President Barrack Obama Essay Example for Free

President Barrack Obama Essay Every politician makes promises of what he or she will do when elected president and many of them do not see their promises through. President Barrack Obama is no exception and he made more than 500 promises to the people of United States of America if elected president. People should not except that promises politicians make to be a 100% fulfilled. However, president Barrack Obama has fulfilled a number of the promises he made to the people while others are to be fulfilled. The paper focuses on some of the promises the president promised during his campaigns for presidency and their state in the present day, a discussion if Obama would invade Iran and the new Arizona Immigrant Bill and whether he should get involved. How well does President Barrack Obama live to the expectations of the people? President Barrack Obama Barrack Obama is the 44th president of America and won the elections on 4th November, 2008 by a landslide win of 52. 9% against his opponent from the Republican Party, John McCain who acquired 45. 7% popular vote. During his campaign, president Barrack Obama made more than 500 promises to the people which were to be fulfilled after he was elected president. It has been one year and seven months since his inauguration on January 20, 2009. Albeit speculations about his promises as campaign tools for presidency, president Barrack Obama has undergone both positive and negative criticisms based on the same promises that defined him during his campaign and has managed to fulfill some of the promises he made to the people of the United States of America, while others stand to be fulfilled (Janny, 2008). I would say that the Obama reign and governance still has time to fulfill the promises it made to the people of the United States of America. Either way, critics would still be made about him either carrying out Bush practices to his administration and of being a president who used vague promises to the people of the United States in order to be elected president. Some believe that president Obama is the most widely criticized president of the United States of America for all times. All in all, the president deserves a pat on the back for the promises he has managed to fulfill, the promises he is still fulfilling and the promises he is to fulfill. Time would tell if his promises were merely campaign tools by the end of his era, which till then, president Obama has a lot to live to the expectations of the people of the United States of America, the people who elected him believing that he was the new dawn for America, an era of the youths to rule (Janny, 2008). Some may argue that president Obama has continued to carry on the practices in the retired president bush regime while others believe that Obama has carried out recommendable efforts to change the country. President Obama made promises to the people of the United States, but the people should not expect the promises to be fulfilled overnight. Some of the things he promised are becoming harder and harder to fulfill for instance the promise of the united states government being transparent, accountable and allowing the press to have access to government records. He promised to end the blanket of secrecy the Bush regime operated under by making the government act responsibly and become more accountable to the people it is serving and thereby making him the most liberal president of the U. S. (Janny, 2008). The promise of openness was signed during his first day in office and to present day still remains making it easier for the Americans to scrutinize the government for there is no secrecy that has been typical of past American governments. However, this promise has been challenged after the high court ruled out publication of torture article for the Guantanamo Bay detainees. The position for not publishing is because the information, if it were to be published would make United Kingdom questions the intelligence of sharing information with the U. S. This has added to the doubts as to whether president’s Obama promises were merely campaign tools (Stolberg, 2010). In the article â€Å"Barrack Obama on the issues: what would be your top three priorities if elected? † (2008), during his campaigns, he made one of his major promises to withdraw the United States troops from Iraq and end the Iraq war. Many citizens embraced the idea with open arms for they believed that the U. S. interference with Iraq was costing the country a lot of money which could be used to salvage other countries’ priorities. He promised the people that he was going to make sure that United States troop’s combats were going to be out of Iraq within six months since his election as president. The promise to remove troops from Iraq came to pass during his first days as president of the United States of America when he ordered that United States military to start preparing to leave Iraq. Today, the president’s promise is getting closer to be fulfilled for he has already set the deadline for withdrawal of the troops as 31st August, 2010 for the promise to be executed on schedule. Alongside with the directives he issued in his first days as president, for the U. S. military to withdraw from Iraq, he believe that by withdrawing the United States military troops, the U. S. would be giving Iraq government autonomy and independence over the future of its people and country. Iraq government will have to deal with terrorist threats themselves and form their own government. This he said because he believed in the diplomatic way of solving conflicts and the U. S. as a mediator between the countries bordering Iraq for peace to be attained in the region. In the article â€Å"Barrack Obama on the issues: what would be your top three priorities if elected? † (2008), President Obama intended to close down the Guantanamo detention camp immediately he took over as president but this was hindered by a number of factors. The camp was to be closed within one year and terrorist suspects were no longer to be interrogated using torture methods. In addition, it was made illegal for the U. S. to have secret detention camps in other countries or for such camps to be built in the future. This involved the closure of CIA secret detention centers, further closure of the Afghanistan and Iraq detention facilities in the future. President barrack Obama, said that by closing the detention camp, it would allow the detainees who have been help up in the camps without fair trial the opportunity of fair trial or release. This was to ensure that the United States of America government practiced more ethical values of dealing with violence and terrorism other that the inhuman methods employed by the Bush administration. The promise still remains to be fulfilled as many countries have shown reluctance to receiving terrorists in their countries. Issues are still arising as to whether the terrorist after being delivered to other countries will be tortured. Arguably, some people believe that the terrorists are too dangerous to be released and therefore the promise stands to be fulfilled within the time that president Obama is in power. President Obama also promised that there would be no tax hikes for those people with an annual income of less than $250,000 which comprises of a large number of people because most of them barely make $100,000 along side his health care reform promise to include more people being insured. In the article â€Å"Barrack Obama on the issues: what would be your top three priorities if elected? † (2008), however, when tax on cigarette was increased, it made the promise during the campaign unrealistic because majority of those who use cigarettes barely make more than $250,000. Many people interpreted his promises differently for it is very