Thursday, October 10, 2019

How effective was Richard III as a king from 1483 †1485? Essay

At first, to associate Richard II with effectiveness seems an odd thing to do. He is a king with one of the shortest reigns in English history. He came to a violent end and his death was not only the end of the Yorkist dynasty, but also an end to the male line of the Plantagenet dynasty that had been on the throne since Henry VI in 1154. Richard III has always been one of the better-known losers of history, with an appalling reputation for excessive ambition and ruthlessness. He was also in the only king to die in battle with the exception of Harold II (Godwinsson) in 1066. On the other hand, there is some evidence of his being an effective monarch. He was an active and hardworking king who wanted to se his ideas firmly established across England. He was also a pious man with a well-used book of hours. He had ability as a soldier and administrator. He also courted popularity by many means. He was dedicated to the promotion of justice, especially for the poor. This was shown in a proclamation issued in Kent following the 1483 rebellion, â€Å"the king’s highness is fully determined to see due administration of justice throughout his realm†¦and to reform, punish and subdue all extortions and oppressions the same.† In addition to the proclamation, Richard also showed his desire to enforce law and order with equality by supplications. This meant access to law was opened up to people who could previously not afford it. Richard’s first act as king was to deliver a strict lecture to his judges in Westminster Hall on the impartial administration of justice for all his subjects. Another way of improving his popularity was to abolish benevolences, which had been greatly resented during Edward IV’s reign. This began to happen when, after his coronation, he went on progress around and made a point of declining benevolences offered to him, stating that he would not practice the extortions of his brother’s reign. The official abolition occurred in 1484. He also established the College of Arms in 1484 and transferred Henry VI’s remains to Windsor, a political gesture, showing that he was respectful towards the dead. Although Richard III had a fairly narrow power base, he did use patronage effectively, especially towards the nobility. This can be shown by his generosity to the duke of Norfolk. His rewards included his duchy, his share of the Mowbray inheritance and the estates of the earl of Oxford. Another nobleman who benefited from Richard’s patronage was the duke of Buckingham, who was amply rewarded for his involvement in Richard’s usurpation, receiving the constableship of England among other things. Richard III showed his courage and his ability to use his powers as king in the speed of his suppression of the 1483 rebellion. The uprising occurred in October in the counties south of the Thames, led by former servants of Edward IV. The duke of Buckingham joined it at a later stage. Large parts of the south were rebelling for over a month, but although the rebellion was serious and threatening, it failed. This was largely due to Richard’s vigilance and effective use of spies. He used the duke of Norfolk to crush the rebels in the South East, and concentrated his own efforts effectively against Buckingham. Due to a combination of Buckingham’s failure to raise support from his tenantry, an exceptional storm that kept him trapped in Wales and his betrayal in Shropshire, Buckingham was brought to Salisbury under Richard’s power and executed in December 1483. In two months the rebellion had been effectively quashed. An important measure of good kingship is the domestic government. Richard continued and developed the Yorkist system of government, including the chamber system begun by his brother, Edward IV. He continued the policy of recovering lapsed feudal dues and improved the Crown’s demesne through forfeiture. He was particularly vigilant in the promotion of law and order as explained previously, establishing the master of requests, John Harrington. He also established the Council of the North to fill the power vacuum he had left under his nephew, the earl of Lincoln. This meant that no one noble was given extreme power, thus limiting opposition to the crown. However, there is an equal amount of evidence suggesting that Richard III was an ineffective king. Although some aspects of his domestic government were strong, as explained in the previous paragraph, his foreign policy was largely unsuccessful. This is shown by the fact that Henry Tudor gained foreign backing to enable him to invade England in 1485. Part of Richard’s failure was due to bad luck. He had inherited a conflict with Scotland and strained relations with the French, as a result of the treaty of Arras in 1482. The situation was worsened after the death of Louis XI because a situation similar to that before Richard’s usurpation had arisen. The French Government did not want noblemen attempting usurpations after being