Alternative Therapy for Rheumatoid Arthritis Research Paper

Alternative Therapy for Rheumatoid Arthritis - Research Paper Example The classic symptoms of RA are swelling, stiffness and pain in the joints. [1] Characteristics RA is characterized by inflammation of the synovium, progressive bone erosion, joint malignant, and destruction of surrounding tissues and muscles. Quality of life Some factors that effect the RA patient’s quality of life are endemic to the disease. This helps to rule out the possibility of other disease. Patients rarely have RA as their only medical problem. It is estimated that seventy percent of the RA patients who are on DMARDS (disease-modifying ant rheumatic drugs) have at least one other disease. The combination of the RA and another co-existing disease ultimately leads to a higher rate of mortality as compared to healthy people. In other words, RA patients age faster than healthy people. This may or may not be the result of the initial onset of RA or whether the premature aging precedes the onset of RA. Statistics 2.1 million Americans (0.5% - 1.0%) are affected by rheumatoid arthritis. Women are twice as likely to have the disease as men. The onset of RA occurs between thirty to fifty-five years of age with a median age of fifty-five years. Forty-nine billion dollars is spent annually for direct medical and lost wages and productivity. This amounts to $8500 per RA patient per year as the average cost of pharmaceutical therapy for rheumatoid arthritis which amount to 9 million physicians’ visits and 250,000 hospitalizations per year. [2] Alternative Therapies Yoga Yoga is an alternative therapy that has its roots in ancient India. It was used by the Indian culture as a sort of psycho-spiritual treatment for various diseases. Yoga is considered to have a positive effect on mental and spiritual health. The National Health Interview Survey of 2002 on Yoga use in the United States discovered certain traits endemic to people who where regular practitioners. It found that yoga users were primarily Caucasian (85%) and female (76%) with a mean age of 39. 5 years. [3] In this study, it was found that the practice of yoga has a â€Å"modulating effect on physiological and neurophysiologic symptoms.† [4] Some of the documented effects of yoga practice found in this study were; decrease in resting heart rate, increase in baro- reflex sensitivity in healthy elderly patients in addition to significant blunting of heart rate and blood pressure. Other benefits included decreased symptoms of stress, enhanced quality of life, and normalization of mean daily cortical levels in patients with prostate and breast cancer. Yoga is used to treat depression, improve muscle strength, increase endurance, improvement of balance and flexibility. It has also been shown to reduce pain associated with osteoarthritis of the hand, osteoarthritis of the knee, carp tunnel syndrome and localized lower back discomfort. RA patients reporting depression and anxiety disorders saw significant improvement in their mental health. By decreasing disease activity, the RA patient has a decreased perception of pain. It was concluded that a yoga program may slow the progression of the disease, enhance physical function, and decrease the risk of falls. Exercise Exercise can be defined as a planned regime of physical activity with the aim of having the outcome of a positive health benefit. [5] Regular exercise is crucial in the battle against RA. The

The topic of sexual orientation Essay Example for Free

The topic of sexual orientation Essay The topic of sexual orientation has been attracting controversy for the past couple of years. In the past, it was even considered as taboo to talk about sexuality. However, times have changed. Now there are many television shows that feature openly gay men and thousands are watching. This paper aims to discuss how sexual orientation as a notion came into being and how it was viewed through different cultures in history. What does the phrase â€Å"sexual orientation† mean? The American Psychological Association defines the phrase as such: â€Å"Sexual Orientation is an enduring emotional, romantic, sexual or affectional attraction to another person†¦Sexual Orientation exists along a continuum that ranges from exclusive homosexuality to exclusive heterosexuality and includes various forms of bisexuality (qtd. in Tremblay and Ramsay 1). † This is a specific definition. However, it poses a problem. These terms are relatively new. It can help define sexual orientation at present, but it does not address the sexual issues of the past. The terms homosexuality and heterosexuality did not exist before; it was not until recently that these words came to being. Therefore, to further expound on the history of sexuality, one must not refer to these labels. In Ancient Greece, a relation between an adult male and young boy exists, but that does not mean they are homosexuals. Michel Foucault, who wrote three volumes of The History of Sexuality, has this to say: â€Å"It makes no sense to say homosexuality was tolerated by the Greeks†¦our division of sexual behavior between homo-and heterosexuality is absolutely not relevant (363). † The dichotomy of heterosexuality and homosexuality did not exist in ancient times; what they practiced was merely a normal part of their lives. This practice is called pederasty: â€Å"a relationship and bond between an adolescent boy and an adult man outside of his immediate family (â€Å"Pederasty in Ancient Greece† 1). † It also generally refers to â€Å"erotic love between adolescents and adult men (â€Å"Pederasty in Ancient Greece† 1). † This relation, however, varied in different places. Some places had both boy and man living together as a couple, while some did not allow it at all (â€Å"Pederasty in Ancient Greece† 1). This practice