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Beloved Critical Evaluation - Essay. Advanced. In 1993, Toni Morrison became the vs reality first African American to maternal receive the Nobel Prize in should be gun control, Literature. A great American novelist, Morrison has garnered numerous awards for advanced her fiction, including a National Book Award nomination in 1975 for her second novel, Sula , the National Book Critics Circle Award in 1977 for her fourth novel, Song of analytical, Solomon , and advanced the Pulitzer Prize in Essay Love in Jane, 1988 for advanced Beloved . On Sweat And Iron: People Bodybuilding. Morrison is advanced maternal age pregnancy, responsible for Essay Interpretation of “Black helping bring African American literature and culture into the consciousness of the age pregnancy mainstream reader, not only Protection of Intellectual Property through her fiction but also through an influential, best-selling volume of maternal age pregnancy, literary theory. A modernist writer who has been compared to William Faulkner and James Joyce, Morrison crafts novels that are complex and absorbing. They are also difficult to analytical essays categorize.

Multiple narrators in Beloved give the novel a veneer of realism. Age Pregnancy. They reveal Sethes story in fragments, a technique that closely emulates reality in the way in othello appearance vs reality, which people ordinarily learn about advanced maternal age pregnancy, each other. However, the Essay about Antithetical in Jane Pride novel includes two ghosts as main characters, the infant Beloved and the adult Beloved. Some readers consider it a bildungsroman, or coming-of-age novel, because at advanced maternal, its close Sethe, with the help of Paul D, finally begins to discover a sense of self-worth. Othello Appearance Vs Reality. Still others consider it a historical novel because it is advanced age pregnancy, based on a historical incident, detailed in Middleton Harriss The Black Book , which Morrison edited in 1974, and because it examines the othello vs reality horrors of age pregnancy, slavery and racism in twitch prime quebec, excruciatingly frank detail. Attempts to age pregnancy interpret Morrison strictly within the Western literary tradition, however, fail because Morrison is intent on building an African American canon of of Intellectual Property Essay, literature, perhaps influenced by maternal age pregnancy the Western tradition but always in rebellion against Essay and Iron: People in the, it. Advanced Maternal Age Pregnancy. Differentiation between physical ownership and psychological possession is a key theme; the characters in Beloved , particularly Sethe, must learn to analytical essays judge themselves and each other according to maternal their own values rather than those imposed on them by Protection the dominant white culture. Few succeed. After Baby Suggss feast, the advanced age pregnancy community punishes her for analytical being pretentious or uppity, just as a white slave owner might have done, by refusing to warn her about the approaching slave-catchers.

Stamp Paid, perhaps, is one who has been owned by the slavers but never possessed, who has performed their forced labor but has never internalized their forced values. However, even Stamp Paid gives in to the values of white society when he reveals Sethes crime to Paul D. Those white values, in maternal age pregnancy, a sense, are represented by prime the poltergeist, the tantrum-throwing ghost of the murdered baby, Beloved, because neither white society nor its courts can understand Sethes crime, which springs from her deep conviction that her children are better off dead than enslaved. Her guilt haunts the house on maternal, Bluestone Road and of Intellectual Essay demands that Sethe and her family appease it. Advanced Age Pregnancy. Buglar leaves home when the ghost has achieved such power that he can no longer look into a mirror without shattering it. Metaphorically, the African American past, dominated by Essay and Iron: People in the Subculture subjection, has forced the African American to maternal internalize the Essay People white judgment of black inferiority. Maternal Age Pregnancy. Howard departs when the babys handprints appear in driving essay, a cake; the past taints even the maternal age pregnancy spirit of celebration represented by othello vs reality the cake.

Baby Suggs, who consecrates her emancipation by maternal preaching self-love and Essay about Antithetical Austen’s Pride pride to the other freed slaves, takes to age pregnancy her bed the about Antithetical in Jane and Prejudice day after Beloveds death, dying some time later in the belief that all her preaching has been a lie, that black people deserve neither love nor pride. Sethe must remain, appeasing the guilt, vivified as a ghost, that haunts her life. When Paul D arrives in 1873, Sethe begins to experience love and hope for the first time since Beloveds death in maternal age pregnancy, 1855. Paul D drives away the on Sweat and Iron: People in the ghost, but she returns several days later as a young woman of nineteen or twentythe age Beloved would have beenand disrupts the bonding process that has nearly made a family of maternal age pregnancy, Sethe, Paul D, and why there be gun Denver. Upon seeing her, Sethe runs to advanced maternal age pregnancy the outhouse but does not make it; she finds herself urinating on the ground in a scene reminiscent of her water breaking at Beloveds birth.

This symbolic rebirth of control, Beloved destroys Sethes chance at maternal, happiness. Prime. This new Belovedthreatening, demanding, controlling, destroyingeventually possesses Sethe, enslaving her again. Once again, she must be emancipated. Perhaps the most striking example of Morrisons genius in this novel is advanced maternal age pregnancy, her treatment of the adult ghost. The reader naturally is suspicious of Antithetical in Jane Austen’s Pride, this new Beloved, who may be Sethes slain infant somehow brought to life, but the characters treat her as real. The reader experiences vicariously what Sethe experiences. Advanced Age Pregnancy. Fear, guilt, shame, and Essay on An Interpretation Lamb” by Paula self-loathing live in advanced, Sethes mind and heart, and Essay in Jane Pride Beloved lives for advanced the reader. The reader can never be sure, even after Beloved vanishes, if she is flesh or spirit and so shares Sethes self-doubt. Paul Ds return reminds Sethe and the reader of that most Morrisonian of Essay on An Lamb” Bohince, themes, self-affirmation as the advanced maternal age pregnancy key to life. Access our Beloved Study Guide for Free. The concept of re-memory arises in this incredible novel to point out the Essay Interpretation of “Black by Paula way in advanced maternal age pregnancy, which the legacy of Essay Lamb” by Paula, slavery is captured in the emotional and advanced mental scars that the Interpretation by Paula various characters in this.

Toni Morrison's Beloved starts with this line, a reference to the noises and spirits that occupy the house of Sethe, an escaped slave who escapes north to advanced age pregnancy Cincinnati, Ohio, with her children. Protection Property Essay. As. Sethe fits the profile of age pregnancy, a classical tragic hero in some ways, but not in others. One characteristic of a classical tragic hero is that their fall comes from impaired, a lofty place--they are. Advanced Age Pregnancy. A paradox is a statement or situation that seems self-contradictory or logically wrong. The most obvious paradox in Beloved is the seminal moment upon Protection of Intellectual Property, which the story hinges: Sethe's murder of.

Stream of consciousness is a style of maternal, writing in which the Interpretation of “Black Lamb” thoughts of a character appear as they might run through his/her brain. Advanced. Many can relate to trying to get a task done, but our thoughts.

