Early Stage Of Dementia

Early Stage Of Dementia Dementia is a common disease in the geriatric population but can also be noticed in any stage of adulthood. In a study issued by European researchers, it is estimated that about 35 million people have dementia worldwide. It is called a syndrome because it involves a serious of signs and symptoms. It is a non-specific clinical syndrome caused by a wide variety of diseases or injuries that affect the brain. Due to alarming increase of number of dementia cases in elderly people, need for extensive research on appropriate care for the elderly dementia patients arises. Nursing home is considered as embodied institution mean to provide constant care. In order to study if the nursing home is the most appropriate care environment for older person diagnosed with dementia, an extensive literature search was performed in accordance to Oxford Brookes style. 10 articles were obtained as a result of extensive literature search after incorporating inclusion and exclusion criterion arising due to the personal need. The results are categorised in to four main themes which are as follows: The facilities and care available at a nursing home. Is multidisciplinary approach essential? Care received in nursing home vs. home care. Impact of elderly people joining nursing home at an early stage. Importance of nursing home in elderly patients in the early stage of dementia After applying CASP tool to all the articles, Careful analysis was done to draw the discussion. Basing on the discussion, nursing home is considered as the most appropriate care environment for elderly patient diagnosed with dementia. Recommendations are proposed on the basis of conclusions and implications of my research in the future are mentioned. INTRODUCTION: Dementia: Dementia is defined as a medical condition which is characterised by loss of cognitive ability which is caused either due to normal aging or any kind of sudden impairment (Berrios, 1987). It is also described as non specific illness causing set of symptoms affecting memory, language, attention and problem solving regions of the cognitive region of the brain (Calleo and Stanley, 2008). Dementia could be either static, caused due to injury of the brain affecting the cognitive area or progressive (slowly progressive and rapidly progressive) resulting in damage of the brain. Although the disease is seen commonly in elderly patients, it occurs at every stage of adulthood (Berrios, 1987).During initial stages of dementia; all the higher mental functions are affected leading to confusion, forgetfulness leading to gradual progression (Gleason, 2003). In aged people, the experience of dementia is worse due to pain and ill health. These symptoms lead to problems associated with ambulation, mood swings, depression, disturbances in sleep pattern, decreased appetite and slowness in activity (Gleason, 2003). Caring People suffering from dementia: During the initial symptoms, the patient is taken care by the family members and relatives. They ensure the patient that the process is normal with aging which makes their lifestyle a bit easy (Algase, 1996). A person suffering from dementia is shifted to a nursing home due to unavoidable circumstances like absence of carers, hectic life schedule and excessive progression of disease, expensive treatment (Weinberger et al., 1993). Nursing home is defined as a place of residence for patients needing continuous support. Nursing home is chosen in many circumstances as mentioned by Weinberger and coworkers. According to him, the need of skilled nursing care, physical intervention and close understanding of the patient play an important role. Along with continuous care, patients in countries like Ireland, United Kingdom and Wales also receive assistance from physical, occupational, speech therapists, social workers, psychiatrists, psychologists to look after the necessities (Kristine et al., 2002). Emergency management is also provided as an essential part of treatment which forms an added advantage. The most important responsibility of the nursing home is elderly care which provides the patients with all the basic services like assistance in living, day care and long term care (Kristine et al., 2002). The Nursing home acts as a caring unit for many dementia patients at various stages of dementia. The quality of nursing home varies and is most important variable in determining efficiency (Kristine et al., 2002).The qualification, knowledge and responsibility of the carers or staff in charge and presence of physicians to monitor health condition of the patient play an important role (Kristine et al., 2002). Although efficiency of care is expected, there are many disadvantages associated with the nursing homes. The patient initially shows signs of disagreement to shift to a nursing home but may agree when explained. The chances of forgetfulness in these issues are also more which could cause agitation after joining (Algase, 1996). The initial adjustment of the patient towards the new atmosphere may create more confusion and deteriorate the health condition which is a major drawback (Steele et al, 1990). The cost of the nursing home and nursing staff is unaffordable by many of the patients which worsen the situation (Kristine et al., 2002). The extent of care and the support of family members play a vital part in influencing treatment. In particular situations like impaired mobility and disability or in cases where elder people are declared as mentally and physically incompetent, care in the nursing home remains as the best factor to increase longetivity of the patients (Steele et al, 199 0). The purpose of this paper is to review various national, International scientific journals and articles which seek to address on Appropriate care of elderly patients diagnosed with early stage of dementia. The intention of the present paper is to provide a suitable answer to the research question; Is the nursing home an appropriate environment for an older adult diagnosed with early stage dementia? To answer the question extensive study on literature search and study was performed. The literature review covered numerous journals, policies, and papers which examined the issues on care provided to the elderly patients in early stage of dementia. The reviews include thorough analysis of elderly dementia patients, forms of care available to them and to examine the best suitable care to improve the health condition of these patients. The present research will evaluate available data on nursing home as perfect environment for caring these kinds of patients. The review elaborates on the exp ectations of the patients and relatives towards care and the attempt of health professionals to live up to the expectations of them. The review also highlights the difference between care obtained in the home and a typical nursing home. It throws light on advantages and disadvantages of care given in nursing homes and these factors are considered later to draw conclusions on the most appropriate environment to care for elderly dementia patients. OBJECTIVE: