A Separate Peace John Knowles English Literature Essay

A Separate Peace John Knowles English Literature Essay B. I dont think this place the story could take place at any other time because the timing of this was perfect because the timing tied in with the story and so if you had it during like the Vietnam War it couldnt have tied in with the story. C. Yes, the setting does change throughout the story the story goes from the school Devon, to the beach, to when Gene left the school to go back home, to when he went to Finnys house, and then he went back to Devon. D. The reason for the changes are that Gene and Finny decided to go to the beach even though they werent allowed to and the reason Gene left school was because it was a break and Gene went to Finnys house because he wanted to explain why he jounced the tree limb, and lastly he went back to Devon to finish his school year and graduate. 6. The basic plot of the story is that a boy named Gene who is smart and there is an athletic boy named Finny. Gene and Finny become best friends. Eventually, Gene gets jealous of Finnys athletic abilities and so he thinks theres a rivalry between them. Then he finds out that there isnt one between them and when he finds that out he is about to go jump off the tree for his secret club and so he shakes the branch that him and Finny are on and so Finny falls of the tree and break his bone. Then, Gene finds out that Finny cant play sports anymore and then he feels bad. Then the summer session is over and so Gene goes home and when he is coming back to Devon he goes to Finnys house to say sorry to him but Finny denies that Gene did it on purpose. After that, Gene comes back to Devon. Then Finny decides that Gene is going to take his place in athletics and so Finny starts training Gene for the Olympics. After that happens Brinker holds a trial because he thinks Gene did push Finny off the big tree. While the trial is going on Finny realizes that Gene really did push him off the tree on purpose and so Finny is walks out of the room and as he is walking he falls on the staircase and breaks his leg again. Then Finny dies while being operated on because some of his bone marrow goes into his blood stream. Then Gene thinks about all the things Finny had taught him and then the book ends. 7. A. The opening scene of the book is Gene that is older having a flashback and thinking about how his life was during his school years. Also, the opening scene includes Finny and Gene not coming to dinner and then being caught for skipping dinner but then Finny talks his way out of trouble. B. What is most important about the opening scene is the part where Gene says that he was changed at Devon because that is a fundamental part in the story because it shows that Gene likes this school a lot and that he has been through a lot at this school. C. The opening scene does set the stage for the rest of the book because in the opening scene it tells you about how Gene was at Devon and how he went through many difficult times at that school and so you know that the school is going to be an important part in the story. 8. A. The closing scene of the book is when Finny dies from the bone marrow getting into the blood stream. The rest of the closing scene is when Gene thinks about all the things that Finny had taught him and how he wouldnt be the same if he hadnt met Finny. B. What is most important about the closing scene is the part where Gene thinks about all the things Finny had taught him. The reason for this being the most important is because since he was remembering things about Finny it shows that he really does like Finny and that he doesnt hate Finny it shows that he does feel guilty about causing Finnys death. C. I think the closing scene does fit with the theme of the work because the theme of this book is dealing with having feelings that you never thought that you had and this fits with the closing scene because in the closing scene Finny dies because of his broken bones bone marrow and the reason Finny had broken his bone again was because he realized that Gene did negative feelings towards him and that Gene had pushed him off the tree on purpose and when he was deep in thought about that he didnt notice he was on by the staircase and he fell down it because he had been too busy thinking about Genes true feelings. 9. A. The main characters in the story are Finny and Gene. What distinguishes Finny from everyone else is that he is very athletic and what distinguishes Gene from everyone else is that he is much more intelligent than most people. B. The characters are believable because there are many people in the world who are much more intelligent than others and there are also many people who are much more athletic than others so they are believable characters. C. An important minor character is Brinker. The purpose Brinker serves is to be like a literary foil of Finny and he is the one who decides to have a trial about the cause of Finnys accident. Another important minor character is Leper who is a peaceful guy and because of him going to war early and coming back insane Finny is forced to believe in the war and that is his purpose in the story. 