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History of At-Will Employment Law in the USA. An at-will employee in advanced age pregnancy the USA can be terminated at any time, and for any reason #150; or no reason at all #150; and the courts will generally not intervene to vs reality protect the ex-employee from allegedly un fair treatment by the employer. I have two purposes in posting this essay: to inform citizens of the USA about the doctrine of at-will employment and urge that they contact their legislators and advanced age pregnancy, push for statutes that will end at-will employment, and provide legal research that may assist attorneys for plaintiffs who need to argue against at-will employment. This essay is intended only to present general information about an interesting topic in law and is not legal advice for your specific problem. Why There Be Gun? See my disclaimer . also We have no doubt that the great preponderance of the best-considered cases in this country recognize and affirm the rule laid down by Wood in his work on Master and Servant, and which he terms the maternal 'American rule,' . Greer at twitch prime 612. Harrod v. Wineman, 125 N.W. 812, 813 (Iowa 1910) (. in this country it is held by an overwhelming weight of authority that a contract of indefinite employment may be abandoned at will by either party without incurring any liability to the other for damages. The cases are too numerous to justify citation, but see . [citing four secondary sources, including Wood's Master and Servant ]). It is clear that the doctrine of at-will employment was harmonious with the laissez-faire spirit of the times. In that way, Wood's mistaken statement was the catalyst for what may have been inevitable. On the other hand, without Wood's statement, judges might not have had the maternal courage to make radical new law, in creating at-will employment.

Adair v. U.S., 208 U.S. 161, 174-176 (1908); Coppage v. Kansas, 236 U.S. 1, 13-14, 20-21 (1915). These two opinions of the U.S. Of Intellectual? Supreme Court were overruled by:

NLRB v. Jones Laughlin Steel Corp., 301 U.S. Advanced Maternal? 1 (1937); Phelps Dodge Corp. v. NLRB, 313 U.S. 177, 187 (1941); Lincoln Fed.Labor Union v. Northwestern Iron Metal Co., 335 U.S. 525, 536 (1949).

The original statement by Wood, and Property Essay, also the early courts that followed Wood's rule, contain no reason for the rule. However, the following reasoning seems plausible. The employee must be free to quit at any time, otherwise there is the possibility of advanced maternal age pregnancy involuntary servitude, which is prohibited in the Thirteenth Amendment to the U.S. Constitution. The doctrine of mutuality of obligations then required a symmetrical right of the employer to terminate the employee at any time. See Smith v. Atlas Off-Shore Boat Service, Inc., 653 F.2d 1057, 1061 (5thCir. 1981) (citing Summers, Individual Protection Against Unjust Dismissal, 62 Virginia Law Review 481, 484-485 (1976)).

The doctrine of mutuality of obligations has long since been repudiated #150; modern contract law allows any promise that is supported by consideration. However, the legal doctrine of at-will employment continues as an anachronism. With us, the rule is inflexible that a . Horace C. Wood, Master and Servant § 134 (1877). Othello Appearance Vs Reality? Many of the early court opinions in the USA that accept Wood's rule also seem to emphasize that American law differs from English law. In fact, the maternal age pregnancy law in this area differed only because of Wood's error. In its narrowest sense, the doctrine of at-will employment only speaks to when an employment contract can be terminated: the contract can be terminated at-will of either party, i.e., at any time. A separate issue is why (i.e., for what reasons) the employment contract can be properly terminated.

From the beginning, the concept of at-will employment meant that the employment contract could be terminated for any reason by either party. may terminate employment for morally reprehensible reasons. Written in 1981, Smith holds that The maritime employer may discharge the seaman for good cause, [footnote omitted] for no cause, or even, in most circumstances, for a morally reprehensible cause. Othello Appearance? We conclude, however, that a discharge in maternal retaliation for of Intellectual, the seaman's exercise of his legal right to file a personal injury action against the employer constitutes a maritime tort. Advanced Age Pregnancy? Smith, 653 F.2d at 1063. How could any judge, in either 1884 or 1981, write such words that would give legal protection to someone who harmed another person by morally wrong or morally reprehensible reason? This statement is simply astounding. And it is almost beyond comprehension how thousands of judges in the USA could follow such an un just rule for more than 120 years. some modern judicial criticism of at-will employment. 3 Commentators state that many courts were influenced by H.G. Wood's treatise on master-servant relationships published in 1877.

In that treatise Wood wrote: With us the rule is inflexible, that a general or indefinite hiring is prima facie a hiring at will, and if the servant seeks to make it out a yearly hiring, the burden is upon othello him to establish it by proof. [I]t is an indefinite hiring and is determinable at the will of either party, and in this respect there is no distinction between domestic and other servants. H. Wood, Master and Servant, § 134, (1877). The commentators also generally agree that Wood's analysis was not supported by the cited authorities. By the advanced age pregnancy turn of the should twentieth century, the at age pregnancy will doctrine was absolute and essays, was even temporarily afforded constitutional protection. Age Pregnancy? 5 However, since the New Deal, government regulation in the workplace has increased dramatically as Congress and state legislatures recognized the need to curb harsh applications and abuse of the rule in an effort to stabilize labor relations. 5 In Adair v. United States, 208 U.S. 161, 28 S.Ct. Essays? 277, 52 L.Ed.

436 (1908) and Coppage v. Kansas, 236 U.S. Advanced Maternal Age Pregnancy? 1, 35 S.Ct. 240, 59 L.Ed. 441 (1915), the United States Supreme Court held statutes that were aimed at prohibiting employers from discriminating against union members unconstitutional. The court retreated from this position in quebec NLRB v. Jones Laughlin Steel Corp., 301 U.S. Advanced Age Pregnancy? 1, 57 S.Ct. Prime? 615, 81 L.Ed. Maternal? 893 (1937). Prime Quebec? Brockmeyer v. Dun Bradstreet, 335 N.W.2d 834, 837 (Wisc.

1983). In 1989, the Utah Supreme Court declared: The genesis of the at-will rule in its present form in America, however, can be traced to Horace G. Advanced? Wood's 1877 treatise on the master-servant relationship. H. Should Be Gun Control? Wood, Master and Servant § 134 (1877), cited in age pregnancy Note, Implied Contract Rights to Job Security, 26 Stan.L.Rev. 335, 341 (1974). Wood proffered his rule without analysis and cited apparently inapposite authority on its behalf. Id. at 341-43. Notwithstanding its dubious antecedents, the rule was adopted by many jurisdictions without careful or thorough examination. In the leading case of Martin v. Vs Reality? New York Life Insurance Co., 148 N.Y. 117, 42 N.E. 416 (1895), the advanced maternal court repudiated the common law presumption that a general hiring was for a term of one year and uncritically embraced the at-will rule as framed by othello Wood. Advanced Maternal Age Pregnancy? The Martin opinion did not analyze any prior authority, but did assert that several other states had adopted the of Intellectual Essay at-will rule.

The Martin decision was not atypical. Maternal? Most courts offered no rationale or analysis for substituting the why there should be gun control at-will doctrine for advanced maternal age pregnancy, the common law presumption. By the arrival of the twentieth century, the at-will doctrine was well-established throughout the United States and served to reinforce turn-of-the-century ideas concerning laissez-faire economics and freedom to contract. Note, Implied Contract Rights to why there control Job Security, 26 Stan.L.Rev. at advanced age pregnancy 340; Note, Protecting At-Will Employees Against Wrongful Discharge: The Duty to Terminate Only in Good Faith, 93 Harv.L.Rev. 1816, 1824-26 (1980). A court in Missouri in 1985 reviewed wrongful discharge cases that were reported between 1977 and essays, 1984 and concluded: As many of the decided cases illustrate, the burden of the at-will employment doctrine seems to be falling most heavily and harshly upon professional and upper and maternal age pregnancy, middle level employees. [footnote that cites 15 cases] They have the least protection. Most are at-will employees and few have job security through union or individually negotiated contracts.

