Wednesday, August 26, 2020

Content-based Image Retrieval With Ant Colony Optimization

Content-based Image Retrieval With Ant Colony Optimization Content-based picture recovery with skin tones and shapes utilizing Ant state enhancement Presentation: Because of the colossal pool of picture information, an a lot of information to be sort out has lead the route for examining and uncover the information to secure likely beneficial data. Heterogeneous fields spread from business to military want to examine information in a methodical and fast way. Remarkably in the territory of intuitive media, pictures have the fortress. There is no adequate instruments are accessible for assessment of pictures. One of the focuses at issue is the compelling pinpointing of highlights in the resemblance and the other one is separating them. NEED AND IMPORTANCE OF RESEACH PROBLEM Current methods in picture recovery and grouping focus on content-based strategies. It look for overview the substance of the picture as opposed to thedata about datasuch as catchphrases, name or properties comparing with the picture. The term content allude to conceals, appearance, surfaces, or whatever other points of interest that can be acquired from the picture itself. CBIR with skin tones is fitting in light of the fact that most net-based picture web crawlers depend simply on metadata and this turn out a great deal of waste in the results.Thus a framework that can sifter pictures lay on their substance with extra property i.e., skin tone would serve better rundown and return increasingly explicit results. Different frameworks like the QBIC, Retrieval Ware and Photo Book and so forth., have an assortment of properties, despite everything utilized in particular control. The shading highlights incorporated with shape for grouping, the shading and surface for recovery. There is no single element which is sufficient; and, additionally, a solitary portrayal of attributes is likewise insufficient. Sonith et al.[1996] depicts a completely computerized content †based picture question frameworks. Ioloni et al. [1998] portrays picture recovery by shading semantics with inadequate information. Mori et al. [1999] have applied powerful programming method for work approximated shape portrayal. Chang et al. [2001] portrays data driven system for picture. Mira et al. [2002] portrays certainty content based picture recovery utilizing Qusi †Gabir filler Vincent et al. [2007] have built up a completely computerized content based picture question framework. Heraw et al. [2008] depicts picture recovery will an improved multi displaying philosophy. Taba et al. [2009] have utilized digging affiliation rules for the element matrin. Destinations In addition, speed changes in industry and databases affecting our view and comprehension of the issue after some time and requesting adjust in issue deciphering approach. Thus, further examination is required in this field to create calculations for select pictures with skin tone and shapes, ready to adapt to continuous innovative changes. Examination of powerful pictures with skin tone and shapes dependent on pixel calculations Separating them dependent on streamlining calculations. Creating computational calculations in separating the pictures. The fundamental goal is to examine the Image Identification and Optimistic strategy for Image Extraction for Image Mining utilizing Ant settlement improvement .ACO, great answers for a given enhancement issue. To accomplish this fundamental goal, the objectives are planned as follows: To Study the Image Mining Techniques. To Explore the Approaches utilized in Selecting the Images To Explore the Extracting of the Features. To apply the amazing Techniques. To Analyze the Experimental Results. To Study the Optimization Techniques. To cut down computation and taking out time. Work Plan: I will start my exploration work by examining various procedures accessible in the writing and measure their relevance in alternate points of view for normal advantage. From that point onward, I want to constrain my exploration enthusiasm down from general to considerably increasingly explicit under the direction of assigned director in the course with the goal that it fits into college doctoral program educational plan. The exploration undertakings are gathered year astute as follows. Year-1: Writing study on different techniques to get a thought of example coordinating, shapes and arrangement. Usage of calculations so as to measure their materialness and adaptability. Scientific displaying of Ant settlement Optimization considering new targets and imperatives existing in Image handling. Accommodation of a paper to a significant gathering Build up a definite exploration proposition and give oral safeguard to get full enrollment of the course Year-2 Proceed and refine the scientific model to make the issue increasingly genuine Create single target streamlining calculations for powerful extraction of Images. Begin to create multi target streamlining calculations for extraction by thinking about enormous scope improvement and grouping Accommodation of two papers to universal meeting and diaries Year-3: Usage of created calculations for examination of pictures and advancement issues Accommodation of a paper to a significant diary Finishing a proposal dependent on the PhD venture Partaking in dynamic examination gatherings. Distribution of examination work. REFFERENCES Beyer K et al. [1999]: Bottom-Up calculation of inadequate and Iceberg CUBEs. ACM SIGMOD. Carter R et al.[1983]: CIELUV shading distinction conditions for self-luminoudisplays. Shading Res. Appl., 8(4), 252â€553. Chang SF et al. [1995]: Extracting multi-dimensional sign highlights for content-based visual question. SPIE Symposium on Visual Communications and Signal Processing. idoni J et al. [1998]: Image recovery by shading semantics with inadequate information. Diary of the American Society for Information Science, 49(3), 267-282. evich V et al. [2008]: Medical Image Mining on the Base of Descriptive Image Algebras. Cytological Specimen Case. In : Proc.of the International Conference on Health Informaticsâ€HEALTHINF, Funchal, Madeira, Portugal, 2, 66â€73. Huan et al.[2008]: Image Retrieval ++ web Image Retrieval with an upgraded Multi-methodology metaphysics . Kluwer Academic Publishers. Jaba Sheela et al. [2009]: Image mining utilizing affiliation rules got from include network. ACM, 440-443. Jain A [1991]: Algorithms for bunching information. Englewood Cliffs, NJ, Prentice Hall. Jain An et al.[1996]: Image Retrieval utilizing shading and shape. Example Recognition, 29(8):1233-1244. James D [1993]: Content based recovery in interactive media imaging. In : Proc. SPIE Storage and Retrieval for Image and Video Databases. Kantardzic M [2003]: Data Mining, Wiley-Interscience. Throat et al.[1997]: Tools for surface/shading based hunt of pictures. SPIE International meeting Human Vision and Electronic Imaging, 496-507. Mira P et al.[2002]: Fast substance based picture recovery utilizing semi gabor channel and decrease of picture include measurement. SSIAI, 178-182. Mori K et al.[1999]: Function approximated shape portrayal utilizing dynamic programming with multi-goals examination. ICSPAT 99. Niblack W et al. [1994]: The QBIC venture: Querying pictures by content utilizing shading, surface and shape. In : Proc. SPIE Storage and Retrieval for Image and Video Databases. Pentland An et al. [1996]: Content based control of databases. Int. J. Comput. Vis., 18(3), 233-254. Rui Y et al. [1999]: Image recovery: current strategies, promising bearings and open issues. Diary of Visual Communication and Image Representation, 10(4), 39-62. Shiaofen Fang et al. [2009]: Facial picture characterization of mouse undeveloped organisms for the creature model investigation of Fetal Alcohol Syndrome. Procedures of the 2009 ACM discussion on Applied Computing, 852-856. Smith J et al. [1996]: VisualSEEK: A completely robotized content-based picture question framework. ACM Multimedia, 87-98. Vincent S et al. [2007]: Web Image Annotation by combining visual highlights and literary data . SIGAPP’07,2007. Zaher Al Aghbari [2009]: Effective picture mining by speaking to shading histograms as time arrangement. Diary of Advanced Computational Intelligence and Intelligent Informatics, 13, 109-114. Zaiane O et al.[1998]: Mining MultiMedia Data. CASCON98: Meeting of Minds, Toronto, Canada, 83-96,. Zhang Ji [2001]: An Information-driven structure for picture mining. In : Proceedings of twelfth International Conference on Database and Expert Systems Applications (DEXA), Munich, Germany. Zhang Ji et al. [2001]: Image Mining: issues, structures and procedures. In : Proceedings of the Second International Workshop on Multimedia Information Mining (MDM/KDD2001), San Francisco, CA, USA.

Saturday, August 22, 2020

Political Corruption in Bulgaria after 1989 Essay

Political Corruption in Bulgaria after 1989 - Essay Example In spite of the fact that giving some improvement in the ongoing years, Bulgaria holds the disgrace of being marked as the defilement capital of Europe. It is the debasement at the political level that is generally perilous in the nation. Every ideological group work with an open subsidizing framework. Such a condition, with no conspicuous administration, doubtlessly empowers debasement. Nonetheless, a few statistical data points will show the 'legislative issues' behind Bulgaria's debasement. While trying to modernize the country's economy, the socialist government authorized diverse industrialization programs. Until democratizing changes started in 1989, Bulgaria stayed a socialist nation. The Bulgarian patriotism experienced an uncommon change since its first multi party races in 1990 (U.S.- Bulgarian Relations, 2008). Be that as it may, the change from the socialist guideline to a free market economy was difficult. The presentation of Banking changes, and program to privatize state-possessed resources ended up being testing issues. Because of the fall of socialism, the nation lost all its Soviet market. The Bulgarian merchandise couldn't locate a decent market. It prompted a significant compression of the monetary framework. The rising swelling and joblessness became serious issues. To add oil to the fire, the Bulgarian government needed to fight with the uncontrolled defilement at all degrees of organization. Over the most recent two decades, Bulgaria experienced complet... Over the most recent two decades, Bulgaria experienced total political change. Say that the political change has contributed a lot to the rebuilding of the country's whole components. Then again, how compelling those rearrangements, is an issue of dynamic discussion. Be that as it may, it could appreciate consistent financial development and macroeconomic security, issues are too much. It battles hard to come up as a law based force. Shockingly debasement has become a watchword in any investigation of Bulgaria. The National Assembly, which should screen all enemy of debasement systems, end up being insufficient. Defilement is among the five most significant issues Bulgaria is confronting today. Five most basic issues Bulgaria is confronting Joblessness 58,40 % Low livelihoods 51,30 % Wrongdoing 45,40 % Defilement 38,50 % Neediness 31,60 % Significant expenses 22,90 % Political precariousness 17,70 % Medicinal services 11,50 % Contamination 3,60 % Training 2,70 % Ethnic issues 2,10 % The entirety of rates surpasses 100, as respondents have offered up to three responses (Source: Five most basic issues Bulgaria is confronting, http://www.online.bg/coalition2000/eng/ci-feb99/2.htm) This social malice happened to spread generally in different fields of Bulgarian open life. Debasement has created as a key standard in numerous fields like organization and legal executive. Ideological group fund, open organization and legal executive are the most influenced territories. The Bulgarian people group has started to comprehend the extent of debasement of pastors and senior authorities. Because of degenerate organization, any official system has become a 'hard nut' for the basic man. He needs to pay a colossal add up to the police, wellbeing

