My First Day in College

My first day in College On August 27, 2012, I began my first day at Petrocelli College. The morning was sunny and warm. I was fill with anticipation. I met my best friend from high school, Nathalie, at the bus stop. We both wonder what our first day would be like. My first day in College was overwhelming because of the excitement, stress and future outlook. I experience excitement. A new beginning is always exciting. For example, I was becoming independent and responsible for making my own decisions.I now have to pay for my college expenses by a work study job. I was also excited to see some students from my high school. For instance, my friend Richard is in all my classes. In addition, I was enthusiastic to meet my new professors and learn about the subjects I was going to be studying throughout the semester. I also experience stress throughout the day. For example, the costs of the books and the bus fare for commuting. In other words, I didn’t have enough money to pay it. I was struggling making new friends. Related reading: Monash College MoodleI’m a shy person and when it comes to socializing I get stressed out. I was confused with my schedule; I had too much time between classes. I was thinking too much on what I was going to do on those long breaks. In addition, my future outlook became focused. For example, I realize attending College was the first step I was taking to accomplish my future goals. I enjoy math and want to become an accountant. Majoring in business and accounting would ensure that I will earn a well paying salary.Therefore, I would be able to financially help my family, and to begin studies to earn a master’s degree. In conclusion, the excitement, stress and future outlook made my first day in college overwhelming. Beginning a new chapter in life initiate my day with excitement. But the financial, social and academic stress disturbs me during the day. It wasn’t only my first day in college it was also my first step in becoming an accountant and pr eparing my future.

Haiti History

Haiti has the distinction of being the first black independent republic, who only two centuries ago was the wealthiest country in the New World and represented more than a quarter of France's economy. Yet today Haiti has been called â€Å"un pays tite-en-bas† where about 80% if Haitians live in absolute poverty, and almost 1/3 of the population is ill or underweight. A long history of political oppression, soil erosion, lack of knowledge and population density of 618 people per square mile has caused modern Haiti to become the poorest country in the Western Hemisphere. After almost 200 years of rule by a series of despotic emperors, eccentric kings, cruel dictators, powerless presidents and tyrannical generals Haiti is living in absolute poverty. Haiti has a GDP of less then $8 billion a year and the per capita income is less then $250 showing how poor Haiti truly is. When half a million slaves revolted against their colonial masters in 1804, Haiti became the first nation to abolish slavery. Haiti saw 22 heads of state in 72 years causing unrest and turmoil between the Haitian people. After four consecutive years of Haitian presidents being murdered or disposed, the United States sent marines to Haiti. When the Americans left in 1934, Haiti was again in turmoil, with frequent coups, revolutions, dictatorship, and street violence until the election of Franiois Duvalier in 1957. Duvaliers rule soon turned into one of repression and fear and he soon declared himself president-for-life in 1964. Following his death, his son Jean-Claude used the same violent methods of his father to keep control of Haiti. Read also History Quizzes Under his poor leadership, Haiti became one of the world's poorest countries. Most of Haiti's economic problems are the result of economic mismanagement and government corruption. Forests were cleared, which caused soil erosion, making the land dry and infertile. Farming employs nearly three-fifths of the workforce (see figure 1). The average salary is only $70 a month, and yet inflation tops 14% a year. The growing population has forced many small farmers to concentrate on growing food for themselves, making it impossible to have any income. Nearly 3/4 of the population of Haiti cooks with charcoal, cutting down so many trees that deforestation of the mountains is a major problem. Only about 4% of the land is forest, compared to 30% of US land (see figure 2 ; 3). Extreme weather conditions further threaten the land, with torrential rains during hurricane season racing down deforested mountains and destroying fields, roads and homes. This has caused a horrific impact on Haiti. Fewer then 13% have access to safe drinking water, and most Haitians struggle to find enough food to eat each day (it is estimated that Haiti produces only 40% of the food it needs). Although public education in Haiti is free, textbooks and other school materials are not, and as a result many children, especially those in rural areas (the 90% of Haitians that live in absolute poverty, also called peasants) cannot afford to go to school. It is estimated that about 90% of Haitians are illiterate. Even though legally, education is free and open to all, only about 30% of Haitian children ever begin school, and of the 30%, only 2% stay in school beyond the 5th grade. Many factors play into the lack of education in Haiti, such as education being mainly in French, even though Creole is the official language in Haiti, also after the fifth year students must pass a difficult examination, which is also in French, causing many students to not pass. The lack of proper teachers and inadequate supplies, as well as overcrowding in schools has made it difficult for Haitians to get an education. Haiti's misfortune has continued through the years with a series of natural disasters. Severe deforestation, leading to flooding and landslides, and a lack of proper emergency services and infrastructure has resulted in the storms causing the deaths of thousands of Haitians. In 2008, four separate hurricanes – Fay, Gustav, Hanna, and Ike – in the space of 30 days led to the deaths of more than 800 people. About 60 per cent of the country's harvest were destroyed and entire cities were rendered desolate and uninhabitable. In January 2010, a devastating 7. 0 magnitude earthquake resulting in the deaths of thousands and the loss of many homes and buildings (see figure 5). Haiti is a country full of tragedy and despair. 380 000 Haitians were infected with HIV/AIDS by 2000 and the life expectancy has dropped to the early age of 53. Only 8 people out of every thousand have telephone service and less then 6% of people have access to electrical power. Yet a small portion of the country is not effected by the massive poverty, but instead live a life of luxury. 0. 5% of Haiti's population earns about 46% of the nations income, thus giving the rich more power causing even more corruption. Many organizations such as The Canadian Red Cross and Hope for Haiti are aiming to restore this once hopeful country. The United Nations Stabilization Mission in Haiti (MINUSTAH) was established on June 1 2004, and continues to help Haiti today. MINUSTAH peacekeepers help provide basic needs such as clean water to cholera affected towns, where close to 50, 000 cases have been reported. The UN has established an emergency response effort to bring relief to this stricken country, yet even with so much help, Haiti is still a country that has lost all its wealth and is now in great debt with the world.

Human Biology Coursework Example | Topics and Well Written Essays - 1000 words

Human Biology - Coursework Example When it comes to the number of chromosomes, the number of nucleus is still the same in mitosis but meiosis contains a haploid number of chromosomes. There is also no exchange of DNA between chromosomes in mitosis while in meiosis, there is at least one cross-over. Transcription is simply a process where genetic information from DNA is transcribed into RNA.This process is important especially when producing proteins.DNA proteins cannot be directly changed into proteins that is why translation to RNA is important. Darwin popularized the theory of evolution and process of natural selection where only the fittest specie would survive. Some animals have evolved and changed their physical features in order to survive the environment. Lamarck on the other hand is known for the Theory of Inherited Characteristics. He said that the off springs of animals would be the one to manifest adaptation to the environment as passed to them by their parents. There are four critical elements namely: variation, inheritance, High rate of population growth, and differential survival and reproduction. A fine example would be the some bacteria increasing resistance to drugs in order to survive. In Eukaryota we have mushrooms and other fungi. Eubacteria includes streptococci which cause strep throat infections and other disease causing bacteria. Helpful bacteria like yogurt is also an example. Archae are only found in environments where there are no oxygen present. There are several traits of primates that makes them different, namely : they feed their young with milk, give birth to live babies, warm-blooded, color vision and have a complicated social organization. Ecology is the discipline that deals with studying the relationships of organisms to one another as well as their surroundings. Ecosystem is the biological environment that contains all the living organisms. Example of an ecological set-up is a lake where fishes and other living things

The Cuban Missile Crisis in 1963. The Role of Diplomacy in Preventing Essay

The Cuban Missile Crisis in 1963. The Role of Diplomacy in Preventing the 3rd Word War - Essay Example The Cuban missile crisis is largely held as the greatest military conflict that occurred during the Cold War. American destroyers were positioned along a picket line with the aim of intercepting Soviet ships moving missiles and atomic warheads to Cuba. Moreover, American air, naval pegged with ground forces got ready for air raids against Soviet missile sites under structure in Cuba. The Strategic Air Command stood put on an extraordinary state of vigilance– â€Å"DEFCON II,† merely one step away from the fact â€Å"war is imminent.† In October 1987, contrary to the setting of Mikhail Gorbachev’s glasnost, it is worth noting that a conference on the Cuban Missile Crisis was conducted. This was the first time, together with living veterans of the Kennedy Government, three reliable Soviet witnesses: the sons of Khrushchev coupled with his closest associate, Anastas Mikoyan, and a past Khrushchev speechwriter were in attendance. After years of persistent secr ecy, the display of reliable Kremlin insiders considerately, cordially, even optimistically linking anec ­dotes and examining the crisis was an exciting novelty, promis ­ing further exposes (Waltz, 2012). Evaluation His heart was thumping rapidly. His hands were quaking, and the tautness was taking his pant away. The tick tack of the watch was retelling him there was not ample time left. Similar to a chess game, John F. Kennedy was at the verge of making a quick and clever decision. Checkmate, and he would triumph in the game. But what if he made an erroneous move? A lot of people’s lives depended on his decision, hence were in his hands. What is branded as the â€Å"Fourteen days of October† (Van De Mark, 1996) stood as the closest that the universe had ever witnessed to a nuclear war. In the course of 1962, the Soviet Union started to construct secret missile headquarters in Cuba for the drive of creating equilibrium over the U.S. arms collection. The U.S., sensi ng a threat from the Soviet Union, took instant actions to  avert this progress. The condition eventually intensified, and neither side was philanthropic upon their stresses (Hershberg, 2004). Yet, as in each chess game, one can either gain, loose, or the game is haggard. In  politics, however, the game is only haggard when there is cooperation amongst the players. In this case, the destiny of millions plainly hinged upon the capability of two people President John F. Kennedy and Premier Nikita Khrushchev, to influence a compromise. Interests and Goals Certain people might claim that beginning a battle would be the greatest answer for  US. Of course, as a global influence, it would not have been tough for them to overthrow USSR. The conflict would not essentially have to be nuclear. One of the choices that Kennedy had was to block Cuba so as to strike the missiles located by USSR in Cuba’s terrain. It is worth noting that some people still consider that it would have be en a harmless option into backing the end of the conflict. However, this would not function as a way to terminate the conflict but somewhat to initiate it. What are thought to be the significances of little wars are often the grounds for bigger ones (Jane and Ramesh, 1989). The United States deliberated on placing an attack on Cuba via air and sea. However, they agreed on a military "solitary confinement" of Cuba. The U.S. proclaimed that it would not license aggressive

Alcoholics Anymous Essay Example | Topics and Well Written Essays - 500 words

Alcoholics Anymous - Essay Example The group also aims to provide an atmosphere where individuals do not receive judgment for their alcohol problems or any mistakes they made in their lives. The goals are to change the mindset of the individuals and their way of thinking towards life. As mentioned above, the group aims to reduce the number of individuals suffering from alcoholism. The group is successful as it began with less than five members and now there are three different groups, with each one consisting of ten members. Furthermore, in the early days of the group, the program was male dominated. However, there are now females joining the program. The group also has many testimonies from members who acknowledge the way the group has helped them stay sober. The facilitators have similar leadership styles in the sense that they do not try to stamp their authority on the group. Their role is simply to modulate the process and ensure that the meetings take place systematically. The facilitators also have a motivational role and attempt to encourage, empathize and give suggestions to members of the group. The group has control over the direction each session takes, as they decide which aspect of the program they want to discuss. The therapeutic interactions can be seen between the facilitators and the individuals recovering from alcoholism. There is a therapeutic interpersonal relationship as the facilitators provide support psychologically for the members. There is also therapeutic communication as the facilitators respond to each patient differently. 6. Did you see any negative behaviors in your group? If so, explain their behaviors and the reactions from other members and facilitators. (For example someone who demoralizes others, someone who says nothing, or someone who completely monopolizes the group). There were no negative behaviors in the

