Ford Motor Company: The River Rouge Manufacturing Complex :: American America History

Ford Motor Company: The River Rouge Manufacturing Complex The first piece of material I gathered was a picture via the internet. This picture is of the River Rouge assembly plant in Dearborn, Michigan. This picture shows the manufacturing of the fender for a Ford Motor Company product. It also shows the facilities of the Rouge plant and how the plant itself was state of the art. This plant was the largest of its kind at the time of its construction. The Ford Motor Company at the time was one of the leaders in labor relations. This picture shows the size of the plant as well as the working conditions in the facility. When viewing the photograph you can see the array of pipes and collection devices to aid in the circulation of air and the collection of dust and other by products made in the plant. The next component I found is another picture of the interior of the Rouge plant. This picture is one of many conveyer belts in the plant. This belt is moving engine parts from the engine assembly to the final assembly. Henry Ford was a pioneer in the use of the assembly line in the automobile industry, and the Rouge plant was the ultimate in that use of the assembly line. This photo shows the depth of the plant, being able to manufacture all components of the cars without having to ship parts to or from other locations in the country. The next collection of photographs is of the exterior of the Rouge plant. These photos were obtained from the Henry Ford Museum in Dearborn, Michigan. These pictures are of the Rouge during the switch of all production, from the Highland Park plant, to the Rouge. It was also the time that the Model A was beginning production. This collection shows examples of four exterior views of the plant, allude to the many different factories within the Rouge plant. The Rouge was a steel mill, a foundry, a power producer and, an assembly line. This all encompassing idea helped ford relegate all aspects of the production of their product. Along with the exterior, the interior showed the extent of the all encompassing Rouge plant. The interior photographs, which were also care of the Henry Ford Museum, show more factories within the factory. For example, the four photos in this collection display metal forming, and metallurgical operations. These pictures included forging, the blast furnaces, removal of slag and, even salvaging scrap from metal ships. The interior had two collections to view and the second reaffirmed what the

Shakespeares Hamlet †Ophelia Discussed Essays -- GCSE English Litera

Hamlet – Ophelia Discussed Courtney Lehmann and Lisa S. Starks in "Making Mother Matter: Repression, Revision, and the Stakes of 'Reading Psychoanalysis Into’ Kenneth Branagh's Hamlet" make a statement regarding the effect of Ophelia’s words, even though she was considered mad at the time: Hamlet's own disgust toward the body and sexual behaviour, coupled with Ophelia's erotically-charged songs, did not suddenly become "about" sexuality after Freud. On the contrary, censorship of the play in performance during various historical time periods indicates that the tragedy has always been perceived of as highly erotic, and often dangerously so. Even in the context of twentieth-century interpretations of Hamlet, critics have been reluctant to engage in genuine confrontations with the problem of the play's sexuality and its underlying anxiety. For this reason, Jacqueline Rose has claimed that critics writing on Hamlet, beginning with T. S. Eliot, have conflated their puzzlement over the play with the Western notion of "woman" as the bearer of an impenetrable secret. (2) Shakespeare’s tragedy, Hamlet, presents almost a dozen male characters for every one female character. The only prominent female characters are two: Ophelia, Laertes’ sister and Polonius’ daughter; and Gertrude, the queen and wife of Claudius and mother of Hamlet. This essay will explore the character, role, and importance of Ophelia. The protagonist of the tragedy, Prince Hamlet, initially appears in the play dressed in solemn black, mourning the death of his father supposedly by snakebite while he was away at Wittenberg as a student. Hamlet laments the hasty remarriage of his mother to his father’s brother, an incestuous act; thus in his first soliloqu... ...akes of 'Reading Psychoanalysis Into' Kenneth Branagh's Hamlet." Early Modern Literary Studies 6.1 (May, 2000): 2.1-24   http://purl.oclc.org/emls/06-1/lehmhaml.htm Pennington, Michael. â€Å"Ophelia: Madness Her Only Safe Haven.† Readings on Hamlet. Ed. Don Nardo. San Diego: Greenhaven Press, 1999. Rpt. From Hamlet: A User’s Guide. New York: Limelight Editions, 1996. Pitt, Angela. â€Å"Women in Shakespeare’s Tragedies.† Readings on The Tragedies. Ed. Clarice Swisher. San Diego: Greenhaven Press, 1996. Rpt. from Shakespeare’s Women. N.p.: n.p., 1981. Shakespeare, William. The Tragedy of Hamlet, Prince of Denmark. Massachusetts Institute of Technology. 1995. http://www.chemicool.com/Shakespeare/hamlet/full.html Wilkie, Brian and James Hurt. â€Å"Shakespeare.† Literature of the Western World. Ed. Brian Wilkie and James Hurt. New York: Macmillan Publishing Co., 1992.

Informative Speech On Nutrition Essay

Public Speaking 230 Informative I. College students are not eating the proper foods or the recommended daily allowances even though they believe they are eating healthy. A. Illustration Suzanne- Started nibbling on potato chips between meals and late at night. – To keep up with studies, she cut back on swimming. – She would prepare her self by eating what she thought was healthy, granola bar or a frozen yogurt. – Larger breakfast- orange juice, bacon, sausage, eggs, hash browns, toast with butter and jam, and black coffee instead of fruit juice, cereal, and skin milk she had always ate at home. – By dinnertime she was starved, she loved fried chicken and a helping or two from the salad bar alternative to french fries. Eric- – Found himself in a similar pattern. – Putting a lot of time into keeping up with his course work – Spending less time than before on sports and bike riding – Eating fast-food restaurants, – Skipping meals from time to time. – Eating candy bars for lunch several times a week Before the semester was over, Eric’s friends started teasing him about the spare tire around his waist, and Suzanne was having trouble zipping up her clothes that fit her perfectly a couple of months earlier. B. The (your college) survey shows students aren’t eating a balanced nutrition; with little time and effort it is possible for students to know and understand their daily allowances. 1. Survey of (your college) Students nutrition 2. History of Nutrition 3.  Food Guide Pyramid C. How many of you feel you are in the same situations as Suzanne or Eric? Whatever the circumstances, many (your college) students are eating wrong and will soon be affected by it. II. A random survey of fifty Cumberland College students reveals that the eating habits of students are often not similar to good nutrition. A Although many students fell like they are eating three meals a day the survey shows many are going without breakfast and picking up an extra meal somewhere else. B. High percentages show that students are not getting enough servings of fruits and vegetables. C. High percentage of student never takes a multiple Vitamin and never eats healthy snacks. III. A brief history of Nutrition and students excessive consumption of fat. A. The first dietary â€Å"standards† were formulated in the US in 1940. During WWII, a food and Nutrition Board was established as a part of the National Research Council of the National Academy of Sciences (Arlin, M.C. The Science of Nutrition). The objective was to provide standards to serve as a goal for good nutrition. Recommended allowances for nutrients are amounts intended to be consumed as part of a normal diet. B. US Department of Health and Human Services stated in The National Adolescent Student Health Survey that most students know that excessive consumption of fat, sugar, and salt increases one’s risk for specific health problems, and most student cannot choose between common foods on the basis of their fat, sugar salt, or fiber content. IV. The key to good nutrition is a varied diet that includes every kind of nutrient. The Food Guide Pyramid calls for limited daily servings of fats, dairy products, oil and sweets: more servings of fruits and vegetables; and  even greater potions of bread, cereals and pastas. A. Meat, Poultry, Fish Group- 2 servings B. Fruit and Vegetable Group- 5 to 6 servings C. Bread Group- At least 4 servings D. Dairy Group- 3 servings should be included in a daily diet. V. Despite the continual changes in food products, one-factor remains constant- food is the only source of nutrition we have, regardless of how, when and where it is prepared. We can’t always dictate how food reaches us, but we can be nutritionally knowledgeable. We can learn to meet our nutritional need in the reality of today’s eating patterns.