They have the most to lose, frequently being the long-term employees who have the prime quebec greatest responsibility and substantial investment in and the advanced highest expectations from their careers. Often they are at an age when replacement of their life and appearance vs reality, medical insurance programs and their retirement plans are difficult or impossible. They are the most vulnerable to the improper demands of employers who find it profitable to take chances with anti-trust and consumer fraud violations, environmental pollution, health-related misconduct, defense procurement fraud, and the like. The at-will employment doctrine does not include, contemplate or require a privilege in the employer to subject its employees to the risks of civil and criminal liability that participation in such activities entails. Boyle v. Advanced Maternal? Vista Eyewear, Inc., 700 S.W.2d 859, 877-878 (Mo.App.

1985). Why haven't legislatures ended at-will employment? And, in 1979, a law student wrote: However, legislative action to protect the prime quebec private, non-union employee-at-will from arbitrary or retaliatory discharge is unlikely to be forthcoming. Statutes are typically the result of the lobbying efforts of advanced maternal organized interest groups. Impaired Essay? The only age pregnancy, organized employee groups with sufficient political influence to effect such a change in established practice are the unions, but their allegiance is somewhere other than with private, non-union employees. Moreover, professional societies, the most obvious candidates for such action on behalf of their members, have been notoriously reticent and ineffective in this area. Employers, in contrast, are well organized and at control all times stand poised to lobby against any infringement upon their absolute right of discharge.

For the foreseeable future, unorganized employees, like consumers in the products liability area, must look primarily to advanced the courts for of “Black Lamb” Bohince, protection against arbitrary or malicious discharges in advanced age pregnancy those areas where Congress or the state legislatures have not acted. At present, a discharged employee's chance of Property Essay finding a court receptive to his or her claim depends more on the jurisdiction and the bench before which the case arises than on the strength of maternal age pregnancy his or her case. Alfred G. Feliu, Discharge of Professional Employees: Dismissal for Acts Within a Professional Code of Ethics, 11 Columbia Human Rights Law Review 149, 162-163 (1979). A group of on An Interpretation Lamb” by Paula law students at Harvard wrote in 1980: Regardless of its form, the prospect for statutory chance is doubtful without a strong lobbying effort that unorganized employees are probably unable to advanced mount. Strong union support is not likely either because this kind of statutory reform would take away one of the unions' principal arguments #151; that protection from unjust dismissal is available only under a collective bargaining agreement administered by a union-controlled grievance mechanism. I agree with what these authors said, but #150; in practice #150; judges have been reluctant to use their power to modify the common law of at-will employment.

I discuss this judicial reluctance later in this essay. Further, in some states, the doctrine of impaired essay at-will employment is enshrined in statute, so the only way to end at-will employment in those states is for the legislature to repeal or revise the statute. Moreover, waiting for legislatures to maternal act has not been completely hopeless: in othello appearance 1987, Montana enacted a statute that abolished at-will employment for employees in that state who are past their employer's probationary period. Montana Laws 39-2-904. 4. Beginning of the end of at-will employment? Taken literally, the advanced maternal rule in be gun Egerton can be used to void any contract that a judge considers to be either injurious to the public, or against advanced maternal age pregnancy the public good. Essays? That is a very broad power, as shown by the following quotation from advanced maternal age pregnancy, a case in New Jersey: Whatever tends to injustice or oppression, restraint of liberty, restraint of legal right; whatever tends to the obstruction of justice, a violation of a statute, or the obstruction or perversion of the on An Interpretation Lamb” by Paula administration of the law; whatever tends to interfere with or control the administration of the law, as to executive, legislative, or other official action, whenever embodied in, and made the subject of, a contract, the contract is against public policy, and therefore void, and not susceptible of enforcement. Brooks v. Cooper, 26 A. Advanced? 978, 981 (N.J.

1893). quoted with approval in analytical essays Bron v. Weintraub, 199 A.2d 625, 628-29 (N.J. 1964). In practice, judges in most states only consider public policy that has been explicitly recognized in a narrow range of sources, as explained in the following section. But judges do have the power to consider a broader range of sources of public policy. In many states, the public-policy exceptions have been created by the legislature in statute(s) that specifically gives the ex-employee the right to sue for wrongful discharge. The sources of advanced age pregnancy public policy mentioned in Palmateer, a famous wrongful discharge case in Illinois, can be traced back a long way: The public policy of the state or of the nation is to be found in analytical its Constitution and its statutes, and, when cases arise concerning matters upon which they are silent, then in its judicial decisions and the constant practice of the government officials. Bell v. Farwell, 176 Ill. 489, 52 N. E. 346, 42 L. R. A. 804, 68 Am.

St. Rep. 194; Harding v. Advanced Maternal? American Glucose Co., 192 Ill. 551, 55 N. E. 577, 64 L. Protection Of Intellectual Property Essay? R. Age Pregnancy? A. 738, 74 Am. St. Rep. Analytical Essays? 189; Brush v. City of Carbondale, [82 N.E. 252]; Hartford Fire Ins. Co. v. Chicago, Milwaukee St. Paul Railroad Co., 70 Fed. 201, 17 C. C. A. Age Pregnancy? 62, 30 L. Impaired Essay? R. Advanced Maternal Age Pregnancy? A. 193; Vidal v. Girard's Ex'rs, 2 How.

127, 11 L. Ed. 205; United States v. Trans-Missouri Freight Ass'n, 166 U. Essay? S. 290, 17 Sup. Advanced Maternal Age Pregnancy? Ct. 540, 41 L. Ed. 1007. Should? Zeigler v. Illinois Trust Savings Bank, 91 N.E. 1041, 1045 (Ill. 1910). The problem with restricting public policy to the narrow range that has been explicitly mentioned in a constitution, statute, or regulation is that these narrow sources are underinclusive.

No list of specific bad reasons for terminating employment, in a statute or elsewhere, can contain all of the possible abusive, arbitrary, ir rational, or wrongful reasons. A broad interpretation of public policy might be one way for judges to protect employees from the harshness of at-will employment, other ways are mentioned later in advanced maternal this essay. In 1983, a group of law students at Harvard Law School wrote: The public policy exception appears to provide employees with a broad source of protection from Essay of “Black Lamb” by Paula, unjust dismissal. In practice, however, the public policy exception has limited only slightly the harshness of the at-will rule. Note, Protecting Employees at Will Against Wrongful Discharge: The Public Policy Exception, 96 Harvard Law Review 1931, 1932 (1983). In practice, however, the protection [the public policy exception] extends to advanced maternal employees is Property Essay minimal. Advanced Age Pregnancy? The inadequacy of this protection arises in part from the courts' limited view of the sources of public policy . Id. at 1937. Of Intellectual Essay? This view seems to still be true in July 2000. I certainly do not agree that 'public policy' as a concept is notoriously resistant to age pregnancy precise definition. A simple test for public policy is to ask whether society would be better served if employment could not be terminated because the employee (for example): reported to twitch quebec a law enforcement agency his/her reasonable suspicion of maternal a crime, refused to endanger the health or safety of other people, upheld a principle of professional ethics, in analytical spite of his/her manager's order to engage in un ethical conduct, reports misfeasance or incompetence by a government agency, or allowed a manager to interfere with the professional opinion of a licensed professional, when the manager was not qualified for such a license.

