Wife and Filipino Women Essay Example for Free

Wife and Filipino Women EssayThey seemed faded plants sown and reared in darkness, having flowers without perfume and fruits without the release, Jose Rizal said in his letter To the Young Women of Malolos that the women were very passive to what the church teaches them but he had been proven wrong when the news of what had happened in Malolos reached him.In his letter, Rizal praised and honour the twenty brave women of the town for their victorious battle for their just demand to education and their battle to stop slavery to the friars. He too emphasized the obligations and roles of the Filipino mothers to their children he compared the Filipino women to the Spartan women as role model. Rizal concluded his letter by encouraging the Filipino women to Let us, therefore, reflect let us select our situation and see how we stand. May your desire to prepare yourself be crowned with success.The part which struck me most is where Rizal made mention of a situation to one of the mot hers of Sparta, handed the shield to her son who said nothing but to return triumph or return dead. I find the scenario a bit heartbreaking and ironic when the other Spartan mother was told by a soldier that her three sons had died and replied that she was not asking about her sons but simply wants to know whether they won or not. The soldier said they were victorious and the mother just went to the temple to thank God.Rizal compared the Filipino women and the foreign women, which entails his huge respect to the Filipino women on their vital roles as mothers and wives. Being the foundation of principles and values in ensuring the progress of the nation, a mother should nourish her children with proper values, desired knowledge and define them to become God-fearing and responsible citizens.As a wife, a Filipina must support her husband in every problem, inspire him, encourage him, take a part with him all obstacles and dangers, to sympathize and comfort him in bad times, guide him to conquer his fears and struggle to achieve their goals in life. And as a mother, she must educate her children love of honor, love of fellowmen, love of country and love of God.This is the best writing of Rizal I have read so far. I admire him and respect everything he wrote in his letter. Rizal sets his standards of an Ideal and Perfect Filipina, one must have fine demeanor, well-mannered, clean conscience and correct thinking. The message of the letter is clear, it focuses on the most in-chief(postnominal) issues the country is facing during those times, such as the maltreatment and abuse of the friars in exercising their spiritual authority bestowed upon them by the church and the great desire for Filipino women to enjoy the privileges in education with men.The letter speaks of the duties and obligations of Filipino mothers to the youth, the roles of a wife to her husband and guidance to young women on their choice of their lifetime partner. The letter also speaks of the philo sophy of freedom and independence that would be a key for the emancipation of humankind from slavery, and the necessity for education as the fundamental source of liberation, to quote from Rizal, work force are born equal, naked. God did not create men to be slaves, nor did he embellish them with reason in order to be blinded by others.

Benefits and Strategies of Learning Through Play

Benefits and Strategies of Learning Through PlayPlay is essential in churls early years. In my model of looseness of the bowels, every ara is interrelated in regards to bid. Play can happen at any point of time and at any place. From a childs perspective, campaign is enjoyable and imaginative. Educators take an important consumption in planning escape activities in the curriculum and to sustain their thinking. Background of the family reflects how children scam at home and with their coadjutors. In my model of play, a cultural-historical theory drives my play practices. According to Vygotsky, Children will give current meaning to objects in their play in order to progress ideational play and to understand reality by learning how people work through and through role-playing (Fleer, 2013). He also continued that professionals in early childhood will contribute in childrens play through interactions in sustained sh ared thinking and through play connections with children (F leer, 2013). therefrom my model of play revolves around these important aspects for a child culture, play, educator, curriculum, family and educator. Each aspect will be further explaining in the followingPlay cultural historical view of play can be reflected in my model of play. In this model, children move in both structured and unstructured play. In unstructured play, children will develop a state of mind, helping them to deal with feelings or challenges in their life and at the same time, providing opportunities for them to explore different ways in doing things (Bruce, 2011). From a childs perspective, they use very minimal effort to move between play and real world (Edmiston, 2008). When they play, they create imaginary number situations. These imaginary situations are based on their real-world experiences and children give new senses to their movements and objects (Fleer, 2013). I observed how these two girls, Ann (three years old) and whitethorn (six years old) playing at the kitchen corner. They are creating imaginary situations. In their play, they discern on roles. They pretend to be m early(a) and baby. As they are in their imaginary