Boy Scouts and Militarism

Boy scouts movements are what we can consider embedded in the culture of many countries. The appeal of this youth movement had captured the attention of young boys worldwide. The Boy Scout movement had built a decent reputation of rearing young boys with admirable characteristics. This gained reputation is the very basis why the Boy Scout movement had become the largest youth-based organization in the world. When people hear of the term â€Å"Boy Scouts†, they associate it much with camping and other fun activities.According to founder of the movement, Robert Baden-Powell, the activities of the Boy Scouts are focused on developing physical and mental fitness, camaraderie, character, and citizenship. The program of the Boy Scout movement claims to be designed to help young people to develop self-reliance, courage, and integrity, among many other admirable traits (Elleke 12-15). The truth behind those stereotypes would not be questioned. What this paper would delve on is what ma ny admirers may had overlooked regarding the nature and the origin of the of the most influential youth movement.Many critics had argued that the Boy Scout movement can find its roots as being militaristic in nature. The concept of militarism may sound too radical when aligned with the seemingly innocent movement, who talks about having fun while aiming towards being better persons. But of course, criticisms would not be heard of if they are lacking solid and convincing basis. If the nature of the origin of the Boy Scouts movement would be reviewed, the possibility of militarism could be easily disregarded. It is beyond question that the Boy Scout movement is promoting very ideal yet admirable concepts for youths.But since there is lots of evidence that suggests militaristic beginnings, this paper would argue, as a reiteration to the arguments of forerunners with the same argument: that it is undeniable that the Boy Scout movement had started as an interest group that is based much on militarism. To springboard this argument, there is no need to look far from the word â€Å"Boy Scouts. † The term â€Å"scouts† alone would ring a military function. The term would suggest military functions that are closely related to information gathering and reconnaissance.IF we give much thought on this term, we could relate it to the incorporation of outdoor activities (e. g. camping, trekking) to Boy Scout programs. The movement claims that those outdoor activities are for developing self-reliance and survival in the wild. It is hard to dismiss the notion that these kinds of activities have resemblances to military training. The question of where would Boy Scouts could use this kind of training would certainly intrigue critics. It appears that knowledge of survival in the outdoors is not as practical as the movement promotes.Knowledge of survival in the outdoors is much useful in the context of war. Militaristic Origins Scouting can be traced back from the tim e of Robert Baden-Powell, a British lieutenant- general who founded the Scouting Movement. It all started and happened during the Siege of Mafeking, Second Boer War. Baden-Powell recruited boys with ages 12- 15 years old whom he eventually trained. From this situation, he founded the Boy Scouts, which is clearly seen to be a product of a militaristic movement. The roots of British Boy Scouts, on the other hand, can be traced from its foundation in May 1909.The organization was actually composed through members of Scout troops in the Battersea District. Although lacking of financial and human power support, the organization survived through various ways of generating these two important resources. To gain financial assistance, the organization pursued to get initial funds through acquiring sponsors. The members used the weekly page of the paper Chums to generate funds from their sponsors. To gain more members, the foundation spread the news of their existence in other parts of the Un ited Kingdom.However, in October of that same year, the British Boy Scouts was reconciled with Baden-Powell’s headquarters. They became the allied organization of Baden-Powell with Sir Francis Vane giving his assurances. That time, he is the Commissioner of Baden-Powell London. One proof that the British Boy Scouts originated from a military orientation is the incident that happened the following month. It was November 1909 when Sir Francis Vane suddenly made a schism right after he was ousted by Baden- Powell from the Scout Association.The two men actually have opposing views regarding the militarism and bureaucracy. Vane made strong arguments regarding Baden- Powell’s militaristic and political leadership over his headquarters staff. Here, the British Boy Scouts proved their support to Sir Francis Vane. They came with Sir Francis Vane in his schism and chose him to be their leader. From this point, The British Boy Scouts expanded its connections and alliances through founding another organization in the early 1910—the National Peace Scouts. It was actually a joined organization with the Boy’s Life Brigade.From a small organization, the British Boy Scouts, late known as Brotherhood of British Scouts, expanded through forming some allies with other countries such as the United States, Hong Kong, Italy, South Africa, Australia, Indi, New Zealand, and South America. It was then called The Order of World Scouts in 1911. From a small organization, it expanded to 12 countries. (Jeal 428) However, The Order of World Scouts suddenly declined and eventually made its downfall when Sir Francis Vane got involved with bankruptcy, making the Brotherhood of British Scouts fell back as a domestic, small organization. The presence of militaristsIn 1910, fifty- six percent of the 250 Presidents and Commissioners, a total of 140 men, were identified as military officers, whether serving or retired (Springhall, 939-940). With this huge militaristic pr esence in the government, the Boys Scout Association can be given doubts as the organization that acts as front for further military ambitions. Involvement of the youth in war In Baden-Powell’s book entitled Scouting For Boys, one chapter discusses marksmanship which is said to be the same with patriotism (Baden-Powell 322). When World War 1 exploded, the scouts were used as auxiliary assistance of the war.Moreover, those who ages fifteen to seventeen could undergo special trainings in basic infantry techniques, entrenching, shooting, and signaling. In addition, a specific cadet corps called Mafeking Cadet Corps helped military missions through transmitting messages, decreasing the duties of the military men while providing the boys with something to do during the siege. The Mafeking Cadet Corps composed of young boys was of great help to the military during the siege in 1899 to 1990. Similarities to militarism The resemblances between the Boy Scout movement and groups with m ilitaristic nature are very striking indeed.The similarities between the two would go beyond similarities in their appearance. Boy Scouts are sporting uniforms that could only have been inspired by military uniforms. But more striking is the use of badges to determine ranks or seniority. The concept of â€Å"badges† could be interpreted as one of the drawbacks of the design of the program of the Boy Scout movement. Boy Scouts could be trained and condition to think that everything they do must translate to merits. This could be more than contradicting to the movement’s preamble that is seemingly altruistic.Many critics had posted the striking similarities, even in the design of Boy Scouting badges to those that the military forces are using. It could also be included that the Boy Scout movements also conduct flag ceremonies in an almost religious manner. Only the military forces practice such religiosity towards nationalistic practices like the flag ceremony. The desig n of conducting flag ceremonies, in relation to the argument that Boy Scouting involves much militarism could have been for re-instilling nationalistic thoughts in the minds of young people.In Baden-Powell’s book, Scouting For Boys, he had something that could be relatively too hard to absorbed by young people, but not of young people under militaristic training â€Å"be prepared to die for your country is it need be, so that when the moment arrives you may charge home with confidence†¦Ã¢â‚¬  The most notable part of his line was targeted to young Boy Scouts â€Å"†¦not caring whether you are going to be killed or not† (Baden-Powell 331-332) For Baden-Powell, the ideal citizenship involves being preparedness for the possibility of death while serving the country.Those lines could be closely associated to what military personnel say all the time, like they are brainwashed or something, especially when they are set to fight in a war. Even the seemingly innoce nt practices of Boy Scouts like songs, chants, and marching finds its roots to military influences. Almost all Boy Scout song and chants have similarities to those of the military forces. There striking similarities in terms of cadence, melody, and content.There is no need to expound on marching as being military influenced. That just requires an open-and-critical mind dashed with even the slightest common sense. Moreover, the similarities go beyond appearances between Boy Scouts and the military. Even the internal design of the Boy Scout program seems to follow militaristic thinking. During the early years of the Boy Scout movement, the divisions of the early version of the Boy Scout movement have very explicit similarities to the way military forces are organized.It was like there is a corresponding branch within the Boy Scout movement to branches of the military forces. In 1912, there was the Sea Scouts, during World War 2 there was the Air Scouts of 1940 (Vane 19). In the founda tional book â€Å"Scouting For Boys†, there was a whole section dedicated for the discussion of the Navy and the Army (Baden-Powell 328-330) Misleading design Militaristic qualities are ever present and obvious at the Boy Scout movement. Yet advocates of the movement persistently dispel the argument that the movement is in anyway militaristic.Their first line of defense was the seemingly innocent and politically stripped words of Robert Baden-Powell (see introduction of this paper). But many critics view Baden-Powell’s design as misleading and leaning towards militaristic ideals. One point of argument by the movement’s critics is that misleading leanings set by Baden-Powell. The founder of the movement claims that Boy Scouts are aiming for high morality. According to critics, that kind of design is also employed by other misleading organizations such as when the pacifist group Boys Life Brigade aiming at â€Å"saving lives.† (Foster) One of the most popul ar interpretations of the Boy Scout movement as a whole is by former president of the United States, Theodore Roosevelt. His comments are devoid of any leanings, but still it provides good material for this discussion â€Å"†¦it does not try to make soldiers out of Boy Scouts, but tot make boys who will turn out as men to be fine citizens, and who will, if their country needs them , make better soldiers for having been scouts† (Roosevelt) A critic had analyzed Baden-Powell’s words to his publisher in 1901.Baden-Powell’s words are â€Å"if you want to ensure peace let them see you are prepared for war†¦Ã¢â‚¬  That alone could paint a militaristic interpretation, yet Baden-Powell added and pertaining to the Boy Scoutsâ€Å"†¦a wise and practical organization of the splendid material lying ready to our handsâ€Å" (Adams 123) The critic had concluded that the real motive behind the creation of the Boy Scout movement is to provide additional defen se for the British military. (Foster) Conclusion The Boy Scout movement started as an organization that has an altruistic mission of helping young people.But political opportunists had recognized the potential of the growing movement. And by their power and influences, they had managed to create a seemingly innocent movement that has subtly incorporated militaristic traits. Moreover, the Boy Scout movement can not deny the fact that their origins are of militaristic nature. Even the founder of the movement had come from the military. It is just understandable that he may incorporate militaristic ideals in the formulation of the organization that he had started.Having a militaristic origin does not reflect negatively on the Boy Scouts of today. What is the most efficient way to do is to separate negative and positive traits from militarism. They should reject negative militaristic traits like leanings towards war. More importantly, preserve positive militaristic traits like high-leve ls of discipline and nationalism. Works cited Adams, William Scovell . Edwardian Portraits. UK: Secker and Warberg. 1957 Baden-Powell, Robert. Scouting For Boys: The Original 1908 Edition.Dover Publications ,Incorporated. 2007 Boehmer, Elleke (2004). Notes to 2004 edition of Scouting for Boys. Oxford: Oxford University Press. Elleke, Boehmer. Notes to 2004 edition of Scouting for Boys. Oxford: Oxford University Press. 2004 Jeal, Tim, Baden-Powell, Hutchinson. The Vane Rebellion Pages. 1989 Michael Foster. MILITARISM AND THE SCOUT MOVEMENT. Scout History Association. 17 April 2008 Vane, Sir Francis. The Boy Knight, The Council of the National Peace Scouts. 1910

