The Fragile X Syndrome

The Fragile X Syndrome The fragile X syndrome is one of the most prevalent mental retardation problems that are inherited to generations. The clinical features of people with this syndrome are very subtle and hard to diagnose. Recent progress in the field of molecular biology and genetics has outlined the molecular mutation, that causes the syndrome was a triplet repeat mutation. Due to repetitive CGG repeat the respective proteins are not expressed. New molecular methods including direct probe analysis and PCR analysis, have simplified the process of diagnosis. The nature of the gene, their respective gene product and its function has not been yet found clearly. Inheritance may be found due to common ancestral flow of X chromosome at birth. Introduction Fragile S syndrome is a genetic disorder that affects the intellectual, physical and mental factors of a human being. It is also known to be martin-bells syndrome and the effects range widely from mild to severe. It is caused by the mutation on the X chromosome of the individual in a single gene called the Fragile X mental retardation gene (FMR1). Psychological problems such as mental retardation may be caused by two main factors, the physical environment or the genetic factor that is hereditary. As we mainly focus on the genetic factor, the FRAXA locus in xq27.3 is associated in causing fragile X mental retardation. Therefore based on molecular genetic testing of FMR1 gene, fragile X syndrome can be diagnosed. Women are only 50% affected by this syndrome when compared to males due to the fact that they have two X chromosomes where as males have one. Most common symptoms found are seizures, mood instability, attention deficit, sensory over stimulation, aggression, autism, speech diso rder and sleep differences. This syndrome also shows certain physical symptoms such as long narrow face, large ears enlarged testacles in males, flexible joints etc., various researches is being done across the world to find a solution for the disease. Various genetic techniques has been developed and handled to identify the fragility of the chromosome. There has been so much improvement in research but a definite solution has not been obtained. The treatment for this syndrome is usually a multidisciplinary approach which includes occupational therapy, medical managements, education and linguistics. The Fragile X Mutation: Genes are the precursors of specific protein molecules which in turn are specific for various functions of the body. The major cause for the fragile x syndrome is due to the mutation in one single gene called the fragile x mental retardation 1 (FMR1) gene which is the precursor for the fragile x mental retardation protein FMRP. This protein is responsible for the normal development and functioning of the brain. Men have only one x chromosome so presence of mutation in that chromosome will cause the disease whereas in females, they have two x chromosomes and hence full mutation in one copy makes them carriers of the syndrome and they may be affected partially according to the amount of mutation and number of cells expressing the FMR-1 gene copy. The inheritance found on the chromosomes is termed as x linked recessive inheritance which is more complex than the normal x linked genes. Fig.1 X chromosome with fragile site [1] Fig. 2 A photograph of X chromosomes showing a fragile site from both a male and a female [2] The number of CGG repeats on the FMR-1 gene determines the complexity of the syndrome. The repeats are classified as short, medium and long repeats. The short repeat of about six to fifty times which is found very common. These short repeats are mostly unstable and do not definitely cause the syndrome. Yet a genetic counseling along with certain tests is recommended. The medium repeat is about 50 to 200 times and is called permutation. The fragile x mental retardation protein (FMRP) has lower risk of the syndrome as short sequence repeats. The long repeats are usually more than 200 and are termed as full mutation where the complete FMR-1 gene is altered and production of the FMRP protein is totally stopped. Among the people with full mutation or long repeats, men will have the fragile x syndrome and women will be carriers. Fragile x mental retardation protein (FMRP) The FMRP protein is found in the ribo-nucleoprotein complex and is encoded by the FMR1 gene. The FMRP weighs up to 60-70 kD. This protein is associated with the polyribosome or polysomes. Two RNA-binding domains, KH domains or K homology domains are possessed by this protein and it binds to fetal human brain to 4% approximately. It also has the ability to bind to its own mRNA. Even a small amount of mutation in one of the KH domain could stop its interaction with the polysomes leading to the fragile x syndrome. Inheritance of fragile x syndrome Males have xy chromosome and hence have only one FMR-1 gene where as females have xx chromosomes and hence they have two FMR-1 genes. On the F1 generation each parent transfers one chromosome each to the offspring where the transfer of the FMR-1 gene is determined. Therefore the possibilities of their offsprings being affected are grouped