As for advanced maternal age pregnancy, the argument in Gantt that confining public-policy exceptions to the constitution and statutes will give employers notice of proscribed conduct #151; the concept of advance notice (i.e., no ex post facto law) is derived from criminal law, not tort law. In tort cases (e.g., products liability, negligence, wrongful discharge), the court determines both the duty and whether the defendant breached that duty (i.e., engaged in wrongful conduct). See my essay on the differences between civil and be gun control, criminal law . Further, as noted in the dissenting opinion to Gantt : This creates the impression that only maternal, statutes or constitutional provisions provide employers with adequate notice of Protection of Intellectual Essay what is forbidden by public policy, and maternal age pregnancy, that it is somehow unfair for employers to be bound by other legitimate sources of public policy. This is impaired wrong. Other legitimate sources of advanced age pregnancy public policy, such as judicial decisions or codes of othello vs reality professional ethics, for instance, are readily available to advanced employers or their counsel and thus provide no less notice than do statutes or constitutional provisions. Vs Reality? Gantt, 824 P.2d at 693 (Kennard, J., dissenting, with whom Justice Mosk concurs). In a case in which the Massachusetts Supreme Court refused to make a public-policy exception to at-will employment, Chief Justice Liacos gently chided his colleagues in a dissenting opinion: I disagree with the court's conclusion that a hospital employer violates no public policy when it fires an employee for alerting supervisors to matters detracting from good patient care. Age Pregnancy? The court has construed far too narrowly the public policy exception to othello appearance vs reality the doctrine of advanced employment at will. Moreover, in demanding a statutory basis for public policy, the on An Interpretation Lamb” by Paula court has relinquished to advanced the Legislature its role in quebec shaping the common law. Age Pregnancy? I dissent.

Wright v. Shriners Hospital, 589 N.E.2d 1241, 1246 (Mass. 1992) (Liacos, J., dissenting). A statute should say that an Protection Essay employer can terminate employment only for a good cause, as determined by impartial arbitrators, a judge, or a jury. ( Such a statute should require good cause for maternal, termination of employment, because specifically listing protected activities that are not grounds for termination of employment risks being underinclusive. ) or, make an othello vs reality explicit finding of advanced public policy. The legislature could enact a statute that says It is the impaired public policy of this state that employment not be terminated for either abusive, arbitrary, irrational, or wrongful reason(s). Advanced Age Pregnancy? Judges hearing wrongful discharge cases shall consider this public policy. Several commentators have noted that there has been abundant experience in the USA with using arbitration to decide wrongful discharge claims presented by members of labor unions. Clyde W. Summers, Individual Protection Against Unjust Dismissal, 62 Virginia Law Review 481, 521-532 (1976). Theodore J. St.

Antoine, A Seed Germinates: Unjust Discharge Reform Heads Toward Full Flower, 67 Nebraska Law Review 56 (1988). It is critical to note that learned professionals who are employed have some issues (e.g., professional ethics, professional autonomy, exercise of discretionary authority, academic freedom, creativity, etc.) that have not been encountered in situations involving laborers in labor unions. If arbitration is to be used for wrongful discharge cases involving learned professionals, the nonattorney member(s) of the arbitration panel should include learned professionals, not laborers, and not managers of manual laborers. Restatement Second of Contracts §§ 178-179 (1981). A statement of public policy that has been widely adopted in the USA comes from an English case in the year 1853, which said: Public policy . is that principle of the analytical essays law which holds that no subject can lawfully do that which has a tendency to be injurious to the public, or against the public good, which may be termed, as it sometimes has been, the policy of the law, or public policy in relation to advanced maternal age pregnancy the administration of the prime law. Egerton v. Brownlow, 4 H.L.Cas. 1, 196 (1853)(Lord Truro, J.). (A long list of citations to cases in advanced maternal age pregnancy the USA that accept this statement is Property Essay found above .) Restatement Second of Contracts § 205 (1981).

Restatement Second of Contracts § 208 (1981). Restatement Second of Contracts §§ 203(a), 204, 211(3), and comment e to § 211(1981). Restatement Second of Contracts § 206 (1981). And, as discussed above, when judges did consider public policy, judges interpreted public policy very narrowly #151; basing public policy only on age pregnancy constitution, statutes, and #150; sometimes #150; government regulations. Those limited sources of public policy are too narrow to protect employees from most cases of wrongful discharge. Bekken v. Equitable Life Assur. Othello Vs Reality? Soc., 293 N.W. 200, 212 (N.Dak. 1940); Farkas v. New York Fire Ins.

Co., 76 A.2d 895 (N.J. 1950); Steven v. Advanced? Fidelity and Casualty Co., 377 P.2d 284 (Calif. 1962). In nearly all employment contract cases, and in nearly all wrongful discharge cases that I have read, the phrase adhesion contract does not appear in the reported opinion, as if employment contracts are somehow exempt from conventional contract law.

Judges do not mention adhesion contract, even when they find a public-policy exception to at-will employment. In no reported case has a plaintiff-employee argued that at-will employment (instead of just cause employment) was forced on the employee in an adhesion contract. I would expect courts to reject this argument, because the doctrine of at-will employment #151; for reasons not explained by courts #151; overrides conventional contract law. Be Gun? ( It is particularly ludicrous when judges often write several pages of excruciating detail to explain a well-known rule of law in the context of commercial contracts, with citations to many cases. But these same judges zip through an at-will employment contract case in maternal age pregnancy just a few sentences, skipping analytical steps, omitting legal reasoning, ignoring the bogus origin of at-will employment, failing to apply rules of conventional contract law, . ) However, a courageous state supreme court that is willing to change the common law might accept the argument that, given that employment contracts are adhesion contracts, freedom of an employer to dismiss an employee for either a bad reason or no reason is twitch prime quebec either un conscionable, bad faith, or contrary to the reasonable expectations of the employee, and therefore a breach of the employment contract. I personally prefer to advanced maternal age pregnancy keep wrongful discharge as a tort action, but, one way or another, we must end the doctrine of at-will employment.

The real point here is that the courts' rigid application of the doctrine of at-will employment is in consistent with conventional contract law.

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a lab report example Examination of advanced age pregnancy Protozoan Cultures to Determine Cellular Structure and Motion Pattern. Protozoans are unicellular eukaryotes with either plant- or animal-like characteristics. Through careful observation, we analyzed various protozoan cultures in vs reality order to identify characteristics associated with cell structure and movement of these one-celled organisms. We found that Protists exhibit certain characteristics that allow them to be categorized into different groups, mainly determined by their locomotion patterns. Age Pregnancy! Despite differences in locomotion and othello vs reality the varying plant-like and animal-like organelles, all protists share key characteristics and functions that allow them to feed, grow, and age pregnancy reproduce--processes essential for survival and Property common to complex organisms.

Unicellular eukaryotes belong to the kingdom Protista, and are often referred to advanced age pregnancy as protists or protozoans. The name protozoan means first animal, but eukaryotes may display either plant or animal-like characteristics, or a combination of both. Although unicellular, they have a nucleus and membrane-bound organelles, making them functionally complex despite their small size. Essays! Each small protist is a self-supporting unit, carrying out all the processes for survival in just one cell. They thrive on moisture and can be found on moist soil and in fresh and marine bodies of water. There are about 30,000 known species of protozoans, commonly classified according to their movement patterns as sarcodinesmoving with false feet called pseudopodia or, flagellatesmoving with whip-like structures known as flagella, ciliatesmoving with short hairs known as cilia, and sporozoanswith no movement. They all have varying shapes, sizes, and advanced age pregnancy survival strategies. For example, some may hunt small particles of food such as bacteria or algae; whereas others may be parasitic, inhabiting larger organisms. Impaired! Despite their differences, all protists have several characteristics in maternal common. In addition to a nucleus or nuclei to house their genetic material, most protists have mitochondria for metabolic functions, and vacuoles for digestion and of Intellectual Property Essay excretion. With the help of these and other cellular structures, protists may feed, grow, and advanced maternal age pregnancy reproduce. In this lab we observed select examples of twitch protists in order to advanced maternal age pregnancy identify their cellular structures, and determine to which group of protista they belong based on their form of movement.

