Case study on hypertesion and chest pains.

Case study on hypertesion and chest pains. History of Present Illness: Mr. AS, an 85 year old, Caucasian male, with a history of hypertension and chest pain presents today not knowing how he got to the assisted living facility. The patient states he arrived at the facility 3 years ago, unaware of how he got there or why (the chart states his arrival as April 28, 2009). Mr. AS states that he was told he had a stroke, and was aware that his legs were not working correctly. He doesnt remember having the stroke, but states that he was 83 years old when it happened. He now has lost the ability to walk and has also given up trying. His legs and arms feel weak. His arms hurt from trying to use his walker. He currently does not lift weights to strengthen his arms so that they dont get as exhausted when using his walker. Patient denies any prickling or tingling sensations. He also only exercises with his walker when he is made to, once a day during physical therapy. He states that he would rather use his wheelchair. He states that he has accepted the fact that h e will not walk again, but is content just breathing and talking. He is not in any pain currently, still has feeling in his legs, but cannot move them. He also states that he was diagnosed with early stages of Alzheimers 30 years ago. His chart states that he was diagnosed with dementia at 55 years old. Patient is oriented to time and place, however, he has trouble remembering what he did yesterday. He can recall memories from years ago. He also states that he spends most of his day sleeping, but doesnt feel tired, rather feels rested. Mr. AS also complains of coughing, that sometimes produces a clear sputum. He states that he was a smoker 20 years ago, for 40 years, with a 160 pack year history. He occasionally wheezes. Past Medical History: Current Medication List: Mirtazapine 15 mg tablet PO once at bedtime for depression. Namenda 10 mg tablet PO every 12 hours for Alzheimers. Allopurinol 300 mg tablet PO 1 daily for hyperuricemia. Aspirin single tablet chewable PO 81 mg to reduce the risk of heart attack and stroke, and pain relief. Certavite antioxidant tablet 18 mg PO 1 daily as multivitamin and mineral supplement. Loratadine 10 mg 1 tablet PO 1 daily for rhinorrhea/allergies. Nifedipine 90 mg tablet PO 1 daily for chest pain and hypertension. Metoprolol tartrate 25 mg PO 1 tablet daily for chest pain hypertension. Nasal decongestant 0.05%SP 2 sprays per nostril 2 times a day for rhinorrhea/allergies. Omeprazole 20 mg 1 table PO 2x a day for ulcers/ GERD. Aricept 10 mg 1 tablet PO at bedtime for dementia. Tamsulosin HCL 0.4mg capsule 1 PO at bedtime for benign prostatic hyperplasia. Zolpidem tartrate 5 mg tablet 1 PO at bedtime as a sleep aid. Acetaminophen 500 mg tablet give 2 tablespoon PO every 6 hours as needed for high temperatures. Patient diagnosed with hypertension when he was 40 years old (currently controlled with medication). Patient states that he had a pace maker put in when he was 45 years old, and thinks it was to relieve chest pain. Patient thinks that he has been told he has high cholesterol, but he is unsure. Patients chart states that he has a history of hypertension, respiratory treatment, and chest pain. Patient was diagnosed with dementia at the age of 55, and had a stroke at 83 years old. Patient also had appendectomy due to appendicitis and an inguinal hernia repair when he was 10 years old. Patient has no known allergies. Family History: The patient states that he has one living adult son who calls often, but doesnt visit much as he is overweight and has back pain. He remembers that one of his grandmothers passed away from TB, but he could not recall when. He has no grandchildren, and does not recall how anyone else in his family passed away. He states that he has no family history of hypertension, cancer, heart disease, diabetes mellitus, or psychiatric disease. He was married twice, and both wives are now deceased, but he does not remember when or the cause of death for either wife. No other information could be appreciated from the chart or patient, so a family member will need to be contacted to assess his risk for diseases. Social History: He currently has a girlfriend who lives in Miami Beach. The patient states that he currently is not sexually active, does not drink, do drugs, or smoke nicotine. He stopped smoking 20 years ago, but before that he smoked for 40-50 years, 4 packs a day (160 pack year history). Currently he does not follow a diet at the ALF, but eats what they feed him every day. He states that he builds clocks during the day as a hobby, and this keeps him happy. Review of Systems: General: Patient denies any fatigue, weight