Malignant Hyperthermia Treatment Case Study

Malignant Hyperthermia Treatment Case Study In this scenario, there is a 35 year old female patient who develops malignant hyperthermia during surgery. Malignant hyperthermia is an uncommon pharmacogeneric disorder that leads to the hypermetabolic reactions of the skeletal muscle. [Ben Abraham, et al, 1998, Britt, 1985, Hopkins, 2008]. Age, type of anesthetic, environmental temperature, mitigating drugs administered simultaneously and degree of stress play an important role in triggering malignant hyperthermia. [Ording, 1985]. Primarily, potent inhalation anesthetic agents and depolarizing muscle relaxants such as succinylcholine are the major triggering factor amongst all the triggering factors. Malignant hyperthermia can happen at any time during surgery especially after the induction of the anesthetic and in the early postoperative period. Besides that, there is a tendency of the recurrent of malignant hyperthermia as well. Even though hypermetabolic reaction of skeletal muscle will cause hyperthermia and rhabdomyolysis but fever is not the earliest symptom of malignant hyperthermia. The earliest signs and symptoms of malignant hyperthermia are increase in the end-expired carbon dioxide concentration (EtCO2), tachycardia and muscle rigidity (especially when succinylcholine is given). [Britt, 1985]. Furthermore, the late sign of malignant hyperthermia is elevation of the body temperature. [Ali et al, 2003; Britt,1985].The other signs and symptoms are unstable blood pressure, tachypnea, hyperkalemia and arrhythmia. According to Hogan, 1998 the estimated incidence of malignant hyperthermia during anesthesia in North America and Europe is 1:15000 anesthetics for children and adolescents and 1:50000- 1:150000 anesthetics for adults. [Hogan, 1998].All ethnic groups are affected with malignant hyperthermia and males are more prone to be affected compared to female. [Britt, 1976; Hopkins, 2008]. The mortality was around 80% thirty years ago and has been reduced to less than 10% with the introduction of the muscle relaxant dantrolene sodium, widespread education and clinical and research investigation. [Ali, 2003; MacLennan, 1990] Malignant hyperthermia is an inherited disorder where the calcium channel that mediates the excitation contraction coupling in skeletal muscle is mutated. As a result, the calcium channel is very sensitive to the anesthetic agents [Hopkins, 2008]. This will lead to the uncontrolled release of cytoplasmic calcium from the sarcroplasmic reticulum upon the induction of anesthetic agents [Hopkins, 2008; Rosenberg et al. 2004]. As a matter of fact, there is a continued interaction between actin and myosin with sustained muscle contraction [Hopkins, 2008; Rosenberg et al. 2004]. The manifestation of the signs and symptoms of malignant hyperthermia can be explained by the increased release of the calcium. At first, this mechanism is compensated by the resequestion of calcium, which has lead to the breakdown of the adenosine trisphosphate (ATP) [Hopkins, 2008; Rosenberg et al. 2004]. This will cause the stimulation of the metabolism and results in increased oxygen consumption, heat and carbo n dioxide production. The breakdown of the ATP causes the release of the potassium into the extracellular fluid results in hyperkalemia and this will lead to the development of cardiac arrhythmias. Besides that, the continuous contraction of the skeletal muscle due to the breakdown of the ATP will lead to the further production of heat. As a result, there will be a further increase of oxygen consumption, carbon dioxide and lactic acid production, which, will lead to metabolic acidosis [Britt, 1985; Hopkins, 2008; Rosenberg et al. 2004]. In addition, the increase of the production of heat will also increase the contractility of the skeletal muscle hence further worsening the rhabdomyolysis process. If malignant hyperthermia is untreated, it might lead to vital organ dysfunction, acute renal failure, disseminated intravascular coagulation, congestive heart failure and even death. In this scenario, since the patient developed malignant hyperthermia during surgery, thereby the management of malignant hyperthermia can be divided into emergency treatment and postoperative treatment. When there is an acute