Assessing the Progress and Challenges of Opt-out HIV Testing in the United States

by Herman Bailey | Jan 24, 2023 | Essays | 0 comments

Opt-out testing for human immunodeficiency virus in the United States: progress and challenges
Summary of the controversial recommendations

The Centre for Disease Control and Prevention (CDC) recommended testing of Human Immunodeficiency Virus (HIV) for all people aged between 13 years to 64 years in all the healthcare settings for screening. They include:

• All patientsaged between 13-64 years should be screened in all healthcare settings. Theseincludepatients in clinic, hospitaladmissions, andemergencydepartments in which the screening yield has a likelihood of being 1 out of 1000 screenedpatients (Palella et al, 1998; Walensky, 2006; Sanders et al, 2005).
• In the clinical settingshaving a less than 0.1% prevalence, they should conducttargettesting that is based on HIV risk, including behavioural risks, STDs, Tuberculosis patients, andrecentimmigrants from countries with highprevalence (Bartlett et al, 2008).
• The patients with risks that are knownfor HIV infection should be testedannually at minimum, andtheyincludepeoplewhoexchangemoneyordrugsforsex, injectiondrugaddictsand their sexualpartners, menwhohavesexualintercourse withmen,sexpartners of personsinfectedwith HIV, heterosexualsand their sexpartners (Bartlett et al, 2008).

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What makes them controversial and whether you feel they are justified?

The screening recommendations by CDC are controversial in many ways. First, the general consent for health care which also encompasses HIV screening in healthcare stings, states that the patients should be informed either in writing or orally that HIV test will be done that they may decline testing or obtain more information concerning the test (Bartlett et al, 2008). However, according to the recommendations provided by CDC, all patients aged between 13-64 years should be screened in all healthcare system. healthcare settings. There is a discord since compulsory testing of patients in all health care settings be it through admissions or in the emergency department is not in line with the requirement for pre counselling of the patients and getting their opinion of getting tested or declining (Bartlett et al, 2008).

As much as the recommendations are controversial, I believe the recommendations of CDC are justified. It is important to conduct screening of HIV on every patient so that any early detection will be enrolled in antiretroviral therapy immediately to prevent late medication that is dangerous

Describe the epidemiological evidence in support of your position

Surveillance of Domestic HIV indicates consistently that about 40% of patients receive diagnosis of AIDs within one year after their first test result that was positive (CDC, 2006; CDC, 2003). Natural history of infection by HIV indicates that averagely 7-9 years after infection elapse before diagnosis, in which an individual may transmit HIV unknowingly or fail to get effective therapy. Palella et al (1998) and Walensky (2006) indicated that highly antiretroviral therapy in the first decade in United States has saved approximately 3 million life years. However, averagely survival rate is estimated to be 11 years longer when commencement of treatment to an individual when they has a CD4 count of 320 cells/μL vs 87 cells/μL (Moore, Keruly and Bartlett, 2008).

Identify whether the prevention program you review is population or high-risk based and how that influences your assessment

The prevention program reviewed is population-based, and it has influenced my assessment in many ways. First of all, the program’s recommendations conflicts with the federal and other state agency laws hence difficult to assess properly (Hanssens, 2007; Gostin, 2006; Bayer and Fairchild, 2006). Moreover, there is the absence of the mandated primary HIV prevention counseling (Hanssens, 2007; Gostin, 2006). There is also the persistent stigma that is linked to infection by HIV (Gostin, 2006; Lifson and Rybicki, 2007; Valdiserri, 2007; Holtgrave, 2007; Gruskin, Ahmed and Ferguson, 2008), the fear of discrimination amongst the patients and the general; belief among people that risk-based testing is very cost effective (Holtgrave, 2007).

References

Bartlett, J. G., Branson, B. M., Fenton, K., Hauschild, B. C., Miller, V., & Mayer, K. H. (January 01, 2008). Opt-out testing for human immunodeficiency virus in the United States: progress and challenges. Jama, 300, 8, 945-51.

Bayer R, Fairchild AL.(2006). Changing the paradigm for HIV testing—the end of exceptionalism. N Engl J Med;355(7):647-649

CDC. (2003). Late Versus Early Testing of HIV—16 Sites, United States, 2000-2003. (July 23, 2003). Jama, 290, 4, 455.

Centers, . D. C. P. (May 01, 2007). Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings. Annals of Emergency Medicine, 49, 5, 575-577.

Gostin, LO.(2006). HIV screening in health care settings: public health and civil liberties in conflict? JAMA; 296(16):2023-2025.

Gruskin S, Ahmed S, Ferguson L. (2008). ProviderinitiatedHIV testing and counseling in health facilities—what does this mean for the health and human rightsof pregnant women? Dev World Bioeth;8(1):23-32

Hanssens, C.(2007). Legal and ethical implications of optout testing. Clin Infect Dis;45(suppl4):S232-S239.

Holtgrave DR.(2007). Costs and consequences of the US Centers for Disease Control and Prevention’s recommendations for opt-out HIV testing. PLoS Med. 2007; 4(6):e194.

Lifson AR, Rybicki SL.(2007). Routine opt-out HIV testing. Lancet;369(9561):539-540.

Moore R, Keruly J, Bartlett JG.(2008). Person-years lost by late presentation for HIV care in Maryland. Presented at: 15th Conference on Retroviruses and Opportunistic Infections; February 3-6; Boston, MA. Abstract 805.

Palella FJ Jr, Delaney KM, Moorman AC, et al; (1998). HIV Outpatient Study Investigators. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. N Engl J Med.338(13):853-860.

Paltiel AD, Weinstein MC, Kimmel AD, et al. (January 01, 2005). Expanded Screening for HIV in the United States—an Analysis of Cost-effectiveness. N Engl J Med;352(6):570- 585.

Sanders, G. D., Bayoumi, A. M., Sundaram, V., Bilir, S. P., Neukermans, C. P., Rydzak, C. E., Douglass, L. R., … Owens, D. K. (January 01, 2005). Cost-effectiveness of screening for HIV in the era of highly active antiretroviral therapy. The New England Journal of Medicine, 352, 6, 570-85.

Valdiserri RO. (2007). Late HIV diagnosis: bad medicine and worse public health. PLoS Med;4(6): e200.

Walensky RP, Paltiel AD, Losina E, et al. (2006). The survival benefits of AIDS treatment in the United States. J Infect Dis;194(1):11-19.

Walensky, R. P., Weinstein, M. C., Kimmel, A. D., Seage, G. R., Losina, E., Sax, P. E., Zhang, H., … Paltiel, A. D. (March 01, 2005). Routine human immunodeficiency virus testing: An economic evaluation of current guidelines. The American Journal of Medicine, 118, 3, 292-300.

Herman Bailey

With a student-centered approach, I create engaging and informative blog posts that tackle relevant topics for students. My content aims to equip students with the knowledge and tools they need to succeed academically and beyond.

The Vagueness of Globalization: Analytical Meaning and Intellectual Value

by Herman Bailey | Jan 23, 2023 | Essays | 0 comments

Introduction

The term globalization is not a single concept that can be encompassed and defined within a set time frame. Similarly, it is not a process that can be defined clearly neither at the beginning nor an end. Globalization cannot be explicated upon with certainty and become applicable to everyone in every situation. The term globalization incorporates cultural stability; the relations, reproduction. Equally, globalization involves economic integration such as the transfer of policies across the border and the discourses of power for instance; it is a global concept, a process, a revolution and the establishment of global market free from the control of social and political issues (Held & McGrew, 2007). Therefore, globalization umbrellas everything with political, economic and social nature, and the concept of globalization has received various definitions over the previous years. Some connotations have referred to globalization as the progress, integration and cooperation, development and stability while other referring to regression, destabilization and colonialism.

