Management Of Chronic Arthritis Pain In The Elderly †Free Samples

Question: Discuss about the Management Of Chronic Arthritis Pain In The Elderly. Answer: Introduction The assignment is the annotated bibliography pertaining to the chronic health condition. The aim of the annotated bibliography is to develop the critical analysis and the solution focused skills. The annotated bibliography is based on the critical evaluation of the evidence-based literature. For the purpose of the assignment, a chronic health condition is selected and a clinical practice issue related to chronic care nursing. The assignment deals with the arthritis in the aged-care setting. The issue with the chronic care nursing selected is the pain management. In order to guide the literature review a research question is developed. For annotated bibliography the completed search strategy is detailed. The annotated bibliography consists of summary and critical discussion. The bibliography consists of atleast 5 scholarly sources. It is followed by the synthesis of all the articles reviewed. Chronic health condition A chronic illness is the long term condition that has no complete cure and is associated with several comorbidities. One of the chronic health conditions that will be discussed in the paper is arthritis in the aged care setting. Rheumatoid arthritis, gout and osteoarthritis are the common problem faced by the elderly patients. Arthritis is the chronic disease that attacks women, men and children at any age. It damages the body joints causing intense pain and discomfort. The most commonly affected joints are the Knees, ankles, neck, back, hips, hands, wrists, fingers, ankles and toes (Walker, 2012). This chronic deforming disease and associated pain can render anyone disabled without proper treatment. Patients with this disease live in uncertainty about the unknown consequences in future. Some types of arthritis are difficult to diagnose. The treatment for arthritis usually consists of pain killers, anti-inflammatory disease and anti-rheumatic drugs. Apart from the pharmacological treatment, non-pharmacological treatment includes modification of lifestyle and pain management techniques. Some of the symptoms of the arthritis is so debilitating that the patients lose mobility and joints strength. The patients are thus forced to change the lifestyle to be able to manage the activities of daily living (Jia Jackson, 2016). Issue related to chronic care nursing The common challenge for the nurses caring for arthritis patients is the symptoms management such as pain and flares. On a daily basis in the emergency room it is heartbreaking to see the patents with arthritis. The patients arrive in ER with intense pain or flares. Middle aged men and women are most frequently encountered in the emergency room. Arthritis and ageing are associated with several comorbidities. It includes osteoporosis, cardiovascular disease and malignancies. With the increasing aging population the prevalence of arthritis especially rheumatoid arthritis is estimated to increase (van Onna Boonen, 2016). These factors significantly hamper the management of arthritis. Over the years there is an increasing concern among the nurses failing to handle pain management concerns of the patients with arthritis. On the other hand, the elderly patients too lack the knowledge required to manage the symptoms, which is a challenge for nurses. As per the literature, there is inadequa te treatment of the pain as it tends to be underestimated. In the management of the patient care, the nurses act as mediator between the patients and the physicians. Nurses play a vital role in outpatient pain management. Pain management is centre in health care today given the opioid crisis (Fitzcharles, Lussier Shir, 2010). There is a lack of knowledge on factors acting as barriers for nurses to implement effective pain management strategies. The rationale for the chosen nursing issue is the experience observed from one of the relative suffering from the arthritis and dissatisfied with the pain management strategies. Patients satisfaction with pain control is known to be associated with the key contributions of the nurses. Thus, it is necessary to identify and understand the barriers of the nurses to manage pain symptoms of the arthritis patients. Search strategy: Research question The research question to guide the literature review as a part of the evidence based medicine, which involves developing a question based on the issues identified with the disease or the patient. Using the research question, evidence will be identified. The research question for the annotated bibliography is- What are the educational needs and barriers of the nurses caring for the patients with arthritis (gout, rheumatoid arthritis, and osteoarthritis)? 