Deontology, Utilitarianism, and Virtue Ethics Essay

Deontology, Utilitarianism, and Virtue Ethics - Essay Example Decisions and actions should be geared towards fulfilling obligations and existing laws. Consequently, acts that meet the expectations are considered ethical and those that do not meet the expectations are considered unethical. The theory therefore offers no regards to people’s immediate welfare, may subject actors to conflict of interest, and it is not based on rationale. Utilitarianism, however, focuses on consequences of an action or decision, instead of existing rules and obligation that a person has to others. According to utilitarian theory, negative and positive effects of a decision or actions are considered and net effects used to determine morality. Those acts and decisions that yield net benefits are considered ethical, unlike those that offer net harm. This establishes the basis of determining morality as a difference between deontology and utilitarianism as deontology relies on rules and obligations while utilitarianism relies on effects of an act or a decision. U tilitarianism also remedies deontology’s weakness of lack of rationale and this identifies a difference. Focusing on consequences also establishes consistency and therefore minimizes conflicts. However, the two theories aims at determining morality in actions and decisions (Manias, E., Manias, N., & Monroe, 2013). Analysis of virtue ethics, with the other two theories, also identifies both similarities and differences. The theory distinguishes rights and wrongs, just as deontology and utilitarianism.

Discipline Essay Example | Topics and Well Written Essays - 500 words

Discipline - Essay Example The long range results of punishment may be negative. Discipline is more than just administering punishment whenever rules are broken, its more about the upbringing and general guidance that’s given to an individual that can enable him choose right from wrong. In order to have effective discipline, love and not anger should be the guiding factor. Most parents are expected to punish their children whenever they misbehave. They end up using physical punishment as a form of discipline when irritated by their children. Physical punishment is just a temporary measure of correction that does not teach the children right values. Physical punishment can cause physical, mental or emotional injury. It can even lead to death. Children learn from adults and can take this as the only way of solving conflicts. Once punished, a child may feel he has paid for the misbehavior and may want to do it again. It’s also hard to use physical punishment once a child grows up. It is common knowledge that eliminating undesirable behavior without having a desirable strategy to stimulate more desirable behavior is generally ineffective (American Academy of Pediatrics, 724). Mistakes committed are good avenues to learn if children are guided properly without us ing physical punishment. Consequences can be used as one of the positive ways to instill discipline in children. Consequences are different from punishment since they involve learning through experience. It teaches children to make their own decisions and take responsibility for their behaviors. Consequences can only be positive discipline if parents can learn to be calm, attentive and to be good listeners. The parents should be ready to accept the solutions of their children as it’s a learning experience. Parents need to communicate clearly the consequences of breaking certain rules to their children. Children can learn from natural consequences or logical consequences

Impact of Teachers on Agriculture Research Paper

Impact of Teachers on Agriculture - Research Paper Example The research will highlight effects of teachers on this discipline (Agbaje, Martin & Williams, 2001). Statement of the Problem It is imperative to have an effective education system, which will ensure improved students’ performance. The effectiveness of an education system derives from the ability of teachers’ to give knowledge to the students. The teachers will have key implications onto agricultural education. Consequently, it is vital to make a research on the implications of teachers in this discipline, which is an integral constituent of the entire education system. Understanding the implications of teachers on agricultural education is fundamental, since it will provide findings which can enable the appropriate authorities improve the education system. Teachers may have huge impact on agricultural education. Therefore, it is critical to understand them so that the authorities can adopt appropriate policy measures, which will ensure improvement in teaching of this discipline (Byrne, 1998). The current performance in this discipline is poor. Hence, it is vital that tutors embrace appropriate teaching strategies, which, in turn, will improve students’ performance. Purpose of the Study   Teachers have the core duty of passing on knowledge to students. Therefore, they are central factor in the students’ learning process. The teaching methods will influence the learning process significantly. Therefore, it would be crucial to understand what teaching strategies can improve students’ performance in agricultural education. Additionally, the research will evaluate not only the teaching strategies, but also their application in inculcating agricultural knowledge. This research will evaluate several aspects on the implications of teachers in this discipline. Therefore, this research will circumnavigate the core roles of the teacher in inculcating agricultural knowledge in students (Croom, 2003). Objectives of the Study This resea rch seeks to accomplish certain objectives, which include; I. Determine the strategies that teachers use in agricultural education II. Determine the impact of such strategies on the students III. Determine whether teachers’ strategies are relevant in agricultural education. IV. Determine whether the teachers have adequate agricultural knowledge to satisfy the students’ knowledge requirements. Research Questions I. What strategies do teachers use in agricultural education? II. What is the impact of teachers’ strategies on students? III. Are teachers’ teaching strategies relevant to agricultural education? IV. Do teachers have adequate agricultural knowledge to satisfy the students’ requirements? Definition of Terms Teaching strategies-The teaching measures that agricultural teachers have embraced in passing knowledge to students. Curriculum - an outline of what students should learn in a certain discipline over a given period. Each subject will norm ally have a curriculum that a teacher should follow. Quality assurance - this term refers to a set of measures that seek to ensure goods or services meet a certain quality threshold. Limitation of the Study The domain of this research will be large since the impacts of teachers on agricultural education will be multifaceted. This means the implications may be educational, psychological, and discipline concerns. Therefore, this

As an ecologically concerned engineer or anthropologist, critically Essay

As an ecologically concerned engineer or anthropologist, critically assess the current Japanese nuclear disaster using academica - Essay Example The Fukushima Daiichi facility was apparently unable to withstand the dual shocks of the earthquake and tsunami within a short timeframe and entered into a situation which can be described as nuclear meltdown of the reactors. The information about the Fukushima disaster was initially limited and possibly misrepresented by TEPCO and Japanese government administrators in order to downplay publicly the degree of seriousness of the situation, and this has led to difficulties in academic or public verification of the ecological and social threats that the meltdown portends for Japan. It is not overestimating the situation to state that in the worst instance a significant portion of Japan could have become uninhabitable due to the disaster, and currently there is an evacuation zone in effect around the facility. This essay will examine the ongoing nature of the Fukushima Disaster, highlighting the fact that the facility may still not have been properly brought under control and the degree of uncertainty that exists because of this in determining the over-all consequences of the event. The Fukushima Nuclear Disaster There is now little doubt that a full nuclear meltdown occurred at the Fukushima nuclear plant in Japan this year. According to Julian Ryall in an article published in the Telegraph as "Nuclear meltdown at Fukushima plant" (12 May 2011), â€Å"Engineers from the Tokyo Electric Power company (Tepco) entered the No.1 reactor at the end of last week for the first time and saw the top five feet or so of the core's 13ft-long fuel rods had been exposed to the air and melted down. Previously, Tepco believed that the core of the reactor was submerged in enough water to keep it stable and that only 55 per cent of the core had been damaged. Now the company is worried that the molten pool of radioactive fuel may have burned a hole through the bottom of the containment vessel, causing water to leak. ’We will have to revise our plans,’ said Junichi Matsu moto, a spokesman for Tepco. ‘We cannot deny the possibility that a hole in the pressure vessel caused water to leak’. Tepco has not clarified what other barriers there are to stop radioactive fuel leaking if the steel containment vessel has been breached. Greenpeace said the situation could escalate rapidly if ‘the lava melts through the vessel’.† (2011: p.1) One of the problems with the design of the Fukushima plant is that it had been storing depleted nuclear fuel rods on the same site as the reactor, cooled with water. After becoming exposed, this fuel may have added to the critical mass of the meltdown reaction and also caused additional radiation to be released into the environment during the initial period of the disaster. The additional force of this reaction may have been sufficient to burn or melt through the very bottom containment layer of the reactor itself, the final protection layer that prevents a meltdown lava flow from entering the l ocal environmental system through the earth and water systems. The use of sea water to flood and cool the reactor following the meltdown has inevitably led to groundwater radiation being released into

Hart and Positivism Essay Example for Free

Hart and Positivism Essay According to Hart law consists of primary and secondary rules. The primary rules are the rules that are â€Å"rules of obligation.† (Hart. Pg 204) This means that primary rules are rules that obligate a person to do something or to not do something. For example, the first Amendment, â€Å"Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceable to assemble, and to petition the Government for a redress of grievances. † (http://www.usconstitution.net/const.html#Am1) The first Amendment is an example of a primary rule because it directly affects the people of the United States of America by allowing them to have the freedom of religion, press and expression. This is an example of obligating a person not to do something, which means that the person is not obligated to have any other religion other than their own, for example. The second part of law is the secondary rules. Secondary rules only affect primary rules. This means that a secondary rule can help clarify, alter, eliminate, bring into effect, verify or determine whether a primary rule has been broken. For example the only reason we have the first amendment of the United States Constitution is because of Article 5 of the U.S. Constitution which states, The Congress, whenever two thirds of both Houses shall deem it necessary, shall propose Amendments to this Constitution, or, on the Application of the Legislatures of two thirds of the several States, shall call a Convention for proposing Amendments, which, in either Case, shall be valid to all Intents and Purposes, as part of this Constitution, when ratified by the Legislatures of three fourths of the several States, or by Conventions in three fourths thereof, as the one or the other Mode of Ratification may be proposed by the Congress; Provided that no Amendment which may be made prior to the Year One thousand eight hundred and eight shall in any Manner affect the first and fourth Clauses in the Ninth Section of the first Article; and that no State, without its Consent, shall be deprived of its equal Suffrage in the Senate. (http://www.usconstitution.net/xconst_A5.html) Article 5 of the constitution is a perfect example of a secondary rule (in this case a â€Å"rule of change†) because it allows one to see exactly how a secondary rule affects a primary rule. With Article 5 of the Constitution, the United States is capable of applying amendments to the constitution (or otherwise known â€Å"the Law of the Land†) of the United States. Article 5 of the constitution is an example of a secondary rule classified as a â€Å"rule of change† as stated by Hart. A â€Å"rule of change† allows an office or officials to be able to implement new primary rules so as to be able to adapt to the changing of times and the constant creation of new situations. The â€Å"rule of change† simply allows the system to be able to adapt to their society and not allow the primary rules to go static. To become a law there are two parts that need to happen, according to Hart. First there needs to be the initiation of a primary rule statute by a delegated official or office in power. Once the primary rule is made a secondary rule, the rule of recognition, is enacted. The rule of recognition simply allows private persons and officials the ability to be able to identify the primary rules of obligation. This secondary rule conclusively identifies the primary rules of obligation so as not to be confused as to what are the obligations the primary rule bestows. To have primary rules of obligation and secondary rules of recognition, there needs to be an office or official to be able to adjudicate these rules. To be able to adjudicate these rules there would need to be an additional secondary rule of adjudication. This would allow a judge to be able to determine whether or not the primary rule has been broken. Within the rule of adjudication there would also be rules on the roles of the judge as well as identifying who are to be the judges. With the rule of adjudication there is no question of whether or not a law has been broken and this solidifies the primary rule of obligation. With the ideas of Hart this shows that laws and morality can be separable, but they are not necessarily separated. It is possible to have a separation between low and morality by having some sort of primary rule that would state â€Å"no one rule will introduce the morals or characters of others into the legal system.† It is also possible though for an official delegate to implement a primary rule into the legal system and have it backed by a secondary rule of recognition. Having the secondary rule of recognition would potentially make the morality based primary law a valid legal law. In Hart’s idea morality and law are â€Å"separable†, in the meaning that they are capable of being separated, but they are in no way impossible to be able to be combined in law. Without there being a way to identify morality and making it a subordinate to statute, there can’t be a definite separation with Harts theory. Work Cited 1. Reading in the Philosophy of Law (pg 202-207) 2. www.usconstitution.net (1st Amendment, Article 5 of the Constitution)

