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

Utilization - Research Paper Example This happens in different forms and kinds, including in the breast. Cancer that affects the breast is called breast cancer. This is one of the most prevalent forms of cancer. Although breast cancer is said to have been first reported in Egypt around 122 B.C, there are no accurate statistics that can clearly prove its earliest reported cases. However, according to the journal, Phenomenal Woman, Hippocrates was the first to give a logical and medical explanation of breast cancer in 460 B.C (2008). This development was further expanded by the works of Galen at around 200 A.D. Since then, more studies and medical research have been done to discover explicit knowledge about the disease. Breast cancer is caused by a number of factors commonly called breast cancer risk factors. Breast Cancer Breast cancer is one of the types of cancers. It manifests itself in the breast. It originates from the milk ducts or lobules of the breast. Although it typically occurs in women, breast cancer can also attack men as well. Breast cancer occurs in the form of a lump on the breast or the side of an armpit. This lump contains thick tissue which is not uniform with the rest of the breast tissue. It can be noticed by simply touching the breast gently to feel the thickness of its inner tissue. Another way of detecting breast cancer is through the observation of any abnormal growth or development in the breast. Such abnormalities are physically observable features of a breast. For instance, some breast cancer cells cause the nipple of one breast to be inverted in such a way that it seems to grow towards the inside of the breast rather than the normal way of growing towards the outside. There could also be skin dimpling or change in skin color at the part of the breast where cancer has attacked the breast tissue. One of the breast cancer risk factors is the transfer of genes responsible for certain types of cancers from parent to child. Breast cancer can be passed from a child bearer to t he baby. This means that the breast cancer cells can be passed from one generation to another through the genes. In such cases, if a mother or father has breast cancer cells, then they can be passed to their offspring or to subsequent generations of their offspring. Another major cause of breast cancer is contributed to lifestyle. This means that the way people conduct their day to day activities has an influence on their chances of getting or preventing breast cancer. Smoking of tobacco has been identified as one of the major lifestyle causes of breast cancer. Lack of breast feeding after child birth also increases a woman’s chances of suffering from breast cancer. In addition to that, abortion also increases the chances of a woman suffering from breast cancer. A poorly conducted abortion procedure can easily result in breast cancer. Breast cancer is typically classified on a number of bases. For instance, when classified according to origin, we have ductal cancer and lobula r cancer. Ductal originates from milk ducts while lobular cancer originates from lobules. When classified according to the stage of the development and spread of the cancer cells, the TNM system is used. The level T is when the cancer cells have only attacked the armpit. The level N is when the cancer cells have spread from the armpits to the whole breast while the level M is when the cancer

A Framework for Thinking Ethically Essay Example for Free

A Framework for Thinking Ethically Essay The article â€Å"A Framework for Thinking Ethically† analyzes the main concept of ethics. The authors explores the arguments of what ethics is and what ethic is not, why ethics is important, five sources of ethical standards, and advises a 10-step framework for making ethical decisions. First, this article helps identify what ethics is not. It points out that ethics is not based on the law and culturally accepted norms; it is neither religion nor a science; and it is not the same as peoples’ feelings. Moreover, the authors describe that many philosophers and ethicists around the world proposed five sources of ethical standards to help understand what ethics are based on. Secondly, the article identified the following five sources of ethical standards: the Utilitarian Approach, the Rights Approach, the Fairness or Justice Approach, the Common Good Approach, and the Virtue Approach. The authors state that using these five approaches helps peoples define what standards of behavior can be considered ethical. Once one puts all these approaches together, there are still problems to be solved. One of the problems is that it is almost impossible to agree to the same set of human and civil rights, and another is that the approaches to ethical behavior do not have the same explanation for particularly difficult situations. Finally, the authors recommend a 10-step process for making the ethical decision. This 10-step process include five activities; 1) Recognize the Ethical Issue, 2) Get the Facts, 3) Evaluate Alternative Actions, 4) Make a Decision and Test it, and 5) Act and Reflect on the outcome. Step 1 and 2 ask to consider the impact and repercussions of the decision. Step 3-5 stress getting all relevant information. Step 6 asks to evaluate the dilemma based on the different approaches. Step 7-8 forces to choose the best approach, and look at it objectively. Finally, Steps 9-10 urge the carefulness needed to implement the decision, and the honest reflection that must follow upon putting the decision to action. This 10 step process gives the decision maker a pragmatic way to debate, mull over, and thoughtfully consider when making ethical decisions.

