Pain Perception And Processing In Alzheimers Disease

Pain Perception And Processing In Alzheimers Disease Alzheimers patients feel pain as powerfully as others. Pain perception and processing are not diminished in Alzheimers disease, thereby raising concerns about the current inadequate treatment of pain in this highly dependent and vulnerable patient group. Pain activity in the brain was just as strong in the Alzheimers patients as in the healthy volunteers. In fact, pain activity lasted longer in the Alzheimers patients. Pain may be even more bewildering to more severely affected patients. The experience of pain may be more distressing for these patients on account of their impaired ability to accurately appraise the unpleasant sensation and its future implications. Doctors can use a tool called the Pain and Discomfort Scale or PADS. Its a system for evaluating pain based on facial expressions and body movements. People caring for someone with Alzheimers disease or other dementias can do an even better job than doctors can. Caregivers have an incredible capacity even beyond doctors to know the behavior of the person they are caring for and to look for the times they are in discomfort or pain. The trick is to watch the facial expressions and movements of patients when they are not in pain, both during sleep and waking hours. Using this as a baseline, you should be attentive to circumstances where they seem agitated, where eye contact is altered, where there is grimacing or a facial expression indicative of discomfort. As Alzheimers disease progresses towards the later stages, the ability of the affected person to communicate becomes increasingly compromised. Caregivers can no longer ask are you comfortable? or, are you in pain? and get a reliable answer. A caregiver has to interpret what behavior means. Are shouts, screams, severe withdrawal, aggression, due to confusion, something else, or are they signs of pain?   The way in which a normal person experience pain differs. Pain is a subjective experience. People who have problems communicating are disadvantaged. Research into the prevalence of pain in elders in nursing homes is estimated at between 40 and 80 percent. There is evidence that people with cognitive disabilities may have an even higher risk of being under-medicated for pain. Painful conditions such as arthritis, cancer, urine infections are sometimes not treated with painkilling medications. Even when people can communicate effectively research suggests that observers tend to assume that people over-report pain either verbally or in their facial expressions.   Effective pain management for people with dementia is a complex issue. Families and health professionals caring for people with dementia have to acquire new skills and it can be a rather hit and miss situation. The first step in pain management is assessment of the discomfort. Acute pain syndromes commonly follow injuries, surgical procedures, etc. and require standard analgesic or narcotic management. Acute pain syndromes are expected to last for brief periods of time, i.e., less than six months. Pain that persists for over six months is termed chronic pain. Chronic non-malignant pain requires a more complex strategy to minimize the use of narcotics and maximize non- pharmacological interventions. Acute pain rarely produces other long-term psychological problems, such as depression, although acute discomfort will produce distress manifested by acute anxiety or agitation in the demented patient. Mildly demented patients can become agitated or anxious with pain because they rapidly forget explanations or reassurances provided by staff. Amnestic individuals may forget to ask for PRN non-narcotic analgesics such as acetaminophen and these patients need regularly scheduled medications. Disoriented patients do not realize they are in a health care facility and aphasic patients may not comprehend the staffs inquiry about pain symptoms. The symptoms of pain expressed by patients with moderate to severe dementia include anxiety, agitation, screaming, hostility, wandering, aggression, failure to eat, and failure to get out of bed. A small number of demented individuals with serious injury may not complain of pain, e.g., hip fractures, ruptured appendix, etc. Assessment of pain in the demented patient requires verbal questioning and direct observation to assess for behaviors that suggest pain. Standardized pain assessment scales should be used for all patients; however, these clinical instruments may not be valid in persons with dementia or psychosis. The past medical history may be valuable in assessing the demented resident. Individuals with chronic pain prior to the onset of dementia usually experience similar pain when demented, e.g., compression fractures, angina, neuropathy, etc. These individuals can be monitored carefully and non-narcotic pain medication can be prescribed as indicated, e.g., acetaminophen on a regular basis, anticonvulsants for neuropathy. The management of pain in any person requires careful consideration about the contribution of each component of the pain circuit to the painful stimulus. Neuropathic pain is produced by dysfunction of the nerve or sensory organ that perceives and transmits noxious stimulus to the level of the spinal cord. Persons with serious back disease may have herniated discs that compress specific nerve roots. This pain is often positional and produces spasms of the musculature in the back. The brain interprets pain in a highly organized systematic pattern. Discrete brain regions interpret and translate painful stimuli from specific body regions, e.g., arm, leg, etc., misfire in that discrete brain region will misinform the person that pain or discomfort is being experienced in that limb or part of the trunk. A person who loses a limb from trauma or amputation may continue to experience painful sensations in the distributions for that limb termed phantom limb pain. Management of chronic pain involves three elements (1) physical interventions, (2) psychological interventions, (3) pharmacological interventions. Physical interventions include basic physiotherapy that incorporates warm or cool compresses, massage, repositioning, electrical stimulation and many other treatments. Dementia patients need constant reminders to comply with physical treatments e.g., using compresses, sustaining proper positioning, etc., and many do not cooperate with some interventions, like nerve stimulators or acupuncture. Physical interventions are particularly helpful in older persons with musculoskeletal pain regardless of cognitive status. Psychological interventions usually require intact cognitive function e.g., relaxation therapy, self-hypnosis, etc. Demented patients generally lack the capacity to utilize psychological interventions; however, management teams should provide emotional support to validate the patients suffering associated with pain. Demented patients may experience more suffering from pain than intellectually intact individuals because they lack the capacity to understand the cause of their discomfort. Fear, anxiety, and depression frequently intensify pain. Pharmacological management begins with the least toxic medications and follows a slow progressive titration until pain symptoms are controlled. Clinicians must distinguish between analgesia and euphoria. Some medications that appear to have an analgesic or pain relieving effect actually have an euphoric effect, which diminishes the patients concern about perceived pain. The goal of pain management is to remove the suffering associated with the painful stimulus rather than making the patient euphoric or high to the point where they no longer care whether they experience pain. Euphoria-producing medications can cause confusion, irritability, and behavioral liability in patients with dementia. Narcotic addiction is not a common concern in dementia patients as these individuals have a limited life expectancy and rarely demonstrate drug-seeking behaviors. Pharmacological interventions always begin with the least toxic, i.e., least confusing, medications. A regular dose of acetaminophen up to 4 grams per day will substantially diminish most pain and improve quality of life. Clinical studies show that regular Tylenol reduced agitation in over half the treated patients. Chronic arthritic pain with inflammation of the joints may also respond to non- steroidal anti-inflammatory (NSAIDS) or Cox-2 inhibitors. The gastrointestinal toxicity associated with NSAIDS is greater than that of Cox 2 inhibitor medications. Patients who fail to respond to non-narcotic analgesics should receive narcotic-like medications, i.e., Tramadol. Patients who fail to respond to maximum doses of Tramadol, i.e., 300 mgs per day, may require narcotic medications.  