development of malignant hyperthermia during surgery, all triggering agents have to be discontinued and the patient has to be hyperventilated with 100% oxygen to lower the end tidal CO2 immediately. This is followed by administration of 2.5mg/kg dantrolene sodium intravenously every 5 minute until the signs and symptoms of malignant hyperthermia are under controlled. [Morgan et al. 2006]. The dose of dantrolene can be titrated up to 10mg/kg. [Gronert et al., 1976; Harrison, 1988]. The monitoring of blood gases, all serum electrolytes, muscle enzyme such as cretine kinase, clotting profile, blood and urine for myoglobin, blood glucose, lactate and urea nitrogen must be carried out frequently during the surgery. Sodium bicarbonate should be given to correct the me tabolic acidosis to the normal level. In addition, patient has to be closed monitored and anti-arrhythmic except calcium channel blocker can be given for arrhythmias. Cooling measures have to be initiated if there is the present of hyperthermia. Ice packs to groin, axilla, and neck, cooling blanket, and nasogastric lavage with iced solution can be used to cooling down the patient. The cooling measures have to be stop if the body temperature is at 38.5oC. In order to treat myoglobinaemia and thus acute prevent renal failure urine output and urine pH should be greater than 3ml/kg/h and pH7 respectively. [Hopkins, 2008]. This diuresis can be achieved by hydrating the patient with crystalloid solutions together with mannitol (0.3g/kg) and furosemide (0.5-1.0mg/kg). [Hopkins, 2008; Mary, 1998]. Hyperkalaemia which is life threatening can be treated with glucose, insulin, intravenous calcium and intravenous potassium chloride. [Britt, 1979; Hopkins, 2008]. Once the surgery is finished, the patient has to be moved to intensive care unit or recovery room until malignant hyperthermia is under controlled and the patient should be monitored closely. Since it is possible for the recrudescence of malignant hyperthermia, dantrolene should be continued giving to patient for at least 48 hours. [Flewellen, 1983; Rosenberg, 2004]. Several laboratory tests such as blood gases, electrolytes, coagulation profile, muscle enzyme, blood and urine for myoglobin should be assessed more frequently. [Hopkin, 2008]. At first, besides dantrolene, procainamide/ procaine was recommended to treat malignant hyperthermia. The use of procainamide/ procaine was due to the successful studies carried out by Harrison, 1971, Denborough, 1972 and Noble, 1973. The study carried out by Harrison, 1971 showed a successful treatment of malignant hyperthermia with large dose of intravenous procaine in 2 out of 5 Landrace pigs. However, the study from Gronert, 1976 showed that the recommendation dose of procaine/ procainamide was ineffective in preventing malignant hyperthermia of the 20 susceptible pigs. Study compared the effectiveness of dantrolene and procainamide conducted by Nelson, 1979 showed that procainamide did not block the contracture response to halothane and it is ineffective for therapeutic and as prophylaxis of malignant hyperthermia. Procainamide or procaine was not been used after all. Harrison, 1975 demonstrated that dantrolene can relax muscle rigor in pigs with malignant hyperthermia and ceased the excessive heat and acid production. The study showed 100% survival rate in the last seven of eight experiments. Besides that, based on Britt, 1984 that 79 patients who received dantrolene therapy showed a significant 16.56% reduction in mortally (p Dantrolene is now the only known therapeutic agent used to treat malignant hyperthermia. Dantrolene is a diphenylhydantoin derivative that is highly lipid soluble but poorly water soluble. [PMJ GG Harrison]. Dantrolene can be administered by oral route or intravenous route. Roughly, 70% of dantrolene is absorbed with the peak plasma concentration reached in 6 hours following the ingestion of dantrolene by mouth. From the experiment performed by Harrison 1975, oral dantrolene was effective in treating procaine malignant hyperthermia. Nevertheless, there is a great variation in the plasma concentration for the oral dantrolene especially in children. Dantrolene is formulated as lyophilized orange powder, which comprises of dantrolene sodium, mannitol and sodium chloride. These