2. The key topics expressed in the research question are the nursing education needs in caring for arthritis patients. The topic also expressed is the challenges faced/perceived by the nurses in caring for the arthritis patients. 3. Search terms The search terms used for extracting the research papers for annotated bibliography and narrowing the research are- Arthritis care, rheumatoid arthritis care, gout management, osteoarthritis, nursing care, arthritis nursing care, pain management arthritis, nursing educational needs for arthritis, nursing barriers for arthritis treatment, provider barriers in gout management, and patient and provider educational needs in osteoarthritis. For effective research the Boolean operators AND, OR and both were used. Databases used To find the best available literature the electronic databases searched were MEDLINE, Cochrane library, and Google scholar. The Cochrane and MEDLINE database are chosen as it is regularly updated. The hierarchy used for searching is the prospective cohort studies and then moving down to the case reports (Rollyson, 2016). The search was restricted to articles published in English language and between 2015-2018. 5. Database searched with keywords and phrases. A total of 110 articles obtained The articles were scanned for titles, and abstracts to determine the relevancy. It will help eliminate the irrelevant articles. For further elimination the full text articles are scanned to determine the relevancy. 6. The first 20-30 articles were related to dementia, knee arthoplasty, aged care setting and the challenges faced by the nurses in these areas. In addition there were some more papers on the recommendations for the arthritis management and patients barriers in arthritis management. There were a total of 67 articles and not many were relevant. Therefore, the search was refined by modifying the search terms. 7. For researching the databases the search terms used were: rheumatoid arthritis AND provider barriers, osteoarthritis AND nursing barriers, gout AND provider barriers, nurses training needs AND arthritis management, nurses educational needs AND caring arthritis, nurses educational needs AND rheumatoid arthritis OR osteoarthritis. These key terms further helped to narrow down the research. The search generated 33 relevant articles 8. The same databases were again used for extracting the research papers using the modified search terms. The inclusion criteria were research paper published between 2012-2018. The patients must be suffering from arthritis and includes nurses and the patients as the research participants. The study conducted in Australia as well as in other country is considered for broad perspective. The exclusion criteria were review papers, reflection reports and case reports. This further narrowed the search. Using these criterion 12 articles were excluded. The search then generated 21 articles and after scanning through titles, abstracts, and full text 16 articles were excluded. Finally five articles were selected for annotated bibliography considering it to be most appropriate. Annotated The study explored the patient and providers perception of the illness, which is gout. The study used qualitative research paradigm. Upon conducting the semi structured face-to-face interview with the patients and the nurses, it was found that the nurses had lack of knowledge about the nature of gout and its recommended management. The nurses failed to utilise the clinical guidelines for gout. The nurses were found to give only suboptimal information. It was due to lack of training and education of gout related best practice. Another barrier for nurses was lack of incentives to improve treatment and symptoms management. Based on the interview the patients too had misconceptions concerning the nature of gout. However, the findings of the study limit generalisability due to caveats and there is small sample size (Green et al., 2015). The strength of the paper is its implications with improving the standards of care and education needs in this condition. The overall text is well organis ed and the research objective is fulfilled. The cross-sectional survey intended to identify the educational needs of nurses caring for osteoarthritis and rheumatoid arthritis. The nurses respondents were found with less confidence in their skills and knowledge when caring for osteoarthritis patients. The method of investigation was appropriate considering the research objective. The nurses were incompetent in pain medication for the patients, advising patients on exercises and unsure about the symptoms management when caring for the rheumatoid arthritis patient. The study implies for future training that must contain key components like medication and joint protection. The study is based on adequate background research and the arguments are well supported with the relevant sources. The results are well explained with