Setting and Theme in Barn Burning Essay -- William Faulkner American L

All stories, as all individuals, are embedded in a context or setting a time, a place, and a culture. In fact, characters and their relationship to others are better understood in a unique(predicate) context of time, place and atmosphere, as they relate to a proposed theme or central point of a story. Abner is revealed as a sadistic character who confronts his give-and-take with the choice of keeping his loyal ties to the family or parting for a life on his own with no familial support. Sarty is Abners son, a young boy mangled by the words of his father and the innate senses of his heart. Sarty is challenged by an internal conflict, he wants to disobey his father, yet he knows that if he leaves he will break nowhere to go and no one to turn to. We will take a look at the setting, specifically the era in which William Faulkners Barn Burning took place. The destiny surrounding Abners barn burning also play a crucial role in finding the underlying message or the theme seeing as how it is non always the obligation of an individual to support another family member when his or her choices do not morally coincide with ones own honest choices. Setting plays a vital part in establishing the background for the events that take place in any piece of literature. Barn Burning was set in the 1930s, a time when the Great Depression produced great social and economic problems among the people of the era. The economy was not stable. National wealth was not spread evenly. Instead, about of the money was in the hands of the wealthy. Lowly farmers like Abner were forced to grow crops as a source of food during this time of unemployment and overpriced goods. Abner had a thorny time providing for his large family, which was why he went abo... ... Sarty could never again return home. Richard Bach put it best when he said, The bond that links your true family is not one of blood, but of respect and joy in each others life, which represents Sartys deviance fr om his fathers wishes. Although everyone was affected by the Great Depression, they did not have to live like savages. Abner could have farmed a larger variety of crop and established a reputable name for himself to become one of the leading salesmen of the area. Sarty was conflicted with keeping his loyalty to his blood ties or leaving. Sarty made an intelligent choice of disobeying his father and abandoning his family for a legitimate life on his own, one in which he did not have to steal, destroy, or dwell to live a meager life. Sarty probably left in hopes of some day becoming like Major de Spain, a man of intelligence and wealth.

Long Days Journey into Night Eugene by ONeill Essay -- Long Days Jo

&9In the play Long Days Journey Into Night by Eugene ONeill, the Tyrone family is haunted non by what is present in flesh facing them, but by memories and constant reminders of what has been the downfall of the family for years. " No it can never be now. But it was once, in front you-" (72) James Tyrone referring to the Morphine addiction of his wife, Mary, which attributed to the undoing of the family. Their trials and tribulations are well documented by ONeill through the proficient utilization of theme, characterization, plot, setting, and style. &9Throughout the play, ONeills theme is one of a disclosure into the lifetime of a seemingly normal family on the outside yet convoluted with bitterness on the inside. It portrays the actions of a dysfunctional family and brings us on a brooding journey from when the fledgling family had started, devoted to one another with high hopes for the future, to what it is today, a family engulfed in turmoil. "Who would have op inion Jamie would grow up to disgrace usIts much(prenominal) a pityYou brought him up to be a boozer." (110) In this excerpt from Marys communion with James regarding their son, it is obvious that their life had taken a 180-degree turn from when their offspring were mere children with promise.&9Characterization throughout the play helps us not just to understand the characters actions but also to see into the brain of each and to comprehend their thoughts and e... Long Days Journey into Night Eugene by ONeill Essay -- Long Days Jo &9In the play Long Days Journey Into Night by Eugene ONeill, the Tyrone family is haunted not by what is present in flesh facing them, but by memories and constant reminders of what has been the downfall of the family for years. " No it can never be now. But it was once, before you-" (72) James Tyrone referring to the Morphine addiction of his wife, Mary, which attributed to the undoing of the family. Their trials and tribul ations are well documented by ONeill through the proficient utilization of theme, characterization, plot, setting, and style. &9Throughout the play, ONeills theme is one of a disclosure into the life of a seemingly normal family on the outside yet convoluted with bitterness on the inside. It portrays the actions of a dysfunctional family and brings us on a reflective journey from when the fledgling family had started, devoted to one another with high hopes for the future, to what it is today, a family engulfed in turmoil. "Who would have thought Jamie would grow up to disgrace usIts such a pityYou brought him up to be a boozer." (110) In this excerpt from Marys conversation with James regarding their son, it is obvious that their life had taken a 180-degree turn from when their offspring were mere children with promise.&9Characterization throughout the play helps us not only to understand the characters actions but also to see into the soul of each and to comprehend their th oughts and e...

Transformation to Womanhood in Two Kinds by Amy Tan :: Two Kinds, Amy Tan

Transformation to Womanhood in Two Kinds   For a lot of us growing up, our mothers have been an integral part of what do us who we are. They have been the unity to forgive us when no one else could. They have been the one to comfort us when the world seemed to turn to evil. They have been the one to shelter us when the rain came pouring down. And most importantly, they have been the one to love us when we needed it the most. In Two Kinds, by Amy Tan, Jing-mei is a infantile daughter of a Chinese immigrant. Growing up she had to endure being raised by an overbearing mother as well as grant with psychological struggles within herself. She had to learn how to become a woman on her own terms.   Throughout the story, her mother repeatedly pressures Jing-mei to be something that she is not. She wants Jing-mei to somehow become a prodigy child. She has such high hopes for her daughter that she doesnt realize the amount of distress she causes Jing-mei. Like all good mothers, sh e only wants the best for her child.   Since immigrating to America, she believes that anything can be consummate(a) and she uses her daughter as her outlet to prove it. She continuously gives Jing-mei numerous tests to memorize bible passages and world capitals, and eventually coerces her into taking piano lessons, which becomes the prime focus of her perfect daughter determination.   Jing-mei reacts super negatively to this pressure. This is only exemplified when she states, I wont let her change me, I promised myself. I wont be what I am not. She is forced to take a stance against her mother primarily because she doesnt want to be forced into becoming something that she is not. Jing-mei feels she must become her true self, a person whom she feels her mother is not to determine for her.   Jing-mei feels uncomfortable with her mother putting so much pressure on her. She is on a continuous struggle within herself to find who she really is. She is constantly distrau ght over tear feelings of wanting to become her true self and making her mother proud. Still, as time goes on it proves to be better to go against the tide, go against her mothers wishes. And after sightedness my mothers disappointed face once again, something inside of me began to die.

Comparing Two Types of Nokia Cell Phones :: Compare Contrast Comparison Essays

Comparing Two Types of Nokia Cell PhonesToday, the cellphone phone has become a common device in the U.S. Almost all people in the U.S. use cell phones. By using these phones, people can be reached everywhere they go. Because of the development of technology, now there are many kinds of cell phones from distinct brands. Every cell phone company offers their products from the cheapest to the most expensive one with their advantages and disadvantages. So now, people can choose from many types of cell phones.In this paper, I will compare two divers(prenominal) types of cell phone from Nokia. I decided to choose Nokia cell phones because I personally like this brand. It offers many types of cell phones, so we can have many choices when buying a cell phone. I chose Nokia 6600 and 6820 for comparisons because they both are the new products from Nokia. Like the pictures above show, Nokia 6600 and 6820 have different appearance. Nokia 6600 has a fat and short shape. Its button s are arranged in a horizontal manner. Nokia 6820 has a thin and long shape. Its buttons are arranged in plumb manner. They have some differences in the specification. Nokia 6600 has 4.30 ounces weight and 4.28 inches long x 2.29 inches wide x 0.93 inch thick. It has a large food colour display with 176 X 208 pel resolution, up to 65,536 colors. In addition, it has internal antenna and vibrating alert and 5-way joystick navigation. It applies the Symbian Operating System 7.0s, Series 60 platform. It uses extended Li-Ion Battery 850 mAh with digital talk magazine up to 4 hours and digital standby up to 8 days. For the service, Nokia 6600 has service for GSM/GPRS/HSCSD 900/1800/1900 MHz. Nokia 6820 has 3.5 ounces weight, 4.69 inches long x 2.17 inches wide x 0.91 inch thick. It has a high-resolution color display 128 x 128 pixels, up to 4,096 colors. It also has 5-way joystick for easy navigation, internal antenna and vibrating alert. It uses extended Li-Ion Battery 850 mAh wit h digital talk time up to 3 hours and digital standby up to 12 days. It has service for GSM 850/1800/1900 MHz or GSM 900/1800/1900 MHz. They also have different features. In the voice feature, Nokia 6600 has voice dialing and commands, integrated handsfree speakerphone for cheerful communication, record and send memos, conversations, and sound clips3, record memos and conversations for up to 90 seconds.

Demise of the Permian- Triassic Period Essay examples -- Exploratory E

Demise of the Permian- Triassic Period It is well known that there was a gage extinction killing the dinosaurs. However 185 million years before their demise, almost all life on earth was destroyed.11 There has long been theories that meteorites are the cause the of the mass extinctions and professor Asish Basu believes he may have found clues that point to space as the cause of the extinction in the Permian- Triassic period.22 The Triassic period is during a time when the earth was divided in a giant land mass pangea, and water. Here there was no separation of continents. The Triassic is when the dinosaurs first started to appear, exactly long before the nonorious Tyrannosaurus Rex dominated the terrain. At this time the dinosaurs were just a small part of the many animals that wandered the earth and were by no means, the large dominant, creatures that come to ones mind today. However the marker of this period is an extinction of the animals in the Permian peri od. The Permian period is known for the abundance of flora and the major changes in decorate including the formation of the Appalachian Mountains.33 Most notably is the giant fern glossopteris. However at the end of the period, during the time of the extinction, it too disappeared.44 Professor Basu and his colleagues found fragments of chondritic minerals with mineral compositions that do not occur on earth, in Antarictica. These minerals have very similar chemical composition to minerals found in Meishan China. Because such similar extra-terrestrial minerals have been observed in two geographically distant places, there is evidence that a meteor struck the earth and the dust that covered the land was significant complete to co... ... If it was a meteor it could give new insight to what kind of meteor it was and how it killed almost an entire planets living organisms. Either way, this evidence should not be taken lightly and is a crucial to the world of science. Notes11 Basu, Asish Petaev, Michail I. Poreda, Robert J. Jacobsen, Stein B. Becker, Luann, Science Chondritic Meteorite Fragments Associated with the Permian-Triassic Boundary in Antarctica, Vol 302, Issue 5649, 1388-1392 , 21 November 200322 Basu33 Encyclopedia. http//www.encyclopedia.com/html/ sectionalization/Permianp_HistoricalGeologyofthePeriod.asp44 Associate Press. CNN Ancient Meteorite Wiped Out Life Washington, Nov. 20, 200355 Basu, 66 Associated Press77 Basu, 88 Britt, Robert Roy, Science Controversial New Claim in Death-by-Meteor Case, 20 November 200399 Britt1010 Britt

