Discussion Forum Post Essay Example | Topics and Well Written Essays - 250 words - 5

Discussion Forum Post - Essay Example The way to accomplish the task was through advocacy for change, coercion by war or military and negotiation of treaties. The central aspect to unify the German states involved appealing for one language and culture. In addition, the German leaders had a romantic assertion that the culture, language and mind of the Germans were unique and superior to others. The achievement of this unity utilized the romantic aspects to preserve the traditional culture and leadership of Germany. Beethoven’s music (Ninth Symphony) maintained a traditional form of classic music and influences of enlightening the audience. Furthermore, the Beethoven’s music reflected the traditions, values and the historical background of the Germans. Moreover, Savage (2) indicates that Bismarck and King William I adopted the unique aspects in Beethoven’s ninth symphony to create a unique German nationalism. The aspects in Beethoven’s music that reflect the German culture include the classic, unique thematic movements. The movements stand independently yet Beethoven designed the music to deliver a uniform message. The other aspect in the music involves the romantic style of influencing the audience to maintain one culture. Furthermore, the themes in the music reflected the unity of the German people (Savage

Poverty in America Essay Example for Free

Poverty in America Essay Poverty is a disturbing but significant global concern. Just as it is for millions of other people all over the globe, poverty is occurring in America. Over the past decades, income disparity is ascending, in addition to the number of communities that failed to keep up with the national economic standard. Although poverty is present everywhere, it is more serious in developing countries, wherein one in every five person lives on not more than $1 for each day, which is the threshold being applied by the World Bank to classify poverty. The unrelenting problem of poverty is a multifaceted one that embraces individuals and communities who, without their fault, find themselves powerless to manage in this information-intensive and constantly developing world. For the majority Americans, poverty implies destitution, or the lack of ability to provide the family with reasonable shelter, clothing, and nutritious food. Despite the fact that material destitution does exist in America, it is relatively confined in severity and scope. To be aware of poverty in America, it is necessary to observe several statistics, as well as to observe the actual living conditions of the persons that are considered poor by the government. Overview of Poverty in America A large numbers of the country’s population live at or below the threshold of poverty, which means payment of bills every month and financing for the essentials, consisting of shelter, clothing, and food, not counting access to health care and a number of simple comforts is a constant struggle. According to estimates in 2003, roughly 25 percent of counties in the United States had low rates of workforce participation, soaring rates of unemployment, high reliance on government transfer expenditures, and incomes that is lower than one-half of the national average or less for each person. The Census Bureau classifies poverty as a family of three earning not more than $14,680, and not more than $9,393 for a worker without any dependent (Blanco, 2004). According to the 2003 statistics of the Census Bureau, almost 36 million Americans lived in poverty, which is 1.3 million more in 2002. Since 2000, the country has experienced an increase of 4.4 million people who lives in poverty (Blanco, 2004). According to a survey, the present American families are experiencing worse living conditions than they have in the previous years, as 10 percent of all families or approximately 7.6 million families in 2003 lived in poverty, which is an enormous ascend from the previous years (Blanco, 2004). In 2005, the registration of the United States Census Bureau of poor individuals in the country totaled to approximately 37 million poor Americans (Rector Johnson, 2004). Therefore, there is one in every eight Americans that is struggling with inconceivable poverty. These millions of Americans are asserted to be deficient of the necessary clothing, shelter, and enough money for the food, as well as being forced to live in unpleasant conditions (Rector Johnson, 2004). Common Factors of Poverty In the concluding half of the 20th century, the three factors that are generally offered to explain movements of poverty in the United States are changes in family structure, economic inequality, and income growth. If the average per-capita incomes are increased, such as increasing wages and employment, then it is expected that poverty will generally decline. Nevertheless, economic inequality can take the edge off the overall constructive impact of income growth if lower-income workforce and unemployed citizens do not benefit from the fruits of such development. On the other hand, changes in the family structure, primarily the ever-increasing number of families headed by female may be linked with higher rates of poverty for the reason that such families are more expected to be poor and are more economically vulnerable. I. Economic Equality Certainly, the country has made several enhancements over the intervening decades in terms of the overall minimum living standard as measured through material conditions. Yet the living conditions of the poor individuals are severely different from that of families and individuals who take advantage of various degree of economic security as measured through income levels that provide unstressed and comfortable situations. The escalation in the number of poor individuals and families in the country ought to provide the government various apprehension, but even more upsetting is the increasing difference between the underprivileged and wealthy in America. In the previous decades, compensation for more affluent Americans has considerably ascended, stimulated by increase in stock options, bonuses, salaries and other rewards. However, the compensation provided for millions of lower-wage workforces dropped off; and in fact, a number of them have even lost their jobs (Blanco, 2004). Therefore, this factor has prevented the advantages of economic growth from being equally drawn out. Moreover, in 2005, non-Hispanic white men, not less than 25 years of age, holding only high-school qualification have $35,679 median income; whereas women within the same age group, need a degree in college in order to obtain a comparable median income (Spriggs, 2007). The outcome is that the households headed by female are harmed by the major earnings gap, which has a poverty rate of 31.1 percent in contrast to their male-headed household counterparts, which only had a 13.4 percent poverty rate (Spriggs, 2007). In 2005, poverty for women is excessively elevated than men, which is14.1 percent in contrast to 11.1 (Spriggs, 2007). The disparity reflects unrelenting gaps in earnings between male and female workers. At the same time, since 1959 the median income of white males with a family of five has been higher than the poverty line, but for women with a family of three, it was only in 1990 that their median income broke beyond the poverty line (Spriggs, 2007). Further, notwithstanding the progressive structure of benefit procedure in Social Security benefits, the constant gap is best reflected in disparities in poverty among the elderly, where the lifetime earnings of women suggest they have lower assets than men. II. Family Structure Higher rates of poverty among women have generally been contributed to the changes in family structure. The percentage of families headed by single female with children rapidly rose over the previous decades of the 20th century, which reached 26.5 percent in 1995 from only 11.5 percent of all families with children in 1970; with higher rates for Hispanics and blacks. At the start of year 2003, roughly 26.1 percent of the entire families with children in the country were headed by single woman. A number of such families do not obtain any or adequate child support from the absent fathers of the children. It is suggested in one study that