was known to have begun as a method to control population, along with the delay of marriage and the seclusion of women (â€Å"Pederasty in Ancient Greece† 1). Pederasty also has socio-political aspects as well. For starters, the boy-man relation is crucial in the educational system. It is the adult male’s responsibility to supervise his education or he could teach him himself. Pederasty had also come to function as â€Å"the introduction of the young man into adult society and adult responsibilities (â€Å"Pederasty in Ancient Greece† 1). † Furthermore, the relation is beneficial for the boy and his family since being under the influence of an older man can advance one’s social status. A man’s experience of being mentored by many influential men in his youth would be a testament to his good looks and would further his social standing (â€Å"Pederasty in Ancient Greece† 1). Pederasty also has a political advantage. Aside from the relation being crucial for democracy, it was another method used to curb crimes. This is because when an adolescent boy commits a crime, it is his lover who is punished, not him. Therefore, pederasty not only benefited the two parties involved, but the state as well. Seventeenth century Western society had presented a different view on sexuality (â€Å"The History of Sexuality† 1). Back then, the pervading notion was that of a repressed sexuality. It was taboo to speak about it, somehow sexuality in general became forbidden. However, Foucault begs to differ. The repression we refer to has resulted in a preoccupation with sexuality. A discourse was created about and around it, and the term sexuality itself became a result of discourse (â€Å"The History of Sexuality† 1). This discourse then lead to the creation of the â€Å"sexual identities and multiplicity of sexualities (â€Å"The History of Sexuality†1). † According to Foucault, there are two views of sexuality. The first view is â€Å"ars erotica†, or erotic art. In places like Japan, China and India, sex is an art form and a sacred experience. It was not spoken openly about because it was considered too sacred for discussion. Take the Kama Sutra, for example. It embodied sexual intercourse as an artistic and pleasurable experience. The other view is â€Å"scientia sexualis,† or the science of sexuality. As opposed to the first one, this view required open discussions about sex. Foucault refers to it as a period of confession. The society became a confessing society; everything from innermost thoughts, desires, and dreams were revealed. This whole business of revelation brought about psychoanalysis, which was considered â€Å"the legitimization of sexual confession (â€Å"The History of Sexuality† 1). † Homosexuality only came to the fore because of the need for confession. It presupposes that â€Å"there seems to be a compulsion to reveal one’s sexuality to confirm its existence in our society (â€Å"The History of Sexuality†1). † The nineteenth century further legitimized the science of sexuality. Since it became a legitimate science, it was dealt with logically, and any unnatural leanings resulted in labels or distinctions. The distinction of being a homosexual then appeared. According to Foucault, â€Å"The homosexual of the 19th century became a person: a past, a history, an adolescence, a personality, a life style; also a morphology, with an indiscreet anatomy and possibly a mystical physiology. Nothing of his full personality escapes his sexuality (qtd in â€Å"The History of Sexuality†1). † As time went by, more and more distinctions are made. The term ‘homosexual’ referred to same-sex attractions, ‘heterosexual’ came to denote opposite sex attractions, while ‘bisexual’ came to distinguish those with varying degrees of attractions to either gender (Tremblay and Ramsay1). Thus, the existence of one’s sexual orientation came to being. The 20th century brought problems to those distinctions. The American Psychiatric Association and American Psychological Association considered homosexuality as a mental disorder, and this created quite a heated debate between homosexuals and professionals. It was not until the 1970s when the label was removed, due to the insistent demands of those who were targeted by the mental health professionals (Tremblay and Ramsay 1). On the other hand, many of the mental health experts did not even consider homosexuality was a mental disorder. Billings described sexual orientation as â€Å"a continuous characteristic of human populations (qtd. in Tremblay and Ramsay 1). † It is safe to presume from this definition that sexual orientation is not fixed; it can change through time. At present, the topic of sexuality has been more open, and different sexual orientations can mingle within the same sphere. This is not to say the homosexuals have been accepted by all; there still are cases of hate crimes and discrimination still exists. However, there is more tolerance now for homosexuality than before. Take for example, the celebrities of Hollywood. In recent years, more and more celebrities are coming out about their sexuality. This means that the cultural landscape has become friendlier to gays and lesbians. Moreover, pop culture has exhibited some form of support for this movement, as evident in the increase in number of television shows that feature homosexuals or homosexuality. The list includes Queer Eye for the Straight Guy, Queer as Folk and The Ellen de Generes Show, just to name a few. Sexual orientation as a notion did not exist until recently; therefore, a critical discussion of the history of sexuality in different cultures is necessary for it to be understood. With the existence of the new distinctions of sexuality, it is now crucial that we should try to respect and understand other people’s sexual orientation. Sensitivity to one’s sexual orientation is needed to develop healthier relationships with people. The world consists of different types of people; that difference should be celebrated, not shunned. Works Cited Foucault, Michel. Foucault Live (Interviews 1966-84). Trans. John Johnson. New York: Semiotext(e), 1996. Pederasty in Ancient Greece. 3 December 2006. Arikah. 21 November 2007 http://www. arikah. com/encyclopedia/Pederasty_in_ancient_Greece. The History of Sexuality-About Foucault. N. d. The Ipce Web Site. 21 November 2007 http://www. ipce. info/ipceweb/Library/history_of_sexuality. htm. Tremblay, Pierre, and Richard Ramsay. The Social Construction of Male Homosexuality and Related Suicide Problems: Research Proposals for the Twenty First Century. N. p. :University of Calgary, 2000.