under two conditions. Condition-1 [3] If a male has a mutated gene in his chromosome it can be transferred only to his daughter because only the Y chromosome can be transferred to his son by him. So if he was crossed with a female with normal genes all their sons will be normal and the daughters will have one fragile gene and remain as carriers. father à ¡Ã‚ ºÃ¢â‚¬ ¹ y mother x xà ¡Ã‚ ºÃ¢â‚¬ ¹ (carrier daughter) Xy (normal son) x xà ¡Ã‚ ºÃ¢â‚¬ ¹ (carrier daughter) Xy (normal son) à ¡Ã‚ ºÃ¢â‚¬ ¹ fragile x gene Condition-2 [4] If a female has one mutated gene in her chromosome and is crossed with a normal male then there is 50% chance of all the offsprings, be it male or female to have the syndrome. father x y mother à ¡Ã‚ ºÃ¢â‚¬ ¹ xà ¡Ã‚ ºÃ¢â‚¬ ¹ (carrier daughter) à ¡Ã‚ ºÃ¢â‚¬ ¹ y (fragile son) x xx(normal daughter) Xy (normal son) à ¡Ã‚ ºÃ¢â‚¬ ¹ fragile x gene Symptoms The symptoms of fragile x syndrome are categorized into : Physical Large eyes Prominent forehead Large testecles Seizures Cognitive development Social and emotional hyperactivity Behavioral Shyness Social anxiety Speech and language Rapid and repetitive Inability to adopt words Over-talkative Autism Flapping of hands Poor eye contact All these symptoms need not be necessarily seen. A combination of various symptoms may vary from person to person based on the amount of gene altered in their chromosome. Sometimes there may also be no visible symptoms making the chances of early diagnosis even worse. Molecular diagnosis [5] The chromosome associated with the syndrome is classified into three major types based on the number of CGG repeats as Normal allele the CGG repeat in FMR1 is 6-50 PCR analysis is sufficient to study all normal type genes Specific point mutations and mosaicism must be studied using specific types of pcr or other molecular methods Visualization is achieved either by radio-active labeling or auto radiography followed by automated sequencing Agarose gel electrophoreses may be used for simple separation analysis with stains such as ethidium bromide. Appropriate size markers and size controls are very important. Controls used for analysis mut approximately contain 50 repeats. Pre mutation The CGG repeat in FMR1 is 55-200 PCR analysis is not possible hence southern blot is always preferred. Since both premutation and full mutation have methylation status, specific methylation sensitive enzymes such as EagI or NreI is used to resolve the size of the fragment. Methylated alleles are cut only by one enzyme where as non methylated normal alleles are cut by both the enzymes. Prenatal diagnosis is very important for pre mutation carriers. Rather than normal PCR a radioactive PCR can be used to test for premutation and then the result can by confirmed using southern analysis. Full mutation The CGG repeats in FMR1 ranges from 200 to thousands This can be analysed only by a southern blot technique. At complications, if a confirmable result could not be obtained from a southern analysis then a radio active PCR can be run combined with a linkage analysis and the result can be confirmed with southern blotting. Intermediate alleles The CGG repeats in FMR1 gene is usually between 45-55 Since they are in the overlapping region between stable normal allele and unstable premutation alleles, diagnosis and interpretation is very difficult Diagnostic Tools and Methods With the advancement in technology DNA tests are always effective in diagnosis of fragile x syndrome. With the findings of Sutherland et al. that folic acid deficient cell culture medium was able to induce a fragile site at xg27.3 cytogenetics was the major way to determine the presence of the syndrome but after cloning of the FMR-1 gene direct methods for identifying the x linked gene has become possible. By using monoclonal antibodies specific to FMRP it is also possible to show the expression of FMR-1. The most common methods used for diagnosis in the genetic level are Polymerase Chain Reaction Southern Blotting Antibody test Denaturing gradient gel electrophoresis Single strand confirmation polymorphism Non-radioactive molecular diagnosis. Polymerase chain reaction Polymerase chain reaction may be defined as a technique where one copy of a DNA is amplified into numerous copies at a rate of 2n where n is the number of cycles. It is achieved under specific conditions of temperature, along with polymerase enzyme. PCR amplification is one of the preliminary methods in diagnosing fragile x syndrome. Since the syndrome is associated with CGG repeats PCR is not considered as the best method always, since the amplification across C-G composition could be unreliable for PCR technique. However now its very much possible for a PCR to identify CGG repeats in combination with various techniques. methylation specific PCR of the FMR1 locus fluorescent methylation specific PCR methyl-CpG-binding PCR Some of the major advantages of PCR are that it is less time consuming, a very small amount of the sample is enough to produce numerous copy and the tri-nucleotide repeat in the FMR-1 gene is accurately sized. There are also various disadvantages of this technique. When there are more than hundreds of tandem repeats