Treatment of Rituximab in Pemphigus Vulgaris Patients

Treatment of Rituximab in Pemphigus Vulgaris Patients Part 3: Clinical Research 2 INTRODUCTION Pemphigus is the name of a group of life-threatening blistering diseases of the skin and mucous membranes. The base of treatment for this disease is corticosteroids; however, recently, new drugs, such as rituximab, have been verified for more severe forms of it. In the authors previously unpublished study, the effect of rituximab on variation in the laboratory indices of pemphigus vulgaris patients is addressed. After investigation of the files of pemphigus patients who received rituximab in Razi Hospital, Tehran, Iran from 2008 to 2013, 39 patients were entered into the study. All patients had lab sheets containing CR (creatinine), urea, ALT (alanine aminotransferase), AST (aspartate aminotransferase), Plt (platelet), Hgb (hemoglobin), and WBC (white blood cell) before and after receiving rituximab. The patients received rituximab 4 times at a dosage of 500 mg in 4 successive weeks. The lab results before receiving the first dose of rituximab were compared to the results after receiving treatment. The effect of rituximab on the variation in lab indices with the adjustment effect of age, gender, disease duration, sites of involvement, received adjoins, and the background disease were also investigated. In the initial analysis, rituximab only had a significant effect on urea reduction. In the CellCept ® (mycophenolate mofetil) receiving subgroup, the mixed consumption of rituximab led to a significant reduction in WBC. In the subgroup having background disease, rituximab had a statistically significant impact on platelet reduction. In the subgroup having no background disease, rituximab had a statistically significant effect on urea reduction. The lab indices were shown to have no significant relationship with age and disease duration. Thus, it can be predicted that disease duration and age would have no effect in the relationship between rituximab and lab indices variations. Although in stratified single-variable analysis for adjusting the effect of other variables (involvement sites and received adjoins) on the relation of rituximab and lab indices, some of these variables showed interacting effects with rituximab on the variations of lab indices. However, due to the low volume of sample and non-normal distribution of most of these variables, it was impossible to do multivariable analysis for investigation of their independent and interactive effects on variations of lab indices in an integrated manner, therefore, we can not make certain comments about their relationships. Chapter 1 Pemphigus is the name of a group of life-threatening blistering diseases that have characteristic acantholysis leading to formation of intraepithelial blisters in mucus and skin [1]. The acantholysis process is induced via attachments of flowing autoantibodies to adhesion molecules in the cells [2]. Patients with pemphigus have mucosal erosions, blisters, papules, and cutaneous erosions. The different types of pemphigus are pemphigus vulgaris, pemphigus foliaceus, immunoglobulin A (IgA) pemphigus, and paraneoplastic pemphigus. Different types of pemphigus are differentiated by clinical symptoms, related autoantigens, and histological methods. Pemphigus vulgaris has mucosal and mucocutaneous involvement. The blisters are acantholytic and suprabasal. The autoantibodies responsible for the disease are against desmoglein (DSG) 1 or both desmoglein 3 and 1. Pemphigus foliaceus only involves the skin. The blisters are acantholytic and subcorneal. The responsible autoantibodies are against desmoglein 1. IgA pemphigus has the form of grouped erythematous crusts, papules, and vesicle plucks. Blisters can be subcorneal or intraepithelial and acantholytic. The responsible autoantibodies are against desmocollin (DSC) 1 [3]. Paraneoplastic pemphigus involves vast and resistant stomatite along with different cutaneous findings. The responsible autoantibodies are against desmoplakin (DSP) or other desmosomal antigens. Pemphigus vulgaris is the most common type of pemphigus, but is still very rare. The chance of its occurrence is between 0.1 to 0.5 per 100,000 people [4]. Pemphigus often happens among adults and the average age of onset is 40 to 60 years old. It is very rare among children [5,6]. Its prevalence is almost the same in the 2 sexes [7]. Almost all the pemphigus vulgaris patients have mucosal involvement. The mouth is the most common site of involvement and is often the first site of involvement. Other mucosal membranes such as conjunctivae, nose, esophagus, vulva, vagina, cervix and anus are rarely involved [8]. As mucosal blisters are fragile and burst easily, in clinical examination it is difficult to find intact blisters, and instead the examiner tends to find mucosal erosions. Buccal and pa latal mucosa are the most common sites of blister involvement in the mouth cavity [9]. Mucosal involvement can be very painful. This pain often increases by chewing and swallowing, which can result in improper alimentation and weight reduction. Most of the patients also have cutaneous involvement appearing in the form of soft blisters in healthy skin or erythematosus. The blisters easily break, resulting in painful erosions. Pemphigus vulgaris rarely causes pruritis. Almost any part of body skin can be involved, but the palmar aspects of the foot and hands are rarely involved. The Nikolsky sign is often observed among these patients (mechanical pressure on the healthy skin results in blistering). Pemphigus is diagnosed based on the clinical, histological, immuno-pathological symptoms and laboratory findings. Even in cases where the clinical symptoms are intensively supporting pemphigus, laboratory investigation is still needed to confirm the diagnosis, as other diseases may have the same symptoms. The first line of treatment of pemphigus is systemic corticosteroids, an d addition of adjuvants may also be needed. Patients who do not respond to the first line of treatment might need additional interventions. In such patients, cyclophosphamides, rituximab, intravenous immunoglobulin (IVIG) or plasmapheresis may be helpful. Initial treatment of pemphigus vulgaris is systemic glucocorticoid, which is often applied in combination with other non-steroidal immunosuppressants such as azathioprine and mycophenolate mofetil. Pemphigus resistant to treatment is a type of pemphigus that does not respond to the aforementioned treatments. Pemphigus is a chronic disease that needs long-term treatment. A retrospective study was conducted during 1982-1993 on 40 patients [8]. On average, these patients achieved complete remission after 7.7 years; 25% had remission after 2 years; 50% after 5 years; and 75% after 10 years [8]. Most pemphigus vulgaris patients respond to initial treatments [9]. The first step, in the patients who do not respond to initial treatment, is increasing the dosage of systemic corticosteroids (1.5-2 mg/kg of prednisolone per day) or adjuvant drug. The adjuvant drug can also be changed (changing azathioprine to mycophenolate mofetil). In resistant cases, cyclophosphamides, rituximab, IVIG, and plasmapheresis could also be used. As pemphigus is an auto-immune disease caused by autoantibodies, treatments that reduce B cells are investigated [10-13]. Rituximab is a monoclonal antibody that targets CD20, located on B-lymphocytes, as its antigen. This drug has been shown to have profound effects on pemphigus treatments [13,14]. In a multicenter study conducted on 14 pemphigus vulgaris patients and 7 pemphigus foliaceus patients, both groups were resistant to systemic glucocorticoids and experienced several relapses during glucocorticoid tapering. They were then put on 1 cycle of rituximab with a weekly dosage of 275 mg/m2 for 4 weeks, and this addition proved advantageous [15]. Although, severe infections were reported in the patients under rituximab treatment, its effect on risk of infection is not clear, as other immunosuppressants were also concurrently used. Reactions during injection are among the most common side effects of rituximab. Deep vein thrombosis (DVT), pulmonary embolism, long-term hypogammaglobu linemia, and neutropenia were also common among the patients under rituximab treatment. Regarding the excellent impact of this drug on treatment of resistant pemphigus, and also on other diseases such as idiopathic thrombocytopenic purpura (ITP), vasculitis, lymphocytic leukemia, systemic lupus erythematosus (SLE), we decided to evaluate the effects of this drug on the variation of lab parameters such as white blood cell (WBC), Hemoglobin (Hg), platelet (Plt), aspartate aminotransferase (AST), alanine aminotransferase (ALT), urea, and creatinine (CR). So far, no study has been conducted on investigation of these variations due to receiving rituximab. OBJECTIVES AND HYPOTHESES Major Objective Investigation of laboratory variations after injection of rituximab in pemphigus vulgaris patients. Minor objectives of the project: Determination of rituximab impact on laboratory indices Determination of rituximab impact on laboratory indices by adjusting for the effect of age Determination of rituximab impact on laboratory indices by adjusting for the effect of gender Determination of rituximab impact on laboratory indices by adjusting for the effect of other treatment methods Determination of rituximab impact on laboratory indices by adjusting for the effect of disease duration Determination of rituximab impact on laboratory indices by adjusting for the effect of disease involved sites Determination of rituximab impact on laboratory indices by adjusting for the effect of Underlying disease Application objectives: Enhancement of health level among pemphigus vulgaris patients and paying attention to laboratory effect of patients after rituximab consumption. Research questions or hypotheses: Rituximab affects the laboratory indices Rituximab affects the laboratory indices with age effect adjustment Rituximab affects the laboratory indices with gender effect adjustment Rituximab affects the laboratory indices with disease duration effect adjustment Rituximab affects the laboratory indices with previous treatment effect adjustment Rituximab affects the laboratory indices with other disease effect adjustment Rituximab affects the laboratory indices with involved sites effect adjustment Chapter 2 Literature Review In 1997, rituximab was approved by the US Food and Drug Administration (FDA) as a treatment for non-Hodgkins lymphoma of B-cell that was resistant to chemotherapy. After that, it was applied for treatment for other diseases such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Wegeners granulomatosis, idiopathic thrombocytopenic purpura (ITP), and Sjà ¶grens syndrome. Ten years later, its impact on the treatment of blister diseases such as pemphigus was shown [16]. In a 2006 study by Larrar et al, 2 children with autoimmune hemolytic anemia who were treated with rituximab experienced acute thrombocytopenia and neutropenia [17]. They resolved in several days, which showed that these hematologic effects are directly dependent on the toxicity of rituximab. In a study by Chairwatanatorn et al in 2003, neutropenia following application of rituximab was tested in 53 patients [18]. All patients except one were under Hodgkins lymphoma treatment. Eight cases of grade 4 neutropenia were observed after 1 to 5 months of rituximab treatment (5 patients only received rituximab and 3 patients were also under additional chemotherapy); 3 patients advanced toward sepsis. Neutropenia was not related to other diseases or treatments, and was related with reduction of neutrophil precursors, except for one of the patients whose bone marrow had hypoplasia. All cases of neutropenia occurred among the patients whose polymorphonuclear neutrophils (PMN) were normally or weakly reduced [18]. In a study by Tesfa et al in 2008, neutropenia occurred 4 or more weeks after rituximab treatment in lymphoma patients [19]. However, the mechanism of how rituximab causes neutropenia is still unknown. In a retrospective study of 113 lymphoma patients under rituximab treatment (alone or along with chemotherapy), 8 patients (7%) had neutropenia. The average onset was 88 days after receiving their last dosage of rituximab. The average time interval of neutropenia was 54 days. Four of the 8 patients underwent stem cell transplantation, 3 patients had neutropenia with fever and 2 of them needed granulocyte-colony stimulating factor (G-CSF) treatment. In the patients who had neutropenia, a