Case Study Essay Example | Topics and Well Written Essays - 500 words - 45

Case Study - Essay Example In response to the second question, granulocytosisis a condition that occurs when there are too many granulocytes in the blood. Granulocytes form and mature in the bone marrow and their role is to attack foreign matter causing inflammation or infection. An increase in granulocytes occurs in response to infections, blood cell malignancies, and some autoimmune diseases. One main cause of granulocytosis is bone marrow disorders.A high white blood cell count is usually an indicator of infection or disease. Granulocytosis is one type of high white blood cell count. (April Kahn) I think the most likely cause for the man’s illness and death was a condition called encephalitis. On the morning of June 4, the patient had symptoms of confusion, disorientation, and lack of reflexes. Some of these symptoms indicate not severe encephalitis while others indicate severe and emergency encephalitis. However, it is worth noting that the patient’s neck was supple. In most cases of encephalitis, there is stiffness of the neck and the back in adults and stiffness if the whole body in babies. (Aksamit) Only occasionally does it happen that the neck and the back are supple such as in this case. Encephalitis which is an infection of the brain might have caused infections in the cerebrospinal system. These infections then might have subsequently caused infection of the bone marrow so causing it to produce more granulocytes and hence the earlier diagnosis of Granulocytosis as well as elevated protein levels prior to his death. Another symptom to this case was the increased abnormal activity which was another clear indication. (New York Times) A serology test and brain biopsy could be used to confirm encephalitis.Serology is a blood test to detect the presence of antibodies against a microorganism.Brain Biopsy involves surgical removal of brain tissue for testing for the

Healthy Grief Essay Example | Topics and Well Written Essays - 1000 words

Healthy Grief - Essay Example The positive attitude develops as a result of someone acknowledging that the departed person or item is irreversible. The acknowledgment will help a person to act a near normal in case of departure. The positive attitude towards grief is what the psychologists refers to as a healthy grief. There are five stages that are involved when helping a bereaved person to recover from the grief. The grieving process established by Kubler-Ross projects some reactions that Job underwent in his life that is described in the Bible. The denial stage is the beginning point of the healing process. At this stage, the bereaved person will want to deny his or her real situation that he or she is facing (Kubler-Ross, 1969, p. 140). In other words, as the term denial suggests, the person will want to focus on other issues in order to feel like he or she is acting on the normal life. Drawing the perspective from the biblical account of Job, after all his children and animals died, he acted as though there was nothing happened to him. He preferred to suggest that all he had was given to him by God and if he had decided to take it back; he had no other measure to deal with the situation. The second stage that forms part of Kubler-Ross grief process is that of anger (Kubler-Ross, 1969). Shortly after the denial process, the bereaved person will come to the reality that he or she has lost a dear one or a property that is so valuable. There is an increase of emotional pain that affect the bereaved person (Nithyananda, 2007, p. 175). The person begins to be troubled by questions regarding the cause of the loss. For example, you will hear people asking, why did this happened to me? The power of anger in manifested in many ways and blames will arise towards himself and to others. In the Biblical story of Job, we see him having anger in the way he tore his clothes and went into the road and stayed without food. The only thing he did was to sit on the road

