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USA Contract Law Assignment Example | Topics and Well Written Essays - 2000 words

USA Contract Law - Assignment Example The contracting parties should be of lawful age and sound capability and they ought to concur commonly on the footing of the agreement. The agreement law is administered by the arrangements of the UCC and the Restatement of Contracts. The UCC administers the offer of substantial and versatile resources, property leases, and budgetary exchanges. The customary law standards of an agreement are summed up, rehashed and distributed as the Restatement of Contracts by the American Law Institute. Legitimate experts quote the arrangements of the Restatement in their composed feelings, however this doesn't have the power of law.[2] At the point when an agreement is made, the two gatherings expect some profit by it and the terms and conditions are consensual. Since unanticipated occasions later on may make a misfortune for any one gathering, it is basic that the two gatherings are exhaustive about the significance of the substance to which they are putting their mark. The entire idea of agreements manage the future and by and large offers ascend to issues; one or the two gatherings may find that the occasions that they had foreseen had not gone their direction. The issue might be because of a 'mistake.'When one or the two gatherings, to the agreement, wrongly accepted that specific realities in the agreement are valid, at that point a 'botch' is said to have happened. In contract law, a mix-up can be utilized to refute the understanding. There are two unique sorts of missteps, as per customary law. A 'one-sided botch' happens when just one gathering is mixed up about the terms or substance of the agreement. A 's hared misstep' or a 'typical error' happens when the two gatherings, to the agreement, are mixed up about a similar term or condition in the agreement. Since these missteps can be utilized as 'pardons' to nullify an agreement, the arrangement of 'target standard of understanding' gets significant in contract law.â

Zappos

Zappos “The best businesses are really ones that can combine passion, profits, and purpose.” © Shutterstock.com | 360bTony Hsieh has managed to create just such a company with Zappos. In this article, we will look at, 1) what is Zappos?, 2) products, 3) business model and key components, and 4) learning from Zappos’ success.WHAT IS ZAPPOS?The CompanyZappos.com is well respected and established retailer of shoes and clothes. The company is headquartered in Las Vegas, Nevada. Within ten years of establishment, it was acquired by Amazon.com and is one of the largest online shoe stores in the world.History of ZapposIn 1999, Nick Swinmurm reached out to Tony Hsieh and Alfred Lin with the idea of an online shoe store. He was met with skepticism because the notion appeared to be a somewhat unusual one at the time. Swinmurm remained convinced of the potential of his idea and convinced the others by highlighting the fact that the US footwear industry is a $40 billion market and 5 percent of this market is being served through mail order catalogs. He eventually managed to get Hseih and Lin on board with a $2 million investment through their investment company, Venture Frogs.The company began its journey as an online store called ShoeSite.com. This name became Zappos in only a few months. The new name was a version of Zapatos which is Spanish for shoes. The name was kept generic to allow the company to expand beyond shoes at a later time. The company started to formalize and excited Hseih into coming on board as a Co-CEO. By 2001, the company had earned revenues of $1.6 million.During the same year, the company increased sales by close to four times and brought revenue up to $8.6 million. To keep up with growing sales, the company opened its own fulfillment center in Kentucky. The company managed costs by spending minimal amounts on marketing and advertising, instead relying on word-of-mouth to raise brand awareness. The encouraging growth till this point set the stage of future goals to be set. Hsieh and the rest of the team looked to the future as far as 201 0 and set a few targets for themselves. These included achieving $1 billion in sales and a place in the Fortune’s list as one of The Best Companies to Work for.With sales reaching $70 million in 2003, the company made strategic decision to discontinue drop shipping. Drop shipping is the method where the company does not manage and hold inventory itself but instead transfers orders directly to a manufacturer or a wholesaler who takes on the responsibility to ship the items onwards. Though this was about 25 percent of the revenue, the company decided to make this decision to create more focus around superior customer service. A customer centric company which promised and delivered a superior user experience could not be created without control over this user experience.By 2004, the risky decision paid off and the company made $184 million in gross sales. The first round of investment was received at this point which added $35 million to the company’s assets.   By 2007, the company had reached $840 million in sales and had expanded substantially to include a variety of fashion products.The Amazon Buy OutThe Amazon sale was announced in 2009, which was a deal worth $1.2 billion. After establishing that Amazon would be open to letting the company operate independently and maintain its culture and integrity, the deal was negotiated. The one major change was to close down the Kentucky warehouse and let Amazon handle part of the order fulfillment and customer experience.PRODUCTS © ZapposThe company began operations as an online retailer for shoes and this continues to be about 80 percent of the company’s business. The store sells popular brands such as Nike, Ugg Boots, Aldo, and Steve Madden. There are close to 50,000 varieties of shoes including niche items such as narrow or wide shoes or difficult to find sizes.The company expanded to other fashion items such as clothes, handbags, eyewear, watches and children’s items in 2007. These items make up 20 percent of store sales. The business is expected to grow in this direction in the coming years given the size of the overall clothing market.BUSINESS MODEL KEY COMPONENTSZappos has been created on a loyalty business model and relationship marketing. The loyalty business model used company resources to work towards establishing and increasing customer and stakeholder loyalty. The idea is that this loyalty will help meet and exceed company objectives and goals. The chain of events in this model would includ e a good quality product and excellent service that creates customer satisfaction. This leads to customer loyalty and recall which leads to repeat customers which then leads to profitability.The company has been successful in its goals as about 75 percent of the business comes from repeat buyers. The main source of the company’s rise to success has been these repeat customers as well as the word of mouth recommendations developed by these loyal and satisfied customers. The established reputation for excellent quality of service has spread through these customers and Zappos has worked to strengthen this reputation through continued support and assistance that often extends beyond any established company policies and rules.The Zappos USPWith the increasing popularity of online shopping, the competitive arena is full of similar businesses vying for the customer’s attention and their business. In this situation it becomes even more important to establish, develop, and maintain a uni que selling proposition that sets you apart from your competition. For Zappos, this differentiating factor has been a concentrated focus on the best customer service that can be offered for an online business. The company continues to offer free domestic shipping on all orders with no minimum order amount or any other caveats. In addition, they continue to offer free and hassle free returns to their customers. This takes away any apprehension a customer may have about making a shoe or clothing purchase online without being able to try on or feel