Christianity and Popular Culture Essay -- Religion God Jesus Papers

Christianity and Popular Culture In his classic work Christ and Culture, H. Richard Niebuhr asserts that the relationship between earnest followers of Jesus Christ and human culture has been an "enduring problem."1 How should believers who are "disciplining themselves for the purpose of godliness" (1 Tim. 4:7) relate to a world whose culture is dominated by "the lust of the flesh, the lust of the eyes, and the boastful pride of life" (1 John 2: 16)? Culture is God's gift and task for human beings created in His image and likeness. At creation humanity received a "cultural mandate" from the sovereign Creator to have dominion over the earth and to cultivate and keep it (Gen. 1:26, 28; 2:15). But sin's effects are total, and culture—whether high, popular, or folk—has been corrupted thoroughly by rebellion, idolatry, and immorality. How, then, should Christians, who have been redeemed, "not with perishable things like gold or silver . . . but with precious blood, as of a lamb, unblemished and spotless , the blood of Christ" (1 Pet. 1:18-19) live in relation to culture? According to Jesus in His high priestly prayer, believers are to be in the world but not of it (John 17:11-16). But in what way? How do believers act in and interact with the "crooked and perverse generation" (Phil. 2:15) that surrounds them and of which they are a part? This is not an easy question, and yet the Church cannot avoid responding to it. Over the centuries, various Christian communities have developed alternative perspectives on this very influential Christ-culture connection. In the extreme, some believers have advocated a complete rejection of culture (Anabaptists, fundamentalists), while others at the opposite end of the ecclesiastical spectrum ... ...se two extremes. It serves as an alternative to both manipulation and meaninglessness. It is an agency of common grace. Since TV manufactures audiences to sell products to, they cannot be manipulated as machines. They cannot be told that life is nihilistic. Rather, they must be entertained. So Jacobson sees a redemptive role for popular culture as an antidote to the present cultural mess. His advice is unique: Turn your TV back on. You will find things worth watching and thinking about. He tells readers what to look for in a variety of programs, and even shows how expressions of grace can be found in Bufy the Vampire Slayer. Notes 1.H. Richard Niebuhr, Christ and Culture (New York: Harper and Row, Publishers, Harper Torchbooks, 1951), chap. 1. 2.Richard J. Mouw, He Shines in All That's Fair: Culture and Common Grace (Grand Rapids: Eerdmans, 2001), p. 9.

