Friday, January 31, 2020

Pateint Non Transport Guidlines Ambulance Essay Example for Free

Pateint Non Transport Guidlines Ambulance Essay Comprehensive documentation provides a defence for Paramedics in a very contentious world. Without documentation, it is very hard to show that something occurred. Thorough timely documentation and the use of the VIRCA method should not be seen as additional and unnecessary paperwork. Instead, it should offer the Paramedic some peace of mind. It has been established at law that a Paramedic owes a duty of care to their patient. The QAS as an organization also owes its patients a duty of care. As such, it is vital that the QAS perform their job professionally and correctly. This is because once a duty of care is established; the QAS has to ensure that they do not breach that duty. Virca Does not apply to case where transport is not required, but the documentation still needs to be completed with all Patient details and applied management and advice given. Patients who refuse transport. There is still a concern amongst Paramedics that they have no defence against negligence apart from transporting every person they attend. In some instances this has not been the case. Documentation provides a defence; and as such, documentation is an integral part of the treatment for each patient a Paramedic attends. It is an established legal truism that a person of sound mind has the right to self-determination; they can choose what is done (or not done) to their body. The voluntary choices and decisions of an adult person of sound mind concerning what is or is not done to their body, must be respected and accepted, irrespective of what others, including doctors, may think is in the best interests of that particular person. The difficulty arises when there is doubt over whether a person is of sound mind. However, in cases where the person does have an adequate mental capacity, a patient does have the right not to be transported. As such, Paramedics need not fear the worst if they are faced with a patient who refuses transport. Instead, they need to have a good understanding of the legal principles behind patients who refuse transport, and its correct documentation. This leads to the next section. Method for Correct Documentation for Non-Transport E-ARF’s – VIRCA The correct method for documentation where a patient refuses transport is to use the VIRCA acronym. V – Refusal must be made voluntarily. I – Pt must be informed of their condition, and risks associated with that condition if they are not transported. R – Refusal must be made relevant to the circumstances. C – Pt must have the capacity to refuse. A – Pt must be provided with sound discharge advice. Every time a Paramedic attends a patient who refuses transport, it is necessary to document that fact by using the VIRCA method. Each element needs to be addressed separately and applied to the particular circumstances of the individual case. How to Integrate Patient Assessment and VIRCA. Having examined each element, there is a need to look at the big picture of patient treatment where the patient refuses transport. As per a memorandum from the Commissioner, a Paramedic should: 1. Assess the patient systematically whenever possible. Of course, sometimes a patient may be aggressively non-compliant, and a full assessment will not be possible. However, even from distant observation a Paramedic should be able to assess some areas. For example, obvious external haemorrhage, incontinence, inappropriate behaviour or language, forced respirations can all be obtained from a patient at a distance. All these findings need to be documented. If possible, try to establish a provisional diagnosis from these findings. Also, don’t forget to obtain history from the patient’s friends, QPS, or from bystanders. They may be able to give a Paramedic a very useful rundown of events, which can help in assessing the patient’s condition. Advise the patient. Inform the patient of your clinical findings, and suggest to them your provisional and differential diagnoses. Make sure they understand the information you are providing them with, as this forms part of the assessment of their capacity to refuse treatment and/or transport. The next step is to inform the patient of the potential risks inherent in them not being transported to a medical facility. It is important to be realistic, or the patient may not believe you. It is very rare, that people will die for trivial complaints but this may cause the patient to doubt your credibility if you seem to over communicate the condition they have if only minor. It is better to provide the patient with more realistic examples of what may happen, and then conclude with the possibility, even if unlikely, that paralysis or death may result. Please note that if a injury or illness may lead to death, however unlikely, then you must inform the patient of this. The point is to be sensible when explaining it, or the impact may be wasted, and the seriousness of the situation be replaced with incredibility. 3. Assess the Validity of the Refusal. To assess the refusals validity, simply apply the VIRCA acronym. Other Alternatives. If the patient is not compliant with the advice of QAS officers, consider other alternatives. If the patient will not go to a hospital, does he have a family doctor that will come to see him? Could family members be used to help convince the patient of the necessity to receive transport? If necessary, consider the use of QPS in assisting with transport, especially patients that may come under the Mental Health Act provisions. Document thoroughly using VIRCA. Having completed all other steps, it is now necessary to document all the above steps to paper. Complete an E-ARF as per the CPM guidelines, including a provisional diagnosis. The E-ARF should be completed with the same care as for any other patient, notwithstanding that the patient may have already left the scene. Include in the E ARF each of the VIRCA steps, and apply them to the circumstances of the case. See the applied example in the next section for a practical application of this.