An Arguement Against Peter Singer’s Famine, Aflunity, and Influence

In his paper â€Å"Famine, Affluence, and Morality† Peter Singer argues that a lack of benevolence from affluent countries to people suffering from poverty in other countries is unjustified and is comparable to doing nothing if one sees a baby drowning in water a few feet away. In the following paper I will discuss how residing in an affluent country does not put individuals under obligation to donate, and the efforts that are already made by individuals and governments in affluent countries are sufficient enough to be considered benevolent.I will present the following arguments to provide reasoning for this. First I will explain how singers drowning baby analogy fails to make a proper comparison to donating. Second, I will show how the assumed responsibility that affluent country should give to the needy is flawed. Third will discuss how donating may actually be counterproductive in the long term. Lastly I will give a comparison towards donating to poverty is no better or mor e beneficial to donating to crime prevention.The main concern addressed in this essay is the analogy Singer makes when he compares the ease of saving a drowning baby to the ease of making a donation to a country in poverty (Singer, par. 6). Singer’s analogy is only correct on the basis that the baby and people living in poverty are both in circumstances out of their control. The difference though, is that the baby he describes is moments away from death, while people living in poverty are mostly not on the brink of death. I believe the vast majority of people would save the baby, yet only a small percentage of people will take the time to donate.Furthermore, I rule out Singer’s argument for proximity (par. 8). Walking around a city like Toronto, one may walk right past homeless people in very dire circumstances, and many people still do not bother to give any assistance. Thus, since being in a very close proximity will usually not yield a donation, in most likelihood, witnessing someone very close to death is probably the best way to evoke enough emotion for an individual to make a donation. Another flaw in Singers paper is that he makes the argument in his thesis that affluent countries should be responsible for countries that are in poverty (par. 3).By being in a â€Å"global village† as singer puts it, then a logical thing to do is donate to country that has the most poverty. Looked at another way we already donate through the government. Foreign aid comes from our tax dollars. So, in essence we are donating, but the government takes care of all the work. I call this the apathetic donor. In contrast though, Canada is considered a very affluent country yet still has small but significant part of its population below the poverty line. An argument could easily be made that a priority should be placed towards the homeless and people living below the poverty line within Canada first.Once dealt with properly, giving the remains out to the res t of the needy world will follow. If Canada cannot take care of the suffering within its own borders, then its priorities should be reviewed. Lastly, if I was forced into a situation to give to a Canadian living in poverty or someone in a foreign country I would place a priority on someone within Canada. A consequence of giving to countries in poverty may actually cause more poverty. Singer claims that the morally right thing to do is to avoid suffering (par. 6).Yet, by donating to a country in need of food that has a significantly fast population growth rate will lead to future famine. The world simply cannot sustain continued population growth. For example Pakistan has a significant part of its population living in poverty and has a high birth rate. At the same time Pakistan has a space program in place. As a result it appears that Pakistan finds space technology is more important than feeding its poor. Additionally, many nations in Africa have been getting foreign aid for decades yet most of these countries remain poor.If donations must be made, the most good that can come from it would be to see my money go towards helping a government get itself prioritized, and certain that the money goes to where it is intended, not the corrupt politicians or leaders that have no care for the suffering. A fair extension of Singer’s argument would be to donate money to stopping violent crime or terrorism around the world. Crime results in the death of good and innocent people just like famine. Also, many people are born into crime countries or situations out of their control much like poverty.Dealing with organized crime in a poor country would certainly save lives, just as dealing with poverty. Also, an individual would be more motivated to take action to donate through fear than sympathy. As noted previously, seeing my money go towards a controllable situation such as crime within my own country of Canada would be a more worthwhile and pragmatic investment. Dona ting to crime prevention in Canada would naturally have a much more beneficial effect for me than giving my money to a foreign nation.Essentially various forms of any crime left unabated in Canada are more likely to spread out affect me at home than a person in poverty in a foreign country. In conclusion, I believe the reasons given refuting Peter Singer’s paper show that donating to people in poverty, and the need to change our moral conceptual scheme is unnecessary in our affluent society. His attempt to evoke an emotional and sympathetic response in the reader by describing the mental image of a drowning baby only hurts his attempt to convince a rational person to donate.Also, if I do choose to donate, does this make me less charitable to donate to someone within my own country, while there may someone needier in another country? Is donating at all even justifiable? especially when some countries only seem to be getting worse off with runaway birthrates, and with corrupt l eaders not doing what’s best for their nation. If I was forced into a situation to choose between putting aside money for myself, my family’s future, or giving it to someone whom I’ve never met in a situation less desirable than mine, the choice is easy and clear.

Business Management and Leadership Personal Statement - 1

Business Management and Leadership - Personal Statement Example While working as an event specialist for Jamaica Chamber of Commerce, I have to handle and manage various financial statements by using the software such as Excel and Quikbooks. The business of Jamaica Chamber of Commerce mainly deals with renting space to those clients or businesses that intend to host any sort of event that may include birthday parties and bridal showers among others. One of my chief roles along with responsibilities as an event specialist in this business is to organize events for the customers and also closing contracts on a weekly basis. Apart from this, I also work as a college assistant at York college. In this job profile, my main tasks are to handle purchase requisitions and also handling e-mails for the department of student activities of this college. Thus, by taking into concern the above discussed tasks that I perform, the online Master’s degree of Business Management and Leadership (M.S.) program would prove quite beneficial for me. This can be j ustified with reference to the fact that the above mentioned core business areas on which the stated online program mainly focus upon will make me to learn and acquire in-depth understanding about how to conduct such activities efficiently within a definite timeframe. From the very beginning, I had a keen interest to work in Army and for that I am currently attending officer candidate school in the Army National Guard. I have certain targets to accomplish in the future. One of such targets is to become a Financial Officer in the Army and thus, I expect that the online Master’s degree of Business Management and Leadership (M.S.) program would guide me to fulfill such target. The fulfillment of such target matters a lot for me owing to the reason that it would make me to realize my own job responsibilities and also enable me to take better professional decisions. There lay certain

Your Painter Essay Example | Topics and Well Written Essays - 250 words

Your Painter - Essay Example Now the unit price of the commodity rises to P2 from P1 and at that price the quantity of that commodity declines to Q2 (This follows from the generally accepted law of demand that a rise in price of a commodity will mostly result in the decline in the demand of the same) (Mankiw, 2008). If ?P denotes the change in price or rise in the same then ?P = P1 – P2; similarly if ?Q refers to the change in the quantity demanded or decline in the same then ?Q = Q1- Q2. Now if Ed refers to the price elasticity of demand then Ed = (?Q/Q1)/ (?P/P1). In the given economic problem, on the quantity demanded side, Q1 = 35 gallons of paint, Q2 = 20 gallons a month. On the other hand the price of the paint was initially $3.00/gallon that is P1 = $3.00 and the price of the paint raised to $3.50/gallon, hence P2 = $3.50. Following the paragraph above, ?Q = (35 - 20) gallons = 15 gallons. Similarly ?P = $(3 – 3.5) = - $0.5. If now we put all these data into the equation that we have mention ed for price elasticity of demand we will find – Ed= (?Q/Q1)/ (?P/P1) = ?Q/Q1 X P1/?P = 15/35 X 3/-0.5 = - 3/7 X 6 = - 2.57 (approximated) Here the price elasticity of demand has been determined at – 2.57, that is less than – 1. Following the price elasticity of demand we classify goods as elastic or inelastic. If the price elasticity of demand is 0 then any rise in the price will not affect the quantity consumption of the commodity.

Australian Media Essay Example | Topics and Well Written Essays - 1750 words

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Human Rights Portfolio - Essay Example With the help of this industry, most of the young dwellers of the area, this previously did not have any job and thus no means to feed their family and themselves, would now be able to survive by providing labor in this industry. Now suddenly Government wakes up and says that since the environment will get polluted because of the industrial wastes produced by this industry therefore any operation of this manner should not be initiated. There definitely is a trade off between the two human rights- the right to food and the right to good environment. The former being the inherent right and the latter being contingent. But clearly, the right to food over here must be given preference over the right to environment. The primary responsibility of the Government here is to safeguard the right to food for its citizens and there by providing an alternate solution to stopping the work of the industry. The alternate means could be any of the plantations of more trees as an initiative by the Gov ernment or by the industry upon the directive of the Government. The Government should also give utmost care to proper disposal of industrial wastes by any such operation, but should not stop the operations of the industry which is providing the basic necessities of livelihood to the citizen. While there are human rights which I think are really inherent (right to food, clothes and shelter) there are several others which I think are continge... 1) Nations which provide most of the inherent as well as contingent rights to their citizens. These are generally the economically developed nations of the World. Not only most of the citizens have access to food, clothing and shelter but also they have the access to good quality of these basic necessities. Proper laws are in place to punish the individuals andor companies which are involved in malpractices related to tempering of the quality of the basic necessity. 2) Nations which provide most of the inherent rights to their citizens but are not able to provide the contingent rights. These are generally the developing nations of the world. 3) Nations which provide neither the inherent nor the contingent rights to their citizens. These are generally underdeveloped nations of the world. Seminar 2: Compare the dangers posed by, and the argument of necessity, regarding drug dealers, human traffickers and terrorists. Necessity is one of the major excuses those criminals across the globe have been using most of the times, as a deterrent to avoid severe penalty. Needless to say, in some of the cases, they are even able to dupe the law thereby avoiding the strictest of punishments. For heinous crimes, any argument of necessity should not be given any heed else it will be a severe deterrent against the path of justice. With the presence of the clause of necessity, the criminal, even after committing the atrocious act, still have a room of escape based on the prudence of the jury of a particular country. A drug dealer may resort to an excuse in which he says that due to economic crisis of his family, he had to resort to such a heinous crime and may seek to smaller punishments like getting jailed for a few years. After the tenure of the punishment is

