Napoleon Essay -- essays research papers

Direction to Freedom or Just Another Tyrant?      When a great many people consider Napoleon Bonaparte they consider either a despot head or a splendid war tactician. Perhaps both are correct however in whatever end any individual comes to, they will realize he was a little man who achieved numerous incredible things. Napoleon vanquished nations and built up a mass realm, which prompted his big name like acclaim. He was a man that regarded societies and each religion and even cried when his men passed on the combat zone. Bonaparte was a stunning individual who drove himself with extraordinary desire to get perhaps the best head ever.  â â â â In life each incredible pioneer has had their own story to tell. Napoleon was brought into the world a Corsican, at Ajaccio, in 1769. He had seven siblings and sisters and he was likewise a descendent from the Florentine honorability. He moved to France and began school at nine years old. At school he was singled out on account of his Italian intonation and on account of his influent French. At the point when he turned sixteen he joined the French mounted guns and turned into a lieutenant in a brief timeframe. Napoleon went through the following seven years perusing crafted by thinkers and teaching himself in military issues, by contemplating the battles of extraordinary military pioneers of the past. He at that point turned into a general and afterward in 1795 was selected to stop an uprising in Paris and withdrew in doing as such. Subsequent to halting the uprising he was then given the situation of president of the inside French armed force in Italy. In 1799 he was chosen as the First Consul of France in light of the fact that the individuals were tired of the catalog. He ascended in power in the military and furthermore strategically. He at that point shaped his own domain and won numerous fights with his brightness.      Bonaparte was a canny man with an extrodinary memory, while remaining extremely receptive toward different people’s convictions. As Vox states â€Å"When he had an hour for preoccupation, he not rarely utilized it in investigating a book of logarithms [†¦]. So retentive was his memory of numbers, that totals over which he had once looked his eye were in his brain ever after (69).† If I lived in his domain I would at any rate regard Napoleon for his brightness, his capacity to remember data, and his will to find out additional. Despite the fact that, Napoleon despite everything remained imperfect. He was still just human ... ...gh his very effective Italian crusades, his progressive changes in the French government and fights against the Third Coalition Napoleon gave France complete control over Western Europe. France at that point turned into an extraordinary country on account of Napoleon’s brightness and accomplishments as a pioneer. Works Citied Blair, Victor. Napoleon, The Man, Encapsulated. 10 Dec. 2002  â â â â Britt, Alber Sidney. The Wars of Napoleon. New Jersey: Avery Publishing Group Inc.,  â â â â 1985 Holtman, Robert. Napoleonic Propaganda. New York: Greenwood Press Publishers, 1969 Holtman, Robert. The Napoleonic Revolution. New York: J.B. Lippincott Company,  â â â â 1967 Markham, Felix. Napoleon and the Awakening of Europe. London: The English      Universities Press Ltd., 1954 Mill operator, Tom. Prior to Brumaire: Napoleon’s Development as a Ruler. 10 Dec. 2002  â â â â Naylor, John. Waterloo. London: Pan Books Ltd., 1960 Vance, Thomas. The Lost Voices of Napoleonic Historians. 10 Dec. 2002  â â â â Vox, Maximilien. Napoleon. New York: Grove Press Inc., 1960

Write a final piece on your experience on this module (Developing work Essay

Compose a last piece on your experience on this module (Developing work and study abilities), - Essay Example With the module that I decided on I have had the option to exceed expectations in my significant subjects and accomplish my objectives separately. I have had the option to accomplish the aptitudes of evaluating as now I know the significant procedures which are engaged with the procedure. Get-together data and deciphering it so as to not play a job in it is a significant element of this module which I have figured out how to exceed expectations in. The module additionally permitted us to function as a gathering and hence it has built up my correspondence and gathering working abilities. With various tasks and assignments I have figured out how to form a report on the significant themes. Likewise introductions have additionally framed a significant part of this module through which I have figured out how to pick up certainty and think about my perspectives, objectives and practices. Over all I have figured out how to oversee time as a result of which I had the option to finish every o ne of these assignments appropriately. Anyway finishing this module has not been as simple as it appears when telling about the accomplishments and this is a direct result of my shortcomings. In any case, then again my qualities have helped me to adapt up to these shortcomings with the goal that I can accomplish my objective without any problem. Most importantly the fundamental qualities that I have are group working aptitudes as a result of which I can have the option to fill in as a pioneer. I can have the option to lead a gathering of people to progress as I have the relative relational abilities which can fulfill all my gathering individuals. Above all else the primary concern that I have gained from this course will help me a ton and that is time the executives. Usage of time is a significant part of life, without which one would not have the option to isolate and use time according to his/her needs. Time the board has caused me to exceed expectations throughout everyday life and I figure it would additionally help me throughout everyday life. In addition I likewise have assurance to finish my objectives and points. Be that as it may, as said by Christopher Moore Nobodys great. All things considered, there was this one person, however we slaughtered him..... It

Logitech International SA Case Study Example | Topics and Well Written Essays - 500 words

Logitech International SA - Case Study Example The capacity to advance is a key achievement factor which decides the presentation of a business association (Logitech Annual Report 2007). Acquiring the items the market at the correct time empowers an organization to beat its rivals and get by in an exceptionally unsafe market. Logitech is working in a worldwide scene presenting it to the vacillations of trade rates (Logitech Annual Report 2007). This conversion scale hazard makes the organization defenseless against the adjustments in estimation of monetary forms. For example, the debilitating of the dollar because of the financial downturn makes its pay in the United States lower when communicated in Swiss franc. This thusly can make financial specialists attentive in putting resources into Logitech taking note of that conversion scale vacillations can recoil the organization's incomes and benefits when communicated in Swiss francs. Monetarily, the organization is additionally presented to the downturn in the United States and the nourishment emergency occurring in Asia. It ought to be noticed that these are Logitech's significant markets. As the extra cash of buyers in these districts is crushed, IT items become unappealing as they go to assigning spending plans for fundamental necessities like nourishment and medication. The entire IT industry is ready to profit by the financial advancement of nations like China and India.

Reasons Why People Prefer the Use of Free Write Essay Topics

Reasons Why People Prefer the Use of Free Write Essay TopicsThere are a number of writers who are interested in the possibility of using free write essay topics to boost their writing skills. With these writers the chance to improve their writing skills with the help of a 'free' article is also attractive.What are some of the reasons why people prefer the use of free write essay topics? The first reason is that they do not have to pay for the entire usage of such topics. These topics can be used at your own will and without any restrictions.The second reason why people prefer the use of free write essay topics is that they can use the information obtained from these topics. These topics are free of charge. The writer can obtain much information regarding the topic if he is willing to spend some time and energy on it.The third reason why people prefer the use of free write essay topics is that these topics are suitable for beginners. It is easy for beginners to learn the technique of writing, reading and editing essays. Most of the writers are able to learn how to do so because the use of free write essay topics is free.The fourth reason why people prefer the use of essay topics is that these topics are useful in terms of understanding and forming a good perception of one's own abilities. It is not wise to take the opinion of someone who does not understand the basics of writing skills.People prefer the use of essay topics because these topics are designed to introduce certain information which is used in the practice of writing essays. These topics can help you in the improvement of your writing skills in terms of identifying the right tone, using correct grammar, correcting the errors in the composition, etc.There are several other reasons why people prefer the use of free write essay topics. For sure you can easily come up with more.

