What Is The American Dream - 895 Words

Since the very first steps taken on American soil, people have dreamt of pursuing the American dream. What is the American dream? Many people believe that the American dream can’t be defined in one simple sentence. To some people the American dream means getting a new car and to others a new home, but for many Americans it has a deeper meaning. As we have seen, equality has been a struggle from the beginning; but it has led to the liberty within the country. The accomplishments that have been made within the United States did not come without struggles. For example, the line of a song by Francis Scott Key, â€Å"The rocket’s red glare, the bombs bursting in air† demonstrates how this country fought to keep its main value: liberty. Not only have soldiers now, but also in centuries past have given up their happiness and many their lives for what they believe is right. Nevertheless, soldiers have faced misery and oppression from their enemies and their own country even to this day. Many soldiers have returned to their homes to find that they no longer have any of the benefits they are entitled to, leaving countless of soldiers going without food because of the lack of aid available to them. As stated by Francis Scott Key â€Å"†¦the land of the free and the home of the brave† demonstrates how soldiers set this country free. This has had an impact on how people value what they have today. Yet many people within this century have forgotten about the values that were established many yearsShow MoreRelatedWhat Is The Dream In The American Dream858 Words   |  4 PagesThe Dream in Of Mice and Men Of Mice and Men is a novel written by John Steinbeck. The book tells a story of how two opposite individuals, George and Lennie cope with their problems as they travel around California in search of ranch work. Throughout the story Steinbeck displays realism. This category of literature is where the author does not sugar coat life. Steinbeck does not â€Å"romanticize the natural world or human nature† (Curry). In doing so in this type of reality many people have a â€Å"dream†Read MoreWhat Is The American Dream?1407 Words   |  6 Pages What is the American Dream? If you ask anyone they will provide you with all types of answers, from making a successful life for one to wishing and hoping that America changes and grows as a whole. Personally I believe that the American Dream is the idea that was put in my head as a small child by parents and the other adults around. For me, this was the motion that in the beginning it’s as simple as going to school and make A ’s so that I can be accepted into a good college, and then you must workRead MoreWhat Is The American Dream?942 Words   |  4 PagesIf asked the question, â€Å" What is the American Dream?†, many people would have a variety of answers. It may depend on many factors including, how one has been raised, their age, socioeconomic factors, and ethnicity. There have been so many changes in our country over the years from the 1900’s until now including wars, racial beliefs and family structures which led to an array of definitions of the American Dream. An American Dream can be different for each person. It can be about many factors as weRead MoreWhat Is The American Dream?1094 Words   |  5 PagesMost Americans are unsatisfied with their lives. So many people live their lives discontented with where they are in life. They are discontented with their status in society, the money they make, goals they have yet to achieve, their profession, how they didn’t com plete their schooling, and the list unfortunately goes on. We as Americans have a large advantage in comparison to most societies within the world, we have the freedom to live the American dream. What is the American dream? The DeclarationRead MoreWhat Does It Mean For The American Dream?864 Words   |  4 PagesWhat does it mean to be an American dream? It is a hope of the American people that everyone has a same opportunity to achieve a success through their resolution, originality, and hard-working. Hundreds and hundred years, millions of people all over the world come to America to search and prove the true of an American dream. Unfortunately, in fact, everybody has different opportunities and obstacles to achieve their dream relate to gender, and especially class. Firstly, a gender is an importantRead MoreAnalysis Of The Article Whats Up With The American Dream 994 Words   |  4 PagesWhat does the american dream mean to you? â€Å"The American dream, to me, means having the opportunity to achieve, because I don t think you should be guaranteed anything other than opportunity† (Leny Wilkens). The Article â€Å"Whats up with the American Dream† is all about how the American Dream is changing. It s transitioning from going to school, working hard, and advancing in your career to being handed a job through the connections you have. The thesis in this article is â€Å"We go to school, studyRead MoreWhat Is The Theme Of The American Dream In The Great Gatsby1508 Words   |  7 PagesGatsby†, F. Scott Fitzgerald suggests that the American Dream is illusory and can never be fulfilled. He suggests this concept through Jay Gatsby, Nick Carraway, Daisy Buchanan, Tom Buchanan, and Myrtle Wilson. When these people try to purse this unfulfilling dream, only sadness and failure is left for them to feel. In the 1920’s, everyone was following a never ending train of disappointment and failure know as the American Dream. The American Dream was the belief that through hard work, determinationRead MoreWhat Is John Steinbecks Theme Of The American Dream831 Words   |  4 PagesJohn Steinbeck describes a world where the American Dream was a wonderful dream to live but very difficult to live because of the challenges. In the 1930s, the Great Depression was occurring and it was horrible. During this time it was very disturbing how many people were living because they could not afford anything. The American dream was honesty not very achievable during this time period. Many people John Steinbeck reveals the reality of the 1930s in his novel. Steinbeck’s purpose in writingRead MoreThe American Dream Is What Most People Hope For. People1684 Words   |  7 PagesThe American dream is what most people hope for. People migrate to the U.S. wanting to have a better life and people w ho live in the U.S hope to have a prosperous life. The Tortilla Curtain by T.C. Boyle shows two different couples trying to achieve the American dream and the things that they face to try and get the dream. Reading this you learn that there are many tribulations that people go through in trying to accomplish the American dream. This book enables the audience to view both perspectivesRead MoreLiving The American Dream : What Do You Think?1889 Words   |  8 PagesWhen you hear about living the American dream, what do you think? Is the American dream the ability to go to school wherever you want and accomplish everything you’ve ever wanted to do with a little hard work and elbow grease? America is moving into a modern technological age, removing jobs from American workers and having a large effect on what American factory work is currently based on. The assembly line is a unique concept that gives each employee a certain category or task that they are required