the product. According to Hsieh,“If we’re serious about building our brand to be about the very best customer service and customer experience; then customer service shouldn’t just be a department â€" it should be the entire company.”Customer Service Secrets That Made Zappos Successful Building A Customer-Focused Culture[slideshare id=256107doc=zappos-lessons-building-a-customerfocused-culture-1202364344232915-2w=640h=330]LEARNING FRO M ZAPPOS’ SUCCESSZappos CultureOne of the goals the company management set for themselves during early stages of the business was to be counted among the top places to work at. The company has managed to achieve this by creating and reinforcing a unique company culture that is a bench mark for other companies. The company believes that culture is a reflection of the brand itself. If the employees are not a reflection of this then the customers are bound to pick up on it. The company also believes that employees need to be happy which can only be if they are inspired rather than just motivated. Employees should always look beyond their own job description and want to do their job and beyond this job. To achieve this, the employees need to feel empowered, feel like they are making progress and that their work holds meaning.The implementation of the key features of this culture may appear strange and somewhat harsh in parts, but they all collectively work towards the strengthening of the culture. Zappos wants all its employees to fit into the very well defined though unorthodox culture of the company. Here are some of the methods Zappos uses for culture preservation.Hiring and FiringMany companies hire employees too fast but are reluctant when it comes to asking the wrong people to leave. Zappos uses the opposite strategy. Applicants and employees at different points in their Zappos tenure are offered between $2000 and $4000 to leave the company, giving them a way out if they are not comfortable or settled. Beyond this, if a person stays but does not settle then they are asked to leave without hesitation.Job Interviews and Performance ReviewsA substantial portion of a job interview deals with questions regarding the company’s culture and how the applicant would fit into it. The HR department works towards determining whether an applicant’s personality matches the company values. Performance reviews for existing employees are based entirely on their ability to fit into the company culture.Core ValuesZappos has ten core values aren’t created by management or forcefully memorized by employees. Instead they are based on the traits that their best employees display.  The ten values are:Deliver WOW through serviceEmbrace and drive changeCreate fun and a little weirdnessBe adventurous, creative and open-mindedPursue growth and learningBuild open and honest relationships with communicationBuild a positive team and family spiritDo more with lessBe passionate and determinedBe humbleThese values are part of everything the company does including the interview process. For example, all potential employees are asked to rate themselves on a scale or weirdness from 1 to 10. The content of the answer is less important that the explanation of it. Values differ from company to company and their relevance is the reason they become successful. Says Hsieh.,“We’re not out there saying other companies should adapt the Zappos culture. We’re just sayi ng….if you want to build a company for the long-term you should have values and a strong culture and in most cases probably not the same values as Zappos. The research has shown that the power comes from the alignment, by having values and a point of view and beliefs and passion for whatever it is that you stand for.”TransparencyThe company tries to take on both positives and negatives about the culture. Employee and public tweets are shared unedited on the website and an annual culture book is published with employee opinions about the company.Customer ServiceBecause customer service is the core of the company’s culture and ethos, all new employees take a turn answering phone calls in the call center as part of their training. Even the CEO spends time over the holidays taking customer calls. There is no maximum time limit on phone call durations and employees may actually direct customers to a competitor if what they are looking for is not stocked.When Culture Is Everything â €" A Brief Lesson From Zappos[slideshare id=27686006doc=20130110-whencultureiseverythingv1-131029060958-phpapp01w=640h=330]Lessons for EntrepreneursThe Zappos CEO Tony Hsieh has managed to create a unique company with a unique culture. There are many lessons that entrepreneurs and even corporates can learn from him.Being Passionate Increases the Chance of Success: An entrepreneur needs to be passionate about what he sets out to sell. If the focus is more on the money that can be earned than this can become a roadblock to success. A passionate belief in what you set out to do means you will want to work harder to achieve your goal as well as inspire and motivate others to do the same. Any hurdles that come along will be easier to overcome if passion is your driving forceUnderstand What Motivates People: People are more likely to be invested in a company which inspires them instead of offering bonuses or increased salaries. Zappos actually offers employees money to quit. This helps cl ear out those people who are only in it for the money.Learn from Your Mistakes: Hsieh feels that his first company was not something he was happy with. He feels that an attempt to build the company culture came too late. Though sold successfully, he learnt from the mistakes he made there and did things differently with Zappos. Focus on the Customer rather than the Product: It is a common mistake to become fixated on the product being sold in a sort of tunnel vision and focus to shift completely away from the customer. Hsieh wanted his company to be an excellent service provider that happened to sell shoes. It wasn’t about the shoes, since he feels more passionate about customer service than the shoes themselves and that is how it should be.Talk to Employees: Happy employees are productive employees. The best way to understand what makes employees happy is to have a clear line of communication with them and continue to talk to them. This sounds simple but can have incredibly positi ve effect. Some things that have resulted from direct employee conversations include a full time life coach and free lunches.Treat Company Values as More than Just Slogans: The ten core company values at Zappos provide guidance for all decisions be it strategic or day to day operational. New employees are asked questions to assess their potential to fit in with the values while existing ones are reviewed based on their ability to align with the established values.Provide Support to Staff: It is important to fully support employees that work according to the core values of the company. This is how it is done at Zappos. Customer support calls that last for hours are a good example of how employees are supported in their fulfillment of the customer service ethos.Understand what Makes you Happy: It is important to understand what makes you, the entrepreneur happy. In some cases, a person may be happy setting up a new firm but not interested in developing it. In the case of Tony Hsieh, h e realized that his heart was not in the venture capital business but rather he was excited by the idea of building up a fledgling business.Be an Enabler: Many entrepreneurs are so invested in their business that they have trouble letting go and not micro managing. Tony Hsieh thinks differently. He believes that as an entrepreneur, it is important to enable people to perform at their best and realize their potential to the fullest rather than be bogged down by a stifling company culture.Relationships Build Opportunities: The focus of building relationships should not be immediate gain but rather to develop the relationship itself. Sometimes, small connections can lead to bugger opportunities in the future.There are many lessons to be learnt from the Zappos story for entrepreneurs in terms of the business itself and its passionate CEO.

