbuminaemia. There is increase level of Alkaline Phosphatase (ALP) due to placenta production. Thus, making it a normal physiological reaction. Serum Uric Acid Serum uric acid is a sensitive indicator of renal damage in pre-eclampsia. Uric Acid 371 umol/L Comment: Serum uric acid level is normal. Suggesting there is no renal damage. PE/ Pre-eclampsia Chart To monitor her blood pressure on lying and standing To monitor her urine whether there is albuminuria or not. To detect pre-eclampsia. Result: Other than the increase in blood pressure prior to delivery, there is no albuminuria noted. Therefore, patient did not have pre-eclampsia. Fetal Kick Chart To monitor the fetal well being. If there is decreased fetal activity, it may indicate some degree of fetal compromise. Cardiotocography (CTG) To monitor the heart rate and contraction of the uterus to detect abnormalities in the pregnancy. Ultrasound. To assess the fetal growth. Identify The Problem in Terms of Priority Gestational Hypertension. Induction of labour in gestational hypertension. Immediate and Subsequent Management Admit to ward for BP monitoring and stabilization. Monitor for any signs and symptoms of impending eclampsia. Bed rest. BP monitoring 2hourly for 24hours. If blood pressure reduce or return to normal patient can be discharge and to come again for antenatal follow up. Bed rest continued if persistent. Antihypertensive medication given if BP consistently noted to be 150/100mmHg. Preferred agent are alpha and beta blockers agent such as labetolol or methyldopa. Pre-eclampsia chart to exclude pre-eclampsia. CTG and fetal kick chart monitoring. Gestational hypertension not resolve, induction of labour is recommended. If induction of labour fails or spontaneous delivery is not possible, prepare for lower segment caesarean section (LSCS). Final Conclusion/ Plan for Further Management/ Patient Progress On admission on 29 November 2010, her blood pressure (BP) was high which was 142/92mmHg lying and 152/104mmHg standing. She was then given 200mg labetolol TDS. Pre-eclampsia chart done to monitor albumin in the urine. She is also monitored on signs and symptoms of impending eclampsia. Her BP was monitored half hourly for 2hour and induction of labour (IOL) is done soon after BP is stabilize. On the next day , 7.15am, Bishops Score was done and result was 2/13. Therefore cervix was not favourable. First 3mg of Prostin tablet was inserted into the posterior fornix. CTG was then done after 1hour to monitor for uterine hyperstimulation of fetal distress. The abdomen and cervix will be reassess in 6hours time. Tablet labetolol was continued and signs and symptoms of impending eclampsia (IE) was monitored. Six hour later, patient had contraction (irregular) but no leaking liquor noted. There was no signs and symptoms of IE, per vaginal discharge and fetal movement was good. Her BP was 129/92mmHg which had decreased slightly. On palpation, her abdomen was soft and non tender. Uterus was 38weeks, presenting part was 3/5 palpable. Bishops Score was done again and cervix is still unfavourable at 3/13. Second prostin was inserted at the posterior fornix. CTG was done 1hour post prostin for monitoring. Six hour later, she had 2 contraction in 10 minutes and it was moderate. There was no leaking, no per vaginal bleeding and the fetal movement was good. Her BP on lying was 112/86mmHg and 122/90mmHg on standing, well controlled BP. Vaginal examination revealed normal vulvovaginal, cervix dilated to 1cm, os was 3cm membrane intact and station was -2. 2hour later, the contraction was 3 in 10minutes and no leaking liquor. Vaginal examination showed 1cm cervix, 4cm os. Artificial Rupture of Membrane (ARM) was done. Clear liquor was noted. Patient was in active phase of labour and was sent to the labour room for delivery. Entonox was given for pain management in the labour room. Contraction was 3 in 10 minutes with moderate intensity and os was 4cm. one and a half hour later, patient complained of having strong contraction and felt the urge to bear down. Vaginal examination done and os was fully dilated at 10cm. She delivered a baby boy weighing 2.53kg with apgar score of 8 in 1minute and 9 in 5minutes. The patient developed first degree tear, placenta was complete weighing 590gm. Estimated blood loss is 250cc. Cord pH was 7.312. In the ward, day 1 post SVD she was alert, conscious, comfortable and was not pale. Her BP was 118/83mmHg which was normal and her pulse rate was 96beats per minute. She was afebrile. Abdominal examination showed that her abdomen soft and non tender. The uterus was well contracted at 18weeks in size. The lochia was normal. Breastfeeding was established and she was ambulating well. The patient can tolerate orally and had pass urine and bowel movement. She had completed her family size and plans to use intrauterine contraceptive device (IUCD) for contraception. Prescription of labetolol was stopped as her BP has been stable and she had delivered her baby. She was then allowed for discharge and to come again 2weeks later to review her BP. She was given hematinics to increase haemoglobin level. Discharge Summary Name : Siti Arifah Age : 31 MRN : N285492 Race : Indonesian Gender : Female Discharge Date: 01/12/2010 Case Summary Date of admission : 29/11/2010 Date of delivery : 30/11.2010 at 22:35 Date of Discharge ; 01/12/2010 31year old, para 3 @38weeks and 4days of POA, post spontaneous vaginal delivery (SVD) with first degree tear diagnosed with gestational hypertension @ 38weeks. Antenatally, Dated at 15weeks. Antenatal clinic uneventful. Booking blood pressure (BP) 100/70mmHg. Has been normotensive throughout pregnancy (BP range 110-120/70-80mmHg) until on 38weeks, noted that BP at clinic 160/100mmHg. Tablet labetolol 200mg given stat at the clinic. Admitted to ward for BP stabilization and started on tablet labetolol 200mg TDS. Medical/surgical History Nil. VDRL/HIV/Hep B Non reactive. Admitted in for BP stabilization. Before admit and in the ward, patient complaint of headache. On day 2 of admission, cardiotocograph (CTG) showed sleeping pattern. Opted for induction of labour (IOL). Prostin inserted 2 times. After 7hours of second prostin insertion, patient went into active phase of labour, os 4cm. Artificial Rupture of Membrane (ARM) was done with clear liquor. Os fully after 1 hour 30minutes without augmentation. Second stage 10 minutes. Third stage 13minutes. She successfully delivered a baby boy of: Weight : 2.73kg pH : 7.312 TSH : pending G6PD : normal Estimated Blood Loss (EBL) : 250cc Currently she is normotensive. There is no acute complaints. No signs and symptoms to suggest of anaemia. She is tolerating orally and ambulating well. Passing urine/bowel open without problems and there is no excessive bleeding. Her baby is well and active, suckling well. BCG/Hepatitis 1st dose has been given. On examination, Her vital signs are stable. She is pink and alert. Abdomen soft and non tender. Uterus well contracted and 18weeks in size. There is no excessive bleeding. Lochia is normal. Mother Haemoglobin: 12.3g/dL Contraception: Intrauterine contraceptive device (IUCD) Plan; Off labetolol EOD BP at local clinic To come again (TCA) in 2weeks to review BP. Continue Haematinics. Medications Tablet Hematinics OD Tablet Gelusil Ponstan TDS Syrup lactulose 15mls TDS Diagnosis: Post- SVD with first degree tear. Prepared by, Connie (CONNIE KABINCONG) House Officer Obstetric and Gynaecology ward UKMMC Referral to Doctor For Continued Management To: Medical officer of Obstetric and Gynaecology Department Date: 01 December 2010 Dear Doctor, Regarding: Siti Arifah, N285492 Thank you for seeing this patient, Siti Arifah, a 31year old Indonesian maid, para 3 post spontaneous vaginal delivery (SVD) with first degree tear at 38weeks and 2days of period of amenorrhoea (POA). She was admitted for blood pressure stabilization and induction of labour. She was referred from antenatal clinic when it was noted that her blood pressure was high which was 160/100mmHg. She never had history of hypertension before until on 38weeks and 1day of POA. However, she had a family history of hypertension. She was given labetolol for blood pressure stabilization and was given tablet Prostin 2times to induce the labour. She was then delivered a baby boy by SVD and her baby was alive and well. Her blood pressure was 118/83mmHg after the delivery. She was then stopped on taking Labetolol. Kindly see this patient for blood pressure monitoring and to exclude pre-existing hypertension in this patient. Thank you. Regards, Connie (CONNIE KABINCONG) House Officer Obstetric and Gynaecology Ward UKMMC Mock Prescription: For Patient on Discharge Name : Siti Arifah Age : 31 MRN : N285492 Race : Indonesian Gender : Female Discharge Date: 01/12/2010 Tablet Haematinics OD Tablet Gelusil/Ponstan TDS Syrup Lactulose 15mls TDS By, Connie (CONNIE KABINCONG) House Officer Obstetric and Gynaecology Ward UKMMC Professionalism Component Communication Issues As communication will be crucial in our future career as a doctor, a good basic has to be established now. As a good communicator we must be able to convey our message and information to our patient either in the form of words or from plain body language. Fortunately, my patient Madam Siti was very cooperative. I was able to establish rapport with her rather rapidly. She became more comfortable while answering my questions. Management wise, I found that she was well assured and well informed about what was being done for her. The doctor in charged informed her about her condition and told her about the possible complication that may arise and enough reassurance was given. Psychosocially, she did admits that she was a little scared of the possible complication that might affect she and the baby. Furthermore, her husband was not able to be by her side for moral support. I spent some times consoling her and she felt better afterward. Financially speaking, she and her husband total household income is currently not sufficient as she only earn approximately RM1000 per month and her husband is currently unemployed and waiting for his permit to return to work to Malaysia. However she claimed that her employer are offering to help her out during her confinement period. Spiritual Issues She is a very religious woman and has a strong spiritual side. She believe that God will helped her through this challenge and it had made her become quite cheerful and optimist despite of her current state. Ethical Issues As medical student, we have been reminded from time to time that medical ethics are crucial in order to be good doctors in the future. A good doctor should always put the patients life at the highest priority and respect the patients right to autonomy, information and privacy. Madam Siti should be counseled on options, pros and cons of the choices and the choice that made by her with guidance and advice by the doctor. No information should be withheld from her. Ethically as patient they also entitled to their privacy and confidentiality. Unfortunately, in a teaching hospital such as HUKM, patients privacy is sometimes compromised. Madam Siti was continuously approached by the students who wished to clerk her although it is very tiring to repeat all the words again and again, she still can tolerate it. Unfortunately there isnt much things I can do to help her but I can learn from this by learning not to disturb patient during the visiting hours or when they are tired while still grabbing every opportunity to learn in the ward. Professional Judgement In managing obstetric patient, we must take into account that we are not only dealing with one life but two. Thus extra caution must be taken. Especially with Madam Siti condition, as hypertension in pregnancy if it is not well controlled and monitored it could easily turns into something terrible very quickly. I felt that the management of Madam Siti was fair, she was properly counseled on maternal and fetal complication that could arise from hypertension in pregnancy. She was also well informed on the results of all the investigation done on her and her current management. Critical Appraisal Hypertension in pregnancy is defined as Blood Pressure more than or equal to 140/90mmHg in previously normotensive women that occur in 20th week of gestation without proteinuria until 6weeks postpartum. Or alternatively, a rise in systolic BP of more than 25mmHg or diastolic BP of more than 15mmHg compared with booking BP. Hypertension in pregnancy caused an increase in maternal and perinatal morbidity and mortality. Normal BP usually never went beyond 120/80mmHg. However in pregnancy plasma volume increases on an average 1200ml. So vasodilatation is needed to maintain the peripheral pressure. If the vasodilatation action is counteract by arterial spasm, hypertension occurs and lead to reduction in perfusion to all organ. This includes the uterus and placental site. Hypertension in pregnancy can be divided to pre-eclampsia, gestational hypertension, chronic hypertention, pre-eclampsia superimposed of chronic hypertension. Pre-eclampsia is defined as hypertension of at least 140/90mmHg recorded on 2 separate occasions with the significant proteinuria of more than 300mg in 24hours urine collection after 20weeks of gestation in a previously normotensive women and resolve completely by 6weeks postpartum. Eclampsia is a serious complication and life threathening complication of pre-eclampsia. It is defined as convulsions occurs in a woman with pre-established pre-eclampsia in the absence of any neurological or metabolic cause. Chronic hypertension is caused either due to essential hypertension or secondary hypertension. Secondary causes include renal artery Stenosis, glomerulonephritis, cushing syndrome and pheochromocytoma. Chronic hypertension is a hypertension diagnosed prior to 20weeks of gestation or history of hypertension preconception and de novo hypertension in late gestation that fails to resolve postpartumly. Pre-eclampsia superimposed on chronic hypertension is diagnosed when there is: De novo proteinuria after 20week gestation Sudden increase in magnitude of hypertension Appearance of features of pre-eclampsia-eclampsia Sudden increase in proteinuria in women with preexisting proteinuria in early gestation in women with chronic hypertension. Risk factors for women to develop hypertension in pregnancy can be divided into obstetric, medicaland social aetiology. In obstetric aetiology, the risk factor can be further divided into maternal and fetal risk factor where: Maternal risk factors are: Nulliparity or primigravida Advanced maternal age or extreme age (35year old) Family history of hypertension, pregnancy induced hypertension, pre-eclampsia and eclampsia. Previous history of gestational hypertension, pre-eclampsia, eclampsia. Maternal obesity (>80kg) Fetal risk factors are: Multiple pregnancy Molar pregnancy Hydrops fetalis From medical aetiology the risk factors are: Diabetes mellitus or gestational diabetes mellitus Established hypertension Connective tissue disease Renal disease: glomerulonephritis, renal artery Stenosis Endocrine disease: cushings syndrome, pheochromocytoma. From social aetiology