graphical illustrations and text is well organised. The survey however, had limitations like small sample size and the recruitment resembles that the professionals were already acquainted with the nurses. The char acteristics of the non respondents were not known thus, there must be bias in the interpretations of the results (Little Rubin, 2014). The nurses perceiving that they do not have the adequate knowledge and skills may not be related to the actual skills and knowledge. There is a need of objective assessment. The study described the kind of education needed by the nurses caring for patients of rheumatoid arthritis. The author conducted survey and analysed using the thematic and summative content analysis. It was found from the survey that the nurses demanded to strengthen their knowledge in medically reacted care. There was lack of knowledge among nurses about the medicine-based information about rheumatoid arthritis. Lack of continual and update education was perceived as a barrier by the nurses. Rheumatoid arthritis has considerable impact on the patients life and nurses need ever widening areas of knowledge (Walker, 2012). Only then nurses can provide the patients with suboptimal information. The overall study is well organised with supporting literature. The research objective was clearly defined; the methodology and the results were presented in easily understandable format. Owing to the difficulty in performing the summative content, the reliability of the paper may be doubted (Gree n et al., 2015). There are different natures of the expressions provided by the nurses and there may be difference in the exact amount of simplifications. The strength of the paper is the consistency in results with other sources. The study explored the nurses involvement in educating patient with rheumatoid arthritis. According to author, the important part of the nurses role is to provide the patient education in rheumatoid arthritis. Based on the qualitative study the nurses perceived educating the non-adherent patients as challenge. It was easy to educate the patients who were committed to their health. The non-adherent patients have different perception of the disease and acceptance, motivation and autonomy. As per the semi structured interview the nurses would be benefitted with more training on dealing with the non-adherent patients. The interview was not enough to understand the experiences faced by the nurses. As the interview is conducted only in one hospital the transferability is doubted. However, the study is helpful in addressing the research question. The results have an important implication which is strong involvement of nurses in patient education in rheumatoid arthritis. The results are valu able as it implies about nurses training to deal with non-adherent patients. Unlike other studies this study has opened a new ways of seeing a problem from the eye of non-adherent patients. The conclusion thus satisfies my own investigation. The method of investigation was appropriate considering it an exploratory study and it very well addresses the research objective. The study conducted cross-sectional descriptive correlational study to examine factors in gout patient affecting the adherence to urate-lowering therapy. The study results imply for nurses to learn skills to educate patients on mechanism of urate-lowering therapy and help them adhere to medication. It implies for the nurses to take lead in educating the gout suffering patients to help them adhere to the management. The results implies for nurses to learn skills to modify patients beliefs about medication. The study did well contribute to the limited research on gout patients issue with medication errors. The methodology of investigation is well justified as per research objectives. It implies for nurses the need to develop skills to explore the patients opinions and concerns about gout and ULT. Only with the help of proper training of nurses will be able to develop appropriate interventions. The limitations of the study include potential response bias, due to participants misinterpre tations of the questionnaire. Overall the study contributes well to the personal research question. Synthesis Based on the literature review the nurse barriers to care for arthritis patients are lack of knowledge, inability to provide optimal information to the patient on managing gout, rheumatoid or osteoarthritis, lack of skills among nurses in educating the non-adherent patients, insufficient medical information about the arthritis pain management, lack of incentives for nurses to manage the arthritis symptoms and patients confusion about the nature of the arthritis. These barriers also imply the training and educational needs of the nurses. Upon synthesising the relevant data, the educational needs of the nurses caring for the arthritis patients is