Ethical Issues Involving Withdrawal Or Withholding Treatments In The Essay

Ethical Issues Involving Withdrawal Or Withholding Treatments In The Intensive Care Unit (ICU) - Essay Example In terms of finance, withdrawal or withholding treatments in the intensive care unit should defend on the capacity of the relatives of the patient to pay for the costs of health care services. However, financial constraints do not make withdrawing or withholding treatment ethical. Withholding treatment is grounded on medical, ethical, social, and religious values of the patient and the relatives of the terminally ill patient. Different patients have different opinions on the issue. However, rich patients prefer to continue the treatment because they can afford to pay the health care bills. On the other hand, most poor and indigent patients and relatives of poor patients prefer to cut off the life support and other health-prolonging medical equipments and medicines to the patients. Ian Thompson (2006) emphasized applying the utilitarianism ethics concept, the nurse and medical doctor can emphasize that the ethics should focus on the principle â€Å"the end justifies the means†. Under this theory, it would be ethically preferable to remove the life support system if the continued use of the life support system would only prolong the suffering of the terminally ill patient. Under the utilitarian ethics theory, the killing of the patient would be preferable because the end result would be the same: the patient cannot escape impending death. On the other hand, Ian Thompson (2006) also explained deontology ethics states that a rule should be implement in all situations. Under the deontology ethics concept, there are no exceptions to the rule. The rule of avoiding the abandonment or killing of the patient should be to upheld in all situations. Thus, the nurse and the medical doctor should not accept the request of the relatives to pull the plug because they can no longer afford to pay for the services of the medical doctor, nurse, and other healthcare costs. In addition, the medical doctor cannot advise the relatives that it is better to shorten the suffering o f the patient by removing the life support. Further, most medical doctors and nurses implement utilitarianism ethics in their practice. The nurses and medical doctors accept the patients’ family’s request to halt the life support system due to lack of funds to paying the increasing hospital bills of the terminally ill patient. The reason is economics. The healthcare center cannot afford to continue the treatment without payment. Likewise, the patient and the relatives do not have funds to pay for the continued treatment of the patient. In the research conducted, physicians and families of patients on life support system agreed on the decision on when to limit the life support system of their terminally ill relatives (Tschudin, 2003). A research was conducted on 3,498 consecutive patients admitted in six intensive care units. 6.6 percent of the total population had their therapy withheld or withdrawn. Consequently, 221 died in the ICU. The proposal to withhold treatment was advised by the physicians on 210 of the 226 patients. The family members proposed the withholding of treatment in the remaining 16 patients (Esteban et. al., 2001). In another research conducted, physicians in Israel withheld and or had withdrawn the patients’ life support system. This is unethical. The study focused on the intensive care unit of a university hospital in Israel. The findings of the research indicated the life support system in 52 of the 385 patients had cardiopulmonary resuscitation.

Health Assessment Essay Example for Free

Health Assessment Essay Assessment of environmental processes includes agents and factors that may cause injury, illness, or death. Choose one of the following age groups: toddler, preschool, and school-age child. List some of the most frequent causes of injuries, illness, or death at the age level. Discuss and describe safety concerns specific to the age, listing the most common causes of injury, illness (acute or chronic), trauma, and death for the age level. Describe how health promotion and health prevention interventions can be incorporated into parent and child teaching. Including in-text citations and references for each of the scholarly sources used. Respond to other learners posts in a manner that initiates or contributes to discussion. School-age children, face daily exposure to environmental agents and factors that may cause injury, illness, or death similar to those of all other age groups. Physical agents such as fires; mechanical agents such as bicycles, skateboards, and cars; biological agents such as bacteria; chemical agents such as asbestos; and radiological agents such as x-rays are the causes of injuries or death. Accidents are the leading cause of death in children over age 1 year in the United States. Accidents from contact sports and cuts, falls, burns, and injuries from firearms, are also increasing. Typically school-age boys have more accidents than girls, perhaps due to differences in personalities, societal expectations, child-rearing practices, and more risk-taking behaviors. Most accidents happen outdoors, and it occur mostly in summer because of outside play. The nurse has a significant role in educating parents and school personnel on ways to prevent dangers to school-age children and to become involved in public initiatives to create a safer society for them. Parents of these children must be involved in community and legislative activities that provide safe play environments. Each child should have a well-maintained bicycle, ride only in safe areas approved by parents, observe rules for vehicle traffic and use a federally approved riding helmet. Parental supervision when children play close to streets and heavy traffic areas. Children should wear a seat belt or be in age-appropriate booster seat as needed; older children should ride with restraint system and in back seat until age 12. Working smoke detectors should be in place in home and school. Children need to engage in age-appropriate activities and wear protective equipment according to the sport. Parents need to ensure safety and maintenance of all sports equipment. Children should play with friends, have a plan for returning home, know home phone number and address, play in safe and known area, and report any suspicious activity threatening their safety to an appropriate adult. Children should know how to locate assistance when in an unsafe situation. Children should avoid insecticides, radiation sources, inappropriate use of medications, and pollution sources; parents need to store all known toxins, chemicals, and household cleaning agents in an adequately ventilated location that is unreachable to children. Edelman, Mandle. Health Promotion Throughout the Life Span, 7th Edition.

