Effective Images of People and Places Created by Dickens

Effective Images of People and Places Created by Dickens Charles John Huffam Dickens was born on February 7, 1812 in Portsmouth. Dickens childhood was not particularly happy one, and many of the events he endured and people he met inspired his books. The second child of a clerk in the navy pay-office, Dickens moved to London with his family when he was two years old. His father was often in debt, and finally in 1824 was sent to debtors prison with the rest of the family in Marshalsea. Dickens, on the other hand was put o work at a shoe-blacking warehouse. Memories of this time haunted him for the rest of his life. Despite the fact his parents failed to educate him, Dickens worked hard to†¦show more content†¦Dickens was very interested in bringing about change and his novels deal with such topics as justice and punishment, the harsh treatment of children and the evils of the factory system. He was an ardent campaigner against public executions, using his fame and influence to bring the horrors of the situation to light. Social change did occur during the lifetime of Charles Dickens. Hew laws were passed to lessen the hours endured by factory workers; young children were prevented from working in factories altogether and The Public Health Act of 1848 made the first step towards improved sanitation and public health. Great Expectations is set slightly before Charles Dickens lived. The first chapter of Great Expectations takes place in a graveyard. A young boy, Pip is observing his dead familys coffins. He is an orphan and lives with his grown-up sister. He is lonely, he never saw (his) father or (his) mother, and never saw any likeness of either of them. and he recalls that, when he was young he used to imagine what they looked like from the appearance of the lettering on their tombstones. The shape of the letters on (his) fathers gave (him) an odd idea that he was a square,stout, dark man, with curly black hair. And he drew a childish conclusion that (his) mother was freckled and sickly from the character and turn of theShow MoreRelatedEssay about Suspense and Tension in Charles Dickens The Signalman991 Words   |  4 PagesSuspense and Tension in Charles Dickens The Signalman In the Charles Dickens story the narrator meets the signalman who is confessing to him his problems. The narrator comes every night to find out that the signalman was seeing a ghost of a man, who was pointing out that certain train accidents are going to happen. After a few days the narrator goes peacefully to the signalmans shed, and finds out that he mysteriously died. The signalman at the train stationRead MoreIrony, satire and humour in Oliver Twist1656 Words   |  7 Pages Analysis of Dickens use of irony, satire and humour in Oliver Twist. 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Throughout thisRead MoreThe Historical Context of A Tale of Two Cities2575 Words   |  11 Pages A Tale of Two Cities, by Charles Dickens, is a story set in the year 1775 and through the turbulent time of the French Revolution. It is of people living in love and betrayal, murder and joy, peril and safety, hate and fondness, misery and happiness, gentle actions and ferocious crowds. The novel surrounds a drunken man, Sydney Carton, who performs a heroic deed for his beloved, Lucie Manette, while Monsieur and Madame Defarge, ruthless revolutionaries, seek revenge against the nobles of FranceRead MoreChapter One and Thirty Nine of Great Expectations Essay1814 Words   |  8 Pagesthe convict, with chapter 39, when the convict returns. Charles Dickens is considered to be one of the greatest English novelists of the Victorian period. This greatest of Victorian writers was born in Landport, Portsmouth, on February 7, 1812. 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Feminism Essay - 1112 Words

Feminism In the past and present women have had to endure sexism as a part of everyday life. This is unfair and unjust to the female species. In this paper I am going to be talking about some of the issues of sexism and how they affect women. Some of the issues I will be talking about are the white males club and how non-membership effects women. What are the benefits of having a membership to it. How women are kept in their place by society and by themselves. How has this unequal affected women through their lives and the business world. If women are being liberated or not. What types of problems women are experiencing. These are the issues we will be discussing in this paper. The first issue we will be discussing in this paper is the†¦show more content†¦Susan Faludi states in her article Blame It on Feminism â€Å" Professional women are suffering â€Å"burnout† and succumbing to an â€Å"infertility epidemic.† What does this say about women and their ability to han dle stress not anything good. Should we blame these problems on Feminism? Or should we blame it on women getting power but not as much as men? Susan Faludi also states this† If women are so equal, why do they represent two-thirds of all poor adults.