Streetcar Named Desire Essay Example | Topics and Well Written Essays - 500 words

Streetcar Named Desire - Essay Example He led life his own way. He was a man who was keen to protect his sexual relationship with his wife and this is one of the reasons why Blanche thought it was important for her to protect her sister from his violent acts. There was sexual tension between Blanche and Stanley from the moment they first meet. In one scene Stella is out of the picture (in the bathroom washing her face) the first time Blanche encounters Stanley. They’re alone together. He takes off his shirt on the grounds that he wants to be â€Å"comfortable.† While Blanche pretends to be ok with this, we know later that such informalities in fact make her feel uncomfortable. In another scene when Stanley rifles through the personal things in Blanche’s trunk, it’s as though he’s violating her as well. The big â€Å"Stelll-ahhhhh!!!† scene is as much about Blanche’s discomfort with Stanley’s destructive sexuality as it is fear for her sister. She’s horrified that Stella goes back downstairs in order to make love with Stanley. She even tried to persuade Stella but she chose brutish love over a better life. Her love for Stanley gave him the advantage over his enemy. Blanches jealousy is also quite noticeable in many scenes. Since she is dealing with the loss of her husband, Belle Reve, she envies her sister’s happiness and protection and how she has sexual freedom. In Scene Four Blanche says: â€Å"What such a man has to offer is animal force. But the only way to live with such a man is to go to bed with him! And that’s your job not mine!† It seems unfeasible for Blanche to relate a man in a non-sexual way, even those men who would be considered inappropriate for her i.e. her brother-in-law, Stanley. Even so, she was always quite eager to get a hold of Stanley’s attention and receive compliments about her physical appearance from him. After their first

What Feminism and Women's Studies Calls for and Performs Essay

What Feminism and Women's Studies Calls for and Performs - Essay Example This paper will focus on identifying significant ideas associated with feminism and women’s studies, and some of the significant role they play in the society. One the significant role played by feminism and women’s studies is to contribute to development of feminist movements and academic studies regarding construction of gender that facilitate harmony in the society. Besides, feminism and women’s studies are applied in gathering ideas that can question various cliches regarding gender, race and religion, which are sometimes considered nature, though they are established through social interactions. In addition, feminism and women’s studies has enable recognition of the effort that her been made by women in the resent years in order to realize the stature of feminism in the present day. Feminism and women’s studies takes interdisciplinary nature, which leads to affirmations of diversity in the perceptions by people who study them. Moreover, feminis m and women’s studies offers a basis of developing strategic discussions, feminist praxis, and for making significant interrelationships across various boundaries that are conventionally conceived. Feminism and women’s studies has facilitated flexibility, and a basis of questioning various notions regarding human assumptions regarding gender and relations. Feminism and women’s studies plays a vital role in encouraging members of the society in developing skills that can enable them think critically and sensitive about issues relating to gender. On the other hand, these studies offer students a critical awareness regarding the operations of gender and the way they operate in various contexts such as institutional, cultural and social. Feminism and women’s studies offers an introduction of critical gender theories that forms a functioning in demanding intellectual environment (Levin, 12). These studies take a vital role of introducing history, feminist theo ries and criticism, which are bases on critical theoretical framework applied in developing vital perceptions and knowledge about gender inequalities. Feminism and women’s studies strengthens ability to discuss and writer about feministic criticism with a high level of coherence, logic, and analytics (Kesler and Sameh, 185). Apparently, feminism and women’s studies requires understanding of feminist critiques, which are applied in making informed judgments and strengthening the society, building public policy and reconstructing sexist institutions. There is need to understand the impact of feminist perception and criticism, and the challenges that they have pose do conventional disciplines of liberal arts. Feminism and women’s studies has led to identification of women’s contribution to knowledge that was overlooked in the past. Feminism and women’s studies serve as vital sources for substantial writing regarding issues that involve women’s race and social classes (Kesler and Sameh, 186). Therefore, this creates familiarity with literature on women’s studies and awareness of significance of vitality of the journals, which involves frequency of publishing articles in Feminist Studies. However, understanding ideas in feminism and women’s studies, it is important to collaborate with in new generations of feminist scholars, activists’ artists, and creative writers. In addition, there is need for