The objective of the research paper is to investigate the literature on qualitative, quantitative and mixed experimental approaches on proper care of elderly patients. These inferences would form the basis for understanding if the nursing home is the most appropriate place for caring dementia patients. METHODOLOGY: In order to concentrate on the objectives of the study, extensive literature exploration was performed. A  literature review  is a body of text that aims to review the critical points of current knowledge including substantive findings as well as theoretical and methodological contributions to a particular topic (Aveyard, 2007). Literature review was considered as a best source of research methodology because of time constraint and lack of ethical considerations to perform primary research. Literature review focuses on primary research done in various clinical circumstances. The other advantage is possibility of comparative study among various qualitative, quantitative and mixed primary researches across the world (Aveyard, 2007). During my study on the available literature, various situations experienced by dementia patients in nursing homes were studied. Ideas about circumstances experienced by the elderly patients in nursing homes were identified. Some of the papers focus on style of practice in nursing home and some of them focus on the attitude of patients towards nursing care. There were many controversies identified according to different perspectives of authors. Through these studies, an idea about the best suitable place of care for elderly patients at early stage of dementia could be conveyed. Research process: The process of research involved organized and vigilant consideration of literature suitable for my research work. The PICO model to formulate a question as suggested by Johnson and Fineout (2005) and by Stone 2002 cited in Gerrish and Lacey, 2010 is shown in the appendix 1 of the present research work. The model gives a simpler representation of the present research work. The four main terms which were used as a part of my literature search included dementia, elderly patients, quality care and nursing home. While using these terms care was taken to use them in combination rather than using singularly which would widen the research area of expertise. The list of search terms and the keyword identification table as suggested by Aveyard and Sharp (2009) is given in the appendix 2a and 2b respectively of the present investigation report. While considering the term dementia, early stage was emphasised in particular to refine my search. In addition to early stage, another term, elderly patients were also used to avoid searching among all the age groups. The term used for search looked like presented below: Dementia OR Alzheimer* OR memory loss and early stage The Boolean operator and was used in between these terms to ensure that research of literature included these three words in combination. In cases of excluding Boolean operator, the research resulted in articles including primary research of dementia at all stages among all age groups. The other important search term was concerned with the age of the patient which was mainly confined to elderly patients. The parameters used included Boolean operator and. The phrase was as follows: Older person OR Elderly OR older adult The other term used in conjugation in the research term included quality care. As quality care is considered as a wide term, a Boolean operator or and truncation symbol, star *was used to enable thorough research without exclusion of any important article or journal. The term entered was presented as below: Quality care * or appropriate care* or concern or caring* or wellbeing or well-being The use of Boolean operator and truncation symbol ensured non omission of important articles containing synonyms or differently presented words. The final term used in literature search was nursing home. Since my research focuses to study the most appropriate care environment for elderly dementia patients at early stage, this final term was used separately. The terms used in comparison included: Nursing home and care home* or residence* In this particular context, nursing home and care home are considered in comparison with residence of the patient. To enable the results to be confined to single term, the Boolean operator, or was used. The operator and was used to search results including both, nursing homes and care homes. The truncation symbol star was used to include articles with words displayed in alternative formats. The final research phrase for search looked as displayed below: Dementia OR Alzheimer* OR memory loss and early stage AND Older person OR Elderly OR older adult AND Quality care * or appropriate care* or concern or caring* or wellbeing or well-being AND Nursing home and care home* or residence* The immediate course of action was to use these terms in appropriate databases, I was guided by the university library manuals of the Oxford Brookes to consider CINAHL, BRITISH NURSING INDEX and MEDLINE as most relevant databases for search. CINAHL deals mainly in Nursing and health care in North America and Europe (Oxford Brookes University, 2009). British Nursing Index includes journals and articles based on care and community health pertaining to nursing and midwifery (Oxford Brookes University, 2009). Medline (Pubmed) is a collection of articles on medicine and nursing compiled by the intervention of National Library of Medicine USA (Oxford Brookes University, 2009). When the entire research phrase was posed in CINAHL, it retrieved 332 articles. When the same research phrase was typed in MEDLINE, it retrieved 75 articles. Further refinement was done in the search by using limiters 20000101-20101231 and retrieved 57 and 54 articles respectively. Inclusion and exclusion criteria were used in particular to include time constraint which enabled to select most recent articles in the present decade. This included articles beginning from 2000 to present. Another inclusion criterion was the place which restricted the search results to the investigation done in the UK. The inclusion and exclusion criteria yielded 55 and 29 articles in CINAHL and MEDLINE respectively (The database searches and hits are shown in the appendix as suggested by Oxford Brookes University, 2011). To analyse the best suitable material to carry forward my research, four main principles as suggested by Aveyard (2007) were used, which included electronic searching, searching reference lists, hand searching of relevant journals and contacting authors directly. Out of all the suggested principles, the first three types were used as analytical tools in deciding best suitable literature. While choosing the primary research material, utmost care was taken to read through the abstract, findings and research methodology involved. This criterion was used for including or excluding the article for my research purpose. For some of the searches, hand searching was also used to obtain certain useful information on statistics in UK (shown in appendix 