Impact of Health Inequalities on Parkinsons Disease Patient

Impact of Health Inequalities on Parkinsons Disease Patient In the department of health publication from ‘Vision to Reality’ (2001), the minister for public health, Yvette Cooper, and the chief medical officer, Professor Liam Donaldson, stated the following: ‘At the beginning of 21st century, your chances of a healthy life still depend on what job you do, where you live, and how much your parents earn. This is unfair and unjust. That is why this Government is committed to narrowing the health inequalities that scar our nation and to improved health for all’. How does this statement support the elderly with Parkinson disease in Bromley trust Kent? Introduction The focus of this community study is to explore the health inequalities which affect a specific group within Bromley community. This group has been defined as those suffering with Parkinson’s disease, a degenerative condition that tends to affect an older client group and can also be associated with complex medical needs. This essay will define and explore the concept of inequalities in health, define the disease ad its effects on people as their families, and relate these to a community in the Kent area served by Bromley NHS Trust. The other aim of this essay is to postulate solutions and interventions which might address some of the health inequalities and challenges posed by this particular condition and its prevalence within the community. The literature points to the specific health problems and challenges of this client group, and there is government and governance literature which specifically addresses their needs. However, it appears there is still a deficit between the needs of clients, which are complex and difficult to address, and the level of provision in health and social care services, which continue to be under-resourced and less than ideally designed. Parkinson’s Disease Parkinson’s is a progressive neurological disease which occurs as the result of the loss of nerve cells in the substantia nigra in the brain (PDS, 2007). The lack of these cells results in a lack of dopamine, a substance that allows messages to be sent to the parts of the brain that control movement (PDS, 2007). When about 80% of dopamine is lost, symptoms start to develop, and levels continue to reduce over time, causing symptoms to increase (PDS, 2007). Two proposed causes are genetic disorders and environmental toxins (PDS, 2007), although a range of other associations continue to be explored. No real cause is known, and there is no known cure, although some medications can mediate the course of the disease and help in symptom control (PDS, 2007). Motor symptoms of Parkinson’s are tremor, bradykinesia and stiffness of muscles, while non-motor symptoms include sleep disturbance, constipation, depression and urinary urgency (PDS, 2007). Fatigue is another symptom (Lloy d, 1999). It is obvious from this range of symptoms that sufferers may need an increasing range of health and social support services and interventions during the progression of the disease. One epidemiological review puts the rate of Parkinson’s disease in the UK population at 19 per 1000 per year, with a lifetime prevalence of 2 per 1000 people (MacDonald et al, 2000). The Parkinson’s Disease Society (PDS, 2007) state that one in 500 people in the UK suffers from the disease. This would suggest a considerable burden on local health and social care services in any locality. However, there is also the issue that such statistics often only represent the tip of the iceberg (MacDonald et al, 2000). There may be a greater number who have not yet been diagnosed or who do not access services and so are not counted in surveys. The age range of sufferers of Parkinson’s disease is 40-90 years, with the greatest proportion in the 70-74 age group, and the next highest rate in the 74-79 age group (MacDonald et al, 2000). This is obviously an age-associated condition. The Bromley Health Services NHS Trust provides an outpatient Parkinson’s clinic run by Dr B Kessel as part of the elderly medicine directorate (www.bromleyhospitals.nhs.uk, 2007). There is also the Joint Allocation panel which the elderly medicine team contribute to in providing complex home care packages. Therefore, it would seem that for this locality, there is some specialist Parkinson’s disease provision. However, there are no figures to describe the uptake and demand on health and social services from Parkinson’s disease sufferers. For example, the demand on community nursing services, social care services, nursing homes, continence services, primary health services and pharmacy services. Parkinson’s disease is usually treated by drug treatments which aim to redress the loss of dopamine (Pentland, 1999). Levodopa-containing agents replace dopamine within the body, while dopamine agonists mimic the action of dopamine (Pentland, 1999). Enzyme inhibitors can be used, which prevent dopamine breakdown, and anticholinergics can reduce the action of acetylcholine which can also improve symptoms (Pentland, 1999). There is ongoing debate and review of the risk-benefit ratio of these treatments but they have been shown to be effective in limiting symptoms (PDS, 2007: Pentland, 1999). Other pharmacological interventions may be utilised to relieve specific symptoms, such as hypnotics for insomnia, antidepressants for confirmed depression, and pain killers and quinine for pain and muscle cramps (Pentland, 1999). Hoever, achieving and maintaining the correct, effective drug regimen as the condition progresses can be problematic for client and medical team (Lloyd, 1999). Health Inequalities It was in 1998 that health inequality reduction became express aims of the NHS in the UK, with the publication of A First Class Service (DH, 1998). Since then, inequalities in health have remained on government and health service agendas. The