Chilhood memories of Frankie Lennon and mine

Readingâ  Frankie Lennonâ feels like you become some portion of the story, you feel associated and included at each scene that unfurls. The characters she presents makes it increasingly striking and genuine, you can’t help yet think about your own family and family members that have been part ofâ your past and molded your own current life. You start to glance back at your own youth and pre-adult years and review the numerous battles you experienced to turn into the individual you are presently. It makes us recollect and wonder how we got over the contentions and confusions and had the option to defy them. Perusers interface with the tales because of likenesses in culture, race, sexuality, and childhood.The creator said in a meeting, and to cite her:â€Å"†¦I describe stories beginning with my youth and take you with me on my fierce life excursion and battle to discover opportunity from the numerous jails that dilemma me.I recount stories that make you think and r econsider issues. I offer the peruser the opportunity to see and experience my exposed emotions, clashes, fears, and battles and you find the opportunity to encounter my hardships alongside me. It will be energizing, amusing, and unfortunate. Also, it will never be dull.†Ã¢â‚¬Å"The  Mee  Street Chronicles: Straight up Stories of a Black Woman’s Life is a turn pager story of gruff recollections in her battle to carry on with her own life and sexual personality. The book goes through ages managing touchy issues like bigotry, abuse, homosexuality, and  â alcoholismâ that  still  exists in our general public today. It lets us enter to places never observed yet will make us mindful of our own emotions, in what we love and dread of, of our wants and what we esteem throughout everyday life. The book reflects that presents to perusers what has occurred and as yet occurring in our lives.  Many individuals distinguish and unknowingly reflect with in any event one s tory in the book. In an extraordinary manner, it astonished and contacted perusers on their very own journey.Like the creator, we likewise save our recollections through diaries, journals, photos, and keep it in our souls. We become glad for these recollections since it is the thing that our character is about. We give them to our kids to disclose to them what our identity is to uncover privileged insights liberating us from refusal. This book advises us that we are not the only one in our battles. We may think we are abnormal and has a dim past, yet who doesn’t? It motivates to proceed onward regardless of how awful it appeared or what individuals have done or said or how terrible it showed up. Others out there alsoâ experienced similar challenges and endure. Other people who rehash similar missteps exactly when they have lifted themselves up, and picking themselves back fit as a fiddle and has at last discovered their way.In it, stories on youth life were delineated like it was your own. Huge characters were depicted as though they were your own family. It is astounding to relate in light of the fact that you have your own auntie , grandma, uncle, and cousins who can be aggravating and terrible when they are around you, then again you genuinely worship. Individuals who in one manner or anotherâ have contributed in molding your life as a whole.One part in the book entitled â€Å"Adversaries† portrays a few sections on the youth occasions in the author’s life. At a youthful age she could in any case recall away from and records of relatives and different feelings in confronting her aunt and the strained experiences that win between them. You feel a smidgen at the edge of your seat as words and feelings are uncovered that makes you be on edge and understand the girl..Somehow, after perusing this specific story, I had the option to identify with the characters and conditions that the creator experienced.  Similar occasions and indiv iduals I grew up with. I recollect these individuals and what they connote had an effect in my life, may  it  be  â good or terrible recollections. Perusing it brings back recollections of children being rebuffed for reasons not clarified unmistakably would now and again make you think since it was silly. People in those days were not even mindful that we kids should be dealt with decently now and again. They simply come lashing out of the blue and give you beating for all the world to see. I had my own essence of that ‘cruelty’ in those days.  I  experienced  some old school discipline where I can get so embarrassed about myself for something I have fouled up, in light of the fact that the ‘crime’ is against the elder’s rules. Characters like â€Å"Auntie† were likewise part of my supposed advantaged youth. My mother’s sister would here and there go on an excursion in our home and would remain for quite a while I think f or a considerable length of time and my life hopeless. I recollect her as the woman who watches out for me, unnerving here and there in light of the fact that she would observe each move I make. She was so harsh and edgy and she is so specific about being proper.She made a lot of effect in the entire family unit with her ceaseless squabbling, contrasting her existence with my mother’s. What’s more awful is we need to endure with her and leaves us no decision, yet  be under her standard when my folks are away for a couple of days. I gave a valiant effort to satisfy her and cause her to feel that I loved her however I was faking it. I imagined hard to be another person only for her to acknowledge me and have an agreeable relationship inside and out. She is presently a ‘stigma’ among us cousins and her fantastic children on the grounds that ofâ the character she played in our lives.The creator in the story needed to experience that sort of misery.â The feelings she felt in certain occurrences and the manner in which she portrays ‘Auntie’ in detail like her appearance, responses, and disposition made me recall and helps me to remember my own auntie. Iâ was contacted such a great amount by the occurrence that her auntie would revile her dad. I can't overlook the manner in which my auntie would double-cross my mom and affront her before us and for others to hear. She looks at her life and her way ofâ bringing up her children to that of my folks. She brags of a superior life and material things contrasted with my mom who needs to work more enthusiastically for a superior life.My auntie and I didn't go on and on. I attempted as well as could be expected to maintain a strategic distance from her, not to be in a similar stay with her  and even look at her without flinching. I didn't know whether it is on the grounds that I was terrified of her or loathed her. She, similar to Aunt appeared to be so amazing to make us sc ared of her.  Picturing Aunt in my brain while perusing causes me to feel terrified just by reviewing how my own auntie was.However, in contrast to the creator, I was rarely angry. I never talked or retaliated. Frankie had the mental fortitude to prevent Aunt from hitting her. I had a lot of hard spankings civility ofâ of my auntie, however in certain occasions from my own folks. In any case, I simply accept it as a major aspect of growing up and that is the manner by which I ought to be taught. Now and then I would consider, lamenting that I didn't address or keep it from coming or could have ran away.If just I had the decision and wishes work out, I could have invested more energy with my mom and have gone through all the more adoring minutes with her. I could have comprehended it better if the she did the punishing herself.REFERENCE :Sundararaj, A. ( 2007, March 14). Step by step instructions to Tell a Story, A Beginner’sGuide to Storytelling. Meeting with Frankie Lenn on. RetrievedMay 23, 2007, fromâ www.howtotellagreatstory.com/byot/byot70.html †60k- Chilhood recollections of frankie lennon and mine Readingâ  Frankie Lennonâ feels like you become some portion of the story, you feel associated and included at each scene that unfurls. The characters she presents makes it increasingly clear and genuine, you can’t help however think about your own family and family members that have been part ofâ your past and formed your own current life. You start to glance back at your own youth and immature years and review the numerous battles you experienced to turn into the individual you are currently. It makes us recollect and wonder how we got over the contentions and complexities and had the option to go up against them. Perusers interface with the accounts because of likenesses in culture, race, sexuality, and childhood.The creator said in a meeting, and to cite her: â€Å"†¦I describe stories beginning with my youth and take you with me on my tempestuous life excursion and battle to discover opportunity from the numerous penitentiaries that dilemma me. I recount stories that make you think and reexamine issues. I offer the peruser the opportunity to see and experience my stripped emotions, clashes, fears, and battles and you find the opportunity to encounter my hardships alongside me. It will be energizing, entertaining, and lamentable. What's more, it will never be dull.†Ã¢â‚¬Å"The  Mee  Street Chronicles: Straight up Stories of a Black Woman’s Life is a turn pager account of gruff recollections in her battle to carry on with her own life and sexual character. The book goes through ages managing touchy issues like prejudice, mistreatment, homosexuality, and  â alcoholismâ that  still  exists in our general public today. It lets us enter to places never observed yet will make us mindful of our own emotions, in what we love and dread of, of our wants and what we esteem throughout everyday life. The book reflects that presents to perusers what has occurred and as yet occurring in our lives.  Many individuals recog nize and unknowingly reflect with at any rate one story in the book. In an extraordinary manner, it shocked and contacted perusers on their very own journey.Like the creator, we likewise safeguard our recollections through diaries, journals, photos, and keep it in our souls. We become pleased with these recollections since it is the thing that our character is about. We give them to our kids to disclose to them what our identity is to uncover privileged insights liberating us from forswearing. This book advises us that we are not the only one in our battles. We may think we are unusual and has a dull past, yet who doesn

