Evaluation of Hemodialysis Patients’ Tumor Marker

Evaluation of Hemodialysis Patients’ Tumor Marker CEA tumor marker level associates comorbidity of hemodialysis patients Purposes: Hemodialysis (HD) affects serum concentration of biomarkers. However, it remains unclear about the effect of HD on the levels of biomarkers, and efficacy of biomarkers in HD. The aim of this study is to evaluate the effects of HD on commonly used tumor markers. Methods: A total of 28 unselected patients (22 men, 6 women) with end-stage renal disease (ESRD), treated with maintenance HD, were enrolled in this study. GOT and tumor markers CA-153, CA-125, and CEA are measured. Results: The mean age was 57.6  ± 12.6 years, HD duration was 51.0  ± 34.0 months. Tumor marker CEA level is correlated to Charlson’s score of HD patients, levels of CA153 and CA125 are not correlated to age, duration of dialysis and Charlson’s score. GOT level is correlated to age, and Charlson’s score. Mean value of CEA level (5.9 ±4.0 ng/ml compared to normal value of 3 ng/ml for non-smoker and 5 ng/ml for smoker) is larger than normal value. Levels of CA153 (13.3 ±11.6 U/ml), CA125 (35.2 ±38.9 U/ml) and GOT value (20.4 ±8.9 U/L) fall in normal range. Conclusions: Concentration of CEA tumor marker is correlated with Charlson’s score which strongly correlated with HD outcome. GOT value is correlated with age and Charlson’s score which implies liver function drop in long term HD patients. Keywords: biomarkers, End-Stage Renal Disease, evaluation, hemodialysis, CEA. Introduction Hemodialysis (HD) is widely used for kidney failure patients who may represent a variety of underlying causes, including diabetes, hypertension, and glomerulonephritis. The dialysis membrane in artificial kidney tube filtrates out small molecules especially for small molecular weight proteins (i.e., et. al. shows that cancer-free HD man demonstrated significantly lower PSA compared to controls [8]. Here we examine the serum level of commonly used molecular biomarkers, i.e., CA-153, CA125, CEA, and GOT of HD patients. Patient and materials Study subjects Experiments performed in this study complied with the current laws and regulations in Taiwan, Republic of China. All procedures are followed by the ethnical guideline and approved by Kaohsiung Armed Forces Hospital committee, Taiwan. A total of 28 persons between the ages of 37 and 76 years with end-stage renal disease, receiving dialysis treatment three times per week, were enrolled in a prospective study in March 2008. Dialysis was carried out using a Nikkiso DBB-22B dialysis machine with 4 hours session. Dialyzer with APS 18MD (Asahi Kasei, Osaka, Japan, polysulfone membrane, surface area 1.8 m2, in vitro clearances for urea, 198 ml/min for QB-200 ml/min). Blood flow rate was setting at 200 ml/min. Patients with vascular success insufficiency which can’t reach required blood flow rate was excluded. Ultrafiltration rate (512 ±85 ml/h) was adjusted according to the patients’ needs. The flow and temperature of the dialysate was 500 ml/min and 37oC, respectively. Vascu lar access was either via an arterio-venous fistula (sixteen treatments), graft (nine treatments), or a Perm catheter (three treatment). Serum CA-153, CA125, CEA, GOT levels were measured before and immediately after HD using low-flux membrane. Blood/serum collection Serum samples were collected from HD patients during and after the course of HD treatment. 5 ml blood was collected in EDTA tube. The serum were then stored in 4oC and processed within 12 hours. The serum samples were centrifuged at 2000 rpm for 10 min prior to splitting into aliquots and stored at -20oC. Laboratory methods The serum levels of CA-153, CA125, CEA and GOT were measured with Abbott Axsym analyzer (Abbott Laboratories, Abbott Park, III). The reference ranges of the markers were: CA-153, 0-31.3 U/ml; CA-125, 0-35 U/ml; CEA, 0-3 ng/ml for non-smoker, and 0-5 ng/ml for smoker; GOT, 0-32 U/L. Statistical analysis The data reported are means  ± standard deviations (SD). Pearson correlation coefficient (r) was used for analyses of linear associations. Because the concentrations of serum tumor markers were not normally distributed, significance of differences was assessed by Wilcoxon Matched-Pairs Signed-Ranks Test. The level of statistical significance was always set at P Results Baseline demographic and clinical data We analyzed 28 patients, of which 22 were men and 6 were women. The baseline demographic and clinical data are summarized in Table 1. All patients are diagnosed as end-stage