if fathers married the destitute mothers of their children, approximately three-quarters of the single-parents would instantly be elevated outside poverty status (Rector Johnson, 2004). Obviously, two parents in a household generally earn more than single-parent. The burden of receiving enough income to raise dependent children outside poverty additionally confronts women who are the single head of the family, as well as getting and paying for child care concurrently with their work and management of the household without help. Since this hazard confronted by women of serving non-working dependents as well as their efforts in looking after their elderly parents is not distributed by society, women who head such families are expected to obtain lower levels of education, therefore, resulting to their lower earnings. Aside from the fact that women are more expected to earn significantly less than men with similar qualifications, mothers have a tendency to accumulate less experience than other workers. III. Income Growth Poverty is associated with the lack of sufficient income, so the core problem therefore is the compensation for the workers. Among the poor, only 11.4 percent or 2.9 million jobs around the clock is available for the whole year (Spriggs, 2007). This sector of the population is further directly impaired by minimum-wage laws that have hindered costs of living. This setback is particularly severe for poverty stricken American-Hispanics and American-Asians, where 18 percent of them worked year-round for full time (Spriggs, 2007). There are several reasons why numerous people lack the income to overcome poverty. For instance, people do not work or if they work, they do not earn sufficient amount of money. Whether in good or bad economic times, the ordinary poor family with children exerts only 800 hours of work throughout a year or 16 hours of work for each week (Rector Johnson, 2004). Evidently, almost 75 percent of poor children would be lifted outside certified poverty status if work is provided in every family, that would increase the work hours to 2,000 for every year or comparable to 40 hours for each week all through the year (Rector Johnson, 2004). In 2005, approximately 61 percent underprivileged families have no less than one worker; and of twice-poor families, 71 percent have no less than one worker. In view of the 1990s record job creation, the number of poor but working people declined to 8.5 million in 2000 from 10.1 million in 1993. In short, America is capable of dealing with poverty. But there have been vast stubborn concerns that have lodged the face of poverty. Mounting disparity in the labor market has increased the share of the working age poor citizens, and the unsympathetic federal minimum-wage laws that have amplified the numbers of poor people working year-round for full-time. In a country with a per capita Gross Domestic Product is exceeding the poverty line for a family of four, it is atrocious that there are still more than 12 million poverty stricken American children, and nearly 3 million people work around the clock, for one whole year who are still finding it hard to make ends meet. Facts Concerning the American Poor Sector Based on the American’s accepted definition of poverty, only a small number of the 37 million individuals fit the poor description, contrary to what the Census Bureau classified. Despite the fact that real material destitution undoubtedly does take place, it is limited in severity and scope. A number of America’s underprivileged lives in material conditions that would be considered as well-off or comfortable some generations ago. The following are information obtained from different government reports regarding people classified as poor by the Census Bureau: 1. Roughly 46 percent of the entire poor households actually own their individual houses (Rector Johnson, 2004). The typical house owned by persons identified as poor by the Census Bureau is a three-bedroom house with a garage, one-and-a-half baths, with at least a patio or porch. 2. About 76 percent of underprivileged families have air conditioning in their houses (Rector Johnson, 2004). By comparison, merely 36 percent of the entire population of the United States benefited from air conditioning 3 decades ago. 3. Only 6 percent of the underprivileged families are considered overcrowded, and not less than two-thirds of them have extra two rooms for every person (Rector Johnson, 2004). 4. The typical poor American has more living space than the average individual living in Athens, Vienna, London, Paris, and other cities all over Europe (Rector Johnson, 2004). 5. Practically three-quarters of poor families own an automobile, while 30 percent own at least two automobiles (Rector Johnson, 2004). 6. Approximately 97 percent of poor households own at least one colored television, while half of the said percentage has at least two colored televisions (Rector Johnson, 2004). 7. Roughly 78 percent own DVD or VCR players, while 62 percent have satellite or cable television reception (Rector Johnson, 2004). 8. Around 73 percent of the poor households have microwave ovens, one-third owns an automatic dishwasher, and over half own a stereo system (Rector Johnson, 2004). Further, as a group, America’s poor are far from being constantly malnourished. In fact poor children have usual protein intakes of 100 percent beyond the medically suggested levels and consume more meat than children of higher-income do (Rector Johnson, 2004). Nevertheless, despite the fact that in general the poor are well-nourished, there are still several poor families who experience short-term distress due to food deficiencies. According to the United States Department of Agriculture, although most of the time the hunger is temporary, still 2.6 percent of poor children and 13 percent of poor families experience food shortage sometime during the year (Rector Johnson, 2004). Approximately 89 percent of the poor account sufficient food to eat to their families, at the same time only 2 percent says they often do not have adequate food to eat (Rector Johnson, 2004). Conclusion / Recommendations Following the United States government classification of poverty, the typical poor American people have a living standard far superior as compared to what the public envisions. Nevertheless, the typical poor person’s living conditions should not be taken to suggest that every poor American lives devoid of hardship. Millions of Americans are still continually struggling to hang on, making tough choices between housing, hunger and health care for their families. Economic inequality, income growth, and changes in family structure without doubt affected poverty trends over the latter half of the 20th century. Poverty in America can be readily reduced, if parents are provided with sufficient hours of work and if fathers are at all times present with their families. Although marriage and work are unyielding ladders away from poverty, the country’s welfare system uncooperatively continues to be unsympathetic to both. Foremost programs such as Medicaid, public housing, and food stamps keep on reprimanding marriage and rewarding idleness. Therefore, if welfare could be turned around to uphold marriage and work, the remaining number of poor family would quickly decrease. Further, as a matter of course, the United States has employed over the years job creation and economic growth to trim down poverty, but at present situation the courses are consequential only to the extent that inequality on wages is reduced. Poor people are generally not victims of themselves, but of appalling economic policies along with obstructions to opportunity. Since work generates income, it is important therefore that the government must provide a great increase in available working hours in different labor sectors for the poor. Along with the work opportunities, it is also important to eliminate economic inequalities based on gender, age, economic status, and many others in order to provide higher wages and higher incomes to the underprivileged sectors of the country. America is a nation with one of the most productive and strongest economies in the world. As such, the country must exert a continuing effort to fully utilize the abundance and therefore eliminate the country ’s alarming poverty rate.