Kings Ghost In Hamlet Essay Example for Free

Kings Ghost In Hamlet Essay During Shakespeares lifetime people were, in general, more religiously devout and more likely to believe in spirits and ghosts. Spirits could be messengers from heaven or evil in nature. This is one reason Hamlet so readily believed his friends when they told him they had seen his fathers ghost; he was also more likely to believe their story because his friend Horatio told it, and he is an intellectual. However, when Hamlet is all too willing to follow his fathers ghost, his friends, Marcellus and Horatio, are very reluctant to follow. Marcellus is reluctant to follow because he is afraid of the ghost. Most people are afraid of the unknown; this would include soldiers, who are used to fighting until the enemy is killed. Marcellus is dealing with a ghost, which he cannot defeat it with his partisan (though he hopelessly offers it), and this scares him. Marcellus is a soldier who is guarding Elsinore, and the ghost is wearing the armor that he wore to defend his land against Fortinbras, the old king of Norway. Another soldier, Bernardo, says, This portentous figure comes armed through our watch like the king that was and is the question of these wars. (Act I, p. 8) When Horatio speaks to the ghost he says, If thou art privy to thy countrys fate, Which, happily, foreknowing may avoid, O, speak! (Act I, p. 9) Marcellus and Bernardo believe it is an ominous sign and that perhaps the ghost has come with a warning about an imminent invasion; one that they would have to defend the castle against. Hamlet also thinks something must be wrong if his fathers ghost is in armor. Marcellus is also afraid of the ghost because it leaves just as the cock crows to signal sunrise. He knows that spirits, including evil ones, cannot bewitch during the day time and he is unsure yet weather the ghosts intentions are good or evil, so he does not want anyone to follow it. Marcellus goes so far as to restrain Hamlet when he tries to follow his fathers ghost. Horatio is also reluctant to follow the ghost because he is unsure of its intentions. He is especially weary because he tried twice to speak with the ghost and it would not answer him, it apparently only wants to speak with Hamlet alone. He warns Hamlet that the ghost might convince him to act  without reason and drive him mad. He tells Hamlet not to follow the ghost because it could lead him off a cliff into the ocean. Despite his friends warnings, Hamlet decides to follow his fathers ghost and receive its message. Though Marcellus and Horatio were reluctant, they eventually follow, catching up to Hamlet after he has spoken with the ghost.