it is impossible for the PCR to determine the complete mutation which may give a different result. Due to differential amplification PCR is incapable of detecting mosacism between pre mutation and normal alleles. Fig 3: fragile x analysis using PCR [6] Southern Blotting Southern blotting is one of the best methods of diagnosing fragile x syndrome. It is modtly used as the confirmatory test after PCR. The variations between the mutations and permutations along with the amount of methylation occurred can be clearly obtained by the southern blotting technique. The process can be summed up in two simple steps: Step 1: the patients DNA is digested using restriction enzymes. Step 2: southern hybridization is carried out along with specific radioactive probes after separation of FMRI region. Using southern Blotting, the differences in full mutation and pre mutation can be easily identified. Full mutations usually cause smearing of the band and are always unstable. The only advantage of this technique is that its accuracy whereas its labor intensive, time consuming. The major drawback of this method is its inability to determine the exact number of tandem repeats of the CGG nucleotides which is very much necessary in determining whether the patient is completely affected or a carrier. Fig 4: fragile x analysis by southern blot [7] N refers to normal Specific tools for analysis DNA probe A DNA probe can be defined as a single strand of DNA which act as a template to identify the target DNA molecule. To identify the fragility of chromosome on the DNA specific probes were designed which increases the accuracy rate of the diagnosis. Chemicon (Millipore) [8] has designed a special probe named The CHEMI probe which is labeled with dioxegenin to detect the CGG repeats in the FMR-1 gene. Markers There were special markers called the microsatelite markers used in linkage analysis. This came to an end with the advent of modern techniques. However these markers are now being used under special circumstances like prenatal diagnosis where southern blotting has failed. Some of the markers used are DXS548, FRAXAC1 and FRAXAC2 combined with PCR. They are considerably accurate and they undergo low recombination mechanism with CGG repeats. Treatments There are no gene therapies or genetic treatments available for fragile x syndrome though a lot of other therapies are available which include speech-language therapy, occupational therapy, physiotherapy and behavioral therapy. There are also a large number of medications available as listed in the table below: Symptoms Medications Seizures Mood instability à ¢Ã¢â€š ¬Ã‚ ¢ Carbamazepine (Tegretol) à ¢Ã¢â€š ¬Ã‚ ¢ Valproic acid or divalproex (Depakote) à ¢Ã¢â€š ¬Ã‚ ¢ Lithium carbonate à ¢Ã¢â€š ¬Ã‚ ¢ Gabapentin (Neurontin) à ¢Ã¢â€š ¬Ã‚ ¢ Lamotrigine (Lamictal) à ¢Ã¢â€š ¬Ã‚ ¢ Topiramate (Topomax), tiagabine (Gabitril), and vigabatrin (Sabril) à ¢Ã¢â€š ¬Ã‚ ¢ Phenobarbital and primidone (Mysoline) à ¢Ã¢â€š ¬Ã‚ ¢ Phenytoin (Dilantin) Attention deficit (With or without hyperactivity) à ¢Ã¢â€š ¬Ã‚ ¢ Methylphenidate (Ritalin, Concerta) and dexamethamphetamine (Adderall, Dexedrine) à ¢Ã¢â€š ¬Ã‚ ¢ L-acetylcarnitine à ¢Ã¢â€š ¬Ã‚ ¢ Venlafaxine (Effexor) and nefazodone (Serzone) à ¢Ã¢â€š ¬Ã‚ ¢ Amantadine (Symmetrel) à ¢Ã¢â€š ¬Ã‚ ¢ Folic acid Hyperarousal Sensory over-stimulation (Often occurs with ADD/ADHD) à ¢Ã¢â€š ¬Ã‚ ¢ Clonidine (Catapres TTS patches) à ¢Ã¢â€š ¬Ã‚ ¢ Guanfacine (Tenex) Aggression Intermittent explosive disorder Obsessive-compulsive disorder (Often occurs with anxiety and/or depression) à ¢Ã¢â€š ¬Ã‚ ¢ Fluoxetine (Prozac) à ¢Ã¢â€š ¬Ã‚ ¢ Sertraline (Zoloft) and citalopram (Celexa) à ¢Ã¢â€š ¬Ã‚ ¢ Paroxetine (Paxil) à ¢Ã¢â€š ¬Ã‚ ¢ Fluvoxamine (Luvox) à ¢Ã¢â€š ¬Ã‚ ¢ Risperidone (Risperdal) à ¢Ã¢â€š ¬Ã‚ ¢ Quetiapine (Seroquel) à ¢Ã¢â€š ¬Ã‚ ¢ Olanzepine (Zyprexa ) Sleep disturbances à ¢Ã¢â€š ¬Ã‚ ¢ Trazadone à ¢Ã¢â€š ¬Ã‚ ¢ Melatonin Table 2: symptoms and medications for FRAXA [9] (*these prescriptions have serious effects. DO NOT INTAKE ANY OF THESE WITHOUT CONSULTING A MEDICAL PRACTITIONER) Current Research Gene Therapy: studies are carried out on the recombination strategy of the target gene, whether removal or replacement of the defective gene with a recombinant gene would eliminate the syndrome. Protein Replacement Therapy: research is being carried out on the possibility of producing FMR protein and supplying to the patients through external sources like food or tablets. Psychopharmacology: research is being carried out in finding medications for all the symptoms of fragile x syndrome. Conclusion Fragile x syndrome is one of the genetic diseases that causes psychological problems due to the lack of FMR protein responsible for the mental behavior of the person. The protein is not expressed in the individual due to fragility of the FMR1 gene in the x chromosome. Though PCR and southern blotting are the only tools available for diagnosis they are considerably accurate and research is being carried out on various re-combinative tools for diagnosis. A complete cure has not been still devised for the syndrome though various behavioral and physical therapies help the patients gain psychological strength.

