Therapeutic Hypothermia for Postnatal Refractory Hypoxemia

Therapeutic Hypothermia for Postnatal Refractory Hypoxemia THERAPEUTIC HYPOTHERMIA FOR POSTNATAL REFRACTORY HYPOXEMIA « A CASE REPORT IN A TERM NEONATE K. Sarafidis1, E. Diamanti1, V. Soubasi1, K. Mitsakis2, V. Orossou-Agakidou1, Bianca Popovici3, M. Moga3 Summary We describe a term neonate treated with whole-body hypothermia several days after birth to counteract refractory hypoxemia due to persistent pulmonary hypertension unresponsive to optimal treatment. This approach was selected to improve oxygenation and protect the brain from the consequences of hypoxemia. In our experience, hypothermia did not worsen pulmonary hypertension, although no beneficial effect on oxygenation was noted. Never ­theless, the favorable neurological outcome of die neonate provides some evidence for neuroprotection against refractory hypoxemia using hypothermia. Key words: persistent pulmonary hypertension of the neonate, neuroprotection, mechanical ventilation Rà ©sumà © Lhypothermie thà ©rapeutique pour lhypoxà ©mie rà ©fractaire post-natale: prà ©sentation dun cas dun nouveau-nà © à   terme Nous dà ©crivons un nouveau-nà © à   terme traità © par hypothermie du corps entier quelques jours aprà ¨s la naissance afin de neutraliser lhypoxà ©mie rà ©fractaire due à   lhypertension pulmonaire persistante qui ne rà ©pond pas à   un traitement optimal. Cette approche a à ©tà © choisie pour amà ©liorer loxygà ©nation et protà ©ger le cerveau contre les consà ©quences de lhypoxà ©mie. Dans notre expà ©rience, lhypo ­thermie na pas aggravà © lhypertension artà ©rielle pulmonaire, mais il na à ©tà © notà © aucun effet bà ©nà ©fique sur loxygà ©nation. Nà ©anmoins, là ©volution neurologique favorable du nouveau-nà © a fourni des preuves de neuroprotection contre lhypoxà ©mie rà ©fractaire à   laide de lhypothermie. Mots clefs: hypertension pulmonaire persistante, neuroprotection Introduction anagement of late preterm and term neonates with moderate-severe hypoxic- ischemic encephalopathy (HIE) following perinatal asphyxia is, hitherto, the only evidence-based application of hypothermia in neonatology as it reduces mortality without increasing major disability in survivors [1, 2]. Other situations such as perinatal arterial ischemic stroke, neonates with HIE beyond the therapeutic window of the first 6 hours after birth or less than 36 weeks gestation and those with unexpected postnatal collapse could potentially benefit from this neuroprotective treatment, but, at present, only few or no data is available [2, 3]. This case describes a term neonate treated with whole-body hypothermia several days after birth to counteract refractory hypoxemia and protect the brain from its consequences. Case report A female, 3.470 g newborn was transferred to our hospital at 10 hours of life for respiratory distress. The baby was bom at 39+4 weeks gestation after caesarian section due to mild fetal distress. Bag and mask ventilation were given at birth, and the 1 and 5 minute Apgar scores were 6 and 9, respectively. Conventional mechanical venti ­lation was started upon admission to our department while the lung X-ray was suggestive of transient tachypnea. Temporal improvement in oxygenation was noted following exogenous surfactant administration (Beractant, 100 mg/Kg/dose). Thereafter, oxygen requirements increased significantly, despite optimal ventilation (including high-frequency oscillatory ventilation) and supportive management (sedation-analgesia, inotropes). Following X-rays consis ­tently showed the absence of parenchymal lung disease. Car ­diac ultrasound confirmed the clinical diagnosis of persistent pulmonary hypertension of the neonate (PPHN), but inhaled nitric oxide (iNO) at 20 ppm and other adjunctive therapies (oral sildenafil, bosentan) had no clinical effect. Repeat sepsis work-up was negative. Continuing, severe impairment in oxygenation prompted us to apply whole-body hypo ­thermia (Tecotherm Neo ®, target rectal temperature 33.5 ±0.5  °C)for 72 hours starting from day of life (DOL) 6, which was well tolerated. During hypothermia, the respira ­tory failure slightly improved, in the short term, as indicated by the reduction of alveolar-arterial difference of oxygen (fig. 1). Despite refractory hypoxemia, no clinical seizures were obsewed whereas there were no pathologic findings on head ultrasound scans and amplitude-integrated-EEG. Interestingly, the sleep-wake cycle was lost during cooling but normalized after the end of this treatment. From DOL 14 onwards, oxygenation started to improve (although still with variable) finally allowing weaning from the ventilator (DOL 20) (fig. 1). Brain imaging (ultrasound scan, magnetic resonance imaging) were normal at hospital discharge (DOL 