4). Due to time constraint in the research work, contacting health care professionals and conducting appropriate interviews could not be performed. As a result of the research methodology, 10 articles were found relevant to the context being investigated. The findings of the papers were thoroughly studied in order to answer the research question. Nursing home was considered to be an ideal place to take care of an elderly dementia patient in initial stage of the disorder. Critiquing my research methodology: There were many criticisms noticed following my research methodology. The main criticisms observed included the following: Inability to access all the journals in the databases as it required paid registration. Most of the websites which have excellent articles require a payment. I managed collect as many as articles I wanted to do answer this research question by login on Athens. It was beyond my finances to fund for all the articles. Lack of time to contact primary health care professionals to incorporate their views as a part of my research work. Lack of time to go through all the publications of a journal which resulted in referring to recent publications. Lack of much information in the title which would enable me to take appropriate decision regarding the content of article which resulted in reading the abstract in order to include article for research. Thus the major constraints of the present research article were identified to be cost and time. However, the freely available data obtained within the specified time were sufficient to draw conclusions to address the research question. For the entire 10 articles, critical appraisal skills programme, CASP (2006) tools were applied to draw the most relevant themes. The main themes identified are: The facilities and care available at a nursing home. Is multidisciplinary approach essential? Care received in nursing home vs. home care. Impact of elderly people joining nursing home at an early stage. Importance of nursing home in elderly patients in the early stage of dementia. RESULTS: The findings of the literature were categorized into main themes which made it easier to draw conclusions. The section depicts the investigation done in the 10 articles grouped together in accordance with the theme. Theme 1: The facilities and care available at a nursing home. Is multidisciplinary approach essential? Author, Year, Location Title Method/Study Results Comments 1. J. Cohen Mansfield and A.Parpura- Gill (2008). International Journal of Geriatric Psychiatry. Practice Style in the nursing home: Dimensions for assessment and quality improvement The investigation examined the operation style of the nursing home in terms of two main components which are the staff and institutional components. The four domains which served as tool to test the staff conduct included knowledge, proficiency of practice style, flexibility and individual care and communication. The three domains used to test the conduct of institution include support of staff, availability of resources and administration of policies. As a result of the investigation, key features of institutional factors and staff were studied and monitored. Based upon the need and demand, the features requiring change and improvement were noted to ensure quality of care. The investigation emphasises on the practice styles of the staff in a nursing home with respect to care provided. The research journal gives an insight of vivid styles of care provided within a nursing home which ensures quality of care. It focuses on the knowledge, communication, flexibility and understanding of the staff in taking appropriate care in elderly persons It also gives a note on changing style of practice to cope up with increasing demand. 2. E.Finemma et al., 2005. International Journal of Geriatric Psychiatry. The effect of integrated emotion-oriented care versus usual care on elderly persons with dementia in the nursing home and on nursing assistants: a randomized clinical trial The investigation is based on randomised clinical trial of two groups of elderly dementia patients, measuring the effects at baseline after specific period of time. The study involved 146 numbers of elderly dementia patients and 99 numbers of nursing staff. The study was performed in 16 psycho geriatric wards located in 14 nursing homes located in the Netherlands. The primary research studied the difference between the usual care and Integrated emotion-oriented care. The nursing assistants were tested on the basis of care given. Positive effects were reportedly noticed in patients experiencing mild to moderate dementia in terms of portraying emotional balance and positive self image. Results also showed that training nursing staff resulted in less stress reactions increasing quality and patience. The investigation revealed that emotion based care showed increase performance in early stage dementia patients when compared to normal usual care. However, It did not show any eye catching increase in quality with regard to people suffering from severe dementia. The study also focuses in reduction of stress in well trained nursing staff. 3. D. Challis et al., 2000. Journal article from Age and Ageing. Dependency in older people recently admitted to care homes. The investigation was based on the study conducted among 308 elderly people aged over 65 in one of the nursing care home located in North west England. The study was conducted within two weeks of admission for people intending to continue treatment for long term. Barthel score and Crichton royal behaviour rating scale were used to analyse the dependency rates. On the basis of Barthel rating scale and Crichton royal behaviour rating scale, 50% of the population were showed to be measured in the low dependency scale (13-20).Out of them, 31% in case of nursing home and 71% in case of residential care homes. On the whole, dementia patients are not assessed primarily before admission into the nursing home. Studies revealed that there was lack of pre admission assessment and diagnosis before joining patients. This study throws light on lack of communication about the pre assessment and diagnostic information about the patients to the health care and nursing staff. Effective targeting of institutionalised resources is focussed with high importance. 