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Despite the robust challenges, the term globalization brings a pool of hidden agendas. An individual geographic location, political ideology, social status, ethnic and religious backgrounds, and cultural background provides the platform for interpreting globalization. For instance, in 1995, the resident of the Third World Network, martin Khor, referred to globalization as colonialism (Held & McGrew, 2007). Concurrently, a journalist of Sweden in his book the “Race to the Top: The Real Story of Globalization (2001) indicated that globalization is the concept of world shrinkage of things moving closer and distances getting shorter. He added that globalization pertain the inclined ease that an individual from the other side through mutual benefits interact with someone on the opposite side (Hay & Marsh, 2001). Therefore, the two dissimilar interpretations reference the rotated perspectives in different world positions.

The nature of globalization provides a span of multitude of communities, disciplines and cultures. Notably, this has opened a room for multiple points of view, social, economic and political. The impacts of globalization are diverse, and the definitions presented by a scholar’s evidences. Therefore, questions still remain based on the potential difficulty of providing an elaborate definition to the concept alongside the challenges intertwine in trying to do so. Globalization is a vague concept because it provides various aspects and scholars who discuss the term provides the different aspects of globalization. The various aspects that include economic, social, political and religious aspects are all housed by globalization concept. Globalization discourses were initially polarized onto the con and pro attacks or celebrations. The view of critics provides that the globalization provides a cover of concepts for global imperialism and capitalism. Therefore, the term is condemned as a different form of logic of capital imposition and the market on a constant and continual on spheres of life and regions of the world(Dicken, 2010). However Hirst, Thompson and Bromley (2009) subscribes that the defenders of globalization provides that it is modernization continuation and progress force, freedom, increased wealth, democracy and happiness. The champions of globalization present it as generating fresh economic opportunities, beneficial, cultural diversity, political democratization and an opening of the new existing world.
The distractors observe globalization as harmful, controlled by the wealthier overdeveloped nations over the poor third world countries and bringing about inclined dominion. Therefore, Kitching (2001).asserts that distractors detect globalization as increase the hegemony of the ‘have nots’ and the ‘haves’. Additionally, the supplementation of the negative view, the critics of globalization reestablishes that globalization leads to the undermining of democracy, inclined destruction of the environment and natural species, and a cultural homogeneity (Mittelman, J2000). Likewise, some scholars imagine the project of globalization whether viewed positively or negatively, as beyond intervention and human control and inevitable. However, others view globalization as a process of generating new spaces for struggles and conflicts, distinguishing between globalization from various aspects (Kitching, 2001).
The assertions of the critical theory that discusses the fundamental transformations in the economy, culture and politics of the world based on a dialectical framework provides distinction between the emancipatory and progressive features. The theory provides ambiguities and articulations of globalization and the imposition of globalization from various aspects. Rodrik, (2011) argues that understanding the concept of globalization is theorizing the term as a product of global restructuring of capitalism and technological revolution that features the technological, economic, cultural and political aspects intertwined. Rodrik, (2011) writes that based n this perspective, an individual should limit both economic and technological determinism as highly contradictory, complex and thus ambiguous set of social relations and institution relations alongside the flow of ideas, goods, cultural forms, services and people. Illustratively, Stubbs and Underhill (2005) argues that the subsequent wars in Iraq and Afghanistan and the September terrorist attacks provides a display of the ambiguities and contradictions embedded in the concept of globalization that demands dualistic and critical perspectives to illuminate and clarify the global events. The author argues that the ensuing of Terror Wars and terror attacks illustrates the contradictions in the concept and nature of globalization that needs dialectical critique and analysis. Stubbs and Underhill, (2005) concludes that some reflections based on the implications of September 11 and continuous terror war for the democratic politics and critical social theory, envisaging a new movement around the globe against militarism and terrorism and for peace, democracy, social justice and environmentalism.
With reference to critical social theory, the concept of globalization incorporates both sets of social relations and capitalist markets and flows of capital, commodities, form of culture, technology, and people across the boundaries of nations via the globally networked society (Rodrik, 2011). Therefore, in a globalized network society, the technological transmutations and the capital work together t generate an increasingly interconnected and globalized world. The revolution of technology mentions the creation of computerized network of transportation, communication and presupposition exchange of the globalized economy. Likewise, the world capitalist market system extension that constantly absorb additional areas of spheres and the world of exchange, production and consumption into orbit is unclearly understood. According to Rodrik (2011) the revolution of technology presupposes global computerized networks and the movement of information, goods and people across boundaries of the nations. Therefore, the global computer and the internet make the concept of globalization possible by producing a technological infrastructure for the world economy. As Ravenhill, (2011) establishes, the satellite communication system, computerized networks, and the hardware and software that facilitate and link together the global economy is dependent on the breakthroughs in microphysics. He writes that the techno-science has generated powerful and sophisticated computer chips, and transistors, technological revolution, and integrated circuits that lead to an infrastructure for the society and the global economy.
Mittelman (2000) accomplishes that based on the technological revolution perspective, the concept of globalization cannot be understood without comprehending technological and scientific revolutions and capital global restructuring that forms the matrix and motor of globalization. However, the theorists of globalization either fails to account for the fundamental significance of technological and scientific revolutions and the new technologies that assists spawn globalization or provide an empirical interpretation of the process in a deterministic framework based on technology that occludes the imperatives economic dimension and the capitalism institutions. Therefore, Mittelman (2000) concludes that such biased optics fails to grasp the science coevolution capitalism, and technology and the highly ambiguous and complex globalization systems that incorporate democracy and capitalism, turbulent mixture of benefits and costs, technological mutations and losses and gains. Therefore, in order to theorize the globalized economic network, it is necessary to avoid the extremes of economic and technological determinism. The use of technological determinants frequently applies the postindustrial discourse, society or postmodern to describe the current developments.
According to Kitching (2001) the economic reductionism and determinism that merely depicts globalization as a market capitalist fails to comprehend the new modes and forms of capitalism itself that are entirely based on the novel of development of technology, culture, science, and everyday life. Furthermore, the technological determinism fails to recognize how the new economy and the new technologies are part of the capitalist restructuring, however, not autonomous forces that themselves are engendering a new economy and society that breaks with the past social organization mode. The postindustrial society has been referred to as information society or knowledge society that information and knowledge are given roles more prominent than the previous days. Therefore, it presumed that information and knowledge sectors are significantly important domains of the contemporary moment (Hirst, Thompson & Bromley, 2009). Hence, the postindustrial theorists are not ideological and are far off the mark as a majority of the critics argues.
Likewise, some post-structural theories stress that the globalization complexity exaggerate the autonomous and disjunction flows of people, culture, technology, and goods, thus the critical theory of globalization views globalization in the capitalist theory that involves restructuring and technological revolution(Hirst, Thompson & Bromley, 2009). Therefore, whoever wants to talk about capitalism, must mention globalization. Besides, it is impossible to debate or argue about globalization without mentioning restructuring of capitalism. The concept of techno-capitalism is beneficial in describing technology and capital synthesis in the current societal organizations (Held, McGrew, Goldblatt & Perraton, 1999). Unlike the postmodernity theories or the information and knowledge society that provides arguments that technology is the new societal principal organizer. The concept of techno-capitalism observes both the enduring primacy of the capitalist relation and the increasing significance of technological role of production. In the era of unrestrained capitalism, it is nearly impossible to object that the contemporary societies are still under the organization of capital and production accumulation and the imperatives of the capitalist continues to dominate distribution, production, and consumption alongside political, social and cultural domains. Therefore, the workers remain exploited by the capitalists, and the capital persists as the hegemonic force.
The view of current globalization definitions can arguably leave an individual feeling more confused in the discourse than before. The presence of numerous definitions and interpretations clearly indicates the diverse opinions developed regarding the globalization concept since it appeared in the Webster’s dictionary in 1961. As Held and McGrew, (2007) establishes, the previous decades have permitted humankind creativity to develop numerous definitions for globalization. Since the debate on the vagueness of globalization majorly stems from the concept of definition, t is significant to observe the definition progressions and the diverse connotations that have emerged. Held and McGrew, (2002) records that there is a minimum of 67 definitions that makes the reference to dimensions of the economy either through selling of goods and services or through market expansion. As established, most of these definitions incorporate other dimensions of political and social aspects. The researcher further illustrates that the definitions tend to be complex and multifaceted. They are hardly confined to few words; however, an elaborate definition focuses on the norm of addressing the concern. The illustrative globalization complexity in an attempt to the process through which globalization effects are experienced, whether economically, politically or socially, an individual often finds the subject debatable and multidimensional. Therefore, it appears to be universal that most of the authors have structured lengthy definitions. Based on the concept, it is reasonable to assume that the term globalization is meaningless and confirming its vagueness.
Held and McGrew, (2007) indicates that the term globalization is evolutionary it is a fluid process that constantly changes as the human society develops. The evidence is provided when assessing the numerous definitional ideas from authors. This paper presents an argument than individual’s own perspective that provides a definition for globalization, thereof, shapes any definition. One could confer based on the impact of globalization for days without exhibiting a clear understanding the clear meaning of the term. Through analysis of the complexity of globalization, it forces the issue to get simplified in at least two sentences. Therefore, the core of the discourse is purely determined by the author. The definition provides an elaborate indication of the perspectives of the author on the concepts of globalization, particularly, the meaning in the geopolitical terms. Therefore, by providing an abstract concept with nothing substantial there is no point of reference. In any way, the overview of definitions has clearly indicated that globalization is many things to numerous dissimilar people. As Garrett (1998) noted, globalization refers to a word of things with dissimilar axes, speeds, terminations, and points of origin and varied relationships to the structures of institutions, in various nations, regions or societies. Therefore, the assertions from the author capture the vagueness of globalization based on the complex definition. Thus, it implies that a further elaboration of globalization would not be beneficial in particular.
The future of globalization is a venture that no scholar would attempt to predict. The concept fluidity provides concrete recommendations for a definition difficult. Just by observing the changes in the definition of globalization over the previous years, it is reasonable to ascertain that the future may never provide any refined or simpler process of arriving at a clearer process conceptualization. Furthermore, the challenge of trying to understand globalization fully may never appear any soon (Dicken, 2010). By exploring the various thoughts and definitions, behind the idea of globalization, it is clear how the concept has been identified by academics and scholars over the course of nearly thirty years. As the existent of globalization is dictated by means and times, to dissimilar international system and societal facets, it implies that it can never be fully defined to the point of satisfaction of all the individuals impacted by the implications of globalization. The challenge provides that the definitions do not permit compressive understanding of the concept of globalization and is inconsistent and less extended to allow what lies on the core of the founder of globalization. Therefore, in reasonable terms, globalization is a term without coherent meaning and too ambiguous.
Ideally, the ambiguity of globalization requires the anti-corporate globalization movement to reconsider its agenda, nature, and goals. The concepts used in globalization are interchangeable to the authors the term globalization has been used where it provides openness. However, the product of globalization is the individual increment of openness of numerous countries and their global economy integration. Likewise, anybody making an attempt to follow the debate of globalization would notice the contradiction claims made by the critics and supporters to the very fundamental question (Hay & Marsh, 2001). Equally, both sides have supported their claim with facts; however, instead of clear truth evolving, there have been inclined heated debates. Therefore, it is reasonable to assert that the term is meaningless.