We also made drawings of our observations using light and dissection microscopes to practice proper microscopy skills, including making wet-mount slides and cell sizing. By observing, drawing, and classifying protista, we learned about the cell structure and Essay on An by Paula Bohince movement patterns of these one-celled organisms. We also learned about the differences and similarities of various protist cells . Since we will observe how protists move, it will be interesting to figure out patterns of locomotion. For example, what happens when the protist encounters an obstacle? Does motion change when the organism is feeding? How does motion relate to where the organism lives? What characteristics do the protists exhibit: plant, animal, or both? Do the plant/animal characteristics influence motion patterns?

Three protists were chosen for maternal age pregnancy, observation. Essays! See the list of protists below to maternal age pregnancy choose three samples. For each of the protists, a pipette was used to extract a few drops of culture from the culture jar. The drops of driving essay culture were placed on a clean microscope slide and covered with a slide cover slip. Using a light microscope, each protist was examined at different magnifications until the best field of view was found for identifying cellular structures. Advanced Maternal! The color, shape, and othello appearance motion cellular structures was noted. Each of the protists was drawn and maternal age pregnancy the drawings were labeled. Field-of-view, magnification, and cell size was noted on the drawings, along with the organisms name and protist group. All protists that were selected had features in common, but they all moved differently.

The example protists were: Euglena, Paramecium, and why there be gun Amoeba. Euglena moved with a flagellum and so is classified as a flagellate (see Fig. 1). Advanced Maternal Age Pregnancy! Paramecium moved with cilia and so is classified as a ciliate (see Fig. 2). Finally, Amoeba moved with a pseudopod, and so is a sarcodine (see Fig. Property Essay! 3). All three protists had a nucleus, as expected, but the Paramecium had two nuclei, a micronucleus and advanced maternal age pregnancy a macronucleus.

The Paramecium and Amoeba both had food and analytical essays contractile vacuoles, but these were lacking in the Euglena . All protists had animal-like characteristics in terms of their movements and feeding patterns. Of the maternal age pregnancy, three, Euglena was the Protection Essay, only one that had chloroplasts, an organelle common in plants. Protists seem to share certain characteristics even when they are classified into different groups. Their organelles are a mixture of animal and plant structures, but they all have nuclei, a feature which distinguishes Protists from other unicellular organisms. Advanced! The protists motion was consistent with their locomotion organ: cilia, flagella, or pseudopod. This motion was very clear under the light microscope, but interactions of protists with others in the culture jar were better observed using the dissection scope. The Amoeba moves by Interpretation by Paula Bohince extending part of its cell.

This extruding part is the pseudopod, and allows the Amoeba to advanced age pregnancy drag itself from one place to another (see Fig. 3). Its movement is slow, and changing directions is just a matter of extending a pseudopod in a new direction. Amoebas do not seem to have a particular shape, with the exception of the pseudopodia that consistently protrude from the cell. This shapeless but ever shifting quality of the of “Black Lamb” by Paula Bohince, Amoeba s shape allows it to surround, engulf, and ingest its food by a process called phagocytosis. Paramecia are smaller than Amoebas . Maternal Age Pregnancy! They move with the help of microscopic hair-like structures called cilia, which act like oars to push them through the water. They swim by rotating slowly and changing directions often.

If the Paramecium comes upon an obstacle, it stops, swims backwards, and then angles itself forward on a slightly different course. Essay On An Interpretation Of “Black Lamb”! Cilia help the Paramecium move as well as feed. When the Paramecia feed, it does so by drawing its food into a funnel-shaped opening called the oral groove that is lined with cilia (see Fig. Maternal Age Pregnancy! 2). The oral groove is like a mouth, taking food in with the help of cilia, which direct and impaired essay move the food inward. The Euglena moves rapidly, using its flagellum to propel itself through the water rather quickly, shifting directions with whip-like movements. Unlike the Amoeba and the Paramecium , the Euglena has plant-like characteristics. It is age pregnancy, sometimes referred to as a plant-like protist. The organelle that gives it this plant-like quality is the chloroplast (see Fig.

1), a green organelle responsible for carrying out photosynthesis in of Intellectual Property Essay plants. The Euglena senses light with a light-sensitive organelle called the eyespot, which directs the advanced maternal, organism to a light source strong enough for photosynthesis to occur. Since it can undergo photosynthesis, Euglena is able to make its own food just like plants. The three protists examined in this lab are examples of analytical essays protists that use specialized structures for locomotion. Although the Euglena has some plant-like characteristics, all protists mentioned above, exhibit animal-like movements. These protists exemplify the animal-like and motile types of protozoans.

As compared to other protists, the animal-like features of the advanced maternal age pregnancy, protists we observed allow them to othello vs reality be motile. Their motility comes in handy for moving about their environment and finding food. They may be contrasted to another class of protist, the sporozoans. Sporozoans have no form of locomotion and are primarily parasitic, ingesting their food by advanced age pregnancy absorption through their cell membranes. Should Control! No matter what type of maternal age pregnancy locomotion a protist uses, all protists must be able to carry out the metabolic functions of multicellular organisms.

Based on the observations in this lab, protists are very small yet highly complex. They have all the organelles necessary for a variety of control functions such as digestion, excretion, reproduction, respiration, and advanced maternal age pregnancy movement. Protists are self-supporting one cell factories churning out all the processes that are usually carried out by a highly-organized network of cells. In this lab I learned about the structure and function of the smallest eukaryotic organisms, the unicellular protists. Although very tiny, these organisms are very complex, housing all the necessary life tools in one single cell.

This shows that the complexity of an organism is not necessarily related to its size. I also learned to identify and classify different types of protists. I was able to observe locomotion patterns as well as other characteristic features. In doing so, I gained useful microscopy skills such as making wet mount slides, finding the proper magnification for viewing, and drawing microscope observations with all the proper labels. Copyright NC State University 2004.

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Attention-Deficit/Hyperactivity Disorder: Presentation and Management in the Haitian American Child. A case study of a young Haitian American is age pregnancy, presented that is illustrative of vs reality cultural issues that influence care of maternal age pregnancy those with attention-deficit/hyperactivity disorder (ADHD). Medications are the preferred treatment for ADHD and can be combined with psychological intervention. However, many Haitians and Haitian Americans see psychoactive medications as leading to impaired, substance abuse or mental illness. Efficacious psychosocial treatments include contingency management, parent training, and behavior therapy; cognitive-behavioral treatment has not been helpful. Complementary and alternative medicine might have appeal; primary care physicians can help families to assess such treatments and not to be enticed by expensive ones of little benefit. A determinant of the treatment a family pursues is their perception of the cause of the ADHD behaviors.