In The Name of Religion Essay - 1725 Words

Throughout history most religions have been primarily based around putting their God above all others, and showing love and acceptance, however in today’s society religion appears to be the fuel to a fire of hate. Religion as a whole has become the most controversial and the most violent cause behind some of the most world breaking news, from wars in the Middle East, to death threats to doctors in my home town. This violent mentality of religion first is demonstrated in the short story A Father by Bharati Mukherjee. In this short story the main character, Mr Bhowmick, creates a miserable life for himself based on what his religion says is acceptable. His family, however, lived life and cherished the freedoms of living in America by†¦show more content†¦There would be no peace in the house until she hid KaliMata in a suitcase† (Mukherjee 364). This quote from A Father shows that the wife knew his love for his goddess was what was tearing apart his life, and ultimately destroying the possibility of happiness. He was an unhappy soul because he did not think about the traditions of his religion and culture was going to affect his everyday life, and how he viewed society. He had a hate in his heart for anyone who did not do things as he thought they should, even his own family and bloodline. When he discovered his daughter may be pregnant, and unmarried, he was disgusted and questioning what could be done so HE did not look disgraceful to a culture that was thousands of miles away. (368) The same type of concern people have for their religion should be take for all of mankind, however in most cultures people who are not as their religion states they should be, are shunned, and even killed. Girls in today’s society are told to not have children without first being married. This tradition is based on a backbone of religion. What should be preached is not whether a piece of paper has been signed, but financial stability and matur ity. Just like in the story A Father, the woman was mature and well established enough to have a baby on her own, but because her father’s culture said it was wrong, he hated her and the situation. This not only leads to an internal war for Mr. Bhowmick, but alsoShow MoreRelatedSymbolism In Parkers Back By Flannery OConnor880 Words   |  4 Pagesinternal struggle with religion. Throughout the story, Parker controls his mixed feelings by getting tattoos. Parker openly refuses God, but agrees to marry a religious woman and gets a religious tattoo. How does the author use symbolism to add significance the Parker’s actions? O’Connor portrays Parker’s changing relationship with religion by adding symbolism to the most important aspects of his life. From a young age the protagonist, Obadiah Elihue Parker, despised religion and finds comfort in tattoosRead MoreGreek And Roman Mythology881 Words   |  4 PagesRoman religion was based on Greek religion. The Greek mythology was founded about a millennium before the Roman. Romans founded their religion on the basis of the Greek religion. So, Greek and Roman religions are similar, because both of them are polytheistic religions. Polytheism is belief in, or worship of, multiple gods or divinities. There were more than thirty gods in each of these cultures. Furthermore, Greeks and Romans had almost the same gods, despite differences in their names. As anRead MorePaganism Essay1136 Words   |  5 PagesPaganism is the oldest religion known to humanity. The word paganism is derived from the Latin word paganus, which means country dweller or civilian, and pagus which means village. People who choose the Paganism religion, believe in more than one god, also known as Polytheism. However, you will still find Pagans who are monotheistic which means believing in one god, and atheistic who are disbelievers and non-religious. Most believers of Paganism find Paganism to be a religion within itself, whereRead MoreNo Religion Teaches Hatred1559 Words   |  7 PagesDoes religion teach to hate any one? Any religion which is truly for God would never teach anyone to hate others. On the contrary it would always teach people to forgive, to be kind and to be fair even to those who are not good to you cannot be for God in any manner....No religion teaches anybody to hate anyone and to fight in the name of religion.The one who truly believes and know the true meaning of their religion will come to know Posted in Agony Aunt by Jay Deep at 9:11 PM on October 27, 2008Read MoreThe Modern Perception Of Hinduism1146 Words   |  5 Pageselite, the commencement of ideas and practices of the ancient religion can be dated back as early as 2500 BCE ( Mittal and Thursby, 2006, 22), long before the colonial impact of the West on the Orient. We cannot deny that the expansion of Hinduism had great help from the West. The colonizers, with the help of the high status Indian castes had a hand in popularising, translating, and distributing texts, as well as naming the religion, arguably their biggest contribution. Hinduism, derived from theRead MoreThe Map Of India, By Aparna Sen s Indian / English Movie, Mr. And Mrs.871 Words   |  4 Pagesmany different religion practices and cultural beliefs. India is a country where the citizens’ live strictly by religion and tradition, by following their castes. It is that, that keeps them strong and has helped them survived for hundreds of years. Correspondingly, in Aparna Sen’s Indian/English movie, â€Å"Mr. and Mrs. Iyer†, the main actor, Raja, survives the dangerous journey solely because he is associated to a â€Å"Tamilian Brahmin† caste. The film highlights the two main religions – Hinduism and IslamRead MoreTracing Narrative Threads in Life o f Pi Essay examples721 Words   |  3 Pagesoften and establish dominance over him. Pi soon learns that Richard Parker is not as big of a threat as his father made him out to be. 2) The name ‘Pi’ As a child, one of Pi’s biggest concerns was defending his name because all of his classmates always teased him about his name, calling him â€Å"Pissing†. The name Pi is symbolic too who he really is. His name makes reference to math, the number of pi, 3.14. The number of pi is theoretically a never ending number, although is shortened because a humanRead MoreThe Religions : Buddhism And Shinto1678 Words   |  7 Pagesformed. Religion is no exception; there have been many instances where religions have influenced each other and blossomed due to new ideas being presented. A good example of this the relationship between the two religions: Buddhism and Shinto. Buddhism was brought into Japan during the early 6th century from Korea, and was later institutionalized as the state religion in the late 6th century by Prince ShÃ… toku. The Prince was a great patron of Buddhism and by having made it the state religion, it wouldRead MoreThe Lottery, By Shirley Jackson1349 Words   |  6 Pages In â€Å"The Lottery,† Shirley Jackson uses symbolism to demonstrate how even with religion present, people still conform to tradition and in this case, human sacrifice. Symbolism is when the author uses symbolism to express a certain idea or quality throughout their work. Tradition has always been important all over the world and it is something that continues to hold strong to this day. â€Å"The Lottery† within itself contains a whole other meaning to the word tradition. It is present every year, whichRead MoreAnalysis and Interpretation – the Nine Billion Names of God1308 Words   |  6 Pages------------------------------------------------- Analysis and interpretation – The Nine Billion Names of God In 1953 Arthur C. Clarke wrote â€Å"The Nine Billion Names of God†. This is a science fictive short story where we meet a group of lamas who wants to write the nine billion names of God. Atypically, the lamas will not use the ‘normal’ alphabet; but their own alphabet where they have invented and written in their holy books. In over three centuries they have been typing these names down, and it would take another fifteen thousand years