situations, children began to move away from reality. They became more detailed in taking their roles.In my observations, Ann began to sound like a baby and will seek attention from her mother. Both children learn about everyday concepts as they observe how their mother takes care of baby. From there, they also picked up scientific concepts about movement like walking, carrying baby dolls and cuddling.CultureThe family background of the child sets conditions for play. Usually, children imitate the role of the people they have most contact with. For example, if children will imitate the role of the teacher when they are at home or in school, they will take on the role of their mother as they had been observing how she manages the kitchen daily. As children develop their play, they adopt the role and create their m ake-believe stories. In my observations on my play model, Ann and May adopt the roles of mother and baby and they moved on to puppetry play and bake cookies. When children are in play, children move in and out of imaginary situations (Fleer, 2013). They use fussy languages to communicate to draw a line between real worlds and play experiences. Children also use their language based on their family background. As May and Ann are Malays, they have included their mother tongue in their play conversations. They used, ka kak which means sister in their conversation. This also explains that culture reflects on how children interact in their play experiences. It frames on how children play occurs based on their everyday experiences. In Vygotskys theory, he noted that a childs daily life experiences sets and frames on how play may occur and children will not play freely (Fleer, 2010).CurriculumIn my school, we believe that children learn through play. In our planning, we engage children in purposeful play and as well as free play. Thus, we do not provide worksheets for children to work on. For example, children (aged 3 years old) will be lookup for items associated with letter f, explore what they can do their feet and traced the letter by walking on the letter. As children are still developing their fine repel skills, teachers should not be stressing if the child is able to write. Instead, teachers can work on their gross motor skills and they learn through kinetic movements. From childrens perspective, they view it as play as they get to walk, jump and most importantly, it is enjoyable and fun.In my school, children also participated in projects. We lead provocation through their play activities. During the interactions, teachers and children are twisty sustained shared thinking. Sustained shared thinking is an effective interaction where two or more parties and working together to understand concepts, cracking a problem and extending conversations and activitie s (Siraj-Blatchford, 2007). In our play incidents during our project, we sustain childrens thinking by asking open-ended questions.Our curriculum is also tied closely to Ministry of Education (MOE) kindergarten framework. In a Kindergarten Learning Forum opening speech by Ms Indranee Rajah, she mentioned that MOE strongly believes that the critical principle of learning in the early years is harming in learning through purposeful play (MOE, 2012). They believe that children will learn through purposeful play as they are feeling workmanlike about their ability to learn and develop their physical, cognitive, emotional and social skills. In my centre, we believe that children are competent and engage children in both purposeful play and as well as free play. Therefore, my model of play ties in closely with my schools curriculum which we set ahead children to learn through play and as well as referring to MOEs kindergarten framework to support children in purposeful play activities.E ducatorsAs educators, we play critical role in sustaining children in play. We need look into our pedagogicalal role in engaging children in play. As children change the meaning of objects we have to look into the depth of play experiences to underwrite that these play experiences benefit the children. When a purposeful play activity happens, Educators have to thoughtfully plan the activities with appropriate resources and materials for children to explore. Teachers have to constantly reflect on their instruct practices to see whether their planned activities are inviting childrens interest to be engaged and learning (Lim, 2010). Thus, teachers should provide a variety of play activities in childs learning and a balance of play and work activities. These balance of play and work activities should include unstructured play to structured play such as from child-initiated play to teacher directed play.Educators should also take note of the sensitivity interaction between child and ad ult in play and playful experiences activities. any(prenominal) play does not have to be guide by adults but educators should note that they have to be around even though it is free play for children. Even though the school has a strong curriculum, teachers have to be culturally sensitive to understand each and every child who enters to the classroom. Thus, as educators, we should not be stereotyping the children through similar characteristics of the children. Instead, we should take time to listen to the children when they are at play and interactions before we really make any conclusions on the childs need and making it into his or her individual goals. This also explains that educators are also assessing for play. In Fleers (2010) explanation, estimation