Conclusion

The stemming literature on the debates of the term globalization has inclined in the previous decade beyond the capability of any individual to extract a workable definition of the concept. Sensibly, the meaning of globalization may be self-evident, however, in another it is vague and obscure as the reaches of the concept are constantly shifting and relatively wide. The debate over globalization presents a robust part of the lifeblood. It reputable to draw that debate is globalization and globalization is debate. Thus, without one, the other is inconvincible. The subject of providing a coherent understanding of globalization can be deemed useless because of the ambiguity, shifting nature and its influence from the viewers’ perspectives. The search of comprehending globalization, therefore, can assist in reconsidering the focus of responses needed, and policy challenges that n turn would shade additional light on the process of globalization and its numerous impacts on the stability. Holding that it is nearly impossible to generate a definition style of the Webster dictionary is part of what evidences the meaningless and vagueness of the term globalization.

Herman Bailey

With a student-centered approach, I create engaging and informative blog posts that tackle relevant topics for students. My content aims to equip students with the knowledge and tools they need to succeed academically and beyond.

Analysis of Dirty Devil Advertisements: A Study of Their Effectiveness and Target Audience Appeal

by Herman Bailey | Jan 23, 2023 | Essays | 0 comments

An advertisement is usually designed to inform, attract, and win the attention of prospective customers. In coming up with an ad, the company has to ensure that it meets all the above qualities within the shortest possible time. Mostly, people do not have time for commercials, and their charges make it necessary for companies to make them as brief as possible. To achieve its desired goal, an ad has to be attractive enough to capture the attention of its target audience. In this paper, out attention shall be focused on two Dirty Devil ads on a similar audience. The first ad is a German version (AndreP) and the second the British version (Dirty devil). Both ads in their own way show how the suction power from a dirt devil vacuum cleaner is effective for cleaning. The paper shall also determine whether the ads achieve their intended objective and if they are appealing to their target audience.

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Before looking at the advert, the brand name of the product speaks a lot, which may attract or put off potential customers. The product mainly targets female clients, who handle the cleaning around. The term ‘dirt devil’ does less in attracting first-time customers, unless they understand what it is all about. It is recommended that a brand given to a product does more explanation of its functions and use rather than wait for an oral or visual explanation. I had to watch the ad for about three times before I get to know what dirt devil is all about. The advertisements welcome us to scenarios that are unrelated to cleaning or the vacuum cleaner before they later climax with the information. It is only after watching the film several times that a person tries to make a connection between the images were shown and the vacuum cleaner. The advertiser may have related the wicked acts of the devil with dirt and the ability of the vacuum cleaner to eliminate such fears.

To figure out which ad conveys its message to the audience well we shall look at the presentation style of both ads. For instance, as mentioned earlier, the target audiences for the German version of the ad are housewives. The announcement has been presented in a rather spiritual manner with the ability to exorcise demons/dirt. This means that the ad intended to capture the religious emotions of its audience. With such considerations in mind, it may be assumed that German housewives are religious and will, be attracted to anything that touches on their spirituality. In the ad it appears that demons are a nuisance and almost impossible to get rid. In cleaning matters, these demons are stubborn dirt that is hard to clean. The use of the ‘dirt devil’ vacuum cleaner hence works like prayers, which are believed to be an absolute way of dealing with evil spirits (Neuendorf 82). To the mind of the audience, it implies that dirt vacuum cleaners remove dirt in the house just like the power of prayers to eliminate evil spirits.

This ad has various limitations in conveying its message to the audience. First, for the for the target audience to get attracted and even buy the product, they must be a committed Christian. They must believe that prayers can exorcise demons. The ad, therefore, narrows down the target audience from just Christian housewives, and not just any Christian, but one who believes in the power of a vacuum cleaner too. The adverts may therefore not have an impact on the majority of the people. In my opinion, the advert could have been less spiritual and just focus on dirt without having to involve matters of spirituality. Business ads should aim at targeting more audience than limiting themselves to just particular class of audience. Political, cultural, and religious matters need not to be placed in ads. By placing a Christian exorcism clip, the ad has already lost a number of audience and potential buyers.