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Cloud computing - Research Paper Example This paper presents an analysis of cloud computing services and its value propositions in the context of a cloud computing vendor. In this scenario, I have chosen AT&T business for the analysis of their potential cloud services and value propositions. AT&T carries on quickly developing its cloud computing services to demonstrate characteristics similar to Amazon Web Services. Nowadays, it is proclaiming Synaptic-Compute-As-a-Service solutions. These solutions present processing a capability that can be used for â€Å"cloud-bursting† of in-house applications or for a testing and development technology based platform. Additionally, the cloud technology based service can be executed like a public cloud, or as a private cloud computing architecture on AT&T’s communication network based infrastructure, which will be linked to a client data center through AT&T’s network (Bradley, 2009; Data Center Knowledge, 2009). In addition, this innovative solution expands AT&T’s cloud computing portfolio, which as well comprises AT&T Synaptic web based hosting: basically a completely controlled hosting species presenting cloud technologies based solutions as well as Synaptic-Storage-As-a-Service. Additionally, by providing computer services and storage, AT&T desires to control its recognizable brand as well as communication network to compete with corporations searching for a comfort level using cloud computing (Bradley, 2009; Data Center Knowledge, 2009). Moreover, the AT&T’s cloud computing based service, which is known as AT&T Synaptic-Computer-Services, offers on-demand CaaS or computing-as-a-service. Additionally, the cloud structure of AT&T technology is based on the Sun Open Cloud Platform as well as making use of Sun Cloud APIs in combination with a VMware virtual architecture. In this scenario, the AT&T communication cloud is a great deal more

Sacrificing Gaddafi Speech or Presentation Example | Topics and Well Written Essays - 1500 words

Sacrificing Gaddafi - Speech or Presentation Example One would require a strong motive to do sacrifice. Sacrifice can be positive too if it brings positive benefits as a result. Gaddafi had been oppressing and subjugating the Libyan people, We can no longer live under this evil subjugation, sacrificing Gaddafi would bring positive results. Libya is not like Tunisia or the Egypt it is place which is completely different. In case of distraction it would just split in to several other states. These were the words of son of Gaddafi on the Libya TV on Sunday. Of course he is very right as Libya is neither Egypt nor it is Tunisia. It is a country that is over 600,000 sq. miles and is populated by less than even 7 million. Since, the 1969, it has been the victim of single leadership, a man who has treated it mercilessly by showing cruelty to anyone who speaks against him or the revolution or the regime he was governing. It is a country that is built over the importance of tribal unity though despite the largest oil reserves in Africa, it cont inues to permit two third of the citizens living under poverty lines. It is a unique country that cannot boast much of its positive bilateral relations with the west or the Europe, as it has only recently made amendments in its relations with the neighbors across the Mediterranean after many years of US and UN imposed sanctions. (Gaddafi: Africa's king of kings) After the cold in 2004, the Europe ties then developed for better. As could be seen Libya became the third biggest oil supplier to European countries, having in the recent years surpassing Saudi Arabia even. The proximity to Europe, relative lack of foreign investment, unexplored terrain gave Libya a deep value a worth of gem equivalence especially for the oil dependent economies of west. (Gaddafi's personal website) The fact that the leader may publicly hang the dissident students was of no greater concern as long as the philosophy of intolerance had extended to, adequately suppressed, the supposed "threat" of Islamism. Sti ll the recent events have just forced world leaders to just re- examine the relationship with the distorted regime. Accounts of the unprovoked sniper attacks on the peaceful demonstrators, use of the violent foreign mercenaries as means of the crowd control, live ammunition being shot in to crowds of protesters, along with the media black-out that tried (un-successfully) to prevent world from finding out the truth This has brought about fresh focus and attention to plight of the Libyan people along with the reaction of their in-humane leader.(Freedom 2011) As he had addressed the nation, Gaddafi’s feebly masked threats were then received angrily by the protesters in the streets. His claims in regard to the celebrations of people of Darnah, Benghazi and al-Bayda were brought about by drunk and drugged youngster led to the furious chanting plus jeering against the Gaddafi and his son. Gaddafi’s warnings of possibility of civil war and separatism evoked slogans emphasizin g the unity of Libyan people and their intention to support one another till they achieved victory.( A new flag flies in the east) The strengthened protest is one of the case in point. Having been silent for a specific period or the beginning periods the Libyan people then made it to the streets in much of the increasing numbers their final destination became the presidential house. However, the difficulties have gone beyond this. Reports of helicopters bombing protestors as well as forcing them out of city centre apartment blocks in order to make room for snipers are also confirmed by those very people who were on the ground. If one watches from their house they could find Saif’

Final research paper Example | Topics and Well Written Essays - 1250 words

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Midazolam & Seizures Essay Example | Topics and Well Written Essays - 250 words

Midazolam & Seizures - Essay Example Midozolam increases the activity of GABA which gives a calming effect to the user. It also relaxes the skeletal muscles and result in sleep. The chemical in the medicine called benzodiazepines bind to the receptors of GABA which enhances the effect of GABA by increasing the frequency of chloride channel opening. According to (Silver,1994,pg 350-60) â€Å"Midazolam is a potent imidazobenzodiazepine used as a premedicant and as an anesthetic induction Agent†.Midazolam is likely an agonist at both BZ1 and BZ2 receptors. Its performance at PBRs is not certain. The quick encephalopathic effects ofmidazolam may be connected to the trizolam like potency and lipophilicity of midazolam. Which are greatest among thebenzodizepines. Midazolam may also exert some anticholinergic activity. Silver, T, 1994. SCIENTIFIC ARTICLE Evaluation of two dosages of oral midazolam as a conscious sedation for physically and neurologically compromised pediatric dental patients. Pediatric Dentistry, 16/5,

Academic Success Essay Example for Free

Academic Success Essay No matter where you are in your life continuing your education can be a challenge. Being able to juggle all your responsibilities can be very hard, but it is one of the keys to success. Everyone strives to be successful in every aspect of their life. You must know what you want to accomplish and be able to create a guided plan to have the best results. Making sure to stay organized and set your priorities in line, will lead to ultimate success. The ways I plan to continue my academic success is by setting educational goals, perfecting my writing process, applying my learning style, and the importance of academic integrity. Goals Setting goals is a very important step to take in your life. It helps with the drive to continue school and the ability to obtain a lasting career. My educational goal is to finish with high academic honors at the end of my courses. Staying on top of my homework will not only have me stress free but will keep me on top so I do not fall behind. Falling behind on schoolwork can be devastating to my grades. Having a set career goal will keep you motivated and give you the drive to be successful. I plan to start off my career in an entry level position and work my way up to a top paying position. Having a top paying job that I enjoy doing, will allow me to be able to provide or my family. (Stratton, R. K. (2005). Writing Process The writing process is a critical part of having success in your education and your career. Perfecting the writing process while continuing your education can be very challenging in many ways. The writing process is broken down into steps to help ensure success; they are topics, subtopics, outline, thesis, rough draft, and final draft. By mastering these steps it ensures you will be successful. Many jobs now require e-mail and written  communication as a prime source of communication. Being able to communicate effectively will help increase a customer’s experience which in turn helps the business become more successful. (Hansen, n.d.) Critical Thinking Critical thinking can be used in all aspects of a person’s life. There are different steps and also different ways in which you can apply critical thinking. Critical thinking focuses on deeper learning, helps with problem solving, and helps a person explore many issues, ideas, and events before having an opinion on a topic or issue. There are many steps to the critical thinking process, remembering, understanding, applying, analyzing, evaluating, and creating ( Ellis, D., Toft, D. (2015). When applying these steps in the order it will help in the critical thinking process. A lot of people use critical thinking on a day to day basis without even considering they are actually using it. The first step of critical thinking is remembering, it is consisted of reading, listing, and defining. The second step of the process is understanding which is demonstrated, group, outline, and describing the events or issues. The next step is applying which can be accomplished by discussing, explaining, and is used to produce your desired results. Classifying, determining, and comparing and contrasting make up the fourth step which is analyzing. Once done analyzing a person can then begin evaluating. Evaluating helps rate truth, judge effectiveness and rank-issues of facts in order. The last step is creating, in this step you organize your thoughts, plan, also you can agree or disagree on a topic. ( Ellis, D., Toft, D. (2015). Responsibilities You use critical thinking on a daily basis in all aspects in your professional career. When thinking about being at work on time, being prepared for daily tasks, and executing them properly you are demonstrating how to use critical thinking in the work place. Critical thinking is also used for responsibilities to society which is called societal responsibility. There are many ways to positively impact your society like paying your bills on time. Keeping your yard clean, recycling, and keeping up with household projects also applies to societal responsibilities. Sending your kids to school to learn and get a great education would be a positive influence on society. It is very important to keep your  professional and societal responsibilities at a positive level to have the greatest impact. Resources There are many great resources that are available on the University database. The course syllabus is made available to help you stay on task and make sure your assignments are completed and turned in on a timely manner. Instructor’s classroom policies are shown to make certain every student knows the rules to follow set by the individual instructors. Phoenix Connect is provided so students can come together to provide feedback and tips to new and seasoned students. The libaray is a great source to use and find resources like articles and books to help with your research. The Center for Writing Excellence has a great tool, the plagiarism checker and the resource generator, which helps with small errors and saves you time. There are many benefits and challenges associated with using outside sources. You have to make sure the sources are creditable to ensure proper information is given. It helps with providing different points of view from various people. With internet so popular in today’s time students have many ways to get great information at the tip of their fingers. Learning Style Knowing your personal learning style can help you advance in everyday life. My personal learning style is Interpersonal, mode 3. I am an active learner, hands on activities is where I excel the most. Mode 3 learning is consisted of testing ideas, being able to practice what you learn, able to thrive with well-defined tasks, and problem solving. An interpersonal learning needs to be provide with constant feedback to demonstrate success. An individual with this learning style is often found in medical fields and IT positions. Knowing your learning style will help you advance in your educational learning. Conclusion Having your educational and career goals in place with a determined outcome will help you advance in all aspects of your life. Perfecting the writing process will help you with resumes, papers, emails, and provide you the tools to be able to communicate effectively. Also making sure you use all the resources given to you that are right at your fingertips. All of these combined will ensure you are able to achieve the highest level of success.   References Stratton, R. K. (2005). MOTIVATION: Goals and Goal Setting [University of Phoenix Custom Edition eBook]. Reston, United Kingdom: Taylor Francis Ltd.. Retrieved from ProQuest Central, GEN480 Interdisciplinary Capstone website. Hansen, K. (n.d.). Quintessential Careers. Retrieved from http://www.quintcareers.com/writing_skills_on_job.html Ellis, D., Toft, D. (2015). Becoming a Master Student. Retrieved from The University of Phoenix eBook Collection Database.