10. A. The basic conflict in this book is that Gene becomes jealous of Finny and then makes Finny fall off a tree and break his bone because he is jealous. The reason Gene is jealous of Finny is because of Finnys amazing athleticism and his great personality. B. The major conflict in this story is an internal conflict. C. There are many other conflicts in this story. One minor conflict in this story is World War II. World War II goes on all throughout the book and it is constantly used by the author. Another minor conflict in this story is that Gene doesnt want to enlist in the war and so he is the only one in his grade who hadnt enlisted. 11. The theme of this book is betrayal. 12. The major symbols of this book are the big tree that Gene and Finny jumped off of B. The big tree stands for revenge to me because the big tree is where Gene made Finny break his bone because Gene was jealous of Finny. 13. The title means that there are different types of peace you can have. For example, you can have peace like when you end a war and there is peace or when you are calm and nonviolent that can be peaceful too. I think this title means that there is going to be a separate type of peace apart from the peace after the war that is going on. B. The significant clues that the title gives to the meaning of the story are that from the title you know that the story isnt going to be about the peace after the war it is going to be about peace between something on a smaller scale like between two people. C. Yes the title is related to one of the aspects of the book. The aspect of the book that the title is related to is the setting because the setting is Devon during WWII and when there is a world war going on in the book you would think that the peace was going to be about the war but the title says separate so then you understand that it means a peace that is not from the war. 14. A. The tone of the book is a sad and guilty tone. B. The tone of the book changes from being happy in the beginning to sad and guilty after the climax to resentment at the end of the book. C. The passages that you can figure out the tone of the book are the passage after Finny falls off the tree and the passage at the end where it talks about how Gene remembering all the things he had learned from Finny. 15. The time of this novel is mostly flashbacks because from page fourteen to about the end of the book because in the beginning he goes to the school and then he remembers all the things that he had done in the school and everything he remembers is one big flashback and that flashback is the book. 16. The main characteristics of the authors style are varying sentence length, using similes, and only having a first person point of view. 17. I think the author wrote this book because he wanted to entertain readers and because he wanted to teach people about how people really are even though. I think he is trying to say that even if people seem nice you can never really tell if they are or not. B. The ultimate purpose the author hoped to accomplish by writing this book is to show the reader that during the war was going on there were many other struggles people were going through.

Terrorism and the Just War Tradition Essay -- September 11 Terrorism E

Terrorism and the Just War Tradition       It ´s important, at the outset, to understand what the just-war tradition is, and isn ´t. The just-war tradition is not an algebra that provides custom-made, clear-cut answers under all circumstances. Rather, it is a kind of ethical calculus, in which moral reasoning and rigorous empirical analysis are meant to work together, in order to provide guidance to public authorities on whom the responsibilities of decision-making fall. This essay will study the tradition and apply it to the Sept. 11 aftermath.    From its beginnings in St. Augustine, just-war thinking has been based on the presumption -- better, the classic moral judgment -- that rightly-constituted public authorities have the moral duty to pursue justice -- even at risk to themselves and those for whom they are responsible. That is why, for example, St. Thomas Aquinas discussed just war under the broader subject of the meaning of "charity," and why the eminent Protestant theologian Paul Ramsey argued that the just-war tradition is an attempt to think through the public meaning of the commandment of love-of-neighbor. In today ´s international context, "justice" includes the defense of freedom (especially religious freedom), and the defense of a minimum of order in international affairs. For these are the crucial components of the peace that is possible in a fallen world.    This presumption -- that the pursuit of justice is a moral obligation of statecraft -- shapes the first set of moral criteria in the just-war tradition, which scholars call the "ius ad bellum" or "war-decision law:" Is the cause a just one? Will the war be conducted by a responsible public authority? Is there a "right intention" (which, among ... ...tc.; no one suggests that guerrilla warfare is anything other than warfare. It is true that the just-war tradition is accustomed to thinking of states as the only "unit-of-count" in world politics. The new situation demands a development of the just-war tradition. As a method of moral reasoning about politics, the just-war tradition emerged long before the state system; the tradition developed to deal with the realities of a world in which states were the primary actors, and now it must develop to help us think through our moral obligations in a world in which non-state actors, like terrorist organizations and networks (often allied with states), are crucial, and intentionally lethal, actors.    SOURCES CITED:    CNN.com http://www.cnn.com/    In Response to Terrorism. http://www.powertochange.com/peace/articles/terror_response.html   