36) as was later neurodevelopment (6 months). Discussion To the best of our knowledge, this is the first case to report the use of whole-body hypothermia in neonates with refractory hypoxemia secondary to PPHN as adjunct to mechanical ventilation and as neuroprotection. PPHN is an important cause of neonatal respiratory failure associated with increased mortality and neurological impairments in survivors [4]. Hypothermia reduces oxygen consumption as well as C02 production [5]. Moreover, experimental animal data show that hypothermia may protect [6] or attenuate the ventilator-induce lung injury mitigating the pro-inflammatory response [7]. Improved gas exchange has also been reported in the latter investigations [7]. Similarly, there is evidence although limited from studies in critically ill adults suggesting an improvement in oxygenation [81 and ventila ­tion [91 with hypothermia. Therefore, this therapeutic technique could potentially be beneficial in our patient breaking the vicious circle of hypoxemia, PPHN and ventila ­tor-induced lung injury. On the other hand, aggravation of Figure 1 Supportive care and serial changes of alveolar-arterial difference of oxygen (AaD02, best and worse) during the first 3 weeks of life (B and C). Initial lung X-rays (A) and snapshot of the a-EEG recording before and during hypothermia (D) are also shown. hfov CMV: Conventional mechanical ventilation, DOL: Day of life, HFOV: High-frequency oscillatory ventilation, iNO: Inhaled nitric oxide PPHN was a possible clinical scenario, given the metabolic response to cold stress (increased catecholamines and pulmonary vascular resistance) [5]. In large randomized controlled trials of hypothermia in perinatal asphyxia, PPHN at randomization was considered as an exclusion criterion [21. It is our clinical observation that a slight and temporal improvement in alveolar-arterial difference of oxygen was indeed observed during hypothermia. However, this could be an oxygen extraction issue. At lower temperatures, oxyhemo globin dissociation curve is shifted to the left resulting in decreased oxygen release to the tissues which in turn have decreased oxygen demands [5]. Nevertheless, the fact that improved oxygenation was not sustained and, also, that coin ­cided with the application of high frequency ventilation does not allow us to support any significant effect of whole-body hypothermia per se on oxygenation. Yet, this trend towards improvement in oxygenation is in line with the most recent relevant meta-analysis, in which hypothermia was found not to increase the risk of PPHN, at least as indicated by the need for Ino [1]. Extracorporeal membrane oxygenation (ECMO) could be an alternative treatment to PPHN [4], but no ECMO center was available. Conversely, this invasive intervention encompasses severe risks for the brain. Actually, for this very reason mild hypothermia was preventively attempted for 12 hours in a small cohort of neonates receiving ECMO. Unfortunately, neurodevelopment outcome was not assessed [10]. We applied therapeutic hypothermia as this is a promising means of neuroprotection in neonates. None the less, two facts merit comment in the present case: the lack of any clinical or other evidence of brain injury (normal head ultrasound scan, a-EEG) when cooling was decided and the application of hypothermia several days after birth. So far, hypothermia is only indicated as early as possible in neonates with evidence of HIE following an acute perinatal event, so as to limit the already activated molecular mecha ­nisms of neuronal damage and death [11]. It is impossible to know whether prolonged hypoxemia triggered such a cascade of events in our neonate. However, therapeutic hypothermia has also been tested in neonatal conditions, independent of neuroprotection. Advanced necrotizing enterocolitis in preterm infants is such an example, where mild hypothermia was applied as an alternative therapy to reduce intestinal injury and distal organ damage [12]. Specific biochemical biomark ers or more sophisticated techniques (e.g., magnetic resonance spectroscopy) could possibly have provided some indications as to the presence of cerebral injury secondary to refractory hypoxemia and the impact of hypothermia. Such techniques, however, are available for use at the bedside only in a few centers [13]. Additionally, our baby-girl was not part of a relevant study and, therefore, no investigations beyond those indicated in everyday clinical practice were performed. Nonetheless, its favorable neurological outcome is encouraging. Since we are not, however, able to know whether and to what extent hypothermia had any neuroprotective effect against hypoxemia related to respiratory failure, this approach needs to be evaluated in large trials.

