Contemporary Issues In Health Policy Health And Social Care Essay

Contemporary Issues In Health Policy Health And Social Care Essay Expert knowledge; published research, existing research; stakeholder consultations; previous policy evaluations; the internet; outcomes from consultations; costing of policy options; output from economic and statistical modeling. This essay will explore the ontogenesis of evidence based health policy making whereby according to Buse et al (2005, p.6) health policy is assumed to embrace courses of action (and inaction) that affect the set of institutions, organizations, services and funding arrangements of the health system. The essay will use various case study examples to highlight the roles played by evidence from research, social and bureaucratic point of view. The National Institute for Health and Clinical Excellence (NICE) in 1999 gives advices on the betterment of acceptable health guidelines for prevention and treatment of diseases in England and Wales. The concept of policy making was not well know before as it these days. The two fundamental rationale for the establishment of health policy includes change in the public health policies and the health care policies ( Gray, p.95, 2001). Public health policy refers to improving the physical, social and biological surroundings. Health care policy refers to financial and administrative changes (Gray, p.95, 2001). Recently the policies are established based on evidence which was not the case before. Health policy making used to be more of recommendation or suggestion based in the past. Quantitative research evidence is likely to be more appreciated in delivering health services (Rycroft-Malone et al 2004). The rise of evidence based healthcare took place in the 1990s in such a way that healthcare researchers, professionals and the health system adopted research evidence for research in clinical decision making. This rise was entitled as evidence based healthcare movement (Davidoff et al. 1995; Sackett and Rosenberg 1995). The terminology evidence based policy has emerged from the notion of evidence based practice, both of them being ushered from evidence based medicine (EBM). The origin of EBM extended back to the mid 19th century in Paris (David L. Sackett 1997). EBM is widely used in the United Kingdom and in the United States by policy creators and therapist for promoting health and treating illnesses which signifies that EBM has both informative and scientific role . The development of evidence based healthcare was driven up by research-practice gap which means that it took long time for the effective interventions to come into clinical practice and it also took a long time to discard the interventions which were ineffective (Antman et al 1992). The problems of these interventions were classified as underuse, overuse and misuse by the Institute of Medicine (1999). For patients suffering grom heart attack , thrombolytic treatment for myocardial infarction is used as a treatment which decreases the chances of the patient to get another heart attack and it also decreases the mortality rate (Walshe, 2006, p.480). Since it had an evidence of a decade or more it became the poster child for the EBM movement. Example for overuse : merger of an organization due to difficulties in service quality, volume and monetory viability. Example of underuse : substitution of GPs with health care professionals for providing the basic healthcare treatment. It generall y involves the primary care and accident and emergency departments. Example of misuse : The fosterage and application of total quality management (TQM) (Walshe, 2007, p.481). Development of basis for evidence involves 8 principles (Kelly et al 2007) : Princliple 1: An assurance to the value of equity. Principle 2: Acquiring an evidence based proposal. Principle 3: Variance in technology. Principle 4: Gradients and gaps. Principle 5: Social values and its result. Principle 6 and 7: Social structure and dynamics. Principle 8: Clarifying partiality. The new labour government which was formed in 1997 declared publically that what matters is what works, directing a reform from imaginary or visionary theorization to a more practical and technological approach in which a negligible role would be played by evidence of effect and impact (Cabinet Office 1999). A variety of reports and data were generated by the Cabinet office and National office for evidence in policy making and the centre for Evidence Based Policy and Practice has been supported by Economic and Social Research Council (ESRC) (Jennifer Dixon, p.481, 2006). For conducting standardized and organized survey of the best evidence on the effects of social and educational policies and practices, The Campbell Collaboration was established (The Campbell Collaboration 2003). In 1997 the Canadian Health Services Research Foundation (CHSRF) was established by the government funds and its aim is to assist evidence based decision making in various health sectors( Dixon, p.481, 2006) . Health policy process involves diverse universal bodies like World Health Organization, the World Bank and the World Trade Organization (Rob Baggot, p.199, 2007). Health Policy Process also comprises of the nation states and their alliances, the G8 group of nations being eminently prevailing. Health policy is also influenced by a wide range of non-governmental organizations which represents professional and sectional interests as well as take up a position from which they can examine bureaucratic policies and recommend policies of their own (Chris Ham et al 1995). Health policy in the UK is formulated by authorities outside its communal horizon. The three key elements include global influences, international institutions and organizations as well as multinational corporations (Rob Baggot, p.197, 2007). Sackett and colleagues (1996) distinguishes EBM from EBP, and defines EBM as meticulous, accurate and wise application for the care of individual patients using current evidence in decision making whereas EBP is more about policy decisions for a group or bunch of people and not individual patients. In case of EBM randomized control trials are carried out which can raise certain arguments about outcomes, which is not the case with EBP. Black (2001) specifies that EBP in not merely a continuation of EBM but it differs qualitatively. The outcomes for policy generally depends on peoples thinking and judgemental behavior (Sackett et al 1996).There are two types of critical commentary for EBP, the first being internal critical commentary, which focuses on the appropriateness of the diverse range of methods for gathering, analyzing and using evidence as a foundation for recognizing and enhancing policies ( Head n.d.).. The external commentary is the second type of critical commentary which focuses on in what manner and place are the EBP benefaction more effective and the way in which they fit into the broad picture of policy debate and evaluation ( Head n.d.). Morgan (2010) recognizes six factors that forms the base for the growth of evidence based health policy (EBHP). They are as follows : The significance and advantage of having multi-disciplinary unit. The requirement to possess ample evidence substructure to draw upon. The indirect correlation between policy and research. The demand for policy exertion to be locally sensitive. The advantage of stakeholder engrossment. Aid from the national Government. These six factors yields a powerful foundation on which EBHP may be established (Morgan 2010). If these above mentioned factors are not satisfied in evidence based health policy then the consequence may be resistance of policy change. According to Carolyn Tuohy (1999, p.14) reformation occurs at certain