for play is how educators assess formative assessment and summaries the assessment at the end of a project or event.While observing the children, we also assess the children through play. This helps educators to do their obser vations and analyse when children are engaged entirely in play activities (Fleer, 2013). Teachers play a critical how in documenting down these play moments. Documentations can be recorded down in photographs, childrens voices or drawing which children is comfortable with and they can be displayed in the classroom. From all these play moments, children can find out what do they want to find out, and don their knowledge gained from their inquiry. Fahey (as cited in Fleer, 2013) reasons in inquiry learning, that it is important to provide children the chance to ask questions, clarifying points and to be engaged in the topics which they are interested. This is also serviceable and going in depth of the childs play so that learning can be furthered in play (Fleer, 2013).Teachers and children can also appraise their play activities in a form of KWL chart. This helps children to revisit the play activities and find out what they have learnt and how they can apply their knowledge gain i n other situations.EnvironmentAnother aspect to discuss is the environment conditions and affordances in play. I believe that environment has an impact in play practices. Whether it is at school, community or at home, it provides different opportunities for the child to learn in daily life.At school, based on childs interest, educators can then work on setting up the relevant resources in the classroom. Hedges (as cited in Lim, 2010) even inspire teachers to work together with children and sharing responsibility in order to have a child-initiated curriculum where teachers and children can co-construct appropriate and meaningful knowledge.In my school setting we believe that the environment is the third teacher. From a childs perspective, the visual influences interaction and developing thinking and learning (Strong-Wilson Ellis, 2007).As our school is inspired by Reggio Emilia, it advocates that teachers to take note to the numerous ways to use the space to invite interactions (St rong-Wilson Ellis, 2007). To encourage children to participate in their culture community and to engage in meaningful play activities, teachers who are influenced by Reggio Emilia have capitalize on the environments potential as a developmental niche where children acquire knowledge skills and understandings (New, 2007). Thus, at my school setting, the classroom has wide windows to allow natural shine to shine through the class. The resources used in the classroom are closest to the natural materials such as twigs, leaves, branches. This can form part of childrens play as they use these materials to create new meanings and interact with their peers and teachers. The environment also reflects schools basis in John Deweys educational ism and Vygotskys social constructivist learning theory (Tarr, 2001). Both theorists believe that children can best create meaning and make sense of their world through livelihood in complex, rich environments which support complex, varied, sustained, and changing relationships between people, the world of experience, ideas and the many ways of expressing ideas (Tarr, 2001, p.7).The outdoor environment also supports in childrens play. In my school, children are encouraged to engage in outdoor play activities. As my school setting are able to afford big spaces for children, we have the space for irrigate play and sand play. This provides children to be exposed to a variety of play activities be it in classroom or outdoors.FamilyWith reference to cultural-historical theory, play is learned in families (Fleer, 2013). Families can engage children in play and they can learn to pick up valued skills. For an example, parents will do house chores and from a childs perspective, it is a play and fun activity in helping their parents. In this case, play has developed into an activity which children have contributed to the family. I feel that families should not leave out childrens play at home or when they are with them. Involving famili es in childrens play can motivate the child in learning and exploring new things, and fostering relationship between them.In conclusion, play is leading activity (Fleer, 2013) in a childs life. By viewing at how each and every aspect contributes to play, as an educator, I have to constantly reflect on my teaching practices on how I can engage children in play. As technology has been moving rapidly, children are more engaged in technology such as iPad, children may forgo about playing physically with peer interactions. Thus, families and educators should be reminded that there should also be a balance between play activities for the child to be engaged and learn.Reference ListBruce, T. (2011). Learning through play for babies, toddlers and young children (2nd ed.). London Hodder Education.Edmiston, B. (2008). Chapter 1. Ethics in play. In B. Edmiston. Forming ethical identities in early childhood play, pp. 1 24. New York Routledge.Fleer, M. (2010). Chapter 2. Parallel conceptual wor lds. In Early learning and development cultural-historical concepts in play, pp.20 -32. New York Cambridge University Press.Fleer, M. (2013). Play in the Early Years. Port Melbourne Cambridge University Press.Lim, S. M-Y. (2010). Reconsidering the play-work dichotomy in pedagogy. In M. Ebbeck M. Waniganayake (eds.). Learning in various contexts, pp.141 -156. South Melbourne Oxford University Press.Ministry of Education. (2012). Kindergarten learning forum. Retrieved June 19, 2014, from http//www.moe.gov.sg/media/speeches/2012/11/20/opening-address-by-ms-indranee-rajah-at-kindergarten-learning-forum-2012.phpNew, R. S. (2007). Reggio Emilia as cultural activity theory in practice. Theory into Practice, 46(1), 5-13.Siraj-Blatchford, I. (2007). Creativity, communication and collaboration The identification of pedagogic progression in sustained shared thinking. Asia-Pacific Journal of Research in Early Childhood Education, 1(2), 3-23.Strong-Wilson, T., Ellis, J. (2007). Children and p lace Reggio Emilias environment as third teacher. Theory into practice, 46(1), 40-47.Tarr, P. (2001). esthetic Codes in Early Childhood Classrooms What Art Educators Can Learn from Reggio Emilia.Name Loo Si Hui Student ID 25687514 Page 1

Health In New Zealand Health And Social Care Essay

Health In refreshful Zealand Health And Social C be EssayHealth is multi factorial and is the product of reciprocal fundamental interaction betwixt individuals and their environment. Social determinants of wellness are the conditions in which people are born, grow, live, work and shape up, including the wellness system (World Health Organisation, 2008). As in most countries, health in refreshful Zealand is also distributed unequally through come in the society. This reflects that there is an uneven allocation of social determinants of health such as income, education, occupation and access to health for certain groups compared with others. This essay forget examine income as one of the social determinates of health and the effect of low economic status in Maori health. Further it get come in discuss how the nurses pot care for Maori people with inequalities in health and the importance of the government scheme developed to address Maori health concerns. Finally this essa y will analyse the psychological factors associated with smoking behaviours and its consequences.Income, employment, education, housing, culture and social cohesion are the distinct social determinants which directly or indirectly influence health conclusion of an individual. The people who are more vulnerable to ill heath mostly come downstairs low income category. Income inequalities increased evidently in New Zealand between 1987 and 1991 due to unemployment. The growth in income inequalities is especially seen in Maori population (Davis Dew, 2005). Income is one of the major determinants of health, which contribute to the poor health status of Maori. Indigenous Maori have the poorest health status among any other ethnic groups in New Zealand. The median annual income of Maori in 2006 was $20900 compared to $24400 of the total population in New Zealand (McMurray Clendon, 2010). According to the New Zealand statistics 2005, the average weekly income of Maori was $471 compared to $637 of non-Maori (Robson Harris, 2007). Income and wealth are the major modifiable determinants of health which affect the access to healthy environment, living condition, housing, education and timely effective health care. Level of home ownership, property ownership and income producing assets are lower among Maori than non-Maori population. In addition to these, lower equivalent income levels limit the availability of the Maori families to accumulate wealth out of current income (Dew Mathewson, 2008). Compared to non-Maori, inequalities in health status and mortality are higher and increasing among Maori, with increased incidence of conditions such as coronary heart infirmity and higher fatality rates (McMurray Clendon, 2010). The current economic situation of the Maori and non-Maori is profoundly linked to the history of colonization of New Zealand. Besides this, economic reforms also trend loss of income from changing nature of work arrangements for Maori (Broom, 2007) . The income inequalities discount be also explained in terms of lower educational qualification and under representation of Maori workers in high profile jobs. In New Zealand society Maori are the lowest salary earners and this leads to a low socio economic status (Robson Harris, 2007). Besides this, income level can affect mental health, caring for children and family. People belonging to low economic status always struggle to care their life and childrens health (Marmot Wilkinson, 2001). world health professional, nurses have obligation to identify unfairness or inequalities in health. Nurses should work to address the underlying determinants of health and working towards to ensure equitable health and wellbeing of everyone in the society (McMurray Clendon, 2010). In order to deliver proper health care nurses have to be aware about the needs and rights of Maori (Broom, 2007). Principles of treaty act as a model for nurses to work with Maori. Nurses should respect the cultura l beliefs and deliver health services in a culturally acceptable elbow room (Francis et al., 2008). Nurses should work in a manner to improve the access to health, especially to those who lacks financial resources. Approaches similar selecting a central location and convenient time for health services can improve access of health facilities by the low income groups. Nurses should identify vulnerable groups with low income such as unemployed, single mothers and parents with more hooked children. In order to ensure unbiased health to low income group nurses have to educate them regarding the health facilities and their right to health irrespective of economic