Coyote Blue Chapter 14~15

Part 14 Falsehoods Have Lives of Their Own It took only a month and a half for Samson Hunts Alone, the Crow Indian, to become Samuel Hunter, the shape-shifter. The change started with the cowhand on the transport confusing Samson with a Mexican. At the point when Samson left the transport in Elko, Nevada, and got a ride with a bigot trucker, he got white just because. He expected, from tuning in to Pokey every one of those years, that after turning white he would promptly have the desire to go out and discover a few Indians and take their property, yet the inclination didn't come, so he sat by gesturing as the trucker talked. When he got out at Sacramento, California, Samson had remembered the trucker's reiteration of racial oppression and was simply getting into the beat of prejudice when he got a ride with a dark trucker who took amphetamines and waxed beautiful about mistreatment, shamefulness, and the fierce oust of the U.S. government by either the Black Panthers, the Teamsters, or the Temptations. Samson didn't know whi ch. Samson was booted out of the truck in Santa Barbara when he proposed that maybe slaughtering all the whites ought to be postponed at any rate until they told where they had concealed all the cash. As a matter of fact, Samson was to some degree soothed to be put out; he'd just been white for a couple of hours and didn't know that he enjoyed it alright amazing it. His prompt concern was to get something to drink. He purchased a Coke at a close by accommodation store and strolled over the road to a recreation center, where, under the branches of a huge fig tree, in the midst of twelve resting bums, he plunked down to think about his best course of action. Samson was simply gathering up a stout instance of sadness when a close by heap of clothes addressed him. â€Å"Any liquor in that cup?† Samson needed to gaze at the oval cloth heap for a couple of moments before he saw there was a furry face toward one side. A solitary red eye, shining with trust, the main break in the dim dinge, parted with the face. â€Å"No, just Coke,† Samson said. Expectation darkened and the eye became as vacant as the attachment close to it. â€Å"You got any money?† the bum inquired. Samson shook his head. He had just twelve dollars left; he would not like to impart it to the cloth heap. â€Å"You're new here?† Samson gestured. â€Å"You a wet?† â€Å"Excuse me?† Samson said. â€Å"Are you Mexican?† Samson thought for a second, at that point gestured. â€Å"You're lucky,† the bum said. â€Å"You can get work. A person stops close here each morning with a truck †gets folks to accomplish yard work, yet he just takes Mexicans. Says whites are too lazy.† â€Å"Are they?† Samson inquired. He figured that in the wake of mistreating blacks, concealing cash, taking area, breaking settlements, and keeping themselves unadulterated, perhaps the whites were simply worn out. He was happy he was Mexican. â€Å"You talk truly great English for a wet.† â€Å"Where does the person with the truck stop? Has he been by today?† â€Å"I'm not lazy,† the bum said. â€Å"I earned a degree in philosophy.† â€Å"I'll give you a dollar,† Samson said. â€Å"I'm experiencing difficulty looking for some kind of employment in my field.† Samson uncovered a dollar from underneath his pocket and held it out to the bum, who grabbed it and immediately emitted it among his clothes. â€Å"He prevents about a square from here, before the throughout the night diner.† The bum pointed down the road. â€Å"I haven't seen him pass by today, yet I was sleeping.† â€Å"Thanks.† Samson rose and began down the road. The bum shouted toward him, â€Å"Hey, kid, return today. I'll watch your back while you rest on the off chance that you purchase a jug.† Samson waved behind him. He wouldn't be back in the event that he could stay away from it. A traffic light away he joined a gathering of men who were holding up at the corner when an enormous entryway sided truck pulled up, the back effectively half loaded with Mexicans. The man who drove the truck got out and strolled around to where the men were pausing. He was short and earthy colored and wore a straw Stetson, rancher boots, and thick dark mustache over the shrewd smile of a chicken cheat. The men who worked for him called him benefactor, however unexpectedly, the normal term for his calling was Coyote. He examined the gathering of men and settled on his decisions with a gesture and the criminal of his finger. The men picked, all Hispanic, bounced onto the rear of the truck. The Coyote moved toward Samson and snatched him by the upper arm, testing the muscle. He said something in Spanish. Samson froze and addressed him in Crow: â€Å"I'm on the lam, searching for a one-outfitted man that executed my wife.