Atlas :: essays research papers

Atlas   Ã‚  Ã‚  Ã‚  Ã‚  In Greek Mythology, the Titans were a race of giants. Atlas was the strongest of all the titans. His father was titan Iapetus and his mother was the Sea Nymph Clymene. His brothers were Prometheus and Cronus. Atlas was the father of the Hesperides (Daughters of the Evening,) the Hyades, and the Pleiades. He was also the king of the legendary Atlantis. In etymology Atlas means “bearer'; or “endurer.'; An image of Atlas is a person with the world on his back. Also a book of maps is called an atlas.   Ã‚  Ã‚  Ã‚  Ã‚  Atlas played a major part in Greek Mythology. He was in the war with Titans against the gods (Olympians.) Atlas partnered with his brother Cronus in the war against Zeus. Atlas stormed the heavens and Zeus punished him. His punishment was to carry the earth, the heavens and the pillar that separates them on his back/shoulders for eternity. This punishment is Atlas’s role in The Odyssey. Hercules became involved with Atlas. Eurystheus, Hercules cousin, challenged Hercules to twelve Labors. The eleventh Labor was to retrieve the golden apples of the Hesperides. Hercules asked Atlas to help him obtain the Golden Apples. In return for Atlas’s help, Hercules took his burden from him while he retrieved the apples. Atlas agreed to Hercules’ proposal. Atlas secured the apples and realized how nice it was not to have the strain of keeping heaven and earth apart for eternity. Hercules deceived Atlas when he returned with the apples. Hercules told Atlas tha t he needed a cushion for his shoulders and asked Atlas to take back the earth momentarily while he can got pads. Atlas agreed and Hercules left never to return. Another part played in Greek Mythology was when Atlas refused to provide shelter to Perseus. Perseus changed Atlas into stone using Medusa. The huge stone is called Mount Atlas.   Ã‚  Ã‚  Ã‚  Ã‚  Atlas has a very distinct appearance. In art, Atlas is depicted as a man bearing a globe. He was strong and well built. His hair was shoulder length and he had a beard and mostache. He was usually depicted kneeling on one knee holding the world on his shoulders.   Ã‚  Ã‚  Ã‚  Ã‚  Atlas had two main values. These values were his strength and his physical endurance.   Ã‚  Ã‚  Ã‚  Ã‚  The main reference to Atlas in the modern world is a book of maps. A book of maps or an atlas is named after Atlas. A figure of Atlas supporting the earth was used in the title pages of early map collections.

The Vampire Diaries: Dark Reunion Chapter Fourteen

â€Å"He's gone round the bend,† Matt said, staring at the empty doorway through which Stefan had disappeared. â€Å"No, he hasn't,† said Meredith. Her voice was rueful and quiet, but there was a kind of helpless laugh in it too. â€Å"Don't you see what he's doing, Matt?† she said when he turned to her. â€Å"Yelling at us, making us hate him to try and chase us away. Being as nasty as possible so we'll stay mad and let him do this alone.† She glanced at the doorway and raised her eyebrows. † ‘Anyone who does follow me, I'll kill' was going a bit overboard, though.† Bonnie giggled suddenly, wildly, in spite of herself. â€Å"I think he borrowed it from Damon. ‘Get this straight, I don't need any of you!' â€Å" † ‘You bunch of stupid humans,' † Matt added. â€Å"But I still don't understand. You just had a premonition, Bonnie, and Stefan doesn't usually discount those. If there's no way to fight and win, what's the point of going?† â€Å"Bonnie didn't say there was no way to fight and win. She said there was no way to fight and survive. Right, Bonnie?† Meredith looked at her. The fit of giggles dissolved away. Startled herself, Bonnie tried to examine the premonition, but she knew no more than the words that had sprung into her mind. No one can fight him and live. â€Å"You mean Stefan thinks-† Slow, thunderous outrage was smoldering in Matt's eyes. â€Å"He thinks he's going to go and stop Klaus even though he gets killed himself? Like some sacrificial lamb?† â€Å"More like Elena,† Meredith said soberly. â€Å"And maybe-so he can be with her.† â€Å"Huh-uh.† Bonnie shook her head. She might not know more about the prophecy, but this she knew. â€Å"He doesn't think that, I'm sure. Elena's special. She is what she is because she died too young; she left so much unfinished in her own life, and-well, she's a special case. But Stefan's been a vampire for five hundred years, and he certainly wouldn't be dying young. There's no guarantee he'd end up with Elena. He might go to another place or-or just go out. And he knows that. I'm sure he knows that. I think he's just keeping his promise to her, to stop Klaus no matter what it costs.† â€Å"To try, at least,† Matt said softly, and it sounded as if he were quoting. â€Å"Even if you know you're going to lose.† He looked up at the girls suddenly. â€Å"I'm going after him.† â€Å"Of course,† said Meredith patiently. Matt hesitated. â€Å"Uh-I don't suppose I could convince you two to stay here?† â€Å"After all that inspiring talk about teamwork? Not a chance.† â€Å"I was afraid of that. So†¦Ã¢â‚¬  They gathered what weapons they could. Matt's pocketknife that Stefan had dropped, the ivory-hilted dagger from Stefan's dresser, a carving knife from the kitchen. Outside, there was no sign of Mrs. Flowers. The sky was pale purple, shading to apricot in the west. Twilight of the solstice eve, Bonnie thought, and hairs on her arms tried to lift. â€Å"Klaus said the old farmhouse in the woods-that must mean the Francher place,† Matt said. â€Å"Where Katherine dumped Stefan in the abandoned well.† â€Å"That makes sense. He's probably been using Katherine's tunnel to get back and forth under the river,† Meredith said. â€Å"Unless Old Ones are so powerful they can cross running water without harming themselves.