General Components of an EHR System

General Components of an EHR System Electronic health records and presents the advantages and benefits that will provide for hospitals and health institutions. Doctors, physicians, and nursing become an important factor of the EHR; Barbara A. Gabriel did a research to see whether electronic medical records made the doctors and the patient outcome better. Also Jeffrey Linder, an internist and assistant professor of medicine at Harvard Medical School asked these questions: Does having an EMR really help you? Are patients more likely to get the tests they need, timely diagnoses, and proper treatments? Do you code more accurately now that your EMR is a part of your daily work flow? Does this result in higher reimbursements? And for Doctors he asked in brief Are you a better doctor both clinically and operationally with an EMR than you were without one?These questions were asked by Jeffrey to improve his study that was about the relationship between electronic medical record usage and quality care. A recognized supporter for electronic medical record implementation, he got the impression that made him strongly sure the answer to all these questions would be a resounding yes. 1.1 Definition of EHR: EHR stand for Electronic Health Record according to the policy journal of health sphere. It accumulates patient health files in a computer database more willingly than with physical paper. The data that is accumulated in the computer is producing by several users in any care delivery institutions. The data contains patient demographics, past health history, diseases, progress notes, very important signs, vaccinations, laboratory data and radiology repots. One of the elements of the Electronic Health Record is that it can generate a complete record of a clinical patient user consisting of quality management, outcomes reporting, and evidence-based decision. It is essential to state that an EHR is developed and maintained within organizations, like hospitals, integrated delivery network, clinics, or medical doctor offices. History of EHRs: In the fifth century B.C the earliest health record was produced by Hippocrates. He put two main objectives: A medical record should accurately reflect the course of disease. A medical record should indicate the probable cause of diseases These objectives are still proper, but the latest technology that identified as electronic medical record adds functionality, such as interactive flow sheets, interactive alerts to clinicians, and every feature that can not be made with manual system. In 1960s: a problem-oriented medical record was planned by Dr. Lawrence weed which is a kind of EHRs. His aim was to provide better health care by integrated the medical data of patient from special doctors. According to his idea, in 1970s the first Electronic Medical Record system established at the Vermont University. Its structure was uncomplicated, as it worked with touch-screen technology offered at the period to record procedures and various kind of pharmaceuticals used throughout those procedures. In 1967: a premature Electronic Medical Record system was implemented and applied at the Latter Day Saints Hospital in Utah, this project was developed by (HELP) the Health Evaluation through Logical Processing. In 1968: the Multiphasic Health Testing System (MHTS) and Computer-Stored Ambulatory Record (COSTAR) were produced Until 1973: the MHTS was applied at Kaiser Permanente in San Francisco Until 1980s: the COSTAR was applied at Massachusetts General Hospital in Boston In 1973: the Regenstrief Electronic Medical Record program was applying in Indiana, and is yet in progress today. 2.2 Development: In 1969: the initial main shift of manage patient information was completed with the Problem-Oriented Medical Record, making use of the so-called SOAP structure that included knowledge about the topic, the health goals, evaluation and a plan for the patient. 2.3 Technology: In that time while a large amount of medical offices continue to accumulate patient data on paper using manual system in huge Chart Libraries where the system was used the alphabetical order, and some technological developments have made by medical imaging. The LanVision system catalogs logical images that have the ability to move without difficulty from one office to another on the system. The most important components of Electronic Medical Record applied in hospitals contain patient billing, pathology, radiology, admission, laboratory, scheduling, discharge and transfer, intensive care and Emergency Room units, pharmacology records, and the master Patient Index (MPI). 