Cloning an Instinct Species in “Jurassic Park” Free Essays

Roger Lee Propes PHI-240 Katherine Allison, Professor April 6, 2012 Cloning an Instinct Species in â€Å"Jurassic Park† When we hear about cloning in the media, they are usually referring to reproductive cloning, human cloning in particular, and it’s scientific and ethical implications. In Jurassic Park, John Hammand, who is a rich entrepreneur, hires a group of scientists to clone dinosaurs from the Jurassic Period. The ethical dilemma presented in Jurassic Park is whether we should use our knowledge of cloning to revive an extinct species that ceased to exist through natural processes. We will write a custom essay sample on Cloning an Instinct Species in â€Å"Jurassic Park† or any similar topic only for you Order Now I believe John Hammand used ethical relativism (Van Camp, Olen, and Barry page 4) because he coordinated this project based on moral truths that were true to him. However, several of the experts he hired to sponsor the park disagreed with the ethical judgments he made while developing the park. I will briefly describe two types of cloning that were combined to successfully engineer the dinosaurs in the movie, and give an example of cloning that has been successful. Then I will give reasons why it is unethical to resurrect species that became instinct through natural processes. The words recombinant DNA technology, DNA cloning, molecular cloning, and gene cloning all refer to the same process: the transfer of a DNA fragment or interest from one organism to a self-replicating genetic element such as a bacterial plasmid. The DNA of interest can then be developed in a foreign host cell. This technology has been around since the 1970’s, and it has become a common practice in molecular biology labs today. â€Å"In 1977 scientists at the Asilomar Conference proposed sweeping regulation on so-called recombinant DNA, technologies which recombine DNA from different species in the test tube† (biology. enyon. edu). Their concerns were by combining DNA of different species disastrous monsters would result. Reproductive cloning is a technology used to generate an animal that has the same nuclear DNA as another currently or previously existing animal. The best and most publicized example of this is the sheep named Dolly. She was the first mammal to be clone d from adult DNA. â€Å"Ian Wilmut, the scientist whose team at Scotland’s Roslin Institute cloned Dolly who was born July 5, 1996, and euthanized in 2003 because of lung disease† (usatoday. om). This successful clone was produced 3 years after the film was produced. â€Å"Dolly, or any other animal created using nuclear transfer technology, is not truly an identical clone of the donor animal. Only the clone’s chromosomal or nuclear DNA is the same as the donor, some of the clone’s genetic materials come from the mitochondria in the cytoplasm of the enucleated egg† (ornl. gov). In the film, the dinosaurs weren’t exact replicas and had mutations caused by the frog DNA that was used. In the film, they discovered dinosaur DNA trapped in the amber of a tree and extracted the DNA. They DNA sequence was not complete so they decided to combine frog DNA in an attempt to complete the sequence. The scientists also manipulated the sequence to ensure that all of the cloned specimens would be female thinking it would be the more docile than the male. Even though females tend to have less strength than their male counterparts, they are usually the one left to tend for the offspring. Dr. Malcolm made the statement that, â€Å"nature always finds a way†. There are many species that have proven that reproduction is a possibility in a single sex environment. Some species, such as anemone fishes, are born all male and when they mature change sex and become female. â€Å"This is very strange life histories in species whose individuals may change sex at some time in their life. They may change from being males to females, protandry, or females to males, protogyny. † (marinebiology. org) Dr. Alan Grant and the children find a nest of eggs that has hatched while they were evading the T-Rex, proving nature found a way. Human beings, in general, are very naive when it comes to the power they actually hold over our world and nature. If we are to consider resurrection instinct species, we should also consider whether they became instinct through natural causes or the human intervention. Also, we should make sure we consider all of the possible mutations that may occur due to the genetic makeup of the DNA used to complete the sequence. Those which became instinct because of being destroy by humans may still be able to survive in the world as it is today. In addition, we should enter the cloning process with the knowledge that nature will eventually find a way and begin to sustain without future interference of human beings. Those which became instinct through natural causes shouldn’t be revived because the world isn’t suitable for their survival, and reviving these species could cause catastrophic changes in the environment, which is evident in the movie â€Å"Jurassic Park†. Works Cited Buchheim, Jason. A Quick Course in Ichthyology. n. d. www. marinebiology. org. Department, Biology. KAP Recombinant DNA Technology. n. d. www. biology. kenyon. edu. Energy, US Department of. Human Genome Project Information. 11 May 2009. 15 03 2012 www. ornl. gov/hgmis. Julie C. Van Camp, Jeffrey Olen, and Vincent Barry. Applying Ethics: A Text with Readings. Ed. Ian Lague. Tenth Edition. Boston: Clark Baxter, 2011. Jurassic Park. By Michael Crichton. Dir. Steven Spielberg. Perf. Laura Dern and Jeff Goldblum Sam Neil. 1993. Wise, Elizabeth. USA Today. 4 July 2006. 15 March 2012 www. usatoday. com/tech/science/genetics. How to cite Cloning an Instinct Species in â€Å"Jurassic Park†, Essay examples

In our performance of Blood Brothers Essay Example For Students

In our performance of Blood Brothers Essay In our performance of Blood Brothers I play the narrator, a nameless, ageless omen of what is to come. Throughout the play the Narrator is a constant presence used to remind the audience of what will happen to the brothers at the end of the play. When emotions are high and the audience is laughing the narrator will say something and the mood will come down because the audience will remember Mickeys and Eddies fate. We feel that the original playwright intended to focus on the class and superstitious aspect of Blood Brother and whilst we are also focusing on the differences in social class between Mickey and Eddie our other main focus is the tragic aspect of the play. We want our audience to question whether the difference between the social classes is right and we want the audience to have a strong emotional reaction to the characters death at the end of the play which is why we have chosen to focus on the issues of social class and the tragedy of what happened.  The Narrator has no name and is referred to only as narrator in the script , this may be because the Narrator, whilst a constant presence, is their to guide the audience through the performance. The narrator can also be seen in some scenes to be manipulating the reactions of the characters and persuading them to act. Age also does not play a part in the narrators performance and his character does not develop with the emotions and progression of the show because he already knows what will happen and so he remains solemn throughout, by doing this he acts as a constant reminder of what will happen. This means that the audience can never become too comfortable with the characters of Micky and Eddie as the know what will ultimately unfold.. The Narrator does change in his performance though as during the first few scenes his attention is focuses on Mrs Lyons and Mrs Johnston and then as the play advances his attention begins to focus on the twins. We chose scenes that we felt would best represent the advancement is Mickey and Eddies relationships because we dont have a long to perform but there is quite a bit to cover. Some of the scenes we have chosen include the scene where they first meet, the scene where Eddie and Mickey are each at their respective schools, the scene where Eddies goes to university, the scene with the pills, and the final scene, in that order. Because there are such large gaps between each scene we have a narrator monologue after each scene so his can tell the audience what has happened between each scene so they dont get confused about whats happened. We also chose these scenes as we feel that by showing the development in their relationship the performance will have a larger emotional impact on the audience as they would have watch these two young boy grow up. We have chosen a catwalk style performance space because we want to interact within the audience in order to maintain their audience and make them feel involved in the performance and the characters lives so they have a stronger emotional reaction at the end of the play. A catwalk stage also allows an immediate connection between the audience and the characters. An example of our performance space is:  We chose to use this type of stage as we felt it would offer us more opportunities to interact with the audience whilst still allowing the audience to see everything thats happening.

