Pfizer Essay Example for Free

Pfizer Essay Pfizer has new technology that helps to access the system easily. They have a smart card consisting of proximity device so that as a person walks near a computer, there is a signal emitted by smart card which verifies you. There is use of pin number so that no one can use another persons card and pin number is used in other parts of the company such as making charges at cafeteria and accessing the building physically. When Pfizer is deploying information system, they take their time to cooperate with people who do business in order to know the risks involved in storing and transferring information. They do not under protect information or overprotect it. Business can be impeded by overprotecting information which can make security be thrown out. They partner with information technology and business in order to protect business, offer quality products and services and make profit. (Betancourt, 2002 pp19-21). Describing policies and measures used by Pfizer to ensure confidentiality, availability and reliability of data and information Confidentiality of data is ensured through a system that employs cryptography such as public key and symmetric key in order to encrypt and decrypt information and data. There is an entity that reads sensitive information and data and the key represents a secret property. To ensure availability of data and information Pfizer has prescription coverage to ensure access to its medicines that are new and widely prescribed. Through number 866 706 2400, there are live operators to guide patients according to their needs and the programs for public assistance according to medical needs and income. The reported outcome of patient’s measures determines how treatment of a disease affects patients. To ensure there are results that are useful clinically data gathered must use reliable cognitive psychology, clinician and patient input. This is done by determining the purpose of patient reported outcome in order to demonstrate its reliability. (Nurss, 1998 pp11-12). How Pfizer organization protect loss of data In order to avoid loss of data, Pfizer protects privacy of information collected from external organizations through online opportunity process of submission which supplements privacy policy of Pfizer which can also apply to personal data and identifiable information. For Pfizer to ensure personal data is secure, it uses data customary that protects electronic and manual processing. Security technology in online opportunity ensures securities that avoid loss of data, misuse of data, unauthorized disclosure, destruction and alteration of data. Steps taken to ensure data remain accessible in event of catastrophic event such as fire and other natural disaster Actions are taken to lower exposure to risk arising from hazard to safeguard development efforts. Developing systems for early warning helps in reducing risks and having capabilities to respond to catastrophic events. Disaster recovery is used in recovering information in event of catastrophe. Disaster recovery planning is devoted to prepare for action to respond to catastrophic event. Assessment in disaster recovery is simulating catastrophic event and planning for disaster recovery in order to have recovery need that are specified. Plan for disaster recovery state duration the recovery should take and the state of data expected by the users and management need to be informed all the time of these specifications which are substantiate by recovery assessment. Things I think Pfizer could do to further enhance information security  There should be enough circulating space inside the organization so that staff can move around freely without use of lifts. Employees should avoid calling their colleagues using phones but instead use face to face communication about information concerning the organization and cellular office space should help to make communication easy. Government should take action to develop mechanisms for sharing information with private sector by engaging private sector actively in determining requirement of information and having a partnership that is based on trust. ( Parker, 1996 pp21-23).

Pain Sensation: Nociceptive receptors and transduction

Pain Sensation: Nociceptive receptors and transduction Pain is a subsystem of somatic sensation which includes a wide range of unpleasant sensory and emotional experiences usually associated with actual or potential tissue damage (Das et al., 2005). Over the years, by means of the evolutive process of natural selection, nature has made sure that pain is a bodily signal we cannot ignore. As a matter of fact, sensitivity and reactivity to noxious stimuli are essential to the well-being and survival of an organism. In dangerous circumstances pain tells the subject to get out of that situation immediatly, this is its main function. Without these attributes provided by pain mechanisms, the organism would have no means to prevent or minimize dangerous circumstances (individuals congenitally insensitive to pain are easily injured and most of them die at an early age1). While most of the sensory and somatosensory modalities are primarily informative, pain is a protective modality. Pain perception (also called nociception) doesnt come from excessive stimulation of the same receptors that generate somatic sensations, as someone could even think, it is a properly devoted subsystem. Nociception (from the Latin nocere, to hurt) in fact depends on specifically dedicated receptors and, due to its vital importance, this kind of information travels through redundant pathways. Pain also differs from the classical senses (hearing, smell, taste, touch, and vision) because it is both a discriminative sensation and a graded emotional experience. In the big picture, pain appears as a more complex whole experience than simple somatic sensation; that is why there are still many obscure aspects not completely understood, especially in the field of pain physiology and pharmacology. For this and other reasons, even nowadays, nociception remains an extremely active area of scientific research. 2. Pain Sensation Nociceptive receptors and transduction Pain sensation begins with relatively unspecialized free nerve cell endings called nociceptors. Like other somatic sensory receptors, they transduce a variety of noxious stimuli into receptor potentials, which in turn trigger action potentials in the pain nerve fibers (afferents). These action potentials are transmitted to the spinal cord and then, through the brainstem, to the thalamus and the somatic sensory cortex according to specific pathways2. Nociceptors are widespread distributed, they also show different degrees of sensitiveness and specialization. There are nociceptors in the skin, in the joints and also in visceral organs, but none of them is found inside the central nervous system (CNS)1. In contrast with somatic sensory receptors (responsible for the perception of innocuous mechanical stimuli), the axons associated with nociceptors conduct relatively slowly, being only lightly myelinated or, more commonly, unmyelinated2. Thus, according to the different kind of axon, there are faster or slower pain pathways. In particular, pain receptors can fall into four major categories depending on their response to the different types of stimulation caused by the damage: mechanosensitive nociceptors: respond to mechanical stimulation and have A-delta fibers, bigger axons with faster conduction velocity; mechanothermal nociceptors: respond to thermal stimuli, A-delta fibers; chemical nociceptors: respond to chemical substances, A-delta fibers; polymodal nociceptors: respond to high intensity stimuli of the previous three types and have C fibers, smaller and unmyelinated axons with slower conduction velocity. The cell bodies of these primary pain-neurons are located in the dorsal root ganglia (for body afferents) and in the trigeminal ganglia (for face afferents)1,2. The transduction of nociceptive signals, which starts with the nociceptive receptors, is a complex task. Tissue damage results in the release of a variety of chemical substances which triggers the response of nociceptors. Some of these substances activate the transmembrane transient receptor potential (TRP) channels, which in turn initiate action potentials2. Another characteristic feature of nociceptors is their tendency to be sensitized by prolonged stimulation, making them respond to other sensations as well in certain circumstances. This prolonged stimulation increases the release of chemical substances, making nociceptors sensitized and reducing their response threshold. Actually, within a few seconds after the injury, an area of some centimeters around the injured site shows reddening caused by vasodilation. This inflammation becomes maximal after about ten minutes and this region shows a lowered pain threshold (hyperalgesia) in response to additional noxious stimuli. This effect is also referred to as peripheral sensitization, in contrast to central sensitization that can occur at higher levels in the dorsal horn1. Although it is still unknown whether nociceptors respond directly to the noxious stimulus or indirectly by means of one or more endogenous chemical intermediaries released from the traumatized tissue, the activation of nociceptors initiates the process by which pain is experienced: these receptors relay information to the CNS about the intensity and location of the painful stimulus. Pain classification The result of sudden painful stimulation can be divided into two categories of sequential sensations separated by a short time interval. A sharp first pain, immediately after the damage, its followed some seconds later by additional, diffuse and longer-lasting second pain sensation. The temporal interval between these two separate sensations is due to the difference between fast transmitting A-delta fibers and slow transmitting C fibers. This phenomenon is also known as double pain sensation. Pain has also been classified into three major types1: Pricking pain: is also called fast pain or sensory pain (first pain) and arises mainly from the skin, carried by A-delta fibers which permit discrimination and localization of the pain. Burning pain: is caused by inflammation, burned skin and is carried by C fibers. This type of pain is a more diffuse, slower to onset, and longer in duration (second pain). Like pricking pain, burning pain arises mainly from the skin, but it is not distinctly localized. Aching pain: is a sore pain which arises mainly from the viscera and somatic deep structures. This pain is carried by the C fibers from the deep structures to the spinal cord and is not distinctly localized. Pain pathways The neural pathway that conveys pain (and temperature) information from the periphery of the body to the higher centers of the CNS is often referred as the anterolateral system (or ventrolateral column). This pathway is physically separated from the system