Monday, January 27, 2020

Social and Economic conditions on NHS Funding

Social and Economic conditions on NHS Funding In the middle ages, access to health care and sanitation facilities was only available to people belonging to a sound socio-economic background. Hill, Griffiths and Gillam (2007) state that in earlier time, even ensuring the supply of clean water and sanitation facilities was a tough task for municipal authorities. It was not until eighteenth century when provision of health services began to get recognition as governments responsibility. The NHS was founded in 1948 and is the currently the worlds largest health service that is publicly funded. The basic idea behind the establishment of the NHS was to ensure that people from all kinds of socio-economic backgrounds receive health facilities without any discrimination. This makes the service free for any individual who is a resident of the UK. According to the official statistics of the NHS, it deals with about 1 million patients every 36 hours. Funds for the NHS come directly from taxation. The NHS budget for 2008-2009 was more than  £100 billion, which means a contribution of about  £1980 by every individual in the UK. Considering the fact that health and education are the most important public services on any governments priority list, however the functionality of these services is directly related to the social and economic conditions. Same goes for the NHS, which has faced management crisis during times of economic austerity, both in present and the past. Although the NHS has seen a sharp increase in funding over the last few decades, however, given the current economic recession, the chances of future funding are quite uncertain. It is feared that either the NHS will go through a funding cut or the government will have to resort to tax-raising measures. Health Care and Social and Economic Conditions: Although good health is a need of every individual, however, the access to health care services is greatly dependent on the social and economic conditions of both the individual and the country he is residing in. An individual can either opt for a private health care service, which is subjected to his willingness and ability to pay for it, or is dependent on the services provided by the government. A large proportion of the population goes for the latter option. A poor socio-economic condition of the country means that either a person sacrifices on his health or will forgo any other of his basic needs in order to pay for medical bills. According to the Social Care Report 2008-2009 issued by the Health Committee of the House of Commons, A care gap may occur if people avoid using services wither because of affordability issues or if the services do not meet their requirement. The report also claims that the past three years have seen a significant drop in the number of people using the public sector health services, despite of the fact that the countrys ageing population have increased by 3%. This makes it apparent that either the public cannot afford to pay for the health care services or the government is finding it difficult to ensure the provision of standardized health facilities on equality basis. At the same time, given the economic crises, the government itself also gets stingy with providing funds due to lack of resources. Consequently, the quality of service provided by the NHS is compromised. Fowler (Taylor and Field 1998, p. 158) states that lack of resources means that new hospital building would not be built advanced medical technology and equipment could not be purchased and the staff would be working under conditions that would demotivate them. This directly questions the value for money provided by the NHS services. George and Miller (1997) state that in 1960s and 1970s politicians started to doubt the economic viability of a universalist welfare state. They argued that achieving economic growth is the governments primary objective that is being sidelined due to increasing public expenditure. Consequently, they demanded a cut in public expenditure, which meant less funding for public sector health services. Powell (George and Miller 1997, p. 8) claimed that public expenditure has overshot economic growth by a substantial margin, thus resulting in disastrous financial effects including internal inflation, external devaluation and foreign indebtedness. Lees (George and Miller 1997, p. 8) argued that medical care should be treated like any other commodity available in the private market. This will not only make the NHS more cost efficient, but will also make it less politicized and will offer more consumer choice. Although while debating on making the public health services free at the point of use, many social scientists and economists agree that it can be easily funded by taxation, they tend to overlook other factors, which may directly or indirectly effect the NHS funding. McLeod and Bywaters (2000) argue