Tuesday, January 28, 2020
LABOR ROOM ACCOMMODATION OF PREGNANT WOMEN IN TAGUM CITY
LABOR ROOM ACCOMMODATION OF PREGNANT WOMEN IN TAGUM CITY PROBLEM AND ITS SCOPE Background of the Study Comfort is a concept that has a strong association with nursing. Nurses traditionally provide comfort to patients and their families through interventions that can be called comfort measures. The intentional comforting actions of nurses strengthen patients and their families. Caring is about how nurses do their work. The effects of caring are difficult to measure; the effects of comfort interventions (including caring) are measureable(http://www.thecomfortline.com/FAQ.html#beginnings).  Date Retrieved May 20,2010.             Hospital has been the traditional setting for providing care for people. These individuals were admitted to the hospital and were not discharged until they were fully recovered or had used all of the service available within the hospitals (Fundamentals of Nursing Taylor et al. 1993). Hospital specifically in labor room is in which women in labor are monitored prior to delivery (http://www.pregnology.com/AZ/L/1). Date Retrieved, May 23, 2010             Physical comfort include deficit in physiological mechanism that are disrupted or at risk because of an illness or invasive procedure.Social comfort can get through family, friends co-workers, society and relationship with all of the above. Environmental needs include orderliness, quiet, comfortable, furniture, minimal oders and safety as far as is possible in the setting. Psychospiritual comfort needs include the needs of motivation and trust in order for the family to rise above or more peacefully through the discomfort of painful procedure or trauma that cannot be immediately relieved. (Kolcaba).             Todays findings, based on responses 10 NHS health trust, were obtained by the conservatives who attached the government for failing to deliver world-class maternity care for women in London, shadow health secretary Andrew Lasey said, new mothers should not be put through the trauma of giving birth in such inappropriate places. A Washington hospital there were six reported case last year (2008) where babies were born on the antecital ward because of delivery rooms on labor ward (http:www.thisisLondon.comVIC) Date Retrieved, February 22, 2010. Birth Center is designed to provide a comforting, safe experience for every patient during labor. The intrapartum nurses on our unit are attentive to specific patient requests and are recognized for their competence and expertise as key health care providers. Their goal is a safe and healthy delivery for every woman. A large percentage of our direct care nursing staff is nationally certified in their field of expertise and several staff members are also Masters prepared nationally certified nurse midwives. In addition to a highly experienced staff, we also have the pleasure of working with Portland Doulas who are available to support our patients (http://www.ohsu.edu/) Date Retrieved, May 20,2010 In the hospital of Cebu Puericulture Center and Maternity House all labor-delivery-recovery rooms (LDRs) are designed to accommodate the birthing process from labor through delivery and recovery of mother and baby. Equipment is moved into the room as needed, rather than moving the patient to the equipped room. Each labor room shall contain a hand washing facility and have access to a toilet room. One toilet room may serve two labor rooms. Labor rooms shall have controlled access with doors that are arranged for observation from a nursing station. At least one shower (which may be separate from the labor room if under staff control) for use of patients in labor shall be provided. Windows in labor rooms, shall be located, draped, or otherwise arranged, to preserve patient privacy from casual observation from outside the labor room. Labor room size should be determined by analyzing the needs of the resident(s) to move about the room in a wheelchair, gain access to at least one side of h er bed, turn and wheel around the bed, equipment, including chair, stretcher, and IV stand (http://mapiles.com/cebu-puericulture-center-and-maternity-house-inc/) Date Retrieved, May 24, 2010. The Labor Room of Davao Regional Hospital, Apokon Tagum City is described as one of the most over-populated areas inside the hospital because without complication 3 cms. and up will enter the labor room if with complications they will directly enter the labor room. There were 10 beds available, if a woman belongs to OB ward she will share the bed to another woman; however, if a woman belongs to private rooms she needs not to share the bed to another woman. DRH is considered as one of the tertiary hospitals in the Philippines. In which, this usually has a full complement of services. Since, Davao Regional Hospital cannot say No to patients because it is a public, government establishment. They cannot control the increasing number of patients that were being admitted. Because of that matter pregnant women is subjected to physical, social, environmental and psychospiritual discomfort. The researchers desire to conduct this study because we anticipated that the comfort of pregnant women needs to be studied further if the number of admitted patient influences the comfort. Furthermore, the problem affects the wide variety of pregnant women in Davao Regional Hospital, Tagum City since they are the one who will be deliberated with their situation inside the labor room, because this problem occurs especially if it is a government establishment. Statement of the Problem             This study aims to determine the relationship between labor room accomodation and comfort of pregnant women in Davao Regional Hospital, Tagum City. Specifically, this study will answer  the following questions: What is the extent of labor room accomodation in terms of: 1.1 Bed assignment 1.2 Nursing assistance 2. What is the level of comfort of pregnant women in terms of: 2.1 Physical 2.2 Social 2.3 Environmental 2.4 Psychospiritual    3. Is there significant difference on the extent of labor room accomodation when analyzed according to:             3.1 Parity             3.2 Hospital room accomodation   4. Is there a significant difference on the level of comfort of pregnant women when analyzed according to:             4.1 Parity             4.2 Hospital room accomodation  5. Is there a significant relationship between the extent  of  labor room accomodation and the level of comfort of pregnant women. Hypothesis There is no significant relationship between the labor room accomodation and the level of comfort of pregnant women. There is no significant