or appetite changes. Skin: Patient denies any changes. Head: Patient denies headaches, bumps/bruises, or dizziness. Eyes: Patient states that he no longer needs to wear glasses since the stroke, as he can now see. Ears: Patient cant hear out of the left ear, but states that his right ear is fine. Nose/Throat/Mouth: Patient denies any changes in smell or taste, or problems swallowing. He feels tickling in his throat when he talks too much. Respiratory: Patient states that he has a constant cough, which sometimes produces clear sputum. He also occasionally wheezes and states that he had asthma as an adult and has used an inhaler. Cardiovascular: Patient denies any pain, but states he has a pace maker. He denies palpitations as well. Gastrointestinal: Patient denies any pain or cramping. Patient has been constipated for the past 20-30 years, only defecating once a month. Genitourinary: He urinates 2-3 times a day, but has no control, and must wear a diaper. Patient denies polydipsia or hematuria. Neurologic: See HPI Musculoskeletal: See HPI Endocrine: Patient denies any excessive thirst, changes in appetite, or weight changes. Hematopoetic: Patient denies any skin color changes, easy bruising, or bleeding. Psychiatric: SIGECAPS negative, and patient denies depression, fluctuating moods, or suicidal thoughts. See HPI Physical Examination: Vital Signs: Temp afebrile to touch, BP 132/72, pulse 60 bpm, RR 16 bpm, BMI 29 General: Overweight male currently not in respiratory or cardiac distress. Skin: Darker brown discolored non-raised plaques on both arms, skin dry and warm to touch. Ulcers present on right ankle (2 cm wide, circular, and 1 cm above medial malleolus) and left shin (3 cm wide, circular, and 6 cm below tibial tuberosity). Left leg is erythematous, at the mid-tibia region. HEENT: No icterus and no jaundice present, head is normocephalic, with normal hair distribuition. No lymphedenopathy present in occipital, periauricular, postauricular, tonsilar, submandibular, subtonsilar, anterior chain, posterior chain, and supraclavicular lymph nodes. Patient cant hear out of left ear. Both ears have compacted cerumen present. Patient does not wear corrective lenses, and could not see the eye chart to assess visual acuity. His eyes react slower than normal to light, but EOM are bilaterally intact. Patients mouth is moist, with a few teeth missing on top and bottom, and no signs of central or peripheral cyanosis. No carotid bruits, no jugular venous distention, and the trachea is midline. The thyroid is non-papable. Lung: Chest is symmetrical, with diaphragm excursion 6 cm bilaterally. Left lung field breath sides decreased compared to the right lung field. There is also wheezing heard in the right lung field. Right lung field is resonant to percussion, but the left lung field is dull to percussion. Vibrations felt throughout for tactile vocal fremitus. No crackles or rales heard. Heart: No thrills, murmers, bruits over the carotid, or extra heart sounds heard. Rate and rhythm are regular, and also symmetric at radial, femoral, dorsalis pedis and posterior tibial pulses. S1 and S2 heard in all regions. Abdomen: Scar preset from a stomach tube that was placed for feeding. Patient doesnt recall when or why the tube was placed. Chart did not specify why either. No bruits heard over the abdominal aorta, renal, or iliac arteries. Borborygmus present. No tenderness, guarding, or rigidity present. There are bulging flanks and spider nevi present. Liver span is 6 cm. Spleen and kidneys non-papable. i Extremities: Patient has weak dorsalis pedis and posterior tibial pulses present (1+ bilaterally). Ankles are swollen, there is no pitting edema present. Musculoskeletal: Lower extremities have normal passive ROM present, but decreased active ROM. Normal passive and active ROM present in upper extremities. Motor strength is decreased in upper(4/5) and lower limbs(3/5). Nervous System: Mental Status: Patient is alert and oriented to place and time, but cannot remember events from yesterday. He can remember events from years ago, and is aware that he is forgetful now with memory loss. Cranial Nerves: Intact, no facial dropping or weakness on either side. Sensory: Lower extremities showed pain sensation and proprioception intact, but no vibration sense present. Reflexes: Lower extremity reflexes were not assessed as patient could not move his legs. Upper extremity reflexes intact. Cerebellar: Babinski intact. Patient could not get out of bed to assess gait. Laboratory Data: Labs taken Dec. 31, 2010 Glucose elevated 122 (normal 70-105 mg/dL) BUN/Cr elevated 1.35 (normal 0.7-1.3 mg/dL) Problem List: 1) Dementia 2) Chest pain 3) Wheezing and Cough 4) Depression 5) Leg/Arm weakness 6) Preventative