An Interview with Maggie Shipstead

An Interview with Maggie Shipstead Maggie Shipstead’s smart, finely wrought, and thoroughly entertaining debut novel, Seating Arrangements, centers on the well-bred Van Meter clanâ€"patriarch Winn, wife Biddy, daughters Daphne and Liviaâ€"as they plan for Daphne’s classic New England wedding against a backdrop of family rivalries, infidelity, scandal, country club politics, and late-night misbehavior. Seating Arrangements was one of my favorite books of the year and I was thrilled (and a bit starstruck!) to have the opportunity to speak with Maggie on the occasion of the paperback’s release this month. *          *          * Marisa Atkinson:  I love what youve said in the past about not writing what you know, but writing what you wonder about. What was it about a family like the Van Meters and their lifestyle that you found compelling, and that sparked what would become Seating Arrangements? Maggie Shipstead:  I grew up in Southern California, and before I went to college, I had no idea that families like the Van Meters even existed. I don’t think I knew what a WASP was, and I definitely did not understand the subtle significance of a bowtie. But at Harvard suddenly I encountered kids my age who seemed to live by a codeâ€"sartorial and otherwiseâ€"that was completely inscrutable to me but made them appear perfectly at home in this intimidating new world. So at first I think I was just intrigued and wanted to know what all these little signifiers (like whale pants) meant. Then, mostly through happenstance and also because I was on the equestrian team, I ended up with some close friends who came from upper crust New England backgrounds but had never fully drunk the Kool-Aid. We talked a lot about the way their families worked, and which traditions they loved and which they were ambivalent about. Where I grew up, I always felt a little out of place, and I think I started wondering about the feeling of belonging and where that comes from and what happens when you can’t find it. Winn Van Meter has observed a particular code as scrupulously as he knows how, but he’s still chasing this feeling of belonging, or what he imagines true belonging would feel like. He’s played by the rules, and he’s baffled by the ways the rules have failed him. That characterâ€"Winnâ€"is the reason I wrote the book. His predicament was what interested me most. MA:  Which five adjectives would you use to describe Seating Arrangements? MS:  Barbed, wistful, insular, old-school, crepuscular. MA:  I read another interview where you said that the scene in which Winn gets hit by a golf cart while riding his bike was loosely based on a friend’s similar experience. Are any of the other characters or their experiences inspired by people or events from your own life? MS:  Only in little bits and pieces. None of what happens, plot-wise, comes from anything real, but inevitably you appropriate physical descriptions and personality traits from people you’ve encountered. I have three friends whose mothers all thought they were Biddy, but all that says is that I have three friends with WASPy mothers who have amazing skin. Certain lines of dialogue are things I’ve actually heard people say, like when Winn asks about someone “Where did he prep?” But that’s a line that strikes some people as cartoonishâ€"often when you pull stuff directly from real life, it feels false on the page. It’s a weird phenomenon. Everything has to be adjusted. At the same time, I try to be accurate, especially with anything historical. The Vietnam draft numbers in the book are all matched with the right birthdays, that sort of thing. The exploding whale came from a newspaper article I read in high school about a scientist who was performing a necropsy on a dead whal e, and it exploded and killed him. Apparently this happens from time to time. Here is the big takeaway from this interview: if you ever come across a decomposing whale that appears to be ballooned up with gases, don’t jab it with anything sharp. MA:  Have you have a chance to meet with any book clubs that were reading Seating Arrangements? There are so many great points of discussion in the bookâ€"which themes/characters/plot lines did the groups that you met with want to dig into the most? MS:  I have, yeah! I’ve been to several book clubs. It’s always a little awkward because, out of politeness, they can’t really tear into a book the way they might ordinarily. I’ve been surprised how deeply book clubbers sometimes psychoanalyze the characters. They’ll talk through the root causes of characters’ actions in a puzzle-solving way that’s very different from how I conceived of the book’s various mechanisms. I tend to get a sort of instinctive feel for a character that then drives his or her actions, but I don’t articulate to myself, you know, “Now Winn does X because he feels Y about himself.” So sometimes a book club discussion illuminates causes and effects I’d never connected. I shouldn’t have been, but I was surprised, too, by the range of responses the characters provoke. At one club, a woman was so frustrated with Biddy because she saw Biddy as lazy. Biddy doesn’t cook dinner; she doesn’t do the dishes; she has a wedding planner. I’d ne ver thought of Biddy that way, but what this woman was saying was all factual. To readers who haven’t spent much time in New England, the characters can seem really alien, and so there’s often some conversation about this WASPy subculture and if people like this really exist. There tends to be some discussion of the likeability or lack thereof of the characters, too, which is understandable butâ€"as Claire Messud has recently said so persuasivelyâ€"beside the point. MA:  Of all