Philosophy on Teaching and Learning

Learning is described as the acquisition of new knowledge which eventually leads to a change in behaviour while teaching is regarded as the transference of knowledge†¦Ã¢â‚¬ ¦ As a teacher, my main responsibility in the classroom is to facilitate and provide guided my students learning. Learning is the acquiring new knowledge which will lead to behaviour change. On the other hand, teaching is transference knowledge in a manner that caters to individual learning styles, in a capable manner. In so doing, I serve as a guide and facilitator. I allow students explore and develop their own learning experience. Every child is a gift from God and is to be treated as such. I ensure that they treated fairly and given equal opportunities. These I do by ensuring that proper resources are readily available in an environment of love and care, so that grow and mature spiritually, intellectually, emotionally, socially and physically, thus fostering holistic development. Through dedication and commitment to the teaching/learning process, I plan my lessons creatively and meaningfully so as to generate students’ interest as well as to foster intrinsic motivation. This is done through the use of technology, research and active discussions which enhance their critical thinking. I also engage them in cooperate learning strategies so that their social skills are developed. To ensure that my objectives are met, I evaluate each lesson and do the necessary adjustments and do assessments at regular intervals. These assessments are done by giving monthly tests, journal entries and class discussions. As an educator, I avail myself totally to the teaching/learning process. In so doing, I equip myself with the required skills and knowledge by attending professional development workshops and pursuing a degree programme.

A King’s Collapse

A King's Collapse Unfortunately, in about every person's life either a tragic event or a series of tragic events can be found and in some cases more than others. To many people a tragic hero could be defined as someone who performs a heroic act, but dies in the process. Nevertheless, this statement is wrong, but instead a tragic hero needs five elements. To be a tragic hero one would need noble stature, a tragic flaw, free choice, excessive punishment and increased awareness. When discussing the play Antigone, a perfect example of a tragic hero would be Creon.Though many people might argue Antigone to be the tragic hero, but she is missing the element of increased awareness. Imagine finding out that your father married your grandma and your brothers killed each other over power. Then your uncle steps in to be king and declares that one of your brothers will get no burial because he was a trader. This information starts off a tragic play called Antigone. In the play, Creon must have n oble stature in order to be the tragic hero. One way Creon has noble stature is that he is the king which gives him power over the people.Antigone voiced this when she told Creon, â€Å"They share my views, but they keep their mouths shut just for you. † (Sophocles 12) Even though Antigone was telling Creon that his people did not share his views, what she said showed that Creon still had power over them. Another two ways Creon has noble stature are that he creates the laws and Creon's decisions affects everyone. This is shown when Creon states, â€Å"It's impossible/ to really know a man, to know his soul,/ his mind and will before one witnesses/ his skill in governing and making laws. (L 198-201) This statement shows that Creon thinks everyone knows him because he is the one governing and making the laws. Creon may be the king of the Thebes, but Creon does have a tragic flaw. Flaws can be found in every single person that has lived either in the past, present or will live in the future. Though there are many people, like Creon, who believe that they have no flaws. This was just a side affect of Creon's tragic flaw which was excessive pride. Creon's excessive pride leads him to not taking any sort of advice from anyone, especially women.This is shown when Antigone tried persuading Creon and Creon replied with, â€Å"No woman's going to govern me- no, no- not while I'm still alive. † (L 599-600) This not only shows his excessive pride, but also that he has absolutly no respect for women. Creon may have especially not listened to women, but he had the same communication level with everyone else, too. This is proven when the chorus leader tries reasoning with him then finally tells him, â€Å"Old man you're like archers shooting at me. † (L 1149) This states that Creon had excessive pride, but he also was persistent and stubborn.Creon may of had excessive pride as his tragic flaw, but he also had the free choice when making his decisions. W ith both Creon's excessive pride and him being the King of Thebes, he created a proclamation. This is one of the many unfortunate events that lead up to the tragic ending in Antigone. With this proclamation Creon was very forceful when making sure everyone knew it and the consequences they would apprehend if broken. Ismene restates, â€Å"For Creon this matter's really serious. / Anyone who acts against the order/ will be stoned to death before the city. (L 41-43) This was the punishment for anyone who would betray him by breaking the proclamation which showed he had his own free choice on what the punishment would be. He also had the free choice on who to forgive and who to punish. This was shown when Creon claims, â€Å"An enemy/ can never be a friend, not even in death. † (L 598-599) When Creon says this it shows everyone that Creon has no respect for traitors at all and they will be punished no matter who they are. Creon's noble stature, tragic flaw and free choices have all lead up to Creon's excessive punishment.To be completely truthful excessive punishment could be a lot of different things, but the most common one is probably death. Though in Antigone death is not Creon's excessive punishment. Instead, Creon's excessive punishment for everything he had done was the loss of his son and wife. In Antigone, Creon had changed his mind about his actions and went to go fix them, but in the end he still lost his wife and son. Creon made it clear that he was going to fix things by saying, â€Å"Alas- it's difficult. But I'll give up. I'll not do what I'd set my heart upon. / It's not right to fight against necessity. † (L 1236-1238) This shows that Creon was finally persuaded into not killing Antigone and burying Polyneices. Creon may of finally changed his mind, but he was too late to save anyone from death. Then after Antigone, his son and his wife he finally admits, â€Å"I killed you, my son, without intending to,/ and you as well, my wife. How useless I am now. † (L 1479-1480) This statement shows exactly what Creon's excessive punishment was which included losing his family.Creon's actions and his excessive punishment lead to his increased awareness of what he had done and the consequences he would now have to face because of them. The last element one needs to inquire before being classified as a tragic hero concludes to be increased awareness. Through all Creon had done, in the end, he finally realized that he should not have been so selfish nor stubborn. Creon lastly voiced the truth as he stated, â€Å"A las for me†¦ The guilt for all this is mine-/†¦ I, and I alone†¦ / I murdered you†¦ I speak the truth. (1463, 1465-1466) This comes to show that Creon comprehended that even though his son and wife killed themselves, he still was the reason in which they killed themselves. For any one person, with is awareness that you comprehend there has to be guilt that follows. His regret is stated as, â€Å"Oh the profanity of what I planned. / Alas, my son, you died so young-/ not your own foolishness but mine. † (L 1410-1412) In this quote it explain not only that Creon made mistakes or that he regrets it, but it also shows that Creon realizes that he made foolish mistakes that he would expect someone much inexperienced to make.Mix this five elements: noble stature, tragic flaw, free choice, excessive punishment, and increased awareness together and one would result with a tragic hero. Since almost everyone in the world has exprienced or seen some type of either tragic event or a series of tragic events in their lifetime it can be concluded that each person has their own definition of a tragic event. In many cases the established definition can be dependent on how severe the tragic event happens to be. The same thing happens when defining what a tragic hero consists of being.The correct difinition for what one needs to be a tragic hero states that a person should ne ed five elements: noble stature, a tragic flaw, free choice, excessive punishment, and increased awareness. Creon from the tragic play Antigone could be cosidered to be a perfect example of a tragic hero. Now many people might beg to differ that Antigone is the real play, but in all actuality Antigone missed one of the elements in the play. The element that allowed Creon tone the tragic hero instead of Antigone was that Antigone had no increased awareness in the end.

Describe the UK carbon reduction strategy, trends and the contextual Literature review

Describe the UK carbon reduction strategy, trends and the contextual issues that are forcing carbon reduction - Literature review Example UK policy: Recent years have seen a significant increase in the U.K legislation’s focus towards reduction in carbon emissions. A number of government departments across U.K have seen adopt and implement greener processes and equipment to help reduce carbon emissions. In 2008, the UK Climate Change Act proposed a target regarding the reduction in carbon emission levels of the country. Through the Act the government obtained its first target for the year 2020 in which the government has taken upon itself to reduce carbon emissions by at least 34%. Along with a short term target the Act also has provided the British government with a long term target for the year 2050 where its target of carbon reduction is 80% (DWP, 2013). The Act provided the basis for a number of legislations such as the CRC EES (CRC Energy Efficiency Scheme), which makes it mandatory for each and every sector to purchase a certain amount of carbon allowances every year (DWP, 2013). In addition to this, the go vernment has made it compulsory for all government departments to adhere to the carbon reduction targets that have been provided to them. These targets are in terms of energy consumption, transportation as well as in terms of solid and water waste (DWP, 2013). The table below shows the sources of carbon dioxide emissions, within U.K, in metric tonnes since 1995. Finally in order to promote the idea of carbon reduction all buildings that cover an area of at least 1000 square meters and provide public access are legally bound to procure a DEC (Display Energy Certificate). DEC rates each building between a scale of A and G with A representing a building with the lowest amount of carbon emissions and G representing a building with the highest amount of carbon emissions (DWP, 2013). Year Energy Supply Transport Business Residential Other 1990 241 120 113 79 39 1995 210 120 107 81 36 2000 203 125 107 87 31 2005 216 129 97 84 27 2008 213 125 90 80 23 2009 190 121 79 75 17 2010 195 119 79 8 7 18 2011 182 117 76 66 17 2012 192 116 79 74 18 Source: (Department of Energy and Climate, 2013) Climate change: Climate change is a phenomenon that leads to a significant change in the temperature of Earth over a period of time. Climate change occurs due to numerous factors for example natural phenomenon such as a variation in solar radiation that hits the earth increase the temperature of the planet. However, over the past few years’ human activities have also contributed to the increase in the overall temperature of the globe. These factors are have collectively been categorized under the heading of global warming (Houghton, 2004). Global warming in its basic terms is the steady increase in earth’s temperature mainly due to the greenhouse gases such as carbon dioxide, chlorofluorocarbons and other pollutants. Due to the increase in greenhouse gases the past few years have been the warmest over a period of hundred years. The effects of global warming are not just re lated to the overall temperature of the planet, but can cause a wide range of physical as well as social impacts (Oxlade, 2003). Experts believe that

At least four general characteristics of materials handling contribute Essay

At least four general characteristics of materials handling contribute to its intrinsic hazard potential. Name and explain four such characteristics - Essay Example In general lack of operational control may increase the scope of intrinsic hazards as it may cause either cause damage either to the operator, the fellow workers or the environment in varied combinations and extremities. Non-Identification of Hazardous Materials: The proper identification and description of the extent of the risk posed by a hazardous material must be well aware to the person handling it. Any lacuna in this would proportionally increase the intrinsic hazard potential of the material. Handling procedures including details on the hazard levels and risks posed must be studied in detail before handling the material Continued exposure of Hazardous materials: If hazardous materials with are not isolated and demarcated, it may lead to uncontrolled exposure of the same to the people handling it which would contribute to the increase of its potential risk. Thus such materials must be isolated and made to be handled by trained persons Personal Safety Equipments: The proper use of Personal Safety Equipments like gloves, goggles, safety shoes, work coat, sunscreen is very important to avert the risk posed by hazardous materials. Improper use of these or not using these while handling a hazardous material increases the intrinsic hazard potential of the