Impacts of malnutrition on children Essay

Capacio (2013) once said that one of the underlying reasons for establishing feeding program is to provide targeted families and their children, an incentive to attend school. It is popular strategy for achieving both educational and social objective among school children, which includes combating and fighting hunger and malnutrition. She further said that its potential impact on education is that aside from alleviating short-term hunger among children, proper nutrition improves children’s cognitive functioning and attention. Better nutrition provides them better assistance to diseases which would keep them from attending school, thus would indirectly improve educational achievement. School feeding programs could help supplement the problem for malnourished children through providing them with healthy meals. Meanwhile, Manasan @ Cuenca (2007) assert that malnourished children often experience loss of mental capacities. They became sickly and loss their presence of mind. Because of this children that are malnourished often have low performance in school. School feeding program is done to reduce the number of malnourished children and improve their nutritional status and at the same time improving their performance in the class. Bundy (2009) suggests that appropriately designed school feeding programs increase access to education and learning and improve children’s health and nutrition especially when integrated into comprehensive school health and nutrition programs. Similarly, a recent review by Jomaa (2011) reveals relatively consistent positive effects of school feeding on energy intake, micronutrient status, school enrollment and attendance of the children participating in school feeding programs compared to non-participants. At present there are approximately 300 million chronically hungry children in the world. One hundred million of them do not attend school. And school feeding programs have been continuously gaining popularity in developing countries, mostly among those affected severely by childhood hunger and malnutrition. These program aims to enhance the concentration span and learning capacity of school children by providing meals in schools to reduce malnutrition. Furthermore, Luistro (2012) said that 42,000 undernourished pupils stand to benefit from the Department of Education’s School Based Feeding Program, which aims to boost their health and help them do well in school. He also added that the feeding program gives nutritious meals to pupils suffering from severe malnutrition for 100 to 200 feeding days. According to Food for Education Stakeholders (2000), evidence strongly suggests that school feeding programs can increase attendance rates, especially for girls. School feeding or take home rations serve as incentives for enrolling children in school and encouraging daily attendance. Early malnutrition can adversely affect physical, mental and social aspects of child’s health, which as a result leads on underweight, stunted growth, lowered immunity and mortality. The lack of nutrition imposes significant economic costs on individuals and nations including how it affects on academic performance and behaviors at school and long term productivity adults. Problems like delayed entry to school, less overall schooling, smaller stature and lower school performance among children represent a great motivation to impose feeding programs. Henceforth, the researchers embark to pursue this study in order to determine the effects of feeding program to the health condition and academic performance of the students in Maasin Central School. In addition, the researchers believe that the results of this study would help curb the problems of malnutrition especially to younger children. THEORETICAL BACKGROUND This study is basically premised on the theories of Ahmed (2004), Jukes, Drake @ Bundy (2008) and Adelman (2008). It is also supported by the following legal bases such as House Bill No. 428, House Resolution No.26 and  DepEd Order No. 43, S. 2011. According to Ahmed (2004), solid empirical evidence of the impact of school feeding programmes on educational outcomes proves that school feeding increases school enrollment and attendance by reducing drop-out. Enhanced nutrition and health of primary school children leads to improved learning and decreased morbidity, paving the way for healthier lives. He further said that the school feeding programmes not only alleviate child hunger in school, but also enhance nutrition, particularly when the food is fortified with micronutrients. This raises the potential to improve a child’s health, school performance and educational attainment. Furthermore, Jakes, Drake @ Bundy (2008) state that when school feeding targets preschool children, it can help give a child a healthy head start and pave the way for a promising future. There is compelling evidence that poor nutrition in early childhood affects cognitive development and learning potential and poor health is an additional barrier to education. They further said that increased access to preschool can enhance education outcomes and equity among children of primary school aged-children. School feeding should be seen as a part of a continuum and one of many potential interventions that support nutrition for pre- primary and primary school aged- children. School feeding in pre- primary schools, for children aged 3 to 5 years can be seen as preventive, and has the potential to bridge the gap between infancy and primary school age- 6 to 11 years in countries where pre- schools are part of the basic education. Meanwhile, Adelman (2008) said that improving micronutrient status through food fortification or micronutrient powders, particularly of iron, B- vitamins, vitamin A and iodine, contributes directly to enhance cognition and learning capacity. Recent studies in Kenya and Uganda proved that both in- school meals and take home rations (THR’s) reduce anaemia prevalence. In addition, Grillenberger (2003) believes that school feeding enhances the diet and increases the energy and kilocalories available to a child. It targets micronutrient deficiencies, which are widespread among school- age children in developing countries and which increase susceptibility to infection, leading to absenteeism and impairing learning capacity and cognition. Alderman (2011) highlighted the importance of school feeding programmes both as a social safety net for children living in poverty and food insecurity, and as a part of national educational policies and plans. School feeding  programs can help to get children into school and help to keep them there, through enhancing enrollment and reducing absenteeism. And once the children are in school the programs can contribute to their learning through avoiding hunger and enhancing cognitive abilities. Furthermore, school health and nutrition interventions have been recognized in addressing the Millennium Development Goals (MDGs) of universal basic education and gender equity in educational access. In order to achieve these goals, it is essential that even the poorest children, who suffer most from ill health and hunger, are able attend school and learn while there. Disadvantaged children- the poor, the marginalized, girls and children in fragile states- often suffer from ill health and malnutrition and therefore benefit most from school feeding program. According to Jacooby (2012) ascertained that school snacks in the Philippines were completely additional resources to the students in the program. That is each additional calorie provided in school led to an identical increase to the total calories consumed by the student during the day. Numerous studies show that in school feeding has a positive impact on school enrollment or participation in areas where initial indicators of school participation are low (Jukes, Drake @ Bundy 2007). Moreover, Greenhalgh (2007) @ Lehrer (2008) claimed that school feeding programs which provide meals at school (SPFs) or related take home rations (THRs) can improve enrollment and attendance, can address chronic hunger or micronutrient deficiencies and, by improving health or by increasing a child’s focus in the classroom, can enhance learning. According to Jomaa (2011), states that school feeding programs (SPFs) are intended to alleviate short- term hunger, improve nutrition and cognition of children and transfer income to families. He also added that the positive impact of school feeding on growth, cognition, and academic achievement of school- aged