the characters in Seating Arrangements, who could you see yourself being friends with in real life? MS:  Dominique is probably the obvious choice for a friend, somewhat intentionally. She’s made an interesting life for herself outside the stifling Van Meter world. None of the characters are like me, really, but I experienced the WASP world from a vantage point similar to hers: close but still outside. And she’s no-nonsense but still compassionate, which are qualities I value in my friends. I would probably be “friends” with Sterling, too, but only because I have a soft spot for troubled, douchey men. MA:  How would you cast a Seating Arrangements movie? (I feel like there has to be a role for Bradley Cooper somewhere, for one!) MS:  This is such a hard one! The book has been optioned for film, but it’s an impossibly long way from an option to an actual movie, so who knows what’ll happen. I can’t get attached to the idea. But as long as we’re playing this game . . . I kind of see Kristen Stewart as Liviaâ€"she projects such an interesting discomfort. Romola Garai as Daphne? Pretty much anyone who’s on Mad Men could be Sterling. I’ve never been able to come up with the perfect Winn. I seriously just Googled “actors in their 50s” to get ideas. Gary Oldman? I don’t know. Maybe Bradley Cooper could just play all the characters, Eddie Murphy-style. MA:  I follow you on Twitter and Instagram, so I know youve been traveling all over the world, most recently to Ireland. Can you talk a bit about what youve been up to there? MS:  I went to Ireland to spend time at an artists’ retreat in County Kerry called Cill Rialaig. I applied two years ago and was given this slot, and it ended up being slightly odd timing with my workâ€"I had just sent back a big revision of my second novel to my editor right before I left, so I felt a little at loose ends. At first I just read a lotâ€"mostly random paperback mysteries left behind by past residentsâ€"but I was there for three weeks and eventually, out of boredom, drafted two partial stories. Boredom is a big motivator for me; I put myself in situations where I’ll run out of other options for entertainment and will be forced to write something out of desperation. After I left Cill Rialaig, I went to Dublin and then on to Belfast, which I thought was a fascinating place. It’s a pleasant, modern cityâ€"by all accounts, it’s been rejuvenated to an incredible degree since the Troubles ended (for the most part) fifteen years ago. But there’s still an edge there. I walked around the divided neighborhoods to see the peace line and the sectarian murals put up by various paramilitaries, which were striking and interesting and sometimes scary. Conflict tourism is an controversial thing, especially for such a recent conflict, but I was glad I got to see the murals. I think they’ll eventually be covered up. At the moment, I’m in Inverness, making my way to Edinburgh, then London, and then the Hay Festival in Wales. MA:  What are you “wondering about” at the moment, and how is that influencing what you’re working on now? MS:  As you mentioned, I’ve been traveling a lot by myself over the past two years. My parents are generous enough to dogsit for me for months at a time, so I’ve spent, um, a month in Bali, three months in Paris, a month in Edinburgh, a month in New Zealand, a month in Aspen, this month in Ireland. It’s a ridiculous litany, I know. But I’m not an outgoing travelerâ€"like I don’t belly up to the bar wherever I go and make friendsâ€"so most of that time is very solitary. I’m interested in the sensation of being in transit and also how, by traveling, we try to make sense out of the fact that we live on a planet. Like how the earth is an actual physical object flying through space and not some sort of magical dimension specially designed for us to putter around in. I just wrote an essay for Lapham’s Quarterly about solo circumnavigation by sailboat, which sounds incredibly terrifying but also strikes me as an undertaking that shows the great lengths people will go to in see king to witness and understand the dimensions of the world. Of course, physical exploration tends to really be about testing the capabilities and confines of the self. Anyway, my third novel, which is barely an embryo, seems like it’s going to come from that stuff. MA:  You’re also an accomplished short story writer. Do you find that your writing process is different for a short story vs. a novel? Do you set out knowing the piece you’re working on is one or the other, or does it develop organically as you’re writing? MS:  I’m working on a couple stories now, but before that I took a long, semi-accidental hiatus from writing themâ€"about two years. When I was in workshopâ€"in college, at Iowa, and at Stanfordâ€"stories seemed like the best way for me to take advantage of the feedback and deadlines. Every time I turned one in, I had to be responsible for a beginning, middle, and end, and stories were a useful way to experiment with different voices and structures without making a huge commitment. My two novels both started as short stories, but neither worked. They felt sort of pointless or something. I find stories very difficult to write; that form doesn’t come naturally to me at all. I wouldn’t have written nearly as many as I have (i.e., a not-staggering fifteen or so) except I was in workshops for so long. I want to keep writing themâ€"I think they help me learn and improveâ€"but I find the novel to be a much more forgiving form, like living in a big house with a yard versus on a boat, w here everything has to be in the right place. The downside to novels, obviously, is that they take forever to write, and then you have to read them over and over