National Service Framework for Older People (DH, 2001) sets out a number of standards to address key inequalities in health experienced by the subject group concerned in this essay. The fact that such standards have had to be set is evidence of demonstrable inequalities linked to these areas. To begin with, inequalities are linked to age. It has been shown that in some health and social care services, older people and their carers have been victims of age-based discrimination in access to services and availability of services (DH, 2001). The locality here, Bromley Trust in Kent, does not advertise specialist Parkinson’s disease services explicitly on their website, and so sufferers of this condition fall under the aegis of elderly care services and also neurology services (trust ref). However, resourcing for such services may not be optimum, with less resources perhaps given to less fashionable areas of health need (DH, 2001), but rather to the more ‘fashionable’ and topical areas such as children’s and cancer services. There are certain areas of need which could be viewed as common to older people’s services and specific to those with Parkinson’s disease, such as community equipment (DH, 2001). Another specific inequality for this client group is access to palliative care services, with many palliative care services only available to cancer sufferers (DH, 2001). Parkinson’s disease is a degenerative and ultimately terminal condition, and as such should be a defining condition for palliative care. However, palliative care services in some areas may be funded by cancer charities such as Macmillan Cancer care, which may pose a challenge. This leads to a policy issue which could only be addressed at policy management level within the local trusts. The burden on family and unpaid carers is considerable, and increases with the progression of the disease (Lloyd, 1999). This leads to further demand on services due to carer-related illnesses (Lloyd, 1999). Again, unequal access to services, here based on the condition and the lack of support for those affected by it, continues to exist. The issue of inequality related to ethnic minority or background (DH, 2001) may also be applicable here, as the locality does contain a range of different minority ethnic groups. However, the demographics are not available to explore the rates of Parkinson’s disease across the different ethnic minorities in the region. The literature does highlight one specific incidence of health inequality in relation to this disease. It appears that sufferers who are hospitalized do not have timely access to their medications due to the restrictions of ward rounds and nursing routines (Agnew, 2006). Another inequality is in access to community care assessments which provide the intense levels of care and support necessary as the disease progresses (Lloyd, 1999). Not only do Parkinson’s disease sufferers suffer from a relative difficulty in accessing and obtaining such assessments, the assessment provides only a partial picture when exploring to what extent the health and social care needs of people with Parkinson’s are being assessed (Lloyd, 1999). The assessments are apparently predominantly medical, failing to address the other range of needs, particularly social and emotional issues and everyday living needs such as personal care (Lloyd, 1999). As these assessments are generally not carried out in the person’s own home, they are inadequate in providing a true picture of the realities of the disease in individual cases (Lloyd, 1999). The more general subject of health inequalities highlights a range of factors which might adversely affect the health and wellbeing of this client group. Poor health is linked to social background factors (Iphofen, 2003). The Bromley community area encompasses a wide range of socio-economic groups, from those deemed to be in poverty through the middle classes to the affluent classes. Research has demonstrated that those low down on the social class hierarchy tend to have worse housing, poor nutritional status, are less fit and are more likely to engage in damaging or risky health behaviours (Iphofen, 2003). It is logical that these people are the most likely to become ill, die sooner, or be most in need of health and social care input and support (Iphofen, 2003). Other factors which may affect health inequalities include culture, gender and ethnicity (Iphofen, 2003). It is also important to consider the role of individual action and self-reliance (Iphofen, 2003), which may seem at odds with current political trends towards ‘nanny state’ policies which are in danger of labelling vulnerable groups and individuals as being to blame for their own ill-health. One example of this is the smoking ban, which has been legislated on the back a growing trend of refusing medical treatment to sufferers of smoking-related conditions until they have given up smoking. A similar trend appears to be occurring for obese and overweight individuals, but it would seem that this form of discrimination, whilst socially and morally wrong, is politically sanctioned. Health Problems related to Parkinson’s Disease. As can be seen from the literature, there are a wide range of health problems which affect Parkinson’s sufferers, primarily related to the disease and its symptoms and their affects on health and independence. Parkinson’s is a long term illness (Rhind, 2007; Kristjanson et al, 2006) and as such will require long term nursing and social support, surveillance and review. Parkinson’s disease causes physical disability, and affects all of the activities of daily living by restricting independence, self-reliance and self care (PDS, 2007). It can affect people’s ability to maintain relationships, carry on in employment and leisure activities, and to continue to live on their own in their own home, or with their families (PDS, 2007). Lloyd (1999) also highlights the fact that