a matter of serious concern. The training and educational programmes can address the knowledge gaps of the nurses, enhance the communication with clinicians and improve relationship with patients. The results aligns with the study of Edgerton et al. (2017), according to which adequate training and education will bring behaviour change among nu rses that in turn will increase patients adherence to arthritis management. It will also help nurses to engage in effective communication with patients. Having adequate education among nurses on arthritis management will allow nurses to manage the dissonant patient expectations and provide care that is consistent with the clinical practice guidelines. The results are appropriate and are also confirmed by study of Larsson et al. (2010). According to this study the when the nurses educate the patient about drugs; it gave the patients power, autonomy and security. Thus, it can be concluded that nurses must be well trained about the arthritis symptoms management and educated about skills to address the patients concerns. References Chua, X. H. J., Lim, S., Lim, F. P., Lim, Y. N. A., He, H. G., Teng, G. G. (2017). Factors influencing medication adherence in patients with gout: A descriptive correlational study.Journal of clinical nursing. DOI:10.1111/jocn.13918 Egerton, T., Diamond, L. E., Buchbinder, R., Bennell, K. L., Slade, S. C. (2017). A systematic review and evidence synthesis of qualitative studies to identify primary care clinicians' barriers and enablers to the management of osteoarthritis.Osteoarthritis and cartilage,25(5), 625-638. DOI:https://doi.org/10.1016/j.joca.2016.12.002 Fall, E., Chakroun, N., Dalle, N., Izaute, M. (2013). Is patient education helpful in providing care for patients with rheumatoid arthritis? A qualitative study involving French nurses.Nursing health sciences,15(3), 346-352. DOI:10.1111/nhs.12042 Fitzcharles, M. A., Lussier, D., Shir, Y. (2010). Management of chronic arthritis pain in the elderly.Drugs aging,27(6), 471-490. DOI: https://doi.org/10.2165/11536530-000000000-00000 Green, C. A., Duan, N., Gibbons, R. D., Hoagwood, K. E., Palinkas, L. A., Wisdom, J. P. (2015). Approaches to mixed methods dissemination and implementation research: methods, strengths, caveats, and opportunities.Administration and Policy in Mental Health and Mental Health Services Research,42(5), 508-523. DOI: https://doi.org/10.1007/s10488-014-0552-6 Jia, X., Jackson, T. (2016). Pain beliefs and problems in functioning among people with arthritis: a meta-analytic review.Journal of behavioral medicine,39(5), 735-756. DOI: 10.1007/s10865-016-9777-z Larsson, I., Arvidsson, S., Bergman, S., Arvidsson, B. (2010). Patients' perceptions of drug information given by a rheumatology nurse: a phenomenographic study.Musculoskeletal care,8(1), 36-45. DOI:10.1002/msc.16 Lillie, K., Ryan, S., Adams, J. (2013). The Educational Needs of Nurses and Allied Healthcare Professionals Caring for People with Arthritis: Results from a Cross?Sectional Survey.Musculoskeletal care,11(2), 93-98. DOI:10.1002/msc.1035 Little, R. J., Rubin, D. B. (2014).Statistical analysis with missing data(Vol. 333). John Wiley Sons. Retrieved from: https://books.google.co.in/books?hl=enlr=id=AyVeBAAAQBAJoi=fndpg=PT8dq=characteristics+of+the+non+respondents+were+not+known+thus,+there+must+be+bias+in+the+interpretations+of+the+results+ots=uyRU7GqVfzsig=z37i7gGdThpwe_P5cmtx4Pyz9Cs#v=onepageqf=false Rollyson, C. (2016).Biography: an annotated bibliography. Open Road Media. Retrieved from: https://books.google.co.in/books?hl=enlr=id=HbFgDAAAQBAJoi=fndpg=PT4dq=annotated+bibliography+of+the+literatureots=7NRgrZErtssig=Peo-fwl8akEHVAUinBqUhB72UB8#v=onepageq=annotated%20bibliography%20of%20the%20literaturef=false Romppanen, T., Rantanen, A., Kuokkanen, L., Roine-Mentula, K., Vuorinen, R., Suominen, T. (2015). The educational needs of nursing staff taking care of patients with rheumatoid arthritis.Journal of Nursing Education and Practice,5(8), 44. DOI:https://doi.org/10.5430/jnep.v5n8p44 Spencer, K., Carr, A., Doherty, M. (2012). Patient and provider barriers to effective management of gout in general practice: a qualitative study.Annals of the rheumatic diseases,71(9), 1490-1495. DOI: https://dx.doi.org/10.1136/annrheumdis-2011-200801 Van Onna, M., Boonen, A. (2016). The challenging interplay between rheumatoid arthritis, ageing and comorbidities.BMC musculoskeletal disorders,17(1), 184.DOI: https://doi.org/10.1186/s12891-016-1038-3 Walker, J. (2012). Rheumatoid arthritis: role of the nurse and multidisciplinary team.British journal of nursing,21(6), 334-339. DOI: https://doi.org/10.12968/bjon.2012.21.6.334

John Stubbs Love And Role Playing In A Farewell To Arms John Stubbs Es