Statement of Purpose for Reporters and Creative Writers

Reporters and creative writers both further the freedoms of people. They give people the chance to read and learn about the world we live in. Reporters and creative writers must be fantastic writers and decent editors. Workers in both of these professions will be editing and revising their own pieces of work. I love writing and being creative in my writing style and spend hours at a time just writing, so these qualities are appealing to me. Though both include literary work, both differ the most in their work environments. Reporters can work irregular hours and travel at a moment’s notice. I would get to travel and experience the world through others’ eyes. Creative writers work from home on their own schedule, at their own pace. They can let their creativity flow freely because they are not confined by a cubicle. The ability to be spontaneous in reporting is highly appealing to my personal taste. With my personality and skills, reporting is a better career for me than creative writing. People now a day’s try to cover up the truth about things that are not so desirable, so that’s why the world needs reporters. People are needed that are willing to dig underneath all the lies to find the truth. Luckily, I have been gifted with a moral shovel that helps me sift through the falsities. It’s in reporter’s job description to write a lot and I enjoy writing. A lot of their time is also spent on the internet or in the library researching a topic they will be reporting on. They haveShow MoreRelatedInstallation Art And Its Impact On Art2857 Words   |  12 PagesINSTALLATION ART Installation art is living art which makes it relevant in our daily lives. It can be seen on display in communities, in business, in architecture, and in education. Additionally, it is pivotal in making a political statement as well as entertainment inclusively film installations, film and television productions. Installation Art did for art, what film did for photography, bringing life and movement into what would otherwise be still. Business use of installation art and the excitementRead MoreLeader Analysis: Winston Churchill2834 Words   |  12 PagesJoyce Russell Leader Analysis: Winston churchill by Alicia Lynch 21 February 2011 Leader Analysis: Winston Churchill Winston Churchill was arguably one of the most significant political leaders in the last century. A soldier, athlete, author, reporter, British politician, and international statesman, Churchill is best known as the Prime Minister of the United Kingdom from 1940-1945. He organized and guided British resistance against Nazi Germany’s effort to subdue the European Continent and heavilyRead MoreWhat Does a â€Å"Political Economy† Approach to Study of the Creative and Cultural Industries Involve? 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Lyric D. Romance 13. Which of the following statements is not an accurate reflection of ancient Greek religious beliefs? A. The Greek god Zeus was subject to the mysterious power of fate. B. The Greek gods were expressions of the world’s uncontrolled forces. C. The Greeks blamed humanity forRead MoreChapter-2-Business-Communication-Essentials-6e Essay11545 Words   |  47 Pagesindividual agendas D) constructive resolution of conflicts E) limited communication Answer: D Explanation: D) Conflict can be constructive if it forces important issues into the open, increases the involvement of team members, and generates creative ideas for solving a problem. Classification: Conceptual LO: 1 Difficulty: Moderate Learning Outcome: Describe best practices in team and interpersonal communication 9) When undertaking a collaborative writing project, which of the followingRead MoreRed Bull Cool Factor7077 Words   |  29 Pagesdrink market. 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To Kill a Mockingbird by Harper Lee - 1265 Words

Brother and Sister; Boy and Girl In the novel To Kill A Mockingbird by Harper Lee, they were both kids. They were both immature children, they both taunted Boo Radley, they both interpreted things similarly and they both eventually came of age. Yet they were both different; one was innocent and one was narcissistic and more. In To Kill A Mockingbird, Jem and Scout are two very similar and different characters throughout the entire novel. They show both common and differentiating traits that determine their character. The traits that these characters had in common were they both thought similarly when a situation arose especially when they were at a younger age, they both started out as immature kids and obsessed over childish things like Boo Radley, and they both eventually came of age. The traits they differed in were that Scout throughout the whole novel was an innocent character even in her coming of age while Jem was a narcissistic one, Scout went against what her family/town wanted her to be (a lady ) while Jem tried more and more to be like Atticus and lastly Scout never understood racism while Jem showed he somewhat did understand it. These two main characters are similar like brother and sister and different like boy and girl. Jem and Scout, being brother and sister, share many common characteristics in To Kill A Mockingbird; one of the large comparisons being that they both commonly but not always interpreted a situation similarly.Show MoreRelatedKill A Mockingbird By Harper Lee1049 Words   |  5 PagesTo Kill a Mockingbird: How a Story could be based on True Events in Everyday LifeDaisy GaskinsCoastal Pines Technical Collegeâ€Æ'Harper Lee was born in Monroeville, Alabama. Her father was a former newspaper editor and proprietor, who had served as a state senator and practiced as a lawyer in Monroeville. Also Finch was known as the maiden name of Lee’s mother. With that being said Harper Lee became a writer like her father, but she became a American writer, famo us for her race relations novel â€Å"ToRead MoreTo Kill a Mockingbird by Harper Lee1000 Words   |  4 Pagesworld-wide recognition to the many faces of prejudice is an accomplishment of its own. Author Harper Lee has had the honor to accomplish just that through her novel, To Kill a Mockingbird, a moving and inspirational story about a young girl learning the difference between the good and the bad of the world. In the small town of Monroeville, Alabama, Nelle Harper Lee was born on April 28, 1926. Growing up, Harper Lee had three siblings: two sisters and an older brother. She and her siblings grew up modestlyRead MoreKill A Mockingbird By Harper Lee873 Words   |  4 PagesIn the book, To Kill a Mockingbird, Harper Lee illustrates that â€Å"it’s a sin to kill a mockingbird† throughout the novel by writing innocent characters that have been harmed by evil. Tom Robinson’s persecution is a symbol for the death of a mockingbird. The hunters shooting the bird would in this case be the Maycomb County folk. Lee sets the time in the story in the early 1950s, when the Great Depression was going on and there was poverty everywhere. The mindset of people back then was that blackRead MoreKill A Mockingbird By Harper Lee1290 Words   |  6 PagesHarper Lee published To Kill a Mockingbird during a rough period in American history, also known as the Civil Rights Movement. This plot dives into the social issues faced by African-Americans in the south, like Tom Robinson. Lee felt that the unfair treatment towards blacks were persistent, not coming to an end any time in the foreseeable future. This dark movement drove her to publish this novel hopeful that it would encourage the society to realize that the harsh racism must stop. Lee effectivelyRead MoreKill A Mockingbird By Harper Lee963 Words   |  4 Pagesgrowing up, when older characters give advice to children or siblings.Growing up is used frequently in the novel To Kill a Mockingbird by Ha rper Lee. Harper Lee uses the theme growing up in To Kill a Mockingbird to change characters opinion, develop characters through their world, and utilizes prejudice to reveal growing up. One major cause growing up is used in To Kill a Mockingbird is to represent a change of opinion. One part growing up was shown in is through the trial in part two of the novelRead MoreKill A Mockingbird By Harper Lee1052 Words   |  5 PagesTo Kill a Mockingbird by Harper Lee takes place in Maycomb County, Alabama in the late 30s early 40s , after the great depression when poverty and unemployment were widespread throughout the United States. Why is the preconception of racism, discrimination, and antagonism so highly related to some of the characters in this book? People often have a preconceived idea or are biased about one’s decision to live, dress, or talk. Throughout To Kill a Mockingbird, Harper Lee examines the preconceptionRead MoreHarper Lee and to Kill a Mockingbird931 Words   |  4 PagesHarper Lee and her Works Harper Lee knew first hand about the life in the south in the 1930s. She was born in Monroeville, Alabama in 1926 (Castleman 2). Harper Lee was described by one of her friends as Queen of the Tomboys (Castleman 3). Scout Finch, the main character of Lees Novel, To Kill a Mockinbird, was also a tomboy. Many aspects of To Kill a Mockingbird are autobiographical (Castleman 3). Harper Lees parents were Amasa Coleman Lee and Frances Finch Lee. She was the youngestRead MoreKill A Mockingbird By Harper Lee1695 Words   |  7 PagesIn To Kill a Mockingbird Harper Lee presents as a ‘tired old town’ where the inhabitants have ‘nowhere to go’ it is set in the 1930s when prejudices and racism were at a peak. Lee uses Maycomb town to highlight prejudices, racism, poverty and social inequality. In chapter 2 Lee presents the town of Maycomb to be poverty stricken, emphasised through the characterisation of Walter Cunningham. When it is discovered he has no lunch on the first day of school, Scout tries to explain the situation to MissRead MoreKill A Mockingbird, By Harper Lee1197 Words   |  5 Pagessuch as crops, houses, and land, and money was awfully limited. These conflicts construct Harper Lee’s novel, To Kill a Mocking Bird. In To Kill a Mocking Bird, Lee establishes the concurrence of good and evil, meaning whether people are naturally good or naturally evil. Lee uses symbolism, characterization, and plot to portray the instinctive of good and evil. To Kill a Mocking Bird, a novel by Harper Lee takes place during the 1930s in the Southern United States. The protagonist, Scout Finch,Read MoreKill A Mockingbird By Harper Lee1876 Words   |  8 PagesThough Harper Lee only published two novels, her accomplishments are abundant. Throughout her career Lee claimed: the Presidential Medal of Freedom, Pulitzer Prize for Fiction, Goodreads Choice Awards Best Fiction, and Quill Award for Audio Book. Lee was also inducted into the American Academy of Arts and Letters. This honor society is a huge accomplishment and is considered the highest recognition for artistic talent and accomplishment in the United States. Along with these accomplishments, her

