Effects of Back Massage on Chemotherapy-related Fatigue

Effects of Back work on Chemotherapy-related FatigueShahida AbbasiThis paper is aimed to critique on a numerical interrogation article. Effects of nates manipulate on chemotherapy-related wear and foreboding Supportive c be and therapeutic touch in lotcer nurse Written by Karagozoglu and Kahve (2013) as part of my assignment.The ProblemThe job is portentous to nursing as noned by Karagozoglu and Kahve (2013) that nurses are directly compound to provide care and deal with patients receiving chemotherapy and their experienced side effectuate. It is also mentioned that problem is importation to nursing, as nursing interventions intend to improve smell of life-time by reducing the stress level of the patient with housecer.Moreover, the train of conducting similar info-based and cross sectional field of operation research was to ensure the military capability of prickle corrade, a nursing intervention, on fatigue process which develops imputable to chemo thera py. Further much, on the care level which develops, and has been explained explicitly. In my pose of view this get butt joint accomplish its purpose as hit the ceilings and Grove (2011) mentioned that effects of independent variables on dependent variable can be rigid through quasi experimental studies. In addition, quasi experimental a quantitative approach hold design is best fit to memorize the impellingness of pole message. In the article research variables back massage independent variable and fatigue as dependent variable has been explained with writings support, whereas I feel the dependent variable apprehension need more elaboration. The investigators promptly introduced the problem statement at the end of the introduction. In my point of view the answer to the problem provide insight into current issues in nursing practice because there was no arena found which determine the effects of back massage in decreasing fatigue and anxiety of chemotherapy patients. In addition, the investigators has stated the assumptions very(prenominal) clearly that back massage providing during chemotherapy reduces fatigue and anxiety Moreover, limitations are not listed explicitly but reader can infer easily as evident by this statement, small example size was utilise therefore, the findings of the study could not be generalized. The limitations of quasi study design are as mentioned in Polit and Beck (2012) noted that in interventional study participants show reluctance to be selected through randomization. Thus these assumptions and limitations are realistic. freshen of the LiteratureThe literature reviewed by the researchers is comprehensive, critical, and logical. Moreover, the literature was published during the period 1988- 2013 and more or less of them were not recent but relevant to the problem. The birth to the research purpose is evident by the literature review. In addition to that the researchers included 21 recent research studies and of th ese three studies published in 2013 were also employ. The investigators paraphrased the reviewed adequately did not use any quotation. The researchers made a case logically for conducting a new study based on the review tax shelter of Human RightsThis study was designed to minimize risk and maximize benefits to participants. Moreover, the researchers indicated very explicitly that participants gave voluntary, verbal and written informed consent and no present of coercion was found. However, it is not evident in study that participants were invited to consent during periods of spunky stress. There is no evidence in the study that individuals can be identified and tieed to study. The researchers very clearly mentioned that approval to conduct the study has been taken from an independent ethics committee of Cumhuriyet University Faculty of Medicine.Theoretical / conceptual FrameworkThe researchers did not describe any theory or cloth to guide their study. Coughlan, Cronin and Ryan (2007) noted that theoretical frameworks tend to be better genuine in experimental and quasi-experimental studies. Burn and Grove (2011) noted that a well-developed quantitative study is based on clearly stated framework and quality of frame work needs to be evaluated for practicality. However, in this study the absence of theory or frame work did not detract the researchers from the significance of the research.HypothesisThe investigators formally stated hypotheses. It is appropriate to see the possibility in quantitative study as the investigators were interested to discharge the effectiveness of back massage. Burns and Grove (2011, p.167) stated that this type of researches are required to countenance hypothesis in order to predict outcome. Moreover, hypotheses are naturally derived from the research problem and transform the problem into predictable results. In this study hypotheses drive two dependent and independent variables. Furthermore, the investigators stated hyp otheses clearly and objectively and the foretelling is evident. It is very obvious that these predictions are supported by the literature.SamplingThe fundament population carefully described by the researchers i-e patients who at least to a lower placewent for chemotherapy. The brand population was appropriate according to the study problem and desirability. However, resource limitations are not mentioned in the study. The investigators described exemplar selection social functions by grown strict eligibility criteria. However, it would be better if they had clearly mentioned the type of take procedure used. Moreover, the sampling method fits with the research design and level of examination of study. However, the authors did not describe potential take in biases. According to Polit and Beck (2012) under representation of the exemplar pertaining to research question should be acknowledge by the researchers. The sample is sufficiently large as Polit and Beck (2012, p.285) propose that small sample size pass on be adequate if researcher is certain about the strong relationship of the independent and dependent variables and it is described under the subheading of methods p.212.This study can be generalized on the fundament population and patients receive chemotherapy. The investigators have described the eligibility criteria to enroll participants on ( p.212) to ensure a representative sample. However, sampling error can be minimized by increasing the sample size. seek DesignThe investigators used quasi experimental and cross sectional design to determine the effects of the interventions. The design used for the level of inquiry of research question and purpose of research was appropriate as Burn and Grove (2011, P.151) mentioned that this study design is to determine the effects of back massage on independent variables. The researcher did not discussed potential effects of befuddle variables and possible measures to control such effects ( hardship ). Polit and Beck (2012) proposes selection of homogeneous sample to control confounder, however, statistical analysis can also be used for the same purpose. The researchers gave enough information based on which study can be replicated. info CollectionThe instruments Personal Information Form, The State solicitude part of Spielberger State- Trait Anxiety Inventry (STAI) Brief Fatigue blood (BFI) were used for data collection. Personal Information consists of nine questions for that detail is given under the subheading of Personal Information on p. 212. Moreover, State- Trait Anxiety strain (STAI) instruments developed by Spielberger et.al in 1964 has been used by Oner and Le Compte. Cronbachs alpha coefficient was given that shows validity and reliability. In addition, Brief Fatigue Inventory (BFI) developed by Mendoza et.al. (1999) which consists of 10 questions was used to assess fatigue, and the same outmatch was used by Cinar, Sezerli,Sarsmaz and Ments. The value of Cronbac h alpha reliability coefficient of the scale verifies its validity and reliability. However, rationale for the selection of instruments was not given. Instruments used in this study were congruent with research questions. Are results of these tests sufficient to indicate their use?The instruments are adapted for use with the study sample.Quantitative AnalysisDetermining the effectiveness of back massage is the third level of inquiry of study question, and for that quasi experimental and cross sectional study design is best fit.The investigators calculated opine and standard deviation for age. Chi-square test has been used for qualitative ordinal variables. A non-parametric Friedman test that is substitute of ANOVA has been used to analyze mean BFI construct for intra group variability. Moreover, a Wilcoxon non-parametric test alternative to paired t-test was used to interpret mean STAI scores of patients before, after and right after chemotherapy. Furthermore, Mann-Whitney U tes t was used for mean STAI and BFI score of patients before and right after chemotherapy. disrespect the fact that data were normally distributed, non- parametric test have been used. The link between the analysis and findings are logical, clear, and are evident by statistical rejection of null hypothesis by P-value. The researchers did not go beyond the data during interpretation of the findings, and they presented statistical result both in the narration and in tabulated form. The investigators used inferential statistic that is enough evidence to establish the correctness of the statistical result as Coughlan Cronin, P., Ryan (2007) noted that statistical significance assist the investigators to order out threat to validity. The investigator presented findings in a table which is clear, simple, and accurate.Conclusions and RecommendationsData analysis clearly explained in reference to research questions and hypotheses.Since the study sample was small, the researchers made approp riate decision based on significant findings and did not claim for generalizations beyond the study sample or population. However, the results are applicable on our patients who are planning for chemotherapy. If we will implement this intervention to our context, accordingly it will lead to increase comfort, decrease fatigue, and anxiety. Furthermore, there are no risks of implementing study findings mentioned explicitly or inferred. The authors also recommended that back massage during chemotherapy is effective intervention to be practiced to control the side effects especially fatigue and anxiety and this recommendation is well supported by the others studies. However, the investigatorsdid not give recommendations for future research studies.To determine the efficacy of back massage, a nursing intervention is a unique study which is significance for nursing practice. In this study the investigators used quasi experimental and cross sectional study design. Moreover, the study purp ose of the study is explicitly stated. The investigators tested hypothesis with instrument which are reliable and valid and they described the instrument very comprehensively. Moreover, sample selection was carried out on strict eligibility criteria. Study findings have been explained in narration and in table. Finally, investigators gave conclusion based on findings that back massage is effective nursing intervention to decrease the fatigue and anxiety of the patients who receive chemotherapy. The investigators also mentioned that study cannot be generalized other than target population.ReferencesBurns, N., Grove, S. K. (2012). Understanding Nursing Research Building an Evidence-Based Practice. Elsevier Health Sciences.Polit, D. F., Beck, C. T. (2012). Nursing Research Generating and Assessing Evidence for Nursing Practice. Lippincott Williams Wilkins.Coughlan, M., Cronin, P., Ryan, F. (2007). Step-by-step guide to critiquing research. Part 1 quantitative research.British Journ al of Nursing,16(11), 658-663.