contents are dissolved in water to yield a solution with the pH of 9.5 for intravenous injection. Moreover, the additional of the mannitol is to improve the solubility since dantrolene is poorly water soluble and mannitol also acts as diuresis, which prevent the deleterious effects of myoglobinaemia. The biological elimination half life of dantrolene is 12 hours. As a result, after 12 hours the plasma concentration of dantrolene will be 4.2ÂÂÂ µg/ml with the administration of 2.4mg/kg body weight of dantrolene intravenously. [Allen et al, 1988; Muehlschlegel Sims, 2009]. Dantrolene is mainly metabolized in the liver through oxidation and reduction reaction. Oxidation and reduction of the dantrolene result in the production 5-hydroxydantrolene and aminodantrolene respectively. Aminodantrolene will then undergo acetylation leads to the formation of reduced acetylated derivative of dantrolene. The metabolites of the dantrolene are excreted in urine and bile with 79% of 5-hydroxydantrolene, 17% reduced acetylated derivative of dantrolene and 4% of the dose is excreted unchanged in the urine. [Dykes, 1975; Lietman et al, 1974]. Moreover, it has been stated that the metabolites of dantr olene especially 5-hydroxydantrolene has some muscle relaxant activity. [Ellis Wessels, 1978; Ali et al, 2003]. According to Malignant Hyperthermia Association (MHAUS) the recommended dosage of dantrolene is approximately 2-3mg/kg. [Schulte-Sasse]. It had been stated by Flewellen Nelson 1980 that, 95% of the skeletal muscle of swine was depressed with the administration of 3.5mg/kg dantrolene intravenously. In addition, clinical study showed that administration of 2.4mg/kg of dantrole intravenously was able to depress 75% of the skeletal muscle in human. [Flewellen et al., 1983]. The dose was proved to be effective in the treatment of malignant hyperthermia.[ Hall et al, 1980; Kolb et al, 1982]. Thus, for acute malignant hyperthermia crisis, 2.4mg/kg of intravenous dantrolene is effective in life-saving of treating malignant hyperthermia. [Harrison 1988; Allen et al. 1988; Flewellen et al., 1983]. The single dose of oral dantrolene that is currently given to patient is 1-2mg/kg four times a day.[ Pandit et al, 1979; Fitzgibbons, 1981]. However, it was found that this recommended dose of oral d antrolene was not effective in preventing malignant hyperthermia in human. [Fitzgibbons, 1981; Flewellen et al, 1983]. Administration of oral dantrolene has been recommended before the operation and after the malignant hyperthermia crisis to prevent the recrudescence. Besides administration oral dantrolene, dantrolene can also be given intravenously as a prophylaxis therapy after the crisis. [Flewellen et al, 1983]. The prophylactic continuous intravenous dose of dantrolene is approximately 2.4mg/kg. [Flewellen et al, 1983]. Dantrolene is a muscle relaxant, which, acts on skeletal muscle cell to inhibit the release of calcium from sarcoplasmic reticulum. This will reduce the contractility of the skeletal muscle cell. According to Ellis,1973, the relaxant action of dantrolene acted directly and specifically on skeletal muscle but did not act on cardiac and smooth muscle. Besides that, dantrolene did not have any action on central nervous system. [Harrison,1988 Ellis, 1972]. Harrison and Chapman 1982, stated that the reduction in the amount and rate of calcium release by dantrolene is effective in preventing and reversing the pathophysiology of malignant hyperthermia in patient. In the experiment carried out by Harrison, 1975 has demonstrated that administration of dantrolene will cause a relaxation of the muscle rigor, cessation of the production of heat and acid. Based on the study carried out by Nelson, 1996 dantrolene is clinically effective in the treatment of malignant hyperthermia and showed a remarkable reduction in death and syndrome associated with malignant hyperthermia. When the syndrome of malignant hyperthermia was first noticed by the world during 60s, the rate of mortality was about 80%. The increasing awareness of syndrome with resultant in earlier diagnosis and treatment markedly reduced the mortality to 28% during 70s. With the introduction of the dantrolene, the rate of mortality reduced to 7%. [Harrison, 1988]. In addition, the experiment done by Harrison, 