Mental Health Nursing Emotional and Psychological

Question: Describe about the Mental Health Nursing for Emotional and Psychological. Answer: Introduction Mental health essentially comprises of a persons emotional, psychological as well as social well-being. Mental health is a very big problem all over the globe. Statistically speaking, four hundred and fifty million people all over the world have a mental health problem. According to Australian bureau of statistics, roughly 30 percent of the adult population, as well as 15 percent of young people, struggle with mental illness (Australian and New Zealand College of Mental Health Nurses, 2002). This makes it imperative or health care professionals to learn crucial mental health skills so that they can be able to handle patients suffering from mental illness. Roughly ten percent of the population experience anxiety at a level that interferes with their daily lives. Anxiety disorders are usually more common in women than in men. People who suffer from mental health problems should receive unwavering support for the recovery framework to be successful. The absence of mental illness ensures that an individual is able to realize his or her potential therefore excelling in whatever he or she undertakes since he or she is able to deal with the normal stress of life (Muir-Cochrane, 2014). As far as the case study is concerned, Georgia suffers from anxiety and a recovery-oriented approach needs to be employed to ensure that she recovers successfully. Anxiety is a serious mental illness and it has to be treated with the seriousness that it deserves. Recovery focuses mainly on an individuals well-being, empowerment as well as autonomy. Recovery should not just concentrate on reducing or eliminating symptoms but it should focus on the patients journey while living with a mental illness. To provide healthcare to Georgia, first, the health professional must embrace teamwork. For proper are to be provided multidisciplinary teamwork must be encouraged. The multidisciplinary team comprises of a nurse, medical and allied health experts. This proves to be very beneficial to the patient since each professional has diverse skills and capacities hence translating to holistic care for the mental patient which assists in his or her recovery (Root, 2000). Protective and Risk Factors As a health professional treating Georgia, I would need to have sufficient knowledge regarding protective and risk factors associated with anxiety so as to provide holistic treatment. The approach to be used must be sensitive to the fact that some factors increase the risk of relapse while others tend to be protective of mental health. The recovery plan must not only focus on treatment of anxiety but also consider other factors like social and economic aspects that affect Georgias life. Protective factors reduce the likelihood that a disorder will develop by reducing exposure to risk as well as reducing the risk factors for those already exposed to the risk. Both protective and risk factors comprise of biological, genetic, demographic conditions, behavioral as well as social-cultural (Muir-Cochrane, 2014). Therapeutic Relationship I would establish a therapeutic relationship between Georgia, her family and me to guarantee effective mental health care. This kind of relationship calls for trust, empathy as well as effective communication. The fundamental purpose of the relationship is to facilitate the development of learning and coping skills by the patient. Secondly, it encourages the patient to carefully state their problems as well as discernments of their distress. Thirdly, it creates a favorable atmosphere where the professional is able to engage with the patient for the purposes of completing a full assessment and care plan. Finally, it facilitates a healthy lifestyle by creating awareness proper diet and nutrition, rest, sleep as well as exercise (Root, 2000). Support System I would establish a good support system for Georgia. The patient does not have a support system since her parents live four hours away and she has also lost touch with her friends. Spending time with others serves as a powerful tool for commitment and confidence to an anxiety recovery program. I would encourage the patient to accept the invitations from her friends since having people who one can comfortably talk to aids in reducing the severity of anxiety (Hyman Pedrick, 2006). Examination Skills I would ensure that I have essential mental state examination skills. Some of this skills consist of listening carefully, introducing myself, observing non-verbal behavior, being honest in my responses, asking open questions as well as keeping communication open so as to allow the patient to explain what they think is the current problem. These skills will ensure that an expert is able to gather and learn a lot about the patients problems, therefore, making it easier to come up with anxiety elimination or reduction strategies (Videbeck, Acott Miller, 2009). Dietary Adjustments I would suggest to Georgia to do some dietary adjustments. A diet that has magnesium mineral aids the muscle tissues to relax. When this mineral is not consumed in the sufficient quantities, it can result in depression, anxiety, and insomnia. Furthermore, if vitamin B and calcium are not taken in adequate quantities as well, it can aggravate anxiety symptoms. Nicotine, caffeine, as well as stimulant drugs, should be avoided at all costs since they tend to stimulate adrenaline glands to release adrenaline which is a stress chemical. I would encourage Georgia to ensure that her diet contains leafy green vegetables, low-fat dairy products as well as whole grain cereals (Root, 2000). Distraction I would also encourage Georgia to stay busy at all times. Naturally, individuals who suffer from anxiety tend to do less mainly because their anxiety makes it difficult for them to enjoy activities of any kind. Anxiety is a condition which calls for one to use his or her brain and when that is not done then the condition tends to get worse. I would encourage the patient to stay busy by distracting herself with healthy activities, for instance, listening to music, playing games or puzzles as well as watching funny shows on television. This will ensure that the mind is always occupied therefore leaving less time to focus on anxiety (Orsillo Roemer, 2005). Professional Conduct Being respectful and non-judgmental will also prove useful as far as treatment of Georgia is concerned. It is fundamental that the health professional who handles Georgia be respectful especially considering the symptoms that she experiences are somewhat laughable. Being judgmental interferes with the treatment and the patient may not be able to respond positively to the medical professional once she realizes that she is being disrespected and judged (Parks, 2011). Professional Boundaries Professional boundaries must be observed at all times. Boundaries essentially refer to verbal and non-verbal communication between groups or individuals. The health professional is tasked with the responsibility of dictating the level of interaction so as to facilitate the achievement of full recovery of the patient. Code of conduct and code of ethics act as other helpful guidelines that professionals should constantly consult when dealing with patients (Orsillo Roemer, 2005). Medication As far as treatment of the condition is concerned, Georgia should be given medication to help her in the recovery process. She should be given anxiolytics which are essentially antianxiety drugs. They are used for relieving acute panic as well as anxiety. Georgia will also be able to sleep better since the drugs relieve insomnia (Quigley, 2007). When these drugs are taken in relatively small doses, they tend to have a calming and slowing down effect. On the other hand, when taken in high doses, they act as sedatives. If she takes these drugs in small doses, they can help her concentrate and breath properly since they will keep her calm and corrected. There are minimal side effects for example nausea, headaches, unsteadiness as well as low blood pressure (Muir-Cochrane, 2014). Behavioral Psychotherapy Georgia should also undergo behavioral psychotherapy as part of his recovery program. Behavioral psychotherapy concentrates on modifying certain patterns of a persons behavior that tend to be bothersome. Through this recovery method, people learn to fight and overcome their fears especially by constantly spending more time in situations that they fear and by learning ways of minimizing their anxiety (Muir-Cochrane, 2014). New skills are practiced through especially if they are given homework exercises. Some of the skills that can be practices comprise of breathing as well as keeping a diary where an individual records his or her feelings, thoughts, and levels of anxiety (Nutt Ballenger, 2003). This form of therapy would be particularly suitable for Georgia since she will learn to control her breathing and the same time learn to take control of the environment around her. If that is done, she will be able to successfully acquire a driving license. Cognitive Therapy Cognitive therapy should also be employed in her treatment plan. Cognitive therapy is crucial since it concentrates on changing thinking patterns (Muir-Cochrane, 2014). It closely examines how individuals think about certain things particularly those that are negative in nature causing one to experience distressing emotion. Cognitive therapy endeavors to replace those negative and bad thoughts and substitute them with realistic and positive ones. It tends to focus more on present and future rather than childhood and past experiences that might be painful to remember (Healey, 2003). This strategy will enable Georgia to come with stress that she is facing currently which is one of her greatest problems in her life. Acceptance and Commitment Therapy Acceptance and commitment therapy can also be effective in the recovery of Georgia. It is founded on the notion of mindfulness which is essentially a mental state of full awareness. This method calls for an individual to concentrate on the moment. Concentrating on the moment allows a person to be calm and grounded hence more likely to accept their current situation and the need for change executed (Ruggiero, 2008). By so doing, the patient is able to have more control and fulfillment in his or her life which is exactly what Georgia needs for her to transform her life (Helgoe, Wilhelm Kommor, 2006). Motivational Interviewing Motivational interviewing should also be incorporated in her treatment approach. This therapy assists an individual to discover the good and the bad reasons associated with making a change. It relies on identifying the readiness of an individual to change and then using supportive and persuasive approaches to try and compel a person to make a decision as to the plan of action to take in the process of making changes (Muir-Cochrane, 2014). This strategy will ensure that Georgia has a good plan as far as the change she is going to make in her life is concerned. This strategy will ensure that at the end of the day Georgia will recover and live a normal life. When the strategy to execute change comes from the patient, following through with the plan becomes relatively easy (Hogan, Przybylowicz Vacek, 2013). Physical Activity Exercise is also recommended. Georgia used to go for her usually walks in the early evening but she has stopped. Going back to this everyday routine will be very important as far as her health and well-being are concerned. Exercise is vital for maintaining mental fitness and reducing stress. According to studies, exercise is effective when it comes to reducing fatigue, improving alertness as well as concentration (Mclean Woody, 2001). Furthermore, it enhances cognitive function. If Georgia starts engaging in physical activity, a lot of the problems that she is experiencing will reduce or go away. Exercise or engaging in physical activity produce endorphins which are essentially chemicals in the brain that function as natural pain killers hence improving the ability of an individual to sleep therefore reducing stress. According to studies, five minutes of vigorous aerobic exercise is sufficient to stimulate anti-anxiety effects (National Institute of Mental Health (U.S.), 2008). Furt her research points out that people who engage in vigorous exercise are 25 percent less likely to develop anxiety disorder over the next five years. This shows how powerful excise is to a persons health and well-being (Davidson Dreher, 2003). Conclusion All in all, mental illness is a very common problem in the world today. Roughly 30 percent of the adult population, as well as 15 percent of young people, struggle with mental illness in Australia. Anxiety is more common in men than women. To try and treat anxiety, a recovery approach must be implemented. First of all the expert must possess certain skills and knowledge for success to be realized. The expert must not be non-judgmental, establish a good rapport, respect the patient as well engage in a two-way communication with the patient. He or she must also advise the patient on the lifestyle changes that have to be made. In addition, he or she must also have knowledge of motivational interviewing, acceptance and commitment therapy, cognitive therapy as well as behavioral psychotherapy. When all these methods are implemented effectively, the chances of recovery as far as the patient is concerned increases significantly. References Australian and New Zealand College of Mental Health Nurses. (2002).International journal of mental health nursing. [Carlton, Vic.], Blackwell Pub. https://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1447-0349. Davidson, J. R. T., Dreher, H. (2003).The anxiety book: developing strength in the face of fear. New York, Riverhead Books. Healey, J. (2003).Mental health. Rozelle, N.S.W., Spinney Press. Helgoe, L. A., Wilhelm, L. R., Kommor, M. J. (2006).The anxiety answer book. Naperville, Ill, Sourcebooks. Hogan, M. A., Przybylowicz, T., Vacek, J. (2013).Mental health nursing. Boston, Pearson. Hyman, B. M., Pedrick, C. (2006).Anxiety disorders. Minneapolis, MN, Twenty-First Century Books. Mclean, P. D., Woody, S. R. (2001).Anxiety disorders in adults: an evidence-based approach to psychological treatment. Oxford, Oxford University Press. https://public.eblib.com/choice/publicfullrecord.aspx?p=241326. Muir-Cochrane, E. (2014).Mosby's pocketbook of mental health. https://search.ebscohost.com/login.aspx?direct=truescope=sitedb=nlebkdb=nlabkAN=816248. National Institute Of Mental Health (U.S.). (2008).Mental health medications. [Rockville, Md.], National Institute of Mental Health, U.S. Dept. of Health and Human Services, National Institutes of Health. https://purl.fdlp.gov/GPO/gpo16485. Nutt, D. J., Ballenger, J. C. (2003).Anxiety disorders. Malden, Mass, Blackwell Science. https://site.ebrary.com/id/10154822. Orsillo, S. M., Roemer, L. (2005).Acceptance and mindfulness-based approaches to anxiety: conceptualization and treatment. New York, Springer. https://public.eblib.com/choice/publicfullrecord.aspx?p=302082. Parks, P. J. (2011).Anxiety disorders. San Diego, CA, ReferencePoint Press. Quigley, A. (2007).Mental health. Detroit, Greenhaven Press. Root, B. A. (2000).Understanding panic and other anxiety disorders. Jackson, University Press of Mississippi. Ruggiero, A. (2008).Mental health. Detroit, Greenhaven Press. Videbeck, S. L., Acott, K., Miller, C. J. (2009).Mental health nursing. London, Wolters Kluwer/Lippincott, Williams and Wilkins.