† That's right, Bonnie remembered, evil things couldn't cross running water, and the more evil you were, the harder it was. â€Å"But we don't know anything about the Originals,† she said aloud. â€Å"No, and that means we've got to be careful,† Matt said. â€Å"I know these woods pretty well, and I know the path Stefan will probably use. I think we should take a different one.† â€Å"So Stefan won't see us and kill us?† â€Å"So Klaus won't see us, or not all of us. So maybe we'll have a chance of getting to Caroline. Somehow or other we've got to get Caroline out of the equation; as long as Klaus can threaten to hurt her he can make Stefan do anything he wants. And it's always best to plan ahead, to get a jump on the enemy. Klaus said meet there after dark; well, we'll be there before dark and maybe we can surprise him.† Bonnie was deeply impressed by this strategy. No wonder he's a quarterback, she was thinking. I would have just rushed in, yelling. Matt picked out an almost invisible path between the oak trees. The undergrowth was especially lush this time of year, with mosses, grasses, flowering plants, and ferns. Bonnie had to trust that Matt knew where he was going, because she certainly didn't. Above, birds were giving one last burst of song before seeking out a roost for the night. It got dimmer. Moths and lacewings fluttered past Bonnie's face. After stumbling through a patch of toadstools covered with feeding slugs, she was intensely grateful that this time she'd worn jeans. At last Matt stopped them. â€Å"We're getting close,† he said, his voice low. â€Å"There's a sort of bluff where we can look down and Klaus might not see us. Be quiet and careful.† Bonnie had never taken so much trouble placing her feet before. Fortunately the leaf litter was wet and not crackly. After a few minutes Matt dropped to his stomach and gestured for them to follow. Bonnie kept telling herself, fiercely, that she didn't mind the centipedes and earthworms her sliding fingers dug up, that she had no feelings one way or another about cobwebs in the face. This was life and death, and she was competent. No dweeb, no baby, but competent. They were gazing down on the Francher homestead-or what was left of it. It had crumbled into the earth long ago, taken back by the forest. Now it was only a foundation, building stones covered with flowering weeds and prickly brambles, and one tall chimney like a lonely monument. â€Å"There she is. Caroline,† Meredith breathed in Bonnie's other ear. Caroline was a dim figure sitting against the chimney. Her pale green dress showed up in the gathering dark, but her auburn hair just looked black. Something white shone across her face, and after a moment Bonnie realized it was a gag. Tape or a bandage. From her strange posture-arms behind her, legs stretched straight out in front-Bonnie also guessed she was tied. Poor Caroline, she thought, forgiving the other girl all the nasty, petty, selfish things she'd ever done, which was a pretty considerable amount when you got down to it. But Bonnie couldn't imagine anything worse than being abducted by a psycho vampire who'd already killed two of your classmates, dragged out here to the woods and bound, and then left to wait, with your life depending on another vampire who had fairly good reason to hate you. After all, Caroline had wanted Stefan in the beginning, and had hated and tried to humiliate Elena for getting him. Stefan Salvatore was the last person who should feel kindly toward Caroline Forbes. â€Å"Look!† said Matt. â€Å"Is that him? Klaus?† Bonnie had seen it too, a ripple of movement on the opposite side of the chimney. As she strained her eyes he appeared, his light tan raincoat flapping ghostlike around his legs. He glanced down at Caroline and she shrank from him, trying to lean away. His laughter sounded so clearly in the quiet air that Bonnie flinched. â€Å"That's him,† she whispered, dropping down behind the screening ferns. â€Å"But where's Stefan? It's almost dark now.† â€Å"Maybe he got smart and decided not to come,† said Matt. â€Å"No such luck,† said Meredith. She was looking through the ferns to the south. Bonnie glanced that way herself and started. Stefan was standing at the edge of the clearing, having materialized there as if out of thin air. Not even Klaus had seen him coming, Bonnie thought. He stood silently, making no attempt to hide himself or the white ash spear he was carrying. There was something in his stance and the way he looked over the scene before him that made Bonnie remember that in the fifteenth century he'd been an aristocrat, a member of the nobility. He said nothing, waiting for Klaus to notice him, refusing to be rushed. When Klaus did turn south he went still, and Bonnie got the feeling he was surprised Stefan had sneaked up on him. But then he laughed and spread his arms. Slowly, Stefan looked Klaus up and down, from the tails of his tattered raincoat to the top of his windblown head. What Stefan said was: â€Å"You asked for me. I'm here. Let the girl go.† â€Å"Did I say that?† Looking genuinely surprised, Klaus pressed two hands to his chest. Then he shook his head, chuckling. â€Å"I don't think so. Let's talk first.† Stefan nodded, as if Klaus had confirmed something bitter he'd been expecting. He took the spear from his shoulder and held it in front of him, handling the unwieldy length of wood deftly, easily. â€Å"I'm listening,† he said. â€Å"Not as dumb as he looks,† Matt murmured from behind the ferns, a note of respect in his voice. â€Å"And he's not as anxious to get killed as I thought,† Matt added. â€Å"He's being careful.† Klaus gestured toward Caroline, the tips of his fingers brushing her auburn hair. â€Å"Why don't you come here so we don't have to shout?† But he didn't threaten to hurt his prisoner, Bonnie noticed. â€Å"I can hear you just fine,† Stefan replied. â€Å"Good,† Matt whispered. â€Å"That's it, Stefan!