Friday, August 21, 2020

New This Week Resources from Big City Publishing

New This Week Resources from Big City Publishing This week, TeacherVision is expanding our resources for Early Education, thanks to Big City Publishing. These new resources are provided to benefit young students by enhancing their motor skills, word, item, and shape recognition, and introduce creative-thinking and problem-solving skills. These activities are perfect for pre-k, kindergarten, and 1st-grade students. Coloring Pages These coloring pages are meant to enhance recognition abilities, motor skills, and even counting abilities in young students. Check out these nine exciting coloring pages for your students! Fruits and Veggies Coloring Page Looner Bunny Slam Dunk Coloring Page Storytime Coloring Page Sunray Bubble Bear Coloring Page Crystal Cat Flower Coloring Page Crystal Cat Garden Coloring Page Misty Pig Butterflies Coloring Page Connect-the-Dots Coloring Puzzle Super Teacher Coloring Page Mazes These mazes provide math practice, motor-skills, pre-writing skills, critical-thinking and problem-solving abilities. There are three great mazes for your young students! Magical Attic Race for the Apples Math Maze Magical Attic Looner Bunny Rocketship Maze Magical Attic Sunray Bear Playground Maze  Coloring Page Word Puzzle Starting reading, writing, and word-recognition skills at a young age is best for young learners, and these word puzzles are a great tool for that. Magical Attic Crystal Cat Jumprope Word  Puzzle Magical Attic Misty Pig Friendship Word Search Cutout Puzzle Scissor skills are a huge part of hands-on learning for young students. This puzzle  uses fine-motor skills and enhances their abilities to build and assemble a project. Magical Attic Disco Cutout Puzzle Videos More ways to increase students motor abilities, as well as, practice following directions! These three video  how-tos provide great activities with something to show for it. How to make a Lunch Box Puppet How to make an Origami Fish How to make a Paper Plate Dinosaur Activities These printable activities are different ways to develop recognition abilities and can keep young students occupied! Magical Attic Match the Shadows Activity Magical Attic Looner Bunny Differences Activity Activity Packets These themed packets are full of puzzles, games, coloring packets, comics and more! These are great for camp, road trips, quiet time, or an everyday activity! Magical Attic Superheroes Activity Magical Attic Just for Fun Fourth of July Activities Magical Attic Road Trip Printable: North Carolina Magical Attic Road Trip Printable: Washington, D.C. Magical Attic Road Trip Printable: San Francisco About Big City Publishing BCP Imagines designs and develops unique multimedia that brings children and their families creative, fun, shared experiences. Our award-winning cross-platform content encourages creative learning, expression and play while helping kids of ALL ages open their imaginations and look at their world in a new way. BCP Imagines' multi-award winning series Drawing with Mark brings the joy of learning to draw to all ages. The Magical Attic, where anything is possible, was created to help foster imagination and creative play while encouraging positive attitudes emphasizing the important lessons of kindness, friendship and helping others. Visit the Magical Attic store or purchase the Drawing with Mark collection!

New This Week Resources from Big City Publishing

New This Week Resources from Big City Publishing This week, TeacherVision is expanding our resources for Early Education, thanks to Big City Publishing. These new resources are provided to benefit young students by enhancing their motor skills, word, item, and shape recognition, and introduce creative-thinking and problem-solving skills. These activities are perfect for pre-k, kindergarten, and 1st-grade students. Coloring Pages These coloring pages are meant to enhance recognition abilities, motor skills, and even counting abilities in young students. Check out these nine exciting coloring pages for your students! Fruits and Veggies Coloring Page Looner Bunny Slam Dunk Coloring Page Storytime Coloring Page Sunray Bubble Bear Coloring Page Crystal Cat Flower Coloring Page Crystal Cat Garden Coloring Page Misty Pig Butterflies Coloring Page Connect-the-Dots Coloring Puzzle Super Teacher Coloring Page Mazes These mazes provide math practice, motor-skills, pre-writing skills, critical-thinking and problem-solving abilities. There are three great mazes for your young students! Magical Attic Race for the Apples Math Maze Magical Attic Looner Bunny Rocketship Maze Magical Attic Sunray Bear Playground Maze  Coloring Page Word Puzzle Starting reading, writing, and word-recognition skills at a young age is best for young learners, and these word puzzles are a great tool for that. Magical Attic Crystal Cat Jumprope Word  Puzzle Magical Attic Misty Pig Friendship Word Search Cutout Puzzle Scissor skills are a huge part of hands-on learning for young students. This puzzle  uses fine-motor skills and enhances their abilities to build and assemble a project. Magical Attic Disco Cutout Puzzle Videos More ways to increase students motor abilities, as well as, practice following directions! These three video  how-tos provide great activities with something to show for it. How to make a Lunch Box Puppet How to make an Origami Fish How to make a Paper Plate Dinosaur Activities These printable activities are different ways to develop recognition abilities and can keep young students occupied! Magical Attic Match the Shadows Activity Magical Attic Looner Bunny Differences Activity Activity Packets These themed packets are full of puzzles, games, coloring packets, comics and more! These are great for camp, road trips, quiet time, or an everyday activity! Magical Attic Superheroes Activity Magical Attic Just for Fun Fourth of July Activities Magical Attic Road Trip Printable: North Carolina Magical Attic Road Trip Printable: Washington, D.C. Magical Attic Road Trip Printable: San Francisco About Big City Publishing BCP Imagines designs and develops unique multimedia that brings children and their families creative, fun, shared experiences. Our award-winning cross-platform content encourages creative learning, expression and play while helping kids of ALL ages open their imaginations and look at their world in a new way. BCP Imagines' multi-award winning series Drawing with Mark brings the joy of learning to draw to all ages. The Magical Attic, where anything is possible, was created to help foster imagination and creative play while encouraging positive attitudes emphasizing the important lessons of kindness, friendship and helping others. Visit the Magical Attic store or purchase the Drawing with Mark collection!

Sunday, May 24, 2020

All Behavior Caused By External Stimuli Operant Conditioning

All behavior caused by external stimuli operant conditioning). All behavior can be explained without the need to consider internal mental states or consciousness. John B. Watson, Ivan Pavlov, B.F. Skinner, are Classical conditioning Pavlov, Operant conditioning, Stimulus response that assumes a learner is essentially passive, responding to environmental stimuli. The learner starts off as a clean slate and behavior is shaped through positive reinforcement or negative reinforcement. Both positive reinforcement and negative reinforcement increase the probability that the antecedent behavior will happen again. In contrast, punishment both positive and negative decreases the likelihood that the antecedent behavior will happen again. Positive†¦show more content†¦After the meat powder and bell were presented together several times, the bell was used alone. Pavlov’s dogs, as predicted, responded by salivating to the sound of the bell without the food. The bell began as a neu tral stimulus (i.e. the bell itself did not produce the dogs. However, by pairing the bell with the stimulus that did produce the salivation response, the bell was able to acquire the ability to trigger the salivation response. Pavlov therefore demonstrated how stimulus-response are formed. He dedicated much of the rest of his career further exploring this finding. In technical terms, the meat powder is considered an unconditioned stimulus and the dog’s salivation is the unconditioned response. The bell is a neutral stimulus until the dog learns to associate the bell with food. Then the bell becomes a conditioned stimulus which produces the conditioned response of salivation after repeated pairings between the bell and food. John B. Watson further extended Pavlov’s work and applied it to human beings. Around 1921, Watson studied Albert, an 11-month-old infant child. The goal of the study was to condition Albert to become afraid of a white rat by pairing the white rat w ith a very loud noise. Behavior modification is a technique concerning the change in the undesired behavior and enhancing desired behavior. It is an approach that aims to modify the behavior of aShow MoreRelatedBehaviorism : A Psychological Perspective1018 Words   |  5 PagesArthur Espinoza Professor McMahon Psychology 101 11/2/15 Behaviorism Behaviorism is a psychological perspective that focuses on an individual’s behavior. The main theorist behind this perspective was John Broadus Watson, who established the psychological school of behaviorism. Through his behaviorist views, he spectated the behavior of humans and animals when put into different situations. 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Through operant conditioning an association is made between a behavior and a consequence for that behavior. (Cherry, 2007) Operant conditioning was first examined by B.F. Skinner, a behaviorist and this is why it is referr3ed to as Skinnerian conditioning. (Cherry, 2007) Skinner held thatRead MoreAll Our Personalities Is Unique Essay1212 Words   |  5 Pagesdevelop explanations of behavior; behaviorist believe that personality develops as people interact with others in their environments. Thus, personality development is a complex process but there are many potential environmental influences that help to shape it (Moore, 2013). Behaviorism is a theory of personality that sees everything in terms of conditioning. The theory was founded by John B. Watson who believed that our responses to environmental stimuli shape our behavior. Behaviorist such as IvanRead More Behaviorism Essay1778 Words   |  8 PagesBehaviorism Psychology is the science of behavior. 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In this paper I will attempt to give a detailed description of the history of behaviorism including information about some of the most influential men associated with thisRead MoreBehavioral Social Cognitive Views of Learning2981 Words   |  12 Pagesï‚ § ï‚ § ï‚ § ï‚ § Definitions of Behavioral Learning Theory Classical Conditioning – Pavlov Operant Conditioning - Skinner Trial-and-error Learning / The Law of Effect - Thorndike Social Learning Theory - Bandura I. ï‚ ¨ Behavioral Learning Theories: Explanations of learning that focus on external events as the cause of changes in observable behaviors†¦ the behavioral view generally assumes that the outcome of learning is the change in behavior. (Woolfolk, 2010, p.198) ï‚ ¨ Behavioral learning theoriesRead MoreThe Theory Of The Social Learning Theory1339 Words   |  6 PagesStanley Hall and Arnold Gesell both American psychologists, described development as a maturational process. A genetically destined series of events that unravels automatically, like a flower. This led to the normative approach, in that measures of behavior are derived from a sample of people and calculated to generalize a representation in development (Berk, 2013, p.11). Research later sought to figure out individualistic development rather than the general population. Sigmund Freud a Viennese physicianRead MoreClassical Conditioning and Behavior2385 Words   |  10 Pagesworldview that operates on a principle of â€Å"stimulus-response.† All behavior caused by external stimuli (operant conditioning). All behavior can be explained without the need to consider internal mental states or consciousness. Originators and important contributors: John B. Watson, Ivan Pavlov, B.F. Skinner, E. L. Thorndike (connectionism), Bandura, Tolman (moving toward cognitivism) Keywords: Classical conditioning (Pavlov), Operant conditioning (Skinner), Stimulus-response (S-R) Behaviorism BehaviorismRead MoreThe Thinking Rat, By Oskar Pineno1194 Words   |  5 Pagesdriven animal whose behaviors intend to get the most from what the surrounding environment has to offer. (Pineno, 2010, p.106) These behaviors are driven by some surprisingly complex and interesting mental abilities. Two of these mental abilities I find most interesting are causal reasoning and metacognition. I am pairing these two mental abilities because together they take down the traditional view of them being an animal that automatically reacts without thinking to stimuli. (Pineno, 2010, p.105)