Arthur Miller’s Crucible? Essay

Even until the last few scenes of the play in Act VI Proctor still feels guilty. He states: â€Å"I cannot mount the gibbet like a saint. It is a fraud. † Just like in Act II he lets his guilt dictate his behaviour. He feels he has already condemned himself to Hell so doing any more lying will make no difference. It is only in the very last scene, when he refuses to allow his confession to be pinned to the church door, that he realises he can still be good and does the right thing. If the paper was nailed to the door the villagers would see that Proctor admitted to witchcraft and assume the others were liars. Some may argue that he is not a good man even at the end of the novel because when he does not allow for the confession to be nailed to the door this is showing his pride; he even shouts: ‘Because it is my name’ In his speech he repeats the word ‘name’ many times which shows how significant his good reputation still is to him and this could be seen as him having dishonourable intentions. However this could be interpreted, I think that the reason that Proctor does not want to have his name put on the church door is because he does not want to be the person who is calling his friends witches in the eyes of the villagers. He states: ‘I have given you my soul; leave me my name’. In signing the paper he has lied and committed a sin which due to his strict beliefs he would feel his soul was not worthy of heaven, however he does not want to commit the sin of tarnishing the reputation of the other honest villagers. I think this shows Proctor to be a good man because he does not care that he has committed a lie and so condemned his soul to hell but does care that he should blacken Rebecca Nurse’s. In the same way he does not care if he is hanged as long as Rebecca can die with her good reputation intact. He also places emphasis on his own name because he does not want to commit the sin of lying to the whole village- this shows that he values the morals he believes in and does not want to lie to so many people. I think Miller shows the struggle within Proctor to do the right thing and die or to do the wrong thing and live as a comparison with those who in the McCarthy regime wrongly accused others to save themselves from imprisonment. Miller is telling the audience that people like him who did get imprisoned were making the real sacrifice and doing the right thing whereas those who accused others were weak like Mary Warren and too cowardly to be imprisoned. John’s refusal to name other people who he has supposedly seen with the Devil also shows that he is a good man because he refuses to condemn others to the fate of death. Unlike the girls and many of the other accused witches he does not use this as an opportunity to dispense revenge on his enemies. In doing this he shows himself to be a moral superior to the other villagers and this also draws parallels with what Arthur Miller himself did when he was questioned by the House of Un- American Activities. He refused to be manipulated and went to prison for a short time rather than allowing himself to succumb to petty vengeance bred by the feeling of fear. Arthur Miller shows John as a hero here because he has done the right thing in the end and not lowered himself to the sinful acts of others in his community. Miller shows that people may act good and show good morals like Mary Warren when she shouts: ‘I believe in God’ but this is a facade because although to the society Mary looks like a reformed sinner in reality she is still sinning. However Proctor and others like Rebecca Nurse have to look like sinners and slaves of the Devil in order to keep to good morals. This irony shown by Miller helps him to illustrate how the McCarthy regime like the witch trials instead of causing goodness bred vengeance and evil. At the end of the play we know John Proctor to be a good man. His initial flaws of guilt and adultery were countered by his eventual admittance of his sins and standing up for the truth. His decisions to eventually tell the truth and die rather than lying and tarnishing the reputation of the villager’s show what a good person he was. His flaws were used by Miller to give his message to American society: people in their time who were being prosecuted by John McCarthy may have flaws just like Proctor but really the true evil lay within the House itself and that the people were innocent and just victims to jealousy and the injustice of hysteria just like Proctor was in Salem. The main technique of irony: the judges and accusers seemed like moral superiors yet the judges were manipulative and the accuser’ vengeful whereas Proctor who was flawed and thus seemed sinful did not succumb to either evils. This helps strengthen Miller’s message about the people who accused others of Communism and the House itself. The universal purpose is to remind people that jealousy and hysteria are dangerous things and that even ideal societies like the democracy of America and the theocracy of Salem can be unjust and uncivilised and this is shown brilliantly by the harsh and cruel manipulative manner of the judges. In Salem’s idea of goodness Proctor was a good man at the end of the play because he was sorry for his sins and believed in God; he even demonstrated this by refusing to lie at the end. Like all humans he had flaws but he overcame these by doing the right thing at the end. In Miller’s and modern times, he is also a good man because we respect people who stand up for what they believe in like Proctor did in the courts and also we value truth he stood for in an ever increasing world of media lies and propaganda. Show preview only The above preview is unformatted text This student written piece of work is one of many that can be found in our GCSE Arthur Miller section.

