Laser Hair Removal: Strategies, Types and Uses

Laser Hair Removal: Strategies, Types and Uses Test patch: [10, 19] A test patch is performed by many physicians before performing the actual fist sitting of the procedure. A test patch is usually done on two or three different spots using different parameters. This helps in physician’s evaluation of the ideal treatment parameters and pain threshold for an individual case and also gives an idea to the patient about the procedure and the associated discomfort. This helps in reassuring the patient about the procedure. The patient is called after 72-96 hrs to assess the development of any delayed adverse effects and if there is no adverse sequel, the procedure can be started immediately. The energy density that is required in the first sitting is the one that caused a perifollicuar erythema and edema in the test spot.[ 30] However, a test patch may not always be feasible and is as such not recommended in all cases. It may be considered important in difficult to treat areas and in patients who are apprehensive. Laser safety It is paramount to observe safety precautions in all cases. This includes laser safety precautions and personnel safety precautions. These have been listed in box 3 Box3: Laser Safety Guidelines [19] Treatment Protocol [19,21] Pat should be asked to wash the treatment area with soap and water to remove any grease, dust or make up. Pre treatment photograph should be taken. The area to be lased should be marked with a white skin marking pencil. [Figure 38.8] Topical anaesthesia or ice cubes can be used to make the patient more comfortable during the procedure especially, if the patient is apprehensive or experienced pain during the test patch. The hair on the treatment area should be trimmed to the skin with the help of an electric trimmer or shaved with a disposable laser just prior to the procedure. The residual hair growth should not be more than 1mm -3mm. If the hair is stuck on the skin surface after shaving, these can be removed with the help of a micropore tape. The exact parameters to be used should be determined based on the test patch result or on basis of the skin and hair type of the patient. Prior to starting the procedure, it is important to recheck the parameters fed in to the system. Make a f inal check on the safety measures prior to starting the procedure as mentioned in box 3. It is especially important to confirm that all personnel in the treatment zone are wearing safety goggles. The patient should be informed before firing the laser. The hand piece should be kept perpendicular to the skin surface with firm but gentle pressure and there should be complete contact of the hand piece with skin. In case of areas such the mandibular edge, where complete contact in not possible the skin should be pulled towards the flat surface, e.g. cheek, to effect a complete contact. The pressure should be enough to reduce the capillary blood flow and push the hair follicles towards the skin surface. All areas should be treated in a single sitting. The complete area should be covered by proper placing of the handpeice with not more than 10% overlap of the treatment area. Care should be taken that the same area is not lased more than once which can lead to development of adverse effects . Care should also be taken to lase the entire treatment area and not leave behind untreated spots . This can lead to development of patchy hair growth. A treatment grid may be used to prevent these errors. Adequate cooling during the procedures can be achieved by using cool air sources or immediate application of ice packs on the treated area by an assistant. The recent equipments come equipped with cryosprays or precooled sapphire tips for intraprocedure cooling. Development of dusky discolouration or blister formation indicates incorrect parameters and these should be immediately rectified or the procedure should be stopped. Certain difficult to treat areas require special care. These are mentioned in box 4. After completing the procedure the patient should be asked to apply ice packs to reduce pain and edema. At the end of procedure a sunblock cream is applied on the treated area. The procedure details should be immediately noted and this should include the patient details and s kin and hair type, procedure details including date/ time, photograph record, fluence, pulse width and cooling method used and lastly the record of any untoward incident should be noted. Post procedure care at home should be explained and this should include avoidance of heat or hot water bags on the area for at least 24-48 hours, using mild soap and pat drying the treated area and in case if there is a blister formation or any other adverse effect, patient should be advised to apply an antibiotic ointment and inform the treating physician. Box 4: Laser hair removal in difficult to treat areas Adverse effects with Laser hair removal [30] Most complications are mild and transient such as pain erythema and edema. Sometimes superficial thermal burns may be seen. [Figure 38.9 and 38.10] These are generally caused due to wrong parameter settings, physician error during procedures, lack of adequate safety measures and inadequate sun protection by the patient. Table 6 lists the complications during a laser hair removal procedure and its management. Apart from these certain