US Representative Congressman Ander Carson

Ander Carson has been in the U.S. congress for a few years, but after beginning as a Democratic Committee Person in the year 2000, he has been featured in several committee assignments (William par 1).Advertising We will write a custom report sample on US Representative: Congressman Ander Carson specifically for you for only $16.05 $11/page Learn More Some of these assignments are generally the government funded ventures which made it possible for Indiana to continue receiving funds from President Barack Obama’s administration. Recently, he challenged the congress by proposing for a new Grant Program that would enable the low-income families to â€Å"†¦access the locally grown food and vegetables† (House Government par.1). He has considered it to be a benefit for Americans in terms of health and access to food throughout the year. While in Miami, 2011, Ander accused the members of the Tea Party that they wanted to hang him on a tree an d bring Jim Crow back instead. This happened when the Congressional Black Caucus’ members was visiting 5 cities in the month of August (Calvin par.8). In February 2011, despite a majority supporting the Bill, Ander Carson voted against the Rooney Amendment 13 to H.R 1 Bill that advocated for the environmental protection of Florida environment from the high levels of phosphorus and neurotoxin chemicals which contaminated its waters (Calvin par.9). In April 2012, Ander successfully passed a bill to protect the small businesses due to the income tax deduction (Danson par. 4).Advertising Looking for report on government? Let's see if we can help you! Get your first paper with 15% OFF Learn More This bill proposed a 20% deduction of tax for all employees considered to employ less than 500 employees in the business. In fact, many small businesses would benefit from the assignment committees of the government funds. Ander’s views Madrassa as the ideal education system for America, especially if it follows the Islamic model. He is a Muslim and has seen how such a system works, and considers it to have a multiple of benefits if well-employed (Schultz par.5). Most of the schools using the Madrassa Education System within the U.S are funded by Muslims. Commentary In fact, it has been reported that Anderson was the one who gathered various reporters and spoke many lies about the Tea Party though that was a wrong decision (Sherman par. 4). It was a betrayal of his colleagues and considered to be so bad that it even appeared in the Sunday Talk show as well as in the headlines just before the Obama Care Vote. I do respect Ander Carson, but I do not agree with some of his commentaries on his fellow colleagues, especially those made at the Tea Party. He owes an apology to all the frontline fighters for civil rights for making insults to them (Paul par. 3). Those comments were thoughtless and unnecessary. This shows that he can never be trusted by hi s colleagues who closely work with him.Advertising We will write a custom report sample on US Representative: Congressman Ander Carson specifically for you for only $16.05 $11/page Learn More As a matter of fact, there is no single leader from the Tea Party who has advocated for neither the return of the Jim Crow Legislation nor the lynching of blacks. Over the years, Carson has been very active in passing many bills in the U.S. Congress that have helped many Americans. I do agree with his view of the low income families earning a living by growing vegetables and other agricultural commodities. These foods are natural and, therefore, do not interfere with the health of the consumers. It will help many Americans live healthier than they did before. Most Americans have overweight complications and other diseases associated with the chemicals found in the fast food. Therefore, the Grant Program will be supported by many due to the many benefits associated with it. Carson should have supported the Rooney Amendment 13 Bill at the Congress as a person who has been in the frontline for the improvement of lives of Americans. The environment should be kept clean just like he is now proposing for the consumption of the natural foods. Despite the fact that he had voted against the bill, it was passed after majority of the members had supported it (Danson par.6). The bill for deduction of income tax for the small businesses is a good idea as it motivates many small businesspeople to continue employing the Americans since they have enough funds left to pay them well.Advertising Looking for report on government? Let's see if we can help you! Get your first paper with 15% OFF Learn More The only problem is that 500 employees are too many to be considered a small business. The limit should be reduced to around 300 employees. I think there are many issues likely to be encountered if Carson continues proposing for the Muslim model of the Madrassa Education System (Jason par.7). This is a very sensitive issue, and it appears that he has some interests of religion which may go well only with Muslims but not for the Christians. He should be careful in his commentary not to have a bad reaction from the Christians in America. Despite the negative sides of Carson, he has successfully assisted many Americans, which is a good thing, by protecting the Wall Street Consumers while serving in the Capital Markets Authority Committee. Carson has done well in his term at the Congress. Works Cited Benson, Jason. Video: Rep Andre Carson Thinks American Schools Should Be Modeled after Madrassas. 2012. Web. Calvin, Andre. Rep. Carson’s Liberal Action Score: 58. 2012. Web. Danson, James. HR 9 – Income Tax Deduction for Small Businesses – Key Vote. 2012. Web. Felix, William. â€Å"Andre Carson U.S. Representative.† Washington Post, 2008. Web. House Government. â€Å"Congressman Carson Seeks to Expand Year-round Access to Healthy Food for Low-Income Families.† House government Online. 2012. Web. Ogden, Paul. â€Å"Congressman Andre Carson Insults History, Makes Light of Lynchings and Jim Crow Experienced by African-Americans.† Ogden on Politics. 2011. Web. Schultz, Denis. Muslim Congressman Andre Carson’s Modest Proposal: Remake American Education System with Madrassas. 2012. Web. Sherman, Jake. Andre Carson: Tea Party Wants Blacks ‘hanging on a tree‘. 2011. Web. This report on US Representative: Congressman Ander Carson was written and submitted by user Bennett Carver to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Is Act 5 a fitting end to the play Hamlet Essays

Is Act 5 a fitting end to the play Hamlet Essays Is Act 5 a fitting end to the play Hamlet Paper Is Act 5 a fitting end to the play Hamlet Paper Essay Topic: Hamlet Hamlet is one of Shakespeares later plays, written in the early 17th Century. However, it is set in a 13th Century Danish Court with Hamlet, the eponymous hero, as Prince. The play Hamlet falls into the literary genre of a tragedy. Traditionally, the tale of a tragedy begins with a hero (in this case Hamlet) who, due to unfortunate circumstances, proceeds upon his/her downfall through the play and is usually slain during the closing stages. Shakespeare follows this pattern meticulously, although more specifically than tragedy, he chooses to pursue the style of Senecan Tragedy. The Senecan Tragedy originated from the Roman philosopher and poet, Seneca, who lived in the first century AD. A Senecan Tragedy contains several distinct factors, such as violence and the use of the supernatural. Shakespeare includes these elements in his play to give Hamlet some kind of familiar, sustained theme for his audience. The most prominent Senecan aspect included, is the structure of vengeance. Both Shakespeare and Senecas plays are divided into five acts. Each act contains its own distinct theme. The first act introduces the appeal for vengeance-more specifically the ghost of Hamlets father. By the end of the act Hamlet appears to be accepting the role of the avenger: O cursed spite, that ever I was born to set it rite! (I-v-190) The second act in Senecan Drama revolved around the expectation of the avenger planning his revenge. Comparatively in Hamlet, Act 2 is the period in which the Prince conjures the idea of using a play within a play (another Senecan aspect) to uncover Claudius thoughts and hence enforce his opinion of whether to proceed or not. The act ends with Hamlets soliloquy, the culmination of which is the rhyming couplet (used by Shakespeare to emphasise his point): The plays the thing/ In which Ill catch the conscience of the King (II-ii-600). The play begins to gather its constructive momentum during Act 3. This is when Hamlet uses his mousetrap (the play). He notices the Kings response and consequently believes in the ghost: O good Horatio, Ill take the ghosts word for a thousand pounds (III-ii-290) He almost acts upon his beliefs but decides the time is not right. Hamlet then confronts his mother in the privacy of her bedchamber, but notices that someone is spying upon them. He has no idea who this intruder may be but irrationally stabs through a curtain, killing the father of Laertes, Polonius. Shakespeare includes this section of the play in Act 3 because it acts as a pre-cursor of things to come in the penultimate and final acts. Act 4 is often used as an interval or a break from the theme of vengeance. Revenge is prevented in this act of Hamlet, as the Protagonist is sent to England to be killed. This helps build up the suspense and therefore adds to the drama of Act 5. Hamlet however, escapes and arrives back in Denmark by the end of the act, now having made a final decision. Act 5 is the infamous climax of Hamlet. In the first scene, Hamlet begins conversing with a sexton in the graveyard. The graveyard is used because firstly, it helps give a powerful motif of mortality, which contributes to the tension within the audience, and secondly because this specific location is a prevailing indication of mortality. This motif is furthermore enforced by Shakespeares selective use of language, which is crucial to portray emotions that are beginning to emerge as the play Hamlet moves towards its climax. The quotation: Why may not that be the skull of a lawyer? Where be his quiddities now (v-i-95) is a good example of this. As the scene develops, the audience discovers that the gravedigger does not realise who Hamlet is and therefore talks to him about Hamlet. This incident is a display of dramatic irony; one example of the Elizabethan humour employed by Shakespeare in Act 5. Equivocation and wordplay, also between the gravedigger and Hamlet, is another style, and there are others. Humour is used in the play Hamlet to create dramatic texture. It lightens the atmosphere of the play and the minds of the audience, therefore providing a starker contrast with the bitterness soon to follow. When the funeral procession enters, Hamlet discovers that the grave is being dug for Ophelia, who has committed suicide. This is the first instance of death in Act 5 and Shakespeare is, in some ways, creating the path towards the climax of his play through the death of Ophelia. The Prince then proceeds with his declaration of intent: It is I, Hamlet the Dane (v-i-250). Through this declaration, Shakespeare informs the audience that Hamlet is finally becoming the avenger by adopting the title of his late father, the King. Laertes then declares Hamlet culpable for the death of his father and sister. Shakespeare uses this emergence of antagonism as another pre-cursor of things to come, thus developing his audiences anticipation. They are parted and Hamlet leaves after declaring his love for Ophelia: I loved Ophelia, forty thousand brothers could not with all their quantity of love (v-i-265). This dialogue shows how each avenger is trying to prove superior to the other. The final scene is the climax of the play. It begins with Hamlet and Horatio being informed that the King has arranged a duel between Hamlet and Laertes. Hamlet agrees, believing that fate will take its toll. This scene acts as a catharsis; resolving the various tensions that Shakespeare has created throughout his play Hamlet. The first to be resolved is between Hamlet and Laertes. Laertes wounds Hamlet with his poisoned rapier. Hamlet then stabs and kills his opponent, ending the rivalry between the two. The second tension to be resolved is that between Hamlet and his mother-who drinks a poisoned drink that was meant for her son. The tension between the Prince and his mother revolved around the marriage of the Queen to the dead Kings brother. She admits guilt: Thou turnst my eyes into my very soul, And there I see such black and grained spots (iii-iv-100) but takes little action. This is why Shakespeare chooses to end her life. Hamlet finds the King responsible for his mothers death and in his rage slays his stepfather. This is the third and major tension that is resolved. Finally, to conclude the play, Hamlet dies. Revenge has been completed: Now cracks a noble heart. Good night sweet prince/And flights of angels sing thee to thy rest! I believe that Act 5 is most certainly a fitting end to the play, Hamlet. The act (in particular the last scene) is both exciting and resolving. The vast amounts of tension and/or suspense that commence from the beginning of the play and persist until the end keep the audience interested and alert throughout. Shakespeares culmination of events along with the denouement in Act 5 manages to resolve the many antagonisms and tensions created between the main characters earlier in the play through the duel scene. Additionally, he ends Hamlet with the arrival of a new monarch, Prince Fortinbras, which restores the harmony within the state of Denmark. This restoration leaves the audience with a feeling of completion, as a worthy end to a play should. Finally, Act 5 is a fitting end to the play because of the bloodthirsty conclusion that helps to fulfil the aspects of Senecan Drama, along with the structure of revenge through the quintet of acts. So, in conclusion, I believe that Shakespeare has designed a very fitting end to his revenge tragedy, Hamlet.