The second ad, the British Version of the dirty devil vacuum compared to the German version is shorter and appears to target younger professional women. The ad displays information that a woman can still be in her neat office attire and still use the vacuum cleaner to clean dirty surfaces. Unlike the first ad, which was scary, this ad included humorous aspects.

Compared to the German ad where one can quickly draw a connection between the ad, brand name and the images, the British version leaves more questions than answers about the product being advertised. The only thing that a person can get from the ad is the humor of the hair changing heads, whose meaning is difficult to depict. A good ad should not only be accompanied by humor but also ensure that it conveys the needed information (Neuendorf 55). A person can only buy a product basing on how it has been displayed the advertisement. If the ad is not appealing enough and leaves a potential consumer with more questions, they may not want to watch a second time, leave alone buy the product.

Looking at the two ads, it is clear that the advertisers wanted to mix various aspects and the product. For instance, the German ad embraces aspects of spirituality and the British ad embraces humor. The German ad may have succeeded in showing that the product can remove dirt, from wherever it is hidden. However, the exorcism does not do much in attracting potential clients rather it scares them. Precautions have to be taken when using the spiritual connection of the people to promote a product. The sensitive nature of religious matters makes it easy for the advert to irritate the target audience, rather than attract then to the product. While designing an advert, the advertiser needs to note that it could be the first and the last time that a person is encountering it. The message being conveyed should, therefore, be simple and clear enough to prompt curiosity and the need to buy the product.

In the world where technology is ruling the activities of man, including cleaning, companies are coming up with products that are sure to blow one’s mind. Before a person tests a product to prove its worth, the advertiser should work at ensuring that he or she is not only aware of its existence, but also curious enough to try it. Most companies with quality products fail at a critical stage of advertisement, which makes them not gain value for their products. In my opinion, the advert on ‘dirt devil’ not only failed in its branding but also in the promotion of the products. The association of the product with the devil is enough to put off potential customers. Adverts need to have the element of positivity that relates with the audience. In this manner, the message will be conveyed effectively and attract potential buyers.

Works Cited

AndreP. “Dirty Devil- The Exorcist.” You tube. Dirty Devil Germany, http://www.youtube.com/watch?v=aGb8pMIeY6w .You Tube. You Tube, April 29, 2011. Web. Retrieved 29, June 2015.

Dirt Devil UK. Dirty Devil vacuum advert. http://www.youtube.com/watch?v=kNaOqZ8E_Vc You tube. Dirt devil UK, December 7, 2010. Web. Retrieved 29, June 2015.

Neuendorf, Kimberly A. The content analysis guidebook. Sage, 2002.

Herman Bailey

With a student-centered approach, I create engaging and informative blog posts that tackle relevant topics for students. My content aims to equip students with the knowledge and tools they need to succeed academically and beyond.

Artistic Representations of the New World: A Comparative Analysis of Paolo De Matteis, Philip Barlow, and Michael Bohme

by Herman Bailey | Jan 23, 2023 | Essays | 0 comments

The painting is a masterpiece by Philip Barlow referred to as the sky includes is a collection of four different paintings. The painting caputres the New World themes of fantasy and landscape. The paintings are present realistic picture and can currently be found in the Philip Barlows’ art gallery website ( “Barlow” , Art 21)

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Figure 5 A depiction of a large station ship in the far future by Micheal Bohme.

The Ark Space is a master piece science fiction artwork by Micheal Bohme, created in 1997. The image is a representation of a large space station in the far future. The piece was published in the exhibition catalogue of the Chicago Art Institute, in the Buildings for space travel (“Mohme”, Art21).

The painting by Paolo De Matteis is referred to as The Triumph of the Immaculate from the Baroque art movement. The masterpiece was painted in Italy around 1710 and can be found in Gemaldegalerie-Berlin ( “Matteis” , Art21).

INTRODUCTION.

There exist various concepts of the new world. They include, science fiction, fantasy, landscape, discovery voyages, the spirits just to mention a few. Works of art play a significant role, for entertainment, educational, a reflection of the society’s moral values, political significance, religious significance, and problems to the society is faced with. Both current and previous artworks carry significant themes of the New World. All these paintings represent a particular social context dispensing on the understanding of its audience. There exists a number of good painters since time memorial. Paolo De Mattei is an Italian painter famous for his painting, The Triumph of the Immaculate. The piece is a fantasy narrative detail, it is a full story presented as a painting. The painting is of the baroque era, with their visceral images and easy to understand. The painting is a dramatic fantasy in that it captures the events and narrative of the ascent to the highest order of existence of well put together beings in drab colors. Ark in Space, a painting by Micheal Mohme is the latest of the three paintings this paper shall discuss. The painting is a depiction of a large space station in the far future. This painting is a reflection of new technological inventions and innovative ideas of the world. The painting is a 19 by 23 in size and it is painted on painted on acylic canvas.

The sky by Philip Barlow, is a collection of four paintings. All the paintings are painted from a horizontal angle and capture the the hilly part of the landscape. The afternoon painting show the sky covered in dark clouds and the landscape all cloudy as if to indicate presence of rain. The second afternoon picture has sparse clouds with a clear sky. In addition, there is an orange light as if to indicate the presence of the sun on that day. The third picture in the collection, is all bright will a very blue sky. There are few clouds and the sun seem to cast a shadow on the landscape. In this painting the time of the day is probably late in the evening when the sun is setting. The last picture is all bright. The landscape is all brown and looks dusty. The sky is partly cloudy and the sun seem to be rising. All the pictures in the sky collection show the sky and the landscape and the different times of the day displaying different weather conditions. These artworks not only show the landcape but also includes some aspects of fantasy of the sky and the landscape of the earth.

The Triumph of the Immaculate is an artistic work created by Paolo De Matteis. The style period of this painting is Baroque. The triumph of the Immaculate is in oil and canvas that is in medium size painting. The images are covered in shadows cast by the brilliant white light from the clouds. The piece was painted in Italy around 1710 and is available in the Gemaldegalerie, Berlin. The painting carrys with it the New World theme of spirits. The images in the painting are glowing a relection of more an unnatural beings. The painting carries the spirituality and fantasy themes. Baroque makes the main character the most dominant in its art and architecture. Other symbolic paintings include God, who is shown in the lighter glow and the Pope, who is portrayed as small and insignificant.

The Ark Space carries the science fiction and space fantasy themes. Tthe painting adopts a 3-D format and reflects moving pictures. The face of the painting is covered in glowing silver like material. In the painting, Micheal, show the future space and scenes of current world explorations. The images in the painting reflect alien life. Looking at the images one would notice other round objects that look like planets, the whole painting is a reflection of how the view of life from another planet looks like. The painting is an imagination and an exploration of the solar system. In the social context the painting is a symbol of the human events and experinces of the mind and soul. The painter has incorporated environmental aspects such as trees and vegetative plantation to symbolize life and human dealings with nature. The painting also captures different times of the day and year.

The three paintings show different style movements and come from different time periods a reflection of the different New World themes. Consequently, the styles employed in the paintings are influenced by the periods they were painted in historical events and cultural aspects and relied on the exact events captured in the paintings. Paolo de Matteis work was purely a fantasy of a religious war motivated by the desire to contribute to the historical religious fight while Barlow’s captures a real events of the landscape. Mohme’s work on the other hand, is a prediction of the future, a representation of both fantasy and science fiction. Therefore, the three paintings serve as a reminder of events that occurred during those periods and expected events of the future.

CONCLUSION

The Triumph of the Immaculate, The Ark Space, and The Sky are significant pieces of art in religious, political, cultural and landscape. The Triumph of Imaculate for instance, captures the spirituality and fantasy themes. Barlow’s piece on the other hand, displays the landscape and atmosphere. The different paintings all relate to the landscape. Through the paintings one can tell the time of the day they each represent.