children receiving SPFs compared to non- school- fed children was less conclusive. This review identifies in the design and implementation of SPFs and calls for theory- based impact evaluations to strengthen the scientific evidence behind designing, funding and implementing SPFs Likewise, House Bill No.428 otherwise also known as â€Å"Child Nutrition Act of the Philippines†- (an Act establishing in the Department of Education a National School Feeding Program for elementary grade pupils) requires the implementation of a National plan of Action that will save millions of elementary school  children from malnutrition and illiteracy by establishing in the Department of Education a National Feeding Program that could significantly reduce the prevalence of malnutrition and swiftly resolve related school and pupil- learning problems. House Resolution No.26- a resolution directing the house committees on basic education, social services, health and government to conduct an inquiry in aid of legislation on the implementation of the Philippine Plan of Action for Nutrition (PPAN) particularly, the various feeding programs for public school children in children in early childhood care and education centers (Day Care Centers), elementary and secondary schools all over the country. The resolution was filed on January 7, 2013 by Congressman Jonathan A. de la Cruz. Finally, DepEd Order No. 43, S. 2011 states that the Department of Education (DepEd) through the Health and Nutrition Center (HNC) should strengthen the School Health and Nutrition Programs (SHNP) into its key programs and aligning all its activities into one seamless whole. This is envisioned to make this Department better able to determine the effectiveness and relevance of its programs, and to make responsive to the DepEd’s mission of enhancing the student’s motivation and capacity for learning, improving learning, outcomes, reducing absenteeism and ensuring that school- age children are able to stay in school as enunciated in the Education for All (EFA) and Millennium Development Goals (MDGs).

Prescribing in practice Essay

Introduction The following assignment will discuss and analyse a prescribing episode, within practice, furthermore will outline safe prescribing from the Nurse Prescribing Formulary (NPF, 2013-2015).To be able to analyse and reflect on my new role as Community Practitioner Nurse Prescriber (CPNP) I will use Gibbs (1988) reflective model and a structure that will allow the use of a consultation model (Appendix1,Fig1). The focus on prescribing within nursing profession was first brought into discussion by Royal College of Nursing (RCN) in 1980 but has proven to be cornerstone after was part of the government agenda as a result of Cumberlege report in 1996.This report outlined the need for nurse to become a prescriber especially in community settings to provide clients with better care, safe and practical access to medication (Nuttal, 2008). Furthermore â€Å"The Medicinal Product Prescribing Act â€Å"1992 outlined changes in circumstances including nurses as prescribers, followed by recommendati ons made by Crown Reports1999 that suggest that health visitors (HV)) should be authorised to prescribe from a limited list, identified as the nurse prescriber’s formulary (NPF). (DH,2004). Scenario For the purpose of this assignment all names has been changed to maintain confidentiality according to NMC (2008).The following scenario it is in relation to a situation experienced while on the morning baby clinic working alongside my mentor .A mother Lisa come for a regular weight check for her 4 month old infant called James .While discussing with Lisa her son weight progress ,she mentioned about her son having very dry scaly skin on scalp since birth moreover Lisa explained that sometimes skin on the scalp become like a patchy crusty rash and James feel uncomfortable , at times not settling. Edwards (2010) suggest that using a holistic assessment it is very important when coming in contact with the client as the problem presented can have a drastic impact on the quality of life for child and the family. As a student under the supervision of my mentor we started a holistic assessment of James and finalise with a prescription decision. I start by using open questions related to Jam es general health and I asked  Lisa if she had any concerns but she confirmed back to me that there was no issues with his health since birth .To make sure that information provided by Lisa was correct and I have accuracy in details exposed I repeated back and she confirmed. As a student practitioner prescriber it is very important to maintain good practice and use assessment frameworks and consultation models as possibility to improve and gain better skills(Nuttall,2008). The Consultation The purpose of the consultation model in prescribing practice is to assist nurses in identifying strategies to deliver a diagnoses and ultimately the appropriate prescription .There are various consultation models used in practice with normative or descriptive character , however for the purpose of this case scenario I will concentrate on Roger Neighbour 1987 consultation model. Moreover Neighbour (2005) outline through his model consultation as a journey divided by check points , connecting which is the first point where client establish the relation with the practitioner is essential followed by summarising, handing over, safety netting and housekeeping. To progress further it is relevant to mention influence of communication skills in consultation process furthermore considering that nurse practitioners don’t need different communication skills in comparison with other professionals prescribers (While,2002) .However(While,2002)found that the need for appropriate environment that can maintain privacy and confidentiality could be a potential barrier during consultation rather than communication especial for those working in client homes. I choose Neighbour 1987 model for consistency and easy to apply in any circumstances moreover stand as a journey establishing relations with the client through empathy and in the same time identify the need for balance between practitioner prescriber and client (Tate,2010).Another positive aspect that I took in consideration when choosing the model was also housekeeping as practitioner have the opportunity through this section to become reflective to avoid any unresolved issues before consultation is complete ( Neighbour,2005) .Despite the decision made to use Neighbour 1987 model I will move further and explain the process and prescribing decision using the principles of good prescribing pyramid ,( Appendix 1, Fig 2)(NPC,1999). Step 1 Assessment; Consider the patient The beginning of consultation according to Neighbour,(1987) is connecting with Lisa and building a relationship ,however in a noisy environment like the clinic I found this difficult .Despite this barrier I manage to find a sitting area that appear to be more private and had the opportunity to manage a discussion with Lisa to establish that I needed to do a physical examination on James .As James was under 16 years of age ,consent from parent or guardian was needed ,therefore Lisa give a verbal consent as she was the biological parent (NMC,2013).To proceed further I use mnemonic OLDCARD to asses James with Lisa’s assistance trying to interact with her and find out if any physical or affective changes occurred. Bryans (2000) suggest that during assessment the practitioner should use knowledge, experience, recognition and prioritisation ,so to proceed further with a holistic assessment and identify symptoms that will help me to rule a diagnosis I felt I needed to ask Lisa more questions .Following the identified symptoms and physical examination I conclude that this was cradle cap a form of seborrheic dermatitis mainly affecting skin on the scalp with patches and thick scaling and sometimes yellow crusty (Sheffield et al,2007).It is important to rule out other conditions when taking assessments as sometimes cradle cap can turn into atopic dermatitis or fungal infection such as tinea capitis or easily misdiagnosed with crusted scabies (Yoshizumi and Harada,2008).Further continuing my assessment I was able to conclude that none of this conditions were present in James situation . It was important to discuss with Lisa during consultation family history that could provide additional support for my final diagnostic conclusion .Going thru such topic area Lisa explain that her husband James dad was suffering with atopic eczema