the risk factors are: Smoking Alcohol consumption Complication that can arise from hypertension in pregnancy are eclampsia, intrauterine growth restriction, renal failure, thrombocytopenia, abruption placenta, subcapsular haemrrhage and liver dysfunction. Treatment wise, patient need to be admitted to hospital first fo r BP monitoring and stabilization. Used of antihypertensive agents that may be used in hypertension in pregnancy is Labetolol, which is a combined alpha and beta blocker. By blocking alpha adrenoreceptor in the peripheral arteries, it reduced the peripheral resistance. At the same time beta blocking effect protects the heart from reflex sympathetic drive normally induced by peripheral vasodilatation. Nifedipine, a calcium channel blocker can be use as an alternative. Delivery is the ultimate treatment of hypertensive in pregnancy and its timing is dependent on the observation of fetal and maternal well being. Prolongation of pregnancy by drug therapy may reduce the risk of prematurity and improves the chances of delivery. Reference Lists Obstetrics By Ten Teachers, 18th edition; Philip N. Baker. Obstetrics Illustrated, 7th edition; Kevin P. Hanetty, Ian Ramsden, Robin Callander. Handbook of Labour Practice, 2nd edition; Dr. Yun-Hsuen Lim, Professor Dr Muhammad Abdul Jamil, and Professor Dr. Zaleha Abdullah Mahdy. A Practical Approach to Obstatric Problems for the Undergraduate, 4th edition; Professor Kulenthran Arumugam.

The Role Of Gawad Kalinga As A Promotional Tourism Essay

The Role Of Gawad Kalinga As A Promotional Tourism Essay Besides the 7,107 beautiful islands, Philippines has so much to offer, from its pristine white sand beaches, splendid views, abundant greens,diverse populations of flora and fauna, unique natural resources and vibrant culture. To add to it is the warm Filipino hospitality, affordable vacation rates that they provide to tourists, enabling them to travel cheap and enjoy the tourism experience even more. Ironic as it may seem, this natural beauty is masked by the ugly face of poverty and despair. A majority of the Filipinos have been living in sub-human conditions in constant struggle to battle deprivation and loss of dignity. Non-Government Organizations such as Gawad Kalinga provide alternative solutions to the barefaced problem of poverty and despair in the Philippines. Gawad Kalinga (GK) has a vision of a slum-free, squatter-free nation a country where Filipinos are at peace and are given the dignity that they deserve. Together with its partners, the process of nation building and Filipino empowerment has transformed over 900 communities all over the Philippines. The Filipino people have the innate culture of giving and sharing, exemplified by the age-old concept of bayanihan. This unique Filipino spirit of being a hero to one another can be the desired push for voluntourism in the Philippines. Gawad Kalinga has, in its history of service, contributed to the domestic tourism scene. With community building and community development programs manifested mainly through its infrastructure and community empowerment activities across the nation, and an extensive number of communities which continue to increase, the organization encourages more volunteers to be involved in their efforts. This potentially relates to an increased movement of people across the country which may be associated with an increase in awareness of the destinations to which they are deployed, a potential increase in travel spending, and a prospective ensuring increase in tourism spending. II. REVIEW OF RELATED LITERATURE DOMESTIC TOURISM Many countries have a rich tradition of domestic travel and holiday which not only predates but exceeds mass international travel. This is particularly the case in Asia where recent economic prosperity and trends in globalization have not merely spurred, but continue to shape traditions in domestic tourism (Singh, 2009).  Tourism in the world is dominantly domestic not international (Cooper, Gilbert, Fletcher Wanhill, 1993). Travel is usually done within ones own country before one ventures out into travelling to destinations other than the country of residence. Domestic tourism involves residents of a country travelling only within that country but outside their usual environment. The main purpose of visit or travel is predominantly for leisure, business or other purposes (Cruz, 2000). TOURISM PROMOTION IN THE PHILIPPINES In the Philippines, the major agencies involved with tourism marketing and promotions are the Department of Tourism and the Tourism Promotions Board (former Philippine Convention and Visitors Corporation). Through the years, tourism agencies have used various slogans to sell the Philippines as a destination. To name a few, in the 1970s Where Asia wears a smile and An island to remember; in the 1980s Fiesta Islands, Theres a Fiesta for Everyone and Fiesta never ends in the Philippines; in the 1990s Islands Philippines, Our Islands Have It, Jeepney Islands (in Europe), and Musical Islands Philippines; in 1999 Rediscovery Philippines; and more recently, in the 2000s WOW Philippines (Cruz, 2000). The countrys new tourism campaign slogan is Pilipinas Kay Ganda under the administration of President Benigno S. Aquino III. The slogan aims to reinvigorate our countrys tourism campaign and double tourist arrivals within the next three years, said a Malacanang press statement reads. Promoting tourist destinations to potential vacationers is a difficult proposition. Most products and services use advertising to entice buyers and compete for the limited time and attention of the media-harried consumers. Likewise, current tourism advertising lacks the resources needed to prolong destination exposure in order to capture awareness and sustain the interest of potential consumers. In the domestic tourism scene, the local government units are tasked to promote their own destinations. These LGUs are given the liberty to formulate their own promotional strategies, according to the market niche that they are targeting realizing that different markets have different needs or motivations for travel. At present, the new administration is allocating budget for new media promotions, which includes launching a new website. This is due to the increasing trend of gathering information thru the World Wide Web. MOTIVATION FOR TRAVEL Throughout history, there have been different reasons why travellers set out on journeys or trips. The chief motivations noted in history were travel for escape, cultural curiosity, spirituality, education, and social status. People go on tours or trips to satisfy a range of needs from excitement and arousal to self-development and personal growth. The work of Stanley Plog, which is often critically accepted as the major approach to tourist motivation, stressed that travellers could be categorized on psychocentric (nonadventurous, inward-looking) to allocentric (adventurous, outward-looking) scale. In a more recent version of the approach, a second dimension, energy versus lethargy, was added to the psychocentric -allocentric dimension, thus developing a four-part categorization scheme. Nevertheless, the approach is still limited because of its North American bias, and it does not consider the issues of multimotive behaviour, nor does it provide measurement details or consider the dynamic nature of motives in the travellers life span (Goeldner Ritchie, 2006). Iso-Ahola (1988), in his work Toward a Social Psychological Theory of Tourism Motivation: A Rejoinder, argues that tourist and leisure behaviour takes place within a framework of