Personal Illness Narratives: Rheumatoid Arthritis (RA)

Personal Illness Narratives: Rheumatoid Arthritis (RA) Introduction This essay employs excerpts from the narrative of a 38 year old woman named Francesca, a lady who has been given a diagnosis of rheumatoid arthritis (RA), to illustrate key concepts form the sociological, and psychological literature. This approach will illustrate the writers ability to critically appraise the literature, its relevance to the narrative in question, and using narrative, places these concepts within a real life clinical situation. This in turn provides insight into the value of narrative as a methodological approach in the 21st Century and how it intertwines with the rich tapestry of sociological theories and concepts that are available to the researcher studying the current sociological evidence base. For the purpose of this assignment, peer reviewed articles and textbooks were searched within the past 10 years. The work introduces RA as a clinical entity (pivotal to understanding the comments of Francesca) and goes on to outline the use of narrative, particularly its utility in the study of chronic disease. The essay then goes on to cover some key important issues, namely: The biomedical versus the sociological approach of illness management The Study of Personal Illness Narratives Sociological perspectives on depression Chronic Illness and Disability Social construction of medical knowledge and the Politics of Disability Labelling Stigma. For each of the above, concepts are presented and mapped against selected statements from the narrative of Francesca (written in italics for clarity). These statements illustrate real world data gleaned from Francesca; valuable comments that are grounded in the experiences of a person living with a chronic disease. The work also contains an appendix comprising a reflective postscript which outlines the way that the work evolved from earliest outline, to the finished product. Rheumatoid arthritis (RA) is a chronic inflammatory disorder that affects not only the synovial joints but multiple body systems (Goodacre 2008). The exact cause of RA remains unknown; it is a disease that affects more women than men, often of a young or middle age demographic unlike osteoarthritis which affects predominately older people. RA follows a somewhat unpredictable course of exacerbations and remissions. RA carries huge psychological problems in view of its unknown aetiology, uncertain prognosis, and loss of function. Additional symptoms include early morning stiffness, pain, limitation of activities of daily living, and socio- economic problems inasmuch as it may have a severe impact upon a persons ability to work and function in society (Kojima et al 2009). The discussion now begins with a section on models of illness. Biomedical and biopsychosocial models of disease The biomedical model of health takes the reductionist view that people are biological entities (Lewis 2009 p745). In the clinical management of RA there is some merit in this biomedical approach, for example the monitoring of inflammatory mediators in the blood as a marker of disease activity or responses to drug intervention is well established in the literature (Lee Kim 2009). This biomedical approach is reinforced by the GP comments from the narrative, i.e. That there was no cure and that the tablets were the key to preserving normal function. This approach may contribute to Francescas frustration, as it ignores the wider psychological and sociological ramifications of living with a chronic debilitating disease such as RA. It is unclear form the narrative whether the GP tempered his comments by adding that there are means by which the signs and symptoms of RA can be successfully managed. Critical appraisal of the literature reveals that biopsychosocial models advocate a more holistic view of illness, for example according to Smith (2002) the biopsychosocial model seeks to address not only the client and his or her illness but also their capacity to deal with being ill. The value of adopting the narrative approach as part of the biomedical model is effectively illustrated at the point where Francesca states I just burst into tears At the perceived effect that this illness will have upon her loss of function in the future. So whereas the biomedical model will operationalise function using objective outcome measures, here the use of narrative permits a biopsychosocial approach that provides rich client centred data on how it feels to be diagnosed with chronic and currently incurable disease. This in turn can help to inform our understanding of Rheumatoid arthritis as a disease thereby influencing the social construction of medical knowledge by giving voice to service users (Balen et al 2009). The Study of Personal Illness Narratives. Illness narratives concern a persons views and beliefs about their illnesses and the effect on their lives (HydÃÆ'Â ©n 2007). There is increasing acceptance and recognition of the valuable role that such grounded narratives play in understanding the journeys that people with chronic diseases such as RA have to embark upon if they are to manage their illness on a day to day basis. For example Haidet et al (2006) found in a narrative study of people with diabetes that people narrated four illness-management strategies whose story elements were in dynamic interplay, each with unique variations for each individual revealing a level of complexity that had not been previously described. As a method, narrative provides rich data (Furman Cavers 2005; Poindexter 2002) and in this case gives a voice to Francesca that would otherwise remain unheard (Grills 1998).Much can be gleaned from studying Francescas narrative, for example Francesca begins to paint a picture of her hopes and fears upon being given a diagnosis of RA combined with an insight into her past and thoughts about the future. Francescas narrative provides us valuable insight into her views of the self- a key component of narrative (Voilmer 2005), her relationships to others, and how these relationships have changed or may change in the future. In her narrative Francesca gives us some insight into the pain of living with rheumatoid arthritis, in her comments we can detect also a stark dichotomy in that she notes how healthy she had been in the past then uses the term Excruciating to describe her current pain, thus Francescas narrative hints at the loss of self in that she will no longer be a dancer or even a valid spouse as exemplified by the narrative quote. I wont be the woman he fell in love with Here she literally describes herself as becoming another person. Here Francesca is able to provide the reader or researcher with valuable information on the loss of the self, which resonates with other narrative research (Roe Davidson 2005; Doba et al 2007). Francesca goes further and also hints at the change in her illness self concept (ISC) that is to say the extent to which a person is defined or consumed by their disease or disability (Morea et al 2008). Francesca also hints at the concept of disease as a biographical disruption, described by Bury, this is said to occur when a persons planned future cannot unfold as planned. (Bury 1982); will he even want to marry me? Im too young to have this. What makes Francescas narrative particularly interesting is the fact that she is a twin; this may emphasise any change in self since she has in essence an unchanging control (her twin sibling) to against which to compare herself as her disease, her self identity (and possibly disability) progresses. The next section outlines sociological perspectives on depression. Sociological perspectives on depression. Francescas depression is likely to be multifactorial; for example there is evidence that the disease RA itself causes depression (Kojima et al 2009) as will living with pain. From a sociological perspective Francescas strained personal relationships may contribute to depression, for example her fear of being rejected as a potential spouse (Waite Gallagher 2001), see below. will he even want to marry me? This feeds in to the earlier section on biomedical versus biopsychosocial models of health and illness and the different paradigms or world views in which they are situated. A biomedical explanation of depression is likely to focus on the biochemical aspects of the person whilst a more sociological approach would acknowledge the impact of socio economics, personal relationships and so on (Covic et al 2003). Caution is needed however here since the short excerpt of narrative that we have provides no direct evidence that Francesca is in fact depressed, indeed a review of the literature suggests that there is a tendency to over diagnose depression (Parker 2007). Chronic Illness and Disability. A chronic incurable disease such as RA would require Francesca to make significant adjustments to her life over time. The sociological literature now provides increasingly refined conceptualisations of these adjustments, acknowledging that the experience of chronic disease necessitates adaptations in multiple domains of the persons life. This adjustment is often referred to as a trajectory (Stanton et al. 2007). This concept, introduced by the sociologist Strauss in an attempt to capture experiences and behaviours occurring in response to chronic illness (Strauss Corbin 1998), goes beyond depicting the physiologic unfolding of disease and encompasses the total organisation of work done over the course of the illness (Strauss et al 1984). Francescas narrative hints at this changing trajectory tracing the commencement of her life changes to a time six months ago when she was much more active and defined herself as a dancer. Furthermore Francesca looks to her future and wonders about h er ability to fulfil the stereotype of a perfect spouse. It is important to engage with how Francesca and her fiancÃÆ'Â © will make sense of the illness. The term illness cognition has been defined as a patients own implicit common sense beliefs about their illness (Leventhal and Nerernz 1985, p. 517). When people experience symptoms, they embark upon a cognitive search which enables them to interpret and make sense of the symptoms they are experiencing. Typically a critical review of the literature distils out into five categories: Identity, including the description of symptoms experienced and their meaning (e.g. pain, fatigue).In the narrative Francesca describes her pain as Excruciating for example. Belief about causes (e.g. accident, genetics or stress). People like to have a label for their symptoms for legitimisation although, once given, people are likely to interpret diverse symptoms as evidence of the label. Francesca has problems with causality and is likely to do so for the foreseeable future since there is no established medical cause for RA. Timeline (beliefs about duration and time for recovery), namely is it acute or chronic? These beliefs will be re-evaluated as time progresses. Consequences (e.g. loss of lifestyle, goals in life). These representations may only develop into more realistic beliefs over time. Francesca uses the narrative to discuss the change in her life from active dancer to unappealing spouse within the space of six months. Beliefs about controllability. (Furnham, 1989; Landrine and Klonoff 1992, 1994) These categories are pivotal to understanding how people make sense of, and decisions about managing a changeable chronic disease such as RA. Evidence of Francesca attempting to make sense of her symptoms by embarking upon a cognitive search may be seen in the example below: I couldnt understand it Im the healthiest person I know. Ive never had problems with my health never had a day off sick in my life. I never go to the doctor, no matter what, Ive always been fit as a flea. From the narrative provided we also have limited information concerning Francescas partners views, for example (although not from Dave himself) Dave wore me down, telling me Ive got to see a doctor This