Stranger in a Strange Land Essay - 1314 Words

Stranger in a Strange Land is a book written by Robert A. Heinlein that completely throws away the social mores of the late fifties/ early sixties society. The book opens with a ship returning from a trip to Mars with an interesting passenger, a man, Michael Valentine Smith who was the son of a previous voyage to Mars that was believed to be entirely dead. This was a human raised by Martians, who are an ancient race that has various powers that are discovered later in the book to be possessed by Smith through his knowledge of their language. When Smith gets to earth the U.S. government, under the pretense that he is not well sequesters him away in a hospital. Smith is spirited away by a nurse and her reporter friend. Smith is taken to†¦show more content†¦In the book Heinlein followed and influenced some of the 1960’s counterculture. The Hippie movement started in the early sixties and continued in force until roughly 1970 (Hippies and 1960’s counterculture). H ippies rebelled against their parents’ conformity and many ran away from home to experiment with their lives and what they could do. Heinlein wrote Stranger in 1962, although in letters to his editor he had been thinking about writing the book since the late forties (Grumbles from the Grave), the book was a huge success largely thanks to the 1960’s counterculture as the book portrays many of their ideals. Stranger in a Strange Land falls in perfect step with the Free Love movement influencing it in a few ways; in the book Michael Valentine Smith creates a small commune in which sex is common, shared, and without jealousy, sex for Smith starts at a â€Å"young† age, although he is a man, socially he has had no experience. This book came about at a time when the hippie movement was gaining steam and it influenced hippie leaders in how they viewed sex the book was written in direct opposition to the social standards of the fifties and it is very different with itsS how MoreRelatedWomen on the Edge of Time and Stranger in a Strange Land Essay1254 Words   |  6 PagesThe novel Women on the Edge of Time and Stranger in a Strange Land have some similarities. They both depict how the gender socialization process is bias and a catalyst to gender disparity in the society. Both stories bring to light how men are given privileged as compared to women in the society. Analyzing the two stories and using outside sources I will draw a conclusion on how gender and power ideologies have equality impacted our society. â€Å"Women on the Edge of Time† is a book written by MargeRead MoreAnalysis Of Richard Rodriguez s A Stranger And Strange Lands Essay2274 Words   |  10 Pagesstudying the concept of reading and writing in different communities. To assess this, we have read two different texts. Richard Rodriguez’s the achievement of desire†, from his autobiography â€Å"Hunger of Memory†; and Lucille McCarthy’s â€Å"A Stranger in Strange Lands: A College Student Writing across the Curriculum† from â€Å"Research in the Teaching of English†. Both answer key questions regarding what it takes to become a great reader and writer, however, from the reading that I have done, each one onlyRead MoreThe Human Martian, By Robert A. Heinlein1658 Words   |  7 Pagesthe the truth about religion to the world and create a utopian society in the novel Stranger in a Strange Land by Robert A. Heinlein. Heinlein served in the Navy and was a socialist politician bef ore beginning his writing career. His second wife had a large influence on his political views and was the one who convinced him to run for the state assembly. After his loss, he became an author. Stranger in a Strange Land is Heinlein’s most popular book, however, his views on socialism and liberalism wereRead MoreNo Men Are Foreign1717 Words   |  7 PagesNo Men Are Foreign ------------------------------------------------- [pic] No men are foreign tell us that we should not consider anyone as foreign or strange. Humanity is the same all over the world and in harming anyone we are harming ourselves. This poem emphasizes the fact that men might belong to different races, nations, but are basically bound by a common bond i.e. they all feel pain when hurt and shed tears on the loss of someone close and wars should not break this common bondage.Read MoreMy Student Personnel Class : An Director Of The International Center At Springfield College901 Words   |  4 Pagesinternational students to be an active part of the college community. To be successful in this field, according to Deborah, ones need to have empathy and communication skills. They should possess the ability to understand what it is like to be a stranger in a strange land, to have an open mind and the patience in understanding differences. Her position demands her to have a balanced role between being an administrator and an educator. She both ensures that the international students’ logistical needs areRead MoreThe Immigrants Experience Through The Graphic Novel The Arrival 1305 Words   |  6 PagesTan sets many emotions and thoughts in motion, without using any words. Tan depicts the many challenges immigrants face when venturing to a foreign land for the first time. This graphic novel depict the immigrant experience in a very effective way. Tan does so by using many different methods to demonstrate this experience, the strange language, strange surrounds, and unfamiliar people, are some of the most prominent. While the immigrant story is often one riddled with struggle, they too have timesRead MoreEssay on History of Thanksgiving885 Words   |  4 Pagesmother country, and inured the difficulties of a strange and hard land, which yet in a great part we have by patience overcome . . .’† (qtd. in Philbrick 6). After the Pilgrims arrived they picked land by rivers with good planting area and called it Plymouth. A harsh winter came quickly upon the Pilgrims where they faced many hardships before spring relieved them. Now was their time to plant and prepare for the oncoming year. They did not know the land well and many people say that the only reason theyRead MorePowers of Horror by Julia Kristeva, Questions and Answers1384 Words   |  6 PagesTo what extent are we all ‘strangers to ourselves’, even in our own countries? Answer with reference to Kristeva’s book. Exile, the reality and practice of being barred from a native country, has prolifically influenced many philosophers’ theoretical writings. Indeed, Julia Kristeva being in exile from her native Bulgaria is a foreigner in an unascertained land. Being an outcast influence’s her philosophical, political and sociological extended essay Strangers to Ourselves published in 1991. TheRead MoreThe Golden Fleece And The Golden Rule880 Words   |  4 Pagesterrible pain and suffering were almost always the outcome. If someone were to treat a guest rudely in their home, it would greatly upset Zeus, as, â€Å"Hospitality was, of course, very important to him, as since all guests, all who seek shelter in a strange land, were under his especial protection† (147). This concept, called xenia, shows up and plays and important role in a plethora of popular ancient Greek myths, including â€Å"The Quest of the Golden Fleece†, â€Å"Baucis and Philemon,† and â€Å"Th e Odyssey†, showingRead MoreThe Odyssey1243 Words   |  5 PagesThe Odyssey In Homer’s epic, The Odyssey, each culture treats strangers and guests with distinct differences from every other culture. One of the most hospitable cultures was that of the ancient Greeks, exemplified in Homer s The Odyssey by both gracious hosts and guests. In Greece and The Odyssey, not only was good hospitality etiquette expected, but the added pressure that if they didn’t treat their guests with respect the gods would punish them further compelled excellent manners. The Odyssey