† Bonnie, though, was studying Caroline. The captive girl was struggling, tossing her head back and forth as if she were frantic or in pain. But Bonnie got a strange feeling about Caroline's movements, especially those violent jerks of the head, as if the girl was straining to reach the sky. The sky†¦ Bonnie's gaze lifted up to it, where full darkness had fallen and a waning moon shone over the trees. That was why she could see that Caroline's hair was auburn now: the moonlight, she thought. Then, with a shock, her eyes dropped to the tree just above Stefan, whose branches were rustling slightly in the absence of any wind. â€Å"Matt?† she whispered, alarmed. Stefan was focused on Klaus, every sense, every muscle, every atom of his Power honed and turned toward the Old One before him. But in that tree directly above him†¦ All thoughts of strategy, of asking Matt what to do, fled from Bonnie's mind. She bolted up from her place of concealment and shouted. â€Å"Stefan! Above you! It's a trap!† Stefan leaped aside, neat as a cat, just as something plunged down on the exact place he'd been standing an instant before. The moon lit the scene perfectly, enough for Bonnie to see the white of Tyler's bared teeth. And to see the white flash of Klaus's eyes as he whirled on her. For one stunned instant she stared at him, and then lightning crackled. From an empty sky. It was only later that Bonnie would realize the strangeness-the fearsomeness-of this. At the time she scarcely noted that the sky was clear and star swept and that the jagged blue bolt that forked down struck the palm of Klaus's upraised hand. The next sight she saw was so terrifying as to black everything else out: Klaus folding his hand over that lightning, gathering it somehow, and throwing it at her. â€Å"Stay here! Right here!† he shouted, and bounded away. Those dreaded words. They catapulted Bonnie right up, and she was running after him before she knew what she was doing. And then the world turned into chaos. Klaus had whirled back on Stefan, who was grappling with Tyler, beating him. Tyler, in his wolf form, was making terrible sounds as Stefan threw him to the ground. Meredith was running toward Caroline, approaching from behind the chimney so Klaus wouldn't spot her. Bonnie saw her reach Caroline and saw the flash of Stefan's silver dagger as Meredith cut the cords around Caroline's wrists. Then Meredith was half carrying, half dragging Caroline behind the chimney to work on her feet. A sound like antlers clashing made Bonnie spin around. Klaus had come at Stefan with a tall branch of his own-it must have been lying flat on the ground before. It looked just as sharp as Stefan's, making it a serviceable lance. But Klaus and Stefan weren't just stabbing at each other; they were using the sticks as quarterstaffs. Robin Hood, Bonnie thought dazedly. Little John and Robin. That was what it looked like: Klaus was that much taller and heavier boned than Stefan. Then Bonnie saw something else and cried out wordlessly. Behind Stefan, Tyler had gotten up again and was crouching, just as he had in the graveyard before lunging for Stefan's throat. Stefan's back was to him. And Bonnie couldn't warn him in time. But she'd forgotten about Matt. Head down, ignoring claws and fangs, he was charging at Tyler, tackling him like a first-rate linebacker before he could leap. Tyler went flying sideways, with Matt on top of him. Bonnie was overwhelmed. So much was happening. Meredith was sawing through Caroline's ankle cords; Matt was pummeling Tyler in a way that certainly would have gotten him disqualified on the football field; Stefan was whirling that white ash staff as if he'd been trained for it. Klaus was laughing deliriously, seeming exhilarated by the exercise, as they traded blows with deadly speed and accuracy. But Matt seemed to be in trouble now. Tyler was gripping him and snarling, trying to get a hold on his throat. Wildly, Bonnie looked around for a weapon, entirely forgetting the carving knife in her pocket. Her eye fell on a dead oak branch. She picked it up and ran to where Tyler and Matt were struggling. Then Matt was on top of Tyler again, holding Tyler's head down, holding himself clear. Bonnie saw her chance and aimed the stick. But Tyler saw her. With a burst of supernatural strength, he gathered his legs and sent Matt soaring off him backward. Matt's head struck a tree with a sound Bonnie would never forget. The dull sound of a rotten melon bursting. He slid down the front of the tree and was still. Bonnie was gasping, stunned. She might have started toward Matt, but Tyler was there in front of her, breathing hard, bloody saliva running down his chin. He looked even more like an animal than he had in the graveyard. As if in a dream, Bonnie raised her stick, but she could feel it shaking in her hands. Matt was so still-was he breathing? Bonnie could hear the sob in her own breath as she faced Tyler. This was ridiculous; this was a boy from her own school. A boy she'd danced with last year at the Junior Prom. How could he be keeping her away from Matt, how could he be trying to hurt them all? How could he be doing this? â€Å"Tyler, please-† she began, meaning to reason with him, to beg him†¦ â€Å"All alone in the woods, little girl?† he said, and his voice was a thick and guttural growl, shaped at the last minute into words. In that instant Bonnie knew that this was not the boy she'd gone to school with. This was an animal. Oh, God, he's ugly, she thought. Ropes of red spit hung out of his mouth. And those yellow eyes with the slitted pupils-in them she saw the cruelty of the shark, and the crocodile, and the wasp that lays its eggs in a caterpillar's living body. All the cruelty of animal nature in those two yellow eyes. â€Å"Somebody should have warned you,† Tyler said, dropping his jaw to laugh the way a dog does. â€Å"Because if you go out in the woods alone, you might meet the Big Bad-â€Å" â€Å"Jerk!