It is not an essay but quistions Example | Topics and Well Written Essays - 1000 words

It is not an but quistions - Essay Example AS a result, the number reduced making it inferior to withstand the forces from the north. The other success was in Gettysburg. In the battle, the army under the command of Lee suffered a significant loss. In the battle, there were massive casualties. As a result, Lee side was demoralised on invasion of the north and, therefore, had to retreat to Virginia. The 1890 can be described as a watershed of the 1900’s in different ways. In the period, various changes defined the 1900’s. First, there was consolidation of various railway projects that had begun in the second part of the century. The consolidation helped in emergence of various industries that helped spur economic growth in the 1900’s. Moreover, the emergence of industries led to economic dominance of United States in the following century. Secondly, industrialization led to increased immigration to America. For example, there was increasing number of immigrants. Most came from Europe. They were looking for work and increased freedom. Consequently, there was growth of cities where the immigrants settled leading to increased urbanization. However, the period also saw increased discrimination. The discrimination was directed to African American. The period saw the passage of authoritarian laws such as Jim Crow laws that authorised segregation of African Americans. The law also allowed lynching of African Americans in the southern side. The changes led to rise of civil rights groups in then 1990’s. Moreover, there was a rise of exceptional leaders agitating for equality of different races over the same time such as Dubois and Martin Luther King. Additionally, the period saw the rise of various political parties. The parties were because of activism of farmers. In the period, farmers complained of reduced prices of commodities such as wheat and cotton. One of such parties was the People’s Party (Populist Party). The party was agitating for political

Kinder Garten Math and English Game System Essay Example for Free

Kinder Garten Math and English Game System Essay My name is Robin Rutherford and I will be your child’s Kindergarten teacher this year. I am looking forward to an exciting and productive year with your child. This is my fifth year as a teacher at Parkview Elementary. I have 14 years of experience teaching Kindergarten. I graduated from TexasTech University with a degree in Early Childhood Development with a teaching certificate Pre-K through 6th grade. Over the years, I have taken many hours of professional development in order to be prepared to meet each child’s needs. I love teaching kindergarten! My mission as a teacher is to help children discover the joy of learning, and to help each child develop a strong belief in his or her own ability. I want them to do their best and to have a sense of pride in doing their personal best. It is also of primary importance to me that my students appreciate and respect other peoples’ differences. I enjoy reading, cooking, photography, scrapbooking and making jewelry. I love animals and have a Cocker Spaniel named Olivia and a Jack Russell terrier named Jack. I also have a large salt water aquarium and a cockatiel named Spike. I am a foster parent and, in time, hoping to adopt. Together we can make this year the best year possible for your child. If you have any questions or concerns, please feel free to call or come up for a scheduled conference. My conference time is Monday through Friday from 12:55- 1:45. The school phone number is 817-. 237-5121. The Beginning of Kindergarten Friedrich Frobel, of Germany, was the founder of the kindergarten – meaning garden of children. The Frobel kindergarten is based on German Idealist philosophy that explored the individual and natural world. The first kindergarten was based on natural play things/toys, songs and dance that promoted cooperative members of the community, and play for all children at all social and ability levels. His philosophy was based on free self-activity, creativity, social participation, and motor expression. News Superintendent of Schools Lynne Erdle invites public input regarding development of the school districts 2013-2014 proposed operating budgets. The budget development period has arrived with the New Year and the Board of Education and district officials have begun work on next years budget. This early in the process, there are many unknowns, including Canandaiguas level of state aid proposed by their Governor, and its Tax Levy Limit for 2013-14 under the law. News The Canandaigua City School District reminds all parents and visitors to our school buildings that proper photo identification is required to be shown for receipt of a Visitor’s badge and for full access to any building during school hours. Photo IDs are inspected and Visitor’s badges are distributed at the Reception Desk at each school building. There are no exceptions to this procedure. All.. News Robyn is a certified elementary teacher and ESL teacher in Illinois, who has taught 4th-6th grade, middle school ESL, and ESL to adults. She specializes in the fields of writing, ESL, academic/career advising, and higher education. She is a professional advisor for the state of Illinois, the Managing Editor of ED News Daily, and a blogger for Chicago Now. She has been published in Linkedin Today, Edudemic, Reading Horizons, BG Patch, The Niles Bugle and more. Robyn was recently?interviewed by Xavier University, discussing her lifes dedication and work in the field of education, as part of their American Dream Project, to be released on their website soon. Robyn was a featured educator and? writer for Edutopia. org. In addition to her passion for writing, she