The secret society - illuminati Essay Example for Free

The secret society illuminati Essay This article is about the secret society. For the film, see Illuminata (film). For the Muslim esoteric school, see Illuminationism. For other uses, see Illuminati (disambiguation). Adam Weishaupt (1748–1830), founder of the Bavarian Illuminati. The Illuminati (plural of Latin illuminatus, enlightened) is a name given to several groups, both real and fictitious. Historically the name refers to the Bavarian Illuminati, an Enlightenment-era secret society founded on May 1, 1776 to oppose superstition, prejudice, religious influence over public life, abuses of state power, and to support womens education and gender equality. The Illuminati were outlawed along with other secret societies by the Bavarian government leadership with the encouragement of the Roman Catholic Church, and permanently disbanded in 1785.[1] In the several years following, the group was vilified by conservative and religious critics who claimed they had regrouped and were responsible for the French Revolution. In subsequent use, Illuminati refers to various organizations claiming or purported to have unsubstantiated links to the original Bavarian Illuminati or similar secret societies, and often alleged to conspire to control world affairs by masterminding events and planting agents in government and corporations to establish a New World Order and gain further political power and influence. Central to some of the most widely known and elaborate conspiracy theories, the Illuminati have been depicted as lurking in the shadows and pulling the strings and levers of power in dozens of novels, movies, television shows, comics, video games, and music videos. The movement was founded on May 1, 1776, in Ingolstadt (Upper Bavaria) as the Order of the Illuminati, with an initial membership of five,[2] by Jesuit-taught Adam Weishaupt (d. 1830),[3] who was the first lay professor of canon law at the University of Ingolstadt.[1] It was made up of freethinkers as an offshoot of the Enlightenment and seems to have been modeled on the Freemasons.[4] The Illuminatis members took a vow of secrecy and pledged obedience to their superiors. Members were divided into three main classes, each with several degrees, and many Illuminati chapters drew membership from existing Masonic lodges. The goals of the organization included trying to eliminate superstition, prejudice, and the Roman Catholic Churchs domination over government, philosophy, and science; trying to reduce oppressive state abuses of power, and trying to support the education and treatment of women as intellectual equals.[1] Originally Weishaupt had planned the order to be named the Perfectibilists.[2] The group has also been called the Bavarian Illuminati and its ideology has been called Illuminism. Many influential intellectuals and progressive politicians counted themselves as members, including Ferdinand of Brunswick and the diplomat Xavier von Zwack, the second-in-command of the order.[5] The order had branches in most European countries: it reportedly had around 2,000 members over the span of ten years.[1] It attracted literary men such as Johann Wolfgang von Goethe and Johann Gottfried Herder and the reigning dukes of Gotha and Weimar. In 1777, Karl Theodor became ruler of Bavaria. He was a proponent of Enlightened Despotism and his government banned all secret societies including the Illuminati. Internal rupture and panic over succession preceded its downfall.[1] A March 2, 1785 government edict seems to have been deathblow to the Illuminati in Bavaria. Weishaupt had fled and documents and internal correspondences, seized in 1786 and 1787, were subsequently published by the government in 1787.[6] Von Zwacks home was searched to disclose much of the groups literature.[5] Barruel and Robison Between 1797 and 1798 Augustin Barruels Memoirs Illustrating the History of Jacobinism and John Robisons Proofs of a Conspiracy both publicized the theory that the Illuminati had survived and represented an ongoing international conspiracy, including the claim that it was behind the French Revolution. Both books proved to be very popular, spurring reprints and paraphrases by others[7] (a prime example is Proofs of the Real Existence, and Dangerous Tendency, Of Illuminism by Reverend Seth Payson, published in 1802).[8] Some response was critical, such as Jean-Joseph Mouniers On the Influence Attributed to Philosophers, Free-Masons, and to the Illuminati on the Revolution of France.[citation needed] Robison and Barruels works made their way to the United States. Across New England, Reverend Jedidiah Morse and others sermonized against the Illuminati, their sermons were printed, and the matter followed in newspapers. The concern died down in the first decade of the 1800s, though had some revival during the Anti-Masonic movement of the 1820s and 30s.[2] Modern Illuminati Several recent and present-day fraternal organizations claim to be descended from the original Bavarian Illuminati and openly use the name Illuminati. Some such groups use a variation on The Illuminati Order in the name of their organization,[9][10] while others such as the Ordo Templi Orientis use Illuminati as a level within their organizations hierarchy. However, there is no evidence that these present-day groups have amassed significant political power or influence, and they promote unsubstantiated links to the Bavarian Illuminati as a means of attracting membership instead of trying to remain secret.[1]