Immigration law Essay Example | Topics and Well Written Essays - 3000 words

Immigration law - Essay Example n bring, employers, however, need to understand how to comply with relevant legislation as well as understanding how to recruit and retain migrant workers. According to Section 8 of the Asylum and Immigration Act 1996 or the law preventing illegal migrant from working which came into effect on 27th January 1997, there are three main components that employers must take into consideration when employing migrant workers: First, it is a criminal offence for an employer to employ someone who has no right to work in the United Kingdom, or no right to do the work they are offering; second, by checking and copying certain original documents belonging to the employee, the employer can establish a statutory defense against conviction for employing an illegal worker; and lastly, the employers are obliged to ensure that their recruitment practices do not discriminate against individuals on racial grounds (Employingmigrantworkers.org, 2007). With these in mind, let us take a closer look at some of the hypothetical cases given on which this paper will focused on. These cases concern Immigration Law and practices in United Kingdom and how employers should address each situation based on their legal ramifications on both the employees and the employers as well. Case # 1: Agrobiz, a large market gardening undertaking, manage an extensive cultivated acreage of soft fruit grown under polytunnels. Local villagers are unwilling to work for Agrobiz because the work is only available for a few months each year and the company only pays a minimum wage. In order to make the work more attractive to worker from abroad, Agrobiz is prepared to offer â€Å"free† chalet style accommodation and meals at its communal catering facility. Legal Implications: Migrant farm work is usually seasonal and inconsistent. Migrants are often needed because local people in the area are unwilling to do this kind of work. These workers are mostly comprised of immigrants, many of whom work illegally in this

Formation of the kindom of saudi arabia Essay Example | Topics and Well Written Essays - 3750 words

Formation of the kindom of saudi arabia - Essay Example These historical compliments can be but are not limited to the formation of the nation, outside influences that impacted upon this formation, foreign-policy decisions, and the way in which governance has come to be institutionalized and defined. As a function of this level of understanding, this particular analysis will first focus upon a brief history of the formation of Saudi Arabia; concentric upon leadership struggles, directional focus, conquests and subjugation. Similarly, an analysis will be made with regards to the current governmental structure that exists within Saudi Arabia. As such, a discussion of foreign-policy that utilizes the situation of how a sign with regards to how the United States and Saudi Arabia sought to accomplish different goals via the use of diplomacy and other foreign-policy instruments. One cannot begin to understand the nation of Saudi Arabia without first underscoring the importance that Abdulaziz had in creating it. Born in the year 1876 in Riyadh, now capital of Saudi Arabia, he and his family were soon forced to flee Riyadh due to the fact that a powerful tribe named the Al Rashi, a warlord from the Najd tribe, attacked and drove them to the desert town of Al-Murrah; a Bedouin tribe that exists in the very far southern deserts of Saudi Arabia. Only 15 at the time, this experience had a profound and lasting effect on Abdulaziz. Though he was not King at this time, this formative experience in the fact that he had been forced to move from his homeland provided for the impetus that he would later utilize as a means of devouring his studies. While living in the southern deserts of Saudi Arabia, he and his family were able to generate income by forming raiding parties and attacking the tribe that initially drove them from their home. These raids turned out to be rather lucrative and more and more raiders began joining the parties. Although Abdulaziz was still in his teens at this time, this understanding of the power of statecraf t and the means by which organization could affect one’s goals proves to be quite powerful. Soon thereafter, the family moved to Kuwait. It was in Kuwait that Abdulaziz’s formal education began. While there, he studied under the emir Mubarak Al-Sabah. During this time, his studies focused specifically on statecraft in the way in which nations performed, organized and how choices were made. However, perhaps the most defining moment in Abdulaziz life was in the year 1901. This was the year in which he and his half-brother, Mohammed, went back into Saudi Arabia and began organizing further raiding expeditions against Rashid and the Najd. Again, these raids proved effective, and Rashid and the tribes that were loyal to him continued to fall back under the mounting pressures that Abdulaziz placed upon them. With such an understanding, the fateful decision was made in January 1902 that Abdulaziz would attack Riyadh and take back his home. The raid was an astounding success w ith Abdulaziz only using 40 men in order to scale the walls, kill the governor, and exert new leadership over the city. This attack marks the beginning of what became known as the Third Saudi State. Although the capture of Riyadh was an important step in exhibiting control over all of Saudi Arabia, it was nonetheless only the first step. However as a

Employees would like to improve the value of their work using the 7 Essay

Employees would like to improve the value of their work using the 7 stage Checkland Soft Systems Methodology (SSM) - Essay Example In the end, the conclusion summarizes the findings and their applicability in the real world. Soft Systems Methodology was developed by Peter Checkland and is a seven step methodolgy to construe models to solve organizational problem situations. It provides a comparison of the current world with certain focused models that can solve ‘soft’ problems. The approach is deemed to be participative and can be carried out by organization members with the support of a facilitator who is familiar with the methodology. It is of most use for people who work and involves drawing rich pictures to expand on different models and systems (Hersh & Hamburg, 2006). The problem under consideration is how can employees improve the value of their work. There are many factors that can accrue to overall improvement in work performance. More importantly, factors that are impeding improvement strategies from being implemented need to be addressed. The value of work done by employees depends partly on the working environment and partly on the employer. Therefore, in order to bring about de finitive change, the employer’s support and cooperation is of great importance. This paper identifies the problems faced by employees in order to improve the value of their work. The first part of the SSM inquiry deals with identification of the problem. The later part deals with root definitions of the systems and the development of potential models; the last steps expound on the efficacy of the proposed recommendations in the real world. For a business organization to function successfully, the value of work of the employees plays a very critical role. It is as much the responsibility of the employees as it is the duty of the line manager to ensure that optimum employee performance is achieved. However, due to any reason, if the employees are not able to put in their best performance, the value of their work is

Week 4 - Article Review Essay Example | Topics and Well Written Essays - 750 words

Week 4 - Article Review - Essay Example The officials with DTI argue that these 31 properties should be tax-exempt because they are currently vacant or they are obsolete and cannot be used for business purposes in their current state. The total tax on these properties comes to a total of around $200,000. In other words, it is almost as if the state of Michigan and the city of Kalamazoo are punishing DTI for purchasing these properties on their behalf and for the betterment of the city, which the owners of DTI claim they may not have purchased these properties otherwise. Later in the article, the president of the company, Ken Nacci goes on to claim that the company would even be happy to pay taxes if the property values of the 31 sites are reduced so that the company does not have to pay such high taxes on properties that are clearly not worth their current value. DTI argues in their claim that the property values are roughly near $1.13 million while the city of Kalamazoo claims their values are more than three times that much. Regardless, the dispute that has been filed with the Michigan Tax Tribunal could result in a turnaround of returned taxes, plus interest to the company if they rule in favor of DTI and DKI. Unfortunately for DTI and DKI, the tribunal is so far backed up that it cannot hear the case for up to several years before a ruling can be made. For now, the company must pay the taxes but if, several years from now, the dispute is heard and ruled in favor of the company, they could be looking at a refund of millions of dollars in paid ta xes plus additional interest on the properties. The legal issue at hand is that the company, DKI, owns 31 real properties in the city of Kalamazoo. The company owns the properties, but purchased them on behalf of the city, which could be argued that in fact the city owns the properties. Therefore, there are several issues such as whether the property is person

West Meets East an Exchange of Royal Letters Essay

West Meets East an Exchange of Royal Letters - Essay Example In his letter, King Louis seems to be interested in personal achievements rather than the general good of France citizens. Motivation to him appears to originate from the concept of punishing sinners and not propagating his religion, as stated in his letter to the King of Tonkin (Spielgovel 431). On the contrary, the King of Tonkin recognized the virtue of fidelity as held by King Louis as well as emphasizing the importance of justice. In his perspective, King of Tonkin notably believes that fidelity and justice would not produce worthy results. The King of Tonkin upholds the custom of his kingdom rather than that of private friendship. He also seems not to have belief and trust in King Louis following the long war that had persisted for several years between the two nations. However, the sense of sincerity from King Louis constitutes the source of his motivation. In addition, the feelings of justice and fidelity also motivate the King of Tonkin (Spielgovel 431). In writing to King o f Tonkin, King Louis had a wooing voice towards capturing the consideration by the King on accepting his request to propagate his religion. In the letter, the voice and language used presents numerous praises with the motive of irony. This would be evidenced by the use of certain praise words that seem to portray an opposite meaning to the King of Tonkin to what he really intends. King Louis also advocates a motive of expanding his personal ambitions and territory of operation. Furthermore, in the letter, King Louis gives reference to his subjects who once received protection under the Realm of the King of Tonkin. This inclusion of the protection accorded to his subjects indicates a point of reference by him in convincing the King of Tonkin to accept his request (Spielgovel 431). The letter by King Louis reveals certain personality traits about him. He does not exist as a theologian but instead uses the virtue of religion in seeking to achieve his personal associations. Also, he rem ains to be an eminent figure in France’s history during the western civilization period. Moreover, King Louis practices an authoritarian leadership style. This becomes evident in his letter when he informs the King of Tonkin about his commands for the Royal Company and Messrs to establish itself in Tonkin soonest possible. In presenting the gifts to the King of Tonkin, the language used in writing does not reflect the willing and free choice of giving, but rather a command. This, thus, portrays a sense of customary formality in his way of appreciation through gifts and not a heartfelt appreciation. King Louis may be a hypocrite in the sense that he pretends to have moral virtues and opinions that he does not actually have. The idea of Christian missionaries reveals this personality in him (Spielgovel 431). In his response to King Louis, the King of Tonkin refused to accept Christian missionaries in his kingdom. He justified his position by asserting that some authorities or e dicts had already introduced a custom that forbids Christian missionaries. In addition, the King of Tonkin justifies his position by way of asking a straight forward question indicating that he could disregard a well-established custom in satisfying private friendship.

