Perspectives on Policing SC2037C Essay Example | Topics and Well Written Essays - 3000 words

Perspectives on Policing SC2037C - Essay Example The criminologists have become increasingly preoccupied with policing over the past two decades and recently there has been growing attention paid to the regulatory activities undertaken by other bodies of officials and to the private security industry. The policing explores the law enforcement, rules and the complexity of the order maintenance, with an explicit focus on the relation ship between the private sectors and public. The creation of professional police was for the benefits of the middle classes and not for the society as a whole. Community policing is a process in which the crime control is shared by the public. The purpose of community policing is to develop the communication between the interest groups and public. In United States during the 1970s the community policing described the tactics of short term to repair the relations of the police minority, when the investigations and the entrenched petrol failed then a largely cosmetic exercise masking reluctance to make the major changes. The community policing strive and define to enact a posited common good. The policing can produce the unanticipated consequences. (Nigel Fielding, 1995) The important developments in the organization of police were occurred in the areas of mobilization of petrol officers and command organization, the work of petrol officers and the organization, and the use and access of systems of information by all level of personnel. While to consolidate the law enforcement there has been some efforts, generally the organizations of police remain resistant to this goal. Numerous changes have been produced by the bureaucratization of the police and those changes were within departments and have been influenced very strongly by the changing situations or conditions from the department of outside. The problem oriented and community based policing are shaping the way in which some organizations of police conduct their business

Marketing 100 Research Paper Example | Topics and Well Written Essays - 2000 words

Marketing 100 - Research Paper Example Sanitarium claims that its Weet-Bix wheat biscuits are an ideal breakfast food because it fulfills calorie needs and energy requirements. Indeed, the major ingredients include fibre, fat and sugar (low), vitamins, milk, zinc, magnesium, folate and iron (Product Review, 2010). The Sanitarium Company offers its products at all retail stores, grocery shops and online stores for convenience of buyers across Australia and New Zealand. The company uses competitive pricing strategy because of highly competitive nature of food and confectionary industry. The prices range from $1 – 10 because of differences in flavours, sizing and quantity. In simple words, the prices will remain competitive because there is greater threat of substitute products from existing companies such as Kelloggs, Uncle Toys, House brands, Nestle and other small scale producers and marketers. It is worthwhile to mention that Kelloggs has been marketing Nutri-grain, Cheerios, Coco Pops and Nesquik in Australian market. In conclusion, there is stiff competition that keeps prices affordable for consumers from different social classes (Demo Design Report, 2006). The Sanitarium Company has already expanded its operations all across Australia because of an efficient distribution and supply chain network. The company supplies its product to all retail and commercial stores, grocery houses, medicine shops and online stores. In this way, Sanitarium has increased market reach of Weet-Bix product and has attracted maximum customers towards its brand. In addition, the company focuses on efficient supply because the Utility of Place and Time play a vital role in success of any food product. Sanitarium has inducted a new eCargo system to ensure flexibility in distribution channels, to reduce human error and to facilitate record keeping, freight and inventory management (Ecargo Report, 2010). The company

Intervention to Reduce Progression of Diabetes

Intervention to Reduce Progression of Diabetes Developing an Intervention to Reduce Progression and the Development of Complications from Diabetes Mellitus in Adults in Glasgow. Introduction Type 2 diabetes is a serious medical condition that is increasingly prevalent in developed countries (International Diabetes Federation, 2013) and the most common variants of the condition are Types I and II. Type I patients have a deficiency in their pancreatic beta cells which leaves them unable to produce insulin. Thus in these individuals, some control over the condition can be achieved using insulin therapy (Schilling, 2007). Type II diabetics, have cells that have become resistant to the effects of insulin resulting in a delayed reduction in blood glucose (Skrha et al., 2010). There are additional types of diabetes; gestational, and a variety of Type III diabetes, however, the overwhelming majority of cases are of Type II with a significant minority of type I cases (Hardt et al., 2008). Complications of Diabetes Regardless of the underlying aetiology, the long-term complications of diabetes are similar. Excess blood glucose is thought to drive increases in oxidative stress both directly and via the derangement of mitochondrial energy pathways (Cade, 2008). Long term macrovascular damage will inevitably increase the risk of coronary heart disease (CHD), and ischaemic heart disease, with diabetics estimated as having a 3 and 5-fold increased risk of CHD mortality for men and women respectively (Loveman et al., 2008). Cerebrovascular disease is also a consequence of the chronic macrovascular damage with similar increases in stroke risk (Naci et al., 2015) Since each organ has its own microvascular supply, chronic hyperglycaemia also results in diffuse and widespread damage to a variety of body organs. As a result, diabetic complications include visual disability due to diabetic retinopathy; the leading cause of blindness in working age adults in the UK (Fowler, 2008; Kempen et al., 2004). In addition, patients suffer end stage renal disease from diabetic nephropathy (Adler et al., 2003), diffuse impairments of autonomic and somatic neural function, including pain perception, due to diabetic neuropathy (Stirban, 2014; Voulgari et al., 2013). Furthermore, the combination of microvascular damage, and reduced pain sensation, usually in the lower limb, results in many patients developing ulceration and necrosis of the inferior surface of the foot, the most common cause of non-traumatic amputations in the UK (Elraiyah et al., 2016). Costs of Diabetes In addition to the significant cost to the individual suffering with diabetes in terms of reduced personal health and quality of life, there are significant financial costs in treating the condition. In 2010-11, the total cost of diabetes to the UK was estimated at  £23.7bn (Hex et al., 2012). This was comprised of  £9.8bn in direct costs related to treating the disease, and  £13.9bn in indirect cost (e.g. lost productivity through absenteeism, early retirement or unemployment, (Hex et al., 2012)). More recently, the direct costs were estimated at  £13.7bn in 2012 (Kanavos et al., 2012). Within these direct costs, only around a quarter is directly spent on treating diabetes its self, and the remaining three quarters is spent on treating the complications following from the disease, (e.g. CHD, retinopathy, liver failure, diabetic foot, neuropathy (Kanavos et al., 2012)). Risk Factors for Diabetes There are a variety of factors that have been identified that places individuals at risk of developing type II diabetes, these include; having a family history of diabetes, obesity assessed using body-mass index, hypertension, visceral adiposity, adverse blood lipids, smoking, and impaired fasting glucose control (Lyssenko et al., 2008). Notably, several of these risk factors, including blood lipids, BMI, hypertension and visceral adiposity, are shared risk factors for CHD, which may in part explain the elevated risk of CHD in diabetics (Haffner et al., 1998). Indeed the clustering of these risk factors has been shown to be predictive of both CHD and diabetes (Haffner et al., 1998) and are collectively referred to as the metabolic syndrome. Moreover, these risk factors, appear to primarily be related to obesity in general, and excessive visceral adiposity in particular (Wozniak et al., 2009). Early work by West and colleagues (1978) demonstrated a strong positive association between rates of obesity and rates of diabetes with a variety of populations. Since then, the epidemiological link between excess body fat and risk of developing type II diabetes in particular has been repeatedly supported. For example, in the Nurses Health Study (Chan et al., 1994) females who had a BMI of greater than 35 kg.m-2 had a risk of diabetes 95 fold higher than those with a BMI of less than 21 kg.m-2 . Epidemiology of Diabetes The incidence and prevalence of diabetes have increased dramatically in the last two decades. Currently, the World Health Organisation estimates that diabetes effects around 9% of the adult global population (International Diabetes Federation, 2013) with variations in prevalence ranging from 26.4% in Kiribati to 1.54% of the population in Manin (International Diabetes Federation, 2013). Overall the UK ranks relatively favourably; in the same data from 2014, the UK had a prevalence of 3.9% (172nd out of 193 countries). Despite this relatively low ranking, the UK, in line with many developed countries, has experienced a rapid growth in the proportion of the population suffering with diabetes. Between 2007 and 2015 the number of patients diagnosed with diabetes increased by 75% from two to three and a half million cases (Diabetes UK, 2015). There are also an estimated half a million undiagnosed individuals at any one time. Indeed, the absence of overt symptoms in the early stages of the disease means that it is not uncommon for patients to have had the disease for several years prior to diagnosis, and confounds attempts to accurately calculate prevalence rates. Scotland has experienced similar increases, with the number of individuals diagnosed with diabetes increasing markedly over the last decade. The Scottish Diabetes survey (2014) demonstrated that the number of individuals with diabetes doubled from approximately 