optimal arousal and incongruity. That is, while individuals seek different levels of stimulation, they share the need to avoid either overstimulation (mental and physical exhaustion) or boredom (too little stimulation) (quoted by Goeldner Ritchie, 2006, p.262). The travel-needs model articulated by Pearce (1988) and co-workers is more explicitly concerned with tourists and their motives and argues that people have a career in their travel behaviour that reflects a hierarchy of their travel motives. People may start at different levels and are likely to change their levels during their life cycle. They may also be inhibited in their travel by money, health, and other people (quoted by Goeldner Ritchie, 2006, p. 263). The grades or levels on the Pearces Travel-needs or Career model were likened to a ladder and was built on Maslows hierarchy of needs. The earliest version of the travel-needs ladder retained Maslows ideas that lower levels on the ladder have to be satisfied before the individual moves to a higher level. Recent and ongoing revisions of this model place less emphasis on the strict hierarchy of needs and more on the changing patterns of motives. More importantly, the travel-needs ladder approach emphasizes that people have a range of motives for seeking out holiday experiences (Goeldner Ritchie, 2006). In the travel-needs model, destinations are seen as settings where vastly different holiday experiences are possible. Thus, travellers motives influence what they seek from a destination, and destinations will vary in their capacity to provide a range of holiday experiences (Goeldner Ritchie, 2006). Richards and Wilson proposes that the search for new travel experiences is primarily argued to reflect peoples increasing recognition and reaction to the homogenous nature of traditional tourism products as well as their increasing desire for altruism, self-change and an ability to confirm their identities and provide coherence within an uncertain and fragmented post-modern life (quoted by McIntosh Zahra, 2007, p. 542). VOLUNTOURISM (VOLUNTEER TOURISM) Volunteer tourism, or voluntourism, is an alternative type of tourism which applies to tourists who, for various reasons, volunteer in an organized way to undertake holidays that might involve aiding or alleviating the material poverty of some groups in society, the restoration of certain environments or research into aspects of society or environment (Wearing, 2001). Voluntourism is seen as utilizing ones discretionary time and income to go out of the regular sphere of activity to assist others in need (McGehee Santos, 2005). Voluntourism, is an alternative type of tourism which applies to tourists who volunteer in an organized way to undertake holidays that might involve aiding or alleviating the material poverty of some groups in society, the restoration of certain environments or research into aspects of society or environment. Munt suggests that volunteer tourism should be seen as an expression of what is recognized as the other dimension of postmodern tourism (quoted by Uriely, Reichel Ron, 2003, p. 58). It is, by default, mass tourism in its early pre-tourism development stage and can be viewed as a development strategy leading to sustainable development and centering to the convergence of natural resource qualities, locals and the visitor that all benefit from the tourism activity (Wearing, 2001). Voluntourism activities [volunteer vacations] involve participants paying to join organized projects (Broad, 2003). It is also described as donating ones time and manpower while on vacation, even if it is just part of their trips (Brown Morrison, 2003). Mead and Metraux describe volunteer vacations as giving time and energy for a good cause and paying for the privilege. It can be taken around the corner in ones home country, or around the world in a far off land. It may involve travel expenses only, or they may cost more than traditional trips (quoted by Brown Morrison, 2003, p. 73). Callanan and Thomas states that volunteer tourism fosters a reciprocal and mutually beneficial relationship between the host and the guest and is seen as offering an opportunity for sustainable alternative travel that is more rewarding and meaningful than other holidays. It focuses on the altruistic and self-development experiences that participants can gain and the assistance that can be delivered to communities in terms of community development, scientific research or ecological/heritage restoration (quoted by McIntosh Zahra, 2007, p. 543). With voluntourism, there is an intense rather than a superficial social interaction that occurs. The accounts between hosts and guests that is created are more engaging, genuine, creative and mutually beneficial. The nature of the experiences gained by tourists is more authentic, genuine, and reflexive, of contemporary cultural content and a meaningful impersonal experience (McIntosh Zahra, 2007). Cohen, Mittelberg, Uriely and Reichel all agree that with respect to tourism studies, the term working holidays was attached to individuals who combine volunteer activity with leisure/tourism pursuits while traveling (quoted by Limjoco Magtoto, 2006, p. 12). In certain aspects, the concept of a working holiday may be considered as a dubious form of relaxation because initially, tourists expect a vacation to be as effortless as possible. Nonetheless, comprising practically of altruistic aims, its palatable appeal gives it an edge in the tourist market. VOLUNTOURISM ACTIVITIES Voluntourism can take place in varied locations such as rainforests and cloudforests, biological reserves and conservation areas. Activities can vary across many areas, such as scientific research (wildlife, land and water), conservation projects, medical assistance, economic and social development (including agriculture, construction and education) and cultural restoration (Wearing, 2001). It may also include opportunities for teaching [conversational English], nurturing at-risk infants and children, renovating and painting community buildings, assisting with health care, and natural resource projects (Brown Morrison, 2003). In his book Volunteer Vacations: Short-Term Adventures That Will Benefit You and Others, Bill McMillon categorizes potential volunteer activities into the following groups: accompaniment and amnesty work; agricultural and farm work; archaeology; community development; environmental protection; environmental research; executive and technical assistance; historical restoration; marine research; medical and dental; museums; outdoor and recreation; public health; railroads; religious organizations; scientific research; social action; state and national parks and forests; trail building and management; and work camps (quoted by Brown Morrison, 2003, p. 77). VOLUNTOURISTS Gazley deems that volunteer vacationers appear to have the same motivations as long-term volunteers but the relative value of various factors is different with self-actualization being very important for short-term volunteers. He further suggests that it may lead volunteers to look for opportunities not only for service but for learning and growth in volunteering which may be increasingly focused on education (quoted by Ellis, 2003, p. 46). The only essential skill required by volunteer organizations is the desire to help others (Brown Morrison, 2003). There is usually, however, the opportunity for volunteers to take part in local activities and interact further with the community. Hence, the volunteer tourist contribution is bilateral, in that the most important development that may