difference on the extent of labor room accommodation when analyzed according to parity and hospital room accommodation. There is no significant difference on the level of comfort of pregnant women when analyzed according to parity and hospital room accommodation. There is no significant relationship between the extent of labor room accommodation and the level of comfort of pregnant women. Review of Related Literature             Several and varied sources were used and read to gather relevant literature and research. Professional books, journals, periodicals and related research were found valuable sources of articles worthy of being included in the chapter. These article were valuable in the construction of research instruments. Moreover, they helped  enriched the  contents of such. Bed Assignment             Hospital address capacity issues in a number of ways. A common approach is to seek licensure for more beds an expensive investment. Expanding bed capacity through licensure may be necessary. But incorporating a bed management system is a less costly solution that makes better use of existing resources. Bed management systems maximize existing capacity by efficiently moving patients through care delivery. Bed manages systems provides nurses data necessary to assess performance measures based on activity, thus increasing resource of effectiveness.(Technology alleviates bed management woes by: Pam Parker, RN, C, BSN, MBA; Nursing Management 2005) Date Retrieved, May 21, 2010. Federal health planners proposed a series standards for most of the nations hospitals that they said would reduce the number of unneeded beds by 100,00 over the next seven years. The standards, which are aimed at further constraining almost runaway hospital charges, would limit acute care hospital beds to four per 1, 000 persons throught the country and set a minimum level of 80 percent occupancy in general hospitals in an effort to force the closing of inefficient and expensive facilities. The specifics of the proposals are also intended in the interests of efficiency to concentrate obstetrical and pediatric services in fewer hospitals and reduce the numbers of high cost (http://news.google.com/newspapers) Date Retrieved, May 23, 2010. The bed must be adjustable that can be lowered or raised to the position to make you feel more comfy while laboring. So while setting yourself in your delivery or labor room and you dont want using pain relief be sure to pray first and offer all the things that will happen at that moment then have a relaxation and breathing techniques, find comfortable position while in labor, listen to soft and romantic music. Think of good memories with your love ones and think something that makes you smile to ease your pain in laboring. Always think positive so that you can manage the pain (http://www.helium.com/items/1809340-what-to-expect-in-the-labor-room) Date Retrieved, May 23, 2010. Nearly all hospitalized laboring women spend most of the time in bed. We made simple but radical modifications to a hospital labor room, which included the removal of the standard hospital bed and the addition of equipment to promote relaxation, mobility, and calm (http://www.ncbi.nlm.nih.gov/pubmed/19489810) Date Retrieved, May 23, 2010. The investigators noted that the bed is a major reason for lack of mobility. Its prominence conveys that it is the appropriate place for laboring women, and a woman in bed offers ready access for interventions, an observation backed up by research. (http://rixarixa.blogspot.com/2009/07/beds-and-birth-rooms.html) Date Retrieved, May 23, 2010. Nursing Assistance             When a pregnant trauma patient presents, nurses face and unusual situation; there may be two injured patients, one inside the another. As nurses, we must asses and treat one patient whose body has been anatomically and physiologically change by pregnancy and another whom we cannot see, touch, inserted an IV catheter into, or place an oxygen mask on. Its essential that we understand the changes associated with pregnancy, which can affect both the nature of an injury and  the body respones to it, and their implication in the assessment and treatment of both patients. (Prauma in pregnancy by: Laura M. Criddle, PWD, RN, CEN, CRN, FAEN) Date Retrieved, May 21, 2010 The labor nurse is responsible for monitoring, blood work, vaginal exams, paperwork and many things that you need for giving birth. She is your direct connection to your doctor or midwife and informing them how your labor is going on. She can also give you some suggestions for comfort in your labor from positioning to medications. (http://www.helium.com/items/1809340-what-to-expect-in-the-labor-room) Date Retrieved, May 23, 2010. In todays hospitals and extended care facilities a nurse assistant is an important part of a health care team that includes many personnel outside of nurses. Nurse assistants are needed to provide routine care so that nurses can provide care that only they can perform, as outlined by each states Nurse Practice Acts. The nurse assistant must not only be very skilled in the actual procedures being performed but must also be able to observe a patients condition and report that information back to the nurse. Due to other responsibilities, the nurse cannot spend large amounts of time in the room with the patient so the nurse assistant is often referred to as the nurses eyes and ears (http://en.wikipedia.org/wiki/Certified_nursing_assistant) Date Retrieved, May 23, 2010. Nurse-midwives are registered nurses with advanced training in care of obstetric patients. They provide care for about 6% of the birth in the United States and Canada (ventura et al. 1998). Nurse-midwives may practice with physicians or independently and with an arrangement for a physician back up. They usually see low risk obstetrics patients .( Wong et al. 2002) Nursing assistance has a traditional role and a professional role to fulfill: of clinical assessment of the progress of labor and physical status of mother and fetus. In addition, emotional support is provided by expressing caring and dependability as well as being an advocate for the childbearing woman if needed. They should display a tolerant non-judgmental attitude, ensuring that the woman is accepted whatever her reactions to labour may be. Women who feel in control of their own bodies, who retain control of their behavior and who feel they have an active part in decision making have a more satisfactory birth experience. (Green et la 1990, Lindow et l 1998, Wallace et al 1995). Physical             Bed rest is often prescribed to pregnant women who shows signs of distress of preterm labor, despite of evidenced of its effectiveness in preventing adverse outcomes. Although often thought of as benign, bed rest may include many psychologic and metabolic changes related to musculoskeletal reconditioning. The long term effects of bed rest need to be better understood, and woman who have been on bed rest may need close assessment and rehabilitation to facilitate a return to function and prevent injury (http;//www.medscape.com/viewarticle/436416). Date Retrieved, February 25, 2010.             