Malnutrition And Liver Disease Health And Social Care Essay

Background and Aims: Malnutrition is a accepted complication of chronic liver disease with of import predictive deductions. Hepatitis C virus liver disease spans a spectrum from chronic hepatitis C, to compensated cirrhosis, and eventually decompensated cirrhosis. Our purpose was to measure the nutritionary position of patients with hepatitis C virus liver disease. Methods: Patients were prospectively enrolled from the out-patient clinics, and categorized into 4 distinguishable populations of 100 patients each: Healthy controls ( HC ) , those with chronic hepatitis C infection ( CHC ) , compensated cirrhotics ( CC ) and decompensated cirrhotics ( DC ) . The validated subjective planetary appraisal tool was used to measure nutritionary position. Consequences: A sum of 400 patients were enrolled, every bit divided amongst the 4 groups. Most of the patients in the HC group were category A ( best nutritionary position ) . In contrast the bulk ( 68 % ) in the DC group were in the category C ( worst position ) . While 86 % of patients in the CHC group had a category A SGA mark, merely 10 % of the CC did. The nutritionary position showed a declining from Class A to C through the 4 groups which was statistically important ( p-value & lt ; 0.001 ) . Decision: Malnutrition occurs early, and progresses unrelentingly throughout the spectrum of HCV disease. Cardinal words: Malnutrition, nutritionary position, hepatitis C virus, liver diseaseIntroductionThe relationship between malnutrition and liver disease has been presuming greater significance due to the acknowledgment that it is associated with inauspicious clinical results. Malnutrition is present in 65-90 % of patients with advanced liver disease and in about 100 % of campaigners for liver transplantation.1, 2. Cirrhotic patients who are malnourished non merely hold a higher morbidity, but besides an increased mortality rate.3, 4. The badness of malnutrition correlatives straight with the patterned advance of the liver disease.5, 6 The main ground for the malnutrition in these patients is hapless unwritten consumption, which may be due to a assortment of causes. Vitamin A and/or Zn lack may give rise to an altered sense of gustatory sensation 7. The dietetic limitations that are normally recommended to these patients, such as limitation of Na, protein, and fats, can deter equal unwritten consumption by rendering nutrient bland. The presence of failing, weariness, and brain disorder may besides lend to reduced unwritten intake8. Malabsorption is another critical ground why patients with advanced hepatic disease go malnourished. A decrease in the bile-salt pool may take to fat malabsorption,9, or bacterial giantism may ensue from impaired small-bowel motility.10 The presence of portal high blood pressure has besides been blamed as a cause of malabsorption and protein loss from the GI track.11, 12 In add-on, the disposal of medicines used in the intervention of hepatic brain disorder may besides lend to malabsorption.13 Hepatitis C virus liver disease spans a spectrum from chronic hepatitis degree Celsius, to compensated cirrhosis, and to eventually decompensated cirrhosis. While the open malnutrition associated with cirrhosis has been documented in literature, there is small informations sing the nutritionary position of patients who have simple chronic hepatitis C, with no grounds of terrible liver disfunction, apart from raised aminotransferases, or the remunerated cirrhotic, and how they compare to the normal population. This information is all the more relevant in the underdeveloped universe, where deficiency of instruction and consciousness, and unavailability to good wellness attention lead to misinformation. Often faith therapists, traditional medical specialty specializers ( hakims ) , quacks and household members enforce rigorous and unneeded dietary limitations, preponderantly of fat and protein, which initiate and worsen nutritionary position. Given these facts, it would be prudent to test all patients with liver disease for nutritionary abnormalcies to place those at hazard of developing malnutrition.14 Subjective planetary appraisal ( SGA ) is a tool that combines multiple elements of nutritionary appraisal to sort the badness of malnutrition signifier mild to severe.15 These constituents are recent weight loss, alterations in dietetic consumption, GI symptoms, functional capacity, marks of musculus cachexia, and the presence of presacral or pedal hydrops. The SGA is an first-class tool to measure nutritionary position in many diseases, and has an interobserver duplicability rate of 80 % .16 Simple bedside methods like the SGA have been shown to place malnutrition adequately ; the usage of more complex hiting systems has non proved superior17.4 M. Plauth, M. Merli, J. Kondrup, P. Ferenci, A. Weimann and M.E.S.P.E.N. Muller, Guidelines for nutrition in liver disease and organ transplant, Clin Nutr 16 ( 1997 ) , pp. 43-55. Abstract | PDF ( 1653 K ) | View Record in Scopus | Cited By in Scopus ( 163 )Materials and MethodsPatients were enrolled from the out-patient hepatology clinics a t the Aga Khan University Hospital in a prospective mode. After a elaborate appraisal by the doctor which included a history and scrutiny, patients were categorized into 4 distinguishable populations of 100 patients each: Healthy controls ( HC ) , those with chronic hepatitis C infection ( CHC ) , compensated cirrhotics ( CC ) and decompensated cirrhotics ( DC ) . Healthy controls were the attach toing house-hold members ( gender and closest age matched ) of the patients who were assessed to be healthy after a history, scrutiny and a negative HCV antibody testing trial. The controls were exposed to the same socio- economic conditions as the patients, and showing of household members of the index patient is standard pattern at our infirmary. CHC patients were those who had grounds of HCV viraemia, raised aminotransferases, normal liver man-made map, and an ultrasound of the liver demoing a healthy liver, without grounds of portal high blood pressure, such as a dilated portal vena, or splenomegaly. Patients were classified as