in contact with Richard III, so shut down relations further. By making a truce with Brittany, Richard III suggested the possible renewal of the Triple Alliance and a possible English invasion to the French Government, which increased their hostilit y. Although Richard III continued and developed the chamber system that had proved so effective during Edward IV’s reign, however, his expenditure was greater than his income and he had growing financial problems by 1485. He was frequently accused of wasting the surplus gained in his predecessor’s reign, although Edward’s military expenses, his funeral and Richard’s own coronation, had considerably reduced it. By 1485 it was necessary for him to request loans from his greater subjects, which were largely not granted and deeply resented. There is also another side to the argument concerning the 1483 rebellion. Richard’s speedy reaction to the rebellion meant that a lot of the danger was reduced; however it did continue to have a detrimental effect on his authority and power-base throughout his reign. Many of the rebel leaders had escaped and crossed the channel to join Henry Tudor in Brittany forming a court in exile. This turned Henry Tudor into a more serious threat and lost Richard a great deal of support. The rebellion also signified the failure to project himself as Edward’s natural successor due to the high number of his brother’s servants who rebelled. Therefore he attempted to impose his rule upon the southern subjects by putting members of his northern retinue in positions of power in the South. This only served to increase resentment as the southern gentry felt these positions were rightly theirs. Only one member of the southern gentry fought with Richard III at the battle of Bosworth. Richard failed to swing the opinions of the â€Å"super-magnates† in his favour. These were a few very powerful men scattered around the country whose support really mattered. This can be shown with the earl of Northumberland. Although he was instrumental in Richard’s rise to power he wasn’t given power over the North as he had expected, and was under the control of the Council of the North chaired by the earl of Lincoln who was an outsider to northern affairs. Thomas Lord Stanley was also important by his ability to change sides at the most opportune moment. Due to Richard III’s failure to firmly secure Lord Stanley on his side, Stanley intervened at the battle of Bosworth at a crucial time against Richard and aided in his loss of the battle. Propaganda was another weak area of Richard’s kingship, which is demonstrated by the ineffectiveness of his 1484 act. This was meant to confirm the validity of Richard III’s claim to the throne and act as proclamation against Henry Tudor. This stated the marriage of Elizabeth Woodville and Edward IV was invalid; therefore any children were illegitimate; that the children of Clarence were debarred from the succession by his attainder; condemned the government of Edward IV due to the Woodville influence, described as harmful to English security, immoral and corrupt. Very few of Richard’s subjects believed the content of the proclamation and it did no good to Richard III’s popularity. Although some of the problems during Richard’s reign were doubtless caused by his personal mistakes almost all of them were reinforced by bad luck. For example, the breakdown of relations with France was already begun in Edward’s reign due to the bitterness caused by the terms of the Treaty of Arras. There is another argument that Richard III could never be a truly effective king due to the nature of his rise to power. This idea means that he was not ineffective because of his own personal abilities but his actions in 1483 meant he faced continual opposition from the day he seized power. Despite how historians have attempted to justify Richard’s usurpation, it was unique in the murder of his nephew’s, showing an extreme level of naked aggression, which shocked even the most hardened of hearts. Although all usurpations have a certain aspect of aggression and ambition, Richard alone isolated so many key groups and is essential the only failed, not establishing his dynasty successfully, usurpation in English history. The case against Richard III concerning the princes in the tower is extremely strong. The rumours concerning their death were politically harmful to Richard III and could easily be scotched by producing the Princes. However, Richard failed to ever offer any alternative evidence to their disappearance. His only counter-argument was under the pretext of protecting them, which did not satisfy his subjects. This lack of faith in Richard III led to the emergence of a Tudor-Woodville alliance as an alternative leadership. Many important members of the English gentry joined the Tudor-Woodville alliance, notably Buckingham when he joined the 1483 rebellion. More members of the gentry joined Henry Tudor in Brittany following the rebellion, as Richard did not succeed in executing the leading rebels. This led