As it flows from his heart, the father is free. This image is one that runs counter to the typical image of money bringing all sort of happiness and solving all sorts of problems. The poem moves full circle by the end with the poet recognizing that the country has become something of a prison for him as well. He admits he is "asleep in America too" (24) and unaware of how to wake himself. This admission at the poem's conclusion demonstrates the shaping of the poet's mind as well as the shaping of generations before and after him. While the poet feels there is a world of different between him and the student with the tongue stud, he realizes they are both within the same stream of time, doing the same things. This stream becomes the "river of bright merchandise" (31) that is nothing but a source of pleasure to all who float upon it. Here the poet is expressing sorrow for the loss of appreciation for how America came to be where it is. Even he, with wisdom and experience, falls prey to the clutches of an instant gratification society hell-bent on serving self first and foremost. The mention of Marx's cry insinuates that when societies begin to think only of themselves, and lose sight of future generations,...
The poet realizes the prison that is so obvious in the beginning of the poem manifests itself differently to different generations. The loss of a work ethic and sense of dignity associated with being American
Heart Failure Guidelines The 2009 revision of the ACC/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults contains a number of evidence-based updates, revised text, and a new section called "hospitalized patient" (Hunt et al. e395). These revisions are the result of a task force that convened in 2008 and represent new findings published between 2005 and 2008. Four stages along a continuum of heart failure are described, with
Heart failure has been described as a "complex clinical syndrome that results from either structural or functional impairment of ventricular filling or ejection," (Alspach, 2014, p. 1). Because of the multifaceted nature of heart failure, it is important to recognize its various symptoms and dimensions. Heart failure in general presents a major public health concern, with current prevalence at over five million adults in the United States and over 650,000
Heart Failure Literature Critique of Articles concerning Heart Failure The two articles in this literature review are concerned with different aspects of care for patients diagnosed with some stage of heart failure (HF). Heart failure is one of the most prevalent and debilitating diseases worldwide and is the leading cause for hospitalizations for people older than 65 years (Schwarz, Mion, Hudock & Litman, 2007). These two articles look at ways of
M.K., a 45-year-old female who has a history of Type II diabetes mellitus and primary hypertension. In addition to this, M.K. is overweight and persists with a poor diet. The patient has also been smoking for the past 22 years, and has recently been diagnosed with chronic bronchitis. Current symptoms include chronic cough, which tends to be more severe in the mornings and productive with sputum, light-headedness, distended neck
Treatment of Heart Failure in Nursing Home Residents Heart failure (HF) symptoms may occur because of systemic and pulmonary congestion, structural defects arising on account of HF, structural defects leading to HF, or from treatment complications. At first, studies addressing the issue of heart failure focused on HF patients and decreased left ventricular contraction. As a result, therapies were tested within this patient cluster. This patient cluster's agreed description is HF
Heart Failure Medication The purpose of the article by Gordin and Fonarow (2016) entitled “New Medications for Heart Failure” is to examine and discuss established guidelines for medical treatment for heart failure. Specifically, the article examines pharmacological interventions for heart failure with regard to ACE inhibitors, beta blockers, aldosterone antagonists and reduced ejection fraction. It looks at recent studies that have allowed new therapeutic methods to be developed using ivabradine and
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