100,000 to 200,000 individuals between 2002 and 2007 despite a stable population of 5 million. Currently estimates for Scotland indicate that there are 276,500 diabetics in Scotland resulting in an overall prevalence that is a third higher than the UK average at 5.2% (NHS Scotland, 2014). Diabetes and Deprivation While the reasons that link indices of deprivation to diabetes are likely multifactorial, they undoubtedly exist. Individuals living in the most deprived areas of the UK are 2.5 times more likely to suffer from diabetes than those in the least deprived areas (Diabetes UK, 2006). Moreover the complications arising from diabetes such as CHD and stroke are more than three times higher in the lowest socio-economic groups and those with lowest educational achievement are twice as likely to have heart disease, retinopathy and poor diabetic control (Diabetes UK, 2006; International Diabetes Federation, 2006). The cause of the increased risk is not clear, however many of the risk factors such as obesity, smoking and physical inactivity, are also higher in those areas with the greatest degree of deprivation (Diabetes UK, 2006; International Diabetes Federation, 2006). From the data outlined above, the development of diabetes is a serious chronic medical condition that can result in early morbidity and mortality and is associated with significant personal and healthcare costs. Despite many of the risk factors for its development being modifiable, it remains a significant and increasing health risk that has a disproportional focus on the areas of greatest deprivation. Given that there is strong evidence that Glasgow has higher rates of both deprivation and type 2 diabetes than the rest of the UK, the aims of this paper are to discuss methods of describing the degree of the problem in Glasgow, as well as identifying, implementing and evaluating initiatives designed to reduce the burden of Type 2 diabetes within that area. Epidemiological Investigation of Diabetes in Glasgow The Centre for Disease Control defines public health research as consisting of four phases, public health tracking, public health research, health intervention programmes, and impact and evaluation (CDC, 2015). Thus before designing and implementing a diabetes focused health initiative, it is necessary to first establish that there is a public health need within Glasgow. This can be undertaken using primary or secondary data sources. Although secondary data sources are repositories of data that have been collected for some purpose other than the investigators main research question, Bailey et al. (2012) suggest that secondary sources also have several advantages. Typically, they are large data sets, and their use is highly cost efficient, as the data collection has already taken place. In terms of this investigation into Diabetes prevalence in Glasgow, there are a number of possible secondary data sources. The most directly relevant data is from the Scottish Diabetes Survey, the most recent data for which covers 2014 (NHS Scotland, 2014). In the most recent report, there is evidence that diabetes is a specific public health concern in Glasgow. For example, while it is not surprising is that Glasgow has the highest number of diabetics, around 22% of Scotlands diabetic population, since it is also the most densely populated region. However, this also translates to the region having the highest age adjusted prevalen ce of diabetes within Scotland at 5.8%. Furthermore the Greater Glasgow and Clyde (GGC) NHS board is criticised as falling behind other NHS health boards within Scotland, in its system of managing and screening its diabetic population in order to limit the progression of the disease. In addition, the Scottish Public Health Observatory (SPHO) provide a number of secondary data sources which may be valuable in triangulating conclusions and include; mortality rates, primary care information from GP practices, the Quality Outcomes Framework (QOF) detailing the performance of GP practices in dealing with key health issues, the Scottish Diet and Nutrition Survey, and the Health Education population survey (Scottish Public Health Observatory, 2015). In addition, both English and Scottish governments produce databases of indices of multiple deprivation (IMD), which can be useful when attempting to standardise the degree of a public health issue by deprivation level. This secondary data should be supported with primary evidence of the population of interest. While there are a number of research designs that could be used to collect primary data on Glasgow residents with diabetes, in this instance a cross-sectional observational design would be most useful. This method has several advantages, it is cost effective, requires only a single group, and each participant is only required to be assessed at a single time-point. This means that it becomes feasible to assess relatively large numbers of people (Bailey Handu, 2012). The limitations of this method are that it represents a single point in time and as a result, cannot be used to determine the sequence of events for a given set of exposures and outcomes. Therefore, it is not possible to infer causality from cross-sectional data. This type of research is most useful for determining prevalence rates for a specific condition (Bailey Handu, 2012).. An ecological study design might also be used, however, in this case, there are wide variations in income levels and deprivation levels within specific postcodes. Thus the possibility for the data to be affected by unknown confounding variables is significant. Similarly a case control study design has some additional control regarding possible confounders, but is again limited in being retrospective in nature and is predominantly used for rare diseases, which type 2 diabetes is not (Greenfield, 2002). Experimental designs such as prospective cohort studies or randomised control trials are the most internally valid designs to attribute causation of a condition to a specific exposure. However, they would not be appropriate in this instance, as they time consuming, expensive, and typically include far fewer individuals. Thus in order to use this type of study, the cost would be greater than the cost of any proposed intervention. In addition, while such designs are internally valid, they often lack ecological validity. That is, while the exposure and outcome can be linked in the study, at the population level, individuals may experience exposure to several predicating factors, and several protective factors. Thus, it is not always straightforward to transfer the findings from a highly controlled study to individuals (Peat et al., 2008). In order to undertake the cross-sectional survey, would require defining a series of areas (e.g. roads or school catchment areas) within specific post-codes to act as the sample frame. The survey data would be collected on these areas. The main problem with collecting this kind of data is a low response rate (Levin, 2006), and the possibility that individuals may responder or not due to the influence of some other factor introducing some systematic bias into the data. The main protection from this is to maximise the response rates. This is best done using face-to-face interviews with individuals in the sample frame (Levin, 2006). Diabetes Interventions The evidence for the type of behaviours that are useful in limiting the adverse complications of diabetes, have been the subject of several large scale epidemiological studies. In the UK the UK Prospective Diabetes Study (UK Prospective Diabetes Study, 1998) and its 10 year follow up (Holman et al., 2008) evaluated the effect of managing type II diabetes through diet alone, versus aggressive management aimed at restricting blood sugar concentrations. The data from the study indicated that while both the aggressive intervention only lowered blood sugar for one year, this translated into significantly lower rates of complications at the 10-year follow up. In the US, the Diabetes Control and Complications Trial (DCCT, 1993) and its 10 year follow up (the Epidemiology of Diabetes Interventions and Complications EDIC (Nathan et al., 2005)) also demonstrated that limiting increases in blood sugar, by maintaining concentrations within strict individualised limits, reduced the incidence of c omplications at the 10 year follow up by 57%. Similar reductions in adverse outcomes have also been found when diabetics have measures of blood lipids, blood pressure, nephropathy, retinopathy and diabetic foot complications assessed at regular intervals. It is also noteworthy that the Greater Glasgow and Clyde NHS region regularly performed in the lowest quartile of Scottish NHS authorities for implementing each of these evaluations (Scottish Diabetes Survey 2014). In long-term conditions such as Type 2 diabetes, the most appropriate strategies to control and manage the condition is for patients, to recognise themselves as stakeholders in their own treatment and to take ownership of the critical aspects of their care such as pharmacological treatment, dietary modifications and physical activity recommendations (National Institute for Health and Care Excellence, 2015). There have been several interventions that have aimed to use patient education to allow for a greater degree of self-management with a resulting closer control of risk factors for diabetic complications. Most recently Minet et al. (2010) evaluated the efficacy of 47 RCT studies aimed at improving diabetic patient education, and found that there was a significant reduction in the degree of hyperglycaemia experienced by the patients at the 6 and 12 month follow up time points. Similar meta analyses have supported the role of education in reducing the incidence of nephropathy and dia betic foot (Elraiyah et al., 2016; Loveman et al., 2008). Given that the UKPDS (1998) demonstrated that even short term reductions in blood glucose can reduce the numbers of patients who progress to sever complications, and given that the majority of the financial burden in treating type 2 diabetes is related to complications rather than the disease its-self. It seems clear that patient education could significantly improve the prognosis of diabetics as well as reduce the costs of future treatment. Implementing an Intervention in Glasgow Having identified a suitable educational intervention, the next stage is to ensure its faithful and