unrealistic not to tax anything that the poor man uses. In addition, increase in tax on cigarettes leads to a decline on those people who use them especially the under aged since they cannot afford it. For a non dictator president like Barrack Obama not to dogmatically impose his ideas on the people, I tend to think that people are being unfair to him and are judging him too harshly. He has done a lot in light of the promises; he is being pushed from all sides by people who are wishing that he fails in his reign as president and also compressed to meet both the republicans and democrats demands of the government. When pushed too much, both internationally and domestically, Obama has ended up not doing anything and this has contributed to the down fall of the United States economy but there is time for him to correct his mistakes and carry on with the promises. What the United States of America people and politicians should be doing is to lend him a hand and not expect him to put the country on track single handedly. President Barrack Obama is also working with people who did not promise anything to the people of the United States of America and therefore they do not feel compelled to help him attain his goals (Janny, 2008). Speculations arise as to whether president Obama could invade Iran after it announced that it has started converting uranium into gas. It is believed that Iran is a step away from making nuclear bomb even after the suspension of such activities in Iran by the International Atomic Energy Agency. President Obama has considered asking other countries to request Iran into giving up through international community and solidarity into pressuring Iran give up its nuclear interests. When diplomatic efforts fails to make Iran cease its nuclear efforts, I think president Obama will result into invading the country through the military striking the productions sites of nuclear in Iran. Invading Iran will no doubt create bad relations of the U. S. with the Arab Emirates but president Obama considers it better than having a liberal Muslim state possess nuclear weapons. In addition to his country’s troops been in Iraq, Obama is left with no choice than to invade Iran if international sanction do not compel the country to stop its quest for nuclear weapons (Janny, 2008). The new Arizona Immigrant Bill is believed to be one of the toughest bills on immigrants. Upon the enactment of the bill, immigrants will be identified, prosecuted and deported back to their home country if suspected to be in Arizona illegally. Immigrants in Arizona are to carry immigration documents which make it an offense not to have the immigration documents in the country. The police will have the power to arrest and detain those people who are in the country illegally. Many people are opposed to it feeling that it opens up the right to harassment of foreigners and any person suspected of being a foreigner thereby undermining the rights of people. Others are for the bill to be enacted and strict penalties be imposed on employers who hire illegal immigrants imposed. This is in line with the belief that most immigrants are taking up the rights of Americans in the workplace while Native Americans continue to suffer for they lack job opportunities which have been grabbed by the illegal immigrants. The bill is also anticipated to build a lot of racism and ethnic outline. Furthermore immigrants will fear reporting anything to the authority for fear of being deported to their country, which is not in line with combating crime in Arizona. Various organizations are opposed to the immigration bill and calls for its revoking for fear that it may spread from Arizona to other states and therefore jeopardizing public safety. President barrack Obama is opposed to the immigration bill in Arizona terming it as misguided and poorly conceived. I think the president should get involved in coming up with immigration reforms but only when he conjures up the democrats together with the republicans into putting in place immigration laws that are not unethical (Janny, 2008). President Obama health care plan was among the promises he delivered during his campaign. He sought to end the way insurance companies abuse the rights of the citizens of America. In the bill, the president aimed at creating and enacting rules that saw everybody being treated fairly when it came to health care and creating health care insurances for the people which are affordable. It was a concern for the president that many Americans could not afford health care insurance and thereby incorporated a promise on health care to broaden the number of people under insurance in the country especially those who are poor. One of the ways that affordable insurance is being maintained is through the tax increase on cigarettes. A large percentage of the money is being channeled to poor families specifically those families that have been victims of tobacco and could not afford health care insurance (Stolberg, 2010). I strongly agree with president Obama’s health care plan. Through his plan more and more people are assured of obtaining medical cover. The move to provide the middle class with tax cuts ensures that those people who were never covered will be covered and afford health care in the united states of America. In as much as critics are arising as to whether universal health care is possible, what Obama is doing to provide affordable medical services affordable is commendable. Insurance companies will also be more accountable for they will have rules that are governing them not to deny health coverage to the people of America. The era where poor American could not afford the similar choices of medical insurance with prominent members of parliament are long gone through the Obama health care plan. The plan aims at providing leverage in terms of insurance with competitive prices of health care insurance and no longer will Americans be discriminated in light of provision of health care. With such propositions, it would be very unwise not to fully agree with what president Barrack Obama is doing for his country (Stolberg, 2010). â€Å"Yes We Can† was the slogan during the campaigns for presidency which saw Obama defeat McCain and become the 44th president of America. Being a young presidential candidate, many youths believed in him and they voted him to bring about reforms in America. Obama widely campaigned and made more than 500 promises to the people of America. Some of the promises have been attained; others are in progress while others may seem to have been forgotten. It is however myopic to discredit what the president has done for his country and what he is trying to do. President Obama has many promises to fulfill and this is worsened by the way he is being judged on a daily basis. It is as if he is walking through the hawk eyes of a people that is relaxing and watching what one man alone can do for his country. By the mere fact that he promised to bring about reforms in the government and move away from practices that were during the Bush era, it does not mean that he will do it alone. The slogan â€Å"Yes We Can† I tend to believe incorporated every individual who is an American citizen to work together to bring about changes in the country. In addition, his time as the president of America is not yet over and the president will do the best he can to fulfill his promises to the nation for the promises are geared towards the development of America and its citizens (Janny, 2008). References Janny, S. : â€Å"The story of Obama, written by Obama†. (2008, May 18). The New York Times, p. 1. â€Å"Barrack Obama on the issues: what would be your top three priorities if elected? † (2008, April 14): Washington post. Stolberg, S. â€Å"Obama Signs Landmark Health Care Bill†: (2010, March 23): The New York Times.