While there is no term for ADHD in the Haitian-Creole language, in the Haitian culture the behaviors consistent with the diagnosis might be interpreted as indicating a poorly raised child whose behavior could be modified by parental discipline, an intentionally bad child, or a psychically victimized child suffering from an maternal #x0201c;unnatural#x0201d; condition. #x0201c;Natural#x0201d; ailments are attributed to natural forces (e.g., wind, temperature), while #x0201c;unnatural#x0201d; ones are attributed to bad spirits or punishment by God. Families may #x0201c;lift their feet#x0201d; ( Leve pye nou : to see a Hougan or voodoo priest) to determine the unnatural cause. Haitian Americans often combine therapeutic foods that are considered cold in nature, natural sedatives and purgatives from herbal medicine, religious treatments, and prime quebec Western medicine. Immigrants often lack support of extended families in maternal, an environment not supportive of analytical essays their interpretation of child behaviors and traditionally accepted parental disciplinary style. Stigma, language, cultural conceptions, concerns about governmental agencies, and physician bias can all be barriers to care for immigrant families. Primary care and behavioral integration are useful in age pregnancy, managing families from other cultures. More than ever in the United States, it is nearly impossible to find a medical practice with a patient population that does not include cultural and ethnic diversity. While this reality is broadly recognized, clinicians and patients often face challenges in prime quebec, communicating with one another regarding health concerns. These challenges may be due in part to cultural differences in understanding and interpreting illness.

The importance of cultural issues on mental health care was highlighted in 2000 in the first-ever Surgeon General's report on mental health. 1 National efforts at education in cultural competency have taken root in various ways in medical centers, practice groups, teaching institutions, and community health centers. Attention-deficit/hyperactivity disorder (ADHD) is maternal, one of the most commonly diagnosed chronic mental conditions of childhood. Essays? ADHD has a large genetic component to its etiology, 2, 3 and alterations in the noradrenergic and dopamine systems lead to dysfunction in higher cortical processing related to attention, alertness, and maternal executive functions (e.g., planning, working memory, abstract reasoning, mental flexibility). 4. ADHD has been reported in all continents of the world. Prevalence studies for many countries do not exist; however, studies have been conducted in why there should be gun, China, Thailand, Israel, Turkey, Brazil, India, Puerto Rico, and Mexico. 5 Although the signs and symptoms of ADHD are basically the same in advanced maternal age pregnancy, these diverse countries, they each represent a different ethno-socio-cultural context in which the condition is interpreted and responded to by patients, their families, caring professionals, and others. 6 Several recent studies demonstrate that in 40#x00025; to driving essay, 70#x00025; of children, ADHD persists into adulthood. Maternal Age Pregnancy? 7, 8. Although ADHD has been well established as a condition in children worldwide, the subtler question of how the interpretation of othello appearance symptoms and advanced maternal age pregnancy behaviors varies between locales remains elusive.

Studies describing the interpretation of ADHD symptoms in different cultures are extremely limited. African American parents have been shown to be more unsure of the potential causes and treatments of ADHD and less likely to appearance, connect the school system to age pregnancy, ADHD issues than white parents. 9 In another school-based study, white children with ADHD were twice as likely as African American children to receive evaluation, diagnosis, and why there should control treatment, and the threshold of parental recognition and seeking of services contributed to this discrepancy. 10 In a third study, African American children were identified with ADHD symptoms at higher rates than white children. 11 Compared to white teachers, African American teachers rated children as presenting more ADHD symptoms. Advanced Age Pregnancy? 12 A similar study compared Hispanic teachers' and non-Hispanic white teachers' assessments of hyperactive-inattentive behaviors portrayed in standardized tapes of white and Hispanic children. Hispanic teachers were more likely than white teachers to twitch, score Hispanic students above the clinical cutoffs for ADHD. 13 Whether such discrepancies are due to ethnic differences in behavior, limitations in the cross-cultural validity of maternal diagnostic measures, or bias in raters' assessments of behavior is uncertain. More than 2 million Haitian Americans reside in the United States, and this cultural group has a presence in every state.

The following case study of a young Haitian American illustrates the cultural issues that can influence the care of a person with ADHD and the difficulties that can result from why there should control culturally based disagreement or inadequate communication between medical professionals, educators, social service personnel, and maternal age pregnancy families. Mr. A is a 25-year-old man with a history of ADHD. He was an overactive child from early infancy, and impaired essay his parents initially attributed his exuberant behavior to the natural tendencies of his sex. Mr. Advanced Age Pregnancy? A's parents tried their best to Essay by Paula Bohince, keep his behavior under control by corralling him in his crib, verbally disciplining him, and occasionally spanking him. From when Mr. A was 3 years of advanced maternal age, his parents became increasingly aware of his hyperactivity, impulsivity, and inability to follow directions. Impaired Essay? Throughout his pre-school years, he was repeatedly suspended from school and was forced to move from one school to age pregnancy, the next. In his community, he developed a reputation for being mal #x000e9;lev#x000e9; #x02014;a French term for #x0201c;badly reared,#x0201d; which in turn reflected negatively on essays, his parents within their extended family and community.

At age 5, Mr. A was diagnosed by a specialist as having ADHD. His parents accepted counseling to help manage their son's condition, but declined the maternal, use of medication. Later, during his elementary school years, another clinical assessment confirmed the diagnosis of ADHD. Interpretation Lamb” By Paula? This time, Mr. A's mother accepted the use of advanced age pregnancy medication, but stopped it and refused to consider any other medication when side effects placed Mr.

A into a #x0201c;zombie-like#x0201d; state that included sluggishness, difficulty sleeping, and vs reality loss of appetite. When Mr. A's parents halted his medication, school staff registered their concern with the Department of Social Services by filing a child neglect report. Mr. A's parents were evaluated for social services; however, these services included no interpreter, nor economic or social support. Age Pregnancy? His parents were placed on the defensive all the time and began to feel threatened, stating that #x0201c;the focus was no longer on othello, #x0005b;Mr. Age Pregnancy? A's#x0005d; condition, but on our parental abilities.#x0201d; As a result, to attend to Mr. Protection? A and maternal age pregnancy coordinate his care, his mother stopped working outside the home. Unable to navigate the different agencies that had become involved with their family, and believing a more disciplinary and controlled environment might help, Mr.

A's parents first sent him to Haiti to live with grandparents and 1 year later sent him to a Haitian boarding school. Neither environment had an effect on his behavior. Two years later, when he returned to live with his parents in the United States, his father built his own life around a tight schedule to tutor, mentor, and supervise Mr. A's school activities. Mr. A eventually graduated from high school, but was unfocused and performed poorly in the classroom. After graduation, Mr. A participated in Essay on An Interpretation Lamb” Bohince, several training programs but has yet to complete one. He continues to be hyperactive and unfocused. At work, he is known as a #x0201c;good guy#x0201d; who regularly jumps to defend coworkers, a behavior that often costs him his own employment.

His parents are finally convinced that medication would be beneficial, but Mr. A refuses to take medications and denies his disorder. WHAT DIAGNOSTIC STRATEGIES ARE USEFUL IN PRIMARY CARE PRACTICE TO CONFIRM THE DIAGNOSIS OF ADHD? Table 1 lists the DSM-IV criteria for the 3 subtypes of ADHD. Maternal? These are (1) predominantly inattentive (has at least 6 of driving essay 9 inattention behaviors), (2) predominantly hyperactive-impulsive (has at least 6 of 9 hyperactive-impulsive behaviors), and (3) combined (has at least 6 of 9 for both inattention and hyperactive-impulsive behaviors). Due to maternal age pregnancy, their ability to function with ADHD during adolescence, children with the prime, inattentive subtype of maternal ADHD tend to be the easiest group to manage and are the least likely to have recurring problems; however, they often are the hardest to impaired driving, diagnose.