that conveys mechanosensory information like touch and pressure (dorsal column-medial lemniscus pathway). However, even though the dorsal route has been always considered a touch pathway functionally separate from the anterolateral pathway, recent reports indicate that the dorsal column can carry noxious information from the viscera and widespread skin regions as well1. Anyway, the main difference between these two systems remains the site of decussation: while the dorsal column is an ipsilateral tract until the medulla (where synapses and decussates), the anterolateral system makes early synaptic connections and decussates right away in the spinal cord, becoming a contralateral tract. Composing the anterolateral system, there are three major ascending tracts: the neospinothalamic tract (the main, central pain pathway, phylogenetically younger, with few synapses), the paleospinothalamic tract and the archispinothalamic tract (which constitute minor parallel pain pathways, phylogenetically older and multisynaptic tracts)1. Every pain tract is made of three kinds of pseudounipolar neurons: first-order, from free nerve endings (nociceptors) to the dorsal horns of the spinal cord; second-order, from the dorsal horns to the thalamus; and third-order, from the thalamus to the primary somatic sensory cortex. The cell bodies of first-order neurons are located in the dorsal root ganglia (DRG) for all three pathways. a) The neospinothalamic tract (central pathway) constitutes the classical anterolateral system. This pathway is responsible for the immediate awareness of a painful sensation and for the understanding of the exact location of the painful stimulus. The first-order nociceptive afferents enter the spinal cord via the dorsal roots of the DRG and, when these projecting axons reach the dorsal horns of the spinal cord, they branch into ascending and descending collaterals, forming the tract of Lissauer2. Once within the dorsal horn, these afferents make synaptic connections with second-order neurons located in Rexeds laminae (layer I to V). Axons of these second-order neurons then cross the midline of the spinal cord, decussating in the anterior white commissure, and ascend to the brainstem in the contralateral (anterolateral) quadrant. Most of the pain fibers from lower extremities of the body and below the neck terminate, through the brainstem, in the ventral posterior lateral nucleus (VPL) of the thalamus. The VPL, which serves as a relay station, is thought to be mainly concerned with discriminatory functions1. Finally, here axons of second-order neurons synapse with third-order neurons that send the signal to the primary and secondary somatosensory cortex (SCI and SCII, respectively). Unlike the rest of bodily afferents, first-order nociceptive neurons from the head, face and intraoral structures have somata in the trigeminal ganglion. Trigeminal fibers enter the pons, descend to the medulla (forming the spinal trigeminal tract) and make synaptic connections in the spinal trigeminal nucleus, then cross the midline and ascend as trigeminothalamic tract (or trigeminal lemniscus). Axons from the second-order neurons terminate in a variety of targets in the brainstem and thalamus, but the discriminative aspects of facial pain are thought to be mediated by projections to the ventral posterior medial nucleus (VPM) of the thalamus and by projections (from here) to primary and secondary somatosensory cortex2. All of the fibers terminating in VPL and VPM are somatotopically oriented and still here the information supplied by different somatosensory receptors remains segregated. Axons from the thalamus synapse with third-order neurons of the SCI, which includes Brodmanns Areas 3a, 3b, 1 and 2. Each of these cortical areas contains a separate and complete representation of the body: they are somatotopically organized maps representing the human body (from the foot up to the face) in a medial to lateral arrangement2. b) The paleospinothalamic tract is a parallel pathway where the emotional response to pain is mediated1. This tract also activates brainstem nuclei which are the origin of descending pain-suppression pathways which regulate the sesation of noxious inputs at the spinal cord level. In the paleospinothalamic tract the majority of the first-order nociceptive neurons make synaptic connections with second-order neurons in Rexeds layer II (substantia gelatinosa). These second-order neurons also receive input from mechanoreceptors and thermoreceptors, and thats why the anterolateral system is also responsible for temperature perception1. The nerve cells that compose the paleospinothalamic tract are multireceptive or wide dynamic range nociceptors. Most of their axons cross and ascend in the spinal cord primarily in the anterior region and thus form the anterior spinal thalamic tract (AST). These second-order fibers contain several tracts and each of them makes a synaptic connection in different locations: in the mesencephalic reticular formation (MFR) and in the periaqueductal gray (PAG), forming the spinoreticular tract; in the tectum, also known as the spinotectal or spinomedullary tract; in the midline thalamic nuclei, forming the spinothalamic tract. Altogether these three fiber tracts are thus known as the paleospinothalamic tract, which is in part bilateral, because some of the ascending fibers do not cross to the opposite side of the cord1. Finally, from the thalamic nuclei, these fibers synapse bilaterally in the somatosensory cortex. Pain is a complex experience processed by a diverse and distributed network of neurons and brain regions. In addition to the sensory-discriminative aspects (carried by the neospinothalamic tract) there are also affective-motivational components of pain2. In the paleospinothalamic pathway there are extensive connections between the thalamic nuclei and the limbic areas such as the cingulate gyrus and the insular cortex. The insular cortex integrates the sensory input with the cognitive components. The limbic structures (amygdala, superior colliculus) project to the hypothalamus and initiate visceral responses to the pain. The thalamic nuclei also projects to the frontal cortex, which in turn is linked to the limbic structures involved in processing the emotional components of pain1. c) The archispinothalamic tract is another parallel pathway, phylogenetically the oldest that carries noxious information1. The characteristics of this tract are very similar to the ones found in the previous pathway. First-order nociceptive neurons make synaptic connections in Rexeds layer II (substantia gelatinosa). From here, second-order fibers ascend and descend in the spinal cord surrounding the grey matter to end synapsing with cells in the reticular formation and in the periaqueductal gray. Further diffuse multisynaptic pathways ascend to the diverse nuclei of thalamus and send collaterals to the hypothalamus as well as the limbic system nuclei. These fibers, like for the paleospinothalamic tract, mediate visceral, emotional and autonomic reactions to painful stimuli. In short, because of the importance of warning signals of dangerous circumstances, several nociception pathways are involved to transmitting these signals and some of them are redundant. The neospinothalamic tract conducts fast pain (via A-delta fibers) and provides information of the exact location of the noxious stimulus. The multisynaptic paleospinothalamic and archispinothalamic tracts conduct slow pain (via C fibers), a pain which is chronic and harder to localize. Through these patways, pain activates many different brain areas which link together sensation, perception, emotion, memory and motor reaction1. 3. Pain Modulation When talking about pain, we always have to consider and keep in mind the discrepancy between the objective reality of a painful stimulus and the subjective rsponse to it. Modern studies have provided considerable insight into how circumsatnces affect pain perception-interpretation and, ultimately, into the pharmacology of the pain system2. For many years it has been suggested that somewhere in the CNS there should be some neuronal circuits modulating incoming painful informations. Evidence for an intrinsic analgesia system was demonstrated by intracranial electrical stimulation of certain brain sites1,3. The circuit consisting of the periaqueductal gray matter (PAG), the raphe nuclei (RN), the locus coeruleus (LC) and the caudate nucleus (CN) contributes to the descending pain suppression mechanism, which inhibits incoming pain information at the spinal cord level6. Stimulation of such areas produce analgesia without behavioral suppression; indeed, touch, pressure and temperature sensation remain intact1. At the interneuronal level, opiate receptors activation causes hyperpolarization of the neurons, which in turn results in the inhibition of firing and in the release of substance P (a neurotransmitter involved in pain transmission) that blocks pain transmission1. In addition to descending projections, also local interactions between mechanoreceptive afferents and neural circuits within the dorsal horn can modulate the transmission of nociceptive informations to higher centers2. Observations by Melzack and Wall led to the idea that concomitant activation of the large myelinated fibers associated with low-threshold mechanoreceptors can mediate the flow of pain. This mechanism, also known as Gate Control Theory13, predicts that (at the spinal cord level) non-noxious stimulation will produce presynaptic inhibition on dorsal root nociceptor fibers and thus blocking incoming noxious information from reaching the CNS1 (i.e. non-painful input closes the gates to other painful inputs, which results in prevention and suppression of pain sensation). This explains also why if you, for example, stub a toe, a natural and effective reaction is to vigorously rub the site of injury for a couple of minutes2. However, there are many different factors that can influence the way we understand pain. Doubtless, three of these are: drugs, prior injuries and, more broadly speaking, circumstances. a) Drugs The brain has a neuronal circuit and endogenous substances to modulate pain. There are two primary types of drugs that work on the brain: analgesics and anesthetics1. The term analgesic refers to a drug that relieves pain without loss of consciousness, whereas the term anesthetic refers to a drug that depresses the CNS. Anesthetics are characterized by the absence of perception for all sensory modalities, including loss of consciousness, but without loss of vital functions. The areas that produce analgesia when stimulated are also responsive to exogenously administered opiate drugs2. As a matter of fact, the most effective clinically used drugs for producing temporary relief from pain are the opioid family, which includes morphine and heroin1. Unluckily, several side effects resulting from opiate use include tolerance and drug dependence (addiction). In