Rawls Principles Of Justice Philosophy Essay

Rawls Principles Of Justice Philosophy Essay What is justice. Merriam-Webster defines justice as the quality of being just, impartial, or fair; the principle or ideal of just dealing or right action; conformity to this principle or ideal. For our purposes, justice is also seen as a concept that is balanced between law and morality. John Rawls states that justice is the first virtue of social institutions. He states that justice is best understood by a grasp of the principles of justice which are expected to represent the moral basis political government. These principles indicate that humankind needs liberty and freedom to the extent that they do not harm others. He believes, correctly I agree, that justice is significant to human development and prosperity. Rawls states that the challenge of justice is to ensure a just distribution of primary goods that include powers and opportunities, rights and liberties, means of self-respect, income and wealth among others. He disputed the earlier predominant common source of injustice, the utilitarianism theory (which states that justice is best defined by that which provides the greatest good for the greatest number of people). The theory of utilitarianism completely ignores the moral worth of an individual. This theory does not take into consideration the minority aspect of the population. Rawls writes about one such example of this mistreatment of the minority in relation to how the Jewish people were treated by the Nazis in Germany. In respect to the mistreatment of minorities, Rawls writes that you cannot reimburse for the sufferings of the distressed by enhancing the hoys of the successful. Fairness, according to him, occurs when the society makes sure that every individual is treated equall y before the law and given a chance to succeed in a socially-moderated life. He developed a concept that he deemed the original position, which gives people a chance to decide on the principles of justice from a veil of ignorance. This original position is a hypothetical situation where no one has any advantage over another. I find the veil of ignorance very interesting. Behind this veil, all individuals are specified as rational, free and morally equal beings in society. They do not know anything of themselves, their natural abilities, or their set position in the society in which they live. They have no idea of their sex, race, nationality, or individual tastes. Would they choose differently if they werent aware of these things? Would their society be less judgmental? I firmly believe so. I believe they would make choices about their lives that would adopt a strategy that would maximize the prospects of the not-so-well off, and make society a better balanced society. According to Rawls, the people in the original position, behind said veil of ignorance, wou ld adopt principles that would monitor the assignment of rights and duties and regulating the distribution of social and economic advantages in the society. His difference principle allows inequalities in the distribution of goods when the states inequalities benefit the least well off members of the society. However, Michael Sandel, noted author of Justice: Whats the Right Thing to Do?, would state that the idea of the veil of ignorance is unachievable. He argues that we are entangled with our communities, our pasts, and our sense of the possible future. If we are ashamed of what our country does, or proud of it, we are tacitly admitting that we are claimed by moral ties that we have not chosen and implicated in the narratives that shape our identity as moral agents. Sandel also believes the just society can be better achieved through a more emotional, patriotic and even religious appeal, rather than through Rawlss abstract liberalism. Sandel thinks that Rawlss liberal theory of justice fails because the neutrality of values associated with it begins with the false assumption that citizens are unencumbered selves totally unbound by any history, civic loyalties, sociopolitical circumstances, aims and attachments. We are all undeniably entwined with our communities. Other than Sandel, another critic of Rawlss position is Susan Moller Okin, author of, Reason and Feeling in Thinking About Justice. One would think that Rawlss theory would support feminist thinkers who seek to overturn the injustices suffered by women. The original position being supposedly blind to gender and tradition, and so, it seems, are the principles of justice Rawls derives. However, Susan Okin has several arguments against Rawlss theories, or in favor of adjustments to his theories. One of her first problems is that Rawlss theory is limited to public justice the deliberators are meant to be heads of families not necessarily gendered but entails that justice does not apply within families. Thus sacrifices for domestic arrangements such as childbearing, childcare, and housework, traditionally made by women, are simply not considered. He simply assumes families are just institutions, which in my opinion is far from true. Rawls also stresses the role of proper moral developm ent, which he believes is to take place within families. Upbringing must be both loving and just. However, how can a proper upbringing take place if the women of the family are not placed on equal foundations with the men? Rawls underplays the role of emotion in rational decision-making. This is not to say that only women use emotions to make decisions, but that the idea that anybody could make any decision free from emotional influences is a characteristically male attribute. Nevertheless, Okin thinks that in the right hands, Rawlss original position, which is blind to gender and tradition, has the potential to provide a framework for critique of systems which are