also has a great love of higher education. She launched and managed the first graduate advising program for National Louis University, supporting over? 2,500 teachers. She holds a B. A. in Elementary Education and an M. Ed. in Curriculum and Instruction, with a concentration in ESL. News Quality Early Childhood Education The agency supports high-quality early learning that promotes kindergarten school readiness for Texas children. The State of Texas is invested in the identification and dissemination of well researched early childhood education instructional strategies. Supported through key partnerships with the Regional Education Service Centers, the Texas Early Learning Council, numerous licensed child care programs, including Head Start, Texas continues to raise the bar for quality early learning. This includes laying the foundation for all investments through the adoption of the Texas Prekindergarten Guidelines (PKG), which emphasize research-based instructional strategies that are developmentally appropriate. Intended to support all students, these guidelines also work to inform teachers in addressing the specific needs of English language learners and students with disabilities. News ABC Phonics: Sing, Sign, and Read! by Nellie Edge book and CD features an innovative â€Å"Multisensory ABC and Phonics Immersion† strategy, creating an engaging and memorable way for children to learn letters and sounds and begin the reading process. The integration of visual, auditory, and kinesthetic learning pathways builds success for all young learners. Delightful watercolor illustrations, ASL signs, and a team of engaging children join you on this lively musical adventure. Because still pictures alone do not fully convey the beautiful flow and motion of ASL, Sign2Me publishers has created complimentary online tutorial videos to help you learn the signs in this ABC Phonics book. â€Å"Family ABC Wall Charts† and â€Å"Parents as Partners† letters are also available. Written by Joseph Gulino A child’s readiness for formal education should not be determined solely by a calendar date and a simple skills test. â€Å"I just try to pull them through! † said the kindergarten teacher when I observed that six of the children in her class of 21 did not seem ready for kindergarten. It was December 1999, I was new to the school, and I was concerned about some behaviors the kindergartners were exhibiting, such as inability to focus or sit still for more than a few minutes, lack of knowledge of letters and numbers, and—most of all—the desire to play rather than learn. As I got to know the students in grades 1 through 8, my concerns heightened. There were five to 15 children in each grade who were either struggling or just not interested in learning. What troubled me most, however, was the lack of a formal readiness testing process as a criterion for kindergarten entry. There also was no process to inform parents regarding school readiness issues, and no organized counseling strategies to assist parents of children who were not ready for formal school experiences. School accountability and student achievement are topics of paramount significance today. But I believe it is unfair to place accountability for student achievement on education systems that not only are financially strapped but are also hindered by current enrollment practices that set up students and schools for failure. That is why it is imperative for educational leaders and legislators to revamp the early years of formal schooling by designing, implementing, and assessing school enrollment practices and procedures founded on sound research.

Personal Reflection on Intermediate Anaesthetic Practice

Personal Reflection on Intermediate Anaesthetic Practice I am a student anaesthetic practitioner with a clinical placement in an acute hospital. I will be reflecting on my personal experience with a 20 year old patient who underwent a Myringotomy and Bilateral Ear Grommets Insertion procedure wherein a local anaesthetic was used and had failed, and prompting the case to be done under general anaesthesia. The operation was deemed necessary by the consultant as the patient was diagnosed with recurrent Otitis Media with Effusion (OME), see Appendix A [on page 23], because it will eventually help to correct his hearing loss and prevent further deterioration as stated by Woolfson and McCafferty 1993. Following the NMC Code of Conduct (2008) on Confidentiality of patients information, I will refer to patient as Mr. B. I will be using the Gibbs Reflective Cycle which is shown in Appendix B as the framework of my reflection Jasper (2003). It will highlight how researching further led to a better understanding of surgery and anaesthetics and to know how to respond if the same situation happens again. Mr. B. had been admitted in the ward at noontime of the surgery. He was seen by the anaesthetist to carry out a preoperative assessment. According to the anaesthetist, he is generally fit for surgery and does not pose as an anaesthetic risk. The anaesthetist discussed with him about her plan to give him a general anaesthesia, but he asked the anaesthetist if the operation can be done without having a general anaesthetic because he prefers to remain awake. The consultant surgeon also came in and explained the surgery. He was allowed to undertake a local anaesthetic provided that he cooperate well and if the local anaesthetic is unsuccessful, an alternative anaesthetics will be used, that is a general anaesthesia. The surgeon and anaesthetist explained what he will experience with local anaesthetics like a burning sensation in his ears, including possibly a degree of pain. Any anaesthetic may arise complications and that other types of anaesthetic is not sufficient for the surgery and therefore needs to