Importance of New Psychiatric Medication Guide

Importance of New Psychiatric Medication Guide CHAPTER 1: THE IMPORTANCE OF A NEW PSYCHIATRIC MEDICATION GUIDE PREFACE: Over the last decade, I’ve served as the medical director of multiple mental health clinics. I’ve worked with thousands of clients amidst a variety of challenging circumstances. Throughout my experience, I became increasingly aware of the challenges that clinicians face about quickly and comprehensively understanding the complexities of psychopharmacology. I’ve seen clinicians spend hours browsing through massive manuals when seeking information about medications, potential side effects, drug interactions and related questions. Although a number of resources and books about psychopharmacology are available in print, no definitive guide of psychopharmacological resources has been created before. Some resources are concerned with defining psychopharmacology, while some concentrate on a specific class of drugs. Those that do attempt to provide a comprehensive overview of psychopharmalogical resources generally do so in a complicated and discursive manner. Until now, clinicians have lacked a single, comprehensive book about psychopharmacology that conveys this vital knowledge in a simple, concise format. To address this challenge effectively, I have compiled this guide that allows mental health clinicians to find all relevant information about important psychiatric medications in shortest possible time. By practicing psychiatric medicine for many years, skimming through hundreds of books and thousand of articles, giving lectures, speaking with fellow clinicians, and treating clients in various settings, I was able to condense relevant information on psychiatric medications into the following guide. This resource changes the way in which clinicians work, equipping them with the necessary tools and information to allow them to provide the best possible care to their clients. In doing so, this book not only covers the essential facts about each psychiatric drug, but it also provides clinically actionable information about every drug and its class, such as latest dosing protocols, clinical indications, side effects and related content. All these aspects are presented in a concise, elegant manner without superfluous intricacy. I’ve intentionally structured this book according to concept learning, categorizing and explaining various drugs in their specific pharmacological classes. Consequently, the guide incorporates the most up-to-date knowledge and practices in straightforward and clinically sound terms. Every drug class is addressed in its own chapter, and important pharmacological agents would be further expanded upon. Heading and sub-headings further elaborate the data. Additionally, helpful pictures, diagrams and tables are included in full-color to summarize concepts efficiently. Moreover, this book’s pocket-sized format is priced affordably and is designed for the busy clinician in practice, the young medical professional in training, and anyone else seeking a clear, quality resource on psychopharmacology. It is my hope that this guide will enable you to glean current, comprehensive information about psychotropic drugs to strengthen your daily practice. INTRODUCTION: Despite decades of research and medical advancements, mental health challenges continue to plague the world’s population in epidemic proportions. The World Health Organization (WHO) predicts that mental illness will become the leading contributor to the global burden of disease by the year 2020. According to the National Institute of Mental Health (NIMH), about 1 in 4 Americans (approximately 61.5 million people) have been diagnosed with some form of mental illness (PhRMA 2014). Mental illnesses are also expensive, costing the US over $317 billion each year (PhRMA 2014). As clinical psychiatry struggles to keep up with the growing burden of disease, the need for better medications and enhanced understanding of the psychopathology of mental illnesses is of utmost importance. Efforts to combat this growing problem have resulted in the creation of new drugs, which are incessantly entering and flourishing in the market, replacing many of the older drugs, now obsolete due to their poor efficacy or harmful side effects. Currently, more than 119 medicines with novel mechanisms of action are being developed to treat a variety of mental health conditions (PhRMA 2014). Some of these innovative approaches include intranasal medication for treatment-resistant depression, a cocaine vaccine, and a rapidly dissolving tablet for autism. Additionally, the discovery of the glutamate system marks a major breakthrough for many psychiatric conditions, such as depression and suicide. Triple reuptake inhibitors, brain-derived neurotropic factor (BDNF), corticotropin-releas ing hormone (CRH), and melatonin are just a few of the mechanisms recently receiving significant attention from researchers. Similarly, the NMDA-receptor antagonist ketamine has shown promising results for the rapid treatment of severe depression and acutely suicidal patients. It seems possible that before long, physicians will be developing personalized treatment plans via gene scanning, RNA fingerprinting, brain mapping, and brain imaging. In light of these breakthroughs and developments, prescribers have a responsibility to their patients to stay updated on the latest psychopharmalogical advancements. The interplay of evolving treatment options, new diagnoses, redefined disorders, and changing treatment recommendations from various professional and regulatory organizations places a tremendous burden on prescribers who need to keep their knowledge current. In the wake of these dynamics, it is highly necessary to update information about new or adjusted medications, not only for medical professionals, but also for the patient. To a prescriber, however, maintaining a robust scientific literacy can involve an overwhelming amount of information that may seem just as daunting as the problem of mental illness itself. Consequently, using a comprehensive and up-to-date guide to stay abreast of new psychiatric medications and regimens is vital for mental health professionals. As the medical director of multiple bustling mental health clinics and having treated thousands of patients over the last decade, I recognize the obstacles faced in day-to-day psychopharmacology practices. I found myself surprised by the lack of any portable, comprehensive resource on psychiatric medications. I have observed professionals waste so much time trying to find just fundamental information about medications, like dosing, side effects, interactions, precautions, withdrawals, and use in special populations. Clinicians lack informative support, as there is not a single book currently available that provides all the essential information about psychiatric medications and psychopharmacology in a concise, reliable, and elegant way. With those challenges in mind, these contents serve as a relevant â€Å"one-stop shop† guide of psychiatric medications for mental health clinicians. Designed for any mental health professionals looking for simple information about the treatment of mental health issues, the material in this book contains a full listing of important information on psychopharmacology. Scouring hundreds of references, lecturing, speaking with other clinicians, and treating patients in multiple settings have allowed me to condense all of the pertinent knowledge in this short resource. Hence, this guide is the result of decades of experience, dedication, and hard work. This book presents that treasure of knowledge—hitherto dispersed across bulky, obscure, and expensive reference texts—in a readily digestible form. It replaces booklets written by non-clinicians, which often lack sufficient detail. It displaces texts that focus solely on basic overviews or on specific classes of drugs. It replaces other lengthy manuals that attempt to encompass all relevant material but which do so in a complicated, discursive manner. Rigorously composed and updated, this guide covers existing as well as new psychiatric medications and their latest dosing protocols. It is my hope that the integration of basic psychiatry and psychopharmacology with the most current guidelines, recommendations, and best practices of prescribing render this information both comprehensive and reader-friendly. This resource thoroughly and clearly covers every topic that is encountered daily by mental health clinicians in the field. The bulk of this text consists of chapters organized by disorder with emphasis on the important classes or individual drugs for that particular diagnosis. Essential information covering every aspect of the medications is provided including: Generic brand names FDA approved indication(s) Off-label uses Medication form(s) Dosage Mechanism of action (MOA) Pharmacokinetics Warnings Drug interactions Common side effects Contraindications Lab tests recommended Overdose information Tapering/withdrawal Special Populations: use in pregnancy, lactation, elderly, and comorbid illnesses (e.g., hepatic and renal impairment) Important notes: evidence-based clinical pointers for further clinical context Having this material handy will change how clinicians work by equipping them with all of the necessary tools so that they can care for their patients in the best possible way. The guide further examines some of the most prevalent psychiatric disorders, including major depression, substance abuse, bipolar disorder, ADHD, psychosis, and schizophrenia. In addition, the book has dedicated sections for the following major topics: must-know changes in the DSM-5, substance abuse, eating disorders, dementia or cognitive disorders, and personality disorders. Other current mental health issues are explored in detail, including psychiatric emergencies (such as suicide/homicide or violence), PTSD, and future medications. This guide also discusses medication use in special populations in-depth, addressing areas such as use in pregnancy, lactation, the elderly, children, and comorbid illnesses (e.g. renal and hepatic impairment). Material is uniquely presented with additional vital information on special cases. Moreover, due to the growing interest surrounding the use of alternative medications in the treatment of psychiatric ailments, a separate chapter is devoted to the various dietary, herbal, and OTC drugs available. In addition to focusing on psychiatric medications, this guide also expands upon the emerging non-pharmacological psychiatric interventions that are being used in current practice. Electroconvulsive therapy (ECT), vagus nerve stimulation (VNS), deep brain stimulation (DBS), and trans-cranial direct current stimulation (tDCS) are covered thoroughly, enabling physicians to sharpen their interventional knowledge and related skills. The contents of this guide are a vital tool for clinicians, allowing them to save valuable time and to succeed in the modern era of medicine through its straightforward presentation, portability, and reliability. As a result, it will be of tremendous help to any prescribing physician who requires a short, clearly presented account of the latest medications used in psychiatry. As a text that intersects clinical psychiatry with psychopharmacology, this guide is intentionally accessible to students, residents, counselors, therapists, psychologists, family physicians, pediatricians, and psychiatrists alike. Simple, concise, current, evidence-based and written from clinical expertise, this book is a vital guide for those responsible for prescribing, dispensing or administering drugs for patients with mental health disorders.