Thursday, May 14, 2020

Informative Speech On Procrastination - 1023 Words

A. Attention Getter: So I’m pretty sure everyone here has had an important assignment to complete before like a project or essay. And most of us usually plan it out where we do a portion of it every day. For example, something like this chart here. But then the next thing you know, the deadline is fast approaching and you still haven’t come close to completing your assignment. And we end up somewhere like this. Well, I believe that we can all relate to this and we have all done this to ourselves before. I’m talking about procrastination. B. Social Significance: For many of us, procrastination is a strong and inexplicable force that prevents us from completing our important and urgent tasks. It’s like the same thing when you bring the like†¦show more content†¦b. The limbic system is one of the oldest and dominate parts of our brain, and it’s always on automatically (Spencer 2014). It tells you to put your hand away from fire, and to run away from undesirable tasks. It tells you to go for immediate mood repair says, Timothy A. Pychyl, Ph.D., a psychology professor from Carleton University. The prefrontal cortex is a newer and weaker part of our brain. It’s the part that allows us to process information and make decisions. This is also what separates us humans from animals, who just follow their stimulus, says Timothy A. Pychyl, Ph.D., author from Procrastinators Digest: A Concise Guide to Solving the Procrastinators Puzzle. But this part of our brain isn’t turned on automatically. For it to function, we have to switch it on ourselves (Spencer 2014). We have to actually sit down and do our homework, project, or whatever assignment we need to actually complete. And the moment you aren’t working on your task, your limbic system takes over and you give in to what feels good, you start procrastinating (Spencer 2014). Transition: After learning about the science behind procrastination, I want to talk about why we procrastinate. B. Main Point 2: Why do we procrastinate? a. In the Washington Post article: The Real Reasons You Procrastinate, Swanson tells us, psychologists believe in a concept called the â€Å"present and future self.† It’s basically the idea that even though we know we are the sameShow MoreRelatedBaby Steps : How And How Can These Be Avoided?1179 Words   |  5 Pagesmeans to say. Rereading or backward movements become a way of assessing whether or not the words on the page adequately capture the original sense intended. Also, Sommers takes time and talks about speech and writing and what differentiates the two.† (WaW Pg. 631) The act of revision is what separates speech from written text. One is able to revise and to craft a well- written text, but is not able to do so from something spoken. In the past week I have spent time and conducted a survey consisting ofRead MoreVisualization on How Self-Handicapping Can Lead to Procrastination and Low Self-Esteem2379 Words   |  10 PagesVisualization on how Self-Handicapping Can Lead to Procrastination and Low Self-Esteem Self-esteem is the central component of every individual’s daily life experiences. Self esteem can be defined as a person’s evaluation of the self, e.g. â€Å"I am not satisfied with me† or â€Å"I like me.† We perform self-evaluations on ourselves everyday; it is a non conscious process where as only the individual knows the end result. Important domains affect us, and unimportant domains do not (things tailored specificallyRead MoreInformative Speech Study Drugs and College Students Essay1104 Words   |  5 PagesInformative Speech Study Drugs and College Students I. Introduction A. Attention Getter: I reached into my backpack, grabbed an Adderall, and went to the bathroom. I smashed it on the bathroom sink and snorted it. I went back to my class and zipped through the rest of my exam, and it made all the difference. This student incident was found in a 2005 article published by Baylor University on the alarming use of â€Å"study drugs.† B. Thesis: Many of you may be unfamiliar with such a topic,Read MoreEssay about informative speech Bill Gates1577 Words   |  7 Pageswhether it be doing essays hours before they’re due, 8 page research papers the night before, rushing to do last minute slides for a presentation or writing your informative speech that’s a third of our grade, during every break I had. We all, including myself, procrastinate. We can all thank Bill Gates for making our times of procrastination slightly more bearable by creating the Microsoft software that is accessible, easy to use and constantly evolving to meet consumer needs.    B. Thesis Statement:  TodayRead MoreEnglish Proverbs and Sayings8785 Words   |  36 Pagesnew words easier better because proverbs and sayings are logical and expressive statements. When pupils learn proverbs and sayings they train their memory, learn how to select necessary words and also develop the emotional expressiveness of their speech. The necessity to find the appropriate Russian equivalents for English proverbs and sayings helps pupils to develop their ability to choose lexical items adequately, stimulates pupils’ desire to use dictionaries and improves their translating skillsRead MoreDeveloping Management Skills404131 Words   |  1617 Pagesmanagement textbook, it is important that you understand its distinctive learner-focused features especially the five-step learning model: Skill Assessment, Skill Learning, Skill Analysis, Skill Practice, and Skill Application. You’ll also find informative research on how much managers’ actions impact individual and organizational performance, and the characteristics of effective managers. †¢ Thoughtfully complete the Skill Assessment surveys in each chapter. These diagnostic tools are designed toRead MoreExploring Corporate Strategy - Case164366 Words   |  658 PagesSource: The Salvation Army News, 5 July (2005). ‘Addressing lessons fro m the emergency response to the 7 July 2005 London bombings’, UK Home Ofï ¬ ce, 22 September (2006). 11 12 Source: The Washington Post, 8 April (2006). Source: Shaw Clifton’s speech, ‘Welcome and Dedication Meeting’, Kensington, London, 8 April 2006. ECS8C_C08.qxd 22/10/2007 11:49 Page 675 BELIEF IN ACTION: THE SALVATION ARMY, A GLOBAL NOT-FOR-PROFIT ORGANISATION 675 APPENDIX 1 Salvation Army international

Wednesday, May 6, 2020

Life, Death and Argumentative Essay

Life, Death and Argumentative Essay To compose a fantastic argumentative essay, there are four important pieces of the essay you're likely to have to know about. If you're new to writing argumentative essays, there are a couple of important factors which you can learn that may help you compose a greater argumentative essay. Before writing an argumentative essay, there's one important thing you should know. You may have a look at the extra info about how to compose an eye-catching essay introduction with a hook. The structure of your paper's outline is just like the structure of your whole essay. Argumentative essay format is dependent on your professor's requirements, because there isn't any frequent pattern for each and every essay. Then you need to endeavour to select the right argumentative essay format. You have to make sure you remain on that 1 side during your whole essay. You can also see essay examples. Remember that the period of your essay is dependent upon the assignment provided to you. Therefore, essays are often quite subjective and offer a point-of-view of the student. The New Fuss About Argumentative Essay To begin with, let's define the kinds of argument available and strategies that you may follow. An argumentative essay is a kind of thesis or composition in which you have to present your view and try to convince others your facts and arguments are correct. After you have selected a topic, you should take into consideration your stance. When you are requested to opt for a great topic for your argument, start with something you're familiarized with. If you really need to get individuals to find things your way, you will need to convince them with evidence and facts. If you would like to learn what an argumentative essay is, the very first thing you need to reme mber is that its principal aim is to convince the audience to accept your perspective. The chief reason why somebody is writing an argumentative essay is to make an effort to persuade or sway another man or perhaps a group of men and women in your rightness in a particular theme. Among the very best custom essay writing services is here to assist you, as we're well conscious of how you can't do everything at the same time, and it's a standard thing whenever there are simply too many things happening at the exact time. A standard argument raised against using school uniforms is the fact that it denies students an opportunity to completely express themselves. Choose from popular topics that folks are passionate about. In the debut, that is the very first paragraph of the essay, Myrtle will want to spell out the problem and state her position. To put it differently, you want to attempt to comprehend where they're coming from. Writers of argumentative reports ought to take car e to keep a scholarly tone when presenting their argument and prevent incorporating the usage of personal anecdotes and unsupported claims. In practice, but the committee has the ability to order many sorts of censorship in any scene they see as inappropriate. Needless to say, you must concentrate on supporting your thesis statement as opposed to the opponents. You can make an article about each topic or question they haveif you get 10 responses, you've got 10 distinct posts or articles to gather. Be aware that it's imperative to offer only up-to-date details. Look through the list of topics cautiously and start making a mental collection of the evidence you're able to use on topics you prefer. Since you can see there are a great deal of templates and topics to refer on. Things You Won't Like About Argumentative Essay and Things You Will Inspiration to make your own advertising or media argumentative essay topics isn't tricky to discover. Bear in mind that sources are an ess ential part of the paper. An argumentative essay is a writing piece intended to persuade a person to believe the way that you do. Essentially anything that has to be understood before reading the remainder of the essay is background info, and ought to be included in the introduction. It is crucial to check reviews about essay writing services in order to be confident they can deliver your task before the deadline. It is possible to take my online IELTS Writing Practice Test anywhere on earth and find a score, corrections, and feedback in only two days. Be certain to read online essay writing service reviews in order to know what type of material you are spending for. Apparently, not only plagiarism factor is crucial, but likewise the overall quality of a custom made paper.

Tuesday, May 5, 2020

The play is entitled Twelfth Night or What You Will and was actually performed to the Queen on Twelfth Night Essay Example For Students