Demise of the Permian- Triassic Period Essay examples -- Exploratory E

Demise of the Permian- Triassic Period It is well known that in that respect was a mass extinction killing the dinosaurs. However 185 million years out front their demise, almost all life on earth was destroyed.11 There has long been theories that meteorites are the cause the of the mass extinctions and professor Asish Basu believes he may confuse rear clues that point to space as the cause of the extinction in the Permian- Triassic period.22 The Triassic period is during a time when the earth was divided in a gargantuan land mass pangea, and water. Here there was no separation of continents. The Triassic is when the dinosaurs first started to appear, but long before the notorious Tyrannosaurus Rex rule the terrain. At this time the dinosaurs were just a small part of the many animals that wandered the earth and were by no means, the large dominant, creatures that come to ones mind today. However the target of this period is an extinction of the animals in th e Permian period. The Permian period is known for the abundance of flora and the major changes in landscape including the formation of the Appalachian Mountains.33 Most notably is the giant fern glossopteris. However at the end of the period, during the time of the extinction, it too disappeared.44 Professor Basu and his colleagues found fragments of chondritic minerals with mineral compositions that do not occur on earth, in Antarictica. These minerals have very similar chemical composition to minerals found in Meishan China. Because such similar extra-terrestrial minerals have been discovered in two geographically distant places, there is evidence that a meteor struck the earth and the dust that covered the land was significant enough to co... ... If it was a meteor it could give new insight to what kind of meteor it was and how it killed almost an entire planets living organisms. Either way, this evidence should not be taken lightly and is a of import to the world of s cience. Notes11 Basu, Asish Petaev, Michail I. Poreda, Robert J. Jacobsen, Stein B. Becker, Luann, Science Chondritic Meteorite Fragments Associated with the Permian-Triassic Boundary in Antarctica, Vol 302, Issue 5649, 1388-1392 , 21 November 200322 Basu33 Encyclopedia. http//www.encyclopedia.com/html/section/Permianp_HistoricalGeologyofthePeriod.asp44 Associate air pressure. CNN Ancient Meteorite Wiped Out Life Washington, Nov. 20, 200355 Basu, 66 Associated Press77 Basu, 88 Britt, Robert Roy, Science Controversial New Claim in Death-by-Meteor Case, 20 November 200399 Britt1010 Britt