holding CC when they had no history of decompensation, and an ultrasound screening characteristics of cirrhosis A ± portal high blood pressure, but no ascites. Finally DC were those who had either a history or physical scrutiny compatible with a diagnosing of decompensation, or a ultrasound demonstrating free fluid in the venters. Decompensation was defined as any episode of variceal hemorrhage, ascites, or porto-sytemic brain disorder. The SGA signifier was filled in all cases by the adviser doctor himself. A nutritionary history was besides noted, with peculiar mention to any protein or fat limitation. Written, informed consent was taken from all the survey participants, and the survey was approved by the university moralss commission.ConsequencesA sum of 400 patients were enrolled, every bit divided amongst the 4 groups. Age and gender were comparable in all 4 groups ( Table 1 ) . Most of the patients in the HC group were category A harmonizing to the SGA, and there were none in category C. In contrast the bulk ( 68 % ) in the DC group were in the category C, while merely 4 % were in the A class. The nutritionary position showed a gradual passage from Class A to C, with a 3rd of CC and the bulk of DC all hiting a C on the SGA. Fourteen per centum of patients with CHC besides scored a B on the SGA. ( Graph 1 )DiscussionThis is the first survey to document the nutritionary position of patients across the whole spectrum of hepatitis C virus infection. Most of the literature has been devoted to the nutritionary facets of cirrhotic and pre graft patients,18, 19 but as our survey shows, that the downslide begins much earlier, even before cirrhosis sets in. Even when these patients visit their doctors for other complaints, the nutritionary lack may non be realized, so the procedure continues unabated, until blunt malnutrition sets in. The huge bulk of patients across all the cohorts were on a diet that was restricted in protein and fat content in changing sums. This stems from the false but steadfast belief that when the liver is affected, it should non be â€Å" burdened † with Calories. This pattern, which is endorsed non merely by patients and their households, but besides unluckily by ill-informed doctors, is likely the ground why up to 14 % of patients with merely CHC are reasonably malnourished, and that the bulk of CC patients are reasonably or overtly malnourished. The major alteration in SGS position in our survey was seen between the CHC and the CC cohort of patients, and this is where the focal point of nutritionary intercession should be. Patients with CHC should be expected to hold the same degree of nutrition as HC, as no important liver harm has occurred, but this was n't the instance. Up to 14 % of such patients had a moderate nutritionary value, most probably a consequence of caloric and protein limitation. Poor nutritionary position contributes to tire, anaemia, and infection, all of which impair successful HCV intervention, as intervention itself causes cytopenias and profound weariness. Patients who are in better nutritionary wellness are more likely to digest intervention side-effects, require less break of intervention, or dose decreases, and hence have a more successful result, as compared to those who are nutritionally depleted20, 21. The CC group besides had a really alarmingly little figure of patients who were good nourished ( 10 % ) . The huge bulk ( 56 % ) were reasonably nourished, and a important figure ( 34 % ) were malnourished. The chief ground we feel, for such a high figure of cirrhotics to be malnourished is PCM, which promotes katabolism, hypoalbuminemia. This is a really delicate group of patients-while they are compensated, they already have extended hepatic harm. Malnutrition accelerates their slide towards decompensation, as there is a direct correlativity between the patterned advance of the liver disease and the badness of malnutrition.5, 20 Patients with cirrhosis who are malnourished have a higher rate of hepatic brain disorder, infection, and variceal bleeding.18, 22 They are besides twice every bit likely to hold stubborn ascites.1 All of these events in a cirrhotic have high mortality rates. Multiple surveies have reported a correlativity between hapless nutritionary position and mortality, and malnutrition is an independent forecaster of mortality in patients with cirrhosis.3, 23 It is no admiration so, that the nutritionally worst group has the maximal figure of patients who have decompensated cirrhosis, followed by CC. Using modes such as media runs, out-patient guidance, and awareness cantonments may all function to contend the disinformation that takes the topographic point of right information, when it is non supplied by the wellness attention supplier. Doctors should besides be made cognizant of non merely the importance of nutritionary rating and guidance in all patients with hepatitis C infection but besides its regular appraisal at follow up visits. Patients should be encouraged to take as normal and balanced a diet as possible, including protein, which is routinely restricted in our scene. The establishment of a bland, protein and Calorie restricted diet is non warranted, and should be counseled against at every brush with the patient and their attenders. Even in advanced cirrhosis, protein should merely be restricted during a period of encephalopathy, and salt should be restricted if there is pedal odema and/or ascites.23, 24Decision:Malnutrition exists throughout the spectrum of HCV disease. It occurs early in the disease procedure, and is grim, with of import predictive effects. Poor unwritten consumption, malabsorption, but most significantly, protein Calorie limitations are all responsible for the province. It is therefore, imperative to measure the nutritionary position of all patients with chronic liver disease and to optimise nutrition in these patients. Malnutrition is a potentially reversible status that, when identif ied and corrected, can take to improved patient results. This survey paperss the baseline nutritionary position of a big cohort of patients in our scene, and provides informations upon which other nutrition interventional surveies may be based.