general, these drugs modulate the incoming pain information as well as relieve pain temporarily, and are also known as opiate producing analgesia (OA). Opioidergic neurotransmission is found throughout the brain and spinal cord and appears to influence many CNS functions: opioids exert marked effects on mood, cognition and motivation1 (e.g. producing euphoria). The analgesic action of opiates implied the existence of specific brain and spinal cord receptors for these drugs long before the receptors were actually found. Since such receptors are unlikely to have evolved in response to the exogenous administration of opium and its derivates, the convinction grew that endogenous opiate-like compounds must exist in order to explain the evolution of these receptors in the body2. Nowadays, three classes of opioid receptors have been identified: ÃŽÂ ¼ (mu), ÃŽÂ ´ (delta) and ÃŽÂ º (kappa). All three classes are widely distributed in the brain, and particularly in the PAG, which is the site for higher cortical control of pain modulation in humans8. Moreover, three major classes of endogenous opioid peptides that interact with them have been recognized in the CNS: ÃŽÂ ²-endorphins, enkephalins and the dynorphins. Enkephalins are considered the putative ligands for the ÃŽÂ ´ receptors, ÃŽÂ ² endorphins for the ÃŽÂ ¼-receptors, and dynorphins for the ÃŽÂ º receptors1. The opioid peptides modulate nociceptive input mainly in two ways: blocking neurotransmitter release by inhibiting Ca2+ influx into the presynaptic terminal; or opening potassium channels, which hyperpolarizes neurons and inhibits spike activity. The various types of opioid receptors are distributed differently within the central and peripheral nervous system and this can explain many unwanted side effects following opiate treatments1. (For example, ÃŽÂ ¼-receptors are widespread in the brain stem parabrachial nuclei, which is a respiratory center. Inhibition of these neurons elicits also respiratory depression). In addition to opiates, the other big family of analgesia producing drugs is represented by the cannabinoids. Like opiates, cannabinoids produce analgesia when microinjected in the PAG and pain itself serves as a trigger for endocannabinoid release3. Results from the study by Walker et al. (1999) indicate that anandamide (an endogenous cannabinoid) fulfills the requirements for a nonopiate mediator of endogenous pain suppression and these data support the existence of endogenous cannabinergic circuitry in the dorsal and lateral PAG. Even if the opiate and cannabinoid mechanisms partially overlap anatomically, the endogenous opiate system is activaetd by intense and prolonged stimuli (such as high threshold electrical stimulation), while endogenous cannabinoids occur mostly in tonic pain suppression, during tests that do not produce significant stress or fear3. Cannabinoids have been used to treat pain for centuries and cannabis is still used despite its illegal status in most parts of the world. The spontaneous and stimulated release of anandamide in a pain-suppression circuit suggests that such drugs may form the basis of a modern pharmacotherapy for pain, particularly in instances where opiates are ineffective3. b) Previous injury A curious effect, well known and documented in clinical literature, is referred to as phantom limb sensation. Following the amputation of an extremity, nearly all patients have an illusion that the missing limb is still present. Although this illusion usually diminishes over time, it persists in some degree throughout the amputees life, and can often be reactivated2. A reasonable explanation for this phenomenon is that the central sensory processing apparatus continues to operate indipendently of the periphery, giving rise to these bizarre sensations. Indeed, considerable functional reorganization of the somatotopic maps in the primary somatosensory cortex occurs immediately after the amputation and tends to evolve for several years2. Neurons that have lost their original inputs respond to tactile stimulation of other (near) body parts, and so it is not unusual for the patient to perceive a phantom limb as a whole and intact, but displaced from the real location. These and further ev idences suggested then that a full representation of the body exists indipendently of the peripheral elements that are mapped2. Anyways, the major problem following phantom limbs phenomena is constituted by the fact that up to 85% of the amputated patients develop also phantom pain4. The description of this common unease can vary from a tingling or burning sensation to some more serious and debilitating issues. Phantom pain, in fact, is one of the more frequent causes of chronic pain syndromes and is extraordinarily difficult to treat2. Neverthless there is no really effective treatment, a study by Jahangiri et al. (1994) demonstrated that preoperative epidural infusion of morphine, bupivacaine and clonidine significantly reduces the incidence of phantom limb pain and phantom limb sensation. Moreover, this kind of treatment has been shown as safe for use on general surgical wards with a low incidence of minor side-effetcs4. Other than amputations, pain perception may also be modulated in certain stressful situations. Exposure to a variety of painful or stressful events produces an analgesic reaction, and this phenomenon is called stress induced analgesia (SIA). It has been considered that SIA can provide insights into both the psychological and physiological factors that activate endogenous pain control and opiate systems1. (For example, soldiers wounded in battle or athletes injured in sports events sometimes report that they do not feel pain during the battle or game; however, they will experience the pain later after the battle or as game has ended). Some studies demonstrated in animals that electrical shocks cause stress-induced analgesia3 and it has been suggested that endogenous drugs, (opiates or cannabinoids) released in response to stress, inhibit pain by activating the midbrain descending system1. Based on these and other experiments, it is assumed that the stress experienced by the soldiers and the athletes suppressed the pain which they would later perceive. c) Circumstances The experience of pain is highly variable between individuals: this highly subjective perception has a complex and often non linear relationship between nociceptive input and pain sensation5. From human experimentation we know that a variety of pain modulatory mechanisms exist in the nervous system, and these systems can be accessed either pharmacologically or through contextual and cognitive manipulation7,6. Various mental processes such as attention, emotional state, past experiences, memories, beliefs and feelings have been shown to influence pain perception and bias nociceptive processing in the humain brain9. All these top-down factors can be grouped together in the category of circumstances that either enhance or diminish pain sensation in regard to dedicated modulatory circuits. Among the cognitive variables influencing pain, the brain mechanisms underlying attentional control have been probably the most extensively studied5. A number of reports show the important role of attentional state in modulating the activity of primary somatosensory areas7. Thus, pain is perceived as less intense when individuals are distracted from it, as proved in an interesting study by Das et colleagues (2005). This research provides strong evidence supporting virtual reality (VR) based games in providing analgesia and positive influence on children with acute burn injuries, with minimal side effects10. VR can be considered an intermediary between reality and computer technology, and its ability to immerse the user interacting with the artificial environment is central in this kind of approach. However, attentional processes interact with mechanisms supporting the formation of expectations about pain and reappraisal of the experience5. The ability to predict the likelihood of an aversive event is an important adaptive capacity11. Our subjective sensory experiences are thought to be heavily shaped by interactions between expectations and incoming sensory information12 and this cognitive factor is important also for pain perception: positive expectations (i.e., expectations for decreased pain) produce a reduction in perceived pain that rivals the effects of a clearly analgesic dose of morphine12. These evidences provide also a neural mechanism that can, in part, explain the positive impact of optimism in chronic disease states. In fact, perceived control, attentional control and the descending pain modulatory system are involved in the placebo-induced analgesia, which is a clinical example of cognitive pain modulation that decreases pain intensity and cerebral responses to pa in5. Such top-down modulatory mechanism is a robust and clinically important phenomenon, which can be demonstrated in approximately one-third of the population9. Moreover, placebo analgesia requires the activation of endogenous opioid-mediated inhibition and neuroimaging techniques showed that there is also overlapping among brain sites activated by opioids and those that are activated during placebo analgesia9. Also the emotional state driven by the (experimental) context alters the attitude of patients and can produce powerful effects on pain perception7. In general, negative emotions increase pain, whereas positive ones decrease it14,7. Neverthless the brain mechanisms underlying these effects remain largely unknown, the prefrontal cortex, as well as parahippocampal and brainstem structures, are thought to be involved in the emotional regulation of pain14. According to Roy et al. (2009) cognitive and emotional processes induced by pleasant or unpleasant pictures interact with pain perception and modulate the responses to painful electrical stimulations in the right insula, paracentral lobule, parahippocampal gyrus, thalamus, and amygdala14. Not only, recent studies suggested that emotionally laden images representing human pain had a unique capacity to enhance pain reports15, in the suggestive perspective that search for the neural bases of human empathy with huge social implications. Thus, even though is well-established that mood selectively alters the affective-reactive response to pain (also called pain tolerance), the interpretation for some of these studies is sometimes difficult, since they do not always clearly dissociate changes in mood from changes in attention7. In fact, other studies showed that emotions can have a direct effect on attention to pain, leading to what is called attentional bias toward pain-related informations, which does not ensure the absence of covariate processes7. In the end, the available data indicate that emotion and selective attention may both interact modulating pain perception and cortical responses. But the observations that emotional manipulations alter pain unpleasantness more than pain sensation, while attention alters both pain sensation and unpleasantness, suggest that different modulatory circuits are involved7 and that they act through at least partially distinct mechanisms, which can be separated by appropriate experimental settings15. All this multiplicity of mechanisms underlying the emotional modulation of pain is reflective of the strong and reciprocal interrelations between pain and emotions, and emphasizes even more the powerful effects that emotions can have on pain perception14. 