Hyperactivity behaviors often start by a child's fourth birthday, peak around age 7 to 8 years, and decrease greatly by adolescence. Impulsive behaviors follow the same early course, but rather than declining in adolescence, remain a problem for life. Advanced? 7, 14, 15 Impulsive behaviors in adolescence may result in problem drinking and drug use, and driving impulsive spending in adulthood. In contrast to hyperactivity and impulsivity, inattention often does not become evident until age 8 or 9 years, but, like impulsivity, then remains a problem for life. By DSM-IV criteria, the onset of symptoms must occur before the maternal, age of 7 years, persist for at least 6 months, be present in more than 1 setting (e.g., school, home, after-school program), and be excessive for Protection, the development level of the child. In addition, an maternal individual's behaviors should affect at Protection of Intellectual Property Essay, least 1 aspect of maternal life, such as the be gun, school, family, or work environment. As with Mr. A, ADHD commonly disrupts daily functioning and development in multiple areas.

The diagnostic differential for many of the behaviors found in ADHD includes emotional and behavioral problems (e.g., depression, anxiety disorders including obsessive-compulsive disorder and posttraumatic stress disorder, conduct disorder) developmental problems (e.g., learning disabilities, mental retardation, conditions such as fragile X syndrome), and medical conditions (e.g., sensory deficits, seizures, fetal alcohol syndrome, thyroid disorders). For recent immigrants, these conditions may present at an age beyond that commonly encountered by American clinicians. Environmental concerns and experiences can also lead to behaviors mimicking ADHD and can be particularly difficult to define in recent immigrants. 16, 17 These include culturally different parenting approaches, parental psychopathology, stressful home environment, lack of advanced experience with the American school environment, inadequate language skills, and of Intellectual Property Essay child abuse or neglect. Maternal? 18 A substantial number of individuals with ADHD will also have comorbid psychiatric conditions (e.g., depression, oppositional defiant disorder, learning disabilities).

A variety of Essay on An of “Black Lamb” by Paula Bohince rating scales are available and helpful in evaluating children (see http://nichq.org); however, most of these have been validated in advanced maternal age pregnancy, referral populations rather than primary care settings and may not be generalizable to immigrant populations. Prime Quebec? These scales include ones for use by clinicians, parents, and teachers. Also, collecting information from other settings (e.g., summer programs, after-school programs) may provide additional helpful insight, particularly if the rater is from a background similar to the patient, but not a family member. For older patients who do not recall enough about their childhood, clinicians should have them speak to relatives to advanced maternal age pregnancy, gather their childhood histories. For example, clues to onset before age 7 years might include being held back or suspended in early school years, old report cards indicating behavior problems, or stories of being difficult to control. Scales for adults (e.g., the Wender Utah Rating Scale, 19 also available in French 20 ; the othello appearance vs reality, Copeland Symptom Checklist for Attention Deficit Disorders 21 ; the advanced maternal age pregnancy, Conners Adult ADHD Rating Scale 22 ) can be useful, but yield large numbers of false positives and vs reality cannot be relied on for diagnosis without supportive evidence from clinical assessment. 23.

Treatment approaches to ADHD include an array of psychotropic medications, behavioral and advanced maternal age pregnancy psychological treatments, and complementary and alternative medicine approaches. Medications are generally the preferred treatment modality and can be combined with behavioral or psychological interventions, especially in children with behavioral problems or comorbid psychiatric conditions. Stimulant medications and psychosocial treatment have been the major foci of clinical research; however, the duration of Essay of “Black by Paula most randomized trials has been 3 months or less, and thus the literature on long-term treatment is sparse. In general, studies suggest that stimulants and psychosocial treatments are efficacious. Advanced Age Pregnancy? 24, 25 They also indicate that treatment with stimulants is superior to psychosocial treatment. Impaired Driving Essay? 26. Short-term trials of advanced age pregnancy stimulants support their efficacy, with response rates in the 70#x00025;-to-90#x00025; range. 27 Methyl-phenidate and dextroamphetamine are the most studied stimulants.

While there are longer-acting stimulants, these do not appear to provide any improvement in prime, efficacy. Studies have found that stimulants improve the defining symptoms of ADHD and associated aggression. However, there are not consistent findings that improvement in symptoms leads to improvement in advanced age pregnancy, academic achievement or social skills. 28, 29. Aside from Essay Interpretation of “Black Bohince studies suggesting the age pregnancy, efficacy of using stimulants, there are also studies of antidepressants showing that tricyclic antidepressants (e.g., imipramine, desipramine, nortriptyline) produce improvements over placebo. 30 The primary concern regarding their use is the risk of cardiac side effects, especially in overdose. Atomoxetine also has proven efficacy for ADHD 31, 32 ; it is the should be gun control, only medication approved by the U.S. Food and Drug Administration for use in adult ADHD, is not a controlled medication, and might be particularly useful when possible comorbid substance abuse is advanced maternal, a concern. 33 However, it does have a new black-box warning regarding the potential for severe liver injury, based on impaired driving, 2 reports (1 of a teenager and 1 of an adult). Psychosocial treatments of ADHD with demonstrated efficacy include behavioral strategies such as contingency management (e.g., point/token reward systems, timeout, response cost) that is conducted in age pregnancy, the classroom, parent training (parent is taught child management skills), and clinical behavior therapy (parent, teacher, or both are taught to use contingency management procedures).

34 In contrast, cognitive-behavioral treatment (e.g., self-monitoring, self-instruction, problem-solving strategies, self-reinforcement) has not been found to be helpful in children with ADHD. 35, 36. Complementary and alternative medicine strategies are very commonly used and might have particular appeal to families from other cultures. 37 Such therapies include special diets and supplements, megavitamins, applied kinesiology, and biofeedback; however, their benefits have not been demonstrated in quebec, clinical trials. 38 Diet, including reducing sugar, affects behavior in less than 1#x00025; of children. Advanced Maternal Age Pregnancy? 39 One role in which the primary care physician can be helpful is to help families assess alternative treatments and not be enticed by expensive treatments of little benefit.

The treatment of ADHD should be viewed as involving 3 stages of therapy: initiation and titration, maintenance, and termination. 40 During the initial phase of treatment, patients and families should be educated regarding ADHD ( Table 2 for examples of Protection of Intellectual Property Essay parental activities that may be helpful), therapeutic goals should be established with the patient and family, and treatment should be initiated. If medications available in short- and long-acting forms are selected, initial titration can best be accomplished using short-acting forms, observing for response and side effects. This can be followed by switching to longer-acting forms if desired. Starting and adjusting medications on age pregnancy, a weekend provides opportunity for parents to observe effects and side effects directly. During the maintenance phase, ongoing family education, dosage adjustment, and monitoring of growth, efficacy, and side effects are appropriate. The duration and approach to termination should be individualized, with regular discussions with patients and families to Essay Interpretation by Paula Bohince, support adherence to treatment rather than unsupervised treatment termination. Stimulant medications and atomoxetine may be stopped at advanced, once, while other medications (e.g., tricyclic antidepressants) may need to be tapered. Trials off therapy, for instance during school holidays, may help determine if medications are still beneficial. In summary, although there are a range of treatment modalities that have been tried in the treatment of ADHD in children, the management approach that has proved most effective includes stimulants and psychosocial treatments focused on behavioral strategies. Of note, in one large study funded by the National Institute of Mental Health, there was no difference in analytical, response to treatment between ethnic groups (Latino, African American, and advanced maternal age pregnancy white).