cessation in maturation was observed in the promyelocytes category (the same as congenital neutropenia or Kostmann disease) [19]. A study by Otrock in 2005 addressed 2 patients who had acute thrombocytopenia after receiving rituximab [20]. One of the patients had hairy cell leukemia and the other one suffered from mantle cell lymphoma. In these patients, thrombocytopenia improved without the need of any treatment after several days. The reason for this is unknown. A study by Leo et al was conducted in 2004 for investigating the safety of rituximab [21]. In this study, the mixture of fludarabine, rituximab and cyclophosphamide was applied for treatment of follicular lymphoma. Surprisingly, severe thrombocytopenia with World Health Organization (WHO) grades 3 and 4 were observed in the patients, which resulted in the end of trial. Cytological and serological analysis was based on direct toxicity of rituximab. Chapter 3 Investigation Method 39 Therapy resistant pemphigus patients in Razi Hospital in Tehran, who had received rituximab from 2008 to 2012 were considered for inclusion in this retrospective cohort study. Data was collected before and after rituximab treatment. The variables included WBC, Hg, Plt, AST, ALT, Urea, and Cr and age, gender, involved sites, previous therapies, underlying disease, and disease duration. Test sheets associated to before and after rituximab application, containing WBC, Hg, Plt, AST, ALT, Urea and Cr were compared. Type of Study This study is a retrospective cohort study conducted on the pemphigus patients resistant to therapies who had received rituximab in 2008-2012. Studied Population Therapy-resistant pemphigus patients who were treated with rituximab in Razi Hospital, Tehran, Iran in 2008-2012. Inclusion Criteria Pemphigus patients who did not respond to the initial therapies (therapy-resistant pemphigus), and then were treated with rituximab. Exclusion Criteria Patients with no required tests before application of rituximab in their file Patients with no follow-up after receiving rituximab Patients whose first follow-up, after the last dosage of rituximab, is greater than 1 month. Sampling Method According to the available files, files of all the patients who had received rituximab from 2008 to 2012 were considered for inclusion. Data Collection The data collection tool included a checklist divided into 2 parts: one for the data before and one for the data collection after rituximab treatment. The variables included WBC, Hg, Plt, AST, ALT, Urea, and Cr and age, gender, involved sites, previous therapies, underlying disease, and disease duration. Project Implementation After studying the files of therapy-resistant pemphigus patients, the patients who had required data in their files were entered into the research. Rituximab treatment was defined as receiving 4 doses of 500 mg for 4 weeks, along with normal saline. Test sheets associated to before and after rituximab application, containing WBC, Hg, Plt, AST, ALT, Urea and Cr were compared. (The maximum time interval between the second test sheet and the last dosage of rituximab could be 1 month.) Data Analysis Finally, the finalized cases that had the inclusion criteria, were analyzed in Stata statistical software (StataCorp, Texas, USA) in terms of variations in WBC, Hg, Plt, AST, ALT, Urea and Cr after application of rituximab as the major variable and investigation of minor variables. Problems and Limitations As the base of this research was on filed files of hospital, inadequacy of data either before or after rituximab application excluded a bunch of samples from the study in a way that among 105 available files, only 39 files had the required data. Variables Major variables: quantitative measurement of white blood cells (WBC), Hemoglobin (Hgb), platelets (Plt), aspartate aminotransferase (AST), ALT, urea, and creatinine (Cr) before and after application of rituximab Minor variables: Gender Age Involved sites Previous therapies Underlying disease Disease duration The data of variables were collected according to the positive findings in the patients files (Table 1). Table 1 Patient variables. Title Variable Type Quantitative Qualitative Scientific Practical Definition Measurement Method Scale Independent Dependent Continuous Discrete Nominal Ranking WBC Number of WBC per ÃŽ ¼(mu)L of blood File reading Cell/mCl Hgb Amount of hemoglobin File reading Gr/dl Plt Number of plackets in patient blood File reading Cell/mcl AST * Amount of AST File reading IU/L ALT Amount of ALT File reading IU/L Urea Microgram of urea per deciliter of blood File reading Mg/dl Cr * Keratin amount File reading Mg/dl age * Years from birth File reading year gender * According to patient phenotype File reading Male/female Underlying disease * Existence of systemic disease File reading Having/not having Previous therapies * Received adjoin before rituximab File reading Azathioprine, IVIG Cyclophosphamide, CellCept ®, methotrexate Involved sites * Involved sites before starting rituximab File reading Upper body, lower body, face. Genitalia, sculp, mucus Disease Duration Months passed from onset to receiving rituximab File reading Month WBC white blood cell, Hgb hemoglobin, Plt platelet, AST aspartate aminotransferase, ALT alanine aminotransferase, CR creatinine, IVIG intravenous immunoglobulin Chapter 4 Results Among 105 therapy-resistant pemphigus patients who received rituximab treatment in Razi Hospital, Tehran, Iran from 2008 to 2012, only 39 patients managed to enter the study. The others were excluded due to inadequate data. Also in the included patient group, the maximum time interval between the last dosage of rituximab and follow-up was 1 month. The data of the remaining 39 patients were analyzed by Stata statistical software (StataCorp, Texas, USA) and the following results were obtained: The age of the patients ranged from 16 to 67 with a mean of 36.46 years. Their disease duration from the beginning of the disease until receiving rituximab ranged from 5 to 84 months with a mean of 39.30 months. Of the patients, 25 (64%) were men and 14 (36%) were women. It does not seem that the sex difference is related to therapy-resistant pemphigus, it is rather associated with the data collection method and exclusion of patients with incomplete files. Investigation of the involved sites showed that 25 patients (64%) had mucosal involvement, 20 patients (51.3%) had upper body involvement, 18 patients (46.2%) had lower body involvement, 19 people (48.7%) had genitalia involvement, 23 people had facial involvement, 36 people (92%) had body involvement, and in 22 patients (56.4%) the scalp was involved. The lab result variations of the mentioned patients were investigated in terms of the involved sites. The patients, before application of rituximab, were simultaneously under treatment with prednisolone and other adjoins. To summarize the unsuccessful treatments, 5 patients had cyclophosphamide, 18 of them received CellCept ® (mycophenolate mofetil), 7 people (17.9%) had intravenous immunoglobulin (IVIG), 5 patients were treated with methotrexate, and 22 patients had azathioprine. All these patients did not respond to corticosteroid and had active disease. In terms of variation in lab test results after receiving rituximab, the patients were investigated in terms of the previous adjuvants as well. Among 9 patients, 12 of them (30.8%) had systemic underlying diseases such as hypertension (HTN), diabetes mellitus (DM), Ischemic Heart Disease (IHD) and many more. The major variables were WBC, Hgb, Plt, AST, ALT, Urea and Cr before and after application of rituximab. Before Receiving Rituximab: The WBC range was 4,000-14,800 with average of 10,092. The Hgb range was 9.1-16.8 with average of 13.8. The Plt range was 100,000-683,000 with an average of 243,384. The AST range was 6-64 with average of 24.56. The ALT range was 10-143 with average of 43.92. The Urea range was 12-145 with average of 37.25. The Cr range was 0.5-1.2 with average of 0.87. After Receiving Rituximab: The WBC range was 5,400-19,000 with average of 9,964. The Hgb range was 7.4-16.7 with average of 13.42. The Plt range was 110,000-440,000 with average of 232,512. The AST range was 10-121 with average of 25.43. The ALT range was 12-144 with average of 48.46. The Urea range was 15-54 with average of 29.12. The Cr range was 0.6-1.2 with average of 0.85. The WBC had no statistically significant variations. The Hgb had no statistically significant variations. The Plt had no statistically significant variations. The AST had no statistically significant variations. The ALT had no statistically significant variations. The Urea had statistically significant variations. The Cr had no statistically significant variations. After receiving rituximab and adjusting for the effect of gender: The WBC had no statistically significant variations. The Hgb had no statistically significant variations. The Plt had no statistically significant variations. The AST had no statistically significant variations. The ALT had no statistically significant variations. The Cr had no statistically significant variations. In the case of Urea, we concluded that it depends on gender, as in men the variation was significant while in women the variations were not statistically significant. When investigating the results with adjustment of the involved sites, the following results were obtained: In patients with lower body involvement, rituximab had no significant effect on WBC, Plt, AST, ALT, Urea and Cr, but it had significant impact on Hgb reduction. In patients whose lower body was not involved, Urea significantly increased after receiving rituximab. In patients whose lower body was involved, rituximab caused a significant reduction in Cr, Urea, and Hgb. In patients whose upper body was not involved, rituximab had no significant effect on the variables. In the patients with or without facial involvement, rituximab had no significant impact on any of the variables. In patients whose genitalia region was involved, rituximab has no significant impact on any of the major variables. In patients with no genitalia involvement, rituximab resulted in significant reduction of urea. In patients with body involvement, rituximab resulted in significant reduction of urea. In patients with scalp involvement, rituximab resulted in significant reduction of urea. The adjustment of previous therapies was also addressed. As all the patients received prednisolone, the effect of adjoins (azathioprine, CellCept ®, cyclophosphamide, IVIG and methotrexate) was addressed: In patients who had received cyclophosphamide, rituximab has no statistically significant impact on the major variables. In patients who had not received cyclophosphamide, rituximab led to statistically significant reduction of urea. In patients who had received CellCept (mycophenolate mofetil), rituximab has statistically significant impact on reduction of urea and WBC. In patients who did not use IVIG adjoin, rituximab had a significant impact on reduction of urea. In patients who did not use methotrexate adjoin, rituximab had significant impact on reduction of urea. In patients who used azathioprine adjoin, rituximab had significant impact on reduction of urea. The adjustment impact of systemic underlying diseases (such as HTN, DM, IHD) was also addressed. In patients with systemic underlying disease, rituximab had significant impact on platelet reduction. In patients with no systemic underlying disease, rituximab had significant impact on urea reduction. There was no statistically significant relationship between the lab test result variations and disease duration and age (Table 1 through Table 8). TABLES Table 1 Age distribution in the studied patients Min Max Standard Deviation Average Age 16 67 13.48 36.48 Table 2 Disease duration distribution in the studies patients Min Max Standard Deviation Average Disease duration 5 84 20.28 29.30 Table 3 Absolute and relative frequency distribution of patients based on their gender Number % Men 25 64.1 Women 14 35.9 Total 39 100 Table 4 Absolute and relative frequency of involved sites at the time of rituximab injection. Frequency % Upper body 20 51.3 Lower body 18 46.2 Face 23 59 Genitalia 19 48.7 Body 36 92.3 Mucus 25 64.1 Scalp 22 56.4 Table 5 Absolute and relative frequency of received adjoins before application of rituximab Frequency % cyclophosphamide 5 12.8 CellCept ® 18 46.2 IVIG 7 17.9 methotrexate 5 12.8 azathioprine 22 56.4 IVIG intravenous immunoglobulin Table 6 Absolute and relative frequency of the patients based on having or not having underlying disease. Frequency

