The Double Ending of The Mountain and the Valley: From Aristotle to Dante

Examining the two endings of Ernest Buckler's The Mountain and the Valley separately may shed new light on the present conviction that David's failure to become an artist is the result of a moral flaw or the inevitable outcome of an internal deficiency. While the novel seems to have two conclusions -- the false but tragic conclusion of the young man left out of the war, and the true but ironic ending of his death in the mountain -- considering the double ending suggests a change in the concepts governing Buckler's characterization of David. The themes and images in the first ending are Romantic and state a Wordsworthian belief in both the imaginative and affective stores of happy childhood and the reciprocity of man and nature. The experiences expressed in the Epilogue, or second ending, deconstruct this earlier process

Suited

Jennifer Morla, a contemporary designer, once said, “asking questions generates more ideas.” I am an external processor, I tend to think out loud in order to generate innovative ideas. When I create work, I do not only think about solving the problem, I also think about influencing the visual world around me, because being a designer gives me power. Design helps others to see the world through my vibrant lens. Suited is about the confidence, character, and style that comes with the decision to be bold in both attitude and appearance. I want women who see the magazine to be inspired and believe in the potential they have to encourage and lead those around them. Through the design for this brand, I want to evoke powerful positive emotions. I plan to suggest these emotions through sleek typography and bold photography. I pair both vibrant and subtle colors together to make it easier for the viewer to navigate through the magazine. I use my designs to evoke an emotion by pushing ideas, manipulating line, experimenting with shapes and colors, and observing detail. My love for sleek serif fonts such as Didot aided to the design of the Suited font. I paired it with Barlow which is a condensed sans serif font that compliments the serif. I chose a colorful palette for the interior of the magazine to create hierarchy and aid the direction for the viewer. My work is visually influenced by Herb Lubalin. He would manipulate type in such an Illustrative and expressive way, that it would be both an image and typography. I like to express an idea with fonts rather than with imagery, and he is an advocate for this. I am most inspired by his design of the font “Avant Garde.” Zuzana Licko and her husband created Émigré magazine which is a magazine created by immigrants for immigrants. The magazine became known as a “revolutionary design publication.” The fonts made for this magazine were so popular that the magazine became a type foundry. She changed the contemporary design world around her, which to me is powerful.https://digitalcommons.murraystate.edu/art498/1066/thumbnail.jp

Twinkle Bhojwani

Being a young designer, it is sometimes inevitable to not have a fickle mind as I try to grow. I want to create aesthetically pleasing work by pushing my brain to move beyond my first idea in order to develop original approaches to the challenges that arise, and that is why I design. I see poor design that evokes an emotion in me to want to fix it. The way things are designed, whether good or bad, communicates just as boldly as the message or the idea. I use my designs to evoke an emotion by pushing ideas, manipulating line, experimenting with shapes and colors, and observing detail. I have made it more interesting by having a relationship with my design. My work ranges from the use of thin and heavy typography, sleek imagery, and bold, solid colors. My design stems more towards designing business systems, package design, advertisements, and layout designs. All of my work has a lot in common, for example in most of my designs I lean more towards serif fonts, lots of white space, and the use of typography more than imagery. Jennifer Morla, a contemporary designer, once said, “asking questions generates more ideas.” I am definitely an external processor, so I tend to think out loud in order to generate ideas. Design heavily influences contemporary society and is influenced by society. When I create work, I do not only think about solving the problem, I also think about changing the contemporary world around me, because being a designer, gives me power. Design gets me one step closer to others seeing the world through my lens. My work is visually influenced by Herb Lubalin. He would manipulate type in such a creative way, that it would look like an image rather than typography. I like to experiment with fonts more than with imagery, and he is an advocate for this. I am most inspired by his design of the font “Avant Garde.”https://digitalcommons.murraystate.edu/art399/1078/thumbnail.jp

Knowledge, attitude and practice of haemovigilance amongst healthcare professionals in Nashik, Maharashtra, India

Background: Haemovigilance Programme of India was launched in 2012 with the purpose to identify, analyse and learn the complications related to transfusion and blood donation, in order to avoid such complications in future. Though it is essential to identify the Adverse Transfusion Reactions (ATR) to reduce the incidence and make transfusion easier; there are rare reports available about knowledge, attitude, and practice (KAP) of Healthcare Professionals (HCP) for haemovigilance.Methods: In this cross-sectional study, pre-validated questionnaire designed for assessing the KAP, the possible ways to improve transfusion reaction reporting and causes of underreporting were distributed among 220 Healthcare Professional (HCP) in Nashik, Maharashtra.Results: The response rate of the study was 93%. Amongst them 58% HCP had poor knowledge while only 9% had good knowledge about haemovigilance. According to respondents, training to the HCP, CME’s, making reporting compulsory and launching of a toll-free helpline number will mark a milestone in improving transfusion reaction reporting. Legal liability issue and lack of time & knowledge were the main factors which discouraged them from reporting.Conclusions: Overall, most of HCP in Nashik have a positive attitude towards transfusion reaction reporting but knowledge regarding the haemovigilance concept is poor and the majority of them never reported ATR. Hence, our study demands increased awareness and continued training to strengthen the haemovigilance system, especially ATR reporting