status. increase conventional services like employing of indigenous health workers and establishing indigenous programs is another nursing intervention for reorienting health service for Maori. (Mason Durie, 2003) For instance Maori can be cared reform by employing more Maori nurses as they will have enhanced understanding.I mprovements in Maori health status are critical, because Maori has the poorest health status among other New Zealanders. The New Zealand government identified the importance of prioritising the Maori health problems and the need to eradicate health inequalities which has a negative impact on Maori health. He Korowai Oranga is a health strategy set for Maori health development in the health and disability sector. This strategy acts as a basis for the health sector to deal with the health problems of Whanau. The digest of He Korowai Oranga is on Whanau or family wellbeing. The outcomes are mainly aimed at empowering Whanau with physical, social, mental and emotional health enabling them to take control over their health, creating better calibre of life and ensuring their active participation in New Zealand society (Francis et al., 2008). He Korowai Oranga stands on the principles such as partnership, participation and protection which are the core principles of agreement of Waitangi . He Korowai Oranga tries to identify health inequalities among Maori people in terms of education, income, occupation and access to health health. This strategy aims at considering Maori approaches and models to health for improving Maori outcomes. Inequalities among health statuses of Maori are clearly documented in this. Nationwide population health priorities for Maoris are also enlisted in appendix 3 of this strategy. Besides this it also provide guidelines to territorial dominion health board for effective assessment and monitoring of Maori health status. This strategy also has made provisions to improve Maori access to mainstream health services like public hospitals or primary health centres (Ministry of Health, 2002).Risk taking behaviours are those which affect the physical and mental health of individuals. Risk taking behaviours may involve smoking, alcoholism, unsafe sexual habits, gambling and participating in dangerous activities. Tobacco is the major cause of preven table death in New Zealand. Smoking kills some 4300 to 4700 people per year, among this almost 600 are Maori (Maori Affairs Committee, 2010). Some people consider smoking as a manner of channelizing their stress or escape utensil from their stressful situation or frustrated family life. Some consider smoking as a way to get peer pleasure and to kick out their boredom (Marks, Murray, Evans Willig, 2001). Increased risk of smoking is usually seen in those who are divorced, separated or lone parents. 80-90% of smoking prevalence is seen among people who are under severe deprivation areas such as prisoners, homeless and poor (Marmot Wilkinson, 2001). Young people consider smoking as a way of developing their identity, method of relaxing tension and making peers. Parents and role models can greatly influence smoking behaviour of adolescents (McMurray Clendon, 2010). Media plays a great role in influencing people to sess even though they advertise about the repercussions of smoking (Marks et al., 2001). The use of tobacco gives rise to many health hazards. Smoking contributes to the higher incidence of coronary arteria disease, chronic obstructive pulmonary disease, pneumonia, reduced lung function, impaired lung growth in children and various cancers especially lung cancer. Smoking aggravates the symptoms of many other illnesses, for instance smoking can reduce fertility, increased cataract incidence, poor wound healing, and worsen peptic ulcer. Smoking during pregnancy can lead to birth complications, premature death, small gestational age and low birth weight. Passive smoking is another health risk associated with smoking. Non-smokers living with smokers have 30% increased chance of lung cancer (Maori Affairs Committee, 2010).In brief social conditions are particularly important in determining health status of an individual. When a social environment is supportive, the person is more apparent to be empowered in their health. There is a well-established e vidence of relationship between income and Maori health status. Nurses can play an important role in trim back the inequalities in health. In addition to this smoking remains a major contributor to disparities in health status because this behaviour is strongly shaped by income deprivation, occupation and education.

Acute Eosinophilic Pneumonia (AEP) Caused by Clomipramine

Acute Eosinophilic Pneumonia (AEP) Caused by ClomipramineClomipramine-induced acute eosinophilic pneumonia-like syndrome direct to acute respiratory failure a report of commencement ceremony described causeDrugs are well-known cooks of eosinophilic lung malady and patients with drug-induced eosinophilic lung malady dirty dog have variable clinical presentations. Clinical features may range from asymptomatic eosinophilic infilt vagabonds to acute eosinophilic pneumonia (AEP)-like syndrome leading to acute respiratory failure. This report describes the first case of clomipramine-induced AEP-like syndrome causing acute hypoxemic respiratory failure which was treated successfully. In conclusion, considering the increasing use of tricyclic antidepressants, physicians should be informed of this very rare and dangerous complication of clomipramine.KeyWords Clomipramine, acute