Great Expectations - Miss Havisham and Abel Magwitch are Living through

Great Expectations - Miss Havisham and Abel Magwitch are Living through Others In the work Great Expectations, by Charles Dickens, two characters live their lives through someone else. Miss Havisham and Abel Magwitch are both elderly and though someone else are able to obtain their goals that they are not able to complete themselves. Abel Magwitch lives his life through the protagonist Pip while Miss Havisham lives her life through the character Estella. Miss Havisham is an aged, mysterious lady who has much anger. This anger derives from her fiancÃÆ' ©e leaving the day of the wedding. This is the moment when she "stopped living" and decides to turn to a life of making other men miserable, just as her ex-fiancÃÆ' ©e had made her unhappy. However, Miss Havisham is too old to be able to hurt other men, so she decides to raise a child. Miss Havisham put Estella in such an environment where all Estella's compassionate feelings were erased and made very dull. Miss Havisham's influence also made Estella feel no remorse for those she hurt. Estella tells Miss Havisham, "If you had brought up your adopted daughter wholly in the dark confinement of these rooms, and had never let her know that there was such a thing as the daylightà ¢Ã¢â€š ¬Ã‚ ¦ and then, for a purpose, had wanted her to understand the daylight and know all about it, you would have been disappointed and angry?" (307). When Estella refers to the light and the dark she is referring to the light as love and compassion and the dark as the cruelty and the sense of a "stone heart." Estella, even as a young woman, cannot see or feel love because Miss Havisham has manipulated her to be just as she wanted, relentless and cold. Moreover, this personality allows Estella to ... .... When fighting with Miss Havisham, Estella says, "Only a little tired of myself." (305). It is later obvious that Estella is tired of not being happy and not being able to have any true feelings. Even though Estella and Pip were given everything they ever wanted, neither of them got fulfillment and true love from their guardians and both ended up being very melancholy. Dickens' point is to show the reader that people need more then just materialistic things to live and be happy; they need love and need to be able to feel compassion and love. This book can be considered a commentary on how the social system is misjudged because the people of the higher lifestyles are not necessarily happy even though they have most material things. This idea is important because it shows what is really needed to be happy and that is love and being able to be compassionate. Great Expectations - Miss Havisham and Abel Magwitch are Living through Great Expectations - Miss Havisham and Abel Magwitch are Living through Others In the work Great Expectations, by Charles Dickens, two characters live their lives through someone else. Miss Havisham and Abel Magwitch are both elderly and though someone else are able to obtain their goals that they are not able to complete themselves. Abel Magwitch lives his life through the protagonist Pip while Miss Havisham lives her life through the character Estella. Miss Havisham is an aged, mysterious lady who has much anger. This anger derives from her fiancÃÆ' ©e leaving the day of the wedding. This is the moment when she "stopped living" and decides to turn to a life of making other men miserable, just as her ex-fiancÃÆ' ©e had made her unhappy. However, Miss Havisham is too old to be able to hurt other men, so she decides to raise a child. Miss Havisham put Estella in such an environment where all Estella's compassionate feelings were erased and made very dull. Miss Havisham's influence also made Estella feel no remorse for those she hurt. Estella tells Miss Havisham, "If you had brought up your adopted daughter wholly in the dark confinement of these rooms, and had never let her know that there was such a thing as the daylightà ¢Ã¢â€š ¬Ã‚ ¦ and then, for a purpose, had wanted her to understand the daylight and know all about it, you would have been disappointed and angry?" (307). When Estella refers to the light and the dark she is referring to the light as love and compassion and the dark as the cruelty and the sense of a "stone heart." Estella, even as a young woman, cannot see or feel love because Miss Havisham has manipulated her to be just as she wanted, relentless and cold. Moreover, this personality allows Estella to ... .... When fighting with Miss Havisham, Estella says, "Only a little tired of myself." (305). It is later obvious that Estella is tired of not being happy and not being able to have any true feelings. Even though Estella and Pip were given everything they ever wanted, neither of them got fulfillment and true love from their guardians and both ended up being very melancholy. Dickens' point is to show the reader that people need more then just materialistic things to live and be happy; they need love and need to be able to feel compassion and love. This book can be considered a commentary on how the social system is misjudged because the people of the higher lifestyles are not necessarily happy even though they have most material things. This idea is important because it shows what is really needed to be happy and that is love and being able to be compassionate.

A Review of The Old Man and The Sea: Hemingway’s Tragic Vision of Man

The Old Man and the Sea is one of the most famous novel written by Ernest Hemingway. In this novel, Hemingway shows the world the story about the great Santiago, an old Cuban fisherman who fights for his honor and pride. In the critical essay, â€Å"Hemingway’s Tragic Vision of Man,† Clinton S. Burhans, Jr writes that he and other authors have interpreted this novel, and he takes into account the following points: heroic individualism, interdependence, and Christian themes. I agree with Burhans’ essay. In the novel, Hemingway addresses the character of Santiago so properly that he inspires these points without doubt. â€Å"He was an old man who fished alone in a skiff in the Gulf Stream and he had gone eighty-four days now without taking a fish† (Hemingway 1): This is how the story begins. The old man had spent almost three months without catching anything, so the next day he made up his mind and proposed to himself that he would take a big fish. That day he went far in the ocean. In the beginning, he feels that he has to redeem his bad luck by catching a big fish. He wants to demostra...

Moral Luck Essay -- Analysis, Williams Bernard

The case of moral luck was introduced by Williams Bernard and developed by Thomas Nagel in their articles respectively. Both raised the question whether luck can influence the judgment of morality. In this essay, the definition of moral luck and four kinds of moral luck by Williams and Nagel will be discussed through several case examples, and then followed with some arguments from Judith Andre, Donna Dickenson and David Enoch and Andrei Marmor who disagree with the concept of moral luck. Let take a simple example from Nagel’s paper to acquire a brief understanding on the idea of moral luck. Driver A and B were both drunk when driving home. Drive A passed the red light and killed a child who was passing the street while driver B got home safely. To Williams and Nagel, driver A should be, of course, responsible for manslaughter under the laws, but also should be morally treated as the same as driver B since the difference outcomes are solely based on luck. As Williams argues â€Å"luck of this kind affects whether he will be justified or not, since if it strikes, he will not be justified† (Williams, p.25). Therefore, in his book â€Å"Moral Luck†, Williams introduced a new term â€Å"moral luck† referring to â€Å"luck that occurs when an agent can be correctly treated as an object of moral judgment despite the fact that a significant aspect of what she is assessed for depends on factors beyond her control† (Nelkin). Nagel agrees to Williams’ idea and categorizes ‘moral luck’ into four different types. They are constitutive, circumstantial, resultant, and causal luck. Constitutive luck refers to â€Å"the kind of person you are, where this is not just a question of what you deliberately do, but of your inclination, capacities, and temperament†. In anoth... ...g the intention is, or how certain we feel about it†, (Enoch and Marmor, p. 422). Williams’s and Nagel’s concept of moral luck encounter more disagreement than being agreed since moral luck is not universally applicable in every situation. The existence of either motive or agent-regret will, in some cases, be enigma since they are private matter and unknown to the rest of us. Therefore, the case of moral luck has been yet remains unsolved due to its inconsistency. On the other hand, if motives and intentions (of being moral) are not counted and/or agent-regret does exist, it will be unfair to the person who is incorrectly treated since the result is actually out of their control. Thus, the moral luck is a sensitive matter and should be applied per case based on the presented facts. There is no such universal formula for relevance of moral luck in each situation.

Btec Buisness Level 3 Unit 1

BTEC LEVEL 3 IN BUSINESS UNIT 3: INTRODUCTION TO MARKETING Assignment Brief Tesco’s and Oxfam’s Concepts of marketing- marketing= a social and managerial process by which individual and groups obtain what they need and want through creating and exchanging products and value with others. Core marketing concepts Markets Exchange transitions & relationships Value satisfaction and quality Products Needs wants and demands B. define aims and objectives Aims: A purpose or intention; a desired outcome Objectives c. Private companies may issue stock and have shareholders.And are invested by individuals. However, their shares do not trade on public exchanges and are not issued through an initial public offering. In general, the shares of these businesses are less liquid and the values are difficult to determine, an example of a private sector is Warburton’s, their aims are to maximise profits or increase value of shares. Public sectors offer shares to the general public, A Public sectors stock can be acquired by anyone and holders are only limited to potentially lose the amount paid for the shares.An example of a public sector would be Tesco’s because they provide a service to the community, another example for Tesco’s being in the public sector is so they can expand internationally, private sectors however would only be able to stay nationally because it s easier to control shares. Tesco’s aims would be to boost the national economy and also to maximise profits. Non profit companies would be charity and sometimes government run organisations. Any money earned must be retained by the organization, and used for its own expenses, operations, and programs.An example of a non profit sector would be Oxfam because they use the money invested in their organisation to help people suffering poverty poor housing in third world countries globally and to invest also using the money to use on their expenses programs etc. Their aims are to imp rove poverty and lifestyle in third world countries. Introduce and explain the two businesses you will be investigating. Refer to their business activity i. e. what they do to make their money, their size and history. Refer to task C and state which sector they belong within. Focus upon and explain one product or service provided by each business.D. i will be investigating Tesco’s and Oxfam. Tesco’s is the third most successful retailer in the world, and they sell all general products needed in a household including, food, clothes, furniture, mobile phones etc they also sell luxury items like gaming equipment, broadband etc, Oxfam is one of the biggest charities globally, they sell clothes, books, board games, etc to make money so they can put it into their company so they can cover expenses and support programs, they also accept donations so they can help other third world countries that are suffering from poverty poor housing etc.Tesco’s was founded in 1942; T esco’s was founded in 1919 by jack Cohan in east London. Oxfam belongs to the non profit sector, they provide products that are cheap so they can provide for programs across the world and supply their organisation with important resources. Tesco’s belongs to the public sector and offer basic products and necessities such as food, housing etc. And services like broadband and banking etc. E. tescos: they want to make cheaper prices so they would be able to get a larger quantity of products sold.Oxfam: more of a variety of products to sell, so customers have more of a choice, this will increase the variety of customers. F. organisational objectives are different from marketing objectives . Marketing objectives are giving a time frame in which they should achieve it, organisational objectives are the overall objectives and are the ones that are the most important. g. The marketing objectives can make you get closer to an organizational objective because it might lead to th e same path. For example marketing objectives are like little steps towards organizational objective. h.Tesco’s marketing objectives is to make prices fair for customers and beneficial for Tesco’s, and also expand their business into different companies. Oxfam’s marketing objectives would be to open more Oxfam shops across the u. k, so they can benefit their programs resources etc. i. Tesco’s might expand their brand into different retailers so it’ll gain more popularity and might even be a leading bran in food clothes etc ii. Oxfam might open stores internationally so will lead to make more money so they can use it so they can run more charitable programs and lead to improve poverty, housing in third world countries around the world. . Explain and justify which of these your business may use when marketing their product or service (one of the businesses products/services you have explained within task d). j. if Tesco’s was marketing a certa in food product Tesco’s would use a marketing technique for example Tesco’s would advertise the product on wallpaper, leaflets ,TV etc also they would put special offers on the product e. g. 2 for the price of one k. Identify and describe the limitations and constraints upon marketing activities.For example if Tesco’s was making a new product and they were given a limited amount of money to invest in this product, this would limit how advanced this product and how useful this product would end up to be. A constraint for tescos would be the price war, all supermarkets, retailers etc want the best prices for their customers and the best prices for customers means more profit for themselves, this would subdued customers to shop at Tesco’s more than other retailers tacos is always making cuts and budgets to make low prices for customers its is a constant restraint for Tesco’s L.For each limitation and constraint explain how this may affect the marketin g operations of your two chosen businesses. The operations wouldn’t run as smoothly because you are not making enough profit to achieve those operations. The price war will affect their special offers new programs because they would have to cut those in making a better price for customers, prices are one of the top priorities for a retailer. m. Produce a comparison table stating and explaining in detail the similarities and differences between the chosen product/service of each organisation across a range of market techniques. Similarities | Differences | | |