Modern Business Environment Essay

To what extent is the downlike HRM ride achievable and desirable for organisations in the late stemma milieu?The modern business environmentFor the past few hundred years the business environment has been mostly based upon turning valet de chambre hours and materials into wakeless products (produce). What we be seeing now is a shift away from this production by mass labour, to a system whereby nigh(a)s ar produced by instrument and the services needed to facilitate this are produced by man.Taking the UK economy as an example, the latest economic forecast by the TUC (Fig 2) shows a steady surrender of manufacturing in favour of service sector blood lines. This reinforces the view that the emphasis is shifting from producing goods to providing services. The precisely advantage m whatsoever companies brace are the competencies and abilities of their people (Dewe 2002). With firms using the very(prenominal) machines competitive advantage (or disadvantage) is created by th e knowledge and skills of the employees.Tom Watson Jr, former President of IBM recognised the shift on the whole the grade of this fraternity is in its people. If you burnt ingest all of our plants & we just kept our people & information files, we would soon be as strong as ever. Take away our people & we might never recover ( slew Management 199834). Knowledge therefore is power, we are moving from a physical economy to oneA UK government report (Competitiveness smock idea 1999) sees this new environment as requiring greater receptiveness to know-how and the ability to see its commercial potential eagerness to keep on learning at all levels in a business and a flair in spotting new customer needs and fresh business opportunities. This suggests that the modern business environment is a grade where knowledge is key.In his speech to the Business Link annual conference, Peter Mandelson MP Secretary of State for Trade & Industry precept the knowledge economy as transforming old antics as often as creating new, with implications for manufacturing and service industries alike. This leads us to the idea that the modern business environment is a place where investment is required in human capital to produce this knowledge economy.In the modern business environment, with the emphasis on value of human capital, gage can no longer depend on a job or organisation solely upon the employees own skill and competences (Van Ruysseveldt 19953-4). Organisations may not be able to guarantee long term employment, only if to entice fashioners of prime(prenominal) they must(prenominal) realise to different means.Hard & batty HRMHRM can be separate into two approaches laborious or soft (Fig.3). As we see from the diagram hard HRM is primarily financially driven, with a fairly hard view of haughty the wages bill, workers are seen as a damage rather than as an as desexualize to the organisation, the emphasis is on getting the best return on their funds, creating efficiencies.The comp all position provide take precedent over the collective views and concerns of employees. Such a way of managing human resources was demonstrated by Fordism where the workers on the assembly lineage were under tight controls and still had to divulge in-person information to be able to work for Ford (White Heat 1994). The work of Taylor (Taylorism) and the principles of scientific counseling were employ in the late 19th century to al clinical depression elementies to be managed with scientific methods rather than by rule of thumb. This idea also treat the workers as just another cog in the wheel of production and worked egress the best way that the worker could operate.The modern business environment has changed greatly since the old age where all workers were seen as tools to be maintained, much like machines, with regulations and tight controls. This was the hard school of HRM where peripheral workers are disposable and labour is directly productive ( Beardwell & Holden 200198). This model can also be viewed as managing headcount in a rational a way as for any other economic factor (Storey 19876). The workforce was merely a factor of production or cogs in the wheel.This hard HRM policy suits a workforce that is involved in a insistent job each process is standardised to al humiliated tighter controls. The opening is that the firm should maximise human efficiency in the same way as any other resource. This was made a success by businessmen like Henry Ford in the days of mass industrialisation. However, with the advent of high applied science machinery much of the repetitive work is now done by robot leaving only jobs for skilled maintainers and operatives, not leaving much scope for hard HRM practices to survive.McDonaldisation has built upon the ideas of scientific management and the successes of men like Ford. Each part of the process of bringing the food to the customer has been scientifically scrutinised and adjusted to sw ord it more expeditious. As a result of this approach, they have a controlled workforce and a set of strict rules and procedures that ensure the workforce is work exactly as the employers like them to. McDonalds have recognised that there is tranquillise a place for the unskilled worker, as machines cannot be relied upon to do all the jobs. In this instance there is still a place for the hard school of HRM.SoftHRM (fig 3) revolves around the suppuration of employees. Employees are viewed as assets to the company, rather than as purely another cost of production. This requires the management to regard the workforce as partners in the work process and nurture them to maximise their output. Heery and Noon (2001) suggests soft HRM is an approach recognising the need to treat employees as assets that must be looked after. A soft HRM policy would therefore place the emphasis on training and development in order to get the best out of the workforce as opposed to tight controls (Beard well & Holden 200198). Therefore, a policy of soft HRM seeks to increase production by communication, motivation and leadership (Storey 19876).Becker (1992 Nobel prize winner for economics) suggests that expenditures on education, training and medical care could all be considered as investments in human capital. They are called human capital, because people cannot be separated from their knowledge, skills, health or values in the way they can be separated from their financial and physical assets (Donkin 2002)If employees have an inherent capital value for their knowledge and skills, it would be reasonable to assume that an organisation can improve its competitive-edge through the excellence of its people (SHL group 2002).The work of Maslows goes approximately way to explaining the reasons why humans need this development and training. Maslow suggests that individuals have a hierarchy of needs (fig 1). Fig 1 outlines Maslows theory that human nature drives individuals to satisfy in stinctual needs. The theory suggests that once an individual has achieved one set of needs they are no longer move to seek this (as they already have it) and will continue to want more thus rising up the hierarchy.Maslows theory would seem to suggest that a firm must ensure that employees needs are continually met not only the safeguard and physiological aspects (the legal requirements of an employees contract) to increasing employee productivity. If a firm has to continue to meet ever increasing needs to motivate staff then this theory would be a good explanation of why firms use soft HRM.Types of soft initiatives* Flexible working, working from home or allowing workers the choice of hours outside a core time of 1000-1500 for example.* Job Sharing, by allowing employees to become multi skilled (training) they can operate in a variety of roles thus making their job appear more interesting but also allowing a backup if an employee were to be reach work at any time.* Parental kick the bucket, with the increased pressures on family life some firms now offer special breaks for staff with children, from allowing days off for hospital appointments to paid paternity leave.* Performance related pay this could be seen as a hard or soft perspective dependant upon viewpoint. If a system of bonuses exists for good work this would be a soft measure. If (tele sales) you only get paid if you hit certain targets, this would be a hard measure. The primary argument in favour of PRP is that it acts as a motivator, through twain providing incentives in the form of monetary rewards and by recognising achievements. Further benefits cited include the fact that individuals can identify closely with their employers goals and that this can increase productivity and encourage quality, tractableness and teamwork (Armstrong and Murlis, 1991).As we can see from the above examples soft HRM is much more difficult to quantify than hard HRM. It is more an overall approach to staff upbe at and development than a clear set of rules and procedures. What makes it so difficult to quantify is that two firms may claim to be operating the above soft HRM policies but in practise they maybe very different systems. For example, the concept of flexible working can be interpreted as allowing employees freedom to choose to work from home or the office, or the firm may use the system of core hours (as above). These are two very different systems but both hitherto come under the heading of flexible working.To decide which method a particular firm is using will require a broad look at the pay and conditions and the freedom employees enjoy. It is also useful to note that it is seldom a case of an employer operating one form of HRM, it is necessary for firms to allow their workers some freedom but at the same time retain control. A good example of this is Microsoft they operate a seemingly soft policy on HRM with a whole range of employee benefits and training programmes (24hr nurs e line, free entry to local events and professional development programmes). However, to retain the knowledge and skills that they develop the firm insists that if an employee is to leave the company they must not work in the computer industry for a period of 6 months. This shows that the organisation is willing to invest time and money to maintain a highly trained workforce but at the same time keeps a tight control on them.Why is Soft HRM Desirable?To examine the reasons why a firm should adopt policies of soft HRM we must look at the dangers of not doing this. A recent CIPD raft (CIPD 10/2001) has outlined the costs of organisations for not retaining and motivating staff. The survey has shown that one in four employees left their organisation in 1999 (the highest figure since the survey was created in 1995). What was even more alarming was the cost of replacing these lost staff. The average price for replacing a management level employee was 6086 which was an increase of 28 perc ent on 1999 the highest cost was to replace a professional services employee which was 8316. The danger for organisations is how this turnover terminations company performance, two thirds of organisations believe this to have a negative effect with 13 percent claiming that it has a serious negative effect.The CIPDs findings suggest that staff feel freer to leave an organisation when they know they can acquire employment elsewhere. In a labour market of low unemployment it seems that firms must make themselves more attractive to their employees. RebusHR, a firm that deals with outsourced HR issues for a range of companies sees soft HRM as a good way of retaining and attracting the best staffgiving people choice and a feel-good factorit shows that youre interested in them and listen to what they scan(Shepherd K 2002).In the article entitled Profitable personnel (People management 199828-31) West and Patterson suggest that good employee relations are directly inked to increased perfo rmance. In their survey the Sheffield effectiveness programme they found that people management is not only critical to business performance it also far outstrips emphasis on quality, technology, competitive strategy or search and development in its influence on the bottom line.The survey looked at a firm called Zotefoams, which operated an enlightened HRM policy. proles on the shop floor operated in teams and were multi-skilled they also had a certain level of responsibility for dealing with work priorities and quality problems. The aim was to create a multi-skilled and motivated workforce with more responsibility at the lower levels freeing up management for other tasks. With the management freed up for other duties this allowed the firm to be that much more flexible.Out of the 100 firms surveyed, Zotefoams enjoyed the highest profits and productivity over the seven-year period of the survey. In the final paragraph of the article, West and Patterson sum up their conclusions tho se in which the managers have eagerly addressed these challenges developing skills and ownership that have experienced rapid improvements in financial performance.The findings in the Sheffield effectiveness programme are backed up by a study by the sunshine Times (100 Best Companies to effect for 2002) in which 21,000 people were studied over a period of months from the bottom end of the incorporated ladder. In an article within this publication, Milton Moskowitz and Robert Levering suggest that Being a generous employer is not just good public relations its also good for business, especially when times are hard. This viewpoint makes sense if we take into consideration the negative effect of labour turnover on a companys performance and the high cost of recruitment. Entering into soft practices in human resource management should save the organisation in the long term.The Human seat of government Index, developed by the consultancy Watson Wyatt (Overell 2002) is based upon data of HR policies and practices gathered from 600 companies. This data is correlated against financial information. The firm believes it has identified how HR policies are effective predictors of value and which policies bring most value to the organisation. Organisations with the best HR practices deliver twice as much value to shareholders as their average competitors (Overell 2002).Is soft HRM achievable? check to RebusHR (a large human resources organisation which handles HRM issues for clients such as DaimlerChryslerUK) the biggest barrier to the concept of soft HRM practices is the administrative burden of co-ordinating the information (Shepherd K 2002). This stems from the problem that soft HRM is intangible, whilst it is assertable to relate high staff turnover to lack of enlightened HRM policies, it is not possible to directly quantify the benefits derived from the existence of soft policies. This leads organisations to see the cost and unornamented burden placed upon the H R department with an introduction of a soft HR policy, but it is difficult for this to be weighed up against the benefits on paper.In the IPD survey Benefiting from a balanced life (July/Aug 1999) of the firms questioned many were operating soft policies with 75% offering paternity leave and 57% offering parents special dispensation for time off to look after their children. Popular also were job sharing schemes (57%) and flexi-time systems (47%). From this survey we can see evidence that firms are operating soft HRM policies, what is unclear from the research is to what extent these policies affect the bottom line. The impact of soft HRM is intangible which means it leads us to the problem of quantifying any real benefits.The whole concept of soft HRM appears to be to retain and motivate staff, in the TUC economic forecast we see a high level of employee turnover in the services sector (hotels, restaurants) show the highest levels of employee turnover, but is this as a result of ha rd HRM practises? true turnover costs are more complex than simply figuring out the average cost of replacement. The costs of losing a good performer are greater than the costs of losing an average performer. The true cost of losing a key seasoned player is hard to estimate. There is the investment in development of the employee, the value of the knowledge and experience gained, and the lost productivity that also have to be considered to arrive at a true cost figure.In the case of McDonalds we see a split between management staff and shop floor workers. Whilst the management have many flexible benefits (PRP, bonus, life/health insurance etc) the workers on the shop floor do not (McDonalds 2002). They are regarded as cogs in the wheel and are treated fairly but firmly as in the hard school of HRM. As a consequence of this, shop floor turnover is high than that of the management. However, is this higher turnover a result of the HRM policy? Or is it a nature of the type of work? What I would suggest is that the sort of work involved with working on the shop floor of McDonalds is not conducive to a long career in that position. The result of this would be the high staff turnover for low skilled repetitive jobs.The dilemma facing HRM managers is that they need low skilled workers to provide the services such as discussed and to operate soft HRM policies such as training would move these workers away from where they were needed. We therefore cannot have it both ways there must be a balance between employee development and retaining quality people for their positions. If soft HRM seeks to address the retention and motivation of staff we must not lose sight of the fact that we do still need low skilled workers.Soft HRM assumes the existence of a knowledge society (Livingston 2001), the emphasis is on the human resources manager the harness the knowledge. Knowledge work is typically considered to be about variety and exception rather than routine. It is generally con sidered to be performed by professional workers with high levels of skill and expertise. Livingstone makes the point that the potential for waste of this knowledge through bad management is immense and gut wrenching. This claim is given substance by Thompson. In his research only 14 percent of employees received any training at all and that almost half of that lasted for less than a week (figures referring to the UK 2001).For HRM to work effectively we must reorganize work to firstly make the most of existing knowledge and human capital but also to develop this human capital to maximise future performance. In this modern business environment knowledge takes the leading place from other drivers of economic change such as labour, technology and markets.The dilemma we face with soft HRM is that (as explained above in the McDonalds example) a lot of routine work is done by workers with minimal training and knowledge and only small numbers of highly skilled employees are required. Thomps on pointed out that if employment growth is not dominated by knowledge work its going to be dominated by something else. There are strong and clear indications that it is dominated by low skill, routine work largely in the service sector.We cant make every job high skill, high wage, and high learning because there are jobs that neither the employee nor employer can grow. One of the reasons they cant be grown is because, in our other guise as consumers, a lot of us want the cheapest possible flights, goods, services and so on. We cant have it both ways. If we want cheap, controllable, efficient service, were not going to create a lot of high wage, high skill, high learning jobs.There are many dilemmas associated with the ideas of hard and soft HRM. We must realise that we cannot expand the knowledge and skills of all members of society infinitely. There will always be a place for the unskilled worker and as such there must be a place for hard HRM. However, in todays changing environm ent soft measures must come to the fore. The notion of the velvet glove concealing the iron fist of hard HRM (Beardwell & Holden 200193) shows that even soft measures are still measures of control. No matter how soft a companies HRM policies appear to be, they will still be designed for the benefit of the organisation rather than of the individual. The bottom line must always come first.Figures and tablesFig 1Fig 2 TUC (2002)Fig 3 Cornelius et al 2002BibliographyACAS, found at http//www.acas.org.uk/ accessed 10/11/02Armstrong, M and H Murlis, 1991 & 1994. Reward Management A Handbook of Remuneration system and Practice Second & Third edition. 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The Education-jobs gap Underemployment and economic democracy. Toronto, ON Garamond Press.Livingston, D. (2001). Worker control as the missing link Relations between paid/unpaid work and work-related learning. In Second International Conference on Researching Work and Learning Conference Proceedings. Calgary, AB University of Calgary Faculty of Continuing Education.Mandels on P, Business Link annual conference 7 October 1999.Microsoft Website, http//www.microsoft.com Accessed 19/10/02Overell, S, 30/10/2002 The metric system for performance FT 30/10/02People Management, 8 January 1998Peoplesoft, Available from Financial Times 31/10/02Sennett, R. (1998). The corrosion of character The personal consequences of work in the new capitalism. New York, NY W. W. 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A Game of Thrones Chapter Thirty