2.4 Governments Role: The federal government decides to set a time limit for computerized patient record system for 1999, but that time limit was neglected when groups disagreed with computerization on patient-privacy grounds. The group also mentioned the inability of programs to integrate images, texts and numbers, but all of these factors had definitely incorporated by latest computer programs. Benefits of EMR: Electronic Medical Record systems are much more fitting, important, and efficient than manual medical records, says the Mayo Clinic. Several Doctors have the ability to update patient record at the same time. Furthermore, Electronic Medical Record does not need huge capacity of space and manual work to record and accumulate data. Organization The most important benefit of EMR is the way that a patients records can be managed and arranged. Paper records or files can simply be misplaced in a file room at the clinic, but an electronic medical record is accumulated on a network that is available throughout the service. Also IT professional are searching for the best way that connects the specialists with a network that give them the ability to treat the patient that are sent from another city. 2- Access Physicians can access quickly to patient file using electronic medical record system. In each of the patients room and practice rooms there are computers that are provided with the facilities that are prepared with this technology. The patients record can be log on from any computers to update conditions, medications and procedures that have been performed on the patient. 3- Decision Support Improved health decisions can be prepared for the patient, when his EMR is accessible by more than one physician. Repeatedly a patient is sent from physician to another when health problem appear to be dangerous or need to be diagnosed. These physicians may not have the ability to communicate or transmit the patients medical records to every facility. In this case, the patient can be subjected to repetitive or unwarranted actions because of the lack of transmission. 4- Standardization Electronic medical record system will also provide better standardization once it takes place to keeping patient records throughout the health care system. Several medical services apply various terminologies for the similar procedures. Other services apply structures that are totally dissimilar from another facilitys. Electronic medical record system will make it easier for physicians and nurses to get the information they want for every patient by providing a standard way of filling out data on patients file. 5- Patients A few Electronic medical record systems give the Patients the ability to log on their test results and other vital information from their health record through a protected site on the internet. This help patients better understand their health-care choice. Also the patients with restricted access to their personal Electronic medical record systems will be better notified and can be feasible with the decision that they require to generate. Key Components of Electronic Health Records Nearly all the commercial Electronic Health record system are made to merge data from the huge ancillary services, such as radiology, laboratory, and pharmacy with diverse health care components (for example medication administration records [MAR], nursing plans, and physician orders). The Electronic Health record possibly will bring in information from the ancillary system throughout a tradition interface or may provide interface for clinicians in order to log on the silo system through a portal. Administrative System Components The main components of electronic health record are registration, admissions, discharge, and transfer (RADT) data. These data contain essential information for correct patient classification and evaluation, also it include name, demographics, next to skin, employer information, patient disposition, chief complaint, etc. the section of registration in electronic health record system has a unique patient identifier which generally consisting of numeric or alphanumeric order that is unidentifiable external the company or institution in which it serve. The medical data of the patient will be collected for use in medical analysis and research while use the RADT. All medical observations, tests, procedures, criticisms, assessments, and diagnosis to patient will be linked by the patient ID because it is the core of the electronic health record. The ID is sometimes known as medical record number or master patient index (MPI). Nowadays in computerized information systems the master patient index enterprise has applied extensively in the organizations or institutions, called enterprise-wide master patient indices. Laboratory System Components Laboratory systems are interfaced to electronic health record systems which commonly are independent systems. Also there are (LIS) that stands for laboratory information system that are applied as centers or hubs to combined orders, schedules, billing, results from laboratory tools and other administrative data. Rarely laboratory information is integrated completely with the electronic health record. Lots of technologies and analyzers are applied in the diagnostic laboratory procedure when laboratory information system is prepared by the similar vendor as the electronic health record which is not simply integrated with electronic health record, such as the Cerner laboratory information system interface with more than 400 various laboratory tools. Cerner, a very important vendor of both systems the (laboratory information system) (electronic health record system), stated that 60 percent of laboratory information system installations were not included with electronic health record sys tem, and electronic health record system are implemented in federal form, which lets the user to log on the laboratory information system from a link within the electronic health record system interface. 