Panayiotopoulos Syndrome in a 3 Year Old Child

Panayiotopoulos Syndrome in a 3 Year Old Child Benign occipital epilepsy of childhood -Panayiotopoulos syndrome- in a 3 year old child Menon Narayanankutty Sunilkumar *, Vadakut Krishnan Parvathy Department of Pediatrics, Amala Institute of Medical Sciences, Amala Nagar, Thrissur-680 555, Kerala, India M N Sunil Kumar V K Parvathy Running title: Panayiotopoulos syndrome in a 3 year old child Manuscript type: Case study * Author for correspondence, Dr. Menon Narayanankutty Sunilkumar ABSTRACT Panayiotopoulos syndrome (PS) is a relatively frequent and benign epileptic syndrome seen in children in the age group of 3-6 years and is characterised by predominantly autonomic symptoms and/or simple motor focal seizures followed or not by impairment of consciousness. Although multifocal spikes with high amplitude sharp-slow wave complexes at various locations can be present in the EEG, interictal electroencephalogram (EEG) in children with this particular type of epilepsy characteristically shows occipital spikes. This syndrome has known to be a masquerader and can imitate gastroenteritis, encephalitis, syncope, migraine, sleep disorders or metabolic diseases. In the absence of thorough knowledge of types of benign epilepsy syndromes and their various clinical presentations, epilepsy such as PS can be easily missed. The peculiar aspects of this type of epilepsy in children should be known not only by paediatricians but also by general doctors because a correct diagnosis would avo id aggressive interventions and concerns on account of its benign outcome. In this case study, we report a case of PS in a 3 year old child. Keywords: Benign occipital epilepsy, Panayiotopoulos syndrome, Autonomic symptoms, Emesis, EEG I NTRO DUCTION The International League Against Epilepsy in their expert consensus has given due importance for the various benign childhood seizures which have good prognosis.1 PS is a common idiopathic childhood-specific seizure disorder formally recognized by the league and is included in the category of benign epilepsy syndromes and is recognized worldwide for its autonomic presentations.2,3 This early-onset benign childhood seizures was described by Panayiotopoulos.4 . It has been defined by Panayiotopoulos as consisting of brief, infrequent attacks or prolonged status epilepticus and characterized by ictal deviation of the eyes and/or head and vomiting, occurring in children usually between the ages of 3 and 7 years.5 Seizures are usually followed by postictal headache and are often associated with interictal occipital rhythmic paroxysmal EEG activity that appears only after eye closure.5 The PS has excellent prognosis and parents can be definitely reassured about its benign course 4,6,7,8,9. The risk of developing seizure disorder in later life is negligible 6. Detection of occipital epilepsy at very early stage is needed to successfully treat this condition and allay the fears of the parents and care givers of these children with PS.In this case report, we discuss about the occipital epilepsy in a 3 year old girl child. CASE REPORT A 3-year-old girl, only sibling from a poor socioeconomic family of a non-consanguineous couple, presented in the Out-patient Department of Paediatrics, Amala Institute of Medical Sciences, Thrissur, Kerala, with complaints of becoming limp after sudden episode of vomiting, followed by uprolling of eyes, stiffening of the both upper limbs and lower limbs and a brief period of drowsiness.The child was happily playing in the house about half an hour back.There was no associated fever,trauma,ear discharge ,no common paediatric illnesses like diarrhea,dysuria,cough,running nose,wheezing,throat pain. A detailed history was taken. The child was born of a non-consanguinous parents,fullterm normal vaginal delivery,with a birth weight of 2.215 kg. She was immunized to date and had normal milestones of development.The history revealed that she had similar episodes of vomiting especially getting up from sleep and having deviation of eyes to one side,becoming limp and followed by drowsiness for few minutes in the past from the age of 1 Â ½ years old. Overall she had 5-6 such episodes and 3 times she had these episodes when she was sleeping.There was no associated fever during these episodes. Two times she had stiffening of all the limbs with deviation of eyes to one side,and followed by drowsiness. There was no focal type of seizures in this child. The parents attributed these to indigestion and gave home remedies as always there was vomiting and tiredness following the episodes.The child then used to play around normally. One month back the child was seen by a local doctor who advised EEG and it was done which was reported as normal and parents were advised follow up. The child on admission was tired, but was conscious. On examination,she was afebrile,signs of meningeal irritation were absent, central nervous system examination was normal,neurocutaneous markers were absent,fundus examination was normal. Other systemic examinations were normal.Laboratory investigations showed hemoglobin (11.7 g/dl) with low indices, total leucocyte count (11,550/cumm), neutrophils (75%), lymphocytes (22%), platelets (210000/Â µl), ESR (35mm at1 hr),serum calcium(10 mg%),SGPT(28mg/dl),serum electrolytes levels were normal.EEG was done(Figure- 1A and B) and reported as symmetrically distributed normal sleep activities,with activation of rare sharp wave discharges arising from the left occipital region.An awake record could not be obtained. The diagnosis of PS was made based on the clinical history and EEG which showed the predominantly occipital spikes. She was started on carbamazepine with increasing the dose schedule to her required weight. The child did not have any allergic reaction to the drug and did not progress autonomic instability. She and her parents were given excellent emotional and pschycological supportive care, After completion of 5 days of observation for her symptoms and any allergy to the she was discharged on day 6 with