Literature Review About IPS And IDS Computer Science Essay

Literature Review About IPS And IDS Computer Science Essay In this chapter is to provide the study and review about Intrusion Detection System and Intrusion Prevention System which have done by expert and professor. According to (Tony Bradley, 2004), intrusion detection system (IDS) is to monitor traffic and monitor for suspicious activity. And it will give alerts to network administrator and the system. And IDS also will respond to malicious traffic by taking action to block the user or the IP address from accessing to the network. According to (Ameya Talwalkar, Symantec Manager of Intrusion Prevention Systems), Intrusion Prevention System (IPS) is a protection technology to provide security of the network. It is the front line to defence against malware, Trojans, Dos attacks, malicious code transmission, backdoor activity and blended threats. The next section will present the details of Intrusion Prevention System (IPS). Figure 1.1 is the flowchart of the key points in literature review about IPS and IDS. What is IPS What is IDS Literature review What is HIDS What is HIPS What is NIPS What is NIDS Identify Pros Cons Which are better to prevent threats Figure 1.1: Classifying the literature review 2.2 Intrusion Prevention System (IPS) There are some benefits have been justified Intrusion Prevention System as a breakthrough in the computer security. According to (Neil Desai, 2003), the main supporting idea on technical side of Intrusion Prevention System is inline network-based system. Besides that, there also have another variation of IPS which is called Layer 7 switches that have include detection and migration of Distributed Denial-if-Service attack (DDoS) and Denial-of-Service attack (DoS) based on awareness of the traffic. Every Intrusion Prevention System will generate alert based on policy or signature and they also will initiate a response which have been programmed into the system. These aleart will happen as a result for a signature match or violation of uniqueness. Secondly, according to (Benjamin Tomhave, 2004) there have a reports have identifies most of the Intrusion Detection System also have been include Intrusion Prevention System capabilities. It given a good defines set of signature or policies. So it makes sense for Intrusion Detection System work with Intrusion Prevention System capabilities. At the end, a successful deployment and the return on the investment will directly relate to how well to manage the solution and how well the network has been design. Thirdly, according to (Joel Esler, Andrew R.Baker, 2007) stated that Intrusion Prevention System are more in defence. It has been design to detect malicious packets inside the normal traffic and stop intrusions dead. And automatically block all the unwanted traffic before it bring any damage to the system rather than giving alert before or after the malicious packets have been delivered. Fourthly, Intrusion Prevention System has been added to existing firewall and antivirus solution. According to (Karen Scarfone, Peter Mell, 2007) Intrusion Prevention System is to monitor traffic and automatically drop the packets which has included malicious, scrutinizing suspicious sessions or taking other actions in immediate real time response to an attack. A good Intrusion Prevention device will check all inbound and outbound traffic. It can check on all types of packets and performs many type of detection analysis, which is a not only individual packet. It also needs to check on traffic pattern, view each of the transaction in the context of the packets come before and after. Lastly, Intrusion Prevention System product should take the advantages and implement some new detection technique and offer other type of intervention method. According to (Joel Esler, Andrew R.Baker, 2007) Intrusion Prevention System products should provide multiple modes of operation for user to choose, so they can become more confident in the product or change their network security policies. There are two types of ISP which are HIPS and NIPS. Host-based Intrusion Prevention (HIPS) is an application which monitors a single host for suspicious activity. Network-based Intrusion Prevention (NIPS) is to analyze protocol activity on the entire network. The next section will discusses about HIPS and NIPS. 2.2.1 Host-based Intrusion Prevention System (HIPS) According to (Dinesh Sequeira, 2002), Host-based Intrusion Prevention System is a software program install on individual system such as laptop, workstations or servers. When it detected an attack, the Host-based Intrusion Prevention System will block the attack at network interface level or tell the application or operating system to prevent the attack. Secondly, according to (NSS Group, 2004) Host-based Intrusion Prevention Systems relies on agents installed directly on the system being protected. Host-based Intrusion Detection Systems are binds closely with the operating system kernel and services, monitoring and intercepting system calls to the kernel or APIs in order to prevent attacks as well as records them. It may also monitor data streams and the environment specific to a particular application (file locations and Registry settings for a Web server) in order to protect these applications from generic attacks which signature has not yet exists in the database. Lastly, according to (Neil Desai, 2003) Host-based Intrusion Prevention Systems are used to protect both servers and workstations through software that runs between the systems applications and OS kernel. The software can be reconfigured to determine the protection rules based on intrusion and attack signatures. The Host-based Intrusion Prevention Systems will catch suspicious activity on the system and then, depending on the predefined rules, it will either block or allow the event to happen. At the next section, we will discuss about Network-based Intrusion Prevention (NIPS) and intrusion detection system (IDS). 2.2.2 Network-based Intrusion Prevention System (NIPS) Network Intrusion Prevention Systems (NIPS) are totally operating on a different concept which serves the purpose to build hardware or software platforms that are designed to analyze, detect, and report on security related events. Network Intrusion Prevention Systems are designed to inspect traffic and based on their configuration or security policy, they can drop malicious traffic as well as prevent the network from being contaminated with malicious data such as virus and worms. Network-based Intrusion Protection System able to detect malicious packets which are design to overlook by firewall filtering rules. Intrusion Prevent System is not a replacement for firewall but it is one part in the intelligent firewall. It is used to increase system specific or network wide security. The advantages of Network-based Intrusion Prevention System discussed as follows: NIPS reduce Constant Monitoring NIPS is an inline network device NIPS perform deep packet inspection NIPS as a tool to prevent attacks Tony Bradley, (2004), [Online] http://netsecurity.about.com/cs/hackertools/a/aa030504.htm [Accessed 5th March 2004] Jonathan Hassell, (2005), [Online] http://searchenterprisedesktop.techtarget.com/news/column/0,294698,sid192_gci1089830,00.html [Accessed 19th May 2005] Neil Desai, (2003), [Online] http://www.symantec.com/connect/articles/intrusion-prevention-systems-next-step-evolution-ids [Accessed 27th February 2003] Benjamin Tomhave, (2004), [Online] http://docs.google.com/viewer?a=vq=cache:ZlxT5m72JZwJ:falcon.secureconsulting.net/papers/218-Research-Paper-FINAL.pdf+Benjamin+Tomhave+2004+IPS+articlehl=engl=mypid=blsrcid=ADGEEShEwpU07d-WvGPhlP3rIASlIyrH0CbGBjGBseUptTNHYRFqaApljgqESo9QEftMQHf3CApOji91saq_gEj-ZlLMXx3aPBS6SckaoJrzVwPiZBwTQ6gcpoHaH0ER-l4_ygilLw9asig=AHIEtbS-NuLUg635h_DHoKW8qafXwRwJUw [Accessed 10th November 2004] Joel Esler, Andrew R.Baker, (2007), Snort IDS and IPS Toolkit, [Online] http://books.google.com.my/books?id=M9plZZxJB_UCpg=PR3dq=Snort+IDS+and+IPS+Toolkit:+IDS+and+IPS+toolkithl=enei=_yDETK7iDM34cYK6la4Fsa=Xoi=book_resultct=book-preview-linkresnum=2ved=0CDYQuwUwAQ#v=onepageq=Snort%20IDS%20and%20IPS%20Toolkit%3A%20IDS%20and%20IPS%20toolkitf=false [Accessed 1st February 2007) Karen Scarfone, Peter Mell, (2007), Guide to Intrusion Detection and Prevention Systems (IDPS) , [Online] http://csrc.nist.gov/publications/nistpubs/800-94/SP800-94.pdf [Accessed February 2007] NSS Group, (2004), Intrusion Prevention Systems (IPS), [Online] http://hosteddocs.ittoolbox.com/BW013004.pdf [Accessed January 2004] Dinesh Sequeira (2002), Intrusion Prevention System à ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬ Securityà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒ ¢Ã¢â‚¬Å¾Ã‚ ¢s Silver Bullet?, [Online] http://docs.google.com/viewer?a=vq=cache:OK14t-hsmQAJ:www.sans.org/reading_room/papers/%3Fid%3D366+Intrusion+Prevention+Systems:+Security%27s+Silver+Bullet%3Fhl=engl=mypid=blsrcid=ADGEEShhB2J1ArllgI1mGNhp91RCpNpSf0t7BGUQtWPwmISpe3xmaTI0ym-Bh0Thlq2Gmoq9K6vRKN7xBKphn_fwCgUFaPej_NetBAPccgZXY0wSVyFAlLzsNkMwZjqSdn4XEdxAybctsig=AHIEtbQqUFej4tL8ln14oplPfky7GGstMA [Accessed 2002]