may be interpreted in various ways, not least that Dave was keen for Francesca to obtain a diagnosis and thereby a label to legitimise the illness, whether such labelling is disabling or enabling is not fully resolved in literature (Huibers Wessley 2006). Francescas comment does however open up the interesting issue of how partners cope with chronic disease, in RA in particular there is evidence that a strong marital relationship correlates with the couples psychological adjustment to the illness (Mann Zautra 1990). These authors go on to claim that in RA, partners are most affected by their perceived vulnerability to disease and coping ability, whereas the wives who have RA were more affected by pain itself and how they will cope with the effects of the disease- reflected in Francescas comments below; I started having excruciating pains in my feet when I woke in the morning To further corroborate the findings of Manne Zautra (1990) concerning male worries about coping at a more abstract level see the example below: Dave has been great but he has his own worries hes just been laid off from his job and hes worrying about paying for the wedding Mann Dieppe (2006) have also more recently acknowledged coping differences between males and females in RA, (n = eight women with RA ages 31-60 years and their partners, and 4 men with RA ages 43-75 years) although methodologically their sampling may be flawed in that those couples currently experiencing severe martial problems are unlikely to submit to the type of phenomenological interviews that they undertook. The social construction of medical knowledge and politics of disability It is not possible in an essay of this length to provide a full account of the politics of disability, primarily since the topic is multi-factorial, fluid and indeed is covered to an extent in the other sub sections of this work, furthermore we have insufficient data from the narrative to comment in depth. Kitchen and Wilton (2003) comment that our views of disability as a medical entity viewed in paternalistic terms have changed in favour or equality and empowerment. However Francesca can expect to experience a host of politically related issues, for example social exclusion and poverty (Foley Chowdhury 2007). Francesca has already stated in her narrative; Ive got to work- we need the money. In terms of medicines social construction, as far back as 1982, Wright Treacher (1982) claimed that medical knowledge inevitably contains a social component incorporating moral values and prejudices, and that diagnosis ascribes a certain meaning. We still see this thirty years later where the GP abruptly (allegedly) advocates of drugs to preserve normal function. This reinforces the paternalistic medical approach. RA in its early stages does not present with any obvious physical deformity and affects the young demographic, it is conceivable that she may experience disbelief from her peers; this may in turn make her life difficult in an era of financial unease, Government budgetary cuts and political uncertainty. Labelling. Labelling theory (social reaction theory) has its roots in the work of sociologist Howard Becker (Becker 1997). It centres on peoples tendency to negatively label those who are different from ourselves. As a person with chronic arthritis Francesca will not be immune to this labelling, for example being labelled as disabled or arthritic are all real possibilities. Arthritis organisations and acts such as the Disability Discrimination Act ( DDA) are at great pains to encourage activity and maintenance of full function and contribution to society, however all this may be negated by her GPs comments that there is; no cure and I had to take tablets everyday to be able to function normally. Labels can however be positive, Francesca describing herself as glamorous for example on two occasions in the narrative, and her previous label of salsa dance teacher is something that defines her in a positive way. Yes, Im a salsa dance teacher Stigma Stigma has recently been defined by Scambler (2009) as a social process, experienced or anticipated by exclusion, rejection, blame or devaluation that results from experience, perception or reasonable anticipation of an adverse social judgement about a person or group(p441) Francesca may feel stigmatised by all of the factors previously discussed, attitude of her GP, loss of self, worry about the future, inability to act out the role of spouse. Factors such as depression, the lack of a cause for her RA and her inability to teach salsa dancing may amplify her feelings of being stigmatised, it is also important form the wider perspective to acknowledge that stigma may affect Francescas partner. Struening et al (2001) for example reported that 43-92% of caregivers (to people with mental health problems) reported feeling stigmatised, again this suggests that living with this disease does not only affect Francesca but also her partner. Conclusion This essay has employed extracts from the narrative of a 38 year old lady with Rheumatoid arthritis, to illustrate some key sociological concepts. The essay has provided a valuable opportunity to map some key concepts from the literature onto a narrative excerpt. Whilst the essay has not been able to enter the field in great depth; It is a testament to the thick description provided by patient narratives that such a wealth of information can be generated form a relatively short piece of description. References Balen,R., Rhodes, C., Ward,L., (2009) The Power of Stories: Using Narrative for Interdisciplinary Learning in Health and Social CareSocial Work Education: The International Journal, pp1470-1227. Becker, H., (1997) Outsiders. New York, NY. Free Press. Covic, T., Adamson,B., Spencer,D., Howe,G., (2003) A biopsychosocial model of pain and depression in rheumatoid arthritis: a 12-month longitudinal study Rheumatology, Vol 42 1287-1294. Doba, K., Nandrino, J.L., Lesne, L., Humez, L., C.