since childhood .This was quite an important piece of information as such conditions like atopic eczema ( dermatitis ) are hereditary conditions often (National Eczema Society ,2011).Atopic dermatitis or eczema is a chronic skin disorder inflammatory with pruritic skin that appears mostly on the face ,neck ,bends of the arms or legs caused by the malfunction in the skin barrier( NICE,2013). Step 2 Which Strategy? In order to progress further following discussion with Lisa under my mentor supervision as a CPNP V100 I made a prescribing decision based on the physical examination and the information provided I concluded that James was suffering from cradle cup (seborrheic dermatitis)(NICE,2013).Furthermore Lisa confirmed that James did not have any allergies and was not on any medication .It was important to relieve the discomfort and unsettling times for James and I decided to prescribe an emollient and a bath additive. Pendleton et al (1984) suggest that practitioner should discover client expectation furthermore should take in consideration other treatment options before prescribing .According to NICE (2013) greasy emollients and soap substitutes or bath additive helps to remove effectively the scales, further more regular washing of the scalp and gentle brushing can help to loosen scales. Another stage followed in the Neighbour (1987) is handing over period but after Justin skin on his scalp was carefully examined no evidence of infection was identified so no referral to the General Practitioner (GP) was necessary. Consider the choice of Product According to NPC (1999) practitioners should use mnemonic ‘EASE’ as can be seen in the chart below to choose appropriate cost effective product for clients. E How effective is the product? A It is appropriate for the client? S How safe is it? E Is the prescription cost effective? To make the appropriate decision for Lisa’s infant, under the supervision of my mentor I used the Nurse Prescribers Formulary (NPF) and decided to  prescribe Oilatum Junior bath additive and cream as I considered this combination more effective in Justin’s treatment .Moreover the packaging was also appropriate as comes in a pump action and this could reduce the infection risks associated with emollients and types of recipients manufactured (NPF,2013-2015). When deciding the prescription products and quantities I also took in consideration Lisa requirements furthermore according to NICE guidelines emollients should be prescribe in large quantities approximately 250-500 grams per week and in the same time cost effective (NICE,2007).It is important when prescribing emollients to discuss with clients /parents /carers possible side effects even this products are considered to be quite safe ,however bath additives should be taken in consideration because tend to leave the s kin slippery after bathing the infant( BNFC,2014) .When prescribing a product especially for infants it is important to educate the parent/carer how to use the product and make sure they are aware of any risks and side effects . Negotiate a contract According to (Courtenay and Griffiths,2005) when prescribing we should view the process as a shared decision-making between client and prescriber .The prescribing decision stands as a contract so it was important to remind myself that I should take in consideration Lisa satisfaction with my decisions .To achieve all my actions it was paramount to have effective communication skills and ability to identify the appropriate therapeutic treatment .Throughout entire process I think that Lisa felt empowered as I hand it over to her the responsibility to apply the emollients on Justin skin ( Braid,2001).As I am not yet non-medical prescriber the prescription for Lisa’s son was written by my mentor and information leaflets regarding seborreic dermatitis were given to Lisa for further guidance. Review According to Neighbour (1987) consultation model this step relates to safety netting and refers to follow up of the consultation and possible outcomes. Furthermore together with my mentor we arranged to follow up in ten days to see if Lisa’s infant was making any progress and treatment was effective .Through this review in ten day time practitioner can identify any more concerns of the parents and possible side effects of the treatment used(  DH,2010b). Record Keeping Following guidance of the Nursing and Midwifery Council (NMC,2006) it is practitioner accountability to ensure records are maintain accurately and prescription details it is recorded in the infant health record (NPC,1999).Moreover I ensured the details of the prescription and the consultation were entered into general computer system within the next 4 hours following consultation and the GP also was aware of the consultation and products prescribed .According to (NMC,2006) details of the consultation and prescription should be entered into the computer system within forty eight hours with exception for special circumstances. Reflection Using Gibbs reflective cycle during consultation process with Lisa’s infant I had the opportunity to identify positive and negative aspects and reflect on the scenario. In the same time final part of Neighbours consultation model refers to Housekeeping and this stands as another stage that give me the opportunity to reflect on my prescribing decision and consultation .I felt that throughout the whole process I used safe and effective decisions even at times I felt a bit nervous however my mentor feedback was positive in regards to my performance .One aspect that I found difficult was the environment ,at the time the baby clinic was busy and noisy and it was difficult to find a private area to conduct the consultation ,but such issues I could reflect on it for my future prescribing practice . Conclusion Through this experience I able to develop on my new role as V100 prescriber using specific tools like the consultation model and good prescribing steps .Furthermore I had the opportunity to apply appropriate communication skills and medical knowledge along with the legislation to conclude with a safe and effective prescribing practice . A new CPNP I can utilize different assessment tools based on a consultation model along with a decision making framework to support my practice and at the same time reflect on my ability to undertake a partnership approach that responds to client needs and concerns. Definitely this experience has been with great importance for my educational journey as V100 nurse prescriber. Reference: Baird, A., (2001) Diagnoses and prescribing .Primary Healthcare 11(5):24-26. Bryans, A., 2000. ‘Providing new insight into community nursing know-how through Qualitative analysis of multiple data sets of simulation data’. Primary Health Care Research and Development, 1: 79-89. Courtenay, M., Griffiths, M., (2005) Independent and Supplementary Prescribing-An Essential Guide, Cambridge University Press. Department of Health (2004) Extending Independent Nurse Prescribing within the NHS in England. London: The Stationery Office. Department of Health (2010b) Nurse Prescribing FAQ, http://tinyurl.com/367d5zx [Accessed on 20 April 2014]. Neighbour, R., (1987).The Inner Consultation: How to Develop an Effective and Intuitive Consulting Style, Lancaster: MPT Press. Neighbour, R., (2005) The Inner Consultation: How to Develop an Effective and Intuitive Consulting Style, Second Edition: Radcliffe Publishing Ltd National Institute for Clinical Excellence,(2013) Seborrhoeic dermatitis. Available on line http://cks.nice.org.uk/seborrhoeic-dermatitis [ Accessed on 20 April 2014] National Prescribing Centre (1999) Signposts for prescribing nurses-general principles of good prescribing .Prescribing Nurse Buletin1.National Prescribing Centre, Liverpool Nursing and Midwifery Council (2006)Standards of proficiency for nurse and midwife prescribers. Nursing and Midwifery Council. London Nursing and Midwifery Council (2008) Guidance for continuing professional development for nurse and midwife prescribers. NMC Circular 10/2008. Nuttall, D.,(2008).Introducing Public Health to Prescribing Practice .Nurse Prescribing 6(7):299-305. Pendleton, D., Schofield, T., Tate, P., (1984). The Consultation: An Approach to Learning and Teaching .Oxford: Oxford University Press. While, A.,(2002).Practical skills: prescribing consultation in practice. British Journal of Community Nursing 7(9):469-473. Yoshizumi, J., Harada, T.,(2008) ‘Wake sign’: an important clue for the diagnosis of scabies. Clinical and Experimental Dermatology (34)6 p 711-714.