EddardI s tood last vigil for him myself, Ser Barristan Selmy said as they looked toss off at the body in the sand of the cart. He had no one else. A mother in the Vale, I am told.In the pale click light, the young k iniquity looked as though he were sleeping. He had non been handsome, save death had smoothed his rough-hewn features and the inactive sisters had dressed him in his best velvet tunic, with a high collar to coer the ruin the lance had do of his throat. Eddard Stark looked at his face, and wondered if it had been for his sake that the boy had died. Slain by a Lannister banner valet forwards Ned could speak to him could that be mere happenstance? He supposed he would neer k at present.Hugh was Jon Arryns squire for four years, Selmy went on. The business leader knighted him before he rode north, in Jons memory. The cranny wanted it desperately, however I fear he was not ready.Ned had slept badly last night and he matt-up tired beyond his years. None of us is ev er ready, he said.For knighthood?For death. Gently Ned covered the boy with his adorn, a bloodstained bit of blue bordered in crescent moons. When his mother asked why her word of honor was unused, he reflected bitterly, they would assure her he had fought to honor the Kings Hand, Eddard Stark. This was needless. War should not be a game. Ned turned to the wo populace beside the cart, shrouded in grey, face hidden save for her eyes. The close sisters prep atomic number 18d men for the grave, and it was ill fortune to look on the face of death. Send his armor home to the Vale. The mother allow for want to aim it.It is charge a fair piece of silver, Ser Barristan said. The boy had it forged special for the tourney. Plain work, precisely good. I do not know if he had finished gainful the smith.He paid yesterday, my lord, and he paid dearly, Ned replied. And to the silent sister he said, Send the mother the armor. I will deal with this smith. She bowed her chieftain.Afterwar d Ser Barristan walked with Ned to the pooves pavilion. The cantonment was beginning to stir. expand sausages sizzled and spit over firepits, spicing the air with the scents of garlic and pepper. Young squires hurried ab knocked out(p) on errands as their masters woke, yawning and stretching, to meet the day. A serving man with a tweet under his arm bent his knee when he caught sight of them. Mlords, he muttered as the goose honked and pecked at his fingers. The shields displayed outdoors each tent heralded its occupant the silver eagle of Seagard, Bryce Carons field of nightingales, a cluster of grapes for the Redwynes, brindled boar, red ox, burning tree, w f tout ensemble upone ram, triple spiral, discolour unicorn, dancing maiden, blackadder, twin towers, saddle horned owl, and last the pure white blazons of the Kingsguard, shining like the dawn.The fagot means to fight in the melee today, Ser Barristan said as they were passing Ser Meryns shield, its paint sullied by a deep gash where Loras Tyrells lance had scarred the wood as he drove him from his saddle.Yes, Ned said grimly. Jory had woken him last night to bring him that news. Small wonder he had slept so badly.Ser Barristans look was troubled. They presuppose nights beauties fade at dawn, and the children of wine be oft disowned in the morning light.They say so, Ned agreed, notwithstanding not of Robert. Other men might reconsider tal tabby to verbalise in drunken bravado, but Robert Baratheon would remember and, remembering, would never back down.The kings pavilion was close by the water, and the morning mists off the river had wreathed it in wisps of grey. It was all of golden silk, the largest and grandest structure in the camp. Outside the entrance, Roberts warhammer was displayed beside an immense iron shield blazoned with the crowned stigmatize of House Baratheon.Ned had hoped to discover the king button up abed in a wine-soaked sleep, but luck was not with him. They arrange R obert befuddleing beer from a polished horn and roaring his pettishness at dickens young squires who were toilsome to buckle him into his armor. Your benediction, one was saying, almost in tears, its made too small, it wont go. He fumbled, and the gorget he was leavening to fit a corpulent Roberts thick neck tumbled to the ground.S sluice hells Robert swore. Do I shit to do it myself? Piss on the some(prenominal) of you. Pick it up. Dont just jut there gaping, Lancel, pick it up The lad jumped, and the king noticed his comp either. impression at these oafs, Ned. My wife insisted I take these two to squire for me, and theyre worse than useless. Cant even congeal a mans armor on him properly. Squires, they say. I say theyre swineherds dressed up in silk.Ned unless needed a glance to understand the difficulty. The boys are not at fault, he told the king. Youre too fat for your armor, Robert.Robert Baratheon took a long swallow of beer, tossed the empty horn onto his sleepin g furs, wiped his mouth with the back of his hand, and said darkly, Fat? Fat, is it? Is that how you speak to your king? He let go his gag, sudden as a storm. Ah, bastard you, Ned, why are you always right?The squires smiled nervously until the king turned on them. You. Yes, both of you. You bring outd the Hand. The king is too fat for his armor. Go find Ser Aron Santagar. Tell him I need the breastplate stretcher. presently What are you waiting for?The boys tripped over each other in their haste to be quit of the tent. Robert managed to keep back a stern face until they were done for(p). Then he dropped back into a chair, shaking with laughter.Ser Barristan Selmy chuckled with him. Even Eddard Stark managed a smile. Always, though, the graver thoughts crept in. He could not help taking note of the two squires handsome boys, fair and rise up made. One was Sansas age, with long golden curls the other perhaps fifteen, sandy-haired, with a wisp of a mustache and the emerald-green eyes of the tycoon.Ah, I deprivation I could be there to jar against Santagars face, Robert said. I hope hell buzz off the wit to send them to someone else. We ought to keep them running all dayThose boys, Ned asked him. Lannisters?Robert nodded, wiping tears from his eyes. Cousins. Sons of manufacturing business Tywins brother. One of the dead ones. Or perhaps the live one, now that I come to think on it. I dont recall. My wife comes from a very large family, Ned.A very enterprising family, Ned thought. He had nothing against the squires, but it troubled him to correspond Robert surrounded by the queens kin, waking and sleeping. The Lannister appetite for offices and honors seemed to know no bounds. The talk is you and the queen had angry actors line last night.The mirth curdled on Roberts face. The woman tried to forbid me to fight in the melee. Shes sulking in the castle now, damn her. Your sister would never have shamed me like that.You never knew Lyanna as I did, Robert , Ned told him. You see her beauty, but not the iron underneath. She would have told you that you have no business in the melee.You too? The king frowned. You are a sour man, Stark. Too long in the north, all the juices have frozen inside you. Well, mine are still running. He slapped his chest to prove it.You are the king, Ned reminded him.I sit on the damn iron seat when I must. Does that mean I dont have the same hungers as other men? A bit of wine now and again, a girl squealing in bed, the feel of a horse amid my legs? cardinal hells, Ned, I want to hit someone.Ser Barristan Selmy spoke up. Your Grace, he said, it is not seemly that the king should ride into the melee. It would not be a fair contest. Who would dare belabor you?Robert seemed honestly taken aback. Why, all of them, damn it. If they can. And the last man left standing . . . . . . will be you, Ned finished. He saw at once that Selmy had hit the mark. The dangers of the melee were only a savor to Robert, but thi s touched on his pride. Ser Barristan is right. Theres not a man in the Seven Kingdoms who would dare risk your displeasure by hurting you.The king rosiness to his feet, his face flushed. Are you telling me those prancing cravens will let me win?For a certainty, Ned said, and Ser Barristan Selmy bowed his head in silent accord.For a moment Robert was so angry he could not speak. He strode across the tent, whirled, strode back, his face dark and angry. He snatched up his breastplate from the ground and threw it at Barristan Selmy in a wordless fury. Selmy dodged. Get out, the king said then, coldly. Get out before I kill you.Ser Barristan left quickly. Ned was about to follow when the king called out again. Not you, Ned.Ned turned back. Robert took up his horn again, filled it with beer from a barrel in the corner, and thrust it at Ned. Drink, he said brusquely.Ive no aridityDrink. Your king commands it.Ned took the horn and drank. The beer was black and thick, so strong it stung t he eyes.Robert sat down again. Damn you, Ned Stark. You and Jon Arryn, I loved you both. What have you done to me? You were the one should have been king, you or Jon.You had the better claim, Your Grace.I told you to confuse, not to argue. You made me king, you could at least have the courtesy to listen when I talk, damn you. Look at me, Ned. Look at what kinging has done to me. Gods, too fat for my armor, how did it ever come to this?Robert . . . Drink and stay quiet, the king is talking. I swear to you, I was never so bouncy as when I was winning this throne, or so dead as now that Ive won it. And Cersei . . . I have Jon Arryn to thank for her. I had no wish to marry after Lyanna was taken from me, but Jon said the realm needed an heir. Cersei Lannister would be a good match, he told me, she would bind Lord Tywin to me should Viserys Targaryen ever try to win back his fathers throne. The king shook his head. I loved that old man, I swear it, but now I think he was a bigger fool than Moon Boy. Oh, Cersei is lovely to look at, truly, but cold . . . the way she guards her cunt, youd think she had all the gold of Casterly Rock between her legs. Here, give me that beer if you wont drink it. He took the horn, upended it, belched, wiped his mouth. I am sorry for your girl, Ned. Truly. About the wolf, I mean. My son was lying, Id stake my soul on it. My son . . . you love your children, dont you?With all my heart, Ned said. permit me tell you a secret, Ned. More than once, I have dreamed of giving up the crown. Take ship for the Free Cities with my horse and my hammer, spend my time struggle and whoring, thats what I was made for. The sellsword king, how the singers would love me. You know what stops me? The thought of Joffrey on the throne, with Cersei standing behind him whispering in his ear. My son. How could I have made a son like that, Ned?Hes only a boy, Ned said awkwardly. He had small liking for Prince Joffrey, but he could hear the pain in Roberts verb alize. Have you forget how wild you were at his age?It would not trouble me if the boy was wild, Ned. You dont know him as I do. He sighed and shook his head. Ah, perhaps you are right. Jon despaired of me often enough, so far I grew into a good king. Robert looked at Ned and scowled at his silence. You might speak up and agree now, you know.Your Grace . . . Ned began, carefully.Robert slapped Ned on the back. Ah, say that Im a better king than Aerys and be done with it. You never could lie for love nor honor, Ned Stark. Im still young, and now that youre here with me, things will be different. Well make this a reign to sing of, and damn the Lannisters to seven hells. I smell bacon. Who do you think our champion will be today? Have you seen Mace Tyrells boy? The Knight of Flowers, they call him. Now theres a son any man would be proud to own to. Last tourney, he dumped the Kingslayer on his golden rump, you ought to have seen the look on Cerseis face. I laughed till my sides hurt . Renly says he has this sister, a maid of fourteen, lovely as a dawn . . . They broke their fast on black bread and boiled goose eggs and fish fried up with onions and bacon, at a trestle table by the rivers edge. The kings melancholy melted away with the morning mist, and before long Robert was feeding an orange and waxing fond about a morning at the Eyrie when they had been boys. . . . had given Jon a barrel of oranges, remember? Only the things had gone rotten, so I flung mine across the table and hit Dacks right in the nose. You remember, Redforts pock-faced squire? He tossed one back at me, and before Jon could so ofttimes as fart, there were oranges flying across the High Hall in every direction. He laughed uproariously, and even Ned smiled, remembering.This was the boy he had grown up with, he thought this was the Robert Baratheon hed cognize and loved. If he could prove that the Lannisters were behind the attack on Bran, prove that they had murdered Jon Arryn, this man would listen. Then Cersei would fall, and the Kingslayer with her, and if Lord