Arthur Miller Essay

The Crucible was written in 1952 by the writer Arthur Miller. It is a story of ‘witch-hunts’ which occurred a lot during the 1950’s. Throughout the play, Arthur Miller has talked about characters facing severe tests that have made them question their own self. It shows the extreme surprising occurrences which were often being caused by what they thought was the devil or his cohorts. The inscrutable sickness fears of witchcraft were happening and it was not long before the girls, and many residents began to accuse other villagers of associating themselves with devils and casting spells. Old grudges and jealousies spilled out into the open, making the atmosphere very tense. A lot of the residents were either forced to give in and live or lie and be put to death by being hanged. In some sense, ‘The Crucible’ has the arrangement of a tragedy, With John Proctor as the play’s tragic hero. John Proctor is an honest, upright, blunt-spoken person, however he is a very good man. The fatal flaw of him is the lust for Abigail Williams which led to an affair (this happened before the play begins). This caused jealousy of his wife, Elizabeth, which sets the entire witch exaggeration within the community in motion. Of all the major characters throughout the play, Abigail is the least complicated. She is sort of the villain in the play. She tells lies, manipulates her own friends and the entire town to her favour. Eventually she sends nineteen innocent people to their deaths due to the lies she tells and the way she manipulated people. Among the witch-hunt mania, Abigail’s motives never seem more complex than just jealousy and the desire to have revenge on Elizabeth Proctor. In the play, Abigail seems to be like a biblical character, like a Jezebel figure, always being driven by a sexual desire and a lust for power. In the first chapter, the audience learn about the affair associated with Abigail and Proctor. We learn that they have had an affair, however the audience soon see that the affair is no longer continuing. ‘Abigail: Give me a word, John. A soft word. (Her concentrated desire destroys his smile. ), ‘Proctor: No, no, Abby. That’s done with. ‘. He reacts negatively, he denies her, and he is repulsed. He is trying to put the adultery in the past. ‘Proctor: Abby, I might think of you softly from time to time. But I will cut my hand off before I’ll ever reach for you again. Wipe it out of mind. We never touched, Abby’, he tries to put his adultery in the past. He tells her that he never touched her, even though he did, and he makes it clear that It will never happen again. Throughout the monologue with Proctor and Abigail, the attitude and mood soon changes because Proctor wants to leave the affair in the past, and wipe it out of mind, like it never happened. ‘Wipe it out of mind’. However Abigail wants to carry on with the sexual desire to carry on the affair with Proctor. At the beginning of the monologue he tries to set her firmly out of his path, however later he gets angry and she can’t believe it. Abigail soon gets quite angry as well, and this part of the play expresses the anger between both of them ‘Abigail (With a flash of anger): How do you call me child! ‘ During Act 1, it seems as though Abigail wants John Proctor ‘Abigail (grasping his hand before he can release her): John – I am waitin’ for you every night’, however as the John Proctor and her keep talking there is a change in her mood because he is not giving into her sexual desire for him. Now her mood changes into anger and jealousy ‘Abigail (With a bitter anger): Oh, I marvel how such a strong man may let such a sickly wife be-‘, here she becomes really jealous that he won’t give into her due to the fact that he loves Elizabeth, and Elizabeth is his wife. The stage directions that Arthur Miller uses in the play tell the reader a lot about the character. When Abigail is going on about the affair between her and Proctor the stage directions are beneficial. ‘Abigail: (grasping his hand before he can release her): John – I am waitin’ for you every night’, this instantly helps the reader visualise the character and will aid the an actor that is performing the play, whilst playing the role to act more effectively. Arthur Miller also uses the language as a benefit for the effective of the play, Miller uses language to effectively set the period and the tone for the play. The language brings an approach of something out of the King James Bible, but somehow makes it universal to modern day, and the stage directions being out an approach of making the play more effective to both the actors and the audience. In court, Proctor has an outburst of truth and attack on Abigail. Abigail’s reaction to this, is that he is lying about what he is saying, she tries to manipulate the court room into believing what she is saying. ‘Abigail: Mr Danforth, he is lying! ‘, later on, she then makes it up that she is seeing a bird up on the ceiling, and she gets the rest of the girls to go with her lying, to make it look as though there is witchcraft going on right before there eyes. ‘Abigail, with a weird, chilling cry, screams up to the ceiling’, ‘Abigail (unperturbed, continuing to the ‘bird’): Oh, Mary, this is a black art to change your shape. No, I cannot, I cannot stop my mouth; it’s God’s work I do. ‘ Here is where she really starts to manipulate people, and lie. The language that Proctor uses to describe himself is not like his prideful ways.