gender-biased. Its just that Rawls fails to do this. The general conception of this principle is that all primary goods, such as liberty and opportunity, self-respect, incomes, and wealth, are supposed to be distributed equally unless an unequal distribution of any or all of these primary goods are to the advantage of the least favored. The good is the satisfaction of rational desire thus making the goods different, but all people having a right to said goods. All individuals have equal right to the most general of basic liberties. Economic and social inequalities are to be set in a way that they are both rationally projected to be everyones advantage, and to be attached to positions that are open to all people in society. Rawls writes about three general principles of justice. The first said principle is the principle of greatest equal liberty. This principle states that each person has an equal right to the most basic liberty. It determines the basic rights that should be retained such as, à ¢Ã¢â€š ¬Ã‚ ¦the political liberties to vote, run for office, own property, and to have freedom of speech. These have to be protected to guarantee the development and prosperity of others. The second of Rawlss principles is the principle of fair equality of wealth and opportunity. According to this principle, everyone should have the same opportunities to make wealth, work, or govern in a public office. The only difference being the knowledge and skills of the individual. He states that it is in everyones advantage if positions of authority are accessible for any person to lead the community. The third principle of Rawls indicates that any social and economic inequalities should be arranged so that they are to th e greatest benefit to the least advantaged individuals in society. It indicates that for any effective change to be considered as an improvement, it should affect the least privileged. This principle is often referred to as the difference principle. Another critic of Rawls is Robert Nozick, author of Anarchy, The State and Utopia, which was primarily written to refute the theories of John Rawls. Specifically, Nozick takes issue with Rawls conception of distributive justice as it pertains to economic inequalities. Rawls wrote that economic inequalities should only be permitted if they are to the benefit of society, and especially if they are to the benefit of its least advantaged members; this has come to be known as the difference principle. Nozick believed that no one had any business permitting economic inequalities at all. To Nozick, as long as economic inequalities arise from voluntary exchange, they cannot be unjust. Rawls saw the importance of liberty, but he also saw the tragedy of inequality, particularly as it pertains to extreme poverty. To Rawls, it is unconscionable that some should be born into a life of misery and poverty while others enjoy great wealth without lifting a finger. To Nozick, the unconscionable thing is that anyone should feel the justified in appropriating property that is rightly entitled to someone else. I believe that while Rawlss theory of justice is admirable, it does have some flaws and weaknesses. Rawlss theory is not a formula for deciding what is right and wrong, but a framework for proposing principles of justice. No one can really know what a specific set of people would actually decide if they didnt know what sort of people they would be, what sort of lives and what appetite for risk they would have. But that does not mean the thought experiment cannot be used as a test. Would people who knew they could turn out to be Jewish, in a context of historic embedded anti-Semitism, agree to principles which allowed public bodies to impose anti-Jewish quotas, purportedly as a way to avoiding the possible consequences of anti-Semitism? Unlikely.

Ocular Manifestations in Hansen’s Disease

Ocular Manifestations in Hansen’s Disease Christina Samuel1, Sundararajan D2 1Postgraduate, 2HOD. Department Of Ophthalmology, Meenakshi Medical College, Kanchipuram, Tamil Nadu, India ABSTRACT Background: Leprosy or Hansen’s disease is a chronic mildly contagious granulomatous disease of tropical and subtropical regions caused by the rod shaped bacillus, Mycobacterium leprae. It affects the skin, peripheral nerves in hands and feet, mucous membrane of nose, throat and eyes. When left untreated it is capable of producing various deformities and disfigurements. Aim: To study the ocular involvement in patients with Leprosy under the parameters of age group, sex type and duration of leprosy. To study the different ocular manifestations and identify the potentially sight threatening lesions and provide early management. Methods: A prospective study of 50 cases diagnosed with Hansen’s disease were included. Detailed history and thorough clinical examination done. Potentially sight threatening lesions were managed conservatively or surgically. Results: Out of 50 cases of Leprosy, 58% had ocular involvement and majority were of the age group 21-40years. Ocular involv ement was predominantly seen in Lepromatous type with 35% having ocular lesions. The most common ocular manifestation observed was superciliary madarosis(48%). Potentially sight threatening lesions accounted for 72.4% of which lagophthalmos was common. No cases of blindness seen. Conclusion: Visual impairment is preventable in Leprosy if detected early. The risk of ocular complications increases with the duration of the disease, despite being treated with systemic anti-leprosy drugs. Keywords: Leprosy (Hansen’s disease), lepromatous, tuberculoid, slit skin smear, ocular involvement INTRODUCTION Leprosy or Hansen’s disease is a chronic infectious disease caused by an intracellular rod shaped acid fast bacilli Mycobacterium leprae which affects the skin, nasal mucosa, peripheral