(2008) Organization of the narrative components in autobiographical speech of anorexic adolescents: A statistical and non-linear dynamical analysis New Ideas in Psycholog,y Vol 26 (2) pp 295-308. Foley,D .,Chowdhury, J., (2007) Poverty, Social Exclusion and the Politics of Disability: Care as a Social Good and the Expenditure of Social Capital in Chuadanga, Bangladesh Social Policy Administration, Vol 41 (4)pp372-385. Furman, R. ,Cavers, A., (2005) Narrative poem as a source of qualitative data The Arts in Psychotherapy Vol 32 (4) pp313-317. Furnham, A., (1989). Overcoming psychosomatic illness: lay attributions of cure for five possible psychosomatic illnesses. Social Science and Medicine, Vol 29 pp61-67. Goodacre,J., (2008) Common chronic inflammatory arthropathies. in Porter,S (eds) Tidys Physiotherapy 14th edition. Churchill Livinsgtone Elsevier. Grills, S..(1998). Doing ethnographic research; fieldwork settings Thousand Oaks. Sage Publishers. Hahn, H., (1985)Toward a Politics of Disability: Definitions, Disciplines, and Policies Social Science Journal, 1985 Vol. 22(4) pp87-105. Haidet, P., Kroll,T.L., Sharf, B.F., (2006) The complexity of patient participation: Lessons learned from patients illness narratives Patient Education and Counselling, Vol 62 (3) pp323-329. Huibers,M.J.H., Wessely ,S., (2006) The act of diagnosis: pros and cons of labelling chronic fatigue syndrome Psychological Medicine, Vol 36, pp895-900. Cambridge University Press. Kitchin, R. ,Wilton, R., (2003) Disability Activism and the Politics of Scale. The Canadian Geographer, Vol 47, 2003. Kojima ,M., Kojima, T., Ishiguro, N., Oguchi, T., Oba, M., Tsuchiya, H., Sugiura, F., Furukawa, T.A., Suzuki, S., (2009) Psychosocial factors, disease status, and quality of life in patients with rheumatoid arthritis. S.J Psychosom Res , Vol 67(5) pp425-31. Epub 2009 Mar 5. Lee, W.S. Kim, T.Y.,(2009) Measuring of ESR with test 1 is more useful than the Westergren method in rheumatoid arthritis. Am J Clin Pathol, 2009 Nov;Vol 132(5) pp805. Leventhal, H., Nerenz, D.R., Steele, D.J., (1984). Illness representations and coping with health threats. In: Baum A, Singer J, eds. Handbook of Psychology and Health, Hillsdale, NJ: Erlbaum. pp219-252. Morea, J.M., Friend, R., Bennett, R.M., (2008) Conceptualizing and measuring illness self-concept: A comparison with self-esteem and optimism in predicting fibromyalgia adjustment Research in Nursing Health, Vol 31 (6),pp563-575 Published Online: 21Jul2008. Mann,C., Dieppe, P.,(2006) Different patterns of illness-related interaction in couples coping with rheumatoid arthritis Arthritis Care Research, Vol 55, (2), pp 279-286. Mann, S. L., Zautra, A. J., (1990). Couples coping with chronic illness: Women with rheumatoid arthritis and their healthy husbands. Journal of Behavioral Medicine, Vol 13 pp327-342. Parker, G., (2007) Is depression overdiagnosed? Yes. BMJ. Vol 335 (7615), p328. Poindexter, C.C.,(2002) Meaning from methods; Re-presenting Narratives of an HIV affected caregiver Qualitative Social Work, Vol 1 pp 59. Roe,D., Davidson, J., (2005) Self and narrative in schizophrenia: time to author a new story Med Humanities,Vol 31 pp89-94. Scambler, G., (2009) Health-related stigma. Sociology of Health Illness, Vol 31 Issue 3 pp 441-455 Published Online: 1 Apr 2009. Smith, R., (2002) The biopsychosocial revolution. J Gen Intern Med, Vol 17(4) pp309-311. Stanton, A.L., Revenson, T.A., ÂÂ ­Tennen, H., (2007). Health Psychology: Psychological Adjustment to Chronic Disease. Annual Review of Psychology, Vol 58 pp565-592. Strauss, A.L., Corbin, J.M., Fagerhaugh, B.G., (1984). Chronic illness and the quality of life, 2 Ed. St. Louis: Mosby. Strauss, A., Corbin, J.M., (1998) Basics of Qualitative Research: Techniques and Procedures for Developing Grounded theory. Thousand Oaks, Sage Publishers. Struening, E.L., Perlick, D.A., Link, B.G., Hellman,F., Herman, D., Sirey, J.,(2001) Stigma as a Barrier to Recovery: The Extent to Which Caregivers Believe Most People Devalue Consumers and Their Families Psychiatr Serv,Vol 52 pp1633-1638, December 2001. Vollmer, F., (2005) The Narrative Self. Journal for the Theory of Social Behaviour, Vol 35,(2), pp189-205(17) Blackwell Publishing. Waite L,J., Gallagher, M.,(2001).The case for marriage: why married people are happier, healthier, and better off financially. New York, NY: Broadway Books. Wehowsky, A., (2000) Diagnosis as care diagnosis as politics International Journal of Psychotherapy, Vol 5, (3), pages pp241 255. Wright, P., Treacher, A. eds., (1982) The Problem of Medical Knowledge: Examining the Social Construction of Medicine (Edinburgh: Edinburgh University Press. Appendix Reflective postscript This is written in the first person since it is a reflective piece of writing This was a challenging yet fascinating project to complete. I was unsure how to approach the topic and how much weight to attach to the various theories available and the comments of Francesca , once it became clear that I was actually trying to explain what was going on with Francesca by using academic theory to illustrate her comments the task became rather enjoyable. Tight word count restrictions as always meant that I had to do some brutal editing, but the positive side to this is that it makes one more selective in ones writing. For example my earliest version was heavy on sociological theory and light on mapping this theory to the comments of Francesca, whereas the final version makes more explicit links between what Francesca says and the theory behind why she says it. The fact that I had some real comments to sink my academic teeth into made the process of literature searching interesting and relevant since I was able to think about Francescas comments and her personal situation for each search that I undertook. The areas that gave me most difficulty were the political aspects of disability since they seemed so wide ranging and actually intertwined with everything that I was writing about. All in all I have learned a great deal about the usefulness of narrative form this project.