War Crimes During the World War II

Table of Contents Introduction What is a war crime? The Holocaust The Bombing of Dresden The Atomic Bombs Conclusion Works Cited Introduction War crimes committed against humanity ought to be shade light on for the sole purpose of avoiding such occurrences taking place again. War crimes have continuously been committed by nations of the earth. This article will briefly discuss three events which should be viewed as war crimes and which took place during the World War II. The article will give the motivations behind those who undertook the actions and will clearly show why the actions should be considered as war crimes.Advertising We will write a custom essay sample on War Crimes During the World War II specifically for you for only $16.05 $11/page Learn More What is a war crime? It is very significant to be clear on what constitutes a war crime for this article to make any sense. The United Nations definition of war crime will be adopted for the argu ment made in this article. The Holocaust Even for those who have a shallow knowledge of the holocaust, it is clear that it has been the biggest genocide to have ever occurred. Six million Jews were systematically killed without mercy. They were lied to, gathered and led to their deathbeds just like animals to an abattoir. It is clear that the holocaust was a war crime by the fact that, these were innocent civilians (UN 1) who were targeted specifically because of the hatred that Hitler had for them. As a matter of fact, the outbreak of the WW II had nothing to do with the Jews and it is clear that the Jews were specifically targeted for elimination. They were transported from foreign regions outside Germany and brought to the concentration camps to face their death. The Holocaust is a classical example of how the deep the hatred of men can be. The Bombing of Dresden This is yet another event that qualifies to be considered a war crime. The bombs were dropped in a highly populated ci ty and there were so many deaths. Targeting of civilians is an act of a war crime and this is what happened at Dresden when the Russians attacked the Dresden. Bombing of residential houses is clear indication of targeting civilians (UN 1) and the Dresden bombing should be classified as a war crime. The Atomic Bombs In as much as the US might have wanted to stop the war by using the atomic bombs, it was aware the bombs would affect the civilians more than anything else. Think of the radiations which were going to affect people for generations.Advertising Looking for essay on history? Let's see if we can help you! Get your first paper with 15% OFF Learn More The physical structures could be easily put up again after the war but the genetically deformation and resultants mutation arising from exposure to the atomic bombs would be disastrous on the human beings. It was clear that the United States wanted to prove its mightiness but then it was done at the expense of innoce nt civilians. It should be noted that Nagasaki and Hiroshima were not villages but cities filled with civilians and not army artilleries. War ships and barracks are not found in cities. It is very clear that the US was on its way to annihilate the Japanese in the most mercilessly and cruel manner. Had war ships and barracks been targeted, it could have been blamed on the war but this was not the case as civilians were targeted. Conclusion The above brief discussion has made it clear that the three events were war crimes. It is a war crime to gather six million people and gas them systematically. It is a war crime to bomb cities with a full knowledge that there are thousands of civilians in those cities and not even a single war ship. Systematic targeting of civilians is considered an act of a war crime and this is what happened in the holocaust, the bombing at Dresden and the dropping of the atomic bombs at Nagasaki and Hiroshima. Works Cited UN. Crimes within the Court’s Jur isdiction. United Nations, 2011. Web. This essay on War Crimes During the World War II was written and submitted by user Greta A. to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Frederick Douglas Life essays