An Unconventional Identity :: essays research papers

An Unconventional Identity Symbolism is a relatively straight forward concept on its surface. It is a visible object or action that suggests some further meaning in addition to itself. Most literary works use symbols to expand on the meaning of the piece of work. "A&P" by John Updike, is a rich story presenting the main idea of man's struggle to attain individuality within society. Through his work, Updike uses the three girl’s sense of non-conformity as symbolism to enhance Updike’s theme of finding individuality and to identify the change in Sammy. â€Å"A&P† starts off with three girls walking into a grocery store â€Å"in nothing but [their] bathing suitsâ€Å" (14). The A&P is â€Å"five miles from a beach† (16), in the middle of town. They are having fun and enjoying themselves although the way they are dressed is not appropriate for where they are, but it does not bother them at all. Soon after their entrance, they catch the eye of Sammy. Sammy follows the girls around the store with his eyes, describing them very thoroughly, even describing one of the girl’s â€Å"sweet broad soft-looking can, with those two crescents of white just under it† (14). Sammy’s sharp and critical observations about the people around him confirms that he is discontent with the norms of society. When Lengel, the store manager, catches the three girls in his store breaking the dress policy, he confronts and informs them that "[t]his isn’t the beach" (17). He then Herber 2 subtly insults them by saying, "[w]e want you decently dressed†¦ here" (17). Although the girls say that they â€Å"are decent† (17), the reader recognizes the fact that the girls are breaking rules by their embarrassment and hurrying out of the store. Yet, even though their rebellion is not intended, because all they initially have to do is â€Å"pick up a jar of herring snacks† (17), their nonconformity makes a significant difference in Sammy's perception of them. In his eyes, the mere fact that they are different from the others, makes them more appealing. After being introduced to the beauty of nonconformity, Sammy is inspired to be the â€Å"unsuspected hero† (18) and quit his job. Sammy, on the edge of reaching his own identity, is presented with a perfect example of what he longs to be - different.