4. Conclusions In conclusion, in the CNS, much of the information from the nociceptive afferent fibers results from excitatory discharges of multireceptive neurons. The pain information in the CNS is controlled by ascending and descending inhibitory systems that can exert both facilitatory and inhibitory effects on the activity of neurons using endogenous opioids or other substances as mediators. In addition, a powerful inhibition of pain-related information occurs in the spinal cord. These inhibitory systems can be activated by brain stimulation, intracerebral microinjection of morphine, and peripheral nerve stimulation1. However, pain is an extremely complex perceptual and cognitive experience that is influenced also by many top down factors such as past sensations, expectations, the context within which the noxious stimulus occurs, the attentional and emotional state. Therefore, for all these reasons, the response to pain can often vary considerably from subject to subject. Case Report: Use of Valproate in Kleine Levin Syndrome Case Report: Use of Valproate in Kleine Levin Syndrome Successful use of Valproate in Kleine Levin Syndrome: a case report and review of cases reported from India Abstract Kleine-Levin Syndrome (KLS) is characterized by recurrent episodes of hypersomnia and other symptoms and it is a really challenging for the physician, since its causes are not yet clear, and available treatment options are not having adequate support. Here we are reporting a case with successful use of Valproate in KLS and also reviewing the cases reported from India. Introduction Kleine-Levin Syndrome (KLS) is a rare disorder which mainly affects adolescent boys and characterized by recurrent episodes of hypersomnia, and sometime along with hyperphagia, behavioral and cognitive disturbances, and hypersexuality (Yao et al., 2013). Several medications (stimulants, lithium, valproate, antipsychotics, antidepressants) have been reported to provide variable benefit in different symptoms, with lithium being the most widely used drug (Arnulf et al., 2005 2012). We are presenting a case of KLS, who had complete remission with valproate and also reviewing the cases reported from India. Case details: A 17 year old single male student of 12th standard, presented to our psychiatric outpatient clinic in September 2004 with hypersomnolence, low mood, decreased appetite and interest in studies, social and sexual disinhibition (such as singing obscene songs loudly at home, and touching unconsenting females’ including mother’s body parts- limbs, face and genitalia). Onset was acute, without any elicitable precipitating factor and course was episodic with average 7-10 days episode in every month for last four months and he maintained completely well in interepisodic period. Provisional diagnosis of recurrent depressive disorder (brief episodes) was kept and he was started on Sertraline (50 mg), on which he responded well. He remained asymptomatic for nearly nine months, but started having similar episodes again from mid 2005, due to which Sertraline was gradually hiked up to 150 mg/day, but of no use. Hence he was admitted in our inpatient setting in March, 2006 for diagnostic evaluation and further management. After detailed evaluation, it was found that his sadness was not pervasive and depressive cognitions and associated disturbances were not present and hypersomnia remained predominant complaint as initially he was sleeping 16-20 hours per day. He was also not responding with these medications, hence differential diagnosis of KLS vs. depression was kept and later finalized to KLS. His heamogram, renal functions, liver functions, blood sugar, routine urine, thyroid functions were within normal limits and chest X ray, ECG, EEG, and MRI brain were nor mal. In view of good literature support Lithium was started from 600 mg/day and hiked to 900 mg/day (serum level 0.8 mEq/liter). On which he has shown significant improvement initially for six month but later again started experiencing similar symptoms. He also had three episodes of fall, unresponsiveness and epileptiform discharge in EEG twice. Hence in view of seizure disorder and lack of response, Neurologist’s consultation was sought, who opined to start antiepileptic medication. Hence lithium was switched to Valproate (750 mg/day) in December 2006, on which he maintained completely well for 4 years, except brief reemergence of symptoms on discontinuing Valproate, which improved completely on resuming the medication. Valproate was gradually tapered and stopped in January 2011 on insistence of patient and family with discussing its pros and cons. Now index case has been maintaining well off Valproate for last three years without any episode of hypersomnolence, sexual disin hibition, sadness, or epileptic seizure. Discussion Based on historical reports by Kliene and Levin, KLS was essentially described and termed by Critchley (1962). Thereafter many researchers have reported their cases and reviewed cases with KLS (Arnulf et al., 2005 2012). Here we are reporting a case with KLS, who responded well with Valproate, after diagnostic dilemma and different psychotropic medications and also reviewing the other cases reported from India. In our electronic search for Indian studies on Kliene-levin syndrome, by using PUBMED and Google Scholar, we could find 15 cases reported from India (Aggarwal et al., 2011; Mendhekar et al., 2001; Prabhakaran et al., 1970; Shukla et al., 1982; Sagar et al., 1990; Narayanan et al., 1972; Agrawal Agrawal, 1979; Malhotra et al., 1997; Gupta et al., 2011). Of them 13 were males and 2 females, similar to male preponderance reported in the literature (Arnulf et al., 2005 2012). While presenting to psychiatric services their age was between 9 to 26 years and they had onset between 7 to 24 years of age. In two-third of patients (10 out of 15 patients) it was preceded with fever and their episodes of somnolence were lasted from 3 days to 10 weeks. Hypersomnia and hyperphagia were present in all, while two-third of patients also had social and sexual disinhibition (11 out of 15 patients). Other symptoms were cognitive disturbances (low intelligence quotient, impaired memory, confusion, and a cademic decline), irrelevant talk, and perceptual disturbances. Nearly one-third of patients improved spontaneously without any medication, while rest was given lithium, carbamazepine, methyl amphetamine, dextro amphetamine, and modafinil. Longest asymptomatic follow-up period is reported for 2 years (Aggarwal et al., 2011) (as depicted in table-1). Though literature supported lithium for higher response rate (Arnulf et al., 2005 2012), but index patient had remarkable response with Valproate, not with lithium, like earlier two reports (Crumley, 1997; Adlakha Chokroverty, 2009). Like earlier report (Adlakha Chokroverty, 2009), index patient also improved on lower dose of Valproate (divalproate 750 mg vs. 500 mg Valproate). Compared to other cases reported from India (Aggarwal et al., 2011; Gupta et al., 2011), index patient had longest follow-up (7 years) and remained asymptomatic in this period, except small exacerbation on discontinuation of Valproate treatment, which improved completely on resuming the drug. Similar to our patient, anticonvulsants (like Valproate) are the preferred treatment for KLS patient, and may also offer benefits in case of comorbid epilepsy (Yao et al., 2013). Valproate may be a good alternative to lithium in terms of efficacy as well as side effect profile. References Yao, C.C., Lin, Y., Liu, H.C., Lee, C.S., 2013. Effects of various drug therapies on Kleine–Levin syndrome: a case report. Gen Hosp Psychiatry. 35, 102.e7-102.e9. Arnulf, I., Zeitzer, J.M., File, J., Farber, N., Mignot, E., 2005. Kleine-Levin syndrome: a systematic review of 186 cases in the literature. Brain. 128, 2763-76. Arnulf, I., Rico, T.J., Mignot, E., 2012. Diagnosis, disease course, and management of patients with Kleine-Levin syndrome. Lancet Neurol. 11, 918-28. Critchley, M., 1962. Periodic hypersomnia and megaphagia in adolescent males. Brain. 85, 627–56. Aggarwal, A., Garg, A., Jiloha, R.C., 2011. Kleine-Levine syndrome in an adolescent female and response to modafinil. Ann Indian Acad Neurol. 14, 50-2. Mendhekar, D.N., Jiloha, R.C., Gupta, D., 2001. Kleine-levin syndrome : a report of two cases. Ind J Psychiatry. 43, 276-8. Prabhakaran, N., Murthy, G.K., Mallya, U.L., 1970. A Case of Kleine-Levin Syndrome in India. Br J Psychiatry. 117, 517-519. Shukla, G.D., Bajpai, H.S., Mishra, D.N., 1982. Kleine-levin syndrome: a case report from India. Br J Psychiatry. 141, 97-98. Sagar, R.S., Khandelwal, S.K., Gupta, S., 1990. Interepisodic morbidity in Kleine-Levin syndrome. Br J Psychiatry. 157, 139-141. Narayanan, H.S., Narayanan Reddy, G.N., Rama Rao, B.S., 1972. A case of Kleine-levine syndrome. Ind J Psychiatry. 14, 356-358. Agrawal, A.K., Agrawal, A.K., 1979. Kleine-levin syndrome: a case report. Ind J Psychiatry. 21, 286-287. Malhotra, S.M., Das, M.K., Gupta, N., Muralidharan, R, 1997. A Clinical Study of Kleine-levin syndrome evidence for hypothalamic-pituitary axis dysfunction. Biol Psychaitry. 42, 299-301. Gupta, R., Lahan, V., Srivastava, M., 2011. Kleine-Levin syndrome and idiopathic hypersomnia: Spectrum disorders. Ind J Psychol Med. 33, 194-8. Crumley, F.E., 1997. Valproic acid for Kleine-Levin syndrome. J Am Acad Child Adolesc Psychiatry. 36, 868-9. Adlakha, A., Chokroverty, S., 2009. An adult onset patient with Kleine-Levin syndrome responding to valproate. Sleep Med. 10, 391-3. Table-1: Reported cases with Kleine Levin syndrome from India

The World of Wrestling Essay -- essays research papers

Response 3 In The World of Wrestling by Roland Barthes, he takes the sport of wrestling and turns it into a modern day myth. He talks of the French wrestling scene describing the spectacle, the venues, and the wrestlers themselves. It is well known that wrestling itself isn’t real, just acting but it is still fancied by many people. The wrestler personalities are typically categorized the bastards and the good guys often having good fighting evil. The role a particular wrestler plays might also change from time to time as in the case of Hulk Hogan. This man changes faces more often then someone would change their socks, having his alliances and enemies changing from week to week.   Ã‚  Ã‚  Ã‚  Ã‚  The entrance music of a wrestler can be very important in reflecting the ch...