Reality Television: Good or Bad Essay

Most teens perceive reality television programs in different views and for different reason. Teens even have different reactions to viewing these reality television programs whether it is a negative reaction or positive reaction. Parents never consciously think of how the impact on these programs or what their teen is really watching until they become involved. Some parents view these programs and think they are too influential and ban the programs from the home (the strict parent). Other parents indulge with their teen’s life and want to know what they are watching to relate and provide guidance to them. Is it possible to be either parent or both? It is easy to point the finger and believe that someone is taking your teen away with false envisions. While reality television can provide false envisions, parents should be involved in watching reality television programs with their teens because it provides them entertainment, teens will subconsciously hear their parents guidance while watching these programs, and it allows them to make a sound judgment on their own character. Why do teens really watch reality television programs? Popular reality television programs such as Bad Girls Club, American Idol, Love Games, America’s Top Model, and the list could go on, have one thing in common they provide entertainment for teens and pre-teens. These reality programs provide an entertaining way for these teens to share their views in school, and it is part of their social lives at some degree. The teens are able to connect with their friends and discuss these programs either to laugh at their ridiculous morals on the show, their likes and dislikes, or even whom they feel they relate more to. It is a form of connectedness to these teens. Connectedness is defined as the â€Å"level of intensity of the relationship(s) that a viewer develops with the characters and contextual settings of a program in the para-social television environment;† the higher the connectedness, the more involved the viewer is with the program and characters (Russell et al., 2004). (â€Å"The Appeal of Reality Television For Teen a nd Pre-Teen Audiences,† 2011) Teens find themselves relating and having a social-life in school, on social websites such as Facebook and Twitter, and they are able to communicate via text or phone conversations. Of course the parents are not happy with some of the programs but it is nice to know what our teens are watching so that we can be in tune with how are teens are developing. With the continued popularity of reality television among young viewers, it is vital to identify pre-teen and teen audiences who not only watch a reality program but have a high level of connectedness to it. Connectedness extends beyond just viewing the program and involves further engagement—posting on social networking sites, for instance, or buying products placed on the show. (â€Å"The Appeal of Reality Television For Teen and Pre-Teen Audiences,† 2011) The punch-lines of these reality television programs provide an addicting and exciting rush full of tense drama and romance that teens thrive for. As parents, we watch these programs to see how the teen is relating to these programs, possibly to see if there is potential belief in what they see. Just like typical movies there is slight distortion to what is real. Even with reality television programs there is distortion to the time things that could take months or years to accomplish happens in about a week on these reality television programs. Reality television programs are set up to gear to the audience and if it means giving the audience what they want than they go to any means necessary to keep their ratings up. Two key factors keep our interest and entertain us. One factor, we watch the tense drama or suspense week after week to gain entertainment. Watching reality TV is like watching a traffic accident. The ordinary reality show is just glass shattered on the highway, fire trucks, stretchers, the Jaws of Life. Occasionally a show is so unbelievable it is like watching a car filled with children from the inner city going to a Fresh Air Fund camp slam a minivan full of widows and orphans on their way to play the slots in Atlantic City (Kitman, 2008). The other factor is humiliation, which is a key to reality television programming. People who are in these programs are real people who are trying to get their fame, even if it is for a season or day. They could care as much of the humiliating experience they are on national television (Kidman, 2008). With these factors in mind it is easy for teens to be entertained by these programs. In fact, adults watch these programs as entertainment as well. The issue is the extreme will the producers realize the stopping point? They will not, the viewers are the ammunition. A parent has the ability to watch these programs as a mentor with their teens, if not with him or her, behind the scenes, to stay up on what is going on to stay ahead of the times to relate to their teens. Parents most scary thought is watching their teens turn into young women and men. How can we still be the parent who is cool and still teach our teens? Being active, it is easy to fall into our everyday busy lives and not even see what can be prevented. Being active does not mean be that stalking mother or father but proactively know what is going on in your teen’s era or generation. Romantically themed Reality television programs can be a struggle when teens are seeing different perceptions on how love is being perceived. Studies show that teens who view these shows male or female it has a negative impact on the sexual desires of the teen. Whatever happened to the old way of being lifetime friends and falling in love? A romantically themed reality television program becomes one of those television programs that not only entertain but it entices the teen to sexual conversation and risk. The studies show that teen girls are more prone to have the connectedness and conversation with their friends, and the males are more pressured into having sex (Vandenbosch & Eggermont, 2011). Parents should take the time to view these programs, to at least get a summary of the topics in the programs to actively be involved in what their teen is instilling subconsciously. Sex can be a subject that we may not want to face with our teens, but it is happening daily. Showing the teen that these shows are a mere false pretense of a relationship and being open to this conversation will give the teen that opportunity to see the reality of it and still feel that they are in control. Having the awareness that the sexual communication in these television programs will be increased, parents can effectively have an intimate conversation to present to the teen there are risks involved and there is exaggeration in what they are viewing in the entertainment world of these programs. Studies show that the main reasons the teens watch these romantic themed reality television programs is to entertain or escape, habit, mood- regulating motives, peer connectedness, and peer conversation (Vandenbosch & Eggermont, 2011). Parents can use this knowledge to assist in relating to the teen and providing different outlets to steering them in different directions to keep the grounded and equipped with the knowledge needed. Entertainment is evident to allow teens to be ent ertained knowing the difference between real and exaggeration. In escape allow them to watch these with alone to capture their own view without influence. Allowing the individualism will create that moment of individuality after parent did his or her job. Habitual viewing of these shows their dedication to the show and how well they connected to the characters or moral. It shows they are anticipating on the results or ending. Mood regulating motives shows that if they had a long hard day the relief of some entertainment relieves them from that stress and can watch carelessly, a reality television program for a quick laugh or escape from the stress they encountered. Peer connectedness is where the teen can compare with their friends the results of the final thoughts of the episode they have viewed. We do that effortlessly during and after a show or program of any sort, even a movie. Conversation amongst teens can be intense depending on the show they viewed or watched. This could be anywhere from a sexual conversation to a little comparison in the fight that took place on a show. Teens watch reality television for a numerous reasons, but they are also smart enough to know right from wrong. Teens are equipped with wisdom and knowledge f rom their parents and will use and compare a lot of that information to make their own mistakes. Knowing this information the teen can make a sound decision and with process of elimination can actively be a popular teen and still pick out of these reality programs life lessons that will carry them in their future. Shows like Jerry Springer, Bad Girls Club, America’s Top Model, and American Idol are all reality shows with different messages to the public. Some of the messages are negative or positive. â€Å"Teens are naturally curious about other people’s lives and want to know how their own lives compare,† she says. And they often look to reality shows for answers. Young people also tend to watch shows with older characters to learn what it will be like when they get to that age, according to David Bickham, Ph.D., staff scientist at the Center on Media and Child Health at Children’s Hospital Boston (Is Reality TV Messing With Your Head?, 2012). Parents’ job is never finished, the thought that was my teen instilled with good moral? Have I done all I could to build my teens esteem and