Business Plan for New Airline Essay examples -- Essays Papers

Business Plan for New Airline HausAir Mission Statement HausAir fixed base operation will provide the highest quality of flight instruction and comfortable charter services to the public; without compromising an ounce of safety, at a price lower than the competition. Human Resources/ Management Functions Breakdown of initial staff to begin at HausAir. (1) Manager/Owner Jason Bushouse (1) Assistant Manager Jeff Doyle (5) Receptionist/Clerical Jason Henderson (Full Time) Julie Vanek (Full Time) Roseanne Francis (Full Time) Pamela Laurie (Full Time) Art Wegner (Part Time) (6) Flight Instructors (Chief) Adam MacDonald (Full Time) Brent Ivey (Full Time) Janessa Luncford (Full Time) James Bushouse (Full Time) Ron Hallaux (Full Time) Randy Renolds (Full Time) (4) Pilot (Chief) Jason Bushouse Tim Dolenz Trevor Blackmer Dwayne Clemmens (4) Mechanics (Chief) Greg Radd (IA; Full Time) Lee Coss (A&P; Full Time) Joan Laukner (A&P; Full Time) Miguel Sanchez (A&P; Full Time) (4) Line Attendents Josh Hodny (Full Time) Mara Kennelly (Full Time) Brett Carlson (Part Time) Tommy Snellings (Part Time) (1) Sales Personnel Mike Campea FBO Organizational Chart Flight Office Service Finance Sales Job Description: Flight Instructor The HausAir flight instructors will follow some basic guidelines. They will be responsible for: - Student training for appropriate licenses - Maintaining proficiency in maneuvers - Proficiency required flight knowledge - Proficiency instructional techniques - Promoting a positive image of general aviation - Perform duties assigned by chief pilot - Maintaining safe and professional habits The position requires a minimum commercial multi-engine land instrument airplane and CFI certificate and those without a CFII will be expected to obtain the certificate within 6 months of start date. Instructors must be able to train a student from wherever their current ability level is to proficiency to the practical test standards for the certificate desired. Instructors will be required to follow HausAir flight training syllabus unless there is prior approval from the chief flight instructor. Instructors will be expected to give biannual flight reviews, checkouts to customers planning to rent aircraft an... ...n income of $5480 with a profit of 2200 a month. Fuel will be stored and fueled by the fuel truck. Line service will fuel all incoming aircraft, regardless of size. Supplies HausAir will carry a wide selection of supplies and keep current with charts, approach plates, books and other aviation publications. We can make between 40-60% profit but will charge what competitors like sportys pilot shop charge. We will match their price and work prices around that range. Insurance Insurance is an important protection for this FBO. Due to the high amount of risk involved in aviation it will be important to hold monthly safety meetings, and have rotating safety officer schedule that will change every day. There are many different kinds of insurance that we must purchase. Some of the insurance coverage that is required: Aircraft hull Aircraft liability Passenger liability Hangar liability Product liability Fire and Natural disaster coverage Auto full coverage Comprehensive public liability Bibliography http://www.airplane.com/be58.htm Richardson, Rodwell, & Baty (1995) Essentials of Aviation Management. Dubuque, IA: Kendall/Hunt Publishing Company.