favourable times and not others and it involves not only health care arena but also the political system. In addition, Tuohy (1999, p.14) mentions that reformation is influenced by various parameters such as history, series of reform and evidence based choice and two other terms which she outlined as institutional mix and structural balance. She describes institutional mix as the eveness of power between three main forms of social control : state hierarchy or authority based control; professional collegiate institutions or skill based control and market or wealth based control. She refers structural balance as the evenness of power between the three main stakeholders : the state, healthcare professionals and private financial interests. Tuohy argues that reform of healthcare would be different across different countries and would be incremental most likely. Evidence based health care focuses primarily on safety measures, analysis, detection and care of health related problems ( Haynes et al 1998). It is also important as well as necessary that the evidence based policy should be put into practice at the right pace, in the right position and in the right manner ( Haynes et al 1998). The outcome of the policies that are not designed properly or not tested may be detrimental (Tunis et al 2003). The data (i.e. efficacy and effectiveness) obtained for patients treatment is important but is not relevant for policy makers when it is considered for the constitution or implementation of regulations (Sturm et al 2002). Policy makers require evidence about healthcare proposals rather than efficacy and effectiveness data. According to Sturm et al (2002) randomized trials tend to be difficult in acquiring the information because RCT requires vast samples and a large unit, lesser duration would leave negligible time for conducting complex randomized studies and lastly there is a frequent change in the policy and healthcare arena. Ministers and civil servants must be willing to indulge themselves in the result monitoring which channels policy making (Ham, 1999, p.202). The clinicians and managers are not able to seek the evidence based practice because it is difficult to find the correct evidence for assisting decision making. The group of people who have high expectations for high quality evidence includes the clinicians, physicians, health policy makers, common public, patients and health care administrators (Tunis et al 2003). Amongst all of them patients and physicians more concerned for high quality evidence. The patients and physicians are guided by medical professional socities for shaping medical conclusions (Tunis et al 2003). Evans (2005) had analyzed the current reforms for over 11 European countries mentioned in the Journal of Health Policy Politics and Law. Evans (2005) observed that the reforms over the past 50 years were analogous , i.e. variation in the reform but parallel development. There are two apparent aspects of reform. The first aspect being the collection of payments for healthcare either by taxation or by mandatory social insurance which was linked to the World War II. The second aspect was the cost which was drive up by the highly motivated and intelligent opponents like the general practitioners and the pharmaceutical industries (Evans 2005). Nutley et al (2002) points out that a very narrow range of evidence is used by the United Nations in the public sector, precisely for research and statistical data, evaluation of policies and proficient information. According to Maynards (2005) observation the inadequacy of transperancy in describing public policy goals, creating trade-offs and allineating incentives was due to the underpinning of poor evidence of reforms in Europe. Evidence can be graded in terms of effectiveness in the National Service Framework on Mental Health (Department of Health ,1999) Type I evidence at least one good systematic review, including at least one randomised controlled trial. Type II evidence at least one good randomised, controlled trial. Type III evidence at least one well-designed intervention study without randomisation. Type IV evidence at least one well-designed observational study. Type V evidence expert opinion, including the opinion of service users and carers. Subtler strategies would be required by the clinicians to alter their usual procedure as evidence in itself is not adequate (Dopson et al 2002). Systematic reviews of RCTS are carried out in order to overcome inadequate evidence. These RCTs were reinforced by the development of Cochrane Effective Practice and Organization of Care (EPOC) team. Social values and political beliefs plays an important role in the development of evidence based health policy (Kelly et al 2007). A combination of social and political determinants of evidence on health would lead to a powerful response. Social beliefs produce injustice in health amongst the different classes of people. The rich and powerful population has got easy access to health services in comparision to the poor people who die at a younger age (Kelly et al 2005). The description and measurement of social determinants of health is a complex process. The psycho social model suggests that biasness based on the social status of an individual leads to stress which in turn produces a disease because of neuroendocrine response (Karasek 1996; Siegrist and Marmot, 2004; Evans and Stoddart 2003; Goldberg et al 2003). Environmental factors, proper sanitation and pure water, balanced diet, vaccination and good housing are essential for improving health (Graham et al 2004). Apart from socia l values and political belief situational factors like an earthquake or draught or some epidemic are also responsible for processing and implementation of policies (Buse et al 2005). Case Studies : Case Study 1 : Topic: European union policy on smokeless tobacco : a statement in favour of evidence based regulation for public health (Bates et al 2003). The significant aim of tobacco control campaigning is reduction of ailment and death from malignancy, cardiovascular disease and lung disease. Bates et al (2005) case study is about the ill effects due to tobacco and substitution of tobacco by smokeless tobacco. Tobacco contains an addictive substance called nicotine and because of nicotines addictive property many users are not able to quit smoking. Smokeless tobacco is considered to be les injurious as compared to smoking cigarette and there was a proof from Sweden which implies that it is used as a replacement for smoking and smoking cessation. This substitution is substantial argument which depicts that Sweden has the least tobacco related diseases. It is difficult for chain smokers to quit smoking but an alternate option to it could be meagrely dangerous forms of nicotine replacement therapies (NRT) may also reduce harm. Proofs from Sweden implies that snus can be used as a replacement against smoking and it has half mortality rate in comparision to other EU. Chewing tobacco like guthka and paan are officially forbided in the EU but is eminently lethal and Bates et al (2003) suggestion might eradicate more products from the market. In the entire Europe, Sweden ranks least smoking prevalence for male and female. Snus is 90% less injurious as compared to cigarette and the mortality rate can be declined if we use it in a limited manner. Smokeless tobacco is also harmful but to a lesser extent as compared to tobacco. For eg, the products made of smokeless tobacco in India and USA leads to oral cancer. In india the prime reason for oral cancer is smokeless tobacco. Diseases related to deaths in Europe due to smoking includes chronic obstructive pulmonary disease (COPD) and lung disease. However, smokeless tobacco do not produce these above