again, and revisions sometimes feel insurmountably complicated, and the whole process can be really punishing. I mean, writing is generally just really hard. MA:  I’m thrilled to hear that you have a new novel on the way, titled Astonish Me. Can you tell me a bit more about it? I understand it’s about a ballet dancer and spans from the 1970s to the present day. Very different from Seating Arrangements! MS:  It is very different from Seating Arrangements. Astonish Me is about a dancer, Joan, in the corps of a ballet in New York (sort of a composite of New York City Ballet and American Ballet Theatre) who helps a Soviet star defect in 1975. They have an affair. It ends, partly because of their very different levels of talent, and she stops dancing and has a son with a man who’s been in love with her since high school. They move to Southern California, and their son ends up having a serious gift for dance. So Joan gets tangentially sucked back into the dance world and has to confront her ambivalence about her past and about what she wanted from ballet versus what she ultimately took from it. The tone is what’s the most different from Seating Arrangements, I think. It’s earnest and intense and a little melodramaticâ€"it’s meant to have a similar feeling to a ballet. MA:  Finally, I’m sure the readers of Book Riot will be curious to know: what are you reading at the moment? MS:  I always have a few things going. I’ve been working my way through the shockingly brilliant, sometimes savage Patrick Melrose novels by Edward St. Aubyn and am on the fourth one, Mother’s Milk. I’m also reading a couple nonfiction books about very specific corners of World War IIâ€"Frozen in Time by Mitchell Zuckoff and The Monuments Men by Robert Edsel. *          *          * Seating Arrangements  is now available in paperback at your favorite bookstore, and Maggie herself may be coming to your hometown soon! Be sure to keep up with Maggie on her blog, like her on  Facebook, follow her on  Twitter, and check out her photos from around the world on Instagram. ____________________________ Sign up for our newsletter to have the best of Book Riot delivered straight to your inbox every two weeks. No spam. We promise. To keep up with Book Riot on a daily basis, follow us on Twitter, like us on Facebook, , and subscribe to the Book Riot podcast in iTunes or via RSS. So much bookish goodnessall day, every day. 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Healthcare Facilities Should Implement Safeguards On Data...

Information security so important in healthcare because being able to share data digitally holds a lot of potential for doctors, nurses and clinicians to send and receive content fast and effectively. Although this is a great thing, on one hand, it is also dangerous because patient data and other sensitive information are even more at risk of being stolen, exposed or accessed by unauthorized parties. Because of this, security must be a top priority for any medical organization today and for the future. In order to ensure patient data will be secure, healthcare facilities should implement safeguards on data information. Types of Safeguards There are many types of ways to safeguard data information in a healthcare facility. These kinds†¦show more content†¦The Technical safeguard provisions consist of five broad categories Access Controls, Audit Controls: Integrity Controls, Person or Entity Authentication and Transmission Security (Sayles, 2013). All of these safeguards are purposed to protect and secure sensitive data. Case #1: Advocate Medical Group Advocate Medical Group (AMG) is a medical group that provides primary and, specialty car services as well as medical imaging, outpatient services and community-based medical practices located in Chicago. This organization is a part of Advocate Health Care, one of the largest health systems in Illinois. It was founded in 1980, and is one of Chicago s leading physician group practices. Although as prestigious as this healthcare organization may seem on July 15, 2013 over 4 million of their members were affected by a major security breach. It is reported to be 2nd largest data breach ever reported through the HHS database (Vogel, 2014). Four laptops containing more than 4 million patient records were stolen. In the Advocate case, several categories of data reported as at risk appeared to qualify as protected health data under federal law, including medical record numbers, health insurance information. Social Security numbers and other information that could be used for fraudulent p urposes were compromised. While the computers were password protected, they were not

How to Make Tris Buffer Solution for Medical or Lab Use

Buffer solutions are water-based liquids that include both a weak acid and its conjugate base. Because of their chemistry, buffer solutions can keep pH (acidity) at a nearly-constant level even when chemical changes are taking place. Buffer systems occur in nature, but they are also extremely useful in chemistry. Uses for Buffer Solutions In organic systems, natural buffer solutions keep pH at a consistent level, making it possible for biochemical reactions to occur without harming the  organism. When biologists study biological processes, they must maintain the same consistent pH; to do so they used prepared buffer solutions. Buffer solutions were first described  in 1966; many of the same buffers are used today.  