It is essay about an event i have visited ( you have to chose the

It is about an event i have visited ( you have to chose the right topic for it - Essay Example The Ham was in the form of a long gown, a collar, and a wraps the right lapel over the left. During lunch hour, we ate delicious triangle shaped rice dumplings made from rice with fillings of nuts, dates, and beans. The staple food for Chinese is rice that helps in the economic growth of the society. I could not help but notice the American culture. The clothing style depends on the status an individual has in the society, occupation, climate, and religion. One of my American friend mentioned that their fashion is greatly influenced by the media and celebrities. She was dressed in cowboy hats and boots and a pair of jeans made her look fabulous. The Americans mostly eat junk food like the hamburgers, hotdogs, cheese, macaroni, and potato chips. In addition, they also eat dried meat as snacks. The amazing European food was distinct from the other foods. I was lucky to taste the Gelato that was sweet and tasty. The Europeans argued that the Gelato was different from ice cream. The gelato has more sugar, softer and creamier compared to ice cream. The European foods have different categories ranging from cereals, meat, fats, and sugar. The Europeans wear upscale and classy clothes. Their fashion entails clean and elegant simple lines that perfectly fit. They prefer wearing different set of colors in different seasons. I was able to interact with the African students and their foods and attire were completely different from the others. Their foods are rich in fiber and often organic. The most interesting meal was the ugali. It is prepared by mixing water and corn to form stiff porridge. It is served with stew and vegetables. Most of the African countries weave clothes from cotton that is grown locally. They also use the dyeing techniques like tie and die. Most of these clothes have a head wrap that is tied around the head and matches the African attire. The Indian Sari is the most common dress in India. Their way of dressing is marked with religion and

Evaluate Auditing Processes Essay Example | Topics and Well Written Essays - 1000 words

Evaluate Auditing Processes - Essay Example The essay will also evaluate the various accounting processes that are being adopted by the federal government in a succinct manner. It is evident that there lay certain specific criteria, which need to be adhered while complying with a standard auditing process. This aspect is also evident in the case of auditing a town or a city. The audit, which has been conducted for the Town of Maywood can be evaluated based on the requirements of GAAS. Theoretically, GAAS is a particular framework, which provides a set of guidelines to be followed by auditors for ensuring accuracy, reliability as well as fairness in the auditing process. The audit conducted for the Town of Maywood was executed with proper observations of the activities performed by the people who were involved with the preparation of its financial statements. It can be affirmed that this particular auditing procedure adhered to the guidelines of GAAS (Kinney Jr, 1986). Notably, the audit report also presented the reason for not considering the financial reports of other towns with which Maywood is associated. This particular aspect also shows compliance of the audit report with the GAAS framework (Public Company Accounting Oversight Board, 2014). Through analyzing the audit report, it can be determined that the audit conducted for the Town of Maywood is in alignment with most of the requirements of the GAAS framework and very little has been omitted or not complied with the same. Prior to the preparation of an audit report, individuals interested both in public administration as well as working as accountants for governmental units must possess an in-depth knowledge about the objectives along with the standards to be followed while preparing an audit report. This may be owing to the reason that the effectiveness of public administration is directly relevant with appropriate

Collapse Essay Example | Topics and Well Written Essays - 1000 words

Collapse - Essay Example The paper will conclude with a critical evaluation f Diamond’s book and summarization of the main points discussed in the whole paper. The author has succeeded in bringing out his message in the book. He has discussed the reasons as to why many societies collapsed especially in the 13th and 14th centuries. Some of the reasons as t why the societies collapsed include outbreak of deadly disease (Bubonic Plague), changes in climatic seasons, and war. Due to the above factors, many people in the societies lost their lives and this led to the reduction of people in the society. There is also the discussion of how the societies were able to recover from the loss. For one, there was strengthening of the army which enabled strong defense against the members of the society. There was cultural survival whereby the culture of the Mongols was dropped and the societies embraced the Chinese cultural traditions. There was multiplication of population due to increase of birth rates. This made the society to replace the people who were lost during the war. According to Diamond, societies collapsed mainly in the fourteenth century due to the outbreak bubonic plague. Since the societies were crowded, the disease widely spread and caused lot of deaths to the people. The outbreak continued up to seventh century whereby by then it had claimed a lot of lives. The disease had spread and had covered most parts of Asia, Europe some parts of north Africa (Diamond 2011 , p. 350). In 1340s, merchants from Mongols and other travelers assisted in the spread of the plague along all the trade routes that were used by the Chinese people. By the year 1348, the disease had spread throughout the Mediterranean basin and most parts of Western Europe. The other reason for the collapse according to Diamond was the changes in climatic seasons whereby in 1300 B.C there was a continued cool season for five years. This made famine to ravage the