Kal Gourav Madhusudan Das

Utkal Gourav Madhusudan Das [pic] Madhusudan Das popularly known as Utkal Gourav, was born on 28th April 1848 in the village of Satyabhamapur, 20 kms away from Cuttack, Odisha. His father’s name was Choudhury Raghunath Das and his mother’s name was Parbati Debi. He had two older sisters and a younger brother named Gopalballabh. Madhusudan Das had his primary education in the village high school learning all subjects including Persian. After his primary education he went to Cuttack High School (later known as Ravenshaw Collegiate School) and completed his secondary education.Later he went to Calcutta (now known as Kolkata) to pursue his MA and BL degrees. He stayed there for fifteen years and then returned to Cuttack and started his legal practice. He was the first Odia to get the Degree of M. A. B. L. from Calcutta University. He was not only a lawyer but he was also a social reformer and a patriot. He worked hard for the social, political and economical upliftment of t he people of Eastern India. He was the founder of â€Å"Utkal Sammilani† which brought the revolution in the social development of Odisha.He gave away all his earnings generously for the higher education of poor children. He became a popular person among the Odia peoples. Many common people of Odisha called him as â€Å"Madhu Babu†. He was an admirable personality holding many high positions and honours in his entire life span. During the British rule Odisha was divided into four different States. To bring Odisha under one independent rule, he organised â€Å"Utkal Samilani† in the year 1903 and started a revolution called â€Å"Desha Mishrana Andolan†, that resulted in the emergence of Odisha as a new State.Apart from this he was also a writer and has written many famous articles and poems in both Odia and English language. The famous poems of Madhusudan Das are â€Å"Jati Itihash†, â€Å"Utkal Santan†, â€Å"Jananira Ukti† etc. Deat h Utkal Gourav Madhusudan Das died at the age of 85, on 4th February 1934. He till the last moments of his life dedicated himself for Odisha. His immense contribution towards the State and Nation would be admired forever and he will continue to remain as a source of motivation for the younger generations to come.