occur in the volunteer tourist experience is that of a personal nature, that of a greater awareness of self. Volunteer tourists will almost always pay in some way to participate in these activities. Furthermore, the amount is usually more than an average tourist would expect to pay on a normal holiday to a similar location (Wearing, 2001). Bud Philbrook, president and CEO of Global Volunteers, sums up the excitement of doing volunteer work on a vacation, when someone adds a volunteer dimension to their vacation, they gain a unique perspective of the community theyre re-visiting. They have the opportunity to learn from and about the local people and make genuine friendships in the process. It is an exceptional experience and very often the highlight of any tripà ¢Ã¢â€š ¬Ã‚ ¦ (quoted by Brown Morrison, 2003, p. 75). VOLUNTOURISM MOTIVATION Wearing states that in a global society that increasingly finds dogma and marketing used to instill values and exploit social relations, volunteer tourism represents both an opportunity and a means of value-adding in an industry that seems to represent consumer capitalism at its worse (quoted by Brown Morrison, 2003, p. 75). Resource mobilization theory argues that the networks an activist establishes, both within and outside of a particular movement, are vital to its success. Social psychological theories purport that, among other things, a consciousness-raising experience is a necessary precursor to social movement participation (McGehee Santos, 2005). The motives afforded by voluntourism would provide an outlet for those seeking unconventional travel experiences to pursue their own benevolent agendas. Furthermore, it can prove to be a far more satisfying experience than those offered by conventional tourism. Volunteer tourism would be a perfect venue wherein the travelers could satisfy their desires for a more in-depth understanding of the people within the tourist destination. It not only would have an impact on the tourists, but also on the locals themselves. Many travelers seek a chance to become immersed in a community or assist with projects when they travel rather than just passing through (Proceedings of Travel with a Purpose Symposium, 2000). MOTIVATIONS TO CONTINUE VOLUNTEERING Sherr (2003) classified the reasons that volunteers maintain their service through time into five factors. First, good communication within the organization is a very important factor to maintain the volunteers work in the long run. Good communication is a flow of quality information from the organization to its volunteers. Information flow consists of, for example, general news within the organization, the organizations 32 expectations of its volunteers, rules and regulations, recognition, and feedback given to the volunteers. There are a variety of forms of communication, such as face-to-face interactions, newsletters, bulletin boards, and more complicated forms such as public displays of recognition. It is reported that face-to-face conversation is the most effective factor to serve the satisfaction of the volunteers and increase their level of commitment. Providing informal recognition and appreciation early in the volunteer experience can affect the volunteers tenure of service at an organization (Stevens, 1991). If the volunteers are satisfied with the quality of the communication, they are likely to stay longer. Second, scheduling, work assignment, and work allocation are crucial factors to maintain the volunteers efforts. Volunteers tend to be satisfied with work if they can schedule their own volunteer hours and days, especially if the schedule is flexible. In addition, they are apt to continue volunteering if they are assigned to work on tasks that allow them to utilize their personal talent or specific skills. Next, if the volunteers can see that the outcome of their volunteering efforts really benefit somebody, they have a propensity to remain in the service. This factor will be reinforced if there is a connection, particularly direct contact, between the volunteers and the people benefiting from their services. In other words, if the volunteers feel that their efforts are worthwhile and important, they will be motivated to continue volunteering. On the contrary, if they feel useless or incapable, they tend to terminate their volunteer work sooner (Wharton, 1991). Fourth, volunteers expect good support from the organization they work for, such as training support and emotional support. Volunteers who participate in training report 33 higher levels of satisfaction than those who do not (Galindo-Kuhn Guzely, 2001). Organizations offering longer training sessions and a variety of training topics are also likely to have a larger number of volunteers who are satisfied and committed (Cyr Dowrick, 1991; Paradis Usui, 1989). Volunteers need emotional support not only from the organizations paid staff, but also among the volunteers themselves. Volunteers have a propensity to continue their service when they perceive that they are a part of the team and each member is willing to collaborate in problem solving, cooperate on projects, and encourage the volunteer initiative and activity (Cyr Dowrick, 1991). On the contrary, if they feel like they are being treated without respect, such as being told what to do and what not to do, they will lose their i nterest and motive for participating in that volunteer effort. Lastly, a strong sense of group integration is another important factor that keeps the volunteer in service. Group integration refers to the bonds that tie volunteers affectively to one another and the organization. Such relationships are independent of the work; instead, they provide a social aspect of the volunteer experience that is associated with satisfaction and commitment. The study by Field and Johnson (1993) indicated that volunteers are more satisfied when they have contact with other volunteers, not only in the work, but also at social events or casual socializing outside of the workplace, such as having an informal dinner with the paid staff and other volunteers, or being invited to join holiday parties (Sherr, 2008). VOLUNTOURISM AND SOCIAL AWARENESS Volunteer tourism presents a unique opportunity for exposure to social inequalities, as well as environmental and political issues, subsequently increasing social awareness, sympathy and/or support (McGehee Santos, 2005). McGehee and Santos explored how an increased social awareness through voluntourism can influence subsequent social activism. A voluntourism experience may provide an indirect or informal channel for an exchange of ideas regarding the issues and inequalities that exist. Though the observation of these social issues and inequalities and the exchange of ideas occur in the local community, it can be deemed apparent that the same occurs elsewhere. It has been proposed that volunteer tourism experiences have the potential to change voluntourists perceptions about society (at a global as well as local level). In the study conducted by McGehee and Santos, consciousness-raising occurred prior to, during, and after the volunteer tourism experiences. It has been found out that many volunteer tourism expeditions improve what is called as global citizenship. One of the many interesting topics in the field of tourism research is that of tourisms potential contribution to global peace and understanding. There are examples from around the globe, of tours that are seeking conflict resolution, greater understanding and even movements for global social justice. However, it remains a matter of some dispute among