† incredibly, this appeared to fulfill the Coyote. The Coyote had been sneaking expatriates into the nation for a long time, and every now and then he experienced an Indian from the South, Guatemala or Honduras, who couldn't communicate in Spanish. Not having the option to reveal to one Indian language from another, he accepted that Samson was one of these. All the better, he figured, it will take more time for him to discover. After the Coyote brought his men over the fringe, he gave them a spot to live (two condos in which they rested ten to a room), food (beans, tortillas, and rice), and three dollars 60 minutes (for backbreaking work that most gringos could never consider doing). He charged his clients eight dollars for every man-hour and took the distinction. Toward the finish of every week he paid his men in real money, in the wake of deducting a sound sum for food and housing, at that point drove them all to the mail station, where he helped them purchase cash requests to send home to their families, leaving them nothing for themselves. Along these lines the Coyote could hold a group powerless to resist him for three or four months before they discovered that they could get more cash-flow working at modest occupations in eateries or inns. At that point he would need to return to Mexico for another heap. Recently, be that as it may, he had been expanding his team with Mexicans who had discovered their own particular manner over the fringe, and this permitted him to extend his time between outskirt runs. The work was the hardest Samson had ever done, and toward the finish of the principal day, back tied and hands bloodied from swinging a pickax, he rested in the rear of the truck until the benefactor slapped him alert and drove him into the condo to give him his bunk. Dozing in a live with nine others was the same old thing to Samson, and the food, albeit zesty, was ample and acceptable. He nodded off tuning in to the tragic Spanish love tunes of his colleagues and feeling especially alone. As the weeks passed he would hear different men in the room murmuring in obscurity and this caused him to feel, much more, that he was the main individual in a universe of one. He had no chance to get of realizing that they were discussing him, about how they never observed him send any cash home, and about how they could take his cash and nobody would know since he was an imbecilic Indian and couldn't communicate in Spanish. Samson tuned in and envisioned that they were discussing their homes and missing their families. He knew nothing of the Latin nature of machismo, which implicitly prohibited the confirmation of a man's despairing aside from in tune. The arrangement was to hold up until the kid was cleaning up, at that point experience his jeans and take the cash. In the event that he dissented, they would cut his throat and cover him on the enormous domain where they were terracing slopes into formal nurseries. Regardless of whether they would have truly executed the kid was dubious; they were acceptable men on the most fundamental level and had just turned their brains to kill since it caused them to feel common and extreme. At the point when the kid was gone their nighttime murmurs turned around to brags of the ladies they would have, the vehicles they would purchase, and the land they would claim when they came back to Mexico. Samson was saved money on a blistering evening when the proprietor of the bequest moved toward the Coyote while the group was taking a break, eating cold burritos in the shade of an eucalyptus tree. â€Å"Immigration took one of the table attendants in my restaurant,† the rich man said. â€Å"Do any of your folks communicate in English? I'll pay you to let him go.† The Coyote was shaking his head when Samson shouted out: â€Å"I communicate in English.† The Coyote's chicken-taking smile dropped like a stone. He had felt that he would have the option to clutch the Indian kid for quite a while, and here he had proceeded to learn English in his extra time. The kid was useless at this point. Better to cut the misfortune and see what he could get. To control their interest and hose their desire, the Coyote told the remainder of the team that the rich American had purchased the kid for sexual purposes, and they all smiled intentionally as they watched Samson ride away in the long white Lincoln. Samson saw that it was simpler as Mexican while working in the café. The work, albeit quick paced, was not substantial, and he was given a bed in the storeroom to rest on until he found his very own position. The proprietor was content with talking a pidgin English peppered with Spanish words and Samson addressed him by talking an altered adaptation of Tonto-talk. At this point Samson had additionally gotten a couple of fundamental Spanish expressions (â€Å"Where are the spoons?† â€Å"We need more plates.† â€Å"Your sister screws jackasses in Tijuana†) which helped him warm up to the Mexican dishwashers and cooks. From the second he had shown up in Santa Barbara, a pounding achiness to visit the family started to settle in Samson's heart. At the point when he lay in obscurity storeroom around evening time, holding back to nod off, it would ascend and wash over him like a dark tide, conveying with it a crawling blind predator that snapped at the last smidgens of his expectation. â€Å"Forget what you know,† Pokey had let him know. In view of this he set to do fight with his rising misery. He wouldn't think about his family, his home, or his legacy. Rather he focused on the discussions he caught in the eatery as he cleared tables and poured espresso. Since he was Mexican, and a humble worker, he was undetectable to the wealthy Santa Barb

Do You Have An Original Idea For Death Foretold Essay Topics?