4. Leontjevas et al., 2009. American Journal of Alzheimers Disease Other Dementias Apathy and Depressive Mood Symptoms in Early onset dementia. As a part of epidemiological study, patients were studied for symptoms of apathy and depressive mood in early onset of dementia. Studies were performed in 63 nursing homes. MADRS, NPI and MMSE scales were used to detect rate of depression and MDS-RAI and GDS were used to detect severity of dementia. Studies revealed that depressive mood disorders and apathy are not observed severely in cases of patients suffering from early onset dementia .The results noted were accounted as 14% in ADL, 13% in GDS and 9% in MMSE. The investigation reveals that the symptoms of mood depression and apathy are seen extensively in patients suffering with early onset of dementia when compared to elderly patients revealing the severity of aggression. Theme 2: Quality of care received in nursing home vs. home care. Author, Year, Location Title Method/Study Results COMMENTS 1. Ehrlich et al., 2006. Home health care management and practice Caring for the Frail Elderly in the Home: A Multidisciplinary Approach The study depends upon short portable mental status questionnaire proposed by Pfeiffer in 1975 to identify dementia in geriatric population. The test confines to recall and memory of short term and long term orientation. Additionally, evidence based practice is applied to screen patients with the disease. The screening methodology enabled identification of patients suffering with dementia. Interdisciplinary approach is applied to propose a model for caring elderly people in home atmosphere. The primary research article focussed on the major disorders affecting the elderly person which forms the basis of joining a nursing home for care. The interdisciplinary approach gives an idea about caring older patient from the most necessary syndromes to enable ease of treatment in the house without intervention of nursing home. 2. Milke et al., 2006. Journal of Applied Gerontology Meeting the Needs in Continuing Care of Facility-Based Residents Diagnosed With Dementia: Comparison of Ratings by Families, Direct Care Staff, and Other Staff The data was collected by sampling method in five different places including Edmonton, Alberta, Canada, Pennsylvania and New York. A total of 184 elderly residents diagnosed with dementia and 197 nursing staff participated in the study. Suitably tailored questionnaires were distributed across the five sites among non direct care staff, family group, direct care group, licensed practical nurses. The results of the investigation provided the comparison of care between families, direct caregivers, and other staff and volunteers. It also gave an idea about extent of care needed by the residents by each class. The results provide comparison of care in nursing home and the care in the patients own house. The research work emphasizes on individual care provided by various groups like families, friends, licensed medical nurses, volunteers and other professional care givers. It gives a relation of trust and cooperation between the patient and care givers. It focuses on various negative aspects of care in the patients house created due to stress, pressure and miscommunication. The article gives insight on the advantages of care provided by professional care givers over the family members in terms of knowledge, patience and quality. Theme 3: Impact of elderly people joining nursing home at an early stage. Author, Year, Location Title Method/Study Results COMMENTS Connor et al., 1991. Papers from British Medical Journal Does early intervention reduce the number of elderly people with Dementia admitted to institutions for long term care? The investigation utilised seven general practice areas located in Cambridge in the form of controlled clinical trials. 2885 subjects aged over 75 diagnosed with dementia were involved. 159 subjects in the group were diagnosed with initial stage dementia, 86 of them required extra support and 73 of the subjects had access to usual services and acted as control. The research revealed that there was no direct contribution of early intervention to long term admission of patients in the nursing home. 9 out of 14 subjects who were living at home without support joined nursing home due to the extended facilities available. The investigation focussed on screening procedures of dementia to identify level of severity of the disorder in the patients. In certain patients, the severity is high requiring instant admission into nursing home and in some cases, support by family members would be sufficient. Evidences also record that early intervention of dementia would decrease the risk of severity in the disease. Theme 4: Importance of nursing home in elderly patients in the early stage of dementia. Author, Year, Location Title Method/Study Results COMMENTS 1. Voyer et al., 2005 Clinical effectiveness in nursing 2. Dettmore et al., 2009 Geriatric nursing Characteristics of institutionalized older patients with delirium newly admitted to an acute care hospital Aggression in Persons with Dementia: Use of Nursing Theory to Guide Clinical Practice The investigation involves cross sectional secondary analysis study of old patients in nursing homes and other health care units. Confusion assessment method was used to test patients with delirium upon their admission. The research work utilizes Need-driven Dementia- compromised Behavior (NDB) model to explain aggression in the individuals undergoing constant core in a nursing home. In the total of 104 patients suffering from cognitive impairment, 68% people were recorded to possess delirium. The MMSE scale was used to screen patients to test the presence of delirium. The major symptoms which were observed in all the patients were bowel incontinence, illness. The most uncommon symptom observed was hearing impairment which occurred rarely. Clinical management algorithm was framed in accordance with the NDB model to study the behavior of aggressive patients and frame a theory to take care of the patients in aggressive moods and to avoid repetition of the syndrome. The research emphasizes on the importance of nursing homes in providing care and offer screening of the disorder. The severity of cognitive impairment doesnt influence the preventive nursing interventions. Independent of the level of impairment, nursing care portrays important feature in improving the quality of patients requiring close care. The patients suffering with dementia undergo frequent episodes of aggressive beahvior making care by professional care givers difficult. The paper focusses on the proposal of clinical management algorithm which is based on ndb model to manage certain aggressive episodes of the patient. 3. Holliday-Welsch et al., 2009 Geriatric nursing Massage in the Management of Agitation in Nursing Home Residents with Cognitive Impairment The study was performed using subjects who are susceptible to agitation and aggrieve mood by nursing staff. The susceptible patients were selected by the use of minimum data set (MDS) report. The data collection was done during 3 days considered as base line, then the intervention followed up to another 6 days continued by follow up for the next few days. it was observed that Subjects agitation was lower during the intervention of massage Than at baseline and remains still low at follow-up. Wandering, verbally agitated, physically agitated and care resistance were proved to be decreased upon intervention of massage. In this study, the five aspects of agitation which are wandering, verbal agitation, physical agitation, abusiveness, socially inappropriate agitation, disruptive aggressiveness. At each of the observation, agitation was scored for five times. Massage is one of the non pharmacological interventions in these patients suffering from agitation. This