tourism analysts as to whether tourism can help foster peace and secure a more harmonious world (Higgins-Desbiolles, F., 2003). VOLUNTOURISM AND CULTURAL TOURISM It is unlikely that [other] cultural tourists will gain the same depth of interaction and experience as a volunteer tourist (McIntosh Zahra, 2007). Admittedly though, this conclusion still requires further empirical validation. In their paper, McIntosh and Zahra examined the nature of the volunteer experience in the search for alternative and sustainable experiences through cultural tourism, in the case of Australian visitors to a Maori community. The findings of the study showed that the main motivation for undertaking the volunteer project was not primarily related to sightseeing but to volunteering, to work; not just to be tourists, to give and to experience a service project. It was examined how open and responsive the host community were initially, and throughout the volunteering project, and what impact the volunteers left on the community. It was found out that the nature of the volunteer tourism experience was mutually beneficial to both the host and the voluntourist. The nature of the experiences gained by the voluntourists were seemingly different from those gained by cultural tourists experiencing the traditional cultural products, as the latters experience border on commodified cultural products. VOLUNTOURISM AND ECOTOURISM Wearing impresses that volunteering on nature conservation projects has become increasingly popular in the last two decades (quoted by Halpenny Caissie, 2003, p. 25). Non-government organizations and government agencies charged with managing biologically significant and recreation-oriented areas are expanding the use of volunteers in their programs designed to conserve biodiversity, foster healthy environments, and operate recreation and conservation programs. In a paper by Halpenny and Caissie, they explored the attitudes and values regarding nature, and the perceptions of nature by the volunteers who participated in the Volunteer for Nature program, a Canadian-based conservation volunteer project. A majority of the volunteers stressed the importance of nature and the environment as a context for self-centered activities such as recreation and therapeutic interaction. The importance of natures existence value, the satisfaction of knowing that nature exists and is being protected was also apparent. Many of the participants expressed concern and empathy for the wildlife and threatened environments. Wearing describes volunteer ecotourism as a bright alternative that promotes host self-determination, local control, sustainability, environmental stewardship and the privileging of local culture and values (quoted by Gray Campbell, 2007, p. 466). III. GAWAD KALINGA THE POWER OF AUDACIOUS GOALS 1. GK777 Meloto knows the importance of coming up with a compelling vision to inspire people. Thus, he came up with GK777. Launched in 2003, GK777 goal to construct 700,000 homes in 7,000 communities in seven years. The objective of the project is to help the poorest of the poor, regain their trust, build their confidence, make them think and act as a community and to share the joy of a country rising from poverty. 2. GK2024 A logical extension of GK777 is GK2024, which seeks to uplift five million Filipinos.The first phase of the journey (from the year 2003 to 2010) aims to achieve Social Justice, and is captured in GK777. The goal has been restated as: raising 700,000 home lots and starting up 7,000 communities by the end of 2010. The second phase (from 2011 to 2017) is the stewardship phase called Social Artistry, and aims to empower GK communities for self-governance, self-reliance, and self sufficiency through community-based programs for health, education, environment, and productivity. It also aims to build a village culture that honours Filipino values and heritage. The final phase (from 2018 to 2024) is envisioned as a time of Social Progress, and seeks to achieve scale and sustainability by developing the grassroots economy and expanding the reach and influence of GK to five million families with support from key sectors of society in the Philippines and partners abroad (Gawad Kalinga, 2009). During this phase, the Filipino will lift himself from poverty by unleashing his potential for productivity and hard work in the right environment. According to the Gawad Kalinga web site, the 21-year journey of Gawad Kalinga represents one generation of Filipinos who will journey from poverty to prosperity, fromneglect to same to honour, from third- world to first world, from second-class to first-class citizen of the world. 1. Companies (private sector) Gawad Kalinga has successfully propagated the idea that the participation of big business in GK is more than just exercising their corporate social responsibility (CSR). They are also involved in a bigger project that is nation-building. Because of GKs novel approach of actively engaging their corporate donors in implementing GK programs and activities on the ground (rather than simply raising funds), the partnership takes on some special meaning for the. 2. Government (public sector) In 2002, President Gloria Macapagal Arroyo challenged GK to build 1,000 homes with P30 million from her presidential fund. In spite of its lack of experience in building at such a scale back then, GK succeeded in building the houses in 70 sites throughout the country within a year. President Arroyos highly-publicized initiative served as a major boost for GK, which began to attract leaders from both sides of the political fence, including opposition leader Sen. Aquilino Pimentel Jr., who provided P40 million from his Countryside Development Fund for schools, livelihood centers, sewage and path walks. Support also came from other senators. Hundreds of governors and mayors have since joined the bandwagon. SERVICE EXPANSION MODEL For several government agencies, partnership with Gawad Kalinga allows them to fulfill their public-service mandates more effectively. Worth noting are the partnerships of GK with the Department of Agriculture (DA), and the Department of Tourism (DOT). The partnership between GK and DA took the form of Bayan-Anihan, the food-sufficiency program of Gawad Kalinga. Bayan-Anihan aims to eradicate hunger by empowering families in GK communities to produce their own food. Under this program, GK families would each be given a 10-square meter lot where they could start a vegetable garden with okra, tomatoes, eggplants, and kangkong for their daily consumption. Launched in 2009, the program seeks to launch 2,500 farms in the next three years to feed at least 500,000 people for life. Another innovative program is GK Mabuhay, which promotes GK sites as tourist destinations. This is a result of the collaboration between GK and DOT. GK villages have become a cultural attraction in themselves, owing to the fact that they were built with the people working together as members of the community. Under this program, GK villagers welcome visitors with warmth and hospitality brought about by their renewed sense of hope. Both GK and the DOT call this campaign the new face of community tourism. Taking center stage are the Mabuhay Ladies, a group of women residents who were chosen to be tour guides in the GK communities that were opened as travel destinations. The DOT conducted workshops for the Mabuhay Ladies, giving them practical guiding tips and techniques on how to be effective tourist hosts and good communicators. The concept of community tourism, according to DOT Secretary Ace Durano, is