Tywin dared to rouse the west, Robert would smash him as he had smashed Rhaegar Targaryen on the Trident. He could see it all so clearly.That breakfast tasted better than anything Eddard Stark had eaten in a long time, and afterward his smiles came easier and more often, until it was time for the tournament to resume.Ned walked with the king to the jousting field. He had promised to watch the lowest tilts with Sansa Septa Mordane was ill today, and his daughter was determined not to miss the end of the jousting. As he saw Robert to his place, he noted that Cersei Lannister had chosen not to appear the place beside the king was empty. That too gave Ned cause to hope.He shouldered his way to where his daughter was seated and found her as the horns blew for the days first joust. Sansa was so engrossed she scarcely seemed to notice his arrival.Sandor Clegane was the first rider to appear. He wore an olive- green cloak over his soot-grey armor. That, and his hounds-head helm, were his only concession to ornament.A hundred golden dragons on the Kingslayer, Littlefinger announced loudly as Jaime Lannister entered the lists, riding an elegant blood bay destrier. The horse wore a blanket of gilded ringmail, and Jaime glittered from head to heel. Even his lance was fashioned from the golden wood of the Summer Isles.Done, Lord Renly shouted back. The Hound has a thirsty(p) look about him this morning.Even hungry dogs know better than to bite the hand that feeds them, Littlefinger called dryly.Sandor Clegane dropped his visor with an audible clang and took up his position. Ser Jaime tossed a kiss to some woman in the commons, gently displace his visor, and rode to the end of the lists. Both men couched their lances.Ned Stark would have loved nothing so well as to see them both lose, but Sansa was watching it all moist-eyed and eager. The hastily erected gallery trembled as the horses broke into a gallop. The Hound leaned forward as he rode, his lance rock steady, but Jaime shifted his seat deftly in the instant before impact. Cleganes point was turned harmlessly against the golden shield with the lion blazon, go his own hit square. Wood shattered, and the Hound reeled, engagement to keep his seat. Sansa gasped. A ragged cheer went up from the commons.I wonder how I ought spend your money, Littlefinger called down to Lord Renly.The Hound just managed to stay in his saddle. He jerked his mount around hard and rode back to the lists for the second pass. Jaime Lannister tossed down his broken lance and snatched up a fresh one, jesting with his squire. The Hound spurred forward at a hard gallop. Lannister rode to meet him. This time, when Jaime shifted his seat, Sandor Clegane shifted with him. Both lances exploded, and by the time the splinters had settled, a riderless blood bay was trotting off in search of grass while Ser Jaime Lannister rolled in the dirt, golden an d dented.Sansa said, I knew the Hound would win.Littlefinger overheard. If you know whos going to win the second match, speak up now before Lord Renly plucks me clean, he called to her. Ned smiled.A pity the Imp is not here with us, Lord Renly said. I should have won twice as much(prenominal).Jaime Lannister was back on his feet, but his ornate lion helmet had been twisted around and dented in his fall, and now he could not get it off. The commons were hooting and pointing, the lords and ladies were trying to stifle their chuckles, and failing, and over it all Ned could hear King Robert laughing, louder than anyone. Finally they had to lead the Lion of Lannister off to a blacksmith, blind and stumbling.By then Ser Gregor Clegane was in position at the head of the lists. He was huge, the biggest man that Eddard Stark had ever seen. Robert Baratheon and his brothers were all big men, as was the Hound, and back at Winterfell there was a simpleminded stableboy named Hodor who dwarfed them all, but the knight they called the Mountain That Rides would have towered over Hodor. He was well over seven feet tall, closer to eight, with big shoulders and arms thick as the trunks of small trees. His destrier seemed a pony in between his armored legs, and the lance he carried looked as small as a broom handle.Unlike his brother, Ser Gregor did not live at court. He was a cave man man who seldom left his own lands, but for wars and tourneys. He had been with Lord Tywin when Kings Landing fell, a new-made knight of seventeen years, even then imposing by his size and his implacable ferocity. Some said it had been Gregor whod dashed the skull of the infant prince Aegon Targaryen against a wall, and whispered that afterward he had raped the mother, the Dornish princess Elia, before putting her to the sword. These things were not said in Gregors hearing.Ned Stark could not recall ever speaking to the man, though Gregor had ridden with them during Balon Greyjoys rebellion, one knight among thousands. He watched him with disquiet. Ned seldom put much buy in in gossip, but the things said of Ser Gregor were more than ominous. He was soon to be married for the third time, and one heard dark whisperings about the deaths of his first two wives. It was said that his keep was a grim place where servants disappeared unaccountably and even the dogs were afraid to enter the hall. And there had been a sister who had died young under deflower circumstances, and the fire that had disfigured his brother, and the hunting accident that had killed their father. Gregor had inherited the keep, the gold, and the family estates. His younger brother Sandor had left the same day to take service with the Lannisters as a sworn sword, and it was said that he had never handed, not even to visit.When the Knight of Flowers made his entrance, a murmur ran through the crowd, and he heard Sansas fervent whisper, Oh, hes so beautiful. Ser Loras Tyrell was excellent as a reed, dresse d in a suit of fabulous silver armor polished to a blinding sheen and filigreed with twining black vines and particular blue forget-me-nots. The commons realized in the same instant as Ned that the blue of the flowers came from sapphires a gasp went up from a thousand throats. Across the boys shoulders his cloak hung heavy. It was woven of forget-me-nots, real ones, hundreds of fresh blooms sewn to a heavy woolen cape.His battery charger was as slim as her rider, a beautiful grey mare, make for speed. Ser Gregors huge stallion trumpeted as he caught her scent. The boy from Highgarden did something with his legs, and his horse pranced sideways, nimble as a dancer. Sansa clutched at his arm. Father, dont let Ser Gregor hurt him, she said. Ned saw she was wearing the rose that Ser Loras had given her yesterday. Jory had told him about that as well.These are tourney lances, he told his daughter. They make them to splinter on impact, so no one is hurt. Yet he remembered the dead boy i n the cart with his cloak of crescent moons, and the words were raw in his throat.Ser Gregor was having trouble controlling his horse. The stallion was screaming and pawing the ground, shaking his head. The Mountain kicked at the animal savagely with an armored boot. The horse reared and almost threw him.The Knight of Flowers saluted the king, rode to the far end of the list, and couched his lance, ready. Ser Gregor brought his animal to the line, fighting with the reins. And suddenly it began. The Mountains stallion broke in a hard gallop, plunging forward wildly, while the mare charged as smooth as a flow of silk. Ser Gregor wrenched his shield into position, juggled with his lance, and all the while fought to hold his unmanageable mount on a straight line, and suddenly Loras Tyrell was on him, placing the point of his lance just there, and in an eye blink the Mountain was failing. He was so huge that he took his horse down with him in a tangle of steel and flesh.Ned heard applau se, cheers, whistles, shocked gasps, excited muttering, and over it all the rough, raucous laughter of the Hound. The Knight of Flowers reined up at the end of the lists. His lance was not even broken. His sapphires winked in the sun as he raised his visor, smiling. The commons went mad for him.In the middle of the field, Ser Gregor Clegane disentangled himself and came boiling to his feet. He wrenched off his helm and slammed it down onto the ground. His face was dark with fury and his hair fell down into his eyes. My sword, he shouted to his squire, and the boy ran it out to him. By then his stallion was back on its feet as well.Gregor Clegane killed the horse with a single blow of such ferocity that it half(a) severed the animals neck. Cheers turned to shrieks in a heartbeat. The stallion went to its knees, screaming as it died. By then Gregor was striding down the lists toward Ser Loras Tyrell, his bloody sword clutched in his fist. Stop him Ned shouted, but his words were in capacitated in the roar. Everyone else was yelling as well, and Sansa was crying.It all happened so fast. The Knight of Flowers was shouting for his own sword as Ser Gregor knocked his squire aside and made a grab for the reins of his horse. The mare scented blood and reared. Loras Tyrell kept his seat, but barely. Ser Gregor swung his sword, a savage two-handed blow that took the boy in the chest and knocked him from the saddle. The courser dashed away in panic as Ser Loras lay stunned in the dirt. But as Gregor lifted his sword for the killing blow, a rasping articulate warned, Leave him be, and a steel-clad hand wrenched him away from the boy.The Mountain pivoted in wordless fury, swinging his longsword in a killing arc with all his massive strength behind it, but the Hound caught the blow and turned it, and for what seemed an eternity the two brothers stood hammering at each other as a dazed Loras Tyrell was helped to safety. Thrice Ned saw Ser Gregor aim savage blows at the h ounds-head helmet, yet not once did Sandor send a cut at his brothers unprotected face.It was the kings voice that put an end to it . . . the kings voice and twenty swords. Jon Arryn had told them that a commander needs a good battlefield voice, and Robert had proved the truth of that on the Trident. He used that voice now. STOP THIS MADNESS, he boomed, IN THE NAME OF YOUR KINGThe Hound went to one knee. Ser Gregors blow cut air, and at last he came to his senses. He dropped his sword and glared at Robert, surrounded by his Kingsguard and a dozen other knights and guardsmen. Wordlessly, he turned and strode off, shoving past Barristan Selmy. Let him go, Robert said, and as quickly as that, it was over.Is the Hound the champion now? Sansa asked Ned.No, he told her. There will be one final joust, between the Hound and the Knight of Flowers.But Sansa had the right of it after all. A few moments afterward Ser Loras Tyrell walked back onto the field in a simple linen doublet and said to Sandor Clegane, I owe you my life. The day is yours, ser.I am no ser, the Hound replied, but he took the victory, and the champions purse, and, for perhaps the first time in his life, the love of the commons. They cheered him as he left the lists to return to his pavilion.As Ned walked with Sansa to the archery field, Littlefinger and Lord Renly and some of the others fell in with them. Tyrell had to know the mare was in heat, Littlefinger was saying. I swear the boy planned the whole thing. Gregor has always favored huge, ill-tempered stallions with more spirit than sense. The notion seemed to frolic him.It did not amuse Ser Barristan Selmy. There is small honor in tricks, the old man said stiffly.Small honor and twenty thousand golds. Lord Renly smiled.That afternoon a boy named Anguy, an unheralded commoner from the Dornish Marches, won the archery competition, outshooting Ser Balon Swann and Jalabhar Xho at a hundred paces after all the other bowmen had been eliminated at the shorter distances. Ned sent Alyn to seek him out and offer him a position with the Hands guard, but the boy was flush with wine and victory and riches undreamed of, and he refused.The melee went on for three hours. closelipped twoscore men took part, freeriders and hedge knights and new-made squires in search of a reputation. They fought with blunted weapons in a chaos of mud and blood, small troops fighting together and then turning on each other as alliances formed and fractured, until only one man was left standing. The victor was the red priest, Thoros of Myr, a madman who shaved his head and fought with a flaming sword. He had won melees before the fire sword frightened the mounts of the other riders, and nothing frightened Thoros. The final tally was three broken limbs, a shattered collarbone, a dozen smashed fingers, two horses that had to be put down, and more cuts, sprains, and bruises than anyone cared to count. Ned was desperately pleased that Robert had not taken part .That night at the feast, Eddard Stark was more hopeful than he had been in a great while. Robert was in high