uncommon adverse effects are possible which the clinician should be aware of. Paradoxical hair growth is seen in 0.6% to 10% of patients treated as per data available from different studies. [30]. The possible etiology is the stimulation of vellus hair to form terminal hairs by the low fluences in the areas near to the treatment zones. Another theory is the synchronisation of the hair growth cycle to form terminal anagen hair from the dormant hair follicles. [ 57] Darker skin types [III-VI skin types] and patients with Hirsutism seem to be more prone to d evelop paradoxical hair growth. Continued laser treatment of the affected area is the treatment for the paradoxical hair growth. Persistent severe urticaria has been reported in a number of patients after laser epilation. Some authors believe it to be due to the delayed hypersensitivity reaction to the ruptured hair follicular antigen. [58]. Nd: YAG Laser treatment of axillary hair has been reported to cause persistent hyperhidrosis. This is possibly due to the stimulatory effect of laser on the hair follicle. [59]. Premature hair greying and ingrowing hair are some other complications reported. [30] Table 6: complications and its management during laser removal What’s New in Laser Hair removal? Newer devices are focussing on faster treatments with better patient experience. Devices with pneumatic skin flattening (PSF) help in reducing pain by working on the ‘gate theory’ of pain reduction. This theory states that on stimulation of the non-nociceptive nerves, signal transmission of pain is reduced. The device suction in the skin that has to be treated and this suction pressure on the skin stimulates the tactile nerve endings that reduces pain sensation transmission. This also helps in bringing the target chromophore closer to the laser window and reduces capillary flow which helps in optimising the treatment as has been explained above [illustration 38.4]. [30] SHRâ„ ¢ technology is another improvement that uses low fluence with rapidly delivered pulses (5-10Hz) and higher average energy. This necessitates the use of multiple passes to build the necessary energy but is faster and has a better patient experience. Another development for performing rapid treatm ents is computer controlled laser scanner mirrors. These help in automatically placing the laser beam in a perfect non-sequential pattern over a larger skin area. [60]. The technology helps in treating larger areas of various sizes by automatically addressing the issues of correct beam placement. Miscellaneous pearls in laser hair removal procedure The procedure of laser hair removal can be optimised by matching the patient and his correct parameters. Table 7 describes the ideal parameters for various skin and hair types Table 7: Laser parameters based on skin and hair characteristics As the hair structure changes from thick terminal hair to thin vellus hair, the laser parameters need to be changed to a smaller spot size. Hence a different laser may be needed as the therapy proceeds. Concurrent use of multiple laser wavelengths could have a synergistic effect and this needs to be probed further. Treatment grids are very helpful to prevent skip areas especially when a large area needs to be lased. Some patients may not respond to the therapy. In these cases, changing the wavelength may be helpful. Conclusion Laser hair removal remains one of the most commonly availed laser populations. The results post therapy are very gratifying. The learning curve with lasers for hair removal is not as steep as with some other indications. It is important not to be very aggressive, since that can lead to adverse effects. Newer technologies minimize pain and the treatment duration time. Home hair removal systems may prove to be a an essential aid in every house hold in the near future especially since the price are reducing and the newer technologies have made these equipments significantly effective. It is important to keep a standard operating protocol and following it diligently to reduce iatrogenic complications. Summary Hair has a lot of aesthetic value irrespective of age and gender. There is a decreased quality of life in hirsute patients. The laser equipments work in the wavelength range of 600-1100nm. Lasers act through the principle of selective photothermolysis and target the melanin but hair reduction occurs by the transfer of heat to the stem cells which are located in the bulge and the hair papillae. This works on the extended theory of selective photothermolysis. The parameters that have to be monitored for optimal therapy are the wavelength, fluence and the pulse width. Multiple equipments are available for hair reduction such as diode, alexandrite, Long pulse Nd YAG and IPL Home use laser hair removal devices are now available but are expensive at present. The commonest indication for hair removal is hypertrichosis in a female, however multiple other indications can be corrected by laser hair removal. Patient assessment includes detailed history and examination. An informed consent shoul d be taken prior to the procedure. The actual procedure is nearly the same with all machines with few subtle differences. Most adverse effects are iatrogenic and following a strict protocol helps in ameliorating these complications. Newer technologies are making the procedure faster and pain free.