Hypertension Case Study Nursing

Hypertension Case Study Nursing 1) CASE SUMMARY Mr. MS is a 58-year-old Malay male who was previously diagnosed with hypertension, gout and triple vessel ischemic heart disease. He first presented with chest pain in March 2010 where he was diagnosed with ischemic heart disease. He was unable to complete an exercise stress test and an angiogram done in Hospital Sultanah Aminah found him to have triple vessel disease. He was told angioplasty was not possible due to the severity of the blocks and was counseled for CABG but he was not keen. Meanwhile, he has had angina attacks 2 to 3 times per week every week since his initial diagnosis for the last 3 months, usually relieved by sublingual GTN and was currently admitted for the 4th time for chest pain not relieved by GTN. ECG done 2 hours after onset of chest pain showed ST depression of 2mm at leads I, aVL, V3 V6 and left axis deviation with no Q waves. Trop T was positive (2.75 ng/ml) at 4 hours after onset and other cardiac enzymes were also raised significantly. He was diagnosed with NSTEMI and treated with aspirin 300mg, IV morphine 2.5 mg, sublingual GTN 3 tablets and subcutaneous clexane 60mg BD for 3 days as well as continuing his current medication regime of simvastatin, metoprolol, cardiprin, ISDN, amlodipine and GTN. Following admission, he was well in the ward with no recurrence of chest pain and did not develop any new complaints. He was discharged after 3 days of inpatient treatment with instructions to attend his follow-up appointment at the cardio clinic in HSAJB on the 16th of June 2010 to make an appointment for surgery. Following this episode of chest pain, which he says is the worst so far, he is now quite keen for CABG. PATIENTS DETAILS I/C NUMBER: 510831015263 AGE: 58 SEX: Male DATE OF ADMISSION: 3/6/2010 R/N: 1348445 2) CLINICAL HISTORY Chief Complaint Chest pain for 1 day. History of Present Illness Mr. MS is a 58-year-old Malay male who was previously diagnosed with gout, hypertension and ischemic heart disease with triple vessel disease. He was awoken from sleep at about 10pm due to a central chest pain of sudden onset. He described the character of the pain as crushing in nature and radiated to his neck. This episode of chest pain was the most severe since he was first diagnosed with ischemic heart disease. The pain was associated with profuse sweating, body weakness and was not relieved by rest. However, it was relieved by sublingual GTN, of which he has a supply of. His discomfort was made worst by exertion so he lay in bed to recover. Despite this, he had another episode of chest pain 30 minutes later. He took the sublingual GTN again but this time, the pain did not resolve. He was then brought to the emergency department of Hospital Batu Pahat by his son. This is Mr. MSs fourth admission for chest pain since March 2010. Since his diagnosis of ischemic heart disease in March, he has experience angina attacks two to three times per week, especially on exertion such as when straining while passing motion. During these attacks, he uses sublingual GTN to relieve his symptoms and normally feels much better after that. He only comes to the hospital when GTN does not work to relieve his symptoms. Systemic Review Mr. MS does not experience symptoms such as palpitations, dizziness, headache, nausea, vomiting, orthopnoea, paroxysmal nocturnal dyspnoea, epigastric pain, shortness of breath, fever, and had no syncopal episodes. He also does not have loss of appetite or loss of weight. Bowel and urinary habits are normal. His sleep has not been affected until this current episode whereby he was awoken by the chest pain. Past Medical History Mr. MS was diagnosed with hypertension 6 years ago when he had an episode of headache. He has been on medication since and was on regular follow-up with KK Rengit. He was diagnosed with gout 5 years ago when he had a left big toe swelling which resolved after some medication. He is not on long term medication for gout. Mr. MS was admitted for the first time 5 years ago in 2005 when he had bilateral renal calculi. He was subsequently referred to Hospital Sultanah Aminah for further management of this problem and it has since resolved and does not have follow-up anymore. Mr. MS was diagnosed with ischemic heart disease in March 2010 when he presented with chest pain for the first time. Following his recovery, he underwent a stress test in Hospital Batu Pahat but according to him, was unable to complete the procedure due to chest discomfort. He was referred to the cardiology unit in Hospital Sultanah Aminah for further management where an angiogram was performed and he was told to have triple vessel disease. He was also told that angioplasty was not possible due to the severity of the blocks. He was recommended to have Coronary Artery Bypass Grafting (CABG) but as of yet, no appointment has been made as he was still unsure of going through with the procedure. Following this episode of chest pain, Mr. MS has decided that going for the CABG is the only thing that will keep him alive. His current medications include: Tab Simvastatin 20mg OD Tab Metoprolol 75mg BD Tab Cardiprin 100mg OD Tab Isosorbide Dinitrate (ISDN) 5mg TDS Tab Amlodipine 10mg OD Sublingual Glyceryl Trinitrate (GTN) PRN He is compliant to his medication regime. Mr. MS is not known to have diabetes or hyperlipidemia. He also does not have any known food or drug allergies. Family History Mr. MS is the 3rd of 9 siblings. His father had hypertension and passed away a long time ago due to unknown causes. His mother and other siblings are healthy. None of them have hypertension, diabetes, ischemic heart disease or malignancy. Social History He lives in a kampung in Rengit with his wife and 5 children. Mr. MS does not smoke nor consume alcohol. He works in a palm oil plantation. The distance from his house to Hospital Batu Pahat is about half an hour. On further enquiry, Mr. MS says that the cost of the CABG is about RM1000, which he can afford. 3) FINDINGS ON CLINICAL EXAMINATION (Mr. MS was examined by me 9 hours after onset of chest pain) Mr. MS was alert, conscious, and communicative. He was not in obvious pain or respiratory distress. He was lying down comfortably on his bed. There were no tendon xanthomata, xanthelasma, pallor, corneal arcus or pedal edema. His JVP was not raised. His clinical parameters are: Blood Pressure : 158/94 mmHg Heart Rate : 94 beats per minute. Regular rhythm Respiratory Rate : 20 breaths per minute Temperature : 37Â °C SpO2 : 97% under room air On examination of the precordium, the apex beat was located at the 5th intercostal space on the midclavicular line and was normal in character. Parasternal heave was not felt and there were no thrills. First and second heart sounds were heard. There were no murmurs or added heart sounds. On examination of the chest, there was no deformity and chest expansion was equal on both sides. Percussion and tactile vocal fremitus was normal and equal on both sides. On auscultation, vesicular breath sounds were heard throughout all lung fields with good air entry. There was no wheezing or crepitations heard. On examination of the abdomen, it was soft and non-tender. There were no masses felt. Bowel sounds were heard and normal. 4) PROVISIONAL AND DIFFERENTIAL DIAGNOSES WITH REASONING Provisional Diagnosis Acute myocardial infarction with underlying triple vessel ischemic heart disease and hypertension With a history of diagnosed triple vessel ischemic heart disease with multiple episodes of angina attacks since the initial diagnosis, it is highly likely that Mr. MS is presenting with an acute coronary event and this should be a priority until proven otherwise. This is evidenced by the presentation of central, crushing chest pain of sudden onset that radiated to the neck and associated with profuse sweating and body weakness which is classical of a myocardial infarction. Mr. MS will require immediate investigations such as an electrocardiogram and cardiac enzymes to differentiate the acute coronary syndromes so that the appropriate management may be instituted for him e.g. if he has an ST-segment elevation myocardial infarction (STEMI), he will require myocardium-saving thrombolytic therapy to disrupt the ischemic event. As Mr. MS did not present with features such as acute shortness of breath, loss of consciousness and severe palpitations, it seems that he does not have complicati ons of acute myocardial infarction but these developments should be watched out for throughout his admission as complications may arise later. Differential Diagnosis Pulmonary embolism Pulmonary embolism is a possibility that can be considered when a patient presents with an acute chest pain that is accompanied by shortness of breath, hemoptysis, tachypnea, fever and even cyanosis and collapse in severe cases. Furthermore, the chest pain is of a pleuritic nature, of which it is worsened on breathing, and a pleural rub can be heard on auscultation of the chest. However, Mr. MS did not present in such a way. At the same time, Mr. MS did not have risk factors such as a deep vein thrombosis, prolonged immobilization or recent surgery. It is still highly likely that Mr. MS has suffered an acute myocardial infarction, and an ECG would help to differentiate between the two as pulmonary embolism might show the classic S1Q3T3 pattern of right axis deviation or right bundle branch block. Either way, the diagnosis should be made quickly so treatment may be instituted before his condition becomes worse or complications develop. Aortic dissection Aortic dissection presents as an acute onset chest pain that is tearing in nature, and often radiates to the back. It is often confused with myocardial infarction due to its presentation but differences include the lack of profuse sweating, signs of heart pump dysfunction and a normal ECG. Risk factors are usually uncontrolled hypertension, connective tissue disorders or chest trauma. Mr. MS has hypertension, but is under control, and does not have the other risk factors. A diagnosis of myocardial infarction should be the priority as thrombolytic therapy is vital, but if there is any reason to doubt that diagnosis, then further investigations should be performed. 