† If women were so equal would all of this be happening? In Society today do men keep women in their place or do women contribute to that. In the article Stoppers: Keeping Women in Their Place Anne Schaef she states† It is very difficult for men to understand how fragile our trust in our perceptions is, how easily we can be talked out of them, and how terrified we are of being labeled sick, bad, crazy, or stupid. The part goes two ways. Women take part in it by not standing their ground because of their self-conciseness about themselves. Men take part in it by making the women fell guilty. Anne Schaef states† Whenever a woman is not fulfilling her prescribed role or doing what is expected if her, she can easily be made to fell guilty. As you can see it’s a two-sided thing if the women could just hold there ground and the men didn’t put guilt trips on them they wouldn’t this problem. The next issue I am going to talk about is why females become feminists. Anna Quindlen states in her article On BeingShow MoreRelatedFeminism : A Studies Of Feminism1559 Words   |  7 PagesFeminism 6 Running Head: PSYCHOLOGY STUDIES:A STUDIES OF FEMINISM PSYCHOLOGY STUDIES: A STUDIES OF FEMINISM CUIYI P. Student Pasadena City College Feminism 1 Psychology Studies: a Studies of Feminism What Does it Means to Run Like a Girl 21th Century Earlier Centuries Feminism became a hot topic in 21th century, but anyone know what is Feminism means? 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Old Male Patient Has Got Admitted In Hospital †Free Samples

Question: Discuss About The Old Male Patient Has Got Admitted In Hospital? Answer: Introducation Mr. Donald John, 81 years old male patient has got admitted in the hospital B side on 10.01.2017 in room no: 261. His feelings, self- esteem and perception level was assessed. He has past history of moderate dementia because of transient ischemic attack and is suspected to have Alzheimers disease since 2014. He also had hyponatraemia secondary to dehydration, low mood, anxiety, hypercholesterolemia, Ischemic heart disease with anterior MI, moderate left anterior descending lesion and stenosis of circumflex. He was an engineer and lives with his wife in his village. During history collection, he was found to have difficulty in expressing emotions and inability to write but has good reading skills. He has feelings of inferiority and is reluctant to interact with others due to his disabilities. He has feelings of unworthiness and lack of meaning for his life. His wife is his full support and his one son and one daughter rarely visits him. Mr. John is diagnosed to have dementia which is a condition in which there can be a gradual deterioration of memory, judgment, language, other cognitive abilities and/or sensorial skills along with orientation to time, place as well as person that declines an individuals ability to participate in daily activities. Dementia develops if any changes or damages occur in the brain (Hinkle, 2014). The important cause of dementia involves brain diseases in whichthe neurons of brain degenerates and destroys quickly as compared to that of normal ageing. Mr. John has Alzheimer's disease(a type of neurodegenerative disorder) which is a type of dementia. It is responsible for 2/3rds of dementia in elderly as in Mr. John. InAlzheimer's disease(AD), the degeneration of brain cells leads to shrinkage of brain especially cerebral cortex, which is the grey matter layer that covers the brain and hypothalamus (Linda, 2011). This grey matter functions in processing of thought as well as many complex bra in functions that includes storing memories, retrieval of memories, mathematics-calculation, spelling the words, planning and organizing. Clumps of abnormal protein fragments (beta-amyloid) called as plaques or twisted protein strands (tau) tangles slowly develops and deposits in the brain, which are responsible for increased loss of brain cells (NHS, 2014). This can cause loss of connection between brain cells and reduce the production of neurotransmitters that are needed to relay impulses from one neuron to another. Moreover, Acetylcholine that is responsible for certain activities that are associated with learning skills, attention abilities and memory capacity (Lewis, 2013, Aminoff, 2016). People having Alzheimers disease can feature with decreased acetylcholine production in the brain along with production of glutamate that is much needed for connecting between brain-neurons are also reduced causing trouble in learning and long-term memory (Jurczak, 2014, NHS, 2015). As dementia progresses, the degeneration of neurons spread affecting the neurons of remaining brain parts. Alzheimers disease, ischemic stroke, low s elf-esteem, reserved personality and cardiac diseases of Mr. John has contributed to progression of dementia to its moderate stage (Zhang, 2014,Fairfax, 2014). Alzheimer's disease (AD) features with slow decline in memory, thinking, reasoning as well as behavior skills that causes interference with daily activities in its severe stage. Some features of Alzheimer's