Sterilization by Saturated Steam | Experiment

Sterilization by Saturated Steam | Experiment Introduction Many microorganisms are non-pathogenic and can live in harmony with humans as they do not cause disease. However pathogenic microorganisms can be deadly and therefore need to be eliminated from certain environments. These environments can be hospitals; individuals are already unwell and their immune systems are compromised making them susceptible to infection, water treatment, food and pharmaceutical production; supply available to communities making everyone susceptible, and laboratories; contamination of microorganisms can cause conflicting results. In order to eliminate microorganisms, sterilization of equipment, hospital supplies and production sites are necessary. Sterilization process may involve different methods using heat sterilization, radiation sterilization, filtration, and chemical sterilization. Radiation involves sterilising using gamma waves or ultraviolet light. Chemical sterilization involves using toxic chemicals such as ethylene oxide to sterilise equipment. Filtration sterilises by filtering out microorganism residues from gases and liquids that are sensitive to heat, making them unsuitable for heat sterilization (Goering et al., 2007). Heat sterilization is classified under dry heat and moist heat. Dry heat involves using heat to sterilize by causing denaturation of proteins and oxidative stress onto the cell (Goering et al., 2007).. Moist heat involves using heat and liquid to destroy microorganisms. The most common sterilization method is the use of moist heat in steam sterilization. Steam is considered an easy and effective sterilant, as it is economical, fast working and is harmless to users. Steam is non toxic and economical as it is simply pressurised water in gas phase. Steam sterilization is a fast working process as steam production does not consume a lot of time and high pressure allows exposure to the entire compartment quickly. Steam sterilization is an effective process as it can destroy living microorganisms and at high temperatures it can prevent regermination by destroying endospores as well. Steam sterilization acts by denaturing proteins within cells thereby killing the microorganism. Water vapour releases large amount of heat during condensation, this heat allows penetration of endospores to occur thereby killing endospores. The steam steriliser works using gravity and is therefore often called a gravity sterilizer. The steam sterilizer can have steam be generated from external source or can be produced from a water reservoir internally. Initially the water from a water reservoir or steam from external source enter the steriliser and is heated using a heating element. The steam being produced rises to the top of the chamber leaving cooler air at the bottom. There are drains at the bottom of the autoclave so the cool air can exit the compartment. As the steam fills the steriliser the thermostatic steam trap located at the bottom of the compartment closes. This allows the pressure of the system to build up causing high pressured steam. The timer begins at this point measuring the time set for sterilisation. To maintain the temperature and pressure at set point the heating element turns on and off. After the set time has finished the steam can be removed either to the water reservoir to cool and allow water to condense and be collector before venting to the room, or can be vented straight into the room or a designated safe zone (Dondelinger, 2008). Problems may occur in steam sterilization where it may not work. This can be due to a variety of technical problems such as leaks in the steam line. To monitor the function of steam sterilisers a Sterikon ® plus Bioindicator vial is added to every batch. Sterikon ® plus Bioindicator is made of essential nutrients needed for bacterial growth including sugar, Bacillus stearothermophilus spores and a pH indicator. In a working steriliser these pores should be destroyed in steam at temperature of 121 °C and pressure of 1 bar (VWR, 2002). When all the pores have been killed the vial should stay a pink/red colour. However if the sterilization did not work, in the next 24 hours the B. stearothermophilus spores within the incubated vial will get the opportunity to regerminate. The growth of B. stearothermophilus is facilitated by sugar fermentation producing acid. This acid causes the pH indicator to change colour to yellow and due to the microbe growth the vial will become turbid. (VW R, 2002). This provides an understanding if the steam steriliser is working to safe conditions and helps keep everything sterile. Another method to monitor steam sterilization is the use of Thermalog strips. Thermalog strips are made of two different outer layers, one side is made of foil and the other made of paper, this paper side allows steam to enter. Within these outer layers there is a chemical enclosed with a paper indicator. This chemical liquefies when steam and heat reaches it allowing it to flow along the paper indicator. The length this chemical moves is dependent on the time of exposure to steam, the temperature of steam and the volume of steam (3M, 2010). On the paper side there are two boxes labelled unsafe and safe. If the steam sterilisation occurs properly the chemical will move into the safe window of the strip. However if it does not there must have not been enough steam produced, not high enough temperature or not enough time within steriliser. This experimental report addresses the necessities needed for complete steam sterilization and producing safe equipment. In order to understand the requirements needed for steam sterilization, the experiment is conducted using different methods and conditions for B. stearothermophilus spore strips. The experiment is important as steam sterilization has important applications in preventing spread of disease within the community by sterilising medical equipment and giving reliable results by sterilising laboratory equipment. Hypothesis: Moist heat may be more effective than dry heat in sterilization process as moist heat plays a substantial role in sterilising spores. Steam sterilization is the most used method of sterilization yet its affectivity may be dependent on specific operation conditions. Steam sterilization needs to be monitored as problems may arise with its function, determine these methods of monitoring steam sterilization process. Materials and Methods: Refer to: BMS2052 Microbes in Health and Diseases Practical Class Notes (2010), Department of Microbiology, Monash University. Pages 35 -37. Results: Results 1.1 Thermalog strips were placed in Schott bottles, one with water and loose cap and the other tightly capped with no water added. After 15 minute sterilization at 121 °C the Thermalog strips read either safe or unsafe in relation to microbial presence. Results 1.2 Two bioindicators, initially pink, were separated one underwent steam sterilization and the other had no sterilization. After incubation for 3 days at 56 °C the bioindicators colours were recorded. Results 1.3 All four screw-capped bottles had one strip of B. stearothermophilus spores inside. These four bottles underwent different conditions, e.g. underwent steam sterilization or had liquids added. All these bottles underwent incubation for 3 days at 56 °C. Discussion Steam sterilization experiment shows the affectivity of steam sterilization, the operation conditions and monitoring the process using Thermalog strips and Sterikon plus Bioindicator vials. In order to determine the requirements needed for steam sterilization Thermalog strips