Frederick Douglas' Life essays Any anti slavery book published in 1845 was considered radical and daring, but for a black man and a fugitive slave, at that, to have done it was near suicide. Luckily, Frederick Douglass, the author of The Narrative of the Life of Frederick Douglass, was able to flee America by way of Great Britain after the book was released so that the United States could have time to embrace it. It was a story all too common in the United States at the time, but nearly unknown except by those to whom were involved, and even then, only the slaves knew the full story. Frederick Douglass knew his escape would have been in vain if he could not make others aware of the atrocities taking place in the south at the time. So, with utter disregard for the consequences of his actions, he revealed to the world the horror that was slavery. Douglass spends much of the novel addressing the most obvious aspect of slavery, which is the cruelty. The novel opens with Douglass talking of being sold from his mother at a young age and then several years later, after hearing of her death, being utterly unmoved as though it had been a total stranger. Although done subtlety, this part of the book hits very hard to the reader, because a reaction like that of Frederick to the death of one's parent is almost unimaginable. He says that his master may have been his biological father (a common occurrence on slave farms) and, the same as in his case, slaveholders sold away children from their mothers "too obviously to administer to their own lusts, and make a gratification of their wicked desires profitable as well as pleasurable." (Pg. 21) By this act many slaveholders had the "double relation of master and father."(Pg. 21) The story is saturated with accounts of severe beatings too numerous to site. Douglass goes from hearing the beating late at night as a small boy, to experiencing the whippings first hand as a young man. The "discipline ...

Ethics at the Top Two Auction Houses Essay Example | Topics and Well Written Essays - 5750 words

Ethics at the Top Two Auction Houses - Essay Example The value for money stretches from a few hundred dollars (e.g., wine) to millions in expensive paintings. (CEC 7) The auction sale of private collections may be held either with a certain motif, under a class of the commodity, or the art's genre or given time period. In 1996, Sotheby's sold at auction the estate of Jacqueline Kennedy-Onassis as a collection, while other public dealings were categorized in 'Old Master Paintings' or 'Jewellery'. Sotheby's fiercest competitor, Christie's also hold such glamorous, multi-million-dollar auction events, as the richest of richest of men grace such occasions. (CEC 7) Although both auction houses hold 'regular' auctions at their subsidiaries throughout the world (Rome, Geneva, Zurich, Amsterdam, Milan, Melbourne and Hong Kong), high-profile auction events are generally held at their London and New York headquarters. (Ashenfelter & Graddy 3-25) The auction houses, which accept items to be auctioned (on a consignment basis), handle each necessary arrangement for the event, including planning, design and distribution of high-class brochures, advanced publicity as well as viewing opportunities. To facilitate sales, merchandise are sold individually (called 'lots'), even large collections are separated and auctioned as a single item. As seller of the consignor's items, the auction house manages all the account procedures: bills the buyer, remits the consignor the money after the purchase of the merchandise, minus the commission, taxes and other expenses. The commission is computed within the 'hammer price,' when the item is settled to the winning bidder. Regarded as 'seller's commission' or 'vendor's' commission, a certain percentage is taken from the consignor. The 'buyer's premium,' or a percentage from the hammer price is also charged to the buying public at the auctions (CEC 8). A percentage of the hammer price, called the buyer's premium, is also charged to people making purchases at auctions. This practice was initially introduced in the main auction rooms of these two auctions giants, sometime in 1975-only a few weeks from each other. Both firms made several changes on this practice through the years (independently from each other), but eventually both of their practices became similar. Auctioneering is not the only source of income of these two firms as both are engaged in other commercial activities, such as offering loans against the security of works of art. Nonetheless, the main sources of revenues remain the buyer's premium and vendor's commission. (CEC 8) The turgid exercise of auctioning fine arts produce a discriminating product market effect other than conventional ventures of selling or buying the items that serves the purpose of assessment value, based on the following (CEC 8). Firstly, clients consider the great importance of consigning their items at auctions due to the high standard of publicity for the merchandise. Likewise, consignors achieve the highest possible

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

Geotechnical - Essay Example Geotechnical engineering uses the geophysical methods in measuring the physical properties on the earth sub surface. These methods have the potential of measuring the anomalies in the properties of soil to identify the position and the presence of minerals (Das and Sobhan, 2013). They involve applying physical methods in measuring the physical traits of rocks and soil thus detecting the physical differences between the rocks that have the hydrocarbons or ore deposits. This paper explores the different types of geophysics method and their use in geotechnical engineering. Electromagnetic induction (EM) involves a method that uses the induction principles in measuring the electrical conductivity of the subsurface. Different from the techniques of conventional resistivity, EM requires no contact in the ground. This eliminates the fast problems of electrical coupling allowing much acquisition of rapid data. Since the EM instruments give an easy and rapid collection of data, the instruments are always used as the tools of reconnaissance used in identifying the greatly detailed anomalies (Nobes, 2000). The induced electromagnetic pulse can be measured using the frequency domain meters and time domain meters. GPR (ground penetrating Radar is utilized in pinpointing the buried objects location and mapping and having stratigraphy mapped out. It gives the shallow subsurface cross-sectional measurements. The method has the ability of locating the nonmetal and metal objects. In many cases, data and profiles are recorded and the result is shown using the real time having the attached display unit of the computer. This results into a fast and easy field interpretation. More data interpretation could be done later (Nobes, 2000). The instruments of GPR have energy beamed into the ground from the antenna in the electromagnetic wave form. An energy position is reflected towards the antenna at the specific subsurface

Ethnic Groups and Discrimination Essay Example for Free

Ethnic Groups and Discrimination Essay I belong to the White ethnic group which was responsible for the colonization of North America. While I am part of the White ethnic group, my family immigrated to the United States from Germany quite some time after the major colonization of North America. When most people think about the colonization of North America they think of White people on the Mayflower landing on Plymouth Rock. While the pilgrims did colonize what is now referred to as New England, the Spanish were actually the first to colonize North America. No matter who first colonized North America, this colonization caused an influx of immigrants that asserted their dominance over the native people. This colonization was also the root cause of slavery being introduced to this New World. Pilgrims are most notably identified as coming to North America to escape religious persecution. The ironic part of the colonization is that the pilgrims forced their religion on those native to North America. It is important to note that this may be one of the first indications of future ethnic and racial problems that would caused by the colonization of North America. I dont think people normally think about racism happening to Caucasians. Unfortunately it is very common for racism to happen to all ethnic groups in the U. S. Caucasian racism and prejudice against other ethnic and racial groups always seem to get the most publicity. It would be better to broaden our view of prejudice and racism so that we could get the whole story. I think that the Caucasian group had brought most of this negative attention on itself. Historically the U. S. has been dominated by Caucasians, which means this group doesnt have as much to worry about restrictions due to ethnicity or racial group. If we break down the Caucasian group even further we can see that this is even truer for the males, which I am, of this group. Male Caucasians have long been the dominant force in U. S. society. The majority of restrictions placed on females and ethnic groups have been enforced by Male Caucasians. The most notable Caucasian discrimination has been against African Americans. African Americans were largely used for slave labor during the beginning of the U. S. Going from slave to equal isnt easy, in both occurrence and acceptance from the former dominant or controlling group. This dominant position can be seen as a major reason why the view of discrimination is still focused on Caucasians. Since the Caucasian males of the past have put restrictions on most other ethnic groups, this wrong was attempted to be undone by Affirmative Action laws (Fullinwider, Robert). While most people see Affirmative Action as being helpful, it has also caused discrimination against Caucasian males. Some government agencies require a quota on hiring certain ethnic groups (this included female Caucasians). This can cause a job candidate that has hirer qualifications to be passed over just to fulfill a quota. I have seen this happen to my father while he was applying for a firefighter/EMT position. You can easily see the Caucasian male dominance by noticing the dual labor market effect. I see it more as a multiple labor market since I would also include female Caucasians as another labor market. Immigrants from Mexico often enter into a portion of this multiple labor market, most notably the farming community. Whether it is farming, manual labor, or the lower-end service sector it seems that it seems more acceptable to Caucasians for other ethnic groups to occupy these types of jobs. When the other ethnic groups occupy positions normally held by Caucasian males, we often see a limitation in their ability to progress in that profession (glass ceiling). If you look at the breakdown of people who run companies you will see this is dominated by Caucasians males, followed by males of the other ethnic groups, then females of all ethnic groups. Discrimination isnt only apparent in the job market, but in how companies invest in certain areas. It is seen in our response to what is happening in other areas of cities or areas of the country. We have slums and ghettos that dont get investment monies to fix them up due to the lower class segregation. We have other areas occupied by a high number of non-Caucasians that dont get investments just because of their ethnicity. New Orleans is a perfect example of all of these inequalities. It was a city segregated by race, ethnicity, and social class standing. The devastation caused by hurricane Katrina happened to people who couldnt afford to get out on their own, and was compounded by the predominantly Caucasian governments lack of response (arguably due to the racial differences between U. S. leaders and with the people effected by the disaster). I dont feel that I fit in with the standard culture for my Caucasian ethnic group or the U. S. mainstream culture. I dont participate in any religions, as I believe in myself and science that can be proved. I dont feel that I am or need to be better than any other ethnic group. I couldnt care less about what style is popular or what haircuts are in. I just try to be myself and try to ignore things that try to sway my opinions. Instead of taking someones word for something I would rather research and come to my own decision (almost to a fault). I think it is better to be different than a lemming following the crowd running off the cliff. References Fullinwider, Robert (2005). Affirmative Action. Retrieved February 1, 2006 from http://plato. stanford. edu/entries/affirmative-action/.