Rights Of Women And Children Sociology Essay

Rights Of Women And peasantren Sociology EssayWoman cognise as the half of the world. In Indian corporation is that there is regular variety and neglect of women, which could be in terms of inadequate nutrition, education, health, blank space and so on. The grapple against violence is actually the struggle against the unequal scattering of power both physical and economic. Although the domains constitution says women concord equal circumstance to men, women argon powerless and be mistreated inside and outside the home.When we testament talk well-nigh the rights of churlren so India has the full-sizest child population in the world. India has line whatever signifi potbellyt commitments towards ensuring the fundamental rights of children. There has been progress in boilers suit indicators infant mortality order ar down, child survival is up, literacy pass judgment have improved and take dropout rates have fallen. But the field of child rights in India is quiete n caught between legal and policy commitments to children. The conundrum of child trafficking is a big issue in India. In such(prenominal) chaos, media plays a vital role as it is known for image building. In this regards media should bring aw beness and should make the children and women aw argon roughly their rights. And in last, media of necessity to improve one factor that it should non bring out only forbid points. If any g overnment scheme is brought in light, its positive aspects should be broadcast by media.Keywords Children, Media, Rights, WomanINTRODUCTIONAt metres the energizing struggles for womens basic democratic right appeared in many countries in the 19th and twentieth centuries. though these movements differed in their reasons and tactics, the mesh for female suffrage, along with former(a) womens rights concerns, cut across many national boundaries.Woman is known as the half of the world. In Indian society is that there is systematic discrimination and neg lect of womens in India, which could be in terms of inadequate nutrition, defense reaction or limited access to education, health and property rights, child chore and domestic violence etc. The fear of sexual violence has been a powerful factor in restricting womens behavior and sense of freedom. The struggle against violence is actually the struggle against the unequal distri besidesion of power both physical and economic among the sexes. Although the countrys constitution says women have equal status to men, women are powerless and are mistreated inside and outside the home. Women face malnutrition, peculiarly for pregnant or nursing women.And when we will talk about the rights of children so India has the largest child population in the world. India has made some signifi displacet commitments towards ensuring the basic rights of children. There has been progress in overall indicators infant mortality rates are down, child survival is up, literacy rates have improved and school dropout rates have fallen. But the issue of child rights in India is still caught between legal and policy commitments to children on the one lapse, and the fallout of the do work of globalisation on the other.Over the last decade, countries across the world have been changing their be economic models in favour of one operate by the free grocery, incorporating processes of liberalisation, privatisation and globalisation. The direct impact of free trade on children may not leap to the eye, but we do know that globalised India is witnessing impairment directs of basic health, nutrition and shelter.The negative fallout is visible children are be deprived of even the scarce social benefits once available they are displaced by forced and economic migration, increasing the number of children subsisting on the streets more than and more children are being trafficked within and across borders and rising verse of children are engaged in part- or full-time labour.MEDIAThe mass medi a are diversified media technologies that are intended to reach a large hearing by mass communication. After the introduction we talk about for the first time the Media in India. As we all know that media is fulfilling the purpose of providing information to large audience through various means of communication. But now media akinwise makes lot of property through major controversies like for e.g. at the time of 16 December, 2012 rape case all people of India are notice news channels for latest updates about the rape case so in between that news channels earn lot of money by giving advertisements (at that time when more people are reflection continuously the news the main aim of adds are fulfilled and and so the news channels take 2 lakhs for 2 min adds and make money).Conclusion is that when such a thing happens like rape or murder which creates interest in public, media take advantage of that time utilizes it as a golden period for them.HOW MEDIA PROTECTS THE RIGHTS?Media protects the rights women, child, disabled minorities. It creates awareness and survey some the public and ask them various questions to make them feel nourishive arrest information it also help us to know about their idea about the cause and after that. Lastly remedies suggestions of different people are taken as to protect the right.Conclusion is that by major publicize media help many people to know the reality help them to fight for their rights.WOMENS RIGHTS, SOCIAL INCLUSION AND THE MEDIAWe aim to increase public awareness about women rights and to respond to demands from womens organization to strengthen communication and solidarity between women. We want to progress women to make greater use of information technology for communication and the media to support networking among womens organization and activists, to promote the merciful rights of women and women equality. We also aim to increase the brain of womens rights, globalization and media among policy make rs and the familiar public. To achieve this we will organize activities such as conferences, workshops, interviews and media interventions (print, radio and web). We will also carry out look for and produce media interventions in order to increase the visibility of womens rights, which will condense on the trafficking of women, gender discrimination and violence against women in the labor market and the objectification and exclusion of women by mainstream media.NEGATIVE POSITIVE ASPECTS OF CHILD RIGHTSThere are both the aspects child rights negative as well as positive. like for e.g. concord to fundamental rights child till the age of 14 child should be given free education but some children are still working at tea stalls etc .on the other hand the gang rape case one person who is guilty in under 18 so no case can menstruate on that boy but u think if he can do such shameful thing or crime of that level then why is he considered as child here negative advantages of rights are taken.Conclusion is that both advantages disadvantages are taken of fundamental rights which can cause major harm to the public ahead in future. need NUMBERSThrough media we get to know about the emergency poem which will help people when he would be in difficulty.112- ecumenic number100- Delhi policePG PRODUCTSThese are several products when we purchase the product some amount of money is apply for education for poor people or for children who cant get enough education.LOOPHOLES1. When any crime happens and police reaches on the spot they fight with each other as under which than the orbit comes, then they move to the victim.2. Victim is taken to trauma center in any case this should not be done as victim can die in way so he/she should be taken to the nearest hospital.3. After happening of any crime politicians should not give their wrong fake speeches against victim as for e.g. in 16 December, 2012 gang rape case many politicians gave their comment like agar-agar ladki l akshman rekha paar karegi to seeta haran hoga. They should not pass comment like this if they are talking about this then why they have adopted western culture they must be following Ram Yug.4. sc/st reservation is another loophole of our society as when one child is general secured 90% marks in 12 then sc/st student secures only 70% but they stand equal when it comes to admission sc/st gets admission but general student does not get education.HOW MEDIA FAIL TO PROTECT CHILD RIGHTS?The countrys existing media policies do not protect childrens right to media due to the absence of particular provisions ensuring childrens participation in media and their information say a study. Though the government is obliged to protect childrens right to freedom of expression according to international convention, it alongside private television channels and radio move give importance to childrens programme and related news. Moreover, the present laws and policies in the country do not protect children privacy and dignity, Said the study. The findings were revealed at a Roundtable discussion on Analyzing Broadcast media policies in the light of Child Right.OBJECTIVEIn presenting paper my objectives are followingsThe role of Media in defend and consuming the rights of children and women.To preserve the basic rights of survival, development, participation and protection of women and children.METHOODOLOGYMethodology used in this paper is a complied study of various papers, websites, print media and electronic media with related topics of the paper.CONCLUSIONThe media plays a very crucial role in safeguarding and protecting the human rights for the women and children of India. It is because of media that the women and children have learnt about their human rights, violation of human rights and protection of human rights. Although looking into the current scenario, the challenges and the not-so-good events occurring daily with children and women all over the country, there i s a requirement of looking into the current media structure, media working and the developmental issues in context to media. The greed that has developed in the recent bypast has actually abolished the main reason of the existence of media which should be curbed as in short as possible.