Barriers to Health Maintenance and Disease Prevention

Barriers to Health Maintenance and Disease Prevention Redante Castro Introduction: There are many factors that interfere with health equity and the ability of the patients to get their healthcare needs met. Whether people are healthy or not, is determined by their circumstances and environment. There are challenges that a patient and healthcare providers encounters in securing and providing health services. These social determinants of health, such as income, education, transportation, housing, and race or ethnicity, have powerful influence on a patient’s life long before they arrive at a hospital or clinic. According to literature, persistent social exclusion and inequities in wealth distribution and in access and use of services are reflected in health outcomes. Social exclusions and inequity are obstacles to human development. It poses barriers to poverty reduction strategies. It hinders social unity and improved health conditions of the populations. Social exclusion and inequity are further compounded by racial and gender discrimination. There are health disadvantages due to differences between segments of populations or between societies. There are health gaps arising from the differences between the worse-off and everyone else. Lastly, there are health gradients relating to differences across spectrum of the population. Studies have shown that the poorest of the poor have the worst health. This is also a global phenomenon, seen in low, middle, and high income countries. Within countries, studies showed that a person with low socioeconomic position has worse health- this is the soci al gradient of health. The poorest have the highest mortality rates. Improvements in income and education has a positive effect on health. One’s occupation is also relevant to health in terms of workplace risks exposure and its role in positioning the person along a society’s hierarchy. There is also demographic transition to consider that affects health, i.e., increasing life expectancy, increasing number of youths, growing number of elderly persons in the population, increased migration, and rapid urban growth. Population distribution and population age structure are crucial determinants of social, economic, and health-related services. For example, people in poverty are likely to be exposed to higher level of stress, economic uncertainty, and unhealthy conditions than their wealthier countrymen. It was recognized by some policymakers and stakeholders that the population’s health cannot be sustained by focusing solely on the financing and distribution of medical services. A more comprehensive and integrated strategies are necessary to foster health in all policies. An approach that integrate considerations of health, well-being, and equity in the development, implementation, and evaluation of policies and services. Determinants of health are being acknowledged and incorporated into health reform processes and policy changes are made. Examples of these policy changes are: regulation of alcohol and tobacco products, the expansion of healthier transportation systems (bicycle paths, pedestrian-friendly roads, and pathways), improvement in air and water quality, expansion of primary health care services, and improvements in nutrition programs. This new focus has helped divert the emphasis away from individual lifestyles and from a focus on disease towards broader determinan ts and actions that created a big impact on population health. However, it is probably fair to say that all community issues are political to some degree. For example, if a factory is poisoning town water system with its effluent and poisonous waste, local officials are faced with the choice of not dealing with the actual cause of the problem, i.e., the dumping of waste and endangering citizen’s health, or addressing the dumping and endangering citizen’s job. Differences of political opinion can have enormous consequences in the health of the community. Health is not merely the absence of illness or infirmity. It is the embodiment of physical, mental, social, emotional and spiritual wellbeing (World Health organization, 2007). Spiritual wellbeing involves one’s religious belief. Religious belief is essentially personal and private matter over which the individual should exercise control and choice. It is of value to understand the relative importance of religious beliefs and practices in protecting and promoting the health of the people of religious faith and the need to protect their rights to practice this belief free from discrimination. There is an abundant evidence in literature that religiousness can generate multitude benefits in health outcomes. For people of faith, their religion and belief system may influence individual health-promoting practices, for example encouraging abstinence from alcohol or not eating pork. They may also influence social environments. Strong social support and participation have been found t o be associated with better health/ longer life and may be offered by some religious communities. To people of faith, prayer is very important while seeking healthcare or undergoing procedures, a prayer of support and encouragement when unfavorable result was received. There are some religious group that blood and blood products are not to be part of any treatment. For some religious groups, contraceptives, abortion and anti-life practices are against their belief system. With these in mind, alternative ways are to be sought to promote the health and wellbeing of the individual without compromising their belief system. Values are criteria that people use to evaluate actions, people and events. What is important to a person may not be important to someone else. Each individual holds numerous values with varying degrees of importance. Values are motivational construct. They refer to the desirable goals people strive to attain. People have different health care value system. There are three ways people will view their health: how they became ill, what made them ill, and how they believed they can be cured. Example, people from the East (China) would value acupuncture for pain management option. This in turn will cause health care providers to look at health treatment plan to accommodate those needs. Among Asian cultures, maintain family harmony is an important value. The interests and honor of the family are more important than those of individual family members. Older family members are respected, and their authority is often unquestioned. Therefore, due to respect for authority, disagreement with tr eatment recommendation by the health team is avoided. (McLaughlin, L. Braun, K. 1998). Ethnic discrimination and exclusion affects all aspects of the individual’s life, including those related to health. Studies show that indigenous working people has low income, low educational level, poor access to healthcare, and has high mortality rate. Health screening, diagnosis, and treatment inequities within and between communities of different race, ethnicity and socioeconomic background are evident. Poverty barriers are linked to lack of primary care physicians, geographical barriers to care, competing survival priorities, comorbidities, inadequate health insurance, lack of information and knowledge, risk –promoting lifestyles, provider-and system-level