medicine- routine physical exam, mini mental status exam, psych evaluation, colonoscopy and rectal exam, pneumovax vaccine, influenza shot Assessment: Dementia: Dementia is an impairment of cognitive function, affecting memory, attention, language, and/or problem solving. This impairment has to be lasting 6 months or longer. The first sign of dementia is usually short term memory loss, progressing to memory forming impairment, and later an inability to learn new things. Usually the patient is aware of the memory loss. Eventually the memory loss is too great, and there is a loss of personal hygiene, eating, and other activities of daily living. This also affects mood, and there can be fluctuations between happiness, sadness, and anger. There can be sleep disturbances and personality changes. Depression is one of the major illnesses that can present with dementia. Lastly, there is a complete dependence on others, as the patient can no longer take care of themselves, is disorientated, has memory loss, and in many cases, cannot swallow properly. There are many types of dementia, and once a person has met the requirements to be diagnosed with dementia, the type must be determined. Each type is caused differently, so treatment can vary slightly. The most common type is Alzheimers dementia. Patients with Alzheimers can be differentiated from other types, as these patients are more likely to get lost in familiar places, try to leave home, have difficulty communicating, and have memory problems. This can occur from tau neurofibrilllary protein tangles in the brain and plaque formation. Also there can be a loss of acetylcholine in the brain. Patients with multi-infarct dementia can be differentiated based on a history of smoking, stroke, atherosclerosis, and hypertension. Multi-infarct dementia occurs from many small strokes affecting the brain. Patients with vascular-type dementia usually have aphasia, apraxia, a difficulty learning math skills, and often present with neglect. This type of dementia occurs due to cerebrovascular d isease or stroke. Lewy-Body dementia presents with recurrent visual hallucinations, motor impairments similar to Parkinsons disease, and varying levels of attention throughout the day. This can occur due to Lewy bodies (abnormal protein) deposits in the brain, and sometimes a loss of dopamine too. Currently, our patient has been diagnosed with dementia. He meets the criteria for this diagnosis: he has memory loss, is aware of his memory loss, has lost the ability to care for himself, has lost some autonomic function and must wear a diaper, and has been having sleep disturbances. Mr. AS does not recall how he got to the facility, and states that he cant remember what he did yesterday, but can remember stuff from years ago. He no longer can live alone at home without someone to care for him, and has been living at the facility since April 2009. He also states that he sleeps more than he used to, sleeping now for most of the day. A family member must be contacted to assess the changes that have occurred prior to his admittance to the facility, as our patient is unable to tell us of any changes in his status. We also need to contact his family to narrow down which possible type of dementia the patient has based off of his previous behavior prior to entering the facility. If he was experiencing getting lost in familiar places, it could be Alzheimers; he has the risk factors of multi-infarct dementia, especially if he has had more than one stroke; lastly we would need to assess his function before and after the stroke to determine if it was vascular type dementia. He currently has no signs or symptoms of Lewy- body dementia. Our patient is also on medications for Alzheimers type of dementia: Mirtazapine, Namenda, Aricept, and Zolpidem tartrate. These medications help relieve some of the symptoms that our patient has, such as depression and sleep disturbances, and can increase the acetylcholine levels in the brain. Chest Pain: Chest pain can be caused by angina, coronary spasm, MI, pericarditis, gastroesophageal reflux, aortic dissection, and many more causes. Our patient is not currently in any chest pain, but he does have a pace maker. He states he does not know why he was given a pace maker, but states that he has never had any problems or complications with it. A family member needs to be contacted to find out why the pace maker was placed. His chart did not state a reason for the pace maker or state why he was having chest pain. The most common reason for a pace maker is to regulate an arrythymia. An EKG record prior to his placement of his pace maker, can help to determine if an arrhythmia was the reason he had one inserted. A recent EKG will