Night World : Witchlight Chapter 12

They were all on their feet by now. Keller's early warning system was screaming hysterically. â€Å"I can't stand it anymore,† Diana hissed. â€Å"What's going on?† Just then, Nissa said in a quenched voice, â€Å"All right, we will. Yes. â€Å"Bye.† She carefully replaced the handset. Then she turned very slowly to face the others. Or not to face them exactly. She was looking down at the floor in an unfocused way that scared Keller to death. â€Å"Well, what is it?† Keller growled. Nissa opened her mouth and raised her eyes to look at Winnie. Then she looked down again. â€Å"I'm sorry,† she said. â€Å"Winnie, I don't know how to say this.† She swallowed and then straightened, speaking formally. â€Å"The Crone of all the Witches is dead.† Winnie's eyes went huge, and her hands flew to her throat. â€Å"Grandma Harman!† â€Å"Yes.† â€Å"But how?† Nissa spoke carefully. â€Å"It happened yesterday in Las Vegas. She was outside her shop, right there on a city street, in broad daylight. She was attacked†¦ by three shapeshifters.† Keller stood and listened to her pounding heart. Winnie breathed, â€Å"No. That's not possible.† â€Å"A couple of wolves and a tiger. A real tiger, Keller, not any smaller cat. There were human witnesses who saw it. It's being reported as some bizarre escape from a private zoo.† Keller stood rigid. Control, control, she thought. We don't have time for grieving; we've got to figure out what this means. But she couldn't help thinking about Grandma Harman's good old face. Not a beautiful face, not a young face, but a good one, with intelligence and humor in the keen gray eyes. A face with a thousand wrinkles-and a story to go with each one. How would Circle Daybreak ever get along without her? The oldest witch in the world, the oldest Hearth-Woman. Winnie put both hands to her face and began to cry. The others stood silently. Keller didn't know what to do. She was so bad at these emotional things, but nobody else was stepping forward. Nissa was even less good at dealing with emotion, and right now her cool face was sympathetic and sad but distant. Iliana looked on the verge of tears herself, but uncertain. Galen was staring emptily across the room with something like despair. Keller awkwardly put an arm around Winnie. â€Å"Come on, sit down. Do you want some tea? She wouldn't like you to cry.† All pretty stupid things to say. But Winnie buried her strawberry-blond head against Keller's chest, sobbing. â€Å"Why? Why did they kill her? It isn't right.† Nissa shifted uneasily. â€Å"Paulie said something about that, too. He said we should turn on CNN.† Keller set her teeth. â€Å"Where's the remote?† she said, trying not to sound rough. Iliana picked it up and punched in a channel. An anchorwoman was speaking, but for a second Keller couldn't take in what she was saying. All she could see were the words on the screen: â€Å"CNN SPECIAL REPORT: ANIMAL PANIC.† And the footage, rough video from somebody's camcorder. It showed an unbelievable scene. An ordinary city street, with skyscrapers in the background-and in the foreground ordinary-looking people all mixed up with†¦ shapes. Tawny shapes. About the same size she was in panther form, and sinuous. They were on top of people. Four of them†¦ no, five. Mountain lions. They were killing the humans. A woman was screaming, flailing at an animal that had her arm in its mouth to the elbow. A man was trying to pull another lion off a little boy. Then something with a white-tipped muzzle ran directly at the camera. It jumped. There was a gasping scream and for an instant a glimpse of a wide-open mouth filled with two-inch teeth. Then the video turned to static. â€Å"-that was the scene at the La Brea tar pits in Los Angeles today. We now go to Ron Hennessy, live outside the Los Angeles Chamber of Commerce†¦Ã¢â‚¬  Keller stood frozen, her fists clenched in helpless fury. â€Å"It's happening everywhere,† Nissa said quietly from behind her. â€Å"That's what Paulie said. Every major city in the U.S. is being attacked. A white rhino killed two people in Miami. In Chicago, a pack of timber wolves killed an armed police officer.† â€Å"Shapeshifters,† Keller whispered. â€Å"Yes. Killing humans openly. They may even be transforming openly. Paulie said that some people claimed to see those Chicago wolves change. She took a deep breath and spoke slowly. â€Å"Keller, the time of chaos at the end of the millennium†¦ it's happening now. They can't cover this up with a â€Å"private zoo† story. This is it-the beginning of the time when humans find out about the Night World.† Diana looked bewildered. â€Å"But why would shapeshifters start attacking humans? And why would they kill Grandma Harman?† Keller shook her head. She was rapidly approaching numbness. She glanced at Galen and saw that he felt exactly the same. Then there was a choked sound beside her. â€Å"That's the question-why,† Winnie said in a thick voice. Usually, with her elfin features and mop of curls, she looked younger than her age. But right now, the skin on her face was drawn tight, and her birdlike bones made her look almost like an old woman. She turned on Keller and Galen, and her eyes were burning. â€Å"Not just why they're doing it, why they're being allowed to do it. Where's the First House while all this is going on? Why aren't they monitoring their own people? Is it because they agree with what's happening?† The last words were snapped out with a vicious-ness that Keller had never heard in Winfrith before. Galen opened his mouth, then he shook his head. â€Å"Winnie, I don't think-â€Å" â€Å"You don't think! You don't know? What are your parents doing? Are you saying you don't know that?† â€Å"Winnie-â€Å" â€Å"They killed our oldest leader. Our wise woman. You know, some people would take that as a declaration of war.† Keller felt stricken and at the same time furious at her own helplessness. She was in charge here; she should be heading Winnie off. But she was a shapeshifter like Galen. And along with the ability to transform and the exquisitely tuned senses, they both shared something unique to their race. The guilt of the shapeshifters. The terrible guilt that went back to the ancient days and was part of the very fabric of Kellers mind. No shapeshifter could forget it or escape it, and nobody who wasn't a shapeshifter could ever understand. The guilt was what held Galen standing there while Winnie yelled at him, and held Keller unable to interrupt. Winnie was right in front of Galen now, her eyes blazing, her body crackling with latent energy like a small but fiery orange comet. â€Å"Who woke that dragon up, anyway?† she demanded. â€Å"How do we know the shapeshifters aren't up to their old tricks? Maybe this time they're going to wipe the witches out completely-â€Å" â€Å"Stop it!† It was Hiana. She planted herself in front of Winnie, small but earnest, a little ice maiden to combat the witch's fire. Her nose was pink and swollen, and she was still wearing those teddy bear slippers, but to Keller she somehow looked valiant and magnificent. â€Å"Stop hurting each other,† she said. â€Å"I don't understand any of this, but I know that you're not going to get anywhere if you fight. And I know you don't want to fight.