disease might be similar to that of age-related changes and other forms of dementia but the differential diagnosis could be made based on the a trace line difference which is discussed as follows. All the persons may encounter 1 or more of these features as they age. 1) Memory loss that affects daily activities- This is the most common feature of Alzheimer's with loss of memory, particularly forgetting the informations that are recently learned, unable to remember important occasions, dates and/or events, repeating the words, asking the same question again and again, increased reliability on memory aids as reminder- notes and/or some electronic devices and/or relatives for activities that they were handling by their own previously as in Mr. John whereas in age- related degeneratio n, the persons may forgets persons names and/or appointments sometimes but can remember it later (Alzheimer's Association, 2017). 2). Difficulties in planning and problem solving- Persons with AD may find difficulties in developing and following a plan/ work that requires numbers, trouble in remembering familiar food-recipes and tracking monthly bills as John suffers. They may not be able to concentrate in things and may take more time to do work than before while in age-related changes, only occasional mistakes occur while working with a checkbook. 3). Problems in completing familiar activities at home or working place or at leisure time- AD persons often find difficulty in completing daily activities. They may have trouble in driving to a well-known place, checking budgets and remembering game rules whereas in senile degeneration, occasional help may be needed to change the microwave settings and/or recording a TV show which is evidenced in Mr. John (McKhann, 2011). 4). Confusing with time and/or place- AD people may not be able to track the dates or seasons, difficulty in understanding things that has not occurred at present and forgetting the place where they are present and how they came there which is similar to Mr. John (McKhann, 2011). In senile degeneration, older person may confuse with the day of the week but trace it out after. 5). Difficulty in understanding visual images with spatial relationships- Having vision problem is a feature of AD as Mr. John. These persons may have trouble reading, differentiating colors or judging distance that can create problems in driving. But in ageing-related changes, the vision changes occur due to cataracts or senile degeneration (Alzheimer's Association, 2017). 6). Troubles with speaking words and/ or writing- AD people may have difficulty in conversing with others; may stop in between conversation and/or trouble in continuing conversation or may repeat words within themselves as like John (McKhann, 2011). AD people may have trouble with vocabulary, selecting right words or naming the things wrongly while trouble occurs only in finding the correct words in age-related changes. 7). Misplacing items with trouble in re-tracing steps- AD people may have difficulty in keeping things in correct places, losing things and inability to go back through steps again and may abuse others. In contrast, people with senile degeneration may misplace things and find trouble with retracing at few times. 8). Poor or impaired judgment- AD people may have poor judgment and/or decision-making process and may pay less attention in self-care activities whereas making bad decision is common in age-related changes. 9). Withdrawal from activities- AD persons may withdraw from routine activities, hobbies, sports, social activities, etc and feels isolated which is similar to Mr. John with feelings of isolation while in age-related changes, they may withdraw from work and familial activities at times (McKhann, 2011). 10). Mood swings and personality changes- AD persons may have confusion, suspiciousness, depression, fearfulness and/or anxiousness as like John who is depressed and confus ed (Alzheimer's Association, 2017). But in a typical age-related degeneration, they may become irritable in performing daily activities. Differential diagnosis has to be made clearly between AD and age-related alterations by comparing the signs and performing appropriate diagnostic examinations (Table-1). The features of diseases other than AD that can cause confusion in thinking, difficulty in focusing on things, loss of memory includes iron-deficiency anemia,diabetes-mellitus, renal disorders, liver diseases, infection, some vitamin deficiencies, thyroid disorders and cardiac, lung and blood- vessel abnormalities (Alzheimer's Association, 2017, Albert, 2011). There is no any single test to confirm the diagnosis of AD. A complete diagnosis should be made by performing clear assessment by considering all the causes. The first step involves collecting medical history with past illnesses and medicine history with family history of AD. Mr. John had transient ischemic attack with suspected Alzheimers disease, depressiveness and anxiousness which suggests that the patient has developed moderate dementia because of AD and its