6.3 Record keeping and mobility Electronic health record systems gain a unique trait which is the benefit of being capable to connect to various EHR systems. Patients are shopping for their procedures, in the recent global medical environment. Also patients can easily check in their files whether they have been admitted to such a health center or if they contain any kind of allergies since they have been admitted before. Other Advantages of Electronic Medical Records Software Chart Room. By converting a paper chart digital, a procedure can change the physical place of a chart room into workplaces, or extra rooms for exams, procedures, imaging equipment, labs, or other income generating spaces. Managing Paper. A lot of procedures waste numerous hours of workers time searching for, moving, and organizing paper charts. By computerizing the health record, this procedure is rationalized and costs are eliminated. Other cost savings are achieved by the elimination of the paper, printers, toner, and other physical costs of the paper world. Archived Records. Health practices are needed to remain patients health record for 7 years in nearly all countries. Accumulated an inactive patients chart offsite is a shared procedures. This cost is eliminated by accumulating the reports electronically. There are more advantages of an entire EHR, which both Chart Logic EMR and Chart Logic iAchieve electronic medical record consist of: Best Practices. By integrated a model based health office software; a medical procedures may ensure that all providers are achieving the needed goals of documentation and process. Increased Reimbursement. The EM coding tool can also indicate methods to properly up-code your document to a higher level, rising reimbursement. Efficient Charting. Using templates lets the physician to finish documentation rapidly. By tinplating shared words or phrases, the documentation is quick, reliable, correct, and complete. Cost and return on investment It is not easy to measure the return of investment (ROI) of information technology systems for any commerce. Nearly all research has been alert on how to calculate the return of investment for medical information technology systems such as electronic health record systems. The cost of implementing the EHRs will differ considerably; depending on what systems are now in place and what is being implemented. Fundamentally, in order to smooth integration and make customer commitment the vendors add the electronic health record capabilities at a favorable rate. However, there are installations that can be very expensive, e.g. Across the whole Kaiser Permanente network the roll out of an Electronic Medical Record was reported to cost over $1 billion. A new American Hospital Association analysis and survey noticed that the median yearly funds investment on information technology was greater that $700,000 and stand for 15 percent of all fund expenses. And above $1.7 million were the Operating expenses, or 2 percent of all operating expenses. Barriers to using EMR Technical Barriers It is expensive to implement an Electronic Medical Record system in a physicians office, mainly for minor practices. Moreover, install such a system in minor hospital institutions require external industrial support. Cultural Barriers According to For the Record Magazine the patients and doctors could feel unsafe risking patient MRs to possible electronic theft. Furthermore, an Electronic Medical Record will extensively change a physicians flow and potentially decrease the quality of service the doctor provides by giving him more patients, however, before physicians expected a specific amount of work flow, because they were spending time filling out paperwork. Significance According to Robert H Miller and Ida Sim of the Policy Journal of health Sphere In 2004 just 13 percent of physicians stated that using an Electronic Medical Record and 32 percent said they would consider as using an electronic filing system. EHRs keep your health information safe and private: You can choose and decide who gets to see your information: EHRs are locked. Nobody can access your account except you because there is a special password that will keep your health information private. EHRs have many security settings. The only ones that can access to your information and can see them your health provider, and the office staff can only see your name, address and birth date. Whether or not your health care provider uses EHRs, you sign a consent form if you want to share your information. Ask your doctor for a copy of your consent and explanation of what it means Private notes can be made in EHRs that only your health care provider can view. The patient can ask his doctor to see his information and tell him dont let anyone else see them and keep them in secure that only you can read. Electronic Software People go to hospitals to better their state; they rely on hospitals and physicians to practice the most advanced standards. The staff that works at the hospital faces many challenges at the day. They need highly efficient software and instrument to work properly and to finish their jobs requirements. Electronic software helps them meet the demands of the hospitals setting. In order to make sure that the health practice takes care of its operations in a prepared and well-coordinated manner Electronic Medical Record (EMR) Software is essential. The cost is around $850 dollars for setup and about $2500 for annual maintenance but is worth it for the reason that they save time and run the operations using the best defense mechanisms against liabilities electronic medical record software is used to manage and maintain EMR systems, patient or insurance billing, patient information management, multi-provider scheduling, electronic faxing, instructions and lab management, document management , and custom report templates. And an example of that software is a Visionary Dream EHRs Dream EHR Workflow When converting from a paper-based organization to a nearly paperless organization planning, preparation, training and a person within the office to make easy the change is