could be used as an effective tool by nursing staff in eliciting quality care DISCUSSION: All the themes identified in the research play a suitable role in delivering the conclusion to provide a suitable answer for my research question. The themes are arranged sequentially to ultimately conclude upon appropriate care for elderly dementia patients at early stage of the disorder. Each of the 10 articles selected, carries an important examination which forms the basis for future implications in the nursing staff. The first theme based in my results is facilities and care available in nursing homes using a multidisciplinary approach. This particular theme identifies the importance of nursing home as an institutionalised care centre to exhibit support and care to all kinds of dementia patients. The study proposed by J. Cohen Mansfield and A.Parpura- Gill (2008) suggests the nomenclature involved in nursing homes including the care provided by the nursing staff. The paper focuses on the improvement of these facilities to improvise style of nursing home which ultimately determines the quality. He regards flexibility, knowledge, communication as an essential factor for influencing care by nursing professionals. Along with characteristics of the staff, he also focuses on certain institutional factors which serve as tool of improvement (Beck et al., 1999). The most important institutional factors include timing of care, alternatives of care, resident and family involvement (Porras, 1987; Kanter, 199 3). The frame work which is important for a nursing home is changed regularly on the basis of organizational and staffs needs to ensure implementing better system for staff especially in case of dementia, where there is a need of care specialist to monitor a group of care providers (Noelker and Harel, 2001). The investigation based by on the study of e. Finnema et al., 2005 portrays the role of emotion oriented care in the patients suffering from mild to moderate dementia in nursing homes. He describes the role of emotional oriented care in influencing body adaptation and balance of the dementia patient seen in early stages (Finnema et al., 2000). General health condition was also proved to improve especially in c

Computers and Homeland Security Essay -- Terrorist Terrorism September

Computers and Homeland Security After the terrorist attacks on September 11, 2001 security became a major concern for citizens and of course lawmakers. Unsure of what could happen next we were all afraid. Homeland Security encompasses policies, laws, organizations, and procedures designed to protect the rights and freedoms inherent in the US Constitution. Homeland defense which is sometime interchanged with Homeland Security deals with extra-territorial threats and preemptive operations (Parons & Oja, 51). Governments in many countries are devoting significant resources to combat this growing threat. In the United Stats, the Department of Homeland Security, or DHS is responsible for reducing America?s vulnerability to terrorism and leading a unified national effort to prevent terrorist attacks on American citizens and assets. The DHS mission statement is: ?We will lead the unified national effort to secure America. We will prevent and deter terrorist attacks and protect against and respond to threats an d hazards to the nation. We will ensure safe and secure borders, welcome lawful immigrants and visitors, and promote free-slow of commerce? (www.dhs.gov). Technology is a key component of DHS. A part of the PROTECT system uses a computer program to depict the dispersion of toxic materials. On October 26, 2001 the President of the United States signed the Patriot Act, which was designed to define terrorist activities and provide la enforcement officials with legal tools for finding, catching, and prosecuted terrorists (Parons & Oja, 51). Computer systems assist efforts to identify terrorists among the millions of people who travel into and within U.S. borders. Terrorists might use cell hones or e-mail t... ...ments and have become more sophisticated at this task thanks to research for ordinary text-to speech and voice recognition technologies. Computers are a huge part of homeland security, without them we would all be at a greater risk for terrorism. Computers are prominent in each and every one of our lives, and they help us in many ways. Works Cited Arnone, Michael. "Internet security 'back to the Stone Age'." 22 Nov. 2005. 30 Nov. 2005 . "DHS Organization." Department of Homeland Security. DHS. 12 Nov. 2005 . National Security Agency Central Security Sevice. National Security Agency. 12 Nov. 2005 . United States Computer Emergency Readiness Team. US-CERT. 12 Nov. 2005 .

Dyslexia :: essays papers

Dyslexia The problem that effects one out of every ten kids in the United States of America is dyslexia. Although to some people this disorder may be very noticeable, it can really sneak up on you. Most of the time kids with dyslexia aren't recognized until they are about eight or nine. The most important thing to remember is that is takes time to solve, and sometimes cannot be cured at all. Dyslexia develops during the first six months of gestation . Neurons are churned out in the brain's ventricular zone. Attached to fibers, the neurons travel to the cerebral cortex, which contains the language centers. Here they hit a barrier, stop and take their place in layers above previously deposited neurons, (which is normal). In the brains of dyslexics, how-ever, there are breaches in the barrier and the neurons enter them, leaving clumps of nerve cells called ectopias, which appear to interface with the brain's ability to receive and transmit certain messages. They are now finding that dyslexia can run in the family. If you or your other relatives have dyslexia that means that there is a chance that your own child could have it. Unlike what most people think, dyslexia is not to be blamed on the parent for negligence in teaching reading and writing. Dyslexia is not any ones fault it simply occurs when the barrier in the language center of you brain cracks. In some experiments done by the University of Montreal, they are comparing good adult readers to dyslexic adult readers. In most cases the adult dyslexics were at about the high school level. When the adult dyslexics were compared to third graders in matching sounds with letters, they scored below the eight and nine year olds that were tested. It's not just a visual problem, actually they can see the letters fine, it is more of a comparing problem. Dyslexics usually cannot spell simple words by just hearing someone speak them to them. Some of the most confusing words for them are cat and dog. Although over time the symptoms can be fine-tuned, they never go completely away. As said before dyslexia is not a disease it cannot be cured with any pill or medicine. The only cure so far is many long and slow classes of multisensory sessions. These sessions go through each letter, sound, syllable, etc. until other parts of the brain help the person to recognize the letters in another helpful way.