good humor, the Lannisters were nowhere to be seen, and even his daughters were behaving. Jory brought Arya down to join them, and Sansa spoke to her sister pleasantly. The tournament was magnificent, she sighed. You should have come. How was your dancing?Im sore all over, Arya reported happily, proudly displaying a huge discolor bruise on her leg.You must be a terrible dancer, Sansa said doubtfully.Later, while Sansa was off listening to a troupe of singers perform the complex round of interwoven ballads called the Dance of the Dragons, Ned inspected the bruise himself. I hope Forel is not being too hard on you, he said.Arya stood on one leg. She was getting much better at that of late. Syrio says that every hurt is a lesson, and every lesson makes you better.Ned frowned. The man Syrio Forel had come with an excellent reputation, and his flamboyant Braavosi style was well suited to Aryas slender blade, yet still . . . a few days ago, she had been wandering around with a swatch of black silk tied over her eyes. Syrio was teaching her to see with her ears and her nose and her skin, she told him. Before that, he had her doing spins and back flips. Arya, are you certain you want to persist in this?She nodded. Tomorrow were going to catch cats.Cats. Ned sighed. Perhaps it was a mistake to hire this Braavosi. If you like, I will ask Jory to take over your lessons. Or I might have a quiet word with Ser Barristan. He was the finest sword in the Seven Kingdoms in his youth.I dont want them, Arya said. I want Syrio.Ned ran his fingers through his hair. Any decent master-at-arms could give Arya the rudiments of slash-and-parry without this nonsense of blindfolds, cartwheels, and hopping about on one leg, but he knew his youngest daughter well enough to know there was no arguing with that stubborn jut of jaw. As you wish, he said. Surely she would grow tired of this soon. generate to be careful.I will, she promised solemnly as she hopped smoothly from her right leg to her left.Much later, after he had taken the girls back through the city and seen them both safe in bed, Sansa with her dreams and Arya with her bruises, Ned ascended to his own chambers atop the Tower of the Hand. The day had been warm and the room was close and stuffy. Ned went to the window and unfastened the heavy shutters to let in the cool night air. Across the Great Yard, he noticed the flickering glow of candlelight from Littlefingers windows. The hour was well past midnight. Down by the river, the revels were only now beginning to dwindle and die.He took out the dagger and studied it. Littlefingers blade, won by Tyrion Lannister in a tourney wager, sent to slay Bran in his sleep. Why? Why would the dwarf want Bran dead? Why would anyone want Bran dead?The dagger, Brans fall, all of it was linked somehow to the murder of Jon Arryn, he could feel it in his gut, but the truth of Jons death remained as clouded to him as when he had started. Lord Stannis had not returned to Kings Landing for the tourney. Lysa Arryn held her silence behind the high walls of the Eyrie. The squire was dead, and Jory was still searching the whorehouses. What did he have but Roberts bastard?That the armorers sullen apprentice was the kings son, Ned had no doubt. The Baratheon look was stamped on his face, in his jaw, his eyes, that black hair. Renly was too young to have fathered a boy of that age, Stannis too cold and proud in his honor. Gendry had to be Roberts.Yet knowing all that, what had he learned? The king had other low children scattered throughout the Seven Kingdoms. He had openly acknowledged one of his bastards, a boy of Brans age whose mother was highborn. The lad was being fostered by Lord Renlys castellan at Storms End.Ned remembered Roberts first child as well, a daughter born in the Vale when Robert was scarcely more than a boy himself. A smart little girl the young lord of Storms End had doted on her. He used to make daily visits to play with the babe, long after he had lost interest in the mother. Ned was often dragged along for company, whether he willed it or not. The girl would be seventeen or eighteen now, he realized older than Robert had been when he fathered her. A strange thought.Cersei could not have been pleased by her lord husbands by-blows, yet in the end it mattered little whether the king had one bastard or a hundred. Law and custom gave the baseborn few rights. Gendry, the girl in the Vale, the boy at Storms End, none of them could threaten Roberts straightforwardborn children . . .His musings were ended by a sonant rap on his door. A man to see you, my lord, Harwin called. He will not give his name.Send him in, Ned said, wondering.The visitor was a stout man in cracked, mud-caked boots and a heavy brown robe of the coarsest roughspun, his features hidden by a cowl, his hands drawn up into voluminous sleeves.W ho are you? Ned asked.A friend, the cowled man said in a strange, low voice. We must speak alone, Lord Stark.Curiosity was stronger than caution. Harwin, leave us, he commanded. Not until they were alone behind closed doors did his visitor draw back his cowl.Lord Varys? Ned said in astonishment.Lord Stark, Varys said politely, seating himself. I wonder if I might trouble you for a drink?Ned filled two cups with summerwine and handed one to Varys. I might have passed within a foot of you and never recognized you, he said, incredulous. He had never seen the eunuch dress in anything but silk and velvet and the richest damasks, and this man smelled of sweat instead of lilacs.That was my dearest hope, Varys said. It would not do if certain people learned that we had spoken in private. The queen watches you closely. This wine is very choice. Thank you.How did you get past my other guards? Ned asked. Porther and Cayn had been posted outside the tower, and Alyn on the stairs.The Red Keep ha s ways known only to ghosts and spiders. Varys smiled apologetically. I will not keep you long, my lord. There are things you must know. You are the Kings Hand, and the king is a fool. The eunuchs cloying tones were gone now his voice was thin and sharp as a whip. Your friend, I know, yet a fool nonetheless . . . and doomed, unless you save him. Today was a near thing. They had hoped to kill him during the melee.For a moment Ned was speechless with shock. Who?Varys sipped his wine. If I truly need to tell you that, you are a bigger fool than Robert and I am on the wrong side.The Lannisters, Ned said. The queen . . . no, I will not believe that, not even of Cersei. She asked him not to fightShe forbade him to fight, in front of his brother, his knights, and half the court. Tell me truly, do you know any surer way to force King Robert into the melee? I ask you.Ned had a sick feeling in his gut. The eunuch had hit upon a truth tell Robert Baratheon he could not, should not, or must not do a thing, and it was as good as done. Even if hed fought, who would have dared to strike the king?Varys shrugged. There were forty riders in the melee. The Lannisters have many friends. Amidst all that chaos, with horses screaming and bones breaking and Thoros of Myr waving that absurd firesword of his, who could name it murder if some chance blow felled His Grace? He went to the flagon and refilled his cup. After the deed was done, the slayer would be beside himself with grief. I can almost hear him weeping. So sad. Yet no doubt the gracious and sympathetic widow would take pity, lift the poor unfortunate to his feet, and bless him with a gentle kiss of forgiveness. Good King Joffrey would have no choice but to pardon him. The eunuch stroked his cheek. Or perhaps Cersei would let Ser Ilyn strike off his head. Less risk for the Lannisters that way, though quite an unpleasant surprise for their little friend.Ned felt his anger rise. You knew of this plot, and yet you did nothing. I command whisperers, not warriors.You might have come to me earlier.Oh, yes, I confess it. And you would have rushed straight to the king, yes? And when Robert heard of his peril, what would he have done? I wonder.Ned considered that. He would have damned them all, and fought anyway, to show he did not fear them.Varys spread his hands. I will make other confession, Lord Eddard. I was curious to see what you would do. Why not come to me? you ask, and I must answer, Why, because I did not trust you, my lord.You did not trust me? Ned was frankly astonished.The Red Keep shelters two sorts of people, Lord Eddard, Varys said. Those who are loyal to the realm, and those who are loyal only to themselves. Until this morning, I could not say which you might be . . . so I waited to see . . . and now I know, for a certainty. He smiled a plump tight little smile, and for a moment his private face and reality mask were one. I begin to comprehend why the queen fears you so much. Oh, yes I do.Yo u are the one she ought to fear, Ned said.No. I am what I am. The king makes use of me, but it shames him. A most puissant warrior is our Robert, and such a manly man has little love for sneaks and spies and eunuchs. If a day should come when Cersei whispers, pop that man, Ilyn Payne will snick my head off in a twinkling, and who will mourn poor Varys then? North or south, they sing no songs for spiders. He reached out and touched Ned with a soft hand. But you, Lord Stark . . . I think . . . no, I know . . . he would not kill you, not even for his queen, and there may lie our salvation.It was all too much. For a moment Eddard Stark wanted nothing so much as to return to Winterfell, to the clean simplicity of the north, where the enemies were winter and the wildlings beyond the Wall. Surely Robert has other loyal friends, he protested. His brothers, hiswife? Varys finished, with a smile that cut. His brothers hate the Lannisters, true enough, but hating the queen and loving the king are not quite the same thing, are they? Ser Barristan loves his honor, Grand Maester Pycelle loves his office, and Littlefinger loves Littlefinger.The KingsguardA paper shield, the eunuch said. Try not to look so shocked, Lord Stark. Jaime Lannister is himself a Sworn Brother of the White Swords, and we all know what his oath is worth. The days when men like Ryam Redwyne and Prince Aemon the Dragonknight wore the white cloak are gone to dust and song. Of these seven, only Ser Barristan Selmy is made of the true steel, and Selmy is old. Ser Boros and Ser Meryn are the queens creatures to the bone, and I have deep suspicions of the others. No, my lord, when the swords come out in earnest, you will be the only true friend Robert Baratheon will have.Robert must be told, Ned said. If what you say is true, if even a part of it is true, the king must hear it for himself.And what proof shall we lay before him? My words against theirs? My little birds against the queen and the Kingslayer, a gainst his brothers and his council, against the Wardens of East and West, against all the might of Casterly Rock? Pray, send for Ser Ilyn directly, it will save us all some time. I know where that pass ends.Yet if what you say is true, they will only bide their time and make another attempt.Indeed they will, said Varys, and sooner rather than later, I do fear. You are making them most anxious, Lord Eddard. But my little birds will be listening, and together we may be able to forestall them, you and I. He rose and pulled up his cowl so his face was hidden once more. Thank you for the wine. We will speak again. When you see me next at council, be certain to treat me with your habituate contempt. You should not find it difficult.He was at the door when Ned called, Varys. The eunuch turned back. How did Jon Arryn die?I wondered when you would get around to that.Tell me.The tears of Lys, they call it. A rare and costly thing, clear and sweet as water, and it leaves no trace. I begged Lord Arryn to use a taster, in this very room I begged him, but he would not hear of it. Only one who was less than a man would even think of such a thing, he told me.Ned had to know the rest. Who gave him the poison?Some dear sweet friend who often shared meat and mead with him, no doubt. Oh, but which one? There were many such. Lord Arryn was a kindly, swear man. The eunuch sighed. There was one boy. All he was, he owed Jon Arryn, but when the widow fled to the Eyrie with her household, he stayed in Kings Landing and prospered. It always gladdens my heart to see the young rise in the world. The whip was in his voice again, every word a stroke. He must have cut a high-flown figure in the tourney, him in his bright new armor, with those crescent moons on his cloak. A pity he died so untimely, before you could talk to him . . . Ned felt half-poisoned himself. The squire, he said. Ser Hugh. Wheels within wheels within wheels. Neds head was pounding. Why? Why now? Jon Arryn had been Hand for fourteen years. What was he doing that they had to kill him?Asking questions, Varys said, slipping out the door.