Acute Inflammation 2nd Degree Burn Case Study Biology Essay

Acute Inflammation 2nd Degree Burn Case select Biology EssayA 43 year old fe potent presents with a ignite on her left forearm. There is signifi toilettet erythema that covers the inviolate proximal forearm in the shape of a circle. She complains of numbness and erotic down her pinky. There is only pain upon contact of the wound so she has to wear a short sleeve shirt. She burned herself while simmering hot water and spilling it on herself. The wound became red and swollen and in st mount ups became worse over the course of two days. She has mild blistering and scalding across her forearm. She is determined to develop a second mark burn beca riding habit of the austereness of the erythema and blistering, that the lack of charring and discoloration does not indicate a terce degree burn. She presents with a classic case of a second degree burn, although many different variations have been documented. The first method of treatment is to impudent and cool the wound. Once the burn has been cleaned and cooled, it can be managed by the use of antibiotics, analgesics, and sometimes topical anaesthetic anasthetics. The prognosis for fire depends primarily on the age of the patient and the surface area of the wound. Also, since burn injuries often present as comorbid conditions, the presence of smoke inhalation psychic trauma, debris, or bone fractures will herculeanly influence the prognosis.Skin burns can manifest in a variety of ways depending on the cause of the burn and as well the validity of the burn. There are up to six degrees of burning, with each level of burn penetrating deeper into the beat layer. Burns can in addition be assessed in terms of total body surface area, which is the percentage affected by partial thickness or full thickness burns. Severe burns may require amputation, surgery, or skin grafting. When the first layer of skin ( carapace) is burned through and the second layer of skin (dermis) is also burned, the injury is call ed a second-degree burn. Blisters develop and the skin takes on an intensely reddened, splotchy appearance. Underneath the epidermis is where the hair follicles, blood vessels, nerve endings and sweat glands reside.Underneath the dermis live the muscles, nerves, giantr blood vessels, and bones. Heart rate and peripheral vascular fortress developments following a study burn injury. This is due to the release of catecholamines from hurt create from raw stuffs, and the relative hypovolemia that occurs from unsound volume shifts. Initially, cardiac output decreases and more or less after 24 hours, cardiac output returns to normal and then increases to toy the hypermetabolic needs of the body.Immediately following injury, vasodilation is the first step in smashing inflammation. Arterioles die dilated and then new capillary beds are formed in the area. This causes heat and redness to form, which allows for increased blood flow. There is increased vascular permeability which ca uses exudate to flow out in the intravascular tissues. The increase of extravascular fluid leads to swelling, or edema. An important function of acute inflammation is to activate and take aim out leukocytes to the site of injury. In the lumen, there is margination, rolling, and adhesion to the endothelium so the leukocytes can bind to the lumen. The next step is called transmigration, which is the migration of leukocytes to the endothelium. Chemokines act on the adherent leukocytes to swear out the cellular telephones migrate through endothelial spaces toward the site of injury. This process occurs predominantly in the venules.Next, leukocytes emigrate toward the injured area through a process called chemotaxis. only granulocytes, monocytes and lymphocytes respond to chemotactic stimuli at their own unique rate. Phagocytosis involves three distinct but interrelated steps recognition of the tinge to be engulfed by the leukocyte, involveion, and degradation of the ingested mate rial. Binding of a particle to phagocytic receptors causes the process of active phagocytosis to occur. The particle to be engulfed is completely surrounded inside a phagosome. The membrane of the vacuole combines with the restrict membrane of a lysosomal granule, which results in the release of the granules contents into the phagolysosome. Throughout the process, the neutrophils and monocytes become increasingly degranulated.Microbial killing is largely carried out by oxygen-dependent mechanisms. Phagocytosis stimulates an increase in oxygen, increased glucose oxidation, and production of reactive oxygen intermediates. The regulators of inflammation have short half-lives and are manufactured in quick bursts, only for the pith of duration that the stimulus persists for. As inflammation progresses, the process also activates a variety of stop signals that actively terminate the reaction. These mechanisms cause a modify from the secretion of leukotrienes (pro-inflammatory) to lipox ins (anti-inflammatory).ReferencesKumar V, Abbas A, Fausto N, Robbins S, Cotran R. Pathologic Basis of Disease. 7th ed. Saunders 2004Burns (Medline) Web site. usable athttp//www.nlm.nih.gov/medlineplus/burns.html. Accessed October 22, 2010.Burns First aid (MayoClinic) Web site. Available athttp//www.mayoclinic.com/health/first-aid-burns/FA00022. Accessed October 22, 2010.Burns-Topic Overview (WebMD) Web site. Available athttp//firstaid.webmd.com/tc/burns-topic-overview. Accessed October 22, 2010.Ernest KimGeneral Pathology degenerative inflammation Chronic BronchitisA 24 year old male presents with shortness of breath and an expectorating cough. He has been smoking hookah tobacco fooling for the past six years. He has always had a weak immune schema and has recently developed a constant cough within the last three months. A chest x-ray revealed hyperinflation of the lungs and auscultation of the lungs revealed prolonged expiration. The patient was determined to have degenerati ve bronchitis due to the past history of chronic tobacco smoking and the consistent cough that has lasted for months. Common manifestations of chronic bronchitis involve wheezing, productive cough, and occasionally chest pain, fever, and fatigue. There are a a few(prenominal) different treatment protocols but the main one is smoking finish and rest. In some cases, antibiotics or bronchodilators are prescribed. Early diagnosis of chronic bronchitis as well as smoking cessation, can drastically make better the probabilities of a good outcome. Individuals with chronic bronchitis that quit smoking early on can greatly slow the progression of lung deterioration otherwise they peril becoming permanently disabled at some point.One major component of the mononuclear phagocyte system is macrophages, which consists of related cells such as tissue macrophages and blood monocytes. Monocytes migrate into many different tissues where they become macrophages. The liveliness of monocytes in the blood is about 24 hours, whereas tissue macrophages have a half-life of about several months to years. Early on during acute inflammation, monocytes emigrate into extravascular tissues, and within 48 hours they are established as the predominant cell type. The same factors that control neutrophil emigration, govern the extravasation of monocytes.When the monocyte gets to the extravascular tissue, it is transformed into a much larger phagocytic cell, which increases its cell size, metabolism, and ability to properly ingest microbes. In acute inflammation, when the invading cell is destroyed, macrophages eventually undergo necrosis or migrate back into the lymphatic system. However, in chronic inflammation, macrophage appeal continues, and is regulated by different mechanisms. This army of regulators makes macrophages important and also powerful mediators in the bodys defense system, but the same arsenal can also create detrimental tissue terms when macrophages are activated in appropriately. As a result, tissue necrosis is one of the main setbacks of chronic inflammation.A wide range of substances in addition to the residual leftovers of macrophages can also contribute to tissue injury in chronic inflammation. Necrotic tissue can elevate the inflammatory response through the indirect activation of kinin, complement and fibrinolytic systems. Other cell types that contribute include mast cells, plasma cells, eosinophils, and lymphocytes. Mast cells are widely spread out in connective tissues and partake in both acute and chronic inflammatory conditions. Although neutrophils are mainly characteristic of short-term inflammation, many types of chronic inflammation continue to exhibit large numbers of neutrophils. Neutrophils are especially important in chronic lung damage induced by persistent tobacco smoking.Granulomatous inflammation is a distinguished pattern of chronic inflammation most notably characterized by its focal accumulations of triggered macroph ages, which often assume an epithelial-like appearance. It is only activated in a limited number of infectious and some noninfectious diseases. The lymphatic system along with the lymph nodes filters and mediates the extravascular fluids. Along with the phagocyte system, the lymphatic system represents a auxiliary or backup defense mechanism that is activated whenever a local inflammatory reaction fails to terminate or neutralize an invading cell.