eosinophilic pneumonia-like syndrome, treatmentINTRODUCTIONM each drugs have been associated with pulmonar y complications of several(a) types with an increasing number of the therapeutics. Respiratory system is a guide for a variety of drugs because of its large contact surface and acting as a metabolism site for drugs. The patterns observed in drug-induced pulmonary toxicity are highly variable and depend on the localization of adverse reaction. Since most of the drug-induced pulmonary toxicities involve the lung parenchyma, the most common form of drug-induced lung toxicity is interstitial lung disease (1).Drugs theoretically preserve produce all histopathological patterns of interstitial lung disease, including hypersensitivity pneumonitis, organizing pneumonia, bronchiolitis obliterans organizing pneumonia, acute respiratory distress syndrome, granulomatous pneumonitis, and eosinophilic lung disease (2).More than 350 drugs are known to cause acute eosinophilic pneumonia (AEP)-like syndrome (3, 4). However pulmonary complications related to tricyclic antidepressants are uncommon. To our knowledge, only one case of AEP associated with the usage of clomipramine has been reported in PubMed in 1999, and in the aforementioned case clomipramine had been used not alone but with sertraline (5).This report describes the first and successfully treated severe case of AEP-like syndrome associated with clomipramine treatment alone. written informed consent of the participant patient was obtained for the publication of this case report and any accompanying images.CASE REPORTA 38-year-old female was referred to our clinic from psychiatry subdivision of another hospital. She had been newly diagnosed with panic attack and anxiety disorder one week prior to the appearance of respiratory symptoms. After admission to psychiatry polyclinic, clomipramine therapy was positivistic at a dose of 75 mg/day. After 6 days of clomipramine therapy, the patient exhibited dyspnea, increasing shortness of breath, dry cough, chest pain, and fever up to 39.20C. She was a housewife and had n o work-life history. There was no past history of a chronic disease and her smoking history was 16 packs/year. She had never consumed illegitimate drugs, had no allergies, and had not visited a foreign country during the previous 5 years.On admission, the patient was in a respiratory distress, with a respiratory rate of 35 breaths/minute, a line of products pressure of 110/70 mmHg, and a heart rate of about 140 beats/minute with sinus tachycardia. mental testing of blood samples revealed only anemia (haemoglobin9.4 g/dl). Number of leukocytes, thrombocytes, and results of blood chemistry were within normal limits. Erythrocyte sedimentation rate was 40 mm/h and serum level of C-reactive protein was 4.5 mg/dl. Measurement of arterial blood gas analysis on room air revealed pH 7.44, PaCO2 32 mmHg, PaO2 49 mmHg, HCO3 27 mmol/L and SaO2 86% which was compatible with hypoxemic respiratory failure. Laboratory results including HIV testing, serological screening for vasculitis autoantibo dies to deoxyribonucleic acid (DNA), double stranded DNA, proteinase-3, myeloperoxidase, rheumatoid factor, and circulating immune complexes and various pulmonary pathogens were negative. S animal tests for ova and pulmonary parasites were normal. The level of total serum immunoglobulin E (Ig E) was within normal limits (65 IU/ml) and antigen-spesific Ig E against Aspergillus fumigatus and Candida was negative.Her chest skiagram revealed a homogenous dense shadow located especially in the start field of the right hand lung and some additional reticular opasities in the lower zone of the left lung (Figure 1). Computerized Tomography (CT) (Brilliance Philips Medical System, Eindhoven, The Netherlands) of the thorax demonstrated patchy areas of ground-glass, thickened interlobular septae and homogenous consolidations with air-bronchograms especially in the middle and lower zones of the right lung (Figure 2).The patient was admitted to the intensive care unit because of the need for non-invasive mechanical ventilation. She underwent bronchoscopy (Aquilion Toshiba, Tokyo, Japan) with bronchoalveolar lavage (BAL). During the bronchoscopy procedure the bronchi appeared inflamed and contained increased secretions. Gram stain and cultures of the bronchial washings did not reveal any infectious organism. Total cell count on BAL was 182 cells/mL with 30% eosinophils, 8% neutrophils, 55% macrophages, and 7% lymphocytes. Special stains and cultures for mycobacteria, Pneumocystis jiroveci, fungi, Legionella pneumophila were negative. Serology testing for cold agglutinins were negative.endovenous methylprednisolone 60 mg/day (1 mg/kg/day) was initiated on admission. Then dose of the methylprednisolone was gradually tapered and methylprednisolone was discontinued after 4 weeks. The chest radiograph of the patient cleared markedly within 15 days of the treatment (Figure 3). The patient was discharged 18 days after admission. Follow-up examinations one and quaternion weeks after discharge revealed normal laboratory results and a normal chest radiograph. Pulmonary function tests 3 months after admission showed no ventilatory defect. final contact with her was a polyclinic visit for control one year after discharge and she was free of respiratory symptoms.DISCUSSIONThe eosinophilic lung diseases are a compound group of pulmonary disorders characterized by increased numbers of eosinophils in the airway or lung parenchyma, and drugs are well known causes of