Ã‚   To be useful, biological buffers must meet several criteria. Specifically, they should be water soluble but not soluble in organic solvents. They should not be able to pass through cell membranes. In addition, they must be non-toxic, inert, and stable throughout any experiments for which they are used. Buffer solutions occur naturally in blood plasma, which is why blood maintains a consistent pH between 7.35 and 7.45. Buffer solutions are also used in: fermentation processesdying fabricschemical analysiscalibration of pH metersDNA extraction What Is Tris Buffer Solution? Tris is short for  tris(hydroxymethyl) aminomethane, a chemical compound which is often used in saline because it is isotonic and non-toxic. Because it has a Tris has a pKa of 8.1 and a pH level between 7 and 9, Tris buffer solutions are also commonly used in a range of chemical analyses and procedures including DNA extraction. It is important to know that pH in tris buffer solution does change with the temperature of the solution. Emeldir  / Wikimedia Commons /  CC0 1.0 How to Prepare Tris Buffer It is easy to find commercially available tris buffer solution, but it is possible to make it yourself with the appropriate equipment. Materials: Calculate the amount of each item you need based on the molar concentration of the solution you want and the quantity of buffer you need. tris(hydroxymethyl) aminomethane  distilled deionized waterHCl Procedure: Start by  determining what concentration (molarity) and volume of Tris buffer you want to make. For example, Tris  buffer solution  used  for  saline  varies from 10 to 100 mM.  Once you have decided what you are making, calculate the number of moles of Tris that are required by multiplying the molar concentration of buffer by the volume of the buffer that is being made.  (moles of Tris mol/L x L)Next, determine how many grams of Tris this is by multiplying the number of moles by the molecular weight of Tris (121.14 g/mol).  Ã‚  grams of Tris (moles) x (121.14 g/mol)Dissolve the Tris into the distilled deionized water, 1/3 to 1/2 of your desired final volume.Mix in HCl (e.g., 1M HCl) until the pH meter gives you the desired pH for your Tris buffer solution.Dilute the buffer with water to reach the desired final volume of solution. Once the solution has been prepared, it can be stored for months in a sterile location at room temperature. Tris buffer solutions long shelf life is possible because the solution does not contain any proteins.

American Beauty (movie) Free Essays

The movie American Beauty bears the name of the most popular in the USA brand of roses. The roses are present in the picture everywhere. They are like a scarlet ribbon running through the canvas of the narration, each time concentrating audience’s attention upon themselves as upon the stereotype of American beauty. We will write a custom essay sample on American Beauty (movie) or any similar topic only for you Order Now This is not a story about empty cellophane bag flying in the wind. This is not a saga about a masturbating wimp American man. And even not about that that life is a shit and women are you know who. This is rather the story of stereotypization of mass conscience that reached global proportion. This is a story about that that our life as any reality is a mosaic with different patterns – sometimes even ugly and detestable. Some of us see the life lines interlacing as a stifling web and others see it as roads running away beyond the skyline. Overall, American Beauty is a film about the life of an average American family, and problems experienced by each member of this family. And in this case it does not matter is the family American, English, French or any other as it was already mentioned the stereotypical conscience became global. Movie plot is simple enough and, to certain extent, hackneyed. To tell the truth the beginning of the picture evokes feelings of boredom as you expect a typical tearful story of jerk husband, stinker wife, their daughter suffering from loneliness and lack of understanding and their neighbors – a bit screwed guy, trading drugs and practicing voyeurisme with his video camera, his father, colonel retired, who hates homosexuals being himself a latent homosexual. However, the way all this story is presented makes this movie different and distinguished. American Beauty is impressive for the fact that there are no right or guilty characters in the story. For example, Lester (Kevin Spacey) is not a dull, horny jerk, he is rather an average man who could not achieve in this life anything or even establish a normal family, where al least someone would understand and support him. His wife Carolyn (Annette Bening) is not a stinker or a whore; she is a simply unhappy woman, which tries hard to bluster way out of difficult life â€Å"I will sell this house today, I will sell this house today†¦Ã¢â‚¬  (Carolyn), but fails. And their daughter Jane (Thora Birch) is not a wicked child dreaming of killing her parents but rather a poor little girl, who feels awfully lonely and seeks for someone to understand her. The central event of the film is the moment when Lester is trying to free himself from the chains of commonness and dullness of the life surrounding him. He quits his well-paid position and starts working in McDonald’s and going in for sport. But the outward manifestation is not the point; the point is that Lester got free inward. He ceased being afraid of his wife, he has got that job which does not give you satisfaction and where you have to lick the boots of your boss is worthless. These changes made Lester feel free and happy! â€Å"I feel like I’ve been in a coma for about twenty years. And I’m just now waking up. † (Lester) But this is the moment when an inevitable end had to come. Lester is killed. Any person from his surrounding could have done it. Daughter Jane, who could not stand his lusty stare at her classmate: â€Å"I need a father who’s a role model, not some horny geek-boy who’s gonna spray his shorts