be changed to a general anaesthetic at any time (Box Hill Hosp. Dept. of Anaesthesia, 2001). A written consent was obtained by the surgeon from Mr. B. The Department of Health Guidelines (2007) on Consent states that Informed Consent ensures the patient has full knowledge of the procedure because it is fully explained to the patient by the surgeon. The patient is also given the time to ask any questions he may have and voice any concerns and honest answers must be provided. I was assigned in the ENT theatre for the afternoon session which has three booked cases. The operating department practitioner (ODP) and I did the necessary checks in the anaesthetic room and safely prepared the anaesthetic materials and equipment in preparation of the list (AAGBI 2004). I also checked the safe and correct functionality of the anaesthesia machine and refilled drugs in the anaesthetic cupboards. Shields and Werder (2002) said that adequate preparation of the anaesthetic equipment, resources and patient is essential to the provision of safe anaesthetic care. The team members gathered to initiate a preoperative briefing. During the briefing, the surgeon mentioned about the order of the list. Mr. B will be done last as he is a private case anyway. After finishing the first two cases, the ODP and I went to the waiting area of patients to fetch Mr. B. I introduced myself and checked his identity. Then I checked that all preoperative preparations were done and documented. The consent form was confirmed to him that it was his signature and dated. As the patient was having a Myringotomy and Bilateral Ear Grommets Insertion, the site of his procedure was not marked. For most procedure, this is an important check. The National Patient Safety Alert NPSA (2005) recommend that by marking the site for the operation with an arrow using a permanent marker will assist in reducing the incidents of wrong site surgery being performed. I also checked him for any allergies, presence of any metalwork, prosthetic aids in his body, contact lenses, crowns and dentures and asked if he has any other significant surgery or illness. Then I accompanied him to the operating room and made him lay down comfortably. While conversing with him, I placed on the external non-invasive monitors such as the blood pressure, ECG and pulse oximeter. I tried to maintain a quiet and supportive environment. I sat beside him and continued to communicate with him as he looked anxious. Kumar (2 000) said that patients are apprehensive about what will happen and the anaesthetic practitioner needs to monitor patients anxiety level throughout the surgical procedure. Meanwhile, the circulating nurse initiated the Time Out check which is carried out in every operation to enhance a safe surgery (World Health Organisation Guidelines for Safe Surgery, 2008). The surgeon applied the local anaesthetic drug Ametop gel 4% onto Mr. Bs ears. Woolfson and McCafferty (1993) suggest that it should be instilled into the external ear canal using a soft, intravenous cannula and a 5ml syringe and performed under a microscope to ensure immediate contact of the gel with the entire ear drums and that the ear canal was filled and the depth of the gel provides self occlusion. According to the BNF (2010) Ametop is a topical local anaesthetic in gel form which contains Tetracaine base 40 mgs. believed to act by blocking nerve conduction mainly by inhibiting sodium ion flux across the axon membrane. The ester type caine anaesthetics are rapidly metabolised in blood mainly by plasma pseudocholinesterase. A slight erythema local skin reaction will be usually seen at the site of the application and as a result of the pharamacological action of tetracaine dilating the capillary vessels.This helps in delineating the anaesthetised area as explained by the National Library of Guidelines (2007). Adequate anaesthesia can usually be achieved following 30-60 minutes application time and anaesthesia is maintained for 4 to 6 hours in most patients after a single application. We waited only for about 30 minutes to anaesthetise his ears. While waiting, Mr. B became anxious as he was seen perspiring a lot. Everyone reassured him. The surgeon began cleaning and draping the area. Working with an operating microscope, the surgeon started to suction and made a small incision in his eardrum. Mr. B reacted to the pain but I encouraged him to keep still. The surgeon continued to suction the fluid present in the middle ear but Mr. B kept on moving his head because the pain was more intense. A tiny grommet was to be inserted into his surgical aperture but he refused as he cannot bear the intense pain. The surgeon stopped and asked the patient not to move if he wanted the operation to continue or if he cannot tolerate, he will be put to sleep instead. Mr. B and the whole team proceeded further as consented. The anaesthetist cannulated Mr. B. using a gauge 18 large bore venflon secured with a transparent and semi permeable dressing connected to a litre of Hartmanns solution which has been labelled and checked by the anaesthetist and the ODP as per NHS protocol for intravenous infusion, AfPP (2007). Clarke and Jones (1998) describes that a Hartmanns or sodium lactate or lactated ringers is a crystalloid type of intravenous fluid that will cross a semipermeable membrane, thus allowing movement of electrolytes to correct any imbalance. It contains calcium, chloride and lactate similar in composition to extracellular fluid as a balanced salt solution. The anaesthetist started the induction and an I-gel airway (see appendix C) was inserted. The surgery was resumed and carried out without any problems. Mr. B. was fully recovered and transferred back to the ward without complications. I felt disappointed because the result of this experience