tell us if his heart rate is normal, and if there are any associated pathologies. His medications include: Nifedipine, Metoprolol tartrate, and aspirin, which are all given for chest pain, usually angina and hypertension. He is also taking Omeprazole for GERD. Wheezing and Cough: The most common cause of wheezing is due to a constriction of the airways. This can be an inflammatory response, such as with asthma. Asthma, however, would also cause shortness of breath, which our patient is currently not experiencing, and would be bilateral (unlike only in one side as with our patient). COPD, emphysema, or a lung tumor could be possible causes for his wheezing and coughing. Smoking is a risk factor for all 3, and our patient has a 160 year pack history. It needs to be determined if his wheezing is occurring in the expiratory phase or the inspiratory phase. During the expiratory phase would indicate bronchial disease, but during the inspiratory phase would indicate a foreign body (such as tumor) or scarring. Wheezing heard in both phases could indicate a collapsed lung or portion of lung. Unilateral wheezing also would be more indicative of a lung tumor. There also are no crackles or rales heard in our patient, so fluid in the lungs or turbulent flow does not seem to be the problem. Depression: The cause of depression is unknown, but it is known to be caused by chemical imbalances in the brain. It can also be caused from stress, or a life changing event, such as death of a loved one or social isolation. Depression can present with a number of symptoms such as: fatigue, lack of energy, feelings of worthlessness, feelings of hopelessness, anger, discouragement, irritability, changes in appetite, changes in weight, sleep disturbances, and thoughts of death or suicide. Although our patient has had sleep disturbances, a SIGECAPS interview was negative. His sleep disturbances can be due to dementia. Currently our patient is on medication for depression, Mirtazapine, and should remain on it, so that he does not become depressed. Arms and Leg Weakness: Arm and leg weakness can be caused by a number of things, such as stroke, infectious disease, amputations, and trauma. Our patient suffered a stroke, after which he states he has not been able to use his legs anymore. His legs may be weak, as the nerves may have been damaged from occlusion, and are not able to send complete signals anymore. His arms may be weak from overuse, as he has been learning to use a walker as part of his physical therapy. His arms have to hold up his body now, as his legs cant. Preventative Medicine: Our patient needs to have continuous routine physical exams to assess his ever changing status. A mini mental status exam also should be performed to monitor any changes, or the rate of progression of his dementia. A psych evaluation is needed to determine the extent of his depression and if it is getting better from his medication, or if he is having a more positive outlook on life. Our patient is at the age where a routine colonoscopy and rectal exam should be performed to monitor for colon cancer, prostate cancer, and BPH. Currently our patient is on Tamsulosin for BPH, so it is essential to continually monitor him. Additionally, our patient is elderly and should have a pneumovax vaccine and an influenza shot as prevention for illness. Plan: In addition to the preventative measures listed, in order to assess the patient fully, we will need to contact his family and inquire about if there were any changes in the patients mood, demeanor, physical abilities, and mental status before he was admitted to the facility. His family will also be questioned about their family history of disease, as the patient could not recall how most of his family passed away. To prove our diagnosis, brain scans (CT and MRI) should be performed on the patient and assessed for changes, loss, or infarcts. The patient is also experiencing a constant cough, with a 160 pack year history of smoking so pulmonary function tests should be performed. A chest xray should also be performed to determine if there are any pathological changes within his lungs (such as a tumor) that are causing his wheezing and decreased lung field sounds. This xray can also be used to assess if there have been any cardiovascular changes. Due to the patients past history, he wil l need to be continually monitored for changes. He will also need a CBC to monitor these changes. The patient also will need to have his medication list continually reassessed (additions or deletions) with changes. Currently he is on medication for allergies or rhinorrhea, but he is not experiencing any symptoms of allergies or rhinorrhea, so Loratadine and his nasal decongestant may be removed.