every time I bring a girlfriend home from school. †(Jane); wife Carolyn, who hates him as she regards him as a sluggard and loser; Jane’s friend, Ricky (Wes Bentley), whom Jane asked to kill her father; Ricky’s father, crazy about patriotism and fascism colonel, who believes his son to have an affair with Lester; and even Lester who feels good and likes his new life. Why not to die at such a moment? To leave this world with pleasant emotions†¦ I guess I could be pretty pissed off about what happened to me †¦ but it’s hard to stay mad when there’s so much beauty in the world. Sometimes I feel like I’m seeing it all at once, and it’s too much. My heart fills up like a balloon that’s about to burst †¦ (Lester) The movie is masterfully shot in all respects. Young film director Sam Mendes has demonstrated fairly good sense of humor and style. Take for example red rose-petals emerging as soon as Lester gets absorbed in his erotic fantasies. Red petals serve as unambiguous, though delicate euphemism of orgasmic feelings of the main character. This cross-cutting image looks very nice though till the end of film it becomes exuberant and starts irritating. And finally the empty bag fluttering in the wind is like a key symbol of the film. It is noticed by Ricky through his camera lens, who looks at the world only in this way, through his camera, as it makes reality to be accepted easier. â€Å"Video’s a poor excuse, I know. But it helps me remember†¦ and I need to remember†¦ Sometimes there’s so much beauty in the world I feel like I can’t take it, like my heart’s going to cave in† (Ricky) Ricky, as a real artist, sees beauty in the things which are seen by others as ugly. This is, as a matter of fact, the notion of â€Å"American beauty†, the world, which you see beyond U. S. model through this or that stimulating means. American beauty is a McDonald’s, but not as a place where you come to gorge fast, sooner as a place of inner freedom. This is a bright scarlet car, of which you dreamt all your life but had not bought because there were more â€Å"useful† things you had to buy. In the long run, American beauty is your inner freedom, freedom in mind and not under the canopy of Star Stripes flag. Bibliography American Beauty. Dir. Sam Mendes. 1999. DVD, 2002. How to cite American Beauty (movie), Papers

Successful Aging Growth

Question: Discuss about theSuccessful Aging for Growth. Answer: Introduction Some of the most fundamental feature of a living creature is growth, development and death. In a human life cycle, individuals, in their growth process, undergo through many stages. In his theory of the psychosocial stages of human development, Erik Erikson established that the growth and development of human beings occur in eight main stages: infancy, early childhood, pre-school age, school age, adolescence, early childhood, adulthood and late adulthood chronologically (Moore, Eyler, Mausbach, Zlatar, Thompson, Peavy Jeste, 2015). Naturally, because of the uniqueness of these stages, each of them poses challenges to the individuals. For instance, late adulthood which starts at the age of 65years, brings a lot of challenges to the aging persons (Calasanti, 2015). As a result of their complexities, the aging become more vulnerable to psychological, mental, and social challenges that makes it quite difficult for them to experience a successful aging process. This paper uses the activi ty theory to examine what kind of lifestyle contributes to a successful aging. Secrets of Successful Aging Successful aging simply refers to an ability of an aging person to lead a life characterized by social, mental and physical well-being. Although old age is a natural process in the stages of human development (for those enjoying longevity), the younger populations always tend to forget that should they be lucky to enjoy a longer life, they would definitely pass through it. Instead of embracing, appreciating and supporting the aging, the younger individuals tend to discriminate and isolate them because they are perceived as bothersome, uncooperative individuals who are a burden to them (Cromley, 2016). This kind of stereotype has been making it difficult for the aging to enjoy their old age. Instead of being proud of their long life, the situation makes them unhappy, withdrawn and less important as compared to the rest of the population. Nonetheless, for one to enjoy a successful aging, one has to adopt a lifestyle that can help to make them satisfied and happier in life. As part of this research, it was necessary for me to engage in a field study to find out exactly what constitutes a successful aging (Rowe Kahn, 2015). Therefore, I had to book an appointment with Joseph, a 71-year old retired civil servant who now lives what, in his opinion, is a successful aging life in his rural home. According to Joseph, he has managed to lead a happier life because of the following reasons: Engagement in Physical Activities: From his responses, Joseph pointed that out one of the secrets behind his successful aging is the active involvement in physical activities. Despite his old age, Joseph has been spending at least 15 minutes each day to enjoy a walk. At times, he can go to the gym to perform light physical exercises. This is something that he cannot fail to do because of its significance to him. He pointed that through such activities, he manages to release stress and shed calories (Nosraty, Jylh, Raittila Lumme-Sandt, 2015). This is good for his health because it enables him to regulate his body weight and put his blood pressure under control (Stowe Cooney, 2015). Adopt a Social Lifestyle: To lead a successful aging life, one should be a social person who is always ready to establish