Investigation of Thyroid Emergencies

Investigation of Thyroid Emergencies Unit 1 Thyroid Emergencies Authors: Dr. Khalid Khatib Dr. Subhal Dixit 1.0 Objectives After reading this unit, you will be able to: Enumerate thyroid diseases which will land the patient in the intensive care unit; Describe the clinical features, investigation and treatment of throid storm; Describe the clinical features, investigation and treatment of hypothyroid coma; and Describe the clinical features, investigation and treatment of obstructive symptoms due to goiter. 1.1 Introduction Thyroid emergencies comprise a miniscule fraction of patients with thyroid dysfunction, who land up hospitalized in the intensive care unit (ICU) as a consequence of their abnormal thyroid physiology or anatomy. As these conditions are infrequently encountered in the ICU, a proper understanding of the hormonal pathophysiology and varied clinical features will lead to appropriate and timely institution of hormonal and supportive treatment, ultimately rendering survival benefit to the patient. The following conditions constitute thyroid emergencies: i) thyroid storm, ii) hypothyroid coma, and iii) massive goiter causing compression of the airways and large blood vessels. 1.2 Thyroid Storm It is also known as thyroid crisis or thyrotoxic crisis and is an extreme physiological condition due to thyroid hormone excess. A very severe, life threatening and decompensated form of thyrotoxicosis, it is rare (seen in 1-2% of patients admitted for thyrotoxicosis); but mortality rates approach 10-20%. Thyroid storm may be seen even in patients who have not been diagnosed with hyperthyroidism. The male to female ratio is 1:3. Causes: i) Grave’s disease, Ã ¬i) Toxic multinodular goiter, iii) Solitary nodular goitre iv) Subacute thyroiditis v) Postpartum thyroiditis, vi) Thyrotoxicosis factitia, vii) Metastatic thyroid malignancy. Whatever the etiology of hyperthyroidism, its conversion to thyroid storm requires the addition of precipitating factors. Precipitating factors: i) Infection, ii) Trauma, iii) Surgery- of the thyroid gland or non-thyroidal, iv)Acute myocardial infarction or Acute coronary syndrome, v) Pregnancy, labor, complicated delivery vi) Burns vii) Medical illnesses- congestive heart failure, diabetic ketoacidosis, cerebrovascular accident, pulmonary thromboembolism, sepsis, viii) Stress- emotional ix) Abrupt interruption of thyroid drug therapy, x) Administration of iodine compounds or radioiodine (I131 or I123 ), xi) Others- chemotherapy for leukemia, radiation therapy to neck malignancies, aspirin overdose, organophosphate poisoning, exercise, status epilepticus and drugs (tyrosine kinase inhibitors, lithium, biological agents like interleukin 2 and interferon). Clinical features: i) Central Nervous System- apathy, agitation, delirium, confusion, paranoia, and coma. ii) Cardiovascular System- congestive heart failure, tachyarrhythmia (atrial fibrillation, supraventricular tachycardia, ventricular tachycardia and ventricular fibrillation,) sinus tachycardia, dilated cardiomyopathy, high cardiac output state, and pulmonary hypertension. iii) Gastrointestinal tract- vomiting, diarrhoea, jaundice, diffuse abdominal pain occasionally presenting as acute abdomen. iv) Respiratory system- dyspnea, tachypnea and acute respiratory failure. v) Thermoregulation- fever, hyperthermia and diaphoresis. vi) Nutrition- weight loss. vii) Renal- proteinuria, acute renal failure.viii) Electrolyte disturbances- hypercalcemia, ketoacidosis, lactic acidosis. viii) Hematology- leucocytosis, hypercoagulable state leading to thromboembolism. Some elderly patients may have very few signs of hyperthyroidism and present with stupor, apathy, coma, and congestive heart failure (apathetic thyroid storm). Diagnosis: i) It usually needs to be based on clinical judgment and treatment started even before laboratory results are available. A semiquantative scale developed by Burch and Wartofsky can be used to definitively identify patients with thyroid storm. ii) Thyroid function tests(TFT): TFTs reveal increase in free T3 and free T4 while TSH will be very low (even undetectable). iii) Other laboratory investigations: Serum bilirubin, transaminases, blood glucose levels may be increased while potassium and total cholesterol may be decreased. Treatment: Principles of treatment: i) Treat the hyperthyroid state. ii) Prevent the effects of circulating T3 and T4. iii) Treat the multiorgan dysfunction. iv) Treat the precipitating cause. i) Treat the hyperthyroid state: 1) Prevent new thyroid hormone synthesis (Thionamides) 2) Prevent new thyroid hormone release (Thionamides) 3) Prevent conversion of circulating T4 to T3 ( steroids, lithium, high dose iodine and iodinated contrast medium) Thionamides: Propylthiouracil, Carbimazole, Methimazole are used in the treatment of hyperthyroid state. Propylthiouracil (PTU): a) Dose: Loading dose- 500-1000 mg followed by a maintenance dose of 250 mg every 4-6 hours. b) It additionally prevents peripheral conversion of T4 to T3. c) It is given either orally (if patient is conscious and able to swallow) or through the nasogastric tube or rectally. d) Onset of action is rapid. e) PTU has potential for hepatotoxicity. f) Hence it is preferred now only in pregnancy, where other thionamides cannot be used. Methimazole or Carbimazole: a) Dose: 20-30 mg every 4-6 hours may even go up to 60-80 mg every 4-6 hours. b) They are preferred over PTU unless the patient is pregnant. c) They can be given orally, through the nasogastric tube, rectally, or even intravenously. Steroids: a) Hydrocortisone is used in the dose of 100 mg intravenously or intramuscularly every 6 hours and continued till the condition of the patient improves completely. b) If Dexamethasone is used, the dose is 2 mg intravenously every 6 hours. c) Doses of both the drugs need to be tapered appropriately before they are stopped. Lithium: a) Dose: 1200 mg per day in 3-4 divided doses. b) Lithium is used if thionamides are contraindicated and patient is allergic to iodine. c) Serum lithium levels are monitored to prevent toxicity. High dose Iodine: a) Lugol’s iodine or potassium iodide solution is used. b) Dose: 0.3 ml or 10 drops of Lugol’s iodine diluted to 50 ml every 8 hours, orally or through the nasogastric tube. c) Its action is due to the Wolff-Chaikoff effect leading to the suppression of thyroid hormone release and peripheral conversion of T4 to T3. d) It should be administered at least one hour after administration of thionamide drugs. e) Sodium iodide may be used intravenously (dose- 500-1000 mg), but it is not easily available as a sterile solution. Iodinated contrast solution: 0.5-1 gm every 12 hours. Cholestyramine at a dose of 4gm, 2-4 times a day orally, reduces enterohepatic circulation of thyroid hormones. In refractory cases, plasma exchange, peritoneal dialysis or hemofiltration may be used to reduce the circulating thyroid hormones. ii) Prevent the effects of circulating T3 and T4: Beta blockers: 1) They block the hyperadrenergic effects of the excessive thyroid hormones. 2) They can be used if there are no contraindications to their use (history of asthma, COPD or congestive heart failure). 3) They must be used with continous cardiac monitoring. 4) Propranolol is used most commonly at the dose of 60-80 mg, three times a day, orally or through the nasogastric tube. It may also be used intravenously at the dose of 10 mg; at the rate of 0.5-1 mg per minute till heart rate is less than 100 per minute and then continued orally as above. 5) If propranol is contraindicated, cardioselective betablockers (metoprolol, atenolol), calcium channel blockers or digoxin may be used. 6) Esmolol, an ultra short acting beta blocker, is preferred by some, as an intravenous infusion of 50-100 mcg/kg/min with a loading dose of 250-500 mcg/kg. iii) Treat the multiorgan dysfunction: 1) Manage the patient in intensive care unit. 2) Take care of ABC (airway, breathing, and circulation). 3) Respiratory support with oxygen therapy or mechanical ventilation (noninvasive or invasive) as required. 4) Resuscitation and hemodynamic support- Intravenous infusions to correct fluid and electrolyte disturbances. 5) Antipyretics- cooling mattresses and cold sponging are used along with paracetamol to reduce the raised temperature. Salicylates are avoided as they reduce thyroid hormone binding to thyroglobulin and may in fact worsen thyroid storm. 6) Treat hypertension. 7) Treat delirium and agitation by sedation with haloperidol and benzodiazepines. 8) Provide nutritional support with adequate dextrose infusions and vitamin (especially thiamine) supplementation. 9) Treat the tachyarrythmias with antiarrythmic drugs if patient is hemo- dynamically stable or by electrical cardioversion if unstable. Treat congestive heart failure with diuretics and ACE inhibitors. iv) Treat the precipitating cause: 1) Search and treat the focus of infection. 2) Use broad spectrum antibiotics on empiric basis as appropriate. 3) Send urine and blood cultures. 4) Treat trauma, diabetic ketoacidosis, myocardial infarction and other precipitating factors as per usual principles. Once thyroid storm has been treated the hyperthyroid state should be treated definitively with antithyroid drugs, radioiodine or thyroidectomy. 1.3 Hypothyroid coma It is also known as myxedema coma or myxedematous coma and is due to very severe, untreated hypothyroidism manifesting with reduced temperature and altered mental status. It is an emergency to be treated in an ICU and has high mortality, but fortunately it is rare. Typically the patient is an elderly female with history of hypothyroidism with or without adequate treatment, who may have stopped treatment, or may have suffered an intercurrent stressful situation (infection). Occasionally coma may be the first presentation of hypothyroidism. Rarely hypothyroid coma may be seen in young females, some of whom may be pregnant. Precipitating factors: i) Burns, ii) Trauma, iii) Surgery, iv) Severe infection- pulmonary or urinary tract infection, sepsis, v) Low ambient temperature, vi) Cardiac diseases- myocardial infarction, congestive heart failure, vii) Cerebrovascular accident viii) Labour, ix) Anesthesia x) Drugs- neuroleptics, sedatives (benzodiazepines), xi) Intake of large amounts of liquids, xii) Seizures, xiii) Gastrointestinal bleeding. Some of the common causes of hypothyroidism are: i) Chronic autoimmune thyroiditis, ii) Thyroidectomy (total or partial), iii) Graves disease treated with radioiodine, iv) Secondary hypothyroidism- hypopituitarism, v) Drugs- amiodarone, lithium. Clinical features: i) Hypothermia- is usually severe with temperature approximately 26.70C (800F). Rarely, temperature may even reach 210C. In some cases, temperature may be normal in the presence of infection. ii) Altered mental status- may present as disorientation, depression, paranoia, hallucination, cerebellar signs, amnesia, disturbed memory, abnormal EEG findings, seizures, status epilepticus, stupor, obtundation or coma. iii) Cardiovascular system- abnormalities present as bradycardia, prolonged QT interval, varying degrees of AV block, ventricular arrhythmias (torsades de pointes), pericardial effusion, reduced cardiac output or shock. iv) Respiratory system- disturbances present as hypoventilation and hypercarbia or respiratory failure requiring mechanical ventilation. v) Renal and electrolyte disturbances- manifests as hyponatremia, edema, retention of urine or rarely renal failure. vi) Gastrointestinal- manifestations are constipation, paralytic ileus, ascites, gastropare sis, and gastrointestinal bleeding. vii) Hematological- problems are coagulopathy due to vonWillebrand syndrome and reduction of coagulation factors, DIC (disseminated intravascular coagulation), granulocytopenia and microcytic or macrocytic anemia. viii) General- manifestations of hypothyroidism like macroglossia, ptosis, generalized skin swelling or cool dry skin, periorbital edema, obesity and depressed deep tendon reflexes. Diagnosis: i) It should be suspected clinically. ii) TSH is raised in most cases. It may rarely be normal in pituitary causes of hypothyroidism. Severe systemic illness and drugs (inotropes, steroids) used to treat the associated systemic illness will cause blunting of the TSH elevation. iii) T3 and T4 levels are low. iv) Hyponatremia, hypoglycemia, hypoxia, respiratory acidosis, hypercapnia, hypercholesterolemia and elevated LDH and serum creatinine kinase levels may be present. Treatment: Principles of treatment: i) Thyroid hormone supplementation. ii) Steroids. iii) Correction of fluid and electrolyte disturbances. iv) Treatment of precipitating cause. i) Thyroid hormone supplementation: a) Supplementation with L-thyroxine with or without addition of liothyronine. b) Therapy is preferably intravenous. c) There is no consensus on the best therapeutic regime. d) Dose of L-thyroxine- High dose (300-400mcg on day 1 and then 50-100 mcg/day on subsequent days) is preferred by some. Though tolerated by young patients, it may cause sudden cardiac death in the elderly. Hence a lower dose is preferred (100mcg on day 1 and then 50-100mcg on subsequent days). e) Liothyronine- at a dose of 10-25 mcg (bolus), intravenously and then 10 mcg intravenously every 4 hours for the first 24 hours and every 6 hours over the next 48 hours and then oral therapy with L-thyroxine (50-100 mcg daily), as feasible. Initial therapy with liothyronine may be preferred, as it has better bioavailability and peripheral conversion of T4 to T3 is impaired in hypothyroid coma. Care should be taken during liothyronine therapy as excess T3 may increase mortality. f) Combi ned T4+T3 approach: to avoid above complications, a combined approach with L-thyroxine and liothyronine is advised as shown in Table no. 1. Table No. 1 Combined L-thyroxine and liothyronine therapy ii) Steroids: a) Hydrocortisone at a dose of 50-100 mg intravenously every 6 hours, is preferred. b) It is required to treat the associated adrenal insufficiency. iii) Correction of associated fluid, electrolyte and other disturbances: a) Maintain airway and provide mechanical ventilation if necessary. b) Hyponatremia- is a frequent occurrence and needs correction by restricting water intake or by intravenous infusion of isotonic saline (if serum sodium is less than 120). If hyponatremia is more severe, infusion of 3% NS is used very carefully. Occasionally, Conivaptan may be used in patients with euvolemic or hypervolemic hyponatremia. c) Hypothermia- is treated with passive and gradual heating with blankets and air warmers. iv) Treatment of precipitating cause: a) Appropriate antibiotics (broad- spectrum) are started for bacterial infections. b) Diuretics are used to treat volume overload and pulmonary edema. c) Intravenous glucose is used in the presence of hypoglycemia d) Inotropes are used if shock is present while digoxin is used with care for congestive heart failure. 1.4 Airway and vascular obstruction due to goitre Gross enlargement of the thyroid gland, especially substernal and intrathoracic extension, causes compression of the airway and the great vessels at the thoracic inlet. Sometimes massive hemorrhage inside a thyroid nodule, malignant thyroid disease, metastasis to thyroid gland and Reiter’s thyroiditis may cause compressive symptoms. Symptoms and signs: i) Dyspnea- usually chronic with acute or subacute exacerbations, ii) Stridor, dysphonia, iii) Dysphagia, choking, iv) Fullness and pressure in neck, v) Superior vena cava syndrome- causing facial edema, cyanosis and venous engorgement of face and arms, vi) Esophageal varices, vii) Phrenic or laryngeal nerve paralysis, viii) Horner’s syndrome, ix) Chylothorax, and x) Sleep apnea. Treatment: a) Continous positive airway pressure (CPAP) application or intubation and mechanical ventilation for maintaining patency of the airways and to treat respiratory distress. b) In a few cases where intubation is not possible, emergency tracheostomy may be required. c) Surgery to relieve the obstruction in the form of thyroidectomy and associated sternotomy, if required. d) Radioiodine and percutaneous laser ablation may be preferred in some patients. 1.5 Let us sum it up Thyroid storm occurs in hyperthyroid patients in the presence of precipitating circumstances leading to a hyperadrenergic condition which is fatal unless treated with care. It is treated with thionamides, beta blockers and correction of abnormal organ function. Hypothyroid coma usually presents in the winter months, in elderly females, in the presence of a precipitating cause. The patient has profound hypothermia and altered mental status or coma. It is treated with supplementation of thyroid hormones and treatment of the associated multiorgan dysfunction. Obstruction of the airway and blood vessels in the neck by an enlarged thyroid gland is very rare.