Importance of customer value Essay

Building and preserving customer value is essential in the new organizational structure taking place in the health-care industry. As businesses and consumers move forward, businesses are being measured more and more by the value they create for their customers. Customer value is the focus of the article â€Å"Customer Value & Business Success in the 21st Century.† Customer value is defined as how a business values customers and how customers value a business’s products or services. The article focuses on health-care organizations, and how there is an expectant trend that individuals will absorb a greater share of their own health care costs. In order for health care organizations to respond to this growing trend toward consumerism, customer value applications must be implemented in daily business activities. The author describes four critical processes and areas that should be of focus in order to build success. The first is to successfully identify what your customers need and expect. The second process is to build service delivery models to meet each target segment. The third area is to understand your customers enough to anticipate customer expectations in order to meet these expectations. The final process is to commit the organization to customer-centered strategic marketing and communications. In today’s unstable market, the only businesses experiencing success are those that are able to meet and exceed expectations of customers. It is essential in today’s fast-paced business to develop quality relationships with customers which results in customer loyalty. The traditional way of pushing the product or service down to the customer is being replaced by tailoring business decisions to meet customer expectations. The delivery of health care is changing to consumer centered health care where each customer is an individual with unique needs and expectations. Consumer centered health care requires altering or creating new products and services to meet needs and expectations. It is also necessary for a health care organization to understand the lifetime value of a customer. The customer is not seen as a one time transaction, but as an ongoing customer receiving continuous service over time. The author states that it should be  a goal to capture the share of the household’s total healthcare over a long period of time. The term customer satisfaction is being replaced by customer value. Achieving customer satisfaction is only the beginning, and building customer loyalty and value are necessary for sustainable growth in the business world today. Unlike traditional ways of conducting business, the new order is primarily focused on meeting individualistic needs of each customer. In order to achieve this goal, an organization must go through a series of steps. This involves understanding what customers value most, meeting and exceeding their expectations, developing services to meet these expectations, and refining services and products through feedback. Grouping by customer needs, market-based segmentation has been far more successful than the traditional method of grouping demographics. Organizations today could highly benefit from market-based segmentation. One significant reason is that reducing customer defection rates could dramatically increase profits. Studies also show that a longer a customer stays with an organization, the more profitable they become. A recent study reporting reasons why customers leave an organization showed that 68% of those surveyed left due to an indifferent employee. It is essential and very necessary to have satisfied employees in order to be an organization that creates value for its customers. Satisfied employees are loyal employees, and loyal employees usually deliver excellent service. Excellent service results in customer satisfaction and loyalty which results in customer value, and higher profits for the organization. Many organizations have only one service model and this result in mediocre service. After understanding customers’ needs and expectations, service models can be developed for each market segment. Grouping by needs and expectations will allow an organization to establish relationship with customers by specifically tailoring services to each segment. Development of these service models will increase customer loyalty that will also increase profits and revenue. Customer value puts the customer in the center of each process of expectation audits (understanding the customer), service models (niche customization), service innovation (understanding customer expectations), and strategic communication (communicating with customers).