Works Cited.

De, Matteis. Paolo De Matteis: Artist File.1920. Frick Art Reference Library

Barlow, Philip. Philip Barlow:Artist File.1998. Philip Barlow Art Gallery.

Mohme, Micheal. Mohme Micheal: Artist File. 1997. The Metropolitan Musuem of Art. New York City.

Herman Bailey

With a student-centered approach, I create engaging and informative blog posts that tackle relevant topics for students. My content aims to equip students with the knowledge and tools they need to succeed academically and beyond.

EBP Proposal Project for Acupuncture: An Evidence-Based Practice Proposal

by Herman Bailey | Jan 23, 2023 | Essays | 0 comments

Abstract

The EBP Proposal project proposed acupuncture as an alternative to adjunct standard medication therapy in pain management of osteoarthritis (OA) amongst women aged 55 years and above. The clinical question is, “In women above 55 year old suffering from osteoarthritis of the lower back, how does acupuncture compared to the adjunct standard medication therapy decrease pain within 6 months?” the aims of the study are; Suggestion for acupuncture therapy for Osteoarthritis patients, Symptom management of OA, Pain alleviation for the OA patients, Improving functional status especially on the joint performance as well as enabling easy and painless movement by the patient, and Controlling disease progress. The paper reviewed, synthesized and summarized different studies from various databases with a span of less than five years. The project will apply quasi-experimental study design by use of a randomized controlled trial of the acupuncture therapies on the sample population of women beyond 55 years with osteoarthritis. Some of the instruments that will be used in the study include chart audit to track changes from the onset of the study to the end, and 100mmVisual Analog Scale (VAS) for measuring pain.

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Acronyms

Part1- Introduction

The identified practical issue the paper will address is the osteoarthritis in women above the age of 55 years. The Evidence-based practice (EBP) project will be present acupuncture as a pain management method on a patient whom has problems with osteoarthritic pain. Many people suffer from osteopathic pain which involves the joint. The cartilage or cushion between joints becomes swollen and stiff due to the break down causing pain. The major factor causing OA consist of excess weight, injury or overuse and genes, and other developmental issues. At least 80 percent of the people over 55 will show x-ray symptoms of Osteoarthritis in at least one joint (Cherniack & Cherniack, 2013). Before 55, Osteoarthritis is common in men. However, after 55 it becomes more common in women (Pelletier, 2010). Pain management is the challenge to these patients. Treatment options include medication, surgery, and therapy. The frequency of the disease calls for the adoption of alternative therapeutic approach in management. Given that it is a chronic illness, development of customized solutions for patients has enabled substantial benefits in the control of the disease. The EBP will majorly focus on acupuncture as a pain management method to osteoarthritis of the lower back for women aged 55 years and above.

People suffering from OA and seek pain relief outside the mainstream medicine have the option of acupuncture. According to Bahrami-Taghamaki et al (2014), acupuncture for thousands of years have been practiced and plays a significant role in pain relief. Using this treatment method, acupuncturists relieve pain by inserting slender metallic needles at specific points on the body. In their study, Manyanga et al (2014) elaborated that well inserted needle produce a signal that travels to the brain along the spinal cord. This triggers a release of enkephalins and endorphins which are transmitters that reduce pain sensation. Similarly, other studies suggest that inserting the acupuncture needle triggers cortisol production. Cortisol is a hormone that assists in controlling inflammation. Relief of pain is a matter of great concern to patients that suffer from OA and therefore detection of difference in results on the 100mmVisual Analog Scale (VAS) line is regarded as a change that is important clinically to patients having chronic pain.

Aim of project:

This project seeks to introduce acupuncture as the efficient, affordable and sustainable pain management solution for osteoarthritis in women over 55 years old. The paper hope to achieve the following improved outcomes:

1. Suggestion for acupuncture therapy for Osteoarthritis patients.
2. Symptom management of OA
3. Pain alleviation for the OA patients
4. Improving functional status especially on the joint performance as well as enabling easy and painless movement by the patient
5. Controlling disease progress

PICOT Question

In women above 55 year old suffering from osteoarthritis of the lower back (P), how does acupuncture (I) compared to the adjunct standard medication therapy (C) decrease pain (O) within 6 months? (T).

(P)- Population: The population will comprise of women aged 55 years and above who are ailing from OA of lower back.

(I)-intervention: Acupuncture treatment method will be given to the subjects.

(C)- Comparison: In the study, adjunct standard medication therapy will be used. The control group would be given adjunct standard medication therapy as a comparative treatment.

(O)- Outcome: Pain alleviation and increased joint functionality from the subjects under acupuncture treatment. This will be measured using 100mmVisual Analog Scale (VAS) that will be administered before treatment and after 6 month acupuncture treatment.

(T)-Time: The outcome will be measured after 6 months.

Significance

Adoption of acupuncture treatment method is of importance to manage the effects and suffering of OA patients. There have been several identified harmful effects of Non-steroidal Anti-inflammatory Drugs (NSAIDs). There are over 12,000 hospitalizations and 2,000 deaths related to NSAIDs complications in the country annually (Pelletier, 2010). Acupuncture is therefore the best alternative to adjunct standard medication therapy. In females above the age of 55 years and above, the body is on a declining scale for most of its biological functions. With respect to the toxicity and unsafe side effects of adjunct standard medication therapy, it is recommendable that this age group of women turns to proven alternative methods such as acupuncture (Cherniack & Cherniack, 2013). The cost of acupuncture is significantly lower than the standard options. Most of the procedures are simple and do not require sophisticated medical equipment for activities such as surgery (Pelletier, 2010).

Part 2- Evidence Review and Synthesis

Search of information is one of the most essential parts of carrying out an effective research on any topic. In order to get the most relevant literature for Evidence Based Practiced, it is quite paramount to have access to some of the most reputable search sites such as ProQuest (South’s Online Library), PubMed, Medline, among others. In order to have access to the most recent publications, I filtered my search to ensure that I only accessed peer-reviewed academic journal articles.

In carrying out appraisal using the Rapid Clinical Appraisal Tools, it mainly aimed at identifying some of the most evident methodological flaws found in the literature as well as providing consumers of specific research evidence with the opportunity to ensure they make highly informed decisions on the quality of the given research evidence. The Rapid Appraisal tool that was used in the appraisal included mixed research methods that were aimed at helping understand the entire article from different perspectives. The article that was used in the appraisal was White, A., Richardson, M., Richmond, P., Freedman, J., & Bevis, M. (2012). Group acupuncture for knee pain: evaluation of a cost-saving initiative in the health service, Acupuncture Medicine, 30, 170-175 from NCBI and in addition to other articles. In order to fully understand the concepts that were appraised in the article, it is quite essential to note the evaluation table and the search tracker template provided in Appendix 1 and 2

Summary of “Keeper” studies

There is a wealth of clinical literature supporting the usefulness of the acupuncture in the treatment of elderly patients suffering from osteoarthritis. Although most of the study shows that more research is needed to ascertain the efficiency of these drugs, they have also found that these traditional techniques have the same effectiveness in terms of reducing pain, but more efficient in terms of their tolerance towards adverse effect. These studies reveal the effectiveness of the acupuncture in treating chronic pain.