to the creation of an alternative court in Brittany allowing Henry Tudor to build up his support base and strengthen his position. Many contributing factors led to Richard II’s failure to widen his power-base. Although he had a very large retinue, who he relied on implicitly, it was too narrow a political base to be secure. This was partly due to Richard’s own personality; he was a suspicious man in general, generous to those who earned his trust, but unwilling to let many close to him. However it was also due to the hostility of a large portion of the population towards him. Richard was never popular in the south and many others could not overcome their personal worries about his self-serving ambition. This meant he was entrapped within the narrow base of his northern support. Although I have explained previously in this essay many ways in which Richard III attempted to win popularity, none seemed to work. The methods employed by Richard, when other kings in history had used them did succeed in gaining support, so it was not due to Richard’s own effectiveness or ineffectiveness. Again the opposition towards him appears to have been based on the events of 1483 where his actions were interpreted as desperate, ruthless and hypocritical. It was not only his supposed murder of his nephews that caused resentment, people in the City of London were also against his murder of Lord Hastings during his time as protector, and uproar was only prevented through the use of Richard’s retinue. Overall I believe that Richard III was ineffective as a monarch between 1483 and 1485. However, this is not wholly because of his individual character, but mainly the events and singularly ambitious nature of his usurpation that he could not conquer by any means. As A.R. Myers said in England and the Late Middle Ages â€Å"Had he come to the throne in the normal way, his ability†¦might have given him a long and successful reign. As it was†¦[his] qualities were not enough to overcome the formidable hostility to him.†

Alcohol Advertising to Youth Essay

Many people are unaware of the prevalence of underage drinking in the United States. Every day in the United States, more than 4,750 kids under age 16 have their first full drink of alcohol. More youth in the United States drink alcohol than smoke tobacco or marijuana, making it the drug most used by American young people. Youth who start drinking before the age of 15 are five times more likely to develop alcohol dependency or abuse in their lifetime than those who begin drinking at 21 years or later. All of these facts were published by the Center on Alcohol Marketing and Youth. They have published many reports on the prevalence of drinking among underage youth. But why do underage youth start drinking alcohol in the first place? According to many studies, alcohol advertising is the main influencer of alcohol consumption among underage youth. Alcohol advertising influences the use of alcohol among youth and increases the likelihood that they will consume alcohol illegally. For example, a study published in 2006 found that for each additional alcohol ad a young person saw (above the monthly youth average of 23), he or she drank one percent more. Also, for every additional dollar spent on alcohol advertising in a local market, underage drinkers consumed three percent more alcohol (Surgeon General, 2007). Because young children are likely to be influenced by alcohol advertisements, there needs to be stricter regulations on the advertising industries ability to advertise alcohol to underage youth. According to the Surgeon General’s Call to Action to Prevent and Reduce Underage Drinking (2007), â€Å"The short-and long-term consequences that arise from underage alcohol consumption are astonishing in their range and magnitude, affecting adolescents, the people around them, and society as a whole. † Therefore, there should be a stricter regulation on alcohol advertising to youth because of the strong influence it has on their behavior and their alcohol consumption patterns. Each year, the alcohol industry spends more than four billion dollars marketing its products (Mosher & Cohen, 2012). There have been multiple studies that have correlated underage youth exposure with a greater likelihood of drinking. It is imperative that the government or advertising industry reduces the impact of alcohol marketing on young people. Reducing underage drinking, like smoking, is an important public health goal (Mosher & Cohen, 2012). Public health departments in California, Massachusetts, and Florida have made crucial strides in reducing underage smoking rates in their states (Mosher & Cohen, 2012). They did this my sponsoring tobacco counter advertising campaigns. This indicates that this type of approach may be effective for reducing underage drinking as well (Mosher & Cohen, 2012). The problem with this for alcohol advertising is that there are already responsibility ads, but they are outnumbered by alcohol ads 226-1 (CAMY News Release, 2004). Alcohol