Complementing Texts: Homer’s The Odyssey and Dante’s Inferno Essay

Ever since human beings started telling stories for entertainment or for edification, heroes have made incredible journeys against what seem like impossible odds. In the beginning, heroes often these journeys to reach a goal, often in defiance of the gods who, for whatever reason, had imposed limits upon the main character of the story. In Homer’s story, The Odyssey, this limitation is that the gods will block his way home until he speaks to the sage Tiresias. By contrast, Dante Alighieri’s character of Dante primarily seeks to find answers to his questions; that is, knowledge, as a means to find salvation. While both heroes interact with the underworld to accomplish their aims, the stories complement each other, rather than mirror each other. In many ways, Dante’s text â€Å"corrects† the story found in Homer’s work, making it suitable for Christian audiences. Careful examination of texts reveals how some of these areas differ significantly between them. Some of these differences include the nature of the underworld itself and the hero’s interaction with it, the knowledge that Odysseus’ mother has of the living world, and the shared rule of the underworld. The Nature of the Underworld and the Heroes’ Interaction with It Like Dante’s Hell, Homer’s underworld is not a pleasant place to spend eternity. It is dark and gloomy; the inhabitants have dulled senses. The underworld into which Odysseus looks is Hades, not the Elysian Fields, where heroes were blessed with eternal happiness. Rather, the â€Å"unhappy dead† live there, cursed to bleak and boring existences for the rest of eternity. The dead who exist in Hades are those who have died unburied, like Odysseus’ friend, Elpenor, who died falling from a ladder leading from Circe’s roof, as well as Tiresias and Odysseus’ unhappy mother. And yet, misery of the inhabitants is one of several similarities between the two underworlds. One interesting difference between the Homer’s Hades and Dante’s Hell is that the stories’ heroes find their entrances in extremely different locations. Odysseus finds the entrance to Hades in a harbor at the â€Å"western edge of the world,† while Dante finds the entrance to Hell in the midst of a dark wood. While these differences might seem insignificant, they are, in truth, indicative of the different purposes behind the journeys that the heroes undertake. The harbor at the end of the world represents physical distance traveled; Odysseus is on a quest to return home to Ithaca, a goal that the gods have prevented him from attaining. It is an earthly goal, however, with measurable distances that must be traversed. While the ocean that Odysseus travels provides room for a communal journey through which he attempts to bring his crew home, Dante’s dark wood provides a far narrower field. It is restrictive and personal, perhaps driven by the solitary nature of Dante’s quest for knowledge and redemption. The distance that Dante must travel, therefore, is not one of finite measurement; rather, it exists within himself. It is a spiritual journey with no physical boundaries. Ultimately, this difference is magnified by the many levels of Hell, with its myriad levels, terraces, and malboges. In addition to the differing nature of the underworld as portrayed by each poet, the nature of the interaction that each hero has with the underworld and its inhabitants also varies. In order to interact at all with the inhabitants of the underworld, both heroes must make a rite of passage. Odysseus enters the realm of Hades by making a blood sacrifice of a ram, collecting its blood in a pit. Through this offering and by offering the appropriate supplications to the gods, Odysseus is able to call forth the souls of the dead. Being surrounded by the dead causes him to become afraid; however, he regains sufficient courage to control them and to question them. The character of Dante, however, must actually pass through the gates of Hell, ‘abandoning hope’ in order to learn what he desires. Although Odysseus is in the world of the dead, he is sure enough of himself to regain control, as opposed to Dante, who relinquishes all of his control to Virgil as then enter the underworld realm. While less â€Å"heroic† than Odysseus’ actions, this submissive behavior is actually of great importance, which again is based in the heroes’ purpose in entering the underworld. It is clear, that although both heroes must enter the realm of the underworld, each for his own purpose, Odysseus does not actually travel through Hades as Dante does through Hell. Rather, the dead approach Odysseus, coming â€Å"up in a crowd from Erebos: young men and brides, old men who had suffered much, and tender maidens to whom sorrow was a new thing; others killed in battle, warriors clad in bloodstained armor† (124) all surround his sacrificial pit in response to the ram’s blood that he has offered. This difference is also a significant one and related to the point made above it. Although Odysseus immediately appears to be the supplicant, by making the blood offering that attracts the dead, he is also in control of it. The dead must do his bidding in order to feed and give him the information that he requires. By contrast, the character of Dante physically travels into the midst of the souls of the damned. While he is under his own volition, Dante is a pilgrim, who must make an effort to gain his knowledge. He follows Virgil as Virgil leads, interacting with the souls on their own level in their own environment. This difference would also make Dante’s tale more appealing to Christian audiences. Although Odysseus’ cunning and strength were admired by the audience that lived at his time, the lesson of humility that the character of Dante both learns and teaches would be considered more acceptable to Alighieri’s audience. Although he is taking the initiative to learn on his own, like a proper pilgrim he is taking instruction from a master and listening to the moral lessons set before him. For those in the audience who recognize that he might have been contemplating suicide, Dante is also in the process of repenting. Knowledge of the Living World Odysseus seeks not merely wisdom from Tiresias, but he also seeks knowledge of his future in the living world. In truth, both Tiresias and Odysseus’ mother have clear knowledge of the living world, which they freely share with him in their turn. What is more, it is accurate knowledge, which allows him to prepare for his