renal failure. The mean age was 57.8  ± 12.6 years. Mean dialysis vintage was 51.0  ± 34.0 months. Measurement of tumor marker concentration of hemodialysis patients The mean value of CA-153, CA125, and GOT fall in normal range (16.5 ±16.3 before hemodialysis, and 18.6 ±16.3 after hemodialysis, compared with 31.3 U/ml normal value, 35.2 ±38.9 before dialysis, and 34.3 ±41.2 after hemodialysis, compared to Correlates of serum markers Correlations between serum markers levels and age, duration of dialysis and Charlson’s score are tested. Of all variables, patient age and Charlson’s score are correlated with levels of some serum markers. CEA level was correlated with Charlson’s score (r=0.42, p=0.03) (Fig. 1).GOT level was correlated with age (r=0.42, p=0.02) (Fig. 2) and Charlson’s score (r=0.48, p=0.01) (Fig. 3). Other variables, including CA-153, CA125 is not correlated with age (r=0.07, p=0.7; r=0.2, p=0.3, respectively), and also not correlated with duration of HD, Charlson’s score (Table 2). Direct effect of hemodialysis on concentration of serum markers Since the data of CA-153, CA125, CEA and GOT fail in normal distribution test, Wilcoson signed rank tested is chosen to compare groups before and after hemodialysis. Groups of CA-153, CA125, CEA, and GOT before hemodialysis are not significantly different to that after hemodialysis (Table 3). Discussion CA-153, CA-125, CEA are commonly used tumor markers. CA-125 is a glycoprotein with high molecular weight (> 200 kDa), and is a cancer antigen for monitor mesothelium especially for ovarian cancer. Recently, CA-125 is used to monitor mesothelial cell viability in PD patients [9,10]. CEA is carcinoembryonic antigen with a molecular weight about 180-200 kDa, commonly used for monitoring gastric cancer [11], weakly correlate with carotid atherosclerosis [12], and with prognostic value of colorectal cancer in PD patients [13]. The mean value of CEA of 28 patients is higher than normal value, which is consistent with previous reports that patients with ESRD are usually with higher risk of cancer, and with higher levels of tumor markers [14]. In our cases, patient no.2, 5, 9, 13 and 27 were expired within 1 year after diagnosis. Patient no. 2 is finally diagnosed as hepatoma, patient no. 5 is cirrhosis of liver and died in septicemia, patient no. 9 is died in leukemia, and patient no 13 is died in lung cancer. It shows that high levels of CEA correlated with Charlson’s score which implies poor outcome, however it remain further confirmation. CA-153 is correlated to risk of liver disease. Though 8% patients were diagnosed liver diseases, but their GOT value fall in normal range, and CA-153 values of them were also normal. There are many reports indicated that long term hemodialysis may affect levels of biomarkers. We showed that biomarkers alter non-significantly after one HD procedure. It is interesting that recent report indicated acute effects of HD treatment on up- or down regulation of apoptotic genes in blood leucocytes [15] Tumor markers were produced by neoplastic cells, and can also be secreted by normal tissue. Many chronic diseases, e.g., inflammation, chronic bronchitis, cirrhosis of liver and renal diseases, affect the metabolism and elimination of tumor markers, may contribute the long term elevation of tumor markers. Our data show that short term effect of HD on patients is not significant. And all 4 serum markers are not correlated with duration of HD. It seems that the response of patients to HD doesn’t directly affect levels of these serum markers. However, CEA and GOT are shown to be candidates markers for monitoring HD outcome as they are positively correlated with Charlsonà ¢â‚¬â„¢s score. Table I Baseline demographic and clinical data GFR, glomerular filtration rate; NPCR, normalized protein catabolic rate, *Modified Charlson’s comorbidity score is calculated according to Beddhu S, 2000. Table II. Correlation of serum markers and age, duration of HD, and Charlson’s score. Table III. Comparison of serum tumor markers before and after hemodialysis Legends to Figures Figure 1.Scatter plots, regression line, and 95% confidence intervals reflecting correlations between serum levels of CEA and Charlson’s score of 28 HD patients. Figure 2.Scatter plots, regression line, and 95% confidence intervals reflecting correlations between serum levels of GOT and Charlson’s score of 28 HD patients. Figure 3.Scatter plots, regression line, and 95% confidence intervals reflecting correlations between serum levels of GOT and age of 28 HD patients.