John Stubbs' "Love and Role Playing in A Farewell to Arms" John Stubbs' essay is an examination of the defense which he believes Henry and Catherine use to protect themselves from the discovery of their insignificance and "powerlessness...in a world indifferent to their well being..." He asserts that "role-playing" by the two main characters, and several others in the book, is a way to escape the realization of human mortality which is unveiled by war. Stubbs thinks that Hemingway utilized role-playing as a way to "explore the strengths and weaknesses of his two characters." Stubbs says that by placing Henry's ordered life in opposition to Catherine's topsy-turvy one, and then letting each one assume a role which will bring them closer together, Hemingway shows the pair's inability to accept "the hard, gratuitous quality of life." Stubbs begins by showing other examples, notably in In Our Time and The Sun Also Rises, in which Hemingway's characters revert to role-playing in order to escape or retreat from their lives. The ability to create characters who play roles, he says, either to "maintain self-esteem" or to escape, is one Hemingway exploits extraordinarily well in A Farewell to Arms and therefore it "is his richest and most successful handling of human beings trying to come to terms with their vulnerability." As far as Stubbs is concerned, Hemingway is quite blatant in letting us know that role-playing is what is occurring. He tells that the role-playing begins during Henry and Catherine's third encounter, when Catherine directly dictates what is spoken by Henry. After this meeting the two become increasingly comfortable with their roles and easily adopt them whenever the other is nearby. This is apparent also in that they can only successfully play their roles when they are in private and any disturbance causes the "game" to be disrupted. The intrusion of the outside world in any form makes their role-playing impossible, as evidenced at the race track i n Milan, where they must be alone. The people surrounding them make Catherine feel uncomfortable and Henry has to take her away from the crowd. He goes on to describe how it is impossible for them to play the roles when they are apart and how they therefore become more dependent upon each other's company. Stubbs goes on to explain how, "neither mistakes role-playing for a truly intimate relationship, but both recognize that it can be a useful device for satisfying certain emotional needs." He says that originally Henry and Catherine are playing the "game" for different reasons but eventually move to play it as a team. Henry is role-playing to regain the sense of order he has lost when he realizes the futility of the war and his lack of place in it. Catherine is role-playing to deal with the loss of her fiance and to try to find order in the arena of the war. When they are able to role-play together, "the promise of mutual support" is what becomes so important to them as they try to cope with their individual human vulnerability. He also analyzes the idyllic world introduced early in the story by the priest at the mess and later realized by Henry and Catherine in Switzerland. They fall fully into their roles when they row across the lake on their way to their idealized world. The fact that they actually are able to enter this make-believe world strengthens their "game" and allows it to continue longer than it would have otherwise. And once they are in this new world they adopt new roles which allow them to continue their ruse. They also need to work harder to maintain the "game" because far from the front they are both still aware the war is proceeding and they are no longer a part of it. The world in which they exist in reality (!) is not conducive to role-playing because it tries repeatedly to end their "game". Stubbs manages to uncover numerous instances in which the two are role-playing and he makes a very interesting case that this is exactly what they are doing and not just his imagination reading into the story. He does make certain assumptions, that their love is not "real",

Freedom Fighters free essay sample

The British colonial authorities derogatorily called the great leader as Father of the Indian unrest. He was also conferred with the honorary title of Lokmanya, which literally means Accepted by the people (as their leader). Tilak was one of the first and strongest advocates of Swaraj (self-rule) in Indian consciousness.  