Back pain during late pregnancy is a frequent clinical problem. Very little is known about the impact of this symptom on the quality of life among pregnant women with back pain. The objective of the study is to know the influence of back pain and physical ability on quality of life in late pregnancy. Irrespective of back pain the pregnant women studied featured lower quality of life (QOL) compared with published data on healthy women. Among the women with back problems, who had the most impaired QOL, the factors affecting QOL were mostly related to physical ability (http;//www.ncbi.nlm.nih.gov/pbmed/10789670) Date Retrieved, February 25, 2010.             All women stated they were physically supported by their female companions. Examples of this physical help included position changing, massaging, and help with walking them to the bathroom. The majority ( n=18) of women stated that the presence of their female relative helped facilitate communicating their wishes and needs to the care providers. The remaining seven women stated that the presence of their female support relative created some minor conflict with midwives, who seemed to view the relatives as interfering with the process of care. (Enkin, M., Keriese, M., Neilson, J., Crowther, C., Duley, L., Hodnett, E., et al. (2000). Previous research has shown that intrapartum practices in Jordan are not always based on the best on the best evidenced in the literature (Khresheh; Kresheh et al., 2007; Sweidan et al., 2008). Women in the sample expected poor support from their healthcare professionals, but when allowed to have support in labor from family members, they readjusted their expectations and had a more positive experience (Dahlen et al., 2008) The physical support provided by the female companion encouraged this sample of pregnant woman to relax. This may reduce their stress response resulting in an improved pattern of labor ( Taylor et al., 2000). The physiological dimension addresses factors that affect the clients physical status, such as rest and relaxation, treatment of medical condtions, level of nutrition and hydration, and elimination of wastes (Kolcaba, 1992a, p. 34). Physical comfort encompassed all the physiological ramifications of medical problems, which may or may not result in physical sensations immediately. Example of some necessary condtions for physical comfort, in this board sense, are homeostatic mechanism such as fluid/electrolyte balance, stable and normal blood chemistries, adequate oxygen saturation, and other metabolic indicators of health. An additional insight about physical comfort came form Hamiltons comfort theme of positioning. The importance of this type of comfort was prominent in ergonomics and was associated with increased function and productivity (http://books.google.com.ph/books). Date Retrieved, May 23, 2010. Social             The friendliness and caring of all staff members was central in achieving social comfort. This included their approach and attitudes, continuity of care and a meaningful schedule of events and activites. In such instances, where patients have a limited network of support, nurses may be the most important source of social comfort and therapeutic use of self may enhance comfort more than nurses might realize. Nurses and other team members can facilitate social comfort of the family unit, however, by making them feel at home, important, intelligent and valued. (http://books.google.com.ph/books). Date Retrieved, May 23, 2010. Many studies have provided evidence about the positive influences that women experience when receiving labor support from a companion present during birth. Sauls 2002 published an overview of the randomized controlled trials related to the effectiveness of labor support on birth and maternal outcomes, reporting that all studies found benefits; the most powerful beneficial effects occurred when support was provided by a birth companion rather than by a health professional. Other studies of laboring have also identified the positive effects of help given by a support companion who was present and provided verbal encouragement (Parpinelli Osis, 2007). A supportive companion has been shown to have a possitive influence on the womans satisfaction with the birth process, and does not interfere with other events, interventions, or neonatal outcome, or breastfeeding. The evidence for the effectiveness of support in labor is strong enough for the World Health Organization to have recommended that woman in labor must be accompanied by people with whom she feels comfortable and trusts ( Bruggemann, , Cecatti, Neto, 2007)             There is scarcity of evidence on the effects of the presence of companion during the birth process in developing countries. In a larger part of this current study (Kresheh, 2008), a total of 226 nulliparous women who were admitted to Al-karak government hospital for birth were asked if they wanted a female relative to stay with them. Findings showed significant effects on labor and birth outcomes, with less use of pharmacologic pain relief, and improvement in the womens general perception of their birth experience (World Health Organization. 2007). Detractors form social comfort include isolation form family, disregard for cultural traditions, uncaring or anxious nursing behaviors, fragmented care, lack of nursing care when desired, poor social support, and limited resources for ongoing care at home after discharge (http://ivythesis.typepad.com/term_paper_topics/2008/12/sample-resear-2.html) Date Retrieved, May 23, 2010. Environmental             Clearly, the right environment for healing and health promotion was considered an important source of comfort by nurses interested in holistic care. Today, environmental comfort is a key aspect of units specifically designed to promote physical and cognitive function of hospitalized persons (http://books.google.com.ph/books? ) Date Retrieved, May 23, 2010. There are more than 4 million chemical mixtures in homes and businesses in this country, with little information on the effects most of them during pregnancy. However, a few are known to be harmful to an unborn baby. Most of these are found in the workplace, but certain environmental pollutants found in air and water, as well as chemicals used at home, may pose as risk during pregnancy.             