The Choice by Nicholas Sparks Book Review

The Choice by Nicholas Sparks Book Review This love story from  Nicholas Sparks follows his usual easy-to-read, entertaining style, with a  Ã¢â‚¬â€¹plot that culminates in a poignant ending, producing real emotion from the reader. The lovers, Gabby and Travis, seem to be cross purposes. Even their dogs seem to be at odds, especially when her dog becomes pregnant. What choices will be made? Too Much Prologue and Epilogue? A major criticism of the novel has been Sparks use of a prologue and epilogue, each of which is in the present, 11 years after the main action. The criticism is not valid, for the prologue creates a sense of impending but unnamed doom that heightens dramatic tension in the novel. Hints are dropped. He brings flowers to his wife of 11 years at her workplace because theyd had an argument three months ago, the last time they had spoken and shared the same bed. As a child, Travis asked his father to tell him stories with a surprise ending because these were the best ones. The story then moves to when they met 11 years earlier. Travis is a single and unattached veterinarian, his life filled with friends and fun. Shes in a long-term relationship. In fact, she has moved to Beaufort, North Carolina to be near her boyfriend. Her dog brings them together. In just a few days, Gabby and Travis fall in love. She resists with all her might, but the inexorable flow of the ocean is working against her. Shortly after meeting her, Travis knew that the solitary journey hed been on for years had somehow reached its end. Both know  snap decisions  can be made, can be exactly right, and powerfully enduring. The Twist Sparks said at a reading that he always knows the twist, the surprise which ends his novels  when he begins writing. This twist will, compared to his other emotionally charged novels, unleash a torrent of tears, Niagara Falls on steroids. But, the emotion will be emotionally cleansing for it involves a choice each of us is likely to face one day. How do we meet the curveball life throws us from time to time? What choice will Travis make? This is the stuff of serious romance novels. Perhaps the most prescient comment is by a  woman at a reading who noted, Life gets turned around by someone, a catalyst, who  melts  the other persons wall. That is true here, but the catalyst is a bit surprising, even for Sparks. Why Are Sparks Novels so Popular? Readers appreciate that Sparks always provides a good story. It has a message and it flows. He seems to understand women. There is always a clear theme, but it isnt written to formula. The Movie The Choice was made adapted as a feature movie in 2016, starring Benjamin Walker as Travis and Teresa Palmer as Gabby, with Maggie Grace and Tom Welling as their other love interests and Tom Wilkinson as Travis father. It received a very poor rating on Rotten Tomatoes.