Theories for Determinants of Emotional States

Theories for Determinants of Emotional States INTRODUCTION An individual fast asleep at night is suddenly awakened by a loud noise coming from somewhere within the house. He immediately becomes physiological agitated: the body begins to sweat, the heart beats faster, and hands begin to tremble. Does he experience fear, or perhaps another emotion such as anger, or even happiness? Schachter and Singer (1962) proposed a two-factor model that specifies the conditions under which people will experience one particular emotion or another when faced with an emotionally exciting event, such as impending danger. This model states that a person’s emotional response to danger is dependent on the interaction between their physiological arousal and cognitive appraisal of the situation (e.g. whether it is dangerous or not). Ordinarily, danger would trigger biological changes, such as increased heart rate, trembling, crying, and perspiration. These physiological changes in turn determine both the intensity (i.e. level) and quality (i.e. type) of our emotional response. However, the particular type of emotion experienced depends on how we cognitively perceive or ‘read’ the situation. For example, we experience fear if the situation is appraised as dangerous or life threatening, such as an approaching lion, or an imminent category 4 tornado. SUPPORTING ARGUMENTS In the scenario described at the beginning of this essay, the individual woken suddenly by a noise, and physiologically aroused will experience emotional arousal. The intensity of his emotions will be a direct function of his level of physiological arousal. So, for example, we will experience very strong emotions if his heart is beating extremely fast and he is sweating profusely. However, the type of emotion experienced will depend on how is appraises the situation. He will experience fear if for example he believes a burglar has broken into the house and is armed and dangerous. By contrast he may experience anger if he knows that his excitable pet dog probably knocked something down while chasing his cat around the house. Or he may experience happiness if he knows the noise was caused by his loving fiancà ©e who has just returned from the airport after long holiday her parents, and perhaps tripped over something when entering the darkened house. Schachter and Singers (1962) two- f actor model is actually a redevelopment of the James-Lange theory. James Lange originally proposed that emotional experience is contingent on the physiological changes induced by an event. Thus, for example, imminent natural disaster for example will first trigger an emotional response in an individual, for example anxiety. Because they feel anxious, the person will experience physiological changes consistent with this emotion, for example increased heart rate, and perspiration. ALTERNATIVE EXPLANATIONS Whether physiological changes precede emotional arousal, or vice versa, is a controversial subject. Psychologist Walter Cannon (1927/1987) proposed an model, known as the Cannon-Bard theory, which contends that physiological arousal is in fact contingent on emotional experience. It can be argued that human beings are not very good at monitoring physiological changes in their body. For example, subtle changes in heart rate, or mild increases in perspiration may go undetected (Chwalisz et al, 1988). If so, then people may simply fail to experience any emotion, regardless of their appraisals of the situation. Yet, people generally react instantaneously to danger, exhibiting signs of emotional disturbance, without necessarily being aware of an increase in heart rate or other physiological changes (Zillman, 1978, 1988). The emotional experience isn’t determined by our detection of biological changes, but rather may be contingent on how we appraisal of the stimulus, and our memory ( i.e. prior experience) and general knowledge about the stimulus. For example, an individual who suddenly comes face to face with a lion will correctly judge that this animal can kill and therefore his life is under threat. This appraisal in turn will produce fear. Similarly, the person may remember that he was viscously attacked the last time he met a lion, and/or more probably be aware of the fact that big carnivorous cats kill people. Another problem with the Schachter and Singer model is their failure to account for how people cope with threat or danger. They assume that physiological arousal elicits emotional arousal, so that they relationship between the two variables is always positive. However, theories on coping propose that two people confronted with the same stressful event may experience marked different intensities of anxiety. More specifically Janis and Mann’s (1977) conflict-theory argued that the level of intensity experienced varies depending on how people deal with stress generated by uncertainty what to do. Complacency results in little or no emotional arousal. Defensive avoidance refers to evasive strategies, such as denial, wishful thinking, and shifting responsibility -emotional arousal is generally low, but easily becomes intense when signs of the danger become salient. Hypervigilance denotes panic, and occurs when the danger seems highly imminent (e.g. an approaching tornado, or impendi ng illness). It is characterised by extremely high levels of emotional arousal. Finally, vigilance refers to a rational, and logical problem solving approach, and emotional arousal is considered to be ‘moderate’, rather than extremely high or low. The problem with Janis and Mann’s (1977) model is that to date there has been a paucity of experimental research testing the association between coping strategies and stress levels (but see Mann Tan, 1993). However, studies have demonstrated correlational relationships between coping styles and emotional arousal (Witte Allen, 2000), suggesting that the former should form an important element of Schachter and Singers (1962) model. More specifically, it is possible that physiological changes generate strong emotions when people cope in one particular way, and little or no emotion arousal when people cope another way. Stimulus Characteristics Schachter and Singers (1962) model makes no reference to features of the stimulus itself. Rogers (1983) argued that the way we respond emotionally to a stimulus, specifically a threatening communication such as a health warning, depends on how we perceive aspects of the stimulus. He argued that dangerous events, such as a probable illness or impending natural disaster contain cues as to the probability of the event, and its seriousness or magnitude. The greater our estimates of the seriousness of a threat, and