For example, Bahrami-Taghamaki et al (2014) argued that with the recent increased awareness of the acupuncture’s benefits for the management of chronic back pain by both the patients and professionals, the technique can be adjusted to become more beneficial than before. As a result, the authors compared the effectiveness of the regular acupuncture with a modified one which has been added confluent acupoints, which is a modification linked to the day time period in time technique acupuncture by conducting a randomized controlled trial using sixty patients from Beijing China. The authors randomly grouped the patients into two individuals to take acupuncture. The control group received the regular acupuncture (RA) while the test group (TA) received regular acupuncture together with acupuncture in confluent points related to time. To determine the changes between the two groups, the authors measured pain score using the Visual Analog Scale (VAS). The results revealed that the pain in the test group decreased from 69.6 ± 7.9 to 11.8 ± 4.9, and for the control group it reduced from 69.2 ± 8.0 to 15.7 ± 10.0 at a probability 0.001. The authors concluded that routine acupuncture with time method acupuncture was more effective and more beneficial to individual with chronic low back pain than the regular acupuncture.

Another study supporting the use of acupuncture in the treatment of chronic pain is a study by Iloth et al (2014). The authors argue that although there is evidence showing that acupuncture is an effective method in the management of chronic pain, it is not clear which method is the most effective. With this claim, the author evaluated the efficacy of trigger point acupuncture and associated it with sham acupuncture in the treatment shoulder pain and function using patients with chronic shoulder pain using randomized 18 patients (15 women and three men aged between 42 and 65 years) into two groups. The patients were neurological healthy and also had non-radiating shoulder pain. The first group received trigger points for muscle while the second group received the sham acupuncture for the same muscle each group received five sessions and outcomes were measured using the VAS and Shoulder function used Constant-Murley Score (CMS). After five weeks of treatment, the pain decreased, and shoulder functionality increased significantly at TrP (P=0.001). Furthermore, the comparison of the two areas using the outcome curve showed a significant difference between the two group (P=0.024). The results affirmed that TrP therapy is more effective for chronic shoulder pain than sham acupuncture treatment.

Manheimer et al (2015) also conducted a systematic review to show the efficacy of acupuncture in the treatment of low back pain. The data extracted were those related to pain, functionality, overall improvements, return to work, as well as analgesic consumption. The meta-analysis analyzing the effectiveness of acupuncture in treatment of short-term chronic pain revealed that acupuncture is more effective than sham treatment. However, the analysis did not show any conclusive analysis for acute low back pain. Additionally, there was also no conclusive of the efficacy of acupuncture compared with other therapies.

Further, a study by Manyanga et al (2014) evaluated the utility of acupuncture in the management of osteoarthritis. The study argues that previous trials have shown conflicting results, and some systematic reviews may have overstated the benefits of acupuncture. However, to provide credible evidences of the benefits of acupuncture, the authors examined two separate controlled trials of up to 2014 from different databases and pooled data expressed as mean differences with a confidence interval of 95%. The analysis of pain intensity by duration showed that there was greater pain reduction for a time greater than four weeks. The results led to the conclusion that acupuncture resulted in significant reduction of pain, improved functionality, as well as the quality of life.

Finally, the study by White et al (2012) provides a trial showing the effectiveness of acupuncture using patients with knee osteoarthritis which would otherwise be referred to an orthopedic surgeon. The authors evaluated the outcomes of the service’s year operations and the patients’ outcome at the end of 2010. Using patients’ data from the referral centers, as well as acupuncture clinics, and also attendance data and MYMOP symptoms and well-being of the patients, the author evaluated the effectiveness of the service and compared with possible outcomes from surgical intervention. The authors concluded that acupuncture was a practical alternative low-cost service for knee surgery services when treating knee osteoarthritis. The cost consequences showed an estimated saving of per year £100 000.

As a result, it is clear that there enough evidence showing that acupuncture is an effective method in the treatment of pain management. The research demonstrates that acupuncture is effective in reducing pain, improving functionality, as well as enhancing the quality of life for patient suffering due to different conditions.

Part 3- Purpose of the project

Clinical questions

The first clinical question is “In women above 55 suffering from osteoarthritis, can acupuncture compared to the adjunct standard medication therapy decrease pain over a 6 month period?”

The second clinical question is “After the implementation of the intervention will there be any improvement in the outcomes among the patients, and what some of the outcomes expected are and how will they be determined or measured?”

The purpose of this project is to bring forward an efficient, affordable and sustainable pain management solution for osteoarthritis in women over 55. The detailed purposes for the study include:

1. Suggestion alternative medication that is accupunure. This purpose is to identify the available acupuncture solutions for Osteoarthritis patients.
2. Symptom management- This project seeks to suggest methods that can be used in identification and control of OA symptoms for new patients. This helps the patients to seek help at the earliest possible opportunity and control the disease as it progresses in its stages.
3. Pain alleviation- This aim is to completely manage the pain suffered by the patient or to significantly reduce the pain to within manageable levels. Pain is a major challenge to Osteoarthritis patients that results in the reduced functioning of the patient’s joints. Management of pain would thus play a significant role in keeping the life of the patient comfortable.
4. Improving functional status- Improving this aims at increasing the joint performance as well as enabling easy and painless movement by the patient. Through this, the disease will have a minimal effect on the life and daily activities of the patient
5. Controlling disease progress- It is important to manage the progress of the disease and spread to other body joints. Managing the development of the disease ensures optimal functionality for the patients over a longer time.

Part 4: Methods

Study design

The clinical question of the study hints to the quasi-experimental study by use of a randomized controlled trial of the acupuncture therapies on the sample population of women beyond 55 years with osteoarthritis. It is quasi-experimental study design because it introduces evidence-based change of practice into a practical setting.

Procedure/intervention

For patients with knee osteoarthritis, they will lay first supine with a pillow under their knees for the treatment of the posterior aspect. The needles for treatment will be 3cm, 30 gauge strong dispensable filiform stainless steel needles. The deepness of the needle insertion will depend on the thickness of the skin and subcutaneous fatty tissues at the acupuncture points. In addition, the patients will be involved in exercises in the form of stretching or regular walking around the health center or at their homes for those receiving home-based care (Frontera, Slovik & Dawson, 2006). In addition, there will be an initial physiological examination to ascertain the state of patients health-wise before, during and after the six months. After the treatment session (6 months), a survey will be conducted to obtain information relevant to help in the intervention or not to their state or illness.

One group of participants will get administered with acupuncture intervention by qualified acupuncturists, while the other group will be administered using for the standard adjuvant treatment by qualified health professionals. Then, a comparison of the result from each of the two groups of providers will enable the researcher assess the accuracy and practicality of the evidence gathered from the literature review that acupuncture offers a better solution to pain problem in women over 55 years with osteoarthritis.

Setting

The study will be set at the health facilities serving the patients who meet the topic criteria according to verified medical records by the sample population, the health providers.

Instruments/scales and measurement of outcomes

The researcher will use a chart audit to track changes from the onset of the study to the end. The chart audit will enable the researcher and the sample population to identify differences in the levels of achievements between the onset of the study and the end thereby giving the kind of accuracy and practicality of using the acupuncture intervention for pain relief among women over 55 years old with osteoarthritis. VAS will also be used to measure pain levels among the women over 55 years suffering from arthritis

Confidentiality

The free will of patients will be sought by use of consent forms after thorough explanation of the study contents as required by the Institutional Research Board (IRB). Also, the free will of the health care providers to introduce the new intervention into their practice will be affected from free will evidenced by given consents and guided by use of theoretical models of behavior change and evidence-based nursing practice implementation. Besides, other ethical consideration like integrity and confidentiality of the patients will be observed by use of pseudonyms and coded data (Manyanga et al, 2014)..

Data collection

Johns Hopkins nursing evidence-based practice model (JHNEBP) will be used as the vehicle to guide the nursing change and process in the study in addition to current applications of Prochaska’s trans-theoretical model of behavior change as a means of effecting behavior change among the health provides to be used as the sample population. Nursing skills will be improved as measured by the patient outcomes using the JHNEBP model enabling cost-effectiveness and improved patient satisfaction. Prochaska’s trans-theoretical model of behavior change, on its part, will ensure that the sample population of heath care providers caring for women over 55 years old with osteoarthritis implement a change in practice as part of their behavior change.