Hydration Management in Acute Stroke Patients

Hydration Management in Acute Stroke Patients Introduction Stroke is a global public health concern with many sufferers presenting with varying levels of confusion (Oh and Seo 2007). Management of hydration in acute stroke patients is not standardised and variations in practice can be very wide between different continents. The sheer number of possible comorbidities and the relative ease with which hydration can trigger concomitant problems can lead to increasing incidence and prevalence of long-term patient care resulting from inadequate hydration management. Optimum hydration assessment and management are key clinical activities; however, inadequate hydration controls by health professionals persist (Oh and Seo 2007). Research shows that to guide fluid management to desired levels, a regular assessment of the volume status has to be made Scope This literature review is based on works that are found on Medical Literature Analysis and Retrieval System Online (MEDLINE), the Cumulative Index to Nursing and Allied Health literature (CINAHL), Cochrane, Department of Health (DoH), National Institute of Clinical Excellence (NICE), National Medical Council (NMC), World Health Organisation (WHO), Wiley Interscience and CKS databases that relate to hydration in stroke patients and nursing awareness of hydration in stroke patients. There is wide literature on different aspects of stroke and many authors have studied the effects of hydration in stroke patients. This review looks at literature that discusses management of hydration and/or the impacts of variations in hydration management on acute stroke patients outcomes like method of feeding, time- compliance in taking readings or measurements, legal issues and ethical issues. Relevance to clinical practice This literature review looks at relevant studies by experts that are found on credible databases. The purposes of the expert studies are reviewed and analysed to inform better understanding of current nursing practice in hydrating acute stroke patients. Several studies on hydration highlight specific difficulties relating to the assessment and management of hydration in acute stroke patients. There are differences between the management and the assessment of hydration in different hospitals and these complicate improving awareness of managing hydration for nurses in practice. If optimum hydration is directly linked to improved outcomes in acute stroke patients, research will be required to identify and overcome barriers to effective hydration management, including the development of specific tools (and knowledge base) to facilitate interventions that promote optimum hydration in seeking improved outcomes in acute stroke patients. Methods of search and documentation n on-line literature search of MEDLINE, CINAHL, COCHRANE, DOH, NICE, NMC, WHO and CKS from 1999 to May 2009 failed to identify enough relevant articles on hydration in stroke patients. Other sources were then reviewed for available literature on medical journals including the BMJ and American Family Physician. For the on-line computer-based literature searches, the following keywords were used: stroke, fluid balance, hydration, cerebrovascular accident (CVA), dehydration, stroke outcome, cerebrovascular disorders, medical management, artificial nutrition and hydration, dysphagia, dysphasia, pyrexia, acute brain infarction, enteral tube feeding, fluid and electrolyte balance, neurology, withholding treatment, pathophysiology and nurses and hydration Hydration and hydration management in acute stroke patients This literature review looks at one of the issues encountered globally in the treatment of acute stroke patients optimum hydration. It takes a particular look at the nursing awareness, measurement, assessment, methods of intervention and the legal issues associated with hydration in acute stroke patients. Stroke is a debilitating condition and can be caused by an ischaemic event or a subarachnoid/intracerebral bleeding. Stroke patients usually present in hospital with co-morbidities (Oh and Seo 2007). Variations exist in stroke fatalities across geographical regions even within the same continent. Studies by Bhalla et al (2003) across four European centres (London, Dijon, Erlangen and Warsaw) have shown significant variation (after adjusting for case mix) in stroke case fatality, in incontinence, dysphasia, dysphagia, conscious level, pyrexia, hyperglycaemia and comorbidity. There were also significant intervention differences between centres in intravenous fluid use, enteral feedin g, initiation of new antihypertensive therapy and insulin therapy, with the London centre having the lowest uptake of interventions. In another European BIOMED Programme, significant variations in case fatality for stroke between European centres (after adjustment for stroke severity) were observed, with the United Kingdom (UK) centres having the highest case fatality and the lowest levels of independence (Wolfe et al., 1999). There were lower intervention rates in the UK centre to correct abnormal physiological parameters in the acute phase which may reflect a difference in philosophy of acute medical supportive care compared with other European countries (Wolfe et al., 2001). Awareness of optimal hydration balance and assessment of the patients hydration condition (in the care of acute stroke patients) is a fundamental part of critical care nursing and optimising the hemodynamic situation can be seen as a team-effort. One of the important factors determining quality of the circula tion is the amount of circulating blood (Hoff et al 2008). Following a stroke, patients may have swallowing impairment and other changes of the gastro-intestinal (GI) tract that could affect nutritional and hydration status and that lead to aspiration pneumonia (Schaller et al 2006). Such changes affect the ability of the acute stroke patient to lead a normal nutritional life. Although the Schaller et al (2006) work did not show a direct link between hydration and other comorbidities, they agree that impaired hydrational status is associated with reduced functional improvement, increased complication rates, and prolonged hospital stays. Hydration and hydration status Hydration balance is a measure of the bodys ability to manage fluids and electrolytes. In order to identify the urgency of interventions, nursing staff should characterize an individuals fluid and electrolyte imbalance as mild, moderate, or severe based on pertinent information including lab tests and other relevant criteria. It is important to recognize that the main electrolyte in extracellular fluid (ECF) is sodium and that of intracellular fluid (ICF) is potassium (Edwards, 2001). Toto (1998) pointed out that large increases or decreases in fluid volume can cause infarct, coma and confusion. This knowledge becomes significant in maintaining cerebral blood flow and in preventing secondary brain insult after an acute stroke. In a complication, respiratory or metabolic acidosis will promote the movement of potassium from the ICF and give rise to high serum potassium levels, which may affect cardiac function (Edwards, 2001). This phenomenon can be seen in many traumatic insults to th e brain. A basic knowledge of this physiology in addition to the homeostatic mechanisms for fluid and electrolyte balance is a vital foundation for nursing practice, and essential to the nurses role in hydration management. Cook et al (2005) highlighted the significance of fluids and hydration in the neuroscience patient and in Cook et al (2004) they highlighted that an understanding of the physiological mechanisms that surround stroke is important for nurses to monitor and treat such patients. Kelly et al (2004) in their study of dehydration and venous thromboembolism (VTE) after acute stroke believed dehydration after acute ischaemic stroke (AIS) is strongly independently associated with VTE, reinforcing the importance of maintaining adequate hydration in these patients. Their study of hydration over a 9-day period showed indication that dehydration was largely hospital acquired and that the association was causal. Although the possibility that VTE was already present at entry to hospital cannot be discounted, tests have shown that VTE is rarely present before the second day post stroke, and then it becomes increasingly prevalent over the next few days. This could be for one of many reasons including poor communication between patient and hospital staff, change of environment for the patient and the physiological impacts of stroke Hydration balance and nutritional/electrolyte balance The differences in how hydration is assessed in different hospitals have been subject of study for some time. The significance of fluid electrolyte homeostasis becomes very relevant in trauma and shock situations such as subarachnoid haemorrhage where an inflammatory response is triggered which causes a significant change in capillary membrane permeability in a short period of time. In such situations, water, electrolytes and albumin move into the interstitial space to permit the site of injury to receive the required factors (third space shift) (Edwards, 2001). A number of physiological mechanisms are required to maintain homeostasis of hydration status, all of which inform proactive nursing assessment, intervention and evaluation. Those with trauma to the nervous system are vulnerable to disruption to the homeostasis of fluid and electrolyte balance (Cook 2005). Older adults may have a poorer capacity to adapt to shifts in acute fluid balance, leading to the possibility of cardiac and renal functions being impaired and, as a result, a lower glomerular filtration rate (Sheppard, 2001). Managing the fluid balance of the stroke patient by intake and output measures needs to be exercised cautiously because even though the patients fluid volume may not have changed, his/her circulatory volume may be significantly lower in instances of major trauma (Edwards, 2001) Good hydration has been shown to reduce the risk of urolithiasis (category Ib evidence) (see Appendix 2), constipation, exercise asthma, hypertonic dehydration in the infant, and hyperglycemia in diabetic ketoacidosis (all category IIb evidence), and is associated with a reduction in urinary tract infections (UTIs), hypertension, fatal coronary heart disease, venous thromboembolism, and cerebral infarct Complications of measurement/control Naso-gastric v PEG, enteral v parentera Patient history taking on presenting in the hospital differs from hospital to hospital. History taking should include assessment of fluid intake and loss, baseline hydrational status, skin turgor, heart rate, blood pressure and urinary output. Normal fluid intake for the average adult is approximately 2-2.5 litres, obtained from food, fluids or metabolic by-products (Edwards, 2001). Methods of measurement are not standardised across hospital settings with Wise et al (2000) showing that faecal fluid losses are often neglected in daily fluid balance charts with the possibility of inaccurate hydration assessment. Fluid assessment must include estimating, as accurately as possible, the quantity of fluid taken in. It must take into consideration the entire processes by which water, potassium and sodium are obtained. Measurements are often mainly focused on the extremes of hydration (optimal hydration and extreme dehydration) and this should not be the case. Assessment of hydrational statu s and need is continuous and begins somewhere along a continuum of severe hypovolaemia/ dehydration to severe hypervolaemia/ overhydration. In looking at dehydration, not only extreme dehydration should be noted. Manz and Wentz (2005) highlight that there is increasing evidence mild dehydration may also account for many morbidities and play a role in various other morbidities. The way in which stroke is managed acutely, such as measures maintaining physiological homeostasis may also vary between different populations (Bhalla et al 2003). The physiological indicators of acute deficits in fluid balance may be masked in individuals where compensatory mechanisms are intact. A history of acute events, mainly from baseline documentation and history taking, may enable better identification of such imbalances (Sheppard, 2001). Fluid and electrolyte homeostasis is brought about by the interaction between the renal, pulmonary, neuroendocrine, integumentary and gastrointestinal systems (Edward s, 2001). According to (Cook 2005), fluid and electrolyte management is a fundamental aspect of the role of the neuroscience