Parkinson’s disease is socially unacceptable and this can have ongoing effects for the sufferer and their carers. One of the problems associated with the disease is dysphagia, the inability to swallow or difficulty in swallowing (Miller et al, 2006). Dysphagia can have obvious physical effects, such as choking, and inability to access proper nutrition or maintain healthy weight (Miller et al, 2006; Lorefalt et al, 2006). It can also have social and psychological effects, such as embarrassment and depression, withdrawal from social eating situations and effects on family and carers (Miller et al, 2006). Treatment for dysphagia is limited, and so the condition can lead to long term alterations in nutritional state leading to interventions such as total parenteral nutrition (Miller et al, 2006; Lorefalt et al, 2006). Another associated set of symptoms are psychological symptoms. These can vary, but can present as depression, sleep, confusion and delirium, hallucinations and dementia (Nazarko, 2005). These can be challenging conditions to treat, and may require a mixture of support, psychiatric intervention, pharmacological intervention and sedation, and family/carer support (Nazarko, 2005). Such symptoms represent a considerable demand on existing services, and as yet, there are no specialist psychiatric services for this client group within the locality under discussion. Addressing Health Inequalities by Condition Management The Department of Health (2001) stresses the following are necessary to combat the continued inequalities experienced by the older age group in accessing services and support: an integrated approach between local authorities and health services; strong clinical and managerial leadership; service user and carer representation at every level; working parties and management groups which continually address and review the situation. Other actions include workforce development (DH, 2001), and there may be a greater need for training and awareness-raising, particularly with nursing staff. Nursing staff need to listen more to Parkinson’s sufferers when providing care (Agnew, 2006). Another issue is the proper assessment of older people’s conditions (DH, 2001), which is important as Parkinson’s disease can present as one of a complex range of multiple diseases or conditions. Modern management of Parkinson’s disease (PD) aims to obtain symptom control, to reduce clinical disability, and to improve quality of life (Pacchetti et al, 2000). Specific instruments or tools may be necessary as part of the assessment process (Heffernan and Jenkinson, 2005). The National Institute for Health and Clinical Excellece (NICE, 2006) make the following recommendations: people with suspected Parkinson’s disease should be seen by a specialist within six weeks; new referrals with later progress of disease should be seen within two weeks; there should be regular, ongoing review of the condition; sufferers should be empowered to participate in their care; and all people with Parkinsons should have regular access to specialist nursing care to provide monitoring and adjustment of medication, a point of contact for support including home visits and a reliable source of information about clinical and social matters relevant to Parkinsons disease. There is a need to access and engage with psychiatric services due to the long-term psychological and emotional effects of the disease (Lloyd, 1999). NICE (2006) argue strongly for specialist nurses and multidisciplinary clinics, which would be appropriate given the complex presentation of the disease. T his comprehensive approach would go a long way to reducing the inequalities experienced by this age group. However, the local services in Bromley may not be currently resourced adequately to meet such targets. Other interventions might also include speech therapy, physiotherapy, occupational therapy and of course palliative care services (Carter, 2006). The local trust has service provision in all these areas, and all but the last can be demonstrated to be involved in the care of clients with Parkinson’s disease in Bromley. However, it might be that more provision and more targeted provision might be necessary to reduce the inequalities suffered by this client group. Some literature suggests the use of complementary therapies such as massage to support those with the condition (Patterson et al, 2005). Other therapies such as music therapy might be appropriate (Pachetti et al, 2000). Music as a therapy acts as a specific stimulus to obtain motor and emotional responses by combining movement and stimulation of different sensory pathways (Pacchetti et al, 2000). In a prospective, randomised controlled trial, music therapy was found to be effective on motor, affective, and behavioral fu nctions, and as such would be a valid addition to therapy programmes for people with Parkinson’s disease (Pacchetti et al, 2000). One example of successful care management has been described by Holloway (2006), who reports in the implementation of a care pathway to meet specific needs. The pathway is user-led, conceptualising the user/carer as the communications centre, resourced and supported in the management of their situation by the professionals to achieve their own integrated package of care (Holloway, 2006). This pathway takes into account individual disease presentation, social factors, severity of illness and degree of use of services (Holloway, 2006). The research showed this pathway to be feasible for implementation within standard, existing clinics and was well received by clients and carers (Holloway, 2006). Another programme which has demonstrated some success and positive outcomes is a club for patients and their carers at a day hospital in Bridlington (Nasar and Bankar, 2006). The multidisciplinary team use the club for patient assessment, education and disease management, while it also provides the patients and