Operational management problems of ASDA Essay Example | Topics and Well Written Essays - 5250 words

Operational management problems of ASDA - Essay Example In managing and operating a business in the retail industry, the management has to continuously evaluate the role of supply chain in order to ensure that there are sufficient number of supplies available as well as the company has several products as inventory for backup which can be called when needed. The role of supply chain is critical in retail industry because consumers are looking for different products at the stores and if they do not find the product they want then this would make them dissatisfied and frustrated. Because of this frustration, consumers might not be willing to come back to the store therefore it might lead to losing customers therefore the role of supply chain is important in managing overall operations of the business as well as ensuring that the customers of the company are satisfied. Purpose of the Research Study: This research report is helpful in identifying and revealing different operational management problems that ASDA currently faces. The role of distribution and logistics have drastically changed in today’s competitive market and supply chain has been now used in order to gain competitive advantage over competitors. Firms in the retail industry have been continuously working to improve their overall supply chain management processes and when firms like Tesco who is the market leader of UK retail industry is also working on improving its supply chain management processes to ensure that the operations of the company are managed without any kind of issues and consumers are able to find their products. Similarly, ASDA has also implemented several operational systems in order to improve the overall process of the organisation as well as make better use of logistics and distribution department of the organisation. ASDA has also setup data warehouse which plays an important role in pro viding information to operate the business processes. Background of the Company: ASDA is one of the largest retail organisation in the UK retail industry. The company provides different products to the customers including toys, food, clothing etc. through its several supermarkets store. The company has been operating in UK as a subsidiary of Wal-Mart, as a result of acquisition held in the year 1999. The overall market share of the retail organisation in the grocery market of United Kingdom is around 16.5 percent (Arch, 2010). Apart from this the company also has mobile service network and has also expanded in several other areas. However, most of these diversifications were unsuccessful (Ellis-Chadwick, Doherty & Anastasakis, 2007). Being a part of Wal-Mart, ASDA is

Evening News Essay Example for Free

Evening News Essay News is information or a presentation about current events and is reported by a variety of means such as newspapers, periodicals, radio, television and websites on the Internet. The reporting of news falls into the field of journalism, which are typically written or broadcast in news style. Most news is investigated and presented by journalists and can be distributed to various sites via news agencies. On the other hand, according to a web encyclopedia, â€Å"Short for Web log, a blog is a Web page that serves as a publicly accessible personal journal for an individual. Typically updated daily, blogs often reflect the personality of the author.†(par. 1). A blog is a mixture of a persons experiences in life and what is happening on the Web. It is like a kind of a personal diary-cum-guide site. There are unique types of people, thus, there are as many unique types of blogs as well. In another case, a blog is also a web site that contains dated entries in reverse chronological order (most recent first) about a particular topic. Functioning as an online newsletter, blogs can be written by one person or a group of contributors. Entries contain commentary and links to other Web sites, and images as well as a search facility is also included. Most blogs also invite feedback and comments from visitors and Internet newsgroup discussions, which tend to be more question-and-answer oriented. People have already maintained blogs before but it only gained momentum in 1999 when automated published systems were introduced. Nowadays, thousands of people use web site blog hosting services to simplify and accelerate the publishing process. The template-based software makes it easy to create an online blog and continuously allows you to add entries. Similarly like news, a blog   is a form of media. However, news is considered a traditional media while blog is connoted as internet type of media. It is a platform to communicate what anyone may wish to let anyone know within reach of an internet connection. In traditional media, you are first defined by your medium. There is some constraint on how the contents are delivered physically or digitally which is determined by your medium. According to Maverick blog article, â€Å"There is a cost versus time versus interest versus access series of constraints that determines who your audience is, how you reach them and what they expect of you. Over time, those constraints have evolved our media into very defined roles†(par. 3). Blogs are different. There is no cost constraint. It costs nothing to create a blog. There are time constraints, but much less than traditional media. Bloggers are not pressured   to publish or create an article on a schedule. Blogging is basically personal and this is where the paths of blogging and traditional media diverge. Traditional media is business, thus it has become exclusively corporate while blogging remains almost exclusively personal. However, some bloggers have started to make money from their blogs but what they put in their blogs is all up to them which gives them satisfaction.   Members of traditional media are employees. They get hired for a specific job and they have to do that job. They get hired by a corporation that is most likely public, which means that their employers are concerned in getting their stock price up above all else. Thus, they write news and articles that is dictated by subjects perceived to make more money.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In comparison to mainstream media, blog gives anyone the freedom to write about anything. They can write opinion. They can report facts. They can ask questions. They can write any topics they want. Individual Web surfers post their own eclectic and varied thoughts. Still, others such as known political parties, religious and professional groups, businesses, and media organizations have created their own blog sites too. A report by Snow states that, â€Å"audience for blogs in general is more than 3.5 million strong, and growing. One group that surveys political blogs believes between 20,000 and 25,000 people are regularly talking about political topics on Weblogs. These days people from every corner of the country are finding each other on screen. The impact of all this dialogue is hard to gauge, but it is clearly shaping politics and media coverage†(par. 16-18). Wright also presented that â€Å"Blogging grew from the ground up as a grassroots effort. What started as a few people conversing about common interests via real-time Internet postings has become a continuous conversation among millions of   bloggers and readers. With millions of bloggers expressing their thoughts, experiences, and information they’ve learned in their fields of interest, this medium has become a worldwide forum†(3). Another interesting development of blog in comparison to traditional media is that even news agencies have created their own section termed newsblogs. Auty argues that â€Å"newsblogs supplement and work alongside traditional news media by filtering and reporting news. She praises the growth of personal diaries and eyewitness accounts (such as those that sprung up after 9/ 11) but overall sees blogs as being a new way of distributing and collecting the news rather than a new source of news itself†(341). The rapid pace of technology is changing the nature of blogs as well. The popularity of digital audio players such as the iPod has spurred the growth of blogs with audio content. People can download a wide range of audio files like music and listen to them at their convenience using a PC or a portable media player. The rapid adoption in the use of cell phones with built-in digital cameras and wireless Internet connections is also changing the face and pace of blogging. Bloggers armed with these tools can snap a picture, writes a short caption and then post it on a moblog or mobile log, regardless of time and place.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Thus, with these conveniences brought about by blogging and the personal satisfaction they give on people, it is not surprising that future generations will no longer subscribe to traditional media. As Wright argues, â€Å"blogs have the power to create businesses, change the course of political history, and transform the way the mainstream or traditional media looks at itself.†(2). BIBLIOGRAPHY Auty, Caroline(Editor). Politics and Government in the Age of the Internet. Bradford, , UK: Emerald Group Publishing Limited, 2005. p 341. Blogging Vs. Traditional Media. Blog Maverick Website. May 13, 2006. 27 Oct. 2006http://www.blogmaverick.com/2006/05/13/ Snow, Kate. The Power of the Blog. ABC News website. Sept. 26, 2004. 27 Oct. 2006http://abcnews.go.com/Politics/Vote2004/story?id=123452page=2 Webopedia. The No. 1 Online Encyclopedia dedicated to Computer Technology. 26 Oct. 2006http://www.webopedia.com/TERM/b/blog.html Wright, Jeremy. Blog Marketing. Blacklick, OH, USA: McGraw-Hill Companies, The, 2005. p 2-3.