a cordial relationship with other people. It can be much fulfilling if an elderly person lives in the midst of other people and accept to relate well with them (Stowe Cooney, 2015). It is necessary to do so because being lonely can cause depression that might be dangerous to the health of the elderly. In our encounters, Joseph revealed to me that he has been having a positive interaction with his 2 daughters, son, grandchildren and childhood friends. His constant interactions with these people have made him to be a happier elderly in their midst. Acquisition of Healthcare Services: Another key component of a successful aging is access to and a proper use of healthcare services. One of the reasons why the elderly persons lack happiness and lose hope in life is ailments (Resnick, Klinedinst, Yerges-Armstrong, Choi Dorsey, 2015). Unlike the younger persons, the elderly are very much susceptible to chronic illnesses that unfortunately come in multiples. It is because of his constant pursuit for healthcare services that Joseph has managed to enjoy a successful aging (Cho, Martin, Poon Georgia Centenarian Study, 2015). He asserted that he always seek for medical intervention in case of any need. Thus, he gets the required diagnoses, treatments, interventions and medication. Eating a Healthy Diet: For a very long time, food has become a major issue of health concern not only for the younger populations, but to the elderly as well. Several researches have revealed that poor diet has caused lots of medical challenges to the people. The elderly persons who do not use a proper diet are prone to illnesses like diabetes and cancer. Therefore, to help the elderly to enjoy a successful life, they should use a proper diet that can help them in leading a healthy life by eliminating any threats (Chan Matchar, 2015). This strategy has been helping Joseph to enjoy a successful aging life. He pointed out that he usually consumes a balanced diet that contains all the necessary food components to protect his body and give him the required energy. The Application of the Activity Theory of Successful Aging One of the theories that should be applied to the care of the elderly persons is the activity theory of successful aging. It was propounded by Robert Havinghurst in 1961 as a response to the disengagement theory of aging that had the elderly should be disengaged from the rest of the society because they are nearing death. According to the activity theory, an elderly person can manage to lead a successful aging life if they remain active in life (Kelly Lazarus, 2015). By being active in life, the elderly can take time to participate in a series of activities that mean a lot to them. Remaining idle can be disastrous because it can negatively impact on their psychological and mental health. At the same time, it can expose them to complex chronic diseases to which the elderly are highly susceptible. Physical activities should be encouraged because they can bring happiness to the elderly in many ways. First, the activities performed can remind the elderly of the enjoyable life they were leading in the past. Through such associations, the elderly can become content and happier because they get to reconnect with their glorious past (Martin, Kelly, Kahana, Kahana, Willcox, Willcox Poon, 2015). It can give the elderly an opportunity to get to associate with the accomplishments made during active life (Nosraty, Jylh, Raittila, Lumme-Sandt, 2015). The other reason why the aging should engage in physical activity is because it can bring them to the right path of attaining a healthy life. Positive social interactions play a significant role in making the elderly persons happier in life because it provides them with the needed company. Just like the rest of the people, the elderly do not like to be neglected and left to live in isolation (Lee Payne, 2015). Instead, they should always enjoy the company of their close relatives because it can make them feel accommodated, respected and honored as an integral part of the larger society. And it is such happiness that defines a successful aging process (Zacher, 2015). The strategy of establishing a cordial relationship with his family members has been enabling Joseph to enjoy a successful aging (Anton, Woods, Ashizawa, Barb, Buford, Carter, Dotson, 2015). So, in all his efforts, Joseph was acting under the guidance of the activity theory of successful aging. It has been the secret behind his active involvement in physical activities. Despite his advanced age, Joseph has not been idling around. Instead, he uses his time to perform light activities that, in his opinion, are aimed at improving his lifestyle (Martinson Berridge, 2015). Through such efforts, he has managed to reconnect with his admirable past to lead a more meaningful and successful aging life. If it were not for this theory, Joseph would not have made an effort to establish a good rapport with his children, grandchildren, health care providers and neighbors. Conclusion Successful aging has remained a challenge in the society. The sensitive and complex nature of the elderly has made them prone to several challenges that many younger people find hard to deal with. At the same time, many elderly persons do adopt a kind of lifestyle that jeopardize their health and prevent them from leading a enjoying their old age. However, as demonstrated by Joseph, a successful aging life if feasible if measures are taken to adopt a healthy lifestyle characterized by a healthy diet, cordial social relationships, engagement in physical activities and accessibility to health care services. All these can be enhanced by the application of activity theory of successful aging which emphasizes