Red Faction :: essays research papers

*************************** 29. Refuse Disposal Plant *************************** Open the elevator door by hitting the button to the right. Head forward, and Gryphon will run up ahead to the incinerator controls. ======================================================================= = Hendrix: This is Ultor's main trash disposal facility. = ======================================================================= ======================================================================= = Hendrix: That's an Ultor Personnel Suppression combot. I didn't = = know they had any on Mars! = ======================================================================= ======================================================================= = Hendrix: I can't see Orion's group on my monitors anymore. = ======================================================================= While Gryphon takes the first left, go forward up the ramp and through the door. Climb the ladder up ahead, then climb a second ladder to get to the roof. You'll be shot at by the combat as you climb, but just ignore it and get up there. He'll have a tough time hurting you while you're up here. Follow the instructions and you shouldn't lose a single point of health, despite the holes he might create with his rockets. As you look around the outer edge of the massive roof, you'll see several groups of ammo crates. Make your way around the outer edge as you make your way to each one to find ammo, medkits, armor, and a rocket launcher. Make sure to snuggle up to each crate and jump on top of it to make sure you get every last piece of ammo and equipment that you can. Once you're done, equip the rocket launcher and climb back down using a ladder away from the one you climbed up. The combot should be shooting at you, so begin making your way to the lower level door. Most importantly, keep moving and take some shots at the combot with the rocket launcher while you can. Keep taking shots at the combot and luring him out the large door on the ground floor until Hendrix cuts in. ======================================================================= = Hendrix: There's a disposal pit at the lowest point of this level. = ======================================================================= ======================================================================= = Hendrix: Try to lure the bot out onto the pit's covering, then open = = the doors from the control room. = ======================================================================= At this point, you've damaged the combot enough and he's really ticked off. Now just turn around and run back to the disposal pit. Once the combot approaches the last corridor leading to the pit's covering, run to the right and climb the ladder to the control room (where Gryphon is cowering in fear). The combot will be unloading everything he's got at you, but ignore it and quickly hit the right button to open the pit, then hit the left button to turn on the ceiling fan to blow the combot down into it. Rather than waiting and watching to make sure it happens,

A Passage to India disseminates a horde

E.M.Forster in his celebrated novel A Passage to India disseminates a horde of messages, one of which is liberal-humanistic attitude that can help stall SEPARATION, which is again a major theme of the novel. Like Whitman’s cry â€Å"Passage to more than India†, Forster’s novel is more than an historical novel about India: it is a prophetic work in which Forster is concerned not only with the path to greater understanding of India but also with man’s quest for truth and understanding of the universe he lives in.Forster shows in the novel how man’s attempts to create unity are continually dominated and shattered by forces he cannot control. On this theme of Separation, Lionel Trilling comments, â€Å"The theme of separateness of fences and barriers , the old theme of   Pauline epistles, which runs through all Forster’s novels is in A Passage to India, hugely expanded and everywhere dominant.† The separation of race from race, sex, cult ure from   culture is what underlies every relationship.In this context, the most obvious of these separations is that between the Indians and the English. The earlier part of the novel is concerned with showing the wide gulf between the rulers and the ruled, between the white Englishmen and the colored Indians.As pointed out in the first chapter of the novel, Chandrapore is divided into two sections: the English Civil Station and the Native Section, the one having nothing to do with the other: the Civil   Station â€Å"shares nothing with the city except the overarching sky.† This division in landscape is symptomatic of the wide gulf that separates the rulers from the ruled. â€Å"Is it possible to be friends with an Englishman ?†the Indians ask and Forster’s answer in the novel is a clear NO as long as the English remain unfeeling, proud and autocratic towards the Indians. Even the Bridge Party thrown to bridge the gulf   between the English and the Indi ans ends in a fiasco. After having invited the Indians to the Bridge Party ,the English do not bother to go out and meet them.It goes without saying that after such humiliation, the Indians harbor nothing but a collective attitude of fear and hatred in response to the collective attitude of contempt shown by the Englishmen. Love and fraternal feelings could have been the right way of treating the modest Indians, feels Forster.Another dramatic   instance of separation in the novel is that which comes to exist between Aziz and Fielding. Here is a crucial situation in which an Englishman sets aside his snobbishness and attempts a genuine rapport with a warm, impulsive Indian, and yet final understanding is shown to be impossible. It is, perhaps, because the primary barrier between them had been their identities: one a member of the ruler class while the other was a member of the subject race. As Arnold Kettle points out, there are political pressures of imperialism which distort the relationship between Aziz and Fielding.But the ebb and flow   of their relationship is disturbed by more serious factors—differences of background and values by the clash of standards on beauty, propriety and emotional expression. â€Å"Kindness, kindness and more kindness†Ã¢â‚¬â€this prescription of Aziz about the racial problem does not seem to go a long way ;a trust in the power of affectionate friendship is not enough to bridge the growing hiatus between close friends even.Further there is the glaring contrast in their characters :between the liberal Englishman â€Å"traveling light† and the impulsive Aziz rooted in â€Å"society and Islam.