Similarities In Frankenstein And A Dolls House English Literature Essay

Similarities In Frankenstein And A Dolls House English Literature Essay A Dolls House, written by Henrik Ibsen, and Frankenstein, written by Mary Shelley, have many connections between them. Different characters and view points were established in both books, characters in both the novels share similar and different personality traits, and the themes and tones of the two are common. Torvald Helmers character in A Dolls House is a husband who is hardworking, gives in to his wife, and a man who must maintain his title. He is a father of three children and a soon-to-be manager of a bank. Be at rest and feel secureHer is shelter for you; here I will protect you like a hunted dove that I have saved from a hawks claws; I will bring peace to your poor beating heart (Ibsen 65) Torvald says this to his wife after he finds out what his wife has done and that his wife no longer wants to be with him. The wife of Torvald Helmer, Nora Helmer, is always happy, lovable, but yet naÃÆ'Â ¯ve. She is characterized as a doll who is played with. I have been your doll wife, just as at home I was Papas doll child (Ibsen 67). She later finds out that she has been played with just like a doll when the truth of her forging her fathers signature is exposed. She states that it was because she was treated like a doll that she has made nothing of her life and soon decides to leave her husband and kids after the truth behind her secret was spilled by Nils Krogstad.. Nils Krogstad is lawyer and works under Torvald Helmer. Krogstad was in an unhappy marriage which led him to be a widower with several children. He suffers from a diseased moral charactersnuffing about to smell out moral corruption and , as soon as they have found some, put the person concerned into some lucrative position where they can keep their eye on him (Ibsen 15). His character is one who is trying to gain back his good title which he lost when he, himself, forged a signature. In trying to do so, he is blackmailing Nora Helmer. Robert Walton, who Victor is telling his story to, starts off the novel Frankenstein. He is a captain traveling to the North Pole. Walton is an explorer, chasing after non-possessed knowledge. I may there discover the wondrous powerI shall satiate my ardent curiosity with the sight of a part of the world never before visited (Shelley 2). As he goes on his voyage, he begins to feel lonely and sad, seeking for a companion that is able to relate and communicate to. Soon enough, he finds Victor, his new companion, at the brink of death and nurses him back to health. Victor Frankenstein is the main character in Frankenstein. He is a Swiss man who grew up in Geneva reading many alchemists works. He then gains interest about modern science and the secret of life. From this day natural philosophy, and particularly chemistry, in the most comprehensive sense of the term, became nearly my sole occupation (Shelley 36). With this new knowledge, he then creates a monster. The monster is Victor Frankensteins creation. He was made from old body parts and enters life with super-human features, such as being strong and having a good endurance. Remember, thou hast made me more powerful than thyself; my height is superior to thine; my joints more supple (Shelley 86). Along with the monsters strength, height, and endurance, it gained knowledge and learned the ability to speak and read. He turns compassionate, gentle, and kind nature but soon seeks revenge against Victor. From the novels A Dolls House and Frankenstein, the characters from both novels are similar but yet different at the same time. Krogstad and the monster are both characters living a hard life where no one is willing to accept them. If necessary, I am prepared to fight for my small post in the bank as if I were fighting for my life (Ibsen 21). Nils Krogstad was wanting to keep his position in the bank because he felt that it was the only way people will accept and re-give him the respect that he has lost. Also, it was his way of making money for his kids that he also wanted to gain the respect back from. Here then I retreated, and lay down happy to have found a shelter, however miserable, from the inclemency of the season, and still more from the barbarity of man (Shelley 94). The monster that Victor created was completely shunned from people. His grotesque features made people scared and disdain him, making him feel sad and misunderstood. Both characters are also seeking for revenge. But let me tell you this-if I lose my position a second time, you shall lose yours with me (Ibsen 24). Krogstad said this to Nora Helmer when he found out that he was losing his job position. He was trying to get Nora to persuade her husband, Torvald Helmer, to keep him in Torvalds business. In doing so, Krogstad blackmailed Nora. Your hours will pass in dread and misery, and soon the bolt will fall which must ravish from you your happiness foreverrevenge remains-revenge (Shelley 155). Victor Frankenstein made a deal with the monster that he would make a companion for it so the monster wouldnt be alone. After Victor decided to destroy the next monster he was going to create, the monster became angry and warned Victor that he will get his revenge for Victor breaking the deal. In the endings of the novels, both characters change and are now different from one another. I have never had such an amazing piece of good fortune in my life! (Ibsen 55). Krogstad life, in the end, is now brig htening up. He found a new companion, which was Noras childhood friend, and was able to support his family again. In time, he knew he will once again be able to be respected. Farewell! I leave you, and in you the last of humankind whom these eyes will ever beholdI shall die, and what I now feel be no longer felt (Shelley 210). After Victor has passed away, the monster did not feel a need to live anymore. He regretted what he has done and to demolish the regrets and wounds he felt, he vanished in the darkness and distance. These two characters started off with similar feelings of sadness and wants of being accepted. Going towards the end of the novels, both changed into two different people, Krogstad