the need for physical fitness as well as healthy social interactions by the aging. References Anton, S. D., Woods, A. J., Ashizawa, T., Barb, D., Buford, T. W., Carter, C. S., ... Dotson, V. (2015). Successful aging: Advancing the science of physical independence in older adults. Ageing research reviews, 24, 304-327. Calasanti, T. (2015). Combating Ageism: How Successful Is Successful Aging?. The Gerontologist, gnv076. Chan, A., Matchar, D. B. (2015). Demographic and structural determinants of successful agingin Singapore. In Successful aging (pp. 65-79). Springer Netherlands. Cho, J., Martin, P., Poon, L. W., Georgia Centenarian Study. (2015). Successful aging andsubjective well-being among oldest-old adults. The Gerontologist, 55(1), 132-143. Cromley, E. K. (2016). Spatial Analysis of Successful Aging in Older Adults based on Objectiveand Subjective Measures. Research Advances in Behavioral, Economic and HealthGeography Inspired by Gerard Rushton, 99. Kelly, G. A., Lazarus, J. (2015). Perceptions of Successful Aging Intergenerational VoicesValue Well-Being. The International Journal of Aging and Human Development, 0091415015591678. Lee, C., Payne, L. L. (2015). Exploring the Relationship Between Different Types of SeriousLeisure and Successful Aging. Activities, Adaptation Aging, 39(1), 1-18. Martin, P., Kelly, N., Kahana, B., Kahana, E., Willcox, B. J., Willcox, D. C., Poon, L. W. (2015). Defining successful aging: A tangible or elusive concept?. The Gerontologist,55(1), 14-25. Martinson, M., Berridge, C. (2015). Successful aging and its discontents: A systematic review of the social gerontology literature. The Gerontologist, 55(1), 58-69. Moore, R. C., Eyler, L. T., Mausbach, B. T., Zlatar, Z. Z., Thompson, W. K., Peavy, G., ... Jeste, D. V. (2015). Complex interplay between health and successful aging: role ofperceived stress, resilience, and social support. The American Journal of Geriatric Psychiatry, 23(6), 622-632. Nosraty, L., Jylh, M., Raittila, T., Lumme-Sandt, K. (2015). Perceptions by the oldest old ofsuccessful aging, Vitality 90+ Study. Journal of aging studies, 32, 50-58. Nosraty, L., Jylh, M., Raittila, T., Lumme-Sandt, K. (2015). Perceptions by the oldest old ofsuccessful aging, Vitality 90+ Study. Journal of aging studies, 32, 50-58. Resnick, B., Klinedinst, N. J., Yerges-Armstrong, L., Choi, E. Y., Dorsey, S. G. (2015). TheImpact of Genetics on Physical Resilience and Successful Aging. Journal of aging andhealth, 27(6), 1084-1104. Rowe, J. W., Kahn, R. L. (2015). Successful aging 2.0: conceptual expansions for the 21stcentury. The Journals of Gerontology Series B: Psychological Sciences and SocialSciences, 70(4), 593-596. Stowe, J. D., Cooney, T. M. (2015). Examining Rowe and Kahns concept of successfulaging: Importance of taking a life course perspective. The Gerontologist, 55(1), 43-50. Zacher, H. (2015). Successful aging at work. Work, Aging and Retirement, 1(1), 4-25.

Malignant Hyperthermia free essay sample

Clinical signs are; Increased end tidal CO2 production which is an early sign, tachycardia, tachypnea, trunk or total body rigidity, masseter (jaw) muscle rigidity after succinylcholine which occurs commonly in children, marked temperature elevation (maybe a late sign), respiratory and metabolic acidosis, myoglobinuria(MHAUS, 2011). If left untreated the patient will experience cardiac arrest, kidney failure, blood coagulation problems, internal hemorrhage, and possibly death (slideshare, 2010) Nursing Assessment Nurses taking care of surgical patients must be knowledgeable regarding MH so they can identify clinical signs and symptoms early on, its emergent treatment, and be able to respond promptly and appropriately. Preoperative assessment by nurses are crucial in identifying the patient, who could be at high risk for Malignant Hyperthermia, so MH triggering agents can be avoided during anesthesia. Example of questions to ask to help screen for MH susceptibility are (AORN 2012): 1. Has anyone ever told you that you had a â€Å"bad† reaction to anesthesia? 2. We will write a custom essay sample on Malignant Hyperthermia or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Has anyone ever told you that you or your family member had a problem with anesthesia? . Have you or a family member experienced a high fever while under anesthesia? 4. Has anyone ever told you or a family member they had a difficult time opening your jaw during general anesthetic? 5. Has anyone in your family died unexpectedly in the operating room? 6. Have you or anyone in your family experienced sunstroke or heat stroke resulting in hospitalization? 7. Have you ever noticed dark â€Å"cola-colored† urine after a general anesthetic or after experiencing a heat-related illness? Treating MH Dantrolene IV is the only drug available in the market to treat Malignant Hyperthermia. It is difficult to mix and is time consuming to reconstitute. It comes in yellowish colored powder that when fully mix with non-bacteriostatic sterile water, the color stays the same. The new brand Dantrium IV (dantrolene sodium for injection) mixes in just 20 seconds (MHAUS, 2011). However, this is not what we have stocked in our cart. According to MHAUS (2011), dantrolene suppresses the exaggerated rise in muscle cell calcium that seems to trigger MH by binding to the calcium channel site in muscle that is responsible both for calcium release and, likely, calcium entry into the cell. Dantrolene may cause significant muscle weakness in patients with preexisting muscle disease and should be used with extreme caution in those patients. When used with calcium channel blockers (verapamil or diltiazem), dantrolene may produce life-threatening hyperkalemia and myocardial