carers with a forum for discussion and an opportunity for social interaction (Nasar and Bankar, 2006). Another important aspect of reducing health inequalities is in developing alliances with service users and engaging with specific groups who are socially excluded (Watterson, 2003). It may be that the reason that Parkinson’s sufferers feel so excluded is due to nurses’ perceptions of them as less than cognitively competent, due to prejudices about the nature of the disease. Service users have important and often critical knowledge and experience about their lives, condition, symptoms and responses to treatment (Watterson, 2003), which could greatly enhance both policy planning and direction and individual care planning and ongoing disease management. There are challenges associated with attempting such engagement, and even further policy and procedure planning, with associated resource input, would be needed to ensure accessibility, effective communication and responsiveness. Conclusion As has been demonstrated, sufferers of Parkinson’s disease, itself a complex aetiology, presentation and progression, have a range of specific and challenging needs which are not being met by the local services in Bromley. While some services exist, there are other models of care, management, assessment and monitoring which have been demonstrated to be effective in other localities, which may be appropriate for this specific client group. Services need to be client centred and comprehensive, utilising tools and guidelines developed specifically for the disease and its symptoms. Services must also be multi-disciplinary, multi-agency and also holistic. However, the provision of such services may not be practical within the current NHS climate. With the direction set out in government and NICE documents, however, it would appear that the drive to improve such services will go ahead. This essay addresses a very small, confined client group with a specific disease presentation. However the scope of health inequalities across the whole population may be much wider and more disturbing. It would appear that there is a need for targeted programmes to tackle health inequalities in almost every service, but if these can be addressed in one area, they can be addressed across the whole service to counteract years of unequal access and provision which have continued to fail those in most need. 3,000 words. References Agnew, T. (2006). Nurses out of step with Parkinsons patients. Nursing Older People. 18(6). 8-9 Carter, L. (2006) The role of specialist nurses in managing Parkinsons disease. Primary Health Care. 16(8). 20-2. Costello, J. Haggart, M. (eds.) (2003) Public Health and Society Basingstoke: Palgrave Macmillan Department of Health (2001) The National Service Framework for Older People Available from www.dh.gov.uk. Accessed 14-4-07. Heffernan, C. Jenkinson, C. (2005) Measuring outcomes for neurological disorders: a review of disease-specific health status instruments for three degenerative neurological conditions. Chronic Illness. 1(2). pp. 131-42 Holloway, M. (2006) Traversing the network: a user-led Care Pathway approach to the management of Parkinsons disease in the community Health Social Care in the Community 14 (1), 63–73 Iphofen, R. (2003) Social and individual factors influencing public health. In: Costello, J. Haggart, M. (2003). Public Health and Society Basingstoke: Palgrave Macmillan. Kristjanson, L., Aoun, S., Yates, P. (2006) Are supportive services meeting the needs of Australians with neurodegenerative conditions and their families? Journal of Palliative Care 10 (2). Lloyd, M. (1999) The new community care for people with Parkinson’s disease and their carers. In: Percival, R. Hobson, P. (eds.) (2003) Parkinson’s Disease: Studies in Psychological and Social Care. London: MPG Books Ltd. Lorefalt, B; Granerus, A; Unosson, M. (2006). Avoidance of solid food in weight losing older patients with Parkinsons disease. Journal of Clinical Nursing 15(11) 1404-12. MacDonald, B.K., Cockerell, O.C., Sander, J.W.A.S. Shorvon, S.D. (2000). The incidence and lifetime prevalence of neurological disorders in a prospective community-based study in the UK. Brain 123 665-676. Miller, N; Noble, E; Jones, D. (2006) Hard to swallow: dysphagia in Parkinsons disease. Age Ageing. 35(6) 614-8. Nasar, M; Bankar, R. (2006) Improving outcome in Parkinsons disease. British Journal of Hospital Medicine. 67(1). pp. 6-7 Nazarko, L. (2005) Part 3: psychological effects of Parkinsons disease. Nursing Residential Care. 7(6).261-4. NICE (2006) Draft Guideline on Parkinson’s Disease Available from www.nice.org.uk Accessed 14-4-07. Pacchetti, C., Mancini, F., Aglieri, R. et al (2000). Active Music Therapy in Parkinson’s Disease: An Integrative Method for Motor and Emotional Rehabilitation. Psychosomatic Medicine 62 (3) 386-393. Parkinson’s Disease Society http://www.parkinsons.org.uk/ Accessed 14-4-07. Paterson, C; Allen, J; Browning, M. (2005). A pilot study of therapeutic massage for people with Parkinsons disease: the added value of user involvement. Complementary Therapies in Clinical Practice. 11(3). 161-71. Pentland, B. (1999) The nature and course of Parkinson’s disease. In: Percival, R. Hobson, P. (eds.) (2003) Parkinson’s Disease: Studies in Psychological and Social Care. London: MPG Books Ltd. Percival, R. Hobson, P. (eds.) (2003) Parkinson’s Disease: Studies in Psychological and Social Care. London: MPG Books Ltd. Rhind, G. (2007) Managing Parkinsons disease over the longer term. Independent Nurse. 22 Jan. pp. 18-9 Wacker, R.R., Roberto, K.A. Piper, L.E. (1998) Community Resources For Older Adults: Programs and Services in an Era of Change London: Sage Publications, Inc Watterson, A. (ed.) (2003) Public Health in Practice Basingstoke: Palgrave Macmillan http://www.bromleyhospitals.nhs.uk/referrers/clinical-services/elderly-medicine/ Accessed 14-4-07.

Ancient Historians: Sparta.