factors, perceived susceptibility to disease, cultural beliefs and attitudes. Social exclusion can be the result of prejudice, which results in different access to health care, education, or other services. These are social norms of acceptance of particular behaviors or practices. Culture influences how people define illness or wellness, how they understand the causes of illness or wellness, and whom they access to improve their health. Greater support from families, friends and communities is linked to better health. Culture-customs and traditions, and the beliefs of the family, practices and behaviors, and community all affect health and even the outcomes of intervention. Example: smoking, or even alcohol abuse, may be accepted part of the culture of a community. In that case, many more people will adopt it than in a community where those practices are considered health risks. Some people think that health is not having any disease or illness, something that one feels. A paper from a conference of international health experts in 2011 sees health as the ability to adapt and to self-manage (Jocelyn Lowinger 2014).Medical News Today (2014) claims that most people accept that there are two aspects of health, physical and mental health. Most people relates physical health to good body health because of regular physical activity (exercise), good nutrition, and adequate rest. To some people, physical health involves structural health and chemical health. Structural health is associated with one’s height/weight ratio, body mass index, resting heart rate, and recovery time after exercise. Chemical health suggests that there are no toxic chemicals in one’s body and that there is a balance of nutrients needed by the body. Mental health on the other hand refers to people’s cognitive and emotional well-being. People have always found it easier to e xplain what mental illness is, rather than mental illness. Most people agree that mental health is the absence of mental illness. Mental health, to some people includes the ability to enjoy life, the ability to bounce back from adversities, the ability to achieve balance, to be flexible and adapt, the ability to feel safe and secure and making the best of what you have. Some views health as reflecting lifestyle, including a moral dimension and emotional well-being (MacInnes Milburn: 1994). Healthy behavior as not smoking, good diet, exercising, and not drinking alcohol to excess, a positive approach to life. Elderly people concepts of health were identified as the absence of disease, as a dimension of strength, weakness and exhaustion and health as a functional fitness. (Williams, R. (1983)†Concepts of Health: an analysis of Lay Logic†. Sociology 17:185-204). Illness results from negative attitudes, arising from a conflict between the individual and society-lifestyles in its widest sense. Ideas about causes of disease tend to emphasize biological rather than behavioral factors. Some of the agents of disease cited by working class women included infection, hereditary factors and environmental factors. The causes of disease are very much outside the control of the individual. Studies have also shown that people’s ideas about disease causation and vulnerability from illness are also influenced by biomedicine, example, and germ theory. However, people tend to take on beliefs which tend to fit with their lay understandings. (Calnan, M. (1987) Health and Illness: the Lay perspective. London: Tavistock). (Blaxter, M (1983) â€Å"The Causes of Disease: Women Talking†, Social Science and Medicine, 16:43-52). On the other hand, non-Western people views illness into two main systems according to anthropologists- personalistic and natur alistic. Personalistic system views illness to be caused by the active and purposeful intervention of an agent that may be: a supernatural being such as a deity or a god, a non-human being such as a ghost, ancestor, or evil spirit, or a human being such as a witch or a sorcerer. In this system, the sick person is a victim, the object of punishment directed specifically against him, for reasons that concerns him alone. In naturalistic system, illness is explained in impersonal, systemic terms. There is a concept of balance and equilibrium. Health prevails when elements in the body – heat, cold, the humors, etc. are in balance appropriate to the age and condition of the individual in his natural and social environment. (Foster, G. Anderson, B. (1978) Medical Anthropology New York: Jon Wiley). There are also beliefs or superstition that people believes as causative factor of illnesses. An understanding of people’s ideas about health maintenance and disease prevention is crucial to the success of health education and health promotion programs. One’s health beliefs may contribute to the knowledge of informal health care-how people manage their own health and whether they choose biomedical health services. Public attitudes towards health professionals and their authority as medical experts are changing. The days of blind trust in a doctor â€Å"who knows best† is history. Social and cultural processes that have encouraged change in interpersonal trust relations have stimulated changes in institutional trust. Beliefs about the limits of medical expertise together with concerns about the effectiveness of professional regulatory systems to ensure high standards of clinical care, magnified by the media coverage of medical errors and examples of medical incompetence, have eroded trust in health care organizations, in the medical professions in general, and in the health system as a whole. The lower level of institutional trust and the emergence of more informed and potentially demanding patients who are aware that expert knowledge may be contested and who may actively seek further opinions poses challenges for both governments and the medical professions and raises the question of wh ether trust is still relevant and necessary to the provision of medical care in the 21st century. (Trust relations in health care – new agenda/The European Journal of Public Health 2006) There should be policies to improve health in early life, such as equal opportunity of access to education, good nutrition, health education; access to health and preventive care facilities and access to adequate social and economic resources. Legislations to help protect minority and vulnerable groups from discrimination and social exclusion should be implemented. Government should intervene to reduce poverty and social exclusion at both individual and neighborhood levels. There should be policy regarding improvement in conditions of work and employees involvement in decision making process. For individuals who turn to drugs, alcohol and tobacco use – there should be a policy that aims to address the patterns of social deprivation in which the problems are rooted. Effective drug policy must be supported by the broad framework of social and economic policy. Conclusion: Countries, such as New Zealand can develop health policy changes in assembling and promoting effective, evidence based practices, place health equity as a shared goal across governments and other sectors of society, build a sustainable global movement and to turn public health knowledge into political action. Governments should recognize that welfare programs need to address both psychosocial and material needs.