are used to measure affectivity of steam sterilization. In the experiment the Schott bottle with water that was loosely capped had a reading on Thermalog as safe. This is due to steam having direct contact to Thermalog strip as water inside the Schott bottle vaporises when inside steriliser and the loose cap on the bottle allows steam to enter during sterilization. However the other Schott bottle that has no water and is tightly capped has a reading on Thermalog strip as unsafe. The Thermalog strip remains in the unsafe window as it has not had enough contact with steam as the cap was tight thereby not allowing steam from the steriliser into the bottle and there was no water within the bottle so steam could not be produced within the bottle either. Thereby this shows for complete sterilization to occur there needs to be direct contact between equipment being sterilised and steam, a high enough temp erature and enough time in the steriliser, all these properties are monitored by Thermalog strips. Thermalog strips are affective at monitoring temperatures and time exposure to steam yet it does not prove that say heat resistance pores will be destroyed at the specific conditions. Therefore Thermalog strips should be used but in combination with other monitoring items. Steam sterilization monitoring can also be done with Sterikon ® plus Bioindicator vials. This experiment shows how the Bioindicator vials work and how effective they are at monitoring the process. Bioindicator vials have B. stearothermophilus spores in a nutrient broth with a pH indicator. Initially both these vials appear to be clear and pink in colour. The Bioindicator vial that is placed in the steriliser stays pink and clear whereas the vial that was not sterilised became cloudy and yellow. This means that the Bioindicator vial sterilised has no bacterial growth, as regermination has not occurred while the vial not steam sterilised did have regermination. Regermination of spores allows formation of bacteria. These bacteria facilitate their growth by fermenting sugar. This fermnattion process generally procuces acidic end products, family of Bacillus do mainly produce lactic acid as an end product. As these products are acidic the pH indicator will change colour in respose to th e formation of these products. The pH indicator changes colour from pink to yellow. The bacterial growth will also cause the vial to look cloudy due to turbidity within. The results showed the Bioindicator vials work consistent with what was expected showing that they are an asset in monitoring steam steriliser function as they show Monitoring the needs to facilitate complete steam sterilisation occurs in the third part of the experiment. Bottle 1 is used as the control showing that the B. stearothermophilus spores have the ability to regerminate from the initial spore strip. If bottle 1 had not shown microbe growth the results obtained would not prove steam sterilization has occurred as the spores may not have had the potential to regerminate at all. Bottle 2 shows that steam sterilization can occur when water is added to the bottle. As the heat within the steam steriliser increases the water within the bottle will vaporise forming steam. This steam will have direct contact with the spores allowing the spores to be completely eradicated. Bottle 3 was tightly capped and had no liquid added to it making it impossible for steam to have direct contact with the spore strip. As the spores were still alive during incubation the spores regerminated and formed bacterial growths within bottle 3, viewed as cloudy. Bottle 3 as it had no contact with steam had only dry heat sterilization working within which is not effective in killing of spores and thereby is less effective than steam sterilization method in bottle 2. Bottle 4/5 was tightly capped and had paraffin oil added to it. It would be expected that this bottle would have bacterial growth as there is no steam in direct contact with the spore strips. The oil could even act as a barrier for any steam, entering through the tight cap, to get in contact with the spores. However the results obtained in the experiment showed that there was no bacterial growth in bottle 4/5. This is most likely due to experimental errors where the spore strip was not completely submerged in paraffin oil and the cap of bottle 4/5 was not tight enough. This would allow steam to enter the bottle and have direct contact with the spore strip as the oil was not covering the whole strip. This experiment showed that for effective steam sterilisation to occur the equipment and instruments must have direct exposure to steam. Steam sterilization experiment has showed that for steam sterilization to occur direct contact with steam is needed; this can be from direct steam from steriliser or water within vaporising. Steam sterilization experiment could have included a few more alternative conditions such as a loosely capped bottle with no water and a loosely capped bottle with oil. This would have showed steam can enter a bottle and cause sterilization. Also a loosely capped bottle with oil would have been able to tell the effect of oil on direct steam sterilization. Steam sterilization is a more effective and time efficient process than dry heat sterilization techniques. Steam sterilization can manage to kill heat resistance bacterial spores whereas most dry heat sterilization cannot. There is a dry heat sterilization method that is effective in killing bacteria regerminating from spores called Tyndallization. Tyndallization involves heating equipment and instruments for a certain time ranging from a few minutes to an hour depending on temperature of heating for three to four days. Initially this will kill all existing bacteria and other microorganisms. On the second day the spores would have regerminated allowing the second row of bacteria to also be killed. The third day will allows time for the late germinating spores to regerminate and heating allows them to be killed (Aminot and Kerouel, 1997). This procedure despite its affectivity this procedure still takes several days to complete therefore steam sterilization is the better option. Sterilization is an important process in hospitals, water treatment facilities, food and pharmaceutical production and laboratories. In hospitals sterilization can prevent the spread of diseases caused by opportunistic pathogens such as Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumonia (Goering et al., 2007). Steam sterilization is therefore an ideal form of sterilization in hospitals to prevent spread of disease with the aid of Bioindicator vials to monitor function in every batch and occasional use of Thermalog strips. Conclusion Steam sterilization can only occur if the equipment being sterilised has direct contact with steam from steam provided in steriliser or from heat causing water within to vaporise into steam. Without steam contact the equipment is having only sterilization by heat which is an ineffective sterilization method on spores. Oils, fats and other hydrophobic substances should cause barriers for steam penetration making sterilisation less likely. It is important to monitor steam sterilisers as many mechanical interruptions could prevent complete sterilisation. Sterikon plus Bioindicator vials are an effective way to monitor steam sterilisers as they produce consistent results showing whether sterilisation has occurred or not. Thermalog strips can also be used to monitor if steam sterilising machines are reaching conditions that allow safe sterilisation to occur, for example the right amount of steam, temperature and pressure.