A pregnant woman can inhale these chemicals, ingest them in food or drink, or, in some cases, absorb them through the skin. For most hazardous substances, a pregnant woman would have to be exposed to a large amount for a long time in order for them to harm her baby. Most workplace have preventive measures to help make sure this doesnt happen. Pregnant women can take steps to help protect themselves and their babies from pollutants and potentially risky chemicals used at home. (http://www.marchofdimes.com/aboutus/681_9146.asp) Date Retrieved, December 19, 2010.             Since almost all non-pharmacological methods of pain relief require you to relax in some ways, having an environment that promotes relaxation can improve your chances of laboring without medication. Even if you choose to use medication during your labor, the environment sets the tone for your labor and may play a part in your mood. (http://www.birthingnaturally.net/birthplan/options/environment.html) Date Retrieved, December 19, 2010. Factors in the environment that distract form pregnant womens comfort are cold, noise, chaos, endless bright lights, bad odors, lack of privacy and uncomfortable stretchers, chairs, and beds. Unmet safety need can detract form comfort and include a lack of properly functioning equipment, security problems, security hazards, inaacurate care poor aseptic/sterile techniques resulting in nosocomial infections and medication or treatment errors. Freeing patients form restraints and restrictive devices such as intravenous lines, noninvasive monitors and intermittent, rather than continuous, monitoring when appropriate (http://ivythesis.typepad.com/term_paper_topics/2008/12/sample-resear-2.html) Date Retrieved, May 23, 2010. The labor room should be such that the woman is not considered is not constrained by lack of privacy or lack of supports such as cushions and beds from adopting her preferred position. In a hospital environment, it may help to move the labor from its traditional place in the middle of the room, and to place other support such as cushions and birth balls the room so that the mother is free to roam from one to another as the labor dictates. Low lighting and music of her choice may help the woman to see a safe and secure place to give birth. Minimizing unnecessary intrusion by the other member of staff is essential.(Fraser et al.2003) Psychospiritual Anxiety is a major distractor form psychospiritual comfort and some include in this context are confusing, incomplete or negative information; threatening diagnoses; fear and the prspect of a change in routine or health status (http://ivythesis.typepad.com/term_paper_topics/2008/12/sample-resear-2.html) Date Retrieved, May 23, 2010. Hamiltons second comfort theme was self-esteem, including faith in God, being independent, feeling relaxed, being informed and feeling useful. The contexts of pyschological and spiritual comfort are combined to form psychospirtual context. Psychospiritual comfort includes mental, emotional, and spiritual components of self. The definition that has evolved is whatever gives life meaning for an inidvial and entails self-esteem, self-concept, sexuality and ones relationship to a higher order or being. (Kolcaba, K., 1997). Parity Traditionally, elder or mature pregnant women are believed to have more adverse pregnancy outcomes than younger pregnant women. In fact, the great majority of the medical literature concerning late childbearing relates to women between the ages of 35-40 years. However, many of these studies showed the pregnancy performance and neonatal outcome among the group of mothers aged >35 years are similar to those of younger age (Kirz et al., 1985; Ho et al., 1986). These findings therefore constitute a challenge to the current definition of advanced maternal age, which uses 35 years as the cut-off point with reference to the age-related effects on pregnancy outcome. The primiparous mothers had a higher incidence of antepartum hemorrhage and hypertensive disorder. The factors influencing birth experience as acceptable were multiparous women (Para 2-3) in 128 (68.08%) cases; primigravidas in 61 (80.26%) cases, study have shown that the pain threshold of pregnant women differs from the number of birth experiences. Furthermore, labour pain is nearly a universal experience for childbearing women but threshold of this pain varies between individuals (http://jpma.org.pk/full_article_text.php?article_id=2106) Date Retrieved, May 24, 2010. Hospital room Accommodation In some countries a labor companion is not allowed for cultural or other reasons (policy does not allow, place too crowded, no privacy, bad advice from companion etc). It was discussed and agreed that there is need for midwives to use their knowledge and scientific evidence available to influence policy to ensure that in those countries where companions are not allowed, this can be considered. In those countries where the companion is allowed but not permitted into the labor ward because they give bad advice, the midwives were challenged to ensure that the companion is given adequate information before the labor starts so that the companion becomes more positive and helpful during labor.  http://whqlibdoc.who.int/hq/2005/ICM_report_eng.pdf) Date Retrieved, May 23, 2010. According to the CHCAAs interpretation, the Ontario Health Insurance Act requires that public hospital must provide overnight accommodation at the standard ward level at no charge to the patient. In addition, The Canada Health Act states that all Canadians are entitled to the level of accommodation required by the patients medical condition at no charge. Funding including Federal Transfer Payments for these scenarios is provided to the hospitals by the province (http://www.chcaa.org/education/HospitalWP.pdf) Date Retrieved, May 23, 2010. Theoretical and Conceptual Framework In the theory of comfort by Katharine Kolcaba staes that the comfort is a concept that has a strong association with nursing. Nurses traditionally provide comfort to patients and their families through interventions that can be called comfort measures. The international comforting actions of nurses strengthen patients and their families ( who can be found into their own homes, in hospitals, agencies, communities, states and nations ). When patients and families are strengthened by actions of health care personnel (nurses ), they can be engage in health seeking behavior. (http://www.thecomfortline.com/comfort-theory.html) The researcher