medications. There is a family history of AD with dementia in his father who has died at 81 years of age (Lewis, 2013). Physical examination was performed to rule out diet pattern, alcohol intake, and use of drugs (current, over-the counter medications supplements), vital signs, heart sounds and general assessment. His examination shows that he has trouble in letting emotions with difficulty in writing but not in reading (Alzheimer's Association, 2017). He has forgetting, repeatedly asks questions, short-temperedness, isola ted and boredom feelings, performing activities repeatedly, wanders with-out purpose, aggressiveness, abusing others, shouting, beating, screaming, agitation, depressive features as trouble ventilating his emotions, poor judgmental capacity, lack of self- control with self- esteem, suspiciousness which makes Mr. John to be anxious, with-drawn, low-mood, confused, lost and frustrated (NHS, 2014). Genetic test may be performed to trace out APOE-e4 and autosomal- dominant AD gene which is not performed in John. Neurological exam was performed carefully to rule out conditions that may indicate brain diseases other than AD as smaller/ large stroke, brain tumors, hydrocephalus, Parkinsons disease or other disorders which can cause memory/ thinking impairment (Sperling, 2011, Alzheimer's Association, 2017). Reflexes, coordination of movements, muscle tone as well as strength, eye movement, speech and sensation were assessed in Mr. John which shows that his movements were not coordinated due to poor muscle strength whereas his speech and sensation remained intact (Hinkle, 2014). His mental status examination shows that his memory is impaired and is unable to solve problems with poor thinking skills. He has trouble in saying the date, place and time; remembers words and follows instructions very slowly and unable to perform simple calculations. The Mini-mental status examination scor e of John is assessed to be 15 which suggest that he has moderate dementia. Mini-cogtests by asking him to recall and repeat things after few minutes of 3 common things were performed in which he was able to recall one objects name only after 3 minutes whereas he was unable to recall other 2 objects name (Jack, 2011). His CT exam shows that he has areas of transient ischemic attack with stenosis in circumflex of brain. Mood assessment shows that he is withdrawn, depressed, anxious, isolated with absence of interest in life. Dementia can lead to varied difficulties in cognition as memory loss, learning difficulties, poor thinking, poor judgment, language with praxic functioning difficulties, decreased psycho-motor speed, and poor problem- solving abilities. Behavioral problems involves self- care deterioration, trouble communications, lapse in speech, absence of clarity, hallucination with delusional thoughts, alterations in gait with balance (NHS, 2014). Emotional problems includes dis-regulated with poorly organized behavior, apathy, energy loss, unwilling to work, delayed thinking, agitation, neglect, paranoia, with mood swings (DH, 2012). The trouble arises based on the shrinkage in the brain lobe. If frontal lobe is involved, the persons self and others awareness are affected as in Mr. John whereas if parietal lobe is affected, the language with speech-comprehension, vision as well as meaning of objects can be impaired. When temporal lobe is damaged, short and long- term memories will be impaired an d memory fades when the damage moves deep into brain areas. Mr. John is on Tab. Risperidone- 500 mg to control his agitation and schizophrenic features. It is a Benzisoxazole derivative which is an antipsychotic medicine that has higher affinity on 5-hydrotryptamine as well as dopamine receptors. Risperidone is mainly for managing schizophrenia, behavior alteration in John with dementia and mood swings (depression) (Galbraith, 2015). The features of John suggest that he is in moderate stage of dementia as forgetfulness, more marked changes, requires more support for daily activities, highly aggressive, gets upset easily, anger, difficulty performing activities, low mood, withdrawn, inability to recall address, names, etc, confusion, needs help for choosing clothes, difficulty to control bladder and bowels, alterations in sleep patterns, personality with behavioral changes (suspiciousness, repetitive behaviors as wringing hands/ tissue-shredding) ((McKhann, 2011, DH, 2012). Mr. John requires a structured physical, mental, emotional, societal, cognitional, sexual as well as spiritual care by social-care specialists that is rendered in aged-care homes. The treatment for John should be provided in stages so as to promote the quality care. Firstly, they will evaluate the reasons for his altered behavior. The workers in aged-care home will establish rapport with him and his family (NHS, 2015). In aged-care homes, they will refer to psychiatrists to evaluate his mental problems, counselors to give individual and family counseling, clinicians to manage his medical issues, staff-nurses to meet his personal-needs and occupational-therapists