The Seagull by Anton Chekhov Analysis

The mark by Anton Chekhov AnalysisThe Seagull is integrity of Anton Chekhovs scratch acclaimed hears, he claimed it to be five tons of sock. It is a comedy of foiled works each char movementer has to deal with their profess disap expressments in their purport in their proclaim way. Like virtu every(prenominal)y of his scarpers The Seagull is set in the untaughtside rather than in the city, the reason for this is that, in the rural beaside populate are forced into the same union with each separate e realday. This similarly brings forth the psychological realism agency in which Chekhov wrote. He was influenced by great Russian Realists homogeneous Tolstoi, Dostoevsky and Turgenev and it is evident in forever and a dayy re importantder(predicate) his assembles including The Seagull. As far as it has been established, The Seagull was the showmagazine of Chekhovs snaps to be acted out in English. The Seagull is a naturalistic act as in which the tone remai ns the same throughout the comprise. It is non a theatrical perfor art objectce s give voice assemble only if rather a play which presents pot of ordinary and everyday career. This is especi tout ensembley evident through the plot and performance. biz and morselion.Although it is hard to establish the exact motoric trice of a naturalistic play beca pulmonary tuberculosis there is no definite action starting, one could say that the reach of Arkadina and her passionatenessr Trigorin is the motoric min as that is when sluicets start to develop.In the low gear Act the audience is presented with the image of a country state setting, the realm is experienceed by a former government employee, Sorin. On appearance its turn overn or rather noticeable that Sorin is a very ailing man. In this act his sister, a famous actress Arkadina arrives at the estate with her grappler, the penr Trigorin, for a brief vacation. During this act all the guests of the estate are on the ir way to keep an kernel on a play written and directed by Arkadinas son Konstantin Treplyov, this is to be he latest attempt to create a fresh and mod theatrical from, and that to a fault presents a dense imageic form of theatrical art. He does this to gather his m new(prenominal)s favor. He really tries to create a t lay offer theatrical genre. The leading lady is a girl from a neighbor estate, called Nina, as the star of the world, which is obviously assumed to be her subprogram within the play. During a discussion well-nigh the play Arkadina manages is clear that she thinks it is roughly the bend and disregards it as ridiculous and in a state of disgrace, Konstantin storms of the stage. It is here where we establish our first crisis. Chekhovs plays created drama out of everyday circumstances such as loving and prospicienting, exchangeable Konstantin longing for his mothers approval here, rather than the grand gestures of heroes and heroines of his in the first plac e plays. The interesting and troubling experience triangles are revealed. The Seagull is a play filled with unrequited cognise because al about all the compositors cases love somebody who does not arrest their lovingness. Nina is courted by Konstantin, who loved and admired the daughter of the estate shop steward, Masha, who is in turn admired by the school teacher Medviedenko. date Masha confides in the good and elderly Doctor Dorn, he simply blames it on the romantic spell the moon and lake has spread amongst the youngsters of the country. Medviedenko loves Masha but she does not note the same nigh him I am touched by your dotingness but I displacenot return it that is all. It is because of all these sub-plots that makes the play almost anti-emotional. In the first act it is established that Konstantin feels like a failure to his mother.The spot act starts with revealing the outside of the estate, during what externalizems to be a lovely aft(prenominal)noon, with Ark adina (amongst others) reminiscing most happier snips the good old days. Short afterward Arkadina and the house steward Shamrayef is caught in the middle of a rather heated argument, right thusly and there Arkadina decides to conk and return to Moscow Under the circumstances I shall go back to Moscow this very day, its a very outstanding way to contend affairs throwing all your dolls out of your cot because someone wouldnt channel you a horse. As the rest of the party started making their way back into the house, Nina stayed behind. Its a rather curious thing when Konstantin surprises Nina with a throw a dead gull. Its queer for a boy who is in love to give the girl of his dreams a dead fall guy that he excavation. Its no surprise when Nina face turns to horror and disgust at the sight of the strange gift, presented to her by the boy who is courting her. Although it is imperative to remember that this seagull induces a very important symbol in the play because Konst antin claims that he pull up stakes soon end his spiritedness in the same way. At that moment Trigorin approaches the scene, upon spotting the handsome and talented writer, Treplyov storms of the stage in a greedy rage. Its obvious that Nina takes a liking to Trigorin when she slavers him to tell her about his life as a writer. He explains to her that its definitely not an well-off one. A communion starts betwixt the twain, Nina tells Trigorin about her desire to pee an actress. Nina confesses to Trigorin that she does realise that its not an easy life but is willing to do everything in her power to make a success of her dreams and aspirations to convey an actress. When Trigorin contacts the strange gift Konstantin has given Nina, it inspires him to write a hornswoggle story, he startsA young girl lives all her life on the shore of a lake. She loves the lake, like a seagull, and shes apt and free, like a seagull. just a man arrives by chance, and when she sees her, h e destroys her, out of sheer boredom. Like this Seagull. It seems as though he is using the story to lure her into his den of poetic romanticism and heat energy and to no ones surprise, it works. Right at that moment Arkadina calls him to reveal to him that she has changed her mind about leaving immediately and would rather like to stay on a little longer. When Trigorin leaves the set Nina stays behind, ranting and raving about how blue and famous he is and describes him as her dream.Chekhov centers his plot on the romantic and tasty conflict between the young and up-coming Nina and the ageing Arkadina as well as the ever experimental Konstantin and the legendary Trigorin. Most of the Seagulls action happens off-stage and the plot is genuine by the way in which the cites deal with what has happened. at that placefore when the play does break down-placely continue in act 3 we are made cognizant of the point that Konstantin tried to commit felo-de-se and that Trigorin and A rkadina are leaving. Konstantins suicide is a result of Nina not returning his love but choosing Trigorin over him where his mother does the same (taking the writers side).Chekhovs The Sea-Gull has similar attributes to the plot as small town. There is a play within a play. In the same way in which Hamlet tries to win Queen Gertrude back from his uncle Claudius, Konstantin tries to win his mother from Trigorin. The plot thickens when Arkadina and Konstantin arouse another(prenominal) argument about Trigorin whilst at the same measure we see that Trigorin and Nina make plans to meet up in Moscow.In between the two acts (that is act one and two) Konstantin attempts to kill himself he fails at this attempt and walks around with a heavily bandaged head for the duration of Act terzetto. At this point Arkadina and Trigorin render come to a decision to depart from the country estate. Trigorin is found eating breakfast in the kitchen, when Nina enters and presents him with a medallion that proving her ever lasting devotion and admiration for him, she also includes a line from one of his own books If you ever need my life, come and take it. At first she seems foolish and you are left with a thought of a buggy teenage obsession, especially when she resorts to begging him to let her see him one last time onwards he leaves to return to Moscow with Arkadina. Nina disappears off-stage just before Arkadina and Sorin enters its easily seen that Sorins sickness is worsening by the minute. Trigorin also leaves the scene, to go sex his packaging for the trip back to Moscow. Arkadina and Sorin engages in a short give voice war, after which Sorin collapses of pure grief, luckily Medviedenko is present to help the weak and sickly Sorin off the stage. At that point Konstantin enters and asks his mother to please change his bandages, plot of land Arkadina s changing his bandages he starts an argument, by disregarding Trigorin. The argument is finish and Konstantin leaves i n tears. Trigorin so reenters and asks her if they stool stay on at the estate but Arkadina flatters him into leaving for Moscow anyway. As Arkadina leaves the stage Nina enters for a final goodbye, she tells him of how she is running away to become an actress once morest her parents wishes. They kiss passionately and scheme to meet in Moscow.Two years pass and once again most of the action took place off-stage like Nina and Trigorin who did meet up in Moscow, had an bout but Trigorin left Nina for Arkadina when Nina lost the baby. Masha, despite her feelings for Konstantin married Medviedenko and they have a child to draw a bead onher. Instead of elaborate notwithstandingts Chekhov focuses on smaller detail in the plot. When act 4 starts we see that Konstantin has finally published some short stories. Arkadina and Trigorin are once again back on Sorins farm because of Sorins doubtful health. The tension is neer lost in the play and there is a very short build up to the climax of the play where Nina comes to Konstantin to say to him without any of the other characters k straight offing. She starts by describing their lives and stating that even though the achieved what they call fored life is remedy not that good. Before she leaves she says that she bland loves Trigorin despite of everything that has happened. That was rather unnecessary, sad guy. Figures, because after that all the characters enter again and we hear a natural gas picnic and then (finally) the play has reached its climax when Konstantin shoots himself like he shot the seagull earlier. He was never pleased with his work and he could never please the woman he lovedso what would you do?There is not some(prenominal) of a denouement as Dorn enters to tell Trigorin to take Arkadina away because Konstantin has shot himself. (I very hope her conscience will drive her insane). Everything that happens in the plot is a result of their surroundings. The environment in which the characters are indue in The Seagull is that of a farm in the country, and without a Playstation Im sure you arouse imagine they did a whole lot of soul search. It is this soul searching that highlights most of the etymons we find oneself in the play.ThemesThe theme of unrequited love and the enactment of time become apparent in the play. As earlier mentioned the play starts off with all the characters loving someone but the somebody they love have another love interest and they show no commitment, its like a vicious circle. Masha really loves Konstantin but he does not return her love so she banks that her love for him will eventually pass with time or if she waits long enough he come to his senses and love her back. precisely this never happens and by the time (of act 3) she changes her mind and decides upon Medviedenkos love which he has had for her from the jump By marrying Medviedenko When Trigorin threatens to leave Arkadina (who is an ageing actress holding on ferociously to her status) she begs him to stay with her Am I then so old and hideous that you can talk to me like this without any shame about another woman I could never endure it should you desert me. As time goes by Sorin becomes more ill. As time passes in the play their desires and love for certain things or people grow stronger which last leaves them hopeless, this brings us to the insurgent theme. Alienation and loneliness come to all the characters at some point in the play. The character that is clearly the most isolated is Konstantin. Once again as we have established numerous times, this is because the character cannot reach the person he or she loves. Konstantin is isolated because of his strange artistic style that he tries to create and because Arkadina, his mother, rejects him piece of music all the other characters look up to her. To put the cherry on the cake for this poor man, when he turns to Nina for comfort she denies him and hence he becomes even lonelier. He truly feels t hat he receives no consciousness and that he wants to be left alone And for heavens sake, all of you leave me alone Go away. In the same way Sorin feels very unfrequented and he has never had the love he wanted Women never care me. He wants to leave the country but everybody is so absorbed in their own lives that no one ever listens to the poor man when he speaks. Towards the end of the play Nina becomes lonely in her own sense when she is jilted by Trigorin, she lost her baby and her parents dont want her. We clearly see her freak out I have been wandering about on the shores of the lake ever since I came back. I have much been near your house, but I have never had the courage to come in. When one becomes lonely you start to decide your life automatically trying to find the source of your alienation. This then brings us to the third theme of self evaluation that includes self awareness or self consciousness. The characters in the play have more than enough time to do this, see ing that the main idea in Chekhovs work is intragroup action. Sorin speaks of how he is actually more suited for the city because all he wants to do on the farm is sleep For some reason boy, country life doesnt suit me Arkadina explains why she looks so fabulous and why Masha looks so much older that herself my heart and mind are always busy. I am always well groomed, as the saying is, and carefully dressed, with my cop neatly arranged. Quite a vain lady if you ask me. Sorin compares his life to Dorns and says that Dorn has had a full life and must not judge his gassy lifestyle of drinking and smoking. Nina evaluates her life by concerning herself with the point the she would do anything to become a famous actress. She states that she would love to swap places with Trigorin anytime To find out how a famous genius feels. What is it like to be famous? What sensation does it give you? Whilst al the characters have time to do self evaluating they try to systema skeletale out lifes meaning which is the next theme YayThis is the theme of existentialism. Existentialism suggests that valet must find something to make life meaningful and to fill their own voids. The one very prominent character in this theme is Masha who brings the theme forth in the beginning of the play when she mourns her life as Medviedenko says why do you always wear mourning? This suggests that her life is meaningless she is frustrated and bored with her life because she cannot win Konstantins love and without that her life is meaningless to her I shall not marry for love, but marriage will at least be a change, and will bring new cares to deaden the memories of the past. twain Konstantin and Nina believe that they will find meaning in their work while Nina believes that as long as she is acting she is fulfilling her purpose I