Cognitive Behavior Therapy: Palliative Care

Cognitive Behavior Therapy: Palliative Care Individuals that have been deemed by their medical team to have serious diseases that are resistant, nonresponsive or have failed reasonable treatments are often referred to specialists for comfort measures only. According to the World Health Organization, Palliative care is the active total care of patients whose disease is not responsive to curative treatment. Control of pain, of other symptoms, and of psychological, social and spiritual problems is paramount. The goal of palliative care is the achievement of the best possible quality of life for patients and their families (WHO, 1990). The National Center for Health Statistics (1996) estimated that 20% of all deaths and 30% of the deaths of elderly individuals occurred in extended care facilities. Extended care facilities are but one place where end-of-life issues are a common fact of daily life. However, regardless of the setting, each individual faces the end of life with his or her own view of life, death and the dying process. The estimated number of patients in palliative care varies due to the difficulty in capturing the actual numbers from hospitals, primary care practitioners, families and emergency rooms. The estimate of patients receiving the Medicare benefit for hospice and palliative care is approximately  ½ million, and it is estimated that, in 2000, approximately 20% of patients dying in the United States received hospice or palliative care services. It should be noted that although many, if not most, individuals in hospice/palliative care settings are age 85 or older, this level of care is not limited to older adults. Motor vehicle accidents, post-traumatic incidents, drug overdoses and other physiologically devastating disorders may result in permanent damage to the younger body as well as the older body. Mortality rates at a young age for those with mental illnesses is decreasing therefore it is estimated that by 2030 there will be 15 million individuals with mental illness residing in long term care facilities (SAMHSA, 2004). This chapter will focus on the reduction or modification of autonomic, psychiatric, or sensory symptom experience of these individuals through use of cognitive behavioral therapy. Cognitive behavior therapy (CBT) uses a structured and collaborative approach while helping individuals to recognize, evaluate and restructure the relationships between their thoughts, feelings and behaviors. Through a process of targeted interventions, the therapist assists individuals to identify, monitor and cognitively restructure the dysfunctional thoughts and/or to modify behaviors that are maladaptive, useless or even harmful (Beck, 1976; Turk, Meichenbaum, Genest, 1987; Freeman Freeman, 2005). CBT includes a range of both cognitive and behavioral techniques such as relaxation, guided imagery/visualization, biofeedback, behavioral experiments, guided discovery, stress management, training in pain or stress management strategies, and cognitive restructuring for dysfunctional thinking and many others . Although there is a paucity of research on the use of CBT in palliative care settings, CBT is effective for many of the psychological issues that are prevalent in palliative care including, depression, anxiety, pain management, and insomnia. The purpose of this chapter is to provide an overview on the use of CBT for assessment and treatment of psychological distress in palliative care settings. Assessment of Emotional Functioning in Palliative Care There are many challenges to the assessment of mood disorders in palliative care settings. An initial challenge is the myth that psychological distress is a normal reaction to end of life. Despite expectations, most individuals in palliative care settings do not have symptoms of anxiety, depression or dementia. Many individuals arrive at this stage of their lives or illnesses with a sense of calm resignation, if not expectations of relief and of going home to God, heaven or family members waiting for them in the hereafter. Therefore those individuals that are experiencing symptoms that require intervention may achieve significant benefit from the interventions. The most common presentations are those of depression, anxiety, pain management failures with exhaustion and anguish, and sleep disorders. The healthcare provider requires tools necessary to differentiate major depression from anger, sadness, and anxiety associated with the symptoms of an untreatable or chronic illness. Assessment of preparatory grief and depression. Another obstacle to the assessment process is simply overcoming the challenges of differentiating symptoms from normal grief of the illness itself. Differentiating between preparatory grief and depression is a key component to the proper assessment of depression in palliative care and has important treatment implications. Preparatory grief can be defined as what an individual must undergo in order to prepare himself for his final separation from this world (Kubler-Ross, 1997). Symptoms of preparatory grief include 1) Mood waxes and wanes with time, 2) Normal self-esteem, 3) Occasional fleeting thoughts of suicide, and 4) Worries about separations from loved ones (Periyakoil and Hallenbeck, 2002). Preparatory grief is a normal, not pathological, life cycle event (Axtell, 2008; Periyakoil and Hallenbeck, 2002). Major depression is defined as five or more of the following symptoms during the same two week period: depressed mood, marked diminish in pleasure, weight loss or gain, insomnia or hypersomnia, psychomotor agitation/retardation, fatigue/loss of energy, feelings of worthlessness or inappropriate guilt, lack of concentration/indecisiveness, and recurrent thoughts of death and suicidal thoughts or plans (APA, 1994). Table 1 provides a symptom list. The list is not intended to be all inclusive however it gives the clinician an overall view of symptoms that may be observed in the individual dealing with depression in a palliative care setting. Although some symptoms of grief and depression overlap, there are ways to distinguish between grief and depression. Table 2 summarizes the ways to differentiate symptoms of grief versus depression according to temporal variation, self-image, hope, anheonia, response to support, and active desire for an early death (Periyakoil Hallenbeck, 2002). The first step to proper recognition of depression involves the identification of possible risk factors (Wilson, Chochinov, de Faye, and Breitbart, 2000). Certain demographic characteristics, such as younger age, poor social support, limited financial resources and family history of a mood disorder, as well as a personal history of previous mood disorders place individuals at a greater risk for developing depression or anxiety in end of life situations. Risk for developing a mood disorder also is elevated with certain types of diagnoses, including pancreatic cancer and brain tumors, and particular medical interventions such as radiation therapy (Hirschfeld, 2000). Symptoms of the illness, including poor symptom control, physical disability, and malnutrition also place individuals at higher risk. The second step to the proper assessment of depression includes utilization of appropriate assessment tools. Many times it is the degree and persistence of symptoms that provide the information necessary when considering major depression. Major depression, which is estimated to occur in fewer than 25% of patients in end of life care, may be best screened with targeted questions such as: How much of the time do you feel depressed? In addition, for those individuals that have a difficult time describing their symptoms or history, asking family members to provide information about a previous history of depression or a family history can be very useful. Although studies validating assessment tools vary greatly, many of the self-report measures have been shown to be effective in palliative care patients. The most common utilized tools in palliative care settings frequently omit physical symptoms of depression. Many symptoms of depression overlap with the terminal disease process (Noorani Montagnini, 2007). Examples of self-report measures that omit somatic symptoms include the Beck Depression Inventory II (Beck, Steer, and Brown, 1996), Hospital Anxiety and Depression Inventory (Zigmond Snaith, 1983), and the Geriatric Depression Scale (Yesavage et al., 1983). The Hayes and Lohse Non-Verbal Depression Scale (Hayes, Lohse, and Bernstein, 1991) is a third party observational measure that can be completed by staff, family, or friends to assist with the diagnostic process. Terminally Ill Grief or Depression Scale (TIGDS), comprising of grief and depression subscales, is the first self-report measure designed and validated to differenti ate between preparatory grief and depression in adult inpatients (Periyakoil et al., 2005). Assessment of anxiety. The symptoms of anxiety may differ in individuals in the palliative care environment. Many times symptoms of anxiety have a physiologic component. For example in those individuals with chronic obstructive pulmonary diseases difficulty breathing, low oxygen levels and overall compromised respiratory function causes air hunger which is experienced as anxiety and even panic. Table 3 lists some of the common anxiety symptoms seen in this population. Family members are often at a loss as to what they can do to assist their loved one that is experiencing anxiety, and especially fearfulness. It is often useful to provide significant others with a checklist of items that are important to report to the healthcare provider. Involving the family has the benefit of giving them a structured guide for response which reduces their own anxiety in response to the patient. In addition the patient may relax more knowing that a family member is involved with their care in an approved, helpful manner. An example of a list of items for family members to watch for and report to the healthcare team is listed in Appendix 1. Cognitive Behavioral Interventions in Palliative Care Psychological intervention in the palliative care setting includes those aspects of treatment that would provide relief from emotional distress while an individual is dying. Often this time period includes depression, anxiety, grief and organic brain dysfunctions such as dementia and/or cerebral vascular diseases. Individuals and their family members are both considered the patient during these times. Many of these individuals are suffering from chronic, unremitting pain conditions which negatively impact their emotional health. Treatments for pain and chronic conditions also play a part in the individuals mental status. The use of Cognitive Behavior Therapy (CBT) is extremely useful for these individuals. Cognitive Behavioral Therapy has the strongest empirical support of any psychological intervention for the management of symptoms typically seen in a palliative care setting. The most common presentations of psychological distress in the dying patient include anxiety, depression, hopelessness, guilt over perceived life failures and remorse. Persistence of these thoughts and feelings interfere with functioning, makes the person generally miserable as well as those around them and can severely affect his/her quality of life. Medical treatments, such as antidepressants, anxiolytics and cholinesterase inhibitors, exist for these problems however supportive psychotherapy such as relaxation training, imagery, distraction, skill training, and negative thought restructuring improves the possibility of remission. CBT can also improve the symptoms of spiritual distress that may include feelings of disappointment, guilt, loss of hope, remorse, and loss of identity. CBT for depression. Symptoms of depression are common in end of life care. It can be one of the most distressing groups of symptoms an individual can experience and may interfere significantly with daily tasks of life. Some experts have estimated that up to 75% of patients with terminal illnesses experience symptoms of depression. Amelioration of some of the symptoms of depression can increase the amount of pleasure and meaning in life, as well as add hope and peace. Treatment for depression can reduce the experience of physical pain as well as general misery and suffering. In addition, reduction of the symptoms of depression may improve the treatment of coexisting illnesses more effective. Most importantly, given that one of the most serious symptoms of depression is suicidal ideation, it makes sense to treat depression in order to prevent successful suicidal outcomes. There is a paucity of literature in the area of the use of CBT with depression in Palliative Care, due to the high attrition rate resulting from physical morbidity and mortality (Moorey et al., 2009). Therefore, these factors pose significant barriers to conducting randomized clinical trials in Palliative Care to address these components. The following is a review of the sparse literature on CBT in Palliative Care with depression. In an attempt to address this problem, Moorey et al., conducted a cluster randomized controlled trial in order to determine if it was possible to teach nurses CBT techniques in order to reduce anxiety and depression symptoms in patients with advanced cancer (2009). Eight nurses were trained in CBT by attending several 1- and 2-day workshops and then were rated on the Cognitive Therapy First Aid Rating Scale (CTFARS) for CBT competence. Seven nurses did not receive training and served in the control group. A total of 80 home care patients entered the trial; however most of these participants were excluded due to being too ill to participate. A total of 16 patients were in the CBT group and 18 patients were in the control group. The participants received home care nursing visits in which assessments were conducted at 6-, 10-, and 16-week intervals. The individuals who received CBT reported lower anxiety scores over time, but no effect of the training was found regarding depression. It was noted that both groups experienced lower rates of depression over the course of the study. The authors noted the heterogeneity of the sample and the high attrition rate due to physical morbidity and mortality presented several barriers to conducting the study and may have played in a role in the findings (Moorey et al., 2009). Cole and Vaughan (2005), in their review on the feasibility of using CBT for depression associated with Parkinsons disease (PD), found that it is a promising option. The authors noted that depressed inviduals with comorbid PD experienced a significant reduction in depressive symptoms and negative cognitions. In addition they experienced an increased perception of social support over the course of treatment (Cole Vaughan, 2005). The recommended course of action for individuals in this setting included: stress management training, relaxation training, behavioral modification techniques for sleep hygiene, and cognitive restructuring. Modification of life stressors contributing to depressed mood should be identified and plans made to minimize stress and maximize quality of life. The use of thought restructuring is recommended in order to maintain a sense of purpose and fulfillment through meaningful activity and to adjust expectations of self and others. Individuals are also encouraged to return to previously enjoyed activities in order to maximize feelings of pleasure and happiness. Through systematic defocusing on physical conditions the person is able to experience more pleasant activities, which are also encouraged. Similarly, Dobkin et al, conducted a study which explored the effects of modified CBT for depressed patients with PD, in conjunction with a separate social support intervention for caregivers (2007). The patients received 10-14 sessions of modified CBT, while caregivers attended three to four separate psychoeducational classes. The modified CBT sessions were