Ancient historians reveal that Spartan society was something to be envied. (DISAGREE). Many ancient historians can agree that the Sparta, was an overall strong, well disciplined, sound governed, equal society, with hard working citizens and incredibly structured military forces. Some ancient historians, such as Thucydide and Plato, admired many aspects of the Spartans good order, and praised how well the Spartans system appeared to be working, whilst other historians, such as Aristotle, were extremely crucial of the Spartan system, and criticised their structure in many of their individual writings.Many claim Spartans system of government included monarchical, and democratic components,although it is acknowledged as being primarily oligarchy. The government structure consisted of, two kings, and unlike most kings, these two did not have absolute power as they shared the power with each other and they also had to answer to a council of elders, or the Gerousia. The Gerouisa was made up of 28 male citizens, all over the age of sixty, who once elected served for live.Below the Gerousia, was another assembly, the Apella. The Apella consisted of male citizens over the age of thirty. To complete the system of checks and balances, the Spartans created a judicial position called  ephor. At any given time, there were five citizens serving in this role. Ephors were citizens over the age of thirty. They were elected to serve one-year terms. Ephors possessed considerable clout. An ephor could bring charges against anyone in Sparta—including one the city-state’s kings.Whilst some historians believed this government system to be efficient, and a sure way to keep matters, and laws fair through-out Sparta, Aristotle disagreed with one judicial position in particular, the Euphors. On them he said ‘The Lacedaemonian constitution is defective in another point; I mean the Ephoralty. This magistracy has authority in the highest matters, but the Ephors are chose n from the whole people, and so the office is apt to fall into the hands of very poor men, who, being badly off, are open to bribes. Aristotle believed that electing men, of no status whatsoever, and giving them such a high state of power was unwise, as a man of no status would be more prone to corruption, including the accepting of bribes. He then states ‘There have been many examples at Sparta of this evil in former times; and quite recently, in the matter of the Andrians, certain of the Ephors who were bribed did their best to ruin the state’ Thus proving his above point, that the Ephors were more likely to be bribed, for their own wealthfare.Throughout majority of Greece, wives were acquired strictly for the production of legitimate heirs, providing food and were used for sexual pleasure. Husbands dominated and demeaned the women, and treated them as objects. Both wives and daughters of any citizen were excluded from all public and intellectual activities, they were kept inside and weren’t allowed to participate in leisure activities , receive an education, or eat as well as their brothers or husbands.Women could not inherit or own any land, and it was considered unwise to educate them. This wasn’t the case with women in Sparta, although they still had arranged marriages, they did not have the right to vote, and were honored most for their production of strong sons, the women still enjoyed status and rights that were exceptional in those times and were considered a scandal to the rest of the essentially misogynous ancient world. Aristotle, from rival Athens, seems to complain about the Spartan society throughout his writings.He is extremely critical of the Spartan system, especially of their emancipated women. â€Å"The license of the Lacedaemonian women defeats the intention of the Spartan constitution, and is adverse to the happiness of the state. † – Aristotle, [On the Lacedaemonian Constitution] In this statemen t, Aristotle believes that by making woman emancipated, this disadvantages men and gives women an opportunity to take advantage of the men, by manipulating and controlling them. .

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Through residency and interaction with the community as well as present and past high school graduates, they evaluate the reasons why youth are leaving rura l communities at such a high rate. They determined youth fall into five categories growing up in small towns: stayers, seekers, achievers, boomerangs, and returners. The different categoriesRead MoreSocioeconomic Inequality Between White Students And Minority Students1605 Words   |  7 Pagesopportunity and social inclusion, social cohesion as well as economic growth and employment† and for these reasons, equality should be promoted (Shrivastava,67). Unequal educational outcomes are attributed to several variables, including family of origin, gender, and social class. Achievement, earnings, health status, and political participation also contribute to educational inequality within the United States and other countries. 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Dover Beach Essay - 1078 Words

In the poem quot;Dover Beachquot;,witten in 1867 Matthew Arnold creates the mood of the poem through the usage of different types of imagery. He uses a dramatic plot in the form of a soliloquy. Arnold also uses descriptive adjectives, similes and metaphors to create the mood. Through the use of these literary elements, Arnold portrays the man standing before the window pondering the sound of the pebbles tossing in the waves as representation of human suffering. The man arrives at the vision of humanity being helpless against nature. Arnold creates the mood by suggesting mental pictures, actions, sights and sounds the man sees. Some examples are quot;folds of a bright girdle furledquot;, quot;lie before us like a land of dreamsquot;†¦show more content†¦In the second part of the poem, Arnold uses the same method of writing, however he speaks of human history to further support the mood of the quot;Sea of Faithquot; and its quot;eternal sadnessquot;. Arnold writes of Sophocles hearing the quot;eternal sadnessquot; on quot;the Aegeanquot; with its quot;turbid ebb and flowquot;. This appeals to the sense of hearing and causes the reader to almost hear powerful waves crashing to the land below. Sophocles