its probability of occurrence, the greater the level of anxiety experienced. In other words, stimulus characteristics determine the intensity of our emotional experience. A large volume of research published since the mid 1970s has found ample evidence in support of Rogers (1983) ideas (see reviews by Eagly Chaiken, 1993; Milne et al, 2000). In fact Rogers formulations continue to influence professional thinking especially in trying to understand people’s emotional reac tions to threatening health communications. It can be argued that Rogers’s ideas do not invalidate Schachter and Singers (1962) model. Stimulus characteristics may simply be something else people consider, in addition to monitoring their physiological parameters, and trying to work out the situation. Or perhaps Rogers’s appraisals fit in with Schachter and Singers emphasis on appraisals of the situation. Thus, if people perceived the situation as highly dangerous, because of the high severity and probability of the danger, then they would interpret their physiological arousal as fear. METHODOLOGICAL AND ANALYTICAL ISSUES Critique of Schachter and Singers two-factor model requires closer scrutiny of the evidence they present in support of their model. Various methodological and analytic constraints limit the conclusions that may be drawn (Coolican, 1994). Firstly, the study design is questionable. This study was set up as a between-groups design with subjects assigned to either one of two physiological arousal conditions – a treatment group (injected with adrenaline), or placebo group (given a saline condition). There was no control group. The presence of a control group is significant because it allows the researcher to demonstrate that observed effects were not simply a result of the ‘anticipatory’ effects of interventions (treatment or placebo) given to subjects. Another problem with the design was the failure to control for background variables that may confound treatment effects. In particular, subjects baseline emotions prior to the study should have been accounted for in the analysis, in order to partial out any pre-intervention differences between groups. The population was a sample of introductory psychology students. This kind of sample is generally better informed that the average man on the street, and have been able to decipher the researchers’ hypotheses, and hence provide responses intended to confirm or refute the predictions. The sample size was also rather limited (just over a 100), making it more difficult to detect statistically significant differences between the groups. This may partly explain the absence of group differences in self-reports of anger between the adrenaline-ignorant and adrenaline-informed groups. The anger condition was problematic because it was felt that subjects didn’t want to display anger towards the experimenter regarding their participation in the experiment. The sample was not randomly recruited meaning that the findings may in fact be specific to the particular subjects used, and may not generalise accurate to the wider population. CONCLUSIONS Perhaps the best evidence in support of the two-factor model lies in the difference observed between the three ‘information’ conditions amongst subjects injected with adrenaline. Those in the adrenaline-ignorant and adrenaline-misinformed group reported the highest ‘happiness’ levels, presumably because, lacking information about why they were experiencing physiological arousal, there automatically assumed that they felt that way because they were happy. This demonstrates two things. Firstly, it shows that physiological arousal may elicit an emotional experience (intensity), and secondly that an understanding of the situation led to a particular type of emotional experience – happiness. This confirms supports the two-factor proposition that emotional experience is a function of the interaction between physiological and situational (i.e. cognitive) factors. Nevertheless, the evidence is questionable, largely due to the absence of a control group, and a lso the small sample size. Schachter and Singers analysis also fails to account for other factors that may moderate that may have an independent effect on emotional experience, regardless of physiological arousal, such coping strategy, memory, prior experience, and general knowledge. There is a strong possibility that the impact of physiological arousal may be significantly attenuated after accounting for additional factors. In essence, emotional experience in certain circumstances may be driven solely by cognitive factors (i.e. thoughts, perceptions, memory), with biological changes have little or no effect peoples emotional response. REFERENCES Cannon, W. (1927/1987) The James-Lange theory of emotions: a critical examination  and an alternative theory. Special issue: 100 years of the American Journal of  Psychology. American Journal of Psychology. 100, pp.567-586. Chwalisz, K., Diener, E. Gallagher, D. (1988) Autonomic arousal feedback and  emotional experience. Evidence from the spinal cord injured. Journal of  Personality Social Psychology. 54, pp.820-828. Coolican, H. (1994) Research Methods and Statistics in Psychology. London: Hodder   Stoughton. Eagly, A.H. Chaiken, S. (1993) The Psychology of Attitudes. Fort Worth, TX:  Harcourt Brace Jovanovich. Janis, I. Mann, L. (1977) Decision Making: A Psychological Analysis of Conflict,  Choice, and Commitment. New York: The Free Press   Mann, L Tan, C. (1993) The hassled decision maker: the effects of perceived time  pressure on information processing in decision making. Australian Journal of  Management. 18, pp.197-209. Milne, S., Sheeran, P. Orbell, S. (2000) Prediction and intervention in health related  behaviour: a meta-analytic review of protection motivation theory. Journal of  Applied Social Psychology. 4, 149-163. Rogers, R.W. (1983) Cognitive and physiological processes in fear appeals and  attitude change: A revised theory of protection motivation. In B.L. Cacioppo,   L.L. Petty, D. Shapiro (Eds), Social Psychophysiology: A Source Book  (pp.153-176). London, UK: Guilford. Schachter, S. Singer, J. (1962) Cognitive, social and physiological determinants of  emotional state. Psychological Review. 69, pp.379-399. Witte, K. Allen, M. (2000) A meta-analysis of fear appeals: implications for  effective public health campaigns. Health Education Behaviour. 27, pp.591-  615. Zilman, D. (1978) Attribution and mis-attribution of excitatory reactions. In J.H.  Harvey, WE.J.Ickes R.F. Kidd (eds) New Directions in Attribution  Research Vol 2. Hillsdale, New Jersey: Erlbaum. Zilman, D. (1988) Cognition-excitation interdependence in aggressive behaviour.  Aggressive Behaviour. 14, pp.51-64.