Application for the Use of Human Research Participants Essay

Application for the Use of Human Research Participants - Essay Example Signed materials can be submitted by mail, fax (434-522-0506), or email (scanned document to irb@liberty.edu). Signed materials can also be submitted via regular mail or in person to our office: Campus North, Suite 1582. Please be sure to use the grey form fields to complete this document; do not change the format of the application. You are able to move quickly through the document by using the â€Å"Tab† key. Note: Applications with the following problems will be returned immediately for revisions: 1) Grammar/spelling/punctuation errors, 2) A lack of professionalism (lack of consistency/clarity) on the application itself or any supporting documents, 3) Incomplete applications. Failure to minimize these errors will cause delays in your processing time. II. BASIC PROTOCOL INFORMATION Protocol Title:  ?UNDERSTANDING THE EXPERIENCES OF STUDENTS WITH DISABILITIES WHO DID NOT COMPLETE HIGH SCHOOL  Principal Investigator (PI): Richard Warner Wieringo Professional Title:  Sch ool/Department: Liberty University School of Education Mailing Address: 125 Woodgate Court APT 2C, Charlottesville, VA 22901 Telephone: (434) 251-2255 LU Email: rwweringo@liberty.edu Check all that apply:  Faculty  Graduate Student  Undergraduate Student  Staff This research is for:  Class Project  Master’s Thesis  Doctoral Dissertation  Faculty Research  Other (describe):  Have you defended and passed your dissertation proposal?  Yes  No  N/A If no, what is your defense date?  Faculty Advisor: Verlyn Evans, Ed.D, Chair  School/Department: Liberty University School of Education Telephone:  LU Email:  Non-key Personnel: Name and Title:  School/Department:  Telephone:  LU Email:  Consultants: Name and Title: Dr. Russ Yocum School/Department: Graduate School of Education Telephone: (434) 592-5462 LU Email: ryocum@liberty.edu Liberty University Participants: Do you intend to use LU students, staff, or faculty as participants in your study? If you do not intend to use LU participants in your study, please indicate â€Å"no† and proceed to the section titled â€Å"Funding Source.† If yes, please list the department and classes you hope to enlist, and the number of participants you would like to enroll.  No  Yes   Department Class(es) In order to process your request to use LU participants, we must ensure that you have contacted the appropriate department and gained permission to collect data from them. Please obtain the original signature of the department chair in order to verify this. Signature of Department Chair Date Funding Source: If research is funded please provide the following: Grant Name (or name of the funding source):  Funding Period (month/year):  Grant Number:  Anticipated start and completion dates for collecting and analyzing data:  III. OTHER STUDY MATERIALS AND CONSIDERATIONS Does this project call for (more detail will be required later): Use of voice, video, digit al, or image recordings?  Yes  No Participant compensation?  Yes  No Advertising for participants?  Yes  No More than minimal

Malcolm X Essay Example | Topics and Well Written Essays - 750 words

Malcolm X - Essay Example A gadfly is someone who is vehemently opposed to some policy of the existing authority and is able to evoke mass support for the same. Socrates was a gadfly because he encouraged those around him to question existing beliefs on morality and ethics. â€Å"He would ask people to explain a concept, point out flaws that would impel them to modify their answer, and continue like this until the person came up with a solid explanation or admit that they didn’t really understand the concept. (Cline) Martin Luther King was inspired by Mahatma Gandhi’s sayings and was led to believe that non-violence could be used by blacks to obtain civil rights in America. The one statement by Gandhi which deeply affected him was â€Å"Through our pain we will make them see their injustice† Malcolm Xs famous statement was :â€Å"And when you see that you have problems, all you have to do is examine the historic method used all over the world by others who had problems similar to yours.†(Message to the Grassroots, 1963) What he was hinting at was the use of violence. He was inclined to believe that if America was justified in employing the blacks to defend herself abroad, then the Blacks in America likewise had the right to defend themselves against atrocities committed against themselves by the whites. These comments were made at a time when the Blacks in America were facing widespread discrimination and there were also instances of blacks being ruthlessly murdered by whites. In short, he professed the use of violence against people who themselves indulged in violence. ‘Creative tension’ is a rather unusual term because it makes use of words that are at odds with each other. Creativity generally blossoms when the person in question has a calm dispos ition, whilst ‘tension’ is generally associated with individuals who are agitated and vexed. So when you combine the two, it would pertain to individuals being tensed and creative at the same time. In the context of this literature, the leaders, namely, Socrates and Martin Luther King and MalcolmX are addressing the concerns of individuals who are in a displeasure able situation and seek a solution to end their misery. By their speeches the leaders are encouraging their followers to talk and find solutions to their problems. In effect they are being asked to become creative problem solvers. So, whilst they were very much in an agitated state of being, and unsure as to what to do next, the leaders by their speeches are adding to the tension and the people, in turn, are becoming creative in their actions. â€Å"Going against the grain of traditional education, Socrates insisted that personal investigation and reasoned argument, rather than ancestral custom, or appeal to the authority of Homer, Hesiod and other respected poets, was the only proper basis for answering these questions†. (Cooper, 1998) He continually stressed on analyzing any problem logically and abstaining from blindly following that which had been preached before. During his times, people who questioned beliefs were treated with imprudence especially when sentiments of a certain section of society were hurt, with chances of violent action being taken against the former them being quite high. Socrates questioned the use of violence and in this way he was forming creative tension in the minds of the people, for the people of his age were blindly following what had been preached before. He was forcing people to rethink on issues of morality which included pondering on what was right and wrong. Martin Luther King used to travel around the country making speeches and exhorted people to be part of the civil rights movement. He advocated the use of new means to achieve freedom. The B lacks of his times were a confused lot what with widespread discriminative practices against their community and no proper ways to give voice to their disgruntlement. It was during such times that King formed creative tension by giving some kind of direction to the civil rights