comprised of the same components of the previous Cole Vaughan, (2005) study, such as, stress management training, behavioral modification techniques for sleep hygiene, relaxation training, cognitive restructuring, modification of life stressors, and increasing engagement in pleasurable activities. The classes were targeted at providing caregivers with ways to respond to the patients negative thoughts and beliefs, as well as, strategies to offer appropriate support. As in the previous study, the modified CBT sessions were comprised of training in stress management, behavioral modification, sleep hygiene, relaxation techniques, an d cognitive restructuring. Participants reported a significant reduction in their depressive symptoms and cognitions and increased perception of social support at treatment termination and one-month post-treatment. CBT for anxiety. Along with depression, anxiety is a common mental health problem in palliative care settings and also appears to be alleviated with CBT interventions. In a small feasibility study examining the use of cognitive behavioral therapy techniques for mild to moderate anxiety and depression in hospice patients, four sessions of CBT techniques was found to significantly reduce anxiety and depression in a majority of patients (Anderson, Watson, Davidson, and Davidson, 2008). Overall, participants in the study found the CBT techniques acceptable, helpful, and qualitatively reported improved mood. A significant reduction in anxiety symptoms also was seen in a randomized controlled trial of CBT administered by home care nurses in patients with advanced cancer (Moorey et al., 2009). CBT techniques are particularly effective to assist with the management of anxiety related to breathing difficulties commonly seen with pulmonary diseases, such as chronic obstructive pulmonary disease (COPD). In a group of individuals with COPD, six sessions of guided imagery, a CBT relaxation technique, was found to significantly increase the partial percentage of oxygen saturation, which is a physiological indicator signaling more effective breathing (Louie, 2004). In another study, as little as 2 hours of CBT group therapy yielded a decrease in depression and anxiety among older patients with COPD, but there was no change in physical functioning (Kunik et al., 2001). CBT for pain management. Pain is not simply a biological response to unpleasant stimuli. It is a complex phenomenon that includes biological, psychological, behavioral and social factors that interact in complex ways to influence the pain experience. Some of the factors that can influence a persons experience of pain include: a) previous pain experiences, b) biologic and genetic predispositions, c) mood disorders such as anxiety and depression d) their beliefs about pain, e) fear about the pain experience, f) their individual pain threshold and pain tolerance level, and f) their skill with coping methods. Cognitive-Behavioral Therapy has the most empirical support for the management of chronic pain, especially when used as part of an interdisciplinary treatment approach to manage pain symptoms (Turk, Swanson, Tunks, 2008). Cognitive behavioral techniques can be used independently to assist with pain management or integrated into a comprehensive cognitive-behavioral case conceptualization framework to address pain (Turk, Swanson, Tunks, 2008). The three components to CBT for pain management are 1) Education and rationale for the use of CBT, 2) Coping skills training, and 3) Application and maintenance of CBT skills (Keefe, 1996). Useful behavioral interventions to assist with pain management include goal setting, relaxation strategies, such as deep breathing and guided imagery, and activities scheduling. Cognitive interventions would include increasing problem-solving skills and addressing an individuals maladaptive thoughts related to pain management. Examples of maladaptive thoughts include: 1) Ive tried every pain management intervention with no success, 2) I cannot do any of the things that I used to do, 3) nothing will help manage my pain, and 4) no one can help me feel better. CBT for pain manage ment has demonstrated efficacy in various diagnoses often addressed in palliative care. CBT has been found to be efficacious in the management of cancer-related pain in single studies (Syrjala, Donaldson, Davis, et al., 1995) as well as in systematic reviews (Abernethy, Keefe, McCrory, Scipio, Matchar, 2006). CBT for sleep hygeine. Insomnia, sleep duration and quality are major concerns for people with pain disorders such as osteoarthritis (Vitiello, 2009). Approximately 60 percent of individuals with chronic pain disorders report frequent nighttime awakening due to pain during the night. Disrupted sleep patterns exacerbate chronic pain intensity and experience which in turn causes more disturbance of the sleep/wake cycle. Successful treatment of interrupted sleep may reduce the pain experience as well as improve the overall quality of life for these individuals. Psychotherapeutic techniques that target sleep disturbances are easily incorporated within behavioral and cognitive management of other co-occurring disorders as well. Sleep disorders are common in patients who suffer from Parkinsons disease (PD) (Stocchi, Barbato, Nordera, Berardelli and Ruggieri, (1998). Specifically, insomnia, nightmares, REM sleep behavior disorder, sleep attacks, sleep apnea syndrome, excessive daytime sleepiness, and periodic limb movement in sleep result from changes in sleep structure, movement disturbances in sleep, disturbances in neurotransmission and medications. Individuals who are sleep deprived are at risk to develop infections, cardiovascular disease, hypertension, diabetes, depression, and require increased time to recover from stress (Schutte-Rodin, Broch, Buysse, Dorsey, and Sateia, 2008). CBT improves sleep by addressing unhelpful beliefs regarding sleep and misperceptions about the amount of sleep that one obtains. Many misperceive the amount of time they are actually asleep. People who suffer from insomnia actually sleep more than they are aware of because they are only attentive of when they are awake. Furthe rmore, many people believe they require 8 hours of sleep in order to be able to function during the day and any amount of sleep that is less is insufficient and will result in reduced ability to function during the day. Therefore, these beliefs and misperceptions can increase ones stress level about sleep and a stress response may result when one thinks about going to sleep. Clearly, a heightened stress response is not conducive to sleeping. CBT increases ones control over their unhelpful and inaccurate beliefs and enables them to replace them with more helpful and accurate beliefs (Whitworth, Crownover, and Nichols, 2007). CBT also addresses the behavioral components of ones sleep routine or patterns that interfere with ones ability to obtain restful sleep. Exercising, smoking, or drinking caffeinated drinks just prior to bedtime can interfere with ones sleep. All of these activities are stimulants that energize the body. Also, not having a bedtime routine, a regular sleep-wake pattern, or taking naps may interfere with ones ability to get restful sleep. Increasing ones sleep hygiene by developing positive habits that influence sleep such as, having a bedtime routine to prepare ones mind and body for sleep, regular exercise several hours before one intends to prepare for sleep, and avoiding coffee, alcohol, and smoking in the evening, as well as, increasing activities that produce relaxation (e.g., taking a hot bath one to two hours before going to bed, meditation, deep breathing, or muscle relaxation) can increase the likelihood of obtaining restful sleep. Another behavioral strategy utilized in CBT i s sleep restriction. This technique attempts to match ones actual sleep requirement with the amount of time one spends in his/her bed. The theory behind this approach is that reducing the amount of time spent in bed without sleep will increase ones desire to sleep (Harvey, Ree, Sharpley, Stinson, and Clark, 2007). Results of a study by Vitiello showed that treatment improves both immediate and long-term self-reported sleep and pain in older patients with osteoarthritis and comorbid insomnia without directly addressing pain control (2009). This study included 23 patients with a mean age of 69 years were randomly assigned to CBT, while 28 patients with a mean age of 66.5 years were assigned to a stress management and wellness control group. Participants in the control group reported no significant improvements in any measure while Individuals treated with CBT reported significantly decreased sleep latency (onset of sleep) by an average of 16.9 minutes and 11 minutes a year after treatment. Interruptions in sleep after sleep onset decreased from an average of 47 minutes initially to an average of 21 minutes after one year. Pain symptoms improved by 9.7 points initially to 4.7 points. Sleep efficacy (how rested does the person feel upon awakening) initially increased by 13 percent and 8 percent a year after treatment. The improvements remained robust in 19 of 23 individuals at a one-year follow-up visit. Furthermore, while many older adults experience insomnia, it is reported that up to two-thirds of those who experience these symptoms have limited knowledge regarding available treatment options. Sivertsen (2006), conducted a randomized controlled trial to compare the efficacy of non-benzodiazepine sleep medications with CBT. This study included 46 patients with a mean age of 60.8 years who were diagnosed with chronic primary insomnia. Participants were randomly assigned to either the CBT intervention (information on sleep hygiene, sleep restriction, stimulus control, cognitive therapy, and progressive relaxation), sleep medication (7.5 mg zopiclone each night), or placebo medication. Treatment lasted 6 weeks, and the CBT intervention and sleep medication treatments were followed up at 6 months. Data regarding total wake time, total sleep time, sleep efficiency, and slow-wave sleep was collected utilizing sleep diaries, and polysomnography (PSG; monitors physiological activity during sleep). Results revealed that total time spent awake improved significantly more for those in the CBT group compared to the placebo group at 6 weeks and the zopiclone group at both 6 weeks and 6 months. In comparison, the zopiclone group did not reveal significant results from the placebo group (Sivertsen, 2006). The CBT group experienced a 52 percent reduction in total wake time at 6 weeks compared with 4 percent and 16 percent in the zopiclone and placebo groups respectively. A statistically and clinically significant finding was that participants receiving CBT improved their PSG-registered sleep efficiency by 9 percent at posttreatment, opposed to a decline of 1 percent in the zopiclone group. Total sleep time increased significantly between 6 weeks and 6 months for the CBT group. The zopiclone group showed improvements at 6 weeks and maintained these improvements at 6 months, but did not show further improvements. The CBT group showed significant improvements compared to the zo piclone group in total wake time, sleep efficiency, and slow-wave sleep; total sleep was the only area that did not yield a significant difference (Sivertsen, 2006). ADAPTING CBT TO THE PALLIATIVE CARE SETTING Overview of CBT in Palliative Care Cognitive-behavioral therapy is effective for many of common mental health issues seen in palliative care and often augments the success of pharmacological interventions. In addition to the individual with the terminal illness, their family members, as well as multiple health providers are considered integral members to the success of the collaborative relationship. Use of a CBT case conceptualization framework and various components offer flexibility, which makes the CBT approach feasible to implement within a palliative care setting. The following section provides an overview of the components of cognitive-behavioral therapy and necessary adaptations to palliative care settings. Collaborative Relationship As mentioned in previous chapters in this book, a collaborative relationship is a core component of an effective cognitive-behavioral intervention. In a palliative care setting, the collaborative relationship often involves more than just the client and the therapist. The interdisciplinary treatment team works with the individual to develop an individualized treatment plan that is central to the case conceptualization and goal setting of CBT. A variety of disciplines, such as nursing and social work, use CBT techniques in palliative care settings. Individuals receiving palliative care often need assistance with CBT interventions as their illness progresses. Individuals receiving palliative care often need assistance from the treatment team with practicing skills, such as relaxation techniques, and adapting CBT interventions as goals of care change. Some individuals in the Palliative Care setting may not be facing death in the near future, and if they are facing impending death, they may not be aware of it. In these cases the primary patient may be the family member or significant other. It is also common practice for most individuals to seek help for mental health problems from their family practitioner even though the typical family practitioner has very little training in psychiatric/mental health assessment, diagnosis and treatment. In cases where the family is relying on an under-trained health care provider it may be incumbent upon the mental health provider to negotiate the gap between family and medical care. Case Conceptualization and Goal Setting Therapy with the dying person should begin with having the person identify, explore and determine outcome goals regarding the issues at hand. Similarly to the primary care setting, case conceptualization and goal setting need to occur almost immediately. The therapist uses the Socratic Dialogue to explore the persons concerns and worries. This gives the individual more of a sense of control over what will be happening in the therapy session. Once this sense of control is established it becomes easier to explore other, more emotion laden topics. Goals should be small, obtainable and proximal to the session to be most effective. For example, Mrs. Jones I will be back to see you tomorrow. One of the things you have decided to practice is your deep breathing at least twice tonight and again in the morning. When I return I will check with you to see how you are doing with the practice. In palliative care setting, it may be necessary to discuss how other people involved in care can assist with reaching goals. For example, nurses might remind individuals to practice relaxation strategies during wakeful periods, as well as talk an individual through the relaxation technique when experiencing a high level of pain. Behavioral Interventions Pleasant Events Scheduling. Activities scheduling is a useful intervention to assist with mood disorders, pain management, and sleep hygiene issues seen in a palliative care setting. Engaging in pleasant events distracts an individual from negative thoughts and provides experimental evidence to support more adaptive thinking styles. Often times in palliative care the first barrier to overcome is identifying pleasant events that can occur in a palliative care setting due to health limitations. Pleasant events need to be person-centered, meaningful, and feasible activities that can be built into a daily routine. Meaningful pleasant events can be identified through both clinical interview and self-report methods. Clinical interview queries should include taking a history of an individuals daily schedule and identify activities the individual enjoyed engaging in on a routine basis prior to their illness. From the generated list of previously enjoyed pleasant events it needs to be determined which activities the individual can continue to enga