Revenge In Hamlet Essay -- essays research papers

Hamlet   Ã‚  Ã‚  Ã‚  Ã‚  Hamlet is a classic example of a tragedy as Hamlet suffers while trying to avenge his fathers death and eventually dies at the end while attempting to do so. Hamlet feels empty without resolution to his father’s death and since there is no justice system that is going to reveal the truth about his father’s death, he must take it into his own hands. Hamlet delays killing Claudius for a long time after the ghost appears. Hamlet delays his revenge of his fathers death not because he is a coward but because his psychological feelings and need for a perfect revenge cause him to delay in order to wait for the perfect moment to kill Claudius.   Ã‚  Ã‚  Ã‚  Ã‚  When the ghost first appears to Hamlet he tells him that it was his brother who slipped poison in his ear while he was sleeping in the orchard and clearly asks him to get revenge for his untimely murder. The ghost speaks to Hamlet about his father and says, “Revenge his foul and most unnatural murderer';(1.5. 31). Although Hamlet has little doubt that the ghost is not his father’s, he must still prove to himself that Claudius is in fact the murderer before he attempts to kill him. Hamlet decides to have the players act out what the ghost has told him and see Claudius’ reaction. When the play “The Mouse Trap'; is performed, Claudius is shocked by the play and storms out, which is the reaction of guilt that Hamlet had hoped for. The play is named “The Mouse Trap'; because it is designed to catch Claudius so that he reveals his distress of the play and shows that he was the murderer. Hamlet is now certain that Claudius is the murderer of his father and he can now carry out his revenge by murdering him.   Ã‚  Ã‚  Ã‚  Ã‚  Hamlets first opportunity to kill Claudius that he actually considers is when Claudius is confessing to god. Hamlet decides not to kill him at this point because he does not want to kill him while he is praying because he will go to heaven. This is the farthest that Hamlet has come to killing Claudius so far as his sword was drawn and ready to be used until he thinks logically and realizes that Claudius will be free from sin at the time of his death. This was a luxury that his father did not even have so why should he allow Claudius to have it.   Ã‚  Ã‚  &... ...es a plan to poison Hamlet but it backfires as Gertrude drinks the cup and both Hamlet and Laertes are cut with the poisoned rapier. When Hamlet learns from Laertes that they are both near death he is put in a must do situation and he reacts without hesitation. He orders the doors locked and for the first time he puts Claudius in a defenseless position and he attacks him with the poison. Claudius dies shortly after and Hamlet has completed his mission to seek revenge for his father’s soul. Hamlet could have easily killed Claudius at any moment if he did not care how it was done. However, Hamlet was looking for the perfect revenge and therefore he passed up many opportunities to kill Claudius. He could have easily followed Claudius out after the play and killed him, he could have easily attacked him while he was praying, or even at any point when he could get Claudius alone, but this would not have been the dramatic revenge that Hamlet was looking for. Hamlet delays his revenge of his fathers death not because he is a coward but because his psychological feelings and need for a perfect revenge cause him to delay in order to wait for the perfect moment to murder Claudius.

Rhyme, Scheme and Meaning in A Poison Tree :: Poison Tree Essays

Rhyme, Scheme and Meaning in A Poison Tree In many cases, poems are very abrupt and awkward sounding when read or spoken aloud.   A simple solution to end a poem’s awkwardness is a rhyme scheme.   Many poems don’t rhyme for reasons of subject matter but to make the poem more interesting and easier to read the poet uses rhyming words.   In many cases, poets use end rhyme, which is using words that rhyme in the end of the phrase or sentence of each sentence.   â€Å"A Poison Tree† by William Blake is a great example of end rhyme used in poetry.     Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   When one looks at the title, â€Å" A Poison Tree† one can assume the poem is going to be about some sort of fauna.   When the reader goes on to read the poem in its entirety, one sees â€Å" A Poison Tree† is simply a symbolic title.   The poem begins with someone telling of his wrath for a friend.   He had once told a friend why he was mad at or angry with him. When he spoke to the friend, the irritation went away.   In another instance, he was also angry with his enemy.   He had never told his enemy basically that he held him with the title of â€Å"enemy† and his angst or hate for him grew.   The poem takes on an â€Å"AA, BB† end rhyme scheme in that a sentence (in a group of two) will rhyme with the next.     Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The poet continues the poem exclaiming what he had to deal with while trying to hide his hate for his enemy.   He had basically tried to hide his hate or anger for his enemy out of fear. â€Å"And I sunned it with smiles, and with soft deceitful wiles† is a phrase in the poem that shows that the person speaking in the poem also tried to hide his hate for his foe.   The sentences in the poem continue to rhyme one after another in groups of two.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The third part in the poem exclaims what happened to the hate and anger he tried to hide while hiding it from his foe.   His hate â€Å"grew both day and night† which can basically sum up that what the speaker really has is angst towards his enemy.   Finally his angst grew so much that it could not be hidden anymore and his enemy found out about his â€Å"secret†.