Viagra and Intellectual Property Rights in China - Free Essay Example

Sample details Pages: 5 Words: 1623 Downloads: 5 Date added: 2019/02/20 Category Law Essay Level High school Tags: Intellectual Property Essay Did you like this example? The company of Pfizer was founded by two German cousins, Charles Pfizer and Charles Erhart in 1849. These two men were based in Brooklyn at the time, selling chemicals from their offices. The first product that these cousins created was an anti-parasitic for treating intestinal worms. Don’t waste time! Our writers will create an original "Viagra and Intellectual Property Rights in China" essay for you Create order While there were other options for this medication on the market, considering the popularity of this affliction in the time period, Pfizer made theirs more appetizing in terms of taste, and therefore more appealing than others. In 1941, their attention shifted to soldiers fighting in the war, leading them to refocus their resources to the production of penicillin (Abrami). This company’s claim to fame, the drug Viagra, was a lucky accident that Pfizer scientists stumbled upon during their research. Pfizer scientists wanted to develop a drug to lower blood pressure and open arteries. They applied for a UK patent, since the scientists were Britain-based, for a class of compounds for the treatment of cardiovascular conditions. When this drug went to volunteer clinical trials, participants discovered that the compound also acted as a treatment for Erectile Dysfunction (ED). However, when tested on monkeys, the drug did not have the same result. Scientists later found that nitric oxide (NO) was unavailable to the anesthetized monkeys, which is why they did not experience the same results, but was crucial to sexual arousal. The scientific outcome of this realization was the new idea that PDE-5 inhibitors were a treatment for ED in otherwise healthy males. After discovering the added benefits of the drug that they had created as a treatment for cardiov ascular conditions, Pfizer filed a secondary use patent application titled â€Å"Pyrazolopyrimidinones for the Treatment of Impotence† (Abrami). After the discovery and development of their unique drug, Pfizer took measures to protect their intellectual property rights in the matter. By 1998, Pfizer held a patent on sindenafil citrate itself, the specific compound that worked as treatment for Erectile Dysfunction. They also obtained US and EU patent rights on PDE-5 inhibitors and the drug became available with a doctor’s prescription by 1998. Their business immediately took off, filling 2.9 million prescriptions for the drug within three months of their launch (Abrami, 7). However, after Viagra’s worldwide launch in 1998, a Chinese firm known as Welman Company (unbeknownst to Pfizer) filed a trademark application for the name â€Å"Wei Ge.† While Viagra’s official Chinese brand name was â€Å"Wan Ai Ke,† much more popular was their Mandarin Chinese street name of â€Å"Wei Ge.† The problem at hand was that, while Pfizer had a patent for the drug and compound itself, they had never filed a trademark application for the name. They did hold a 3D trademark for their ocean blue, rhombic pill, which had been granted in 2001. In 2003. Welman Company launched an Erectile Dysfunction drug using the â€Å"Wei Ge† name, which they had received a trademark for in 2002, and a similar look of pills (Abrami). Welman’s launch of such a similar drug launched a momentous dispute between the two. In 2005, Pfizer filed a lawsuit against Welman Company. They claimed that while they did not hold a specific trademark for the name, they had the rights to the unregistered, famous trademark. The Paris Convention, which Pfizer cited in their argument, mandated that member countries, including China, â€Å"agreed to ‘refuse or to cancel the registration, and to prohibit the use, of a trademark which constitutes a reproduction, an imitation or a translation, liable to create confusion, of a mark considered . . . as already being the mark of a person entitled to the benefits of this convention’† (Abrami, 9). While Pfizer had a patent on the drug itself and a trademark on the appearance of the drug, they did not have a trademark on the â€Å"Wei Ge† name. Welman Company capitalized on this loophole and attempted to make their own drug, so similar to that of Pfizer that they would profit of it themselves. As a response, Pfizer filed a lawsuit against the Chinese firm and cited the Paris Convention, claiming that the trademark belong to them and they should be the only ones to reap the benefits of it (Abrami). However, before the Paris Convention, intellectual property rights (IPR) were a foreign idea to much of the population of China. China did not develop their first Patent Law until 1984, nor their first Trademark Law until 1982 (Abrami, 2). The majority of their IPR improvements were not prompted until 2001, caused by China’s pending membership in the World Trade Organization, after which they had to comply with the TRIPS Agreement, or Trade-Related Aspects of Intellectual Property Rights. The State Intellectual Property Rights Office then declared that a firm could apply for three different types of patents: an invention