future, should he ever arrive at his destination. In a sense, both Tiresias and Odysseus’ mother are as living beings that have merely been transported to a new existence on an alternate plane, in that they can take initiative to see what lies ahead and then share it with him. Given that in other myths inhabitants of Hades are able to travel freely between the worlds with the gods’ permission, it seems apparent that the ancient Greeks saw the underworld as a place from which people could escape to return to the living if they had enough virtue or if they had a hero to aid them. This kind of belief is opposed to both Dante’s belief and to the belief of the Christians who formed his audience. Dante’s souls, perpetually trapped in their state of torment, must continuously atone for their actions on earth. They are surrounded by the reminders of their sins, perhaps tormented by the very things that they desired in life. At times, their appearance is dramatically altered to match their crimes. The only hope for the souls in Hell is Judgment Day, at which time they may be redeemed–or they may find themselves condemned to suffer throughout eternity. Even then, redeemed souls would not interact with the living; instead, they would pass into Heaven. Once again, the difference between the two realms and their inhabitants may be explained by virtue of the perception of the audiences for which the poets were writing. To the Greeks, life in the underworld was not necessarily a punishment. Certainly, the inhabitants of the underworld could experience punishment, even that of a perpetual nature. One good example of this kind of punishment would be Sisyphus, condemned to roll a boulder to the top of a hill for eternity, only to have it escape him and roll to the bottom again before it reaches the peak. However, the underworld is a plane of existence to which all humans will eventually travel. The underworld itself is divided into sections that provide reward or punishment or which simply continues the miserable existence that people had when on earth. This difference is, once again, quite different from the perspective of the Christian audience served by Dante, which viewed the underworld for punishment only. It is this understanding of the underworld being for punishment that would also limit the dead’s interaction with the living. Dante’s dead are unable to access the living world and, when encountering the character of Dante, are unable to learn from what he tells them. They have no minds and no insight, unlike the dead that Odysseus encounters, who know that they are suffering and why and yet are unable to interact with the world of the living in order to minimize their experiences. The Shared Rule of the Underworld In The Odyssey, both Hades and his wife, Persephone, rule the underworld. Although Hades has control over the underworld as a whole, Persephone is the Queen of the Women, with the ability to overrule even her husband in control of that group. In terms of importance, while this difference might seem trivial to some readers, it is perhaps of greatest significance of all of these points. Hades is not omnipotent, in that Persephone has equal control, if not greater control in some aspects of ruling the underworld. She strikes fear in Odysseus’ heart equal to that of her husband, in that Odysseus describes Hades as â€Å"mighty,† but Persephone as being â€Å"awful,† which would be synonymous with her being terrifying. This kind of rule would be unsurprising to the ancient Greeks, who lived in a world ruled by many gods. It also paralleled the arrangement of the gods on Mount Olympus, to a certain extent: Hades and Persephone, who ruled the world of the dead, mirrored Zeus and Hera, who ruled the world of the living. To the Christians that formed Dante’s audience, this arrangement would have been more than just a little shocking. Christians worship a single God who, while He might have different and while He may employ different helpers in the angels and the saints, has dominion over the living and the dead. As with the ancient Greek deities, God and Satan somewhat mirror each other. Despite Satan’s impressive appearance in The Inferno, however, he is as much a prisoner of Hell as its other residents. In addition, Satan does not mirror God’s power; rather, he is only capable of destruction, not creation. Conclusion In many ways, Dante’s Inferno complements and corrects Homer’s The Odyssey. Both are tales that bring a hero into contact with the underworld in order to achieve a particular goal. In the case of Odysseus, this goal is worldly and finite, while in the case of Dante, the goal is spiritual and may lead to eternal salvation. Several differences, among others, that indicate the complementary and corrective nature of Dante’s work are those of the nature of the respective underworlds and the heroes’ interaction with the inhabitants, the knowledge that the dead have of the living world, and the shared rule that Hades and Persephone have over the ancient Greek underworld. The story of heroic travels through the underworld is not a new one, neither was it new when Homer wrote The Odyssey. In the days of passing history and learning through oral means, such stories were necessary teaching tools. However, each culture imposed its morals and beliefs on this kind of tale. The different between these two stories provide an excellent example of how this cultural influence stamps this kind of heroic story with differences throughout history.

The Hidden Truth About Photography Argumentative Essay Topics