Dangerous Knowledge Essay -- Essays Papers

Dangerous Knowledge The pursuit of forbidden knowledge is the impetus and downfall of man's quest to understand the unknown. In the Bible, God warns man that knowledge brings more regret than it does value: "He that increaseth knowledge increaseth sorrow" (Ecclesiastes 1:18.). Throughout the history of mankind, man has been faced with the temptation to reach the level of God. The Tower of Babel is the first attempt by man to become as powerful as God when man tries to build a tower that reaches the heavens. " 'Come, let us build for ourselves a city, and a tower whose top will reach into heaven, and let us make for ourselves a name; lest we be scattered abroad over the face of the whole earth' " (Genesis 11:4). In the end, God punishes man for attempting to know what God should only understand. "So the LORD scattered them abroad from there over the face of the whole earth; and they stopped building the city" (Genesis 11:8). The pursuit of knowledge is at the heart of Mary Shelley's Frankenstein and Robe rt Louis Stevenson's The Strange Case of Dr. Jekyll and Mr. Hyde. The main characters, Victor Frankenstein and Dr. Jekyll, attempt to reach beyond accepted human limits and access the secrets of life. As a result, the ruthless pursuit of knowledge proves dangerous as both men eventually destroy themselves and everyone dear to them. The thirst for knowledge is a hidden evil that man can only see after it has destroyed his life. Frankenstein is a young scientist who is blinded by the fame and dangers of the knowledge of creation. "So much has been done," exclaims Frankenstein after he hears a lecture on famous scientists. "More, far more, will I achieve: treading in the steps already marked, I will pioneer a new way, explore unk... ...one, but scientist Lewis Thomas says, "We cannot wish away the "Frankenstein Impulse"-we must instead try to channel it in a democratic and ethical direction" (Article Finder). The thirst for knowledge is a hidden evil that man can only see after it has destroyed his life. Had Frankenstein and Jekyll followed the advice of Thomas then maybe their findings would have turned out to be good rather than evil. Perhaps God grants the pursuit of knowledge to those he knows will abuse it in order to make an example of their irresponsible pursuit of knowledge and to prove that some knowledge is off limits to man. Works Cited Goodall, Jane. "Frankenstein and the Reprobate's Conscience." Studies in the Novel 31.1 (1999): 19. Madigan, Timothy J. "Defending Dr. Frankenstein." Free Inquiry 14.4 (1994): 48. Ribalow, M.Z. "Script Doctors." The Sciences 38.6 (1998): 26.

Hezbullah: Impact of Ideology on Group Structure, Strategy, Targets and Tactics Essay

Hezbullah or Hezbollah, which literally means â€Å"Party of God†, is an organization based on Lebanon. It is a religious-political-paramilitary organization of several thousand Shiite Muslim militants that plays a significant role in the Lebanese politics. Hezbullah, while maintaining to be a major contributor to social programs and services in Lebanon, has been considered an Islamic struggle movement. The group also is a foremost provider of agricultural services, medical aid, and school operations in Lebanon. The group is also a significant and influential power when it comes to the world of Lebanese politics. With its outright mission, to destroy Israel, it has been condemned by many governments – but others have praised the party. Western countries, most notably the United States, consider Hezbullah as a terrorist organization. Other countries that recognize in some part or in whole the group as a terrorist organization include the Great Britain, Australia, Canada and several others. Origins It was in the year 1982 that Hezbullah surfaced in Lebanon as it was invaded by Israel and was dubbed as â€Å"Operation Peace for Galilee†. Hezbullah was set in resistance against the Israeli occupation of Lebanon amid the Lebanese civil war. Inspired by the great Iranian political and religious leader, Ayatollah Khomeini, the leaders went for the training and organization of some Iranian Revolutionary Guards. Although the first manifesto of the group did not directly mention the destruction of Israel, the leaders of Hezbullah made several claims on destroying the â€Å"Zionist entity† forcing themselves to the lands rightful owners own. They referred to the Israeli invasion of Lebanon that during the course, claimed not only livestock, lands, homes, but more especially lives. The group started only as a small militia but slowly gained followers that agree to the views and ideologies of the left-leaning group. They started to gain social power, as getting seats in the Lebanese government, being able to create social development programs, as well as getting control and owning their own radio station and a satellite television station. As Shiite Muslims account for majority of its members, their members now vary from all domain of Lebanese population, especially after the 2006 Lebanon war or the July war that featured the warfare between Israel and Hezbullah themselves. Given their broad tally sheets of members, they are able to mobilize protests to the hundreds of thousands of their members, creating a major concern for the Lebanese government itself. Objectives The 1985 manifesto of the Hezbullah enumerated their three main goals as follows: (1) to put an end to any â€Å"colonialist entity† that existed in Lebanon, (2) to bring the Phalangists, a right-wing party in Lebanon, to justice for the â€Å"crimes† they had perpetrated, and finally (3) to the rightful establishment of an Islamic regime in Lebanon. The