Essay --

â€Å"The Judge’s Wife† a short story written by Isabel Allende presents many of the necessary techniques required to write an effective short story. Alledende’s keen use of setting, character development, and point of view dramatically affect the way the reader perceives the story during crucial turning points throughout the story. Alledende uses these devices to make the theme of fate being inescapable, no matter how hard on tries to avoid it. setting, character development, and point of view play a vital role within the story and without them it would be impossible to fully understand the story. In The Judge's Wife Nicolas Vidal is the main character. He was born a fatherless to a prostitute and was foretold at birth that he would lose his head to a woman. Keeping this in mind, he hardened his heart to allow no woman to come close to him emotionally. As Vindal grew up he became an outlaw and leader of a gang. On the wedding day of Judge Hidalgo, Vidal looks down on the judge’s bride, Casilda, and is not impressed. Vidal's gang have been plaguing the judge’s jurisdiction as well as surrounding areas despite the numerous attempts to stop Vindal. To solve this problem judge Hidalgo set a trap by caging Vidal's mother in the town square surrounded by guards. The judge believes that Vidal will come to rescue his mother, but after three days it is clear that he is not going to fall for the judge's trap. Vidal's mother hangs herself out of embarrassment that her son did not come to save her. As a result, Vidal hunts down Hidalgo. During Hidalgo's escape he suffers a h eart attack loses control of his car and dies. Only his wife and kids survive. Casilda hides her children in the nearby caves for safety as she awaits Vidal's gang, with the i... ... also allows for deeper plot development with the characters back stories and ties two seemingly unrelated events into one flowing story removing the need to use in medias res. The shared point of view is extreamly important in connecting the story with the theme and allows for the reader to pick up on the foreshadowing and irony present throughout the story. â€Å"The Judge’s Wife† is not a long story, but in those few pages Allende creates a piece readers can understand to the point of empathy. Throughout the piece the use of theme, setting and character development make this story effective in developing a deep story in a small amount of time. Allende does an excellent job of writing a short story. Even though the story lacks symbolism it makes up for that lacking by making effective use of setting to really pull the story together and develop the story completely.

A History of Our Planet :: Creating Writing Essays

A History of Our Planet " Serina where are you?" "Serina?" "I’m here. I was hiding." "What from?" Oh, not much, just sitting and thinking really." So, do you want to come to the beach with us?" God I remember conversations like that. Simple and easy. All we needed was a nice day and a good tan. I look back at that and long for it. Well, sometimes I do. Most of the time I don’t have the energy to remember. If I do get enough time to start to think about that kind of thing I am much more likely to just fall asleep. I guess that is what happens with responsibility, you lose time to remember who you are and what makes you happy. I guess it sounds like I am complaining but I’m not. Not really. I am much happier now. I guess I should tell the whole story. If this is for history then it should be complete. In those early days we all lived in simple beauty and happiness. We were ignorant of things beyond our own pleasure. I would spend days sitting outside and talking to friends. I would make wonderful bags, and jewelry. I loved working with the bark of the trees near my house. It gave me a real connection to nature. Well, what I thought was nature. I had lots of friends we would go to the beach and swim in the surf. I can still almost taste the bitter vinegar taste the ocean had. We never had to cover up we went wearing what was comfortable, usually nothing at all. We had no need for modesty we were all the same. Not that we looked alike but there was no sexual difference. We were all women. This paradise was perfect and uninterrupted until the day that everything went dark. I was lying in my bed and all of a sudden everything was gone. I had no idea what had happened. I couldn’t see. I couldn’t talk. I couldn’t even move my fingers. My mind was racing and all I could do was lie there. For hours I lay there like this. Eventually I began to be able to move my hands and slowly the rest of my body came to life. What I discovered as I awoke was that I was bound and wrapped in a black rubbery sheet. A History of Our Planet :: Creating Writing Essays A History of Our Planet " Serina where are you?" "Serina?" "I’m here. I was hiding." "What from?" Oh, not much, just sitting and thinking really." So, do you want to come to the beach with us?" God I remember conversations like that. Simple and easy. All we needed was a nice day and a good tan. I look back at that and long for it. Well, sometimes I do. Most of the time I don’t have the energy to remember. If I do get enough time to start to think about that kind of thing I am much more likely to just fall asleep. I guess that is what happens with responsibility, you lose time to remember who you are and what makes you happy. I guess it sounds like I am complaining but I’m not. Not really. I am much happier now. I guess I should tell the whole story. If this is for history then it should be complete. In those early days we all lived in simple beauty and happiness. We were ignorant of things beyond our own pleasure. I would spend days sitting outside and talking to friends. I would make wonderful bags, and jewelry. I loved working with the bark of the trees near my house. It gave me a real connection to nature. Well, what I thought was nature. I had lots of friends we would go to the beach and swim in the surf. I can still almost taste the bitter vinegar taste the ocean had. We never had to cover up we went wearing what was comfortable, usually nothing at all. We had no need for modesty we were all the same. Not that we looked alike but there was no sexual difference. We were all women. This paradise was perfect and uninterrupted until the day that everything went dark. I was lying in my bed and all of a sudden everything was gone. I had no idea what had happened. I couldn’t see. I couldn’t talk. I couldn’t even move my fingers. My mind was racing and all I could do was lie there. For hours I lay there like this. Eventually I began to be able to move my hands and slowly the rest of my body came to life. What I discovered as I awoke was that I was bound and wrapped in a black rubbery sheet.