California, a Place, a People, a Dream

California, A Place, a People, a Dream In â€Å"California, A Place, a People, a Dream,† James J. Rawls gives his version of the California dream, and describes the paradoxes that are associated with that dream. According to Rawls, the California dream is a love affair with an idea, a marriage to a myth, or fantasy. (Rawls 22, 23) Everyone has their own version of the California dream. It might be something, or nothing at all. As I began reading Rawl’s essay, I found it interesting how the world views the environment that you live in, and how different they think your life is from theirs. The California dream is often viewed in the imaginations of Americans and immigrants as the optimal land of opportunity, sunshine, jobs, and Hollywood glamour. â€Å"Founded on expectation and hope, the California Dream promises to fulfill our deepest longings for opportunity and success, warmth, sunshine and beauty, health and long life, freedom, and even a foretaste of the future,† says Rawls. (Rawls 23) For many people, they think of California as their own perfect world. According to Rawls, one paradox for California is a land of great expectations and disappointment. The gold rush experience was forged on this paradox of expectation. (Rawls 26) For many people their expectations of California came from what they heard: California is the land of great opportunity. Another paradox is growth. In 1962, California became the most populous state. Land was being quickly developed into track homes, and twisted freeways. By 1973, cities across the state 1. were passing ordinances to limit growth. The land of dreams and opportunities was quickly turning into a land of nightmares. The paradox of plenty and getting rich is what immigrants and people from other parts of America believed California was all about, and part of the California dream. Many argue that the dream that once was is no longer a reality with all of the social, political, and environmental issues. This morning I read a blurb on the internet that named the ten most expensive cities in the United States to live in were located in California: Palo Alto, San Francisco, Pasadena, and Newport Beach were a few of those named. I have often read about the American dream, but not the California dream. Being a native Californian, perhaps I have taken for granted all that California has to offer, as it just seems part of my every day life. I could never understand why my in-laws would always say how lucky I was to live in California, and so close to the beach. Why did they make such a big deal when they visited? There were beaches in New Jersey where they were from. They always insisted on going to Santa Cruz or Monterey each time they came to visit. They live three hours away from the beach, or shore as they called it. Until I visited the east coast, little did I realize at the time how living on the east coast was very different from living on the west coast. It is hot and humid during the summer, and cold and wet during the winter. At least in the bay area the seasons are not so drastic. I do not believe there is a California dream. I have always felt that people make their own dreams. For some it is the roll of the dice, and luck. For others it is the way things were meant to be. Promise and paradox are at the center of the California dream. † (Rawls 29) â€Å"In spite of the withering analysis of the past, the promises of California remain undiminished, bringing 2. new generations of newcomers from around the world. † (Rawls 29) There are new perceptions and new dreams. Everyone dreams. Whether it is a life in a different place – or where they currently live people have been dreaming since the beginning o f time – and will continue to dream. What one perceives as the California dream, another may perceive it as something entirely different. 3.

National Identity in Film

The Piano, by Campion, and Truman Show, by Weir both interact with concepts of national identity in separate ways.   Both of these films are products of New Zealand culture, either through production or in cultural discourse.   Both films have also been well received and heavily awarded. The Piano tells the story of Ada McGrath.   She is a Scotswoman from New Zealand who is sold into marriage.   The film is staged in 1851. She doesn’t speak throughout the majority of the film, but expresses herself through her piano playing; this is until her husband leaves her piano on a beach.   This is symbolic of his lack of love for her and an example of the emptiness in Ada’s life.   The piano is then sold to their neighbor George Baines who convinces Ada to give him piano lessons and eventually sexual favors.   As Ada gradually falls in love with Baines through their connection of the piano, she finds meaning for her life. The Truman Show is directed by Australian Peter Weir and written by New Zealander Andrew Niccol.   The story follows Truman Burbank who is unaware that his entire life, since birth, has been an organized farce for a television series/project.   He is luckily chosen, out of a group of five baby orphans, to be the star of the show.   The Truman Show represents Truman’s life.   Viewers are told that Truman’s birth was broadcast live on television, but his child rearing is not presented in the film. The idea behind national identity is that one defines their self through the identity of their nation.   In their article, National Identity and Self-Esteem, Jeff Spinner-Halev and Elizabeth Theiss-Morse analyze the nature of national identity.   They adopt the theory that if the self-esteem of an individual is tied to their nation than it’s the perfect proponent to maintain safe and secure nations.   They feel that there is an immediate connection between self respect and group identity; so much so, it could lead to one sacrificing their own personal needs for the good of the group. They also acknowledge that there is a competitive nature within group self esteem; this meaning that most groups want their group to do better than others.   This is often seen in the patriotic nature of political propaganda, carried out by many countries to convince soldiers to go to war.   This system of control is one known for cajoling groups to fallow a certain program or way of thinking by catering to individuals’ wants, needs, or taking advantage of their fears. This complex of national identity is a major aspect of a government’s societal control, as well as a significant ideal satirized in The Truman Show.   It is most visibly personified in the character of the show’s producer Christof.   He argues that human beings accept the world in which they are presented, and uses this to justify why Truman hasn’t figured out his predicament up to this point.   All of the employees, of the studio, acting as Truman’s family, friends and extras living within the town, can all be viewed as nationalists to the studio’s regime. The National Identity of these films can be directly corresponded to the culture and history of New Zealand.   In 1945, the New Zealand Film Critic Gordon Mirams argued that if there was a New Zealand culture, it was a mostly a Hollywood creation. The only thing more popular than going to the movies, in New Zealand, was drinking tea, during that time period. This idea is supported by the statistic that for many years New Zealanders were the most frequenters of the movie world. In their book New Zealand Film 1912-1996 Helen Martin and Sam Edwards analyze the filmography of many films produced during this century in New Zealand.   This book basically analyzes the entire history of film in New Zealand.   The two authors managed to find more than 162 films.   In formulating their list and deciding on what they would identify as New Zealand Films, they decided the film had to have a significant connection to the location in terms of the film’s creators, cast, copyright holder, financiers, production team, and technical equipment. They also felt that a film that holds a sociological connection to New Zealand should be categorized as a New Zealand films as well.   Thus, they included The Piano in their list of films pointing out that though it was not filmed in New Zealand, its story was still set there.   The authors also felt it the film addressed social issues pertaining to the history of New Zealand within the time frame it was set. The Piano, identified as a socially conscious New Zealander film, it is identified as such through its understanding of national identity and the plight of the New Zealand people.   This can be seen in the fact that the film is a historically place romance, and has much cultural significance.   The film is often credited for its style, in that it is deemed as a historical romance and a contemporary romance in a historical setting. In his article, Lost causes: the ideology of national identity in Australian cinema, John Slavin does an in-depth analysis of the cultural connotations present in cinema when using it to understand a nation.   His stance is that cinema as well as reality have an interweaving relationship with each other that ultimately define the national identity of a nation.   He further explains this in his closing statements when he says, Ideology transforms individuals into constitutive social subjects by interpelation, the Althusserian term for the seductive mirror images of coherent identity promoted by cultural artifacts such as the popular cinema. But this thesis follows the suggestion that it is the purpose of ideology to represent an imaginary relationship of the cinematic viewer to his/her real conditions of existence. Those real conditions, based on psychic and social displacement are symptomatic of the Marxist definition of alienation†¦ In other words, representations of identity, both national and individual, are thrown into critical doubt within the mythic narratives. (Slavin, 2002). Slavin’s view that though ideology is used in film, national identity is virtually dependant on film narrative is very ironic, considering that he uses ideology by connecting his argument to Marxism.   In the end, the interpretation of his argument, just like national identity, are both dependant on the work and views of their creator, no matter how drenched in history they. Even within this corruption of the true nature of things, Slavin acknowledges that the transitional tendency of film images, etiquette and social relations over the years is a perfect source for study of socio-economic change.   Once one grasps a clear understanding of cinema’s use of ideology to mold national culture, the only question left is, how is ideology used, and national culture shaped, specifically within these two films? In their novel, Piano Lessons: Approaches to the Piano by Felicity Coombs and Suzanne Germmell, the authors work to claim a better understanding of The Piano.   They point out the films originally human nature in the fact that there is no main villain.   The audience is often incited to pity, empathize and despise all three main characters. Baines, Stewart, and Ada can all be viewed as human because they all have their flaws.   It is wrong for Stewart to disregard his wife they way he does, though the nature of his arrange marriage is a notable statement pertaining to the era of the film’s plot.   The audience is allowed to relate to this sociological circumstance, while at the same time despise Stewart for his treatment of Ada.   Whereas Ada is presented as a victim of the cultural norms of her time period, she still transcends beyond this, to adopt contemporary ideals and relate to the audience.   The fact that she cheats on her husband is a motive for dislike, but it is also key to the liberation she achieves from her mundane existence. The fact that she does not embody the role of the victim throughout the entire film is testament to the film’s reality.   Baines also becomes an equally likeable figure in that his sexual advances evolve from something seemingly corrupt to an actual full blown love affair.   This triangular relationship between the three main characters says a lot about male and female relations during the time.   The authors also correspond to Ada’s relationship with men to the nature of post-colonialism, which was also a big part of New Zealand at this time and also a big part of this film. The relationship between the oppressor and the oppressed is a key theme in the relationships Ada has with men.   The colonial history of 1850’s New Zealand is encompassed within the plot.   This is an example of how ideology is used in narrative to enhance the value of a message more relevant.   In confronting these ideals of colonization, the film came under much scrutiny.   Many felt the film gave a false presentation of race.   During this time there were many Maori, who argued they were the product of White New Zealanders’ social injustice. They felt the film’s disregard for their cultural relevance was a form of national mythmaking, in avoiding the argument that whites staked claim on their land. This conflict is overlooked by the plot, but the nature of its severity is still implied through the topic being completely disregarded. It is also a common controversy within the land that many foreign investors come and buy land, from potentially the wrong owners. By disregarding their true history, the national identity presented for New Zealand is that of a small land with a history for sale. The connection with national identity here is cultural.   This differs from the connection visible in The Truman Show. Just like The Piano, The Truman Show poses an argument larger than itself in respect to national identity, only this film speaks more metaphorically.   The idea previously posed in National Identity and Self Esteem, was that national identity is largely the product of a model that is followed by a group of people.   These people are so caught up in the ideals of the group, they rather sacrifice their own individual comforts for the good of the team. The authors found that these groups are also very competitive with one another, identifying their identity with that of the group and basing the groups identity on their contrast from other groups.   This becomes very relative to some of Rene Girard’s views.   In his seminal theory of mediated desire Rene Girard argues that human desire is imitative.   His views is that the goals we hold most personal are actually the desires of others which we want to achieve because others want to achieve them. This is very compatible with the ideals of national culture and the cult group fallowing it incites.   This is also seen constantly in The Truman Show, the main motivation for Truman to escape the studio/town is to travel to Fiji after his one true love.   If the character personifying his school crush had never desired to move there, Truman would have never desired to follow.   This is a direct personification of Girard’s theory, as well as an example of Morse and Halev’s version of national identity.   Here it is easy to see the differing way in which The Truman Show represents national identity from how it is used in The Piano. In sum, through an understanding of identity theory and New Zealand culture, we can develop a better understanding of the directors’ use of national identity in the films The Piano, and The Truman Show.   National identity is depicted in The Piano through its cultural connotations, historical representation, and it authenticity to social norms. Despite all of its awards, the films inability to stay true to the ethnic history of the town is proof that it attempts to mold national identity through its filmic ideals.   The directors pick and chose the ideology they identify with and disregard the other aspect of New Zealand culture.   Whereas The Truman Show does not attempt to shape the national culture of New Zealand, it is virtually unidentifiable as a New Zealand film, except for the fact that is written by a New Zealander. What the film contributes to national identity is its use of the theories backing it, and its own underlying message on the nature of the conflict. What the film reveals about national identity is its dependency on the narrative of a film.   The ironic fact is that it does this through its own abuse of the power.   Truman represents everyman against the crowd.   The complex world he interacts with is very similar to the real world, only in his world he really is the center of attention.   The most intimate aspects of an individual’s life, like marriage, personal goals and beliefs are all a product of a false reality. This concept is very similar to Freudian theory, Marxist theory, biblical references and even many science fiction narratives.   What the films reveals about national identity is its core nature.   The entire town operates in one direction and for one purpose.   Truman is the only one who is unaware of this purpose, but he still seems to follow along contributing to what he feels is the best interest of the group.   His desires are compatible with his nation’s desires, until he breaks free from this methodology of control.   Both of these films interact with national identity theory; both are products of New Zealander culture, and both are great films. Work Cited Adorno, Theodor W. and Max Horkheimer. Dialectic of Enlightenment: Philosophical Fragments. 1947. Trans. Edmund Jephcott. Stanford: Stanford UP, 2002. Chatman, Seymour (1978) Story and Discourse: Narrative Structure in Fiction and Film (Ithaca, NY: Cornell University Press). Cheshire, Ellen. Jane Campion. Great Britain: Pocket Essentials, 2000. Eric Young (Executive Producer). (1998). â€Å"How's It Going To End? The Making of The Truman Show, Part II† [DVD (Special Feature)]. Paramount Pictures Home Entertainment. Girard, Renà ©. Deceit, Desire, and the Novel: Self and Other in Literary Structure. Trans. Yvonne Freccero. Baltimore, MD: Johns Hopkins UP, 1965. Helen Martin and Sam Edwards, New Zealand Film, 1912-1996. Auckland: Oxford University Press, 1997. vi+215 pp. Illustrations, bibliography, index. Kaufman, Cynthia. â€Å"Colonialism, Purity, and Resistance in The Piano.† Socialist Review 24 (1995): 251-55. Sanes, Ken. Truman as Archetype. Transparencynow.com. 1996-2001. 29 July 2004. . Slavin, John (2002) Lost causes : the ideology of national identity in Australian cinema. PhD thesis, Department of English, University of Melbourne. The Piano. (2007, January 18). In Wikipedia, The Free Encyclopedia. Retrieved 22:37, January 22, 2007, from http://en.wikipedia.org/w/index.php?title=The_Piano&oldid=101515698 The Truman Show. (2007, January 19). In Wikipedia, The Free Encyclopedia. Retrieved 22:33, January 22, 2007, from http://en.wikipedia.org/w/index.php?title=The_Truman_Show&oldid=101870034 The Truman Show (1998) Directed by Peter Weir, screenplay by Andrew Niccol (Hollywood, CA: Paramount).