The play is entitled Twelfth Night or What You Will and was actually performed to the Queen on Twelfth Night Essay The play is entitled Twelfth Night or What You Will and was actually performed to the Queen on Twelfth Night. Twelfth Night is the twelfth and last night of Christmas, traditionally a time of holiday and festival eg. Feast of Fools. In the time of Shakespeare a Lord of Misrule was chosen usually a servant who became , for a short period, master of the household, in charge of an up-side down world were everything is not as it seemed, like the play. Shakespeare elects to specify Ilyria as the setting of the play. Ilyria was know to Shakespeare and his contemporaries as the actual region off the coast of the Adriatic Sea in what is today Albania. As such, it was a distant land with which the English of the time had very little contact, and therefore a generically exotic setting for a play replete with romance and intrigue, as well as one that offered the preconditions for a shipwreck. A modern audience might find a comparison with Disneyland. A fool can be defined in many ways according to the Collins English Dictionary. The word could mean a person lacking in sense and judgement, a person made to appear ridiculous, one who professionally counterfeits folly for the entertainment of others, a jester or clown or someone unwise, silly and absurd. Shakespeares fools cover the broad spectrum of these definitions but the most obvious at first glance is Feste who is defined as the professional fool. Malvolio, Viola, Olivia, the knights à ¢Ã¢â€š ¬Ã¢â‚¬Å" Sir Toby and Sir Andrew also all fit the definitions of a fool and are characters which Shakespeare presents purposely to create the chaotic romantic comedy. It is evident from the name of the character, Malvolio, that Shakespeare intended him to be disliked by the other characters in the play and the audience as mal in French means bad according to the Collins English Dictionary mal- is a combining form for anything that is bad eg. malaria . Malvolio in the Renaissance film directed by Trevor Nunn is dressed in a black suit and a black cloak which stresses the idea that Malvolio is a Puritan. It is likely that the characters in the play and the audience recognise this as for example Andrew Aguecheek says suitor to Olivia If I thought he was a puritan I would beat him for it. Puritans were a very fanatical group who believed for example that the theatre was a wicked place and that people should only meet together in church. At the time of the play was written Puritan movements were very active and were campaigning for the theatre to be closed. Understandably, Shakespeare did not like the Puritans because of this threat as he would be out of work and would not be able to express his art to people. Consequently, Shakespeare uses the character Malvolio as a device to show his hatred for Puritans and to make a mockery of them in front of a theatre going anti puritan audience. Through Malvolios speech and behaviour Shakespeare crafts an unlikeable character from the start, for example he is offensive to Feste, criticising him as a barren rascal who would be outwitted by an ordinary fool and is foolishly tactless saying I take theses wise men, that crow so at these set of kind of fools,no better than fools zanies which is unwisely insulting Olivias father and her also. In Act 2 Scene 2 we see Malvolio as lying, arrogant and self centred as he throws down the ring that Olivia has given him at Cesarios feet saying If it be worth stooping for,there it lies, in your eye; if not , be it his that finds it. , he is treating Cesario as if he is above him when he also is just a servant and the dramatic irony of it is that in her true identity Viola is above him. . He is obviously full of his self-importance and thinks he has the authority to change his orders from Olivia to what he thinks best as he incorrectly passes on the message that Cesario should not be neve r so hardy to come again in his affairs, unless it to be report your Lords taking of this. whereas infact Olivia wants him to come this way to-morrow. A Shakespearean audience would have been appalled with this behaviour from a servant and so Malvolio is a very emotive character. Malvolios tone of voice is portrayed to be pompous and snivelling by the Andrew Hawforth from the Renaissance film production which I studied to help with this essay. I think this is appropriate for the play from the way Malvolio treats others and the way in which he acts. The whole charade of Act 2 Scene 5 and Act 3 Scene 4 intensifies the purpose Malvolio is playing in Shakespeares desire to mock Puritans and show his hatred of them. Malvolio has dreams of grandeur and in Act 2 Scene 5 Shakespeare purposely makes a mockery out of the character by having him foolishly speaking aloud his humorous but unexpected inner thoughts. To contribute to the foolishness of his words as a director I would want Malvolio over dramatically acting out actions to his daydream for example on the line Calling my officers about me, I would want him to be waving his arms about in a pompous manner and on the lines I extend my hand to him thusà ¢Ã¢â€š ¬Ã‚ ¦.. egard of control to be going through the actions of what he is saying This scene presents a dramatic irony as the audience knows that the tricksters are watching which Malvolio on stage does not. This dramatic irony is present also in Act 2 Scene 5 as the audience knows about the letter trick when Olivia does not. In both these instances the tricksters are present who also know exactly what is going on know therefore this is device forcing the audience onto a par with the trickster s so they are subconsciously being manipulated by Shakespeare to mock Malvolio. Both scenes are highly comical because of the unprecedented behaviour of Malvolio in his actions and words which lead to the conclusion that he is a fascist and a hypocritical fool as he loses all his prime and proper inhabitants because of his excitement in being desired by a woman. Malvolio gets very excited when he sees the letter on the ground in his ladys hand and says these be her very cs, her us and her ts. This statement is confusing as these letters do not correspond with anything in the inscription and could be put down to the Shakespeares carelessness, however why does Sir Andrew underline it after if this is so? According to an assumption by Prof. G. B. Harrison Malvolio is unconsciously guilty of a bawdy jest eg. cut meaning the female pudendum genitals. Malvolio in Act 3 Scene 4 continues ironically to make sexual references, he is desperate to bed with Olivia and misunderstands her in his excitement. Throughout the play he seems to have created a rather sad and somber exterior, in the film production he dresses in black and carries an expressionless face, however after reading the request of a smile he does not seem perturbed to do so I will smile. As a director after this line I would have Malvolio with a perfect smile on his face as if he has frequently practised which would make him seem even more as a joke. He is ridiculously stupid to wear the yellow cross gartered stockings and the outfit is a humorous dramatic device to make the audience laugh as after all the play is a comedy. Elizabethan and contemporary audiences alike would find a mans legs in cross-gatered stockings extremely funny because of the tendency for men to have funny shaped legs. I think this joke would appeal to a contemporary audience also, because of who the character is which even in a modern world can be associated with eg. the miserable manager. However, the contemporary audience may not find the added comedy of a Puritan acting in this way amusing as that bares relevance to the time of Shakespeare. The Renaissance video provides further comedy by Malvolio putting on a toupe before visiting Olivia which I think is an excellent idea as it perfectly fits in with the context of the play. To Kill a Mocking Bird by Harper Lee and The Bluest Eye by Toni Morrison EssayViola and Sebastian are separated which also bears relevance to the fact that Hamnet and Judith are when Hamnet dies in 1596, the play was written four years later. Viola arguably is an unwise fool as she dresses up as a boy without thinking of repercussions such as the event of female attention. The gender muddle happens in another two of Shakespeares plays, Hamlet and Henry 1V. There were no decent females available to act therefore all female parts were played by young boys. However, it was hard to get a boy acting a believable woman therefore female charactervs dress up as males to combat the problem. Perhaps the reason for Shakespeare doing this was to create good excuse for male actors playing the female to act the correct sex. Viola is foolish not to sense the attraction Olivia has for her as the signals from as early as the first meeting seem clear Olivia hints to her she would like her to come again eg. unless perchance you come to me again, she unveils her curtain to show her the picture , this is especially shocking because of her mourning and she is conscious of how she looks to Viola Ist not well done? , which is strong sign of the attraction. In addition, when she talks to Viola she desires to be alone eg. Give us this place alone and Let the garden door be shut, and leave me to my hearingà ¢Ã¢â€š ¬Ã‚ ¦ . On the other hand Viola could been seen as being misjudged being called a fool as after all she disguised herself as a man to protect herself from the harm she would come to as a woman. It could also be said that a woman would not find it likely that she would be pe rceived as attractive by other women in disguise as a man so the problem naturally would not have arisen. Viola as a woman was not able to pick up the signals from Olivia properly that were being directed as if to a man.. Duke Orsino is evidently a very foolish character as from the outset of the play the audience is directed to the fickleness of his moods. For example, when he first orders music to accompany reverie over Olivia à ¢Ã¢â€š ¬Ã¢â‚¬Å" If music be the food of love, play on but then suddenly commands it to be stopped à ¢Ã¢â€š ¬Ã¢â‚¬Å" no-more! Although seemingly steadfast in his suit for Olivia in the first scene, as the play unravels it appears that Orsino is not truly in love with Olivia but in love with his role as an irrational lover immersed in a romantic reverie. As he seems to revel in long poetic like prose full of romantic imagery eg. the lamb that I doth love of his love for Olivia . This is indeed foolish, as Orcenio does not seem to know his own emotions and intentions. Orsino could also be called foolish to not realise Violas intentions towards him as she does make it obvious on some occasions for example when she says she is in love and Orsino inquires What kind of woman ist and she replies Of your complextion and continues to say she is of his years too. In the video production Viola played by Imogen Stubbs makes it quite obvious from the way she looks at Orsino that she is in love with him yet he is man not looking for these kind of signals from another so therefore maybe he is not a fool in this respect. Additionally Maria and Toby are also fools as perceptive Feste suggests there is something between Maria and Toby but they are too foolish to act upon it eg. Maria tells Feste no more of that. Toby obviously holds some affection for Maria as he names her Penthesila Queen of the Amazons half in admiration and half in jest at Marias diminutive size. There are certain hurdles which are barriers for them getting together for example Sir Tobys foolishness in the respects that he is a person who lacks sense or judgement and is unwise, silly and absurd due to his permanent drunkenness with the other knight, Sir Andrew Aguecheek as observed by Olivia he is half drunk all of the time. Both are foolish to feel the social difference is a bar rier because in true love barriers can be over come. Sir Toby combined with Sir Andrew make a very funny comic duo and their humorous antics together are still funny for a contemporary audience as they echo a comedy duo were one bounces off the other in the sketch. The charade of the sword-fight is reflective of a comedy sketch of today and in the play is a good comical dramatic device to get the audience laughing. It is very comical when Sir Toby sets up Viola and Sir Andrew saying to each how much a devil fighter each one is when Viola does not want to fight and Sir Andrew is wimpish. In Elizabethan times women did not fight and it is humorous, particularly to a Elizabethan audience that Sir Andrew is terrified of a girl. The mix-up between Viola and Sebastian is also highly comical and really shows à ¢Ã¢â€š ¬Ã¢â‚¬Å" up the characters Sir Toby, Sir Andrew and especially Olivia for not recognising a person who she proclaims love. In the conclusion of Twelfth Night every one is happily paired like the madness of the festival time of Christmas ends the madness of the mix-ups and confusion is resolved which is reminiscent of the theme that the path to find true love is never simple and many barriers arise. However Malvolio is a character who does not get paired off but finishes with saying I will be revengd on the whole pack of you, which ironically 40 years later after the time of the writing of the play in the English Civil War the puritans, lead by Oliver Cromwell triumphed over the royalists with Charles 1st. Shakespeare would also not want Malvolio finding love as a Puritan. However Malvolio is a complicated character as even though is arrogant and a kill-joy maybe he did not deserve the long à ¢Ã¢â€š ¬Ã¢â‚¬Å" drawn out cruel treatment that he received from Maria, Sir Toby and Feste . From a contemporary audiences point of view, consequently, Malvolio earns both derision and sympathy for the way he is treated, especially from the mean Feste. However, this probably would not be so from a theatre loving Shakespearean audience who have just watched an excellent play which the Puritans would want to ban therefore they would not feel sympathies for a Puritan. In reflection Shakespeare has cleverly presented the fools in the play for many purposes which collectively is to bring humour and wit to the play whos comedy is timeless.

Friday, April 3, 2020

Losing Faith in Dave Eggers Zeitoun free essay sample

Natural disasters affect many individuals throughout the world. One natural disaster that was known to affect the lives of thousands of Americans is Hurricane Katrina. One particular person affected by this hurricane is a man named Abdulrahman Zeitoun, who ventured through the destructed city of New Orleans helping those in need, while experiencing the malevolent actions placed upon him. Abdulrahman Zeitoun is an individual that underwent an enormous change as a result of Hurricane Katrina. Abdulrahman’s faith was being tested. After the hurricane, Zeitoun experienced many unfortunate events throughout New Orleans and was accused of looting and suspected of being a terrorist taking advantage of the anarchy New Orleans was in. Zeitoun thought he was doing â€Å"[God’s] work† (Eggers 262) by staying in the destructed city and helping those in need, explained in Dave Eggers’ book, Zeitoun. How could a man continue to believe in his faith in God when things he thought were right brought misfortune to him? Zeitoun started to doubt his religion, his God. We will write a custom essay sample on Losing Faith in Dave Eggers Zeitoun or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page A change which he experienced due to the results of Katrina. The love towards Abdulrahman’s wife, Kathy Zeitoun, diminished as a result of the hurricane. As stated in Naomi Martin’s article of the trial between Kathy and Abdulrahman, Kathy Zeitoun was considered as his ex-wife, indicating the bond between husband and wife was no more. The separation between the couple could also be considered as Abdulrahmans disbelief in his faith, since he believed the things God hated most were murder, divorce, and waste (Eggers 48). The divorce with Kathy showed Abdulrahmans faith in his religion slowly fading. One of my classmates shared the fact that Zeitoun was such a God fearing man within Dave Eggers Zeitoun, no one would have guessed divorce was an outcome. My classmate, Andrea Brunner’s, response towards the change Abdulrahman experienced was not a surprise for her since she believes people can change and we can never ge to know others very well. Even with Eggers book there are slight changes of Abdulrahmans character, so it should not be much of a surprise if it continues after the events of Katrinas aftermath. The results of Hurricane Katrina brought a heavy toll on Abdulrahman’s mind  and body. He experienced a excruciating pain on his side, which continue to grow each day he spent in New Orleans. Abdulrahman â€Å"had lost [his] perspective† (Eggers 262), since the pain he experienced was considered a punishment from God for staying in Orleans, for not listening to those that warned him of the impending doom. As a strong believer towards his religion, Abdulrahman thought he was doing what God intended by staying, but instead was punished for what he thought was right. During his time in New Orleans Abdulrahman was confine within a makeshift prison cell, evaluating his life, beliefs, and prideful nature. At this moment in Dave Eggers’ Zeitoun Abdulrahman accepts his predicament, God has abandoned him.Wounded within a cage, like a wild animal. Abdulrahman knew his current â€Å"environment would drive any sane man mad† (Eggers 264) indicating that his mind is developing for the worst. Abdulrahman Zeitoun is a person who underwent an enormous change as a result of Hurricane Katrina. The confusion and detachment of his own faith, the marriage between him and Kathy, and the heavy toll Katrina had placed on Abdulrahman presented an enormous change on him. The downfall of Zeitoun shows how people can change at any moment throughout life and the hardship one experience can alter the individual’s perspective completely.

