American Siblings By Shephard Essays - True West,

American Siblings By Shephard True West is an intense dramatization of the relationship between two brothers: Lee and Austin. As each scene progresses, the brothers' rivalry and animosity towards each other become more and more apparent, building towards a single emotionally involving climax. Throughout the play, the characters undergo subtle changes as each brother subconsciously attempts to absorb the part of the other brother's life which he feels might complete him. This role reversal is the pivotal instrument in which Sam Sheppard shows the intensity of sibling rivalry. The play starts en medea res. Lee and Austin have not talked to each other in some time, and Lee obviously resents Austin. In the conversation Lee almost has something to prove to Austin. A few sentences into the conversation, Austin's estimation of Lee and Lee's hostile resentment of this view become apparent: AUSTIN: I've got too much to deal with here to be worrying about? LEE: Yer not gonna' have to worry about me! I've been doin' all right without you. I haven't been anywhere near you for five years! Now isn't that true? (P. 8) Austin clearly thinks of his brother as a responsibility, and does not think of him as an equal, much less as someone who can take care of himself. For Lee on the other hand, being looked down upon by his younger brother is insulting. Lee's reaction to his brother is immediately defensive. When the subject of Lee staying at their mother's house comes up, Lee snaps at Austin: AUSTIN: Well, you can stay here as long as I'm here. LEE: I don't need your permission do I? And later, LEE: She might've just as easily asked me to take care of her place as you. AUSTIN: That's right. LEE: I mean I know how to water plants. (P.7) Throughout this scene, Lee's hostile attitude towards Austin constantly disrupts the flow of the conversation, and is a continual reminder that these two men have an unresolved internal conflict. Both brothers realize that they each come from two different walks of life, but it is Austin who chooses to believe that his way of life is superior. While Austin has, as Lee puts it, "...the wife and kiddies...the house, the car, the whole slam...(p.9)," we never discover if Lee owns anything at all, or is just a transient burglar. Lee has much to be jealous of in Austin. Austin, however, has very little to be jealous of in Lee. Lee is a thief who hasn't ever settled down into anything. In this first scene, the overall emphasis of power between the brothers is material possessions, and Austin definitely has the power over Lee. The first scene defines each character and what they are. Austin is an ambitious man who wants very badly to finish his movie script and sell it. He says to his scripting agent, "I've got everything riding on this, Saul. You know that. It's my only shot. If this falls through...(P. 35)." At the same time he is very patient and timid with his brother. Lee is very competitive, emotionally explosive and content to scrape by with the minimum of money. He does not feel that he is socially fit to live in a social community, as he says: LEE: This is the last time I try to live with people! (P. 46) And later, LEE: Hey, do you actually think I chose to live out in the middle a' nowhere? Do ya'? Ya' think its some kinda' philosophical decision I took or somethin'? I'm livin' out there ?cause I can't make it here! (P. 49) The first major change in one of the brothers is in Austin. After Austin's agent offers Lee a deal which Austin was hoping to get, Austin almost refuses to believe it. When Lee needs Austin to be his writer, Austin becomes adamantly against Lee, and furiously tries to talk his agent out of the deal with Lee. Throughout the play until this point, Lee's dialogue has been considerably lengthier than Austin's has. In this scene, Austin's dialogue is explosive in its length when compared with Lee's sparse one liners. This change marks the end of the way things used to be for them. Austin's reaction to his brother is not the timid, patient person who we met in the first scene. In contrast, while Lee is being a little more ambitious and social than we have been led to believe he normally is, the major change is that it is Lee who is calm