Role of Symbols and Symbolism in C. S. Lewis Chronicles of Narnia :: Chronicles of Narnia Essays

Role of Symbolism in C. S. Lewis' Chronicles of Narnia It has always been amazing to realize how well the literature I read as a child has stayed with me through the years. It takes an exceptional writer to compose a narrative that maintains a storyline on the same level of a child's understanding; it takes everything short of a miracle to keep a child's interest. However, that undertaking has been accomplished by many skilled authors, and continues to be an area of growth in the literary world. Only this year the New York Times has given the genre of children's literature the credit it deserves by creating a separate best-sellers list just for outstanding children's books. Yet, on another level, children's literature is not only for the young. I believe that the mark of a brilliant children's author is the age range of those who get pleasure from the stories; the wider the range, the better. I believe a retention of knowledge, as well as the love for a book (whether as an adult or child) is partly linked to the quality of words and imagination utilized in the author's tales. C. S. Lewis is a wonderful example of an author whose work extends to reach beyond the level of children, and brings into view the scenery of Narnia as an expression of life. His storytelling style brought the lands and people of the chronicles intothe view of my mind's eye as a child, and in the same way let my imagination interact with the story. Now I am an adult, and I have come to realize that the symbolism and parallels in the Chronicles of Narnia, which I may have overlooked with my child's mind, are presently real to me. The Chronicles of Narnia are wonderful to read whether one be six or thirty-six; they relate to childhood as well as life in a general sense. While the Chronicles tell the story of an imaginary land full of talking animals and heroic princes/princesses, I tend to look further into it in order to grasp the symbolism and relation to life. Symbolism plays an important role in the chronicles by being the background and foundation of a character. I get the impression that in some ways the characters were constructed around their symbolic purpose, and not the opposite way.

Politics, Payoffs, and Illegal Immigration Essay -- Essays Papers

Politics, Payoffs, and Illegal Immigration According to the U.S. Immigration and Naturalization Service, from 1993 to 1995 the United States has experienced the largest two year decline in immigration since the years 1930-1932. In 1995 there were 720,461 legal immigrants admitted to our country; some people would make the argument that this is far too many immigrants ( U.S. Immigration and Naturalization Service). It is impossible to clearly define the term "anti-immigration" because it is not a thing, it is a thought, a philosophy, a movement that appears in the abstract. In order to gain a better understanding of anti- immigration, I turned to the Internet. The medium of the Internet provides an accessible forum for the "world community" to express themselves outside the context of any controlling influences. However, deriving a definition of the term anti-immigration by the standards and understanding derived from the Internet becomes very confusing. There are those sites that advocate curtailing of all immigration both le gal and illegal; there are those that simply address the illegal immigration issue, and then there are those that address illegal immigration while at the same time arguing that legal immigration should be cut back--not stopped altogether. Interestingly enough, sites created on the west coast lean heavier on their argument against illegal immigration; the opinions expressed in these sites have an emotional basis. Sites that come from the east coast are more factual, and tend to deal with the immigration policy in its entirety, both legal and illegal. The purpose of this paper is to examine the anti-immigration information as it is presented on the Internet from a logical perspective. Lack of assimilation, dr... ...he links contained in this site are all related to the illegal immigration issue in California, and are peppered with such terminology as: "conflict," "infestation," "hatred," "race war," and "invasion." The site also makes mention of The Federation for Immigration Reform (FAIR) that was discussed earlier in this review, simply stating that FAIR has 70,000 members. There is no constructive information presented in this site, and like "The Daily Bruin," this site serves only to divide and instigate problems, rather than to propose any logical solutions to the perceived problem of immigration. "U.S. Immigration and Naturalization Service : Immigration to the United States in Fiscal Year 1995" (http://www.usdoj.gov/ins/public/stats/115.html) "Immigration law sets double standards for criminals" (Mitchell, Abra 1995) (http://pm.znet.com:80/leland/dec1995/in4-dec.htm)

Essay --

The movie industry is a booming market during this century. 72/100 of americans go to the movies each year and there are millions of dollars made only on the price of a movie ticket alone. Pirating movies is a common action in the united states and around the world everyday but does this actually have an effect on the movie industry and profits? To answer this question, one must look at three aspects, the industries market, how easy it is to pirate movies and the laws against piracy. With these three aspects, the effect of pirating movies should become clear. Could a simple download have this big of an affect on an industry that makes millions a year in profits? First, does the industries market actually have an impact from piracy of movies? Supporters of stronger intellectual property enforcement like the men and women who proposed the Stop Online Piracy Act and Protect IP Act bills in Congress claim that piracy of movies is a large issue in the United States. It is estimated that between $200 and $250 billion per year in losses to the united states economy. They also claimed that this causes a loss of 750,000 jobs in the united states. These estimates are wrong. A estimate of $58 billion, was produced by the Institute for Policy Innovation.Stopping Internet piracy may benefit filmmakers but only some filmmakers, and only some of the time. Scholars debate whether this piracy of movies has an affect everyday. This is one of the problem because it seems that it depends on what movie or how often someone would use an illegal site. A recent updated study by economists students at the Munich School of Management and Copenhagen Business School showed a drawing from nearly five years' worth of data. The students looked at box off... ... should soon come to a halt but instead this law is not enforced as well because with the privacy software on the internet, finding who is responsible for the start of a website or even streaming of a movie is very difficult. The pirating of movies does have an impact on filmmakers and the movie industry but if it took away enough money from the business the film makes and the industry would do more to enforce these laws. The industries market, how easy it is to pirate movies and the laws against piracy all contribute to the filmmakers and industries loss in money but the gains from each movie do not compare to the money that is made in the theaters. Once a movie has been successful in theatres, they should have enough money to not let pirating affect the industry. Pirating movies does affect the industry and is illegal but it does not have a significant effect.