The Frankenstein Phenomena in Life and Education :: Mary Shelley Frankenstein Essays

The Frankenstein Phenomena in Life and Education When we consider most traditional Hollywood Frankenstein films, the 'monster' is depicted as evil because he is 'malformed' but this is not always the case. The simple one-to-one relationship of ugly equals evil was not prominent in the Mary Shelley's original book or in more true-to-text films such as The Bride or more recently Kenneth Brannagh's attempt to make the authoritative film interpretation, Mary Shelley's Frankenstein. In these versions, the monster was portrayed as more human in his endeavors to question his origins, find a father and be happy. However, his physical characteristics have become the most salient feature in popular culture, so much so, that he is generally viewed as unquestionably evil bec ause his appearance offends the eye. The signs in this case are the monster's scars, his stitches, the bolts that hold his head on, the hands of a murderer sewn on, his club feet, his staggering jerky walk, his strange and retarded speech. We often take t hese signs as bei ng indexes and symbols of evil and malevolence that signify insidiousness and threat, even though these are characteristics of so many real conditions in our fellow humans. When we consider such people, we call these signs symptoms, infir mities, disabilities and medical problems. Are we so sure that we can separate how we view these signs depending on whether we are watching movies, such potent sources of how we regard our world, or when we deal with patients or students in the 'real' wor ld? Looking at how people that are considered aberrant either physically or mentally are portrayed in movies gives a good view on how society as a whole may see them, in my opinion. In the film The Bride, the monster's only companion after his escap e is a dwarf who was a circus performer. Although, this movie is definitely a more positive and sympathetic portrayal of the monster's condition, it also highlights the assumption that anybody with a physical makeup that is unusual, is considered just as much a 'monster' by society. In this discussion, I will initially take the representation of dwarves in movies and myth, and how they are perceived by society as being prototypical for a range of other physical differences that are considered negatively i n this culture. I choose dwarves because I believe they have been one of the most pervasively stereotyped groups in movies and myth and whose negative depiction continues to persist even in the politically correct era because now they can be labeled as "w eird but cool.

Unfortunate effects on rural public education in Ecuador

Educator George Washington Carver one time stated, â€Å" Education is the key to unlock the aureate door of freedom † ( State University 2002 ) . Such key will ne'er be held by the manus of Ecuadorians as the state of Ecuador battles to supply a satisfactory instruction system to kids in rural countries. The hapless instruction system is a cardinal subscriber to Ecuador ‘s province as a underdeveloped state. This restricting factor has created a barbarous rhythm of kid labourers and inequality among kids in rural and urban communities ( Salazar and Glashinovich 1996 ) . This paper will supply an in depth analysis of the instruction systems in Ecuador and the reform required to supply kids with a better hereafter. Ecuador ‘s substandard instruction system is a effect of the deficiency of authorities support towards substructure and handiness. With the deficiency of money towards instruction, jobs such as inconsistent instruction, hapless attending, and inequalities between rural and urban scho 1ols arise. Attempted advancement has been made by reformers such as President Rafael Correa who works with authorities support to better school systems ( Bellettini 2004 ) . It is people like President Rafael Correa who are undoubtably the greatest beginning of hope to the instruction system of Ecuador. Last April, I travelled to Ecuador with Canada World Youth. The intent of the trip was to organize a partnership between the Canadian and Ecuadorian pupils. The trip provided me with a cross-cultural experience as I learnt the necessity of foreign for rural instruction. Our group of 14 pupils raised $ 10,000 which was used to patronize the instruction of 4 pupils in Ecuador including their high school fees. The neglecting instruction system instated in rural Ecuadorian communities is faced with legion issues affecting, inconsistent instruction, and hapless attending. These issues are presented due to the deficiency of authorities support and support for instruction. The jobs presently present in Ecuador make it hard for Ecuadorians to go comfortable and contribute to society. Political instability within the state ‘s ain boundary lines have invited violent protests refering the old three democratically elected presidents ( Lopez and Valdes 2000 ) . Political issues every bit good as the economic crisis have proved to foster the potency of reconstructing proper and effectual instruction patterns in rural Ecuador. Many societal establishments demand governmental support, but it is the instruction system in Ecuador that is the most despairing. Research workers have highlighted that the instruction system has easy been bettering since the 1990 ‘s ( Vos and Ponce 2004 ) . Although, in comparing to old decennaries, the educational development has decreased in effectivity while educational inequalities has drastically grown between the urban and rural communities. The Ecuadorian authorities has set aside deficient financess for their societal plans as they entirely contribute four per centum of the states Gross Domestic Product, compared to the mean 12 per centum that the general Latin American state invested ( Ibid 2004 ) . Not merely has the Ecuadorian authorities neglected financess for the necessary societal plans but they have besides transferred their focal point to societal protection plans. This transportation of precedences has cut the support for instruction plans by 50 per centum ( Cibilis, Giugale and Lopez-Calix 2003 ) . The budget cut has affected all school systems across Ecuador, particularly the Ru 2ral communities. The limited support has caused a lessening in school substructure, teacher salary, and teacher preparation plans. The school systems are enduring and necessitate more investing and greater reform schemes. The authorities must increase their investing to at least five per centum of the state ‘s Gross Domestic Product in Oder to be successful ( Schiefelbein 1992 ) . In 2007, President Correa was elected to office