mentioned diseases. A complete ban on the products that are least injurious forms of smokeless tobacco should be substituted by a regulation for all products that are smokeless instead and the products that are seriously harmful to the society should be eliminated. This policy is fair, rational, beneficial for chain smokers, self control might be developed amongst the smokers, toxicity controls would be applied and it might prove to be beneficial worldwide. Case Study 2: Topic: Translating research into maternal health care policy: a qualitative case study of the use of evidence in policies for the treatment of eclampsia and pre-eclampsia in South Africa: (Daniels et al 2008). Deaths of pregnant women and infants due to eclampsia and pre-eclampsia is one of the prime concern of the society. A qualitative case study approach was used in South Africa for analyzing the policy procedure. This case study explores about the usage of magnesium sulphate in curing pre-eclampsia and eclampsia in South Africa from 1970 to 2005 for which RCTs and systematic analysis were carried out. Pre-eclampsia and eclampsia are one of the prime reasons for maternal and infant morbidity and mortality universally and this is the case generally in developing countries. South Africa did not have a national maternal care policy before 1994 and hence every institution had its own guidelines for treating eclampsia and pre-eclampsia. In the mid 1990s the democratic government changed and various health policy reforms took place which resulted in the formation of new national policies for maternal care. These policies were evidence based and evidence was generated from RCTs and systematic reviews. The new government identified the health of females and children as a first concern and gave greater importance to it. The new government engaged academics in policy making from local networks in the National Department of Health. The local academics had much more understanding of evidence based practice and they used their strategies for policy process. The research identifies that affiliation amidst knowledge generation and application is critical thus research in healthcare policy making is also converted into an attempt to study. If pregnant females are suffering from hypertension it may lead to her death. Hypertension was regarded to be the main cause of death for females in 1998. Evidence was generated from research by doing two multi-center RCTs and three systematic reviews which shows that magnesium sulphate is effective in curing eclampsia and pre-eclampsia. Garner et al elucidates that in 1995 a survey was carried out which shows that magnesium sulphate was the most promising drug in curing eclampsia. This study thus uses evidence from research for developing guidelines and policies for maternal health. Case study 3: Topic: The impact of Chinas retail drug price control policy on hospital expenditures: a case study in two Shandong hospitals(Meng et al 2005). This is a retrospective case study which deals with the cost reduction of retail drugs and medicines in two Shandong hospitals in China. For the past two decades the pharmaceutical expenditure in China is found to be more than the overall economic growth (Wei 1999). Pharmaceuticals contributed to about 44.4% of the total health cost in 2001 in China. Hence the Chinese government adopted a systematic approach in cutting down the costs of retail drugs. In order to bring a change in the retail costs of drugs the financial data and records were viewed and analyzed. For the examination of the changes in the cost tracer condition approach was used and cerebral infarction was the health issue. About 104 and 109 cases of cerebral infarction were selected from the two hospitals prior to reform as well as after reform. The usage of drug was measured on the basis of prescribed daily dose (PDD). The usage of the drug after reform can be viewed from the literature of the hospital. But it was obse rved that even after implementing the pricing policy in the two hospitals the usage of drugs increased rapidly. In the provincial hospital there was a significant decrease in drug utilization whereas in municipal hospital there was a drastic increment of 50.1% even after reform. The provincial and municipal hospitals spent about 19.5% and 46.5% of the expenditure respectively on the top 15 drugs for treating cerebral infarction whose costs have been decided by the government and this took place after reformation. Allopathic drugs accounted for about 65% and 41% in the provincial and municipal hospitals respectively, though it did not had sufficient evidence for safety and efficacy in treating cerebral infarction. The Chinese government brought about a change in its policies for drug pricing after 2002 so that a control over the pharmaceutical expenditure could be made. In order to overcome the conflicts in pharmacy settings, countries such as Sweden approached direct salary compensation of the pharmacists. The drugs which came under the category of Urban Health Insurance Scheme were set up by the State Commission of Development and Planning. Policy makers have made a number of efforts in order to reduce the cost of pharmaceuticals. Various initiatives taken by the policy makers include preparation of a drug list, sharing costs for various schemes on health insurance, monitoring the GDP of hospitals and marking up regulations. The drug list includes two types of drug: Part A and Part B. Central government decides the cost of drugs for Part A and Part B but Part A drugs are generally used by the retailers whereas Part B drugs are used by the provincial government. Utilization of the drug along with the price determines the drug expenditure hence there should be rational usage of drugs and the prescribers should use various strategies for controlling drug expenditure. Conclusion : According to Walt (1994, p.1) since health policy is about power and processà ¢Ã¢â€š ¬Ã‚ ¦. It is concerned with who influences whom in the making of policy and how that happens. Health policy is all about decision making, consistent approach, expertise knowledge and positive action and it is emanated by senior officials, directors, ministers and government bodies. Evidence based policy stimulates a crystal clear and parallel application of evidence in health policy framework. Policy making is influenced by various social values and political belief like racial minority, holy belief, statistical features, unhealthy conditions and contagious diseases. Evidence based healthcare movement brought about a drastic change in the 1990s for the development of health protocols. Scientific research or RCTs play a key role in the development of EBP making. Incorporation of the contemporary nonpareil evidence would decline the hindrance between the creation of evidence and its appliance, and there would be an increment in the bulk of patients to whom the best treatment is offered. Bates case study is more of social belief because the public should co-operate with the health professionals to quit smoking. Even though he replaced tobacco by smokeless tobacco, it is still harmful to health. From the above mentioned case studies it can be observed that not all the health policies are implemented because of issues related to the government or the common public. Policy makers in the earlier period were not aware of the health protocols in depth as they are today and this awareness among the policy makers is brought by reformation in the public health protocols and the healthcare protocols. The support and approval from the government is mandatory for the implementation of the policy which indicates that political support plays more important role than the social support in developing policy.