patent, a utility model patent, or a design patent. After becoming a player in the global market, China’s trademark and patent laws became more inclusive. When Welman Company released their version of Pfizer’s ED drug, Pfizer had the grounds to argue that â€Å"Welman’s pills intentionally looked similar to Viagra, and in direct violation of existing Pfizer trademark rights held in China† (Abrami, 8). A back-and-forth legal battle between the two firms ensued, the results of which we have yet to see (Abrami). Similar to the dispute between Pfizer and Welman Company regarding Viagra, Cipla also got caught in the midst of a patent war. After AIDS was identified in 1982, British pharmaceutical company Burroughs Wellcome introduced the first drug that had been shown to slow the progression of AIDS in 1987. Although this was a groundbreaking treatment, the price was so expensive that nobody who needed it could afford it. Dr. Yusuf Hamied, chairman of Cipla, worked to develop an affordable alternative. In 1992, Cipla announced that it had reserve-engineered AZT and was able to produce and sell their serving for a fraction of the price of large MNCs. After this revelation, MNCs faced backlash, but cited high RD costs as the reason why they could not make their drugs more affordable. Many invested entities demanded that they drop the suit they had filed against the South African government (where the need for this drug was astronomical), including AIDS activists and humanitarian organizations. Ev entually, they dropped their suit and Cipla was allowed to continue production of affordable alternatives to their expensive drugs (Deshpandà ©). Legally, when Hamied began his work on the AIDS drug alternative, the 1970 India Patents Act was in effect. This act only recognized patents on the process of creating a drug, not on the drug itself. By reserve-engineering the drug and therefore using a different process of creation, Hamied was not in violation of the India Patents Act. While Cipla’s production of AZT would be a violation of Intellectual Property Rights since they did not develop the drug themselves, they did not legally violate the patent laws in play. Additionally, when Welman Company began producing their own version of Viagra, it was an underhanded attempt to make profits and gain business for themselves. They intentionally used a trademark that was associated with a different firm so that they would gain business from the confusion as well. Dr. Yusuf Hamied of Cipla argued that, while his methods may be questionable, his intentions were of a humanitarian nature, as well as being ethically and legally soun d. Additionally, as opposed to Welman Company, Cipla was selling their drugs for as cheap as possible, not increasing the price in an attempt to make profits. Their man concern was ensuring that those who needed access to their medication could have it. While both of these cases could be considered violations of intellectual property rights, their motives were very different: while Welman Company was concerned primarily with business and profits, Cipla had humanitarian intentions (Deshpandà ©). After the legal battle between Pfizer and Welman Company, it was determined that Welman Company would be allowed to keep the trademark on the Chinese name for Viagra, â€Å"Wei Ge.† The root of this issue was that, after Viagra’s launch, the name commonly used for this medication in China was â€Å"Wei Ge,† even though Pfizer only held a trademark for â€Å"Wai Aike,† a direct translation that never gained popularity (Chow, 83). Pfizer did not file a trademark application until May 1997, at which point it already belong to Guangzhou Viamen Pharmaceutical Company (Chow, 88). Because the media will coin a name in their language instead of using the English name, â€Å"a Chinese entity might obtain a registration for the Chinese transliteration of the English brand name before the U.S. brand owner can do so in China† (Chow, 88-89). One serious implication of this â€Å"is that the brand owner loses control over the Chinese-language name for its brandà ¢â‚¬  (Chow, 88). Because Wei Ge was already associated with the Viagra brand, when Guangzhou Viamen Pharmaceutical gained ownership of the name, it resulted in a huge loss of business for Pfizer (Chow). A solution that Chow presents in his article â€Å"Lessons from Pfizers Disputes Over its Viagra Trademark in China† is that Pfizer should have sought out the trademark for the Wei Ge name sooner. He claims that, in order to â€Å"maintain Chinese brand control, MNCs should develop and maintain a Chinese-language trademark in China prior or simultaneous to the time that an English-language trademark is obtained in the United States† (Chow, 104). At this point, Pfizer had gotten a patent for the drug itself and a trademark for the English name Viagra. However, when the Wei Ge name was coined in China, Pfizer should have immediately submit an application for the trademark to ensure that they received the business for their brand. If they had obtained the trademark to the Wei Ge trademark sooner, they would have the rights to the name instead of Guangzhou Viamen Pharmaceutical, and would have gained much more business in the global market (Chow).