The Hidden Truth About Photography Argumentative Essay Topics You might have to figure out what you wish to write in your essay. Out of the many kinds of essays, photo essays are definitely the most illustrious. It is possible to buy argumentative essay from a specialist writer. You could be writing an argumentative essay to argue for a specific point of view or to may do a persuasive essay to spell out the steps necessary to finish a task. Therefore, either you would like to learn more about how to compose an essay, or you desire some essay writing services or even in the event you would like to go through some sample essays, then just refer to WritingBest and all of your requirements will be fulfilled once possible. If you are searching for top essay writing companies, try out the mentioned above. By obeying the above-given ideas you will readily attain an impactful argumentative essay. The most effective argumentative essay writing service on the world wide web is a business that gives good quality and reasonably priced help on argumentative essay and argumentative essay topics. The Bizarre Secret of Photography Argumentative Essay Topics So it makes sense that parents begin the lengthy journey of letting go! Students lead busy lives and frequently forget about an approaching deadline. Life After Photography Argumentative Essay Topics A great photograph can tell numerous things to the viewer. If you believe a photo essay is something that you may want to try, here are a couple of ideas to hopefully get you going. 1 photo essay idea I have always wished to try is to photograph one landmark from a number of different vantage points. Shot planning Before selecting from the a variety of photo essay topics one has to plan the shots that are required to be taken for the essay. Photo essays techniques are quite important. Have a look at the Eiffel Tower, and what number of photographs are taken of it. They can be a great source of entertainment and a form of art, but when it comes to portraying reality, it may not succeed all the time. Sometimes they can also create a hyper-reality which exaggerates the reality and thus cannot be the truth. Definitions of Photography Argumentative Essay Topics There have been a number of incidences before where photographs are faked or misinterpreted creating havoc situation. For example it's helpful to preserve our culture, ancients medieval and contemporary architecture of the Earth, history might also be understood through the photographs in a better means. No matter in which you live, there'll be countless neighborhood events throughout the year. There's no exception for art. Top Photography Argumentative Essay Topics Secrets To defend your subject, you can recall the effect of overloaded schedule on college g rades. In order to be a good photographer, you must find some simple education on the subject to be aware of the fundamentals. So as to compose such essays a fundamental idea is necessary by the new students from the skilled individuals. Have a good idea of what you wish to accomplish, and create it like you were teaching another person. Take camera with you whenever you go to school and earn a report on a common school day. Companies which provide communication essay services should have a vibrant group of work force that is highly qualified in the majority of academic fields. If it's so, then you might be having some challenging time for a student along with being a writer. Our group of competent experts will supply you with details answers. A Startling Fact about Photography Argumentative Essay Topics Uncovered Below you can receive some fresh insight on the subject. As previously mentioned, photography topics and ideas are available everywhere. General overview would incorporate information that's covering the topic for language essay for a whole while specific overview is only going to speak about particular problems. Critics always debates on the subject of whether photography is truly an art or only a mechanical procedure. Get acquainted with the next creative argumentative essay topics and select the one that fits your needs the very best. As always, our list is only here in order to light a spark of imagination and motivate you to develop an original topic by yourself. If you're assigned a specific topic, consider the techniques to develop it. Quite frequently, the ideal topic is one which you truly care about, but you also will need to get ready to research it. Occasionally, selecting a perfect argumentative essay topics will be quite tough. If you successfully determine the objective of language essay than you ought to make sure that the subject of language essay should fit in the objective. Argumentative writings is a particular kind of a paper. By way of example, in college, you might be requested to compose a paper from the opposing viewpoint. In the end, towards the conclusion of your conclusion, you might reflect on the way the essay compares to something else such as modern occasions or the future. For an argumentative essay it's a good idea to set up three claims which provides a strong reason behind your stance on the topic issue. Obviously, you need to carefully choose every shot.

Mt. Cameroon, East Of Nigeria - 999 Words

Mount Cameroon is located within the Republic of Cameroon, east of Nigeria. It is considered to be one of Africa s most active and largest volcanoes, having recently erupted in 2000 followed by a smaller eruption in 2012. Mt. Cameroon belongs to a seamount chain of volcanoes that extends northeast from the Gulf of Guinea. Cameroon does not lie on a plate boundary, making it an intraplate volcano. Despite being one of the most active volcanoes in Africa, the risks it poses does not necessarily include the massive, fiery, plinian eruptions one would associate with a volcano considered very large and most active over an entire continent. However, Mt. Cameroon does have other risks and hazards due to its nature, and requires preventative†¦show more content†¦While Cameroon has shown moderate eruptions in the past, the volcano also showcases a more effusive type of eruption. The low viscosity lava flow Cameroon exhibits is not much of a surprise because the volcano is part of a chain of volcanoes, indicating that it is currently sitting over a hot spot. The significance behind a chain of volcanoes is that hot spots, mantle plumes, â€Å"... tend to be largely unaffected by plate motions† (howvolcanoeswork). This allows the mantle plume to create a volcano, have the crust shift due to plate tectonics, create another volcano, and so on. The fact that Mt. Cameroon is intraplate also reinforces a hot spot mechanism because there is no subduction present to cause flux melting. The last major eruption of Mt. Cameroon took place in 2000. It was reported that during the initial explosion, â€Å"... [Cameroon] produced only tephra and ballistic blocks† (Smithsonian). An a a lava flow was also noted, which flowed about 850 meters. Due to the volcanoes remote location, information about the a a lava flow was collected using the MODIS Thermal Alert System, or MODVOLC. The way this works is that NASA has a satellite equipped with Moderate Resolution Im aging Spectroradiometer sensors that orbits the Earth in a 48 hours period. While it performs it s global scan, a specific algorithm is used to search each pixel in every image it takes for heat anomalies. These

Creating Advanced Robot, Drone And Internet Of Things Are...