Sunday, March 8, 2020

The Elgin Marbles essays

The Elgin Marbles essays Of all the museum collections in the world, none have such a tainted background as the Parthenon Sculptures in the British Museum. Upon mention of these sculptures, many heated discussions of imperialism, nationalism, ownership, and restitution arise. To understand this debate, one must disregard nationalism in order to neutrally examine the sculptures for what they are, art. This paper is an analysis about which country should be the proper house of the marbles based on the ideals of being reasonable and the knowledge of what the marbles truly symbolize. Though there are supportive arguments in favor of returning the marbles back to Greece, it would certainly remain in the best interest of the Parthenon Sculptures to remain in the British Museum. To be completely knowledgeable on this debate, one must know the origins of acquisition of the sculptures. During the late eighteenth and early nineteenth centuries, trends of examining ancient Greek and Roman culture took place in order to imitate many of the ancient social beliefs that influenced expansionist policies. This was evident all over Western Europe, but it was especially noticeable in England. In 1799, British man, Thomas Bruce, the 7th Earl of Elgin, was appointed to be the ambassador to Constantinople (Turkey). Bruce always had this idea, since being a boy, of wanting to make England more familiar with Greek art (greece.org/ parthenon/marbles/). At the time Turkey was occupying Greece, so Bruce took a group of painters, architects, and sculptures to Greece to begin this goal. This is the point where the debate begins. Critics of Lord Elgin cite that he did not obtain the proper authorial permission to actually extract the sculptures away from the Parthenon. At the time of obtainment of the sculptures, Elgin followed legal and standard procedures for the acquiring them. At the Parthenon, Bruce was initially allowed to only make drawings of artwork but wa...

Friday, February 21, 2020

Abortion rights supporting Pro-Life Essay Example | Topics and Well Written Essays - 1250 words

Abortion rights supporting Pro-Life - Essay Example The opponents of abortion point out that aborting the foetus is equivalent to murder since life starts at conception and foetus can feel pain (Beckwith 45). One would argue that no civilised society that allows intentional harming others and taking human life without punishment. Pro-life arguments assert that abortions are unsafe and lead to medical complications that increase the chances of pelvic inflammatory diseases and miscarriages (Kaczor 76). However, pro-choice arguments assert that pro-life arguments are based on religious beliefs that vary depending on the cultural values of the society and modern medical abortion procedures are safe for the mother (Lee 56). The proponents of abortion assert that abortion is effective in birth and population control since mothers do not have sufficient resources to take care of unwanted children. According anti-pro-life arguments assert abortion is essential in cases of rape since it minimises the psychological trauma and stress that is ass ociated with unwanted pregnancies (Singer 34). This paper will critically discuss the pro-life arguments of abortion and demonstrate why abortion should be banned in the society. Abortion should be abolished since human life is sacred and aborting amounts to killing innocent unborn babies. The unborn baby has same rights as the mother who should be protect the right to life since life begins at conception (Lee 88). In this case, no civilised society allows for murder or intentional harm without any punishment and abortion should be treated the same. Abortion should not be used as a contraceptive or population control method since there are millions of childless couples willing to adopt unwanted children in the society (Beckwith 87). Reinman asserts that abortion is associated with severe medical complications that endanger the life of the mother (p 56). According to available medical statistics and expert opinions, women who abort have a higher likelihood of developing pelvic inflam matory disease and may experience miscarriages in the future (Beckwith 121). In this case, about 15 percent of the first-trimester miscarriages are related to prior abortion experiences. It is evident that abortion endangers the health of the mother by increasing the risks of reproductive diseases, cancer, ectopic pregnancies and infertility thus women should not undertake a process that can permanently damage their body. Physicians and gynecologists have a professional responsibility of safeguarding the dignity of life in their practice and observing the ethical guidelines that prohibit abortions and inducing the patient to undertake medical procedures that may lead to death. In this case, doctors must be on the forefront in discouraging abortions and encouraging other scientifically accepted and safe birth control methods. Abortion only provides an opportunity for medical personnel to make money as most of the abortion cases are not documented in the health facilities. In this cas e, abortion is not helpful the affected women and taxpayers’ money should not be wasted in setting up abortion clinics in the health facilities. Abortion eliminates the potential future societal contributions of the unborn baby thus reducing the economic, social and political benefits to the society (Kaczor 63). The society would be worse if national heroes such as scientists, presidents, entrepreneurs and other people who have made great changes to their communities and entire country were aborted (Lee 98). In this case, abortion must be abolished since the society has the duty to grant the unborn babies a chance to serve the community and make a difference on the

Wednesday, February 5, 2020

Analyzation paper on the Novel the bluest eye by Toni Morrison Essay

Analyzation paper on the Novel the bluest eye by Toni Morrison - Essay Example At the beginning of the story she is ruled by two desires. The first one is to understand love and to know how makes people love her. And the second is considered not to observe parent’s quarrels that make her feels horrible. She has been interested in the feeling of love, and her life experience gives her an opportunity to face with the special and even strange manifestation of love. The matter is that Pecola has been raped by her father Cholly Breedlove. This man has problems with the alcohol that may be predetermined by his hard childhood. He loves his daughter and reflects this love in a brutal and violent form. The feelings, that he is experienced in the moment of raping Pecola, may be described as love and hatred. His character has been cruel and alcohol helps him to become mad. Still, that is considered to be the only form of love that Pecola knows in her life, and as it is suggested in the novel â€Å"wicked people love wickedly, violent people love violently, weak people love weakly, stupid people love stupidly, but the love of a free man is never save† (Morrison, 163). Her father’s freedom in love is considered to be dangerous and it reflects on a daughter. Pecola is represented as fragile and delicate child through the entire story. Her life is suffering with no positive implications in reality. She is in need to endure the boys who tortured her after school, the classmates who ridicule her, or Mr. Yacobowski who rejects to touch her hand. Pecola is a true victim of the entire society in general and of her own views in particular. The matter is that this girl is considered to be sure in her ugliness and uselessness in this world. Her black skin is interpreted by her as a huge drawback in her life and in all the society. Black means ugly for Pecola and nothing can change her vision. Her dream is represented as a desire to have blue eyes and white skin. Pecola has an imaginary illusion