anchored this theory in their research since the dependent variable in this research is comfort. Basically the main topic here is about the comfort that the mothers in the labor room are experiencing. every patient in the hospital deserves to have comfort. Kolcaba derived the contexts in which comfort is experienced form the literature of holism and she defined them as physical, psychospiritual, environmental and social. The physical comfort pertains to the bodily sensations. Psychospiritual relate to internal awareness of self, including esteem, self-concept, sexuality and meaning in life, relationship to a higher order or being. Environmental have relevance to external surroundings, conditions and influences. Social appertain to interpersonal, family and societal relationships. In this research, the researchers are trying to find out the relationship of lack of beds in the comfort of pregnant women in the labor room of Davao Regional Hospital Tagum City. Figure 1 shows the conceptual framework of the study. It consist of three variables. The Independent variable is the labor room accommodation and the dependent variable is the comfort of pregnant women. The moderators are the parity and ward.  Independent variable Dependent varieable Comfort of Pregnant Women Physical Comfort Social Comfort Environmental Comfort Psychospiritual Comfort Labor Room Accommodation Bed assignment Nursing Assistance Parity Hospital Room Accommodation Moderator variable  Figure 1 Conceptual Paradigm of the Study Significance of the study             This study will give benefits and useful information to people in the field of nursing particularly: Pregnant women: the outcome of the study will help them obtain their desired comfort when in labor. Nurses:  The outcome of the study will give them the knowledge the value of comfort of Pregnant women. Administration:  The outcome of the study will recognize adjustment to cater and to give genuine care for all the pregnant women. Student Nurses: The outcome fo the study will assist them to provide more extensive comfort of pregnant women appropriately. Definition of terms             For easy understanding, in the study the following major terms are herein defined conceptually and operationally. Labor room accomodation. The labor room should be such that the woman is not considered is not constrained by lack of privacy or lack of supports such as cushions and beds from adopting her preferred position. In a hospital environment, it may help to move the labor from its traditional place in the middle of the room, and to place other support such as cushions and birth balls I the room so that the mother is free to roam from one to another as the labor dictates. Low lighting and music of her choice may help the woman to see a safe and secure place to give birth. Minimizing unnecessary intrusion by the other member of staff is essential.(Fraser et al.2003). In our study, it refers to the intrapartal care received by the pregnant women in Davao Regional Hospital. Bed assignment. Hospital beds are electrically operated. The staff will show you how to work your bed properly. Your hospital bed is probably higher and narrower than your bed at home, and includes bedside rails for your protection. The rails may be raised for your safety or at your request, if youre resting, recovering from surgery or taking certain medications. http://www.multicare.org/allenmore/hospital-amenities/ In our study, beds are classified as to what hospital room accommodation is choosen. Nursing assistance. The Nursing Assistant is an important member of the health care team who often holds a high level of experience and ability, but without qualification is unable to often perform some tasks due to issues of liability and legality. http://en.wikipedia.org/wiki/Certified_nursing_assistant. In our study, it focuses on the maternity care from which the pregnant women is subjected inside the labor room until she is
Monday, January 20, 2020
Dame Ragnell: Searching for the Truth Essay -- Arthurian Legends Lite
Dame Ragnell: Searching for the Truth Throughout the Arthurian legends, the role of the mysterious hag is one that continually appears. The hag is often associated with great magical power and revelations - both physical and psychological. In "The Wedding of Sir Gawain and Dame Ragnell," Dame Ragnell is the magical hag that aids Arthur in his quest for the answer to the "Holy Female Question." It is ultimately because of the noble, chivalrous and courtly Sir Gawain, that the true identity of the hag can be revealed. While Dame Ragnell is not an evil character, the hag is ultimately a character of question. One must wonder how trustworthy the hag truly is when magic is involved. From other Arthurian legends, such as Sir Gawain and the Green Knight we can see that the hag is a malevolent character who uses the hag image as a guise to fool others. In the end, the hag's real image is generally revealed along with her goal. Dame Ragnell is not a beautiful woman who has intentionally taken the form of a hag trying to deceive o thers like Morgana LeFey in Sir Gawain and the Green Knight. Dame Ragnell offers the truth to the men of the story and proves Sir Gawain to be as honorable as his reputation says he is. The story begins with Arthur hunting a stag in the forest. After the kill of the stag he stumbles upon a giant of a knight, Sir Gromer Somer Joure. In order to live, the knight makes a deal with Arthur. If he returns in a year and a day with an answer to the question "What do women want?" his life will be spared. Arthur and his confidant, Sir Gawain, ride throughout the land with two books. In these books they write down the answers they receive from women all over the land to Sir Gromer's question. Upon comparing their b... ...n cursed? Where is the proof of this curse? Apparently she can become fair at some point on her own. Does this mean she too practices magic? How do we know Sir Gromer and Dame Ragnell are not one in the same? How do we know Dame Ragnell is not really Morgana LeFey? Who IS Dame Ragnell? What exactly is her goal in this story? Does Dame Ragnell simply want to show the men with the highest power the way to fulfill a woman's true desire? Is she, like countless political women, plan to change things from the inside of hierarchy? Dame Ragnell may not have been quite the innocent maiden she was portrayed as in her marriage to Sir Gawain. The lessons she teaches, and the awareness she brings to the court of Arthur are definitely timeless lessons that human beings are constantly being taught. Never judge a book by its cover - you never know what it might really have to say.