Literature Summative Assesment

Rules of the Game Pre Reading: A. Read the cartoon and answer the questions.1. What country do the mother and daughter live in? They live in America.2. Was the mother born there? How do you know? No, she wasn’t born in American. I know because in the cartoon the daughter asks the mother if she means America and the mother says no where we are from original, our mother country.3. Why is the mother angry? The mother is angry because the daughter doesn’t know her and her mother's origins.4. Why is the daughter angry? The daughter is angry because her mother keeps nagging her.B. The mother and daughter in this cartoon do not understand each other. In your opinion, which of the following factors are to blame for this lack of understanding? Explain. The different in their †¦. Language : the mother was born and raised in another country so her English isn’t as fluent as her daughter's, who was probably born in the USA, this may cause a â€Å"shortage† in com munication or embarrass the daughter. Culture : the mother probably comes from a more traditional culture, which may cause a conflict between her and her daughter. C. Do you think the same types of conflict between parents and children are common in our country? Why or why not? I think that the same types of conflicts exist in our country because it consists of different ethnic groups and minorities. Every generation differs from the one before it, especially when the parents are born and raised in other countries. For example, the Russian immigrants who have trouble learning the Hebrew language and their children who adjust more easily. Basic Understanding Part 1What lesson does the narrator learn from her mother? The narrator learned from her mother that she can get what she wants without nagging.What hopes does the narrator's mother have for her children? The narrator's mother hopes for her children that when they grow up they will learn in a University.Is the family poor? Does narrator think so? The narrator's family is poor because she lives above a bakery with two bedrooms flat, but the narrator doesn't think that her family is poor because she says that her bowl was always full and that she ate five meals a day.Do you think the narrator's memories of her childhood are pleasant or unpleasant? All in all, I think the narrator's memories of her childhood are pleasant. She fondly remembers her life in San Francisco's Chinatown, which were filled with games in back alleys, fragrance of Chinese food and the different shops in the area.Why do the children prefer the alley to the playground? The children prefer the al ley to the playground because its’ darkness gives a sense of mystery and adventures.Why is the narrator scared of the sanddabs? The narrator is scared of the sanddans because it reminds her story that her mother told her about a careless girl who ran into crowded street and was crushed by a cab.What joke does the narrator play on the tourist? The tourist asked the narrator and her brother to pose for a picture in front of the â€Å"scary† restaurant, and after he took the picture, she told him to have dinner in the restaurant. The tourist asked what they served, and she shouted: â€Å"Guts and ducks and octopus gizzards! † and ran off.How did the narrator get her name? What does this tell us about her parents' desire to adapt to their new culture? The narrator was named after the street that her family lived in, and it tells us that†¦What is the tone of this passage? The tone of this passage is deductive and defensive , the mother explains the many abilitie s Chinese people have.Vocabulary practice: Write a sentence about the story using each pair of words/ phrase. 1. Invisible / strength: Waverley's mother taught her the art of invisible strength. 2. Strategy / arguments: Waverly learned from her mother the strategy for winning. 3. Rise above / circumstances: Waverly’s mother wanted her family to rise above their circumstances. 4. Two bedroom flat / Chinese bakery: Waverly lived in a two bedroom flat that sat above a small Chinese bakery. 5. Alley / playground: the best playground for the Chinese children was the dark alleys. 6. Playmates / adventures: The playmates always find adventures in the dark alleys. 7. Named after / official: the narrator is named after an official name of a street. 8. Wicked / Chinese torture: the wicked people should be tortured in Chineseculture. Understanding the poem: Answer the questions. 1. Point of view is the perspective from which a story is told. Whose point of view is rules of the game told from? The story is told by the narrator's point of view. 2. How did Waverly get her name? She was named after the street that her family lived in. 3. Where does the story take place? Copy and complete the chart. The setting City| San Francisco. | Neighborhood| China town. | Home| Jong family home| 4. What do we learn about Waverly's family? Waverly's family is a Chinese poor family that lives in Chinatown in San Francisco and in her home there is one girl named Waverly and her two brothers. Basic Understanding Part 2 1. What do we learn about Chinese culture from this incident? we learn from this incident that Chinese people attribute great importance to modesty and humility. It was shameful for the mother that her son was disappointed with his chip gift. 2. Is Waverly happy with her gift? How do you know? Waverly was happy with her gift which is life savers candy because she says that she kept eating them all the night because they were her favorites. 3. Why does Mrs. Jong tell Vincent to throw the chess set away? Mrs. Jong told Vincent to throw the chess set away because it was used before and he knows that because there are missing parts. 4. What is it about chess that attracts Waverly? She sees that the chessboard seems to elaborate secrets waiting to be untangled. 5. How does Waverly convince her brother to let her play chess? She uses the Lifesavers (her gift from the Christmas party) as a bribe to be let into the game. 6. Why do you think Mrs. Jong tells Waverly not to rely on other people to explain the rules? Because there is a sentence which says: â€Å"better you take it, find out yourself†. This means that it's better to find the answer yourself because Waverly has to learn to go forward alone without any help. 7. Why do Waverly's brothers lose interest in chess? Waverly's brothers lose interest in chess because they become more interested in roaming the streets in their Hopalong Cassidy cowboy hats. Vocabulary practice A. Which word in each group has a different meaning from the other two?donated / given / receiveddecent / poor / fineroken / lacking / missinggraciously / impatiently / politelyextra / replacement / substitutetactic / strategy / foresighthide / reveal / showadversary / partner /opponentB. Complete the sentences with the correct form of the words from exercise A. There may be more than one possible answer. 1. The gifts at the Christmas party were given. 2. It would have been a decent chess set- except that it was obviously used. 3. Several of the chess pieces were missing, but Mrs. Jong accepted the gift politely. 4. Vincent wouldn’t let Waverly play until she offered her life savers as replacement for the chess pieces. 5. Waverly studied the instruction book and learned some important strategies for winning at chess. 6. She learned that chess is a game of secrets which she must never reveal. 7. Soon, Waverly wasn't losing any games -but she lost her adversaries! Understanding the story: Answer the questions. 1. Which gift does Waverly choose at the Christmas party? The gift that Waverly chose was heavy and compact one that was wrapped in shiny silver foil and a red satin ribbon. 2. Who gets the chess set? Vincent, Waverly's brother gets the chess set. 3. What is wrong with the chess set? The wrong thing about the chess set is that it was used before and there are missing parts. 4. How is the problem solved? The problem was solved by putting a buttons (Lifesavers) instead the missing parts. 5. How does Waverly learn to play chess? She learns the rules of the game and goes on to continue playing chess. 6. How old is Waverly at this time? Waverly is six years old. Basic Understanding Part 3 1. Why is the man surprised by Waverly's question? — 2. What are these the names of? â€Å"These† is the names of strategies in chess which Lau Po taught Waverly. 3. What do we learn about Chinese culture from Mrs. Jong behavior? We learned about Chinese culture that it is built on modesty. 4. What strategy does Waverly use to convince her mother to let her compete in the tournament? The strategy that Waverly used to convince her mother to compete in the tournaments is the art of invisible strength 5. Why do you think the boy wrinkled his nose? Because he is 15 years old and she is 9 years old and he thought that she is young to play chess. 6. What does the wind represent in this passage? The wind represents the thinking power of Waverly. 7. What does Waverly silence tell us about accepted codes of behavior in the Jong family? It's tells us about the respect and listening to elders and for what he says because he has more experience than us. 8. How does Mrs. Jong justify Waverly's special treatment? Mrs. Jong justified Waverly's special treatment by telling Vincent:† Waverly squeezes all her brains out for winning chess. You play, worth squeeze towel†. 9. How does Waverly behave at chess competitions? What does this tell us about her character? It tells us that Waverly is very smart because she made for her opponent a good measure and that will make him think less because he is thinking that he is going to win and then Waverly will win. Vocabulary practice: A 1. Form as many phrases as you can by combining words the box. You may use words more than once, but use each word at least once. *champion *game *regional *chess *grand master *smile *child *local *status *etiquette *national *tournament *exhibition *prodigy *triumphantnational championchess national championlocal championlocal tournamentchess gamechild prodigyhess etiquetteexhibition gametriumphant smilegrand master statusregional tournamentA 2. Complete the sentence with the words combinations you formed. You may use words more than once, but use each word at least once.Waverly learned the fine points of chess etiquette from Lau Po.After watching an exhibition game, a man suggested that Waverly should play in local tournament.Waverly said that she didn't want to play in the local champion, but she really did.After Waverly won an important national tournament, shop owners in the neighborhood decided to sponsor her in national champion.By her ninth birthday, Waverly was a national champion, but she was still 429 points away from grand master status.6Waverly had become a child prodigy and her picture appeared in life magazine.At the end of a game, Waverly would flash her opponent a triumphant smile.B. Match the words from A and B to form verb phrases. Use each phrase in a sentence about the story. Make any necessary changes. A B 1. Attend 2. Want desperately 3. Defeat an opponent 4. Display trophies 5. Do chores Understanding the story: Answer the questions.Who helps Waverley become a better chess player? Lau Po, an old man helped Waverley to become a better chess player.Who watches Waverly exhibition games in the park? Some of Chinese people and tourists watch Waverly's exhibition games.Why does Waverly think her mother will not allow her to play in chess tournament? Waverly thinks that her mother will not allow her to play in chess tournament because she thinks that her mother will not let her play with strangers.What does Mrs. Jong give Waverly at her first tournament? Why? Mrs. Jong gave Waverly a small tablet of red jade which the sun's fire to give her luck in the tournament.How do people in the neighborhood show their pride in Waverly's achievements? The Chinese bakery beneath their home displayed her growing collection of trophies in its window, a flower shop, headstone engraver, and funeral parlor offered to sponsor her.What concessions do her parents make to allow her practice? Her parents allowed her not to clean to allow her practice .At what age does Waverly become a national chess champion? Waverly became a national champion in age nine.How does Waverly dress for competitions? Waverly wears a crisp pink and white dress with scratchy lace for the competitions.Basic Understanding Part 4 1. Why does Waverly find it difficult to practice at home? Waverly finds it difficult to practice at home because her mother who stands beside her while she is trying to plan her steps in the game. 2. How do you think Waverly's brothers feel about her special treatment? I think that he feels so angry about that, because they do all the work in the home when she is practicing all the time. 3. Why do you think Mrs. Jong insists that Waverly accompany her to the market? Mrs. Jong insists that Waverly accompany her to the market because she wants to boast and show that Waverly is her daughter. 