Do You Have An Original Idea For Death Foretold Essay Topics?It's no wonder that so many people are turning to the internet to complete their last works of literary art - there are so many different types of ideas and topics to choose from that one can't help but find a piece that hits the right notes for them. It's no secret that if you have a natural talent for writing, it can make a world of difference when it comes to landing that dream job.For example, a student in school might 'choose' a topic of interest that they wish to explore further in an academic paper, but because of some personal issue, they cannot seem to do so. At this point, what happens is they turn to their friends and other writers for advice on the subject matter of their piece. Most people that have a knack for writing, would not mind reading the things that others are writing about because it makes them feel as though they're contributing something.When you think about it, could you do this? Could you read the works of other writers and pick out the ideas that they are using in order to make their sentences move and other aspects of their writing seem more natural? I bet you could!So, why is it that students or adults struggle to find interesting and innovative death foretold essay topics to write about? Well, most people think that since they're writers and have a natural talent for writing, they'll be able to go and experiment with any idea or subject matter that they wish to, so why not write about this?This simply isn't the case with death foretold essay topics. Most people just need to take a deep breath and calm down and realize that it takes a considerable amount of time to sit and think about a topic and to truly assess the potential value of an idea. With the amount of information that's out there, there'really no reason to jump in without fully evaluating your thoughts and determining if a topic is worth pursuing.The most important consideration to have is that you look for a t opic that you're comfortable with. If you have a natural talent for writing, you should not be limited to a topic that people 'choose' for you. In other words, you don't have to create a whole new essay just to follow someone else's idea or inspiration.Additionally, you must also ensure that the essay topic that you're creating is something that you feel strongly about. You might think that you'd have all the time in the world to sit down and research on a topic, but if you don't have the passion for the topic, you'll never be able to bring anything of worth to the table.Another important tip that a lot of people fail to know is that you must think outside the box when it comes to writing a topic for an essay. It's important to actually consider a topic that is completely unique, but that doesn't get taken on by everyone. Remember that a big part of this is having an original idea, but you must do your best to stay away from common ideas and concepts to avoid being dismissed and get your work published in some prestigious literary magazines.

The Underground Railroad And The American Civil War

In 1619, the first Africans arrived in Jamestown, Virginia setting in motion one of the darkest eras in American history. Slavery would continue throughout the 17th and 18th centuries and eventually divide the nation in the bloody battles of the American Civil War (1861 – 1865). On January 1, 1863, four million slaves were freed when President Abraham Lincoln signed the Emancipation Proclamation. However, the road to freedom for many slaves was long and brutal. Countless African American slaves were tortured and terrorized and many lost their lives. In the early 1800s, a secret network of routes and safe houses was established to help fugitive slaves reach freedom. This system became known as the Underground Railroad and spanned across twenty-nine states. Routes also led to Canada, Mexico, and the Caribbean. Historians believe the origins of the Underground Railroad can be traced back to the Quakers (Penrice). Without the courageous efforts of the dedicated Quaker men and women, the Underground Railroad would not have been successful in leading an estimated 100,000 slaves to freedom (Myths of the Underground Railroad). When British Colonial America was first colonized, a lack of labor to work the land became a dilemma. Indentured servants from Europe were initially used but as the agricultural economy grew, so did the demand for cheap labor. The problem was resolved with the introduction of African slaves. With the completion of the American-built ship,Show MoreRelatedUnderground Railroad Essay Outline1333 Words   |  6 PagesTHE UNDERGROUND RAILROAD 1 The Underground Railroad Raymond Allen Setlock West Catholic High School THE UNDERGROUND RAILROAD 2 Our country’s history had its good times and also its bad times. 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Corporate Finance - 1062 Words

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Otherwise (IRR COC), Project A should be taken. #12 Mr. Cyrus Clops, the president of Giant Enterprises, has to make a choice between two possible investments: The opportunity cost of capital is 9%. Mr. Clops is tempted to take B, which has the higher IRR.†¨ a. Explain to Mr. Clops why this is not the correct procedure.†¨ His decision was based upon the IRR Rule, but comparing their NPVs at the cost of capital, Project A has a higher NPV. Therefore, he should have chosen Project A rather than Project B. b. Show him how to adapt the IRR rule to choose the best project. He can salvage the IRR rule by focusing on the IRR on the incremental flows. In this problem, Project B has smaller cash flow than Project A. The incremental flow can address whether it is worth making the additional investment in Project A. c.Show him that this project also has the higher NPV. The IRR on the incremental investment of 10% is in excess of the 9% opportunity cost of capital (IRR COC). 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Analysis Of The Book The Child By Tiger - 1603 Words