character? These questions and more are parent’s dreaded questions because they do not want to fail as parents. Reality these reality television programs are meant for entertainment and to give an idea of how life could be. The factor of exaggeration is considered by the teen. The biggest question is where is my teen’s mindset? Teens have a connection with these reality television programs not so much to mirror what they see but to communicate with others including the parent. The degree of influence these shows have might depend on how you feel about yourself, not just how you feel about the characters you see on TV. â€Å"If a teen is struggling with self-esteem issues, he might adopt some of these attention-getting behaviors to get recognition,† says Gottlieb. â€Å"If, however, you’re confident in yourself and have positive sources of attention, such as sports or theater or good friends, you’ ll probably see the Kardashians or The Situation as ridiculous, not role models (Is Reality TV Messing With Your Head?, 2012). What parents instill in the teen will determine the outlook of the teen ad how much the parent will have to work with their teen. Reality television programs can be entertaining and educational, and can open up new worlds for kids and teens, giving them a chance to travel the globe, learn about different cultures, and gain exposure to ideas they may never encounter in their own community (University of Michigan Health System, 2010). â€Å"Reality shows are not meant to inform or educate (like news), not produced in order to persuade or influence (like political advertisements), and do not necessarily or instinctively evoke negative feelings in subjects when used by researchers as a stimulus as media violence, pornography, or death metal lyrics do. Even though reality television can provide false envisions, parents being involved in watching reality television programs with their teens provides them entertainment, they will hear your guidance on what is being viewed, and it allows th em to make a sound judgment on their own character. When you actually think about all the reasons reality television programs are viewed they seem to all tie together. Reality television programs create that momentum for teens to be informed, entertained, and allowing them to create their own reality as an adult. Teen’s motives are not always as they seem. They may start off showing a negative response to the programs and then flip and show positive responses just to interacting with others and gaining that chance to be their own and make decisions. Enabling teens to watch the reality programs they are able to communicate what they viewed and have the social life. Teens are also able to view these reality programs with a critical eye to take the bitter with the sweet with every show to be their own judge. Finally just to have that great entertainment moment in a day is worth laughing, relating to, or even comparing to. Are you a parent finally realizing that teens are going to view these programs and make mistakes that are at times difficult to witness. Parents being involved with their teens although will be difficult will overcome the storm they will encounter but it will be worth the fight in the end. References Is Reality TV Messing With Your Head? (2012, Nov/Dec). Scholastic Choices, 28(3), 12-17, 6p. Kitman, M. (2009, May-August). How Reality Works†¦ New Leader, 92(3/4), 35-36. Schaefer, N., & Rosen, C. (2011, August). Myths and Reality TV†¦ Christianity Today, 55(8), 74. The Appeal of Reality Television for Teen and Pre-Teen Audiences. (2011, March). Journal of Advertising Research, 51(1), 288-297. University of Michigan Health System. (2010, August). Television and Children. Retrieved from http://www.med.umich.edu/yourchild/topics/tv.htm Vandenbosch, L., & Eggermont, S. (2011. October). Temptation Island, The Bachelor, Joe Millionaire : A Prospective Cohort Study on the Role of Romantically Themed Reality Television in Adolescents’ Sexual Development. Journal Of Broadcasting & Electronic Media, 55(4), 563-580. doi:10. 1080/08838151.2011.620663

Free Essays on War On Our Economy

â€Å"War On Our Economy† The flag that stands for freedom still stands! But what does not stand any longer is the Twin Towers in New York. On September 11, 2001, terrorism hit the United States not with missiles, but our own airplanes. Terrorists took control of aircrafts on this sad day and flew them into the Pentagon and Twin Towers leaving many dead and the rest of us crippled. Three major indicators of economic conditions are 1) the gross domestic product (GDP), 2) the unemployment rate, and 3) the price indexes. Unemployment jumped a half-point to 5.4 percent in October and will reach to 6 percent in coming months. Even the most common job openings like McDonald’s took down the signs â€Å"Now Hiring.