Understanding The Misunderstood Art From Different Cultures :: essays research papers

Understanding the Misunderstood Art From Different Cultures Art is a medium used by people world wide to express their ideas, their fears, and their joys. The artist takes the experiences of life and translates them into a visual object, rich in colors, shapes and sizes, for all the world to observe. As a casual observer of art, one is able to relive the feeling or experience the artist was trying to display, if only for a brief moment in time. No matter what cultural background one comes from, art appreciation and enjoyment erases the barriers and the limits, and allows cross-cultural understanding and appraisal. Art has always relied heavily upon universal symbols. One of the most well known universal symbols is the cross, meaning of course, religion. Religion of a culture is one of the most frequently misjudged and stereotyped aspects From the prehistoric times of the cave man to present day, art has depicted religious scenes native to a specific culture. This is where most of the cultural boundaries lie. To one person, a smiling monkey can instill a primal feeling of fear, while to another the first reaction is one of amusement. This difference in reaction is based upon religious upbringing, and nothing more. To certain culture, a smiling monkey is the scariest thing they could ever imagine, and to another, it means laughter. A close minded person viewing an ancient religious mask would see nothing more than nonsense, while one who wishes to understand art would see the beauty of that culture and it's beliefs, and would try to place themselves in a way so that they may understand the original meaning ofthe mask, and form an educated opinion on it. Anyone can enjoy a piece of art, but what is it that makes a piece of art "good"? Is it the realism of the piece? Or the absolute perfectness of a sculpture? Maybe good art is abstract, an array of shapes put together to make a point. Or maybe good art is a classical sculpture that catches the light just so and brings a warm smile to the viewers face. Is it a measure of craftsmanship? A measure of mediums used? A measure of technique? Or is it just a measure of how it affects the viewer? Is good art visually irritating or visually pleasing? The beauty of art is impossible to define, for it's beauty inherently lies in the eye of the beholder. As Georg Wilhelm Friedrich Hegel said, "Beauty is the spiritual put into a form." So, in defining beauty, one is attempting to define the spiritual beliefs behind the form.

The Sisters of Charity and their Service in the Civil War :: American America History

The Sisters of Charity and their Service in the Civil War In Lincoln's inaugural address on March 4, 1861, he pronounced that the Union could not be dissolved by an act of secession (Ward 34). On April 12, 1861, the first shot was fired upon Fort Sumpter, and so began the Civil War in the United States. On April 9. 1865, Grant and Lee met at the Appomattox Court House, for the surrendering of the Confederate Army, and then the Civil War officially ended. In the four years of conflict between these dates, our nation lost by death and disease 600,000 men. The task of caring for so many dying, sick and maimed men was an ordeal. Four Orders of Catholic Sisterhoods participated in caring for the wounded and dying. The orders were: Sisters of Charity, Sisters of St. Joseph, Sisters of Mercy, and the Sisters of the Holy Cross. The work of the Religious Catholic Sisters during the Civil War was commendable. When the war began, the Sisters were the only organized and trained female nurses. The surgeons "liked them because they had been bred to disci pline". Even President Lincoln had a high opinion for the tremendous service of the Catholic Sisters during the Civil War. "Mother", Elizabeth Ann Seton, was the founder and first Superior of the Sisters of Charity in the United States. In March, 1850, the American Community of The Sisters of Charity of Saint Joseph's of Emmitsburg, MD united with the French Daughters of Charity, co-founded by St. Louise de Marillac and St. Vincent de Paul. The merger and growth of the religious community resulted in the establishment of more providences throughout the United States. "Their mission was to serve persons marginalized by poverty, illness, ignorance, disability and injustice". The "black caps" as they were called by the soldiers, lived out their mission to its fullest during the Civil War. The Civil War separated the American Sisters of Charity geographically because their community had houses in the North and the South. The Sisters in California functioned outside the conflict, but they did contribute personnel and resources. When President Lincoln sent forth an appeal for volunteer nurses, nearly every Sis ter answered. On June 1, 1861, Brigadier General John F. Rathbone wrote to Bishop John McCloskey to request Sisters of Charity to assist at the military hospital in Albany, New York. One Sister went, and after a few days, Rathbone declared: "The superiority of the Sisters of Charity as nurses is known wherever the name Florence Nightingale is repeated .

The Importance of Individuality in John Knowles A Separate Peace :: Separate Peace Essays

The Importance of Individuality in John Knowles' A Separate Peace "There is a time in every man's education when he arrives at the conviction that envy is ignorance; that imitation is suicide; that he must take himself for better for worse as his portion. It is harder because you will always find those who think they know what is your duty better than you know it. It is easy in the world to live after the world's opinion; it is easy in solitude to live after our own; but the great man is he who in the midst of the crowd keeps with perfect sweetness the independence of solitude." (Ralph Waldo Emerson) A Separate Peace (1959) written by John Knowles, expresses the true struggle to respect ones individuality. In 1942 at a private school in New Hampshire Gene Forrester became good friends with his roommate, Finny. He envies Finny for his great Athletic ability. In spite of the envy, Gene and Finny do everything together and one day for fun they decide to jump out of a tree into the river. After that they form the Super Suicide Society, the first time t hey jumped being their reason for formation. During one of their meetings they decide to jump off at the same time. When they get up on the limb Gene bounces it and Finny falls on the bank. He shatters the bones in his leg and will never again play sports. Nobody realizes that Gene deliberately made Finny lose his balance. Because of the accident Gene does not play sports either and continues being friends with Finny. One night, some of the other guys from Devon School woke Gene and Finny up in the middle of the night. They are suspicious of the "accident." They conduct a trial to blame Gene for what has happened to Finny. Eventually Finny gets upset in the midst of argument and runs out. He ends up tripping and falling down the stairs, and breaking his healed leg allover again. It was a cleaner break this time but they still have to set it. Gene confesses to Finny that he bounced him out of the tree. While setting the break there are complications and Finny dies. Gene learns that h e is his own person and now that Finny is gone he can finally be content with himself. In the beginning Gene feels inferior to Finny.