product advertising has increased significantly in recent years, while responsibility ads have decreased. According to a new study from CAMY at Georgetown University, the number of responsibility ads dropped by 46 percent from 2001 levels, while the number of alcohol commercials increased by 39 percent. Industry spending on responsibility ads also fell—down 57 percent from 2001. This is unacceptable. According to CAMY Executive Director, Jim O’Hara, â€Å"This minimal amount of responsibility advertising does little to reinforce the message of parents and teachers who are trying to prevent underage drinking. Our children need to receive a more balanced message about alcohol. † According to the same study, for every dollar spent on responsibility ads in 2002, the industry spent $99 on product ads, where in 2001, the ratio was $1 to $35. Alcohol companies should be required to sponsor a certain amount of responsibility ads each year, that is relative to the number of alcohol product ads they place. This would help to increase the amount of responsibility ads underage youth is exposed to and thus, increasing the amount of reinforcement they receive to not drink underage and illegally. According to the CAMY study at Georgetown University in 2002, of 59 alcohol marketers advertising on television, only four places responsibility ads in 2002. Adolph Coors Co, Anheuser-Busch Companies Inc. , SABMiller PLC and Diageo PLC were the four parent companies whose brands placed responsibility ads in 2002. Anheuser-Busch placed the most ads, but they still spent 45 times more on product ads and placed 89 more product ads than responsibility ads (CAMY, 2002). Underage youth were 287 times more likely per capita to see a TV commercial promoting alcohol from 2001 to 2006 (Nielsen Media Research, 2006). Other studies have found that youth exposed to alcohol in movies and to alcohol in signage near schools as well as youth ownership of alcohol promotional items are all associated with a greater likelihood of underage drinking (The Surgeon General, 2007). Therefore, because of youth’s potential to be greatly influenced by alcohol advertisements, this high amount of exposure to alcohol advertisements increases the consumption of alcohol among underage youth. There is opposition to stricter regulations on alcohol advertising; some feel that these regulations will not have any effect on the consumption and use of alcohol among underage youth. According to Marcus Grant, the president and founder of the International Centre for Alcohol Policies said that in many Scandinavian countries where alcohol advertising was banned, the prevalence of alcohol abuse was still high. Also, according to the industry Association for Responsible Alcohol Use (ARA), no evidence exists to support the notion that beverage alcohol advertising has any significant effect on the rate of alcohol abuse. According to the ARA, Denmark has a ban on all broadcast advertising except on low alcohol-content products, as well as various restrictions on print and outdoor advertising. It has one of the highest reported rates of intoxication among young people. Therefore, they feel that increasing the amount of regulations of alcohol advertising, or the banning of alcohol advertising as a whole, will not result in a decline in the rate of alcohol consumption among underage youth. While alcohol marketers have made reforms in their marketing practices, these revisions fall short (Mosher & Cohen 2012). In 2006, The STOP Act was passed, requiring that the U. S. Department of Health and Human Services report annually on rates of exposure of youth to positive and negative messages about alcohol in the mass media. Advertisers are aware of the media usage of youth and current alcohol regulations do not do enough to protect underage youth from viewing alcohol advertisements. According to CAMY reports on Youth Exposure to Alcohol Ads, the advertising industry has reduced youth exposure to its advertising in magazines and cut its spending on radio. However, youth exposure to alcohol advertising on television grew by 30 percent between 2001 and 2006 (Mosher & Cohen, 2012). Because youth, ages 12 to 20, are only 13. 3 percent of the national TV viewing audience, the current threshold of not placing ads where underage youth are more than 30 percent of the audience allows alcohol advertising on programs where there are more than twice as many youth as the viewing population (Mosher & Cohen, 2012). It is obvious that current regulations do not do enough to support the goals of Congress, and of the Surgeon General, to decrease alcohol advertising exposure and alcohol consumption among underage youth. Therefore, stricter regulations need to be put into place to restrict the advertising industry from placing alcohol advertisements within youth-consumed media. CAMY issued a report of eight methods for states to limit and reduce youth exposure to alcohol advertisements. According to CAMY, only 11 states implement more than one â€Å"best practice† policy, a