improvement in clinical conditions on multivitamins, hematinics and deworming drugs with an advice to follow-up . DISCUSSION PS described by Panayiotopoulos4 is a common autonomic childhood epileptic syndrome with a significant clinical, pathophysiological characteristics and is multifocal.10 PS is now formally recognized as a distinct clinical entity within the spectrum of benign focal epilepsies of childhood.11 PS affects 13% of children aged 3 to 6 years who have had 1 or more afebrile seizures and 6% of such children are in the 1- to 15-year age group.6,7,12. Autonomic epileptic seizures and autonomic status epilepticus are the cardinal manifestations of Panayiotopoulos syndrome.12. The main aspect of PS is that irrespective of their location at onset, there is activation of autonomic disturbances and emesis, to which children are particularly vulnerable. These symptoms and pattern of autonomic seizures and autonomic status epilepticus in PS do not occur in adults and are very specific to childhood. 12 PS is often confused with occipital epilepsy and acute non-epileptic disorders such as encephalitis, syncope, cyclic vomiting or atypical migraine even with characteristic clinical and EEG manifestations. 13 The clinical and EEG features of PS is due to a a maturation-related diffuse cortical hyperexcitability 4,6. This diffuse epileptogenicitywhich may be unequally distributed,is predominating in one area of the brain , and is often posterior. The explanation for the characteristic involvement of emetic and the autonomic systems may be attributed to epileptic discharges which are generated at various cortical locations andthis in turn influence the children’s vulnerable emetic centers and the hypothalamus 4,6. The diagnosis is based entirely on clinical presentation and EEG.12 PS has some of the key clinical features which are often present as single, focal seizures with an unusual constellation of autonomic, mainly emetic, symptoms,associated behavioral changes, and sometimes seizure like clinical manifestations such as unilateral deviation of the eyes and convulsions 3,4,7,8,9,13. The emetic triad in PS (nausea,retching, vomiting) culminates in vomiting in 74% of the seizures; in others, only nausea or retching occurs, and in a few, vomiting may not be present. Other autonomic manifestations include pallor, , mydriasis or miosis, flushing or cyanosis thermoregulatory and cardiorespiratory alterations. Frequently incontinence of urine and/or feces, hypersalivation, cephalic sensations, and modifications of intestinal motility are also seen9. Half of the convulsions end with hemiconvulsions or generalized convulsions. Two thirds occur during sleep as was seen in our child for about three times.. Autonomic status epilepticus enveals then.. The seizures usua lly last for 5–15 min, but half of them are prolonged, sometimes for hours, constituting autonomic status epilepticus. The patient recovers within a few hours. even after the most severe seizures episodes and status.12 An electroencephalogram is the only investigation with abnormal results, usually showing multiple spikes in various brain locations.12Multifocal spikes that predominate in the posterior regions characterize the EEG 6.The EEG variability in our child of 3 years is showing the characteristic occipital spikes from the left occipital region. The EEG done 5 months back was normal in our child. PS is the second most frequent benign syndrome of childhood after rolandic epilepsy,which primarily affects 15% of children at a peak onset at age 7–9 years 1. Another epileptic syndrome categorized with PS and rolandic epilepsy is the Gastaut type childhood occipital epilepsy 2, manifesting with frequent and brief visual seizures. However, this is rare,of uncertain prognosis, and markedly different from PS,despite common interictal EEG manifestations of occipital spikes 6.Occipital spikes in non-epileptic children with defective vision, occipital slow spike-and-wave found in some patients wi th the Lennox-Gastaut syndrome, focal epilepsy due to occipital lesions, seizures originating in the temporal lobe secondary to an occipital abnormality, and complicated or basilar migraine must be considered in the differential diagnosis.5 There are typical and atypical case of PS15,17,18 .Lada et al 15 conducted a retrospective study of 43 patients with PS who were seizure free >2 years. In their analysis girls predominated ,as in our child was a girl.. The first seizure was seen in 5 years of age. 86% had emesis as the symptom with the seizures. Seizures during sleep (84%) were more common than those in wakefulness. EEG showed occipital spikes in more than 50% of patients.. Prognosis was excellent and 80% children have been free of seizures for > or =2 years as is in a typical case of PS.15 DeÄÅ ¸erliyurt et al16 did a case series study of patients with PS and postulated that PS is associated with high rates of febrile convulsions, afebrile convulsions/epilepsy, migraine, and breath-holding spells in the patients and families suggested the importance of genetic factors 17.Febrile seizures are to be considered in the differential diagnosis because the recovery of consciousness from seizure is fast and Control of the seizure is paramount. uncomplicated usually.18 Ferrie et al. 17 postulated an atypical evolution of PS in a case report. The management of PS is not complicated. Education and knowledge about PS is the cornerstone of management. Control of the seizure is paramount. Prophylactic treatment with antiepileptic medication may not be needed for most patients. The emphasis is on treatment of possible fever and mainly of the underlying illness.One third (30%) of the seizures are relatively brief and self-limited. They subside spontaneously within 2–10min. The other two thirds (70%) have long-lasting seizures(>10 min) or status epilepticus (>30 min to hours). These should be appropriately and vigorously treated as for status epilepticus19,20. Parents of children with recurrent seizures should be advised to place the child on its side or stomach