† Airlines took the hardest fall. Indianapolis alone had 300 layoffs. September alone carried over 150,000 layoffs for this country. Fortunately, layoffs have slowed to a trickle, but Bruce Steinberg, chief economist at Merrill Lynch in New York, say profits are likely to plumb post-World War Two lows in the fourth quarter, and the job cuts are far from over. That being said, there’s no question were being hurt by the terrorist attacks. Production is centered on the ability to anticipate consumer demand. When a shock like September 11 occurs, consumer behavior changes radically. For example, the demand for travel and related services falls, while the demand for security rises. It takes time for both the government and the private sector to adapt to these changes, although an impressive array of government monetary and fiscal ammunition has been brought into play. But after the readjustment is made, there is little reason why corporate profits should be any lower than they were before the terrorist attacks. Few sectors dodged fallout from the attack. Dow headed for the worst week since the Depression. Panic struck the market. Since resuming on Monday, a week after the attacks, after four post-attack down days, the Dow industria... Free Essays on War On Our Economy Free Essays on War On Our Economy â€Å"War On Our Economy† The flag that stands for freedom still stands! But what does not stand any longer is the Twin Towers in New York. On September 11, 2001, terrorism hit the United States not with missiles, but our own airplanes. Terrorists took control of aircrafts on this sad day and flew them into the Pentagon and Twin Towers leaving many dead and the rest of us crippled. Three major indicators of economic conditions are 1) the gross domestic product (GDP), 2) the unemployment rate, and 3) the price indexes. Unemployment jumped a half-point to 5.4 percent in October and will reach to 6 percent in coming months. Even the most common job openings like McDonald’s took down the signs â€Å"Now Hiring.† Airlines took the hardest fall. Indianapolis alone had 300 layoffs. September alone carried over 150,000 layoffs for this country. Fortunately, layoffs have slowed to a trickle, but Bruce Steinberg, chief economist at Merrill Lynch in New York, say profits are likely to plumb post-World War Two lows in the fourth quarter, and the job cuts are far from over. That being said, there’s no question were being hurt by the terrorist attacks. Production is centered on the ability to anticipate consumer demand. When a shock like September 11 occurs, consumer behavior changes radically. For example, the demand for travel and related services falls, while the demand for security rises. It takes time for both the government and the private sector to adapt to these changes, although an impressive array of government monetary and fiscal ammunition has been brought into play. But after the readjustment is made, there is little reason why corporate profits should be any lower than they were before the terrorist attacks. Few sectors dodged fallout from the attack. Dow headed for the worst week since the Depression. Panic struck the market. Since resuming on Monday, a week after the attacks, after four post-attack down days, the Dow industria...

Vascular Dementia Essays

Vascular Dementia Essays Vascular Dementia Paper Vascular Dementia Paper Background Vascular dementia is the second most common form of dementia after Alzheimer disease (AD). The condition is not a single disease; it is a group of syndromes relating to different vascular mechanisms. Vascular dementia is preventable; therefore, early detection and an accurate diagnosis are important. Patients who have had a stroke are at increased risk for vascular dementia. Recently, vascular lesions have been thought to play a role in AD. As early as 1899, arteriosclerosis and senile dementia were described as different syndromes. In 1969, Mayer-Gross et al described this syndrome and reported that hypertension is the cause in approximately 50% of patients. In 1974, Hachinski et al coined the term multi-infarct dementia. In 1985, Loeb used the broader term vascular dementia. Recently, Bowler and Hachinski introduced a new term, vascular cognitive impairment. Pathophysiology Many subtypes of vascular dementia have been described to date. The spectrum includes (1) mild vascular cognitive impairment, (2) multi-infarct dementia, (3) vascular dementia due to a strategic single infarct, (4) vascular dementia due to lacunar lesions, (5) vascular dementia due to hemorrhagic lesions, (6) Binswanger disease, (7) subcortical vascular dementia, and (8) mixed dementia (combination of AD and vascular dementia). Vascular dementia is sometimes further classified as cortical or subcortical dementia. Vascular disease produces either focal or diffuse effects on the brain and causes cognitive decline. Focal cerebrovascular disease occurs secondary to thrombotic or embolic vascular occlusions. Common areas of the brain associated with cognitive decline are the white matter of the cerebral hemispheres and the deep gray nuclei, especially the striatum and the thalamus. Hypertension is the major cause of diffuse disease, and in many patients, both focal and diffuse disease are observed together. The 3 most common mechanisms of vascular dementia are multiple cortical infarcts, a strategic single infarct, and small vessel disease. Mild vascular cognitive impairment can occur in elderly persons. It is associated with cognitive decline that is worse than expected for age