Rusian History essays

Rusian History essays Russia has always played a major roll in global politics, economics and thought. However, in the past two centuries, Russia has had probably the greatest influence on the international world in modern times, surpassed only by the United States. The Russia that we've known this century though, has its roots in last centuries Russian. At the end of the nineteenth century, Russia experienced great changes internally, politically, socially and spiritually. The half century leading up to the Communist revolution in 1917 was a time filled with sweeping changes, literary triumphs and military defeat. All of these factors played in the eventual revolution and not only affected politics and thought in Russia, but in every nation on earth. After the defeat of the Russian army in the Crimean War, Russian realized that it needed to modernize its country, socially and militarily. Alexander II realized that to modernize mean that Russia needed to westernize. So in 1861 he emancipated the serfs from bondage. The emancipation was mean to bridge the gap between the elite and the general population, but was not the first of such liberal western type reforms. Catherine and Peter the Great had also made western type reforms during their respective reigns. All of their reforms, and especially Alexander's, were influenced by western thought. These thought were introduced into Russia by its Western European educated ruling class. Under Alexander II, the ruling class began to see serfdom as an immoral part of society. This moral problem was accompanied by the economics of the day, and the ethical conclusion was that serfdom must be dismantled. The abolition of serfdom was Alexander II greatest contribution to history. However, the 'Liberating Czar' enacted a whole series of fundamental changes including; comprehensive reform of the judicial system that finally introduced the unheard of idea of equality, trial by jury, public proceedings in legal matt...

Letter to Presidential Candidate Essay Example | Topics and Well Written Essays - 500 words

Letter to Presidential Candidate - Essay Example The demographics of the region indicate that women are more likely to vote democrat than men and white people are more likely to vote republican than minorities. In addition, more black men than other races were likely to vote democrat. Age groups seemed to be evenly divided among all groupings between democrat and republican. These demographics suggest you should do well in our state. An appeal to the youthful element of your campaign may help you to swing some of the younger voters to your party while your primary focus should be on increasing your appeal to the white population. If you focused on appealing to the white female population, you would be able to also maintain your appeal to the minorities and women who are already pre-disposed to your party. The majority of Virginia’s population has an income level between $30,000 and $150,000 and tends to vote Republican. This population group is also marked as having moderate education levels (high school graduate through four-year college degree) and voting Republican. Democrats are strong on the extremes – very low income and very high income plus very low education and very high education. While the population is relatively split between Republican and Democrat, our independents tend to lean more toward the Democratic party, by 56 percent in the last election. Most of the citizens of Virginia live in either suburbs (39%) or rural areas (33%). Suburbs voted 55% republican and rural areas voted 51% republican. The strength of the Democratic Party in this state is in the smaller cities (61% democrat). It will also be helpful for you to know how the voters of Virginia feel about some of the more important issues. Values issues were considered either extremely important (46%) or very important (20%) in the last election cycle. Most of the voters rating values as an important were Republicans (63% and 51% respectively) while

Charter Schools in the Lottery Documentary Essay

Charter Schools in the Lottery Documentary - Essay Example One might suggest that the movie in question makes a good argument about the topic. However, in order to prove that it would be advantageous to work out a set of criteria that should be used to measure the effectiveness of the arguments that are made by documentaries. This paper will present four such criteria.  The first one, as well as the most obvious one, is objectivity. Indeed, people tend to watch documentaries since they hope that the director is not biased and is willing to show the actual state of affairs, not from a particular side. It is clear that to do so, the documentary should not give preference to one particular point of view, but feature different approaches. Speaking of The Lottery it is clear that opposite ideas about the issue of charter schools are presented: the pro side is backed up by the staff of Harlem Success Academy, parents, and activists; the con side includes public advocates, representatives of the teachers union, staff of public schools and so on. It would not be a mistake to point out that fact that it is a great advantage of the movie in question lies in the fact that it features interviews with people who strongly believe in the validity of their claims: this allowed the director to present opposing views.  Another criterion that would contribute to the effectiveness of arguing a particular topic is the balance between emotional neutrality and encouragement. It is true that documentaries usually send a particular message to the audience, and this message is usually backed up by the appeal to emotions. It is thought that â€Å"self-assertive emotions drive us towards individual action and reaction† (Austin and Jong 113). In other words, they reinforce the position that is already taken by a person on a particular issue and allow one to take appropriate action.