Analysis of SSR Sequences in Rice

Analysis of SSR Sequences in Rice 3. MATERIALS AND METHODS 3.1. Plant Material Total of twenty one introgression lines carrying African rice genes and its parent lines were used in this study (table 1) 3.2. Methods 3.2.1. DNA extraction Genomic DNA was extracted from young leaves of the seedlings grown in fields of Huazhong Agricutural University, Wuhan, China. Method used was according to Cetyltrimethyl ammonium bromide (CTAB) method reported by Xu et al. (2011), but with some improvements. Preparation of 1.5%CTAB buffer CTAB 3.0g 1M Tris pH8.0 15.0ml 0.5M EDTA (ethylenediaminetetraacetic acid), pH8.0 6.0ml NaCl 12.28g dd H2O 200.0ml PVP40Mw40, 000 1.0g Tris-base buffer to make sure pH=8 Two gram of fresh or frozen leaf tissue was ground to a fine powder in liquid nitrogen with a conical hand tissue grinder by using mortar and pestle. The powder was transferred to 1.5ml Eppendorf tube content 750ÃŽ ¼L of 1.5*CTAB and 25ÃŽ ¼L ÃŽ ² –mercaptoethanol. Then incubated for 1hour in a 65 ºC water bath with an interval mixing by inverting the tubes every 15min. Add 750ÃŽ ¼L of chloroform: Isoamyl alcohol (24:1) was done in a fume hood. The samples were gentle mixed by shaking for 30min in shaker at room temperature and then spin in the microfuge at 10000rpm for 10min to precipitate the cell debris. The upper aqueous phase (supernatant) was pipette and transferred into fresh eppendorf tubes. The same volume from preceding mix was put to the liquid in fresh eppendorf and the mixed shaking for 30 min in the shaker then spin in microfuge at 10000 rpm for 10 min. The supernatant was pipette and transferred to fresh eppendorf tubes, and then 2/3 the volume from iso-propyl alcohol 70% was added to each sample, then the samples was put in refrigerator 1 hour. After that centrifuged for 3 min with the rotational speed of 7000 rpm in 220c. After this step DNA collected on the tube sides. The supernatant was carefully discarded from the tube, DNA pellets appeared as tiny white tear drop-shaped smears on the tube sides. The pellets were washed twice with 75% ethanol, then air dried by inverting the tubes up side down over tissue paper. To re-dissolve DNA pellets 100ÃŽ ¼L of ddH2O was added to the tubes and immediately stored at –200C 3.2.2. Quality and quantity check of DNA DNA was checked for its purity and then quantified. The genomic DNA was run on 1.0% agarose gel stained with ethidium bromide and photographed under UV transilluminator using Image Lab TM software Version 4.0.1. The concentrations of the pure genomic DNA as assessed by agarose gel electrophoresis were estimated on spectrophotometer ND-2000. Based on the quantification data, all the genomic DNA samples were diluted to a final concentration of 100 ng†¢ÃŽ ¼L-1 with double-distilled water (ddH2O) and stored at -20o C for further use. 3.2.3. SSR analysis 3.2.3.1. PCR amplification and agarose gel electrophoresis A total of 50 microsatellite primer pairs were used for analyzing and identification 21 genotypes and then 22 polymorphic primers were selected to provide genetic identity and assess the genetic relationships among genotypes. PCR was performed in 20 ÃŽ ¼L reactions by using Thermal cycler touchdown as described by Don, et al. (1991), with some modifications. PCR mixture component The Touchdown-PCR program: PCR products were analyzed by electrophoresis using 2.0% agarose gel in 1x Tris Acetic cid EDTA (TAE), stained with ethidium bromide solution. then gel was visualized and photographed under UV light using Image Lab TM software Version 4.0.1. The SSR markers with high polymorphism were further used in SSR fingerprinting analysis 3.2.3.2. 6% denature polyacrylamide gel electrophoresis (PAGE) polyacrylamide gel electrophoresis has been used an unique analytical tool for many studies related to the identification of cultivars, species and F1 hybrids 3.2.3.2.1. Materials A. preparation of 6% PAGE for SSR analysis B. preparation of 10*TBE (Tris-borate EDTA) buffer Dissolved in 800 ml double distilled water, filtered through 0.22  µm filter paper, made up to 1000 ml. C. preparation of 40% Acrylamide d. Silver staining Preparation of silver solution 2.5g AgNO3 (Silver nitrate) 2000 ml Distilled water Then shaking well Preparation of developer solution 28g NaOH (Sodium hydroxide) 10ml HCHO (Formaldehyde) 2000 ml Distilled water 3.2.3.2.2. Method The large and short spacer glass plates, combs, and other pertinent materials were cleaned with water and completely dry. The inside of both plates were cleaned with 95% ethanol to facilitate drying. 650ÃŽ ¼L of Repel-silane was applied to long plate and spread evenly using tissue paper. 800ÃŽ ¼L of glide-acrylamide (200ÃŽ ¼L qin he gui wan + 10 ml 75% alcohol then agitate) was applied to short plate and distributed evenly using tissue paper and leaved to dry for a short time. Glass plates and sealers using clamps were assembled according to manufacturer’s instructions. 60ml of 6%PAGE, 40ÃŽ ¼L of TEMED (Tetra-methyl-ethylene-diamine), and 400ÃŽ ¼L of 10% ammonium persulfate (APS), previously stored at 40C were mixed into beaker. The gel was leaved to polymerize for about 1hr. After 1hr polymerization it was assembled in an electrophoresis unit. After cleaning the wall with 1X TBE buffer, the gel was pre-run at constant 1500w for 30 min to clean the gel and pre heat the buffer to about 60-650. 20ÃŽ ¼Lof PCR amplified product was mixed with 5ÃŽ ¼L of the loading buffer and added 5ÃŽ ¼L in each well. The electrophoresis unit was resumed and allowed to proceed at 1200w constant until loading buffer covered more than 3/4 of the distance. Finally the unit was disassembled and the gel was subjected to silver staining. Silver staining Gel was soaked for 20-30 min in staining solution with gentle shaking followed by washing in water for 3 sec. For developing color, gel was soaked in developer solution with gentle shaking until band appeared. The gel was rinsed in water for several minutes. Then the gel was air dried and visualized under normal light. 3.2.3.3. Data analysis 3.2.3.3.1. Analysis of polymorphism Unambiguous polymorphic bands were scored visually for the presence or absence of corresponding bands among the tested accessions. Stutter and background bands were excluded. Those SSR markers displaying no polymorphisms, non-specific banding patterns or without PCR products were discarded. Molecular data were prepared by scoring the SSR markers amplification profile as present or absent for each marker to generate a binary matrix. 4. RESUTS The study was designed to provide genetic identity for introgression lines carrying African rice genes by using molecular markers. Twenty one rice genotypes were used in this study (Table 1). A total of twenty two pairs of SSR primers distributed in 9 rice chromosomes were selected to analyze the twenty one genotypes. The sequence and the details of selected primers showed in table 2 4.1. Analysis of polymorphism SSR-PCR reaction system was optimized with 3% agarose gel electrophoresis and SSR markers were analysed with 6% denaturing polyacrylamide gel electrophoresis. Polymorphism was analysed with composited 22 pairs of SSR primers and optimized SSR-PCR system to determine the appropriate SSR markers applied in fingerprint mapping. Banding patterns generated by primer pairs RM310, RM213, RM202, and RM80 in 21 genotypes are shown in Fig 1.and Fig 3., while RM337 are shown in Fig 2. A total of 91 alleles were detected across 21 rice genotypes using 22 SSR markers. The maximum number of polymorphic alleles was 6, while the minimum number of polymorphic bands (2 alleles) was amplified with the markers RM 85, RM240. The average number of polymorphic alleles per marker was 4.1. Molecular data were ready for recording the SSR markers amplification profile as current (1) or absent (0) for each marker to create a binary matrix. The binary matrix data were analyzed through the use of the Similarity for Qualitative Data (SIMQUAL) module to generate Dice similarity coefficients [Dice LR. 1945]. The similarity coefficients were used to construct dendrograms using the Unweighted Pair Group Methods with Arithmetic means (UPGMA). 4.2. Cluster analysis The SSR markers were able to distinguish between different rice genotypes. The high degree of polymorphism of microsatellite markers allows rapid and efficient identification of rice genotypes. These markers classified the rice genotypes into eight clusters. (Fig4.) According to the results of pylogenetic tree twenty one genotypes were divided into eight groups according to the standard genetic similarity o.73. The lowest diversity was found between ILA65 and ILA78 (similarity level 98%) that strengthen the supposition of close relationship between them. While the highest diversity was found between J23B and other genotypes used in this study at similarity level 35%. These obtained results could be due to the number of SSR markers used in the study or the bias of genetic similarity estimation conducted by the UPGMA-based method. 4.3. Principal component analysis A principal component was performed using 22 SSR markers. The Values of the Eigen values and their contribution to variation are presented in Table 3. The score plot of 21 genotypes based on the first two principal components is presented in Fig 5. 4.4. Genetic similarity among Rice genotypes The Dic similarity was computed according to the obtained data from the polymorphic primers. The similarity index value obtained for each pair wise comparison among the 21 genotypes and presented in Table 4. The similarity coefficients ranged from 23.08% to 97.8% among tested genotypes. ILA 65 and ILA78 were the most similar among all the genotypes with a coefficient of 0.9780. The least similar genotypes were J23B and ILA19, ILA123 with a coefficient of 0.2308. 4.5. The fingerprints for identification The results showed the molecular identification of 21 Rice genotypes using 22 SSR polymorphic sequences. The thirteen Pair of these SSR primers were selected from the polymorphic primers which can amplify clear bands and have more alleles to identity nineteen introgression lines carrying African rice genes and three varieties. Table 5 The microsatellite assay generated cultivar-specific alleles in some of the genotypes screened; these used as DNA fingerprints for genotypes identification. This will be the assistance for the establishment and defense of proprietary rights and the determination of cultivar purity. The core SSR used to generate the fingerprint code of each used germplasm Table 6. 5. DISCUSSIONS In our study, microsatellite markers were used for investigating genetic diversity of 21 rice genotypes under study (Table 1). To this end, 22 primer pairs of microsatellite were used which had relatively high polymorphism in available literatures (Table 2). According to the previous results primer pairs will be referred to as loci and DNA bands as alleles (Sefc et al., 2000). The number of alleles obtained by microsatellite markers varied from 2 to 6 with an average of 4.1 alleles per locus. However, the average numbers of alleles detected in present study were significantly higher than this reported by JOSH et al. (2006) in non-Basmati aromatic rice genotypes of India which equals 2.6. The disparity among reports might be due to genotype number, SSR loci distribution, concerned sets of germplasm and gel electrophoresis method adopted in various studies. Higher number of alleles was found when a large number of landraces from a wide range of geographical origins were included in the study (Brondani et al., 2006). The cluster analysis, using unweighted pair group method of arithmetic means (UPGMA) was constructed for measuring genetic diversity and relatedness among the genotypes (Fig. 3). 5.1 cluster analysis based on SSR markers The similarity matrix was computed using SSR markers based on Dic’s coefficient following the UPGMA method using SHAN programme of NTSYS-pc. The Dic’s similarity coefficient for the SSR data set varied from 0.2308 to 0.9780. According to the results of phylogenetic treeà ¯Ã‚ ¼Ã‹â€ Figure1) Twenty one introgression lines and cultivars were divided into eight groups according to the standard genetic similarity which is 0.73. The first group ILA17, ILA13, STB, STA/F The second group ILA11 The third group ILA145, ILA21 The fourth group ILA12, ILA166, ILA1 The fifth group ILA147, ILB19, ILA172, ILA65, ILA78, ILA30, ILA29, ILA60 The sixth group ILA19 The seventh group ILA123 The eighth group J23B In group fifth we can distinguish two sub groups: sub group V-1 having ILA147, ILB19 and sub group V-2 having ILA172, ILA65, ILA78, ILA30, ILA29, and ILA60 but they were closely related groups. And five groups according to the standard genetic similarity which is 0.67. ILA17, ILA13, STB, STA/F ILA11, ILA145, ILA21, ILA12, ILA166, ILA1 ILA147, ILB19, ILA172, ILA65, ILA78, ILA30, ILA29, ILA60 ILA19, ILA123 J23B Rice genotypes clustered into eight well defined groups in accordance with their pedigree, probably due to the origin genetic of these materials, because most genotypes obtained from other genotypes and had similar pedigree. The studied Rice genotypes were showed existence of genetic diversity among 21 rice genotypes. The SSR markers played an important role in studying the germplasm diversity in rice (Yu et al., 2005). The results indicated that SSR analysis could be a better method to study the genetic diversity in rice. The highest genetic distance was found between ILA17 and J23B, where they held the first and last position of the dendrogram. On the other hand, the lowest genetic distance was found between ILA65 and ILA78 in the same group. This result consistent with the pedigree of these two ILs which shared a high proportion of ancestry (Table 1) SSR markers efficiently separated the rice genotypes into groups consistent with their origin and pedigree. Gerdes and Tracy (1994) explained that pedigree relationship can be used as an indicator to test the effectiveness of markers in determining relationships among breeding lines. Our results showed that the SSR markers were able to detect the extent of genetic diversity among rice genotypes used in this study. 5.2 Principal component analysis The principal component analysis study was also done using the subroutine EIGEN. The PCA results showed that the PC1 contributed 65.1389% followed by PC2 7.8560% and cumulative variance of first two PCA was 72.9948%. The results were close similarity of the results obtained based on unweighted pair group method with Arithmetic average (UPGMA) 5.3 similarity index A similarity matrix according to the proportion of shared SSR fragments was used to establish the level of relatedness between the tested genotypes. Pair-wise estimates of similarity ranged from 0.2308 to 0.9780 and the average similarity among all genotypes was 0.6807 (table 3.). Two genotypes ILA65 and ILA78 were the closest related genotypes with the highest similarity index of 97.8%. This was followed by 94.51% similarity between two pairs of genotypes ILA166 and ILA1. The lowest similarity (23.08%) was observed between genotypes ILA19 and J23B, ILA123 and J23B. As expected, J23B had the greatest dissimilarity with all the other tested genotypes. The similarity coefficients of J23B with all the other genotypes ranged from 0.2308 to 0.4396. It could be concluded that Simple Sequence Repeat markers could identify the different rice genotypes, and some of rice genotypes under investigation have probably originated from closely related ancestors and possess high degree of genetic sim ilarity. 5.4 DNA fingerprinting analysis Finally the thirteen pairs of SSR primers were selected from the polymorphic primers as the core set of SSRs (Table4) which could detect varying numbers of polymorphic bands. Their amplified bands were clear, legible, easy to count, and distinguishable from one another. These markers were distributed among 8 rice chromosomes. The microsatellites exhibited several bands that were shared among the check genotypes. Eight accessions (ILA123, ILA19, ILA21, ILA12, ILA145, ILA11, STA/F, STB) displayed unique bands in comparison with all other genotypes with different microsatellite markers. SSR markers analysis will help the identification and differentiation of introgression lines. The information will enable construct a DNA fingerprinting database of tested rice genotypes (Table 6). Construct a unique DNA fingerprints of the tested genotypes can distinguish each of the tested materials and provide basic guidelines for its conservation. CONCLUSION Through the present study, a total of 18 introgression lines carrying African rice genes and three Varieties were identified with specific SSR primer. DNA-based SSR markers revealed high genetic diversity among the genotypes and were able to differentiate them successfully. The similarity index values ranged from 0.2308 to 0.9780 Highest similarity (0.9780 ) observed between ILA65 and ILA78, whereas lowest similarity (0.2308) obtained between ILA19 and J23B, ILA123 and J23B. Thus, it can be inferred that more diversity was detected using SSR markers as it is evident from its similarity value. Results showed the high polymorphism and abundance of SSR sequences in rice. Total of 13 primers were selected to generate fingerprint of 21 genotypes Amany Kamel Elhabbak