Richard Wagner :: essays research papers fc

Richard Wagner TIME LINE: Wagner’s Life 1813: Wilhelm Richard Wagner is born on May 22. Wagner’s father dies on November 23. ;1814: Wagner’s mother remarries  §Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1815: Wagner’s mother has a daughter Cacilie  §Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1821: Wagner’s step-father dies  §Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1829: Wagner composes his first music: two piano sonatas and a string quartet  §Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1830: Writes a piano arrangement for Beethoven’s Ninth Symphony  §Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1832: Begins work on first opera, Die Hochzeit  §Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1833: Begins work on Die Feen  §Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1836: Marries Minna Planer  §Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1839: Flees to London to avoid creditors, then to Paris  §Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1847: Takes an interest in Greek plays  §Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1857: Begins work on Tristan & Isolde  §Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1858: Minna finds love letter Richard wrote to Mathilde  §Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1859: Moves to Paris with Minna and completes Tristan & Isolde  §Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1862: Richard and Minna separate and Wagner moves to Vienna  §Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1864: Wagner begins affair with Cosima Von Bulow  §Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1865: A daughter Isolde is born to Richard and Cosima and he moves to Switzerland  §Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1867: A second daughter, Eva, is born to Richard and Cosima  §Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1869: A son, Siegfried, is born to Richard and Cosima  §Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1870: Richard and Cosima finally get married  §Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1878: Begins writing a series of reactionary essays  §Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  1883: Richard Wagner dies of a heart attack in Venice on February 13. The funeral   Ã‚  Ã‚  Ã‚  Ã‚  was held at Bayreuth on February 18. WAGNER’S WORKS OPERA  Ã‚  Ã‚  Ã‚  Ã‚  COMPLETED Die Feen  Ã‚  Ã‚  Ã‚  Ã‚  6 Jan 1834 Das Liebesverbot  Ã‚  Ã‚  Ã‚  Ã‚  Dec 1835 Rienzi  Ã‚  Ã‚  Ã‚  Ã‚  19 Nov 1840 Der fliegende Hollà ¤nder  Ã‚  Ã‚  Ã‚  Ã‚  30 Oct 1841 Tannhà ¤user  Ã‚  Ã‚  Ã‚  Ã‚  13 Apr 1845 Lohengrin  Ã‚  Ã‚  Ã‚  Ã‚  28 Apr 1848 Das Rheingold  Ã‚  Ã‚  Ã‚  Ã‚  26 Sep 1854 Die Walkà ¼re  Ã‚  Ã‚  Ã‚  Ã‚  23 Mar 1856 Siegfried  Ã‚  Ã‚  Ã‚  Ã‚  5 Feb 1871 Gà ¶tterdà ¤mmerung  Ã‚  Ã‚  Ã‚  Ã‚  21 Nov 1874 Tristan und Isolde  Ã‚  Ã‚  Ã‚  Ã‚  6 Aug 1859 Die Meistersinger  Ã‚  Ã‚  Ã‚  Ã‚  24 Oct 1867 Parsifal  Ã‚  Ã‚  Ã‚  Ã‚  13 Jan 1882 RICHARD WAGNER   Ã‚  Ã‚  Ã‚  Ã‚  Richard Wagner was one of the most influential and controversial classical composers of all time. Most of his works were operas and they addressed many aspects of his personal feelings: society, politics, religions, etc. Though many hated (and still hate) him and his work, most revere him to be a multitalented genius that brought 19th Century music to higher levels. Wagner’s Life Wilhelm Richard Wagner was born on May 22, 1813 in Leipzig. At six months old, Wagner lost his father Frau Karl Friedrich to typhoid, which he caught from the corpses lying unburied in the streets after the Napoleonic War in Leipzig. Less than a year later, Wagner’s mother married Ludwig Geyer, who Wagner believes is his real father, even though nothing was ever proved. Geyer, like Wagner had an artistic gift. He was an actor a painter, dramatist, and singer. As a child, Geyer was determined â€Å"to make something† of Wagner (Jacobs 3). He failed at drawing and painting. Wagner did not realize he had a talent until Geyer was on his deathbed with collapsed lungs.