1. Introduction: As we know in 21 century technology is so advanced, using it we can develop advanced robot, drone and etc. Augmented realty and Internet of things are hottest topic of our era. Augmented reality is a live, direct or indirect, view of a physical, real-world environment whose elements are augmented by computer input such as video, graphics and etc. This technology change what s real and what s computer generated by enhancing what we see, hear and feel .We make an augmented reality based product Virtual Mirror. It will simulate makeup on a person’s face in both real time and 3D. The unique technology tracks a person’s facial features The past work done on it so far is quite good but we think to advance it or go to higher level. Virtual Mirror virtually demonstrates endless beauty products and fashion style in a cutting edge technology which give e-commerce and retail market to enhance their business. After each tester choice, user have to remove the produc t you just put on to try out the next, which is not only time consuming but can also be hard on your skin, so Virtual Makeup Mirror is the solution of this problem. It provide customer to choose very wide range of product thereby increasing customer satisfaction. 2. Virtual Mirror: Virtual Mirror is an augmented reality based application. As we know â€Å"Mirror â€Å"reflect light and produce image whatever in front of it. Virtual Mirror is based on its original function of reflection. It consist of LCD and Microsoft

Aboriginal Suicide Free Essays

string(47) " You fought for bread, you fought for clothes\." Suicide and Healing: Aboriginals Overcoming the Hardships and Barriers Aboriginal peoples have had to endure many tragedies throughout history, which has affected them emotionally and mentally. It is no wonder that this group of people are amongst the highest suicide rates in Canada (Royal Commission on Aboriginal Peoples, 1995). This is a look at those tragedies and how it is tied in with suicide, also mechanisms used by Aboriginals to start the healing process. We will write a custom essay sample on Aboriginal Suicide or any similar topic only for you Order Now Definition of Suicide amongst Aboriginals Suicide and its roots in Aboriginal communities is said to be one of the many outcomes of colonialism and are matters of great concern. The impact of someone dying from suicide affects the family and the community. Many contributing factors of suicide and its attempts in both Aboriginal and non- Aboriginal are as followed: sexual abuse, family violence, solvent abuse, addictions, lack of proper leadership, deterioration of family structure, etc. Studies have shown that the rate of suicide of all age groups amongst Aboriginals is 2 to 3 times higher than compared to the rate of non-Aboriginals. When it comes to the youth it is 5 to 6 times higher. This could be due to the fact that Aboriginal communities are so close knit that when one commits suicide it causes a ripple effect. That being said we must take into consideration that, â€Å"suicide is not just a problem in itself, but the symptom of deeper problems† (Royal Commission on Aboriginal Peoples, 1995, p. 2). Residential Schools In the early 19th century the Canadian government took it upon themselves to educate and care for the Aboriginal peoples. They thought that the best way in doing so was to assimilate Aboriginals with Christian beliefs, the English language and Canadian customs. Their idea was that Aboriginals would take their adoptive lifestyle and teach it to their children, with the notion that the native traditions and practices would be diminished or completely abolished within a few generations. The Canadian government felt that children were easier to mold than an adult (N. A. , 2010). They wished to minimize the amount of contact a child had with his or her parents and elders, so Aboriginal children were forced to relocate off reserve to a boarding school. Here the children would learn how to survive in mainstream society, and forget who they were and what their culture had taught them. The schools were not geared toward academics, but sought to train them in manual labour and industrial work. These Aboriginal children were forced to live, work and learn in unsafe conditions; due to the fact that facilities were not up to par, and the cheapest of supplies were used to erect the buildings (Kirmayer et al. , 2007). The church officials used punishment to humiliate, undermine and cause pain to the children. For instance, upon arriving at the residential school the children were assigned numbers that would identify them and given severe haircuts; hair has tremendous symbolism in many Aboriginal cultures. Many of the children were sexually abused, and in most cases it did not stay closeted in the residential schools, but made its way back to the communities where the victims would then become the perpetrators (Kirmayer et al. , 2007). Indian agents saw the Aboriginals extended family living as unfit and unnatural, and sought to shape them into a ‘normal’ nuclear family. Aboriginal children were taking from their homes and placed in residential schools, which were usually located a significant distance off reserve. This made it nearly impossible for the families to visit one another. The children were allowed to write letters in order to keep in contact with their family, but the letters were looked over by the school officials to ensure no complaints were being made about their harsh treatment. This form of assimilation had a harsh impact on aboriginal community, culture and society. It also took a toll on the parenting practices amongst many of the Aboriginal peoples (Kirmayer et al. , 2007). Impacts of Residential Schools When the law that allowed government officials to take Aboriginal children out of their communities passed, the effects were tragic. Many of the surviving adults are still tremendously traumatised, that they find being a good parent and community member troublesome (Alberta Health, 1995). The amount of abuse that Aboriginal children had to endure during those dark times has been connected to the current suffering of their communities. A lot have turned to alcohol and other substances to deal with their pain; this in turn causes dysfunctional family units and communities. Many of the former students cannot speak their languages and more or less feel too ashamed to teach it to their own children. This is because the staff took it upon themselves to punish ever child who acted or spoke like an ‘Indian’. When the children returned home there was a communication failure with their elders, because they were too ashamed to speak in their language; reasons stated earlier on. Since they could not communicate to one another the opportunity to respect their elders