Aligning stakeholders

A stakeholder is a person who has interest in a particular project and benefits from it. The stakeholders whom will be involved in this project include clinician, staff nurses, consultant, nurse coordinator and nurse director. They will all played different and important roles in the process of implementing the project. When new evidence is implemented into practise, women above 55 suffering from osteoarthritis would be a part of the stakeholders.

The Gathering Point Community Acupuncture, being the project owner, would have the privilege of benefiting from the success of implementation of evidence-based practice (EBP) project within its premises. The nurse director is the chief decision maker and supervised all the aspects of the project. He will be responsible for ensuring that the team adhered to established project standards, methodologies, processes, tools, policies and procedures (Grisham, 2010). He will be in charge of administering the program, training and coaching the employees on acupuncture therapy. Finally, he will also ensure that quality is maintained throughout the project so that efforts to improve quality would meet or surpass the needs or expectations of customers respectively.

The nurse coordinator is important in the project for collection, analyzing, organizing and distributing information about the EBP project and include but not limited to ISO 9001. Moreover, he is the reporting generator. Through his computer literacy, he generated reports about the project and to other stakeholders of the projects. The consultant on other hand offered assistance in training, providing advice on quality improvement aspects and ensured the new ideas were introduced to enable the project to be a part of the changes in the field (Binder, 2011).

The main purpose of staff nurses is to assist in the care of the women whom are suffering from osteoarthritis. On the other hand, the clinician will be providing the healthcare recommendations on osteoarthritis. Finally, the nursing director will ensure the smooth running of the project by providing a conducive legal environment and supplying necessary resources to run the project.

Part 5- Data Analysis

Expected Outcomes to be analyzed and how they will be analyzed

The intervention seeks to improve the current conditions of the patients, and hence the outcomes expected will assist in determining the effectiveness of the treatment. The various patients will show different changes after implementation of the study in other words; there will be variations in the pain levels. In the process, data on the various patients in regard to the intervention will be obtained. Most of the changes after implementation of the intervention will be physical, thus, data may be collected through observation. For instance, patients will be in a position to walk with minimal assistance or support, while others will not require any assistance in order to walk due to significant levels of pain. As such, information can be obtained through observation hence it will be integral in collecting such information. In addition, a t-test will be done to compare the effectiveness of the intervention among the patients affected in various parts of the body. The t-test will be used to measure dependent variables like natural therapies, physical activity, weight management or surgery. The analysis of variance, on the other hand, will be used to measure the independent variables which include level of pain and muscle strength.

Statistical analysis relating the data collection tools to be used

Some of the data collection tools will be through interviews, questionnaires, or observation of the patient before and after the intervention. The expected outcomes from the intervention will provide data/information which will be analyzed and later on interpreted. The information obtained from the various categories of patients, depending on the affected body parts will be analyzed statistically. The analysis will incorporate utilization of the paired t-test which will assist in determining the effectiveness of the intervention (Hill, 2012). There will also be an analysis of variance to examine the categories of patients. Additionally, the collected data will not only be analyzed using descriptive measures but also run through other tests to ascertain the correlation of the variables from the patients against the expectation of the adopted expectation of the adopted intervention.

The types of demographic data you plan to report on your participants

The participants have different attributes or features which can be used to differentiate them. Demographic data to be reported will be composed of age, income level, education level, geographical location, sex, race, gender, and religion. The demographic data regarding the participants will assist in knowing how they will affect or are affected by both the dependent and independent variables. Hence, they are integral in the analyzing of data and also for interpretation purposes. The demographic variables will be analyzed by conducting a t-test for comparative purposes and how they affect the study.

Conclusion

When it comes to health making choices physiotherapists and patients bring a range of values, preferences, experiences and skills. The practice of EBP is based on patients’ preferences and knowledge, and physiotherapists’ clinical skills.

Regarding systematic reviews, it is evident that exercise tends to lower pain and enhance function in patients. Nonetheless, there is no enough proof that acupuncture ultimately diminishes pain and that psycho-educational interventions improve psychological results.

Among physiotherapists, the most significant aim for the treatment of osteoarthritis is to lower pain and increase muscular strength. Physiotherapists are responsible for providing exercise, massage and stretching treatments for patients. Characteristics of patients cannot define the differences in clinical practice and acupuncture was linked with having searched medical databases to assist in answering the clinical question.

References

Bahrami-Taghamaki, H., Liu, Y., Azizi, H., Khorsand, A., Esmaily, H., Bahrami, A., & Zhao, B.X. (2014). A Randomized, Controlled Trial of Acupuncture for Chronic Low-Back Pain. Alternative Therapies in Health and Medicine, 20(3).

Binder, J. (2011). Global project management: Communication, collaboration and management across borders. Aldershot, Eng: Gower.

Cherniack, P., & Cherniack, N. S. (2013). Alternative medicine for the elderly. Berlin: Springer.

Grisham, T. W. (2010). International project management: Leadership in complex environments. Hoboken, N.J.: John Wiley & Sons.

Iloth, K., Saito, S., Sahara, S., Nartoh, Y., Imai, K., & Kitakoji, H. (2014). Randomized Trial of Trigger Point Acupuncture Treatment for Chronic Shoulder Pain: A Preliminary Study. Journal of Acupuncture and Meridian Studies, 7(2), 59-64.

Manheimer, E., White, A., Berman, B., Forys, K., & Ernst, E. (2015). Meta-Analysis: Acupuncture for Low Back Pain. Annals of Internal Medicine, 142 (8).

Manyanga, T., Froese, M., Zarychanski, R., Abou-Setta, A., Friesen, C., Tennenhouse, M., & Hay, B. (2014). Pain management with acupuncture in osteoarthritis: A systematic review and meta-analysis. BMC Complementary and Alternative Medicine, 14: 312. Retrieved from http://www.biomedcentralcom/1472-6882/14/1312

Odom, S. L., Brantlinger, E., Gersten, R., Horner, R. H., Thompson, B., & Harris, K. R. (2013). Research in special education: Scientific methods and evidence-based practices. Exceptional children, 71(2), 137-148.

Pelletier, K. R. (2010). The Best Alternative Medicine. New York: Simon & Schuster,

Roberts, P. (2011). Effective project management. London, UK: Kogan Page.

White, A., Richardson, M., Richmond, P., Freedman, J., & Bevis, M. (2012). Group acupuncture for knee pain: evaluation of a cost-saving initiative in the health service. Acupuncture Medicine, 30, 170-175. Doi: 10.1136/acupmed-2012-010151

Appendices

Appendix 1

Search Tracker

Appendix 2

Evaluation Table

Evaluation Table

Synthesis Table

Herman Bailey

With a student-centered approach, I create engaging and informative blog posts that tackle relevant topics for students. My content aims to equip students with the knowledge and tools they need to succeed academically and beyond.

The Genre of “No Country for Old Men”: A Mixture of Many Genres

by Herman Bailey | Jan 23, 2023 | Essays | 0 comments

Introduction

“No Country for Old Men” Is a western film of 2007 that was written, edited and directed by Ethan Coen and Joel based on the novel of “No Country for Old Men” by Cormac McCarthy. The book tells of a story of a man who gets an opportunity of delivering a fortune that does not belong to him. The study entails cat and mouse kind of drama as the path of the three main characters in the desert intertwine in west Texas. This paper will propose and discuss its own argument as to which genre (s) it believe s “No Country for Old Men” should be placed based upon the rhetorical choices of the author. The paper believes that the book of “No Country for Old Men” does not belong to one particular genre and is made up of a mixture of many genres.