† While goodwill and spontaneous affection breaks down the initial barriers between them, there are signs that Fielding’s immature imagination   and Aziz’s sensitiveness are going to bode ill for their future relationship.And this is what exactly happens later. Misunderstanding crops up between th em in their attitudes towards Adela and leads to the break in their relationship.After Aziz’s release from the prison, Fielding asks Aziz to withdraw the brutally revengeful demands clamped on Adela   Ã‚  and Aziz refuses and they part ways. When they are reunited at the end ,their ways of life have changed too radically –Fielding supporting the Anglo Indians and   Aziz   ,Indian nationalism.Apart from these major schisms there are other minor separations and gaps in the novel . Men themselves are segregated from the rest of the creation. Young Mr. Sorley ,an advanced Christian Missionary ,accepts that God in his divine love brooks no separations and will extend his hospitality to the animals too, to the monkeys and jackals. But he is less sure about wasps and cannot at all admit into Divine Unity things like â€Å"oranges, cactuses, crystals and mud.Or for that matter the â€Å"bacteria inside Mr. Sorley’s head!† â€Å"We must exclude something f rom our gathering or we shall be left with nothing†, he nervously insists. And yet the forced exclusion is inane because men, after all, are only a small part of Creation: â€Å"It matters so little to the majority of living beings what the majority that calls itself human , desires or decides.†

In what ways does Shakespeare make Duncan’s death dramatic? Essay

â€Å"Macbeth† is a tragedy filled with deceit, evil and ambition. However what makes this play so great is the way in which Shakespeare unfolds the drama to us. In the play â€Å"Macbeth†, Shakespeare makes the death of Duncan dramatic in many ways. A way in which Shakespeare makes Duncan’s death appear so dramatic is by the fact that his â€Å"loyal and trusted servant† is the one to kill him. This sense of irony heightens the drama as from the description of Macbeth, he would be the last person to expect this from. Macbeth is the hero of the play as well as being the villain and it is this dual role that makes the play seem so dramatic. Shakespeare adds a twist into the play by making Macbeth appear to be something which he is not. He is first presented to us as a loyal servant to the king and to Scotland. This is reflected by Duncan’s appreciative comments such as â€Å"more is thy due than more than all can pay† and the superlative â€Å"o worthiest cousin.† We are told that due to his heroic acts in the battlefield, he is going to replace the Thane of Cawdor, who has been deceitful, and betrayed Duncan. This tells us that Duncan has already been betrayed before. Macbeth is courageous and looks up to Duncan, to whom he sees it his duty to protect and honour. We find out that Duncan himself is not a fighter himself as he is unaware of what brutal things have happened on the battlefield because he says, â€Å"What bloody man is that? He can report, as seemeth by his plight† (Act 1, Scene 2, line 1) This tells us Duncan is the type of King who stays in his castle and leaves the soldiers do the fighting. There has been a civil war in Scotland, which indicates to us that Duncan’s kingship is being doubted, hence the reason for the Thane of Cawdor betraying him and thus becoming a traitor. We are also made aware of the central issue of the chain of Beings and the Divine Right of Kings. The order is God, King, Nobles and finally ordinary people. The King sees himself, as does everyone else, as God’s representative on Earth, and killing him is by far worse than killing an ordinary person. If the chain is ever broken chaos is said to break out and in this way Shakespeare makes Duncan’s death dramatic as by killing him, Macbeth will cause chaos because he is in fact murdering someone who has been chosen by God. Duncan is the King of Scotland. Recently there has been political unrest, and there has been an attempt to overthrow him. He is presented to us as a religious, innocent and naà ¯Ã‚ ¿Ã‚ ½ve man. Duncan is seen as naà ¯Ã‚ ¿Ã‚ ½ve. He says, â€Å"There’s no art to find the mind’s construction in the face†. (Act 1, Scene 4, line 11-12) This metaphor indicates to us that he is a naà ¯Ã‚ ¿Ã‚ ½ve man. He is so innocent that appears that it will be easy for Macbeth to take advantage of him. Here he claims that one cannot tell by looking at someone what they are thinking. As he believes this, he makes no attempt to see through people. This makes us question his judgement as he had built â€Å"absolute trust† on a man that had betrayed him. This also makes the audience wonder whether he will be deceived again by the man that will take the The Thane of Cawdor’s position and therefore add to the sense of drama by giving the audience a sense of intrigue. Macbeth is in a dilemma whether he should or should not kill the king. This is all revealed in Macbeth’s soliloquy where he speaks alone to the audience, revealing his inner most thoughts. This is a dramatic way in which Shakespeare lets us know what the characters are really thinking. In this speech Shakespeare creates a sense of catastrophe by the language with which he gives to Macbeth. He recognises that he should not do the â€Å"deed† when he states that as the â€Å"Host† † he should against his murderer shut the door not bear the knife myself.