The Impact Of Media On The Media - 920 Words

Growing up in the 1970’s, violence in the media, and television in general, was reserved for late prime time programming and the 11 o’clock news. With deregulation of the broadcast industry in the 1980’s, under the presidency of Ronald Reagan, violence on TV became mainstream (American television, n.d.). With more channels to watch, the advent of 24 hour news, along with more content to view, the audience as well became increasingly younger. Alongside standard television programming, cartoons became even more violent. With each passing decade thereafter the trend of increasing violence in the media and television continues into present day. Violence in the media has become so prevalent that it seems to elicit almost automatic aggressive behavior in those who view it. Perhaps, this was Bandura’s initial point with his experimentation involving the Bobo doll in the 1960’s. To further understand this concept, viewed was a video on YouTube entitled The Brain: A Secret History-Emotions; Bandura Doll Experiment (Debate Films, 2011). The 1960’s footage involved two elementary school children, one male, one female, viewing an adult male in an enclosed room viciously attacking the Bobo doll by punching, kicking, and striking it with a hammer. The duration of the assault was approximately 10 minutes. The female child was placed in the same room and for the same time period. Quickly, the child began assaulting Bobo the same way she had seen the adult by punching andShow MoreRelatedThe Impact Of Media On The Media2801 Words   |  12 PagesMisrepresentation of Blacks in the Media Mammies to nannies, bucks to thugs and deadbeats, servants to crooks in positions of power: this is the evolution of Black images in the media. Although in more recent years, it seems that film and television representation has evolved for the better, there are always messages that are not positive being subliminally sent through to the viewing audience. Regarding this, movie and television show characters are not the only representations in the media. In fact, what is possiblyRead MoreThe Impact Of Media On The Media913 Words   |  4 Pagesthat were rarely discussed in media are now at the frontline of our media coverage, such as police brutality, racial disparity and immigration reform. Everything from political party preference to the increasing diversity of race and sexual orientation in each generation has an effect on the values portrayed in media. The value of each new generation effects how the media shapes itself to market to that general public. In order to understand th e fluidity of the media, it is important to examine theRead MoreThe Impact Of Media On The Media1285 Words   |  6 Pageswere given to the media according to the Constitution and are roles that they must follow. However, the media has not been following those three roles and instead has focused on reporting other issues that have no importance at all. As a result, the media has been highly criticized since it has only been reporting only the government line on issues because the media is owned by six corporate conglomerates. Although the American media has changed throughout the years due to the media ownership, it hasRead MoreThe Impact Of Media On The Media929 Words   |  4 PagesAs we all know that there so many changes which have occur in Media world. From Radio to tv,from balck and white tv we have switched on to colour tv and etc.Apart from all these these changes the major change which took place in our media over the years is on the contents of our programmes of our cha nnels.This article is also about ‘COMPARISIONS,CHANGES AND DIFFERENCE BETWEEN THE CONTENT OF DOORDARSHAN AND LATEST CHANNELS’. 1.Description of doordarshan 2.Shows of doordarshan 3.Arise of other channels(StarRead MoreThe Impact Of Media On The Media903 Words   |  4 Pages The Life that is My Media Media according to Dictionary.com is defined as â€Å"the means of communication, as radio and television, newspapers, and magazines, that reach or influence people†. While the definition is correct at the same time it fails to recognize another form, which is social media sites on the Internet. An unprecedented amount of technology uses as tools of influence to convince citizens to purchase and consume on a regular basisRead MoreThe Impact Of Media On The Media892 Words   |  4 PagesAs I pondered what I would do for this action project I knew I wanted to steer more towards women in the media. I have always been curious about what the public thinks about certain things, what is trending, what the common thought is on a specific thing, idea etc. As I thought about what my main focus was going to be, I remembered talking to my family about what I was learning and discussing in my Gender and Women’s Studies class and brought up how there seems to be a stigma in todayâ €™s culture onRead MoreImpact Of Media On Gender And The Media1303 Words   |  6 PagesImpact of Media on Gender Annie Hernandez Keiser University August 13, 2014 Abstract Boys and girls have for long spans of time considered themselves to be different. The media and advertising has played a significant role to make sure that they influence the way that boys and girls view themselves. Society has always had a main focus on getting people to behave in certain ways, the media has been magnificent at causing each gender to classify themselves in particular waysRead MoreThe Impact Of Media On New Media1313 Words   |  6 Pagesreceived information and news through paper-based media,like newspapers,magazines and books.Owing to the appearance of mobile phones and IPADs,people can look through news easily and conveniently,paper-based media need to innovate and reform.This assignment will present the status quo of paper-based media,it will explain the combination of new media and paper-based media,the significance of paper-based media innovation. McLuhan Marshall said that media are the basic motivation of social developmentRead MoreMedia s Impact On The Media843 Words   |  4 PagesMedia is defined as the method that people use as two way communications to send and receive information. The people who receive information or media messages are known as â€Å"Receiver† while Media is known as â€Å"Sender† (Lunenburg, 2010). Media has been a part of people’s life since the late 1930s, used as a method to convince and control attitudes and beliefs (Barrett Braham, 1987).In the twentieth century, media is easy to access due to the increase of technology. The significant rise of mediaRead MoreThe Impact Of Media On Social Media Essay1035 Words   |  5 PagesNegative influence of Catfishing in Social Media Most of us use social media in some part of our day. Statista statistics claim, â€Å"In 2016 there is 78 percent of U.S. Americans had a social media profile, representing a five percent growth compared to the previous year.† This number will increase as we rely more and more on technology. One of the negative social media trends that have been increasingly popular is catfishing. Catfishing as google dictionary defines it as to â€Å"lure someone into a relationship