† a voice finished for him, and with a feeling of gratitude that bordered on the religious, Bonnie saw Meredith beside her. Meredith, holding Stefan's dagger, which shone liquidly in the moonlight. â€Å"Silver, Tyler,† Meredith said, brandishing it. â€Å"I wonder what silver does to a werewolf's members? Want to see?† All Meredith's elegance, her standoffishness, her cool observer's dispassion were gone. This was the essential Meredith, a warrior Meredith, and although she was smiling, she was mad. â€Å"Yes!† shouted Bonnie gleefully, feeling power rush through her. Suddenly she could move. She and Meredith, together, were strong. Meredith was stalking Tyler from one side, Bonnie held her stick ready on the other. A longing she'd never felt before shot through her, the longing to hit Tyler so hard his head would come flying off. She could feel the strength to do it surging in her arm. And Tyler, with his animal instinct, could sense it, could sense it from both of them, closing in on either side. He recoiled, caught himself, and turned to try and get away from them. They turned too. In a minute they were all three orbiting like a mini solar system: Tyler turning around and around in the middle; Bonnie and Meredith circling him, looking for a chance to attack. â€Å"I did it! Yes. All right! Yes!† Bonnie shouted, flinging the stick away. Triumph erupted from her in a primal shout. â€Å"We did it!† She grabbed the heavy body by the back of the mane and pulled it off Meredith, where it had fallen. â€Å"We-â€Å" Then she broke off, her words freezing in her throat. â€Å"Meredith!† she cried. â€Å"It's all right,† Meredith gasped, her voice tight with pain. And weakness, Bonnie thought, chilled as if doused with ice water. Tyler had clawed her leg to the bone. There were huge, gaping wounds in the thigh of Meredith's jeans and in the white skin that showed clearly through the torn cloth. And to Bonnie's absolute horror, she could see inside the skin too, could see flesh and muscle ripped and red blood pouring out. â€Å"Meredith-† she cried frantically. They had to get Meredith to a doctor. Everyone had to stop now; everyone must understand that. They had an injury here; they needed to get an ambulance, to call 911. â€Å"Meredith,† she gasped, almost weeping. â€Å"Tie it up with something.† Meredith's face was white. Shock. Going into shock. And so much blood; so much blood coming out. Oh, God, thought Bonnie, please help me. She looked for something to tie it up with, but there was nothing. Something dropped on the ground beside her. A length of nylon cord like the cord they'd used to tie up Tyler, with frayed edges. Bonnie looked up. â€Å"Can you use that?† asked Caroline uncertainly, her teeth chattering. She was wearing the green dress, her auburn hair straggling and stuck to her face with sweat and blood. Even as she spoke she swayed, and fell to her knees beside Meredith. â€Å"Are you hurt?† Bonnie gasped. Caroline shook her head, but then she bent forward, racked with nausea, and Bonnie saw the marks in her throat. But there was no time to worry about Caroline now. Meredith was more important. Bonnie tied the cord above Meredith's wounds, her mind running desperately over things she'd learned from her sister Mary. Mary was a nurse. Mary said-a tourniquet couldn't be too tight or left on too long or gangrene set in. But she had to stop the gushing blood. Oh, Meredith. â€Å"Bonnie-help Stefan,† Meredith was gasping, her voice almost a whisper. â€Å"He's going to need it†¦Ã¢â‚¬  She sagged backward, her breathing stertorous, her slitted eyes looking up at the sky. Dazed, she turned to Caroline, who was shivering and retching, sweat beading her face. Useless, Bonnie thought. But she had no other choice. â€Å"Caroline, listen to me,† she said. She picked up the largest piece of the stick she'd used on Tyler and put it into Caroline's hands. â€Å"You stay with Matt and Meredith. Loosen that tourniquet every twenty minutes or so. And if Tyler starts to wake up, if he even twitches, you hit him as hard as you can with this. Understand? Caroline,† she added, â€Å"this is your big chance to prove you're good for something. That you're not useless. All right?† She caught the furtive green eyes and repeated, â€Å"All right?† â€Å"But what are you going to do?† Bonnie looked toward the clearing. â€Å"No, Bonnie.† Caroline's hand grasped her, and Bonnie noted with some part of her mind the broken nails, the rope burns on the wrists. â€Å"Stay here where it's safe. Don't go to them. There's nothing you can do-â€Å" Bonnie shook her off and made for the clearing before she lost her resolve. In her heart, she knew Caroline was right. There was nothing she could do. But something Matt had said before they left was ringing in her mind. To try at least. She had to try. Still, in those next few horrible minutes all she could do was look. So far, Stefan and Klaus had been trading blows with such violence and accuracy that it had been like a beautiful, lethal dance. But it had been an equal, or almost equal, match. Stefan had been holding his own. Now she saw Stefan bearing down with his white ash lance, pressing Klaus to his knees, forcing him backward, farther and farther back, like a limbo dancer seeing how low he could go. And Bonnie could see Klaus's face now, mouth slightly open, staring up at Stefan with what looked like astonishment and fear. Then everything changed. At the very bottom of his descent, when Klaus had bent back as far as he could go, when it seemed that he must be about to collapse or break, something happened. Klaus smiled. And then he started pushing back. Bonnie saw Stefan's muscles knot, saw his arms go rigid, trying to resist. But Klaus, still grinning madly, eyes wide open, just kept coming. He unfolded like some terrible jack-in-the-box, only slowly. Slowly. Inexorably. His grin getting wider until it looked as if it would split his face. Like the Cheshire cat. A cat, thought Bonnie. Now Stefan was the one grunting and straining, teeth clenched, trying to hold Klaus off. But Klaus and his stick bore down, forcing Stefan backward, forcing him to the ground. Grinning all the time. Until Stefan was lying on his back, his own stick pressing into his throat with the weight of Klaus's lance across it. Klaus looked down at him and beamed. â€Å"I'm tired of playing, little boy,† he said, and he straightened and threw his own stick down. â€Å"Now it's dying time.