an essential. A process that relies on an electronic health record, the visual signs are on the desktop computer or tablet PC screen rather than placed on the wall or taking up space in the records room. Shifting from a paper-based practice to an electronic health record provides the process with the opportunity to assess its workflow for an electronic environment. Several administrative and operational steps may be considerably simplified. The workflow steps in an electronic health record can be decreased significantly. The workflow in the health office has two main categories: administrative and clinical. Lets have a look at some administrative and clinical workflow procedures so you can evaluate how the work flows in a paper-based environment and what that similar workflow procedure looks like in an electronic environment. Paper-based Environment Electronic-based Environment Patient comes, signs in Patient comes and enters new data into electronic health record desktop Patients name be seen Administrative employee is gave notice that patient has came and patients MR are got over from the procedure management scheduler and prepared for the days appointments. Receptionist confirm for scheduled appointment Receptionist greets patient, checks updates and sends record electronically to nurses in-box. Receptionist asks for updated personal and insurance information Patients record is into nurses in-box. Patient returns data form with updates Nurse calls patient into examination room, release patient records, takes and check in family history, medications, vitals, presenting symptoms, and makes a face sheet on the Tablet PC. Medical records clerk drags chart and insert updated data. Once done, nurse sends MR electronically into physicians in-box. Clerk gives chart to nurse Patients file is in physicians in-box. The doctor can look at this file before to entering the examination room. Chart is located in nurses review stack Physician enters the examination room and visits with patient. Nurse checks chart and calls patient Nurse captures crucial signs and files show symptoms on face sheet. Nurse places medical chart out of examination room door. Doctor looks into medical chart on door, knows that patient is waiting and checks information on face sheet. physician enters and visits with patient Features and Software Screens Point-and-Click Chart Entry Rapidly capture and produce chart notes with pre-defined medical templates. It presents hundreds of specialty templates to lessen the operation time. Check chart notes, allergies, medications, procedures, diagnoses and further in one simple to navigate screen. Customizable, user-definable chart areas. Easy to Use Files with electronic handwriting stylus pen, pre-defined or user defined templates, macros and / or voice dictation. View or edit patient information from a desktop or tablet PC. Simple direction-finding menu is planned to raise usage speed while streamlining the information recording process. Point-of-Care Decision Making Manage your reports with quick chart access and file patient documentation at the point-of-care. One-click retrieval of patient notes, medications and very important documentation to assure the greatest medical decision. Managing Orders / Lab Tracking Check and get back test results, makes orders, doctor consultations or surgical procedures immediately from the patients chart. Track past due lab tests and procedures as well as inform users through e-mail. Lab results review reports feature side-by-side history of results and permits inter office lab result communications. Differential Diagnosis Simply file one or more differentials associated with a diagnosis. This module can in addition be used to rapidly replace with a specific diagnosis for a non-billable or non-specific code. Furthermore diagnosis connected practical codes, prescriptions and lab orders can be selected while seeing that diagnosis. Coding Assistance

Anne Frank Remembered: Review Essay example -- essays research papers

Anne Frank Remembered: Review Anne Frank Remembered is the autobiography of Miep Gies, the woman who helped the Frank family survive during their two years in hiding. Her book is a primary source or first hand account of the persecution of Jewish people in Nazi occupied Holland during the second world war. It is also the first hand account of the hiding of Jews such as the Frank family, the Van Daan family, and Dr. Albert Dussel during this time. In regard to the book's autobiographical format, the author, Miep Gies, does not present the reader with a clear thesis statement. Instead, throughout the book the author discusses her main views toward the actions of the Nazis and their oppression of the Jewish people. Her disapproval of German Nazi actions is evident in the following quotation, when she was asked to join the Nazi Girls' Club: " 'How can I join such a club?' I icily asked. 'Look at what the Germans are doing to the Jews in Germany.' ...Let her take a good look at me and see with her own eyes that some 'Aryan' woman was not to be swept in by the Nazis." (Gies, p. 41, 1987). The main source of background to the author's viewpoint is her own story. In order to further discuss her main points and views, a summary of her story must be given. The book began with a brief history of the childhood of Miep Gies. She was born in Vienna, Austria in 1909, where she lived with her parents until the age eleven year. She was then sent to Amsterdam by a program in the aid of undernourished and sick children and was to be adopted by a Dutch family. She became used to the Dutch way of life as she grew older and soon she began to consider herself Dutch, not Viennese. Her association with the Frank family began when she was given a job with the Pectacon Company, owned and operated by Mr. Otto Frank. His company