saw the waves as sounds of quot;human miseryquot;. Arnold is portraying the parallel thought between the speakers feelings and Sophocles same sadness over the changing of the land. The metaphor of the tides and the sea is suggested by the sounds and view of the speakers window, but Arnold uses Sophocles as another example of natures strength over the entire world. Arnold uses this to illustrate the speakers despair and helplessness over his situation. Arnold uses this writing to exhibit the conflict between the land and the sea, and how more than just land suffers from the destruction. Arnold wants to show how deep the speakers emotions run for his home. In the third stanza, Arnold uses imagery and metaphors to depict the setting, which further set the mood of the poem. The first three lines portray and insinuate prospects of a visual image. The last five lines appeal to the auditory sense in the form of despair. In the first part of the stanza, Arnold characterizes the sea as divine.Show MoreRelatedDover Beach Essay1187 Words   |  5 Pagesthe biggest questions of life: poetry. All teasing aside, the poem is indeed best suited to deal with matters of the unknown because poems are intrinsically left open to interpretation. In the simplest terms, Matthew Arnold’s 18th century poem â€Å"Dover Beach† is about the unknown. The poem doesn’t just reflect on that idea, no, it edifies about humanity’s history with ‘questions that have no answers’ and the great internal and external conflicts inherent within. In the end, the poem attempts to findRead MoreDover Bitch and Dover Beach Comparisons14 61 Words   |  6 PagesAt first glance, Anthony Hechts Dover Bitch is not only funnier than Matthew Arnolds Dover Beach, but also describes a more liberated relationship; the poem is as free from what some would consider stuffy Victorian morals as it is from references to Sophocles. Hechts urbane and flippant persona tends to win over its audience, whether they find irony in the poem that adds to their appreciation of Dover Beach, appreciate the poem as a criticism of Victorian morals, or laugh at Arnolds apparentRead More Essay on Dover Beach: An Analysis1052 Words   |  5 Pages An Analysis of Dover Beachnbsp;nbsp;nbsp;nbsp; Dover Beach intrigued me as soon as I read the title. I have a great love of beaches, so I feel a connection with the speaker as he or she stands on the cliffs of Dover, looking out at the sea and reflecting on life. Arnold successfully captures the mystical beauty of the ocean as it echoes human existence and the struggles of life. The moods of the speaker throughout the poem change dramatically as do the moods of the sea. The irregular, unorderedRead MoreA Comparison of Fahrenheit 451 and Dover Beach1216 Words   |  5 Pagesbrings home a book of poetry one day and begins to read the poem Dover Beach by Matthew Arnold to his wife and her guests. Many critics think that Bradbury picked this poem because it paralleled life in his book. The poem Dover Beach can be compared to Fahrenheit 451 because both pieces of writing talk about themes of true love, fantasy and allover hopelessness. One of the ways Fahrenheit 451 can be related to Arnolds Dover Beach is by connecting the absence of true love in both of them. ThroughoutRead More Matthew Arnolds Dover Beach Essay927 Words   |  4 PagesMatthew Arnolds Dover Beach Great works of poetry convey a feeling, mood, or message that affects the reader on an emotional, personal level. Great works of poetry can do that -- translate a literal story/theme -- but masterpieces, like Matthew Arnolds Dover Beach, are a double-edged sword, containing a second, figurative theme -- a message between the lines and underneath the obvious. Not only is Matthew Arnolds 1867 poem, Dover Beach, a unique and beautiful literary work describingRead More Essay on the Victorian View of Dover Beach893 Words   |  4 PagesThe Victorian View of Dover Beach  Ã‚     Ã‚   As the narrator of Matthew Arnolds Dover Beach looks out his window, he sees a beautiful world of nature: the sea and the cliffs under the glow of the moon. Describing this scene to his lover, he invites her to [c]ome to the window so that she might see it too (6). However, it is not just a beautiful beach that the speaker wishes his lover to see. Rather, he wants her to see Dover Beach as an ironic image that is a representation of his whole worldRead MoreEssay on Perceptions in Matthew Arnolds Dover Beach1176 Words   |  5 PagesPerceptions in Matthew Arnolds Dover Beach Matthew Arnold’s â€Å"Dover beach† describe the way in which perceptions are mislead society. The use of metaphors, symbolisms, allusiveness, technical quantities, and imagery assist the speaker’s thought regards between what is seen and what is real. Dover beach was written during Victorian era. Which brought civilization based on industry, value and money. This is the time which people start questioning the existence of God. The speaker observed the plightRead More A Comparison of Fahrenheit 451 and Dover Beach Essay1205 Words   |  5 Pagesbook of poetry one day and begins to read the poem Dover Beach by Matthew Arnold to his wife and her guests. Many critics think that Bradbury picked this poem because it paralleled life in his book. The poem Dover Beach can be compared to Fahrenheit 451 because both pieces of writing talk about themes of true love, fantasy and allover hopelessness. nbsp;nbsp;nbsp;nbsp;nbsp;One of the ways Fahrenheit 451 can be related to Arnold’s Dover Beach is by connecting the absense of true love in both ofRead More Conflicting Imagery in Matthew Arnolds Dover Beach Essay519 Words   |  3 PagesArnolds Dover Beach      Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In the poem Dover Beach, the poet uses conflicting imagery to give meaning to the poem. The differences in the way that the poet sees the relationship between the beach and the sea and the way that most people would see it become more pronounced as the poem develops. He also uses the change in attitude from the first stanza to the last to emphasize his message.      Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The poem starts with   the normal image one would expect of a beach andRead More Comparing Matthew Arnolds Dover Beach and Gerard Manley HopkinsGods Grandeur1291 Words   |  6 PagesComparing Matthew Arnolds Dover Beach and Gerard Manley HopkinsGods Grandeur      Ã‚   Matthew Arnolds Dover Beach, and Gerard Manley Hopkins Gods Grandeur are similar in that both poems praise the beauty of the natural world and deplore mans role in that world. The style and tone of each poem is quite different, however. Arnold writes in an easy, flowing style and as the poem develops, reveals a deeply melancholy point of view. Hopkins writes in a very compressed, somewhat jerky style