Alcohol and Its Effects on Children

Andrelea Foerster Marriage & Family Dr. Ekechukwu 4/12/13 The Impact on Children of Alcoholic Parents The significant and detrimental impact on family life and child development caused by parental alcohol use cannot be underestimated, often putting children in danger. Alcohol use and disorders are a major public health problem. Alcohol abuse in poor and deprived communities is particularly deleterious as the scarce financial resources of the family needed for food, health care, and education are diverted to alcohol. Pinto, Violet) It rarely exists in isolation as a problem and is commonly intertwined with mental health, bereavement, family breakdown or domestic violence. Children are impacted in a number of different ways: parental alcoholism affects them financially; it affects their home environment; they may be exposed to unsuitable care and care givers or inadequate supervision, poor role models and inappropriate behavior; and their physical/emotional development and school atten dance can suffer.Many children whose parents drink at a significant level can often find themselves having to take on the role of care giver, both for their siblings and their parents. Approximately 5-10% of the country's population suffers from DSM-IV alcohol abuse, and this figure appears to be growing. Alcohol use problems affect spouses and children, unfortunately, in addition to the heavy substance users themselves. A recent study estimated that one in four American children have a parent who meets criteria for DSM-IV alcohol abuse. Brennan, Patricia) It is important to understand the feelings a parent will be experiencing in relation to their alcohol use and to recognize that just because a parent may or may not have disclosed that they have an alcohol problem, it does not necessarily mean the problem is not there. In practice, most standard policies and procedures are reactive to the parent admitting they have a problem. Consequently, workers from universal services often foc us on gaining evidence and then initiating procedures, which is a difficult balance to strike as workers often have to make social services referrals when disclosures are made. If you do not know what the problem is you cannot fix it' is a good place to start. In fact, it is difficult to meaningfully help a parent before they have accepted there is a problem; you cannot force change or engagement. From both sides, this can be difficult to manage as the positivity of a parent's disclosure can be overshadowed by a reaction to the referral to children's social care. Understandably, this can cause a dilemma for the professional and a great deal of anxiety for the parent. Encouraged by the disinhibiting effects of alcohol, they find it easier to enter the world outside their family borders in search of relief and self-assertion. † (Tomori, Martina) Professionals often worry about immediate safety when a parent has a drinking problem. Because they did not have an example to follow f rom their childhood and never experienced â€Å"normal† family relationships, adult children of alcoholics and addicts may have to guess at what it means to be normal. They sometimes can't tell good role models from bad ones.Some are not comfortable around family because they don't know what to do or how to react. Many adult children of alcoholics or addicts find it difficult to give themselves a break. They do not feel adequate, and feel that they are never good enough. They may have little self-worth and low self-esteem and can develop deep feelings of inadequacy. Because they judge themselves too harshly, some adult children of alcoholics may take themselves very seriously. They can become depressed or anxious because they have never learned how to lighten up on themselves.They can get very angry with themselves when they make a mistake. Many adult children of alcoholics find it difficult to let them have fun. Perhaps because they witnessed so many holidays, vacations and other family events sabotaged by the alcoholic parent, they do not expect good things to ever happen to them. In order to have an intimate relationship, one must be willing to look to another person for interdependence, emotional attachment, or fulfillment of your needs. Because of trust issues or lack of self-esteem, adult children of addicts may not be able to let themselves do that.They don't allow themselves to get close to others. After growing up in an atmosphere where denial, lying and keeping secrets was the norm, adult children of alcoholics can develop serious trust problems. All the broken promises of the past tell them that trusting someone will backfire on them in the future and because the alcoholic parent was emotionally unavailable or perhaps physically not around, adult children of alcoholics or addicts can develop an absolute fear of being abandoned. As a consequence, they can find themselves holding on to relationships they should end just because they don't want to be alone.If their alcoholic parent was mean or abusive when they were drunk, adult children can grow up with a fear of all angry people. They may spend their lives avoiding conflict or confrontation of any kind, thinking it could turn violent. Because they constantly judge themselves too harshly, many adult children of alcoholics are constantly seeking approval from others. The can become people-pleasers who are crushed if someone is not happy with them. They can absolutely fear criticism. Many children who grow up with an addicted parent find themselves thinking they are different from other people and not good enough.Consequently, they avoid social situations and have difficulty making friends. They can tend to isolate themselves as a result. Perhaps to avoid criticism or the anger of their alcoholic parent, many children from alcoholic homes become super responsible or perfectionists. They can become overachievers or workaholics. On the other hand, they can also go in the oppo site direction, becoming very irresponsible members of society. Handling disclosure is the key to being able to start to support a parent and get them the help they need.Listen to what the parent is saying and recognize that by starting to talk about the alcohol problem they are acknowledging it exists. This is the first step and can be a very vulnerable time; parents can become distressed at this stage. The parent is usually in a very negative space and it is important that this is a positive interaction where they feel supported and have hope. If this is handled badly their defenses usually go up and they disengage. Ideally, parents should be listened to and reassured that they have done the right thing in acknowledging they have a problem and that they will be given the right support.Stay with them until they have finished saying everything they want to–they will usually indicate why drinking became a problem. End by reassuring them and explain what you are going to do to try to help them. This might involve referral to your local alcohol service, providing them with printed information or calling someone else to look after the children. It is a good idea at this stage to give them a diary sheet to keep track of what they are drinking, when and why. You can now also draw up a safety plan or contingency plan with the parent.This is important as it empowers the parent to take control of the situation, even while the problem drinking continues, and it is something they can immediately succeed at. It should prioritize the child's needs and safety, which will also help the parent deal with feelings of guilt. We have all been in a room or meeting with a parent where we have suspicions of parental alcohol use. It is really important not to ignore this, but ‘say what you see' and offer help. Don't add a judgment, an assumption or interpret; simply say to the parent what you see.Examples of this could be: ‘I smell alcohol on your breath–if you need support with that we can help' or ‘you seem unsteady on your feet, your speech seems slurred'. This is an important process for the parent even if it does not lead to a disclosure as it forces them to face some of their own denial. If this is not done they may convince themselves everything is fine. Fundamental to working with parents is accepting that it takes time to change. Goals need to be pragmatic, realistic and timely, with a focus on finding solutions rather than obstacles.Sometimes you have to accept that it may only be possible to put a simple routine in place and that the parent will need support with anything that needs longer-term planning. A useful tool is a basic wall chart, which does actually need to go on the wall so it can be checked. The chart should outline tasks to be completed each day. Allocate a specific day for household tasks; for example, laundry on Mondays and food shopping on Tuesdays. This is useful as it enables the parent to have some basic structure to their time.They can also tick things off as they are completed, which will increase their confidence and make day-to-day life seem more manageable. It is also not reliant on the problem behavior changing immediately. Things often get worse before they get better–be prepared initially for the parent to deteriorate before they improve. It is a process and parents need to learn new coping mechanisms; support networks can help. Think about things that can be changed and what can be put in place to support parents and their children through the period of change.Accepting and anticipating a realistic timetable is crucial. For example, when a child has had little or no supervision and a parent then starts to put boundaries in place the child will react negatively, especially if the parent is still drinking. Putting this part of the program in place will increase parents' stress levels and could result in further drinking and disengagement with services. Therefore, think about support plans you might need for both parent and child. If the parent is still drinking they will find it difficult to maintain the changes.The situation could be handled by addressing the drinking first and ensuring the parent is engaged with an alcohol service that can provide relapse prevention support. Next, introduce intensive parenting support so the family has the maximum chance of benefiting from the intervention and maintaining the changes by using this support network to protect the family against wobbles. Think about the family as a system and look at what works well within it and ways other areas can be improved. This needs reviewing constantly, as if one factor changes the family dynamics will change.For example, if a parent's alcohol consumption changes, the family system will change and these periods of adjustment are stressful for all involved. Sometimes you have to accept that the parent's alcohol abuse might not improve immediately. However, the situat ion may change and, importantly, things may improve for the child over time–don't give up. Children will record their parent's actions at their worst. When Mom and Dad are most out of control, they are the most threatening to the child's survival. The child's survival alarm registers these behaviors the most deeply creating shame.Any subsequent shame experience, which even vaguely resembles that past trauma, can easily trigger the words and scenes of said trauma. What are then recorded are the new experience and the old. Over time an accumulation of shame scenes are attached together. Each new scene potentates the old, sort of like a snowball rolling down a hill, getting larger and