1988 showed that 100% survival rate was achieved with the administration of dantrolene. Long term administration of dantrolene orally is associated with some side effects such as hepatotoxicity and vomiting, which sometimes may be accompanied by diarrhea. [ Faling et al, 1980; Wilkinson et al, 1979]. However, the occurrence of hepatotoxicity is rare and several studies have been failed to prove whether hepatotoxicity is due to ingestion of dantrolene orally alone. [Flewellen et al, 1983; Dykes 1975; Durham et al, 1984]. As the reconstitution solution that is formulated for intravenous injection is highly alkaline, if extravasation occur it may irritate the vein which will lead to phlebitis and tissue necrosis. Therefore, dantrolene is recommended that to be injected into the large vein via a central venous catherter.[Ward et al, 1986; Muehlschlegel Sims, 2009]. Besides that, the mannitol that added to the dantrolene powder will cause osmotic diuresis with the loss of fluids and electrolytes. This will increase the risk of the patient who has poor renal function. [Bastro n,1983]. In addition, in the experiment that carried out by Flewellen and Nelson, chronic administered of dantrolene intravenously will result in difficulty in walking especially down stair. Muscle weakness lasting up to 48hours in 12 malignant hyperthermia subjects and associated with difficulty in walking, especially down stairs. [Flewellen Nelson,1983]. In the clinical studies that performed by Flewellen and Nelson and Oikkonen and his colleagues, patients were experienced fatigue and difficulty in swallowing accompanied to the long term administration of continuous intravenous dantrolene.[ Flewellen Nelson, 1983; Oikkonen et al, 1987]. The other common side effects of administered of dantrolene are dizziness, light-headedness, drowsiness, weakness, malaise and nausea. [Ward et al, 1986; Dkyes, 1975]. There is an adverse interaction of dantrolene when co-administration with verapamil. Co-administration of dantrolene and verapamil will cause hyperkalaemia and depression of the cardiac contractility. [Rubin Zablocki,1987; Saltzman et al, 1984]. The studies carried out by Lynch and colleagues and Saltzman and colleagues stated that administered dantrolene and verapamil concomitantly will cause remarkable hyperkaelemia and cardiac depression in dogs and swine. [ Saltzman et al, 1984; Lynch et al, 1986]. However, not all the calcium channel blockers will cause hyperkaleamia and the depression of cardiac contractility. Neither nifedipine nor amlodipine has significant of hyperkalaemia and depression of cardiac contractility when given together with dantrolene. [Freysz, 1996; Saltzman et al, 1984]. Besides having adverse effects and adverse interaction, another disadvantage of dantrolene is its cost. Dantrolene is an expensive drug, for intravenous dantrolene, it costs ÂÂ £15.08 per 20mg vial. As it is a huge amount of dantrolene are needed for immediate use, this has became an issue for some hospitals when purchase the dantrolene as dantrolene is very expensive especially intravenous dantrolene and dantrolene has a limited shelf life of 18 months to 2 years. [Allen et al, 1988; Hall, 1980]. In conclusion, malignant hyperthermia is uncommon life-threatening inherited disorder of the muscle cells. A sudden hypermetabolic reaction of the skeletal muscle when exposed to potent volatile anaesthetics and depolarizing muscle relaxants such as succinylcholine will endanger the patient by causing hyperthermia and massive rhabdomyolysis. Studies showed that appropriate dose intravenous dose of dantrolene is effective in treating patient during acute malignant hyperthermia crisis. Thus, 2.4mg/kg of dantrolene should be given intravenously during acute malignant hyperthermia crisis and continue giving 2.4mg/kg dantrolene after the crisis for 48 hours to avoid recrudescence of malignant hyperthermia. Besides, hypermetabolic reaction and the mortality rate of malignant hyperthermia can be reduced by taking precautions and increasing the awareness of patient who is malignant hyperthermia susceptible. With appropriate counseling, pre-operative screening and intraoperative monitoring th e vital signs and symptoms of malignant hyperthermia can prevent the potential lethal complications arise.