believe, and do not suffer so much, and when I think of my calling I do not fear life. One never thinks that Konstantins void has truly been fulfilled even though he does publish some work. In the same manner Sorin never comes close to finding the meaning of his life and at times he wonders why he is still alive.The last theme I will be discussing is the theme of the role of the artist. each(prenominal) four of the protagonists Arkadina, Nina, Konstantin and Trigorin, are artists. They are either aspiring or settled artists. Co-incidentally they are all in love but they all handle their situations very differently. Kostantin uses his artistry to gain his mothers approval of him and it is also because of his failure in the beginning of the play that he believes that is the reason Nina stopped loving him because he says All began when my play failed dismally. A woman can never forgive failure. It seems Chekhov was a smart man On the opposite end on the rope of success, Trigorin receives a great amount of attention because of his fame. Everybody appreciates him and does not judge him, so it is easy to see why Konstantin felt violate and asham ed, and to top it off Nina gives Trigorin a gift and says Think of me sometimes. She positively furious for his fabulous artistry. Both Trigorin and Arkadina had a good life because people respect them. She uses her position as the established actress to excuse the manner in which she speaks at times. People almost put her on a pedestal as Nina says How strange it is to see a famous actress weeping This is because Nina really longs for fame and the elysian life of an artist. In the play Chekhov makes it out to be the ultimate thing as Nina goes as far as to say For the bliss of being a writer or an actress I could endure want, and disillusionment, and the hatred of my friends It could be said that in The Sea-Gull there is an illusion at the beginning of the play that the life of an artist is great however towards the end of the play when sounding at Nina and Konstantin it is in fact not so very accepted. imageThe first character I will discuss is Konstantin Treplyov. Konstanti n is an emotion and equivocal (or over dramatic depends on which way you look at it) character and this is evident in the fact that he first threatens to commit suicide So shall I soon end my own life. He does not only attempt it, he succeeds at it. This is a result of the fact that he never finds anything to fill his existentialistic void with. The one thing he believes will fill it is Nina, Konstantin is hopelessly in love I want to see her, I must see her. I shall follow her. But Nina never returns his love. He likes to an person despite the fact that he inhabits his fictional character of writing might not be welcomed by everybody but still he writes it No, we must have it under new form. If we cant do that, let us rather not have it at all. He is a very jealous man he mostly portrays this green-eyed monster towards Trigorin who has everything he dreams of, an established career as a writer and the affection of both Arkadina and Nina.Nina Zarietchnaya is the second characte r to discuss. She is ambitious and she will do anything to become a famous actress. She even slipped out of the house as her parents did not approve of her dream. She is passionate about her acting but she does not believe in herself enough to conquer It is a dream of my life which will never come true. We come to see that Nina is lonely towards the end of the play because her parents have written her off and Trigorin has dropped her like a hot potato. She says to him when he leaves her for Arkadina One must know how to bear ones cross She competes with Arkadina for Trigorins love. Nina is the character to see herself as the seagull, signing off earn under the name and always drawn to the lake and free until someone shoots her down.Arkadina is the mother of Konstantin and a very long-familiar actress. Because of her acting ability she is judgmental when it comes to Konstantins pays What decadent rubbish. She thinks less of her son than herself and a lot of her actions are self cent ered. Actresses in this particular play have a high status, and Arkadina becomes egoistic and arrogant when asked about other artists Dont ask me who those antediluvians are I know cryptograph about them. She is so cowardly that Konstantin will take away her limelight even though she has long passed her prime. She is a very stingy person she wont give silver to her ill brother or to Konstantin who needs new clothes even though she does have the money I really havent the money. And later on she says Of course I have some money, but I am an actress and my expense for dress alone is enough to bankrupt me. She is Trigorins lover.Trigorin is a well-known(a) writer who never, well, stops writing. Whenever he has an idea or hears something he likes he writes it down and he sometimes gets lost in a fantasize world. He is drawn to the lake where he could fish the whole time as there is nothing that he finds more pleasing and this is seen when he says There must be a lot of fish in this lake. He is however rather modest when he replies to Ninas question on his fame all you exaggerate my fame, or else, if it exists, all I can say is that one simply doesnt feel fame in any way. One could say that he is a follower, when Arkadina wants them to leave he puts up a half hearted constrict and then leaves. When the opportunity arises for him to have an affair with Nina he grabs it but then leaves her again. He does not see himself as a good writer but merely as someone doing his duty Here lies Trigorin a clever writer, but he was not as good as Turgenev. He is admired by all the characters in the play and he is Arkadinas lover. He never gets into any real conflict with anyone. They all see him as a great artist for whom thy have great respect.The other two characters we meet in The Seagull are Masha and Sorin. Mash is upset with her life because she cannot fill up her void, she loves Konstantin but he does not love her back. (Why cant these people just move on?) This is evident when she says I dress in black to match my life. I am unhappy. She marries Medviedenko to get over Konstantin she has a baby with her keep up but refuses to go business firm to look after the child Nonsense, Matriona will feed it. She is rude towards her husband Would I might never see your face again. Sorin is quite the opposite, he is quiet and misunderstood because no one listens when he talks. He is accessory towards everyone but especially toward Konstantin I am devoted to him and he is fond of me He never really got to do the things he wanted to do and he lives in a country that he hates. He even mentions how he never got marries, spoke eloquently or became an author.The other characters in the seagull play rather minor roles, but we can still come to notice their unique character traits. Medviedenko is a polite man and very apologetic despite the fact that Masha is being a female dog toward him, he replies I should not have troubled you all but the baby Dorn is a doctor and his opinion is respected. He also has a secret attraction towards capital of Minnesotaina. He is very observant and also a father figure for both Masha and Konstantin I do not love my father, but my heart turns to you. For some reason, I feel with all my soul that you are near to meLanguage, duologue and symbolismThrough the dialogue the tension of the play is kept throughout because there is not a lot of action that takes place. It is for this reason that the speech is filled with pauses especially between acts. Just like there are pauses, moments of silence also carry saddle and contributes to the mood and feel of the play. Chekhov uses language that can easily be understood and he does not write in metrical patterns. The word in the play is of utmost importance and the feel end weight of the play lies with it. The characters are a true representation of life and thusly they communicate in that manner. Sometimes the characters talk in short sentences and not in paragr aphs in order to keep the action in the play going strong. In The Sea-Gull, the play which Konstantine wrote is filed with personification and the unhappy moon now lights her lamp in vain. Chekhov likes to refer to well known characters in the script like Napoleon, Caesar and Alexander the great. He also makes use of quotes by William Shakespeare Thou turnst my look into my very soul -As mentioned earlier there are a fewer comparisons between The Sea-Gull and Hamlet. The dialogue is packed with descriptions as Chekhov pays attention to the finest details in the play. For instance where Arkadina speaks of how good she looks, she really goes overboard in her descriptions. Dorns character often sings tell her, oh flowers The characters sometimes sit and philosophise about life and Chekhov makes use of metaphors for example when Konstantin describes how he feels about Nina not loving him wake to find this lake dried up and sunk into the earth.Repetition in wrangle become apparent, I t hink the reason for this is, because of the theme of existentialism, the repetition in linguistic communication contribute to the repetition of their meaningless, pretentious and void less lives. Most words are repeated three times (three was considered an unlucky or deplorable number) words, words, words. and have to go back to it and begin to write, write, write. As this is naturalism Chekhov wrote in everyday prose with the normal cliches as well. To establish the simplicity of the play he refers numerously to nature. Banham Chekhovs way is to supply a thousand details for his creatures to remain true to themselves while they also interact and reflect the embracing mood of the moment as a group Banham, M. 1988. Cambridge Guide to field of force. New York Cambridge University instancy.The main symbol in the play is the seagull, which is also what the play is called. Funny enough, the play was divine by an actual dead seagull Chekhov found on the beach. The seagull is mention in the beginning of the play and we are constantly reminded of it. The seagull is an innocent bird with an average life that is destroyed by kind indifference this is the image we create. Firstly we see Konstantin as the seagull after shooting it he places it at Ninas feet and threatens to take is life in much the same way. He thought of himself as an aspiring artist until he killed the seagull his mother mistreated him. The same violence he portrays is cleanup the seagull is a symbol for the inner conflict and violence hurt him. The same way Nina also associated herself with the seagull by signing letters she writes to Trigorin as the seagull. Nina becomes the wounded seagull which returns home to the river to heal. Ninas dedication to her art ultimately reverses her fate and she becomes strong, and takes strength like the seagull I am a seagull Another rather important symbol is the lake. For every character the lake has a different meaning. For Trigorin for instance it is a p lace where he is at peace and he can catch fish all day. For Nina it is a safe haven and a reminder of home where she receives comfort. Konstantin gets the simplicity he wants from it when he stages his play there no artificial scenery needed. The eye travels directly to the lake, and rests on the horizon. This is Anton Chekhovs way of moving to naturalistic theatre. The weather in the play is a symbol of moods. Every time there is a storm brewing we know an argument is on its way. In the beginning the weather is bad when he fails and later when he shoots himself. In other words, the weather is used as a foreshadowing mechanism. This again can be emphasised by the way Chekhov incorporated simplicity in the naturalistic manner that he wrote in.Other elementsSome interesting things about Chekhov come to mind. His very first plays were one act comedies which were very entertaining. His first full length plays Ivanov and The wood demon was unsuccessful. The Wood demon was so badly criti sised that Chekhov vowed never to write again. In the same manner The Seagull was also unsuccessful when it was first practiceed at the Alexandrisky Theatre in St Petersburg. The main reason for this is because people were not use to new ideas and this play had nothing in common with the other democratic plays of that time because it was devoid of dramatic action and more internal action was focused on. It was Vladimir Nemirovich Danchenko who came to Chekhovs rescue and convinced him to let the newly found Moscow art theatre perform his play, this lead to the great success of The seagull. Konstantin Stanislavsky staged The Sea-Gull in 1898 and as you can imagine he turned it into a great success. It is interesting to know that Chekhov an Stanislavsky did not get along, for Chekhov did not like the way Stanislavsky directed his play, with total and complete devoid of action onstage. But we know this was the major display to the internal action of a character and the play was inde ed popular so you can imagine Chekhov quickly forgave Stanislavsky.The Sea-Gull was performed in the Joseph Papp Public Theatre as part of the New York Shakespeare Festival summer season in Central Park from the 12th of howling(a) 2001 to the 26th 2001. (One would think Shakespeares plays should be performed at his festival.) Directed by Mike Nichols and (this is my favorite part), starred Meryl Streep as Arkadina and Natalie Portman as Nina.The Royal Shakespeare Company performed the piece in January 2008 and then most recently The Classic Stage Company in New York metropolis revived the work in March 2008 in a production. It was Paul Schmidts translation and it was directed by Viacheslav Dolgachev.An acclaimed Russian critic, Nebakov, stated that Chekhov was not a great writes but a pleasant one. Chekhov noted that fiction was his wife and drama his noisy impudent and tiresome mistress. His reputation rests on the plays The Seagull, Uncle Vanya, The three sisters and the Cherry Orchard. He is the son of a former serf but his grandfather bought their freedom. His father beat him up but he inherited his mothers gentleness. Chekhov studied medicine but his writing took up most of his time. He started off with his short comic sketches and that paid for his university fees. Chekhov fell in love with Olga Knipper, a leading actress, and married her in 1901. He died shortly after of Tuberculosis in Germany at the age of 44.The Seagull is a boundary play for the world of drama. Influenced greatly by existentialism it portrays how each individual must find a manner in which to fill their own empty gap of void in their lives in order to live a happy life. It is a comedy in which we observe how people can rub each other up n the wrong way causing so many hilarious conflicts and how people end up failing one another. The way in which Konstantin has to work to win his mothers affection is ridiculous but captivating. Although the tone never changes there are clear cha nges in the characters.I rather enjoyed reading The Seagull because of the fact that nothing is going on yet it involves so much action and therefore it is different from popular normal comedies.BibliographyBanham, M. 1988. Cambridge Guide to theatre. New York Cambridge University PressChekhov, A. 1994. Uncle Vanya and other plays. Translated by B.Hulick. Canada Bantam books.The seagull. 2007. Wikipedia. (online). Available from http//en.wikipedia.org/wiki/_seagull (accessed on 12 August 2008)Hochman, S. 1984. Encuclopedia of world drama. 2nd ed. New York McGraw-Hill.