Fiji Water Essay

FIJI Water has recently been accused of greenwashing. Greenwashing is a term that is used to distinguish companies that mislead their consumers into believing that they atomic number 18 an environmentally safe company. With the threat of global warming due to greenhouse gases, many people have become super sensitive to companies that arent doing their part to keep the world a great place to live for thousands of years to come.This has caused problems for FIJI Water because their business is successful only if they are able to get consumers to buy their pissing even though they arent an environmentally friendly company. Fiji, an island located in the middle of the Pacific Ocean, has to ship bottled water 5,500 miles to the United States, which produces 216,000,000 pounds of greenhouse gases per trip. This has a huge impact on the environment and therefore has led to many conservationists attacks due to FIJI Waters claim to go one C negative.FIJI Water promised to reduce their pac kaging by 20 percent per year, supply at least 50 percent of the energy used at its plants with renewable energy, optimized logistics and use more carbon-efficient transportations modes, restore degraded grasslands in Fiji, and support recycling programs for plastic bottles. They claimed that this would have a net reduction of carbon in the atmosphere, and used the slogan every drop is green to symbolize that their company wasnt doing any harm to the environment.While they promised this and created a website to show that they were going carbon negative, there were no numbers to prove that they actually accomplished what they intended to do. I completely agree with the conservationists that they are greenwashing because its hard to believe that a company exporting 90 percent of their products to places that are thousands of miles away and emit a ton of greenhouse gases would be able to be carbon negative. some(prenominal) companies dont get caught for their greenwashing, but when it s completely obvious its hard to fool customers, especially conservationists.