Free College Admissions Essays: Physics and Philosophy :: College Admissions Essays

Physics and Philosophy    Physics has always been the science that interests me most. It seems to me that physics tackles fundamental questions about the universe and it feels more relevant than other sciences. I enjoy experimental work in physics but do sometimes feel limited by the resources available at my college. I would like the chance to use more sophisticated equipment to investigate more advanced level physics. Actually doing some of the important experiments of the last century, such as Rutherford's proof for the existence of the proton would add a new level of realism to particle physics. My interest in Philosophy developed through my study of Law at AS-level. I started to take an interest in jurisprudence and read a number of texts on the subject. I found that these contained many terms that I had never really encountered before. This has left me wanting to find out more about philosophy and different ways of thinking.    I have chosen these subjects because I enjoy them and would like to look into them in more depth than I have done in the past. I have chosen Physics and Philosophy because the combination of subjects requires both mathematical and scientific ability but also aptitude in written communication and logic. I would like to leave my options open in terms of possible career and I feel that by developing a number of different skills this will give me the best possible knowledge base.    I would like to use the opportunity of higher education to strengthen my mathematical and science related abilities such as investigation and problem solving. However parallel to this I would also like to further improve skills in areas such as discussion and structured argument. I would also like to develop my written communication skills and I feel that this courses especially the Philosophy aspect would let me advance my writing style.    One of my main interests outside school is computers and the Internet. I have been using the Internet regularly for a number of years for many different purposes including research and communication. I have also developed my own web page and looked at things such as HTML and CGI scripts. My other interests are general socialising and also keeping fit. I am a member of my local gym and also regularly go swimming. I have gained my NPLQ lifeguard qualification and also have recently passed my two star canoe test and hope to progress onto my three star certification.

Development Of The Human Zygote Essay -- essays research papers fc

Development of the Human Zygote Hundreds of thousands of times a year a single-celled zygote, smaller than a grain of sand, transforms into an amazingly complex network of cells, a newborn infant. Through cellular differentiation and growth, this process is completed with precision time and time again, but very rarely a mistake in the "blueprint" of growth and development does occur. Following is a description of how the pathways of this intricate web are followed and the mistakes which happen when they are not. The impressive process of differentiation changes a single-cell into a complicated system of cells as distinct as bold and bone. Although embryonic development takes approximately nine months, the greatest amount of cellular differentiation takes place during the first eight weeks of pregnancy. This period is called embryogenesis. During the first week after fertilization, which takes place in the Fallopian tube, the embryo starts to cleave once every twenty-four hours (Fig. 1). Until the eight or sixteen cell stage, the individual cells, or blastomeres, are thought to have the potential to form any part of the fetus (Leese, Conaghan, Martin, and Hardy, April 1993). As the blastomeres continue to divide, a solid ball of cells develops to form the morula (Fig. 1). The accumulation of fluid inside the morula, transforms it into a hollow sphere called a blastula, which implants itself into the inner lining of the uterus, the endometrium (Fig. 1). The inner mass of the blastula will produce the embryo, while the outer layer of cells will form the trophoblast, which eventually will provide nourishment to the ovum (Pritchard, MacDonald, and Gant, 1985). Figure 1:Implantation process and development during embryogenesis (Pritchard, MacDonald and Gant, 1985) During the second week of development, gastrulation, the process by which the germ layers are formed, begins to occur. The inner cell mass, now called the embryonic disc, differentiates into a thick plate of ectoderm and an underlying layer of endoderm. This cellular multiplication in the embryonic disc marks the beginning of a thickening in the midline that is called the primitive streak. Cells spread out laterally from the primiti... ...e a normal infant. When something does go wrong, the embryo or fetus will unfortunately have some type of defect. The amazing accuracy with which a single cell can become something as complex as a newborn infant is a truley incredible feat! Works Cited Baker, David A. "Danger of Varicella-Zoster Virus Infection." Contemporary OB/GYN April 1990: 52. Carlson, Bruce M. Patten's Foundations of Embryology. McGraw-Hill Inc. 1981. Cunningham, MacDonald, and Gant. Williams Obstetrics, Supplement no. 10. 18th ed, Prentice-Hall, Inc. Februay/March 1991: 2,3. "Folic Acid for the Prevetion of Recurrent Neural Tube Defect." Medicine March 1993. Harrison, Ross G. Organization and Develpment of the Embryo. Yale University Press. 1969. Leese, Conaghan, Martin, and Hardy. "Early Human Embryo Metabolism." Bio Essays vol. 15, No. 4 April 1993: 259. Pritchard, MacDonald, and Gant. Williams Obstetrics. 17th ed, Prentice-Hall, Inc. 1985: 139-142, 800. Pritchard, MacDonald, and Gant. Williams Obstetrics, Supplement no. 13. 17th ed, Prentice-Hall, Inc. July/August 1987: 2. "Teratology." ACOG Technical Bulletin February 1985.