A Game of Thrones Chapter Sixty-eight

Daenerys Wings shadowed her fever dreams. â€Å"You don't want to wake the dragon, do you?† She was walking down a long hall beneath high stone arches. She could not look behind her, must not look behind her. There was a door ahead of her, tiny with distance, but even from afar, she saw that it was painted red. She walked faster, and her bare feet left bloody footprints on the stone. â€Å"You don't want to wake the dragon, do you?† She saw sunlight on the Dothraki sea, the living plain, rich with the smells of earth and death. Wind stirred the grasses, and they rippled like water. Drogo held her in strong arms, and his hand stroked her sex and opened her and woke that sweet wetness that was his alone, and the stars smiled down on them, stars in a daylight sky. â€Å"Home,† she whispered as he entered her and filled her with his seed, but suddenly the stars were gone, and across the blue sky swept the great wings, and the world took flame. † . . . don't want to wake the dragon, do you?† Ser Jorah's face was drawn and sorrowful. â€Å"Rhaegar was the last dragon,† he told her. He warmed translucent hands over a glowing brazier where stone eggs smouldered red as coals. One moment he was there and the next he was fading, his flesh colorless, less substantial than the wind. â€Å"The last dragon,† he whispered, thin as a wisp, and was gone. She felt the dark behind her, and the red door seemed farther away than ever. † . . . don't want to wake the dragon, do you?† Viserys stood before her, screaming. â€Å"The dragon does not beg, slut. You do not command the dragon. I am the dragon, and I will be crowned.† The molten gold trickled down his face like wax, burning deep channels in his flesh. â€Å"I am the dragon and I will be crowned!† he shrieked, and his fingers snapped like snakes, biting at her nipples, pinching, twisting, even as his eyes burst and ran like jelly down seared and blackened cheeks. † . . . don't want to wake the dragon . . . â€Å" The red door was so far ahead of her, and she could feel the icy breath behind, sweeping up on her. If it caught her she would die a death that was more than death, howling forever alone in the darkness. She began to run. † . . . don't want to wake the dragon . . . â€Å" She could feel the heat inside her, a terrible burning in her womb. Her son was tall and proud, with Drogo's copper skin and her own silver-gold hair, violet eyes shaped like almonds. And he smiled for her and began to lift his hand toward hers, but when he opened his mouth the fire poured out. She saw his heart burning through his chest, and in an instant he was gone, consumed like a moth by a candle, turned to ash. She wept for her child, the promise of a sweet mouth on her breast, but her tears turned to steam as they touched her skin. † . . . want to wake the dragon . . . â€Å" Ghosts lined the hallway, dressed in the faded raiment of kings. In their hands were swords of pale fire. They had hair of silver and hair of gold and hair of platinum white, and their eyes were opal and amethyst, tourmaline and jade. â€Å"Faster,† they cried, â€Å"faster, faster.† She raced, her feet melting the stone wherever they touched. â€Å"Faster!† the ghosts cried as one, and she screamed and threw herself forward. A great knife of pain ripped down her back, and she felt her skin tear open and smelled the stench of burning blood and saw the shadow of wings. And Daenerys Targaryen flew. † . . . wake the dragon . . . â€Å" The door loomed before her, the red door, so close, so close, the hall was a blur around her, the cold receding behind. And now the stone was gone and she flew across the Dothraki sea, high and higher, the green rippling beneath, and all that lived and breathed fled in terror from the shadow of her wings. She could smell home, she could see it, there, just beyond that door, green fields and great stone houses and arms to keep her warm, there. She threw open the door. † . . . the dragon . . . â€Å" And saw her brother Rhaegar, mounted on a stallion as black as his armor. Fire glimmered red through the narrow eye slit of his helm. â€Å"The last dragon,† Ser Jorah's voice whispered faintly. â€Å"The last, the last.† Dany lifted his polished black visor. The face within was her own. After that, for a long time, there was only the pain, the fire within her, and the whisperings of stars. She woke to the taste of ashes. â€Å"No,† she moaned, â€Å"no, please.† â€Å"Khaleesi?† Jhiqui hovered over her, a frightened doe. The tent was drenched in shadow, still and close. Flakes of ash drifted upward from a brazier, and Dany followed them with her eyes through the smoke hole above. Flying, she thought. I had wings, I was flying. But it was only a dream. â€Å"Help me,† she whispered, struggling to rise. â€Å"Bring me . . . † Her voice was raw as a wound, and she could not think what she wanted. Why did she hurt so much? It was as if her body had been torn to pieces and remade from the scraps. â€Å"I want . . . â€Å" â€Å"Yes, Khaleesi.† Quick as that Jhiqui was gone, bolting from the tent, shouting. Dany needed . . . something . . . someone . . . what? It was important, she knew. It was the only thing in the world that mattered. She rolled onto her side and got an elbow under her, fighting the blanket tangled about her legs. It was so hard to move. The world swam dizzily. I have to . . . They found her on the carpet, crawling toward her dragon eggs. Ser Jorah Mormont lifted her in his arms and carried her back to her sleeping silks, while she struggled feebly against him. Over his shoulder she saw her three handmaids, Jhogo with his little wisp of mustache, and the flat broad face of Mirri Maz Duur. â€Å"I must,† she tried to tell them, â€Å"I have to . . . â€Å" † . . . sleep, Princess,† Ser Jorah said. â€Å"No,† Dany said. â€Å"Please. Please.† â€Å"Yes.† He covered her with silk, though she was burning. â€Å"Sleep and grow strong again, Khaleesi. Come back to us.† And then Mirri Maz Duur was there, the maegi, tipping a cup against her lips. She tasted sour milk, and something else, something thick and bitter. Warm liquid ran down her chin. Somehow she swallowed. The tent grew dimmer, and sleep took her again. This time she did not dream. She floated, serene and at peace, on a black sea that knew no shore. After a time—a night, a day, a year, she could not say—she woke again. The tent was dark, its silken walls flapping like wings when the wind gusted outside. This time Dany did not attempt to rise. â€Å"Irri,† she called, â€Å"Jhiqui. Doreah.† They were there at once. â€Å"My throat is dry,† she said, â€Å"so dry,† and they brought her water. It was warm and flat, yet Dany drank it eagerly, and sent Jhiqui for more. Irri dampened a soft cloth and stroked her brow. â€Å"I have been sick,† Dany said. The Dothraki girl nodded. â€Å"How long?† The cloth was soothing, but Irri seemed so sad, it frightened her. â€Å"Long,† she whispered. When Jhiqui returned with more water, Mirri Maz Duur came with her, eyes heavy from sleep. â€Å"Drink,† she said, lifting Dany's head to the cup once more, but this time it was only wine. Sweet, sweet wine. Dany drank, and lay back, listening to the soft sound of her own breathing . She could feel the heaviness in her limbs, as sleep crept in to fill her up once more. â€Å"Bring me . . . † she murmured, her voice slurred and drowsy. â€Å"Bring . . . I want to hold . . . â€Å" â€Å"Yes?† the maegi asked. â€Å"What is it you wish, Khaleesi?† â€Å"Bring me . . . egg . . . dragon's egg . . . please . . . † Her lashes turned to lead, and she was too weary to hold them up. When she woke the third time, a shaft of golden sunlight was pouring through the smoke hole of the tent, and her arms were wrapped around a dragon's egg. It was the pale one, its scales the color of butter cream, veined with whorls of gold and bronze, and Dany could feel the heat of it. Beneath her bedsilks, a fine sheen of perspiration covered her bare skin. Dragondew, she thought. Her fingers trailed lightly across the surface of the shell, tracing the wisps of gold, and deep in the stone she felt something twist and stretch in response. It did not frighten her. All her fear was gone, burned away. Dany touched her brow. Under the film of sweat, her skin was cool to the touch, her fever gone. She made herself sit. There was a moment of dizziness, and the deep ache between her thighs. Yet she felt strong. Her maids came running at the sound of her voice. â€Å"Water,† she told them, â€Å"a flagon of water, cold as you can find it. And fruit, I think. Dates.† â€Å"As you say, Khaleesi.† â€Å"I want Ser Jorah,† she said, standing. Jhiqui brought a sandsilk robe and draped it over her shoulders. â€Å"And a warm bath, and Mirri Maz Duur, and . . . † Memory came back to her all at once, and she faltered. â€Å"Khal Drogo,† she forced herself to say, watching their faces with dread. â€Å"Is he&mdash?† â€Å"The khal lives,† Irri answered quietly . . . yet Dany saw a darkness in her eyes when she said the words, and no sooner had she spoken than she rushed away to fetch water. She turned to Doreah. â€Å"Tell me.† â€Å"I . . . I shall bring Ser Jorah,† the Lysene girl said, bowing her head and fleeing the tent. Jhiqui would have run as well, but Dany caught her by the wrist and held her captive. â€Å"What is it? I must know. Drogo . . . and my child.† Why had she not remembered the child until now? â€Å"My son . . . Rhaego . . . where is he? I want him.† Her handmaid lowered her eyes. â€Å"The boy . . . he did not live, Khaleesi.† Her voice was a frightened whisper. Dany released her wrist. My son is dead, she thought as Jhiqui left the tent. She had known somehow. She had known since she woke the first time to Jhiqui's tears. No, she had known before she woke. Her dream came back to her, sudden and vivid, and she remembered the tall man with the copper skin and long silver-gold braid, bursting into flame. She should weep, she knew, yet her eyes were dry as ash. She had wept in her dream, and the tears had turned to steam on her cheeks. All the grief has been burned out of me, she told herself. She felt sad, and yet . . . she could feel Rhaego receding from her, as if he had never been. Ser Jorah and Mirri Maz Duur entered a few moments later, and found Dany standing over the other dragon's eggs, the two still in their chest. It seemed to her that they felt as hot as the one she had slept with, which was passing strange. â€Å"Ser Jorah, come here,† she said. She took his hand and placed it on the black egg with the scarlet swirls. â€Å"What do you feel?† â€Å"Shell, hard as rock.† The knight was wary. â€Å"Scales.† â€Å"Heat?† â€Å"No. Cold stone.† He took his hand away. â€Å"Princess, are you well? Should you be up, weak as you are?† â€Å"Weak? I am strong, Jorah.† To please him, she reclined on a pile of cushions. â€Å"Tell me how my child died.† â€Å"He never lived, my princess. The women say . . . † He faltered, and Dany saw how the flesh hung loose on him, and the way he limped when he moved. â€Å"Tell me. Tell me what the women say.