Hypothalamic Lesion :: Medicine Health Research

Hypothalamic Lesion from the Perspective of Neurologist and Neurosurgeon The hypothalamus is a substructure of the diencephalon and acts as one of the most significant control centers of the brain. It is located inferior to the thalamus, encapsulates the ventral portion of the third ventricle, and lies just superior to the pituitary gland, which it has direct regulatory control over (Gunderson, 1996). Neurosecretory neurons in the hypothalamus secrete releasing and inhibiting hormones which are carried to the anterior pituitary where they exert their effects via hypothalamic-hypophyseal portal veins. Included in the many functions of the hypothalamus are regulation of food and water intake, autonomic function, emotions, body temperature, motor functions, and circadian sleep-wake cycles (Kalat, 2004). Hormones secreted by the hypothalamus include Thyrotropin- releasing hormone, Gonadotropin-releasing hormone, Growth- releasing hormone, Corticotropin-releasing hormone, Somatostatin, and Dopamine (Klaus,n.d.). Medically, a lesion is a term referring to abnormal tissue in the body that can be caused by many factors including disease, trauma, infection, or neoplasm which is an abnormal growth of tissue, such as a tumor (Healthopedia.com, n.d.). For the purpose of this paper tumor and lesion will be used interchangeably. As a neurologist I am a medical doctor with specialized training in diagnosing, treating, and managing disorders of the brain and nervous system, including diagnosis of brain tumors. As a professional I act as the primary care provider for patients with chronic neurological problems and as a consultant to other physicians who have clients suspected of having a condition involving the nervous system (Life NPH, n.d.). A neurological examination allows me to effectively diagnose the condition of the patient and suggest appropriate treatment options. I first review the patient's health history with special attention to the current condition. A patient suspected of having a disorder of the nervous system will be subjected to a general neurological examination which includes testing of eye movement and pupil reaction, hearing, reflexes, balance and coordination, sense of touch, sense of smell, facial muscle functioning, gag reflex, head movement, mental status, abstract thinking, and memory (Malhi, 2000). A full neurological examination is generally administered, despite any preconceived opinions of a patient’s potential ailment, in order to illustrate the condition as clearly as possible and rule out any alternative diagnosis. An examination takes 90 minutes or more in most cases and consists of a battery of tests. A neurological exam tests for a client’s level of function of the area of the nervous system involved in a given

7 Year War

The war consisting of three names, known to the Europeans as â€Å"the 7 year war,† the Canadians as â€Å"The conquest,† and to the English Americans as â€Å"The French and Indian War. † The French and Indian War started in 1756 and lasted roughly 7 years. It all started at â€Å"The Forks of Ohio. † Present day Pittsburgh, Pennsylvania. Both Great Britain and France hoped to get there first and take control of the land for themselves. The river was a natural highway for trade and both sides had their own plans for the land.France formed alliances with the Native Americans who lived around their forts and would most often live and work along side of the natives taking in their way of life The river would be a way for them to travel faster for trade amongst other colonies, they built most of their trading posts along the rivers. The French traded amongst the Native Americans for valuable animal fur, which later they would send to Europe to be sold. Anothe r reason the French became a great threat to Great Britain, they had and controlled more land.By 1700 the French land stretched from Canada, across the Great Lakes, down to the Mississippi River and to New Orleans. This and the wanting The â€Å"Forks of Ohio† themselves will be the cause of the war we know today as the â€Å"French and Indian War. † The British, busy building their colonies along the coast of the Atlantic. These settlers were brought to America with the desire to become rich or to practice their own religious beliefs freely. Most of their living being made farming or trading.The British outnumbered the French due to the fact that they built more small villages and towns, bringing more British over in their conquest for riches. The vast number of British caused for them to move around in search for more land, moving them west, most often causing conflict with the Native Americans trying to protect their land. Between the years 1689 and 1748 a series of three wars were fought amongst them both all for control of North America, in which neither side fully won.On Great Britain’s side, a young twenty-one commander in chief was the start to the notorious war, firing the first shots starting the first true war, â€Å"George Washington. † The two armies collided near The Forks of Ohio in 1754 causing Britain’s victory over the French for a short period of time. Once French soldiers surrounding the area caught word of the attack they band together and went in search of George Washington and his men.The French soon arrived to find George and his men hiding in a stockade they had built to fend of the French soldiers, the stockade soon developed the name â€Å"Fort Nessecity. † Washington and his men soon out numbered caused the British to surrender and to their surprise was able to return home. When this war began the French teamed with the Canadian colonists and their native alliances they traded amongst for ye ars. The French proved loyal to the Natives over the period of time they conducted business together.This help make up for the vast outnumbering Britain had over the French. Britain teamed with the American colonies and 4 of the 6 Iroquois Nations, who were not to fond of the French to begin with, due to the taking over their land and changing their way of life by driving out their game they used for hunting and destroying their crops. 