Lady Macbeth is not the main driving force behind King Duncan’s murder Essay

In my opinion, Lady Macbeth is not the main driving force behind King Duncan’s murder. The onus for this heinous deed rests with Macbeth himself, as he would have committed this treacherous act even if Lady Macbeth had not goaded him on. When the witches make their predictions, they told Macbeth that he would be Thane of Cawdor and then later King. I firmly believe that these predictions caused Macbeth to start thinking, and thus started a chain of events that ended up with Duncan being murdered. Macbeth’s reaction to the witches’ prophecy was one of fear and agitation. â€Å"Good sir, why do you start, and seem to fear things that do sound so fair?† says Banquo. I feel that Macbeth fears the prophecy because he had been thinking about becoming King before. Deep inside him, Macbeth had the ambition to become King, and this is exactly what the witches prophesized and it was as if they had read his mind. This must be the reason the witches had chosen Macbeth, and not Banquo or any other Thane in Scotland. The witches’ prophecy ignited his deep dark ambition, and he starts to think about how he will become King. However, the witches cannot be held responsible for Duncan’s murder because Macbeth already did have the thought of being King before. The thought was already in Macbeth’s head, all the witches did was to act as a catalyst in making him pursue his ambition. Macbeth then becomes â€Å"rapt withal† because, I feel, he starts thinking about the different ways he can become King. One of them was to murder Duncan himself, and this must have been the â€Å"horrid image† Macbeth thinks about. Although this image scares him, it stills raises the question of whether Macbeth really is as noble and loyal a Thane as people say he is. If he were such a noble Thane, why would he think about killing his own King? One important point to mention here is that he is already thinking about killing King Duncan without any intervention of Lady Macbeth, who has not even been introduced into the play. However, Macbeth then decides that since he was made Thane of Cawdor without doing anything, he might become King without having to do much either (â€Å"without my stir†). Macbeth decides that if he becomes King it will be because of sheer good luck, not because he did something to try becoming King. I feel that this decision might have been made because he knows that he is one of the most powerful Thane in Scotland and so expects to be made Duncan’s heir to the throne. However, King Duncan names the heir of his throne to be Malcolm, his elder son, who shall be known as the Prince of Cumberland. It is then that Macbeth decides that he must take some action if he ever hopes to be King. â€Å"The Prince of Cumberland-that is a step, on which I must fall down, or else o’erleap For in my way it lies. Stars hide your fires, Let no light see my black and deep desires,† says Macbeth. This is very much a contrast to the decision he had made of doing nothing against Duncan in the previous scene. His loyalty to his King looses out to his ambition. Lady Macbeth is then introduced into the play when Macbeth sends a letter to her, telling her about the strange events that happened that day, perhaps because he knew that his wife would be there to give him the strength he needed to do anything against the King. Lady Macbeth’s first reaction after reading the letter is that Macbeth is too kind and noble to do anything bad to become King. She knows that Macbeth has the ambition, but she also knows that he would be hesitant to do the evil things to achieve his ambitions. â€Å"Art not without ambition, but without the illness that should attend it,† she says. From the first meeting between Lady Macbeth and Macbeth, I can conclude that Lady Macbeth wants to be Queen more than Macbeth wants to be King. Such was her desperation to be Queen that Lady Macbeth was even prepared to call on the evil spirits to make her strong, and she wants to assume masculine qualities â€Å"unsex me here† so that she will not have any womanly weaknesses. She had spoken of pouring her â€Å"valour† into â€Å"Macbeth’s ear, and valour (according to Shakespearean audiences’) is a masculine quality. This would have shocked the audience in the Elizabethan era, because at that time they believed that the universe, the natural world and human society were ordered in one great chain or hierarchy. According to the great chain, women should be weak, and their husbands should rule all wives. However, in this scene, Lady Macbeth is shown to have a lot of mettle, and has a power over her husband. She tells him that people can see right through him. â€Å"Your face, my Thane, is a book where men May read strange matters†. She then tells him to disguise his real thoughts and deceive people into believing something. â€Å"Look like th’ innocent flower, But be the serpent under’t.† Macbeth’s will to murder Duncan wavers because he starts to list the reasons for why he should not stray onto the path of evil. He fears judgment from God and his conscience will haunt him for his entire life. â€Å"Bloody instructions, which being taught return To plague th’ inventor†. He then says that he is Duncan’s â€Å"kinsman and his subject† and should protect Duncan since he is his host, and not â€Å"bear the knife myself.† He says that Duncan is a good, kind and virtuous King and the only thing driving him towards Duncan’s murder is his â€Å"vaulting ambition.