appropriate replication within patients with Diabetes in Glasgow. A limitation of much of the available research is that interventions are predominantly applied in academic settings, and the effectiveness of interventions in community and primary care settings are frequently lower than anticipated from the scientific literature. This is a continuing challenge for implementing evidence-based strategies for public health issues. Kilbourne et al. (2007) recommend the REP framework, which although originally devised for faithful implementations of HIV educational programmes has been evaluated and found to help improve the effectiveness of other public health interventions. In order to use the REP framework for educational programmes aimed at Diabetics in Glasgow, the four stages of the REP framework would be developed. Pre-condition requires the identification of a suitable educational intervention. In this phase it is important that the chosen intervention is both feasible and appropriate for the setting in which it will be used. Pre-implementation requires that all staff involved in the intervention undergo training not only in the interventional educational curriculum, but also in the underpinning theories that shaped the original intervention. Implementation requires the educational programme is rolled out to diabetics within Glasgow, and that feedback is sought from stakeholders including patients undergoing the education. In this way it is possible to modify the intervention to better fit the situation, while still remaining faithful to the initial conceptual design. Finally, maintenance and evaluation requires further feedback regarding the effe ctiveness of the intervention, as well as ongoing support for partners who are delivering or helping ensure the continuation of the intervention. Monitoring an Evaluation For the proposed educational intervention, the evaluation would use the RE-AIM framework. This is the most widely adopted model for evaluation of public health interventions originally proposed by Glasgow and Colleagues (1999). This framework proposes the evaluation of five key elements of the intervention. Reach assess the number of individuals from the target population who received the interventions. Efficacy evaluates the degree to which the education intervention improved patients ability to manage their condition (e.g. better control of blood glucose, maintained or lowered blood pressure). Adoption would focus on the number of patients receiving the educational intervention whose behaviour was altered as a result. Implementation attempts to assess the degree to which the intervention was faithful to the evidence base upon which it was designed or was there pragmatic or other issues that meant the interventions was poorly delivered, or delivered in a manner not originally envisa ged. Maintenance attempts to quantify the degree to which the intervention becomes self-sustaining. This can be at an institutional level, i.e. does the health authority feel the programme is sufficiently successful to continue its development. However, it can also be at the individual level, were patients value the intervention and it becomes part of the persons habitual processes. Conclusion The aim of this paper was to investigate an intervention aimed at reducing the complications of type 2 diabetes in individuals diagnosed with the condition, living in Glasgow. It has established that in order to implement any such strategy, it is necessary to evaluate the degree of the problem using secondary and if required primary sources of data. In addition, any intervention should be evidence based, and attempt to replicate those interventions that have been demonstrated to be successful. This should be attempted in a strategic and structured manner in order to ensure high fidelity conversion from research evidence to intervention. The intervention its-self needs robust evaluation to determine if it was effective, and if not was it because of a failure of the underpinning theories or a failure in delivery. Unless they are well managed, individuals with Type 2 diabetes are at a significant risk of serious and life threatening complications. Educational interventions may be one wa y to provide effective strategies to enable better outcomes and reduced personal and financial costs. References ADLER, A.I., et al., 2003. Development and progression of nephropathy in type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS 64). Kidney International. 63(1), pp. 225-232. BAILEY, S. and HANDU, D., 2012. Introduction to epidemiologic research methods in public health practice. Jones Bartlett Publishers. CADE, W.T., 2008. Diabetes-related microvascular and macrovascular diseases in the physical therapy setting. Physical Therapy. 88(11), pp. 1322-1335. CDC. 2015. Public Health Cycle [Online]. [Viewed 4th April 2016]. Available From: http://www.cdc.gov/ncbddd/hearingloss/publichealth.html. CHAN, J. M., RIMM, E. B. COLDITZ, G. A. 1994. Weight gain as a risk factor for clinical diabetes mellitus in women. Diabetes Care, 17, 961-9. DIABETES CONTROL AND COMLICATION TRIAL RESERCH GROUP, 1993. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl j Med. 329(14), pp. 977-986. DIABETES UK 2006. Diabetes and the disadvantaged: reducing health inequalities in the UK World Diabetes Day 14 November 2006. A report by the All Parliamentary Group for Diabetes and Diabetes UK. https://www.diabetes.org.uk/Documents/Reports/Diabetes_disadvantaged_Nov2006.pdf. DIABETES UK. 2015. Diabetes Facts and Stats November 2015 [Online]. [Viewed 20th March 2016]. Available From: https://www.diabetes.org.uk/Documents/Position statements/Diabetes UK Facts and Stats_Dec 2015.pdf. ELRAIYAH, T., et al., 2016. A systematic review and meta-analysis of adjunctive therapies in diabetic foot ulcers. Journal of Vascular Surgery. 63(2), pp. 46S-58S. e2. FOWLER, M.J., 2008. Microvascular and macrovascular complications of diabetes. Clinical Diabetes. 26(2), pp. 77-82. GLASGOW, R.E., VOGT, T.M. and BOLES, S.M., 1999. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. American Journal of Public Health. 89(9), pp. 1322-1327. GREENFIELD, T. 2002. Research Methods for Postgraduates, London, Arnold. HAFFNER, S.M., et al., 1998. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. New England Journal of Medicine. 339(4), pp. 229-234. HANLON, P., et al., 2005. Why is mortality higher in Scotland than in England and Wales? Decreasing influence of socioeconomic deprivation between 1981 and 2001 supports the existence of a Scottish Effect. Journal of Public Health (Oxford, England). 27(2), pp. 199-204. HARDT, P.D., BRENDEL, M.D., KLOER, H.U. and BRETZEL, R.G., 2008. Is pancreatic diabetes (type 3c diabetes) underdiagnosed and misdiagnosed?. Diabetes Care. 31 Suppl 2 pp. S165-9. HEX, N., et al., 2012. Estimating the current and future costs of Type 1 and Type 2 diabetes in the UK, including direct health costs and indirect societal and productivity costs. Diabetic Medicine. 29(7), pp. 855-862. HOLMAN, R.R., et al., 2008. 10-year follow-up of intensive glucose control in type 2 diabetes. New England Journal of Medicine. 359(15), pp. 1577-1589. International Diabetes Federation 2006. Diabetes, deprivation and outcomes in a wealthy world. Diabetes Voice, 51, 37-40. INTERNATIONAL DIABETES FEDERATION. 2013. IDF Diabetes Atlas [Online]. [Viewed 20th March 2016]. Available From:https://www.idf.org/sites/default/files/EN_6E_Atlas_Full_0.pdf: IDF. KANAVOS, P., VAN DEN AARDWEG, S. and SCHURER, W., 2012. Diabetes expenditure, burden of disease and management in 5 EU countries. LSE Health and Social Care. KEMPEN, J.H., et al., 2004. The prevalence of diabetic retinopathy among adults in the United States. Archives of Ophthalmology (Chicago, Ill.: 1960). 122(4), pp. 552-563. KILBOURNE, A.M., et al., 2007. Implementing evidence-based interventions in health care: application of the replicating effective programs framework. Implementation Science. 2(1), pp. 1-10. LOVEMAN, E., FRAMPTON, G.K. and CLEGG, A., 2008. The clinical effectiveness of diabetes education models for Type 2 diabetes: a systematic review. Health Technology Assessment. 12(9), pp. 1-136. LYSSENKO, V., et al., 2008. Clinical risk factors, DNA variants, and the development of type 2 diabetes. New England Journal of Medicine. 359(21), pp. 2220-2232. MINET, L., et al., 2010. Mediating the effect of self-care management intervention in type 2 diabetes: a meta-analysis of 47 randomised controlled trials. Patient Education and Counseling. 80(1), pp. 29-41. NACI, H., et al., 2015. Rethinking the appraisal and approval of drugs for type 2 diabetes. BMJ Open. 351(h5260),. NATHAN, D.M., et al., 2005. Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study Research Group: Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med. 353 pp. 2643-2653. NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE, N. 2015. Type 2 diabetes in adults: management: NICE guidelines [NG28] [Online]. [Viewed 20th March 2016]. Available From:https://www.nice.org.uk/guidance/ng28: NIHCE. NHS SCOTLAND 2014. Scottish Diabetes Survey 2014. Scottish Diabetes Survery Monitoring Group. PEAT, J., BARTON, B. ELLIOT, E. 2008. Statistics Workbook for Evidence-Based Health Care, Wiley-Blackwell. SCHILLING, J. A. 2007. Diabetes Mellitus: A guide to patient care, Ambler, USA, Lippincott. SCOTTISH PUBLIC HEALTH OBSERVATORY. 2015. Overview of Key data sources [Online]. [Viewed 4th April 2016]. Available From: http://www.scotpho.org.uk/publications/overview-of-key-data-sources/introduction. SKRHA, J., CERIELLO, A. GITT, A. K. 2010. Chapter 6 Microvascular and Macrovascular Complications. In: HALAN, P. (ed.) DIAMAP 1 : Roadmap for Diabetes Research in Europe. http://www.diamap.eu: European Union. STIRBAN, A., 2014. Microvascular dysfunction in the context of diabetic neuropathy. Current Diabetes Reports. 14(11), pp. 1-9. UK PROSPECTIVE DIABETES STUDY (UKPDS) GROUP, 1998. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). The Lancet. 352(9131), pp. 837-853. VOULGARI, C., PAGONI, S., VINIK, A. and POIRIER, P., 2013. Exercise improves cardiac autonomic function in obesity and diabetes. Metabolism. 62(5), pp. 609-621. WEST, K.M., 1978. Epidemiology of diabetes and its vascular lesions. Elsevier. WOZNIAK, S.E., GEE, L.L., WACHTEL, M.S. and FREZZA, E.E., 2009. Adipose tissue: the new endocrine organ? A review article. Digestive Diseases and Sciences. 54(9), pp. 1847-1856.