Arthurian Romance

King Arthur has been an important figure in English literature since singers and story-tellers first described his great exploits in the 6th-century. Of course, the legend of   King Arthur has been appropriated by many story-tellers and  poets, who have embellished upon the first, most modest tales. Part of the intrigue of the stories, which became part of Arthurian romance, though, is the mixture of myth, adventure, love, enchantment, and tragedy. The magic and intrigue of these stories invite even more far-fetched and elaborate interpretations. While these stories and bits of  poetry depict a utopian society of long ago, though, they also reflect the society from which they were (and are being) created. By comparing Sir Gawain and the Green Knight and Morte dArthur with  Ã¢â‚¬â€¹Tennysons Idylls of the King, we see the evolution of the Arthurian myth. Sir Gawain and the Green Knight Defined as narrative, written in prose or verse and concerned with adventure, courtly love and chivalry, Arthurian romance derived the narrative verse form from 12th-century France. The anonymous 14th-century English romance Sir Gawain and the Green Knight is the most widely recognized example of Arthurian romance. Although little is known about this poet, who we may refer to as the Gawain or Pearl-Poet, the poem seems fairly typical of Arthurian Romance. Here, a magical creature (the Green Knight) has challenged a noble knight to a seemingly impossible task, in the pursuit of which he meets fierce beasts and the temptation of a beautiful woman. Of course, the young knight, in this case, Gawain, displays courage, skill and chivalric courtesy in overcoming his foe. And, of course, it seems fairly cut-and-dried. Beneath the surface, though, we seem some very different features. Framed by the treachery of  Ã¢â‚¬â€¹Troy, the poem links two main plot motifs: the beheading game, in which the two parties agree to an exchange of blows with an ax, and the exchange of winnings, in this case involving temptation that tests Sir Gawains courtesy, courage, and loyalty. The Gawain-Poet appropriates these themes from other folklore and romance to accomplish a moral agenda, as each of these motifs is linked to the quest and ultimate failure of Gawain. In the context of the society in which he lives, Gawain faces not only the complexity of obeying God, King, and Queen and following all of the overlapping contradictions which his position as knight entails, but he becomes a sort of mouse in a much bigger game of heads, sex, and violence. Of course, his honor is constantly at stake as well, which makes him feel as though he has no choice but to play the game, listening and trying to obey as many of the rules as he can along the way. In the end, his attempt fails. Sir Thomas Malory: Morte DArthur The chivalric code was slipping away even in the 14th-century when the anonymous Gawain-Poet was putting pen to paper. By the time of Sir Thomas Malory and his Morte DArthur in the 15th-century, feudalism was becoming even more obsolete. We see in the earlier poem a fairly realistic treatment of the Gawain story. As we move to Malory, we see a continuation of the chivalric code, but other features demonstrate the transition that literature is making at the end of the Medieval period as we move into the Renaissance. While the Middle Ages still had promise, it was also a time of great change. Malory must have known that the ideal of chivalry was dying out. From his perspective, order falls into chaos. The fall of the Round Table represents the destruction of the feudal system, with all its attachments to chivalry.Although Malory was known as a man of violent temperaments, he was the first English writer to make prose as sensitive an instrument of narrative as English poetry has always been. During a period of imprisonment, Malory composed, translated, and adapted his great rendering of Arthurian material, which is the most complete treatment of the story. The French Arthurian Prose Cycle (1225-1230) served as his primary source, along with the 14th-century English Alliterative Morte dArthur and the Stanzaic Morte. Taking these, and possibly other, sources, he disentangled the threads of narration and reintegrated them into his own creation.The characters in this work stand in stark contrast to the Gawain, Arthur, and Guinevere of earlier works. Arthur is much weaker than we usually imagine, as he is ultimately unable to control his own knights and the events of his kingdom. Arthurs ethics fall prey to the situation; his anger blinds him, and he is unable to see that the people he loves can and will betray him. Throughout Morte d Arthur, we notice the Wasteland of characters that cluster together at Camelot. We know the ending (that