As one of the founders of the Non-Aligned Movement, he was also one of the principal leaders of India’s independence movement in the 1930s and ’40s. Nehru established parliamentary government and became noted for his â€Å"neutralist† policies in foreign affairs. The son of the wealthy barrister and politician Motilal Nehru, Jawaharlal Nehru became a leader of the left wing of the Congress when fairly young. Rising to become Congress President under the mentorship of Mohandas Karamchand Gandhi, Nehru was a charismatic and radical leader, advocating complete independence for India from the British Empire. He is often referred to as Shaheed Bhagat Singh Born to a Jat Sikh family which had earlier been involved in revolutionary activities against the British Raj, Singh, as a teenager, became an atheist and had studied European revolutionary movements. We will write a custom essay sample on Freedom Fighters or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page He also became attracted to anarchism and marxist ideologies. He became involved in numerous revolutionary organizations. He quickly rose through the ranks of the Hindustan Republican Association (HRA) and became one of its leaders, converting it to the Hindustan Socialist Republican Association (HSRA). She was not allowed to adopt a successor after his death by the British, and Jhansi was annexed. With the outbreak of the Revolt she became determined to fight back. She used to go into the battlefield dressed as a man. Holding the reins of there horse in her mouth she used the sword with both hands. Under her leadership the Ranis troops showed undaunted courage and returned shot for shot. Considered by the British as the best and bravest military leader of rebels this sparkling epitome of courage died a heros death in the battlefield. The first name that comes to mind is that of the famous Rani Laxmibai of Jhansi. His response to her fiery speech brought into her life the impact of a visionary who saw in her oratory and brilliance a leader of the future. The period from 1917 to 1919 was the most dynamic phase of Sarojinis career. During this time, she campaigned for the Montagu Chelmsford Reforms, the Khilafat issue, the draconian Rowlett Act and the Satyagraha. When Gandhi launched the Civil Disobedience Movement ,she proved a faithful lieutenant. With great courage she quelled the rioters, sold proscribed literature, addressed frenzied meetings on the carnage at Jallianwala Bagh in Amritsar. In 1930 when Mahatma Gandhi chose her to lead the Salt Satyagraha the stories of her courage became legion. After Gandhis arrest she had prepared 2,000 volunteers under the scorching sun to raid the Dahrsana Salt Works, while the police faced them half a mile up the road with rifle, lathis (canes) are steel tipped clubs. The volunteers wildly cheered when she shook off the arm of the British police officer who came to arrest her and marched proudly to the barbed wire stockade where she was interned before being imprisoned. Freedom struggle was in full force and she came under the influence of Gopalakrishna Gokhale and Gandhi. She was a leader of Womens Satyagraha for which she was imprisoned. She helped her husband in the cause of Indigo workers in Champaran, Bihar and the No Tax Campaign in Kaira, Gujarat. She was arrested twice for picketing liquor and foreign cloth shops, and in 1939 for participating in the Rajkot Satyagraha. Born to Gokuladas Makharji of Porbandar. Kasturba married Mohandas Karamchand Gandhi (Mahatma Gandhi) through arrangement. They were both 13 years old. At that time, she was illiterate, and so Gandhi taught her to read and write — a potentially radical move, given the position of women in India at that time. When Gandhi left to study in London in 1888, she remained in India to raise their newborn son Harilal. She had three more sons Manilal (1892), Ramdas (1897), and Devdas (1900). In 1906, Mohandas Gandhi decided to practice brahmacharya, and the couple became celibate. Although she stood by her husband, she did not always easily accept his ideas. Gandhi had to work hard to persuade her to see (and agree to) his points of view. Kasturba was deeply religious. Like her husband, she renounced all caste distinctions and lived in ashrams. Kasturba often joined her husband in political protests. She traveled to South Africa in 1897 to be with her husband. From 1904 to 1914, she was active in the Phoenix Settlement near Durban. During the 1913 protest against working conditions for Indians in South Africa, Kasturba was arrested and sentenced to three months in a hard labor prison. Later, in India, she sometimes took her husbands place when he was under arrest. In 1915, when Gandhi returned to India to support indigo planters, Kasturba accompanied him. She taught hygiene, discipline, reading and writing to women and children. Kasturba suffered from chronic bronchitis. She became an active member of Congress Party after marriage and participated in public processions during the Salt Satyagraha. She was arrested on the charge that she was a vagrant and hence not released in 1931 under the Gandhi-Irwin Pact which stipulated release of all political prisoners. Other women co-prisoners refused to leave the premises unless she was also released and gave in only after Mahatma Gandhi intervened. A public agitation secured her release. In 1932, she was held prisoner at