Sunday, January 12, 2020
Book Review of a Thousand Splendid Suns
Book Review of A Thousand Splendid Suns 17th century Afghanistan poet Saib-e-Tabrizi wrote this commendatory poem after visiting Kabul. ‘Every street of Kabul is enthralling to the eye; Through the bazaars, caravans of Egypt pass; One could not count the moons that shimmer on her roofs; And the thousand splendid suns that hide behind her walls. ’ In this world there are still many women say that they are suffering unfair treatment and demand for the right to vote, the right to manage.But to the women who had experienced two Afghanistan war (The first time Afghanistan war: from 1979 to 1989, the former Soviet Union armed invasion of Afghanistan. Second Afghanistan war: the second Afghanistan war in 2001 is based on United States-led coalition forces on October 7, 2001 for Afghanistan war cover to the Organization and the Taliban, for the United States on the revenge of the 911 incident, also marks the start of the war against terrorism. Not ended. ), the only thing what t hey want is to live.Khaled Hosseini has lived in the United States since he was fifteen years old and is an American citizen. His 2003 debut novel, The Kite Runner, was an international bestseller, selling more than 12 million copies worldwide. His second, A Thousand Splendid Suns, was released on May 22, 2007. In 2008, the book was the bestselling novel in Britain (as of April 11, 2008), with more than 700,000 copies sold. In 2006, he was appointed United Nations High Commissioner for Refugees (Office) goodwill ambassadors, currently residing in Northern California.The Buffalo News says ‘Hosseini's literary abilities are such that he is able to do what all great artists do: take individual stories and, through the alchemy of insight, compassion and expression, universalize themâ€â€thereby turning them into art. ’ For reasons why he wrote this novel, Khaled Hosseini is saying ‘ although life is filled with pain and bitterness but each a sad plot can let people see hope in the Sun. Each faces behind dusty has a soul. Dedicated to Afghanistan's women.In 2003, returning to Kabul I see wearing traditional female twos and threes to go masked costume in the streets, was trailing behind their children dressed in rags, begging passers-by give change. At that moment, I would like to know, where they have been taken to life. What they dream, hope and desire? Did they talk about love? Husband how man? Spread in Afghanistan in the years to 20 years of war, they lost what? I talked with many women in Kabul; their stories are real people and heart.When I began to write of the thousand splendid Suns (a Thousand Splendid Suns), I find myself constantly think of those full of toughness of Afghanistan women. I though they may not be thrown describing Laila or Mariam source of inspiration for the role of the story, however their voices, faces and life stories of perseverance has always haunted me, and about the novel, I had a most inspiring is from Afghani stan collective spiritual power of women. ’ Mariam (She is my favorite role in this book), the illegitimate child of a Herat businessman, is forced into a loveless marriage at age fifteen to a middle-aged Kabul shoemaker, Rasheed.He demands absolute obedience from his spouse, as well as strict observance of Islamic customs restricting the movement, appearance and attire of women. In the early years of their marriage, Rasheed's mandates run counter to the modernizing forces in Kabul, where many women hold professional jobs, teach at the university, or run for public office. But with the rise of the Taliban, a whole society falls into lockstep with these dictates of Sharia, traditional Muslim law.Laila, a woman young enough to be Mariam's daughter, becomes a reluctant member of this household, when her parents are killed in a bombing, and all her friends have either die d or departed from Kabul. Rasheed takes her on as a second wife, and his bullying and overbearing behavior gr ow all the worse as the two women band together to resist his authoritarian control over their lives. When they try to escape, an Afghani man betrays them at the bus station and takes Laila's hard-saved money. This makes Rasheed even more abusive.A few years later the Taliban come into town, and all the stereotypes of the Taliban are emphasized, as if Hosseini was given the charter to reinforce them. Mariam ends up killing Rasheed in trying to save Laila from being killed by him. So, Mariam is executed by the Taliban, who â€Å"cannot†accept her story because of her being a woman. Thus, Mariam's woeful existence comes to end. Her whole life is a necklace of tragic events, pieced together one after another. And with her death, the reader is left with an enduring sense of sadness for M ariam, especially in the fact that Hosseini never did give her a break in her fictional life.As for Laila, she ends up traveling to Pakistan to marry her original love(r), eventually returning b ack to Kabul to work with an orphanage. The novel traces the trials and tribulations of Mariam and Laila as they struggle for survival, and eventually plan for a daring escape attempt that puts them at odds. Not only with Rasheed, but also with an entire society that sees them as little more than chattel. Hosseini skillfully develops the complexities and predicaments of his plot, which constantly intersects with political and social events in recent Afghan history.When I saw this book, thinking it may like The Kite Runner; finally, we will smile for the happy ending. But I was wrong. I was shocked when I read to Mariam lastly dead in order for Laila’s escaping. In the past years, Mariam has been in a miserable life. A birth is being neighbors’ laugh at, played a trick on illegitimate. Once a month to see her father. Then, naively think can and live with the