1755, General Braddock, appointed general at the time led yet another attack at â€Å"Fort Duquesne,† the new name of the French fort at the â€Å"Fork of the Ohio. Alongside the General came George Washington, now Junior leader of the British army. It was this battle that General Braddock became injured and later died. The battle lasted only about three hours and ended with the British once again retreating. This battle soon came to become â€Å" The Battle of the Wilderness. † The British strategy of attack was no match for the defens e of the French. The French and Natives would hide amongst the trees and the wilderness leaving the British shooting in the dark and wide open targets. 756, this year became the start of what seemed to be a huge loss amongst the British. â€Å"Fort Oswego† in New York was captured by the French. 1757 â€Å"Fort William Henry,† soon became French territory. Attack after attack by the French caught the British army off guard as the French and Natives pulled land after land from underneath the British. This battle caused different countries all over the world to take sides.By 1756 war was not just in North America anymore but consisted of most of the countries throughout the world. In 1757, William Pitt took over the position of leadership for Great Britain. In 1758, Pitt ordered an attack at â€Å"Fort Louisburg† a French fortress off the coast of Canada. They thought that if they could get control of the key then they would have access to the rivers running throu gh, making for battle by water a lot easier of a solution for them.The British brought with the double the men than what existed at the fortress at the time, outnumbering the French, this led to the surrender by the French and gave the British two heads up on the battle. The war started to take a turn for the best for Great Britain. Soon the British had control of â€Å" Fort Frontenac† on Lake Ontario in the year 1758. This loss for the French really made a dent in the British victory, making it harder for the French trade.The fall of 1758, the French abandoned â€Å"Fort Duquesne† causing the British to take control of the Forks of Ohio. The name â€Å"Pittsburgh† soon became the new fort name, after William Pitt, Pitt was the reasoning for the turn of the war in the British favor, earning him the title of the name. 1759, the invasion in Canada was sent under way. â€Å"Lake Champlain† was claimed by the British clearing another path to Canada for the B ritish.Summer, 1759 James Wolfe led a large fleet up the St. Lawrence River, targeting Quebec. Wolfe and his men set up fort across the river from Quebec, planning out a way to carry out their attack. Months pass, several attempts on Quebec’s steep land fails. Wolfe catches word of a secret trail that became ideal for the attack. September, the night attack by Wolfe and his men , sent under way led to the surrender of the French in Quebec.The French retreated to Montreal, although on both sides both generals lost their lives, Wolfe and Montcalm the British proudly marched in to Quebec on September 18th the year 1759. This battle was one of the last chances for the French to have any control over North America. The wars continued but never again did the French see another victory. Great Britain had taken over and their forces seemed to be too overwhelming for the French. The war around the war continued and still led to the French and their allies failing. 763 came around and both the British and the French decided it was time for a Truce. The treaty called â€Å"The peace of Paris† was drawn up and signed. The terms, The French gave up Canada, India and the Florida territories. The British now had control of most of North America. Although it felt like peace had been made at last even though Great Britain’s powerful force took over most of North America, this war had and impact that would not be avoided not only for the colonists but for the Native Americans as well.Great Britain now controlled vast’s amounts of land and more land meant more soldiers to protect this land. This became costly, the new government then imposed new taxes for the colonists. As imagined, the colonists grew unhappy with this decision. They felt the victory had to do with them as well and their new found freedom should be enjoyed, this was not the case. This will soon cause even more conflict in the future. The Native Americans, felt the impact in the worst way.After British victory more and more settlers moved to North America taking control of even more land, creating their tobacco crops and scaring away the wildlife the Natives become accustomed to hunt. The Native American not only were being pushed out of their land but could not continue their way of life they lived for centuries. This became a problem and caused war amongst the natives and the British. 1763, a proclamation was created, making the first reservation between the Appalachian and the Mississippi River for the natives.This was an attempt at peace, trying to avoid war with the natives. War is costly and Great Britain trying to maintain their vast majority of land had too many cost to deal with as it was. This law was to protect the land from the settlers. This treaty did little or nothing for the Natives as the settlers still continued to move west forcing the natives from their land. The taxes and the proclamation caused even more anger amongst the colonists, they beg an a disagreement with the British rule.The relationship between Great Britain and The American colonies would soon fall apart leading to none only than â€Å"The American Revolution. † A new war at hand. Bibliography: Santella, Andrew, â€Å"We the people, The French and Indian war,† (Compass Points Books, 2004) , 4-48 Anderson, Fred, â€Å"Crucible of war,† (A Division Of Random House, New York), 479 Vaugeois, Dennis â€Å"The last of the French and Indian War,† Montreal, (Mcgillqueens University Press, 2002) 1-100

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Justin Bieber Purpose World Tour Performed At The...