the Tihar Jail where she protested the indifferent treatment of political prisoners by launching a hunger strike. Her efforts resulted in an improvement of conditions in the Tihar Jail but she was moved to Ambala and was subjected to solitary confinement. She was politically not very active after her release. Her father Upendranath Ganguly hailed from Barisal district of Eastern Bengal but settled in the United Province. He was a restaurant owner and a very adventurous man. Mother Ambalika Devi was the daughter of Trailokyanath Sanyal,a renowned Brahmo leader who wrote many beautiful brahmo hyms. Upendranath Gangulys younger brother Dhirendranath Ganguly (D G) was one of the earliest film directors. Another brother Nagendranath, a soil biologist was married to Rabindranath Tagores only surviving daughter Mira Devi though they got separated after sometime. Her sister, Purnima Banerjee was a member of the Constituent Assembly of India. On August 8, 1942, the AICC passed the Quit India resolution at the Bombay session. The government responded by arresting the major leaders and all members of the Congress Working Committee and thus tried to pre-empt the movement from success. A young Aruna Asaf Ali presided over the remainder of the session on 9 August and hoisted the Congress flag at the Gowalia Tank maidan. This marked the commencement of the movement. The police fired upon the assembly at the session. Aruna was dubbed the Heroine of the 1942 movement for her bravery in the face of danger and was called Grand Old Lady of the Independence movement in her later years. Despite absence of direct leadership, spontaneous protests and demonstrations were held all over the country, as an expression of desire of India’s youth to achieve independence. Aruna Asaf Ali was awarded International Lenin Peace Prize for the year 1964. She was awarded India’s highest civilian award, the Bharat Ratna, posthumously in 1997.

Italian Preterite Perfect Tense - Trapassato Remoto

Italian Preterite Perfect Tense - Trapassato Remoto You’ve learned about the passato remoto tense, which is the one you use in literature or to talk about events that happened in history. But you have also learned the trapassato remoto tense? As you’ll see below, it’s a tense for students who are more advanced in their studies. It’s used primarily in literary contexts and is known in English as the preterite perfect. It’s a compound tense formed with the passato remoto of the auxiliary verb avere or essere and the past participle of the acting verb. For example, a sentence like the one below, in a literary context, would require the trapassato remoto. As soon as Julia had gone down the stairs, she left the building. - Dopo che Giulia ebbe sceso le scale, uscà ¬ dal palazzo. â€Å"Ebbe sceso† comes from the conjugated verb â€Å"essere - to be† and â€Å"sceso† is the past participle of the verb â€Å"scendere - to go down.† The action indicated by the verb scendere (to descend- conjugated in the past perfect) occurs prior to the action indicated by the verb uscire (to exit, to leave- conjugated in the passato remoto). The past perfect is a verb form that is used to refer to events, experiences, or facts that happened or were already completed before a point of reference in the past. In each sentence set in the trapassato remoto, you will encounter an expression of time, such as the following: appena (barely), dopo che (as soon as), or finchà © non (up until). For example: Partirono, quando ebbero ricevuto la notizia. - They were leaving when they received the notice.Renata entrà ², appena Giorgio fu uscito. - Renata entered just after Giorgio had left.Andà ² a casa, quando ebbe finito di lavorare. - He went home when he had finished working.Dopo che ebbe letto quel libro, lei ne comprà ² uno nuovo. - After she had read that book, she bought a new one.Non appena ebbi iniziato a guidare, ebbi bisogno di usare il bagno. - As soon as I started driving, I had to use the bathroom. Most verbs of the second conjugation are irregular in the passato remoto tense. To see how avere and essere are conjugated in the remote past tense, see the table below. TRAPASSATO REMOTO OF THE VERB AVERE Person Singular Plural I (io) ebbi (noi) avemmo II (tu) avesti (voi) aveste III (lui, lei, Lei) ebbe (loro, Loro) ebbero TRAPASSATO REMOTO OF THE VERB ESSERE Person Singular Plural I (io) fui (noi) fummo II (tu) fosti (voi) foste III (lui, lei, Lei) fu (loro, Loro) furono Note that if the verb requires â€Å"essere,† then you must change the ending of the past participle to agree with the subject in gender and number. For example: Dopo che le ragazze furono salite sull’autobus, si sedettero. - After the girls got on the bus, they sat down. The past participle â€Å"salire† ends in an -e because the subject is a group of girls. Click here to read more about gender and number agreement.