Rise and fall of marks and Spencer Essay Example

Rise and fall of marks and Spencer Essay Example Rise and fall of marks and Spencer Essay Rise and fall of marks and Spencer Essay Porters five model industry analysis , BCG Matrix and the Value Chain analysis are used to evaluate the whole spectrum of factors that contributed to the rise and decline of Marks and Spencer. An attempt is also made to suggest future strategies to be adopted to regain the lost ground. MS Background The company was started in Leeds in 1884 by Michael Marks , a Russian immigrant. Ten years later , Tom Spencer joined partnership with Marks and MS was born (Beaver, 1999). Their partnership had all the components of success, uniting entrepreneurial flair with the commercial expertise required to create a string of Penny Bazaars (Christopher, 2001). In the 1920s, the business exercised a revolutionary policy of buying directly from manufacturers rather than going through wholesalers. These unique relationships with suppliers gave the business an advantage and convenience that few of its competitors could match. The growth of MS was fast and in 1926 it was listed in the London Stock Exchange as a public company (Whitehead, 1994). Two years later, Simon Marks took over the reins of MS from his father. He introduced the St. Michael brand , a symbol of excellence and quality. In 1930s, MS flagship store was opened at Marble Arch, London. Afterwards, food departments, which sold canned products, were introduced into the company. Moreover, MS started to made forays into the foreign markets in 1970s and had a mixed success in its foreign operations. It opened its first overseas store in Canada in 1973 and then the expansion continued in Europe (Daniels, 1995). It also exported its St. Michael brand merchandise to franchised stores in seventeen countries. This environmental analysis generates information which is structured and directed in a meaningful way for marketing and strategic planning process with respect to the present and anticipated situations. The internal environments are explored using the strength and weaknesses where as the opportunities and threats are analyzed for the external. The detailed factors that characterizes the strengths , weaknesses , opportunities and threats are listed as Appendix I. PEST Analysis Through the PEST analysis the external macro environment is explored. Here factors pertaining to the political, economical socio-cultural and technological aspects are looked into. Political The stability of the present labour government, its taxation policies, anti monopolistic policies, the employment laws and the formation of the competition commission so on are having a direct impact on the retail industry as well as M S. Mergers and acquisitions are not encouraged and hence thoroughly investigated. Because of the presence of the strong trade unions the companies are not in a position to introduce operation simplification just as the legendary Marks could introduce it in Marks and Spencer, immediately after the Second world war. As such firms have had to adapt to wage rises and have been forced to find other ways to lower costs. Supermarkets such as Tesco have in the past reduced costs by exploiting suppliers by taking advantage of their strong buyers bargaining power. Farmers in particular have been the subject of such exploitation though the governments competition commission has since attempted to rectify the situation by introducing a code of practice (BBC online 2001, Supermarkets code too weak ) Economic Corporation tax is currently 30% for large firms. Tax credit is allowed for research and development. Inflation and interest rates are at reasonable level with positive indicators in GNP growth rate. Even though recessionary trends are speculated about its drastic effects are not yet perceptibly seen in the economy. Of course the economy show signs of weakening. The underlying rate of inflation was 2.3% for March 2002. The Bank of England is attempting to keep inflation below 2.5% and hopes to prevent a rise in interest rates. A rise in interest rates will complicate any financing decisions and may hinder any long-term investments as it will increase the cost of debt as such alternative forms of investment such as equity become a more desirable form of investment though historically equity finance is seldom used for financing long term objectives due to the fact that it can be very costly and will dilute shareholder control. For the past two years the prediction of an impending recession has loomed large though this has not happened. Many economists predict an imminent recession. If that prediction is proved correct , history dictates that , in times of recession , consumers will be more price sensitive and less likely to purchase high priced goods due to a lack of disposable income. Socio-cultural Current trends suggest that over the last 10 years there has been a large rise in the popularity of bulk buying , with food items in particular being bought in bulk. Moreover there has been a increase in demand for convenient foods such as sandwiches and microwave meals. The impact of September 11th in conjunction with the rise of charity initiatives suggest that many people are likely to adopt a more sympathetic view to world problems and thus greater importance is likely to be placed on corporate responsibility and charity initiatives. Though Tesco and Gap practices in the past have been deemed irresponsible and yet their profit was not adversely affected. Technological The ever-increasing popularity of the Internet and the advent of broadband technology has resulted in many firms now offering online services allowing for home shopping. The use of intricate computer systems has enabled firms to automate and accelerate many procedures previously done by hand. Linked system have also enabled easier account collection, statistical analysis and identification of demographic data Porters Five Model Industry Analysis The widely accepted and commonly used Porters five model industry analysis rests upon the industry dynamics which in turn are influenced by the forces of macro and micro environments. This analysis is not one of activity alone but an on-going process. These forces exercise relative power at a point of time and it is really important to identify which of these five forces are the key forces at operation and evolve a strategy to position itself to take advantage of the opportunities and over come the threats. Because of the dynamic nature of these forces the analysis is to be repeated on an on-going basis so as to deprive of the potential competitors to overtake , regain , sustain and improve the market share and growth as the situation demands. The threats from the New entrants , buyers and suppliers bargaining power , substitutes and competitive rivalry are analyzed and shown in Appendix II Porters 5 forces model suggests that when buyers exert a high degree of choice and are able to choose from a variety of substitutes product quality, price, product differentiation and branding are likely to become prevalent factors as concerns the success of a firm. As such this is likely to be common within the market MS operates as there is a high degree of competition incurred in direct and indirect forms meaning buyers (customers) will have a high degree of choice thus firms must cater to this in the manners outlined above. Additionally the fickle nature of the fashion industry i.e. product life cycle is low due to ever changing fashion trends means that a quick and efficient response to customer demand can critically affect the degree of success a firm experiences. Additionally an awareness of future environmental conditions can be of vital importance to a firms success as the importance of price, product quality branding and differentiation can vary greatly within different cir cumstances. I.e. during a period of recession price becomes a prevailing factor, which is likely to dictate customer choice. Whereas during a period of prosperity quality and brand become dominant factors. The Core Competences Critical Success factors and Competitive Advantage Core competences arises from the unique and distinctive way that M S builds, develops , integrates and deploys its resources and competences. It can be evaluated like this. M S has a clear customer focus. Because of the inbuilt , robust competences the uniqueness of M S cannot be easily imitated. With regard to its flexibility this is one area in which M S did not respond timely in adequate measure. They lagged behind other competitors in adapting to the changes in the market or industry conditions. The company has paid a bitter price for this laxity. The extent to which value is added to the product/service is quite is good. Finally, with respect to sustainability M S could not retain the tempo of its momentum and march even though it is still the market leader. The critical success factors and core competences are pictorially depicted and is shown in Appendix III. Competitive Advantage M S could attain competitive advantage by developing and implementing these distinctive resources capabilities and competences. The strategies adopted after the great fall of 1998 enabled M S to regain its lost territory. The competitive advantage of M S can be explained in terms of its reputation for quality ,its special relationships with its suppliers and its customers. M S has a very exacting but mutually profitable relationship with the suppliers. It demands high quality at reasonable cost and flexibility in return for large volume of business. Its relationship with the customers is based upon its reputation for good service , refunds , exchange of goods and high quality value for money goods. Real competitive advantages take longer to build and last longer. M S has the best brands on high street. The customers associates with the company with dependability and value for money. The employees are always a privileged lot resulting in their high involvement and commitment. In the end result it has a performance that is superior to most of its high street competitors.