41. ADHD AND ITS CARE FROM A HAITIAN PERSPECTIVE. While there is no corresponding term for ADHD in the Haitian-Creole language, in on An Lamb”, the Haitian culture the behaviors consistent with the diagnosis of ADHD might be interpreted as indicating the following: Among Haitians, the interpretation of ADHD-related behaviors varies widely from family to family depending on advanced maternal age pregnancy, religious affiliations, level of education, and experience with school and primary care systems. Stigma, language, cultural conceptions, concerns about othello appearance vs reality, governmental agencies, and physician and teacher bias can all serve as barriers to care for advanced age pregnancy, immigrant families ( Table 3 ). An important determinant of the treatment or other intervention strategy a family pursues is essays, their perception of the cause of the ADHD behaviors.

Whether the cause is natural or unnatural is extremely important in the Haitian belief system. Maternal Age Pregnancy? #x0201c;Natural#x0201d; ailments are often attributed to natural forces (heat/cold, gas, wind, temperature), while #x0201c;unnatural#x0201d; ailments are attributed to bad spirits or punishment inflicted by God. These are treated using either natural remedies or religious intervention. 42 Such belief systems can influence a family's acceptance of a physician's diagnosis of ADHD and analytical essays their adherence to Western medical treatments. In the advanced age pregnancy, United States, as in many other countries, the Interpretation Lamb”, diagnosis of ADHD is mainly a medical one and involves pediatric and family medicine providers, social workers, and psychologists. However, for most of the population in Haiti, a child would not be brought to a primary care physician for care of a behavioral problem. Doctors are generally seen only for physical illness and emergency care; access to primary care is limited and maternal generally available only to the most affluent. ADHD manifesting as a negative behavior usually is handled by parents, extended family, and school teachers through verbal or corporal discipline.

Verbal discipline includes preaching to the child, comparing the child to should control, others, begging the child to advanced maternal, behave, and humiliating the prime, child. Corporal discipline and punishment can be inflicted by any member of the advanced maternal age pregnancy, family, neighbors, and impaired schoolteachers, all of whom are given full authority to educate and #x0201c;correct#x0201d; the child. Immigration adds a complex dimension to raising children. New families find themselves devoid of the support of the extended family, in an environment that is not supportive of their interpretation of child behaviors and traditionally accepted parental disciplinary style. Like many Haitian American parents living in the United States faced with similar circumstances, Mr.

A's parents chose to send him back to maternal age pregnancy, Haiti with the hope that a more authoritative parenting style, the enforcement of discipline in school (schoolteachers are very respected), and removal of the interference of the American social worker would offer a better environment for rearing their child. Mr. A went to live with his grandmother first and then off to a boarding school, a setting seen by many Haitian parents as the ultimate answer to a child with behavioral problems. There are many beliefs among Haitian Americans surrounding the use of medication. Many in the Haitian American community see the use of psychoactive medications as a gateway to substance abuse or mental illness. Therefore, even parents who agree to allow their children to try them will most likely have low thresholds for terminating medication and be unsupported by twitch quebec family members, friends, neighbors, and even religious leaders. Mr.

A's parents received much unsolicited advice, and some friends wanted them to #x0201c;lift their feet#x0201d; ( Leve pye nou : to see a Hougan or voodoo priest) who might be able to determine the advanced maternal, unnatural but real cause of their son's problem. Being transnational and having access to both native Haitian medicine and Western medicine, Haitian Americans routinely combine therapeutic foods that are considered cold in nature, natural sedatives and purgatives from traditional herbal medicine, religious treatments, and analytical essays Western medicine to treat illness. Examples of folk treatments for ADHD include mint tea, sweetsop (apple custard), or leaf teas (usually hot drinks); tizanne (usually cold drinks) of lettuce or other refreshing vegetables; and baths with boiled leaves ( bain de feuille ), which are often used as natural sedatives. While it may be difficult to establish trust with Haitian families initially, such trust in the doctor-patient relationship is essential in obtaining their participation in maternal age pregnancy, the development of a treatment plan to which they will adhere. Clinicians should work to disarm or to gain acceptance with parents and family members. It may be helpful to learn a few words of Creole or tidbits of Haitian history, to be respectful of combining benign natural remedies with conventional Western medicine, and to why there, find ways to show respect for the family's heritage. Engaging families in supportive behavioral management approaches (see Table 2 ) can give them a sense of control and involvement that will help build adherence to other treatments recommended. Cultural sensitivity is age pregnancy, essential in dealing with not only Haitian patients but also patients from various cultural and ethnic backgrounds. Essays? One definition of advanced age pregnancy cultural competency is #x0201c;a set of othello appearance congruent attitudes, behaviors, and policies that come together in a system, agency, or amongst professionals and enables them to work effectively in cross-cultural situations.#x0201d; 43 Haitians, like most immigrant patients, need sympathetic advice and help from their physicians, as they often feel governmental agencies such as the local department of social services place a great deal of pressure on them to either medicate their children or move their children to other school systems.

In direct contrast, it is maternal, also important not to should control, #x0201c;overemphasize#x0201d; a patient's culture when considering a diagnosis and treatment. While many of the advanced age pregnancy, barriers listed above may be relevant for some patients, culture is only one factor in why there, their understanding of advanced age pregnancy their illness. Educational, social, economic, and individual factors may also hold relevance. Because the interface of Essay Lamb” Bohince psychiatric disorders#x02014;in this case ADHD#x02014;and culture is advanced maternal age pregnancy, complex, it is essay, a useful context for advanced maternal age pregnancy, examining the Protection Essay, integration of advanced age pregnancy psychiatric and of “Black by Paula primary care. While there are a number of models of such primary care and behavioral integration, one, called #x0201c;primary mental health care,#x0201d; 44#x02013;47 is maternal, particularly useful in managing families from other cultures. The goal of this approach is to resolve problems within the primary care service context: #x0201c;primary mental health#x0201d; is designed to support the ongoing behavioral health interventions of the primary care provider. Driving Essay? This model of behavioral health care is consistent with the philosophy, service goals, and health care strategies of primary care. This approach involves making psychiatric consultative services available to primary care providers and allows for behavioral health and primary care comanagement of patients who require more concentrated services, but nevertheless can be managed in advanced maternal, primary care. Both consultative and Protection Property Essay condensed specialty treatment services are delivered as first-line interventions for primary care patients who have behavioral health needs.

In summary, there are several options for age pregnancy, assisting Mr. Essay On An Lamb” By Paula Bohince? A and advanced maternal his family and other Haitian children and why there control adults with ADHD: Drug names: atomoxetine (Strattera), desipramine (Norpramin and others), dextroamphetamine (Dexedrine, Dextrostat, and advanced maternal others), imipramine (Tofranil and others), methylphenidate (Metadate, Ritalin, and others), nortriptyline (Pamelor, Aventyl, and others). The authors acknowledge Jean-Robert Boisrond, Coordinator of the Haitian Health Institute at Protection of Intellectual Property, Boston Medical Center, Boston, Mass., for assistance in preparation of the case and for commitment to advanced maternal, the special needs of the Haitian people. Cultural Currents presents clinical experience derived from the essays, practices of clinicians caring for advanced maternal, patients and families whose cultural backgrounds are outside of the mainstream of society. At times, those very clinicians will be in the position to provide rich insights afforded by their own unique cultural backgrounds. These case reports and commentaries provide knowledge and strategies helpful in the clinical encounter with patients from impaired essay other cultures.

This article is based on a Grand Rounds presented at the Department of Family Medicine, Boston Medical Center, Boston, Mass., on Sept. 16, 2003. The authors received no direct support related to this article. Dr. Culpepper has been a consultant for Eli Lilly. Drs.

Prudent, Johnson, and Carroll report no financial or other relationship relevant to advanced age pregnancy, the subject of this article.