The Accidental Tourist Essay Free Essays

Life just is. You have to flow with it. Give yourself to the moment. We will write a custom essay sample on The Accidental Tourist Essay or any similar topic only for you Order Now Let it happen. † -Jerry Brown If an individual allows changes to occur in one’s life, then love can be the wonderful result of that acceptance. The theme of reasons why we love and how we love different people is demonstrated throughout the book The Accidental Tourist, written by Anne Tyler. There are two main characters that undergo and accept the changes in their lives, and one character that stays static throughout the book, helping one of the characters to change. Macon Leary is first grounded by loneliness and comfort, then slowly opens himself up to what appears to be a whole new world for him. Then, there is Sarah Leary, who controls some of the changes in her life, and tries to make the best of the rest of them. The character that remains the same throughout the book is Muriel Pritchett—a dog-trainer who takes an interest in Macon and helps him to accept the changes in his life. Above all, the universal theme of this book is love—a surprising new journey for all the characters. In the beginning of the book, it is explained how Macon and Sarah Leary’s son is murdered and how their marriage suffers because of this. Sarah leaves Macon, which is the beginning stage of Macon’s renovated life, but one that does not start off happily: â€Å"He didn’t eat real meals anymore†¦His hair, which Sarah used to cut for him, jutted over his forehead like a shelf. Ande something had caused his lower lids to droop. He used to have narrow gray slits of eyes; now they were wide and startled†¦Ã¢â‚¬  (14). Macon is not at all used to living alone. He wants to control everything and likes nothing to be left to chance—Sarah’s departure is not something he can control and he does not deal with it well. Macon begins to think that he cannot live without his wife, but soon realizes a few things that really make him think about the marriage: His brain buzzed with little worries†¦The worries changed, grew deeper, he wondered what had gone wrong with his marriage. Sarah had been his first and only girlfriend; now he thought he should have practiced on someone else beforehand. During the twenty years of their marriage there’s been moments—there’s been months—when he didn’t feel they had really formed a unit the way couples were supposed to. No, the stayed two distinct people, and now always even friends. Sometimes they’d seemed more like rivals, elbowing each other, competing over who was the better style of person†¦ (15-16) Macon realizes that he and Sarah never actually became one person; they had always stayed as two separate people living in a stale, routine marriage. Finally, Macon comes to terms with the fact that Sarah is not coming home to him: â€Å"Well, of course she wasn’t there. He knew it the instant he stepped inside that house, when he smelled that stale hot air and heard the muffled denseness of a place with every window shut. Really he’d known it all along. He’d been fooling himself. He’d been making up fairy tales† (41). Macon knew that when he got home from his business trip that Sarah would not be there waiting for him like she used to. Although he did not ask for this change in his life, and after living alone for a while, moves back with his sister and brothers—a comfortable change for him. This all begins to change when Macon meets an unusual woman working at the animal hospital where he takes his dog and becomes acquaintances with her. Muriel allows Macon to open up to her, and Macon shows his willingness to do so: ‘I lost my son,’ Macon said. ‘He was just†¦he went to a hamburger joint and then†¦someone came, a holdup man, and shot him. I can’t go to dinner with people! I can’t talk to their little boys! You have to stop asking me. I don’t mean to hurt your feelings but I’m just not up to this, do you hear? She took one of his wrists very gently and she drew him into the house, still not fully opening the door, so that he had a sense of slipping through something, of narrowly evading something. She closed the door behind him. She put her arms around him and hugged him. (189-190) At first, Macon does not give Muriel Pritchett a second thought, but before he knows it, he is dating her and soon living with Muriel a nd her young son. This shows a tremendous change for Macon, and a step forward in his life. Muriel helps Macon to see the world in a different way. She is the character that seems to know exactly what she is after in life, and therefore does not change during the course of this book. On the other hand, all Macon does throughout the book is change his life in extreme ways. Macon learns how to love and trust Muriel in a way that he never has with anyone. In an addition to Macon’s changing life, there is his wife, Sarah, who makes the decision to leave Macon a year after the death of their son. Sarah feels that Macon does not express his emotions as she would like him to, and that he does not provide her with the comfort she needs and has needed in the past. This frustrates Sarah greatly and she does not feel as if she can continue in the marriage: I said to you the other day, I said, ‘Macon, now that Ethan’s dead I sometimes wonder if there’s any point to life. ’ Do you remember what you answered? †¦ ’You said, ‘Honey, to tell the truth, it never seemed to me there was all that much point to begin with. ’ Those were your exact words†¦ ’You just go on your same old way like before. Your little routines and rituals, depressing habits, day after day. No comfort at all. ’†¦ ‘I just can’t live with you anymore,’ Sarah said. 3-4) Sarah is heart-broken with this decision, as is Macon, but she is just not happy with her marriage. During Macon and Sarah’s separation, Sarah starts to move on and begins dating a man. Though she has an apartment of her own, which is what she wanted, Sarah realizes how much she truly loves and misses Macon, and mak es a slight and almost unnoticeable attempt to get back together with him much later in the book during a conversation between her and Macon: ‘It [the rain] looks like strips that just fade away about halfway down from the sky. ’ ‘I wish I were there to watch it with you,’ Sarah said†¦ ‘Macon? Do you†¦What’s her name? The person you live with? ’ ‘Muriel,’ he said. Which he knew before she asked, he suspected. ‘Do you plan on staying with Muriel forever? ’ ‘I really couldn’t say,’ he said. (289-290) Sarah is now the one longing for Macon. Macon thinks that the only thing to do is go back to Sarah, since, after all, he had been longing to get her back for some time. Macon returns to his house with Sarah, leaving Muriel: â€Å"He rode on through the city, up Charles Street, into his old neighborhood. He parked and cut the engine and sat looking at the house. The downstairs windows were dark. The upstairs windows were softly glowing. Evidently, he had come home† (291). Macon is reluctant about coming home to Sarah, but in the back of his mind he still feels like he needs her because they shared so much of their lives together. Soon after, while Macon is on another business trip to Paris, his back goes out and Sarah flies in to take care of