larger as it picks up snow. As the years go on, very little is needed to trigger these collages of shame memories. Shame as an emotion has now become frozen and embedded into the core of the person's identity.Children of alcoholics grow up trying to control their parents drinking by hiding or throw ing away the alcohol. Then they try the use of guilt control – (If you really love me you'll stop), or (You care more about that bottle than you care about me). They don't realize that you cannot control or reason with a disease. Some try to cure the disease by being the perfect child; by keeping perfect grades, always being good, being responsible and trying to cure the illness, while keeping the path smooth for the drinker.To an outsider looking in, they are the perfect child. The truth of the matter is they are. People just don't see the whole picture. Other children may choose to be the scapegoat, the one in trouble all the time. They are the family's way of not looking at what's really happening. Then there are those who become the class clown, making everyone laugh and all the while knowing that life is not really that funny. And then there is that little child off in the corner; the withdrawn child who never gives anyone any trouble and feels like he/she is invisible.A ll of these children look like a child, dress like a child, to some degree they behave like a child, but they sure as hell don't feel like a child. Children of alcoholics grow up and become adults quickly. But underneath the mask of adult behavior there is a child who was neglected. This needy child is insatiable. What that means is that when the child becomes an adult, there is a hole in his/her soul. They can never get enough as an adult. An adult child can't get enough because it's really a child's needs that are in question.Growing up and not having your needs met as a child creates many scars; co-dependency being one of the most serious. Much has been written about co-dependency. All agree that it is about the loss of selfhood. Co-dependency is a condition wherein one has no inner life. Happiness is on the outside. Good feelings and self-validation lie on the outside. Children of alcoholics, learn to be care takers or rescuers early in life. They've developed a mechanism that h elped in coping with fear, pain, insecurity and growing up in an abusive alcoholic family.Usually this is how the child copes with not being able to get their own needs met. â€Å"Self-confidence and readiness to accept different, sometimes negative views and responses of others, coupled with the ability to cope with occasional refusals or failures, are the key characteristics that help adolescents adopt healthy patterns of social behavior. † (Tomari, Martina) But later in life, as an adult, those well learned habits imprison them in frustrating, painful, co-dependent relationships, at home and at work.Some of the most common side effects are guilt; the child may see himself or herself as the main cause of the mother's or father's drinking. Another is anxiety; the child may worry constantly about the situation at home. He or she may fear the alcoholic parent will become sick or injured, and may also fear fights and violence between the parents. Then the embarrassment; parents may give the child the message that there is a terrible secret at home. The ashamed child does not invite friends home and is afraid to ask anyone for help.Then comes confusion; the alcoholic parent will change suddenly from being lovey to angry, regardless of the child's behavior. A regular daily schedule, which is very important for a child, does not exist because bedtimes and mealtimes are constantly changing. And then the anger; the child feels anger at the alcoholic parent for drinking, and may be angry at the non-alcoholic parent for lack of support and protection. Inability to have close relationships because the child has been disappointed by the drinking parent many times, he or she often does not trust others.Although the child tries to keep the alcoholism a secret, teachers, relatives, other adults, or friends may sense that something is wrong. Child and adolescent psychiatrists advise that the following behaviors may signal a drinking or other problem at home. Failure i n school, lack of friends, withdrawal from classmates, delinquent behavior, such as stealing or violence, frequent physical complaints, such as headaches or stomachaches, abuse of drugs or alcohol, aggression towards other children, risk taking behaviors, depression and suicidal thoughts.Some children of alcoholics may act like responsible â€Å"parents† within the family and among friends. They may cope with the alcoholism by becoming successful â€Å"over achievers† throughout school, and at the same time be emotionally isolated from other children and teachers. Their emotional problems may show only when they become adults, but in fact they have been â€Å"adult children† their whole lives. â€Å"Adult Child† carries a double meaning: the adult who is trapped in the fears and reactions of a child, and the child who was forced to be an adult without going through the natural stages that would result in a healthy adult.When the adult child of a dysfuncti onal family begins to enter the â€Å"real world† schools and the workplace they discover their family system is not the reality shared by their classmates and co-workers. Many adult children become loners or form tight, unhealthy relationships with other children of dysfunctional homes. These relationships actually re-enforce their dysfunctional view of the world by â€Å"finding another person who really understands. † The tightness of the bonds created in these relationships is accented by the child's lack of an individual sense of identity.They do not yet know where they stop and someone else begins. As a result they are unable to define their limits and begin to take on other people's opinions, defects and needs. If the adult child is able to form lasting friendships (some never do), it is usually with other adult children who provide familiar characteristics similar to the family's dysfunction. Adult children can be very slow to recognize the patterns of family p roblems. They spent their lives being trained by the family to not see the problem, even when they are re-created in friendships, marriages and work relationships.Whether or not their parents are receiving treatment for alcoholism, these children and adolescents can benefit from educational programs and mutual-help groups such as programs for children of alcoholics, Al-Anon, and Alateen. Early professional help is also important in preventing more serious problems for the child, including alcoholism. Studies from the US and Australia have shown that easy local alcohol access is associated with adolescent alcohol consumption and alcohol abuse. Dale, Richard) Child and adolescent psychiatrists help these children with the child's own problems, and also help the child to understand they are not responsible for the drinking problems of their parents. The treatment program may include group therapy with other youngsters, which reduces the isolation of being a child of an alcoholic. The c hild and adolescent psychiatrist will often work with the entire family, particularly when the alcoholic parent has stopped drinking, to help them develop healthier ways of relating to one another.One very successful form of recovery for adult children involves acknowledging the existence of an inner child. The child, who was small, lost and without hope never really went away, but froze. Recovering adult children can find that inner child and resume the process of nurturing to allow him/her to complete the job of growing into a healthy adult. Many counselors, therapists and psychologists have been valuable to many adult children in the process of recovery. Growing up in an alcoholic family is certainly traumatic, and it seems there are no positive aspects involved.The fact of the matter is these children will be scarred for life and most likely need some kind of counseling in the future depending on the severity of the abuse. Too many children in America have lived through this dre adful lifestyle. Alcohol simply should never be abused, neither should the children. One misconception that many alcoholics and addicts seem to have is that their drinking or substance abuse is not affecting anyone else. Many times they will make statements like, â€Å"I'm not hurting anyone but myself! † Unfortunately, there is a great deal of research and a vast amount of anecdotal evidence that this is simply not the case. Hurt people . . . hurt people. † The behavior of addicts and alcoholics can affect everyone around them, including family, friends, employers and coworkers. Perhaps those most vulnerable to the effects of alcoholism or addiction are their children. If you have a drinking or a drug abuse problem and you have children in your home, they are being affected, sometimes so profoundly that the effects last their entire lifetimes. Children of alcoholics and addicts can have deep-seated psychological and emotional reactions to growing up with an addicted pa rent. Emergent from an alcoholic family is harrowing.In these homes, children experience a daily environment of inconsistency, chaos, fear, abandonment, denial, and real or potential violence. Survival becomes a full-time job. While most of us know that alcoholism is a disease, too few recognize it as a family disease, which may emotionally, spiritually and often physically, affect not only the alcoholic but each member of the family. Little emotional energy remains to consistently fulfill the many needs of children who become victims of the family illness. For many years, professional psychologists were barely aware of the vast pool of suffering of the family of alcoholics.They concentrated on healing the alcoholic and felt that it solved the problems of the family as well. Today they realize that the whole family suffers this sickness and all must be made well. By looking at what it is like to live in an alcoholic's home, the side effects, and how to cope with the problem there is conclusive evidence to see how the disease negatively affects the children. Dale, Richard A. , et al. â€Å"Alcohol environment, gender and nonfatal injuries in young people. An ecological study of fourteen Swedish municipalities (2000-2005). †Ã‚  Substance Abuse Treatment, Prevention, and Policy  7 (2012): 36.Academic OneFile. Web. 18 Apr. 2013. http://proxy01. nwacc. edu:2076/ps/i. do? id=GALE%7CA307422823&v=2. 1&u=nwestakcc&it=r&p=AONE&sw=w Tomori, Martina. â€Å"Personality characteristics of adolescents with alcoholic parents. †Ã‚  Adolescence  29. 116 (1994): 949+. Academic OneFile. Web. 18 Apr. 2013. http://proxy01. nwacc. edu:2076/ps/i. do? id=GALE%7CA16477257&v=2. 1&u=nwestakcc&it=r&p=AONE&sw=w Brennan, Patricia A. , Emily R. Grekin, and Constance Hammen. â€Å"Parental alcohol use disorders and child delinquency: the mediating effects of executive functioning and chronic family stress *.   Journal of Studies on Alcohol  Jan. 2005: 14+. Academic OneF ile. Web. 18 Apr. 2013. http://proxy01. nwacc. edu:2076/ps/i. do? id=GALE%7CA132050571;v=2. 1;u=nwestakcc;it=r;p=AONE;sw=w Pinto, Violet, and Rajan Kulkarni. â€Å"A Case Control Study on School Dropouts in Children of Alcohol-Dependent Males Versus that in Abstainers/Social Drinkers' Children. †Ã‚  Journal of Family Medicine and Primary Care  1. 2 (2012): 92. Academic OneFile. Web. 18 Apr. 2013. http://go. galegroup. com/ps/i. do? id=GALE%7CA313826180;v=2. 1;u=nwestakcc;it=r;p=AONE;sw=w