in Ecuador. He created a platform that believed in instruction excellence and instruction reform ( Economist 2009 ) . Since 2007, Correa has spent about $ 280 million on school substructure and care ( Ibid 2009 ) . In add-on the President has introduced logic trials which instructors must go through in order to educate the young person. These logic trials are designed to increase a instructor ‘s credibleness and ability to teach immature pupils ( Ibid 2009 ) . Those who do non go through the logic trials are required to take a twelvemonth long preparation class which will assist to develop their instruction schemes and cognition. The logic trials benefit the school systems as instructors become more prepared and have more effectual instruction methods. These trials will be a compulsory step for all instructors, and will shortly increase the quality of Ecuador ‘s public instruction system. The deficiency of authorities investing towards societal plans, specifically instruction systems has greatly inf 3luenced handiness, learning methods, and school substructure. The rural communities are far more underprivileged so the urban public schools in Ecuador. In rural parts and in most parts of Latin America, instructors are likely to be under qualified and uneffective at teaching. Similarly to Ecuador, 40 to fifty of Latin American instructors have no professional preparation or makings ( Schiefelbein 1992 ) . The deficiency of preparation and makings is a consequence of hapless support and investing by the authorities. Training plans and workshops are non available to all instructors particularly those in the rural communities. In Latin America, people who graduate with higher degrees of instructions tend to travel to the urbanised metropoliss and obtain comfortable occupations ( Schiefelbein 1995 ) . Sadly, those who have hapless degrees of instruction, become instructors. Teacher ‘s with no preparation and limited cognition dictate the quality of a school. Furthermore, the lear ning population in Ecuador earn low wages as the authorities does non believe that instructors merit higher wages ( Schiefelbein 1992 ) . A typical public school teacher in rural Ecuador by and large earns $ 350 per month ( Torres 2005 ) . Teachers make an insufficient wage because there is limited support. Without support and low wages, most teachers at the public school degree have two or more occupations to pay for their fundss. Multiple occupations on the spell, means that instructors sometimes neglect to demo up to teach. The Foundation for Sustainable Development claims that there is a high rate of absenteeism among instructors ( 16 per centum ) † ( FSD 2003 ) . With instructors absent from categories 16 per centum of the clip during the scholastic twelvemonth, pupils are losing important acquisition chances. Most of the instructors absent for that clip would be working at other occupations seeking to derive a greater income. The quality of learning in rural Ecuador and in the public system is really low as the instructors are under qualified and largely disinterested in instruction. Although some instructors are effectual, the huge bulk of those effectual instructors are accepted to learn at private schools. Private schools in Ecuador have the money unlike public schools to afford exemplarily instructors. Unfortunately for the public system, qualified instructors escape to the private schools wh 4ere their wages are frequently five to ten times higher so the populace system ( Schiefelbein 1995 ) † The typical school is unable to engage extremely skilled instructors and will happen it hard to implement inventions to better its educational quality † ( Schiefelbein 1992: 36 ) . The methods of direction are unequal in states like Ecuador. Unfortunately due to budget restraints, instructors do non hold entree to a course of study to assist better their lesson programs. Without a common course of study to be followed by all public schools, the acquisition becomes inconsistent and unequal between different schools and parts ( Schiefelbein 1992 ) . Simple accomplishments that involve reading, composing, comprehension are hard to accomplish in rural Ecuador ( Ibid 1992 ) . Teacher ‘s do non posses the necessary certificates and stuffs to learn these kids, as the authorities neglects them of the necessary resources. With limited support invested in instruction, many effects arise with improper learning methods between schools in rural Ecuador. The greatest effect of hapless instruction is the rate of pupil repeat. In Latin America, merely 19 per centum of nine twelvemonth olds attend schools, but about 50 per centum of the first class pupils repeat as they are unable to carry through the instructor ‘s demands ( Schiefelbein 1992 ) . The state of Ecuador would drastically profit if more money was invested into increasing the quality of learning as it would diminish the rate of pupil repeat. Repeating a class is non merely reeling the pupil ‘s ability to larn and affect themselves in the work force but it besides posses monolithic affects on the educational system financially. In rural Ecuador, repeat is two times higher so the states average ( Ibid 1992 ) . If the Ecuadorian g 5overnment were to put more money in to developing an accessible course of study for all instructors, repeat rates would diminish. The Ecuadorian public school system posses many jobs for people in rural communities. The incompatibility in learning methods are followed by widespread hooky as parents would instead direct their kid to work every bit opposed to inscribing them in a rural school. Limited entree to schools and excess pupil costs for those in rural Ecuador are some of the major factors that affect registration rates and attending. There are huge differences and unfairnesss that are noticeable when comparing urban and rural instruction systems. Although public instruction is free for kids ages five to fifteen old ages old, enrollment rates suffer drastically in rural communities. In urban developed countries, kids have an norm of 12 old ages of schooling while kids from rural Ecuador merely have an norm of four old ages ( Cibilis et al. 2003 ) . Of those kids who had four old ages of schooling, merely 19 per centum of the entire rural population is enrolled in school compared to eighty per centum of th e entire urban population ( Ibid 2003 ) . Education unfairnesss are besides impacting those kids who wish to go to higher instruction degrees as merely two per centum of the poorest quantile attend higher instruction ( Ibid 2003 ) . The Ecuadorian authorities must larn how to scatter their support every bit among communities so that instruction