Midterm Essay Cj210-04

Midterm Essay Exam xxxxxxxxxxx Kaplan University CJ210-04 1. What are methods of inquiry and how are they used in criminal investigation? The main methods of inquiry are the reconstruction of the past and the discovery or creation of new knowledge. In order to reconstruct the past there are three sources available to the investigator. These are people, physical evidence and records. People are a good source of information once you learn the art of questioning and how to sift through the lies and deceptions. Physical evidence paints a picture or can accurately recreate a crime.Records are used to show an investigator trends leading up to the crime. Now the discovery or creation of new knowledge is what separates the skilled investigator from the rest. This involves instinct, experience, an open mind and what some consider gut feelings. You need to think outside the box. 2. What is the optimal mindset of an investigator and how are the concepts associated with the optimal mindset of an investigator manifest? I believe the optimal mindset of an investigator is to be wary of all. An investigator needs to believe all suspects are guilty until proven otherwise.Never dismiss a clue or lead and never let your guard down. The manifestation of this mindset comes with common sense, experience, training and traits that some people are just born with. I think some of these traits can be learned but the best of the best are born to be investigators. 3. What is the scientific method and how is it applied to criminal investigation by criminal investigators? â€Å"The scientific method is a way of observing, thinking about, and solving problems objectively and systematically. † The criminal investigator uses this process much like a mathematician solves a problem.They identify the problem then come up with a theory. Then they collect data through observations and experimentation. This then helps the investigator to draw conclusions. 4. Discuss the three primary sources o f information for criminal investigators and provide detailed practical examples of each source listed. The three primary sources of information for criminal investigators are physical evidence, people and records. Physical evidence is comprised of things found at a crime scene such as fingerprints, tool marks, bullets, casings, hairs, fibers and many other things.When it comes to people this includes friends, family, witnesses, victims, business associates and people that share the same recreational interests. An example of records could be phone calls, credit card purchases and video surveillance tapes from banks, parking lots, and just about anywhere you go anymore. References Osterburg, James & Ward, Richard (2010). Criminal Investigation: A Method for Reconstructing the Past. Sixth Edition. Anderson Publishing http://www. ncjrs. gov/App/Publications/abstract. aspx? ID=78300

Morally chaotic world In King Lear

Shakespeare presents a variety of ways in which moral chaos is brought about, including the disruption of the natural order and the characters possession of typically corrupted morals, even going as far as questioning the morals of his own society. However, having different principles in a modern audience, we tend to have different interpretations of ‘moral chaos’ to that of a contemporary audience. In king Lear, Shakespeare arguably does create a ‘morally chaotic world’, particularly trough the notion of the ‘natural order’ being disrupted. The betrayal of the children against their fathers illustrates a significant disruption of nature, as it was considered natural and necessary for children to have unfaltering obedience for their parents, particularly their fathers. When Cordelia publicly refuses to obey her father’s wishes, she goes against the true qualities of a 17th century daughter in the natural order and it is arguably this initial rebellion that causes the suffering and tragedy throughout the rest of the play. According to feminist critics, Cordelia’s refusal to flatter Lear can be interpreted as an opposition to Lear’s authority and thus a direct challenge to the natural patriarchal order of the seventeenth century, the short emphatic sentence ‘Nothing’ stressing this assertiveness. We also see this betrayal of the father in the character of Edmund. By claiming ‘’I find it not fit for your o’er looking’’, not only does Edmund feign innocence, but he also portrays himself with overt concern for his father, reinforcing his false virtue. Edmund’s initial silence makes his soliloquy in the next scene in which he exclaims ‘’Legitimate, Edgar. I must have your land’’ exciting and surprising to the audience. The audience is privy to the Edmund’s scheming which creates a sense of dramatic irony, however in most productions; the Machiavellian Edmund is played as a ‘suavely intelligent, rather dashing figure’, creating a paradox as he is clearly evil yet alluring to the audience at the same time. Illegitimates were problematic for the rigid early modern social structure and were viewed as ‘extras’ that society struggled to accommodate. Therefore to a contemporary audience, the poor treatment of Edmund would come as no surprise; however a modern audience would interpret such extreme views on illegitimacy as immoral. As modern critic Foakes comments, â€Å"Edmund is the most dangerous and treacherous of the characters. Yet, he begins from a cause that we cannot identify as unjust†, illustrating how to a modern audience, Shakespeare does create a morally chaotic world through the poor treatment of Edmund, as the seventeenth century societal norms are so foreign from that of ours. Lear’s abdication can also be viewed as morally chaotic, as it was strongly believed in Jacobean society that Kings were chosen by divine right. In Lear’s pledge