being happy with the life that he will soon be getting and the monster having regrets then disappearing into the sea. A Dolls House and Frankenstein have similar themes. Themes are explored in a literary and are the main ideas of the works. Within the two novels, these themes are discovered: secrecy, role of women, and misleading of appearances. In both of the books, it contains secrecy that separates one from another. Victor felt that sciences secrets must not be shared with others out in the world. He began created a monster in secrecy, which came alive, and planned to destroy it without anyone knowing either. In doing so, he isolates himself from the outside world. Nora Helmer kept her secret of forging her fathers signature from her husband. To Nora, the secret was more meant to protect her husband than lie to him, hoping that they would remain together. The theme of a womens role is noticed in both novels. Women in Frankenstein have the roles of the innocent, loving, and sacrificial mother. This, to my mother, was more than a duty; it was a necessity, a passion-(Shelley 20). In this quote, Vict or is describing her mothers passion of helping the poor. The sacrificial role held by women is shown in A Dolls House. After her father passed, Nora gives herself up to Torvald, her husband. Her abandonment of her family once her secret has been found out is another sacrifice that she had taken. Appearances are misleading and are clearly shown as the novel is unraveled. The monster in Frankenstein is first seen as only a ugly creature with super-human traits and no heart. Later in the novel, the monster is able to speak, read, and feel just like a regular human. This is shocking both to the narrator and reader. A Dolls House, appearances of the characters are mislead to fit with them, then reveals the reality of the plays characters and situations.

The Purpose of Disguise in Twelfth Night Essay -- Twelfth Night essays

Theme of Disguise in Twelfth Night The notion of disguise is very important theme within Twelfth Night.   From my point of view I feel that the crux of the play is primarily based on this concept.   Indeed "there's something in it that is deceivable" summarizes this point precisely.   Disguise runs like a thread through the play from start to end and holds it all together just as tightly as thread would fabric.   Yet, paradoxically as the plot progresses there are many problems, deceptions and illusions, which provide a comment on human behavior and creating the needed escape of comedy. The place of women within the theatre is well known, that being that they had no place within the stage.   Women's parts were played by young men in Shakespeare's day, so that the audience would have found sophisticated in Viola's part:   a boy dressing up as a woman who, in the play disguises herself as a man. The first example of the use of disguise in the Twelfth Night is Viola's disguise as Cesario.   As aforementioned this notion is central to the plot.   I think it is clearly evident that the fluctuation in attitude to the dual role and the situations and tribulations imposed upon the character Viola/Cesario, ends up creating a better understanding of both sexes and thus, allows Viola to have a better understanding of Orsino.   Viola learns whil... ... "Nothing that is so, is so" Works Cited and Consulted: Bloom, Harold, ed. William Shakespeare's Twelfth Night. New York: Chelsea House Publishers, 1987. Grief, Karen. "Plays and Playing in Twelfth Night". Bloom (47-60). Nevo, Ruth. Comic Transformations in Shakespeare. London: Methuen & Co., 1980. Shakespeare, William. The Arden Edition of the Works of William Shakespeare: Twelfth Night. Ed. J. M. Lothian and T.W. Craik. UK: Methuen & Co., 1975. Thatcher, David. Begging to Differ: Modes of Discrepancy in Shakespeare. New York: Peter Lang, 1999. Vickers, Brian. Appropriating Shakespeare: Contemporary Critical Quarrels. New Haven: Yale U P, 1993 The Purpose of Disguise in Twelfth Night Essay -- Twelfth Night essays Theme of Disguise in Twelfth Night The notion of disguise is very important theme within Twelfth Night.   From my point of view I feel that the crux of the play is primarily based on this concept.   Indeed "there's something in it that is deceivable" summarizes this point precisely.   Disguise runs like a thread through the play from start to end and holds it all together just as tightly as thread would fabric.   Yet, paradoxically as the plot progresses there are many problems, deceptions and illusions, which provide a comment on human behavior and creating the needed escape of comedy. The place of women within the theatre is well known, that being that they had no place within the stage.   Women's parts were played by young men in Shakespeare's day, so that the audience would have found sophisticated in Viola's part:   a boy dressing up as a woman who, in the play disguises herself as a man. The first example of the use of disguise in the Twelfth Night is Viola's disguise as Cesario.   As aforementioned this notion is central to the plot.   I think it is clearly evident that the fluctuation in attitude to the dual role and the situations and tribulations imposed upon the character Viola/Cesario, ends up creating a better understanding of both sexes and thus, allows Viola to have a better understanding of Orsino.   Viola learns whil... ... "Nothing that is so, is so" Works Cited and Consulted: Bloom, Harold, ed. William Shakespeare's Twelfth Night. New York: Chelsea House Publishers, 1987. Grief, Karen. "Plays and Playing in Twelfth Night". Bloom (47-60). Nevo, Ruth. Comic Transformations in Shakespeare. London: Methuen & Co., 1980. Shakespeare, William. The Arden Edition of the Works of William Shakespeare: Twelfth Night. Ed. J. M. Lothian and T.W. Craik. UK: Methuen & Co., 1975. Thatcher, David. Begging to Differ: Modes of Discrepancy in Shakespeare. New York: Peter Lang, 1999. Vickers, Brian. Appropriating Shakespeare: Contemporary Critical Quarrels. New Haven: Yale U P, 1993

Evidence Of Technological Change :: essays research papers