Emotional Fundamentalism in River of Earth Essay -- Literary Analysis

James Still's River of Earth presents the bleak realities faced by an Appalachian family that struggles with meeting their most basic needs. The Baldridge's struggle with poverty is surely representative of many Appalachian families during the Depression era. The hardships of poverty, and its psychological and physical effects, are worsened by the isolation and sense of helplessness felt by the characters within River of Earth. Religion functions as the combatant to these struggles; the form of Christianity offered by Still strays from the standard fundamentalist fire-and-brimstone preachings often associated with evangelism in the Appalachian region. Instead, a more emotional form of fundamentalism is found. Religion is a positive, empowering force that is both spiritually and socially freeing for the otherwise repressed and isolated characters within the novel. Within the text, Still offers little escape for the characters. They are grounded and focused on the realities at hand. There is little indulgence in fanciful things or things not of this world. Religion is one of the few escapes the characters are allowed. Still does not offer a standard fundamentalist take on Christianity, despite the strong fundamentalist strains that are often associated with Appalachia. Generally, fundamentalism strongly emphasizes innate depravity and the damnation sinners face. Instead, Still lightens the message. Sermons on hope, grace, and mercy are extended to the characters. Through this more forgiving variety of Christianity, the characters are able to look forward to an eternal existence without adding any more stress to their current existences. It is suggested there is a tendency in Appalachia to lean towards forms of Christianity that pe... ...tianity that thoroughly responded to the needs of individuals. The isolation and desperation found in Depression-era rural Appalachia greatly influenced the type of Christianity that involved in the region. The need for society, community, control, and most significantly, optimism, spawned a form of Christianity that was both social and accommodating to sensitive emotional needs. Works Cited Photiadis, John D., and John F. Schnabel. "Religion: A Persistent Institution In A Changing Appalachia." Review Of Religious Research 19.1 (1977): 32. Academic Search Complete. Web. 3 Apr. 2012. Still, James. River of Earth. Lexington: The University of Kentucky Press, 1978. Print Tillich, Paul. "Paul Tillich on the Method of Correlation." The Christian Theology Reader. Ed. Alister McGrath. West Sussex: Wiley-Blackwell, 2011, 43-46. Print. .

Spirit Bound Chapter Fourteen

THE LAST TIME TATIANA HAD wanted to yell at me, she'd simply taken me to one of her private sitting rooms. It had made for a weird atmosphere, like we were at teatime–except people didn't usually scream at other people during teatime. I had no reason to believe this would be any different†¦ until I noticed my escort was leading me to the main business buildings of the Court, the places where all royal governing was conducted. Shit. This was more serious than I'd thought. And indeed, when I was finally ushered into the room where Tatiana waited†¦ well, I nearly came to a standstill and couldn't enter. Only a slight touch on my back from one of the guardians with me kept me moving forward. The place was packed. I didn't know for sure which room I was in. The Moroi actually kept a bona fide throne room for their king or queen, but I didn't think this was it. This room was still heavily decorated, conveying an old-world royal feel, with painstakingly carved floral molding and shining gold candleholders on the walls. There were actually lit candles in them too. Their light reflected off the metallic decorations in the room. Everything glittered, and I felt like I'd stumbled into a stage production. And really, I might as well have. Because after a moment's surveying, I realized where I was. The people in the room were split. Twelve of them sat at a long table on a dais at what was clearly meant to be the focal point of the room. Tatiana herself sat at the middle of the table, with six Moroi on one side and five Moroi on the other. The other side of the room was simply set with rows of chairs–still elaborate and padded with satin cushions–which were also filled with Moroi. The audience. The people sitting on either side of Tatiana were the tip-off. They were older Moroi, but ones who carried a regal air. Eleven Moroi for the eleven acting royal families. Lissa was not eighteen–though she was about to be, I realized with a start–and therefore had no spot yet. Someone was sitting in for Priscilla Voda. I was looking at the Council, the princes and princesses of the Moroi world. The oldest member of each family claimed the royal title and an advisory spot beside Tatiana. Sometimes the eldest waived the spot and gave it to someone the family felt was more capable, but the selectee was almost always at least forty-five. The Council elected the Moroi king or queen, a position held until death or retirement. In rare circumstances, with enough backing from the royal families, a monarch could be forcibly removed from office. Each prince or princess on the Council was in turn advised by a family council, and glancing back at the audience, I recognized clusters of family members sitting together: Ivashkovs, Lazars, Badicas†¦ The very back rows appeared to be observers. Tasha and Adrian sat together, and I knew for a fact they weren't members of the Royal Council or family councils. Still, seeing them set me at ease a little. I remained near the entrance to the room, shifting uneasily from foot to foot, wondering what was in store. I hadn't just earned public humiliation; I'd apparently earned it in front of the most important Moroi in the world. Wonderful. A gangly Moroi with patchy white hair stepped forward, around the side of the long table, and cleared his throat. Immediately, the hum of conversation died. Silence filled the room. â€Å"This session of the Moroi Royal Council is now in order,† he declared. â€Å"Her Royal Majesty, Tatiana Marina Ivashkov, is presiding.† He gave a slight bow in her direction and then discretely backed off to the side of the room, standing near some guardians who lined the walls like decorations themselves. Tatiana always dressed up at the parties I saw her at, but for a formal event like this, she was really channeling the queen look. Her dress was long-sleeved navy silk, and a glittering crown of blue and white stones sat atop her elaborately braided hair. In a beauty pageant, I would have written such gems off as rhinestones. On her, I didn't question for a moment that they were real sapphires and diamonds. â€Å"Thank you,† she said. She was also using her royal voice, resonant and impressive, filling the room. â€Å"We will be continuing our conversation from yesterday.† Wait†¦ what? They'd been discussing me yesterday too? I noticed then that I'd wrapped my arms around myself in a sort of protective stance and immediately dropped them. I didn't want to look weak, no matter what they had in store for me. â€Å"Today we will be hearing testimony from a newly made guardian.† Tatiana's sharp gaze fell on me. The whole room's did. â€Å"Rosemarie Hathaway, will you please come forward?† I did, keeping my head high and posture confident. I didn't exactly know where to stand, so I picked the middle of the room, directly facing Tatiana. If I was going to be paraded in public, I wished someone would have tipped me off to wear guardian black and white. Whatever. I'd show no fear, even in jeans and a T-shirt. I gave a small, proper bow and then met her eyes directly, bracing for what was to come. â€Å"Will you please state your name?† she asked. She'd already done it for me, but I still said, â€Å"Rosemarie Hathaway.† â€Å"How old are you?† â€Å"Eighteen?† â€Å"And how long have you been eighteen?† â€Å"A few months.† She waited a couple moments to let it sink in, as though this were important information. â€Å"Miss Hathaway, we understand that around that time, you withdrew from St. Vladimir's Academy. Is this correct?† That's what this was about? Not the Vegas trip with Lissa? â€Å"Yes.† I offered no more info. Oh God. I hoped she didn't get into Dimitri. She shouldn't have known about my relationship with him, but there was no telling what information could spread around here. â€Å"You went to Russia to hunt Strigoi.† â€Å"Yes.† â€Å"As a type of personal revenge following the attack at St. Vladimir ‘s?† â€Å"Er†¦ yes.† No one said anything, but my response definitely caused a stir in the room. People shifted uneasily and glanced at their neighbors. Strigoi always inspired fear, and someone actively seeking them out was still an unusual concept among us. Oddly, Tatiana seemed very pleased by this confirmation. Was it going to be used as more ammunition against me? â€Å"We would assume then,† she continued, â€Å"that you are one of those who believe in direct strikes against the Strigoi?† â€Å"Yes.† â€Å"Many had different reactions to the terrible attack at St. Vladimir's,† she said. â€Å"You aren't the only dhampir who wanted to strike back against the Strigoi–though you were certainly the youngest.† I hadn't known about others going on vigilante sprees–well, aside from some reckless dhampirs in Russia. If that was the story about my trip she was willing to believe, that was fine with me. â€Å"We have reports from both guardians and Alchemists in Russia that you were successful.