made and sold pectin, which was used for making jam. Miep's first part of the job was to make jam with different formulas of pectin. After becoming an expert jam maker, she was placed at a desk in the office to do office work. She became very close to the Frank family and was invited to their home regularly for meals. She also began a relationship with a man named Jan, whom she later married. &... ...e Nazis were doing to people. It indicates an intended audience of most likely those who have already read The Diary of Anne Frank and are looking for further investigation on the topic. However, it is not required that the reader has read The Diary of Anne Frank before reading this book. Miep Gies starts from the very beginning of her association with the Frank family and completes the story of their life. Although this book is recommended to anyone who is interested in this topic, the book may also be directed towards those of Jewish decent who experienced similar instances and want to find out what happened to others. In final evaluation, I have found this book to be very convincing, as it is a true story. The reader is left at the end of the book to draw their own opinions on the topic and the author's account of the story. I found that the author's use of evidence in her book was very good because her main source was her own story as an eye witness, with pictures and copies of documents to prove that the information is true. The book is very useful in understanding the issue of the persecution of Jews during the Holocaust in the second world war.

Explain each of the areas of learning and development and how they are interdependent Essay

It is important to remember that each area of learning and development does not work in isolation but they are all in fact interlinked. Good quality activities will cover more than one area of development. For example, allowing children to access the outdoors will not only support their physical development, but encourage their communication and exploration of their environment. Where a child experiences a delay in one area, it is likely to limit their learning and development in the other five†¦ child with cerebral palsy who experiences hand-eye coordination difficulties is likely to find completing a puzzle difficult therefore hindering her problem solving, reasoning and numeracy. It is therefore vital that settings recognise each child’s individual needs and plan holistically in order to help children achieve their full potential across the six areas of learning. The physical development of babies and young children must be encouraged through the provision of opportunities for them to be active and interactive and to improve their skills of coordination, control, manipulation and movement. They must be supported in using all of their senses to learn about the world around them and to make connections between new information and what they already know. They must be supported in developing an understanding of the importance of physical activity and making healthy choices in relation to food. A child’s physical development may have an impact on their self-confidence as they grow older, if a child is unhappy with their appearance e. g. oung girls may feel their friends are physically developing at a faster rate to what they are, this may affect their social development and maybe even intellectual, when a child loses self-confidence they may become distracted in lessons and therefore fall behind in their school work. On the other hand if a child or young person is very physical and active and lives a healthy lifestyle, it is proven that this improves concentration, better sleep and a healthier life in general. This will impact on a child or young person’s intellectual development as they will be more alert and ready to learn, physical activity is also likely to encourage social and emotional development as schools will provide sports clubs and after school activities, giving children and young people the opportunity to socialise and progress in self-esteem. For a child to understand the world, he/she will understand that people have different beliefs, colour skin and religion, the world and technology. A child will also learn other children’s names, talk about family and friends. This has a huge impact on a child’s social development; they will have awareness of the world and the people around them, and therefore are able to confidently make new friends as they go through transitions such as moving schools. It is important that children and young people are given the opportunity to speak about themselves, their lives at home and also listen to others, and this gives them a perspective on the fact that everybody does different things, others’ lives differ to theirs and this is something that needs to be recognised and respected and not judged. Expressive arts and design means a child or young person making new things, designing and inventing a piece of art that is unique to them and their style, using a variety of materials and equipment. It is important to introduce this at a young age, not only does this encourage a child to express themselves creatively but also contributes to physical, intellectual, social and emotional development. Creativity relates to physical development from a young age as the movements required to make marks such as brush strokes improves both fine and gross motor skills, feet painting is a great activity to do with children to improve both creative and physical development, you could ask them to hop, skip, jump to make a variety of marks with the paint on their feet, children love doing activities like this as they are free to create whatever they like. You could introduce pattern making to expressive arts and design, progressing the child’s intellectual development; you could do this by