him. Things seem to be going well, but then Sarah sees Macon packing his things a few days later, which provides yet another change for Sarah, as well as Macon: Sarah said, ‘Macon? †¦ ‘What are you doing? ’ ‘I’m packing to leave. ’ ‘But what about your back? ’ she asked. ‘And I’ve got all those appointments! And we were going to take a second honeymoon! ’ ‘Sweetheart,’ he said. He lowered himself cautiously till he was sitting on the bed. He picked up her hand. It stayed lifeless while she watched his face. à ¢â‚¬ËœYou’re going back to that woman,’ she said. ‘Yes, I am,’ he said. ‘Why, Macon? ’ ‘I just decided, Sarah. I thought about it most of last night. It wasn’t easy. It’s not the easy way out, believe me. †¦ he saw now how such couples evolved. They were not, as he’d always supposed, the result of some ludicrous lack of perception, but had come together for reasons that the rest of the world would never guess. (339-340) Macon realizes that he is happier with Muriel, and although he does not want to cause Sarah pain, this time, it is Macon that is making a change that Sarah cannot help—instead of the other way around. Therefore, Sarah must accept these changes in her life, along with all the ups and downs. Finally, Muriel Pritchett is shown to be the one character that does not go through changes in the duration of the book, already having experienced major alterations in her earlier life. Muriel assures Macon of himself and makes Macon feel needed for the first time in a long time: â€Å"Macon presented himself in front of her, holding out the pizza. ‘Ta-da! ’ he whispered. She looked up at him and gave that perky smile of hers—an ornate, Victorian V. ‘Ma,’ she said, ‘I’m going now! Macon’s here! ’ It had been a long time since anyone made such an event of his arrival† (196). Macon shows that he is beginning to allow himself to care for Muriel, and to be happy with her and this change in his life—being needed. Later on, when Macon is at his sister’s house, he begins to actually miss Muriel: Macon laid the photos aside without looking at the rest of them. He knelt to pat Edward†¦Macon suddenly wished he were at Muriel’s. He wrapped his arms around Edward and imagined he smelled her sharp perfume deep in Edward’s fur†¦ above all else he was an orderly man†¦ There was no room in his life for anyone as unpredictable as Muriel. Or as extreme. Or as†¦well, unlikable, sometimes†¦ Then he knew what mattered was the pattern of her life; that although he did not love her he loved the surprise of her, and also the surprise of himself when he was with her. (201) As much as Macon never thought he could care for Muriel, he finds himself almost loving her, and loving himself more whenever he is with her. He begins to enjoy his time with Muriel, and now moves with the flow of life, instead of life passing him by while he is still standing still. After Macon leaves Muriel to get back with Sarah, he finds that Muriel will not give up on him. She follows him to his business trip to Paris: â€Å"‘†¦why Muriel? Why are you doing this? ’ ‘Because I felt like it,’ she said. ‘You felt like spending five days alone in a Paris hotel? That’s what is will be, Muriel. ’ ‘You need to have me around,’ she said. ‘Need you! ’ ‘You were falling to pieces before you had me† (318). Muriel is very persistent—just like when she had been pursuing Macon; she refuses to give him up. In the end, Macon cannot refuse Muriel, and leaves Paris without Sarah. This shows Muriel to be a stagnant character in this book—with her unwillingness to give up and her belief in the goodness of people. In conclusion, Macon and Sarah prove to be the characters that undergo the most rapid changes, and Muriel remains static. Above all, Macon’s desire to control his own life in such a regimented way as packing for trips with a great notion of order is probably due to the fact that he does not trust other people. He feels that he cannot rely on others and instead can only trust himself. However, this all changes with the help of Muriel, who proves to be one of the most beneficial people to come into Macon’s life. Sarah learns the hard way that you cannot always go back to people and places in your life and try and fix things that are not worth fixing, or not capable of being salvaged. In this case, it was she and Macon’s marriage. Sometimes it is better to let go of the past and move on to the future. The main theme of this book is love, and it is substantiated by Macon’s capability to lose sight of his fear and love someone completely different from himself and all that he has known. All of this happened because of one individual’s acceptance of change and the flow of life. How to cite The Accidental Tourist Essay, Essay examples

Use of Acupuncture for Treatment of Lateral Epicondylitis free essay sample

Lateral epiconylitis is a commonly encountered condition resulting from minor injury to the extensor muscles of the forearm, which originate from lateral epicondyle of humerus. This condition is characterized by pain and tenderness over the lateral epicondyle of humerus. Pain is typically present upon the resisted dorsiflexion of the wrist, middle finger or both (Buchbinder, Green Struijs, 2007). Lateral epiconylitis is known by many analogous terms like tennis elbow (TE), rowing elbow, tendonitis of the common extensor origin, peritendonitis of the elbow etc. In the United Kingdom, the incidence of tennis elbow in general practice has been estimated to be about four to seven per 1,000 persons a year (Buchbinder et al). Though TE is a self-resolving condition its symptoms can persist for as long as 18-24 months. Pain of tennis elbow can interfere with normal day to day functioning like carrying objects, lifting and gripping things etc. Though pain of TE can be initially cured with various conservative treatment modalities and rest, it can frequently recur after resumption of activity. We will write a custom essay sample on Use of Acupuncture for Treatment of Lateral Epicondylitis or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Thus TE can cause significant amount of chronic pain and disability, which can lead to considerable morbidity and financial cost (Buchinder et al, 2007). Thus there is a need for an efficient treatment modality for TE. Till date, physicians and physiotherapists are uncertain about the exact etiology and best management option for patients with TE. There are several conventional therapies which are being used for treatment of TE. These therapies are believed to relieve pain, promote tissue healing and improve joint mechanics. These conventional therapies include anti-inflammatory medicines [NSAIDS (non-steroidal anti-inflammatory drugs) and corticosteroids], physiotherapy interventions (such as stretching and strengthening exercises), cast immobilization, ultrasound therapy, using ice packs, neural stretches, deep friction massages, surgery etc (Trinh, Philips, Ho Damsma, 2004). Various non conventional therapeutic modalities like acupuncture, pulsed electromagnetic field therapy, transcutaneous electric nerve stimulation etc have also been used for treatment of TE. In 1992, Labelle et al attempted to perform a quantitative meta-analysis in order to evaluate the therapeutic effectiveness of above mentioned treatment modalities (both conventional and non-conventional) for patients suffering from TE. They considered the results of 18 clinical trials