On, March 26th, 2016, I attended the Justin Bieber:Purpose World Tour performed at the Savemart Center. Then I attended a live Jazz performance on April 22, 2016. The band was The Rich Severson Quartet and was held at The Tasting Room in Fresno, California. Instrumentation Justin Bieber s band had multiple instruments included in the performance. For instance, guitars both electric and acoustic, keyboard, piano, drums, and DJ equipment that produces musical-like instrumentation. In addition, Justin Bieber was the lead vocalist. The Rich Severson Quartet was formed by four members each playing a different instrument. Included was an electric guitar, electric bass, drums, and a keyboard. Solos A distinctive solo during Justin Bieber s performance was when he started to play the drums. The stage elevated him into the air above the crowd, while he played for about two minutes. Musically, the lead vocalist impressed the crowd with his talent on the drums. It amped up the crowed by the high intensity sound. Where as, during the The Rich Severson Quartet performance the solo was more calm and relaxed. There was no focal point on the artist, rather the sound was just heard more clearly. The solo that stood out to me was during the song â€Å"Bop till you Drop,† when Karl the keyboardist produced a soft, mellow sound. It was much slower than the rest of the song and it brought on a calm and cool feeling. General Mood The mood during the song â€Å"Where are you now† by Justin Bieber

Essay about Amazing Grace or Disgrace - 1215 Words

Imagine living in the 1700s when slavery was a normal part of people’s everyday lives. Would you be for slavery, or against it? People in today’s society would denounce slavery as cruel or inhumane. But in the eighteenth century, most of the western society accepted slavery and the slave trade. It took heroic efforts be brave, dedicated political leaders to eventually turn the tables. Amazing Grace is a historical film that depicts the life and work of British politician and abolitionist campaigner William Wilberforce. The film takes place in Britain between 1780 and the early 1800s, during which Wilberforce was working to write and pass a bill to abolish the slave trade. While watching this historical film, one might automatically assume†¦show more content†¦His persistent hard work and dedication to the cause eventually led him to successfully pass a bill through Parliament in 1807 abolishing the slave trade in the British Empire forever. In the opening scen e of the film, Wilberforce is traveling by horse drawn carriage through a rain-soaked English countryside. Putting his health at risk, a very ill Wilberforce forces the carriage to pull off to the side of the road and gets out to save a black horse being whipped by his masters. The two middle class commoners who were punishing their horse immediately stopped when they realized who was talking to them. They reeled back in admiration and acceptance of his forceful orders, and agreed to stop beating the horse. Throughout Amazing Grace, William Wilberforce is projected as a flawless character with nothing but greatness thrust upon him. Any negative characteristic showing that Wilberforce was not faultless, such as his addiction to opium and his multiple failures to pass the abolition bill, was claimed to be either â€Å"forced† upon him or blamed on his betrayal by others. This is one small inaccuracy that is subtly revealed throughout the duration of the film, establishing Wilb erforce to be some sort of â€Å"saint.† However, Wilberforce was not the only person who was continuously fighting to abolish the slave trade.Show MoreRelatedWhat Makes Gods Grace so Amazing981 Words   |  4 Pages Djanin Djoy D. Eng17 BB Sept. 22, 2008 SPEECH TOPIC: What Makes God’s Grace So Amazing? SPEECH PURPOSE: This speech is to inform others about what the word grace really mean and what it is for. This also aims to let others know the significance and purpose of existence of God’s grace in our lives. SPEECH TITLE: â€Å"The Free Gift† People use the word grace in several different ways such as, â€Å"saying grace† before meals, being â€Å"grateful† for someone’s kindness, or simply â€Å"congratulations†Read MoreThe Role Of Animals In Disgrace By J. M Coetzee1344 Words   |  6 Pagesman as a species† (Berger 4). 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Medea and the Myth of Feminism free essay sample

Medea the Myth of Feminism It is only males who are created directly by the gods and are given souls it is only men who are complete human beings and can hope for ultimate fulfillment; the best a woman can hope for is to become a man (Plato 90e). Euripides Medea was written in a time where even the word feminism did not exist and yet he gave Medea a role of substance and a stature of strength. It is a wonder whether or not Euripides knew Just how much power he put into the hands of this woman as well as many more in the creation of her character. Perhaps not in his time and perhaps not y intention, but since then Medea the play and Medea the woman have filled a symbolic role in the area of feminism, the debate being for or against it. In countless cultures and streams of media, the woman stands timeless. We will write a custom essay sample on Medea and the Myth of Feminism or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page What this paper intends to explore is the levels of the performance and how they stack up to the idea of feminism by framing Euripides possible intent, understanding various audience response to various productions, and finally studying Medea herself to see whether her roots of vengeance are in feminism or rather immorality. At the beginning of our quest we find the author, alive at a time in which ancient Greece was overwhelmingly patriarchal, but where did Euripides find himself? Is it possible to suspect that he may have allied himself among other voices which held sympathy for the plight of women? Could he have been the model of a proto-feminist or was he a misogynist? In either case, Medea seems to be the place to look. While pursuing her ambition, Medea disregards many of the feminine characteristics of the patriarchal Greek society. She questions the inequality of women, contradicts Jasons chauvinist beliefs, challenges the stereotype that women are weak and passive and ltimately completely disregards the feminine role of motherhood. Euripides portrays a woman who completely subverts feminine norms, overcomes masculine bonds and, given that his depiction of Medea was highly influential and replicated to some extent by most later authors, the Medea viewed as a figure of feminine power in modernity is at least in part dependent on Euripides (Mastronarde 52). Honing in on the text, one might examine Medeas opening speech, a fine feminist harangue (Hadas 81), showing that, Medea has been treated unjustly by men, and her eloquent indictment of womens lot is never denied (Foley 265). This speech is the first introduction to Medea as a strong and independent woman, but the words are not hers alone. These lines have sometimes been seen as Euripides bitter reflections on his own isolation as an advanced and intellectual