Britain and the empire The Great Irish Famine Essay

Britain and the empire The Great Irish Famine - Essay Example This essay will focus on Christine Kinealy’s findings on the famine, mostly related to the relationship of Britain and Ireland during the years of the famine including relationship of the famine with churches, with monarchy, and the nationalist movement. Ever since the famine occurred in 1845, there have been a number of books and literature works published on it, yet the work of Kinealy has taken the famine literature to another level. Kinealy uses many sources and research materials that were otherwise not used to evaluate the famine. With these sources, she demonstrated another aspect of the famine with the relationship of Ireland and Britain during the famine. She focused on the role of the government and also on the importance of saving lives through private charity. Another aspect which Kinealy focuses on is the food supply which no one had ever discussed before. She talked about how Ireland produced enough food even after the potato blight. It was her work which gave a new vision to the impact of the famine and the aspects which were given least attention. The book is an evaluation of Kinealy’s survey A Death Dealing Famine which she conducted in 1997. Her intention towards this book was not to give a general history, but to examine the famine through the number of different contexts and through her narrative. On her research of different contexts, there is new material presented on charity, memory, and the religious response. The interpretation of Kinealy is identical to the controversial claim in 1997 that Ireland had in reality not suffered with deficit of food and the famine was artificial. Kinealy carried out a lot of research on the famine and chose to write about her ideology. Her book was highly criticized as it gave a different yet true picture of the Irish famine after about 50 years of misinterpretation. Her view and research actually