on a protected surface and administer a preparation of intravenous rectal benzodiazepine (BZD). In an emergency facility, the child’s airway should be kept clear, oxygenation maintained, and intravenous or rectal antiepileptic drug (AED) given to halt the s eizure. A BZD is probably the first choice. The great majority with PS do not need AED treatment even if they have lengthy seizures or have more than two recurrences. There is no increased risk of subsequent epilepsy or neurologic deficit. If a child has multiple recurrences (only about 5% exceed 10 seizures) and if the parents too worried prophylaxis can be given.Continuous prophylaxis consists of daily medication with any AED with proven efficacy in partial seizures.Although there is no evidence of superiority among monotherapy with phenobarbitone, carbamazepine(CBZ), sodium valproate or no treatment in PS, most authors prefer CBZ 14.Our child was started on Oxcarbazepine ,a structural derivative of CBZ with no side effects since last 1 month.Autonomic status epilepticus in the acute stage needs thorough evaluation; aggressive treatment may cause iatrogenic complications including cardiorespiratory arrest.12The adverse reactions of the antiepileptic drugs such as severe allergic r eactions ,abnormal liverfunction tests and idiosyncratic reaction should be kept in mind and monitored.14 The prognosis of PS is excellent 4,6,7-9. The lengthy seizures and status do not have any adverse prognostic significance, and the risk of developing epilepsy in adult life is probably no more than that of the general population 6. One third of patients (27%) have a single seizure only, and another half (47%) have two to five seizures. Only 5% have >10 seizures, but outcome is again favorable. Remission usually occurs within 1 to 2 years from onset.6. CONCLUSION PS is a common cause of epilepsy in children and a knowledgeable doctor does not miss it. Physician education of PS and recent guidelines on epilepsy management is vital in detecting PS at very early stage, so further lifesaving interventions can be done and prevent delay in the trearment administration. Multiple antiepileptic drugs use is required in only in a small proportion of patients. Seizures in PS, like febrile convulsions, despite their excellent prognosis, are a frightening experience for the in experienced parents, who often think that their child is dead or dying. Parents of young children should have general information by the family doctor regarding PS. Parental education and a supportive group comprising the paediatrician, neurologist, nursing staff and the social worker can help and reassure these distort parents as was done in our child who is doing fine with no recurrence in the last 1 month. ACKNOWLEDGEMENT The authors acknowledge the help of Dr Ajith TA, Professor Biochemistry, Amala Institute of Medical Sciences, Amala Nagar, Thrissur, Kerala during the preparation of the manuscript. REFERENCES Commission on Classification and Terminology of the International League Against Epilepsy. Proposal for revised classification of epilepsies and epileptic syndromes. Epilepsia 1989;30:389–99. Engel J Jr. A proposed diagnostic scheme for people with epileptic seizures and with epilepsy: Report of the ILAE Task Force on Classification and Terminology. Epilepsia 2001;42:796–803. Berg AT, Panayiotopoulos CP. Diversity in epilepsy and a newly recognized benign childhood syndrome [Editorial]. Neurology 2000;55:1073–4. Panayiotopoulos CP. Panayiotopoulos syndrome. Lancet 2001;358:68–9. Andermann F, Zifkin B.The benign occipital epilepsies of childhood: an overview of the idiopathic syndromes and of the relationship to migraine. Epilepsia. 1998;39:S9-23. Panayiotopoulos CP. Panayiotopoulos syndrome: a common and benign childhood epileptic syndrome. London: John Libbey, 2002. Panayiotopoulos CP. Vomiting as an ictal manifestation of epileptic seizures and syndromes. J Neurol Neurosurg Psychiatry 1988;51:1448–51. Caraballo R, Cersosimo R, Medina C, et al. Panayiotopoulos-type benign childhood occipital epilepsy: a prospective study. Neurology2000;55:1096–100. Kivity S, Ephraim T, Weitz R, et al. Childhood epilepsy with occipital paroxysms: clinical variants in 134 patients. Epilepsia 2000;41:1522–33. Guerrini R, Pellacani S.Benign childhood focal epilepsies. Epilepsia. 2012;53::9-18. Koutroumanidis M. Panayiotopoulos syndrome: an important electroclinical example of benign childhood system epilepsy. Epilepsia. 2007;48:1044-53. Covanis A. Panayiotopoulos syndrome: a benign childhood autonomic epilepsy frequently imitating encephalitis, syncope, migraine, sleep disorder, or gastroenteritis. Pediatrics. 2006 ;118:e1237-43. Michael M, Tsatsou K, Ferrie CD. Panayiotopoulos syndrome: an important childhood autonomic epilepsy to be differentiated from occipital epilepsy and acute non-epileptic disorders. Brain Dev. 2010;32:4-9. Ferrie CD, Beaumanoir A, Guerrini R, et al. Early-onset benign occipital seizure susceptibility syndrome. Epilepsia 1997;38:285–93. Lada C, Skiadas K, Theodorou V, Loli N, Covanis A.A study of 43 patients with panayiotopoulos syndrome, a common and benign childhood seizure susceptibility. Epilepsia. 2003;44:81-8. DeÄÅ ¸erliyurt A, Teber S, BektaÃ…Å ¸ O, Senkon G. Panayiotopoulos syndrome: A case series from Turkey. Epilepsy Behav. 2014;36:24-32. Ferrie CD, Koutroumanidis M, Rowlinson S, Sanders S, Panayiotopoulos CP.Atypical evolution of Panayiotopoulos syndrome: a case report. Epileptic Disord. 2002;4:35-42. Knudsen FU. Febrile seizures: treatment and prognosis. Epilepsia.2000;41:2–9. American Academy of Pediatrics. Practice parameter: the neurodiagnostic evaluation of the child with a first simple febrile seizure: Provisional Committee on Quality Improvement, Subcommittee on Febrile Seizures. Pediatrics 1996;97:769–72. Mitchell WG. Status epilepticus and acute repetitive seizures in children, adolescents, and young adults: etiology, outcome, and treatment. Epilepsia 1996;37:S74–80. Legend to figures Figure (1A and B): EEG of the child showing the occipital spikes (arrow heads).