5) IDENTIFY AND PRIORITISE THE PROBLEMS 1. Acute chest pain Mr. MS has acute chest pain with features very suggestive of a classical picture of myocardial infarction as he presents with crushing central chest pain that radiates to the neck and associated with profuse sweating and weakness. Given that he is known to have triple vessel ischemic heart disease and that he has suffered many angina attacks since his initial diagnosis, it is highly likely that he is having an acute myocardial infarction. Without further a due, he needs an electrocardiogram (ECG) and cardiac enzymes tested to distinguish between the different acute coronary syndromes so that the appropriate treatment protocols may be initiated for him as soon as possible to disrupt the ongoing ischemia. As Mr. MS is having severe chest pain that may overstimulate his sympathetic system and cause further ischemia, he will require immediate supportive therapy such as effective pain medication and oxygen therapy. 2. Triple vessel ischemic heart disease awaiting CABG Mr. MS was diagnosed with triple vessel ischemic heart disease when he first presented with chest pain in March 2010 and has since experienced many episodes of angina. Given his diagnosis and disease pattern, he is at a very high risk of developing a severe acute coronary event that may prove fatal if the infarction is too extensive or if complications develop. As percutaneous revascularization with a stent or balloon was not possible for him, he will require a CABG to both relieve his symptoms and reduce his mortality risks in the long term. He was unsure of going ahead with the operation previously, therefore no appointment date was given for surgery. However, now that he has changed his mind, every effort should be made by both the doctors in charge of him here in Hospital Batu Pahat and in the cardiology unit of Hospital Sultanah Aminah to arrange for his surgery as soon as possible, given the circumstances of his condition. 3. Compliance to medication Mr. MS is on several medications for his triple vessel ischemic heart disease and will require revascularization surgery soon in order to decrease his mortality risks. However, waiting for a CABG in the government setting may take some time, even under dire circumstances due to the nature of the system. Therefore, it is extremely crucial that Mr. MS is compliant to his medication regime while awaiting a CABG to prevent another episode of infarction. He should be counseled to fully understand this and the situation of his ischemic heart disease. It is also the responsibility of his doctors to ensure that he is taking the right combination of medications with the aim to prevent another acute cardiac event. Meanwhile, a sufficient supply of sublingual GTN should be provided for Mr. MS in cases of angina attacks at home. He should come to the hospital immediately if GTN fails to relieve his symptoms. 4. Regular screening for comorbid diseases Mr. MS has not been diagnosed with diabetes or hyperlipidemia previously but these diseases are strong risk factors for the long term implications of his ischemic heart disease. Therefore, Mr. MS should be screened regularly e.g. twice yearly during his follow-up appointments. Early detection of diabetes is necessary so that treatment can start as soon as detected in order to prevent his ischemic heart disease from becoming worst than it already is. As for his lipid control, if his lipid profile is found to be outside the normal limits, the dosage of his medication can be increased as necessary. Following his CABG, he will need to maintain a healthy lifestyle of a good, well-balanced, low-salt and low-fat diet and regular exercise within his limits. 6) PLAN OF INVESTIGATION, JUSTIFICATIONS FOR THE SELECTION OF TESTS OR PROCEDURES, AND INTERPRETATION OF RESULTS 1. Electrocardiogram (ECG) To look for any changes that may indicate an ongoing ischemic event, such as ST elevation or depression and T wave inversion in order to support the diagnosis of an acute myocardial infarction so appropriate treatment can be started. Differentiation of ST segment elevation or depression is also crucial in initiating treatment as thrombolytic therapy is only indicated for ST-elevation myocardial infarction. Results: ECG on admission (2 hours after onset) shows sinus rhythm with ST depression at leads I, aVL, V3 V6 with left axis deviation. T wave was present and normal. Interpretation: The ST depression in the leads above indicate an ischemic event at the anterolateral sections of the heart. The lack of ST elevation concludes a diagnosis of either unstable angina or NSTEMI, depending on the levels of cardiac enzymes. There is no sign of old infarction. 2. Cardiac Enzymes To look for elevated levels of cardiac enzymes such as troponin T, creatinine kinase (CK), lactate dehydrogenase (LDH) and aspartate transaminase (AST) that will indicate myocardium ischemia and necrosis. If elevated, a diagnosis of NSTEMI can be made in accordance with the ECG changes. However, cardiac enzymes when done too early after onset may not show any rise in levels 1. This does not mean that necrosis has not taken place and the test should be repeated once more at 6 hours after onset 1. Results: Troponin T (4 hours after onset) 2.75ng/ml ↑ (12 hours after onset) (60 hours after onset) Normal Range (U/L) CK 997 ↑ 263 ↑