father, but has to face her mother's death and father’s betrayal. At the age of 15, she is arranged to mar ry Rasheed, a shoemaker from Kabul who is thirty years her senior Also is not out of the mother's grief is far to marry someone from distance. She turned to Jalil again,’ tell them. Tell them you won’t do this’ Waiting. A silence fell over the room. Jalil kept twirling his wedding band, with a bruised, helpless look on his face. From inside the cabinet, the clock ticked on and on. †When I saw here, I feel myself becoming Mariam, despite knowing the answer is ‘ no ‘ but also hope that their father would not do such cruel things. In Kabul, Mariam becomes pregnant seven successive times, but is never able to carry a child to term, and Rasheed gradually becomes more abusive. â€Å"His powerful hands clasped her jaw.He shoved two fingers into her mouth and pried it open, then forced the cold, hard pebbles into it. Mariam struggled against him, mumbling, but he kept pushing the pebbles in, his upper lip curled in a sneer. ‘Now chew,’ h e said. Through the mouthful of grit and pebbles, Mariam mumbled a plea. Tears were leaking out of the corners of her eyes. ‘CHEW! ’ he bellowed. A gust of his smoky breath slammed against her face. Mariam chewed. Something in the back of her mouth cracked. ’Good,’ Rasheed said. His cheeks were quivering. ‘Now you know what your rice tastes like.Now you know what you've given me in this marriage. Bad food, and nothing else. ‘Then he was gone, leaving Mariam to spit out pebbles, blood, and the fragments of two broken molars†. Beside the shortly peace time of weeding,, Mariam has always been that a dozen years of life. Full of cursing and render phase. Read here, how much I hope that she will be a turning point in life. She can have a happy life, a long time to heal he pain since childhood and adolescence. But life is often not as we expected. After Laila marry to Rasheed, Mariam's identity than wife more like a maid.Mariam also abhorred La ila, but after all, both they are poor women. So, when Mariam says â€Å"There's nothing more I want. Everything I'd ever wished for as a little girl, you've already given me. You and your children have made me so very happy. It's all right, Laila jo. This is all right. Don't be sad. â€Å"Laila could find no reasonable answer for anything Mariam said. But she rambled on anyway, incoherently, childishly, about fruit trees that awaited planting and chickens that waited rising. She went on about small houses in unnamed towns, and walks to trout filled lakes.And, in the end, when the words dried up, the tears did not, and all Laila could do was surrender and sob like a child over whelmed by an adult's unassailable logic. All she could do was roll herself up and bury her face one last time in the welcoming warmth of Mariam's lap. Later that morning, Mariam packed Zalmai a small lunch of bread and dried figs. For Aziza too she packed some figs, and a few cookies shaped like animals. Sh e put it all in a paper bag and gave it to Laila. â€Å"Kiss Aziza for me,†she said. â€Å"Tell her she is the noon of my eyes and the sultan of my heart.Will you do that for me? †I can not control my excitement and couldn't help but shed tears. This great Mariam, although she was so limited in education, her fate has been so bumpy. But she still pay her own life in exchange for the freedom of Laila . And finally, as she died lonely, was killed by Taliban with stones. Her fate was unfortunate. Her fate was always driven. Even if Her one day have mastered fate, ending is ironic. She is not demanding from fate what, a little happy, it will make them happy. ‘Mariam wished for so much in those final moments.Yet as she closed her eyes, it was not regret any longer but a sensation of abundant peace that washed over her. She thought of her entry into this world, the harami child of a lowly villager, an unintended thing, a pitiable, regrettable accident. A weed. And ye t she was leaving the world as a woman who had loved and been loved back. She was leaving it as a friend, a companion, a guardian. A mother. A person of consequence at last. No. It was not so bad, Mariam thought, that she should die this way. Not so bad. This was legitimate end to a life of illegitimate beginnings. This paragraph for Mariam after her and Laila killed Rasheed, at the end of the execution ground inner monologue. ) Fate did not forgive her, but she eventually forgave fate. She was patience, she is great. Than Mariam, I personally think that Laila is much more fortunate. She was born in a wealthy family, has a good education. But war deprived this beauty girl of happy life. She was forced to separate from her lover- Tariq and all her families died because of the war. Due to be alone in the world, she was forced married Rasheed.The girl's life was completely changed because of the war. It is no doubt that she felled from heaven into hell. But luckily the nice girl met be auty minded Mariam. Because Rasheed found that the first child is not his own, also began to maltreat her. All the good luck seemed to give the Laila. After Mariam and Laila’s escape failed, Laila met Tariq again on the streets of Kabul. Finally, Mariam and Laila killed their husband together. Mariam clocked all charges and let Laila peaceful leave with Tariq. Thanks author for Laila does a person know to be grateful. As she walks to her desk at the front of the class, Laila thinks of the naming game they'd played again over dinner the night before. It has become a nightly ritual ever since Laila gave Tariq and the children the news. Back and forth they go, making a case for their own choice. Tariq likes Mohammad. Zalmai, who has recently watched Superman on tape, is puzzled as to why an Afghan boy cannot be named Clark. Aziza is campaigning hard for Aman. Laila likes Omar . But the game involves