† All at once, she flung her arms around Winnie. â€Å"I know how you feel-it's so awful. I felt the same way when Grandma Mary died, my mom's mother. All I could think of was that it was just so unfair.† Winfrith hesitated, standing stiffly in Diana's embrace. Then, slowly, she lifted her own arms to hold Iliana back. â€Å"We need her,† she whispered. I know. And you feel mad at the people who killed her. But it's not Galen's fault. Galen would never hurt anybody.† It was said with absolute conviction. Hiana wasn't even looking at Galen. She was stating a fact that she felt was common knowledge. But at the same time, now that she was off her guard, her expression was tender and almost shining. Yes, that's love, all right, Keller thought. And it's good. Very slowly, Winnie said, ‘I know Galen wouldn't. But the shapeshifters–â€Å" â€Å"Maybe,† Galen said, â€Å"we should talk about that† If Winnie's face was pinched, his was set in steel. His eyes were so dark that Keller couldn't distinguish the color. â€Å"Maybe we should talk about the shapeshifters,† he said. He nodded toward the kitchen table, which was still strewn with the parchments. â€Å"About their history and about the dragons.† He looked at Diana. â€Å"If there's any chance of-of a promise ceremony between us, it's stuff you ought to know.† Iliana looked startled. â€Å"He's right,† Nissa said in her calm voice. â€Å"After all, that's what we were doing to start with. It's all tied together.† Keller's whole body was tight. This was something that she very much didn't want to talk about But she refused to give in to her own weakness. With a tremendous effort, she managed to say steadily, â€Å"All right. The whole story.† â€Å"It started back in the days humans were still living in caves,† Galen said when they were all sitting down at the kitchen table again. His voice was so bleak and controlled that it didn't even sound like Galen. â€Å"The shapeshifters ruled then, and they were brutal. In some places, they were just the totem spirits who demanded human sacrifice, but in others†¦Ã¢â‚¬  He searched through the parchments, selected one. â€Å"This is a picture of a breeding pen, with humans in it. They treated humans exactly the way humans treat cattle, breeding them for their hearts and livers. And the more human flesh they ate, the stronger they got.† Iliana looked down at the parchment scrap, and her hand abruptly clenched on a tissue. Winnie listened silently, her pointed face stern. â€Å"They were stronger than anyone,† Galen said. â€Å"Humans were like flies to them. The witches were more trouble, but the dragons could beat them.† Iliana looked up. â€Å"What about the vampires?† â€Å"There weren't any yet,† Galen said quietly. â€Å"The first one was Maya Hearth-Woman, the sister of Hellewise Hearth-Woman. She made herself into a vampire when she was looking for immortality. But the dragons were naturally immortal, and they were the undisputed rulers of the planet. And they had about as much pity for others as a 7. rex has.† â€Å"But all the shapeshifters weren't like that, were they?† Iliana asked. â€Å"There were other kinds besides the dragons, right?† â€Å"They were all bad,† Keller said simply. â€Å"My ancestors–the big felines-were pretty awful. But the bears and the wolves did their share.† â€Å"But you're right, the dragons were the worst,† Galen said to Iliana. â€Å"And that's who my family is descended from. My last name, Drache, means ‘dragon.' Of course, it was the weakest of the dragons that was my ancestor. The one the witches left awake because she was so young.† He turned to Winnie. â€Å"Maybe you'd better tell that part. The witches know their own history best.† Still looking severe, Winnie thumbed through the parchment scraps until she found one. â€Å"Here,† she said. ‘It's a picture of the gathering of the witches. Hecate Witch-Queen organized it. She was Hellewise's mother. She got all the witches together, and they went after the shapeshifters. There was a big fight. A really big fight.† Winnie selected another piece of scroll and pushed it toward Diana. Diana gasped. The parchment piece she was looking down at was almost solid red. â€Å"It's fire,† she said. ‘It looks like-it looks like the whole world's on fire.† Galen's voice was flat. â€Å"That's what the dragons did. Geological records show that volcanoes all over the world erupted around then. The dragons did that. I don't know how; the magic's lost. But they figured that if they couldn't have the world, nobody else would, either.† â€Å"They tried to destroy the world,† Keller said. â€Å"And the rest of the shapeshifters helped.† ‘It almost worked, too,† Winnie said. â€Å"But the gathering of witches managed to win, and they buried all the dragons alive. I mean, they put them to sleep first, but then they buried them in the deepest places of the earth.† She bit her lip and looked at Galen. â€Å"Which probably wasn't very nice, either.† â€Å"What else could they do?† Galen said quietly. â€Å"They left the dragon princess alive-she was only three or four years old. They let her grow up, under their guidance. But the world was a scorched and barren place for a long time. And the shapeshifters have always been†¦ the lowest of all the Night People.† â€Å"That's true,† Nissa put in, her voice neither approving nor disapproving, simply making an observation. â€Å"Most Night People consider shapeshifters second-class citizens. They try to keep them down. I think, underneath, that they're still afraid of them.† â€Å"And there's never been an alliance between the shapeshifters and the witches,† Keller said. She looked directly at Diana. â€Å"That's why the promise ceremony is so important. If the shapeshifters don't side with the witches, they're going to go with the vampires-â€Å" She stopped abruptly and looked at Galen. He nodded. â€Å"I was thinking the same thing.† â€Å"Those animal attacks,† Keller said slowly. ‘It sounds as if the shapeshifters are already making their decision. They're helping to bring about the time of chaos at the end of the millennium. They're letting the whole world know that they're siding with the vampires.† There was a shocked silence. â€Å"But how can they decide?† Winnie began. â€Å"That's just it,† Nissa said. â€Å"The question is, is it just the ordinary shapeshifters who're doing it, or is it official? In other words, has the First House already decided?† Everyone looked at Galen. â€Å"I don't think so,† he said. â€Å"I don't think they'll make any decision yet, at least not in public. As for what they're doing in private, I don't know.† His voice was still flat; it made no excuses. He looked around the table, facing all of them. â€Å"My parents are warriors. They don't belong to Circle Daybreak, and they don't like the witches. But they don't like the vampires, either. More than anything, they'll want to be on whichever side is going to win. And that depends on which side gets the Wild Powers.