nurse. Artificial feeding and fluids are the options for a patient who has an advanced, life-threatening illness and is dying. The patient, family members and doctor can talk about these options and the benefits and risks (Ackermann 2000). Hydration and electrolyte status are crucial mediators to the extent of the neuro-hormonal response to trauma. Edwards (1998, 2001) highlighted that homeostasis is maintained by a constant movement of water, sodium and potassium between intra- and extracellular compartments. While the movement of water and electrolytes between the cellular compartments is highly significant, it is important to recognize that in acute and chronic illness intracellular fluid (ICF) is reduced and extracellular fluid (ECF) increased almost to the extreme (Edwards, 2001). This is highly relevant for cerebral metabolism, because transport of oxyge n, glucose, proteins and other products for cellular metabolism—and their by-products—may be severely impaired. Stroke may affect ones level of alertness, perception of thirst, ability to access liquids, and ability to swallow them when offered. Stroke victims with such impairments may be at increased risk for diuretic-induced dehydration (Churchill et al 2004). Managing hydration balance is of crucial importance and the mechanisms for the adequate monitoring and controls need to be in place. Nursing management questions in the assessment of hydration in acute stroke patients should include whether use of intravenous fluids during the first week of stroke was recorded. Questions should also include whether the patient was fed orally, by nasogastric tube, through percutaneous gastrostomy tube, by intravenous methods or not at all? The fact that these questions can be raised enforces the need for adequate documentation and recording of acute stroke patient records. Bhall a et al (2002) says that the use of artificial ventilatory support with intubation or nasal intermittent positive pressure ventilation should be documented as well as the use of supplemental oxygen given through nasal catheters or masks. Enteral tube feeding is a vital means of feeding and balancing hydration levels in patients with stroke. There are no set standards for hospitals in the UK and hospitals have recorded much variation between them in the timing of the start of enteral tube feeding and whether a nasogastric or percutaneous endoscopic gastrostomy (PEG) tube is used (Ebrahim and Redfern 1999). Some clinicians delay tube feeding for 2 weeks or more, and although early nutrition is unlikely to be harmful, whether any nutritional benefits offset the difficulties and complications of initiating and maintaining early enteral tube feeding is unclear. If the timing or route of enteral tube feeding does affect outcome, the present variation in practice means that large numbers o f patients are being denied best treatment. Whether enteral tube feeding via PEG rather than nastrogastric tube or early initiation of enteral tube feeding improve outcomes was tested in the FOOD trials and no evidence of significant benefit from PEG rather than nasogastric tube feeding was found. Neither was any hazard from early tube feeding found (The FOOD collaboration 2003). The explanation for any difference between PEG and nasogastric groups is not clear, but one factor might be the effect of a long-term PEG tube on dependency since more patients in the PEG group were still receiving such tube feeding than in the nasogastric group at follow-up (The FOOD collaboration 2003). The survivors in the PEG group were also more likely to be living in institutions and had lower quality of life. Another intriguing finding was the excess of pressure sores in the PEG group, raising the possibility that those with such tubes might move less or be nursed differently. Weaknesses in this test results include insufficient statistical power to exclude more modest differences between groups; no information about the proportion of eligible patients enrolled in each centre; our use of an informal (although reliable and highly predictive) assessment of nutritional status; absence of precise monitoring of patients daily intake of nutrients (rather than fluids); absence of on-site source data verification or collection of information on changing nutritional status (e.g. in-hospital weights); possible bias due to masking of secondary outcome measures. Although compliance was not 100%, this fact results from the inevitable difficulties of adhering to rigid schedules when patients conditions change. Difficulties with nasogastric feeding in stroke patients (who are often confused and uncooperative) have led to increasing use of PEG tubes at an early stage. Enthusiasm for this method has been encouraged by the results of a trial that reported much lower case fatality rates in patien ts fed via PEG (13%) rather than nasogastric tube (57%) (The FOOD trial collaboration 2003). Due to significant alterations in fluid balance after enteral tube-feeding in patients, close attention to the recording of fluid balance such as intake/output measurements, body weights and simple bedside assessments is needed to detect fluid imbalances and other serious complications at an early stage (Oh and Seo 2007). One explanation for the varying and inconsistent readings in fluid hydration between enteral and PEG might b Stroke patients and the impacts of stroke on life Difficulty with swallowing is a common problem in acute stroke patients, and can lead to aspiration pneumonia, dehydration, and exacerbation of any existing malnutrition (Finestone and Greene-Finestone 2003). In Oh and Seo (2007) the authors set out to examine the fluid and electrolyte complications after enteral tube feeding in acute brain infarction patients. The background is that inconsistencies in the results of the water and electrolyte complications associated with enteral tube feeding are partly because of uncontrolled disease-related variables. The implication is that these variables were not adequately managed. Stroke patients very often present with dysphagia and this is very commonly dehydration associated with undernutrition (The Food Trial 2005). Up to half of stroke patients in hospital have dysphagia, which precludes safe oral nutrition for the first few days and can persist for long periods (Mann et al 1999). Although a 50% prevalence can be considered to be high, th e nutritional/fluid status of a stroke patient can rapidly deteriorate in hospital. The difficulty in feeding stroke patients with dysphagia coupled with the discomfort associated with stroke can exacerbate undernutrition and/or dehydration. Studies show that undernutrition shortly after admission is independently associated with increased case fatality and poor functional status at 6 months (The FOOD trial collaboration 2003). The current financial burden of efficiency savings and reduced budgets in the NHS hospitals results in reduced staff numbers so that patients can not be attended to on a one-on-one basis so that ensuring appropriate hydration levels is done by periodic but regular monitoring of charts. An option for the future in this area may be to involve the patients family members in hydration monitoring and provide them with appropriate training if evidence can show that being around loved ones improves outcomes and early warnings. In acute stroke, artificial nutrition t hrough an enteral route is needed because of dysphagia and since oral feeding is unsafe in some dysphagic patients, enteral nutrition is often administered as nasogastric or percutaneous endoscopic gastrostomy (PEG) tube feeding (Finestone and Greene-Finestone 2003). Naso-gastric tube feeding (a prevalent enteral method) has been reported to improve clinical outcomes more than the parenteral route in brain-injured patients (Rhoney et al 2002). Oh and Seo (2007) in their study used 85 subjects, but their work was limited by the fact that it was performed retrospectively and some of the subjects records were incomplete. Also, because the patients in the study were from one hospital it is not conclusively known whether the results can be generalised to the whole population./p> Legal and other aspects Japanese physicians attitudes towards artificial nutrition and hydration (ANH) as a life-sustaining treatment (LST) were examined to find out if they withhold or withdraw the LST when treating older adults with stroke-caused profound impairment with no hope for recovery. The study findings show that the informants held different views towards LST because most doctors considered ANH to be indispensable and ANH is automatically provided to patients (Aita and Kai 2006). With the advancement of medical technology, decisions to withhold or withdraw LST are among the most difficult to make for health professionals (British Medical Association 2001). Physicians caring for stroke patients often encounter comatose or semi-comatose patients with severe stroke for whom it is difficult to determine whether or not to continue care (Asplund and Britton, 1989). By administering LST, some patients in this patients group, whose bodily functions other than brain function could remain stable, could pot entially survive for months or years without achieving awareness or being able to interact with others (Aita et al 2008). Certain Japanese physicians have criticized the current efforts regarding life prolonging as Aita et al (2008) states: Prolonging the process of dying like this constitutes the violation of dignity and human rights. The life-prolongation only serves hospital operators who want to make profits by keeping hospital beds occupied. They also said this practice impacted the carers and that some nurses also feel emptiness toward the manipulative life-prolongation when taking care of these elderly patients. In the West, some countries have worked out nation-wide guidelines related to withholding or withdrawing LST that say stroke-caused profound impairment with no hope for recovery is a potential reason to withhold or withdraw LST (British Medical Association, 2001). Ackermann (2000) believes withholding and withdrawing therapy challenge family physicians to be excellent communicators with patients and families and recommends that family physicians should continue to be strong advocates for dying patients. Sprung et al (2003) highlighted differences between withholding and withdrawing therapy showing that withdrawal of therapy is followed by a nearer and more rapid death than withholding therapy, and that physicians and nurses were more inclined towards withholding rather than withdrawing therapy. Food and water are considered symbols of caring (Ackermann, 2000), therefore, it may be natural for physicians to give a special status to ANH as food and water. Whether to withdraw ANH from a patient in persistent vegetative state has also drawn substantial media attention in the U.S. (Casarett et al., 2005; Ganzini, 2006). The findings of the study also suggest that the physicians double standard is partly based on their subjective judgment whether the treatment is ordinary or extraordinary. However, the standard of ordinary/extraordinary care has long been criticized as too vague to guide decision-makers in the U.S. (Beauchamp and Childress, 2001). It is believed the current legal framework has also inappropriately led some physicians to simply continue care regardless of the patients conditions, thus resulting in putting an unnecessary burden on patients. The physicians subjective interpretation of the current legal framework may lead to decisions not to initiate mechanical ventilation in some older adults for fear of facing a situation in which physicians cannot withdraw it at a later stage Conclusion Hypovolemia and hypervolemia occurred frequently after acute stroke but were often not recognized as such by nurses. The nurses predictions of current volume status do not seem sufficiently reliable to serve as a basis for therapeutic decisions. More advanced techniques for bedside assessment of volume status may be indicated for optimizing volume status in patients with acute stroke (Hoff et al 2004). Whereas studies have looked at the optimal method of improving hydration, whether correcting dehydration in stroke improves outcome is not very clear. Given the complexity of the cell death cascade following brain ischemia, novel approaches and combination therapy are inevitable for victims of stroke (Fisher and Brott 2003). The review indicates that standards vary from country to country in the legal framework for withdrawing and withholding hydration and nutrition during end stage care.