† This was the first time I'd heard the Alchemists mentioned in public, but of course they'd be a common topic among the Council. â€Å"Can you tell me how many you killed?† â€Å"I†¦Ã¢â‚¬  I stared in surprise. â€Å"I'm not sure, Your Majesty. At least†¦Ã¢â‚¬  I racked my brain. â€Å"Seven.† It might have been more. She thought so too. â€Å"That might be a modest estimate compared to what our sources say,† she noted grandly. â€Å"Nonetheless, still an impressive number. Did you perform the kills by yourself?† â€Å"Sometimes I did. Sometimes I had help. There were†¦ some other dhampirs I worked with once in a while.† Technically, I'd had Strigoi help as well, but I wasn't going to mention that. â€Å"They were close to your age?† â€Å"Yes.† Tatiana said no more, and as though receiving a cue, a woman beside her spoke up. I believed she was the Conta princess. â€Å"When did you kill your first Strigoi?† I frowned. â€Å"Last December.† â€Å"And you were seventeen?† â€Å"Yes.† â€Å"Did you perform that kill yourself?† â€Å"Well†¦ mostly. A couple friends helped with distraction.† I hoped they weren't going to push for more details. My first kill had occurred when Mason had died, and aside from the events surrounding Dimitri, that memory tormented me the most. But Princess Conta didn't want too many other details. She and the others–who soon joined in the questioning–mostly wanted to know about my kills. They were slightly interested in knowing when other dhampirs had helped me–but didn't want to go into when I'd had Moroi help. They also glossed over my disciplinary record, which I found baffling. The rest of my academic details were mentioned–my exceptional combat grades, how I'd been one of the best when Lissa and I had run away our sophomore year and how quickly I'd made up for lost time to become top in my class again (at least as far as fighting went). They talked also about how I'd protected Lissa whenever we were out in the world alone and finally concluded with my exceptional trial scores. â€Å"Thank you, Guardian Hathaway. You may leave.† Tatiana's dismissive voice left no room for doubt. She wanted me out of there. I was only too eager to comply, giving another bow, and then scurrying out. I cast a quick glance at Tasha and Adrian as I did, and the queen's voice rang out as I cleared the door, â€Å"That concludes our session today. We will convene again tomorrow.† I wasn't surprised when Adrian caught up with me a few minutes later. Hans hadn't ordered me to come back and work after the session, so I had decided to read that as freedom. â€Å"Okay,† I said, slipping my hand into Adrian's. â€Å"Enlighten me with your royal political wisdom. What was that all about?† â€Å"No clue. I'm the last person to ask about political stuff,† he said. â€Å"I don't even go to those things, but Tasha found me at the last minute and said to come with her. I guess she got a tip-off you'd be there–but she was just as confused.† Neither of us had said anything, but I realized I was leading him toward one of the buildings that housed commerce–restaurants, shops, etc. I was starving all of a sudden. â€Å"I got the impression this was part of something they'd already been talking about–she mentioned their last session.† â€Å"It was closed. Like tomorrow's. No one knows what they're discussing.† â€Å"Then why make this one public?† It didn't seem fair that the queen and Council could pick and choose what they shared with others. Everything should have been public. He frowned. â€Å"Probably because they're going to hold a vote soon, and that'll be public. If your testimony plays some role, then the Council may want to make sure other Moroi witnessed it–so that everyone understands the decision when it comes.† He paused. â€Å"But what do I know? I'm no politician.† â€Å"Makes it sound like it's already decided,† I grumbled. â€Å"Why have a vote at all? And why would I have anything to do with government?† He opened the door to a small cafe that sold light lunch food–burgers and sandwiches. Adrian had been raised with fancy restaurants and gourmet food. I think he preferred that, but he also knew I didn't like always being on display or being reminded that I was with a royal from an elite family. I appreciated that he'd known I'd just want something ordinary today. Nonetheless, our being together earned us a few curious glances and whispers from the diner's patrons. At the school, we'd been a source of speculation, but here at Court? We were a main-stage attraction. Images were important at Court, and most dhampir-Moroi relationships were carried out in secret. Us being so open–especially considering Adrian's connections–was scandalous and shocking, and people weren't always discreet with their reactions. I'd heard all sorts of things since returning to Court. One woman had called me shameless. Another had speculated aloud why Tatiana hadn't simply â€Å"dealt with me.† Fortunately, most of our audience was content to stare today, making them easy to ignore. There was a small line of thought on Adrian's forehead as we sat down at a table. â€Å"Maybe they're voting to make you Lissa's guardian after all.† I was so astonished that I couldn't say anything for several seconds when the waitress suddenly appeared. I finally stammered out my order and then stared at Adrian with wide eyes. â€Å"Seriously?† The session had been an examination of my skills, after all. It made sense. Except†¦ â€Å"No. The Council wouldn't go to the trouble of holding sessions for one guardian assignment.† My hopes fell. Adrian gave a shrug of acknowledgment. â€Å"True. But this isn't an ordinary guardian assignment. Lissa's the last of her line. Everyone–including my aunt–has a special interest in her. Giving her someone like you who's†¦Ã¢â‚¬  I gave him a dangerous look as he grasped for a word. â€Å"†¦ Controversial could upset some people.† â€Å"And that's why they actually wanted me there to describe what I've done. To convince people in person that I'm competent.† Even as I spoke the words, I still didn't dare believe them. It was too good to be true. â€Å"I just can't imagine it, seeing as I seem to be in so much trouble with the guardians.† â€Å"I don't know,† he said. â€Å"It's just a guess. Who knows? Maybe they do think the Las Vegas thing was just a harmless prank.† There was a bitter tone in his voice over that. â€Å"And I told you that Aunt Tatiana was coming around to you. Maybe she wants you as Lissa's guardian now but needs to make a public display to justify it.† That was a startling thought. â€Å"But if I do get to come with Lissa, what are you going to do? Get respectable and come to college too?† â€Å"I don't know,† he said, green eyes thoughtful as he sipped his drink. â€Å"Maybe I will.† That was also unexpected, and my conversation with his mother returned to my mind. What if I was Lissa's guardian in college and he was with us for the next four years? I was fairly certain Daniella had thought we'd be splitting up this summer. I'd thought so too†¦ and was surprised to feel how relieved I was that I might get to stay with him. Dimitri always left my heart full of pain and longing, but I still wanted Adrian in my life. I grinned at him and rested my hand on his. â€Å"I'm not sure what I'd do with you if you were respectable.† He lifted my hand to his lips and kissed it. â€Å"I've got some suggestions,† he told me. I didn't know if it was his words or the feel of his mouth on my skin that sent shivers through me. I was about to ask what those suggestions were when our interlude was interrupted†¦ by Hans. â€Å"Hathaway,† he said, one eyebrow arched as he stood over us. â€Å"You and I have some very different ideas about the definition of ‘punishment.'† He had a point. In my mind, punishment involved easy things like lashings and starvation. Not filing. Instead, I replied, â€Å"You didn't tell me to come back after I saw the queen.† He gave me an exasperated look. â€Å"I also didn't tell you to go off on a playdate. Come on. Back to the vaults.† â€Å"But I have a BLT coming!† â€Å"You'll get your lunch break in another couple hours like the rest of us.† I tried to repress my outrage. They hadn't been feeding me bread crusts and water during my work detail, but the food hadn't tasted much better. Just then, the waitress returned with our food. I grabbed the sandwich before she even set the plates down and wrapped it in a napkin. â€Å"Can I take it to go?† â€Å"If you can eat it before we get back.