Personal Narrative - Knee Injury Essay -- Personal Narrative Essays

Personal Narrative- Knee Injury I was always an active person from being in sports to hanging out with friends. I always had something planned, or came up with something on the fly. My junior year in high school was a very tough time for me. I was involved in a lot of activities, organizations, and clubs. I was very active in one organization where I had to be up at school every morning at 7:15 for that meeting. Meaning I would not leave school sometimes until 6:45 to 7:00 in the evening. On the weekends I would have something to do either with friends or family. I would never go a weekend with nothing to do. Either I was out running errands or at the mall buying some new clothes. The problem came in on November 22, 2000 at an away game at North Side High. It was the third quarter ...

What Does the Concept of Dignity mean to Stevens?

Stevens is a unique character whose life evolves solely around his profession and how he can both maintain his dignity and become recognised through his work. The concept of dignity has ruled his entire life and he believes it his duty to remain dignified in all circumstances in order to be classed as a â€Å"great butler†. His metaphorical journey however reveals that in trying to accomplish this, he has lost the vital element which must be sustained in life, human warmth. Stevens defines dignity as, â€Å"Something one can meaningfully strive for throughout one's career†, compared to Mr Graham's views that â€Å"dignity is something one possesses,† which seems more reasonable from the reader's point of view. The critic Richard Locke asks what dignity there is in not making one's own mistakes and refers to the consequent sorrow and remorse that follows, saying â€Å"such rueful wisdom much be retrospective. † This certainly explains Stevens' unemotional behaviour in his mission to attain dignity because he has since regretted not â€Å"making his own mistakes† and living life to the fullest. Instead, he delicately portrays his Father's views, who was â€Å"indeed the embodiment of dignity†, because he is not able to conceive his own opinions having followed Lord Darlington's orders all his life. Furthermore, Stevens has incorporated the Hayes Society perspectives of dignity and related them to that of his father stating that he had, â€Å"Dignity in keeping with his position†, again proving that he can not form his own views and has again had to use someone else's. Stevens is so concerned with dignity and yet his misinterpretation of it, together with the emphasis his father put on it, has left him unable to calculate his own ideas on what dignity actually is and has thus naively lead him into an empty life. It is his father's stress on the tiger anecdote that has in my view confused Stevens, the idea being that a butler resorts to dramatic lengths to ensure that â€Å"no discernible traces† of the tiger â€Å"are left†. It is the fact that his father â€Å"knew instinctively that somewhere in this story lay the kernel of what true dignity is,† and Stevens does not, but yet continues to follow his father's perspectives because he considers him a â€Å"great butler†. Everyone is motivated by aspirations to climb higher, and Stevens' ultimate goal is to be acknowledged as a â€Å"great butler†. He feels he comes significantly closer to his quest at a conference Lord Darlington, holds for the most important delegates in Europe. At the conference he believes that he is heavily relied upon to oil the friction between the delegates from different countries by ensuring that the guests have nothing whatsoever to complain about. Whilst the delegates attend these various conferences, Stevens' father is very ill, however Stevens is more willing to return to work than attend to his sick father who is the only family Stevens has left. There has always been a cold relationship between the two, both of them only conversing over professional issues, and Stevens respects his father not for being a good father but a good butler. As Stevens is devoid of sentiment he can only judge others based on their dignity and we see how important Stevens' views on dignity are because it defies how he interacts and relates with others. Not only does he describes his father as â€Å"dark and severe†, which is dignity personified, he refers to him in the third person, â€Å"I hope father is feeling better now. † His lack of emotion proves to the reader how empty Stevens is, and in order for him to fill this emptiness, Stevens primarily concerns himself with dignity. Despite his father always being detached, he ironically asks, â€Å"Have I been a good father? † However, Stevens coldly dismisses his gesture, and in doing this, he loses any chance of a positive relationship with his remaining family. Furthermore, it is his arrogant ignoring of Mr Cardinal who tells him of Lord Darlington's wrong attitude to the Nazis and of Miss Kenton's attempts to give him one last chance to propose, that severely damaged his chances of becoming a â€Å"great person† and hence a â€Å"great butler†. However, he ironically recalls this experience with â€Å"a large sense of â€Å"triumph†, and consequently dismisses any hope of happiness as he is prepared to place professionalism before relationships. Stevens is also unable to communicate to the reader his true intentions for undertaking the excursion, stating that he wishes to improve the current â€Å"staff plan† however the reader perceives that he wants to visit Miss Kenton, and hence becomes â€Å"an unreliable narrator†, always placing a professional spin on everything. He believes that he is respected for his dignity, and thus judges others on how dignified they are. Dignity means everything to Stevens, it being all he has and hence his profession becomes his life, unable to even call holiday clothes by their true name but instead a â€Å"costume. † A costume implies a disguise worn to hide the true person underneath thus stating that Stevens is not the person to undertake holidays as it distracts him from his work. Another significant point demonstrating Stevens' unreliability is his relationship with former employer Lord Darlington. Everyone must feel good about themselves in order to remain optimistic in life and Stevens accomplishes this by feeling good about being a good butler working for a good master. Despite dedicating the best years of his life to Lord Darlington, Stevens is then quick to deny any knowledge of his former employer once we hear of his connections with the Nazis in World War Two. At Mortimers Pond significantly halfway through the novel, another butler of a lesser stature than himself attends to his car and he asks if he actually worked for Lord Darlington, to which Stevens replies, â€Å"Oh no, I am employed by Mr John Farraday. † Stevens is deliberately misleading about his past relationship with Lord Darlington because of his associations with the Nazis, as the truth would have severely damaged his self-esteem. However, the reader is first given a hint of Stevens' unreliability through his deliberate changing of his mind and misinterpretation of events which have occurred. Stevens corrects himself when he recalls passing Miss Kenton's room and originally believes that she is crying, however on reflection he realises that it is not due to the untimely death of her Aunt, but her acceptance to marry Mr Benn, and that her efforts to provoke him into action had gone unnoticed. Miss Kenton