nerves and the anterior segment of the eye.1 Mycobacterium laprae was discovered by a Norwegian physician G.Armauer Hansen in the year 1874.1 The most ancient writings of ‘’SUSHRUTA SAMHITA’’ compiled in 600BC refers to leprosy as Vat Rakta or Vat Shonita and Kushtha2,3. Leprosy occurs in all ages and both sexes. Male: Female ratio is 2:14. Leprosy bacilli has a predilection for neural tissue and their target is Schwann cell. The fate and type of leprosy depends on the resistance and immunity of the affected individual5 ( Jopling, Mc Douglass 1996). There are 11million cases throughout the world and about 1/3rd have ocular manifestations.6 Prevalence of blindness due to leprosy is 4.7% of the population in India.7,8 Various studies shows ocular involvement in Leprosy patients. The frequency and types of involvement depends on the duration and form of the disease.2,9 Ocular lesions are common in lepromatous type of leprosy and presents with lepromatous nodules, conjunctivitis, keratitis, pannus, scleritis and uveitis. Lesions are rare in Tuberculoid type of leprosy and are secondary to the involvement of branches of facial nerve which presents with paralytic lagophthalmos, exposure keratitis and neurotrophic keratitis. Acute iridocyclitis and scleritis are seen in type 2 lepra reaction occurring in lepromatous leprosy.6 Blindness has been reported in 7% of patients secondary to lagophthalmos, uveitis, exposure keratitis and cataract8. Proper attention and early detection can prevent potentially sight threatening lesions. MATERIALS AND METHOD The present study was carried out in the out patient Department. of Ophthalmology and In patient department of Dermatology at Meenakshi Medical College and Hospital, Kanchipuram from March 2012-May 2014. In this study a total of 50 patients were taken, 38 males and 12 females of the age group 20years and above . Prior to the study an informed consent form from the patients and ethical clearance was obtained from the Institutional Ethics Committee. Inclusion Criteria: All diagnosed cases of leprosy. Old and new cases, both genders and age group of 20 years and above. Exclusion Criteria: Non compliant patients, Patients with pre existing ocular disorders due to other causes than leprosy. Type of study: A cross sectional descriptive study for a period of 14 months. Procedure: Relevant details of both ocular and systemic history, including details of lepra reaction and clinical examination of patients was recorded on a proforma. A detailed slit lamp examination of the anterior segment of eye was done. Visual Acuity recorded with help of Snellen’s chart10. Corneal sensation was checked with a wisp of cotton. IOP was recorded with help of Schiotz tonometer10. Fundus examination with 78D and IDO done. Lab investigations like haemogram, ESR, Urine routine and RBS done. Slit skin smear and skin biopsy from the ear lobe was performed by the Dermatologist and report obtained as positive for M.leprae (Ziehl Neelsen technique)11. Patients were started on systemic anti leprosy drugs(multi drug therapy) and treatment for lepra reactions. Patients with ocular manifestations were treated accordingly to their need of Lubricant eye drops, topical antibiotic with steroid drops, eye ointments, frequent blinking exercises, physiotherapy, lid taping at nigh t time and spectacle correction. RESULTS: In this study of 50 patients with leprosy, majority belonged to the age group of 21-40years (46%). 76% were males and 24% were females. Out of 50 cases, 30% were tuberculoid type, 22% lepromatous type and 48% borderline type. Out of 50 cases 58% had ocular involvement in which 45% were within the age group 21-40years. Out of the 29 cases with ocular involvement 72% were males. 35%with ocular manifestations were of lepromatous type of leprosy. 41.4% gave a positive history of lepra reaction. The ocular involvement was directly proportional to the duration of leprosy. 55% had leprosy more than 5 years. Superciliary madarosis (48%) was the most common ocular manifestation. The potentially sight threatening lesions were Lagophthalmos(35%), seen more in lepromatous type(14%). 28% had corneal hypoesthesia, 21% with exposure keratitis, 17% had corneal opacity, anterior uveitis and conjunctivitis each accounted for 7%. It was interesting to note that 60% of patients with lagophthalm os had exposure keratitis. DISCUSSION: The involvement of eyes in leprosy is due to infiltration of the tissues by the bacilli and damage to the nerves12. In this study 58% of the patients had ocular involvement. This can be compared to other studies of Wani.S.et al 2005 which showed 69% of ocular involvement, Gnanadoss A S et al 1986 showed 59.2% 13. Studies conducted by Shields shows 33% of potentially sight threatening lesions which included keratitis, iritis, lagophthalmos and secondary glaucoma14. In our study the potentially sight threatening lesions were lagophthalmos, exposure keratitis, uveitis, corneal hypoesthesia and corneal opacity which accounted nearly for 72.4%. Majority of the patients in our study were of the age group 21-40 years and male predominance was seen in both for, affected eyes with leprosy(76%) and ocular involvement (72%). This can be compared with the study by Wani.S et al (82.6%)12 which also showed predominance for men. This study further shows that ocular manifestation were se en more in lepromatous leprosy (75.36%) followed by borderline(14.49%) and tuberculoid leprosy(10.14%)12. In our study conducted, ocular involvement was 35% in lepramotous, 31% in borderline and 17% in tuberculoid type. The reason being that M.leprea has a favourable environment in the anterior segment of the eye and the bacilli is found more in lepromatous type of leprosy. Madarosis was the commonest ocular manifestation in our study which was