and learn their language and culture diminished. The gap on communication also led to a rejection of their traditional values and beliefs, because the elders were the teachers of the community. While attending the school a significant amount of students were victims to sexual abuse at the hands of educators, fellow students and administrators. But, the abuse didn’t stop there the victimized students began internalizing, normalizing and even recreating the sexual abuse within their own communities. They themselves sought the power those of authority once had on them. This in turn added more dysfunction to the family ties with Aboriginal communities. The parents whose children were taken from them felt guilty, like the children blamed them for the reasons they were being taken, they no longer felt needed anymore. Some may say this is the reason many turned to alcohol and drugs (Kirmayer et al. , 2007). Jealousy and greed were taught in the schools and missions. You fought for bread, you fought for clothes. You read "Aboriginal Suicide" in category "Papers" There was no love involved. You were taken from your family and held in the missions for 10 months straight. The mothers and dads couldn’t exercise their love. Now there are lots of people, who don’t know how to raise kids, because this is what they went through, and that’s what they pass on, because that’s the only thing they know (Alberta Health, 1995, p. 9). The 60’s Scoop The term Sixties scoop refers to the adoption of Metis and First Nations children that took place during the 1960’s. The name was derived due to the fact that during that decade the number of adoptions that took place in Canada was the highest in its history, in most cases children were literally scooped up from their families and community without the consent of their parents and fellow band members. During this time government officials and social works saw the Aboriginal peoples as unfit and could not adequately provide the children with what they needed. One of the reasons they thought this was because their houses were not similar to the Euro-Canadian houses for example; children ate wild meat and bannock and rather than having their cupboards stocked full of food, Aboriginals simply hunted and gathered what was needed. Many of the Aboriginals who were affected saw the removal of their children as a deliberate act of cultural genocide (Sinclair, 2011). About 70% of the children taken from their families were placed in non-Aboriginal homes, many of these homes denied them of their heritage and culture. A vast majority of the foster families told the children they were of a different race such as Italian or French, rather than telling them where they had originally come from. A lot of the children suspected they were of Aboriginal decent, but could not confirm it. This was due to the Government policy that birth records could not be issued unless both the child and parent had given their consent. Many of the children floated from foster family to foster family and never really experienced true stability. On numerous occasions Aboriginal children went from loving, caring and well intentioned Aboriginal families; to places of slave labour and physical, sexual and emotional abuse. For, abuse of any kind was not uncommon and usually covered up, to hide just how unjust the government was (Hanson, 2009). Impacts of The 60’s Scoop Many of the children experienced marginalization, identity confusion, attachment disorders, emotional emptiness, abuse, self-hatred, racism and even substance addictions. These experiences later affected their family units and communities, because they were taught that this was right. A study done in Prince Albert penitentiary found that 95% of incarcerated Aboriginals had been in foster care as a child. Also, a vast majority of surviving children are sexually exploited or live on the streets. This tragedy was yet another blow that language and culture amongst Aboriginals peoples had to endure (Kirmayer et al. , 2007). Linking Tragedy to Suicide As stated earlier both of these tragedies have led to further cases of physical and sexual abuse, but there are links between them and the high number of suicides in Aboriginal communities as well. Studies have found hat mental illness, family breakdown and child abuse are higher in those who have experienced these tragedies than those who haven’t. Some of these mental health problems have been diagnosed as residential school syndrome or RSS, some may say that the government spends too much time trying to diagnose them rather than trying to fix the problem. Aboriginal peoples not only suffered during these times, bu t the long lasting effects still reside with them today. So, Aboriginal peoples are still suffering. In fact, these negative consequences have a substantial impact on Aboriginal families and communities. Although many have not been able to cope with their pain, some have gone on to live healthy and successful lives. The many types of abuse these children faced have been very traumatic, and studies have shown that separation from families has the severest impact on one’s mental health. Suicide itself is associated with emotional deprivation, separation of families and losses in early life. That being said, when the children were separated from their families and taken from what was familiar to them during both of these tragedies spoken of earlier, they became high risk (Kirmayer et al. 2007). There are 4 families of related factors of suicide within Aboriginal communities, they are: * Psycho-biological factors- which are the various mental disorders linked with suicide. * Life history or situational factors- which are the trauma one faces in early childhood, dysfunctional family, unable to relate or trust both peers and members of authority, absence of spiritual and religious b eliefs, imprisonment and substance abuse. * Socio-economic factors- unemployment, poverty, stability, prosperity and low class status. Culture stress- the loss of norms, values and beliefs there were originally to taught to one in their own culture (Royal Commission on Aboriginal Peoples, 1995). Aboriginal Healing Processes Every community and Aboriginal individuals are unique in their own way. But, the beliefs these communities and band members hold are quite similar. In these communities the care and love everyone has for one another is tremendous, they feel a sense of belonging within the larger universe. When looking at any issue within a community the Aboriginal peoples believe that ou can’t just look at one aspect of a person or community, but rather the total person, total community and total environment. In order for a person to be healthy they must take care of themselves as a ‘whole’. For Aboriginal peoples this means that