was clearly contrary to initial expectations. A minor operation like this can be done under local anaesthetics and is a quick procedure. It could have finished if only the patient cooperated well. Although this experience was frustrating for the patient as he requested to be awake during the procedure, still it went well and the treatment for a possible hearing loss and deterioration was done for him. The duties and responsibilities expected from me as an anaesthetic theatre practitioner were performed according to the policies and procedures of my clinical placement. The whole team cooperated well and performed their job accordingly. I have also found out a controversial issue regarding the Ametop gel which has aroused my doubt. Netdoctor (2004) points out that Ametop is a topical anaesthetic for dermal analgesia which must not to be applied to broken skin, mucous membrane or to the eyes or ears. Tetracaine gel could be ototoxic like other local anaesthetics and should not be introduced to the middle ear or use in procedures which might involve penetration into the middle ear. Therefore, Mr. B. might be at risk for ototoxicity. In addition to that, the local anaesthetic did not fail but it is because the surgeon did not wait longer enough until Mr. B was pain free before starting the surgery. A proper consent was secured earlier from him, thus, saved the time in securing a fresh consent. Moreover, it saved NHS resources akin to if the list was cancelled and rescheduled and along with the unsatisfactory hospital experience of Mr. B. The surgery could have been done quickly and safely under a most and effective local anaesthetic rather than topical and waiting for a clinically acceptable anaesthesia before commencing the surgery. I suggest that next time this event occurs again, I would tell the whole team in the preoperative briefing, to give ample time for the anaesthesia to take effect before we can start the surgery. I would also write an incident report so that a proper evaluation could be done and errors will be omitted in the future for the safety of the patient.

Consultation Skills In Relation To Non Medical Prescribing Nursing Essay

Consultation Skills In Relation To Non Medical Prescribing Nursing Essay To illustrate this I will utilise the model of reflection adapted from (Boud, Keogh and Walker 1985) as to focus on influences on prescribing, psychology of prescribing working through the consultation, decision-making and therapy, and referral. Being present in the consultation as a non-medical prescriber challenged me to ask questions about my own practice and the consultant psychiatrist, focussing on how we arrived at our decisions and occasionally resulting in contrasting views. According to (Butler et al 1998) many authorities advise that the prime skills associated with the prescribing process are: Adequate exploration of the patients worries Adequate provision of information to the patient regarding the natural processes of the disease being treated The advisability of self-medication in trivial illness The issue pertaining to poor communication has a negative impact with patient-practitioner relationship and was acknowledged in an informative paper by (Britten et al 2000). Ultimately, all of the failures of communication were linked with an absence of the patients involvement during the consultation process. There is evidence that failure to actively engage in, or even consider, the patients perspective is a common failing amongst prescribers. (Britten et al 2000). Very often there is a focus on the term compliance and it is only recently that nurses are focussing on the more apt term of concordance. The term compliance was viewed as being authority laden (Marinker 1997) where it was expected that patients complied implicitly and without question when a prescription was given. There was little acceptance that patients would actively participate in the decision making process that surrounded the generation of the prescription. (Cox et al. 2002) Objective recognition of the patients perspectives, requirements and beliefs need to be acknowledged and then the recognition of any major differences between these and the prescribers needs could be perceived when providing nursing care. It is not just the act of writing out the prescription that is important, but it is the understanding of the processes and dynamics of the interactions that are taking place between prescriber and patient that are the fundamental key to good prescribing practice (Kuhse et al 2001). The consultation I chose to focus on was carried out by a consultant psychiatrist who for the purposes of this work shall be known as DR S, with myself as an observer of the consultation. The patient to be seen was a 45 year old gentleman who will be known for the purposes of this work as Mr A, who had been referred by dermatology to the mental health out-patients clinic as a new patient. Dermatology had referred this gentleman after a 12 month history of attending their department where Mr A had complained of persistent generalised skin irritation, and despite receiving treatment with them it appeared he may have an underlying mental health issue. Dr S began the interview by thoroughly reading the referral from dermatology and establishing what had been the concern from their point of view. The patient was then seen and before Dr S had chance to ask the patient anything Mr A expressed that he was confused as to why he had been referred to the mental health department, and not dermatology, which he perceived his medical complaint to be related to. The British Medical Journal (2000) has recognised a common theme amongst studies of patients in that they have a tendency to prefer prescribers (doctors or nurses) who listen and provide time for the