Iga Nephropathy In Kuwait Health And Social Care Essay

Methods: From all nephritic biopsies done between January 2000 and December 2004 in Mubarak Al Kabeer Hospital, instances of IgA kidney diseases were selected and their medical records every bit good as biopsy findings were reviewed. Consequences: Eighty patients ( 9.2 % of all native kidney biopsies ) were diagnosed to hold IgA nephropathy. Sixty nine biopsies were included in the survey and eleven were excluded because of presence of any of the exclusion standards or losing clinical informations. Forty three ( 62.3 % ) instances were males, and 26 ( 37.7 ) instances were females. Fifty instances ( 72.5 % ) were below the age of 40 old ages. Average continuance of follow up was 3.6 ±1.3 old ages. The first presentation included nephrotic scope albuminuria ( 49.3 % ) , and nephritic damage ( 50.7 % ) . During the follow up period, 56 ( 81.2 % ) were stable or improved. Hass categorization of biopsies showed ; 36.2 % had Class I, 27.5 % had category II, 13.0 % had category III, 5.8 % had category IV, and 17.4 % had category V IgAN. Females had milder signifiers of the disease than males. Macroscopic haematuria and nephritic damage at presentation were seen more in patients with category IV and V. The presenting serum creatinine and uric acid were higher in those with Hass categories III to V. Deterioration of nephritic map during the follow up period was more important in presence of high blood pressure, nephritic damage and macroscopic haematuria at clip of biopsy. Decision: The incidence of IgAN in Kuwait is approximately 9.2 % . Nephritic damage at presentation and macroscopic haematurias were seen in patients with more aggressive nephritic lesions and property to hapless result. Cardinal words: Proteinuria, IgA nephropathy, nephritic Biopsy, Hass categorizationIntroductionIgA kidney disease ( IgAN ) was first described in 1968 by Berger and Hinglais. ( 1 ) It is now recognized as the most common primary glomerulonephritis worldwide. ( 2 ) It presents with haematurias and frequently proteinuria. Although a moderate grade of albuminuria is common in patients with IgAN, nephrotic syndrome is considered uncommon in these patients. ( 3 ) The class of IgAN is variable, and 15 % -40 % of patients progress to end-stage nephritic disease over 10-20 old ages. ( 4 ) The pathogenesis of IgAN is complex and non wholly understood. Both environmental and familial factors have been found to be involved in the disease oncoming and patterned advance. ( 4,5 ) Humoral unsusceptibility is believed to play an of import function, characterized by the prevailing mesangial IgA1 deposition and associated secondary inflammatory response. ( 5 ) Curative attempts have been directed at either cut downing or forestalling antigen entry, and changing the unnatural immune response and its effects. However, the appropriate therapy for IgAN remains unsure and healing therapy is still non available. ( 6,7 ) The purpose of this survey was to reexamine instances of IgAN in Mubarak Al kabeer Hospital- Kuwait between January 2000 and December 2004, and to analyze the spectrum of clinical presentation and histopathological findingsMethodAll nephritic biopsies performed in Mubarak Al kabeer Hospital from January 2000 to December 2004 were retrospectively reviewed. Biopsies performed on grownup patients with IgAN were selected and reviewed. Patients were excluded from the survey if clinical or serologic grounds of Henoch Schonelin peliosis, collagen vascular diseases, liver cirrhosis, diabetes mellitus, or other kidney diseases were present. Kidney transplant instances were besides excluded from the survey. Clinical and research lab informations at presentation and during the follow up period and the intervention given were obtained by careful retrospective survey of the infirmary records of each patient. The histopathology glass slides were reviewed and the pathology studies were retrieved from the section of pathology computerized filing system. Each kidney biopsy was prepared by cutting paraffin blocks at 3 um subdivisions and staining 2 slides with peroidic acid schiff, 2 slides for Hematoxylin and Eosin, 1 slide for Jones Methenamine splinter and one slide for trichrome. Immunoperoxidase staining was besides performed routinely on all slides for IgG, IgA, IgM and C3. Antibodies were from Dako and titration was performed harmonizing to the cusps with the antibody phials. Electron microscopy ( EM ) was non routinely done on all instances in the establishment, nevertheless, on selected instances EM was performed and the movies were retrieved and reviewed along with the EM study.Statistical methods:ISSN 1110-0834Numerical variables are expressed as Mean  ± SD. The relation within and between the clinical and the histopathological variables were obtained utilizing ?2 trial or Fisher ‘s exact chance trial for categorical variables and nonparametric Mann Whitney U and Kruskal Wallis trials for uninterrupted variables. P & A ; lt ; 0.05 was considered as statistically important. Statistical analysis was performed utilizing SPSS for Windowss version 16 ( SPSS, Inc, Chicago, IL )ConsequenceA entire figure of 1575 nephritic biopsies were performed in the institute during the 5 old ages study period. Eight hundred 70 one biopsies were performed on native kidneys, and 704 were performed on transplanted kidneys. Eighty patients ( stand foring 9.2 % of the native kidney biopsies, 5.1 % of the entire biopsies ) were found to hold IgA nephropathy harmonizing to the biopsy consequences. Eleven patients were excluded from the survey because of losing informations or the presence of any of the exclusion standards. Sixty nine patients were enrolled in the survey. Forty three ( 62.3 % ) were males and 26 ( 37.7 % ) were females. The average age at presentation was 35.52 ±10.13 old ages. Fifty patients ( 72.5 % ) were below age of 40 old ages and 19 ( 27.5 % ) were ? 40 old ages. Average continuance of follow up was 3.6 ±1.3 old ages. Cases were presented by either microscopic ( 82.6 % ) or macroscopic haematurias ( 17.4 % ) . Nephrotic scope albuminuria was seen in 34 ( 49.3 % ) instances while non-nephrotic albuminuria was detected in 35 ( 50.7 % ) instances. High blood pressure was detected in 35 ( 50.7 % ) of instances and nephritic damage was detected in 35 ( 50.7 % ) of instances. Fifty Six ( 81.2 % ) were stable or improved during the follow up period. Serum IgA, C3, and C4 degrees were all within the normal mention scope. Patient clinical and laboratory informations were mentioned in tabular array I. Evaluation of nephritic biopsy slides was performed harmonizing to the Hass categorization of IgA nephropathy ( 8 ) showed ; 25 patients ( 36.2 % ) had Class I IgAN, 19 ( 27.5 % ) had category II IgAN, 9 ( 13.0 % ) had category III, 4 patient ( 5.8 % ) had category IV, and 12 patients ( 17.4 % ) had category V IgAN. ( table II ) ( fig 1, 2 ) Seven ( 10.4 % ) patients were treated with methyl Pediapred pulsation for crescentic lesions, 41 patients ( 59.4 % ) treated with unwritten steroids, 10 ( 14.5 % ) received mycophenolate mofetile or Imuran, 18 patients ( 26.1 % ) received cyclosporine, and 58 patients ( 84.1 % ) treated with angiotonin change overing enzyme inhibitors or angiotonin receptor blockers. Fish oil was given as an accessory therapy in 46 ( 66.7 % ) instances. Females had milder histological signifier of the disease ( category I ) whereas males tended to hold more aggressive signifiers ( category IV and V ) ( P & A ; lt ; 0.05 ) . No relation was found between the Hass categorization and any of the age at presentation, high blood pressure, presence of hydrops or the degree of albuminuria ( P & A ; gt ; 0.05 ) . Macroscopic haematuria was seen more in category IV ( 75 % ) and category V ( 25 % ) than category I ( 8 % ) ( P & A ; lt ; 0.05 ) . Nephritic damage at presentation was seen more in patients with category IV ( 75 % ) and category V ( 91 % ) than category I ( 28 % ) ( P & A ; lt ; 0.001 ) . The showing serum creatinine and uric acid were higher in those with Hass categories III to V than category I and II ( P & A ; lt ; 0.001, & A ; lt ; 0.05 severally ) . ( table III ) Deterioration of nephritic map during the follow up period was more important in presence of high blood pressure, nephritic damage at clip of biopsy, and macroscopic haematuria ( P & A ; lt ; 0.05 ) whereas the showing degree of