that the inflationary pressures on the NHS funding of the pharmaceutical and medical technology industries and the continued presence of private health care services are two major constraints on measures for equitable health care. Moreover, the deteriorating condition of hospital buildings and their repair and maintenance costs also add to the financial pressures. Funding Public Health Services: Although the funds for the functionality of the NHS are directly acquired from taxation, however, it should be noted that all the capital works such as building hospitals are funded through Private Finance Initiative (PFI). This means that these capital works are being financed through loans raised by private sector financing institutions. According to Pollock, Shaoul and Vickers (2002) this is a very expensive way of financing the NHS. Using Private Finance Initiative requires the NHS to pay an annual fee including the cost of borrowing. Considering the fact that the NHS is a free service at the point of use, this method leads to an affordability gap for the NHS trusts. As a result, the NHS is forced to resort to external subsidies, charitable donations, sale of assets and even cuts in bed capacity and hospital staff. This in return makes the NHS questionable as the idea behind its establishment was to ensure access to health facilities to everyone without any class difference. When a large proportion of a service is being funded by the tax payers, then the service providers are suppose to make sure that they are being cost efficient and provide the value for money. Unfortunately, this has not been the case with the NHS. Davies (2007) states that the NHS was provided with unprecedented funds, however it still overspent by a substantial amount. Moreover, clinical outcomes, waiting periods and the level of satisfaction of patients are all less as compared to that provided by private health care services. According to Davies (2007), the government argues that if the NHS manages itself efficiently, the NHS trusts can achieve significantly positive results. Conclusion: The problems in the health sector are similar to any other economic problem. It is facing a price hike due to gaps in demand and supply. The list of people waiting to get medical treatments is mounting up but there is a shortfall of resources to cater that list. One suggestion given to deal with the problem is to impose user charges on the services provided by the NHS. Some critics argue that if user charges are imposed it will give two benefits. Firstly, it will generate funds for the NHS to finance the shortfall. Secondly, people will start taking care of their health and will make healthy choices in order to avoid seeking a medical care. The first argument is a socially unfair argument. The current economic conditions are such that people make sacrifices even when choosing in between the basic necessities. Imposing user charges on health means that they will start avoiding seeking medical treatment not because they do not need it, but because they cannot afford it. The second argument requires one to assume that people are aware and educated enough about what right choices they need to make in order to seek minimum medical help. Countries like France and Germany have already tried this approached and it only resulted in undermining the ef ficiency of public sector health services, rather than helping to achieve the required results. Therefore, imposing user charges for the NHS consumers should not be considered. Instead, the government and the NHS trusts should look for alternative instruments. In order to deal with the problem the government will have to make both short term and long-term strategies. In short term, it should be ensured that the NHS becomes cost efficient and the consumers get value for their money. This can be done by minimizing dependency on the private finance initiative. On long term basis, preventive measures should be taken and the emphasis should be on primary care. People should be educated such that take care of their health so that they are least prone to diseases. REFRENCES Davies, P 2007, The NHS in the UK 2007/08, London. George, V and Miller, S 1997, Social policy towards 2000: squaring the welfare circle, Routledge, London. Hill, P, Griffith, S and Gillam, S 2007, Public health and primary care: partners in population health, Oxford university Press Inc., New York. McLeod, E and Bywaters, P 2000, Social work, health and equality, Routledge, London. Taylor, S and Field D 1998, Sociological perspectives on health, illness and health care, Blackwell Science Ltd., London. Pollock, A, Shaoul, J and Vickers, N 2002, Private finance and value for money in NHS hospitals: a policy in search of a rationale, viewed 21 October 2010, Thomson, S, Foubister, T and Mossialos E 2010, Can user charges make health care more efficient?, viewed 21 October 2010, 2004, Health Economics, Biz/ed, viewed 21 October 2010,