† â€Å"I think they want something else,† Keller said. â€Å"like?† They want to know that the witches are treating them fairly and not just trying to use them. I mean, if they thought that Circle Daybreak had found the Witch Child but wasn't going to promise her to their heir, well, they wouldn't be happy. It's not just a matter of having a kinship bond with the witches. It's a matter of feeling they're being treated as equals.† Nissa's light brown eyes narrowed, and she seemed almost to smile. â€Å"I think you've summed it up very well.† â€Å"So what it all comes down to,† Keller said pointedly, â€Å"is what happens on Saturday night. If there's a promise ceremony, it means the witches have found the Wild Power and that they're willing to tie her to the shapeshifters. If not†¦Ã¢â‚¬  She let the sentence trail off and looked at Hiana. There, she thought. I've put it so plainly and simply, you can't deny it now. And you can't help but see what's at stake. Diana's eyes were like faraway violet storm clouds. Keller couldn't tell what she was thinking. Maybe that the situation couldn't be denied but that she herself wasn't involved. Winnie took a deep breath. â€Å"Galen.† Her face was still drawn and unhappy, but the burning anger in her eyes was gone. She met Galen's gaze directly. Tm sorry,† she said. â€Å"I shouldn't have said those things before. I know you're on our side. And I'm not like those people who don't trust the shapeshifters.† Galen smiled at her faintly, but his eyes were serious. â€Å"I don't know. Maybe you shouldn't trust us. There are things in our blood-you can't get rid of the dragon completely.† It was strange. At that moment, his eyes looked not only dark but almost red to Keller. Exactly the opposite of their usual golden-green. It was as if a light were smoldering somewhere deep inside them. Then Winnie abruptly extended her hand across the table. â€Å"I know you,† she said. â€Å"And there's nothing bad in your blood. I won't mistrust you again.† Galen hesitated one instant, then reached out with something like gratitude and took her hand. â€Å"Thanks,† he whispered. â€Å"Hey, if I were the Witch Child, I'd promise to you in a minute,† Winnie said. Then she sniffled, but her smile was much more like the old Winnie's smile. Keller glanced at Iliana almost casually and was riveted by what she saw. The girl had changed again. Now she didn't look like a princess or an ice maiden but like a very young soldier about to go into battle. Or maybe a human sacrifice who could save her tribe by jumping into a volcano. Her hair seemed to shine, silvery and pale, and her eyes were deep, deep violet in her small face. Her slight shoulders were back, and her chin was determined. Slowly, staring at something invisible in the center of the table, Iliana stood up. As soon as the motion drew their attention, the others fell quiet. It was obvious to everyone that something important was happening. Iliana stood there, her hands clenched by her sides, her chest rising and falling with her breathing. Then she looked at Galen. Finally, she looked at Keller. Tm not the Witch Child any more than Winnie is. And I think you know that by now. But†¦Ã¢â‚¬  She took a breath, steadied herself. Keller held her own breath. â€Å"But if you want me to pretend to be, I'll do it. I'll go to the promise ceremony with Galen-I mean, if hell do it with me.† She gave a half-embarrassed glance at Galen, looking shy and almost apologetic. â€Å"Will he ever!† Winnie said enthusiastically. Keller could have kissed her. Galen himself didn't rise to the occasion properly at all; instead, he opened his mouth, looking uncertain. Fortunately, Iliana was going on. â€Å"Then I'll go through with it. And maybe that will be enough for the shapeshifters to join with the witches, as long as they don't find out I'm a fake.† She looked unhappy. She was so adamant that for a moment Keller was shaken. Could it be she wasn't the Wild Power? But no. Keller knew she was. She just hasn't awakened her power yet. And if she continued to deny it, she never would. She said, â€Å"Thank you, Iliana. You don't know how much, how many lives you're going to save. Thank you.† Then the excitement got the better of her, and she took Iliana by the arm and gave her a sort of shaking squeeze of affection. â€Å"You're a trooper!† Winnie said, and hugged her hard. â€Å"I knew you'd come through all the time, I really did.† Nissa smiled at her with genuine approval. Galen was smiling, too, although there was something in his eyes†¦ â€Å"There's just one thing,† Iliana said a little bit breathlessly, rubbing her arm where Keller had gripped it. â€Å"Ill do this. I said I would. But I have two conditions.† Keller's excitement deflated. â€Å"Conditions?† â€Å"You can have anything you want,† Winnie said, blinking away happy tears. â€Å"Cars, clothes, books†¦Ã¢â‚¬  â€Å"No, no, I don't want things,† Diana said. â€Å"What I mean is, I'm doing this because I can't just stand around and not do anything when stuff like that is going on.† She shivered. â€Å"I have to do anything I can to help. But. I'm still not the right person. So the first condition is that while I'm pretending to be the Wild Power, you guys have somebody out looking for the real one.† Keller said smoothly, â€Å"I'll tell Circle Daybreak. They'll keep looking and checking other Harmans. They'll do it for as long as you want them to.† They would, too. It was a small price to pay. â€Å"And the other condition?† Keller asked. â€Å"I want to go to Jaime's party on Saturday.† Instant uproar. Even Nissa was talking over people. Keller cut short her own exclamations and gestured for everybody to shut up. Then she looked Diana dead in the eye. ‘It's impossible. And you know it's impossible. Unless you've found a way to be in two places at once.† â€Å"Don't be stupid,† Diana said. That small, determined chin was tight. â€Å"I mean before the promise ceremony thing. I want to go just for an hour or two. Because she's one of my very best friends, and she's gotten attacked twice because of me.† â€Å"So what? You're already making it up to her. You're saving her life and her twin brother's life and her parents' lives-â€Å" â€Å"No, I'm not. I'm faking being a Wild Power when I know it isn't true. I'm acting a lie.† There were tears in Diana's eyes now. â€Å"But I'm not going to hurt Jaime's feelings, and I'm not going to break my promise to her. And that's that. So if you want me to go through with your little charade, I'll do it, but I want to go to the party first.† There was a silence. Well, she's stubborn, I'll give her that, Keller thought. Once she decides on something, she absolutely won't be budged on it. I guess that will be helpful when the Wild Powers fight the darkness someday. But right now, it was simply infuriating. Keller drew a very long breath and said, â€Å"Okay.† Winnie and Nissa looked at her sharply. They hadn't expected her to give in so fast, and they were undoubtedly wondering if their boss had some trick up her sleeve.