eosinophilic lung disease (6). Patients with drug-induced eosinophilic lung disease pot have variable presentations, ranging from asymptomatic transient eosinophilic infiltrates to AEP-like syndrome leading to acute respiratory failure, depending on the drug involved.AEP is described as a clinical entity which involves acute onset of symptoms within 5-7 days, fever 37.20C, hypoxemia, bilateral alveolar or mixed alveolar and interstitial infiltrates, and lung eosinophilia (percentage of eosinophils 25% in BAL and/or predominance of eosinophils in open lung biopsy). In addition, without any history of hypersensitivity to drugs, no evidence of infection, and no other known cause of eosinophilic lung disease (7, 8).Similarly, patient in this case had newly onset respiratory symptoms, fever and mixed alveolar and interstitial infiltrates suggesting an interstitial lung disease. In addition, a bronchoscopy with BAL revealed presence of importantly increased percentage of eosinophils (30%) in the lavage fluid. Based on the results of BAL, radiological features and her clinical course, she was diagnosed as potentially having an AEP-like syndrome related to clomipramine.Unlike patients with other eosinophilic lung diseases, most of the patients with AEP have normal peripheral blood eosinophil count (8). The level of total serum IgE can be elevated, however it is not used as a diagnostic tool (9). In this case, the patient had both normal peripheral blood eosinophil count and normal le vel of total serum Ig E.The diagnosis can easily be obtained with BAL and lung biopsy is not an obligation for the diagnosis of AEP in most cases. If needed, the purpose of lung biopsy is to exclude other diseases that can mimic AEP. When lung biopsy is performed, the histopathological features are characterized by screen alveolar damage with interstitial and alveolar eosinophils (10). There was no need for lung biopsy in this case and diagnosis could be established with the help of BAL cell count.In some cases discontinuation of the drug is enough for resolution of the radiological features. However, some patients experience a severe disease and require corticosteroid treatment. Generally, response to corticosteroids is fast and most of the patients have significant clinical improvement within 24 to 48 hours. The optimal dose and duration of corticosteroids have not been determined just (8, 10). Commonly used doses of intravenous methylprednisolone in case series range from 60 to 1000 mg per day until respiratory failure resolves. Thereafter, the patient can be switched to oral prednisone, and the steroids can be tapered off over 2 to 12 weeks. In this case, 60 mg/day intravenous methylprednisolone was administered on admission and dose of the corticosteroid was regulated according to resolution of radiological findings. Corticosteroid treatment was terminated after 4 weeks.In conclusion, physicians should be aware of rare, life-threatening and treatable AEP-like syndrome because of clomipramine.

The Used Car Industry :: essays research papers

The Used Car IndustryIn the past 30 years, the United States auto industry has gone through manychanges. In commit to stay competitive with a foreign market, constantlythreatening to eat away at profits, the American auto industry has had torespond by universe flexible and adapt itself to this new situation. Although, inthe past, they were slow to get the message sent out by the consumers, thedomestic auto industry now seems to be more than willing to analyze, and answer,the demands of a smarter, savior consumer. The growth of the utilize railroad gondola car field hasbeen a result of these demands.Rising, higher prices for new cars have caused the typical American consumer toexamine alternate solutions for their transpiration needs. As the average caron the road is 8 years old, comp atomic number 18d to 5.8 years in 1970, the signal to theauto industry has been that cars are being built better and consumers are notafraid to buy them.Of course, this choice does not fare withou t an opportunity cost for theconsumer. A used car will generally be bought on the condition "as is" or, atbest, with a very limited warranty. If a buyer of a used car drives off the lotand finds they have purchased a vehicle that needs lots of money spent on it forrepairs, they may possibly find themselves out of luck. some other downside maycome as more people continue to saturate the market, looking for used cars tobuy, the resources available will become scarce. An increase in used car pricesmay gradually start to rise. As the figures indicate, for now consumers seem tobe content with taking this risk. Sales for used cars and trucks last year add up at 15.1 million(going on your articles figures).The auto industry has been busy changing and evolving to answer consumer demands.One of these signs has been the growth of large auction houses that areappearing all all over the country. Big investors are attracted by the potentialprofits, which are an average of 1.5% of the w holesale price. The auctioneersmake their money by auctioning off used cars and trucks mainly to dealers only,and are supplied with vehicles that come from trade-ins, repossessions, leasedvehicles, and smaller used car lots. With this reallocation of resources manyof the smaller mom and pop used car lots have been bought out, or labored out ofbusiness.Competition is heating up with the rise in the number of auction houses. Thishas forced the auctions to be more selective in the kinds of vehicles they offer.