Padma Bridge Paragraph Essay

BANGLADESH ECONOMY IF PADMA BRIDGE NOT ESTABLISHED INTRODUCTION: The Padma Bridge is a multipurpose road raile bridge across the Padma river to be constructed in Bangladesh. When completed it will be the largest bridge in Bangladesh and the first fixed river crossing for road traffic. It will connect Louhajang, Munshiganj to Shariatpur and Madaripur, linking the south-west of the country, to northern and eastern regions. The project covers three districts — Munshiganj (Mawa point/North bank), Shariatpur and Madaripur (Janjira/South bank). The total area of land to be acquired and required for its components is 918 hectares. The requisition of land for the construction yard will be for six years on a rental basis. As per the new design, an additional 144.04 ha has been identified for acquisition, bringing the total to 1062.14 hectares. This additional land is required because project site lost significant land due to erosion, for transition structures and due to a change in railway alignment. The two-level steel truss bridge will carry a four-lane highway on the upper level and a single track railway on a lower level. The project will include 6.15  km long and 21.10 m wide bridge, 15 km of approach roads, toll plazas and service areas. Literature Review: It is a sad state of affairs when an entire nation has to suffer for the actions of just a few. The World Bank has claimed to have found credible evidence of a high-level corruption conspiracy among selected government officials involved in the Padma Bridge project. The cancellation of the $1.2 billion credit for the Padma Bridge project will have an adverse effect on the Bangladesh economy for years to come. It will also make it difficult for the current government to begin what it thought would be one of its signature achievements. The government will look for alternative sources of funding for the Padma Bridge. Malayasia has shown some interest. However, the World Bank decision will surely affect the terms and conditions that any prospective donor would offer for funding the project. And it definitely would not go in our favour. Hypothesis: If government of Bangladesh solve the problem about the corruption issue and find some other sources to build ta bridge and to help the busniess and economy of Bangladesh. Firstly we have to stop corruption and find out the sources who will help us to build Padma bridge. Objectives: 1. Main objective: The main objective is to find out the main causes of establishing of padma bridge and find out a solution of a problem. 2. Specific objectives:a. find out the potential causes of padma bridge corruption;b. find out a complete solution of this situationc. Business affects and benefits of the problem and solution.2. Materials and Methods: Description: Materials: I want to complete my research with possible data and documents from every source I can go through Research Methodology: a. reason of not starting the project; b. affects in business; c. who are responsible. Statistical Approach:business affect for not building padma bridgewhat is the solutions to solve this problem3. Timeframe:– I need approximately 15 days for this research. Because in 15 days I use 10 days for collecting the information and 5 days for analyze and complete the research. Working time : Every day 9:00am – 8:00pm (Except Friday & Saturday). 4. Statement of Budget:  Ã¢â‚¬â€œ 1. | tranportation| 4000/| 2. | food| 3000/| 3. | Equipment| 3000/| TOTAL| | 10000BDT| 5. Reference:  Ã¢â‚¬â€œ The Daily star,13th january 2013 Wikipedia of padma bridge

One Hundred Years of Solitude by Marquz – Destructive Consequences of Solitude IOP

Solitude is defined as remoteness from society or the state of being remote from others. In Marquez' OHYOS, solitude is what ultimately brings the village of Macondo to its tragic end. Throughout the novel we explore the interesting theme of the various forms and reasons behind solitude and its consequences. Psychological studies show that, on the individual level, various needs are assumed to promote growth and self-actualization. For instance, John Burton's Deviance, Terrorism and War specifies eight basic human necessities: the need for others' response (and consistency thereof); stimulation; security (for instance, freedom from everyday preoccupation with death fears); recognition (through which individuals receive social confirmations that their reactions to social stimulations are relevant and approved); distributive justice (not merely a consistency in response but a response or reward deemed appropriate in terms of individuals' experiences and expectations); the need to appear rational (which follows from the need for consistency of response– rationality calls attention to the fact that there is a need for consistent behavior in others); need for meaning to be deduced from consistent response; and the need for a sense of control. From this list are various â€Å"camps† promoting the centrality of their distinctive need systems. These include, for instance, the need to belong, to bond or connect with others; the need for meaningfulness and the need for transcendence. As put by Richard Nixon, â€Å"Unless a person has a reason to live for other than himself, he will die–first mentally, then emotionally, then physically. † Studies of terminally ill individuals reveal the need for assurance that they have a legacy, that their lives made a difference, and that others are who they are because of oneself and that these others will carry one's memory with them. The mere fact that isolation is commonly known as a form of torture demonstrates that too much solitude leads to destructive consequences. These studies are relative to my topic because throughout the novel we encounter situations in which characters