4. How does Waverly feel about her mother's boasting? Waverly feels embarrassed when her mother boasted her. 5. What do you think Waverly wants to escape from? I think that Waverly wants to escape from her mother's nagging. 6. How does Mrs. Jong react when Waverly finally arrives home? She says calmly:† we not concerning this girl. This girl not have concerning for us. † 7. Who does Waverly see as her opponent? Waverly sees her mother as her opponent in the chess game. 8. What do you think Waverly's daydream symbolizes? The imaginary game could symbolize the transition from childhood to approaching adulthood. Vocabulary practice: A 1. Match the sentence beginnings in A to the endings in B. 1. Mrs. Jong thought of herself as –Waverly's protective ally. 2. She had a habit of – standing over Waverly while she practiced. 3. Waverly's parents made many concessions – to allow her practice. 4. Waverly had to accompany her mother – to the market on Saturday. 5. Waverly thought her mother was using her – to show off. 6. She thought her mother's behavior – was embarrassing. 7. Waverly pulled away from her mother – and knocked into an old woman. 8. The woman's bag of groceries – spilled to the ground. 9. Waverly fled from the market – looking for escape routes. 10. When she finally returned home – the door was locked. 11. Waverly stood there and – waited for her punishment. B. Complete the paragraph with the correct form of the words and phrases from the list. Advance * alone * angry black slits * chessboard * disappear * fly out* grow light * rise up * scream * triumphant smile. Waverly lay on her bed. In her mind she saw a chessboard her opponent was opposite her – two angry black slits on her face was a triumphant smile. As Waverly's opponent advance Waverly's pieces scream, retreated and fell off the board. Waverly felt herself grow light and she rise up into the air. She flies out of the window and over the city until everything below disappear and she was alone. Understanding the story Answer the questions 1. Why is it difficult for Waverly to concentrate at home? Waverly found it difficult to practice at home because her mother who stands beside her while she trying to plan her steps in the game. 2. What further concessions do her parents make to allow her to practice? She doesn't have to eat all the food that her mother made for her, she doesn't have to wash the dishes, and she doesn't have to tidy her bed. 3. What is Waverly's one obligation at home? The only thing that Waverly does at home is practicing chess. 4. How does Mrs. Jong show that she is proud of her daughter? How does Waverly react? Mrs. Jong shows her daughter that she is proud of her by insisting that she accompanies her to the Saturday market days walk with her proudly between the shops and saying â€Å"this is my daughter wave-ly Jong† to anyone who looked their way. One day Waverly tells her mother that she wishes she wouldn’t do that, and reproaches her mother that If she wants to show off, she should learn how to play chess. 5. Describe the scene that Waverly imagines at the end of the story. Waverly imagines a chessboard and her mother standing in front of her as her opponent and Waverly sees her white pieces falling off the board one by one and her mother's pieces are approaching her. Analysis and interpretation A 1. In this story the game of chess is used as a metaphor for life. Rules of the game† refers not only to the rules of chess, but also to the rules of life. Do you think this is a good comparison? Why or why not? It is a wonderful comparison; the rules of chess that Waverly learns are similar to the life skills for achieving success. This is the art of invisible strength. Examples: 1. Self control –†Bite back your tongue† â€Å"Vincent at first refused to let me play, but when I offered my Life Savers as replacements for the buttons that filled in for the missing pieces, he relented. â€Å". 2. Hiding your desires –†strongest wind cannot be seen† 3. Withholding knowledge – â€Å"I also found out why I should never reveal â€Å"why† to others. A little Knowledge withheld is a great advantage one should store for future use†. â€Å"It’s a game of secrets in which one must show and never tell. † 4. Foresight – â€Å"see the endgame before the game begins† â€Å"†¦ It is essential in the endgame to have foresight, a mathematical understanding of all possible moves. â€Å". 5. Planning –† the one who plays better has the clearest plans for both attacking and getting out of traps. † A 2. Answer the following questions, keeping the chess – life metaphor in mind. 1. When Waverly is six years old, her mother teaches her an important rule of life:† The art of invisible strength†. By this she means remaining silent, hiding her desire in order to get what she wants. How does this lesson help Waverly get what she wants from her mother? Give two examples from the story how does it later help her succeed at chess? Thus it is that Waverly, the protagonist and narrator of this short story, possesses a strange hybrid mix of values and lessons she has learned, some from her Chinese heritage taught to her by her mother, and some from her American heritage: her birth country. The art of invisible strength, then, is part of Waverly's Chinese heritage: â€Å"I was six when my mother taught me the art of invisible strength. It was a strategy for winning arguments, respect from others, and eventually, though neither of us knew it at the time, chess games†. This â€Å"art of invisible strength† is described by her mother as not confro nting others openly. Instead, you must seem to go along with them whilst subtly leading them in the direction that you prefer. 2. Waverly says of chess:† A little knowledge withheld is a great advantage one should store for future use†. Do you think this is true in life as well? Explain. Yes, I think this quote is true in life as well as in chess. I think it's true because the more knowledge we have, the more we can make use of it in the future knowledge can be a weapon for the future. 3. At the end of the story, Waverly imagines a game of chess in which her mother is her opponent. Who is wining this game? How does Waverly react when she understands that she cannot defeat her mother? How does this imaginary game reflect what is happening in Waverly's life? In the game Waverly visions in her mind that her mother is her opponent and she is winning. When Waverly understands that she cannot win this game, she felt herself growing a light and suddenly flies out the window. This game reflects Waverly's life in the sense of the on-going conflict with her mother, in which she feels she cannot win, and prefers to run away. 4. When Waverly says at the end of the story † I closed my eyes and pondered my next move†, do you think she is talking only about chess? What else might she be referring to? What do you think her next move will be? I don't think that Waverly is talking only about chess; I think she is also talking about her next move at home if to apologize to her family or to keep on not talking to them, but I think at the end she will apologize to her family because she is still young and she still needs her parents. B 1. Conflict is the struggle between opposing forces. One of the main themes of the story is the culture conflict between American- born Waverly and her Chinese- born mother. The chart below outlines some main differences between the two cultures. Read the chart and answer the questions that follow. Chinese people value †¦| American people value †¦| group cooperation | Individualism and personal freedom| maintaining â€Å"face† by showing respect and avoiding open confrontation or criticism | Open discussion and self- expression, even if it means direct confrontation and criticism| modesty, humility| Assertiveness| A formal social society in which status is based on age, gender and family| an informal society in which status is based on personal achievements, with equal opportunity for all| Respect for elders; obedience| Self- determination; independence| Mystery and magic| Rational thinking and logic| 1. What are some of the main differences between Chinese and American culture? The differences between Chinese culture and American cultures are: The Chinese culture in built on modesty, humility, Reciprocity and understanding between each other and also to give respect to elders. The American culture everyone has to go in his own way and to be assertive, to do the maximum to get to his/her goal even to â€Å"Run over† people. 2. Which aspect of each culture do you prefer? Explain. I prefer the American people's values because their cultures and values are liberal and are similar to the values that I was brought up on. 3. How is your own culture similar to / different from Chinese and American culture? My culture is similar to the Chinese culture in the aspect of giving respect to the elders and to be modesty. B 2. Which thinking skills did you use to answer the questions in B1? Explain. * Comparing and contrasting: finding similarities and differences and drawing conclusions. I used the thinking skill Comparing and contrasting because I was asked to find similarities and differences between a different cultures and the best way to finds differences between two categories are Comparing and contrasting. C 1. Now apply this thinking skill to the story. Copy and complete the diagram below with words from the list. How are Waverly and Mrs. Jong similar? How are they different? Support your answers with examples from the story. Waverly: mischievous, competitive, Americanized, independent and selfish. Mrs. Jong: modest, boastful, proud and superstitious. Both: strong-willed, traditional, clever, stubborn, determined, hard-working, confident, ambitious. Examples:Mrs. Jong is determined to teach Waverly the â€Å"art of the invisible strength†.Waverly is determined to learn how to play chess.Mrs. Jong is modest because when Waverly won her first game she said that it's luck.C 2. We often compare and contrast in our daily lives. Give one example of how you have used this thinking skill in the past few days. I used this thinking skill of compare and contrast that happened a couple of days ago between the choices of buying a new acoustic guitar or to continue practicing on my old guitar and when I will get better in playing the guitar I will buy a professional acoustic guitar. D 1. Imagine that a student from another country has joined your class recently. Although he seems bright, he doesn't pay attention in class, doesn't do his homework and doesn't interact with the other students. Which of the following might be connected to his behavior, in your opinion? Explain. He doesn't pay attention in class and he doesn't do his homework though he seems bright because he might have difficulties with the language and with new students whom he didn’t know. D 2. We can also use this thinking skill to gain a fuller understanding of people and events in literature. How is the characters' behavior in this story connected to their cultural backgrounds? Discuss the following, keeping in mind what you have learned about Chinese and American culture. (Page 78) 1. Mrs. Jong is showing her modesty by attributing Waverly's success in the chess game to luck rather than her excellent skill in playing chess. 