† He took Stefan's staff away from him as easily as if he were taking it from a child. Picked it up with a flick of his wrist and broke it over his knee, showing how strong he was, how strong he had always been. How cruelly he had been playing with Stefan. One of the halves of the white ash stick he tossed over his shoulder across the clearing. The other he jabbed at Stefan. Using not the pointed end but the splintered one, broken into a dozen tiny points. He jabbed down with a force that seemed almost casual, but Stefan screamed. He did it again and again, eliciting a scream each time. Bonnie cried out, soundlessly. She had never heard Stefan scream before. She didn't need to be told what kind of pain must have caused it. She didn't need to be told that white ash might be the only wood deadly to Klaus, but that any wood was deadly to Stefan. That Stefan was, if not dying now, about to die. That Klaus, with his hand now raised, was going to finish it with one more plunging blow. Klaus's face was tilted to the moon in a grin of obscene pleasure, showing that this was what he liked, where he got his thrills. From killing. And Bonnie couldn't move, couldn't even cry. The world swam around her. It had all been a mistake, she wasn't competent; she was a baby after all. She didn't want to see that final thrust, but she couldn't look away. And all this couldn't be happening, but it was. It was. Klaus flourished the splintered stake and with a smile of pure ecstasy started to bring it down. And a spear shot across the clearing and struck him in the middle of the back, landing and quivering like a giant arrow, like half a giant arrow. It made Klaus's arms fling out, dropping the stake; it shocked the ecstatic grin right off his face. He stood, arms extended, for a second, and then turned, the white ash stick in his back wobbling slightly. Bonnie's eyes were too dazzled by waves of gray dots to see, but she heard the voice clearly as it rang out, cold and arrogant and filled with absolute conviction. Just five words, but they changed everything. â€Å"Get away from my brother.†

Cyberbullying Essay: Define, Prevention and Effects

The model answer for  Cyberbullying Essay. Structure of Essay:Introduction –  Definition of Cyberbullying, instances, how cyberbullying begins, age group cyberbullying is most active.Effects of Cyberbullying –  Mental & Physical, Isolation, effect on friends and familyHow To Prevent Cyberbullying  Ã¢â‚¬â€œ Steps to be taken by parents, school authorities, governmentConclusionCyberbullying Essayco.uk/wp-content/uploads/2016/01/maxresdefault-2-1024x576.jpg" alt="Cyberbullying Essay" width="755" height="425" />What is Cyberbullying?1. IntroductionDefinition: Cyberbullying  is the act of bullying in the form of digital media or devices. It is a modern term for bullying, which emerged with the rise of the internet and mobile devices. Cyberbullying takes place on digital devices like cell phones, computers, and tablets. It can take the form of texts through SMSes, online chat forums, social networking sites and gaming forums. Acts such as posting, sending or sharing negative content that is harmful, mean or obscene, defines cyberbullying. Cyberbullying can also take the form of some illegal physical activities and unlawful behavior. The internet is the place where cyberbullying is most common. Social media sites like Facebook, Snapchat, and Instagram, to name a few are the most common sites for cyberbullying. With the introduction of free messaging apps, the instances of cyberbullying have increased. The rampant use of mobile phones has brought cyberbullying at the tip of fingers and cyberbullies make use of these technologies to prey on potential victims.Examples and Instances of Cyberbullying:Born in 1996, Amanda Todd was like any other teenager with dreams and a fascination for the internet. She met a stranger online who flattered her and convinced her to go topless. The stranger took pictures of her and kept stalking here for several other shows. When she tried to fight back the photos were sent to her family and friends. After which, she was abused and disrespected in school by her friends. Going into major depression and anxiety, she tried taking her own life several times and finally succeeded. A month before she killed herself she released a video telling her story which became viral after her death and people realized how dreadful it was. This is a  prime example of how cyberbullying can destroy innocent.How Cyberbullying Begins:We live in a world dominated by technology and not only teenagers, but adults too are addicted to the use of electronic devices and the internet. The internet has played a major role in connecting the entire world and individuals from across the continents. Cyberbullying starts in the virtual world. The cyberbullies enjoy the anonymity and the infinite reach of the internet to prey on unsuspecting and potential victims. Once they get hold of something personal of the victim, they start to either blackmail or harass them.Age Group in Which Cyberbullying is Most Active:Victims of cyberbullying are most commonly from the age group of 12 to 18. Teenagers get attracted to the online glamour and the attention that they get from strangers. The virtual fandom is what they seek, and they tend to do