Arthur Millers A View From the Bridge Essay -- Arthur Miller View Bri

Arthur Miller's A View From the Bridge Manliness, Hostility and Aggression are all important in "A view from the bridge" where Eddie Carbone plays the main character he is a longshoreman working on the Brooklyn docks in New York. He tries to keep his status as "the man" in his household. He is very hostile towards Rodolfo because he thinks he is a homosexual. Marco knows Eddie feels this way about Rodolfo and is unhappy that Eddie feels this way about a member of his family. This creates aggression from Marco throughout the play and results in various conflicts between himself and Eddie in which Marco demonstrates his masculinity over Eddie this makes Eddie feel threatened and insecure. Eddie has many different things that he considers to be manly e.g. "to be a breadwinner". He feels that Rodolfo does not conform to his idea of masculinity because of the way he cooks, cleans, sings and makes dresses. Which at the time of the play would not be considered to be things done by a man. Eddie also has strong views about the way that Catherine behaves. He shows this by criticizing the way she dresses and the way she behaves when he says "your walkin wavy" and "you're still a baby". He feels like she is still his little girl and he is unhappy that she is growing up so quickly. He is also unhappy with her job because of the neighbourhood it is in and he thinks she should stay at school for longer. I think he disapproves of this not because of the neighbourhood, or the fact she should still be at school, but because he thinks she is still a baby and he should still be looking after her when she is perfectly capable of doing it herself. Eddie behaves peculiarly when he asks Rodolfo if he can box which lea... ...ead the drama "A view from the bridge" it was initially intended to be performed on the stage this would have made the play more dramatic because the audience would feel like they are a part of it. The setting would cause problems because it is constantly changing so the stage set-up would have to be skilfully done so as little time was wasted as possible changing the set. We acted a small part of the play in groups which helped us to understand why Arthur Miller had so many stage directions in the script. It is because every little detail needed to be shown to reveal the authenticity of the play and to give it a feeling of what it was actually like to be there. When we acted our scene from the play it was difficult to keep up with all the different stage directions but once we practiced it became easier and it made the scene look much more realistic.