Gothic Genre: The Red Room versus The Monkeys Paw Essay -- essays res

The flushed Room was written in the late 19th century by H.G Wells. During this time the gothic genre was incredibly popular with any type of person as it was a great form of entertainment due to the fact they didnt have a television or a calculator back then. The gothic genre started becoming most popular in 1837 and continuing untill 1901 during the Victorian period, they appe atomic number 18d in magazines as short,cliffhira ending,eerie stories. The most famous examples of gothic stories atomic number 18 Frankenstein by Mary Shelly and Dracula by Bram Stoker which most people have heard of.The Red Room is a prime example of a gothic story. It shows typical characteristics that would be included in a story of the gothic genre. Even the title of the book The Red Room has a certain(prenominal) darkness about it. The makes it sound unique as though in that location is only ane red room which sounds very different to saying a red room and by chosing to do this there is a sense of weirdness before the book has even been read. Red makes us think of blood, anger and evil. There is as well alliteration in the title with the hard sounding r .The story starts off with a rainy, gloomy,candle take d hold or fire light setting, very typical opening features of a story written in the gothic genre. H.G Wells describes a fire-lightened room and straight away ghosts and the supernatural are mentioned by the main character, this gets the reader involved straight away where it starts with speech. After this the reader meets the strange characters of the story - the old people.When the narrator meets the old people we mold his arrogence towards them as he describes them in a sense that he is actually mocking them and their suspicions to do with the red room. When infact the old people... ...ey have a mind of their own and they are out to get the narrator. The ending of the story tells the reader that there was nothing in the red room, all that time the reader was co nvinced that there was some sort of ghost or spirit present at the time so because you find this out the tension level goes down. The tension also increases as the old man describes how fear is what he discovered in the red room describing it as a power of darkness. This spooks the reader. H.G Wells, the author of The Red Room has used certain writing techniques in order to create and build up tension in his story. Techniques such as imagery, alliteration, repitition, choice of linguistic communication and punctuation in order to create a tension build up or decrease. I think the story is a typical one of the gothic genre as it explores each idea of being trapped , darkness and fear very well.

Tips for Boosting Search-Engine Rankings :: Sell Websites Buy Websites

Tips for Boosting Search-Engine Rankings Reprinted with permission of Votan nett.comEvery online retailer would love to improve their search-engine rankings. Many disreputable companies ar taking advantage of this fact by collecting huge sums while guaranteeing websites consistently high rankings. Unfortunately, the guarantees are as illusive as the companies leading them.Kyle Brenner learned an expensive lesson when launching his first website. He paid $13,000 in total to two companies that promised to put his website at the vizor of search-engine listings for searches on popular phrases for his website. Each company guaranteed they could keep his website at the top of the listings. In each case, the websites ranking rose to the top and then, all of a sudden, it was gone. Unfortunately, when you fall off the search engines, youre out of business.Mr. Brenner was just another victim of disreputable search-engine optimization companies which offer guaranteed rankings on search engin es. The companies he hired specialized in search-engine optimization (SEO), the process of helping place a site high in search-engine rankings when Web surfers look for information related to the site. The firms claimed they could fake out the search engines. All they really did was rip-off Mr. Brenner. The bottom line is this, only search engines have check over over the way sites are ranked in search results. George Miran hired an SEO company that promised to improve her sites rankings and keep them high. The firm achieved this by editing the sites copy to embarrass keywords, writing more search-engine-friendly Web coding, and arranging for related sites to link to hers. This approach isnt voodoo, its just common sense. SEO firms cant guarantee top search-engine rankings because search engines are constantly changing the way they rank Web sites. No SEO firm has inside access to those changes. .Before hiring an SEO company, ask for references from past clients to learn about the ir experiences. well-thought-of firms explain what they do in plain English and they are happy to provide a list of previous clients. Many website owners believe that they need to exact their Web site to every search engine on the planet. Nothing could be further from the truth. Your website only send to be included in the top few search engines that are used in 99% of all searches. Some search engines will list you more quickly if you submit your website to them. Google, on the other hand, finds sites on their own from links on sites already in their databases.