fairly new. This has been a sought-after activity among the more adventurous travelers, who choose not just to travel but to take part in community concerns. This travel-for-a-cause stance has been supported by the DOT through its other partnerships with socio-civic groups, Durano said BUiLDING THE GK BRAND Contributing to the rapid growth of Gawad Kalinga is the reputation it has built over the years. Gawad Kalinga has succeeded in creating an image that appeals to donors, volunteers, and other stakeholders. For example, GK is fashioned as a nation-building movement. It seeks to build a nation empowered by people with faith and patriotism and one that is made up of caring and sharing communities, dedicated to eradicate poverty and restore human dignity (GKBI, 2009). Since it was founded in 1995, Gawad Kalinga has managed to put a unique spin to its programs and activities. Because of this, GK has always looked fresh and dynamic to interested observers. For example, GK was originally known for building faith communities because of its values formation programs, and because of its association with the Couples for Christ. When it made inroads in building homes in war-torn Mindanao, GK communities were dubbed as peace zones where Muslims and Christians work together to address poverty. Recently, GK communities have become eco-friendly villages as well because they have begun to integrate environmentally-sound practices in their way of living. GK villages have likewise been transformed into tourist spots that showcase the inherent charm and uniqueness of each place. Aside from the colorful houses and beautifully landscaped surroundings, each GK community offers the warmth, hospitality, and inspiring stories of its residents, who represent the triumph of the Filipino people against poverty and oppression. IV. CONCEPTUAL FRAMEWORK The conceptual framework is presented by Figures 1 and 2, which are the Concept Map and Concept Table respectively. Figure 1. Concept Map of the Study GK cm3 Premise: Tourism promotions play a large role in encouraging people to engage in tourism ventures. The natural beauty or landscape of the destinations, the facilities and services of the tourism supplier, and the organizations government mandated and non-government mandated, stimulate tourism response. Domestic tourism is an amalgam of internal and inbound tourism. At present, traditional or conventional tourists dominate the domestic tourism markets

Portrait of a Victim in Toni Morrisons The Bluest Eye :: Bluest Eye Essays

Portrait of a Victim: Toni Morrison’s The Bluest Eye      The Bluest Eye (1970) is the novel that launched Toni Morrison into the spotlight as a talented African-American writer and social critic. Morrison herself says â€Å"It would be a mistake to assume that writers are disconnected from social issues† (Leflore). Because Morrison is more willing than most authors to discuss meaning in her books, a genetic approach is very relevant. To be truly effective, though, the genetic approach must be combined with a formal approach. The formal approach allows the unpacking of the rich language, imagery, and metaphors of Morrison’s writing, and the genetic places it in the larger context of her social consciousness.   In The Bluest Eye, Morrison’s uses her critical eye to reveal to the reader the evil that is caused by a society that is indoctrinated by the inherent goodness and beauty of whiteness and the ugliness of blackness. In an interview with Milwaukee Journal staff writer Fannie Leflore, Morrison said that she â€Å"confronted and critiqued the devastation of racial images† in The Bluest Eye.   The narrative structure of The Bluest Eye is important in revealing just how pervasive and destructive the â€Å"racialization† (Morrison’s term for the racism that is a part of every person’s socialization) is (Leflore). Morrison is particularly concerned about the narration in her novels. She says, â€Å"People crave narration . . . That’s the way they learn things† (Bakerman 58). Narration in The Bluest Eye comes from several sources. Much of the narration comes from Claudia MacTeer as a nine year old child, but Morrison also gives the reader the benefit of Claudia reflecting on the story as an adult, some first person narration from Pecola’s mother, and narration by Morrison herself as an omniscient narrator. Morrison says, â€Å"First I wrote it [the section in The Bluest Eye about Pecola’s mother] out as an ‘I’ story, but it didn’t work . . . Then I wrote it out as a ‘she’ story, and that did n’t work . . . It was me, the author, sort of omnipotent, talking† (Bakerman 59). Morrison intentionally kept Pecola from any first person narration of the story. Morrison wanted to â€Å"try to show a little girl as a total and complete victim of whatever was around her,† and she needed the distance and innocence of Claudia’s narration to do that (Stepto 479).

A Walk to Remember by Nicholas Sparks Essays -- school students, logic,

Nicholas Sparks’ A Walk to Remember is a classic â€Å"coming-of-age† novel that is a simple enough read to allow high school students to relate to the storyline. When Landon Carter finally accepts his feelings for Jamie, who has helped him become a better person in more ways that either of them know of, he reaches the pinnacle of his transformation from a troubled and resentful teenager into a respectful and selfless young man. A text included on a required reading list for high school students should have a theme that allows them to relate to the characters, to figuratively put themselves in their shoes and feel as if they are part of the story. It should also develop the students’ moral compass and teach them a valuable lesson that will help them throughout their lives. A Walk To Remember is a great Coming-of-Age novel for high school students to read because it allows students to hear the main character’s voice change and mature throughout the novel an d provides an opportunity for them to reflect on whether it is best to listen to logic or to listen to one’s heart, Landon’s personal growth, and the brevity of life. Landon Carter is a typical high school senior who’s always behaved himself based on logic, but as he encounters many fateful events that grant him a sense of self-awareness he realizes who he truly is, and is appalled by what he finds. Throughout the story, Landon spends more and more time with Jamie, a girl who is ousted by most of the senior class because of her religious devotion. Although he is not thrilled by her company at first, he truly ends up appreciating what she represents, which we see when he says, â€Å"The more I hung around Jamie, the more I realized she had a lot of different emotions†¦ that was the first tim... ...ould be a part of required reading lists for high school students because it introduces them to concepts like logic and feelings, levels of maturity, and the brevity of life that allow students to find their true calling. This novel will teach them to develop the skills they need to make conscious decisions, whether they base them on logic or they go with their hearts as well as developing the right level of maturity they need to succeed in the real world. Students need to be able to reflect on matters that will be meaningful regarding the decisions they will have to make in the future so that they are knowledgeable about their choices. This novel is a great example of how a required book should teach students an indispensable lesson about logic, feelings, and moral values. Works Cited Sparks, Nicholas. A Walk to Remember. New York: Warner Books, 1999. Print.