The Symbols in the Tell-Tale Heart

01121133 A Professor: Introduction to English Literature and American Literature, Tue 78 Paper1: The Tell-Tale Heart Oct, 23, 2012 The Symbol in â€Å"The Tell-Tale Heart† According to the Norton Introduction to Literature, the definition of symbol is that† A symbol in a work of literature compares or puts together two things that are in some ways dissimilar. A symbol in literature usually carries richer and various meanings, as does a flag or religious image. And because of its significance, a symbol usually appears or is hinted at numerous times throughout the work† (Booth 209).Thus, symbols are used in literature to represent something more than the literal aspect itself. They can come in the form of phrases, colors, objects or events. Through this, the writer can effectively suggest unsaid ideas and meanings to the audience. The use of symbolism serves as clues by the author, to infer something more or a deeper meaning. Therefore, this essay is going to anal yze this story by interpret symbols appeared in the story â€Å"The Tell Tale Heart. † In the story, the narrator claims that he is not mad, but his behavior, thought and words tell a different story.The narrator is determined to kill the old man in the story, not because jealously or animosity but because â€Å"one of his eyes resembled that of a vulture- a pale blue eye, with a film over it† (Poe, The Tell Tale Heart). The narrator put the subjective feeling on the eye; the narrator said the old man’s eye is an â€Å"Evil Eye† (Poe, The Tell Tale Heart). An eye is covered by a veil or film; it symbolically means that the narrator has issue with the â€Å"inner vision†-what is commonly known as one’s outlook on the world. So our reading of the story is through the eye which is defined by the narrator.Then, when we read the story, we will be leaded by the narrator’ subjective feeling through what the narrator call an† Evil Eyeâ €  (Poe, The Tell Tale Heart). So, one of the old man’s eyes symbolizes the narrator’s world of the heart. According to The Tell Tale Heart, â€Å"I undid the lantern cautiously-oh, so cautiously — cautiously (for the hinges creaked) –I undid it just so much that a single thin ray fell upon the vulture eye. † We could know that the lantern in the story can be adjusted to as much or as little as you want, and the narrator keeps most of light hidden; only allowing one ray to escape.The narrator said,† I found the eye always closed; and so it was impossible to do the work; for it was not the old man who vexed me, but his Evil Eye† (Poe, The Tell Tale Heart). The narrator wants to kill the old man because of that eye, so the narrator could only kill the old man when the old man’s eye wide-opened; however, we could know if the old man opens his eye, he will know that the narrator is going to kill him. And, in the story, the narrato r keeps emphasizing that what the behaviors are done is so cautious and that the old man won’t find it. So, the ray from the lantern symbolizes the contradiction in the narrator’s heart.The bedroom is the place where we usually feel safe; most of the time, when we are on the bed, we are usually vulnerable because of a lack of sense of crisis. However, Poe write the bedroom as a dangerous place where might even be killed. It is defined as a burial. The biggest symbol in the story is all the contradictions which symbolize the narrator who is insane. We can see lots of contradiction in this story. First, â€Å"It took me an hour to place my whole head within the opening so far that I could see him as he lay upon his bed† (Poe, The Tell Tale Heart).It is really strange to spend an hour placing one’s head within the door. Second, â€Å"I undid the lantern cautiously-oh, so cautiously — cautiously (for the hinges creaked) –I undid it just so much that a single thin ray fell upon the vulture eye. And this I did for seven long nights –every night just at midnight –but I found the eye always closed; and so it was impossible to do the work; for it was not the old man who vexed me, but his Evil Eye† (Poe, The Tell Tale Heart). There are two contradict points in above sentence.One is that everyone should have a consciousness if there is â€Å"a single thin ray† fell upon our eyes; much less, the old man have been done like this lasting for eight days. The other one is that the narrator says that killing the old man only happens when that the old man’s vulture-blue eye is open. But if the old man opens his eye, he will know the narrator is going to kill him, also, when someone knows that you are going to be killed, you may scream or make some big noises or even some body reactions. In this way, this event may be found by others.According to the story, this kind of condition is not a result that th e narrator wants. So we can know these things are contradict. Third,† And the old man sprang up in bed, crying out –â€Å"Who's there? † I kept quite still and said nothing. For a whole hour I did not move a muscle, and in the meantime I did not hear him lie down. He was still sitting up in the bed listening† (Poe, The Tell Tale Heart). Generally speaking, after we say â€Å"who’s there? † we usually go check out what happens or keep sleeping if no one answer us. We won’t sit up in the bed listening for a whole hour.Fourth, â€Å"I knew that he had been lying awake ever since the first slight noise† (Poe, The Tell Tale Heart), and â€Å"although he neither saw nor heard† (Poe, The Tell Tale Heart). One says the old man heard something, the other one says he didn’t hear or see anything. These two sentences conflict to each other. Fifth,† the sound would be heard by a neighbor† (Poe, The Tell Tale Heart), and â€Å"it would not be heard through the wall† (Poe, The Tell Tale Heart). If the sound would be heard by a neighbor, it would be heard by a neighbor.If the sound would not be heard through the war, it would not be heard by a neighbor. So, we could know these two sentences conflict to each other. Sixth, â€Å"There was nothing to wash out –no stain of any kind –no blood-spot whatever† (Poe, The Tell Tale Heart). The narrator cut off the old man’s head, legs and arms. It is impossible that no blood is on the floor. To sum up, according those contradictions, we could suspect reasonably that the narrator is insane and the narrator doesn’t kill the old man, this whole story is imagined by the narrator.In conclusion, after reading The Tell-Tale Heart, we can know that this story is not only a horrible story, it also teach us every story might have some significant meanings behind them. Reading is not only to understand the meanings on the surf ace but also to think deeply and train our ability of analyzing mentally. We should not be afraid of those symbols, and we shouldn’t be frustrated by those symbols; we should try our best to think about what the writers try to tell us truly. Works Cited Booth, Alison and Kelly J. Mays, eds. The Norton Introduction to Literature. 10th ed. New York: Norton, 2010. Edgar Allan Poe, â€Å"The Tell-Tale Heart†