individual to express their concerns without feeling hurried Dr S asked Mr A why he had been attending Dermatology to which Mr A detailed a 12 month history of describing an itchy scalp, generalised skin irritation and said no treatment had so far helped him. Mr A then went on to express that he felt all of these symptoms may be due to a parasite, or a bug which was doing something to him, and described a feeling of the bug weaving something on his face which enveloped his eyes. Other symptoms he described was that this bug or parasite was all the time making him feel thirsty and taking moisture from his body, and could somehow transpose itself to other people, including his own GP and friends describing like a magnetic type effect. From this initial information it was evident that Mr A was suffering from a delusional disorder which was quite systemised and concrete and Mr A appeared not to display any other symptoms of mental health. A diagnosis of parasitosis delusional disorder was made. It was clear Mr A needed treatment but the main factor to consider was that Mr A did not believe he any form of mental disorder and therefore there was a real issue surrounding concordance with proposed treatment. Usually, it is difficult to obtain informed consent to treat patients with delusional parasitosis with antipsychotics. Therefore experienced clinicians tell their patients that the antipsychotics are effective `against the itch or the `problems with the pests in order not to have to lie. (Musalek, 1991; Driscoll et al, 1993; Winsten, 1997; Freudenmann, 2002). This is due to the patients level of insight hindering their decision to accept treatment, because they hold a non-reality based idea that it is a somatic illness. It is therefore found that the patient will normally have sought help from their G.P., dermatologists and will often be adverse to the idea of seeing a mental health professional A full medical history was taken, looking at any familial medical problems, family composition and looking at the social aspects of MR A to include areas of employment, relationships, and any drug/alcohol usage. There have been some criticisms of the education of nurse prescribing in relation to the communication skills of nurses, where it is felt that historically there has been too much of a focus on taking a history and coming to a diagnosis. It was apparent to me that Dr S had to use his skill as an experienced mental health clinician to challenge Mr As concept of his illness not being related to a problem with his mental health Dr A approached the issue of explaining Mr A symptoms, not referring to mental health or delusions, but explaining Mr As perceived   symptoms by informing him that although he believed that these experiences were real to MR A , that his brain was interpreting false signals resulting in these unusual thoughts. Dr A went on to use the analogy of an amputee who perceives that he can still feel is amputated leg, through false interpretations of the brain. Drew et al. (2001). found that prescribers would emphasise the positive benefits of the medication far more frequently than they would discuss the risks and precautions, despite the fact that the patients perception was that such a discussion is seen as essential. Therefore looking at this, this could lead to patient confusion, with patient anxieties, and a degree of ambivalence to medication being offered to them. It is transparent that if there is a degree of empathic display between that of the patient and the prescriber, there is a greater chance of concordance. This will hopefully lead to an increased level of compliance/concordance and patient satisfaction resulting in desired clinical results Here we face the issue surrounding honesty, integrity, consent and acting in the best interest of the patients in focussing on treatment The issue of treatment was then discussed by Dr A, who said to Mr S that he believed he could help him by prescribing some medication for him that would help relive the distressing symptoms he was experiencing. Mr A initially expressed some confusion once more why he was not seeing dermatology as he perceived the problem needed treating by them This indicates that Mr S was still not displaying any insight and the questions of concordance issues were reconsidered. The National Institute for Clinical Excellence (NICE 2002) recommends that a risk assessment should be performed by the mental health clinician responsible for treatment and the multidisciplinary team regarding concordance with medication, and depot preparations should be prescribed when appropriate. Mr A questioned the proposed medication and it was explained to him that he would be given a course of Neuroleptic medication of a new medication called Aripiprazole. Dr A said that although the medication leaflet would mention the medication was used for Schizophrenia, that Mr A should not be too worried about that as that was not the reason why he would be taking it. Dr A then went on to say that the leaflet would also explain possible side-effects and that although it listed quite a few they were quite rare. The paper by (Cox et al.2000) found that it was common practice for prescribers to initiate the discussions about just what medication they were going to prescribe, rarely refer to the medicine by name and equally rarely refer to how a newly prescribed medication is perceived to differ in either action or purpose, to those previously prescribed. Patient understanding is rarely checked as it is usually assumed after the prescriber has given the prescription. Even when invited to do so, patients seldom take the opportunity to ask questions. (Cox et al 2000) I felt it was the right thing to initiate pharmacological treatment, although on reading further research surrounding the best treatment for Parisitosis I would question the choice of medication Mr A was commenced on However, after spending many clinical hours with this particular Consultant Psychiatrist, I am aware that he has high tendency of prescribing Aripiprazole for the majority of his clients. On questioning Dr A about his decision for choice of medication, Dr A commented that it is the newest and most effective of the atypical medications with lesser incidence of side effect relative to other medications in its group.   