about 48% when compared with Shield’s 1974(54%)14 and Acharaya B P (59.2%)15 and Wani.S. et al (72.46%)12. Lagophthalmos accounts for 35% in our study when compared to Wani.S et al (28.98%)12 , Acharaya B P (34.3%)15 , Lamba et al 1983 (13%)16 , Shields 1974 (29%)14 and Weerekon 1972 (27%)17. Lagophthalmos is commonly associated with lepra reaction in the face and damage to the facial nerve and also depends in patients with lepromatous leprosy(14%) which is similar to the observation by Wani.S et al (18.84%)12. In this study corneal in volvement was seen in 66% of the patients, corneal hypoesthesia 28%, exposure keratitis 21% and corneal opacity in 17%. In the study conducted by Wani.S et al corneal involvement (36.23%)12 . Radhakrishnan N et al observed that the major cause of blindness in leprosy was exposure keratitis due to lagophthalmos(23%) and leucoma (25%)18. Cataractous changes in lens was seen in 17% of the patients, but it was not a complication due to leprosy or MDT but merely due to senile lens changes in the older age group of the patients in our study. This is also supported by the study from Gnanadoss A S et al13. Iris pearls seen in anterior uveitis are said to be the pathognomic of leprosy19,20. But in our study uveitis was observed only in 7% of the patients when compared to Wani S et al12 which showed 31.88%. This probably is due to the small sample size of our study and also the duration of leprosy not being more than 10 years for all patients ,because uveitis is seen mostly in chronic cases o f leprosy. This is supported by various studies like Lamba 1983 16(14%), Hornblass 197321 (16%) and Gnanadoss A S et al 198613 (5.6%). In this study all patients with ocular manifestations were either treated formerly(58.6%) or presently (41.4%) with systemic anti leprosy drugs. Courtright et al suggested that ocular pathology will still occur in MDT treated leprosy patients22. Thus treatment does not prevent the occurrence of ocular lesions12. Moreover once the patient is on treatment the ocular reaction is seen more in the first 6-12 months due to reactions23. The progressive leprosy related lesions are the result of chronic nerve damage. CONCLUSION: The risk of ocular lesions increases with the duration of disease, lepra reaction and facial patches in this reaction. Screening of all patients affected with leprosy can help in identifying the potentially sight threatening lesions which can be treated earlier. Visual impairment if detected early is preventable. The Multi Drug therapy for leprosy has improved the outcome of the affected with leprosy but does not retard the development of ocular complication. LIMITATIONS: Owing to the small sample size in this study many other ocular manifestations could not be assessed. A relationship between uveitis, Complicated cataract and leprosy can be suggested if the patients presents with a longer duration of leprosy more than 10 years, as in this study we had only 4 patients in that category. ACKNOWLEDGEMENT It is with the sense of accomplishment and deep gratitude that we dedicate the work to all those who have been instrumental in its completion. We are greatly thankful to the RMO, Meenakshi Medical College Hospital and Research Institute, Kanchipuram. To our Associate Professors, Assistant Professors, Colleagues and Staffs of the Department of Ophthalmology and Dermatology for their timely help, support and constant guidance in our work. REFERENCE 1.Lewallen, Paul Courtright. An overwiew of ocular leprosy after two decades of multidrug therapy. International Ophthalmology Clinics world blindness. Sept2004, vol47(3):87-99. 2. Dharmendra. History of spread and decline of leprosy. Leprosy.Vol I, Bombay: Kothari Medical Publishing House,197;7-21. 3. Rastogi N, Rastogi RC. Leprosy in ancient India. Int J Lepr 1984;52:541-3. 4. Park K. Epidemiology of Communicable Diseases. Park’s Textbook of Preventive and Social Medicine. 17thedn., Jabalapur: M/S Banarsidas Bhanot Publishers, 2002; 242-253. 5. The disease In: Handbook of Leprosy, 5th edn., Delhi CBS Publishers and distribution; 1996;10-53. 6. Sihota. Tandon disease of uveal tract. Chapter 17.Parsons’ Diseases of the Eye,20th Edition. New Delhi. Elsivier 2007;239-72. 7. Thompson Allardice et al, Patterns of ocular morbidity and blindness in leprosy: Leprosy review vol 77(2) June 2006. 8. Ffytche TJ. Residual sight threatening lesions in leprosy patient completing Multidrug therapy and Sulphone monotherapy, Lepr. Rev, 1991;62: 35-43. 9. Mark J. Mannis Mascai, Arthur. Leprosy, chapter 62. Eye and skin disease, Lippincott- Raven publishers, 1996;543-50. 10. Orthoptists and Prescribing in NSW, VIC and SA. The Royal Australian and New Zealand College of Ophthalmologists. Retrieved 29 July 2010. 11. PVS Prasad. Microbiology. In: all about leprosy. 1st edn. Jaypee brothers publishers,2005.pg 4-11. 12. Junaid S. Wani, Saiba Rashid M.S. Ocular manifestations in leprosy- A clinical study; JK- Practitioner 2005; 12(1): 14-17. 13. Gnanadoss AS, Rajendran N. Ocular lesions in Hansen’s (leprosy). IJO 1986;34:19-23. 14.Jerry A Shields; George O; Waring; AJO,1974,77;880-890. 15. Acharaya B P. Ocular involvement in Leprosy- A study in mining areas of India. IJO 1978; 26:21-4. 16. Lamba PA; Arthanariswaran: Leprosy India 1983,55;490. 17. Lloyd Weerekon: BJO. 1972,56;106. 18. Radhakrishnan N, Albert S. Blindness due to leprosy. IJO 1980;28:19-21. 19. Ffytche. T.J., 1981, Trans. Ophthal. Soc. U.K. 101:325. 20. Hogeweg, M. Leiker, 1983, Brit J Dermat.109:477. 21. Albert Hornblass: AJO.1973,75;478. 22. Courtright. P., Lu Fang Hu. Multi drug therapy and eye diseases in leprosy. A cross sectional study in People’s Republic of China. Int . J. Epidemiol. 1994;23(4):835-42. 23. Dr. Margreet Hogeweg, Prevention of Blindness due to Leprosy. ICEH, http://www.iceh.org.uk.