depression. Once a patient has been successfully treated for 36 hours with intravenous dantrolene, he/she may be switched to oral dantrolene until the CK or Creatine Kinase level is trending down and there is no further evidence of acidosis or hypermetabolism and temperature spikes. A recommended 36 vials be stocked. Treating Malignant Hyperthermia crisis is a complex nature, and it involves several staff members. The first thing to do in the event of suspected MH crisis is to recruit extra staff. The following steps are outline by role (MHAUS, 2011): The surgeon should stop or complete the procedure as soon as possible. The anesthesia provider stops inhalation agents; stops warming blanket; increase minute ventilation; inserts esophageal temp probe; inserts NG tube for lavage as needed; administers dantrolene IV; inserts an arterial line; draws blood for chemistry, ck, coagulation, ABG. If peaked T waves on ECG, administers calcium then glucose and insulin. If T waves are not peaked and arrhythmia present, injects bicarbonate. The circulating nurse brings in MH cart; mixes dantrolene based on 2. 5 mg/kg with 60 ml of non-bacteriostatic sterile water, repeat dose until the signs are controlled. The circulating nurse should document the event. A second nurse assist in mixing dantrolene and hands syringe to anesthesia provider. A third nurse brings in emergency crash cart; places urinary catheter; assist in drawing blood or with other task. A fourth nurse brings in plastic bags with ice and cold IV fluids; places ice bags on exposed parts like groin, axilla, and neck (without compromising sterility); iced saline lavage of any open body cavities such as the stomach, bladder, or rectum. Cold I. V. fluids are administered using 0. 9% sodium chloride, but Lactated Ringer’s is avoided so that acidosis is not worsened (Martin, 2009). Stop cooling measures when temperature falls to 38 °C (MHAUS, 2011). A laminated copy of MHAUS dantrolene dosage chart is located on top of MH cart to minimize precious time wasted in calculating dosage per kilogram. As soon as patient is stabilized, transfer patient to ICU or call transfer center for an emergent transfer to UH Case SICU or ED. Knowing your Role All staff involved in the MH crisis response should conduct a debriefing meeting as early as possible. Points to consider including (AORN, 2012): 8. Was the MH cart adequately stocked and immediately available? 9. Were enough staff members available to manage the crisis effectively? 10. When staff members responded, were they familiar with task expected in MH crisis? 11. Was MHAUS appropriately notified? 12. Do staff members have other ideas about planning care for a future MH crisis? 3. Has a root-cause analysis been done (MH is considered a sentinel event)? Staff Competency By using the mannequin as our patient, and mixing the expired dantrolene from MHAUS, perioperative staff did fairly well during the MH mock drill simulation by following thru with the expected roles. MH drill should be held at least quarterly to help perioperative st aff practice early recognition of MH crisis and how to act accordingly. MH drill also improve OR (operating room) team coordination and provides opportunities to serve in each of the four roles mentioned (Martin, 2009). Prevention Early detection of clinical signs and symptoms of MH, knowing your role and a prompt response to this emergent crisis can save your patient’s life. MH crisis prevention is the key and the best treatment you can provide to your patient. Knowledge about MH is a must for nurses taking care of a patient before, during and after operative care. Armed with this knowledge, you can make a difference in your patient’s lives.

The Man Behind Jay Gatsby essays

The Man Behind Jay Gatsby essays In the novel "The Great Gatsby" by F. Scott Fitzgerald, no one really seemed to know the man known as Jay Gatsby. When he was rich and powerful, he was a man everyone "wanted to be well acquainted with." But when he died, life went on without him. It seemed as if nobody cared that he was the man behind the extravagant parties and all the good times. He was dead and nobody mourned or gave any signs of sympathy. This shows the difference of opinions of the great Jay Gatsby throughout the story. He was an icon of not only every man's image of the American Dream, but he was also a part of Americanism and the American Experience. He was seen as the richest and luckiest man during his time. Unlike any of the other characters in the novel, Jay Gatsby does not change during the course of the story. He as a person may not have changed, but the way that people perceived him certainly became different. When he was alive and well, he was the perfect example of the American Dream. "He took out a pile of shirts and began throwing them one by one before us, shirts of sheer linen and thick silk and fine flannel which lost their folds as they fell and covered the table in many-colored disarray (Fitzgerald 97). This illustrates how he had more money than he knew what to do with. He could afford to have oversized parties every weekend and live the lavish style that he did. Jay Gatsby was the person to know when it came to West Egg. In the beginning, he was only known as Jay Gatz. He was a poor boy who had joined the army. He only had his charm to get him by. With that, he met Daisy. She was a very rich and sheltered girl from a wealthy family. They were in love from the beginning. Unfortunately, Daisy believed overall that security was of more importance than of love. From that moment on, Jay Gatz wanted one thing; to get rich so he could gain Daisy's approval and also to show her that a poor boy can become wealthy. This obsession ate up and de...