The early evidence on the importance of technological changes a source of the shifts in the relative demand for different types of labor during the 1980s came from case studies. The Bureau of labor Statistics conducted several case studies of the effects of changes in production processes in particular industries (Mark, 1987). In an industry that experienced a significant change in technology, the usual pattern was a dramatic reduction in the employment of production workers with an increase or no change in the number of skilled workers in that industry. More recently there have been several econometric analyses of the effects of variables like the (appropriately lagged) rate of investment in computers and/ or other forms of â€Å"information capital† and the ratio of expenditures on research and development to sales on changes in the skill composition of industries (for examples, Berman, Bound and Griliches, 1994). The results of these studies are consistent with those of the case studies and the hypotheses that the recent technological change has shifted the relative demand for skilled labor to the right.   Ã‚  Ã‚  Ã‚  Ã‚  Changes in production techniques have widened across the country quickly, especially the multinational firms. Thus, if technological change is an important determinant of relative demand shifts, one would expect to observe patterns in other industrialized countries similar to those in the United States. Some of the recent studies report results for a variety of old industrialized (OECD) countries that are indeed consistent with the U.S. results (Collechia and Papaconstantinou, 1996; Machin, Ryan and Van Reenan, 1996). These countries vary a great deal with respect to changes in their situations with respect to trade, labor market institutions (like the importance of trade unions), and unemployment. Obviously, the relative demand for skilled labor in each of them is rising rapidly. In my view, it is the fairly strong evidence in favor of the wage inequality and technological change story.   Ã‚  Ã‚  Ã‚  Ã‚  A factor that is often cited as the specific issue of the post-1980 is the widespread adoption of computer technology throughout the economy. As mentioned above, the rate of skilled labor has tended to be greatest in those industries with the highest rate of investment in computers. There is also evidence that workers who use computers on the job have, other things constant, higher earnings than those who do not (Krueger, 1993). In my view, it is probably too early to determine that how much of the technological change dues to computers affect wage inequality, but we will know more about the answer to this question in 20 years.

Ceramics of the North and South Coasts Essay -- Pottery Mochica Cerami

Ceramics of the North and South Coasts Ancient Peruvian Ceramics of the North Coast March 11, 1997 The first pottery pieces found in Peru were made somewhere between 1500 and 1000 b.p. The pieces were found in the central Andean region where a religious cult lived. This cult was called Chavà ­n, after the best known ceremonial center, Chavà ­n de Huà ¡ntar. The religious center was the home to massive temples that were highly embellished with low relief sculptures of gods, animals, and symbols. The pottery found in the area where vessels that were well made and highly decorated with a similar motif as the temples. But the evolution of Peruvian pottery becomes somewhat confusing and complex after this first civilization of potters. There is a division of people into the North Coast and the South Coast. The split created two styles of pottery, although similar, they never quite merge. I am only going to talk about the north coast traditions. On the North coast there are five cultures that evolve into the dominant Mochica style, which was one of the most vigorous and prosperous cultures of Ancient Peru. The next earliest North Coast style, other than the Chavà ­n, started with the Cupisnique people in the Chicama valley. Their ceramics â€Å"closely resembled those of highland Chavà ­n. They were well made and polished, though somewhat thick walled and heavy. The type of firing used produced a dark semireduced ware that varied from brownish gray to carbon black in color. Decoration consisted of bold, curvilinear human, feline, and birds of pray heads, eye patterns, pelt markings, and other brief symbols of geometric devices.† In the valley to the south of the Cupisnique were the Salinar people who someti me during the fifth century b.p. moved into the north coast of Peru and spread its influence throughout the Cupisnique area. Salinar pottery, â€Å"though deceptively primitive in ornamentation, was technologically superior to that of the Cupisnique. Vessels were made of well-prepared clays that were fully oxidized in firing, making them an even orange color. Cream and red slips were used to accentuate sculptural forms and create flat geometric patterns, but not to draw figurative motifs. The technical advances of the controlled oxidation firing and slip decoration soon had their effect on contemporary Cupisnique ceramics.† Personally, I enjoyed the bottle forms they used wi... ...V period they had an extensive kingdom established and it brought together the peoples of all the north coast valleys. The ceramics were decorated in flowing, expressive lines and the modeled vessels showed attention to individual detailed ornamentation. But the creative flow in the ceramic styles was hindered somewhat because of a strict militant rule of the warrior-priest class that was beginning. Yet this was still the most creative time for the Mochica people. The final period in Mochica ceramics, due to a collapse of the culture, brought an abrupt termination of the great art tradition that it had expressed so well. The vessels found from this period show a carelessness in painting designs, and less attention to details in the sculptural forms. Many of the figures modeled in to the vessels were warriors dressed for combat. The decline in quality that can be observed, and the nervousness and tension that were expressed in their designs and forms was related to the pressure from the militant expansionist group, the Wari. The struggle between the Mochica and the Wari, was long and fierce, ending in a total collapse of their culture and a loss a 1200 year ceramic tradition.