total of 22 states implement no policies at all. It is important for these states to implement all of eight of the methods to ensure that underage youth are not exposed to these ads and the consequences of seeing these ads (Swift, 2011). According to a study conducted by Leslie B. Snyder, Ph. D. , of the University of Connecticut, Storrs, and colleagues, a random sample of young people between the ages of 15 to 26 years old were interviewed. The researchers reported these results: (1) For each additional alcohol advertisement viewed per month, the number of drinks consumed increased by one percent (2) The same percentage increase, one percent per alcohol advertisement per month, applied to underage drinkers (those younger than age 21) as well as legal aged drinkers (3) Youth in markets with high alcohol advertising expenditures ($10 or more per person per month) also increase their drinking more over time, reaching a peak of 50 drinks per month by age 25 and, (4) Young people drank three percent more per month for each additional dollar spent per capita in their market (Buddy T., 2006). This research shows that advertising expenditure had a direct influence on the amount of alcohol consumed by underage and legal aged drinkers. According to Snyder, â€Å"The results also contradict the claims that advertising is unrelated to youth drinking amounts†¦ Alcohol advertising was a contributing factor to youth drinking quantities over time,† (Buddy T. , 2006). The facts cannot be denied; alcohol advertising is effective. The bottom line is, the more advertising young people see, the more they drink (Buddy T. , 2012). CAMY has found that many parents are beginning to become concerned about the overexposure to alcohol advertisements that their children see. Two-thirds of parents believe more ads mean more youth drinking and 75 percent of parents agree that the alcohol industry should do more to limit youth advertising (Buddy T. , 2012). It is unacceptable that nothing more has been done to prevent this while there have been multiple studies done on the correlation between alcohol advertising and underage drinking, and they all have concluded the same results: Exposure to alcohol advertising increase the likelihood for underage drinking and increased alcohol consumption. Alcohol advertisements need to be regulated across all media forms: online, television, magazine and print, radio, etc. Young people should not be exposed to alcohol advertisements, especially within the media channels that they use most. Television alcohol ads should not be allowed to be on shows with certain percentage of underage viewers, the same goes for magazine and radio advertisements. While it will be hard to regulate this, more can be done to make sure the message of preventing underage drinking is reinforced through responsibility ads. If stricter regulations on alcohol advertisements cannot be put into place, then the amount of responsibility ads countering the alcohol ads needs to be dramatically increased. Underage youth need to constantly be reinforced with the message of not underage drinking as well as the warnings of drinking such as drunk driving. In conclusion, more needs to be done to reduce the amount of youth exposure to alcohol product advertisements and to prevent underage drinking. It is the responsibility of the government and of alcohol marketers to make sure they are protecting youth, not corrupting them at a young age. Youth exposure to alcohol advertisements increase the amount of alcohol consumed by underage drinkers and current regulations are simply not doing enough to prevent this. References â€Å"Alcohol Ads Outnumber Responsibility Ads 226-1. † About. com Alcoholism. N. p. , 2002. Web. 11 Dec. 2012. â€Å"Alcohol Advertising and Youth. † Johns Hopkins Bloomberg School of Public Health. CAMY. org, Apr. 2007. Web. 11 Dec. 2012. Mosher, James F. , JD Cohen, and Elena N. Cohen. â€Å"State Laws to Reduce the Impact of Alcohol Marketing on Youth. † Camy. org. Alcohol Policy Consultations, 1 May 2011. Web. 11 Dec. 2012. â€Å"Prevalence of Underage Drinking. † Johns Hopkins Bloomberg School of Public Health. N. p. , July 2011. Web. 11 Dec. 2012. â€Å"State Report Update 2012. † Johns Hopkins Bloomberg School of Public Health. N. p. , 1 May 2012. Web. 11 Dec. 2012. Swift, James. â€Å"States Not Reducing Youth Exposure to Alcohol Ads. † Youthtoday. org. YouthToday. org, 4 May 2012. Web. 11 Dec. 2011. T. , Buddy. â€Å"Alcohol Advertising Increases Youth Drinking. † About. com Alcoholism. N. p. , 19 Jan. 2006. Web. 11 Dec. 2012 T. , Buddy. â€Å"Teen Drinking Influenced by Alcohol Advertising. † About. com Alcoholism. N. p. , 19 Oct. 2012. Web. 11 Dec. 2012. T. , Buddy. â€Å"Underage Drinking Troubles Parents. † About. com Alcoholism. N. p. , 27 Dec. 2007. Web. 11 Dec. 2012. U. S. Department of Health and Human Services. The Surgeon General’s Call to Action To Prevent and Reduce Underage Drinking. U. S. Department of Health and Human Services, Office of the Surgeon General, 2007.