only male names. Because if it's a girl, Laila has already named her. In the end of this novel, Laila with Tariq together go back to Kabul and set up a locally school. Laila do this in order to repay this piece of land and her Savior Mariam. Finally, I want to talk about on the Mariam and Laila common husband Rasheed. Mariam and Laila live in a patriarchal authoritarian society, where women must obey their fathers, husbands and sons, only a son can give them access to social status. Rasheed for their husbands, the â€Å"me, and do not allow cursing, screaming, begging and howling, only the daily routine of playing and being hit. And that violence is a social and legal recognition. To a certain extent, we should not condemn Rasheed. Although he married to the pretty young girl Laila by telling lies, said Tariq is dead. Has a very oppressive side of his character. He was the victim of the system. He not only represents himself, mapped out a malformation of social moral values. In Afghanistan even more we don't know where in the world, there are many men are affe cted by social oppression and do the same cruel treatment of women and children.This book makes me sigh, how many injustices and tribulations a woman can bear. Originally Jalil like Nana, instead finally came into Nana seduce Jalil; just because have no child, ridiculed in a wife bear husband ridicule, irony and even beatings; to innocent little lives in the stomach, Laila can give up name node, you can discard face, She can give up everything that she can give up. Afghanistan woman in the face of suffering like a snowflake falls in General on other people's Windows, quietly melting, no sound, no moaning, only silent obedience of loneliness and despair.But suffering does not make them progressive annihilation, but shaped their great personality and will. Beset the outbreak of war, disease, families of the lost, which, on their face with a bear patiently the calm, give them the desire to live more strongly. Any suffering won't make them shaken confidence in life, because in their min d, have no â€Å"disappointed†, not â€Å"sad†. Unfortunately for it, they must endure, and it is still affordable. Normally I'm more of an action-adventure type reader when it comes to novels and recreational reading.But I was given the chance to read A Thousand Splendid Suns by Khaled Hosseini (author of The Kite Runner), so I decided to try something out of my normal genre. I am so glad I did. This is a stunning and moving novel of life and love in Afghanistan over a 30 year period. And the past Afghanistan in my eyes has been always associated with wars, the Taliban, Bin Laden, displacement, terrorists and Jihad. By the author and his beautiful writing, I saw Afghan are yearning for freedom, hope in the future In our society now, from the films, books or other media, we tend to see are both indifference of humanity in a little bit.And this book tells the inexcusable age, two Afghanistan unlikely friendships between a woman and not destroying love story. Husseini st roke light, sincere, simple, time spans forty or fifty years, depicting two different character actress: Mariam and Laila, struggling their tragic twists and turns of fate, their stories heavy despair and warm bright, behind the sad story of the stubborn looking good and hope not to be destroyed. Through it, we should realize, that human society still need to love and trust. Humanity just like the splendid suns will follow in every corner of the world.
Friday, January 3, 2020
Analyzing Three Levels Of Entrepreneurship Individual...
The model above is analyzing three levels of entrepreneurship: individual level, firm level and macro level. Entrepreneurial activity starts at the individual level and is always trackable a single person, which is the entrepreneur. Entrepreneurship is induced by an individual’s skills, attitudes, motives and psychological ability. The entrepreneur as an individual is affected by the circumstances in which he or she is acting, as a result, entrepreneurial actions and motives are influenced by the business environment, cultural and institutional factors and macroeconomic conditions (Pirich, 2001). According to the model above the origin of entrepreneurship will be at the individual level, but the realization of it, is achieved†¦show more content†¦Another reason is entrepreneurs can add to national income in form of higher tax revenues which can lead to higher government spending for other struggling sectors and human capital. Entrepreneurship can create social changes through their unique contributions to new goods and services by reducing the dependence on outdated systems and technologies in this way they improve the quality of life (Seth 2016). Looking at the equation; Economic Development = Economic Growth + Standard of Living (Seth, 2016) and findings above, we can see clearly the relation between the entrepreneurship and economic development. Entrepreneurship is having a positive impact on economic growth and standard of living and in this way, indirectly, is impacting positively the economic development. 2.2 SMEs Owned by Immigrant Entrepreneurs and Their Impacts in Economic Growth Issues related to what actually constitute medium or small scale enterprises are something of a major concern in most literature. Different categories of definitions have always been provided by different authors. SMEs have not been indeed spared with the definition problem that is commonly associated with concepts having numerous components. Different researchers define firms by size based on their own opinions. While others base their definitions on capital assets, others use turnover level and skill labor. Others also define SMEs based on production method and legal status of the business (Brzozowski,
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