Diabetic Ketoacidosis

DIABETIC KETOACIDOSIS INTRODUCTION Diabetic ketoacidosis (DKA) is a very serious complication of diabetes mellitus, a metabolous disorder that is characterized by hyperglycemia, metabolic acidosis, and increased body ketone concentrations. The most common causes of DKA atomic number 18 infection and poor compliance with medication regimens. Other causes include undiagnosed diabetes, alcohol abuse, and a multitude of medical conditions such as cerebrovascular accident (CVA), complicated pregnancy, myocardial infarction, pancreatitis, and stress. Diabetic ketoacidosis is a complicated pathology.Early recognition of DKA, a sizable dread of the pathological processes of DKA, and aggressive treatment are the keys to successful treatment. With good care, DKA can be managed and the uncomplaining of will survive. OBJECTIVES When the student has finished studying this module, he/she will be able to 1. Identify the correct definition of DKA. 2. Identify a elementary function of insulin. 3. Identify the insulin derangements of types I and II diabetes. 4. Identify the basic cause of DKA. 5. Identify two specific causes of DKA. 6. Identify the two pathogenic mechanisms that produce the signs/symptoms of DKA. . Identify metabolic consequences of increased ductless gland concentrations in DKA. 8. Identify the criteria utilise to diagnose DKA. 9. Identify common signs and symptoms of DKA. 10. Identify laboratory abnormalities seen in DKA. 11. Identify complications of DKA. 12. Identify the three most indigenous(prenominal) therapies for treating DKA. 13. Identify the correct roles of sodium hydrogen carbonate and orthophosphate in treating DKA. 14. Identify an crucial rule for using yard replenishment in DKA. 15. Identify an consequential rule for switching from IV to subcutaneous insulin.EPIDEMIOLOGY Most cases of DKA are seen in patient roles with type I diabetes, but approximately 10%-30% of all cases of DKA occur in patients with type II diabetes. 1 The inc idence of DKA appears to be rising, and this whitethorn not be related to the well publicized increase in the incidence of diabetes that has become a serious public wellness problem. 2 Diabetic ketoacidosis accounts for 50% of all diabetes-related admissions in young people with the unsoundness, and DKA is the most common cause of diabetes-related death in children and adolescents with type I diabetes. Diabetic ketoacidosis is much more than common in children than in crowings, it is more common in women than in men, and it is more common in Caucasians. 4 The exact incidence of death from DKA is not known, but it has been estimated to be between 1%-10%. 5 Survival depends on the severity of the case, the age of the patient, the presence/ absence of certain medical conditions, and how quickly DKA is recognized and how effectively it is treated. If the condition is promptly diagnosed and properly treated, the mortality rate can be 250 mg/dL) metabolic acidosis ( lineage pH ? . 30) and an elevated direct of blood serum ketones ( 5 mEq/L) and/or ketones in the urine. 11 Patients will also sustain an anion open (Na+ Cl- + HCO3-), an elevated blood urea nitrogen (BUN), hyponatremia, hyperkalemia, and the serum amylase may be elevated. The radical body phosphate level may be low but the serum level may be normal or elevated. At this time, there is no universally agreed upon consensus for the symptomatic criteria of DKA, and some sources feel that an anion gap 10-12 mEq/L and serum bicarbonate (HCO3) ? 8 mEq/L should be part of the criteria. Learning intercept Some authors feel that most important test for diagnosing DKA is total blood ketone concentration. 12,13 The acidosis and hyperglycemia of DKA and the electrolyte changes that are so commonly seen in DKA are closely related. The shift in metabolism and the high concentration of acidic ketones seen in cases of DKA produces a metabolic acidosis. Acidosis and insulin deficiency causes chiliad to shif t from the intracellular space to the extracellular space and serum hyperkalemia is common.However, the osmotic diuresis that is characteristic of DKA causes potassium to be excreted in the urine although the serum potassium level may be high, the patient may be profoundly depleted. Sodium and phosphate are also excreted by the osmotic diuresis, and hyponatremia is common. However, the serum phosphate level is often falsely normal or falsely elevated because phosphate, like potassium, is excreted in the urine but acidosis induces phosphate to move from the intracellular space to the extracellular space.The serum level might be normal, but the actual total body load is low. Learning Break The serum glucose can be very elevated in severe cases of DKA. However, serum glucose can be close to normal, and approximately 10% of patients with DKA will be euglycemic with a serum glucose ? 250 mg/dL. 14 COMPLICATIONS OF DIABETIC KETOACIDOSIS Patients who have diabetic ketoacidosis that is prom ptly recognized and promptly and correctly treated should survive. The complications of DKA are complications of treatment and rational edema.Treatment complications are hypoglycemia, hyperkalemia, and occasionally pulmonary edema. These can be avoided by using low-dose insulin therapy, monitoring blood glucose very closely, and by carefully managing gas replacement. Cerebral edema is a very serious complication of DKA. It occurs in approximately 1% of all children with DKA, but the mortality rate and the rate of neurological sequelae for these children have both been reported to be 21%, and the mortality rate and rate of sequelae can be as high as 24% and 26% respectively15,16 Adults with DKA rarely develop cerebral edema. 7 Signs and symptoms include mental status changes, bradycardia, seizures, abnormal response to pain, and decorticate and decerebrate posturing. TREATMENT FOR DIABETIC KETOACIDOSIS The most important treatments for DKA are unsound replacement, insulin therapy, and correcting electrolyte balances. Obtain baseline serum electrolytes, BUN, creatinine, serum glucose, an arterial or venous blood gas (either one is appropriate), a complete blood count, an ECG, and a CXR. Consider other laboratory studies if DKA is thought to be caused by an underlying disease. Fluid replacement Fluid replacement will replace the tranquil deficit, help decrease the blood glucose level, and maintain renal function. If the patient is severely hypovolemic, give 1 liter of 0. 9% sodium chloride over 30 minutes. If the patient is mildly dehydrated, check the serum sodium. If it is normal or high, give 0. 45% sodium chloride IV at a rate of 250-500 mL/h. If the serum sodium is low, give 0. 9% sodium chloride IV at a rate of 15-20 mL/kg per hour. Once the blood glucose is approximately two hundred mg/dL, a solution of % dextrose with 0. 45% sodium chloride can be used. 18Learning Break In the first hour of treating a patient with DKA, fluid replacement is more impo rtant than insulin therapy and should take precedent. 19,20 Insulin therapy Insulin is a critical part perhaps the critical part of the treatment of DKA. It can be given as an IV excerpt or frequent subcutaneous injections they are equally effective. Most clinicians prefer the IV route as the onset of action is quicker and the half-life is shorter with the IV route than the onset of action of and half-life of insulin given subcutaneously because of that, therapy can be closely monitored.The American Diabetes Association recommends giving an initial IV bolus of fixity insulin, 0. 1 U/kg. (Note If the serum potassium is 3. 3 mEq/L insulin should not be given). Following the bolus dose, start a continuous IV extract of regular insulin at a rate of 0. 1 U/kg/h. An alternative is to omit the bolus dose and start a continuous IV infusion of regular insulin at a rate of 0. 14 U/kg/h. If the serum glucose does not decrease by 10% within an hour of jump the insulin, give 0. 14 U/kg as a bolus dose, then continue the IV infusion.Once the serum glucose is 200 mg/dL, reduce the insulin dose to 0. 02-0. 05 U/kg/h or give subcutaneous doses of rapid-acting insulin, 0. 1 U/kg every two hours. The goal at this point is to keep the serum glucose between 150-200 mg/dL. 21 0. 1 U/kg IV bolus v 0. 1 U/kg/hr * v When serum glucose 200 mg/dL, decrease infusion to 0. 02-0. 05 U/kg/h v Keep serum glucose between 150-200 mg/dL until DKA resolves * If serum glucose doesnt v by at least 10% in the 1st hour of insulin therapy, give an IV bolus of 0. 14 U/kg and adjust the infusion. Correcting electrolyte imbalances If the serum potassium is 3. 3 mEq/L, do not start insulin therapy and give 20-30 mEq of potassium per hour until the serum level is 3. 3 mEq/L. Fluid replacement and insulin therapy lower blood sugar and correct acidosis and they also move potassium into the cells. If the serum potassium is 3. 3 mEq/L, serious arrhythmias could result. Once the hypokalemia has be en corrected, insulin therapy can be started, and 20-30 mEq of potassium can be added to each liter of IV solution in order to maintain a serum potassium level between 4. -5. 0 mEq/L. Learning Break Serum glucose and serum potassium should be checked every hour until the patient is stable. Two other considerations for treatment are administering sodium bicarbonate to help correct the acidosis and replacing phosphate losses. Using sodium bicarbonate is controversial. Severe acidosis can decrease myocardial contractility, can cause and prolong coma, shifts the oxyhemoglobin dissociation curve to the right, etc. , so correcting an acidosis would seem important. However, there are risks involved (e. g. making body hypokalemia worse, cerebral edema), there are some(prenominal) clinical studies that indicate sodium bicarbonate therapy is not effective for patients with DKA, and for many patients the acidosis will correct with fluids and insulin and because they have adequate stores of bi carbonate. 22 The use of sodium bicarbonate should not be standard care for DKA. However, the American Diabetes Association does recommend that if a patient has a severe acidosis with a pH 6. 9, the patent should receive 100 mEq of NaHCO3 in 400 mL IV fluid along with 20 mEq of potassium chloride this should be infused at 200 mL/h.Repeat this every two hours until the pH is ? 7. 0. 23 Low phosphate levels will usually correct as the hyperglycemia and acidosis are corrected, and phosphate replacement is not standard care for DKA. However, if the phosphate is very low 1. 0 mg/dL or the patient has anemia, cardiac disease, or hypoxia, 20-30 mEq of phosphate can be given. 24,25 SWITCHING TO SUBCUTANEOUS INSULIN Diabetic ketoacidosis is considered to be resolved when the blood glucose is 200 mg/dL and at least two of these laboratory values are present a venous pH 7. 3, an anion gap 12 mEq/L, and a serum bicarbonate level 15. mEq/L. 26 If these laboratory values are present and t he patient can eat, it is safe to start subcutaneous insulin. Intravenous insulin should be move for one to two hours after the first dose of subcutaneous insulin has been given. If this is not done, hyperglycemia and ketosis may recur. NURSING CARE, PREVENTION AND EDUCATION When providing care for a patient in the acute phase of DKA, the nurse should focus on hydration status/fluid replacement, monitoring of acid-base status, serum glucose, and serum electrolytes, close observation of the patients neurological status, and vital signs.Once a case of DKA has resolved it is important to know why it happened. Infections, medical conditions, and drugs are common causes of DKA. However, one of the most important causes of DKA is patient non-compliance with diabetic treatment regimens patients do not take their medication or do not take them properly, they fail to follow their prescribed nourishment and lifestyle plans, and they do not or cannot understand the basics of self-care and pr evention as they relate to diabetes.If non-compliance was the cause of a particular case of DKA, it is very important to determine why the non-compliance occurred, and there many possible reasons. Some of the more common ones are Poor access to medical care The patient may not have access to health care information, may not have easy access to a physician, clinic, etc. , may not have or not know how to use community or public access health care resources. The patient may not have silver for medications. drop of information The patient may have a poor understanding of diabetes, and the patient may not understand the treatment regimens that have been prescribed. Lack of information can be damaging in many ways. If the patient doesnt understand the disease of diabetes, he/she might be less free to comply with lifestyle and diet restrictions and less willing to take medications. The patient would not recognize possible warning signals of DKA. Emotional issues For many people, diabe tes requires lifestyle changes that they may not be willing to emotionally accept.Learning Break Although it may be said that non-compliance happens when the patient fails to provide good self-care, the word fail typically has a negative connotation. Also, when many people hear the term non-compliance, they think of a person willfully failing to do what he/she knows is best. However, there are many cases of non-compliance that happen because the patient has not been properly educated, or doesnt have or doesnt know how to get the resources he/she needs.So when it has been determined that non-compliance was the cause of a particular case of DKA, interview the patient and find out a) the emotional impact of diabetes on the patients life, b) how much he/she knows about the disease and the treatments, and c) what financial, medical, personal, and social resources the patient has available for self-treatment. Some of these issues must be addressed by social workers, psychologists, or the patients physician. However, nurses have a primary role in supporting and educating patients who have had an incident of DKA related to on-compliance. The nurse will often be the first person to find out that the patient did not seek medical attention for an infection because of financial concerns, or due to inability to each a physician, or because of a lack of understanding of the implications of infection in diabetes. The nurse must then discuss making the appropriate referrals and then set up a teaching plan. Some of the breast feeding diagnoses that might apply in theses situations would be imbalanced nutrition, noncompliance, knowledge deficient, and risk for injury. SUMMARY Diabetic ketoacidosis is a metabolic disorder characterized by hyperglycemia, metabolic acidosis, and elevated body ketone concentrations. The basic cause of DKA is insulin deficiency, absolute or relative. The insulin deficiency most often occurs because of infection or non-compliance with diabetic treat ment regimens. Excess hormone concentration and a metabolic shift are the pathogenic mechanisms that cause the signs and symptoms of DKA. The hormone concentrations cause hyperglycemia, and the metabolic shift causes acidosis and elevated body ketones. The basic diagnostic criteria for DKA are a blood glucose 250 mg/dL, a serum pH 7. 3, and elevated serum and/or urine ketone concentrations. Other important criteria are an anion gap 10-12 mEq/L and serum bicarbonate (HCO3) ? 18 mEq/L. Hyperkalemia and hyponatremia are common in DKA. Hypophosphatemia can be seen. However, the total body load of potassium and phosphate is often low. Common signs and symptoms include dehydration, mental status changes, polydipsia, polyuria, vomiting, weakness, and weight loss. Complications of DKA include complications caused by treatment and cerebral edema. Treatment for DKA should focus on fluid replacement, insulin therapy, and correcting electrolyte abnormalities. Sodium bicarbonate is not standard care. If DKA if promptly recognized and properly an aggressively treated, patients should survive. REFERENCES 1. Wilson JF. In the clinic Diabetic ketoacidosis. Annals of Internal Medicine. 2010 152ITC-1-ITC-16. 2. Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in bountiful patients with diabetes. Diabetes Care. 2009321335-1343. 3. Wolfsdorf J, Glaser N, Sperling MA.Diabetic ketoacidosis in infants, children, and adolescents a consensus statement from the American Diabetes Association. Diabetes Care. 2006291150-1159. 4. Hamdy O. Diabetic ketoacidosis. eMedicine. phratry 9, 2009. Available at http//emedicine. medscape. com/article/118361. Accessed celestial latitude 24, 2010. 5. Hamdy O. Diabetic ketoacidosis. eMedicine. September 9, 2009. Available at http//emedicine. medscape. com/article/118361. Accessed December 24, 2010, 6. Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 200932 1335-1343. . Rucker DW. Diabetic ketoacidosis. eMedicine. June 4, 2010. Available at http//emedcine. medscape. com/article/766275. Accessed December 24, 2010. 8. Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009321335-1343. 9. Kitabchi AE, Umpierrez GE, Murphy MB, Barrett EJ et al. Management of hyperglycemic crises in patients with diabetes. Diabetes Care. 200124131-153. 10. Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009321335-1343. 11. Hamdy O.Diabetic ketoacidosis. eMedicine. September 9, 2009. Available at http//emedicine. medscape. com/article/118361. Accessed December 24, 2010. 12. Wilson JF. In the clinic Diabetic ketoacidosis. Annals of Internal Medicine. 2010 152ITC-1-ITC-16. 13. Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009321335-1343. 14. Miles JM, Gehr ich JE. Glucose and ketone body kinetics in diabetic ketoacidosis. Clinical Endocrinology & Metabolism. 19831303-319. 15. Glaser NS, Wooton-Gorges SL, Buonocore MH, Marcin JP, Rewers A, business line J. et al. Frequency of sub-clinical cerebral edema in children with diabetic ketoacidosis. Pediatric Diabetes. 2006775-80. 16. Wolfsdorf J, Glaser N, Sperling MA. Diabetic ketoacidosis in infants, children, and adolescents a consensus statement from the American Diabetes Association. Diabetes Care. 2006291150-1159. 17. Haringhuizen A, Tjan DHT, Grool A, forefront Vugt R, van Zanten ARH. Fatal cerebral oedema in adult diabetic ketoacidosis. The Netherlands Journal of Medicine. 20106835-37. 18. Wilson JF. In the clinic Diabetic ketoacidosis. Annals of Internal Medicine. 2010 152ITC-1-ITC-16. 19.Goyal N, Miller JB, Sankey SS, Mossallam U. public utility company of initial bolus insulin in treatment of diabetic ketoacidosis. Journal of Emergency Medicine. 201038422-427. 20. Rucker DW. Diab etic ketoacidosis. eMedicine. June 4, 2010. Available at http//emedcine. medscape. com/article/766275. Accessed December 24, 2010. 21. Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009321335-1343. 22. Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009321335-1343. 23.Wilson JF. In the clinic Diabetic ketoacidosis. Annals of Internal Medicine. 2010 152ITC-1-ITC-16. 24. Kitabchi AE, Umpierrez GE, Fisher JN, Murphy NB, Stentz FB. Thirty years of personal bang in hyperglycemic crises diabetic ketoacidosis and hyperglycemic hyperosmolar state. Journal of Clinical Endocrinology & Metabolism. 2008931541-1552. 25. Wilson JF. In the clinic Diabetic ketoacidosis. Annals of Internal Medicine. 2010 152ITC-1-ITC-16. 26. Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009321335-1343.