Presentation of Self Free Essays

â€Å"When an individual enters the presence of others, they commonly seek to acquire? information about him or to bring into play information about him already possessed. They? will be interested in his general socio-economic status, his conception of self, his attitude? towards them, his competence, his trustworthiness, etc. Although some of this information is? sought as an end in itself, there are usually quite practical reasons for acquiring it. We will write a custom essay sample on Presentation of Self or any similar topic only for you Order Now Information? about the individual helps to define the situation, enabling others to know in advance what he? ill expect of them and what they may expect of him. Informed in these ways, the others will? know how best to act in order to call forth a desired response from him. †-Erving Goffman In â€Å"The Presentation of Self In Everyday Life,† by Erving Goffman he seeks to show the reader how everyone sets out to present themselves to the world around them, always trying to maintain the role they have selected for themselves, since those whom they meet not only try to decide what role it is you are playing, but also whether or not you are competent to play that role. Erving Goffman portrays everyday interactions as strategic encounters in which one is attempting to sell a particular self-image and, accordingly, a particular definition of the situation. I agree with Erving Goffman, in everyday life I believe we all play different roles to different people to portray ourselves in the way we want to be seen. The impression we have on people and society depends on the character and role we play.In my life today I try to please people the best way I can while still making myself happy I can relate to Goffman’s writings because I also believe myself that we are all actors playing a role in society that we choose to play. The ways we portray ourselves to the people around us can differ from friends to parents because we want a sense of acceptance from all. I agree with this very much. Growing up I know that I occasionally would lie to my parents to play the role that they wanted to see. The image my parents may have thought me to be, at times, actually was not me.I wanted to be my parent’s princess and the golden child, so I acted in a way to seek their approval which in some ways was not the â€Å"real† me. These conditions occur because of the existence of self presentational rules according to Goffman. â€Å"When one individual enters the presence of others, he will want to discover the facts of the situation. Were he to possess this information. †Also when meeting an individual we try to get information about them so we can act accordingly to their approval. How we act with one friend may not be the way we act with another. We determine the person’s status and attitude and decide for ourselves if we want to be a part of that. When we gather the information when first meeting someone, it determines the way we think and act towards them. Erving Goffman revolves his view of the human life around the belief that we are all actors who have both a front stage behavior and a back stage behavior. From an early age we have become skilled actors and move in and out of roles with precision such as with our family and friends. We follow the formal societal rules when we are on the front stage reciting a script, playing a role.This would include going to work, presenting ourselves as the person we should uphold to take part in society. On the other side, Goffman says our back stage behavior is informal, as we’d act when we are amongst friends. When I myself am in the public eye instead of in the social scene amongst my friends I find myself acting in a different way to please the group of people I am around. Erving Goffman had a good perception on society and natural human behavior that I myself can relate to and agree with. How to cite Presentation of Self, Papers

Bartolome de Las Casas, the Devastation of the Indies Essay Sample free essay sample

And of all the infinite existence of humanity. these people are the most transparent. the most barren of evil and fraudulence. the most obedient and faithful to their native Masterss and to the Spanish Christians whom they serve. They are by nature the most low. patient. and peace-loving. keeping no scores. free from imbroglios. neither excitable nor quarrelsome. These people are the most barren of resentments. hates. or desire for retribution of any people in the universe. And because they are so weak and obliging. they are less able to digest heavy labour and shortly dice of no affair what malady. The boies of Lords among us. brought up in the enjoyments of life’s polishs. are no more delicate than are these Indians. even those among them who are of the lowest rank of labourers. They are besides hapless people. for they non merely possess little but have no desire to possess worldly goods. For this ground they are non chesty. embittered. or greedy. Their meals are such that the nutrient of the sanctum male parents in the desert can barely be more penurious. pantie. and hapless. As to their frock. they are by and large naked. with merely their pudenda covered slightly. And when they cover their shoulders it is with a square fabric no more than two varas in size. They have no beds. but sleep on a sort of matting or else in a sort of suspended cyberspace called hamacas. They are really clean in their individuals. with qui vive. intelligent heads. docile and unfastened to doctrine. really disposed to have our holy Catholic religion. to be endowed with virtuous imposts. and to act in a reverent manner. And one time they begin to hear the newss of the Faith. they are so repetitive on cognizing more and on taking the sacraments of the