J.M. Coetzee’s Disgrace: Post-Apartheid South Africa Essay -- South Afr

Through the perspective of an unconventional college professor, J.M. Coetzee’s Disgrace addresses the transition into post-apartheid South Africa, societal acceptance and rape through David Lurie and Lucy Lurie’s complex father-daughter relationship. While living in his daughter’s countryside home, David Lurie’s experiences reveal that despite the powerful political reform, crime continues to dominate the African people. Aspects of South African history are used to emphasize racial tension and the shift from a white to a black dominated South Africa. Coetzee also suggests the instability of the African society through constantly depicting his characters as emotionally unable to adapt to adverse situations. Although David and Lucy were initially introduced as polar opposites, their value of privacy and refusal to endure public humiliation and shame draw a parallel between the predator and prey of the novel. David Lurie ultimately evolves from his sexual en counters with Soraya, Melanie and Bev Shaw by realizing the traumatizing implications of his actions after the Lucy’s rape. J.M. Coetzee, a white South African writer, was strongly influenced by his personal experiences while he witnessed the social barriers during the apartheid. As the novel begins, Coetzee describes the sexual relationship between the protagonist David Lurie and Soraya, a prostitute that David routinely indulged in every Thursday. â€Å"For a man of his age, fifty- two, divorced, he has, to his mind, solved the problem of sex rather well† (Coetzee 1). In his mind, however, he did not put into perspective the thoughts of Soraya. He satisfied his desires at the expense of another’s emotional wellbeing. Despite Soraya’s acceptance of prostitution, her reaction towar... ...Originally, David uses his status as a white male in South Africa as his leverage and source of power, however, this tactic quickly fails and causes him to seek a new lifestyle. Lucy’s farm life introduces David not only to natural beauties but the strength people have to provide the services that they do such as managing a last resort animal aid center. By the end of his experiences, he learns that he does not belong in the environment that he used to surround himself with in the city, but that he enjoys himself when he has the company of animals and his daughter. His shift in standards of living and customs demonstrates the racial impacts of the apartheid. The connection between Lucy’s disgrace as the victim and David’s shame as the rapist demonstrates hardships both flaws. Each aspect of these flaws represents the difficulties of the apartheid in South Africa.