Eng Comparison Essay :: essays papers

Eng Comparison Essay Innocence, happiness, success, and optimism, are all characteristics of human kind. A cure for cancer is superior to the elimination of physical abuse and suicidal death’s. A result to have all people treated equally appreciated and loved. Is it a possible gesture? It may not happen in our lifetime, but if powerful and caring individuals join forces, it is possible to draw conclusions. To live the dreams and allusions each identity performs and has a reality to people and society. Within the three novels, Ellen Foster, A Virtuous Woman, and A Cure for Dreams, all written by the author Kaye Gibbons, each character from different novels struggles to face reality and find the correct path that will lead them to the right direction in life. While coping with the endless pain, Ellen, Jack, and Betty have only hope to lead them into the direction they encounter to approach. A fate in their lives can change forever. In addition, keep their â€Å"depressing days† only a me mory so that they will become successful. All characters are determined to overcome their obstacles and misery through hope, courage, and inspiration. Throughout Kaye Gibbon’s novels, each unified character portrays a resemblance to overcome their obstacles through hope. In Gibbon’s first novel, Ellen Foster the main character, Ellen a young child struggles to survive and live a normal childhood. Making matters worse, Ellen’s father was a drunken alcoholic who physically abuses her mother and sexually harasses his own daughter. As a result, Ellen’s mother commits suicide and her father dies from over dosage. As her, own parents abandon their precious child; Ellen was alone in search of a new home and family. As hope motivates Ellen to seek forward and find her new home she begins to believe what an ideal family would be like, â€Å"I had not figured out how to go about getting one for the most part, but I had a feeling it could be got†. Similar in Ellen’s case, in Gibbon’s second novel A Virtuous Woman, Jack is in search to regain himself after a heartbreak loss to his wife Ruby who died several months prior from lung cancer. Jack is an old farmer and relied heavily towards Ruby. He is now left on his own, he acknowledges that only hope may lead him back on his tracks and leave all the crucial memories behind.

Scenario Planning Essay -- Business, Strategic Organizational Plannin

Nowadays business leaders need to understand environment which is going to be more complex. Organisations are open system so that organisations need to adapt environment which they operate in. Matridakis, Hogarth and Gaba (2010) argued that traditional tools did not fit well to new complex environment. Although complex environment and level of uncertainty cannot be explained by forecasting, most of the traditional method including strategic planning and organizational development method are tried to use past trends and forecast future. Therefore, scenario planning gets more recognition from the manager whose company operates in such kind of volatile, uncertain environment. Kahane (1992) (Cited in Charmack et al 2001) scenario planning is an effective method for understand critical future uncertainties and investigating drawbacks of the organisations. There are so many aspect and definition of scenario planning. â€Å"Scenarioâ€Å" means an outline or synopsis of a play. The word scenario is derived from the Italian word scena, scene, that comes from the Latin scaena. According to Schwartz (1998:6) scenarios present alternative of future. Kahn and wiener (1967) defined â€Å" Scenarios are narrative description of future†(Cited in AC/UNU Millennium Project) Porter (1985) defined scenarios â€Å"an internally consistent view of what the future might turn to be – not forecast but one possible future outcome† There is big argument on the scenarios, whether it is static or dynamic. Becker (1983) defined that scenarios are people imaging for future like photo. Although Wack (1985), Schoemaker (1991), van der heijden (1996) supported dynamic view of scenarios and they stated that Scenarios are the process of evolution that was linked to strategic devel... ... In conclusion, scenarios are related to future, according to some of the authors scenarios have a static vision, but for the others scenarios include dynamic aspects. Scenario planning is process of positioning plausible scenarios. Some of the author in this field using different name for scenario planning such as scenario thinking, scenario based planning. It includes two sides, first scenario development and then strategy development. O’brien (2003) stated that scenario planning is a soft problem structuring method and qualitative approach. Schoemaker (1997) stated that scenario planning allows more subjective element and macro environment variable than computer simulation programs. Also these methods include system dynamics and risk analysis. It is easy to conclude that scenario planning is a managerial tool of strategic thinking (Bood and Postma 1998).

Sudan: Social Inequality, the Fight for NaturalResources, Civil War Ess

Sudan: Social Inequality, the Fight for NaturalResources, Civil War Ethics of Development in a Global Environment: War& Peace Fighting between the Muslim government in Khartoumand Christian rebel forces located in southern Sudan has long been ignored.This struggle has caused nothing but devastation and depravation for in theregion. More than two millionpeople have died as a result of the conflict, including many innocent civilians. In addition, extremely valuableresources that would surely benefit the entire global economy, are beingneglected and the with the minimized benefits only helping a few . As is the case in most if not all civilwars power is what each side is struggling over. .The north and south werejoined for no good reason and their religious and cultural differences haveadded fuel to their dispute. Since the conflict began in 1983, the re-appearanceof war between Northern and Southern Sudan has generally been interpreted as atypical ethno-religious conflict deriving from differences between Muslims andChristians, or Arabs and Africans. While this categorization had served as anaccurate description of the earlier manifestation of this conflict in the 1950s,it is widely believed that the nature of the conflict has evolved. Though classifying this war as anethno-religious one still has some bearing on how the war is being conductedand perceived, the main reasons for fighting definitely transcend race andreligion to a certain extent. Conflicts are processes, not static events,and over the last three decades the developments in the Sudan have graduallyand consistently changed the nature of the conflict from being a classicethno-religious conflict. This warnow mainly focuses on the seizure of the area... ...ths of over two million. If the U.S. wants to get to the oil it is imperative theydeal with the humanitarian crisis and avoid the foreign policy mistakes theyhave made in the past. [1] SudanA Political And Military History:http://news.bbc.co.uk/2/hi/world/analysis/84927.stm [2] Ibid [3] Sudan A Political And Military History:http://news.bbc.co.uk/2/hi/world/analysis/84927.stm! [4] Why Doesnt The World Act?:http://news.bbc.co.uk/2/hi/world/analysis/84985.stm [5] Suliman, Mohamed. Civil War In Sudan: The Impact OfEcological Degradation. [6] Bussiness and Human Rights:http://www.business-humanrights.org/Sudan.htm [7] U.S. Warns Khartoum over attacks:http://news.bbc.co.uk./2/hi/africa/1859987.stm [8] U.S. Warns Khartoum over attacks:http://news.bbc.co.uk./2/hi/africa/1859987.stm [9]http://www.pbs.org/newshour/bb/africa/jan-june99/sudan.html