I had to question myself that there may be other factors influencing in the prescribing decision which were not based on any of the NICE guidance or that of the British Journal of Psychiatry. In fact, Dr A replied to me with medical jargon relating to molecular structures of both the brain and chemical make-up of Aripiprazole which was hard to follow due to its complexity. I was conscious that as a consultant psychiatrist of many years experience, I was not sure of the honesty or consequences if I had challenged Dr A about his continued choice of Aripiprazole against other choices of medication any further. After researching treatment for this disorder, I felt that the initiation of a typical antipsychotic should have seriously been considered due to its proven faster working efficacy. However, it is known that typical antipsychotics have an increased prevalence of side-effects. Therefore I had considered the preliminary use of typical antipsychotics to establish a degree of insight into the beneficence of taking medication, and if it was felt that further pharmacological treatment is required then switch to a typical antipsychotic as recommended by the NICE guidelines. An article in the British Journal of Psychiatry (2007) highlighted that delusional parasitosis has shown significant treatment results with the use of typical antipsychotics. (Traberts 1995) found that the introduction of typical antipsychotics has substantially improved remission rates (Frithz 1979) described another important treatment in delusional parasitosis is to consider typical anti-psychotic depot medication. This was suggested, as was earlier highlighted that one of the main stumbling blocks is a lack of insight that causes patients t be reluctant to accept oral medication. However, the administration of medication in injection form might be viewed by the patient as the answer to their somatic perception of their illness. It would be hoped that the injection would lead to a degree of insight where the patient may be more open to accept regular medication At the end of the consultation the patient Mr A agreed to take the medication as prescribed and was offered a further out-patients appointment in 2 weeks time. Ultimately, I accept a clear indication for medication, and in conjunction with this at a later stage this could be combined with some cognitive behavioural therapy should symptoms persist. Clinical Governance plays an important part in relation to prescribing., and in particular for non-medical prescribers role .(Bradley E and Nolan P 2005) state that training courses must remain up-to-date and flexible and must change in response to changes in government policy on non-medical prescribing, with nurse prescribing leads being involved in any discussion about course development.

The Relevance of Edith Wharton’s Roman Fever to the Modern World Essay

The Relevance of Edith Wharton’s Roman Fever to the Modern World According to the World Health Organization, â€Å"of the 75 million children under five in Africa a million and a half die each year of pneumonia.† As distressing and sad as this statistic is, it points out the great danger pneumococcus still is to young people in the developing world. It’s in the developed world, but at a time before antibiotics, at a time when acute respiratory ailments posed an even greater but still preventable threat to the younger set that concerns us here and that inspires a deeper look at the full implications of respiratory disease. The WHO goes on to say that acute respiratory infection (ARI) â€Å"is one of five conditions which account for more than 70% of child mortality in Africa.† So not only is pneumonia prevalent, it is still deadly. The danger it poses to young people has life-influencing ramifications, ones with an incredible emotional content. Though more treatable now, as we’ll see later, the persistence of pneumonia f its in with the puzzle as it presents itself, since it is linkable to a much more fundamental human ailment. In Edith Wharton’s â€Å"Roman Fever† we also see ailments of a pulmonary and life-changing import. Indeed, the entire story seems shot-through with infection. Wharton writes of Mrs. Slade and Mrs. Ansley, both widowed, both taking their daughters to Rome on holiday as they had been. Their own intertwined histories Wharton describes at the story’s onset as â€Å"all of the movings, buyings, travels, anniversaries, illnesses† (emphasis mine) (751). Wharton then begins the tale with illness. It is only as the narrative progresses that we get a sense of how important illness is to become: Yes; being the Slade’s widow wa... ...an be treated with antibiotics, it can be treated with aversion therapy or the simple addition of marriage. Other love preventatives such as war and country music are both quite feasible and can actually be very profitable for Western nations, though they seem a little cruel, especially the latter. Wharton’s â€Å"Roman Fever† at the very least points the way; it is a warning that love and pneumonia are inextricably linked, an idea that we’d do well to pay more attention to today when the ease of a high technology lifestyle fosters an arrogance that all the world’s problems have been solved. Works Cited Wharton, Edith. â€Å"Roman Fever.† Edith Wharton: Collected Stories 1911-1937. New York: Literary Classics 2001. 749-62. World Health Organization. â€Å"Childhood Diseases in Africa† Fact Sheet N 109. March 1996. 14.3.2003 http://www.who.int/inf-fs/en/fact109.html