poet. There is much truth in this view, but the lines are also Medeas, the complaint of a woman of great intellectual capacity who finds herself excluded from the spheres of power and action (Knox 314). It is this exclusion that leads her to the inexcusable action of killing her children, or is it so inexcusable? When focusing on Euripides intent one might see that: Euripides made Medea herselt choose to murder ner chi Idren as the hurtful part of her revenge against Jason. It perhaps sounds at first as if this might tell in favor of the idea that Euripides was hostile to women. But in fact it turns out to have quite the opposite result, because of the way Euripides treats his material Euripides has created this new Medea who chooses to kill her own children. He condemnation the murderous deed: shows us with painful insight and utterly without mind of the woman who has the ability to do such a the torment before the final decision, the ultimate grief, and, here in he final scene, the inevitable results. Medea is now finally untouched, untouchable by human hands and by human emotions (March 35-36; 43). By this evidence it would appear that Euripides has molded a woman for women. Unfortunately, while the presentation of this piece could certainly cause a discomfort among male audience members, it equally might encourage greater suspicion and scorn by males of females. Euripides Medea questioned prevailing norms and beliefs, primarily those of the heroic masculine ethic, though perhaps at the expense of women, and not in their support. The meaning of Euripides words cannot be eciphered simply by picking and choosing sections of the play to analyze. To understand his intent there is the need to understand the totality of the narrative as well as the audience he wrote for. Playing to a primarily male audience, Euripides does not introduce Medea immediately but has the chorus and nurse tell of her first, giving the audience a misconception of Just how much power the woman holds. In fact supported by Medeas cries of anguish heard offstage she is first represented as emotional and submissive. By Euripides authorial intent, he lulls the audience into a state of pity here there should be fear. Skillfully contrived is the choral passage in which we first hear the agonized voice of Medea from offstage. If we had been prepared to see a woman of monstrous power and witchery, a being of preternatural passion and resource, we are deceived (Musurillo 54). Medea is first painted as nothing other than what you would expect of a woman, a merit of pity though not empathy, however when first seen she shifts to reasonable and calculating. Returning to analyis of her first speech, one can more deeply apply what she is saying to her situation. Her eloquent first speech on the wrongs of women deceptively applies only in part to herself. For Medea is far from the passive victim of marriage and masculine brutality that she claims to be (McDermott 259). Within the world of the play Medeas deception makes sense in winning the approval of the chorus, however to spectators the mismatch of her words to her situation carries a different meaning. It paints a new picture and a new woman who is willing to exaggerate and lie in order to achieve her goals. It becomes clearer as the play progresses that Euripides initial ortrayal of Medea serves as a baseboard for growth from helpless to dangerous, parallel to the audience reaction as it stems from pity to loathing. An ancient Athenian audience would have found little to no fault in Jasons actions, by a public standard, Jason satisfied his marital obligation toward Medea and returned favor for favor by bringing her to Greece (Walsh 295). This leaves it to Medeas character to be the cause of any unsettlement. Her ultimate action of killing her children, makes her most territying, tor sne is not a victim and not vulnerable†that is, not teminine†yet he has been identified as and with other women (Rabinowitz 132). With this information, only fear is struck by Medea in the name of women. Regardless of Euripides intent, proto-feminist, misogynist, or most likely of all neither, his audience rests at the wrathful hands of a powerful woman, but empathy is unlikely. It is important however, to take into account various audiences beyond simply that of Euripides time. A present audience interprets a performance of Medea much differently than ancient Greeks would have and there are countless Medea inspired adaptations which ancient Greeks never had the chance to experience. It is these productions and these audiences that are next to be studied on the road to feminism. To approach from another end of the spectrum, a drastically different style of performance than that of western culture may be studied. Carol Sorgenfrei provides this with her 1975 work, Medea: A Noh Cycle Based on the Greek Myth. Noh theatre, like many traditional Japanese theatre forms, prioritizes stylization above realism in performance, a practice that aligns well with a myth of murder and revenge. The stylization draws away from the brutal acts, allowing the audience a chance to accept Medea for her motives instead of unquestionably condemning her. By adhering to the structure of Noh, Sorgenfrei creates a world where time, place, and gender are transcended in favor of larger-than-life emotions and issues (Edelson 1). It is also worthy of note to state that Noh theatre is an all-male performance style (as it would have been in ancient Greece as well). One might take it upon themselves to understand by this knowledge that the theatre form is inherently sexist, yet, since the 1960 s, theater practitioners have drawn on these traditional forms to rediscover feminine and feminist messages (2). Furthermore the stylization and art that go into the intricacies of embodying a female are no Joke within the ritualistic practice. As denoted in the title, Sorgenfreis piece is a cycle play referring to the five different plays that would be performed in a traditional Noh performance. These plays are thematically based, in the order of God, Warrior, Woman, Frenzy, and Demon. Drawing inspiration from Noh style, Sorgenfreis Medea, develops the Medea myth through her plays five scenes, which progress through the different traditional categories despite the thematic linkage (2). As for the audience of this particular performance, it is no surprise that not only is it drastically different than that of Euripides and ancient Greece but also vastly different than that of Zeamis and the fifteenth century (the roots of Noh theatre). Sorgenfrei writes very consciously for a feminist audience in 1975. This retelling of the Medea myth from a female point of view in a beautifully feminine style of Japanese theatre, despite its male performance history, allocates the piece among cultural feminism, praising what is feminine while still acknowledging the differences among men and women. Feminine, however, is not the same as feminist. For that title we might analyze Medea in the fourth scene, the frenzy play, where Medea gives birth to herself as the Sun God. In one sense, the birth metaphor is emblematic of the mother/daughter bond, but its