† His voice was skeptical, seeing as the vault was pretty close. Clearly, he was underestimating my ability to consume food. In spite of Hans's disapproving expression, I gave Adrian a kiss goodbye and a look that told him maybe we'd continue our conversation. He gave me a happy, knowing smile that I only saw for a second before Hans ordered me away. True to my expectations, I managed to get the sandwich down before we arrived back at the guardians' building, though I did feel a little nauseous for the next half hour or so. My lunchtime was almost dinnertime for Lissa, out in the human world. Returning to my miserable punishment, I cheered up a little at the joy running through her via our bond. She'd spent the whole day on her campus tour of Lehigh, and it was everything she'd hoped it could be. She loved it all. She loved the beautiful buildings, the grounds, the dorms†¦ and especially the classes. A glimpse at the course catalog opened up a world of subjects that even St. Vladimir's superior education hadn't offered us. She wanted to see and do everything that the school had to offer. And even though she wished I was there, she was still excited about the fact that it was her birthday. Priscilla had given her some elaborate jewelry and had promised a fancy dinner that night. It wasn't exactly the type of celebration Lissa had hoped for, but the thrill of her eighteenth birthday was still intoxicating–particularly as she looked around at the dream school she'd be attending soon. I confess, I felt a pang of jealousy. Despite Adrian's theory about why the queen had called me in today, I knew–as did Lissa–that the odds of me going to college with her were still probably nonexistent. Some petty part of me couldn't understand how Lissa could therefore be excited about it if I wasn't going to be along. Childish of me, I know. I didn't have long to sulk, though, because once all the touring was done, Lissa's entourage returned to the hotel. Priscilla told them they could clean up for an hour or so before heading to dinner. For Lissa, this meant more fighting-practice time. My brooding mood immediately turned irate. Things got worse when I realized that earlier in the day, Serena had told Grant about Lissa and Christian's desire to defend themselves. He apparently thought that it was a good idea too. It would figure. Lissa had two progressive guardians. Why couldn't she have gotten some stodgy, old-school person who would be horrified at the thought of a Moroi even thinking about fighting off a Strigoi? So, while I sat helpless and unable to smack sense into any of them, Lissa and Christian now had two instructors. Not only did this mean more learning opportunities, it also meant Serena had a competent partner to demonstrate certain moves with. She and Grant sparred, explaining maneuvers while Lissa and Christian watched wide-eyed. Fortunately (well, not for Lissa), she and I soon noticed something. The guardians didn't know the true reason Lissa was interested in fighting. They had no idea–how could they have?–that she wanted to go hunt and stake a Strigoi in the feeble hope of bringing him back to life. They thought she just wanted to learn basic defense, something that seemed very sensible to them. So that was what they taught. Grant and Serena also made Lissa and Christian practice on each other. I suspected there were a couple reasons for this. One was that Lissa and Christian didn't have the skill to do much damage to each other. The second reason was that it amused the guardians. It did not amuse Lissa and Christian. There was still so much tension between them, both sexual and angry, that they resented being in such close contact. Grant and Serena stopped the two Moroi from doing any more face punching, but simple dodges often meant brushing against each other, fingers sliding against skin in the heat of the action. Every once in a while, the guardians would have someone play Strigoi–putting Lissa or Christian on the offensive. The two Moroi welcomed this to a certain extent; after all, direct attacks were what they wanted to learn. But, when Christian (playing Strigoi) lunged at Lissa and pushed her into a wall, learning offense suddenly didn't seem like such a good idea to her. The maneuver pressed them right up to each other, his arms holding hers. She could smell him and feel him and was overwhelmed by the fantasy of him just holding her there and kissing her. â€Å"I think you two should go back to basic defense,† said Grant, interrupting her traitorous feelings. He sounded like he was more worried about them hurting each other than the possibility that they might start making out. It took Lissa and Christian a moment to even register his words, let alone part from each other. When they did, both avoided eye contact and returned to the couch. The guardians launched into more examples of how to avoid an attacker. Lissa and Christian had seen this so many times that they knew the lesson by heart, and their earlier attraction gave way to frustration. Lissa was too polite to say anything, but after fifteen minutes of Serena and Grant showing how to block with your arms and dodge someone reaching for you, Christian finally spoke. â€Å"How do you stake a Strigoi?† Serena froze at Christian's words. â€Å"Did you say stake?† Rather than being shocked, Grant chuckled. â€Å"I don't think that's anything you need to worry about. You want to focus on getting away from a Strigoi, not getting closer.† Lissa and Christian exchanged an uneasy look. â€Å"I helped kill Strigoi before,† Christian pointed out. â€Å"I used fire at the school's attack. Are you saying that's not okay? That I shouldn't have done it?† Now Serena and Grant traded glances. Ha, I thought. Those two weren't as progressive as I thought. They were coming from a defense point of view, not offense. â€Å"Of course you should have,† said Grant at last. â€Å"What you did was amazing. And in a similar situation? Sure. You wouldn't want to be helpless. But that's the point–you have your fire. If it came down to you fighting a Strigoi, your magic's going to be the way to go. You already know how to use it–and it'll keep you safely out of their range.† â€Å"What about me?† asked Lissa. â€Å"I don't have any kind of magic like that.† â€Å"You'll never get close enough to a Strigoi for it to be a problem,† said Serena fiercely. â€Å"We won't let you.† â€Å"Besides,† added Grant with amusement, â€Å"it's not like we just go around handing out stakes.† I would have given anything for them to go take a look in her suitcase right then. Lissa bit her lip and refused to make eye contact with Christian again, for fear of giving away their intentions. This was not going according to their crazy plan. Christian again took the lead. â€Å"Can you at least demo it?† he asked, trying–and succeeding–to look like someone just seeking the sensational and exciting. â€Å"Is it hard to do? It seems like all you have to do is aim and hit.† Grant snorted. â€Å"Hardly. There's a bit more to it than that.† Lissa leaned forward, clasping her hands together as she followed Christian's lead. â€Å"Well, then don't worry about teaching us. Just show us.† â€Å"Yeah. Let's see.† Christian shifted restlessly beside her. As he did, their arms brushed, and instantly they moved apart. â€Å"It's not a game,† Grant said. Nonetheless, he walked over to his coat and produced his stake. Serena stared incredulously. â€Å"What are you going to do?† she asked. â€Å"Stake me?† He gave that small chuckle of his and searched the room with his sharp eyes. â€Å"Of course not. Ah. There we are.† He walked over to a small armchair that had a decorative pillow. He lifted it up and tested its width. It was fat and thickly filled with some sort of dense stuffing. He returned to Lissa and gestured for her to stand. To everyone's astonishment, he handed her his stake. Locking his body into a rigid position, he gripped the pillow hard between his hands and extended it out a couple feet in front of him. â€Å"Go ahead,† he said. â€Å"Aim and hit it.† â€Å"Are you crazy?† asked Serena. â€Å"Don't worry,† he said. â€Å"Princess Voda can afford the incidentals. I'm proving a point. Strike the pillow.† Lissa hesitated only a few more moments. An excitement that seemed unusually intense filled her. I knew she'd been anxious to learn this, but her desire for it seemed higher than before. Gritting her teeth, she stepped forward and awkwardly tried to impale the pillow with her stake. She was cautious–fearing she'd hurt Grant–but there was no need for her to worry. She didn't even budge him, and all she managed with the stake was a slight snagging of the fabric on the surface. She tried a few more times but achieved little more. Christian, being who he was, said, â€Å"That's all you can do?† Glaring, she handed him the stake. â€Å"You do better.† Christian stood, snarky smile disappearing as he studied the pillow critically and sized up his blow. As he did, Lissa glanced around and saw the humor in the guardians' eyes. Even Serena had relaxed. They were making their point, proving staking wasn't an easy thing to learn. I was glad, and my opinion of them rose. Christian finally made his move. He did actually pierce the fabric, but the pillow and its stuffing proved too much to break through. And again, Grant wasn't shaken at all. After more failed attempts, Christian sat down again and handed the stake back. It was kind of fun to see Christian's cocky attitude shot down a little. Even Lissa enjoyed it, despite her own frustration over how difficult this was becoming. â€Å"The stuffing's got too much resistance,† Christian complained. Grant handed his stake to Serena. â€Å"What, and you think a Strigoi's body is going to be easier to get through? With muscles and ribs in the way?