Church and on detecting the Godhead cult that. genuinely. the missionaries who are here need to be endowed by God with great forbearance in order to get by with such avidity. Some of the secular Spaniards who have been here for many old ages say that the goodness of the Indians is undeniable and that if this talented people could be brought to cognize the one true God they would be the most fortunate people in the worldâ₠¬ ¦ . The common ways chiefly employed by the Spaniards who call themselves Christian and who have gone at that place to uproot those pathetic states and pass over them off the Earth is by unjustly engaging cruel and bloody wars. Then. when they have slain all those who fought for their lives or to get away the anguishs they would hold to digest. that is to state. when they have slain all the native swayers and immature work forces ( since the Spaniards normally spare merely the adult females and kids. who are subjected to the hardest and bitterest servitude of all time suffered by adult male or animal ) . they enslave any subsisters. With these infernal methods of dictatorship they debase and weaken infinite Numberss of those pathetic Indian states. Their ground for killing and destructing such an infinite figure of psyches is that the Christians have an ultimate purpose. which is to get gold. and to swell themselves with wealths in a really brief clip and therefore rise to a high estate disproportionate to their virtues. It should be kept in head that their insatiate greed and aspiration. the greatest of all time seen in the universe. is the cause of their villainousnesss. And besides. those lands are so ri ch and felicitous. the native peoples so mild and patient. so easy to subject. that our Spaniards have no more consideration for them than animals. And I say this from my ain cognition of the Acts of the Apostless I witnessed. But I should non state â€Å"than beasts† for. thanks be to God. they have treated animals with some regard ; I should state alternatively similar body waste on the public squares†¦ . I one time saw this. when there were four or five Indian Lords lashed on grids and combustion ; I seem even to remember that there were two or three braces of grids where others were firing. and because they uttered such loud shrieks that they disturbed the Spanish captain’s slumber. he ordered them to be strangled. And the constable. who was worse than an executioner. did non desire to obey that order ( and I know the name of that constable and cognize his relations in Seville ) . but alternatively put a stick over the victims’ linguas. so they could non do a sound. and he stirred up the fire. but non excessively much. so that they roasted easy. as he liked. I saw all these things I have described. and infinite others. And because all the people who could make so fled to the mountains to get away these inhuman. ruthless. and fierce Acts of the Apostless. the Spanish captains. enemies of the human race. pursued them with the ferocious Canis familiariss they kept which attacked the Indians. rupturing them to pieces and devouring them. And because on few and far between occasions. the Indians justifiably killed some Christians. the Spaniards made a regulation among themselves that for every Christian slain by the Indians. they would murder a 100 Indians†¦ . Among the notable indignations they committed was the 1 they perpetrated against a cazique. a really of import baronial. by name Hatuey. who had come to Cuba from Hispaniola with many of his people. to fly the catastrophes and cold Acts of the Apostless of the Christians. When he was told by certain Indians that the Christians were now coming to Cuba. he assembled as many of his followings as he could and said this to them: â€Å"Now you must cognize that they are stating the Christians are coming here. and you know by experience how they put So and So and So and So. and other Lords to an terminal. And now they are coming from Haiti ( which is Hispaniola ) to make the same here. Make you cognize why they do this? † The Indians replied: â€Å"We do non cognize. But it may be that they are by nature wicked and cruel. † And he told them: â€Å"No. they do non move merely because of that. but because they have a God they greatly worship and they want us to idolize that God. and that is why they struggle with us and capable us and kill us. †Ã¢â‚¬ ¦ He had a basket full of gold and gems and he said: â€Å"You see their God here. the God of the Christians. If you agree to it. allow us dance for this God. who knows. it may delight the God of the Christians and so they will make us no injury. † And his followings said. all together. â€Å"Yes. that is good. that is good! † And they danced round the basket of gold until they fell down exhausted. Then their head. the cazique Hatuey. said to them: â€Å"See here. if we keep this basket of gold they will take it from us and will stop up by killing us. So allow us project away the basket into the river. † They all agreed to make this. and they flung the basket of gold into the river that was nearby. This cazique. Hatuey. was invariably flying before the Christians from the clip they arrived on the island of Cuba. since he knew them and of what they were capable. Now and so they encountered him and he defended himself. but they eventually killed him. And they did this for the exclusive ground that he had fled from those cruel and wicked Christians and had defended himself against them. And when they had captured him and as many of his followings as they could. they burned them all at the interest. When tied to the interest. the cazique Hatuey was told by a Franciscan mendicant who was present. an ingenuous rogue. something about the God of the Christians and of the articles of the Faith. And he was told what he could make in the brief clip that remained to him. in order to be saved and travel to Heaven. The cazique. who had neer heard any of this before. and was told he would travel to Inferno where if he did non follow the Christian Faith. he would endure ageless torture. asked the Franciscan mendicant if Christians all went to Heaven. When told that they did he said he would prefer to travel to Hell. Such is the celebrity and award that God and our Faith have earned through the Christians who have gone out to the Indies.