In Thomas Wolfes’ story â€Å"The Child by Tiger† Dick Prosser a deeply religious veteran from the South begins working for a white family after serving in the United States Army. Prosser was well liked by the Shepperton family and the boys of the neighborhood, until the day that Dick Prosser’s PTSD was triggered and killed many people of the town. The boys of the town looked up to Dick, they thought that he was able to do everything. He was also considered to be very smart for an African American. Thomas Wolfe uses George L. Dillon’s styles of reading in â€Å"The Child by Tiger†. Wolfe uses two out of three of George L. Dillons styles of reading, one of the styles is the Anthropologist style. In Thomas Wolfe’s story Anthropologist style is a way of looking at the social norms and values of the story. Dillons Anthropologist style of reading is represented in Wolfe s story by showing the effects of PTSD and the way African Americans were v iewed and treated. Wolfe uses another one of George L. Dillon s styles of reading. Digger for Secrets is also used in â€Å"The Child by Tiger.† Digger for Secrets style is how the readers go beneath the surface of the story to uncover things that are not directly stated. George L. Dillons Digger for Secrets style can be uncovered in the way Thomas Wolfe describes Dick Prosser s physical appearance and how deeply religious Prosser was for someone who served in the army. One major use of the Anthropologist style is Thomas Wolfe showing whatShow MoreRelatedKaren Chua s Battle Hymn Of The Tiger Mom880 Words   |  4 PagesEvery parent wants the best for their child. There are different styles of parenting around the world that are used to ensure that their children do succeed. 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Tiger parenting is aRead More The Tiger and The Lamb Essay1223 Words   |  5 PagesThe Tiger and The Lamb The Tiger and The Lamb were both poems by William Blake. In this essay I am going to compare the two poems. Blake, as a child, was an outcast and didnt have many friends. He was educated at home by his parents and found sociability difficult. His family believed very strongly in God but did not agree with the teachings of the church. During his lonely hours, Blake often read the Bible. He had a lot of free time to think about ideas, reflect on life and to strengthen hisRead MoreLife of Pi Analysis with How to Read Literature Like a Professor1656 Words   |  7 PagesLife of Pi Analysis With How to Read Literature Like a Professor 1. Chapter 12: Is That a Symbol? A. Example one In the early stages of Life of Pi, Martel mentions a place that Pi and Ravi had gone to visit while on vacation. While looking aimlessly through the window, they noticed three hills. 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Blake’s work†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦8 2 Paired poems-one of the most important characteristic†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦....8 Conclusion†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦..11 References†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦...12 INTRODUCTIONRead MoreEssay about Apocalypse Now1649 Words   |  7 Pageschaos reigned. The return to a more primitive, instinctual life style was also apparent when Willard and Chef, while gathering mangos, are attacked by a tiger, and when Coppula uses the element of surprise to show that the characters have entered the cycle of predator and prey. It is this aspect of the movie that most clearly parallels Conrads book, and the most visible interpretation of the movie. Coppulas movie can also be viewed in a moral context. I viewed this movie as a documentary of a journeyRead MoreBinary Opposition of Life of Pi5401 Words   |  22 PagesPi from various angels. But most kinds of analysis about the novel are focus on existing doubts about the story, and the religious symbols in the novels. The binary opposition narrative in the novel discussed rarely. The novel is full of the binary oppositions narrative, these made the story distinctive. By expounding the existence of the binary oppositions in the novel, to reveal the meaning of the novel conveys. Key words: Binary opposition; Pi; Tiger; Evil; Ego Yann Martel (1963-present) isRead MoreThe Lamb and The Tyger by William Blake Essay1758 Words   |  8 PagesSongs of Innocence and of Experience.† Identified with â€Å"the contrasting and complementary natures of youth and maturity, as stated in Steven Clarks review, â€Å"Songs of Innocence and Experience (Book)† (256), each collection of poems showed a large spectrum that ranged from a trusting nature, such as that of a child, to a more experienced standpoint, such as that of an adult. Despite being considered two separate collections, â€Å"The Songs of Innocence† would commonly have a corresponding companion poem in

Defending Landowners In The Grapes Of Wrath Essay Example For Students

Defending Landowners In The Grapes Of Wrath Essay Grapes of Wrath Explain how the behavior of the Joadsshows Steinbecks view of the responsibility of the individualto society as a whole. Chapter 14 made an interesting point. At one point in the chapter it was stated that a farmer lost hisfarm. As this mans family picks up their belongings andheads west they meet up with another family dealing with asimilar situation. Now these two families share a commonbond. A brotherhood is forming. This is the catalyst. Nolonger is it one farmer saying he lost his land but two farmersunited saying they lost their land. Much the sametransformation happens to the Joad family especially to thecharacters of Ma, Young Tom, and Rose of Sharon. At theonset of the novel we see the Joad family struggling just tokeep their immediate family together. They are focused onjust themselves. By the end of this wonderful book we seethe Joad family branching out in many different ways toembrace all of mankind as one big family. Ma Joads mainconcern at the beginning of the story is her family. She wantsto keep the unit together and works diligently to achieve thisgoal. However, one by one, family members leave the groupfor various reason s leading to the slow but sure disintegrationof the Joad clan. The first to go is Noah; then Grandpa andGrandma die;Connie walks off and leaves Rose of Sharon;Young Tom leaves because he has gotten into trouble again;and Al becomes engaged and decides to go with hisfiancees family. Ma deals with each loss as best she can. Asthe story progresses, we find Ma Joad becoming more andmore concerned with people outside the family unit. Shefeels the need to share whatever meager food andbelongings her family has with other families enduringhardships. She saw the needs of her own family at thebeginning of the story and by the end of the novel, she seesthe needs of her fellow man. Young Tom appears to beself-centered when he if first introduced. He has just leftprison after serving four years for murder. Tom want toenjoy life to the fullest and to be with his family. He is verydisturbed to find the family home deserted and almostdestroyed. He by this time has reacquainted himself with JimCase y, an ex-preacher. The more Tom listens to Jim and hisviews on life, the soul of man, and the fellowship of mankind,the less he focuses on himself and his needs. He then beginsto focus on the plight and abuse of the homeless farmers. Hestarts to realize that in order for the migrant workers tosurvive and succeed they must unite. He knows that if theyband together as one, they can demand that their God-givenrights under the constitution be honored. They can begin togain respect from their fellow man. After Jim is killed, Tomtakes up the cause of his people. He plans to work withthem. Just as Jim taught him, Tom realizes that man is nogood alone and that every mans soul is just a piece of abigger one. Rose of Sharon is totally focused on herself fromthe beginning. She is pregnant for the first time and in lovewith her husband so her little world is complete. Sheconstantly bemoans the fact that she needs nutritious food soher baby will be healthy. She is always concerned that whatshe d oes or what others do to her will hurt her baby in someway. She is so wrapped up in herself and the baby she iscarrying that she does not realize that her family is fallingapart. She whines and moans her way through most of thebook until her baby is born dead. The death of her childseems to transform her. At the very end of the novel shebreast feeds a dying man. To me this is symbolic of drinkingfrom the milk of human kindness. She gives of herself to saveanother human being. She too is learning about thefellowship of man. In conclusion, as the Joad familyseemingly disintegrates, they actually merge in to a larger,more universal family the family of man. Book Reports .u52cf88d65e8ef451a2af873c05139703 , .u52cf88d65e8ef451a2af873c05139703 .postImageUrl , .u52cf88d65e8ef451a2af873c05139703 .centered-text-area { min-height: 80px; position: relative; } .u52cf88d65e8ef451a2af873c05139703 , .u52cf88d65e8ef451a2af873c05139703:hover , .u52cf88d65e8ef451a2af873c05139703:visited , .u52cf88d65e8ef451a2af873c05139703:active { border:0!important; } .u52cf88d65e8ef451a2af873c05139703 .clearfix:after { content: ""; display: table; clear: both; } .u52cf88d65e8ef451a2af873c05139703 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u52cf88d65e8ef451a2af873c05139703:active , .u52cf88d65e8ef451a2af873c05139703:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u52cf88d65e8ef451a2af873c05139703 .centered-text-area { width: 100%; position: relative ; } .u52cf88d65e8ef451a2af873c05139703 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u52cf88d65e8ef451a2af873c05139703 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u52cf88d65e8ef451a2af873c05139703 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u52cf88d65e8ef451a2af873c05139703:hover .ctaButton { background-color: #34495E!important; } .u52cf88d65e8ef451a2af873c05139703 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u52cf88d65e8ef451a2af873c05139703 .u52cf88d65e8ef451a2af873c05139703-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u52cf88d65e8ef451a2af873c05139703:after { content: ""; display: block; clear: both; } READ: 12 Angry Men Essay