manifesto also featured some of the ideologies of the group. The group condemns the â€Å"Zionist occupation of Palestine† outright and added by several claims that â€Å"there is no legitimacy for the existence of ‘Israel’†. The Ideology of Hezbullah is derived from the Islamic Shiite Ideology popularized by Ayatollah Khomeini, known for leading the Islamic revolution in Iran in the 1970’s. The Founding Statement of Hezbullah contains a section that reads: â€Å"We see in Israel the vanguard of the United States in our Islamic world. It is the hated enemy that must be fought until the hated ones get what they deserve. Our primary assumption in our fight against Israel states that the Zionist entity is aggressive from its inception, built on lands wrested from their owners, at the expense of the rights of the Muslim people. Therefore our struggle will end only when this entity is obliterated. We recognize no treaty with it, no cease fire, and no peace agreements, whether separate or consolidated. We vigorously condemn all plans for negotiation with Israel, and regard all negotiators as enemies, for the reason that such negotiation is nothing but the recognition of the legitimacy of the Zionist occupation of Palestine.† It was entitled â€Å"The Necessity for the Destruction of Israel† which pretty much sums it all up. Structure From 1992 up to the present, the organization has been headed its Secretary-General, Hassan Nasrallah. Originally a military commander, but with the background of studying Shiite theology in Iran and Iraq, Nasrallah made it higher in the ranks with ease. Some reports suggest that he took advantage of the inside rivalry in the group to capture the Secretary-General position from Ayatollah Ruhollah Musavi Khomeini. Another leader, Sheikh Mohammed Hussein Fadlallah, has been the group’s spiritual leader since its founding. However, Fadlallah, died of a liver hemorrhage recently, 4th July 2010, at the age of 75. There is still a huge blank space to be filled in the group’s spiritual leader’s death. One other leader can be considered as the brains of the Hezbullah operations worldwide. It was Imad Fayez Mugniyah who was considered as the key planner, the mastermind, the engineer that finds time to plan details and execution of its terrorist operations. Mugniyah got his talent from experience, training with al Fatah in the 1970’s in the midst of the Lebanese civil war. It was in the 1980’s that the two, al Fatah and Mugniyah, were expelled from Lebanon by Israeli forces. But with his talent and skill, he quickly went up ranks after joining the Hezbullah. However, it was on 13 February, 2008, that Mugniyah was killed in a car bombing incident in Damascus supposedly pinned to Israel but with no solid grounds. The group is structured into three sub-groups namely the Bayt al-Mal, Jihad al Binna and the IRSO (Islamic Resistance Support Organization). Hezbullah gets its finances from support from various governments, Iran, Tehran and Syria, as well as donations from the Lebanese people and both local and international Shiites. With the current finances, the influence and the power both as a group and in the government, its forces gained momentum as gaining several thousands in members. The Lebanese government itself secured Hezbullah’s existence with policies that allow the group to continue on in their fight for liberty and recover occupied lands. According to data from the United States, the two states, Iran and Syria, contribute to not only the finance, but also to the training, weapons, explosive, diplomatic and political aid of the group. Hezbullah is believed to have a budget ranging from $200 million to $500 million, about $100 million coming from Iran. Operations Hezbullah’s main base for operation is in the Lebanon’s Shiite-populated areas. This includes Beirut, Bekaa Valley and southern parts of Lebanon. But with recent intelligence reports from the U. S.  suggest that the group has been starting its expansion of operations, from Africa to Europe, South America and even in North America. The group has at least five thousand core members, consisting of militants and activists. But it varies notably from time to time due to conflicts that the group engages in, most probably conflicts with Israel. US intelligence also reports the presence of at least 60,000 firearms and other weapons in the hands of Hezbullah. It includes both short and long range rockets, and even anti-tank, anti-aircraft and anti-ship arsenals. With periodic conflicts with Israel, people are concerned that a third Lebanon war may erupt if tensions remain high. Although Israel has officially withdrawn from Lebanon in 2000, and despite the UN certification of the withdrawal of all forces, Hezbullah still periodically create problems in the disputed Shebaa Frams border zone. Consequently, a full scale war erupted during the summer of 2006 and if it weren’t for a UN-led-ceasefire, it probably wouldn’t have stopped any time soon. Even so, it stopped only after taking more than a thousand lives and hundreds of thousands homeless or forced to flee especially the five-week long conflict. Some major attacks attributed to Hezbullah includes the kidnapping of several Americans in Lebanon during the 1980’s; suicide attacks in a U. S. Marines barracks in Beirut, Lebanon which kills over two hundred American soldiers; the 1983 U. S. Embassy bombing in Beirut that killed 63 people, including 17 Americans; the French multinational force headquarters bombing in 1983 that killed 58 French soldiers; the hijacking of TWA flight 847 that featured in an infamous footage of a pilot with a gun to his head; an attack that killed hundreds in