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From many reviewers of “No Country for Old Men, “it is evident that the novel is characterized by mixture of genres. The sharpest critics of “No Country for Old Men” authored by Cormac McCarthy are carol Oates, James Wood and William Deresiewicz. In his criticism, Deresiewicz contends that the cinematic and streamlined plot of the novel seems as a modelled and a calculated readers assault (Deresiewicz 38-40). Similarly, Wood criticizes the novel sharply as metaphysically cheap and a “genre guff” (93). On the other hand, Oates dismissed the novel by describing it as a “meretricious thriller” (Oates 44). However, the author is also supported by other reviewers on his work. According to Hodge, the novel of “No Country for Old Men” Is not a crude genre fiction (66). In his essay in 2006 responding to the sharpest critics to McCarthy, Hodge argues that it is possible that the author could be possibly be having something in his mind that is larger rather than the deceiving entertainment (66). The argument and the assumptions of Hodge disapproves the idea that the novel was another stripped, unimportant down thriller as argued by Wood (88).

However, from the arguments brought forward by Hodge, it is evident that he exceeds his scope of argument. Despite the fact that he brings out the extreme comments made by Deresiewicz, Wood and Oates as well as identify significant thematic links between “No Country for Old Men” and other earlier works done by McCarthy. Moreover, instead of Hodge arguing that the novel of “No Country for Old Men” is not a genre fiction, he argues that the novel is not a meretricious or extreme genre fiction. In brief, Hodge is in agreement that the novel is mimicking the genre fiction conventions. However, he adds that “No Country for Old Men” transcends the trappings of the seedy genre. Additionally, he acknowledges that the novel has also exploited the thriller convention, but opposes that the novel withholds the ultimate genres pure satisfactions (66). From his argument, it is evident that Hodge believes that he can prove that “No Country for Old Men” gives relevance to the genre conventions and protects McCarthy on that charge.

Whether the McCarthy scholars were influenced by the essay written by Hodge or they are simply sharing similar desire of protecting the literary reputation of McCarthy, they have embraced the genre plus argument proposed by Hodge. Moreover, they contend that the novel “No Country for Old Men” is more than a standard fiction genre but something more less that a masterwork. The genre-plus argument proposed by Hodge compared to the positions presented by Deresiewicz, Wood and Oates looks like a pragmatic compromise. The genre-plus argument acknowledges the strong resemblance of the novel to genre fiction, but does not also vilify its author for experimenting on such course materials.

There are some considerable similarity, in fact, between the attitude of Hodge toward “No Country for Old Men” and the positions embraced by Deresiewicz, Wood and Oates. Their similarity is evident when Hodge makes a clearly sharp distinction between “Border Trilogy,” a more celebrated McCarthy’s fiction and the “No Country for Old Men. “Moreover, the trio’s bias is also shared by Hodge from his argument against genre fiction, because of a simple assumption behind the argument of genre-plus that “No Country for Old Men” is a reflective work of genre work. It is of great significance to note that both positions championed by the trio on one hand and Hodge on the other hand fail to address the crucial question put forward by Hodge in his essay. The main question by Hodge was that given the literary positon of McCarthy, his prejudice towards genre works, and his contempt for commercial fashions, why would he write a novel that resembles a standard pulp fiction alarmingly. On one hand, Hodge and his supporters cannot address fully this question since they are focusing on how “No Country for Old Men” transcends genre fiction instead of addressing why it has resemblance to genre fiction from the first instance. On the other hand, the trio are unable to address the question since they are focusing their arguments on excoriating the author for mimicking cheap fictions.

The best approach for analyzing the genre of the novel is by confronting the resemblance of the novel to genre fiction. The legitimate concern from the reactions to the novel, from both hostile and sympathetic readers, suggests an interesting answer to the question posed by Hodge. The function of the resemblance of “No Country for Old Men” to gene fiction is to manipulate and provoke the reader’s moral and aesthetic anxieties about fictions. The paper can sharpen this argument or thesis by making four claims that are interrelated

1. By embracing agreements of several genres, “No Country for Old Men “prompts its readers and audience to treat it as a genre work and not just as a single literary genre. That is also the position of the paper that the novel incorporates a mixture of several genres
2. As a result of the characteristic way in which the novel mimics genre fiction, “No Country for Old Men” brings out a strong cultural bias surprisingly against the genre fiction
3. By the novel eliciting this bias, it pushes the readers to of the novel to articulate particular grounds for their hostile attitude towards the general genre fiction and not “No Country for Old Men” in particular
4. Lastly, by pushing the readers to explicitly make their tacit bias, “No Country for Old Men” Invites the readers to reconsider their intuitions about the novel and the genre fiction in general.

If in the novel of “No Country for Old Men” call to mind of the readers an assortment of popular genres, and if indeed it is causing a deep cultural bias against genre fiction, then it should be very much evident not only through the negative and extreme reviews by Deresiewicz, Wood and Oates, but also to the reviews that are positive. Fr instance, the positive reviews by Ira Boudway, Patrick Ness and Adam Begley. Each of these authors expressed their admiration for the novel while regarding it as a genre work that is violent, and more specifically as a thriller. For example, Begley is his description termed it as a “bloody, taut thriller,” while Nes referred to it as a “ruthless and sinewy thriller.” On the other hand associates the novel to another violent genre by characterizing it as “a movie ready narrative, a crime novel and that is hard boiled unremittingly and is threatening to burst into steam.” Concurring with Kirn is randy Boyagoda who stated that the “the stoic dialogue, chase, shootouts gives the novel a pulpy texture sometimes and sometimes the prose of the novel can be so heavy with action and intensely visual that it read cinematically” (44).

The cinematic qualities and novels violence is also recognized by Michiko Kakutani but she does not think the novel as a crime novel but as a “hard boiled, new wave western.” Also in agreement is Yvonne Zipp who states that “No Country for Old Men” is a brutal western. However, whereas Kakutani regard the novel as an affair that is lowbrow, she puts the novel in a place of its won by noting that the plot of the novel sounded like an old episode of A-Team. This further complicate the efforts of the paper to pin point the genre of “No Country for Old Men.” Other reviewers such as Adan Jones content that it could be a gangster film playing out in the western locations. Similarly, Sarah Emily Miano and Henry Kisor described the novel as a western thriller with Sarah further stating that “No Country for Old Men “is now a familiar complain that the novel has “all Tarantino flick pulp”

The paper made some observations from the provided sample of moderately reviews that are sympathetic. First, initially it is practically impossible to think the novel as falling under any genre except genre fiction. Particularly the novel strikes its audience and readers that it is a generic novel, that is, a novel that easily fits into several different genres. Moreover, the status of “No Country for Old Men “as a genre fiction attracts sharp criticism the sympathetic reviewers. The reviewers use several words to express their disdain when referring to the unremitting violence of the violence.

Conclusion

In conclusion, the paper analysed the novel of “No Country for Old Men” by McCarthy. From the discussion of the paper, the essay believed that the book does not belong to particular genre and is made up of a mixture of many genres based on the rhetorical choices of the author. Referring do different arguments by authors who were both sympathetic and hostile to the novel, it is evident that “No Country for Old Men” incorporates all forms of genres and it can be described as a generic genre. Other notable genres as portrayed by reviewers include thriller, genre-plus, meretricious thriller among others.

Work cited

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McCarthy, Cormac. No Country for Old Men. New York: Alfred A. Knopf, 2005.

Miano, Sara Emily. “Take the Money and Run.” Rev. of No Country for Old Men. Times (UK). Times, 5 Nov. 2005. Web. 07 August 2015.

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Oates, Joyce Carol. “The Treasure of Comanche County.” Rev. of No Country for Old Men. New York Review of Books 20 Oct. 2005: 41-44.

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Herman Bailey

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