Narcotics Investigator Essay Research Paper Narcotics are free essay sample

Narcotics Investigator Essay, Research Paper Narcotics are all compounds that produce insensibility to external stimulations through depression of the cardinal nervous system. Most narcotics today are extracted from opium poppy. Narcotics research workers investigate, and arrest condemnable suspects who are involved with the usage, sale, and distribution of illegal drugs. Their work varies from drug foraies, obtaining information about suspects, groking suspects, and finishing paperwork. Narcotics probes include the usage of clandestine officers and sources to do controlled purchases of narcotics, serve hunt warrants and run drug intercession plans. Millions of dollars are recovered each twelvemonth in narcotics apprehensions. This money is used excessively fund the constabulary section, for wagess, and for drug intercession plans. To go a narcotics research worker a high school sheepskin is the minimum instruction needed? Police Academy preparation is besides necessary, by province jurisprudence. To progress in this line of wo rk, college classs are besides necessary. We will write a custom essay sample on Narcotics Investigator Essay Research Paper Narcotics are or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Some helpful traits are ability to both think and act rapidly, bravery and honestness. Besides the ability to cover with a assortment of people, the ability to work independently or as portion of a squad, dedication, and physical strength. The occupation mentality is steady for the hereafter because of the turning drug jobs in our state. The occupation of boundary line patrol is closely related to narcotics research workers, because they must halt the import and export of narcotics along out state s boundary lines. Work is done chiefly at police central office. Outside central office, research workers go to offense scenes to roll up grounds, stay in autos for surveillance inside informations, and run intoing with people about anyplace. The occupation is really nerve-racking, and it may affect long work hours. Most significantly, the occupation can take to injury or even decease. The salary scope is from $ 20,000 to $ 33,000 per twelvemonth. This is low wage for such a bad occupation, but some people find the occupation exciting. Benefits include insurance, and a pension. Some narcotics research workers may go defeated with the judicial system failures, and deficiency of public support. The emphasis and hazards might impact relationships. Many research workers fell most comfy around other research workers and associates. Besides, they must maintain a clean record, and take part in activities that reflect positively upon the constabulary section. For more information on narcotics research workers , contact the National Sheriff s Association in Virginia, the Career College Association in Washington D.C, or in other lifes, encyclopaedia, or books.

Free Essays on The Influence Of The Witches Over Macbeth

â€Å"†¦All hail Macbeth! Hail to thee, Thane of Cawdor!† (1.3.49-50) This one prophecy, told by the three witches, changed the course of the entire play and ultimately caused a chain reaction of temptation, murder, and fate to control the life of Macbeth. The three witches in Macbeth are introduced at the beginning of the play. They tell Macbeth three prophecies: â€Å"All hail, Macbeth! Hail to thee, Thane of Glamis†¦ All hail, Macbeth! Hail to thee, Thane of Cawdor!†¦All hail, Macbeth, that shalt be king hereafter†(1.3.48-50) Macbeth thinks nothing of the first prophecies until he realizes that the second prophecy has come true. King Duncan has pronounced Macbeth Thane of Cawdor. He says, â€Å"No more that Thane of Cawdor shall deceive/Our bosom interest. Go pronounce his present death/And with his former title greet Macbeth†(1.2.64-66) This one action shows that the witches have the ability to reverse the natural order of things. By doing this, the witches encourage Macbeth to consider his future. In the play, these three witches have the ability to foresee the future and as a result, they can influence Macbeth. However, they only tell him the prophecies and apparitions; none of the witches hold the dagger that kills Duncan or have murderers assigned to kill Banquo and MacDuff’s family. Macbeth is the only one who takes the prophecies to the next level. The idea of free choice over fate is introduced as a result of the actions Macbeth chooses in regards to the witches prophecies. Macbeth realizes that one prophecy has come true, which gives the witches more credibility. As a result, he assumes the third prophecy will also come true. However, King Duncan and his eldest son, Malcolm stand in his way. Macbeth comments, â€Å"The Prince of Cumberland (Malcolm)- that is a step/On which I must fall down or else o’erleap,/For in my way it lies†(1.4.48-50). Macbeth sent a letter to Lady Macbeth explaining ... Free Essays on The Influence Of The Witches Over Macbeth Free Essays on The Influence Of The Witches Over Macbeth â€Å"†¦All hail Macbeth! Hail to thee, Thane of Cawdor!† (1.3.49-50) This one prophecy, told by the three witches, changed the course of the entire play and ultimately caused a chain reaction of temptation, murder, and fate to control the life of Macbeth. The three witches in Macbeth are introduced at the beginning of the play. They tell Macbeth three prophecies: â€Å"All hail, Macbeth! Hail to thee, Thane of Glamis†¦ All hail, Macbeth! Hail to thee, Thane of Cawdor!†¦All hail, Macbeth, that shalt be king hereafter†(1.3.48-50) Macbeth thinks nothing of the first prophecies until he realizes that the second prophecy has come true. King Duncan has pronounced Macbeth Thane of Cawdor. He says, â€Å"No more that Thane of Cawdor shall deceive/Our bosom interest. Go pronounce his present death/And with his former title greet Macbeth†(1.2.64-66) This one action shows that the witches have the ability to reverse the natural order of things. By doing this, the witches encourage Macbeth to consider his future. In the play, these three witches have the ability to foresee the future and as a result, they can influence Macbeth. However, they only tell him the prophecies and apparitions; none of the witches hold the dagger that kills Duncan or have murderers assigned to kill Banquo and MacDuff’s family. Macbeth is the only one who takes the prophecies to the next level. The idea of free choice over fate is introduced as a result of the actions Macbeth chooses in regards to the witches prophecies. Macbeth realizes that one prophecy has come true, which gives the witches more credibility. As a result, he assumes the third prophecy will also come true. However, King Duncan and his eldest son, Malcolm stand in his way. Macbeth comments, â€Å"The Prince of Cumberland (Malcolm)- that is a step/On which I must fall down or else o’erleap,/For in my way it lies†(1.4.48-50). Macbeth sent a letter to Lady Macbeth explaining ...