Management Respiratory Distress Syndrome Infants Health And Social Care Essay

Management respiratory Di idiom Syndrome Infants Health And Social lot EssayRespiratory di stress syndrome (RDS) is unmatchable of the most common consequences of untimelyness and a leading ca function of neonatal mortality and morbidity as a consequence of childish lungs. RDS particularly affects newinnate(p) infants born out front 32 weeks of gestational age but is also recognised in babies with slow up lung festering of different aetiology i.e. maternal diabetes. Since its initial recognition at that place form been vast advances in understating the pathology and management of this complex syndrome. However, in recite to understand the pathology behind RDS it is imperative to obtain a unspoiled rear end of normal lung maturation and physiological changes that occur in the respiratory organisation during the transition from fetal to neonatal feel.Physiological Development and Function of the lungsDuring intrauterine growth, fetal lung development begins as primae val as 3 weeks and progresses until 2-3 long time. convention every(prenominal)y it is divided into 5 stages embryonic, pseudoglandular, canalicular, saccular and finally dental consonant1 (Table 1). During the embryonic stage, the lungs develop from the fetal ectoblast to form the trachea, the main bronchi, the five lobes of the lung and the major blood vessels that connect the fetal lungs to the heart the pulmonic arteries. This is followed by the pseudo glandular stage which results in the formation of the terminal bronchioles and associated primitive alveoli. These thence advertise divide in the Canalicular stage to form the primary alveoli and subsequently the dental capillary hindrance. This stage also comprises the note of Type 1 and 2 pneumocytes which go forth later go on to develop wetting agent. at that placeof babies born subsequently 24 weeks, give up a chance of survival as the platform for basic gas exchange has begun to develop. During the saccular st age there is further differentiation of type 1 and type 2 pneumocytes and the protects of the airlines, in particular the alveoli, curve to enlarge the surface ara beat for gaseous exchange. This is followed by the dental consonant stage which occurs through the transition form fetal to neonatal life up until 2-3 years. The hallmark of this stage is alveolar consonant formation and multiplication to join on the surface atomic number 18a lendable for gas exchange to meet the adjoin respiratory demands as the infant grows.StageTime period morphologic DevelopmentEmbryonic0-7 weeksTrachea, main bronchi and five lobes of the lungs develop from the fetal ectoderm. pulmonic arteries form and connect to heart.Pseudoglandular7-17 weeksFormation of terminal bronchioles and alveoliCanalicular17-27 weeksFormation of alveoli-capillary barrier and differentiation of type I and II pneumocytesSaccular28-36 weeksWalls of airway thin for in effect(p) gas exchangeAlveolar36 weeks -2 years Alveolar multiplicationTable 1 Stages of Lung DevelopmentOnce the pulmonary epithelium develops, it begins to mystery liquified into fetal lungs, the pile and rate of which is imperative for normal lung growth. an different(prenominal) historic factor essential for normal lung development and choke is the performance of wetting agent.At some 24 weeks of gestation the enzymes and lamellar bodies involve for wetter action and storage begin to appear 3. frankincense a normal fetus age is not ready to be delivered at this stage cod to surface-active agent deficiency. As type II pneumocytes mature between 32-36 weeks, wetting agent production increases and it is stored in the lamellar bodies of these cells.Surfactant is a complex mixture of phospholipids, apathetic lipids and proteins 1, 4 that has a sound intent in checking the alveolar-capillary interface and reduction surface tension. It is secreted as a thin film at the liquid-air barriers to expedite alveolar elaborateness and preclude end-expiratory tumble of small alveoli, especially at low alveolar volumes.A key event in the development of the lungs is the establishment of spontaneous breathing post- oral communication. Prior to delivery the fetal lungs precipitate lung bland production and as the lungs mature there is simultaneous maturation of the lung lymphatic system. During labour the mechanistic compression of the fetal chest of drawers forces astir(predicate) 1/3 of this lung fluid thus preparing the fetus for spontaneous external external respiration. This lead exact several(prenominal) stimuli including hypoxia, hypercrabia and acidosis as a results of labour5 and hypothermia and tactile stimulation. Furthermore the stress of labour stimulates chemo-receptors in the fetal aorta and carotids to trigger the respiratory centre in the medulla to commence breathing. As the fetus emerges from the birthing canal, the fetal chest re-expands creating negative airway crush w hich subsequently draws air into the lungs. This again forces the lung fluid out of the alveoli and brooks for adequate lung expansion. As the newborn cries there is further expansion and lung aeration generating convinced(p) intrathoracic hug which maintains alveolar patency and forces any remaining fluid into the lymphatic circulation.As the neonate adapts to extra-uterine life, the normal muscles of respiration browse to maintain breathing ( traffic pattern 1). In order to inhale, the block and external intercostals muscles contract to increase the size of the thorax. This gene place negative air pressure in the pleura and lowers the air pressure in the lungs so that the gradient between atmospheric air and alveolar air causes air to enter into the lung of the neonate. As the neonate inhales, the elastic flush force of the lung increases. Once inspiration ceases, the elastic recoil force of the lung causes expiration. The diaphragm and external intercostals muscles relax, the thorax returns to its pre-inspiratory volume resulting in an increase in intra-thoracic pressure. This pressure is now greater than atmospheric pressure and air moves out of the lungs producing exhalation.Figure 1 The Mechanics of breathing6For most neonates, this transition from fetal to extra-uterine life is uneventful and completed during the first 24 hours of life. The neonate is able to establish good lung spot, maintain cardiac output and thermoregulate. However, for a certain population of neonates, commonly those that be born premature and thus called preterm, this transition is little sub collectibled and it is these babies that go away require the support and c ar of the whole paediatric department.Respiratory Distress SyndromeRespiratory distress syndrome (RDS) is the most prevalent disorder of prematureness and despite a outflank understanding of its aetiology and pathology, RDS becalm accounts for material neonatal mortality and morbidity. The incidence R DS is inversely proportional to gestational age2 much(prenominal) that it shines with advancing gestational age, from closely 60-80% in babies born at 26-28 weeks, to about 15-30% in babies born at 32-36 weeks 1. Risk factors for developing RDS argon summarised in Table 2 and include maternal illness, complications during pregnancy and labour and neonatal complicationsTable 2 Risk Factors for RDS1Respiratory distress symbolizes early in post-natal life particularly during the phase of transition from fetal to extra-uterine life. These babies exit present with signs of grunting, cyanosis, penniless flaring, intercostal and subcostal recession, increased respiratory effort, and less commonly apnoeic episodes and circulatory disaster. The severity of symptoms experienced argon related to the pathology of disease and it is important to identify babies at greatest risk and commence management early in order to prevent respiratory complications much(prenominal) as degenerative lu ng disease (previously called bronchopulmonary dysplasia), pulmonary hypertension and in adverse cases respiratory nonstarter and even death.Identifying normal transition and respiratory distress is largely establish on evaluating the risk factors for RDS, measureing the severity of symptoms and close neonatal observation if in doubt. Babies that are born close to term or those via caesarean section may display a difficult albeit a normal transition. These babies present with transient tachypnoea of the newborn in the first few hours with respiratory rates of about 100 breaths per minute and increased type O requirements. Symptoms are brusk lived, self limiting in most cases and usually relived by oxygen. Neonates who misplace from RDS leave alone present with worsening symptoms of longer duration, respiratory rates of one hundred twenty and increased respiratory effort with a longer requirement for oxygen. rec everyplacey if plausible usually begins after 72 hours and is associated with declined oxygen requirements and better serviceable residual capacity.Pathophysiology of Respiratory Distress SyndromeSince its initial recognition, more than 30-40 years ago, much has been elucidated about the pathophysiology of this complex syndrome. In the premature neonate, the structurally greenish and bed wetter deficient lung is unavailing to maintain the basic lung mechanics required for adequate respiration. As aforementioned lung mechanics rely on wetter production, alveolar multiplication and maturity for effective gas exchange, chest wall elasticity and a functionally developed diaphragm. It is and so evident that premature neonate who lack bed wetter and have structurally immature lungs will develop RDS, atelectasis and abnormal lung function. In these neonates the essential first breaths are followed by a secondary pathological shower characterised by tissue damage, protein relief valve into the alveolar space and inflammation, which may resolve or progress to BDP or chronic lung disease of prematurity (CLD)7.In neonates with RDS, end-expiration results in the collapse of alveoli payable to wetter deficiency and a subsequent reduction in the functional residual capacity (FRC). The FRC is the volume available for gaseous exchange i.e the volume of gas left in the lungs after exhalation. It is determined by an obscure balance between the collapsing and expanding forces of the chest wall and lungs7. An ideal FRC enables the best workable lung mechanics, efficient cellular respiration and gaseous exchange.As the FRC is reduced at end-expiration due to alveolar collapse due to high surface tension, the pressure that will be required to re-inflate the already immature lungs is increased. This in turn increases the respiratory effort pauperismed for adequate gas exchange which presents clinically as increased respiratory rate and subcostal/intercostal recession. yet reaching an optimal FRC may be further impeded by both( prenominal) wetter deficiency and by the preterm infants impaired ability to clear fetal lung fluid. Radiographically a chest x-ray will show the characteristic ground-glass appearance with gaunt lung volumes and the cardinal features of respiratory stress, tachypnoea, pinched flaring, intercostals recession, subcostal recession, increased breathing effort and grunting will begin to manifest early on.Despite this effort to breathe, alveolar ventilation remains poor. As these areas are receiving an adequate blood supply this produces a ventilation/perfusion mismatch resulting in right to left intrapulmonary shunting1. The lungs are unable to maintain good gas exchange and blood oxygen saturation and the level of carbon dioxide begins to increase resulting in respiratory acidosis, hypoxaemia and hypercarbia. The neonate further struggles to breath and attempts to aim higher(prenominal) negative pleural pressures to ventilate the lungs. The ensuing acidosis further diminishes we tter production and neonates deteriorate rapidly as blood oxygen saturations plummet. The instinctive progression of the disease if left un inured will lead to pulmonary oedema, right-sided heart-failure and in the end the most devastating outcome, neonatal death.Therefore the management of these neonates requires an aggressive multi-disciplinary team shape up based on the pathology of these aforementioned homeostatic mechanisms. Alongside this the basic principles of neonatology thermoregulation, nutritional support, effective cardiovascular support and infection manipulate, are all fundamental in achieving the best therapeutic goal. Ultimately the aim is to pop the question adequate ventilatory support, allow the lungs to heal, impede further pulmonary injury, correct hypoxaemia and acidosis and above all to glide by the neonate alive.Management of RDSAs aforementioned the aim of interference is to call down lung healing and reduce further pulmonary insults. We have alre ady established that with increasing gestational age, particularly post-32 weeks, the infant will require less aid to help it cope with the transition from fetal to neonatal life. However, forrader 32-weeks there is an increased propensity to develop RDS and as the neonate is unable to cope, some form of respiratory support is required. Over the past 40 years there have been numerous management therapies including ventilatory support, surface-active agent therapy, nitric oxide therapy and confirmatory therapeutics strategies amongst others. The mainstay of intercession today remains supportive and involves the use of antepartum steroids, wetter replacement therapy, day-and-night validatory airway pressure and mechanical ventilation, which all aim to address the pulmonary inadequateness that manifest in these individualsAntenatal GlucocorticoidsGlucocorticoid receptors are expressed in the fetal lung at early gestation and as the fetus grows stimulate surfactant production p ost-32 weeks. Alongside receptor expression there is an increase in fetal cortisol levels at late gestation9, which coincides with lung maturation, type II pneumocyte differentiation, surfactant synthesis as well as alveolar thinning. If birth occurs before this increase in serum cortisol, the pulmonary system has not mature adequately and therefore there is an increased propensity to develop RDS. Thus a sensation dose of glucocorticoids such as dexamethasone or betamethasone in the antenatal period promotes lung maturation.One of the first published polishs that showed the talent of antenatal steroids in preterm labour was produced by Crowley in 19958. Crowley showed that steroids inclined in preterm labour were effective in preventing RDS and improving neonatal mortality rates. Since then several randomise controlled clinical ladders have evaluated the efficacy of steroids in cut back RDS. A new-fashioned Cochrane check over of 21 trials assessed the effects of antenatal corticosteroids, assumption to women expected to go into preterm labour, on fetal/neonatal mortality and morbidity8. The authors conclude that a single dose of antenatal steroids promoted fetal lung maturation thereby reducing the risk of RDS and the need for assisted respiratory management. The mechanisms by which glucocorticoids are thought to exert their efficacy are described below.Firstly, glucocorticoids stimulate phospholipid production. Phospholipids are a major component of endogenous surfactant and as a result augment surfactant synthesis in the biochemically immature and surfactant deficient lung 9, although the exact mechanisms by which this occurs remains to be elucidated. secondly glucocorticoids enhance lung maturation and development. As aforementioned, in order to produce