are driven to insanity as a result of their solitude, even if it is a self-selected decision. To quote Francis Bacon, â€Å"Whosoever is delighted with solitude is either a wild beast or god. † One is the example of Jose Arcadio Buendia, the first great solitary of the novel. He becomes so obsessed in his pursuit for truth and knowledge that he neglects his family and ultimately loses all touch with outer reality. Another is the example of Colonel Aureliano Buendia, who retreats into the solitude of his sadness and becomes incapable of expressing emotion other than sorrow and resignation. Aureliano Buendia is an interesting character because, in the novel, he first expresses his clear preference for solitude after his encounter with a girl who is forced to sleep with other men in order to pay her debt to her grandmother. Because he feels uncomfortable in society, he retreats into the comfort of his own solitude, which brings me to introduce psychologist Abraham Maslow's hierarchy of needs. The hierarchy of needs is a sequential, graduating set of needs that a person must satisfy to reach one's full potential or self-actualization. The needs are ranked bottom from top as physiological needs, safety needs, love and belonging needs, self-esteem needs, and self actualization. These needs must be satisfied in order to get to the top, but one may go backward as well as forward, which relates to the theme of time as a cycle, and the Buendia's inability to progress. Because they are unwilling to communicate outside of themselves, the Buendia family is never able to move forward but moves instead in cycles, or a downward spiral, collapsing in on itself. According to Marlow, when one is unable to achieve the needs of love and belonging, it is assumed they regress back to the stage of securing their safety needs, which is most clearly demonstrated in Aureliano Buendias case. The solitary characters are often contrasted to the antisolitary characters of the novel such as Ursula Buendias and Pilar Ternera, and other characters who combat their solitude. Ursula Buendias and Pilar Ternera both live very long lives and devote their lives to strengthening social bonds. In her younger years, Pilar Ternera comforts the Buendia men with her sex and bear many of their children. She is extremely prosperous as the madame of a nunnery, which stands for a bountiful sexuality. Many other instances in the novel indicate that sex and love is used to combat solitude, especially the notion of free love. The most obvious example for this is perhaps the cold, barren relationship of Aureliano Segundo and Fernanda del Carpio in contrast with his relationship with Petra Cotes, in which his farm animals begin to proliferate and bring him great prosperity. This instance conveys the message that sexual liberation leads to progress and prosperity. Incest is a secondary theme of solitude. Essentially, incest is the practice of keeping family members within the family, which demonstrates the Buendias' habit of isolating themselves from the rest of the community and their inability to reach out to others. The incest that occurs throughout the novel only perpetuates the Buendias' solitude, and reflects the eventual destruction of the town. From the very beginning of the novel, Ursula warns of deformity as a result of incestuous relationships, and ironically, the last of the Buendias is born with the tail of a pig, and ends the family line. The novel ends with an interesting passage, in which the narrator explains, â€Å"He had already understood that he would never leave†¦ races condemned to 100 years of solitude did not have a second opportunity on earth. † Here solitude can be seen very differently, portraying the solitude of Latin America forced upon their race by the West, who denies their access to the opportunities of the developed world, in comparison to the Buendias inability to join the moving world. â€Å"The opposite of solitude is solidarity,† says Marquez. Solidarity is defined as a union of interests, purposes or sympathies among members of a group, or a fellowship of responsibilities and interests, an obvious lacking quality in the town of Macondo. Psychological studies show that social systems have various â€Å"needs† to function successfully. There is, for instance, the social need for a collectively shared sense of order and that rules for a society's game board of life are understood and respected by all social actors. An ordered world is a predictable world and the essence of society is the predictability of its members' actions. There are the needs for solidarity between social members (including, as anthropologist Clyde Kluckhohn observed, â€Å"a set of common values that give meaning and purpose to group life†), their willingness to accept their social duties and to make personal sacrifices for the welfare of others, and their cooperation with each other. Further, if we perceive social systems to be analogous to organisms struggling to survive in potentially hostile environments, there are such individual needs as defense, coordinated action toward collective goals, and the ability to adapt to challenging new internal and external conditions. The Buendias are obviously lacking in this cooperative quality and often struggle with their meaning in life, which is reflected in the destruction of the town. In quoting HG Wells, â€Å"A downtrodden class.. will never be able to make an effective protest until it achieves solidarity. † In order for the Buendias to leave their solitude, solidarity must first be achieved. From this it can be concluded that Marquez is promoting the same message for the solitude of Latin America, having been so long controlled by the West, before they must suffer the consequences of Macondo and the Buendia family.