2. Lao Po teaches Waverly to be humble and not announce the end of the game with arrogance and pride because she may be mistaken, and her opponent may still make a move and win the game. This saying also reflects a belief in mystery and magic, rather than logical reasoning. 3. Waverly cannot say anything to disagree with her mother, because in Chinese culture children show obedience and respect for their elders and do not contradict their parents. 4. When Waverly tells her mother that she can't practice when her mother stands over her, she is expressing her own feelings and asserting herself. This is an example of how her behavior has become Americanized. 5. Waverly is being impolite to her mother. She is showing her disrespect to her elders. This behavior contradicts the values of respect and obedience to the elders that is valued in the Chinese culture. Here Waverly shows the influence of the American cultural values of assertiveness and independence. D 3. Find additional examples in the story of how the characters' cultural backgrounds are reflected in their behavior. . One of the mothers at the Christmas party slaps her son because he did not show appreciation for her gift. His mother has to apologize to the crowd for his bad manners. 2. Waverly talks back to her mother and criticize her. She expresses her opinions openly- a quality values by the American culture. 3. Mrs. Jong gives Waverly a small tablet of red jade for luck before the chess tournament. This is an example of the importance of magic and mystery in Chinese culture. D 4. Tell your classmates about a time when you used the thinking skill of making Connections to help you to understand something better. Two weeks ago I saw a friend that Is walking and his leg is broken, I asked him what happened to him and he said nothing, two hours later other friend told me that they lost the football league game and his friend was quit the game after 30 min, then I understood that he was hurt in the game. E 1. Because of the cultural differences between them, Waverly and her mother view things from different perspectives. Decide whether each of them would agree or disagree with the following statements. Explain your answer. 1. Mrs. Jong would probably agree. Waverly would probably disagree. Waverly would think that children need to adopt the values of the culture they live in. 2. Waverly would probably agree. Mrs. Jong would probably disagree. Mrs. Jong would believe that cultural values should be passed on from generation to generation. 3. Mrs. Jong would probably agree. Waverly would probably disagree. Respect for parents and obedience is part of the Chinese culture. Waverly would think that children should express their own opinions openly and not have to behave as their parents wish. E2. Discuss the statements above with a partner. Whose perspective do you identify with- Waverly's or her mother's? My partner disagree with this statement because he think that if the children will obedience for everything which his parents says to him the boy will not be wrong and he will not learn from his mistakes. F. thinks back over the story. Answer the questions. 1. How is the theme of cultural conflict reflected in the story? The theme of cultural conflict is reflected in the conflict between Chinese-born Mrs. Jong and American born Waverly. Waverly and her family live in Chinatown in San Francisco. They live above a Chinese bakery, shop in a traditional Chinese stores (like the medical herb shop and fish market), go to the First Chinese Baptist Church and get presents from a Chinese Santa Clause. The Chinese immigrant parents want to preserve their traditional culture, whereas the children want to integrate in American society. Waverly's mother emphasizes traditional Chinese values of self-control and obedience, whereas Waverly wants to assert her independence. The young Chinese American fined them pushed away not only from American society but also from their Chinese parents and heritage. 2. How is the theme of conflict between mothers and daughters reflected in the story? This story is really one big struggle about independence between Waverly and her mother. Waverly, as the story progresses, becomes more aware of her talent, shows embarrassment at the way her mother takes pride in her and wants to exploit her gift and talent to bring attention to her: â€Å"My mother would proudly walk with me, visiting many shops, buying very little. â€Å"This is my daughter Wave-ly Jong,† she said to whoever looked her way. One day, after we left a shop I said under my breath, â€Å"I wish you wouldn't do that, telling everybody I'm your daughter. While the narrator enjoys the challenge of winning at chess for its own sake, clearly the mother enjoys the success of her daughter for the admiration it brings to her. At the end, the imaginary of the chess board in Waverly's dream is used to symbolize the conflict between Waverly and her mother, as each struggles for mastery over the other. The way that the story ends, with Waverly closing her eyes and â€Å"pondering my next move,† shows Waverly's desire to escape her mother and treats her conflict as a game of chess. Although Waverly has lost this round, she is considering how to ventually beat her mother and gain the independence she so desperately desires. 3. in the beginning of the story, Waverly is more in touch with her Chinese culture. How has this changed by the end of the story? In the beginning of the story, Waverly is more in touch with her Chinese culture because she is younger and her mother has more control over her. She lives and plays in a Chinese neighborhood. By the end of the story, Waverly is older and has been more exposed to American culture. She has attended chess tournaments, each one further away from home. As a result she is less in touch with her Chinese culture. 4. Mrs. Jong is upset because Waverly is becoming Americanized, but she herself adopts certain aspects of American culture. Find examples in the story. Mrs. Jong names Waverly after the street they live on. She takes her children to a Christmas party. She allows Waverly to play in the chess tournaments and she gives Waverly special privileges (according to the American rules). 5. Waverly sometimes sees her mother as her opponent. Are they â€Å"playing† by the same rules? Explain. How does this affect their relationship? Waverly learns the Chinese rules of behavior and uses them to get what she wants. For example she uses self-control and manipulation to get her mother to allow her to play in the local chess tournaments. However, as Waverly gets older, she and her mother don't always play by the same rules. Mrs. Jong plays by the Chinese rules of behavior, whereas Waverly has begun to reject these rules in favor of the American values of self expression and independence. This causes conflict in their relationship. 6. Explain the ending of the story. What does Waverly's daydream symbolize? Do you think it could be metaphor for growing up? Explain. At the end of the story Waverly imagines a chess game with her mother as her opponent. Mrs. Jong sits opposite from her, winning the game of inner strength. The chess game is a metaphor for her struggle and rebellion against her mother, and therefore for growing up. In her imaginary game, Waverly breaks free from her mother's influence. She leaves the safety of her home and neighborhood and floats above the city. She is free but also alone with no one to guide her or tell her what to do. She must now make her own decisions. Waverly has to plan her next move at home concerning her relationship with her mother. The imaginary game could symbolize the transition from childhood to approaching adulthood. G. Like the United States, Israel is a country of many immigrants. Have you, or has anyone you know, ever experienced a cultural conflict similar to the one Waverly experiences in the story? Share an example of this with your classmates. I had a Jewish friend that his parents came to Israel from Russia, but he was born here and was raised up on the Israeli culture. His parents want him to be surgeon so he could make the Russian community proud but he wants to be musician so he had many fights with his parents until they give up. Bridging text and context A. Read the background information. To what extent is the information reflected in the story rules of the game? (Page 79) The two stories is very similar because the two stories are about the Chinese immigrants families. and both families has one girl and two boys, in both stories the girls have Arguments with their mothers and there are conflicts between the American culture and the Chinese culture. B. How does reading biographical information about Amy Tan add to or change your understanding of the story? The author's difficult relationship with her mother is reflected in Waverly's difficult relationship with her mother, whom she sees as her opponent in the imaginary game. The culture's conflict that Chinese Americans experience is another theme that is reflected in the story. Waverly does not entirely identify with the American mainstream or with her parents' Chinese culture. C. Compare and contrast the fictional character of Waverly Jong with the author, Amy Tan. The character Waverly Jong is both similar and different from the author Amy Tan: 1. Both were the only daughters of Chinese immigrant parents and both had difficult relationship with their mothers. 2. Amy Tan became a successful writer, while Waverly became a successful chess player. Reflection 1. Did you enjoy reading the story? Why or why not? I enjoyed reading the story because it reminds me of myself, even though I am not an immigrant, but still there are many things that happened to Waverly that happened to me also, and it's good to see how people from different cultures react to similar situation, because if this kind of situations will return in the future, I will know how to deal with them. 2 . What did you found interesting or memorable about the story? What I found interesting in the story are the conflicts between Waverly and her mother because it happens to everyone, not only them but it's memorable because they have a different culture which will make them look differently from myself in a similar situation. What interest me is the comparison between their culture and my own.

Punishment vs Discipline Essay

Ashlee Johnson 04/29/10 Punishment vs. Discipline HFS 4213 Children cannot possibly benefit from â€Å"discipline† in the form of punishment. Simply put, punishment is disrespectful treatment of a child that will result short- term cooperation but further behavior problems long-term. No child should have to endure such negative modification methods intended to humiliate them with a goal of teaching appropriate behavior. Sadly, however, some adults think they are doing what is best for the child. But what can a child possibly learn from hearing a parent say, â€Å"If you hit your brother one more time, I’m gonna spank you! † The child interprets that message as â€Å"if I hit him, then you’re going to hit me. † There is no valuable lesson being taught in such a situation. Thankfully, organizations such as NAEYC have set forth guidelines for appropriate teaching techniques for parents and educators to utilize at home and in classrooms. By taking the initiative to research alternatives to punishment, one would see the egative impact this has on children. Anger, aggression, damaged self-esteem, fear, hostility, resentment, and deceitfulness are Just a few of the ways children respond to the emotional, physical, and verbally abusive means of punishment they may experience in an environment of uninformed adults. Even though it may be unintentional, the results can be devastating. There are many ways that discipline can be positive and actually help children learn. Effective child guidance approaches will instill in a child a way of controlling their own behavior. Children should have the power to make choices, and then they will learn from the consequences of their actions. They have a right to be respected and need to learn how to handle their emotions. It is our duty as early childhood educators and parents to allow young children an opportunity to gain knowledge and understanding from the experiences we offer them in safe, nurturing environments.