Monday, January 27, 2020

Empirical Literature on Asthma Care

Empirical Literature on Asthma Care This brief critically considers the empirical literature on asthma care. Emphasis is on UK studies although research from the USA (and other countries) is also considered. It is argued that both environmental and genetic factors are implicated in asthma onset, based on epidemiological evidence. Deficits in care provision persist: these gaps in care may be attributable to a wide range of modifiable factors, including unsatisfactory health professional (GP, nurses) input, limited use of care plans, and patient unawareness. Overall, however, conclusive inferences about asthma care provision are hampered by: A preponderance of retrospective/correlational studies, and a paucity of randomised control trials, which demonstrate causality; A paucity of research on particular gaps in asthma care; Failure to account for third-variable moderator effects. The Office for National Statistics (2004) publishes comprehensive statistics on asthma-related mortality, morbidity, treatment, and care, collapsed by demographic categories. Data is collected from the General Practice Research Database (GPRD). Issues addressed include mortality, prevalence, time trends, patients consulting general practice, incidence of acute asthma, and hospital inpatient admissions. Research suggests that health care providers often fail to agree on the precise criteria for diagnosing asthma, whether mild or severe (e.g. Buford, 2005). Severe asthma is often defined based on pulmonary function measurements, such as forced expiratory volume in 1 second, and hospitalisation. However, neither of these indicators reliably predicts asthma severity (Eisner et al, 2005). Eisner et al (2005) evaluated the efficacy of a method for identifying a cohort of adults with severe asthma based on recent admissions to an intensive care unit (ICU) for asthma. Four hundred adults with severe asthma enrolled at seventeen Northern Carolina hospitals were surveyed. A control group of patients hospitalised without ICU unit admission was also recruited. The study examined whether admission to an ICU unit is in itself a reliable indicator of asthma severity. Asthma patients with a recent ICU admission generated higher asthma scores (based on the frequency of current asthma symptoms, use of steroids and other medications, and history of hospitalisations/intubations), and poorer quality of life, were more likely to have been hospitalised, visited an asthma specialist in the previous twelve months, been in an asthma-related emergency department, and received inhaled corticosteroids in the past year. Data analysis controlled key background variables (e.g. demographic factors), increasing confidence in the reliability of the findings. However, this study was based on quasi-experimental design and hence may be confounded by sampling bias. Trends in annual rates of primary care consultations, mortality, and hospital visits/admissions were monitored for children under 5 years and 5-14 year olds. For children aged For 5-14 year olds, weekly general practice visits rose in the early 1990s (circa 70/100,000 in 1990), showed a fluctuating pattern through the mid 1990s, but has declined steadily since 1997 (about 50/100,000 by 2000). The number of patients treated annually for asthma has risen slowly but steadily, although this increase seemed to level out by the mid/late1990s. Both mortality rates have dropped steadily since the early 1990s, from about 14 million in 1990 to circa 2 million by 2000. Annual hospital admissions has also fallen steadily, from just under 30/10,000 in 1990 to about 15/10,000 by 2000. These patterns suggest an increase in self-management (e.g. action plans) that obviates the need to visit a general practice, and that asthma care overall is having the desired effect on mortality. The prevalence of wheezing and asthma in children has generally increased during the last 40 years. Although there is a paucity of reliable national statistics, data is available from specific parts of the UK, notably Leicester, Sheffield, and Aberdeen (see Figure 1). The prevalence of wheezing increased from 12% (1990) to 26% (1998) in Leicester, and from 17% (1991) to 19% (1999) in Sheffield. The prevalence of asthma showed a similar pattern in both cities, rising from 11% (1990) to 18% (1998) in Leicester, and from 18% (1991) to 30% (1999) in Sheffield. Wheezing incidence rates for Aberdeen increased from 10% (1964), to 20% (1989), 25% (1994), and 28% (1991). Data from national birth cohorts suggests a sharp increase in the average weekly GP consultations for hay fever/allergic rhinitis from 1991 to 1992. The rates rose from circa 13/100,000 (0-4 year olds) and 40/100,000 (5-14 years olds) in 1991 to about 25/100,000 (0-4 year olds) and 76/100,000 (5-14 year olds) as 1992 approached. Trends subsequently dropped off slightly but then started to show an increase again around 1998. By the year 2000 the figures were roughly 20/100,000 (0-4 year olds), and 56/100,000 (5-14 year olds). Data from a nationally representative sample of schools across the country suggests that the prevalence of asthma was fairly even across different regions. However, Data for England suggests a higher prevalence outside big cities. The greatest proportions of wheezing was found in the South West, while the highest proportion of asthma cases was found in East Anglia and Oxford (see Figure 2). In a recent Annual Report, Asthma UK (2003/2004) noted that one child in 10 has asthma and a child is admitted to hospital every 18 minutes due to an asthma attack. Over 600 copies of Asthma in the Under Fives are downloaded from the UK Asthma website monthly and on average every classroom in the UK has at least 3 children with asthma. The impact of acute asthma can be debilitating. Around 5.2 million people in Britain are presently being treated for asthma, and asthma prevention/care costs the NHS on average almost  £900 (i.e.  £889) million per year. GPs across the country treat over 14,000 new episodes of asthma each week, and UK Asthma met almost 25,000 requests for health promotion documents and other materials. About 40% of workers who have asthma find that working actually exacerbates their asthma, and 1 in 5 asthmatic people feel excluded from areas of the workplace in which people smoke. Over 12.7 million working days in the UK are lost as a result of asthma, and it is estimated that the annual cost of asthma to the economy is  £2.3 billion. Asthma UK also states that 82% of people who are asthmatic find that passive smoking triggers their asthma, and 19% of people with asthma indicate that their medical condition makes it difficult for them to play with children in their family. One in 3 children has had their routine daily activities disrupted due to asthma and 39% of asthmatic people are badly affected by traffic fumes (which stop them exercising). About 500,000 people have asthma that is very difficult to control. In 2003/2004 over 90 researchers worked on Asthma UK-funded projects and, Asthma UK spent  £2.5 million on asthma-related research. The group funded/is funding 63 research projects. These statistics paint a rather bleak picture of asthma prevalence, incidence, and the effects on people’s lives. Numerous epidemiological studies have been published that address the etiology of asthma in population groups (International Archives of Allergy Immunology, 2000; Kitch et al, 2000; Schweigert et al, 2000; Tan, 2001; Court et al, 2002; Smyth, 2002; Weissman, 2002; Tan et al, 2003; Wenzel, 2003; Gibson Powell, 2004; Barnes, 2005; Pinto Almeida, 2005). Barnes (2005) considered evidence on the role of genetic factors in resistance to atopic asthma, Studies which focus on the role of genetic factors in resistance to tropical/parasitic diseases (e.g. malaria) overlap with genetic associations found for asthma. It was concluded that genetic factors might be implicated in the development of allergic illnesses. Pregnancy is thought to increase the probability of asthma attacks in about 4% of all pregnant women. Beckmann (2006) assessed eighteen pregnant women with asthma. The study was based on a longitudinal design. Participants were recruited from local prenatal clinics and private enterprises, and enrolled during the first trimester. Patients kept a daily log recording peak expiratory flow data until delivery. Three peak-flow assessments were recorded after which the best value was entered into the log. Asthma was diagnosed by a health professional. Participants were also required to record asthma symptoms, exacerbations, medications, and cigarette use. To increase participation, subjects were reminded by telephone to complete their log. Data analysis showed that peak expiratory flow (PEF) was variable as a function of particular trimesters. Peak air flow was highest during the second trimester, with a statistically reliable difference between the second and third trimester. Unfortunately, the small sample size limits the generalisability of the findings. However, the study was based on a longitudinal design, allowing tentative causal inferences. Schweigert et al (2000) reviewed the literature on the role of industrial enzymes in occupational asthma and allergy. Enzymes used by detergent manufacturing companies (e.g. amylases, cellulases) are toxicologically benign, with mild irritation effects on the body. However, these enzymes do affected asthma and allergy. Thus, the industry is required to adhere to exposure guidelines for these enzymes. Kitch et al (2000) considered literature on the histopathology of late onset of asthma (i.e. onset in adulthood), and whether allergic exposure and sensitivity have the same impact on asthma development in adulthood as they do in children. Epidemiological studies suggest that the prevalence of asthma in older adults aged 65years or more is between 4% and 8%. The illness appears to be more common in women, especially those with a long history of smoking, and with respiratory symptoms (e.g. cough, wheeze, shortness of breath). Asthma in adulthood often developed before the age of 40, with maximum incidence occurring around early childhood. Beyond the age of 20 years the incidence of asthma tends to remain stable through young, middle-aged, and older adulthood. Death rates in adults are generally lower than figures for children; â€Å"Mortality rates attributable to asthma among those aged between 55 and 59 years of age and 60 and 64 years of age were 2.8 and 4.2 respectively, per 100,000 people, the highest rates among all age groups† (p.387). However, as adults get older asthma is less and less likely to be identified as the main cause of death due to the increased incidence of other pathology. Epidemiological research in Japan highlights a link with air pollution (International Archives of Allergy Immunology, 2000). The prevalence of asthma among kindergarten and elementary school children has increased steadily since the early 1960s, rising from 0.5-1.2% between 1960 and 1969, to 1.2-4.5% (1970-1979), 1.7%-6.8% (1980-1989), and 3.9-8.2% (1990 onwards). By contrast, data indicates little or no change in asthma prevalence amongst adults. Figures range from 1.2% in 1950-1959 to 1.2-4.0% (1960-1969), 0.9-5.0% (1970-1979), 0.5-3.1% (1980-1989) the 1960s to 1.6-2.9% (1990 onwards) (see Figure 3). Asthma in Japanese children is more common amongst boys than girls although this gender difference has diminished noticeably since the 1960s. Asthma usually appears in infancy or early in childhood but has been known to begin across all age groups. Inherited (genetic) dispositions to allergies have been implicated in the onset of asthma. There is normally a strong correlation between asthma onset and a family history of asthma. Overall, asthma-related mortality in Japan has decreased since the mid 1990s. Delays in seeking treatment and rapid exacerbation of symptoms have been strongly implicated in asthma mortality. Unfortunately, this article offers little information about the designs of studies reviewed. Inferences regarding the possible causes of asthma morbidity and mortality may be inconclusive if much of the evidence is derived from cohort studies, rather than case control studies that more effectively eliminate alternative causes. The premenstrual period in women has been implicated in asthma exacerbation. Tan (2001) reviews epidemiological literature suggesting that female sex-steroid hormones may be significant in understanding the premenstrual-asthma link, albeit the available evidence is tenuous. The luteal phase of the menstrual cycle is associated with airway inflammation and hyper-responsiveness, and hence may explain asthma exacerbation during the premenstrual phase. However, this increase in asthma severity can still be treated effectively using the normal drugs. Studies suggest that premenstrual asthma affects the rate of hospital admissions – the majority of adults admitted are women, indicating that hormonal factors play an important role. Other evidence suggested that emergency presentations increased before ovulation. It is suggested that oral contraceptive pills or gonadotrophin releasing hormone analogues may be especially effective treatments. However, premenstrual asthma was rarely associated with serious mortality. Unfortunately, most of the studies reviewed were retrospective and questionnaire based, and hence subject to response bias. There was a paucity of randomised control trials, or pseudo experiments that may permit causal inferences. Court et al (2002) considered the distinction between atopic (extrinsic) asthma, common in younger people, and non-atopic (intrinsic) asthma, found mostly in older groups. Additionally, they also considered whether identification of asthma cases in epidemiological research should be based on a doctor’s diagnosis or self-reported asthma symptoms. Nearly 25,000 people in England were surveyed. Data was collected regarding whether participants had experienced wheezing in the past 12 months and/or had been diagnosed as asthmatic by a doctor. People with atopic asthma were more likely to have experienced wheeze and been diagnosed as asthmatic in the past, compared with the non-atopic group. Logistic regression analysis showed that gender, social class, smoking status, living in an urban/rural area, and house dust mice (HDM), were all risk factors for the presence of wheeze both with (age not significant) and without (urban/rural area not significant) a diagnosis of asthma. Wheeze/asthma was more prevalent in women, younger people, lower social classes, previous/current smoking, living in an urban area, and greater HDM IgE levels. Smoking status, social class, and age were all risk factors for wheeze in both atopic and non-atopic cases. Gender was also a risk factor for atopic subjects, and urban living for non-atopics. Other research has considered the epidemiology of severe or ‘refractory’ asthma, which is rather less well understood compared with milder forms of asthma. Wenzel (2003) reviews evidence indicating that severe asthma (defined as asthmatics requiring continuous high-dose inhaled corticosteroids or oral corticosteroids for over half of the preceding year) may account for circa ≠¤ 5% of asthma cases. Data from a large Australian-based study, which has followed a large cohort of asthmatics for over three decades, implicates childhood pulmonary problems with reduced lung function in adulthood. Data suggests that over two-thirds of severe asthmatics were afflicted with asthma in childhood. Other risk factors implicated include genetic mutations (in the IL-4 gene and IL-4 receptor), and environmental factors (e.g. allergen, tobacco exposure, house dust mite, cockroach and alternaria exposures), respiratory infections (e.g. pathogens like chlamydia), obesity, gastroesophageal reflux disease, increased body mass index, lack of adherence to corticosteroid regimes, and poor physiological response to medication. Physiological factors are also implicated, notably structural changes in airway reactivity, inflammation of the peripheral regions of the lungs. Steroids are the main form of treatment. Tan et al (2003) demonstrated the role of respiratory infection in patients with severe (i.e. near fatal) asthma, acute exacerbations, or chronic obstructive pulmonary illness (COPD). Participants had all been diagnosed as asthmatic by a physician and were undergoing treatment. All showed evidence of forced expiratory volume in 1 second (FEV1) increase of 200mL. COPD patients were suffering from chronic cough and dyspnea, with a predicted FEV1% 50%, with no ÃŽ ²-agonist reversibility. Near fatal cases were patients undergoing ventilatory support in the intensive care unit of a hospital (National University Hospital and Alexandria Hospital, Singapore) as a result of a severe exacerbation. Acute asthma subjects were characterised by non-improvement following administration of ÃŽ ²-agonists, and/or severe exacerbation judging from clinical/blood data. Analysis showed that near-fatal cases were the least likely to have the influenza A + influenza B virus, but the most prone to have adenovirus and picornavirus, compared with the other two groups (see Figure 4). This suggests that viral infection may be a risk factor for severe asthma. However, due to sampling size/bias (n= 68), and failure to control for key background variables (e.g. asthma history, smoking history, prior medication use, and outpatient spirometry), the findings can be considered tentative. Smyth (2002) reviewed epidemiological studies on asthma in the UK, and worldwide. The number of new asthma cases seen by GPs has increased noticeably since the mid 1970s. Nevertheless, asthma incidence has tended to decrease since the early 1990s, consistent with data from the Office for National Statistics (2004). By the year 2000 circa 60-70, 40-50, 20-25 new cases (per 100,000 of a given age group) were reported amongst, respectively, preschool children, 5-14 year olds, and people older than 15 years. Significant ethnic differences have been reported, with high asthma prevalence in Afro-Caribbean children. Since 1962, the number of preschool children hospitalised for asthma rose steadily, then peaked in the late 80s and early 90s, and has begun to decline since. The hospitalisation rates in 1989 were 90/10,000 (preschool children), 30/10,000 (5-14 year olds), and 10/10,000 (15 years or older). By comparison the rates for 1999 were 60/10,000, 20/10,000, and 10/10,000 respectively ( see Figure 5). The British Thoracic Society identifies specific benchmarks or ‘best practice’ which health professionals are required to meet when caring for asthma patients (BTS, 2004). These recommendations are mostly based on scientific evidence from RCTs, epidemiological studies (cohort and case-control), meta-analytic reviews, and other good quality research. The recommendations related specifically to the following topics: Diagnosis and assessment in children and adults (e.g. key symptoms, recording criteria which justified diagnosis of asthma); Pharmacological management (e.g. use of drugs [inhaled steroids, ÃŽ ²2 agonist] to control symptoms, prevent exacerbation, eliminating side effects, employing a ‘stepwise’ protocol for treatment); Use of inhaler devices (technique and training for patients, agonist delivery, inhaled steroids, CFC vs. HFA propellant inhalers, suggestions on prescribing devices); Non-pharmacological management (e.g. breast feeding and modified milk formulae for primary prevention, and allergen avoidance for secondary prevention, alternative medicines); Management of acute asthma (initial assessment, clinical features, chest x-rays, oxygen, steroid treatment, referral to intensive care) Asthma in pregnancy (drug therapy, management during labour, drug treatment in breastfeeding mothers); Organisation and delivery of care (e.g. access to primary care delivered by trained clinicians, regular reviews of people with asthma, audit tools for monitoring patient care after diagnosis); Patient education (e.g. action plans, self-management, compliance with treatment regimes). Overall, despite these guidelines, recent research suggests that patients’ treatment needs are not being met. For example, Hyland and Elisabeth (2004) report data on the unmet needs of patients. Focus groups were organised between parents, patients, and clinicians. Patients and parents reported various needs that weren’t been met including frequent exacerbations, and a preference for less complex drug regimens (i.e. with fewer drugs). Many individuals had worries regarding treatment and experienced asthma symptoms 3 or more days per week. As Levy (2004) suggests, there is a need for health professionals to address these concerns, especially in relation to the BTS guidelines. Levy, a GP and Research Fellow in Community Health, identified current deficiencies in the care of asthma victims. These comprised: Higher than expected exacerbations (42/1000 patients per year); Under-diagnosis: more patients presenting for treatment with uncontrollable asthma, who had not been diagnosed previously; Deficiencies in treatment uptake: many patients fail to collect their prescriptions; Many patients with symptoms delay presenting for treatment, until their medical situation becomes critical; Health care professionals are failing to assess patients objectively (PEF, oximetry), both pre- and post-treatment; Failure to adhere to national guidelines for the care of acute asthma (e.g. not enough oral steroids and ÃŽ ²-agonists are prescribed for patients presenting with asthma attacks. Considerable variations across GPs, NHS Trusts, clinics, and other sources of care provision: patient follow-up appointments range from a few days to six months, in direct violation of standards set by the British Thoracic Society (BTS, 2004). Levy suggests various strategies for improving asthma care including diagnosis criteria (e.g. â€Å"any patient with recurring or respiratory symptoms [cough, wheeze, or shortness of breath], or who has been prescribed anti-asthma treatment should be considered to have asthma† (p.44)), use of computerised templates, having systems or triggers in place for recalling patients (e.g. patients requesting more medication, or who have been seen out of hours), introducing more effective protocols for monitoring and informing asthma patients (e.g. using a checklist to ascertain various key information on patients status, such as effects of asthma on patients life, recent exacerbations), providing written self-management plans (e.g. how to detect uncontrolled asthma, using PFM charts), and having an agreed procedure for managing acute asthma attacks (e.g. selecting a low threshold for using oral steroids). Currently there is a lack of research testing the value of these recommendations on asthma health outcomes. However various strategies are continually being implemented in various parts of the country to improve the quality of asthma care. For example, Holt (2004) describes the effects of implementing the RAISE initiative, launched by the National Respiratory Training Centre, in a primary care setting. This scheme is designed to raise awareness of existing variations in standards of care, improve standards of care through education, support, and feedback, increase awareness and understanding of respiratory disease, use asthma as platform to demonstrate the value of shared experiences across different agencies/professionals, and augment the profile of primary care settings as the main source of asthma care and innovation. The RAISE led to various improvements, such as: The use of ‘active’ and ‘inactive’ asthma registers, to distinguish patients who currently have asthma symptoms from those who don’t. Introduction of computerised templates to improve accuracy and reliability of data recording during consultations (e.g. progressing sequentially from assessment of symptoms, to peak flow, inhaler, and advice stages). Use of symptom questionnaires (e.g. handed out with repeat prescriptions) that help patients with well-managed asthma decide whether they can opt for a telephone consultation, rather than taking the trouble to visit the practice for a face-to-face consultation. Haggerty (2005) identifies several factors paramount to effective care and management of asthma in UK patients. These comprise adequate patient education about the nature of asthma (e.g. number of asthma episodes, use of quick relief medicines, long term symptoms, restrictions on daily activities, and emergency visits), use of asthma action plans, and customised treatment plans (to achieve early control), and addressing patients own concerns and perception. Treatment for asthma is usually in the form of regular inhaled corticosteroids (ICS), oral corticosteroids (OCS), and ÃŽ ² agonists. These treatments are usually administered by a health professional when symptoms manifest and/or become severe. However, since asthma can often exacerbate rapidly, before an individual can seek medical help, it is vital that asthma patients receive the necessary care from health professionals, and also self-management skills. GPs and nurses play a critical role. Griffiths et al (2004) conducted a randomised control trial to assess the effect of a specialist nurse intervention on the frequency of unscheduled asthma care in an inner city multiethnic clinic in London. The role of specialist nurses in asthma care has been uncertain. Interventions in which specialist nurses educate patients about asthma, after hospital attendance with acute asthma, were shown to have inconsistent effects on unscheduled care. However, outreach initiatives to educate medical staff had shown no effect. Thus, an intervention was designed that combined patient education with educational outreach for doctors and practice nurses. It was suspected that such an integrated approach would benefit ethnic minority groups, especially given their higher hospital admission rates and reduced access to care during asthma exacerbation. The key research question was whether specialist nurses could improve health outcomes in ethnic minority groups. Outcome variables were the percentage of patients receiving unscheduled treatment for acute asthma during a 12 month period, and time to first unscheduled attendance with acute asthma. The study was based on 44 practices in two east London boroughs. Participants comprised over 300 patients (aged 6 to 60) who were admitted to or attending the hospital, or the out of hours GP service with acute asthma. Half the sample were classified as South Asians, 34% were Caucasian, while 16% were Caucasian. The intervention was based on a liaison model. Practices were assigned to either a treatment or control condition. Practices randomised to the treatment condition ran a nurse led clinic involving liaison with GPs and practice nurses, incorporating education, raising the profile of guidelines for the management of acute asthma, and providing on-going clinical support. In practice these practices received two one-hour visits from a specialist nurse who discussed guidelines for managing patients with acute asthma. Discussions were based on relevant empirical evidence. A computer template was provided to elicit patient information on various treatment issues, such as inhaler technique and peak expiratory flow, and offer self-management advice. By contrast, control practices received a visit promoting standard asthma care guidelines. Data analysis showed that the intervention lengthened the time to first attendance (median 194 days for intervention practices, and 126 days for control practices), and also reduced the proportion of patients presenting with acute asthma (58% treatment practices versus 68% in control practices (see Figure 6). These effects were not moderated by individual differences in ethnicity, albeit Caucasians seemed to benefit more from the intervention compared with minority ethnic groups. O’Connor (2006) noted that asthma care in the UK remains below the required standards. The majority of the 69,000 hospital admissions and circa 1400 deaths annually are attributable to poor patient adherence to treatment regimens. Nurses, it is argued, play an important role in promoting adherence. Additionally, use of a new inhaled corticosteroids – circlesonide – may also help increase adherence. Circlesonide is much easier to use than more established asthma drugs (e.g. it has a once-daily dosing). Evidence is reviewed suggesting that peak expiratory flow remains stable when patients are given circlesonide compared with a placebo. Tsuyuki et al (2005) assessed the quality of asthma care delivered by community-based GPs in Alberta, Canada. They reviewed clinical charts for over 3000 patients from 45 primary care GPs. Of this number 20% had ever visited an emergency department or hospital, 25% had evidence that a spirometry had been performed, 55% showed no evidence of having received any asthma education, 68% were prescribed an inhaled corticosteroid within the past 6 months, while a very small minority (2%) had received a written action plan. Figure 6 shows percentage of participants receiving medication. Sixty-eight percent were prescribed an inhaled corticosteroid, 11% were given an oral corticosteroid, and 80% received a short acting ÃŽ ²-agonist, while 8% were prescribed a long acting ÃŽ ²-agonist. Participants with an emergency room/hospital event were (marginally) more likely to be prescribed medication (no group differences in use of short acting ÃŽ ²-agonists). Regarding pulmonary testing, 25% had evidence of a pulmonary function test (not peak flow), 46% had peak flow monitored, 34% showed no evidence of pulmonary function tests, while 26% had an x-ray. Again individuals with an emergency room/hospital event were more likely to be tested (see Figure 7). Data about education received by patients was also evaluated. Twenty-two percent received information about environmental triggers, 20% on inhaler use, 10% on how to perform a home PEF test, 2% on written action plans, while 55% received no education at all. Those with an emergency room/hospital event were more likely to receive education. Receiving asthma education, use of spirometry, and prescription of inhaled corticosteroids, were all predicted by number of asthma-related clinic visits (4 or more) and having an emergency room/hospital event. Additionally, asthma education was predicted by cormorbidities, and absence of documentation regarding asthma triggers, while use of spirometry was predicted by being a non-smoker, and symptoms or triggers. Finally, use of inhaled steroids was predicted by symptoms. Overall, this study highlights numerous gaps in the care provided by GPs, partly echoing criticisms of GPs in the UK (Levy, 2004). For example, Levy (2004) cited ‘under