glorification of motherhood also implies that a womans self-fulfillment can best be attained by fulfilling her biological capabilities (Dolan 30). Seeing as Medea is a mother to herself though, it would appear that Sorgenfreis intent is that, birth is a metaphor tor revealing ones true selt, becoming oneselt, independent ot a partner or arents. Not only does Sorgenfreis Medea serve as the antithesis to the glorification of motherhood, but she also subverts the concept of birth as something that can be successfully and independently accomplished without the aid of man (Edelson 6). If this transformation is not convincing enough, then the transformation of Jasons character in the final demon play certainly thrusts the play into feminism. At this point in the cycle play Jason and the children reveal themselves as demons and, by displacing Medea and focusing solely on Jasons (and the childrens) transformation n Demon Play, Sorgenfrei forces the viewer to explore the cause of Medeas suffering instead of only investigating the effect of her actions (7). The audience, throughout Sorgenfreis production, due to the stylization of noh performance as well as the cycle transformations, is able to question Medeas past and her motives instead of assuming the worst from the start. Sorgenfreis as well as many other variations of Medeas tale open the doors to inquiry for viewers. As performances vary, so does the message of femininity, but it really comes down to the character herself and the motivation behind her actions. If her strength is solely for the sake of revenge then women lose merit, however if she acts in defiance to a patriarchal society she is a voice for feminism. In studying the woman we might discover hints as to whether or not she, as a character, is a feminist. The obvious first argument is that feminism is not an option for Medea as a character. The time period in which she is set in the play and in which her character was created do not allow such a term. However, for the sake of this paper and staying true to the idea that characters never die, it is now assumed that she is still alive oday and thus feminism exists. Now, to discover whether Medea is a feminist or not it seems vital to set aside any notions of her being simply a victim of patriarchy. To see her only as such is to exclude very important aspects of her character which tie her to humanity. It is her darkness that is relatable and takes her beyond a pitiable subject to be observed. It is the independence throughout her struggles that makes her more than two dimensions. Medea is a compelling character. Through plays, films, operas, paintings and novels, we have heard her story told again and again and e remain fascinated by her. Our fascination is not without reason, for Medea brings us face to face with darkness that lurks within anyone and catastrophe that can befall any marriage. We watch and listen to her because she speaks to us of ourselves (Fuller 3). Her story is not uncommon, the betrayal of a spouse and the desire for revenge. This theme can be found reinterpreted within films such as War of the Roses and The First Wives Club. Both embody the spirit of Medea, the story of a woman who gives up everything for a man only to be left for a younger woman. So it s seen that the character lives and changes as time passes. What these film adaptations lack is the darkness that individualizes Medea and the accumulation of this darkness to the point of murdering her children. However, this theme too may be found in literature such as La Llarona and even in history such as the Andrea Yates trial. Its clear that Medea, even in her darkness, is an influence to art and to life, but another question rises in this darkness. By throwing her maternal nature aside does she also discredit the female race or does the strength it takes to murder ones own hildren become commendable? Motive is the question at hand and Medea does nerselt no tavors at tirst glance . The decision to murder ner children in return tor the joy she will receive in witnessing Jasons anguish gives Medea little respectability. It is precisely at this point, where rage and pain and revenge come together, that Medea creates a problem for feminism (5). She flaunts her immorality, showing no remorse whatsoever for her actions. While it is admirable of a woman to overcome her situation, Medeas display of heartlessness after the fact of murdering her hildren leaves her alone, independent, and selfish. On the other hand it is so difficult to grasp the understanding of killing a child and the action is so inconsistent with Medeas prior feminism. Her original revenge was upon Creon, Jason, and his bride. It is reasonable to consider based off this knowledge that Medeas hand was moved by the authorial intent of Euripides rather than by her own will. Perhaps this was essential though, perhaps with a loss of darkness comes a loss of complexity and then what need would there be to discover why this troubled woman acted as she did. There would be no question of her feminist nature because there would be no care. A last note on Medea herself, she is not human, at least not fully. She is a mythical creature who by the end of the tale is taken into the sky by a chariot. So, take into account the action that takes place within other greek myths, birth from Zeus thigh, rape by Zeus in the form of a swan (among other animals). By these mythological standards is child murder something that can be Judged by mankind? By keeping in mind that Medea has a part of the divine within her, her actions become less of an atrocity and more of a symbol. Seen in this light, that Medeas are not the acts of a literal person but rather are symbolic, the child murders then become more understandable (11). Her children too then become a symbol of her marriage which is destroyed and thus the children must be destroyed. Seldom do women, let alone feminists, act out so much as to murder their children over the betrayal of their husbands, but divorces and custody battles do not stray too far from it. Medeas actions, when taken literally, may be unforgivable by a feminist society, but symbolically she hits right on target. Children become the battleground for the arents rage and disappointment and most often they are the collateral damage in the marital wars (13). Medea lives on, struggles on with a voice unafraid to speak out against the wrongs done to her. This is the voice that feminists cling to while they avoid acknowledgement of the rash action of murder. When it comes down to it though, Medea is studied because she is relatable, darkness and all. In order for a woman to know herself, she must come to terms with her own capacity for darkness, rage, and power and this is what Medea has to offer. There has yet to be an adaptation in hich she experiences the same pain and anger without the result of destruction, but maybe that is the standing lesson. Medea continues to struggle because women continue to struggle and as women evolve so shall she as she has before. In order to stand for women, it is not essential to be a model woman, only to continue on in the struggle, to continue fighting, and so she does.