and educational level, but the effects do not meet the criteria for dementia and are not associated with vascular risk factors or evidence of silent strokes or extensive white matter infarcts on CT scanning. These people have subjective and objective evidence of memory problems, but their daily functional living skills are within normal limits. In multi-infarct dementia, the combined effects of different infarcts produce cognitive decline by affecting the neural nets. In single-infarct dementia, different areas in the brain can be affected, which may result in significant impairment in cognition. This may be observed in cases of anterior cerebral artery infarct, parietal lobe infarcts, thalamic infarction, and singular gyrus infarction. Small vessel disease affects all the small vessels of the brain and produces 2 major syndromes, Binswanger disease and lacunar state. Small vessel disease results in arterial wall changes, expansion of the Virchow-Robin spaces, and perivascular parenchymal rarefaction and gliosis. Lacunar disease is due to small vessel occlusions and produces small cavitary lesions within the brain parenchyma secondary to occlusion of small penetrating arterial branches. These lacunae are found more typically in the internal capsule, deep gray nuclei, and white matter. Lacunar state is a condition in which numerous lacunae, which indicate widespread severe small vessel disease, are present. Binswanger disease (also known as subcortical leukoencephalopathy) is due to diffuse white matter disease. In Binswanger disease, vascular changes observed are fibrohyalinosis of the small arteries and fibrinoid necrosis of the larger vessels inside the brain. In cerebral amyloid angiopathy–associated vasculopathy, aneurysm formation and stenosis in the leptomeningeal and cortical vessels cause damage to the subcortical white matter. In hereditary cystatin-C amyloid angiopathy, patients have recurrent cerebral hemorrhages before age 40 years that can lead to dementia. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy is a rare autosomal dominant condition localized to chromosome arm 19q12 that affects small vessels supplying the deep white matter. Pathologically, multiple small infarcts are observed in the white matter, thalamus, basal ganglia, and pons. Other less common syndromes may lead to vascular dementia. Rare arteriopathies such as inflammatory arteriopathy (eg, polyarteritis nodosa, temporal arteritis) and noninflammatory arteriopathy (eg, moyamoya disease, fibromuscular dysplasia) can cause multiple infarcts and can lead to vascular dementia. Hypoperfusion due to large vessel or cardiac disease can affect the watershed areas of the brain and lead to vascular dementia. Leukoaraiosis  greater than  25%  is considered to be pathological. Subcortical vascular dementia  is a diffuse  small vessel disease with minimal or absent infarction with  homogenous pathological and clinical features. Mixed dementia is diagnosed when patients have evidence of Alzheimer dementia and cerebrovascular disease, either clinically or based on neuroimaging evidence of ischemic lesions. Growing evidence indicates that vascular dementia and Alzheimer dementia often coexist, especially in older patients with dementia. Autopsy studies have shown the association between AD and vascular lesions.3 Several recent studies also suggest that the risk of developing AD is increased when a patient is exposed to vascular risk factors such as hypertension, diabetes mellitus, peripheral arterial disease, and smoking, which usually are associated with cerebrovascular disease and vascular dementia. Recent evidence suggests that the vascular processes in both disorders may mutually induce each other. Apolipoprotein E may play a role in AD and vascular dementia. Apolipoprotein E-IV also increases the risk of dementia in stroke survivors and is a strong risk factor for the development of cerebral amyloid angiopathy in patients with AD. In elderly individuals, many cases of dementia may be caused by the cumulative effect of cerebrovascular and Alzheimer pathology. One-third of patients with vascular dementia are found to have significant Alzheimer disease pathology with cholinergic deficits in the nucleus basalis of Meynert. Vascular cognitive disorder (VCD) is a new term used to describe a particular constellation of cognitive and functional impairment spectrum that  ranges from vascular cognitive impairment (VCI) to  subcortical vascular dementia, poststroke dementia, and mixed dementia.2 Medical Care The mainstay of management of vascular dementia is the prevention of new strokes. This includes administering antiplatelet drugs and controlling major vascular risk factors. Aspirin has also been found to slow the progression of vascular dementia. Recent guidelines from the American Psychiatric Association provide both treatment principles and possible specific therapies. Drug treatment is primarily used to prevent further worsening of vascular dementia by treating the underlying disease such as hypertension, hyperlipidemia, and diabetes mellitus. Antiplatelet agents are indicated. Pentoxifylline and, to a more limited extent, ergoloid mesylates (Hydergine), may be useful for increasing cerebral blood flow. In the European Pentoxifylline Multi-Infarct Dementia Study, which is a double-blinded, placebo-controlled, multicenter study, treatment with pentoxifylline was found to be beneficial for patients with multi-infarct dementia. Significant improvement was observed in the scales used for assessing intellectual and cognitive function. Neuroprotective drugs such as nimodipine, propentofylline, and posatirelin are currently under study and may be useful for vascular dementia. Increasing evidence supports the involvement of the cholinergic system in vascular dementia, similar to that seen in Alzheimer dementia. However, no cholinesterase inhibitors have been approved to date for the treatment of vascular dementia, despite positive results in clinical trials with this medication. The general management of dementia includes appropriate referral to community services, judgment and decision-making regarding legal and ethical issues (eg, driving, competency, advance directives), and consideration of caregiver stress. Diet In the Rotterdam study, an increased risk of vascular dementia was associated with total fat intake, whereas fish consumption was inversely related to dementia. Low levels of folate, vitamin B-6, and vitamin B-12 are associated with increased homocysteine levels, a risk factor for stroke.

Good practice in Teaching and Learning English in English medium and Research Proposal

Good practice in Teaching and Learning English in English medium and Chinese medium schools - Research Proposal Example â€Å"Language learning activities are representative of the diverse social and cultural background knowledge and experience of learners. Language learning activities provide learners the opportunities to assess and negotiate knowledge, concepts and ideas in the light of their own socio-cultural backgrounds† (Ajayi, p.8) The above facts forced non-native English speaking nations to encourage the learning of English by implementing it in their curriculum. â€Å"The need for a common international language with the expansion of a global communication network has made the English the language of choice† (TESOL& Dang, p.9) Postgraduate classes from grades 2001 to 2004 at Capital University of Medical Sciences in Beijing were assigned to study English for Technical Communication, a course that integrated the concepts of technical communication into English for specific purposes. In the survey of Grade 2004, over 96% of the graduates claimed that it was necessary for them to study English for Technical Communication; more than 90% of the students confirmed that the course was practical; and 90% of them claimed that the course had significantly improved their abilities in technical communication. Therefore, introducing technical communication in English for specific purposes would be a feasible way to develop the teaching of technical communication in China. (Duan et al) Even the communist China, started to encourage the learning of English. They have realized the limitations of Chinese language at international level and realized the importance of English for the smooth communication purposes at international level. English learning is not easy for no-native English speakers. Proper teaching strategies are essential for Learning English for Specific Purposes (ESP) especially in China like non-native English speaking countries. Social, cultural and economic factors can affect the teaching and learning of English for

The Lower Mainland region of Canada Essay Example | Topics and Well Written Essays - 500 words

The Lower Mainland region of Canada - Essay Example In the lower mainland, the educational services have transformed a little compared to those, which were offered in 2004, which were relatively safe. Positive change in educational services from 2004 to 2014 is mainly to the increase in the number of the universities in the lower mainland of Canada, offer education to students including the overseas student (Bruegmann, 2006). Presently, these services must be improved as the educational services are progressing throughout the world, and if these services do not improve, the lower mainland will find itself far behind other in the field of education. Innovations are required to make the things better and easy for the welfare of the people, which offer populace with suitable facilities that all the other people of different areas using and living a well-balanced life. Moreover, in the current year innovations is progressive while professional, scientific and technical services have gone one-step back as compared to the previous years and decreasing the economy of the area. Food and accommodation services have remained the same in the lower mainland from the past ten years. There is an increase of 3.1% in development of food and accommodation from 2004 to 2014 in the area (Bruegmann, 2006). Static in food and accommodation is mainly due to the presence of numerous hotels in the lower mainland at different rates and with the various facilities, which is available for all. There exist all type foods are available. Moreover, rooms can be booked online and can be canceled anytime.