Thursday, January 23, 2020

Using Creative Writer 2 :: Computers Software Internet Technology Essays

Using Creative Writer 2 Contents Getting Started Creative Writer 2 Home Page Hardware and Software Requirements Internet E-mail Making Web Pages Web Publishing Creative Writer 1.0 Compatibility Troubleshooting When You Have a Question Getting Started Before you set up Creative Writer 2, it is best to close other applications. Also, do not remove the Creative Writer 2 disc from your computer during Setup. If you follow these guidelines, but still encounter problems during Setup, check that your computer has the minimum requirements necessary to install Creative Writer 2. To install Creative Writer 2 under Windows 95 or Windows NT 4.0 1  Ã‚  Ã‚  Ã‚  Ã‚  Insert the Creative Writer 2 disc in your computer's CD-ROM drive.   Ã‚  Ã‚  Ã‚  Ã‚  Creative Writer 2 Setup will start. If it does not start, double-click the My Computer icon on your desktop, double-click the Creative Writer 2 disc, then double-click Setup. 2  Ã‚  Ã‚  Ã‚  Ã‚  Follow the instructions on the Setup screen. Note: If you are running Windows NT, you must be logged on to an account with Administrator privileges to install the product. Creative Writer 2 is installed in the Microsoft Kids folder on the Start menu. Where to Find Help Check the Creative Writer How to... Help (under the big green question mark) for information on how to use Creative Writer or for tips on cool things to do. Creative Writer 2 Home Page Please visit the Creative Writer 2 home page at the Microsoft World Wide Web Site. The address is: http://www.microsoft.com/kids/creative2.htm You can also use the Internet Explorer shortcut provided on the Creative Writer 2 disc. Look there for information on updates and activities relating to Creative Writer 2! Hardware and Software Requirements System Requirements Computer: ï‚ · A multimedia PC or compatible with a 486/33 or higher microprocessor. Memory (RAM): ï‚ · 8 MB of RAM (16 MB recommended for best performance). Hard disk space: ï‚ · 16 MB of free disk space for minimum configuration, 22 MB for full configuration. The Web Publishing Wizard requires approximately 1MB of additional space. Also, additional hard disk space is required for creating documents. CD-ROM drive: ï‚ · 2X CD-ROM drive: This CD-ROM drive can transfer data from the CD-ROM at 300 KB per second while using less than 40% of the CPU bandwidth and has an average seek time of less than 400 milliseconds. ï‚ · MS-DOS CD-ROM Extensions (MSCDEX) version 2.2 or later. Video display requirements: ï‚ · Super VGA display capable of displaying 256 colors at 640 x 480 resolution. Using more than 256 colors may affect performance. A local bus video card is recommended. Operating system requirements: ï‚ · Microsoft Windows 95 or Microsoft Windows NT, version 4 or later. Sound requirements: ï‚ · Windows-compatible 8-bit sound card capable of playing wave sound effects and MIDI music.

Sunday, January 19, 2020

Mary, Queen of Scots Essay -- History

Mary, Queen of Scots Mary Stewart was born December 7, 1542. Her father was James V, King of Scotland and her mother was Mary of Guise of France. Mary was the third child and only daughter of James V and Mary of Guise, since both of her twin brothers had died before she was born at Linlithgow Palace, Scotland. Seven days after Mary was born, James V, died and his infant daughter succeeded to the Scottish throne. Mary Stewart became Mary, Queen of Scots. In 1547 an English invasion led to the military occupation of the country. By 1548, the Scottish were actively seeking French aid and betrothed their young queen to the French dauphin Francis, the son of Henry II, on the condition that Henry send an army to Scotland to drive the English out. French troops arrived in Scotland and the 5year old queen left to spend the next 13 years in France. Mary soon learned to speak in French, which became the language of her choice for the rest of her life. Her education taught her to sing, play the flute and dance gracefully. She spoke and read in six different languages. Mary also had to change the spelling of her last name to Stuart because at the time the French did not have a w in their alphabet. In April 1558 Mary married Francis at Notre Dame Cathedral. Within months, international events changed Mary Stuart’s life dramatically. On November 17, 1558, the queen of England, Mary I (Tudor), died and was succeeded by her Protestant half-sister Elizabeth I. As granddaughter of M... Mary, Queen of Scots Essay -- History Mary, Queen of Scots Mary Stewart was born December 7, 1542. Her father was James V, King of Scotland and her mother was Mary of Guise of France. Mary was the third child and only daughter of James V and Mary of Guise, since both of her twin brothers had died before she was born at Linlithgow Palace, Scotland. Seven days after Mary was born, James V, died and his infant daughter succeeded to the Scottish throne. Mary Stewart became Mary, Queen of Scots. In 1547 an English invasion led to the military occupation of the country. By 1548, the Scottish were actively seeking French aid and betrothed their young queen to the French dauphin Francis, the son of Henry II, on the condition that Henry send an army to Scotland to drive the English out. French troops arrived in Scotland and the 5year old queen left to spend the next 13 years in France. Mary soon learned to speak in French, which became the language of her choice for the rest of her life. Her education taught her to sing, play the flute and dance gracefully. She spoke and read in six different languages. Mary also had to change the spelling of her last name to Stuart because at the time the French did not have a w in their alphabet. In April 1558 Mary married Francis at Notre Dame Cathedral. Within months, international events changed Mary Stuart’s life dramatically. On November 17, 1558, the queen of England, Mary I (Tudor), died and was succeeded by her Protestant half-sister Elizabeth I. As granddaughter of M...