† This poetic language makes us realise that Macbeth is sensitive and adds a sense of drama as it makes us more aware that what he is doing is greatly wrong. The heavy sounding d of â€Å"deep damnation† sticks in the audiences ears as Macbeth is sensitive as indicated by the poetic language. â€Å"Hath been so clear in his great office, that his virtues will plead like angels, trumpet-tongu’d, against the deep damnation of his taking-off† (Act 1, Scene 7, line 18-20) The imagery of angels telling heaven and voices like trumpets to cry out against the deed, which is not what he wants, and so he eventually decides not to do it. This makes Duncan’s death dramatic because it is such a huge decision to make and there is a ‘twist and turn’ in him making his decision, and the fact that Duncan is linked with religious imagery in the form of angels. Shows the impact of the death high lighting that â€Å"every eye† shall be affected reinforcing what a loved man Duncan is Act Two opens dramatically with darkness surrounding the stage and the audience in suspense as to whether or not Macbeth will commit â€Å"the horrid deed.† However, by the end of the scene, Macbeth decides to kill Duncan, after being persuaded by his wife. Lady Macbeth has ambitions for him. She wants him to be king and has always wanted this for her husband, and is determined that he fulfils his ambitions. She persuades him and tells him her plan. All Macbeth has to do is put it into action. This leaves the ball in Macbeth’s court. Everything is set up for him, and all that is left for him to do is commit the murder, which also adds to the drama. Lady Macbeth also adds drama as she waits downstairs waiting for Macbeth to report to her after he has murdered Duncan. This leaves us in suspense over whether he is going to follow his own will or that of his wife, and we are kept in suspense. Just before killing Duncan, there is another soliloquy. Macbeth imagines that there is a dagger in front of him, which is guiding him towards killing Duncan. He is ready to kill, and he is in a horrific state. All the evil things are coming together, and he is breaking the order. In doing this, he is going against the Divine Right of Kings, and is going against the whole world. There is darkness and Macbeth does not want the whole world to see how evil he is. When the bell rings, that is the point where he proceeds to murder Duncan, who once again has failed to read ‘the minds construction in the face.’ We are not shown the killing and in this way it appears more dramatic as we are left to imagine for ourselves. After killing Duncan, Shakespeare makes things more dramatic and this is shown by the language that Shakespeare gives to Macbeth to convey his sense of guilt. He tells his wife, â€Å"One cried ‘God bless us!’ and ‘Amen’ the other, as they had seen me with these hangman hands, list’ning their fear, I could not say ‘Amen’ when they did say ‘God Bless us’.† (Act 2, Scene 2, lines 29-32) Macbeth cannot pray, and this is shown to us when Macbeth is obsessed with his inability to say â€Å"Amen†, as he knows that he has been seen with his bloody hands after murdering Duncan. He is conscience stricken as he struggles to say â€Å"Amen†. Macbeth now feels cut off completely from God, and there is no longer a relationship between himself and God and because God has seen everything he has done, he can never turn to him again, and pray. Macbeth also feels haunted by a voice saying that he has murdered and will never sleep again, â€Å"Me thought I heard a voice cry, ‘sleep no more: Macbeth does murder sleep† (Act 2, Scene 2, lines 37-39) Now Macbeth thinks he hears a voice that is telling him that he will never sleep again. All this makes Duncan’s death so dramatic, not because of the way Macbeth killed him, but the consequences going through Macbeth’s head afterwards. Not only is Macbeth unable to pray, but now he is unable to sleep as well. Also the fact that Macbeth feels that not even an entire ocean can wash his hands of the deed, suggests a state of total damnation. He says, â€Å"Will all great Neptune’s ocean wash all this blood clean from my hand? No, this my hand will rather the multitudinous seas incardine, making the green one red† (Act 2, Scene 2, lines 63-64) Macbeth feels that not even an entire ocean can remove the guilt and wash the blood from his hands, and instead the countless masses of water will turn blood red, because there is so much of it, and the green sea a red sea. Macbeth’s guilt is expressed through the image of blood, and he believes no matter what he does or where he goes, the guilt will always be there with him. Macbeth finally admits how great the crime he has committed is, when he says, â€Å"Wake Duncan with thy knocking! I would thou couldst† (Act 2, Scene 2, line 77) Macbeth wishes he could turn back time. He wishes that the moment when he plunged the dagger into Duncan’s flesh never happened, and that he could make it disappear. He says that if it were possible to bring Duncan back to life he would. This seals Macbeth’s misery, and makes the death seem even more dramatic because the murderer himself is miserable and regrets killing Duncan.

My Dream Essay

Hello everybody, i’m Doan Phuong Ly and i have been studied at Saigontech since 2012. My main major is Business Management. And i will have 2 more semesters to finish this program. I do really enjoy the business so that after graduating from this college , i hope that i can afford myself to attend the higher business program like MBA or rather , i will attend some Advanced Diploma certification which is necessary to my business in the future. As a person who are interested in business, i need to know the essential needs and basics of business so when i joined this course i feel it seems very useful and necessary to achieve my goals in my work life now and in the future. Eventhough, this course is short but it includes alot of content about the business such as the business environment, how to creating – financing – marketing and managing a business. In my life now, i have quite a lot of problems when i want to open my own business, such as opening my fashion shop, i’ve met quite a lots of trouble to identify and find out the best way to reach to my purpose. Fortunately, when participating in this course, there are too many things in books and also my instructor support a lots of business knowledge. It helps me to apply to my business work now, and if i can go further, i can understand the economic situation so that i may manage my business more effectively and i will achieve much success in my future.