Principles of Visual Communication Messages Essay - 1

Principles of Visual Communication Messages - Essay Example This paper highlights that the scene where the art was created is some distance away from where community members reside. They were trying to raise some money by converting the parking lot into a modern park with a good playground. It is one of the strongest examples of my artistic work that has been nicely decorated to capture almost all aspects of the modern artistic work. This is because of the color used, outward appearance and the shape of the art. Its outward image also gives more than one representation of what the artist was trying to explain unlike his first artistic work that showed only one meaning. There was no mixing of information and the features presented within the art are proportional to one another. This work is of high quality though seen by most people as cheap and low in quality. For this reason, most people consider his work as deceitful. In fact, this type of work is not devious since an experienced and knowledgeable individual does it. â€Å"Davis argues tha t he normally does his work in this manner in order to save time and avoid arrest by law enforcers†. Ethical perspective â€Å"The image produced has some ethics in it, for instance the car parking being changed to a park implies that there are some reasons for that; may be the surrounding has attractive environmental features where people may relax their minds by looking at them rather than being a parking lot.† The presence of a person within the work shows that it is meant for people and the way it is presented shows ethics since there is no disorderliness. It is also clear and of three-dimensional appearances and; therefore, the whole piece can be easily analyzed. It can also be photocopied easily and produce other similar pieces within a very short time unlike other art works which are in sketchy form .

Expansion On Authur Millers Death Of A salesman Essay

Expansion On Authur Millers Death Of A salesman - Essay Example man, such as an ancient version of Willy Loman from Arthur Miller’s play â€Å"Death of a Salesman,† would be no more shocking or dramatic than fish going bad. However, a modern audience has a much more difficult time relating to the sanctity of the mighty. It is much easier for them to expect downfalls of their leaders and more shocking to them when they see someone more like them, a common man, fail due to his own mistaken beliefs. Thus, in modern times, Miller’s ‘low man’ Willy is the quintessential classic tragic hero of the modern age. Although the tragic hero was a character in ancient Greek plays long before Aristotle codified the term, they all shared these same characteristics that Aristotle identified. As has been mentioned, in ancient times, these ideas were reserved for men who had the potential to reach greatness of some kind – usually men with a claim to nobility. Despite their greatness, they become destined to fail because of some tragic flaw in their character. This tragic flaw is typically, but not always, the flaw of excessive pride in one’s own abilities. No matter what the flaw is, it is always tied strongly to the reasons for their success and is therefore something the individual is justifiably proud to exercise (Aristotle, 1998). According to Zarro (2001), â€Å"the tragic effect will be stronger if the hero is ‘better than we are’, in that he is of higher than ordinary moral worth. Such a man is shown as suffering a change in fortune from happiness to misery because of a mistaken act, to which he is led by his hamartia (his ‘effort of judgment’) or, as it is often literally translated, his tragic flaw.† Society has shifted since then in such a way that today, we consider the common man as having a greater chance of higher than ordinary moral worth in his dedication to making an honest living for modest goals. Today’s tragic hero cycle focuses more on the three events than the noble status. The social