to make John to perform simpler activities. In aged homes, the societal workers will be assessing, counseling, communicating, caring, supporting and guiding John by developing a framework of management and will be managed accordingly. The nurses have to clearly diagnose the stage of patient by comparing it with diagnostic criteria. She should assess his background, history, likes/ dislikes; capacities and abilities to plan interventions. Nurses should provide person- centered care which involves caring persons at the centre of other care rendered based on his needs, wishes, believes and preferences. This person- centered care can minimize agitated feelings in John. This approach involves valuing him, giving respect, enabling social relationships and choices, giving opportunities to John to stimulate him, recognize as well as consider him as a whole (NHS, 2015). Nurses should identify Johns needs and plan for supportive care based on his preferences. Nurses should meet his daily needs, support him to perform elimination and provide diversion activities. Non- personal-centered care can also be given by dictating the care-needs to his wife by considering his needs. John can be referred to support workers who focus on his skills with abilities rather than the skills he has lost. Strategic plans can be developed based on his disabilities as urinary bowel incontinence, anxiety, depression, agitation, repetitive words, etc (Gray, 2013). The history of John indicates that he has depression because of his ageing process and Alzheimers disease. His disabilities have affected his self- identity; respect, and esteem which have developed negative thoughts in him (Orth, 2012).On examination, he assessed to have inability to express his feelings and write. He has inferior feelings and feels hesitant to mingle with others because of his disabilities. He looks to have low mood, anxious, isolated and withdrawn. He expresses that he is worthless, hopeless and there is no meaning for his life. His modified behavior may lead to inability to express his needs that may again stimulate frustration in John expressing with challenging- behavior. AD is found to interfere with the regulation of neurotransmitter which affects the mood (begins at the early stage of AD development) and hence it leads to the development of depression (Ellison, 2016). Moreover, damage/ error theories suggest that presence of chronic diseases such as hypertension, ischemic stroke, cardiac diseases, etc contributes to depression development which is similar to John (Jin, 2010). The disabilities that are caused by his multiple disorders has increased his feelings of stress that made him dependent on his wife for support which has lead to worthless, hopeless feelings and insomnia resulting in depressiveness. Even, the disengagement theory suggests that as the person ages, he starts to withdraw and isolate himself from interaction with society that causes decline of continuity in daily activities causing physical with psychological changes as in John. The immunological theory adds that as the person ages, the functions of immunology declines slowly resulting in Alzheimers disease, cardiac diseases, etc leading to depressive ideas as John experiences. Depressive features increases and takes a different quality, as AD intensifies. Apathy commonly occurs when the depressive features emerges in the moderate stage of AD with classic symptoms that includes feelings of agitation, withdrawn, weeping, difficulty in expressing feelings of joy (anhedonia), lack of appetite, severe hallucinations, suicidal thoughts and psychotic delusions which is evident in Mr. John with these features. When the neuro and cognitive impairment intensifies to a more severe stage, the affected persons may not able to remember depressive symptoms and/or to clearly understand or articulate its meaning (Ellison, 2016). In the severe stage of dementia, the unwanted disruptive behaviors that include resisting for getting care, expressing delusive feelings or showing increased agitation behavior and sometimes self- destructing behaviors will provide cue for developing depression. Though these are not evident in Mr. John, he should be closely observed for these featu res to handle it at the earliest. Thus, adequate treatment and proper care can delay the progression of dementia and its related feature. Reference Albert, M.S et al. (2011). The diagnosis of mild cognitive impairment due to Alzheimers disease: recommendations from the National Institute on Aging-Alzheimers Association workgroups on diagnostic guidelines for Alzheimers disease:Alzheimers Dementia.7:2709 Alzheimer's Association. (2017). 10 Early Signs and Symptoms of Alzheimer's. Retrieved from https://alz.org/10-signs-symptoms-alzheimers-dementia.asp Aminoff, J.F et al. (2016). Handbook of Clinical Neurology. London: Elsevier Department of Health- DH. (2012). Caring for our future: Reforming care and support (White paper) Norwich: The stationary office. Ellison, J.M. (2016). Depression and Alzheimer's disease. Retrieved from https://www.brightfocus.org/alzheimers/article/depression-and-alzheimers-disease Fairfax, C.N. (2014).Social Work, Marriage, and Ethnicity: Policy and Practice: J Human Behav Soc. 