Atmosphere and Tension in Great Expectations Essay -- Great Expectation

Atmosphere and Tension in Great Expectations In this essay I am going to write about how Charles Dickens creates atmosphere and tension in the opening chapter, of Great Expectations. Because the audience cannot see what Dickens wants them to, he has to create atmosphere and tension to guide the audience through the incident, as well as hooking the audience by keeping them interested. Dickens intentionally creates that atmosphere because he wants us to feel sympathy for Pip and what he’s going through. And if we care about what happens to Pip we keep interested. Atmosphere and tension set the tone and mood of the book. Dickens begins his book by starting with Pip at the graveyard to create atmosphere and tension, by referring to death and tombstones. The story is set in a time were disease and death were common, before any major advances in medicine, and it was ordinary to loose a lot of your close family to illness. We are told by Pip, that his mother, father, and five little brothers were buried there but that is all we are told. By doing this Dickens has deliberately created a felling of solitude and helplessness and makes the reader feel and identify with Pip. Dickens tells us the churchyard is overgrowing with nettles and there are gravestones all around the area. Instantly the graveyard creates a morbid feeling, and knowing that Pip’s dead relatives are surrounding him produces a scary feeling, that you wouldn’t want to be in yourself. The reader becomes worried that a young child is in such a place alone, which adds to the dread that something might go wrong. Dickens also uses weather to create atmosphere and tension by making it seem bitter, and cruel. The weather is described as a â€Å"raw afte... ...e tombstone obviously isn’t Pips he thinks he is going to die because of how the convict is acting physically and verbally. It feels personal to him and this is a fear-building phrase. Pip is portrayed as being venerable and young. Dickens wants you to see him as an innocent, to see him scared of what is going on as it is a new and shocking experience. Dickens wants us to understand and sympathise with him. Pip describes the convict as â€Å"a fearful man† and the convicts first words as â€Å"a terrible voice†, which tells us that Pips first impression of the convict is a fearful one. The convicts orders are written as if they were directed at the reader. For a second we become pip and undergo what Pip is going though. This creates tension as the reader begins to understand what pip has felt. Dickens uses colour as another factor to create atmosphere morbid.

The Role of American NGOs in the Regulation of Cruise Ship Pollution Es

The Role of American NGOs in the Regulation of Cruise Ship Pollution Each year, thousands of tons of pollution are generated on cruise ships and dumped into the world’s oceans. This pollution threatens the marine environment, the cruise ship industry, and the people who depend on a healthy ocean. Neither historical nor current international oceanic regimes provide comprehensive regulation on cruise ship pollution. To address the threats posed by limited oceanic pollution regulation in American and international waters, several American nongovernmental organizations have pursued diverse tactics to generate government, industry, and consumer response. To the extent that NGOs are able to influence policy, the actions of these groups challenges the realist notion that non-state actors have little influence on policy. A case study of three prominent American NGOs demonstrates how different strategies can be implemented to influence oceanic policy. The Bluewater Network, Oceana, and Conservation International have tried to abate pollution from cruise ships by either lobbying the government for improved policies, generating public awareness of the cruise ship pollution issue, or working with the cruise ship industry to implement stronger pollution controls. These actors have responded to the weakness in the oceanic policy regime. Although cruise ship pollution remains a major threat to national and international waters, American NGOs have been successful in generating increased awareness of the issue and have been able encourage policies that will make cruises more sustainable for both the environment and the industry (Oceana). The Development of Oceanic Policy International agreements have established the United St... ... The cruise ship pollution campaign has been strengthened by the cooperation among organizations that the Bluewater Network petition facilitated. Heightened public awareness, engendered by NGO campaigns, has pressured the U.S. government and the cruise ship industry to respond. If policy changes, such as those presented in the Clean Cruise Ships Act of 2004, occur, the activities of Conservation International may allow the cruise ship industry to comply with environmental regulations while maintaining high profits. The confluence of each NGO’s actions may provide the means necessary for a strong domestic ocean regime. In the absence of international cooperation, a strong American ocean policy is an important step in safeguarding the world’s oceans. Various strategies have allowed NGOs to highlight cruise ship pollution as an issue that can not longer be ignored.