surfactant, fetal lungs must produce type II pneumocytes which will then generate lamellar bodies in which surfactant is stored. Glucocorticoids enhance this process, promoting pulmonary epithe lial cell maturity and differentiation into type II pneumocytes9. Furthermore glucocorticoids cause a go down in pulmonary interstitial tissue thereby decreasing alveolar wall thickness. A thin alveolar wall thickness facilitates efficacious gaseous exchange and will therefore assist ventilation and oxygenation of the neonate once born thus decreasing the chances of developing RDS. Another cognize benefit of antenatal glucocorticoids is found in reducing oxidative stress on the immature lung and prevention of pulmonary oedema9.This accumulative evidence suggests that glucocorticoids are essential for normal pulmonary development and giving a single dose to mothers at risk of preterm birth may substantially decrease the chances of the infant developing RDS.Surfactant TherapyAs discussed before, endogenous surfactant has a fundamental role in maintaining the alveolar-capillary interface in order to prevent end-expiratory alveolar collapse. This is achieved by thin spread of surfacta nt around the alveoli which ultimately acts to reduce surface tension. The most important component of surfactant which achieves this fundamental function is a phospholipid called dipalmitoylated phopshatidylcholine (DPPC)11. DPPC also stabilises the alveoli at end expiration, further preventing alveolar collapse. Alongside DPPC the synergistic actions of surfactant proteins (SP) SP-B and SP-C also lower surface tension11. Thus a deficiency in surfactant will cause alveolar collapse, decrease pulmonary compliance, increased pulmonary vascular resistance and produce ventilation-perfusion mismatch. Hence the aim of exogenous surfactant therapy is to reverse this pathological cascade and ultimately prevent alveolar collapse thereby limiting pulmonary damage and improving ventilation.Since the first clinical trial assessing the use of surfactant in managing neonatal RDS by Fujiwara in the 1980s10, our understanding of the composition, structure and function of surfactant has progressed vastly. In this uncontrolled trial the chest x-rays of 10 babies diagnosed with RDS, both clinically and radiologically, showed significant improvement after exogenous modified bovine surfactant was look ated with a fall requirement for ventilation. Since then several randomised controlled trials12 have shown that surfactant therapy, alongside antenatal steroids and ventilation continues to improve neonatal morbidity and mortality.Both natural (derived from an animal source) and synthetic (manufactured chemically) surfactants are available to use in managing RDS. Meta-analysis of trials comparing the two types of surfactant have shown that natural surfactants show a more rapid response in ameliorate lung compliance and oxygenation12 thereby reducing neonatal mortality. Furthermore natural surfactants are less sensitive to inhibition by accumulative products of lung injury such as serum proteins.Surfactants need direct delivery to lungs and usually require canulization with sho rt periods of assisted ventilation. Traditionally two therapeutic start outes have been established in managing RDs with surfactant. The first adopts the use of surfactant prophylactically, with surfactant given immediately after birth to enable the neonate to cope with extra-uterine life. The self-explanatory benefit of this approach is that surfactant is administered to the baby before severe RDS develops resulting in long-term pulmonary sequelae for the neonate. However this technique is invading, as surfactant tribunal requires endotracheal canulation, it is expensive and furthermore it may result in the unnecessary treatment of neonates. Moreover poor intubation with failed attempts and prolonged apnoeic episodes may further damage the lungs resulting in CLD. Despite this, there is a strong torso of evidence for prophylactic use of surfactant and current guidelines state that all preterm babies born before 27 weeks of gestation, who have not been given antenatal steroids should be intubated and given surfactant at birth7.The second therapeutic approach evaluates the role of surfactant in rescue treatment used in neonates with an established diagnosis of RDS requiring ventilation and oxygen. The advantages of rescue treatment include that it is uncommunicative for neonates in whom RDS is confirmed and it may decrease the morbidity associated with unnecessary intubation. The unambiguous disadvantage is that delay in surfactant delivery may allow for irreversible lung injury to develop with lessen efficacy of surfactant memorial tablet12. some(prenominal) studies have aimed to clarify the issue between prophylactic and rescue surfactant treatment. A randomised trial by Rojas et al. showed the benefits of surfactant delivery within 1h of birth in neonates born between 27-31 weeks14 with an established diagnosis of RDS who were treated with endless positive airway pressure soon after birth. 279 infants were helter-skelter assigned either to the tr eatment conference (intubation, very early surfactant, extubation, and nasal continuous positive airway pressure) or the control group (nasal continuous airway pressure alone). The results of this training exhibit that infants in the treatment group i.e. those treated with surfactant, showed a decreased need for mechanical ventilation with a decrease in the incidence of CLD and pneumothoraces. Neonatal mortality rates were equivalent between both groups.A meta-analysis by Soll and Morley compared the effects of prophylactic surfactant to surfactant treatment of established respiratory distress syndrome (i.e. rescue treatment) in preterm infants33. The authors analysed eight studies comparing the use of prophylactic and rescue surfactant treatment and concluded that the majority of the evidence demonstrated a decrease in the incidence of RDS when surfactant was given prophylactically. Moreover the meta-analysis showed that infants treated with prophylactic surfactant had a better clinical outcome with a reported decrease in the risk of pneumothorax, pulmonary interstitial emphysema, CLD and mortality33.As a result of such studies most neonatal units continue to practice delivery of surfactant prophylactically in preterm babies at high risk of RDS. However, some literature still debates whether there are any real advantages of prophylactic surfactant over rescue treatment. What is evident is that surfactant therapy should play a fundamental role in the management of RDS. Future trials will need to further assess the indications for surfactant therapy in treating neonatal RDS and perhaps in the management of other pulmonary insufficiency disorders that affect the neonate. Although much remains to be elucidated about the complex pulmonary surfactant system, since its introduction 25 years ago, surfactant therapy has been at the forefront of reducing RDS and its role in decreasing neonatal mortality and morbidity cannot be disputed.Mechanical ventilationMechani cal ventilations is one of the cornerstones of neonatal intensive care units and regardless of the modality used, the primary function is to maintain adequate oxygenation and ventilation. The goals of mechanical ventilation areto establish efficacious gaseous exchangeto limit pulmonary insult and CLDto reduce the respiratory effort and work of breathing of the patientTo achieve these basic goals several techniques, devices and therapeutic options are available to the neonatologist that can be either invasive or non-invasive.Continuous Positive Airway PressureThe use of CPAP continuous positive airway pressure, in the treatment of RDS was first described in the 1970s and has since been identified as a important management strategy. CPAP applies positive end expiratory pressure (PEEP) to the alveoli throughout inspiration and expiration so that the alveoli remain inflated thereby preventing collapse. The pressure required to re-inflate the lungs is reduced as partially inflated alveol i are easily to inflate than completely collapsed ones. living organism studies with premature lambs have shown the benefits of nasal CPAP over mechanical ventilation. CPAP acts to lower the markers for CLD for modelling granulocytes, and markers of white cell activation, increases the amount of surfactant available, improves oxygenation and lastly corrects ventilation/perfusion mismatching2, 15. Moreover CPAP produces a more regulated pattern of breathing in neonates by stabilising the chest wall and reducing thoracic distortion16.Like surfactant therapy there are two ways in which CPAP can be administered. The first rule, InSUrE intubation, surfactant and extubation, adopts a brief intubation to administer surfactant and extubation to CPAP approach and the second is the capital of South Carolina method in which babies are started on CPAP in the delivery room and are only automatically ventilated, and intubated if the need for surfactant is established.Several studies have shown the benefit of the first approach. A moot by Verder et al. randomised 68 neonates with moderate to severe RDS 35 infants were randomised to surfactant therapy following a short period of intubation and then extubation to CPAP and 33 neonates were randomised to nasal CPAP alone. The results of this study showed that infants in the earliest group had a reduced need for ventilation 21% in parity to 63% in the second group16,17. Another similar trial by Haberman et al. assessed the use of surfactant with early extuabtion to CPAP and subsequently the results showed a decreased need and duration for mechanical ventilation12. Furthermore a recent Cochrane review of six studies using the InSuRE method showed that neonates with RDS treated with early surfactant therapy followed by nasal CPAP, were less likely to need mechanical ventilation and develop air leaks in comparison to neonates that were treated with the Columbia approach (i.e. early CPAP therapy followed by surfactant if needed )17, 18. A more recent review by the same authors further confirmed the findings of the initial review and the comparative risk for developing CLD was 0.51 (95% CI 0.26-0.99) with early surfactant treatment and nasal CPAP when comparing the two methods18.The Columbia method requires the stabilisation of neonates with CPAP in the delivery room with intubation and surfactant therapy used as necessitated. This approach was take when retrospectives studies done by Avery et al. and later Van Marter et al. evaluated the clinical outcomes in six-fold neonatal units across the US2. In both cases a lower incidence of CLD was observed in the Columbia University Hospital which adopted CPAP as a primary treatment strategy as opposed to intubation and mechanical ventilation like other units. Leading on from this Ammari et al.. evaluated the Columbia method recently. The outcomes of 261 neonates with birth weight So far the evidence base for the Columbia method has been derived from retrospect ive cohort studies with a lacking in RCTS and therefore a lack of stronger evidence. One RCT that had aimed to evaluate the Columbia method was the recent COIN trial by Morley. This study evaluated whether the incidence of death or BPD would be reduced by CPAP rather than intubation and ventilation soon after birth13. 610 neonates born between 25-28 weeks were randomised to CPAP or intubation and ventilation at 5minutes after birth and surfactant was administered at the neonatologists discretion. The results of the study demonstrated that at 28 days of gestation, infants in the CPAP group had a decreased need for supplemental oxygen and fewer deaths2,13. However worrying results from this study were that approximately 46% of babies in the CPAP group went onto require intubation and had a higher rate of pneumothoraces13.There are few randomised control trials assessing the benefit of CPAP alone in managing RDS and the results of the Columbia Hospital study have been irreproducible i n other centres. The mainstream use of CPAP for managing RDS remains to start CPAP in the delivery room, after intubation for surfactant treatment. There is not becoming evidence to show that CPAP alone can prevent RDS and associated complications in comparison with invasive ventilation. The evidence does suggest that there is a decrease in complications with surfactant therapy and CPAP but the relationship with CLD is less transparent.At present there are two RCTs ongoing that may provide further brainwave into the role of CPAP in RDS when complete. The first trial is the SUPPORT study, which is randomising infants between 24-27 weeks to CPAP ascendent in the delivery room with stringent criteria for subsequent intubation, or intubation with surfactant treatment within 1 h of birth with chronic mechanical ventilation2. The second is the trial by the Vermont-Oxford Network in which infants born at 26-29 weeks gestation will be randomised after 6 days into one of three groups (1) intubation, early prophylactic surfactant, and subsequent stabilisation on mechanical ventilation (2) intubation, early prophylactic surfactant, and rapid extubation to CPAP and lastly (3) early stabilisation with nasal CPAP, with selective intubation and surfactant administration according to clinical guidelines2. The immediate management of the RDS neonate with CPAP remains disputed and maybe the results of these ongoing RCTS will provide invaluable answers to the many uncertainties border this device.Nasal intermittent positive pressure ventilationAnother comparatively recent development in non-invasive ventilation that has evolved from NICU ventilator machines and CPAP devices is the use of NIPPV for managing RDS. Sometimes called BiPAP (for bi-level positive airway pressure), this form of non-invasive ventilation is able to provide two levels of airway pressure, without the need for intubation. BiPAP maintains positive pressure throughout respiration but with a slightly highe r pressure during inspiration. By doing so BiPAP/NIPPV is able to assist neonatal breathing byreducing the work of breathingimproving tidal volumeincreasing blood oxygen saturation and increasing removal of CO2 thereby limiting hypoxaemia and respiratory acidosis.As the neonate inhales, the NIPPV device generates a positive pressure thereby assisting the neonates spontaneous breath and providing ventilatory support. This is at a slightly higher positive pressure. As the neonate begins to exhale, the pressure drops, but a positive airway pressure remains in the lungs to prevent alveolar collapse and thus increase gaseous exchange.NIPPV may be a authority beneficial treatment for the management of babies with RDS and has been used in NICUs since the 1980s. Recently triune studies have aimed to evaluate the efficacy of NIPPV in stabilising neonates. A randomised controlled prospective study by Kulgeman et al.. found that NIPPV was more successful than NCPAP in the initial treatment o f RDs in preterm infants19. Kulgeman and his colleagues randomised infants A further study by Sai and colleagues also established the advantages of NIPPV over CPAP in managing RDs and reducing the need for mechanical ventilation and intubation in preterm infants. In their study 76 neonates between 28-34 weeks gestation with RDs at 6h of birth were randomised either to early NIPPV (37 neonates) or early CPAP (39 neonates) after surfactant use20. Firstly they documented that the failure rate with NIPPV was less in comparison to the CPAP group (p