† (Macbeth is shown here as being a tragic hero, an otherwise noble and virtuous character who falls due to one particular flaw, ambition. There are many other Shakespearean plays with tragic heroes, such as Othello, which tells a story of a man destroyed by jealousy.) When his wife arrives Macbeth tells her that he will not murder Duncan. (â€Å"We will proceed no further in this business†) This depicts Macbeth’s confused state of mind and his vacillation whether or not to assassinate Duncan. Here, Lady Macbeth shows her deep resolve and when she persuades and manipulates Macbeth into killing Duncan. She accuses him of cowardice and lack of love for her. â€Å"And live a coward in thine own esteem.† She claims that he was drunk when he promised her he would kill Duncan (although nowhere has the audience actually seen Macbeth promise this). She even says that she would dash the brains of her very own child if she had promised to, and so Macbeth should also be loyal to his promise. â€Å"Have plucked my nipple from his boneless gums, And dashed the brains out, had I sworn as you Have done this† These words from Lady Macbeth suggest that she is less moral than Macbeth and even evil. While she sees nothing wrong in Duncan’s murder, Macbeth, despite his deep ambition, fears the consequences of his immoral deeds. Another reason for not killing Duncan was because he was afraid of getting caught, and not because he wished to remain loyal. Getting caught would jeopardize his chances of becoming King forever. â€Å"If we should fail?† is what he asks Lady Macbeth. After Lady Macbeth formulates a plan, which impresses Macbeth and he says â€Å"Bring forth men-children only.† Macbeth is convinced that this plan was foolproof, and he succumbs to his ambition and proceeds to murder Duncan. This reveals that he wanted to kill Duncan all along, and was just waiting for the right opportunity to present itself. The moment Lady Macbeth came up with a plan, he readily agreed. Lady Macbeth believed that this was the time to murder Duncan without getting caught, and this is what she made Macbeth believe. If Lady Macbeth had not been there Macbeth would has probably stuck to his decision of not killing Duncan at that time but he would have killed Duncan later. He says this in the end of the scene- â€Å"I am settled and bend up each corporal agent to this terrible feat.† He even starts making plans of what to do with the daggers after he murders Duncan- â€Å"When we mark with blood those sleepy two.† Fate was also playing its hand at making Macbeth feel that it was his destiny to kill Duncan when Macbeth starts hallucinating and sees a dagger, leading him to Duncan’s room. (â€Å"Is this dagger which I see before me?†) It shows that fate also played its role in trying to push Macbeth into murdering his King. Later, Act Two Scene Two we see Lady Macbeth waiting for Macbeth, who has left to murder Duncan. It is then when she says that she would have killed Duncan herself if he hadn’t looked like her father sleeping. Lady Macbeth did not have the courage to kill someone who looked like her father. â€Å"Had he not resembled my father as he slept, I had done’t,† says Lady Macbeth. This tells us that she is not as brave and courageous as she made herself sound before, and still had some womanly weaknesses. This would have made Elizabethan audiences feel that although Lady Macbeth is evil and is stronger than her husband in some aspects, she is still the dutiful daughter she should be. This father-daughter relationship was considered very important at that time, and they were also very important in Shakespearean plays. There are many other examples of father daughter relationships in other plays written by Shakespeare, such as Othello and King Lear. When Macbeth arrives after killing Duncan he starts wavering again, he was worried about the consequences of him murdering murder. He was afraid of being judged by God for the evil he had done. Macbeth deeply regrets killing Duncan, and this was his immediate reaction, so he probably never wanted to. This is shown when Macbeth hears the Thanes knocking on Duncan’s bedroom door- â€Å"Wake Duncan with thy knocking. I would thou couldst.† There is also a marked contrast between the reaction of Lady Macbeth and Macbeth once they both have Duncan’s blood on their hands. Macbeth starts going mad with guilt from the sight of the blood, while Lady Macbeth just tells him to wash it off, as if nothing happened. She said that â€Å"My hands are of your colour; but I shame To wear a heart so white.† From the murder onwards all the devious plots and plans were made by Macbeth and not Lady Macbeth. He is the one who kills Banquo, because he knows that Banquo suspects him of foul play. (â€Å"To be thus is nothing, But to be safely thus.†). This shows that Macbeth is also quite evil and black hearted and will do anything to be King. From the murder onwards Macbeth is the real driving force and not Lady Macbeth. In conclusion the final responsibility for his actions rests with Macbeth himself. The witches’ predictions did stroke his ambition and Lady Macbeth egged him on to commit acts of perfidy. However Macbeth always had a choice. Witches had predicted that Banquo’s sons would be Kings. Banquo chose to do nothing- leaving matters to fate. Macbeth became Thane of Cawdor by being a loyal subject and he could have chosen to remain so until his destiny ordained him King. He could have easily said that since he was destined to be King it would somehow happen anyway. Instead he chose to murder his King and arranged to kill his best friend. His ambition drives him to rule as a tyrant, and he chose to abandon his former path of duty and honour – which ultimately leads to his downfall and tragic end.