Fences by August Wilson Essay Example | Topics and Well Written Essays - 500 words

Fences by August Wilson - Essay Example Upon the analysis and criticism of Wilson’s play, the arguments of Birdwell are evident. Therefore, the assertions of Birdwell are valid according to the nature of events in the Wilson’s play. Some of the fences outlined in the paly are realistic. There are events that manifest real life fences in the play. The realistic fences in this story dominantly manifest defensive features. For instance, Rose requires a fence that engulfs her homestead (Janet, 20). This was a realistic fence that was constructed by Bono and Troy upon a request from Rose. The major purpose of this fence was to defend Rose’s family. Evidently, this fence had a key objective of defense. There is a fence that defines the perimeter of the baseball field. Troy and other playmates maintain the game within the defined confinements (Janet, 35). In this context, the fence plays a defensive role as they prevent interruptions of the game. The real fences are as well evident in mental hospitals. In this case, they play a defensive role as they protect occupants within the hospital. Real fences in the story do not require a deep analysis and evaluation. They are obvious observations in the events of the p lay. They are clearly evidenced in the play. Apart from the real fences, there are metaphorical fences as well. These fences exist in the play to convey certain implications. Therefore, they are not obvious revelations in the story. The identification of these fences requires an analysis and critical response towards the play. In this case, there are diverse events and features of the play that portray existence of fences. Metaphorical fences in this play are dynamic. They manifest both defensive and obstructive roles according to the context they are placed. In this case, the metaphorical fences have a major role of communicating the themes of the play. Upon criticism, the metaphorical fences convey essential themes of the play. Diversity in generations is a manifestation of metaphorical

Competition and Competition Policy Essay Example | Topics and Well Written Essays - 4500 words

Competition and Competition Policy - Essay Example As the essay discusses Blue Beer plc is an important producer of beer in Newcastle. Statistics shown that Blue Beer plc accounts for some 12% of all beer sold in the United Kingdom but that its Bluelite plc is especially successful and accounts for 40% of all non-alcoholic beer consumed in the UK. Blue Beer has been negotiating with County Beers Ltd with a view to merger. County Beers is the principal other producer of non-alcoholic beers and after merger the new company, British County Blue, will control 65% of the market in non-alcoholic bee. According to the paper findings the overall policy of the European Union of competitive practices is as follows – â€Å"In a free market, business is a competitive game. Sometimes, companies may be tempted to avoid competing with each other and try to set their own rules for the game. At times, a major player in the game may try to squeeze its competitors out of the market. The European Commission acts as the referee to ensure that all companies play by the same rules. This discussion stresses that markets started being highly competitive and this forced businesses to pursue ways and means to survive and grow. Price cutting, mergers and acquisitions, and formation of cartels began to be accepted as a way to keep away competition. Monopolies or monopolistic tendencies began to be seen in the market creating unfair competition for smaller players.

Art History and Appreciation Essay Example | Topics and Well Written Essays - 500 words

Art History and Appreciation - Essay Example The whims and fancies of the mysterious race of women fighters have been well depicted through the painting "The Battle of Amazons". Excellent use of color combination and images can capture the mind of an onlooker. The submissiveness and resistance of the women folk reveal more clearly and artistically in the given painting. The journal article entitled: "Comparison of The Heart of the Andes, The Volga Boatmen and the Battle of the Amazons Paintings" by Steven Nickerson shares his view about the painting. The author remarks; "Amazons were a mysterious race of women - warriors who hated men and kept them as slaves for hard works." Content HomeArts & Entertainment (Nickerson, Steven, 2008). Fredrick Edwin Church's "The Heart of the Andes" depicts an excellent combination of dark colors which express a dark and sorrowful mood. The beautiful picture of the landscape constitutes effective examples of symbolism. The flowing river, falling trees, and the mourning people are symbolizing the inevitable struggle between life and death. The online article entitled: "The Heart of the Andes" states: "The picture caused such a sensation that people waited for hours in line to approach it on the last day of the exhibit" (Church, E. Frederic., n. d.). Like, "The Battle of Amazons" it also explores several inner meanings.