Wednesday, October 9, 2019

Case Study Analysis Essay Example | Topics and Well Written Essays - 2000 words

Case Study Analysis - Essay Example The environment may range from tangible to intangible factors, humans to objects. However, for Tim’s case the influences are situational given the problems he sought to solve arose from non ideal situations. The situation in this case is low morale. Morale is a psychological attitude characterized by enthusiasm and energy to work. Workers in the club clearly have low morale. The second problem is the lack of adequate motivation from the employee’s environment namely the management and fellow employees. This is an analysis of the psychological ties motivation and morale has by examining the workplace discrepancies (Nelson, 2010). The first discrepancy in the organization is the conflict between the management and employees. The case study on â€Å"money is not always the best reward† points out that the first problem Tim encounters is that of employees on stress leave due to conflict with management. Barling (2005) holds that conflict may result in psychological s trains such as stress. Three employees out of seventy five on stress leave is an indication that the problem is spinning out of control. This also reflects that the organization lacks appropriate conflict resolution strategies. This discovery also implies the lack of confidence the employees have in the management. Tim further discovers that additional four employees had work related accidents. Further research further shows that psychological strain may increase accidents at the workplace (Barling, 2005). Logic dictates that the club should investigate the cause of these accidents, but instead they set up a compensation policy and left it at that. A second problem at the club is that employees receiving directives from many authorities such as the board of directors overstepping their boundaries and giving direct instructions to employees. The result of this is that the employees experience conflict of interest which may lead to psychological strain. This conflict of interest goes as far as interdepartmental conflicts in between the club employees. Seeing as the employees roles were not well defined, they were not sure which functions to perform and how to perform them. In summary, the company did not a have proper job description and specification outline. The company also lacks Human Resource guidelines and Operational policies to guide the running of the institution (Nelson, 2010). Tim’s solutions: Tim’s critical decisions utilize a few psychological perspectives. Establishing that the main problem the employees have is low morale and lack of motivation as the start. Tim then set out to solve this problem. The findings of Elton Mayo concur with Tim’s reluctance to prioritize monetary reward to in solving his problems. The Hawthorne studies reveal that human needs in all spheres of life are complex; therefore, they require more than material rewards. Essentially a sociological approach, the human relations approach, however, has some es sential psychological characteristics that reflect on the situation at the club. The first, vital aspect Mayo reflects on is that individuals like feeling a sense of autonomy at the wok place. As such, they prefer that the management consult them on issues that involve their work situation. Modern work perspectives view employees in an organization as key partners, a source of sustained competitive advantage

Tuesday, October 8, 2019

Crusiate Ligaments Sprain Essay Example | Topics and Well Written Essays - 2500 words

Crusiate Ligaments Sprain - Essay Example However, in complex sprains a large segment of the fibres are torn and the ends of the ligament may have separated from each other. This would result in immense pain as well as instability of the joint and it may require surgical treatment. Rouzier indicates that sprains may be graded according to their severity: According to the Chester Knee Clinic, the knee is a well exposed structure that consists of two joints and made up of three bones namely, the femur, tibia and the patella. They further go on to describe its anatomy in greater detail: The tibio-femoral joint has medial and lateral compartments. The medial and lateral femoral condyles articulate with the medial and lateral tibial plateaus. The patella covers the front of the knee. The patello-femoral joint is the articulation of the patella with the femoral trochlea. All joint surfaces are covered with hyaline articular cartilage. This anatomy of the knee joint offers no real support to the joint's stability. Thus, ligaments are essential in regulating the movement of the knee joint and maintaining its stability. Various stabilizing configurations are brought into play as the knee moves through its full range of motion, giving dynamic stability to the joint (Smith and Moran 1). Avery describes the knee joint as consisting of four essential ligaments that aid in its stabilization. The sides of the joint consist of the medial and lateral collateral ligaments which aid in the side-to-side stability of the joint. In the front of the joint is the anterior crusiate ligament (ACL) which serves to prevent the tibia from sliding forward and rotating during various agile activities such as jumping. Opposite to the ACL is the posterior crusiate ligament (PCL) which prevents the tibia from sliding back. The crusiate ligaments regulate movement as the centre of rotation changes during movement. The presence of the menisci is another important feature for not only do they act as shock absorbers, but they also aid in weight distribution (ehealthMD 1). Incidentally, the crossing of the ACL and PCL in the centre of the knee is what gives rise to the term "crusiate". Representations of these structures courtesy of the Journal of the American Medical Association are as seen in Figures 1 and 2 below. Figure 1: Anatomy of the Right Knee Figure 2: Anatomy of the right knee with ligaments cut. Knee Biomechanics As Elliot explains, clinical biomechanics refers to the research conducted on the actions of walking, tissue mechanics, neuromuscular control and the evaluation of movement when an individual is undergoing rehabilitation when recovering from disease or injury (1). The Chester Knee Clinic provides a comprehensive understanding of the biomechanics of the knee. The bones of the knee joint, unlike the hip joint, are not a close fit to one another. This variation allows for a wider range of motion to occur in order for an individual to carry out daily activities. However, this range of motion is still limited in its inherited stability due to the bony structure of the joint. According to the KneeDoc, "the lack