AIDS in Africa :: HIV AIDS essays research papers

The AIDS epidemic has reached disastrous proportions on the continent of Africa. Over the past two decades, two thirds of the more than 16 million people in the world infected with Human Immunodeficiency Virus (HIV), which causes AIDS, live in sub-Saharan Africa. It is now home to the largest number of people infected, with 70 percent of the world’s HIV infected population. The problem of this ongoing human tragedy is that Africa is also the least equipped region in the world to cope with all the challenges posed by the HIV virus. In order understand the social and economic consequences of the disease, it is important to study the relationship between poverty, the global response, and the effectiveness of AIDS prevention, both government and grass roots. Half of the world’s cases are found in what is referred to as the AIDS belt, a chain of countries in eastern and southern Africa that is home to two percent of the global population. The main vehicle for spreading HIV throughout Africa is heterosexual intercourse. In contrast, this is the opposite compared to the U.S. where the virus is usually transmitted through homosexual intercourse or contaminated syringes shared by drug users. Besides heterosexual intercourse, HIV transmission through transfusion and contaminated medical equipment is common in sub-Saharan Africa. Africans infected with HIV die much sooner after diagnosis than HIV infected people in other parts of the world. In industrialized countries, the survival time after diagnosis of AIDS ranges from 9 to 26 months, but in Africa the survival time for patients is 5 to 9 months (UNAIDS 3). Factors, such as lower access to health care, poorer quality of health care services, poorer levels of average health and nutriti on, and greater exposure to pathogens that cause infection all contribute to the shorter survival in Africa. It is difficult to stop the flood of AIDS cases in Africa because it is not yet known by researchers the factors that contribute to outstanding prevalence of the disease among heterosexuals. This diagnosis will help determine how likely it is that heterosexual epidemics will spread to Asia or the West. Even though AIDS is heavily researched, its origin still remains a partial mystery. It is know that HIV is a zoonosis, a human disease acquired from animals. The virus evolved from a Simian Immunodeficiency Virus (SIV): a type of slow virus found naturally in monkeys and apes which, while not harming the host, produces diseases in other primates (Caldwell 97).

Creon and Haemon Essay

How would you direct the confrontation between Creon and Haemon in order to achieve your chosen impact for your audience? The scene of confrontation between Creon and Haemon comes when Creon has sentenced Antigone, future bride of Haemon, to be shut up in the cave. I would want to show a contrast between the characters with costume, so that the audience would get a visual representation of their emotions. I would dress Creon in an extravagant red silken robe, with gold trimmings. This would highlight his status as King, and also the red could signify a bloodthirsty attitude, as Creon is revelling in Antigone’s fate. Contrastingly, Haemon would be wearing a simple black cotton robe, without any trimmings. This would show that he doesn’t care for superficial extravagance, and black is also a colour of mourning; this would symbolise Haemon’s feelings towards Antigone’s fate. In the opening of this scene, Creon greets Haemon pleasantly. I would direct Creon to grip Haemon’s right hand with both of his own hands, in a friendly, pleading handshake; this would show warmth for Haemon, which is what Creon wishes to express at this point. He would maintain eye contact and stand with legs shoulder-width apart He would speak in a soft tone, with a slow pace, medium pitch and a relatively low volume, again to give the impression of warmth. In the line ‘we are always comrades, and my love for you is unshaken’, I would direct the actor playing Creon to emphasise the words ‘always’ and ‘unshaken’, stressing these superlatives, in order to exaggerate the positive feelings, diplomatically Haemon’s response would be in kind, reciprocating the respect. He would accept the handshake, and keep eye contact. His vocal qualities would be as those of Haemon. He would say ‘I know I am your son, Father’, stressing the word ‘Father’ to show respect and also family love. During this exchange, they would both be very close physically, to show that they are, at this point, still emotionally close. The lighting would be a straw wash from above over the stage, of medium intensity: neutral. Creon would be next to a podium, centre-stage-left. Haemon would be centre stage, and the Chorus would be arranged in a semi-circle around them. During Creon’s following speech, I would want the audience to witness a change in Creon’s approach. The first noticeable change in attitude would be when he says ‘Don’t be taken in/ Boy. Don’t let any woman ensnare you. ‘ His tone would become harsher, and lower almost as if speaking in a whisper. He would also grasp Haemon on the word ‘Boy’, to show the audience that he wants to instil certain sexist values in Haemon, as it is a subject he feels passionately about. Furthermore, he would almost spit the work ‘woman’ and emphasise the word ‘ensnare’ to present acidity to the audience. He would say ‘Don’t be taken in, Boy’ without changing his tone or pace, simply increasing intensity, to show the audience how sincere he is. He would continue