Importance of Postoperative Pain Management

Importance of Postoperative Pain Management CHAPTER-II Review of literature is a key step in research process. The literature review is to discover what has previously been done about the problem to be studied what remains to be done, what methods have been employed in other research and how the result of other research in the area can be combined to develop knowledge. It is essential step; it can be done before and after selecting the problem. It can help to determine what is already known about the topic (A.P.Jai, 2005). This chapter attempts to present a review of studies done methodology adopted and conclusion attained by earlier investigators which helps in this study. The sources are internet search, textbook, published journal, editorials published and unpublished thesis. In this chapter, the researcher presents the review of the literature under the following headings, Section-I: Studies related to importance of postoperative pain management. Section-II: Studies related to Using Numeric Rating Scale for pain Assessment. Section-III: Studies related to effectiveness of music therapy among General Surgical Patients. Section-IV: Studies related to Effectiveness of Music Therapy among Post Caesarean Mothers. Section-V: Studies related to Gate Control Theory of Pain (Melzack and Wall (1965). Section-VI: Conceptual Framework Based on Gate Control Theory of Pain (Melzack and Wall (1965). SECTION-I: STUDIES RELATED TO IMPORTANCE OF POSTOPERATIVE PAIN MANAGEMENT. Kolawole and Fawole, (2003) conducted a study on Postoperative pain management following caesarean section in University of llorin Teaching Hospital (UITH).llorin, Nigeria. Prospective descriptive design was used to assess the effectiveness of various common methods of analgesia used in hospital following caesarean section. This study was conducted over a period of 18 months. Pain assessment was carried out by 4-point Verbal Rating Scale of None, Mild, Moderate, and severe. The first 24hrs postoperatively was particularly painful for the patient with 79.6% and 54.6% reporting moderate to severe pain in the recovery room and day 1 respectively. They concluded that the pain remains a significant problem following surgical operation in our environment. (PMID.15008293) Seers and Carroll, (1998) conducted a study on Relaxation techniques for acute pain management. They were used a systematic review of randomized controlled trials and seven studies involving 362 patients were included. Three of the seven studies demonstrated significantly less pain sensation or pain distress in those who had relaxation, four studies did not detect any difference. It was concluded that the well designed and executed randomized controlled trials are needed before the clinical use of relaxation in acute pain management can be firmly underpinned by good quality research evidence. So we can recommend that the relaxation in acute pain settings is carefully evaluated and not used as the main treatment for the pain management. SECTION-II: STUDIES RELATED TO USING NUMERIC RATING SCALE FOR PAIN ASSESSMENT. Yaakov Beilin, Jabera Hossain, and Carol, (2009) conducted a study on Numeric Rating Scale and Labor Epidural Analgesia, in this study a Numeric Rating Scale(NRS) used to evaluate pain in research studies, they define desire for additional analgesic medication as a clinically relevant outcome in research studies about pain and compare it with the results of the NRS. A post hoc analysis of three studies that conducted previously in concerning labor epidural analgesia was performed. In all three studies, score was obtained before and 15 min after analgesia. They found that the very few patients (2%) with a score of 0-1 wanted more medication. When the score was 2 or 3, 51% of the patients wanted more medication, and score was >3, almost all patients (93%) wanted more medication. Grouping the final NRS scores into 3 categories (0 or 1, 2 or 3, and >3) is more useful to the clinician than using individual NRS scores. Cinzia Brunelli, (2009) did a study on Comparison of Numerical and Verbal Rating Scales to measure pain exacerbations in patients with chronic Cancer pain. Crosses sectional multicentre study conducted on a sample of 240 advanced cancer patients with pain, background pain and BP were measured by 6-point VRS and 11 point NRS. In order to evaluate the reproducibility of the two scales, a subsample of 60 patients was randomly selected and the questionnaire was administered for a second time three to four hours later. The proportion of inconsistent evaluations was calculated to compare the two scales capability in discriminating between background and peak pain intensity and Cohens K was calculated to compare their reproducibility. It concludes that NRS revealed higher discriminatory capability than VRS in distinguishing between background and peak pain intensity with a lower proportion of patients giving inconsistent evaluations (14% vs. 25%) (Cohens K of 0.86 for NRS vs 0.53 for VRS) while the reproducibility of the two scales in evaluating background pain was similar (Cohens K of 0.80 vs. 0.77). Nathalie Dieudonne, Alexandra Gomola, Philippe Bonnichon, and Yves M.Ozier, (2008) conducted a study on Prevention of postoperative pain after thyroid surgery. In this study double-blinded, randomized, placebo-controlled trial used to evaluate the analgesic efficacy of bilateral superficial cervical plexus blocks performed at the end of surgery. Ninety patients were randomized to receive 20 mL isotonic sodium chloride or 20 mL bupivacaine 0.25% with 1:200,000 epinephrines. Postoperative pain was assessed every 4 h using an 11-point numeric rating scale (NRS-11). All patients received acetaminophen every 6 h. In addition, morphine was administered following a standardized protocol if the NRS-11 score was à ¢Ã¢â‚¬ °Ã‚ ¥4. The main outcome variables were pain scores (NRS-11), the proportion of patients given morphine at any time during the 24-h period, and the amount of morphine administered. The Bupivacaine group had a smaller proportion of patients given morphine (66.0% vs 90.0%; P = 0.016), and lower initial median pain scores (P = 0.002). SECTION-III: STUDIES RELATED TO EFFECTIVENESS OF MUSIC THERAPY AMONG GENERAL SURGICAL PATIENTS. Sigma Theta Tau International, (2009) conducted a study to assess and compare the effect of music therapy on postoperative pain of patient undergone elective abdominal surgery. A quasi-experimental design was used and convenient samples of 30 (15 in each expcontrol group). Pain was measured by Verbal Rating Scale. Music therapy was given as per patients wish to experimental group and intensity of pain was monitored before and immediately after recovery from anesthesia, during the 1st and 2nd postoperative day for both the groups. Results revealed that those patients who listened to self selected music tapes had significant differences (p Tse MM.Chan Me. Benzie, (2005) conducted a study to find the effectiveness of music therapy on postoperative pain and analgesic use following nasal surgery. Sample size was 57 patients (24females33 males) who were matched for age and sex and then non-selectively assigned to either an experimental or a control group. Music was played intermittently to members of the experimental group during the first 24hrs postoperative period and pain intensity was measured by Verbal Rating Scales. It shows the significant decrease in pain intensity over time were found in the experimental group compared to the control group (p Nilsson, Unosson and Rawal, (2005) conducted a study on Stress reduction and analgesia in patients exposed to calming music postoperatively. The randomized controlled trial was designed to evaluate the effectiveness of music therapy. Seventy-five patients undergoing hernia repair in day care surgery were allocated to three groups: intraoperative music, postoperative music and silence (control group). Patients postoperative pain, anxiety, blood pressure (BP), heart rate (HR) and oxygen saturation were studied. The postoperative music group had less anxiety and pain and required less morphine after 1hr compared with the control group. The result concluded that intraoperative music may decrease postoperative pain, and that postoperative music therapy may reduce anxiety, pain and morphine consumption. SECTION- IV: STUDIES