conducted in the period from 1966 to 1990. From their analysis they concluded that the various randomized and controlled trials, which they had analyzed, were of poor quality and did not provide sufficient scientific evidence to support or oppose the therapeutic benefit of any of these conventional or non-conventional treatment modalities. Labelle et al (1992) did find some weak evidence supporting the beneficial effect of ultrasound therapy in comparison to that of placebo therapy in treatment of patients with TE. More recently, a systematic review of the literature, comprising of randomized controlled trials evaluating the effectiveness of various treatment options for TE was carried out by Assendelft, Green, Buchbinder, Struijs, Smidt, (2003). They have suggested significant beneficial effect of NSAIDS (both topical and oral) in comparison to placebo in the providing short term relief from pain in patients with TE. However they found little evidence regarding the beneficial effect of NSAIDS (both topical and oral) in providing long term pain relief. While the use of topical NSAIDS was not found to be associated with significant side effects, use of oral NSAIDS, typically aspirin was associated with significant side effects like gastro-intestinal bleeding etc. This review found limited evidence regarding the beneficial effects of steroid injections in comparison to placebo, local anaesthetic agents, elbow strapping or physiotherapy. Assendelft et al also found insufficient evidence to support long term or short term beneficial effect of treatment modalities like acupuncture, physiotherapy exercises, orthoses (elbow strapping), extra corporeal shock wave therapy and surgery. They have recommended long term use of oral and topical NSAIDS and physical therapies (elbow strapping, physiotherapy, etc and avoidance of provoking activities as the first line of treatment, especially in the early stages of the disease.   They have also suggested the use of corticosteroid injections as second line therapy for providing relief from pain. However the pain relief provided by corticosteroids is usually temporary in nature with the pain recurring again after a few months. Thus they have suggested that the patients receiving such therapy should be counselled about not subjecting the extensor muscles to increased activity during the pain-free period resulting from use of corticosteroid injections. On the other hand, Bisset, Paungmali, Vicenzino, Beller,   Herbert, (2005) from their systematic review of literature, comprising of studies evaluating   the effectiveness of   various physical interventions (non pharmaceutical or   non-surgical therapeutic modalities) for treatment of TE have shown short term benefit   with the use of physical interventions like ultrasound therapy, ionisation, and acupuncture. However no evidence of long term benefit due to these therapeutic modalities was observed in this review; benefit due to these interventions was usually seen to last between two to eight weeks. Bisset et al observed insufficient evidence regarding the beneficial effect of manual therapy (involving manipulation of elbow or cervical spine), use of elbow strapping and physiotherapy exercises in the management of TE. They also observed the presence of sufficient evidence that disapproved the beneficial effect of extracorporeal shockwave therapy and laser therapy in the treatment of TE (both in short term and long term). However they have indicated the requirement of larger studies in future in order to confirm this finding. Since no clinical study till date has been able to demonstrate definite clinical efficacy of any conventional therapeutic modality in treatment of TE, there has been increasing trend towards the use of non-pharmacological treatment modalities, especially acupuncture, since last two decades, for alleviation of chronic pain due to TE. One major advantage of using acupuncture for treating   pain of TE over the conventional anti-inflammatory drugs like NSAIDS (oral or topical), corticosteroids etc is that it is free from the numerous deleterious   side effects commonly associated with the use of these drugs. Also the evidence supporting the use of these conventional pharmacological interventions is no better than that supporting acupuncture [National Institute of Health (NIH), 1998]. Despite the growing popularity of acupuncture in treatment of pain related to lateral epicondylitis, presently, there is little evidence which confirms the efficacy of acupuncture in treatment of tennis elbow. The studies conducted until now have produced conflicting results. Bisset et al (2005), in their systematic review of literature considered four studies evaluating the therapeutic effect of acupuncture in treatment of TE. Three studies out of these four compared acupuncture with placebo whereas one study compared acupuncture with ultrasound. The overall evidence considered in this review supports short term beneficial therapeutic effect of acupuncture over placebo in patients with TE. Two studies, (Fink, Wolkenstein, Karst, Gehrke, 2002; Molsberger Hille, 1994) which compared acupuncture with placebo are described below in details. Fink et al (2002) conducted a study to evaluate the clinical efficacy of acupuncture in   treatment of TE. They also tried to compare the therapeutic effects produced by stimulating selected acupuncture points (as defined by traditional Chinese acupuncture) in contrast to those achieved through stimulation at non-specific points (these puncture points were at least 5 cm away from the traditional Chinese acupuncture points). The results of this study indicated that use of acupuncture with correct location and stimulation, in accordance to the recommendations of tradition Chinese acupuncture helped in significantly alleviating the pain, reducing disability of arms, shoulders and hands (measured through DASH questionnaire) and improving the strength of the extensor muscles in the patients suffering from TE. However these therapeutic effects (pain relief and muscle strength) of acupuncture were less evident in long term. In this study, at the time of follow-up after two months, though the overall functioning of the arm was observed to be better in the treatment group as compared to the control group, the differences in pain intensity and muscle strength were no longer found to be significant. The main aim of the study by Molsberger Hille (1994) was to find out whether acupuncture showed an intrinsic analgesic effect even after only one treatment session in comparison to that of placebo treatment for TE pain. In one single session of acupuncture treatment, patients in the treatment group were treated at a non-segmental distal point on the fibulo-tibial joint of the homolateral leg. The painful area of the elbow itself was not needled. The depth of insertion was 2 cm and during the procedure of needling, the patient was asked to move the painful arm. Patients were treated for a total of 5 min. Overall reduction in the pain score was 55.8% in the treatment group and 15% in the placebo group. After one treatment session, 79.2% (19 patients out of 24) patients in the treatment group reported pain relief of at least 50%, whereas in the placebo group only 25% patients (6 patients out of 24) reported pain relief. The average duration of analgesia after one treatment was 20.2 h in the treatment group whereas that after placebo was 1.4 h. All these results show that acupuncture has a statistically significant intrinsic analgesic effect in the clinical treatment of TE pain, which exceeds that of placebo treatment.   