albuminuria, age, gender, and Hass categorization had a non important consequence on the impairment of kidney maps ( P & A ; gt ; 0.05 ) . The higher the showing serum creatinine the more the impairment of nephritic map during the follow up period ( P & A ; lt ; 0.05 ) . ( table IV ) Fig. 1: A instance of crescentic IgA kidney disease. Mesangial enlargement with a cellular crescent. PAS x 400 Fig. 2: Immunoperoxidase staining shows a outstanding Mesangial form. IgA immunoperoxidase x 400 Table I: Clinical and laboratory informations of patients holding IgA nephropathy ( n=69 )Age in old ages ( mean ±SD )35.52 ±10.13Gender ( male ) N ( % ) 43 ( 62.3 ) Smoking N ( % ) 17 ( 24.6 ) Hypertension N ( % ) 35 ( 50.7 ) Hematuria N ( % ) Microscopic Macroscopic 57 ( 82.6 ) 12 ( 17.4 ) Proteinuria N ( % ) Nephrotic scope Non- Nephrotic scope 34 ( 49.3 ) 35 ( 50.7 ) Serum creatinine  µmol/l ( mean ±SD ) 162.97 ±148.1 Creatinine clearance ml/min/1.73m2 ( average  ± SD ) 48.2 ±37.1 Nephritic damage N ( % ) 35 ( 50.7 ) Serum albumen gm/l ( mean ±SD ) 31.33  ±7.08 Serum Cholesterol mmol/l ( mean ±SD ) 5.65 ±1.9 Serum Triglycerides mmol/l ( mean ±SD ) 1.96 ±1.1 Serum IgA degree gm/l ( mean ±SD ) 2.69 ±1.0 Serum C3 degree gm/l ( mean ±SD ) 1.04 ± 0.15 Serum C4 degree gm/l ( mean ±SD ) 0.94 ±0.12 Edema N ( % ) 30 ( 43.5 ) Treatment given N ( % ) Methyl Pediapred pulsation Angiotensin change overing enzyme inhibitors Oral Steroids Azathioprine Cyclosporine Fish oil 7 ( 10.1 ) 58 ( 84.1 ) 41 ( 59.4 ) 10 ( 14.5 ) 18 ( 26.1 ) 46 ( 66.7 ) Duration of follow up ( mean ±SD ) old ages 3.6 ±1.3 Prognosis N ( % ) Stable / Improved Deterioration of nephritic maps 56 ( 81.2 ) 13 ( 18.8 ) Table II: Histoathological spectrum of nephritic biopsy consequences harmonizing to Hass categorization among IgA N patients ( n=69 )Hass ClassificationNumber ( % )Class I 25 ( 36.2 ) Class II 19 ( 27.5 ) Class III 9 ( 13.0 ) Class IV 4 ( 5.8 ) Class V 12 ( 17.4 ) Table Three: Relation between clinical presentation and Hass categorization ( n=69 )Clinical andresearch lab informationsHass ClassificationTrial of significanceP valueClass IN ( % )Class IIN ( % )Class IIIN ( % )Class IVN ( % )Class VN ( % )GenderMale Female 12 ( 48 ) 13 ( 52 ) 10 ( 52.6 ) 9 ( 47.4 ) 7 ( 77.8 ) 2 ( 22.2 ) 3 ( 75 ) 1 ( 25 ) 11 ( 91.7 ) 1 ( 8.3 ) & A ; lt ; 0.05*Age at presentation& A ; lt ; 40 old ages & A ; gt ; 40 old ages 20 ( 80 ) 5 ( 20 ) 9 ( 47.4 ) 10 ( 52.6 ) 8 ( 88.9 ) 1 ( 11.1 ) 3 ( 75 ) 1 ( 25 ) 10 ( 88.3 ) 2 ( 11.7 ) & A ; gt ; 0.05High blood pressure11 ( 44 ) 9 ( 47 ) 4 ( 44.4 ) 3 ( 75 ) 8 ( 66 ) & A ; gt ; 0.05Edema13 ( 52 ) 6 ( 31.6 ) 5 ( 55.6 ) 2 ( 50 ) 4 ( 33.3 ) & A ; gt ; 0.05Nephrotic scope Proteinuria12 ( 48 ) 6 ( 31 ) 5 ( 55.6 ) 3 ( 75 ) 8 ( 66.7 ) & A ; gt ; 0.05Macroscopic haematuria2 ( 8 ) 4 ( 21 ) 0 ( 0 % ) 3 ( 75 ) 3 ( 25 ) & A ; lt ; 0.01*Nephritic damage7 ( 28 ) 8 ( 42.1 ) 6 ( 16.7 ) 3 ( 75 ) 11 ( 91.7 ) & A ; lt ; 0.001*Showing serum Creatinine  µmol/l84.4 ±31.7 171.3 ±179.6 203.2 ±198.7 288.5 ±84.5 278.5 ±140.1 & A ; lt ; 0.001*Serum Uric acid mmol/l312.6 ±71.8 381.4 ±171.3 428.2 ±20.3 459.5 ±188 412 ±143.9 & A ; lt ; 0.01* Table Four: Factors finding deterioration of the kidney map during the follow up Period ( n=69 )Clinical andresearch lab informationsDeterioration of kidney mapTrial of significanceP valueYesn ( % )Non ( % )Gendermale female 11 ( 25.6 ) 2 ( 7.7 ) 32 ( 74.4 ) 24 ( 92.3 ) & A ; gt ; 0.05Age& A ; lt ; 40 old ages & A ; gt ; 40 old ages 11 ( 22 ) 2 ( 10.5 ) 39 ( 78 ) 17 ( 89.5 ) & A ; gt ; 0.05High blood pressureYes No 10 ( 28.6 ) 3 ( 8.8 ) 25 ( 71.4 ) 31 ( 91.2 ) & A ; lt ; 0.05*HematuriasMicroscopic Macroscopic 8 ( 14 ) 5 ( 41.7 ) 49 ( 86 ) 7 ( 58.3 ) & A ; lt ; 0.05*AlbuminuriasNon-Nephrotic scope Nephrotic scope 5 ( 14.3 ) 8 ( 23.5 ) 30 ( 85.7 ) 26 ( 76.5 ) & A ; gt ; 0.05Nephritic damage at presentationYes No 10 ( 28.6 ) 3 ( 8.8 ) 25 ( 71.4 ) 31 ( 91.2 ) & A ; lt ; 0.05*EdemaYes No 6 ( 20 ) 7 ( 17.9 ) 24 ( 80 ) 32 ( 82 ) & A ; gt ; 0.05DiscussionMany studies of glomerulonephritis associated with mesangial IgA sedimentations have been published since the original study of IgAN by Berger and Hinglais. The evident incidence of this upset has varied in surveies from different states. In France, ( 9 ) Spain, ( 10 ) Japan, ( 11 ) and Italy ( 12 ) the incidence has ranged from 11.7 to 43.3 % of nephritic biopsies. Much lower incidences have been reported in the United provinces, ( 13 ) England, ( 14 ) and Canada ( 15 ) with the incidence runing from 2.0 to 8.5 % in these states. Berger ( 16 ) suggested that the higher reported incidence of this disease in certain states compared to others may reflect the pattern of everyday one-year uranalysis in the states with high incidence rates. To the best of our Knowledge this is the first survey from the Arab states showing the incidence of IgAN. We reported the incidence to be 9.2 % of native kidney biopsies in Kuwait. Since the original description of IgAN, a figure of surveies have attempted to correlate initial clinical and pathological findings with the subsequent class of the disease. The present survey was in conformity with the old surveies in demoing that females had milder pathologic alterations whereas males were shown to hold more aggressive signifiers. ( 17 ) There is a distinguishable geographical difference in the incidence of macroscopic haematuria in grownup patients. ( 18 ) In European states the reported incidence exceeded 50 % , ( 19,20 ) whereas in Japan, the incidence scope was from 15 to 31 % ( 21,22 ) This difference in distribution can be attributed to difference in the disease nature that could be linked to familial factors. ( 19 ) The predictive significance of macroscopic haematuria was controversial. In the present survey macroscopic haematuria was detected in 17.2 % of instances and found to be associated with aggressive histologic findings and correlatives with hapless forecast. This confirmed the consequences of the South West Pediatric Nephrology Study Group. ( 17 ) Furthermore, Bennet and Kinciad-Smith ( 23 ) reported that nephritic map became significantly worse in those with macroscopic haematurias, and emphasized the high incidence of crescent formation in these instances. However, Clarkson et Al. ( 24 ) demonstrated that nephritic map and lesions were significantly better in patients with macroscopic haematurias than those without it. In our survey nephritic damage at presentation was seen more in patients with category IV and category than category I. Correlation between more extended pathologic characteristics and terrible clinical manifestation were besides documented by Hass et Al. ( 25 ) The presenting serum uric acid correlated with the diseased findings with higher degrees in those with Hass categories III to V than category I and II. This confirmed the consequences of Myllimaki et Al. ( 26 ) who proved a strong correlativity between serum uric acid degree and badness of nephritic harm on biopsy. The overall forecast of IgA N remains to be confirmed. In grownup surveies the incidence of nephritic inadequacy varies from less than 10 % to 48 % in patients followed for more than 1 twelvemonth. ( 27 ) The present survey is in conformity with this consequence as nephritic inadequacy was seen in 18.8 % of instances. Bartosik et Al. ( 28 ) proved that the clinical parametric quantities, such as high blood pressure and badness of albuminuria appear to be stronger predictive indexs than histological findings. Furthermore, Van Der Peer et Al. ( 29 ) found that those with more high blood pressure, more albuminurias, and more pronounced histologic findings deteriorate their nephritic map more during follow up. Other survey showed that females and younger patients were found to hold a better forecast. ( 30 ) In the present work, impairment of nephritic map during the follow up period was more important in presence of high blood pressure, nephritic damage, and macroscopic haematuria at clip of biopsy whereas, the showing degree of albuminuria, age, gender, and Hass categorization have a non important consequence on the impairment of kidney maps. In decision, the incidence of IgAN in Kuwait is 9.2 % . A multicenter survey should be conducted to observe the exact incidence. About 18.8 % of instances deteriorate their nephritic maps during the survey period but a longer follow up is needed.

Ethical Issues in Health - 2073 Words

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