asks him â€Å"Do you want me to stay†, giving Stevens the opportunity to react and tell her how he feels, however he ignores these blatant signs and continues to neglect the forming of relationships in order to protect his reputation. The reality is that he changed his mind about these events in order to shield himself from the painful truth that he is destined to spend the rest of his life alone because he chose dignity above warmth. Everything Stevens encounters on his excursion, he relates to his profession. He travels to Mursden, not as a tourist, but an admirer of the famous silver polish, and naively believes that using this has had positive repercussions all over Europe. However, Stevens has again attempted to selfishly pass something off as his own, so that he can feel good and important, helping him to fill the emptiness left from a lack of human warmth and intimacy. Despite Stevens' clear longing for a close relationship with anyone, he still feels the urge to place his pride above what really matters. At Mortimer's Pond, he refuses to walk around it for fear of dirtying his shoes because no self-respecting butler would allow that to happen and says, â€Å"My footwear is not such as to permit me easily to walk around the perimeter. † Stevens gullibly believes that others really care about how he looks and acts, and he must therefore strive to create a good impression and remain dignified. He sadly also realises that in order to qualify as a â€Å"great butler†, he had to work for an employer of proven â€Å"moral worth†, yet he has just disowned any knowledge of working for Lord Darlington when quizzed about it earlier. Realistically, Stevens is living in the past and refuses to change his ways because they have brought him his dignity, and his archaic, well structured English clarifies the fact that he has learnt his English from historical, classical books and not social context or conversations. The mere fact Stevens lives in the past is saddening as life should be full of new experiences, but instead he effectively shields himself behind his profession and exploits it as an excuse to visit new places. His old-fashioned lifestyle furthermore forbids him to look symbolically beyond the surface at Mortimer's pond and delve underneath to find the truth, and only when he meets Miss Kenton is he forced to change his perspectives and views on life. His relationship with Miss Kenton has allowed him to modernise his views as he would before judge people on the surface and converse with them on purely professional terms. Although his liaison with Miss Kenton has not altered his perceptions on dignity, he has become aware that there is perhaps more to life than work Although the reader may sympathise with Stevens and respect him, his pitiful behaviour is also both extremely noticeable and frustrating. In the unfortunate incident concerning the dismissing of the two Jewish maids, Stevens will not admit that he did not stand up for something he knew was wrong. He says, â€Å"We must not let sentiment creep into our judgement†, but ironically it is his higher regard for dignity which has ensured that he avoids sentiment throughout his entire life, and once again the reader becomes aware of Stevens' outdated response because he is prepared to place dignity above what is right. Furthermore, he ironically says that dignity is â€Å"not removing one's clothing in public†. Whether he is attempting to banter is left deliberately ambiguous, however what he says is ironic to the reader because he does not remove his clothes in private and maintains his professional persona even in his social life. To remove clothing suggests relaxation and freedom, a characteristic the reader never associates with Stevens because of his overwhelming obsession with dignity which has cost him so much. Stevens views dignity as a key to success, living his whole life by it and striving to remain dignified in every single possible circumstance he is subjected to. In his fixation with dignity, he has ultimately committed the deadly sin of pride and has thus condemned himself to a life of emptiness. He is deliberately aiming to aspire to the stature of his father, Stevens believing that he achieved so much acclaim through his dignified manner. However, at the end of the novel, it is left ambiguous whether he will strive to maintain his dignity or seek to change his ways and become more intimate and emotional with people when he discovers that â€Å"bantering is the key to human warmth. â€Å"

Anti Discrimination Essay

Anti-discrimination occurs when a person is treated less preferred than others because of their age, gender, ethnicity, disability or religion. Anti-discrimination also refers to the law on the right of people to be treated equally. Three anti-discrimination laws include: Racial Discrimination Act 1975 Anti-Discrimination Act 1977 Disability Discrimination Act 1992 The Anti-Discrimination Act 1977 is an Act relating to discrimination in employment, the public education system, delivery of goods and services, and other services such as banking, health care, property and night clubs. The Act helps unlawful racial, sexual and other types of discrimination in certain circumstances and promotes equality of opportunity for all people. The Act was granted Royal Assent on 28 April 1977 and came into effect on 1 June 1977. It was the 48th Act of 1977. Since then the Act has been amended and reformed about 90 times Racial Discrimination happens when someone is treated less fairly than someone else in a similar situation because of their race, colour, descent or national or ethnic origin. Racial discrimination can also happen when a policy or rule appears to treat everyone in the same way but actually has an unfair effect on more people of a particular race, colour, descent or national or ethnic origin than others. Since the Act was passed in 1975, over 10,500 complaints have been received. The power of the national Parliament to pass this over-riding law arises under the â€Å"external affairs† power contained in the Australian Constitution. The power arose from the International Convention on the Elimination of all Forms of Racial Discrimination to which Australia is a treaty. This use of the power in this manner was confirmed in the landmark High Court decision in 1982. Disability Discrimination is when people with disabilities face huge social barriers at jobs, education and access to government. Disabilities also increase the chance of violence and other extreme forms of discrimination,  as well as banished from family and institutionalization. In the 1960s and 1970s, young activists and scholars organized a disability rights movement to improve the quality of life for people with disabilities, modeled after other civil rights movements. In general, the legal rights and responsibilities of employees in relation with anti-discrimination may include that you have the same right to training, promotion and work benefits as other employees e.g. if you have a disability, employers must provide you with any special facilities or services you need to access training, promotion or work benefits, as long as this won’t cause them unjustifiable hardship. You generally have the right to stay on in your job if you have a disability, or you acquire a di sability after you begin the job. An employer can only dismiss you, medically retire you or make you redundant because of your disability. As when you apply for a job, your