Urban wildlife management in arizona Essay Example | Topics and Well Written Essays - 250 words

Urban wildlife management in arizona - Essay Example This is something that makes the wild animals insecure and can be used in explaining the fact that they have been attacking human beings without being provoked. The fact that their natural habitat has been invaded is already enough provocation to them (Luniak, 2004). This leads to the solemn point that the government should also make sure that in the bid of expanding citys wildlife should always be considered. There are a number of ways in which wildlife can be considered in such a case. This is because in this case they as just as endangered by the situation just like human beings are. There can be made plans that will see to it that their inhabitants are fortified in such a way that they will not be easily found in the areas that are inhabited by human being (p. 67). The wild animals that cannot be easily put away from human beings habitat could also undergo scientific gene modification to make sure that the hostility that they have towards human beings is moderated. Some people would argue that this would be endangering the wild animals, but industrialization and urban growth are already putting them and human being in danger with each side fighting for survival at any cost (p.

To what extent can the trial and execution of Ruth Ellis 1955 be Outline

To what extent can the trial and execution of Ruth Ellis 1955 be considered a turning point in approaches to the punishment of criminals in Britain in the years 1830-1965 - Outline Example treadwheel) but also the use of crank machines, shot drills, and picking oakum1, 2. With the purpose of â€Å"grinding corn, pumping water, and other prison purposes†, the criminals had to work between 8 to 10 hours a day manually revolving the mill by stepping on the 16 feet wood cylinder3. In 1865, the number of days wherein the prisoners will have to use the treadmill or crank was limited to only 3 months of their entire sentences4. The penal transportation is referring to the process of transporting convicted criminals to a separate colony (i.e. Van Diemen’s Land in Australia)5. Since the 1820s, there was a false belief that the act of transporting convicted criminals to a separate colony could help decrease the crime rate in Britain. In 1837, the group of penal transportation committee was finally convinced that this particular penal punishment was not effective and has to be removed immediately. Eventually, the Penal Servitude Act 1853 became the substitute for penal transportation6. As a correctional facility, convicted male offenders were kept in Pentonville Prison since 1842 whereas the female offenders were kept in the Brixton Prison since 1852. In 1857, the British government officially abandoned the use of the â€Å"prison hulks† which are old sailing ships7. Between 1877 to 1878, all prisoners in Britain were being managed by the British government. Other form of punishment includes hanging in public which officially ended in 18688. Ellis used a .38 revolver to shoot David four times yet she remaind calm after committing the crime. During the trial, Ellis boldly stated that â€Å"it was obvious that when I shot him, I intended to kill him†9. Specifically the facts presented in the court gave the jury the false idea that Ellis was â€Å"a cold-blooded killer†10. Even though the use of hanging as a form of capital punishment has officially ended in 1868, Ellis became the