Franklin D. Roosevelts Declaration of War Speech -- Speaking Communic

Franklin D. Roosevelts Declaration of War Speech President Franklin D. Roosevelt was one of the almost powerful and remembered presidents in United States history. When he spoke his words current a sort of empowerment and relief to his auditory sense. On December 8, 1941 Franklin D. Roosevelt delivered a Declaration of War talking to that would be remembered for years to come. Aside from the subject, this speech has been remembered because the arguments are well supported. Also, Roosevelts excellent word choice coincided with his drab tone while rhetorically appealing to the logos. On December 7, 1941 the Japanese Empire attacked the island of Oahu. The next day president Roosevelt addressed the Vice president, sexual relation and the nation over the radio. He alerted the nation on the problems the United States were go about with and the actions the country would take in its defense. The purpose of the broadcast was to let his audience know that th e premeditated, surprise attack on Pearl Harbor would not be stood for. Roosevelt very clearly stated that the U...

Beaches Essay -- Descriptive Personal Narrative

Beaches atomic number 18 stunning forms of nature. Each one varies from another. Some can be rocky, some receive white sand, some meet black, some are small, and some are large. I love all sorts of landes. Each edge I have visited has been a memorable experience, solely one in particular stands come bug aside of the closet in my mind.During my junior year I went on vacation to a resort in Jamaica with a extraordinary rim. It was a large beach with white sand and remarkable palm trees. There was also a long row of enormous rocks that extended far out into the Caribbean Sea. I found that those rocks made a great coiffe to walk out on to watch the glorious sunsets.I thought this Jamaican beach was great for a couple of reasons. One reason was that it was the perfect place to watch the sunset. The other was that it was a great place to lay out relaxing and tanning during the day. Each day, Id wake up in the morning, grab a soft white towel, and head for the beach. I was alway s one of the first to settle on the sand. I soft found myself the perfect spot along the crashing waves each and every day. Id sit on that towel all day long. I got up only to run into the Caribbean Sea to cool myself off. During the day the beach rattling was a great place to be, however, the late afternoon and nighttime were beautiful beyond compare. One night in particular, the sunset was truly a memorable sight. Every sunset Id witnessed had been great, but this particular evening was my favorite. That night I walked out onto...

Race: Is It a Valid Issue? Essay -- Sociology Racism Prejudice Essays

Race Is It a Valid Issue? Biological advancements such(prenominal) as Darwinism and Mendelian genetics had a profound impact on the study of race in the scientific community. These new concepts flushtually light-emitting diode some(prenominal) scientists to question the validity of traditional notions about race. The resulting debates continue even today. The idea of race, especially in citizens of this country, evokes strong feelings because of the enormous social implications associated with racial identity. The social connotations of racial categories have had a profound influence on the air scientists understand human variation. Early ideas of race were colored by these connotations, and they still play a critical role in the way we understand race today. This paper will explore, with an emphasis on historical context, the current debates over whether to continue to inlude race in scientific, and especially medical, studies. Recently, some scientists have advocated the elimi nation of race from scientific studies altogether. They argue that it is not a useful category for the study of human subjects. Others argue just as strongly that it is. It will be helpful to first examine the historical development of the concept of race before examining the usefulness of race in scientific investigations. Race is a relatively new concept. Ancient civilizations, though they encountered and included people from many different parts of the world, did not shop social distinctions based on physical appearance. They distinguished people harmonise to customs and religion not race. Acclaimed classicist Frank M. Snowden writes The Egyptians, whose contacts with Nubia dated tolerate to the Old Kingdom, did not usually designate Kushites by color terms. though the monarchs of... ...ction. New York G. P. Putnams 1940. Sauer, Norman J. Applied Anthropology and the Concept of Race A bequest of Linnaeus Race, Ethnicity, and Applied Bioanthropology. Ed. Claire C. Gordon. Arli ngton, VA National Association for the Practice of Anthropology 1993. Shanklin, Eugenia. Anthropology and Race. Belmont, CA Wadsworth Publishing phoner 1994. Smedley, Audrey. Race in North America Origin and Evolution of a Worldview. San Francisco Westview Press, Inc. 1993. Snowden, Frank M., Jr. Before Color Prejudice The Ancient figure of Blacks. Cambridge, MA Harvard UP 1983. Stepan, Nancy. The Idea of Race in Science heavy(p) Britain 1800-1960. Hamden, CT Archon Books 1982. Williams, David R., Risa Lavizzo-Mourey, and Rueben C. Warren. The Concept of Race and Health Status in America. humanity Health Reports. 109, no. 1 (January/February 1994) 26-41.