Macroeconomics Term Paper Example | Topics and Well Written Essays - 2000 words

Macroeconomics - Term Paper Example The housing market like any other market follows the basic supply and demand laws. Demand means the amount of good consumers demand at a certain price. While supple means the amount of goods the suppliers/ produces are willing to supply at a certain price. Generally when there is a price rise, demand falls and where as supply increases when there is higher price (supply and demand, 2008). But incase of the US housing market there was almost abnormal rise in the prices and then a sudden fall ushered in from 2006 onwards. This was preceded by a stable housing price environment in most parts of the 1990s while an increasing trend was witnessed towards the end of the 1990s. Housing prices rose by a whopping 87% during the period January 2002 to June 2006. While the sudden decline started in 2006 and gathered enormous proportions in the years 2007, 2008 and is still continuing. Housing prices were down by roughly 25% in 2008 third financial quarter in comparison to the peak levels of 2006 . During the middle part of the 1990s governmental regulations in relation to lending norms were relaxed drastically and ensuing regulations followed which made it mandatory for housing loan institution like Fannie Mae and Freddie Mac to increase their share of US mortgages belonging to middle as well as low income families by significant levels. During the era 1999 US federal rules also made it sure that these two institutions which hold a major portion of the US mortgages accepted greater amount of loans but with minimal and in many cases, absolutely no down payment. Almost a similar kind of regulation was passed in the year 1995 in context f bank's landings through which they were made to lend heavily to minority sections of the population in the vicinity of the banks in the process prudent lending mechanisms and evaluation of credit worthiness were overlooked. This was the 'Community Reinvestment Act'. Testimony to the afore mentioned fact Fannie Mae and Freddie Mac's overall shar e of mortgages under their holding went up to 45% in the year 2001 from only 25% in the year 1990. This fact is shown in Fig.2. It is also evident from the figure that how these two institution's share of the outstanding mortgages went up continuously throughout the 1990s and also almost through the 2000s. Fig.2. Outstanding Mortgages and Fannie Mae and Freddie Mac's share of them. Source: Gwartney, et al. Interest rate manipulation During the period between 2002 and 2006 the US Fed ushered in an extended low interest rate phase. As a result of the ensuing low rate scenario there was a huge demand for the houses and consecutively the prices also soared in the sector. Fig.3. 1-Year Treasury Bill Rate & Fed Fund Rate Source: Gwartney, et al. Fig.3. shows that how the fed had kept the interest rate for

Jean Racine Essay Example | Topics and Well Written Essays - 2250 words

Jean Racine - Essay Example An interesting case in this point can be round in Racine's preface to Phedre. The seventeenth-century reader would likely have been surprised to find there no mention of pardon, whose parasitic rival version of the same story set off an unusually venomous battle. (Bold, 2001) According to Bold "Racine's own creation is modestly represented, as a carefully charted divergence from the Eurpidean 'Route' to which Racine remains richly indebted, serving 'Phedre' as an exemplary character". "The litotes of this opening, which might be read as a ritual gesture of authorial self-effacement, conceals in fact a far more complex irony in as much as it erases more than we at first think more, that is, than the simple vanity of a purely original creation, an inventio ex nihilo. One is, upon reflection, struck by a number of things in this apparently modest statement. This is certainly one of the very few places where one can find the character of Phedre described, at whatever level, as reasonable. It has also been fairly argued that Euripides's tragedy Hippolytus given the play's title and the stepmother's early guilt-ridden suicide is not really about Phedre anyway. More importantly, as it implies only a difference between the Latin and the French versions, Racine's dismissive reference identifies the Senecan text as the site of corruption and consequently, as an alibi for his own text's purer origins". (Bold, 2001) 'Phedre' the entire play revolves around the concept of 'monster'. To how much the statement is true can be determined from the fact that 'Phedre' represents the corruption and evil enriched in the social attitude of French culture of the then seventeenth century. Racine wanted the society to confront to the social dilemmas so it seems as if he has shown the French society, a mirror so that they might acknowledge their reality in the form of corruption and vulgarity. The main monster according to my perception is the evil that resides deep within a human, now it depends upon the person as to whether he feeds and nourishes that evil so that the evil grows up to become a 'monster' or he remains callous towards the evil, so that eventually he is alleviated. Let us see and examine every central character of 'Phedre' in the light of 'monstrous' appeal. 'Hippolytus' in other monsters Though Hippolytus is unmonstrous as compared to other characters in 'Phedre', but he fails to succeed through the rein of monstrous characters. One reason might be the strength of his inner self and conscience, which escorted him to remain aloof from participating in the devilish works of 'Phedre'. His reason for being morally ethical is the true love of 'Aricia', which lead him towards the light instead of thrusting into the darkness of horror which otherwise would have transformed him into the monster. He is the only character perceived to be 'human' as he knows the morals of relations, and unlike other characters in 'Phedre' he has trained his ego towards goodness and moral values. The reason for other