Tuesday, January 14, 2020

The Re-Occupation of Rhineland

This source is suggesting that Hitler was only sending troops to his land which already belongs to Germany. He had right to do this as if you have a garden you are allowed to go there. We can agree with this source because the Rhineland was part of Germany but it had been demilitarised under the Treaty off Versailles. Many people felt the Treaty was unfair and harsh on Germany. Hitler’s actions were reasonable as he was not invading another country.Some people thought though it was breaking the Treaty but doesn’t mean it is going to lead to war. Some of the British also support and hostile to fascist Hitler because they were more concerned about communist Stalin’s Russia. People also thought to believe that Hitler was a peaceful man who wants peace and not a threat to the Britain. British people also trusted Hitler because they made a naval Agreement with him in 1935. They took far more notice of Hitler’s promises.It is reliable because the source is from a British politician so he would know the position of the government and why they have taken no action over the breaking of the Treaty of Versailles. He is trying to explain to the public why the government has taken no action against Hitler. He is trying to justify the government’s decision to do nothing. However the source is not valid because there were lots of other reasons why Britain didn’t oppose against Hitler.Economic trouble during the early 1930s meant Britain had reduced their spending on Arms and their military. Previous to the remilitarisation of the Rhineland, Britain had followed a policy of disarmament which left them vulnerable. Britain believed that even combined with France, they did not have enough power to overcome Germany, not only that but also that they had already met to discuss the possibility of future remilitarisation but had decided against taking any action should it occur.Britain's first priority was to protect their Empire therefore a W ar was not in their best interests as it would mean that the Navy would have to concentrate on other countries instead of the Empire. The policy of appeasement meant Britain wished to avoid War, and the fear that a possible European War could occur also prevented them from conflict as this would help to form an alliance between two powerful fascist leaders, Hitler and Mussolini which was a dangerous risk that Britain was not prepared to take.Britain was also concerned about with the actions of Japan and Mussolini’s invasion of Abyssinia. Overall nobody wanted another war because people could still remember the casualties of First World War. Finally I don’t agree with what this source is suggesting was the main reason that British did not oppose Hitler’s remilitarisation Rhineland in 1936. As we know this source is reliable because many people in Britain at the time thought Hitler was a man of peace and he is only sending troops to Rhineland which belongs to Germ any anyway.However the reason is not completely valid. So with the benefit of hindsight we also know so many things that many public didn’t know at that time. As I mentioned above Britain was behind on rearming. They were more concerned about Mussolini’s invasion of Abyssinia. Britain was also going through economic depression as the America’s Wall Street crashed in 1929. Finally there was a little Britain could do to Stop Germany because nobody wanted another war at any cost.