HIV and Its Coreceptors Outline Essay -- Biology AIDS

What is HIV? The Human Immune System * In order to understand HIV, one must understand the human immune system. The first line of defense is a person’s skin, mucous membranes, and other secretions which prevent pathogens from ever entering your body. Pathogens are considered things your body does not want, for example bacteria and viruses. * The second line of defense includes nonspecific mechanisms which attempt to contain the spread of pathogens throughout one’s body. The second line of defense relies heavily on the use of white blood cells, which ingest invading organisms. About 5% of white blood cells are made of monocytes, which develop into macrophages. The role of these macrophages is vital to the human immune system, as they are able to engulf pathogens without having to self destruct. * The body’s third line of defense is a highly specific means of distinguishing â€Å"self† from â€Å"non-self† and destroying all â€Å"non-self†. All of one person’s cells are marked with a unique set of proteins which label them as â€Å"self†. Certain cells in the body are capable of recognizing every antigen (molecules belonging to viruses/bacteria) that may enter one’s body over a lifetime. These cells include macrophages, T-Cells, B Cells, and interior thymus cells. These cells rely on Helper T-Cells to alert them of antigens in the body, thus creating an immune response. Once recognized, Killer T-Cells actively destroy pathogens and even the body’s own cells if that have been invaded by a pathogen. How HIV attacks the Body * As commonly known, HIV cannot penetrate your immune systems first line of defense. You cannot contract HIV by breathing bad air or by holding the hand of somebody who is HIV positive. You have to wo... ... lymphocytes. Phipps and Branch observed Fyn Kinase activity in patients with and without HIV. Those with HIV contained high Fyn Kinase activity and low levels of Fyn protein. They also found that Fyn Kinase activity increases within 30 minutes of infection of the CD4+ T cells. This new-found information revolutionized the way testing for HIV occurs. References: Alkhatib, G. et al, "CC CKR5: A RANTES, MIP-alpha, MIP-1 beta Receptor as a Fusion Cofactor for macrophage-tropic HIV-1." Science 272, 1955 (1996). Grimes, W., R. Hallick, M. Hewlett, J. Aronson, and B. Fishel. Biology 181 Laboratory Manual 2002. Hayden-McNeil Publishing, Inc. Moore, J.P. "Co-receptors: Implications for HIV Pathogenesis and Therapy." Science 276, 51, 1997. Purves, W., D. Sadava, G. Orians, and H. Heller. Life: The Science of Biology , Sixth Edition 2001. Sinauer Associates, Inc.