Camelot must eventually fall into its spiritual Wasteland, that Guenevere will flee with Launcelot, that Arthur will fight Launcelot, leaving the door open for his son Mordred to take over – reminiscent of the Biblical King David and his son Absalom – and that Arthur and Mordred will die, leaving Camelot in turmoil). Nothing–not love, courage, fidelity, faithfulness, or worthiness – can save Camelot, even if this chivalric code could have held up under the pressure. None of the knights are good enough. We see that not even Arthur (or especially Arthur) is not good enough to sustain such an  ideal. In the end, Guenevere dies in a nunnery; Launcelot dies six months later, a holy man. Tennyson: Idylls of the King From the tragic tale of Lancelot and the fall of his whole world, we jump to Tennysons rendition of Malorys tale in Idylls of the King. The Middle Ages was a time of glaring contradictions and contrasts, a time when chivalric masculinity was the impossible ideal. Jumping forward so many years, we see the reflection of a new society upon Arthurian romance. In the 19th-century, there was a resurgence of Medievalist practices. Extravagant mock-tournaments and pseudo-castles took attention away from the problems that society was facing, in the industrialization and disintegration of cities, and the poverty and marginalization of vast numbers of people.The Medieval period  presents chivalrous masculinity as an impossible ideal, while Tennysons​  Victorian approach is tempered with a great deal of expectation that ideal manhood could be achieved. While we see a rejection of the pastoral, in this era, we also notice a dark manifestation of the ideology governing the separate sphe res and the ideal of domesticity. Society has changed; Tennyson reflects this evolution in many of the ways he presents problems, passions, and strife. Tennysons version of the events that shroud Camelot is remarkable in its depth and imagination. Here, the poet traces the birth of a king, the building of the Round Table, its existence, its disintegration, and the final passing of the King. He traces the rise and fall of a civilization in scope, writing about love, heroism, and conflict all in relation to a nation. Be he is still drawing from Malorys work, so Tennysons details only embellish upon what we already expect from such an Arthurian romance. To the story, too, he adds an emotional and psychological depth that was lacking in earlier versions. Conclusions: Tightening the Knot So, through the gap of time from the Medieval literature of the 14th and 15th-century to the Victorian era, we see a dramatic change in the presentation of the Arthurian tale. Not only are the Victorians much more hopeful that the  idea  of proper behavior will work, but the whole frame of the story becomes a representation of a falling/failing of the Victorian civilization. If women would only be more pure and faithful, it is surmised, the ideal presumably would hold up under the disintegrating society. It is interesting to see how these codes of behavior evolved over time to fit the needs of writers, and indeed of the people as a whole. Of course, in the evolution of the stories, we see an evolution in characterization. While Gawain is an ideal knight in Sir Gawain and the Green Knight, representing a more Celtic ideal, he becomes increasingly mean and conniving as Malory and Tennyson sketch him with words.Of course, this change in characterization is also a difference in the n eeds of the plot. In Sir Gawain and the Green Knight, Gawain is the individual who stands against chaos and magic in the attempt to bring order back to Camelot. He must represent the ideal, even if that chivalric code is not good enough to stand up completely to the demands of the situation.As we progress onward to Malory and Tennyson, Gawain becomes a character in the background, thus a negative or evil character that works against our hero, Lancelot. In the later versions, we see the inability of the chivalric code to stand up. Gawain is corrupted by anger, as he leads Arthur further astray and prevents the king from reconciling with Lancelet. Even our hero of these later tales, Lancelet, is not able to hold up under the pressures of his responsibility to both the king and the queen. We see the change in Arthur, as he becomes increasingly  weak, unable to hold the kingdom together with his human powers of persuasion, but more than that, we see a dramatic change in Guinevere, as she is presented as more human, even though she still represents the ideal and thus the cult of true womanhood in some sense. In the end, Tennyson allows Arthur to forgive her. We see a humanity, a depth of personality in Tennysons Guinevere that Malory and the Gawain-Poet  were  not able to accomplish.