Sunday, January 19, 2020

Freud and Psychodynamic Theory :: Papers

Freud and Psychodynamic Theory Freud was born on May 6, 1856, in the Moravian town of Freiberg, then a part of the Austro-Hungarian Empire, today a part of Czechoslovakia. He was born into a family full of enough complexity and confusion to give him significant material for his ruminations on the individual mind and its connections with others. His mother, Amalia, an assertive, good-looking woman, was twenty years younger than her husband Jacob. She was his third wife; he was forty at Freud's birth. Freud's siblings were two half-brothers, grown-up, a constant reminder of the oddity of his position. His own confusions, hatreds, love and desires from this period appear to have had significant impact on his later work on development. Components Of Personality Id As the baby emerges from the womb into the reality of life, he wants only to eat, drink, urinate, defecate, be warm, and gain sexual pleasure. These urges are the demands of the id, the most primitive motivational force. In pursuit of these ends, the id demands immediate gratification: it is ruled by the pleasure principle, demanding satisfaction now, regardless of circumstances and possible undesirable effects. If a young child was ruled entirely by his id, he would steal and eat a piece of chocolate from a store regardless of the menacing owner watching above him or even his parents scolding beside him. The id will not stand for a delay in gratification. For some urges, such as urination, this is easily satisfied. However, if the urge is not immediately discharaged, the id will form a memory of the end of the motivation: the thirsty infant will form an image of the mother's breast. This act of wish-fulfillment satisfies the id's desire for the moment, though obviously it does not reduce the tension of the unfulfilled urge. Ego The eventual understanding that immediate gratification is usually impossible (and often unwise) comes with the formation of the ego, which is ruled by the reality principle. The ego acts as a go-between