things for gaining followers on social sites such as Facebook and Instagram. But older victims can get caught in it too. School students are easy to target, and if they have a bully within they school then, it becomes more difficult to escape the bullying.2. Effects of CyberbullyingMental And Physical Effects:Cyberbullying can result in increased distress for the victims along with increased anger and frustration. They will vent this out on various oc casions, and it might force them to get addicted to the virtual world where they can have several identities to hide their real one. The victims will automatically have lower self-esteem since that is the sole purpose of bullying. Prolonged bullying will lead to severe withdrawal from their family and friends. They will begin favoring isolation most of the time and indulging in harmful activities like drugs and alcohol.Feel Alone and Isolated:Most of the victims are forced to stay away from any and all social sites in a bid to escape the cyberbullies. They separate themselves to feel a sense of protection form the outer world. Most of the victims do not reveal anything to their parents or family members to disappoint them. To escape the bullies, they may try to change their schools or home, but they are hardly able to escape the clutches of the tormentors. Most of the time the victims would give up fighting the bullies and kill themselves to escape the pain and horrors of the continuous cyberbullying.Disinterested in Attending School:If a schoolmate bullies a  Ã‚  kid, then the first way for him to avoid the bullying is to stop going to school. He/she would choose to skip classes to escape the tormentors temporarily. The feeling of embarrassment and humiliation from the fellow students will prevent the kid to return to school and have a healthy school life. Their grades will start dropping, and most of the time they will drop out.Victims Might Get ill:Apart from the usual mental and physical effects of cyberbullying, it can take a toll on the health of the victim. Symptoms like headaches and stomach problems are very often seen in the victims. It can also result in issues that are caused due to stress like various skin conditions and stomach ulcers. Due to binge eating or skipping meals several weight issues can arise, and they might have to deal with insomnia and other sleeping disorders.3. How To Prevent Cyberbullying?Identify Victims:Identifying victims may be a challenge if they are introverts initially, but every victim leaves off some prominent clues to their condition and their troubles. Isolating oneself and staying alone is one such clue. If they seem to be depressed all the time or are usually anxious and angry, then it may signal that they are going through some form of bullying.Steps to be Taken by Parents and Family Members:The primary step is to prevent the kids from coming in contact with these harmful and dangerous predators that are always prowling about for a victim. Try to keep the computer in a common area and stay updated with all the latest websites and trends on the internet. Teach them about the internet and how to use it responsibly and safely. Communication is an essential step in getting to know about their situation. Talking to the child will help in building trust, and they will be more comfortable in sharing their troubles with the parents. Once they share what is happening, try not to overreact and blame them for the incident. Ask them to be strong and let them know that they will always have their parents by their side. Cyberbullying is an actual threat and not a childish thing. Realizing the gravity of the situation is important in solving it.Steps to be Taken Schools and Colleges:The faculties should be aware of any student showing the signs of being a bully or being bullied. If they have any concern, then they should delicately handle the situation and inform the authorities to take over the case. Schools should have counselors to assist the students and help them overcome any tough situation.Steps to be Taken as a Country and Laws Necessary:Laws against cyberbullying have been in place for quite some time though they were introduced after many such cases were highlighted. The rules are designed to protect the victim and keep the case information confidential. The law enforcement authorities should be proactive in the investigation of such a situation unlike in the Amanda Todd case where the police wer e slow in taking action and did not consider the matter important which ultimately cost the life of an innocent kid.  4. ConclusionCyberbullying is a serious issue, and it can be truly horrific to go through such a difficult period. Staying strong and fighting back is the only option against these bullies. It’s possible to get over it and live your life again. Seeing a counselor can help the victims handle the incident in a better and a safe way. Life does not get over if you are a victim of cyberbullying and it is possible to fight back.Statistics Regarding Cases of Cyberbullying:According to the US Department of Justice, in the year 2010 to 2011, 9% of the total students aged between 12 and 18 were cyberbullied. A survey conducted the year 2012; it was found that almost 55.2% of students belonging to the LGBTQ community were cyberbullied. Over the past years the rate of cyberbullying has increased, and in the year 2016, a survey found that the number of people who have faced cyberbullying at least once in their lifetime doubled from about 18% to nearly 34%. This is evidence of how rampant cyberbullying is becoming. By the year the percentage of high school students who were bullied had become 5%, and the percentage of middle school students who had become victims of cyberbullying was 24%. Through the help of several surveys, it was found that girls were targeted more than boys in cases of cyberbullying.