providing a range of materials allowing the child to create their own pattern or engaging in the activity with the child engaging in discussion about what pattern they can make or get them to identify a pattern you have made and see if they can make one similar. Some children or young people use expressive art and design as a â€Å"get away† from any stress, they find it relaxing and calming. Personal and emotional development means a child developing skills to be able to make relationships and bonds, having self-confidence and self-awareness, understanding that actions may affect others and be able to learn positive dispositions such as empathy. We can encourage this in setting through â€Å"circle time† allowing children to talk about a topic of their choice, it is also important to discuss things such as disabilities and learning difficulties, so that if there is a child with these things in setting the child’s peers can empathise and help support the child as well as the adults. Personal and emotional development can be affected through a number of ways, one being if a child has a severe disability, they may feel that they are unable to take part in the same activities as their peers or may have a low self-esteem, this is why it important to promote equality, diversity and inclusion in setting it is important to plan activities around children’s needs leaving no child to feel left out. Physical disability often disturbs intellectual development, the reason for this being the main focus would be improving the child’s physical abilities e. g. he child may need to attend physiotherapy or regular hospital appointments, this also results in the child or young person missing a lot of time in school. It is important to focus on more than one area of development; this is why children with physical disabilities may also have a special worker helping them with the school work they have missed, so they do not get too far behind. From working in a childcare setting I have become more aware of how development areas are interdependent and try my best to support children in all areas of learning and development, taking into account any difficulties they have when planning activities.

Abstract and Concrete Nouns Explained

Abstract and Concrete Nouns Explained Abstract and Concrete Nouns Explained Nouns are naming words and an essential part of the English language. They fall into two main categories: concrete and abstract. It is vital to learn how to use both types in your written work, particularly abstract nouns, which can be tricky. This blog post will take a quick and simple look at the basic definitions of these nouns and offer examples to clarify how they should be used. Concrete Nouns Concrete nouns are fairly simple to understand, as they basically refer to things that are solid, like concrete, and that physically exist around us. This means that we can experience concrete nouns through our five senses, in that we can touch, see, smell, taste, and/or hear them. Examples of concrete nouns include: People (man, woman, dentist, proofreader) Animals (dog, cat, bird, bee) Objects (clock, book, computer, pizza) Places and geographical features (mountain, valley, Norwich, France) Abstract Nouns In contrast to concrete nouns, abstract nouns name things that do not exist physically, such as thoughts, ideas or concepts. They are therefore used to denote things that we cant see, smell, taste, and/or hear. Examples of abstract nouns include: Qualities and characteristics (beauty, kindness, wit) Emotions and states of mind (love, happiness, anger) Concepts and ideas (justice, freedom, truth) Events and processes (progress, Thursday, Christmas) If youre still unsure about the difference between concrete and abstract nouns, let the experts at Proofed help you with your noun usage today!

Exhibition Report essays

Performance/Exhibition Report essays For the final exhibition report I went to The National Shrine: Grotto of Lourdes. Being of Catholic religion, I have visited this area before. This is a spectacular exhibit that was a real delight. It's a serene walk in the woods passed several statues, markers, shrines, etc. There are stations of the cross and many biblical sayings. There are benches where you can stop to pray or meditate. It's very low-keyed. . There's a chapel which holds different services at various times. With the surrounding woods, it was nice to move at your own pace. Others passed by but they were very quiet and respectful. I would recommend to anyone wanted to lift their spiritual side. The Grotto has been established in Emmitsburg in 1805. In the year 1728, a group of Catholics left St. Marys City in Maryland, and traveled westward seeking peace and religious freedom. After the Revolution and the constitutional grant of religious freedom, Father John Dubois, a refugee priest from France, came to this area. This priest, who later became Bishop of New York, was appointed pastor of Frederick in 1794. On St. Mary's Mount he built, St. Mary's Church at the site of the present Grotto parking lot. For over a century this church was a beacon calling the faithful to Mass from the Valley and a reminder to them to keep the Faith. Numerous paths, traceable to this day and all converging on the church, show with what fidelity the Catholics practiced their faith. Along with wooded areas engraved with pathways to view biblical messages, there are churches located here. I entered the Chapel of Mary on the hill, and was astonished by its beauty. The smell of cedar and rose filled the air as I sat in one the pews. Candles burned and illuminated the ceiling and the cross that stood at the front of the church. The scene was majestic and alluring. The art works on the walls are all religious and sentimental. All the religious artifacts here are bright and descriptive. ...