RELATED TO EFFECTIVENESS OF MUSIC THERAPY AMONG POST CAESAREAN MOTHERS. Arastirma TAF pre Med Bull, (2009) conducted a study to evaluate the effectiveness of music therapy on postoperative pain after Caesarean section. The sample size was 100 and randomly allocated into two groups (50 in each group).Group 1, patients listened to music through a headphone for 1hour immediately before surgery where as in group-2, not listen to any music during the same period. In the postanaesthesia care unit patients were connected to I.V. PCA device when they were able to respond to commands. The patients level of satisfaction with perioperative care was assessed by a 10cm Visual Analogue Scale and the severity of postoperative pain was assessed by VAS. The results shows that the postoperative tramadol consumption, total amount of tramadol consumption, additional analgesic use and all VAS values were lower in group-1(p Amin Ebneshahidi, and Masood Mohseni, (2008) conducted a study to evaluate the effect of patient selected music on early postoperative pain, anxiety and Hemodynamic profile in Caesarean section. The sample size was 80 who were undergoing elective C.S.surgery enrolled randomly to listen 30 minutes of music or silence by head phones postoperatively. Pain and Anxiety were measured with visual Analogue Scale. Results says that the pain score and postoperative cumulative opioid consumption were significantly lower among patients in the music group (p SECTION-V: STUDIES RELATED TO GATE CONTROL THEORY OF PAIN Marial, (2007) did a study to assess the effectiveness of back massage on pain during first stage of labour among mothers in selected maternity centre at tirupur. 60 samples were selected by using convenient sampling method for the study (experimental group-30 and control group-30). Experimental group received massage were as the control group did not. She used Melzack pain gate control theory for conceptual frame work. Data was collected using behavioral intensity and visual analogue scale. The statistical calculation done was frequency mean, SD, chi-square andt test. The result of the study shows that massage is a cost effective nursing intervention that can decreases the pain perception during labour. Jacintha, (1995) did a study on the effect of back massage during the first stage of labour. She divided the samples in to two groups of 30 each. The experimental group received back massage for 10 minutes per hour. She used non participatory observation technique to observe the maternal behavioral every hour. She used Melzack pain gate control theory for conceptual frame work. The experimental group was interviewed regarding their experience and feelings of back massage before shifting them to the post natal ward. 100% of mothers remembered massage given to them during labour, with feeling of comfortable in 76.66% and relaxed in 43.33%. All the mothers were of the opinion that all mothers in labour should be given back massage. Locsin, (1981) did a study to assess the effectiveness of music on the pain of selected postoperative patients during first 48 hrs. The 24 female gynecology and/ obstetric patients were assign to two groups (control and experimental). The measurement of the experimental variable was done by an Overt Pain Reduction Rating Scale (OPRRS) which is devised by the writer. Significant differences were found between the groups of postoperative patients in their muscular-skeletal and verbal reactions during the first 58hr at the 0.05 level. The conceptual framework of the study was based on the concept of distraction following the Gate Control Theory of Pain by Melzack Wall (1965). The finding says that the music can be used as a nursing measure for postoperative patients. SECTION-VI: CONCEPTUAL FRAMEWORK BASED ON GATECONTROL THEORY OF PAIN (MELZACK AND WALL (1965) The conceptual frame work for the present study was derived from Gate Control Theory of Pain (Melzack and Wall, 1995) Application of Gate Control Theory of Pain Polit and Hungler, (1965) state that a conceptual framework is inter related concept on abstraction that is assembled together in some rational scheme by virtue of their relevance to a common scheme. It is a device that helps to stimulate research and the extension of knowledge by providing both direction and impetus. The present study was aimed at determining the effectiveness of music therapy on intensity of post operative pain among primipara mothers who had Caesarean Section. The conceptual frame work of this study was derived from gate control theory of pain. Gate Control Theory of Pain: Many theories of pain have been presented in the literature. These include specificity, pattern, affect and psychological/behavioral theory (Mander 1998). The most widely used and accepted theory is that of Melzack Wall (1965). These researchers have established that gentle stimulation actually inhibits the sensation of pain. Their gate control theory states that a neural or spinal gating mechanism occurs in the substantiate gelatinosa of the dorsal horns of the spinal cord. The nerve impulses received by nociceptors, the receptors for pain in the skin and tissue of the body, are affected by the gating mechanism. It is the position of the gate that determines whether or not the nerve impulses travel freely to the medulla and the thalamus, thereby transmitting the sensory impulse or message, to the sensory cortex. The pain impulses will be carried out by the small diameter slow conducting A-delta and C fibers. Impulses traveled through small diameter fibers will open the pain gate and the person feels pain. Pain gate is also receiving impulses produced by stimulation of thermo receptors or mechanoreceptors transmitted via large diameter; myellindated A-delta fibers inhibit superimpose the small diameter impulses. (Myles -2003) If the gate is closed, there is little or no conduction, for example distraction, counseling and massage techniques are ways to release endorphins, which close the gate. This prevents or reduces the clients perception of pain (Freeman and Lawlis, 2001) If the gate is open, the impulses and messages pass and are transmitted freely. Therefore, when the gate is open, pain and sensation is experienced. (Potter and Perry, 2009) Many non pharmacological procedures such as hydrotherapy, music therapy (distraction), application of heat or ice, massage, vibration, TENS and movement stimulate the nerve endings connected with large diameter fibres which can produce a reduction of pain by closing the pain gate. Based on the principle of gate control theory, the following conceptual framework was developed. Method used to reduce intensity of postoperative pain is instrumental music which is composed by violin among Primipara mothers who had Caesarean Section. Stimulation of Pain Receptors: Surgical trauma of the uterus due to Caesarean Section stimulates pain receptors in lower abdomen and lumbar area of the back. In the control group there was more stimulation of pain receptors in these areas due to the close contact between the contracting uterus and abdominal and lower back structures. In case of experimental group(Music therapy), there was less stimulation of free nerve ending in the lower abdomen and lumbar area of back compared to the control group due to the distraction caused by music therapy. Travelling of Pain Impulses: Normally pain impulses are traveling through small short conducting A-delta and C fibres. Impulses from stimulation will be distracted by instrumental music and decrease in pain perception produce a reduction of pain by closing the pain gate in experimental group. Gating Mechanism: Pain impulses after the Caesarean Section are transmitted through the spinal nerve segment of T11-12 and accessory lower thoracic and upper lower sympathetic nerves, which are traveled through (A-delta and C) small diameter and slow conducting amyelinated fibres and reach the pain gate and open the gate thus the mother perceives pain in the lower abdomen and lower back. Impulses reduced by music due to decreased in pain perception to travel through fast conducting myelinated A-delta fibres which impose small fibres and close the pain gate. SUMMARY This chapter dealt with the studies related to importance of postoperative pain management, application of music therapy and conceptual frame work based on gate control theory of pain.