Saturday, January 11, 2020

As I Lay Dying 9

May 10, 2010 013 Child Relations In the book â€Å"As I lay Dying† by William Faulkner the character that is dying name is Addie Bundren, the mother of five children. She was also the wife of no good Anse Bundren. Anse is lazy, selfish, no good farmer, who can hardly be called a farmer because he does almost none of the work himself. Out of an act of lust Addie and Anse married and ended up giving birth to Cash and Darl soon after. After the birth of her two sons Addie was bent on not having any more children. The birth of Cash confirms her feeling that words are irrelevant and that only physical experience has reality and significance. Through the act of giving birth she becomes part of the endless cycle of creation and destruction, discovering that for the first time her aloneness had been violated and then made whole again by the violation† (Vickey 54). Anse wanted as many children as possible so that he would have as many hands a possible to work for him, but Addie w as determined to have no more. This made their marriage very rocky and lead to Addie requesting to be buried with her blood relatives in town. In this time period this was hard because of the lack of transportation that they had as well as a lack of money. Her determination to not have any more children was brought to an end because she had an affair with Whittfield, which lead to the birth of Jewel. Anse did not know of this affair so he thought that jewel was his child. Addie decided to make it up to Anse by giving him two more children. â€Å"She consciously and deliberately gives Anse Dewey Dell to negative Jewel and Vardaman to replace him† (Vickey 55). Among the five children that she had Addie treated them all in a different way. Addie especially treated Cash, Darl, and Dewey Dell very differently. The relationship between Cash and Addie is magnificent for many reasons. Out of the five children that Addie had she liked Cash’s personality the most. Cash is the oldest of the five children. In addition to being the oldest, Cash is also a man of very few spoken words. He can be considered a very simple character compared to the others of the novel. For example, in his first narrative excerpt from As I Lay Dying Cash speaks in list form. {draw:custom-shape} This is one of the most simplistic forms of communication known. As a skilled carpenter, Cash, went and built his mothers coffin, especially to her liking in front of the window in which she was slowly dying. Cash and Addie had a relationship based off very few spoken words. â€Å"Her blissful union with Cash exist beyond body language: Cash did not need to say it [love] to me nor I to him† (Clarke 38). Clarke is explaining in this passage how there are no words needed in the relationship between Addie and Cash. As Cash built his mothers coffin, for each piece that he completed he held up for her approval. â€Å"She’s just watching Cash yonder† (Faulkner 9). This shows how Addie was continuously looking out the window to check on Cash’s progress on her coffin. Cash is extremely determined to complete the coffin. â€Å"With Cash all day long right under the window, hammering and sawing at that——â€Å"(Faulkner 19). This is proof of their strong relationship because he spends all his time doing this strenuous task. â€Å"Work is Cash’s way of communicating with Addie, his means of getting and holding her attention, and thereby assuring that unspoken understanding that has always existed between them†(Bleikasten 179). Bleikasten is showing that Cash rarely speaks unless it is through his actions such as building the coffin. Although Addie and Cash did have a very good relationship, Cash still needed something to help him cope with the death of his mother. For him this would be his carpentry skills. â€Å"The carpentering itself is an activity in which Cash can immerse himself sufficiently to insulate himself from the harsh reality of his mother’s imminent death† (Powers 56). This is simply saying that Cash is using carpentry to replace his mother after her death. The work of mourning begins before death has actually occurred† (Bleikasten 178). The mourning begins early because Cash already has a strong feeling that his mother is about to pass on so he begins to work on her coffin. â€Å"The building of the coffin should become for Cash the object of a manic counter investment. If he cannot be the jewel, he can at the very least be the jewler, the maker of the perfect shrine in which the mother’s precious body is preserved. In nailing Addie into the coffin, Cash encloses himself with her, burying his desire and pain† (Bleikasten 179). Cash making the most perfect coffin possible is his special way of mourning and the completion of the coffin with his mother’s body in he is enclosing his pain. â€Å"The infant loved by his mother grows to be a man of deeds; and Addie, in the absence of Jewel, calls out to him at the moment of her death—and he continues that relationship in his silent agony on the wagon†(Williams 117). Addie and Dewey Dell did not have the best relationship but at the same time did not have the worse possible relationship. Addie felt indifferently towards Dewey Dell, meaning that she didn’t particularly care what happened with her. She didn’t really care because Dewey Dell was only meant to negate Jewel because it was her illegitimate child that Anse did not know of. Addie purposely gave Anse Dewey Dell and Vardaman to make up for the birth of Jewel. Dewey Dell clearly did not have the strongest relationship with her mother though. â€Å"Dewey Dell is not so clearly disturbed by her mother’s death, yet her activity with the fan at Addie’s bedside may be seen as similar in protective function to Cash’s carpentry†(56 Powers). Dewey Dell too had something to substitute for her mother’s death. Dewey Dell, terribly preoccupied by the bud of life within herself- the result of going to the woods, the ‘secret shade,’ with Lafe- can scarcely attend to Addie’s death†(Powers 56). Dewey Dell quickly became pregnant after an agreement that she had with Lafe. Lafe manipulated the agreement and found a loop hole and ended up picking cotton into her basket. As she lost her virginity under the secret shade and realizes soon after that she is pregnant â€Å"Dewey Dell admits that ‘the process of coming unalone is terrible’† (Williams 105). It quickly became clear that â€Å"Dewey Dell has no need to replace the mother figuratively, for she replicates the mother in her own pregnancy† (Clarke 41). This shows that Addie and Dewey Dell really did not have a close relationship because even through her pregnancy she should have been attending to her mother’s needs as she left this world. Further more as they took the casket into town, Dewey Dell’s intent to go to town was so that she could try to find some abortion medicine, because like her mother she did not necessarily want her first child at that point in time. So the daughter goes through the same experiences as her mother: in pregnancy Dewey Dell discovers as Addie did her destiny as begetter, and like her mother she is snatched from aloneness only to be thrown back to it†(Bleikasten 180). Although Addie and Dewey Dell have many similarities when it comes to their pregnancies they are also different. â€Å"Unlike Addie, she is determined, if possible, to effect their separation. Thus, she will not name her condition even to her self because to do so would be to transfer her pregnancy from her private world of awareness to the public world of fact† (Vickery 61). Darl and Addie on the other hand had the worst possible relationship ever. This was proven several times throughout the novel As I Lay Dying by William Faulkner. Darl had said â€Å"I cannot love my mother because I have no mother† (Faulkner 95). This shows exactly how they have a bad relationship, but it is not just a one way street, Addie in turns hates Darl also. â€Å"Addie claims to have been tricked by a word in Darl’s conception; she says that my revenge would be that he would never know I was taking revenge. And when Darl was born I asked Anse to promise to take me back to Jefferson when I died† (Williams 115). This is the beginning of the dislike on Addie’s behalf because she did not want another child to begin with, so she intended on getting revenge on Anse. â€Å"He too must finally cast the son most like him (Darl, the one that folks say is queer, lazy, pottering about the place no better than Anse, the one who most resembles his father looking out over the land†¦with eyes [that] look like pieces of burnt out cinder†(Williams 115). In this passage Williams describes why Addie actually hates Darl. She hates Darl because she hates Anse with a passion, and Darl acts just like Anse in the sense that he is lazy like his father. Because Addie accepts the fact that she and Anse live in different worlds, her second child, Darl, comes as the ultimate and unforgivable outrage† (Vickey 54). Since Darl receives no love from his mother he makes it his duty to terrorize everyone else in the Bundren family minus Anse. â€Å"Never having had a mother, Darl is more surely poss essed by her than any of his brothers. Darl’s eyes, as Dewey Dell describe them, are full of the land dug out of his skull and the holes filled with distance beyond the land†(Bleikasten 188). Darl is known for his abilities to communicate without words, â€Å"at times, a kind of nonlinguistic â€Å"feminine† intuition† (Clarke 35). Using this ability he continuously terrorized Dewey Dell because he was the only one whom knew of her pregnancy in the Bundren house hold. In one of Dewey Dell’s narratives she said â€Å"He said he knew without words like he told me that ma is going to die without words, and I knew he knew because if he had said he knew with words I would not have believed that he had been there and saw us† (27). What Dewey Dell is explaining is that Darl speaks to her without words and knows of all things that are happening and only the most important things Darl says with no words, such as the death of their mother. Darl also takes it upon himself to confuse his youngest brother Vardaman even more than he already is. For example, Vardaman says â€Å"My mother is a fish† (84). This shows how confused Vardaman really is. The conversation that Darl and Vardaman had concerning Vardaman’s mother being a fish and the horse being Jewel’s mother really left Vardaman confused. As if this little part was not confusing enough for the five year old, Darl then confesses that he does not have a mother. â€Å"I haven’t got ere one, Darl said, Because if I had one it was. And if it is was, it can’t be is. Can it† (101)? This conversation leaves Vardaman in a world of confusion. He now starts to doubt if Darl and Jewel are really his brothers. â€Å"Darl, who seems to float through a world of words, passing into peoples minds and crossing vast spaces at will† (Clarke 46). Darl was able to make everyone miserable because he had no substitute for his mother’s death unlike everyone else in the family. Vardaman had the fish to replace their mother, while Dewey Dell had her pregnancy to occupy her mom, Jewel had his horse, and Cash had his carpentry to replace the emptiness left by their mother’s death. Darl had no substitute â€Å"because he never had a mother to replace† (Clarke 46). Darl said this several times throughout the novel in many variations. For example, â€Å"I can not love my mother because I have no mother† (95). There is a reason why Darl feels this way and Addie in turn hates Darl also. Darl’s feeling that he is not a part of his mother is more than just an expression of sibling rivalry. Addie’s rejection of him is absolute; it is the most terrible thing she does. † The rejection by his own mother makes Darl feels that he has no mother especially as a support system. In turn Addie rejects him because he is just like his father Anse of whom she despises as said previously. As a resulting factor â€Å"for Darl, the constant e xception, the journey is a continual nuisance, and he wants only to see his mother- distinctly dead- buried and out of the way†(Powers 61). Darl is constantly suffering emotionally throughout his life due to the absence of his mother, and continues to be affected by his lack of motherly guidance once Addie actually passes away. â€Å"His brothers, as we have seen, all end up some how displacing their grief and replacing Addie: Jewel with a horse, Vardaman with a fish, Cash with a coffin. But Darl’s mother is literally irreplaceable† (Bleikasten 188). Darl’s mother is irreplaceable because all his life he never had one because he was despised by Addie. In conclusion Addie Bundren had very different relationships with her children. After her death all her children had different ways of coping with her loss also. The relationship with Addie varied greatly from her children Cash, Dewey Dell, and Darl. Cash, her oldest child, she had a great relationship with. They loved and understood one another through the minimum use of words possible. Often times they communicated through body gestures and other types of movement. To substitute the emptiness in Cash’s heart due to the death of his mother, he focused on carpentry. Cash hand built Addie’s coffin to her approval as she looked beyond the window as she lay there dying. Addie and Dewey Dell had a relationship in which they felt indifferently about one another. They basically coexisted within the same house hold. Addie brought Dewey Dell into the world with a purpose: to â€Å"negative† Jewel because he was Addie’s illegitimate son. Dewey Dell also had a replacement for her mother after her death. At the time of Addie’s death, Dewey Dell is pregnant with her first child. This pregnancy takes the focus that Addie would have had on Addie and redirects towards an illegitimate child of her own because she is not married. And then there was Darl. Addie and Darl had the worst relationship possible between a mother and a son. They hated each other. Addie despised Darl because he was just like her husband Anse of whom she also despised. Darl also was her second child who she really did not want to have at all. This was the point in which she vowed to seek revenge upon Anse and made Darl an outcast. As for Darl, he hated Addie because she never mothered him his whole life, which left him broken emotionally causing him to terrorize the rest of his siblings especially his younger ones. Darl did not have a substitute for the death of his mother. In Darl’s eyes he had no mother so the mourning of her would be pointless for him. Work Cited Bleikasten, Andre. _The Ink of Melancholy_. Requiem for a Mother. Indiana University Press, Bloomington. 1990 Faulkner, William. As I Lay Dying. New York: Vintage, 1990. Powers, Lyall H. Faulkner’s Yoknapatawpha Comedy. : The University Of Michigan Press. Ann Arbor. Vickey, Olga W. The Novels of William Faulkner: A Critical Interpretation. Baton Rouge: Louisiana State University Press, 1959. Print Williams, David. _Faulkner’s Women: the Myth and the Muse_. University of Toronto Press. 1977.