† Grant got back into his position, and without hesitation, Serena struck with the stake. Its point burst through the other side of the pillow, coming to a halt just in front of Grant's chest as tiny fluffy pieces of stuffing drifted to the ground. She jerked it out and handed it to him like it had been the simplest thing in the world. Both Christian and Lissa stared in amazement. â€Å"Let me try again,† he said. By the time Priscilla called them to dinner, there wasn't a pillow in that hotel room left untouched. Boy, she was going to be surprised when she got the bill. Lissa and Christian hacked away with the stake while the guardians looked on with a superior air, confident their message was being delivered. Staking Strigoi was not easy. Lissa was finally getting it. She realized that in some ways, piercing a pillow–or a Strigoi–wasn't even about understanding the principle. Sure, she'd heard me talk about lining your shot up to get to the heart and miss the ribs, but this was more than knowledge. A lot of it was strength–strength she physically didn't have yet. Serena, though seemingly petite, had spent years building up her muscle and could get that stake through practically anything. One hour-long lesson wouldn't give Lissa that kind of strength, and she whispered as much to Christian when the group went out to dinner. â€Å"You're quitting already?† he asked, voice equally low as they rode in the backseat of an SUV. Grant, Serena, and a third guardian were there too, but they were deep in discussion. â€Å"No!† Lissa hissed back. â€Å"But I've got to, like, train before I can do it.† â€Å"Like lift weights?† â€Å"I†¦ I don't know.† The others were still talking to each other, but Lissa's topic was too dangerous for her to risk them hearing. She leaned close to Christian, unnerved yet again at how his closeness and familiarity affected her. Swallowing, she tried to keep her face impassive and stick to the topic. â€Å"But I'm just not strong enough. It's physically impossible.† â€Å"Sounds like you're giving up.† â€Å"Hey! You didn't make it through any of the pillows either.† He flushed slightly. â€Å"I almost got through that green one.† â€Å"There was hardly anything in it!† â€Å"I just need more practice.† â€Å"You don't need to do anything,† she shot back, fighting to keep her voice quiet through her anger. â€Å"This isn't your fight. It's mine.† â€Å"Hey,† he snapped, eyes glittering like pale blue diamonds, â€Å"you're crazy if you think I'm going to just let you go and risk–â€Å" He cut himself off and actually bit his lip, as though will alone wasn't enough to stop him from talking. Lissa stared at him, and both of us began wondering how he would have finished. What wouldn't he risk? Her putting herself in danger? That was my guess. Even without talk, he spoke volumes with his expression. Through Lissa's eyes, I saw him drinking in her features and trying to hide his emotions. At last, he jerked away and broke that intimate space between them, getting as far from her as he could. â€Å"Fine. Do whatever you want. I don't care.† Neither of them spoke after that, and since it was lunchtime for me, I returned to my own reality and welcomed a filing break–only to be informed by Hans that I had to keep working. â€Å"Come on! Isn't it lunchtime? You have to feed me,† I exclaimed. â€Å"That's just beyond cruel. At least throw me some crumbs.† â€Å"I did feed you. Or, well, you fed yourself when you inhaled that sandwich. You wanted your lunch break then. You got it. Now you keep working.† I slammed my fists against the endless piles of paper before me. â€Å"Can't I at least do something else? Paint buildings? Haul rocks?† â€Å"I'm afraid not.† A smile twisted the corners of his lips. â€Å"There's a lot of filing we need done.† â€Å"How long? How long are you going to punish me?† Hans shrugged. â€Å"Until someone tells me to stop.† He left me alone again, and I leaned back in my chair, forcibly trying not to flip the table in front of me over. I thought it would make me feel momentarily better, but it also meant I'd have to redo the work I'd done. With a sigh, I returned to my task. Lissa was at dinner when I tuned back into her later. It might have technically been in honor of her birthday, but really, it was all royal conversation with Priscilla. That was no way to spend a birthday, I decided. I'd have to make this up to her whenever I earned freedom. We'd have a real party, and I'd be able to give her my birthday present: gorgeous leather boots that Adrian had helped me acquire back at school. Being in Christian's head might have been more interesting, but since that wasn't an option, I returned to my own and mulled over my earlier talk with Adrian. Was this punishment finally going to end? Was an official royal decree going to put me and Lissa together at last, despite the guardians' normal policy? Trying to figure it out was like being on a hamster wheel. A lot of work. No progress. But it got me through the dinner conversation, and before I knew it, Lissa's group was getting up and heading for the restaurant's door. It was dark out now, and Lissa couldn't help but feel the weirdness of being on a human schedule. Back at school or the Court, this would be the middle of the day. Instead, they were now heading back to their hotel and would be going to bed. Well, probably not right away. I had no doubt that if Lissa and Christian could get over their current huff, they'd be back to stabbing more pillows. As much as I wanted those two dating again, I couldn't help but think they were a lot safer apart. Or maybe not. The group had hung out at the restaurant far past the normal dinner hour, so the lot was mostly empty as they walked across it. The guardians hadn't exactly parked in the back, but they weren't near the main entrance either. They had, however, made a point of parking next to one of the street lamps illuminating the lot. Except it wasn't lit now. The light had been broken. Grant and Priscilla's guardian noticed it right away. It was the kind of little detail we were trained to notice: anything unusual, anything that might have changed. In a flash, the two of them had stakes out and were flanking the Moroi. It only took seconds for Serena and the guardian assigned to Christian to follow suit. That was something else we were trained to do. Be on guard. React. Follow your colleagues. They were fast. All of them were fast. But it didn't matter. Because suddenly, there were Strigoi everywhere. I'm not entirely sure where they came from. Maybe they'd been behind the cars or on the parking lot's edges. If I'd had a bird-eye's view of the situation or been there myself with my â€Å"nausea alarm,† I might have had a better sense of it all. But I was watching the scene through Lissa's eyes, and the guardians were going out of their way to block her from the Strigoi who seemed to have appeared out of thin air as far as she was concerned. Most of the actions were a blur to her. Her bodyguards were shoving her around, trying to keep her safe as white, red-eyed faces popped up everywhere. She saw it all through a fear-filled haze. But before long, both of us could see people dying. Serena, just as fast and strong as she'd been in the hotel room, staked a male Strigoi cleanly through the heart. Then, in return, a female Strigoi leapt at Priscilla's guardian and broke his neck. Lissa was distantly aware of Christian's arm around her, pressing her against the SUV and shielding her with his own body. The remaining guardians were also still forming a protective ring as best they could, but they were distracted. Their circle was faltering–and they were dropping. One by one, the Strigoi killed the guardians. It wasn't for lack of skill on the guardians' part. They were simply outnumbered. One Strigoi tore out Grant's throat with her teeth. Serena was backhanded hard against the asphalt, landing facedown and not moving. And, horror of horrors, the Strigoi didn't seem to be sparing Moroi either. Lissa–pushing so hard against the SUV that it seemed as though she might become one with it–stared wide-eyed as one Strigoi swiftly and efficiently ripped into Priscilla's neck, pausing to drink her blood. The Moroi woman didn't even have time to register surprise, but at least there had been no real suffering. The endorphins dimmed the pain as the blood and life were drained from her body. Lissa's emotions shifted into something beyond fear, something that hardly felt like anything at all. She was in shock. Numbed. And with a cold, hard certainty, she knew that her death was coming and accepted it. Her hand found Christian's, squeezing it tightly, and turning toward him, she took small comfort in knowing the last sight she would see in life was the beautiful, crystalline blue of his eyes. From the look on his face, his thoughts were along similar themes. There was warmth in his eyes, warmth and love and– Total and complete astonishment. His eyes widened, focusing on something just behind Lissa. At that same moment, a hand grabbed Lissa's shoulder and whipped her around. This is it, a small voice inside her whispered. This is where I die. Then, she understood Christian's astonishment. She was facing Dimitri. Like me, she had that surreal sense of it being Dimitri yet not being Dimitri. So many of his features were the same†¦ and yet so many were different. She tried to say something, anything, but while the words formed on her lips, she just couldn't manage to get them out. Intense heat suddenly flared behind her, and a brilliant light lit Dimitri's pale features. Neither Lissa nor I needed to see Christian to know he had produced a ball of fire with his magic. Either the shock of seeing Dimitri or fear for Lissa had spurred Christian into action. Dimitri squinted slightly at the light, but then a cruel smile twisted his lips, and the hand resting on her shoulder slid up to her neck. â€Å"Put it out,† said Dimitri. â€Å"Put it out or she dies.† Lissa finally found her voice, even with her air cut off. â€Å"Don't listen to him,† she gasped out. â€Å"He's going to kill us anyway.† But behind her, the heat died. Shadows fell across Dimitri's face once again. Christian wouldn't risk her, even though she was right. It hardly seemed to matter. â€Å"Actually,† said Dimitri, voice pleasant amid the grim scene, â€Å"I'd rather you two stay alive. At least for a little while longer.† I felt Lissa's face move to a frown. I wouldn't have been surprised if Christian's did too, judging from the confusion in his voice. He couldn't even manage a snarky comment. He could only ask the obvious: â€Å"Why?† Dimitri's eyes gleamed. â€Å"Because I need you to be bait for Rose.†