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Nurses Role In Taking Care Of A Patient With Alzheimers Disease: Medical and Biological Sciences. 28(2): 5-10. doi: https://dx.doi.org/10.12775/MBS.2014.014 Lewis, S.M., Heitkemper, M. M., Dirksen, S.R. (2013). Medical Surgical Nursing: Assessment and Management of Clinical Problems. (9th ed.). Missouri: Mosby. Linda, C et al. (2011). Alzheimer's Disease. Retrieved from https://books.google.co.in/books?isbn=0313381100 McKhann, G.Y. (2011). The diagnosis of dementia due to Alzheimers disease: Recommendations from the National Institute on Aging-Alzheimers Association workgroups on diagnostic guidelines for Alzheimers disease: Alzheimers Dementia. 7Answer(3): 263269. doi:10.1016/j.jalz.2011.03.005 NHS. (2014). Dementia guide. Retrieved from https://www.nhs.uk/Conditions/dementia-guide/Pages/dementia-behaviour.aspx NHS. (2015). Dealing with challenging behavior. Retrieved from https://www.nhs.uk/Conditions/social-care-and-support-guide/Pages/challenging-behaviour-carers.aspx Orth, U. 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Megan Renee Essays - Guiding Light, Grant County, Georgia

Megan Renee Megan Renee ?Please, just let me hold her,? she pleaded, ?just once ?I'm sorry,? replied the plump nurse coldly, ?but I have my orders, and besides, it will only make things that much worse.? To an outsider, it was a heart-wrenching scene. To the hospital, it was something that they dealt with on a daily basis. To her family, it was a mistake that never should have happened. To Sara, it was a day that changed her life forever. ?Katie, I can't look-tell me what it says,? requested Sara Holten. ?Do you really want to knowasked her best friend Katie Landiman, comparing the results to the package instructions. ?I have to know, I don't have a choice here.? ?It's positive Sara, you're pregnant,? Katie said reaching out to comfort her friend with a hug, wishing she could help more. ?How could you do this to us was the only thing Mr. and Mrs. Holten said when Sara told them. Her mother cried, and her father just turned away from her and didn't say anything. Her boyfriend Joel just reminded her that he had a football scholarship, and that he was in no position to take care of a child. He offered to pay for her to ?take care of it', and she left before he could say another word. Sara was only sixteen, but up until now, she was considered very mature and responsible for her age. She had a 3.7 grade point average in high school. She was going to graduate a year early, and had even begun to take classes at the local community college. She felt that she could, and wanted more than anything to take care of this baby, but They wouldn't allow it. Once her parents finally decided to talk to her, they gave her a choice?well an ultimatum really. They first tried to convince her to have an abortion, ?it will solve everything,? they insisted. When she refused to even talk about it, they then suggested adoption. They told her that they could send her to a special place where there were other girls in trouble like her. She would have the baby and then it would be given to a nice family. Sara kept it as a suggestion, hoping that her parents would eventually come around and let her keep the baby. Then they told her that was it. If she didn't take one of those options, she w ould be kicked out with out a penny of support. They gave her one-month to decide. Sara knew that she could never live with herself if she had an abortion, it was not even a possibility. She wanted this baby so much and just knew that it was a baby girl. She even named her Megan Renee. She pictured what she would look like. Blond hair and soft blue eyes. The tiny little fingers that would clasp around hers, the little legs that would kick in excitement. She wanted so badly to see her baby girl's little face, to hold her in her arms and rock her to sleep. She told her parents she would go to the home, but secretly she was trying to figure out a way to make it work. She knew deep down though that it never would. She had no real money of her own, and she didn't know anyone who would or could take her in. When she was six months along she finally gave up and decided that the best thing for Megan was to find a good home for her. She started to interview potential parents-to-be. She went through eleven couples, and ruled out six right away. Not that they wouldn't make good parents, she just didn't think that they would make the right parents for her baby. She finally narrowed it down to two couples. They were very nice people and had a little boy who was six. They had a little girl also, but she died when she was only four days old. After three miscarriages, they couldn't bare to try any more. They had a beautiful house, and their son Alex was so sweet. Sara knew right away that her baby would be in good hands with this family. The other couple