Disc Brake System: How Does It Work Essay

Brake system is a device that creates frictions to slow down and eventually to stop the movement of an object. There are a few different types of brakes; however, they are all built on the same principle of friction. In automotive, the most common type of brake today is the disc brake because it provides higher efficiency and more safety to users. Disc brake consists of brake fluid, a piston, a caliper, brake pads, a rotor, and a hub. The following is a basic description of a disc brake’s mechanism. 1.When the brake pedal is pressed, the brake fluid is forced to enter the caliper cylinder where the piston is sitting in. In turn, that fluid pushes the piston, which is attached with a brake pad on the other end, toward the rotor. 2.Once the brake pad is in contact with the rotor, the caliper contracts to bring the other brake pad to contact with the other side of the rotor as well. The pushing of both brake pads against the rotor generates a friction force that will slow the rotation of the rotor and eventually bring it to a stop. 3. Because the wheel attaches to the hub and the hub attaches to the rotor, thus, when the rotor is slowed down, the wheel is also slowed down. 4.Meanwhile, the friction between the tire and the surface of the road also acts to slow the rotation of the wheel. Disc brake can generate a significant amount of friction. This is why its main applications usually involve movement with great velocity such as cars and aircraft. Because disc brake does require more maintenance than other simpler brake and because brake is directly related to your safety when driving, it is recommended to have your brakes checked regularly by a licensed brake technician/specialist.

Advantages and Disadvantage of Total Instrument Operation

The first advantages is that total station can be a relatively cheap means of fast, high-precision measurements. -Total station needs line of site, but It does not need volleyball of the sky. Total station can be used Indoors, In a mine, or under tree cover that would not be suitable for GAPS measurement. -Third, total station Is suited to take ground measurements. Whereas GAPS Is best suited to grid or geodetic measurements, total station Is best at ground coordinates.Using GAPS to derive ground coordinates (and distance) requires use of an estimated call factor and a mathematic geode to approximate distances on the Earth's surface. -The final advantage to total station is that you don't necessarily need to occupy the point you are trying to measure. Using more advanced functions like offsets, resections, etc. You can measure a point indirectly though combinations of multiple angular and/or distance measures. Disadvantage -Firstly, line of sight is the principle disadvantage to opti cal measurement. GAPS does not need LOS. Secondly, (barring use of a robotic system) total station measurement requires at least a two person survey crew. GAPS only requires one person to survey. -Cumulative error is the third disadvantage. Human and machine error Is tattled with optical work. With each setup and stationing error is imparted to the measurements and subsequent setups and measurements accumulate the errors of previous setups. If you have a 5†³ gun, as much as 2. 5†³ of angular error Is Inherent to every shot. The error in gaps in not cumulative. Each shot has a â€Å"knowable† sphere of error that does not add up from shot to shot to shot. The final disadvantage Is that measurements are not geodetic. An estimated scale actor and correction for earth curvature Is necessary to make measurements relative to the ellipsoid, which Is the basis of the TM/State Plane grids. Advantages and Disadvantage of Total Instrument Operation By Bernardino -Total station needs line of site, but it does not need visibility of the sky. Total station can be used indoors, in a mine, or under tree cover that would not be suitable for -Third, total station is suited to take ground measurements. Whereas GAPS is best suited to grid or geodetic measurements, total station is best at ground coordinates.The final advantage to total station is that you don't necessarily need to occupy the point you are trying to measure. Using more advanced functions like offsets, -Cumulative error is the third disadvantage. Human and machine error is additive previous setups. If you have a 5†³ gun, as much as 2. 5†³ of angular error is inherent to -The final disadvantage is that measurements are not geodetic. An estimated scale factor and correction for earth curvature is necessary to make measurements relative to the ellipsoid, which is the basis of the TM/State Plane grids.