An Analysis of Robin Hood

The story is part of every culture. Some of them teach the way of life, Other stories show how we become a cultural way, the other stories show how the kingdom was built. Not only because it existed for centuries but also because of the major change that occurred in recent years, mainly due to the historical events that occurred during shooting, all Robin Hood movies It differs from that of. This movie is enough to change the plot of the movie and change some of the prototype. The work of two historians explores this work and explores personal thought and analysis of legend of Robin Hood. The first one is Holt's work in his book Robin Hood, followed by Hilton's article The Origin of Robin Hood. The purpose and discussion and method of each job will be reviewed. By carefully studying the two works, the theoretical methods of each writer are also analyzed. These two sections will be compared and analyzed to see information shared by historians and different information. In the 19th cen tury, the legend of Robin Hood was specifically targeted at children. Wreath for children is for children of Ritsin's Robin Hood series made in 1820. A novel by Robin Hood for children began to appear. It's not that children have never read Robin Hood's story before, but this is the first time they have specifically mentioned in Robin Hood's literature. A very influential example of these children's novels is Robin Hood's Robin Hood and Little John (1840). It was adapted from France by Alexandre Dumas of Le Prince Devore (1872) and Robin Hood Le Procrit (1873). Egan ordered Robin Hood to be born, but brought up by forestry officer Gilbert Hood. The story of Robin Hood. Lord Gisborne is involved in one of medieval folk songs on Robin Hood. Robin and his Little John colleagues were paving the way for controversy and parting Little John was alone, but Sergeant Nottingham grabbed him and tied him to the tree. Robin met Sir Gai who swore to kill the gang leader. When they found each othe r's identity, they pulled out the sword and fought. Robin killed Lord Gay and put on his clothes. They planned to rescue when his captured letter arrived at Robin's companion in the forest. When a priest told Robin to be arrested on the way, Little John and Mucci grabbed him and broke his neck. John and Mucci visited the king of London in disguised form and then returned the Nottingham document with noble signs. The sheriff did not recognize them, they welcomed the two men and treated them with feasts. That night, John and Mucci killed Robin prison and released Robin.

Jim Crow Research Paper Example | Topics and Well Written Essays - 1000 words

Jim Crow - Research Paper Example The Jim Crow was characterized by tough anti-black polices or laws (Packard 2003, 222). Under the Jim crow, people of color especially African Americans were seen as people who belonged to the lower or second class in society. The Jim Crow rallied for implementation of anti-black policies because many theologians and Christians preached that the white people were children of God. They taught that God cursed people of color especially black men to be servants, and due to this, God endorsed racial biasness (Boskin 1976). In addition, craniologists and social thinkers argued that the culture of the black people was inferior and that they were intellectually inferior to the white people. Those politicians who were against social integration believed that the black culture could not mix with the white culture as this could lead to mongrelization of the white race which they perceived to be superior than any other race (Klarman 2006, 211). The media propagated racial segregation in their articles where they referred to black people as darkies, coons, and niggers. Their messages in the articles spread anti-black information and stereotypes. For instance, in schools, white children saw black children as inferior and worthless. Under the Jim Crow, all social institutions such as schools and churches reinforced oppression of the people of color particularly African Americans (Parish 2008, 93-95). The Jim Crow norms worked in combination with the Jim Crow policies. The Jim Crow norms were responsible for black exclusion from significant facilities such as jobs, transport, and schools. The 13th and 15th amendment of the US constitution had given black people same rights and legal protection as white people (Stetson 2011, 188). However, when Rutherford was elected the US president, border and southern States started restricting the freedoms and rights of black people. Even the highest institution in the land, the Supreme Court, reinforced racial segregation with the