Using Time Expressions and Tenses in English

Using Time Expressions and Tenses in English Here is a quick overview of time expressions used with specific tenses including examples and explanations. Days of the Week Days of the week can be used with most tenses in English.  Notice that all days of the week are capitalized: MondayTuesdayWednesdayThursdayFridaySaturdaySunday Examples: Ill see you next Sunday.We had a meeting last Thursday.Jennifer has her programming course on Wednesday. When speaking about an action that is repeated EVERY Saturday, Monday, etc., use the day of the week, add s and use either the present simple to speak about present routines or the past simple to discuss past habits. Do not use with the continuous, perfect, or perfect continuous forms.   MondaysTuesdaysWednesdaysThursdaysFridaysSaturdaysSundays Examples:   We have our class on Tuesdays and Thursdays.  I used to play tennis on Saturdays. The Weekend British English: at the weekend OR at weekends (in general)American English: on the weekend  OR on weekends (in general) Use the present simple to speak about habits on the weekend. On the weekend is also used with the future and past ​tenses to speak about the next or last weekend. I play tennis at weekends.She visits her mother on the weekend.Were going to the beach on the weekend. (next weekend)They visited Chicago on the weekend. (last weekend) Times of the Day Use the following time expressions to express things that happen during the day. These expressions can be used with the past, present, and future forms.   in the morningin the afternoonin the eveningat night NOTE: Make sure to note that we say at night NOT in the night They do the cleaning in the morning.He goes to bed late at night.Well do the homework in the evening.She had a drink in the evening before she went to bed. Time Expressions to Use With the Present Simple Use every with segments of time such as every day, month, year, every two months, etc. She travels to Las Vegas every year.Jack tries to exercise every day. Here is how to use adverbs of frequency (usually, sometimes, often, etc.): They sometimes play golf.She rarely smokes. Time Expressions to Use With the Present Continuous Use now, at the moment, right now, or today with the present continuous to speak about what is happening at the present moment. Tom is watching TV now.Im working on the Smith project today.Jane is doing her homework at the moment. Time Expressions Often Used in the Past Use last when speaking about the previous week, month or year They went on holiday last month. Use yesterday when speaking about the previous day. Use the day before yesterday to speak about two days earlier.   I visited my best friend yesterday.They had math class the day before yesterday. Use ago when speaking about X days, weeks, months, years before. NOTE: ago follows the number of days, weeks, etc. We flew to Cleveland three weeks ago.The class started twenty minutes ago.   Use in  with specific years or months with past, present, and future tenses. She graduated in 1976.Well see each other in April.   Use when with a past time clause. I played tennis every day when I was a teenager. Time Expressions Used in the Future Use next to speak about the next week, month, or year. We are going to visit our friends in Chicago next week.Ill have some time off next month.   Use tomorrow for the next day. Hell be at the meeting tomorrow. Use in X weeks, days, years time with the future continuous to express what you will be doing at a specific of time in the future. We will be swimming in a crystal blue sea in two weeks time. Use by (date) form with the future perfect to express what you will have done up to that point in time. I will have finished the report by April 15. Use by the time time clause with the future perfect to express what will have happened up to a specific action in the future. She will have bought a new home by the time he arrives.

April Fools Day Quotes

April Fools Day Quotes William Shakespeare famously said, Better a witty fool than a foolish wit. On  April Fools Day, showcase your wit and humor with these quotes. If you are a prankster, play a harmless prank, and tease your friends. If you are not a prankster, beware of those who are. Mark Twain, Puddnhead Wilson April 1. This is the day upon which we are reminded of what we are on the other three hundred and sixty-four. Plato Even the gods love jokes. George Orwell The aim of a joke is not to degrade the human being, but to remind him that he is already degraded. Will Rogers The trouble with practical jokes is that very often they get elected. Myra Cohn Livingston The maple syrups full of ants.A mouse is creeping on the shelf.Is that a spider on your back?I ate the whole pie by myself.The kitchen sink just overflowed.A flash flood washed away the school.I threw your blanket in the trash.I never lie- I- April Fool! Charles Lamb Here cometh April again, and as far as I can see the world hath more fools in it than ever. Poor Robins Almanac, 1790 The first of April, some do sayIs set apart for All Fools Day;But why the people call it soNor I, nor they themselves, do know,But on this day are people sentOn purpose for pure merriment. Thomas Shadwell The haste of a fool is the slowest thing in the world. Arabian Proverb A fool may be known by six things: anger without cause; speech without profit; change without progress; inquiry without object; putting trust in a stranger; and mistaking foes for friends. Horace Mix a little foolishness with your prudence: Its good to be silly at the right moment.