the Israeli embassy and a Jewish community center both in Argentina in 1992 and 1994 respectively. The most recent major attack claimed by the Hezbullah was on 2006 when they launched a surprise raid on a border post in northern Israel. They took two Israeli soldiers in captive that caused an intense military campaign to be forced against Lebanon. But there was more to the campaign of the Hezbullah. By 2003, they have worked diligently with other Palestinian terrorist organizations such as Hamas, Islamic Jihan, and the Popular Front for the Liberation of Palestine, and especially Tanzim. It has also been reported that Hezbullah has been a major firearms supplier with their allies as in the Hamas. Analysis It has been with mixed decisions whether Hezbullah is to be considered as a terrorist organization or not. It is a known fact that some countries do not consider the group as a terrorist organization in whole. The United States however, has issued statements against the group, considering them to be a highly-organized terrorist organization. To be able to analyze the group itself, there is a need to answer this question: Should the Hezbullah be considered as a terrorist organization? For the sake of unbiased perspective, we must consider all perspectives. In the Hezbullah perspective arguments include that fact that (1) the main ideology of the group is based on Islamic ideologies, only more radical ones, (2) every country has the right to protect and maintain its liberty in ways it can, and finally (3) the group is actually a part of the Lebanese government. But then again, nothing gives the right for any person, group and even a country to declare that a country has no reason to exist and that the country and its people should be obliterated. By this argument plus the known attacks that they have committed and claimed for, it can be concluded that the group can be considered as a terrorist organization. After setting the fact that Hezbullah is a terrorist organization, an analysis can be put in this perspective. From its origin standpoint, the group can be considered outright to be a radical and extremist in thoughts and in action. It is based from their ideological background that was actually derived from a radical form of Islamic Shiite Ideology that Khomeini had started. Its aim, more than anything else, is to destroy the country of Israel and its occupants, and kill the Jews. The structure of the group can be considered to be a help in their aims and objectives. Considering the separate leadership roles in the group, namely the political, religious and military roles, there are good opportunities to focus to their separate roles. There is a much efficient set of directives that would be of help to the members of the group. But there also is a backfire, if there are any occasions that the three leaders would disagree, the whole group could turn into a separate sub groups, reducing considerably the ability to achieve the objectives of the group. Considering the strategies of the organization, it could be noted that this is interwoven with the organizations structure. The military strategies of the group should coincide with both the religious and political perspective of the group, and vice versa. With the strategy of the organization to attaining its aims, they will be bounded by international policies only if they want to. Their tactics to complete their objectives can be considered to have lessened in the amount of violence that they have made in the older movements. Whether it could be accountable for the tighter defense being pushed by their opposition, i. e. U. S. , Israel, or to internal erosion with the group’s desire to succeed, will be a question to be answered in the future. Their targets remained the same, the â€Å"Zionist entity† that they refer to Israel, added to the â€Å"vanguard† of Israel, the United States. But the question mark lies in the present execution of their objectives, whether they will take it hard, as in violence that includes the public, or will they use a more reasonable action. The group structure and strategies very much meet their deed to accomplish its task. They may be planning to be more of a supporting group to other terrorist organization with the way they are moving as of the moment. They have no other engagement as of the moment. A possible scenario could be that the group would slowly blend to other terrorist organizations and would create a larger one, with a bigger objective than the original. They may consider to continue on supplying and supporting groups such as Hamas, to help them achieve their ultimate goal.

Marketing Plan For Hiring A Marketing Consultant - 985 Words

Have you ever thought about hiring a Marketing Consultant? Do you wonder how they might be able to help, and what the real benefits might be? I have been a freelance Marketing Consultant for almost 3 years now and have worked with 20 clients in a range of sectors. I provide proactive support with marketing planning and implementation across digital marketing, marketing communications and PR. I work with clients in a flexible manner - some require help with a one-off project, however others need regular assistance on a part-time basis. Being a Consultant means that I have to â€Å"hit the ground running†. I research my clients before I have even met them and after the initial meeting, develop a proposal which clearly sets out where they need support and how I can provide this. By the time I actually start working with them I am already immersed in their business and able to start actively marketing in order to to produce results. 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