Saturday, January 11, 2020

Higher education Essay

A committee to look into the functioning of Bangalore University has suggested splitting university into five different universities, Bangalore South, North, East, West and Central. The expert committee consisting of Manipal Global Education Chairman T V Mohandas Pai, former vice-chancellors Dr N Rudraiah, Prof N R Shetty, educationists R Natarajan, KRS Murthy, K Narahari and the principal of University Visveswaraya College of Engineering (UVCE), Dr K R Venugopal, who is also the special officer has submitted its report to the Karnataka government. Reportedly, the report makes three major recommendations — to split Bangalore University into five, to upgrade UVCE as a centre of excellence on par with Indian Institutes of Technology (IIT) and Bangalore University to focus only on research and development. Prof N R Shetty, former VC of Bangalore University, who was on the committee said, â€Å"Considering the huge number of colleges affiliated to Bangalore University and the availability of funds through Rashtriya Ucchathar Shiksha Abhiyan (RUSA) for creation of new universities, we have recommended that five, including Bangalore University, be carved out of the existing university.† As per the report, BU has 614 affiliated colleges and, under the RUSA scheme, there is an option for states to create one university with 100 colleges. â€Å"As far as funds are concerned, it will not be a burden on the State government since the RUSA scheme proposed by MHRD will provide funds for the newly created universities based on the quality of education,† Shetty said.â€Å" There is a need to improve research and technology under Bangalore University. With such a high number of affiliated colleges, it won’t be possible to concentrate on research activities,† he added, reported New Indian Express.

Monday, January 6, 2020

I Learned About Literature, Reading, And Even - 1773 Words

Throughout the course of this class, I learned much about literature, plot, form, and more so about the meanings with which authors imbued their works. All of my life, I have seen myself as a fan of literature, reading, and even (on occasion) devouring books as the mood took me. My pleasure in them was tied to certain ineffable qualities of the books, primarily related to the sense of enjoyment I received from it. This in turn was tied to the pacing of the plot, the familiarity of the main characters, and the extent to which I could relate to them. In other words, reading had always been an affair chiefly centered squarely on me, and what I could receive from it, primarily being enjoyment. During this course however, I began to notice a change in my literary consumption, for instead of analyzing only how a work made me feel, and what I liked from it, I began to wonder what the author was thinking, and what the motivation of the author had been to come up with such a piece. 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Friday, January 3, 2020

Top-5 Movies about College Life

For some reason, people like watching movies and reading books about their own life. Not their own in particular, that is, but the life of their own social or professional group – programmers like movies about programmers, teachers like movies about teachers and so on. Sometimes they like them because they get something right, sometimes – because they get everything hilariously wrong. College movies are special in this respect because they are interesting not only for college students, but for the people whose college years are long past – just because it is fascinating to remember this period of your life. If you don’t know what to watch, here are five movies you may want to start with. Animal House, 1978 Animal House follows the exploits of a group of happy-go-lucky fraternity members and their struggle against an upright dean of their college who desperately wants to get rid of them and their fraternity. Hilarity, as one can expect, ensues. Shot for a meager sum of 2.8 million, the movie eventually gathered about $141 million, becoming one of the most successful movies of all time and immediately achieving the status of a living classic. So you may be sure it is really worth watching. Accepted, 2006 Unpretentious yet still funny movie about a high school graduate who, after being rejected by all possible colleges, uses unconditional approach to the problem by starting a fake college of his own. This fine establishment quickly gathers around itself a number of similar rejects and forms its own curriculum, including a wide range of ridiculous disciplines. Finally, as is expected, the college is accepted as a real one. Old School, 2003 Three old friends, depressed by their lives, rent a house in the vicinity of a college and, trying to relive their days at college, start a fraternity. To their surprise, this fake fraternity attracts a great amount of other people looking for an outlet for interminable boredom and blandness of their everyday lives. Thus what started as a prank becomes quite real, leading to both funny and sad consequences. Rudy, 1993 If you are in for something less funny and more serious, pay attention to Rudy. Based on a true story, it tells us the story of Daniel †Rudy† Ruettiger, whose greatest dream is to attend the University of Notre Dame and play football for its team. Although he faces considerable obstacles, he manages to fulfill his dream. It may be considered to be a pretty usual plot for a sports film, with one correction – it is a very good sports film. A Beautiful Mind, 2001 Although not a college movie per se, A Beautiful Mind has a rather big section based on college years of the main character, mathematician John Nash, during which he first encounters his mental illness. In addition to these five titles you may be interested in some other movies on the same topic: Revenge of the Nerds. Good Will Hunting. The Social Network. The Rules of Attraction.