the mind, body, soul and emoti onal spirits must all work together in order for one to be healthy. They also believe in the circle of life, that in order for the human race to progress we must follow the values of balance and harmony. Traditional healing is very important in the Aboriginal culture, in fact many traditional healers are now working within hospitals all across Canada. But, there are many hardships facing these healers such as; finances, conflict with hospital staff and even Aboriginals who do not value this approach (Alberta Health, 1995). What happens in one stage of a person’s life is interconnected with every other aspect of his or her life. Although many of the children who survived these above tragedies do not remember what happened or do not wish to think about it, they must try to heal and explore in order to keep on surviving. As children, there are limited options, but as an adult we have choices to overcome these hardships, whether we choose to or not is totally up to oneself. In order to survive one must follow a positive path and take the following steps into consideration: * Acknowledge that they have been hurt * They must ‘own’ these feelings of hurt and pain. * Explore and try to remember what happened to them. * Learn to share these feelings with people who care and are not judgemental. * Make choices that will help you live in a more positive lifestyle (Mussell et al. 1993). Some may say that the government succeeded in bringing down the Aboriginal peoples, but they are wrong to think that they will stay down. Many Aboriginal peoples have gone on to live happy healthy lives and will continue to teach their children these ways. But, in order for the people to survive we must help and try to live balanced lives free of racism and hate (Alberta Health, 1995). Healthy communities are our greatest resource. But there are barriers that prevent us from experiencing good health and they are often as a result of our own lifestyles. Most of us have the knowledge of how to enhance our own health but knowing does not always translate into doing. Enhancing our health may require lifestyle change and habit changes, and that is difficult. It is easier to do things that make us feel good if we have resources available and support from those around us and our community (Alberta Health, 1995, p. 68). References Royal Commission on Aboriginal Peoples. (1995). Choosing life: Special report on suicide among Aboriginal people. Ottawa, ON: Canada Communication Group. Alberta Health. (1995). Strengthening the circle: What Aboriginal Albertans say about their health. Edmonton, AB: Aboriginal Health Unit Alberta Health. Kirmayer, L. J. , Brass, G. M. , Holton, T. , Paul, K. , Simpson, C. , amp; Tait, C. (2007). Suicide among Aboriginal people in Canada. Ottawa, ON: Aboriginal Healing Foundation. Mussell, W. J. , Nicholls, W. M. , amp; Adler, M. T. (1993). Making meaning of mental health challenges in First Nations: A Freirean perspective. Chilliwack, B. C. : Sal’I’Shan Institute Society. Sinclair, R. (2011). Origins Canada: Supporting those separated by adoption; The 60’s scoop. Retrieved from http://www. originscanada. org/the-stolen-generation/ N. A. (2008, May, 16). Residential schools: A history of residential schools in Canada. Retrieved from http://www. cbc. ca/news/canada/story/2008/05/16/f-faqs-residential-schools. html Hanson, E. (2009). Sixties Scoop: The sixties scoop amp; Aboriginal child welfare. Retrieved from http://indigenousfoundations. arts. ubc. ca/home/government-policy/sixties-scoop. html How to cite Aboriginal Suicide, Papers

Oliver Twist and Therese Raquin Essay Example For Students

Oliver Twist and Therese Raquin Essay A Comparison between the First Chapters of Oliver Twist and Therese Raquin  Oliver Twist and Therese Raquin are written by Charles Dickens and Emile Zola respectively. Oliver Twist is a critism towards the Victorian Times where classification among the high, middle and low classes was very strict. In the novel, the orphan, Oliver uses humour to get back on the society. Therese Raquin is set in Paris in the 1800s. The plot revolves around Therese Raquin who has a loveless marriage with a sickly weak man, Camille. She falls for his friend Laurent and they plot to kill Camille, resulting in a nightmare. Oliver Twist and Camille Raquin are both the main male characters experiencing low standards of living. Their sufferings bring about the miserable lives of other characters, this sense of depression in the novel is introduced in the openings.  In Oliver Twist the first sentence directly hints the consequences that is about to come, into this world of sorrow and troubleit remained a matter of considerable doubt whether the child would survive to bear any name at all. Already the opening suggests an issue. The difficulty of the babies birth mentioned emphasizes the sorrow and trouble mentioned earlier in the line. By describing this situation, it also hints to the reader that more issues relating to this new born child will come. In contrast to Oliver Twist the sense of trouble in Therese Raquin is not introduced by a situation but a description of the environment. Zola uses pathetic fallacy for the majority of the first chapter, On fine days in the summer, when the streets are burning with heavy sun, whitish light falls from the dirty glazing overhead to drag miserably through the arcade. This second paragraph illustrates the association between positivity and negativity. The whitish light from summer gives a positive feeling while the misery gives a negative feeling. Even though it is a fine day, the whitish light falls will always carry misery with it. It is hinting that the joy of removing a trouble may be followed or drag more troubles along with it. For example, later in the novel Laurent and Therese gets rid of Camille but in return it haunts their relationship. This association is also made in Oliver Twist, however in a different way. The positive feeling is not emphasized by imageries but the sense of life in characters. Dickens has done this by giving details to characters using speeches, for example, the joy of the surgeon is expressed by, Its all over, Mrs. Thingummy! This technique makes the reader feel as if they are experiencing the situation first handed. Compared to Therese Raquin the characters feelings are not expressed but described only, this makes the reader feel as if they are experiencing the situation second handed. Zola uses descriptions of larger locations, slowly narrowing down to a smaller place. The passage to the Arcade of Pont Neuf is followed by the shops interior descriptions to introduce the characters. In comparison to Oliver Twist, the baby is introduced before the workhouse location and the characters there during his birth.