† He turned his face away. His eyes were haunted. â€Å"They say the child was . . . â€Å" She waited, but Ser Jorah could not say it. His face grew dark with shame. He looked half a corpse himself. â€Å"Monstrous,† Mirri Maz Duur finished for him. The knight was a powerful man, yet Dany understood in that moment that the maegi was stronger, and crueler, and infinitely more dangerous. â€Å"Twisted. I drew him forth myself. He was scaled like a lizard, blind, with the stub of a tail and small leather wings like the wings of a bat. When I touched him, the flesh sloughed off the bone, and inside he was full of graveworms and the stink of corruption. He had been dead for years.† Darkness, Dany thought. The terrible darkness sweeping up behind to devour her. If she looked back she was lost. â€Å"My son was alive and strong when Ser Jorah carried me into this tent,† she said. â€Å"I could feel him kicking, fighting to be born.† â€Å"That may be as it may be,† answered Mirri Maz Duur, â€Å"yet the creature that came forth from your womb was as I said. Death was in that tent, Khaleesi.† â€Å"Only shadows,† Ser Jorah husked, but Dany could hear the doubt in his voice. â€Å"I saw, maegi. I saw you, alone, dancing with the shadows. â€Å" â€Å"The grave casts long shadows, Iron Lord,† Mirri said. â€Å"Long and dark, and in the end no light can hold them back.† Ser Jorah had killed her son, Dany knew. He had done what he did for love and loyalty, yet he had carried her into a place no living man should go and fed her baby to the darkness. He knew it too; the grey face, the hollow eyes, the limp. â€Å"The shadows have touched you too, Ser Jorah,† she told him. The knight made no reply. Dany turned to the godswife. â€Å"You warned me that only death could pay for life. I thought you meant the horse.† â€Å"No,† Mirri Maz Duur said. â€Å"That was a lie you told yourself. You knew the price.† Had she? Had she? If I look back I am lost. â€Å"The price was paid,† Dany said. â€Å"The horse, my child, Quaro and Qotho, Haggo and Cohollo. The price was paid and paid and paid.† She rose from her cushions. â€Å"Where is Khal Drogo? Show him to me, godswife, maegi, bloodmage, whatever you are. Show me Khal Drogo. Show me what I bought with my son's life.† â€Å"As you command, Khaleesi,† the old woman said. â€Å"Come, I will take you to him.† Dany was weaker than she knew. Ser Jorah slipped an arm around her and helped her stand. â€Å"Time enough for this later, my princess,† he said quietly. â€Å"I would see him now, Ser Jorah.† After the dimness of the tent, the world outside was blinding bright. The sun burned like molten gold, and the land was seared and empty. Her handmaids waited with fruit and wine and water, and Jhogo moved close to help Ser Jorah support her. Aggo and Rakharo stood behind. The glare of sun on sand made it hard to see more, until Dany raised her hand to shade her eyes. She saw the ashes of a fire, a few score horses milling listlessly and searching for a bite of grass, a scattering of tents and bedrolls. A small crowd of children had gathered to watch her, and beyond she glimpsed women going about their work, and withered old men staring at the flat blue sky with tired eyes, swatting feebly at bloodflies. A count might show a hundred people, no more. Where the other forty thousand had made their camp, only the wind and dust lived now. â€Å"Drogo's khalasar is gone,† she said. â€Å"A khal who cannot ride is no khal,† said Jhogo. â€Å"The Dothraki follow only the strong,† Ser Jorah said. â€Å"I am sorry, my princess. There was no way to hold them. Ko Pono left first, naming himself Khal Pono, and many followed him. Jhaqo was not long to do the same. The rest slipped away night by night, in large bands and small. There are a dozen new khalasars on the Dothraki sea, where once there was only Drogo's.† â€Å"The old remain,† said Aggo. â€Å"The frightened, the weak, and the sick. And we who swore. We remain.† â€Å"They took Khal Drogo's herds, Khaleesi,† Rakharo said. â€Å"We were too few to stop them. It is the right of the strong to take from the weak. They took many slaves as well, the khal's and yours, yet they left some few.† â€Å"Eroeh?† asked Dany, remembering the frightened child she had saved outside the city of the Lamb Men. â€Å"Mago seized her, who is Khal Jhaqo's bloodrider now,† said Jhogo. â€Å"He mounted her high and low and gave her to his khal, and Jhaqo gave her to his other bloodriders. They were six. When they were done with her, they cut her throat.† â€Å"It was her fate, Khaleesi,† said Aggo. If I look back I am lost. â€Å"It was a cruel fate,† Dany said, â€Å"yet not so cruel as Mago's will be. I promise you that, by the old gods and the new, by the lamb god and the horse god and every god that lives. I swear it by the Mother of Mountains and the Womb of the World. Before I am done with them, Mago and Ko Jhaqo will plead for the mercy they showed Eroeh.† The Dothraki exchanged uncertain glances. â€Å"Khaleesi, † the handmaid Irri explained, as if to a child, â€Å"Jhaqo is a khal now, with twenty thousand riders at his back.† She lifted her head. â€Å"And I am Daenerys Stormhorn, Daenerys of House Targaryen, of the blood of Aegon the Conqueror and Maegor the Cruel and old Valyria before them. I am the dragon's daughter, and I swear to you, these men will die screaming. Now bring me to Khal Drogo.† He was lying on the bare red earth, staring up at the sun. A dozen bloodflies had settled on his body, though he did not seem to feel them. Dany brushed them away and knelt beside him. His eyes were wide open but did not see, and she knew at once that he was blind. When she whispered his name, he did not seem to hear. The wound on his breast was as healed as it would ever be, the scar that covered it grey and red and hideous. â€Å"Why is he out here alone, in the sun?† she asked them. â€Å"He seems to like the warmth, Princess,† Ser Jorah said. â€Å"His eyes follow the sun, though he does not see it. He can walk after a fashion. He will go where you lead him, but no farther. He will eat if you put food in his mouth, drink if you dribble water on his lips.† Dany kissed her sun-and-stars gently on the brow, and stood to face Mirri Maz Duur. â€Å"Your spells are costly, maegi.† â€Å"He lives,† said Mirri Maz Duur. â€Å"You asked for life. You paid for life.† â€Å"This is not life, for one who was as Drogo was. His life was laughter, and meat roasting over a firepit, and a horse between his legs. His life was an arakh in his hand and his bells ringing in his hair as he rode to meet an enemy. His life was his bloodriders, and me, and the son I was to give him.† Mirri Maz Duur made no reply. â€Å"When will he be as he was?† Dany demanded. â€Å"When the sun rises in the west and sets in the east,† said Mirri Maz Duur. â€Å"When the seas go dry and mountains blow in the wind like leaves. When your womb quickens again, and you bear a living child. Then he will return, and not before.† Dany gestured at Ser Jorah and the others. â€Å"Leave us. I would speak with this maegi alone.† Mormont and the Dothraki withdrew. â€Å"You knew,† Dany said when they were gone. She ached, inside and out, but her fury gave her strength. â€Å"You knew what I was buying, and you knew the price, and yet you let me pay it.† â€Å"It was wrong of them to burn my temple,† the heavy, flat-nosed woman said placidly. â€Å"That angered the Great Shepherd.† â€Å"This was no god's work,† Dany said coldly. If I look back I am lost. â€Å"You cheated me. You murdered my child within me.† â€Å"The stallion who mounts the world will burn no cities now. His khalasar shall trample no nations into dust.† â€Å"I spoke for you,† she said, anguished. â€Å"I saved you.† â€Å"Saved me?† The Lhazareen woman spat. â€Å"Three riders had taken me, not as a man takes a woman but from behind, as a dog takes a bitch. The fourth was in me when you rode past. How then did you save me? I saw my god's house burn, where I had healed good men beyond counting. My home they burned as well, and in the street I saw piles of heads. I saw the head of a baker who made my bread. I saw the head of a boy I had saved from deadeye fever, only three moons past. I heard children crying as the riders drove them off with their whips. Tell me again what you saved.† â€Å"Your life.† Mirri Maz Duur laughed cruelly. â€Å"Look to your khal and see what life is worth, when all the rest is gone.† Dany called out for the men of her khas and bid them take Mirri Maz Duur and bind her hand and foot, but the maegi smiled at her as they carried her off, as if they shared a secret. A word, and Dany could have her head off . . . yet then what would she have? A head? If life was worthless, what was death? They led Khal Drogo back to her tent, and Dany commanded them to fill a tub, and this time there was no blood in the water. She bathed him herself, washing the dirt and the dust from his arms and chest, cleaning his face with a soft cloth, soaping his long black hair and combing the knots and tangles from it till it shone again as she remembered. It was well past dark before she was done, and Dany was exhausted. She stopped for drink and food, but it was all she could do to nibble at a fig and keep down a mouthful of water. Sleep would have been a release, but she had slept enough . . . too long, in truth. She owed this night to Drogo, for all the nights that had been, and yet might be. The memory of their first ride was with her when she led him out into the darkness, for the Dothraki believed that all things of importance in a man's life must be done beneath the open sky. She told herself that there were powers stronger than hatred, and spells older and truer than any the maegi had learned in Asshai. The night was black and moonless, but overhead a million stars burned bright. She took that for an omen. No soft blanket of grass welcomed them here, only the hard dusty ground, bare and strewn with stones. No trees stirred in the wind, and there was no stream to soothe her fears with the gentle music of water. Dany told herself that the stars would be enough. â€Å"Remember, Drogo,† she whispered. â€Å"Remember our first ride together, the day we wed. Remember the night we made Rhaego, with the khalasar all around us and your eyes on my face. Remember how cool and clean the water was in the Womb of the World. Remember, my sun-and-stars. Remember, and come back to me.† The birth had left her too raw and torn to take him inside of her, as she would have wanted, but Doreah had taught her other ways. Dany used her hands, her mouth, her breasts. She raked him with her nails and covered him with kisses and whispered and prayed and told him stories, and by the end she had bathed him with her tears. Yet Drogo did not feel, or speak, or rise. And when the bleak dawn broke over an empty horizon, Dany knew that he was truly lost to her. â€Å"When the sun rises in the west and sets in the east,† she said sadly. â€Å"When the seas go dry and mountains blow in the wind like leaves. When my womb quickens again, and I bear a living child. Then you will return, my sun-and-stars, and not before.† Never, the darkness cried, never never never. Inside the tent Dany found a cushion, soft silk stuffed with feathers. She clutched it to her breasts as she walked back out to Drogo, to her sun-and-stars. If I look back I am lost. It hurt even to walk, and she wanted to sleep, to sleep and not to dream. She knelt, kissed Drogo on the lips, and pressed the cushion down across his face.