patterns and handiness is the same for every kid. One of the most common grounds for the deficiency of registration, is due to school handiness. Although the Correo authorities is get downing to put more in school substructure and care there are still minimum public schools available for kids in rural countries ( Economist 2009 ) . â€Å" Merely 42 % of kids among those in the poorest quantile have entree to preschool instruction † ( Cibilis et al. 2003: 271 ) . There is perceptibly more chance for preschool instruction in urban communities as they are given a higher precedence over rural public instruction. Coincidentally there are more kids in rural Ecuador who need public instruction than urban countries. The unequal funding and hapless handiness to public schools for those populating in rural Ecuador posse major determinations on parents. They frequently have to make up one's mind whether or non to inscribe their kids due to fiscal restrictions. Although Ecuador promises to function the populace with free instruction there are still excess costs that are non covered by the authorities. With restricted financess, households have trouble paying for uniforms, school supplies, and transit ( Vos and Ponce 2004 ) . The indirect costs linked to the deficiency of authorities investing are a considerable decrease in household income because the kid is no longer working ( Ibid 2004 ) . Many households in rural Ecuador are faced with the hard determination on whether to direct their 6 kid to school or hold them work. With more authorities support towards public instruction, parents would non hold to pay excess costs for school. Therefore, parents would be more inclined to inscribe their kids to go educated. Although it is apparent that the rural instruction system in Ecuador is despairing for money and seems slightly incapacitated, there are reform patterns taking topographic point that are proven to be effectual. Presently in Mexico, instruction reform is taking topographic point that could be implemented in to Ecuador ‘s instruction system. Education reform known as â€Å" Telesecondary † would be movable and an effectual agencies of reform in rural Ecuador. Telesecondary is a learning scheme that delivers greater instruction through new engineerings. It consists of utilizing computing machines, cyberspace and mass media ( Cibilis et al. 2003 ) . The pupils larning from this advanced instruction method distance themselves from the teacher. The chief intent of Thursday 6 7is reform is to give all kids the ability to larn at their ain gait with a structured and dependable beginning of information ( Cibilis et al. 2003 ) . Another recommendation and applicable instruction reform scheme would be following the theoretical account of the â€Å" Escuela Nueva † . The Escuela Nueva undertaking is presently being practiced in Mexico. Escuela Nueva is community based which focuses chiefly on active engagement, and concerted acquisition ( Schiefelbein 1992 ) . The undertaking helps kids larn critical life accomplishments by using their cognition learnt in category to the outside community. This theoretical account of instruction responds straight to the instruction challenges that are presently present in Ecuador. It helps to extinguish hapless educational substructure, repeat rates, and under qualified instructors. The Escuela Nueva plans help schools to accomplish a standardised course of study, better instructor preparation and greater community enga gement. Once portion of the Northern Inca Empire, Ecuador has suffered a riotous yesteryear. Such is exemplified as the state has faced hapless administration and instability of fundamental laws as they have merely late imposed their twentieth fundamental law since 1830 ( State University 2002 ) . However, the greatest job to confront the state is that of instruction. The hapless instruction system is a cardinal subscriber to Ecuador ‘s province as a underdeveloped state. Ecuador ‘s substandard instruction system is a effect of inconsistent instruction, hapless attending, and the nonobservance of minority groups. Progress has been attempted by reformer President Correa who has concentrated 1000000s of dollars on breaking instruction in Ecuador. Undeniably, it is he w 8ho serves as the greatest beginning of hope to the instruction system of Ecuador. Although the President and his authorities have made much advancement during his two-term reign, there are many stairss to be taken to make declaration, including the riddance of child labour. Subsequently such extended instruction jobs are followed by the changeless conflict with child labour in add-on to hapless economic patterns. It is educational reform which will take to the development of Ecuador as its citizens become literate and receive extra chances, such as occupations, thereby decreasing poorness ( Bellettini 2004 ) . Education may be the job, but it is besides the solution to increase Ecuador ‘s patterned advance to go a developed state.

To The Hills of Kodaikanal

By Pranav R Kalathungal Last March, I, along with my whole family went for a trip to Kodaikanal. Though we travelled in a comfortable airbus, the journey felt very boring. After two hours, we started playing some games and suddenly things started to get interesting. The games and jokes along with some snacks elevated all our travel sick spirits. We had stared our journey the previous night at nine. After some hours of playful pranks and laughter, slowly everyone started getting drowsy and one by one people started nodding off to sleep. As the noise quietened down and the lights dimmed on the request of elderly people, and I too gradually settled down to sleep. What I saw the next morning when I opened my eyes, took my breath away. We were travelling on a road built into the side of a hill and were flanked by scenic mountains overflowing with luscious beauty on the other side. The scene was heavenly. I can still see the scene in my mind when I close my eyes. Through this heavenly path we reached a homely, beautiful, comfy cottage from where we had our breakfast. After a lovely and stomach filling breakfast, we started a tour of the place. We visited a garden so enriched with natural beauty, that it was paradise itself. The notoriously famous suicide point seemed to me, as if it was inviting people with its deadly beauty, into its treacherous depths. Hours seemed to pass away in minutes in this glorious land and suddenly it was time to go back. And so, thus ended a wonderful journey which will forever remain engraved in the canvass of my mind. I urge you, each and every one of my friends, to undertake a similar journey if you get a chance.