to ‘’express our darker purpose’’ the use of the adjective ‘darker’ to describe his actions illustrates the unnatural nature of such a decision. In Jacobean society, a king was an agent of God, and so it was seen as God’s responsibility to decide when his reign should end. A king’s handing power down the throne was against the divine order, and it was believed that Satan, through various evil spirits, was responsible for all attacks on the divine order. In Macbeth, a similar play, when King Duncan is murdered, the natural order is breached and chaos ensues: the day becomes as dark as night, Duncan’s horses turn wild and eat each other and a civil war breaks out. From a New Historicist stance, critics such as Tennenhouse argue that Shakespeare illustrates what happens when there is a ‘catastrophic redistribution of power’, therefore promoting the oppressive structures of the patriarchal hierarchy. However, other critics suggest that the tragedies occur because of society’s already ‘faulty ideological structure’, particularly emphasised in the David Farr production through the skewed girders, broken windows, sizzling strip-lighting and the eventual collapse of the flimsy kingdom walls. Moreover, Shakespeare appears to be presenting a morally chaotic world through the way in which the characters can be seen as possessing seen corrupted morals, motivated purely by materialism as opposed to moralistic values. We see this in the elegant and superficial speeches of Gonerill and Regan who claim to love Lear ‘Dearer than eyesight’, the hyperbole in these statements highlighting their manipulative nature and greed for worldly goods. Their actions throughout the rest of the play prove the fabrication of these initial promises. Johnson comments that King Lear is a play in which the ‘Wicked prosper and virtuous miscarry’. I find this view accurate as the audience can witness how the Machiavellian characters such as Gonerill and Regan are rewarded for their materialism, and given total rights over the kingdom, whereas the virtuous characters such as Cordelia and Kent are punished for their honesty and moralistic values, consequently demonstrating a world of chaotic morals. Lear himself is presented as morally ambivalent, similar to Claudius in Hamlet, initially valuing riches and reputation, which were the very things that fuelled his disillusionment and moral blindness. The love test he uses to bribe his daughters with ‘the largest bounty’ can be seen as an obvious attempt to buy their love and consequently boost his self-image. His rash reaction to Cordelia’s refusal to perform, pledging to ‘disclaim all paternal care’ illustrates how his hubris stops him from being able to differentiate between his honest daughter and his deceitful daughters. It also demonstrates the way in which the antagonists exploit the hamartia of the protagonist, heightening the tragic nature of the play. However, towards the end of the play, Lear’s character undergoes anagnorisis and so he comes to possess more virtuous principles. In Act 3, for the first time he recognises the plight of the ‘Poor naked wretches’ that are forced to ‘bide the pelting of [the]pitiless storm’, the alliteration in ‘pitiless’ and ‘pelting’ demonstrating the extreme suffering endured by those in poverty. Through Shakespeare’s emotive lexis, Lear is presented as regretful, empathetic, and compassionate, which directly contrasts with his initial selfishness and fixation with worldly things, and it is this contrast that presents a sense of moral confusion. On the other hand, through employing moral characters that remain virtuous throughout the play, Shakespeare doesn’t present a completely morally chaotic world. Cordelia’s character is the personification of virtue and morality, creating a direct juxtaposition with the immoral, Machiavellian characters such as Gonerill and Regan. When required to bargain her love for rights over the kingdom, she comments â€Å"I cannot heave my heart into my mouth†, portraying her honest nature. The idiom â€Å"heart in your mouth†, which suggests nervousness or fear, demonstrates that Cordelia does not see any reason to fear losing the land, emphasising her lack of materialism and strong moral compass. Expanding on this, Lear later describes her tears as â€Å"The holy water from her heavenly eyes†, the alliteration of ‘holy’ and ‘heavenly’ stressing her virtue and linking her to the Gods. Foakes comments â€Å"The optimistic thrust of Edgar's moralizing hints at the possibility of a happy ending. ’’ The play concludes with the moralistic character Edgar reigning over England, and although good characters such as Cordelia die, (which wasn’t received well by Shakespeare’s original audience), evil is ultimately eradicated whilst good triumphs. By the end of the play, Evil can even be seen to be eradicated by evil itself. Gonerill poisons Regan, and mentions in an aside after Regan feels the effects â€Å"If not I’ll ne’er trust medicine†, the secretive nature of this aside presenting her murderous and calculating nature. Shortly after, she commits suicide, which would have been seen as a great act of sin by a Jacobean audience, but ultimately evil defeats itself, evoking a rebalancing of morals and a move back towards the natural order. The play clearly descends from the embodied values of medieval morality plays, which was a popular form of drama in the sixteenth and seventeenth centuries. These plays present a direct conflict between good and evil, and ultimately the evil and chaos must be destroyed, and a moral lesson is learned. Overall, there are many aspects of King Lear that evoke a seeming moral chaos, however by the end of the play, as in all morality plays, the chaos is removed and moral order is restored, resulting in catharsis for the audience.