in this manner, speaking in harsh tones. The next change in Creon’s demeanour would come when he says ‘I will do it. And she must die’. Here, he would revert to speaking with authority, assertively. He would stress the modal verbs, ‘will’ and ‘must’ to show that he is completely fixed upon the idea, and is unwavering. This would show the audience his stubbornness. At this point, low-intensity, subtle red uplighting would have slowly faded in, to cast shadows upon Creon’s face to make him seem more imposing and venomous. It would be barely noticeable by the audience at this stage, as it would be slowly and subtly introduced. Creon would also step back and stand straight at this point, and pause after the line, to highlight its significance to the audience. He would have his hands calmly by his sides. Creon would continue to rant, his volume increasing, and the red uplighting becoming stronger, as the straw wash slowly faded and his hand gestures becoming increasingly evident and expansive. On the line ‘Anarchy, disobedience,’ he would be banging his fists on his podium in anger, to show the audience how passionately he feels about the subject. He would be nearly shouting at this point, and Haemon would recoil slightly, in fear and surprise at Creon’s outburst. Creon would next shift toward the end of his speech, and I would want my audience to see him bring back subtle persuasion, using the fact that he is Haemon’s father to his advantage: ‘Let it be by a man’s hand, eh son? / Not by a conspiracy of women! ‘. I would want him to go back to speaking in lower tones, almost at a stage-whisper level, as he wants to instil his own sexism, and apparent paranoia regarding women, into Haemon yet again. This repetition would show the audience just how sexist Creon is. I would therefore have the actor emphasise the words ‘man’ ‘son’, ‘conspiracy’ and ‘women’ to show this, and put one arm around Haemon. The red uplighting would also dim at this point, the straw wash becoming more prominent; this would visually represent the change in tone to the audience. Following the Chorus’ somewhat neutral response, Haemon would reply by at first speaking pleasantries: ‘It’s not for me to say you are wrong’ is quite self-deprecating and is complimentary to Creon. Haemon would therefore speak it in a soft tone, and would physically lower himself by bending knees and back slightly. His volume would be medium at this point, and he would make no hand gestures. The lighting would remain as a straw wash, all red gone at this point. Haemon would emphasise ‘me’ and ‘you’ to underline the fact he is making a direct comparison between himself and Creon. Haemon would change in approach right on the line ‘But I can sometimes hear people whisper’. The word ‘but’ here is a clear discursive marker in the text, indicating a change. Also, Haemon begins to discuss how ‘people’ see Antigone’s punishment as unjust. He would thus take a step back is if expecting an outburst from Creon, and emphasise words like ‘people’ and ‘whisper’ to show the audience that the character aims to dissociate himself from the views. He would become more pleading as the speech progresses, ‘let me beg you to have second thoughts’ and ‘I beg you Father’. This is again showing he accepts inferiority, but also makes clear to the audience that he is against his fathers actions. The metaphors regarding the failure of stubborn things would be spoken with a degree of accusation regarding Creon; Haemon would look at Creon when saying ‘inflexible’ and ‘refuses’ to indicate that there refer to Creon. At the end of the speech he says ‘Take good advice when it is offered. ‘ This is a direct question to Creon, and I would have Haemon on one knee, clasping Creon’s hand at this point, to show his desperation to the audience. In the ensuing stichomythia, I would instruct Creon to increase in volume, pace and raise his voice at the end of each sentence. Also, I would want him to spit phrases like ‘You’re a woman’s mouthpiece! ‘, whilst shaking his arms, palms clawed and facing up to show rage to the audience. Comparatively, I would instruct Haemon to remain calm, speaking in controlled tones and a steady volume throughout, making few hand gestures. Haemon would instead increase in cold contempt, by sharpening the sound of his vowels at the ends of sentences, and speaking in a low tone, and emphasising certain words. He would emphasise the word ‘demented’, but without raising the volume of his voice a great deal. Also, at the end, when Haemon says ‘†¦ this disgusting spectacle/ In company with a madman, are welcome to it’, I would want him to speak this calmly; without varying his pace. He would say this emphasising ‘disgusting spectacle’ and ‘madman’ by raising pitch and volume a little. This would show the audience that he feels contempt toward Creon, but is above just shouting. Creon, on the other hand, would be virtually screaming ‘Bring her out, the bitch’, emphasising the word ‘bitch’ by stressing the harsh vowel sound, and gesturing wildly towards the side entrance, as if indicating from where she should be brought. This would show the audience that Creon has lost his composure, and has lost control of his rage. The lighting would be red uplighting again on Creon only, to cast shadows across his face, whilst a blue gel, to mix with the straw wash, would be coming in from above. Overall, this should all contribute into presenting Haemon into an emotionally controlled, stable character, whereas Creon would appear as quite the opposite; unreasonable, stubborn and emotionally volatile. The objective would be to present the characters as such, to encourage the audience to sympathise with Haemon, even empathise with him; ideally, the audience too would feel frustrated and contemptuous towards Creon.