employer must provide any special facilities or services you need to continue to do your job, as long as this won’t cause them unjustifiable hardship. If there are non-essential parts of your job that you can’t do, your employer must make arrangements to cover these in some other way. As for Race Discrimination you have the right to report any incidents if a person has harassed/bullied you this might include: your race, color, nationality, descent, ethnic or ethno-religious background of any of your relatives, friends, associates or work colleagues. If this does occur these penalties can be brought up to court for a trial. Problems faced by people affected by Anti-Discrimination might include African Americans who are called names who are harshly abused and harassed because of their race and their skin colour. All over the world, as a society we have been unable to accept being classified under one label. Our place as a racial state has changed throughout history, but still remains a mix of two ideas, racial dictatorship and racial hegemony, working to becoming a racial democracy. In the beginning, and for most of its history, from 1607 to 1865, most non-whites were firmly eliminated from politics. The racial dictatorship organized the â€Å"color line† rendering it the fundamental division in society. These â€Å"color lines† seem to be most prevalent in institutions where the color of your skin determined where you lived, what school you attended, and where you sat in restaurants and public transportation. It took real people from different cultures and grouped them into one generalized category. Instead of being labeled as your country of origin or where you lived, like (Americans) or (Africans), they were simply labeled black, therefore making them seem inferior to the dominant race. By grouping them into one category of little meaning, it takes away from their individuality and culture. The dominant group, in this case the United States, survives by a mixture of forcing and giving permission. For instance, blacks were given the right to education, however the level of education received by blacks compared to whites is different. Far more white people attend higher education institutions as opposed to blacks. Of all the students enrolled in higher education institutions, 70 percent of them were white while the remaining 30 percent of students. There is a large disparity in these numbers, however compared to a couple of decades ago, minorities, especially blacks, weren’t even allowed to attend school. Minorities’ attendance is even on the increase while white a ttendance in higher education is decreasing. Between 1991 and 1995, while the white enrollment was decreasing the black enrollment was increased by 9 percent. In the past the minority population made significantly less than the dominant race, and unfortunately it is still that way. While the gap is closing in disparity, there is still a huge jump in the earning of whites compared to those of blacks. Between 1980 and 1984, white men aged 18-64 made and hourly wage of $2.10 while there black counterparts only made an hourly wage of $1.86. (These men were performing similar jobs and yet the white male still made more earning than the black male. What also helped to close the gap was the black race was becoming educated and therefore more skilled. They were able to attend school now and become knowledgably in their skills and therefore make more money. These statistics should help to show that while racial disparity still exists, our dictatorship still exists but not as openly as in the past. For instance, real estate agents are more likely to point a white couple in the direction of white neighborhoods and a black couple in the direction of a black neighborhood. While helping them both equally, they are dictating where the couple’s should end up. Until politics serves the people and not the politician’s motives, we will never reach a racial democracy. As long as people are still saying discrimination, we will never reach a racial democracy. These problems were resolved since the Act was passed in 1975; over 10,500 complaints have been received. The power of the national  Parliament to pass this over-riding law arises under the â€Å"external affairs† power contained in the Australian Constitution. The power arose from the International Convention on the Elimination of all Forms of Racial Discrimination to which Australia is a treaty. This use of the power in this manner was confirmed in the landmark High Court decision in 1982. The Civil rights act 1964 was enacted to ensure that people in protected classes were not treated differently when it came to employment decisions, such as hiring, promotions and termination. Companies had policies that openly discriminated against employees for reasons, such as color or sex that were not related to the quality of job performance. In order to make the workplace equitable in its treatment of all employees, the government made it illegal to consider the protected classes in work-related decisions. The Equal Employment Opportunity Commission (EEOC) received more than 93,000 complaints of discrimination in fiscal year 2009. An employer may not intend to treat employees differently, but an employee behavior may have the impact of discrimination. For example, someone telling a sexually laced joke may not intend to harass an employee, but the impact of the conversation may have led to a hostile work environment. Employees who experience discrimination in the workplace may suffer from low morale, which directly impacts work performance. If employees do not feel valued for the work that they do, then they will not be motivated to continue to perform at a satisfactory or above satisfactory level. These employees may be more likely to seek jobs in other companies or to file discrimination complaints with the Equal Employment Opportunity Commission. Although the EEOC filled just over 300 lawsuits out of the 93,000 complaints it received in 2009, the time and money used to respond to complaints may impact the company’s profits. Also, a complainant may receive a â€Å"right to sue† letter from the EEOC. This gives the employee the ability to sue in court for discrimination, whether the charges are true or false. Again, the expense to a company may be greater than if it had implemented policies and workplace behavior expectations that would give everyone a clear mind on what to do and what not to do. Having a policy that forbids harassing  behaviors by employees shows that the company is proactive in protecting the rights of all employees. Disciplining or firing employees or members of management who have been proven to act in a discriminatory manner is a good defense against a claim of disparate treatment. This could help the company avoiding the expense and bad publicity which could be a great help at the end. Anti-Discrimination helps a lot of people around the people not only from work; it helps people from schools, shows and movies. It gives everyone a equal fairness on how they should get treated, and this why I think anti-discrimination is a great solution to make a world a better place. Bibliography www.antidiscrimination.gov.au www.wikipedia.org www.antidiscrimination.lawlink.nsw.gov.au www.humanrights.gov.au www.antidiscrimination.tas.gov.au/ www.ag.gov.au www.lawcouncil.asn.au www.adcq.qld.gov.au www.adc.nt.gov.au www.usq.edu.au www.thefreedictionary.com www.dictionary.com www.business.gov.au