Go Sound the Trumpet Synopsis

Rodney Carey African American History Dr. Reginald Ellis Go Sound the Trumpet: Synopsis In the book Go Sound the Trumpet by Canter Brown Jr. , he talks about the documentation of different African Communities in Florida and the communities of the freed slaves. He tells us what happened to slaves after they were freed and where they went. Some of these communities he described as unidentified and he talked about one in particular that escaped identification. Information about the community known as Angola had come up and suggested they were in The Bahamas.A few months after this information came up; John M. Goggin released additional information and offered new insight on the community. The Bahamian Department of Archives published additional documentary evidence in 1980 regarding Seminole Settlements at Red Bays, Andros. It took another decade before the link between the Bahamian exiles and the old Florida homes of the slaves was established. Another author offered details where neig hboring Cuban fishermen identified a community with the name Angola, which had existed as a focus for diplomatic and economic activities within the broader Atlantic world.He argued that its presence additionally had created impacts that influenced the course of United States history and, to a lesser extent, the British and Spanish Empires. Some basic facts of the story are shortly after English planters, primarily from Barbados, found what is now known as South Carolina in 1670; Spanish colonial officials decided to weaken, if not destroy, the Carolinian initiative. They did this by attempting to undermine an economy that based itself on slave labor while also commanding efforts to grant greater protection for St.Augustine against English incursions. Authorities addressed the latter goal in part by construction of the massive stone fortress still known as the Castillo de San Marcos and, in 1683; they initiated a black military service tradition through authorization of the colonyâ⠂¬â„¢s first free black and mulatto militia companies. In 1683 the government granted freedom to runaway slaves from Carolina, regardless of race, as long as the runaways agreed to convert to Roman Catholicism.This was a crucial step toward the goal of undermining Carolinian slavery. The book also talks about another initiative that involved the authorization of a free black town located north of St. Augustine; this was caused by the founding of Georgia in the early 1730’s. The Patriot War of 1812-1814 involved Georgians teaming with several individuals who had arrived in East Florida from the United States since the Revolutionary War in their attempt to overthrow Spanish rule in the colony; they were unsuccessful.In September 1812, Seminoles and their black vassals, allied with Spain to turn back a Patriot advance. After this, English plans moved toward the introduction of chattel slavery into the colony. This resulted in the dispersal of the majority of its few remaining fr ee black inhabitants to small settlements in the remote peninsula, with many maroons associating with Seminole Indians, who were also recent arrivals from Georgia. In 1784, Spain returned to power which brought reinstatement of the asylum policy, and a rise in Florida’s maroon population.Fort Mose however, remained an abandoned ruin, and for the time being, no equivalent community rose within the colony. After the Patriot War, black refugees hurried themselves into the Manatee River because the site of their black settlement there was located on a point of land at the Braden-Manatee River. At the Manatee, the refugees took advantage of opportunities for trading deer skins, plumes, and agricultural crops for desired goods. There were also relatively easy channels of communication to Spanish officials at Havana and elsewhere at this spot.Records left by two of the Cuban fishermen preserved the name of the black community, Angola. Although these blacks got to the Manatee River i n 1812, the book suggests that they may have lived there for years before this; at least on a seasonal basis. There was a letter found from an English merchant that supports the possibility that the maroons had centered their activities in the area of the Manatee River as early as 1772. It described the keys to the south of Tampa Bay as the â€Å"haunt of the picaroons of all nations. As Angola inhabitants built their community, word of their existence spread not just within the Spanish Empire but also to the British. Two officers, Edward Nicolls and George Woodbine, recruited men there for British operations along the Gulf coast during the War of 1812. Following the Battle of New Orleans in January of 1815, Nicolls and Woodbine managed to enlist about 400 black warriors in Florida and returned most of their men to the Apalachicola River area. Upstream at Prospect Bluff, they had facilitated construction of a fortified outpost, known as the Negro Fort.The two officers had also crea ted Florida’s second free-black refuge of the period while likely enhanced Angola’s population. Surviving papers of the merchant concern John Forbes & Company hinted at Woodbine’s possible return to that vicinity in 1815 with eighty â€Å"slaves. † There was a raid in 1821 that destroyed the Angola community. Brown talks about records available today that contain subtle references that suggest that the memories of the 1821 raid remained vivid in survivors’ minds just as the recollections of the Battle of the Suwannee did.There was an interview by Jan Carew; with one of the descendants on Andros in 1972 about memories of the battle where she said â€Å"I heard ‘bout the battle of Swannee against General Jackson, my grandmother tell me ‘bout it and her grandmother tell her ‘bout it long before,†. She continued to say â€Å"Stories like that does come down to us with voices in the wind, she tell me how the Old Ones used to ta lk ‘bout the look on them white soldiers faces when they see Black fighters looking like they grow outta the swamp grass and the hammocks, coming at them with gun and cutlass.Jackson get hurt at the Swannee man. The ancestors brutalized him there. † She concluded by saying that â€Å"My old face beat against eighty-odd years. . . . But when Jesus of Nazareth decide to send Mantop to carry me to the Great Beyond, wherever my blood-seed scatter, they will spread the word ‘bout how Black and Seminole ancestors fight side by side at Swannee. † In 1835 there was a battle between the maroon and their allies known as the Creeks; and the Angolans.The well-equipped Angolans made their stand and this lead up to the Second Seminole War’s outbreak spreading from the Peace River’s headwaters west to Tampa Bay and north to the border of a white settlement. The Creeks were led by Peter McQueen’s nephew Osceol, while Minatti’s war chief Harry car ried on the military heritage for generations earlier by Francisco Menendez and others. When battle started in December, it quickly became apparent that it was far more than an Indian war because of the amount of blacks participating. As General Thomas S.Jesup declared in 1836, â€Å"This . . . is a negro war, not an Indian war. † The general added, â€Å"Throughout my operations I found the negroes the most active and determined warriors, and during the conferences with the Indian chiefs I ascertained that they exercised an almost controlling influence over them. † When Andrew Jackson left the presidency in March 1837, the maroons remained in Florida and at war. At one point historians questioned how the Seminoles obtained enough weapons and supplies to launch a resistance campaign in the mid-1830s.It was actually the free blacks and Red Stick Creeks; not the Seminoles, who utilized connections of past days to obtain the necessary equipment for war. There was also a q uestion of how they could do so when their peninsular reservation kept them from the coast? The answer to this question is answered by the fact that many of the same Cuban fishermen who had lived near the Angolans worked at Charlotte Harbor in the early 1830s.In 1835, these old business associates of the Angolans even managed to have the area’s United States customs inspector suspended, leaving the door wide open for whatever transfers were needed. As Second Seminole War expert John K. Mahon noted, â€Å"Every warrior seemed to have a rifle, and a superior one at that. † Brown also noted that future researchers may well discover the origins of those firearms in British or Spanish armories, dispatched to Florida by high-ranking officials in recognition of past valor, imperial promises, and pressures applied by Edward Nicolls, George Woodbine, or their friends.