Course of True Love Never Did Run Smooth Essay

I. Introduction Comparing Shakespeare’s A Midsummer Night’s Dream and Middleton’s The Changeling seems to be a very unusual topic for the first sight. The earlier is a festive merry comedy and the latter is said to be a revenge tragedy, moreover, is claimed to be a later transformation of Shakespeare’s Othello. Certainly, if we look at the structure of The Changeling on the surface we see a plot of a conventional drama of revenge, but as we observe closer it becomes evident that The Changeling lacks some of the significant features a tragedy has to retain. As far as the situation is concerned the plot could turn out to be a comedy. After some conflict and misunderstanding Beatrice and Alsemero could get married and live happily ever after, as it happened to the two couples in A Midsummer Night’s Dream. In fact in the latter the basic situation was even more complicated, Hermia’s father knew that she wanted to marry Lysander and he opposed to it, but in The Changeling the lovers did not really have an objection from the ‘paternal’ side. What are the differences then? How could Shakespeare write his merriest comedy from a situation that turned out to be a cruel revenge tragedy for Middleton? The first part of he answer definitely lies in the different periods they lived in. The Elizabethan and Jacobean age, although they seem to retain little difference for us, hold numerous significant contrasts. Their world picture and understanding life differed in a lot, and so did their dramatists and audiences. Considering the title, characters and the structure of he plays we cannot see outstanding differences between them. Both the titles have comic connotations, suggesting a happy ending to the audience. As for the characters, The Changeling lacks the tragic hero and more importantly the Machiavellian malcontent, which was necessary for a revenge tragedy. What we find instead are simple, everyday individuals who find themselves in a peculiar situation which they cannot handle. In A Midsummer Night’s Dream we also find various situations of disharmony, misunderstanding, quarrel and stress, but they all turn into order by the end. The main contrast is in the attitude of the personae, that is the handling of the situation in a positive or in a negative way. The structural similarity is the use of a subplot, which in both cases serves as an emphasis of the main plot. In A Midsummer Night’s Dream the mechanicals’ earthly word and speech is aimed at stressing the different worlds of the play and also serves laughter. In The Changeling the mad-house plot serves same reason, but as it is a satire it makes us realise that the world of apparently normal people is full of madness, while in a madhouse everything turns out to be fine. Raising these points now we have to have a closer look on the two dramas and see that the so called revenge tragedy is rather comic and the happy comedy held more tragic signs than the actual tragedy. II. Tragedy and comedy The division of drama into comedy and tragedy has always been the first aspect of literary criticism. We have fixed ideas in our minds what are the so called tragic and comic elements. Using Norhtrop Frye’s terms, in tragedies these are the great tragic hero, conflict with something grand, like fate, gods, fortune. According to Frye the tragic hero is somewhere between the divine and the â€Å"all to human†, apparently a type which cannot be found in The Changeling. On the other hand if we put the typical pattern of comedy onto the plot of the drama we can see that it is consistent, whereas, adapting again Frye’s definition, what normally happens in a comedy is that a â€Å"young man wants a young woman, that his desire is resisted by some opposition, usually paternal, and that near the end of the play some twist in the plot enables the hero to have his will. These patterns tend not to change with time, but certainly in transitional periods the emphasis could shift. The Jacobean period being the age of crisis in both literary and social aspects, it has developed its own characteristics as tragedy and comedy are concerned. Jacobean drama was more concerned with revenge and blood but the focus was not on the individual but on a social type. The same tendency occurred in the comedie s, they were rather satires, parodies than real merriment. Jacobean pessimism, like today that of the post-modern took a reaction against the optimism of the preceding age, which is pointing towards the comedies of the French Classicist period, rather than having roots in the Elizabethan. III. The titles As I have mentioned, the titles both carry the connotation of change, but in a symbolic way, examining how the human power can accept change, how it can adopt to different troubled situations. They both have comic connotation and both suggest some passivity on the side of the characters, that is, they are changed by an external force, something that is standing outside them. The word ‘changeling’ had different meanings for the Jacobean audience, but mainly carried the act of change, transformation from one thing to the other. As the word ‘dream’ would have the same connotation, as our dreams are alterations of real life and of the self. The word ‘changeling’ had four different meanings that time: a person given to change, a half wit, a woman who had sexual intercourse or an ugly and deformed child changed by the fairies. Midsummer night, being the shortest night of the year also suggests change, change in the moon and season, demonstrating the difference in performance at night or day. As Martin White puts it The Changeling is built on a structure of antitheses ironically inverted and juxtaposed. These are castle/asylum, madness/sanity, reason/passion and appearance/reality. These antitheses are also present in the latter, substituting the castle for Athens and the asylum for he forest. The world turned upside down is comic in Shakespeare’s time, the theme of change is more important than that of the characters; on the other hand Middleton stresses the change of characters, and â€Å"the action turns upon the contrast between the character’s demands upon life and their limitations when an unwanted set of circumstances reveals them. IV. The characters In spite of this difference The Changeling also has the elements of comedy. As the characters are mediocre, they differ from the heroes of grand tragedy. In Jacobean times contemporaries would have seen The Changeling as a drama which has a plot based on a conventional revenge tragedy, but Middleton’s handling of the plot and the characters managed to end up in story of a group of quite ordinary people whose fate is the logical consequence of their stupidity and simplicity. On the contrary the protagonists of A Midsummer Night’s Dream are really remarkable as they do not accept their fate and the will of the father, but they try to break out of it by escaping to the wood, that is, by responding positively to the situation. This is the basic difference between the acting of the couples, Hermia-Lysander and Beatrice-Alsemero. Hermia: But I beseech your grace that I may know The worst that may befall me in this case, If I refuse to wed Demetrius. (I. 1. 62-4) Lysander: I am, my lord, as well-derived as he, As well-posessed: My love is more than his, [†¦ And, which is more than all these boasts can be, I am beloved of beauteous Hermia. (I. 1. 99-104) However, Beatrice does not ask his father for permission for marrying Alsemero, she is just asking for more time, and Alsemero does not seem to act either, as he says â€Å"I must part and never meet again / With joy on earth. † (I. 1. 205). He wants to leave, which clearly demonstrates his p assive attitude. They cannot face a situation that is not favourable for them, they are not fighting for their love, which is evident from the fact that much of what they say they say as ‘asides’. Their main problem is the lack of communication and mistrust, although Vermanendro likes Alsemero, and what is more, later admits that if he had another daughter he would give her to Alsemero. So the changes mentioned above has to come in a different way: in A Midsummer Night’s Dream the lovers started to act and the fairies interfere with the magic juice, which causes a crookedness in the play but here all the obstacles are turned into advantages. The remarkable thing is that they never stop communication, which would allow for a tragic outcome. Even when the lovers are completely crossed they manage to cope with the situation, thus making everything in the best possible way, and they are never ready to submit to their fate. Alsemero and Beatrice are entirely the opposite, their failure of communication with each other and their surroundings result in the murder of Alonzo. They are both shallow personalities, going on their own way. Alsemero, when first speaking to Beatrice, immediately kisses her and admits that he loves her. As Beatrice is concerned she has an ignorance of the world and even of herself. Her incapability of seeing reality changes her from a maid to a whore and a urderess, as Farr claims. She is a conventional spoiled child; like a princess in a fairy tale she is acting without calculating the human element. She thinks she will not be guilty as De Flores kills her fiance, and also fails to realise that De Flores will not be satisfied with money. She acts without thinking and consideration, as she says: I sha ll rid myself Of two inveterate loathings at one time, Piraquo, and his dog face. (II. 2. 146-8) Being unable to see what is going on Beatrice unquestionably thinks that this is the best solution for her problem, using a man she hates for killing another man she hates. Reality is not revealed to her even by putting this improbable situation into words. The treatment of the heroine illustrates the difference of Middleton’s drama from the typical revenge tragedy of the age. In fact, no one has the cause to kill in this drama, as Farr puts it: â€Å"Middleton’s presentation is not the conflict between passion and power but the unmasking of lust by the logic of commonplace happenings. † The other difference is De Flores, who is not a characteristic malcontent either. He is in love with Beatrice and it is his lust that makes him a murderer. Although he is always one step before Beatrice and we can assume that he is aware of his murder we do not have the same feeling towards him as towards the typical malcontents in tragedies, such as Iago or Richard III. We feel pity for him from the beginning for the undeserved loathing of Beatrice. He is not evil, he would not have done anything bad to Beatrice or anybody else. It is Beatrice who is evil, but just to a limited extent as she cannot realise the weight and consequence of her ideas and thus starts behaving in a negative way, opposed to the lovers of A Midsummer Night’s Dream. She is the ‘deed’s creature’ (III. . 137), nothing else but an unthoughtful person who cannot part reality from her passion. She still thinks at the end that it is a significant basis for her self defence that ‘love has made me / A cruel murd’ress. (V. 3. 64-65). On the contrary in A Midsummer Night’s Dream it is the situation that is foolish not the cha racters: they are intelligent people in an inherently foolish situation, but the plot does not lack the hint of a tragedy, which is present on two levels. On the one hand, it is threatening with the harsh Athenian law, and on the other, it is there in the subplot, in the performance of the mechanicals. Also we must not forget that the closest drama of Shakespeare is Romeo and Juliet, which has much resemblance with this plot. But here, although the characters are the playthings of the fairies, they manage to understand the experience of irrational love and so their behaviour is not at all irrational or foolish. V. The structure Concerning the structure the outstanding similarity is the use of a subplot. It has two functions, reinforcing the twin themes of the dramas, which are castle/madhouse and reality/illusion. The main plot and the subplot are not together at all throughout the action but the presence can be felt in both cases. In A Midsummer Night’s Dream the subplot is the earthly world: the language is ordinary and has a very big contrast with the poetic lines of the lovers, especially with the rhyming couplets of the fairies. In The Changeling the characters of the main plot speak in an ordinary way, and there is more wit in the speech of the madhouse people. Both subplots serve as the comic elements in the drama, but with a different aim. The theme of the jealous husband and the wife is a social satire on the one hand, and on the other, it acts as a reflection and foreshadow of the action of the main plot. It demonstrates the crookedness of the world, that apparently mad people can handle the situation in a better way while sane people’s relationships end with four cruel murders. In A Midsummer Night’s Dream, however, the function of the subplot is just the opposite. The play acted by the mechanincs, despite its clumsiness, is a tale of woe, suicide and fatalism, quite contrary to the play which contains it.