Why Do Children Talk To Themselves? :: Psychology Psychological Papers

Why Do Children Talk To Themselves? Whether you are a parent, teacher, child care giver, or a child observer you may have noticed that many children talk to themselves. Laura Berk reports that, â€Å"private speech can account for 20-60 percent of the remarks a child younger than 10 years makes† (78). Why do children do this? Does it benefit the child as Vygotsky would say, or is it just that the child is making egocentric remarks that play no positive role in normal cognitive development as Piaget would claim? I am going to be looking at the differences between Vygotsky’s and Piaget’s points of view. Then, I will look at Laura Berk’s findings in her article, â€Å"Why Children Talk to Themselves.† I will also talk about other findings concerning this topic. Jean Piaget and Lev Vygotsky were developmental psychologists interested in the origins and processes of cognitive development. These two psychologists disagreed sharply on the role that private speech played in one’s cognitive development. Vygotsky called this private speech while Piaget called it egocentric speech. Piaget observed the activities of three to eight year old kindergarten children, and discovered such uses of speech as verbal repetitions of another individual, monologues during an activity, and non-reciprocal remarks in collective settings. In these instances their speech was not directed towards other individuals. In Piaget’s mind these patterns of speech showed evidence of egocentrism, a sign of cognitive immaturity, and an inability to share the perspective of another individual. However, he argued, as the children grow older they socialize increasingly more with others, and their speech becomes communicative. Their speech moves away from being self- to other-oriented, a sign that they are able to adopt the perspectives of others. A child overcomes egocentrism by beginning to think critically and logically, causing egocentric speech to fade away. Vygotsky believes that a child’s cognitive development originates in socialization activities, and then goes through a process of increasing individuation. He argued that self-directed speech did not show any cognitive immaturity, but did show some form of development. He claims that private speech represents a functional differentiation in the speech of a child, or that a child begins to differentiate between speech that is directed towards the others and speech that is self-directed.

The Power of Change :: Personal Narrative Writing

The Power of Change My best friend’s ex-boyfriend used to tell her â€Å"that’s the difference between you and me†¦you’re a tree and I’m a blade of grass. You’re problem,† he would say, (apparently never having learned that starting off any piece of advice with â€Å"your problem† is the kiss of death) – â€Å"your problem is that you need to learn to bend.† He might have questioned his desire to have her heed such advice some months later after she dumped him for his best friend and tossed the shredded bits of his world into thousands of irreparable pieces. And, as clichà © as his words of guidance may seem, I have now begun to think him rather astute, for in the months that followed their separation my friend transformed her behaviors in the most fundamental and opposing ways: she traveled more, replaced her old job with one she actually liked, gave herself over to the pleasures of a most memorable one night stand, and today smiles r andomly and with more charm than I have ever remembered. It is a fiction that we become less spontaneous and more rigid as we get older, that we are all blithe and adaptable children. As for me, I hated change as a child, resisted it like a dry naked body would sliding down a fire pole. I experienced each new thing as a betrayal. A new friend in the circle meant, not more love to go around, just less time for the old ones. It also meant going off the course, entering something unseen, welcoming an unknowable unfolding. Change was not transformation. It was exchange – this for that – an end for a beginning. How we come into this world– that is– the state in which we arrive is a complete mystery to me. While other children, my siblings included, relished new pets, or a new piece of furniture for their bedroom or the hope of a family vacation, I capitulated to a kind of juvenile asceticism. When I was eight I spent the whole of a trip to Disney World grumpy and brooding, not because I wanted something I was denied, but because I sensed that in the excitement that fueled everyone else – that in that exodus from our routine of school and homework and sports and homemade dinners – there was the prospect that anything could happen. And anything could change everything.