Destiny :: essays research papers

Pre-Destination vs. Self-Determination People like to believe that they have the freedom to choose to be or do whatever it is that they want to be or do; it is, however, quite the opposite. This sense of freedom is called self-determination. At the other end of the spectrum, when no matter what we do seems to make any difference or when events just seem to happen and we think about them as being out of our control or somehow planned by some force unknown to us (such as a God), that is called pre-destination. Self-determination has its limitations as to what people are allowed to do, but pre-destination has no limits of any kind. Self-determination is, in fact, used to mask pre-destination, to keep people content in following a pre-set path that life offers. Without pre-destination, how do we know what the weather will be like, or if the sun rises, or if someone will stop at a red light? Without these paths where would our lives be going? People do these every day things that are simply there to keep them going down the pa th that they have always been on. When people get off that path, such as when they stop doing drugs, then their lives are on a new track. But the new track doesn’t necessarily have anything unique about it, it’s just a new path and already pre-determined. And once on a path, it is very difficult to veer away from the pre-determined, pre-disposed activities that a particular lifestyle requires. Smith 2 Pre-destination, not our life choices, guides our lives. There is no other way to explain things such as people who grow up poor yet somehow manage to create a multinational company and become multimillionaires. Although some might say that these people chose to follow a particular path that led them to their fame and fortune. Instead, it should be argued that even if these people were born poor, they were they were destined to create that company. They were given the drive to make that company into what it was. Anyone can choose to start a company, but few actually have the ability to make that company a success. Choice does not have anything to do with ability: I choose to be a billionaire but I do not have the bank account to be one. Predestination explains almost ninety percent of what happens in the world, from birth to death, and even pure luck.