A Famous Personality Who Has a Great Influence on Me

In the world, most of people need to change themselves. It might be they meet somebody who inspires them to do something that never done before and I am one of those people. I love volleyball so much since I watched SAORI KIMUEA on a TV. She is a Japanese volleyball player and very famous because of her beauty, talent, and skills of competition which are reasons for me want to be like her. The previously, I met her. I disliked exercising very much I had never thought that sports were very exciting. I wasn't interested in any sports.I was very an inert person and didn't prepare to study, do activities with friends, or the challenging things until I had seen the fierce volleyball game that SAORI KIMURA played, I felt enjoyable and wanted to play, the same time I really admired her smile, beauty, and sweet moving which are the important things for me or can say another way that I want to change myself form an inert person into an enthusiastic person. Initially, I just only watched I did n't know the rules of volleyball and how to play it.I didn't have courage I was afraid of the mistakes, but I want to be the best volleyball player, so I decided to play for my dream. I tried to play, but my first time wasn't easy I began to use my arms to hit the ball, suddenly the ball was backward. In fact, it should be forward, at that time my friends laughed very loud. It was so embarrassing, but I had never surrendered, I tried again I practiced harder and harder. Finally, I can play volleyball better than before, and last year, I became to be a volleyball player of my school team I was very glad.The volleyball taught me many things such as what is the teamwork? Don't be afraid and technical of doing new things because everything has to practice the same as playing volleyball. For those reasons, I don't have to worry about mistakes when I do the challenging things. I have to thank Miss SAORI KIMURA who is my inspiration she makes me know the endeavor and have more daring espec ially, I can play the volleyball like her even thought I haven't been good enough yet, but I promise that one day I will be the famous volleyball player like SAORI KIMURA.

Mile and Time Downwind Distance

1. A plane travels from Orlando to Denver and back again. On the five-hour trip from Orlando to Denver, the plane has a tailwind of 40 miles per hour. On the return trip from Denver to Orlando, the plane faces a headwind of 40 miles per hour. This trip takes six hours. What is the speed of the airplane in still air? X = speed of plane in still air (x+40) = speed of plane downwind (x-40) =speed of plane against the wind distance = speed *travel time downwind distance = headwind distance 5(x+40) = 6(x-40) 5x+200=6x-240 6x-5x=240+200 x=440 mphSo, The speed of the plane in still air is 440 mph if I am not mistaken. 2. Two bicycles depart from Miami Beach going in opposite directions. The first bicycle is traveling at 10 miles per hour. The second bicycle travels at 5 miles per hour. How long does it take until the bikes are 45 miles apart? D=RT 45=(10+5)T 45=15T T=445/15 T=3 hours. 3. Jesse rents a moving van for $75 and must pay $2 per mile. The following week, Alex rents the same van, is charged $80 for the rental and $1. 50 per mile. If they each paid the same amount and drove the same number of miles, how far did they each travel? 5+2m=80+1. 5m subtract 75 from both sides subtract 1. 5m from both sides .5m=5 multiply both sides by 2 m=10 miles . 4. During a 4th of July weekend, 32 vehicles became trapped on the Sunshine Skyway Bridge while it was being repaved. A recent city ordinance decreed that only cars with 4 wheels and trucks with six wheels could be on the bridge at any given time. If there were 148 tires that needed to be replaced to due to damage, how many cars and trucks were involved in the incident? Okay. There were 32 cars , we have x + y = 32 ars have 4 wheels so 4x , trucks have 6 wheels so 6x the total number of wheels adds up to 148, so 4x +6y = 14: x+y=32 4x + 6y = 148 -4x – 4y = -128 4x + 6y = 148. 5. For this question, you will need a parent/guardian or a friend. Have this individual grab a handful of coins making sure there are only two types of coins in the group (i. e. , nickels and dimes, quarters and pennies, pennies and dimes, etc). Your parent/guardian or friend should tell you the type of coins they’ve chosen, how many coins they have and the dollar amount of the group.From this information, you will set up two sets of equations and determine how many of each coin they have in their hand. Please send your instructor the name of the individual who helped you with this question, your two equations and the work you did to solve the system. She has 11 coins worth 83 cents. P and Q will the number of pennies and quarters, P + Q = 11 P + 25Q = 83 P + 25Q – P + Q = 24 Q = 83 – 11 = 72. So, 24 Q = 72 Q = 3. Q = 3 can be put into the equation to solve for P. If we use the first equation, we get P + 3 = 11 P = 8, so three quarters and eight pennies.