Independence in the tasks of daily living Essay

Outcome1-understand principles for supporting independence in the tasks of daily living-Individuals can benefit from being as indepenent as possible in the tasks of daily living as it depicts that people having the same level of choice, control and freedom in their daily lives as any other person. Each of the three main political parties expressed their approval of the Independent Living Strategy published in 2008, which sets out actions aimed at improving the choice and control disabled people have over the services they need to live their daily lives. The aims of the strategy are that: * disabled people (including older disabled people) who need support to go about their daily lives will have greater choice and control over how support is provided; and *disabled people (including older disabled people) will have greater access to housing, education, employment, leisure and transport opportunities and to participation in family and community life. In June 2010, the Government stated that it was looking at further ways of taking the Independent Living Strategy forward. Active participation promotes independence in the tasks of daily living as this gives the client the confidence and independence needed to complete tasks by themselves without the support of others. Daily living tasks may affect those depending on their culture or background, as what someone may have been brought up believing, may not necessarily be accepted as the general view of society within Great Britain in these current times. I would identify suitable opportunities for an individual to learn or practice skills for daily living by providing a wide range of activities. I would observe/monitor their skills to identify what they can/can’t do, and also listen to them and ask any questions about what they would like to do. It is important to clarify the role and responsibilities for providing support in order to ensure that all codes of conduct, professional boundaries and legalities are upheld. Outcome 2-be able to establish what support is required for daily living tasks- Establish what support is required for daily living tasks In order to access information regarding an individuals support plan I would request this from my line manager using all organisational policies and procedures and adhering to all Acts of Parliament. In order to clarify with the individual and others the requirements for supporting an individuals independence in daily living tasks I would ask the individual concerned what they would, and how they would like to achieve independence, as well as following any care plans and discussing with others any information that the client may have passed onto them with regards to how they would like to achieve this. In order to access any additional guidance in order to resolve any difficulties or concerns about support for daily living tasks I would contact my line manager via telephone or in person, whilst accessing any care plans and referring the situation to my line manager if there had been any disputes between myself and the client. Outcome 3 – be able to provide support for planning and preparing meals- In order to support the client to plan meals that contribute to a healthy diet that reflect the individuals culture and preferences I would clarify with the individual any foods they can or can’t eat depending on culture and medical conditions and what they prefer to eat, whilst following any current guidelines for healthy eating. I would actively support them in the preparation of the food by encouraging them to prepare it themselves following all health and safety policies and referring the client to any ‘cook books’ etc. I would encourage the client to store food safely by discussing and referring  them to any food safety policies i.e. basic food hygiene, as well as actively supporting them in the initial storing of the food. Outcome 4- Be able to provide support for buying and using household and personal items- Different ways of buying household and personal items include using the internet and shopping in person. In order to identify household and personal items that are needed for the client I would discuss with, and if necessary supervise the client whilst they decided and tooks notes, depending on what they currently had in the house and therefore did or didn’t need. In order to support clients to buy items in the way they preferred I would discuss with and accompany the client whilst either shopping on the internet or in person etc. In order to support the client to store and use items safely I would discuss with and refer them to any health and safety instructions that may come with or be noted on the products. Outcome 5- To be able to provide support for keeping the home clean and secure- I would support the individual to keep their home clean in a way that supports active participation and safety by observing and discussing with them any issues that they may have, then referring them to any policies issued to the general public or organisations, and actively supporting them whilst they implemented these policies. I would supervise and describe different security risks to the client, whilst encouraging them to take notes as to what these are and describing to them ways to implement any concerns that either myself or the client had, I would also advise my line manager as to what these risks are so that any actions could be securely documented. Some of these risks could include leaving doors and windows open or unlocked, or by allowing people into their home without asking for I.D etc. I would support the individual to use agreed security measures by referring  them to any leaflets or policies that had been issued either externally or internally by an agreed and secure source, and promoting active participation in the implementation of these security measures. Outcome 6- Be able to identify and respond to changes needed in support for daily living tasks- In order to record any changes in the individuals circumstances that might affect the type or level of support that is required I would discuss these with the client and my line manager whilst recording these in the individuals care plan. I would adapt support in agreed ways of working to address concerns, changes or increased independence by discussing with the client and my manager what these may be. I would also takes notes and implement any changes in the individuals care plan.

Hawthorne, Brown and Poe Essay

The gothic component of the American Romantic Period of 1800-1860 produced several eerie and gothic works by talented literary minds. Three such pieces, â€Å"The tell-tale heart,† â€Å"The Birthmark,† and Wieland were written by Edgar Allan Poe, Nathaniel Hawthorne and Charles Brockden Brown. These works of fiction delve into the minds of seemingly unstable protagonists, and in so doing participated in the general Romantic theme of reacting against reason. These authors also adhered further to the Romantic notion of elevating the human spirit as persons in need not of salvation but of being aroused to a truer relationship with the self. Thesis: The main characters of each story defy the conventions of the time through gothic settings, anti-religious demonstrations and revolutionary psychological insights that lead to a better understanding of the dark side of human capabilities. A. Wieland by Charles Brockden Brown 1. Wrote extensively on an array of topics 2. Ushered in the ideas of the American Romantic Period 3. Strong psychological state of female character 4. Weak psychological state of male characters 5. External force having the power to awaken his true character B. â€Å"The tell-tale heart† by Edgar Allan Poe 1. Psychologically challenged character 2. More insight into the inner workings of the unsound mind 3. Takes the reader into uncharted territory 4. Narrator an exercise in self-knowledge 5. Death of a beautiful woman C. â€Å"The Birthmark† by Nathaniel Hawthorne 1. Death of a beautiful woman 2. Gothic tradition of darkness and mystery 3. Puritanical hypocrisy 4. Salvation through self knowledge Conclusion: The three authors Brown, Poe, and Hawthorne, along with their works Wieland, â€Å"The tell-tale heart,† and â€Å"The Birthmark,† demonstrate several aspects of the American Romantic Period in which they were written. They display the gothic preoccupation with the ghostly and/or mysterious qualities of the unknown. They also delve into the psychological mysteries of the mind and demonstrate the moral weaknesses of humans. Finally, they seek to bring humans into such contact with the self so that elevation and improvement of the mind and spirit can come about through a thorough knowledge of the self and its functions.