Employer-Employee Relations Quiz

Employer-Employee Relations Quiz Name MGT 434/ Employment Law Date Instructor Employer-Employee Relations Quiz The Company of Little Lamb hired Mary as a programmer for a special project. There was a contract for that specific project, and near completion. However, the company was still in need of her services. So, they asked Mary to continue working with the company until the project was finished. There was no mention of any contract made; however, the supervisor of the company began to work directly with Mary.They wanted her to use company materials, equipment and at the same time remain on company work schedules. The company after two years went through financial difficulties and they asked Mary to leave. But a mere thirty days later the Little Lamb Company acquired a major contract. They hired Mary’s relative and never offer her the opportunity to return. Investigation: Is Mary an independent contractor or an employee? Describe the factors that led to her determination. Th ere is a need to know the release of Mary from her employment.The employment-at-will was under action for legal set of guidelines. There are two related questions that needed to be answered first and these are: 1) her status while working at the Company, if she was an independent contractor or an employee; and 2) the nature of the employer-employee relationship, if it underwent change over the course of time. Based on the information given, May was a skilled programmer who worked outside the context of regular office hours and direct supervision from the company manger or supervisor.There was a contract that was made for a specific project. It was pointed out that the project was near completion and therefore there was a time element to the work that it was not expected to go on and on forever. This means that Mary knew that after the project was completed, her services was no longer needed and the company had no obligation to retain her services or to make her an employee of Little Lamb Company. Has the employer-employee relationship changed over the course of time? Is so, how?Even so, when the project was completed for Little Lamb Company, Mary was still asked to continue working as a programmer and her services. There were changes in the employer-employee relationship. Her supervisor began to work closely with her in the new project. Mary was asked to continue using materials, equipment, and to follow the work schedules provided from the company. This simply means that Mary was considered as a valuable asset to the company and she was not working outside the company but within the company’s location.This made the job more gratifying along with having sources at her finger tips. Mary worked there for an additional two years. This suggests that she was working there even after she completed the second project. She is considered as an employee of the company. This brings the discussion to the last question: was Is Mary’s release legal under the d octrine of employment-at-will? Explain why or why not? If not, which of the following exceptions to employment-at-will have been violated? Explain why.Based on the doctrine of at-will-employment Mary’s release from employment was legal. According to experts; â€Å"An at-will-employment arrangement is an arrangement in which the employee serves at the unilateral pleasure of the employer† (Reda, Reifler, & Thatcher, 2008). This simply means that the employer can terminate the services of Mary without giving any explanation and there is no legal problem for doing so. This is because there were no written employment agreements, plans, letters, or similar writing that Mary could have used to show that there was a breach of agreement.There was a contract made but it can only be understood as contracts that were made for the first and second project. Following the completion of these two projects Mary was given another work load but there was no contract concerning her salary and other benefits that she could expect from the company. In this case the employment can only be understood as at-will-employment and the employer has the right to terminate her services without just cause.In many cases the need to reorganize and to reduce the number of employees are valid reasons for the company to release somebody from employment and the courts will judge in their favor. Exceptions to At-Will Employment The doctrine of at-will-employment clearly favors the employer. The employer need not prove just cause before terminating the services of Mary. There are instances where the Company Little Lamb may be found to be in breach of the following: 1) breach of public policy; 2) breach of implied covenant of good faith and fair dealing; and 3) breach of implied contract University of Phoenix Syllabus (2011).Even though at-will-employment gives the employer the ability to terminate employment at will, Mary can complain against unlawful termination if Mary was dismissed b ecause she was asked to commit a crime, released from employment because she was a whistleblower against the illegal activities of the employer, dismissed because she served on a jury against the employer’s wishes or dismissed because she exercised her legal right – this is considered a breach in public policy.Based on the information given Mary was not released because she was a whistleblower or testified against the company. Her employment was terminated because the company went through a financial difficulty. There could be an implied breach of contract with good faith along with fair dealing taking into consideration because Mary worked so hard for the company. This was evidenced by the fact that she was asked to do another special project when the first one was near completion.This is also made clear when Mary was asked to continue working for Little Lamb Company for two more years. This principle is based on the idea that there exists a special relationship of tr ust and reliance between the employer and employee and this can be measured by length of service (Vettori, 2007). In the case of Mary two years of work under at-will-employment is not enough to show that there was a special relationship of trust and reliance.At first glance it may seem that the Little Lamb Company is in breach of implied contract because of the way it treated Mary, starting from changing her status from a contract to an at-will employee with letting her stay and work for two more years can be interpreted as the company being satisfied by the way she perform as a programmer. This does not immediately mean that there was a contract implied or otherwise. In Guz v. Bechtel National, Inc. he California Supreme Court decided that: â€Å"even if the employee has worked for a company for a long time, and during that tenure received pay raises, commendations, promotions, and other recognitions of continuing good performance† this does not by itself create an implied c ontract protecting the employee from being released without just cause (Orrick, 2010). In Conclusion, Mary worked at Little Lamb Company for more than two years, first as an independent contractor and then as an employee.It was clear that there was a change in the employer-employee relationship because she was asked to do things that only apply to employees. As a result, when she was released from employment there could be grounds to contest the dismissal based on the breach of implied contract, breach of public policy with covenant of good faith and fair dealing consideration which brought attention in any deciding factors. However, there was no contract or any form of written agreement stating that Mary can only be terminated by first establishing just cause.This is because she is under at-will-employment and in this scenario the employer can terminate her services without just cause. It is very clear that the doctrine of at-will-employment protects the interest of the employer an d if Mary wanted to have job security the only way to do so would be to secure an agreement or a contract from Little Lamb Company that she can only be terminated with just cause. References Law Library-American Law and Legal Information. (2010).Employment at Will-Breach of an Implied Covenant of Good Faith and Fair Dealing. Accessed 01 August 2010 from http://law. jrank. org/pages/6433/Employment-at-Will-Breach-an-Implied-Covenant-Good-Faith-Fair-Dealing. html Reda, J. , S. Reifler, & L. Thatcher. (2008). New Jersey: John Wiley & Sons, Inc. Vettori, S. (2007). The Employment Contract and the Changed World of Work. VT: Ashgate Publishing. University of Phoenix syllabus, (2011) MGT 434 Employment Law, Little Lamb Scenario

Why John a Macdonald Is Consider One of the Greaters Prime Minister

The greatest prime minister in Canada Introduction †¢After 143 of Canada been created by the father of confederation, it can be realize that nothing of this would have happen if it was for the persistence of Prime Minister John A. Macdonald †¢Three British colonies were formed into four Canadian provinces. The British Province of Canada was divided into the new Canadian provinces of Ontario and Quebec, and two other British colonies, New Brunswick and Nova Scotia, also became provinces of Canada. Promise to connect west with east and in today’s environment that connection is still and icon in Canadians †¢Convince one important person in Nova Scotia so that this province would not retired from the confederation †¢Server 2 term in †¢He is consider one of the father or confederation †¢Second longest prime minister in Canada history†¢Only prime minister with six majority governments †¢won praise for having helped forge a nation of sprawling geographic size, with two diverse European colonial origins, numerous Aboriginal nations, and a multiplicity of cultural backgrounds and political views Thesis Sir John A. Macdonald, Canada’s greatest Prime Minister was responsible for the founding of Canada and work hard to make this nation stable and prosperous The greatest prime minister in Canada Introduction †¢After 143 of Canada been created by the father of confederation, it can be realize that nothing of this would have happen if it was for the persistence of Prime Minister John A. Macdonald †¢Three British colonies were formed into four Canadian provinces.The British Province of Canada was divided into the new Canadian provinces of Ontario and Quebec, and two other British colonies, New Brunswick and Nova Scotia, also became provinces of Canada. †¢Promise to connect west with east and in today’s environment that connection is still and icon in Canadians †¢Convince one important person in No va Scotia so that this province would not retired from the confederation †¢Server 2 term in †¢He is consider one of the father or confederation Second longest prime minister in Canada history †¢Only prime minister with six majority governments †¢won praise for having helped forge a nation of sprawling geographic size, with two diverse European colonial origins, numerous Aboriginal nations, and a multiplicity of cultural backgrounds and political views Thesis †¢Sir John A. Macdonald, Canada’s greatest Prime Minister was responsible for the founding of Canada and work hard to make this nation stable and prosperous