Since this study dealt with short term analgesic effects of acupuncture, further studies need to be carried out in future in order to evaluate the long-term therapeutic value of acupuncture for treatment chronic tennis elbow. Davidson et al (2001, cited in Bisset et al, 2005) conducted a study to compare the   therapeutic effect of acupuncture with that of ultrasound treatment in patients suffering from TE. Though significant improvement in two outcome measures i.e. pain reduction and disability prevention were observed in both the groups, no statistically significant differences in terms of these outcome measures were observed between the two groups. Thus this study indicates that there is no difference in therapeutic benefit between ultrasound and acupuncture in patients with TE. However it is difficult to reach to any definite conclusion from the results of a single study. More studies are required in future in order to arrive at a definite conclusion. In a publication by the NIH in 1998, it was determined that the results of various studies conducted till date has been promising enough to support the use of acupuncture as an adjunct treatment or an alternative to classical conventional therapeutic modalities for patients with TE. Trinh, et al (2004) conducted a systematic review of literature regarding use of acupuncture in treatment of TE, using the best evidence synthesis approach (BESA), which aimed at qualitative analysis of clinically homogeneous studies. The results of this review strongly suggested that acupuncture was an effective therapeutic modality for attaining short-term pain relief in patients with TE. Though there was a great deal of clinical heterogeneity between various studies considered in this review, five studies out of six studies considered in this review indicated that acupuncture treatment was more effective compared to placebo treatment. The studies conducted till date have failed to provide us with definite results. This can   be attributed to a variety of factors like: flaws in study design, heterogeneous treatment protocols, small sample size, inherent difficulty in the use of appropriate controls etc (NIH publication, 1998). Selection of method for performing the procedure in control group for these studies poses to be a difficult problem. Method of performing the   procedure in control group is important because the insertion of placebo needles itself results in inherent analgesic effect due to release of local ÃŽ ²-endorphins (opioid like substances), which can influence the outcome of the study too (NIH publication, 1998). Future research is recommended to resolve the issues discussed above. Thus there is a need for large scale, well-designed, multicentric, randomized control trials in future that will use standardized treatment protocol and appropriate methods for performing the procedure in controls. It is evident from the above discussion that various studies which aimed at assessing the   efficacy of acupuncture in treatment of TE had employed different processes for performing acupuncture, in terms of location of puncture points, depth of insertion of needles, the number of needles used, duration of treatment etc. In order to arrive at a definite conclusion regarding the efficacy of acupuncture in treatment of patients with TE and in order to maximize the chances for a successful treatment with acupuncture, there is a need for a uniform, accurate and complete description of the most effective method to be used for performing acupuncture in patients with TE. With this in mind, Webster-Harrison, White Rae (2002) conducted a study in order to develop a standardized treatment protocol for acupuncture therapy in patients with TE. They adopted a modified Delphi’s consensus technique to combine the opinions of fourteen British acupuncture experts into a standardized treatment protocol. This protocol contained eight items pertaining to the treatment of TE using acupuncture and has been described in table 1. The various items considered in this protocol were: selection of acupuncture points; length and diameter of needles used; depth of insertion; duration of treatment; interval between successive treatments; whether the needle should be stimulated or not; the type of response to be achieved upon stimulation and number of treatment cycles needed. Use of this protocol in randomized multicentric trials conducted in future is likely to give accurate results (Webster-Harrison et al). Conclusion From the discussion in this paper it becomes apparent that till date no study in published   literature has been able to demonstrate long term beneficial effects of any pharmacological, surgical or physical therapy in comparison to that of a placebo therapy for treatment of patients with TE. Among various non-pharmacological therapeutic options, acupuncture presents an effective and safe adjunct treatment or an alternative to classical conventional therapeutic modalities, especially in cases where these conventional therapeutic modalities had previously failed (NIH, 1998). Presently, the optimal treatment option for patients with tennis elbow in clinical care largely remains unclear. Acupuncture appears to be a lucrative treatment option for both clinicians and patients. However, the therapeutic benefits provided by use of acupuncture are not supported by sufficient evidence, at present. There is a need for well designed, high quality research studies, especially randomized control trials in future, in order to help in establishing the appropriate place for acupuncture in treatment of patients with TE in modern medical practice. References Assendelft, W., Green, S., Buchbinder, R., Struijs, P., Smidt, N. (2003). Extracts from concise   clinical evidence: Tennis elbow. British Medical Journal, 327, 329-340. Bisset, L., Paungmali, A., Vicenzino, B., Belle, E., Herbert, R.D. (2005). A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia. British Journal of Sports Medicine, 39(7), 411 422. Buchinder, R., Green, S., Struijs, P. (2007). Tennis elbow. American Family Physician, 75 (5),   701-702. Retrieved on 30 June 2007 from http://www.aafp.org/afp/20070301/bmj.html Fink, M., Wolkenstein, E., Karst, M., Gehrke, A. (2002). Acupuncture in chronic   epicondylitis: A randomized controlled trial. Rheumatology, 41(2), 205 209. Labelle, H., Guibert, R, Joncas, J., Newman, N., Fallaha, M., Rivard, C. (1992). Lack of scientific evidence for the treatment of lateral epicondylitis of the elbow: An attempted meta-analysis. Journal of Bone and Joint Surgery, 74, 646–51. Molsberger, A., Hille, E. (1994). The analgesic effect of acupuncture in chronic tennis elbow   pain.   British Journal of Rheumatology, 33(12), 1162-1165 National Institute of Health (1998). NIH consensus conference: Acupuncture. Journal of   American Medical Association, 280, 1518–24. Trinh, K.V., Philips, S.D., Ho, E., Damsma, K. (2004). Acupuncture for alleviation of lateral   epicondyle pain: A systematic review.   Rheumatology, 43, 1085–1090. Webster-Harrison, P., White, A., Rae, J. (2002).Acupuncture for tennis elbow: An e-mail   consensus study to define a standardised treatment in a GP’s surgery. Acupuncture in Medicine, 20(4), 181-5.