Efficacy of combination of tablet mifepristone and misoprostol for first trimester pregnancy termination at different gestational age

Background: Medical method of abortion is a safe, effective and affordable method for first trimester termination. However, nausea, vomiting, diarhoea, excess bleeding and incomplete abortion are known side effects. The aim of study was to compare the success rate of abortions in both groups, to compare the induction-abortion interval in both groups and to study the side effects of the drugs.Methods: This study was conducted in department of obstetrics and gynecology, NIMS Medical College, Jaipur, India during June 2017-August 2017. Total hundred cases were taken and divided into two groups. Group A was gestational age upto 49 days, Group B was gestational age 50-63 days. Both groups were given tab. mifepristone 200mg. followed by 48 hrs. by 4 tablets of tab misoprostol.Results: The results of the given regimen were highly successful and complete abortion was achieved in 96% and 94% in group A and group B respectively. The difference between two groups was statistically not significant (p value =0.64). Failure rates were seen in only 4% of group A and 6% of group B. Pain abdomen was seen in 16% of group A and 38% of group B patients. The difference between both groups was statistically significant (p value=0.02). Nausea was seen in 10% of group A and 30% of group B patients. The difference between both groups is statistically significant(p value=0.018).Conclusions: First trimester pregnancy can be successfully terminated with combination of mifepristone and misoprostol upto 63 days (9 weeks) of pregnancy

Long-term follow-up of anorectal malformation – how long is long term?

Introduction: The ultimate goal of treatment in patients with anorectal malformation (ARM) has moved from mere survival to alleviating symptoms and improving quality of life (QoL), which has become established as an important endpoint in medical care. Adolescents and adults with ARM face several major functional and psychological problems requiring continuity of care.Materials and methods: All patients more than 15 years of age presenting with ARM between June 2010 and 2015 were evaluated. Clinical features, investigations, type of surgery done at birth, present treatment given and outcome were analysed. Anal continence was assessed by Kelly’s scoring system. Psychological assessment was done using QoL score.Results: Six male and seven female patients, aged 16–32 years, presented to our institute with problems related to ARM. Two presented with anal stenosis, two with mucosal ectropion, four had constipation and soiling despite adequate opening, two had megarectosigmoid and three had undergone ileostomy elsewhere for distension/obstruction owing to impacted faecoliths during adolescence. Surgical treatment was offered to 10 patients, out of whom two patients on ileostomy refused to undergo any surgery. Patients underwent Malone’s antegrade enemaprocedure (two), ectropion excision (two), revision anoplasty (two), excision of pouch and anoplasty (two). Psychological assessment showed that patients felt embarrassed and depressed and used lifestyle-coping behaviour. After bowel management and surgery, mean continence and QoL scores improved from 2.7 to 5.1 and 1.26 to 3.04, respectively, which was statistically highly significant (P=0.001).Conclusion: Long-term follow-up of patients with ARM is essential to maintain overall QoL. Improvement in continence by bowel management programme and appropriate surgical intervention leads to improvement in QoL.Keywords: adults, anorectal malformation, complications, quality of lif

HelpMe Telecom - Service Support Organization (SSO) Operating Plan

Introduction: HelpMe Telecom is a leading telecom company, and has had a string of highly successful quarters. The company’s revenues are increasing mainly due to the explosive growth in the wireless sector. HelpMe Telecom also offers a suite of wire line products and local telephone service to a wide range of customer and business market segments. One key issue facing HelpMe Telecom today is customer satisfaction; the company has yet to increase its ratings amongst its principal competitors today. Service Support Organization: Service Support Organization (SSO) is one business unit which supports the sales and marketing units. SSO handles customer orders for various wire line products. SSO’s order volumes have increasing for the past few months, and the organization is faced with decreasing order quality, extremely long order processing intervals, employee morale and employee turnover; these issues have significantly affected customer satisfaction ratings. An extensive situational analysis of SSO done for the field project indicates that that the focus of any improvements needs to be on the people and the overall ordering process existing within SSO. The order process today lacks the project management purview which is needed to ensure accountability and assign responsibility to each of the suppliers in the ordering process. Without proper metrics in place, SSO also finds it difficult to drive performance with its suppliers. The current ‘own-the-order’ culture within SSO is also impacting performance. The culture is truly focused on helping customers one-at-a-time; whereas a culture shift is needed to help improve the process, which in turn would help many customers at a time. With these recommendations, SSO team has compiled process improvement initiatives and action plans; in addition metrics have been identified to validate these initiatives. Conclusion: With HelpMe Telecom facing intense competition externally, SSO is only more at pressure to deliver. With customer satisfaction ratings decreasing, the current SSO management team understands the need and has accepted the challenge in trying to change employee culture, processes and systems that have stymied the organization for past ten years or more