Wynn Resort Essay Example for Free

Wynn Resort Essay Executive Summary 1.) Purpose To know if what is the overall strategy of Steve Wynn to make Wynn Resorts, Ltd. on the right track and quite a remarkable company. 2.) Statement of the Problem There are three problems which I found out in the case, and these are the three challenges that Wynn will have to face, and the future may throw some curveballs along the way. First is need to secure a way to maintain the competitive advantage as increased competition is introduce both domestically and abroad into the gaming industry. Second, The Macau government reserves the right to take control of the Wynn Casino in 2017; this would be detrimental to the profits for the company, and some solutions will need to be devised to ensure that the survival of the company is not majorly dependent on the revenues generated by Wynn Macau resort and casino. A third concern about future success, but certainly not the final concern, is the loss of Steve Wynn himself. Losing Steve Wynn would mean losing his expertise, passion and governmental ties. In the most likely scenario, a loss of Steve Wynn may result in the sale of the firm to a competing company, such as MGM Inc. 3.) Alternative Courses and Actions Wynn must focus on differentiating the company by concentrating on the atmosphere and design of the resorts. Wynn Rsort must enhance customers service and luxury as full-service provider. 4.) Recommendation Wynn must not only focus to target high-end gaming customers, but he must also offer affordable goods and services to the middle-income clients. This segment includes vacationers and younger people looking for relatively inexpensive place to say with the understanding that most of their budget will go to dining and entertainment. Methods of Analysis 1. SWOT Analysis SWOT ANALYSIS Strengths 1. The greatest operational strength Wynn Resorts, Ltd. has is the founder himself, Steve Wynn. 2. The resort has earned AAA five diamond, Mobil five-star, Forbes five-star, and Michelin five star ratings for hotel, as well as one Michelin star for restaurant Wing Lei, and is considered to be one of the finest hotels in the world. 3. One of Wynn Resorts’ greatest marketing strength is strategic development of its product. The product that Wynn sells is a luxury destination experience that makes customers feel pampered and value through high-quality amenities and customer service. 4. Steve Wynn is widely considered the â€Å"Father of Luxury Gambling†, and he is largely responsible for the image change and societal perspective change of the city of Las Vegas. | Weaknesses 1. The company’s complete dependence of Steve Wynn is a significant weakness. 2. Focusing solely on the high-end market could be a marketing weakness in that Wynn is missing a large customer base of middle-income clients. 3. Wynn Resorts’ biggest disadvantage is its youth. MGM Resorts and Caesars Entertainment are companies with history and territory. They have the majority of premier legal gambling locations such as Atlantic city under their thumb and they will create difficult barriers to entry for Wynn Resorts.| Opportunities 1. As the boomers retire, they are spending more money on leisure and recreation, and they are piling into the casinos, this growing represents an opportunity for the gaming industry and for Wynn Resorts specifically. 2. The development of a casino in Macau is a strategic opportunity. 3. Wynn Macau provides the opportunity for cross-marketing with Wynn Las Vegas, because the target market segment in both Wynn Las Vegas and Wynn Macau is high income, customers have resources to travel and vacation in other parts of the world, which can make cross-marketing very effective.| Threats 1. Social norms in the United States differ from those practiced in Macau and should not be universally applied. 2. The ability of the government to take control of the casino at any time it deems appropriate is a significant threat to the success of Wynn Resorts because it could lose control of its operation in Macau. 3. Another threat exists in the possibility of Wynn Resorts, Ltd. being unable to collect on its gaming debts. 4. The loss of Steve Wynn, himself.| Bibliography 1. http://www.studymode.com/essays/Swot-Analysis-Wynn-Ltd-946073.html 2. http://www.investingvalue.com/investment-leaders/steve-wynn/index.html

Grow Little Cell Grow! Investigating Neurogenesis Essay -- Biology Ess

Grow Little Cell Grow! Investigating Neurogenesis Neurogenesis, the production of new nerve cells, has been a revolutionary finding as nerve formation has always been thought to end with adulthood. It has not been until recently that such dogma has been contradicted as research findings report that neurogenesis continues in the hippocampus throughout most of the adult life of mammals and primates (1). Recent correlations have been further made between neurogenesis and depression as the latter depletes neuron cells in the brain while antidepressive drugs have demonstrated to increase neuronal growth (2). Neurons are the building blocks of the nervous system as they are responsible for the input, processing and transmission of information. Neurons are derived from stem cells as the latter differentiate into specialized cells and make progenitor cells which are responsible for the formation of neuron and glial cells. Although the majority of neurons are formed during the pre-natal and perinatal stage of development, neuron formation continues in the dentate gyrus of the hippocampus (2). The hippocampus, which lies beneath the cortex is a major factor of learning and memory formation and can indirectly influence emotion. Progenitor cells which are present in the sub ventricular zone of the hippocampus are responsible for such growth as they produce daughter neuron cells through division (2). In the 1960s, Joseph Altman from MIT reported that new neurons were being produced in the dentate gyrus of the hippocampus of adult rat brains. Although such findings were groundbreaking, they failed to create the stir that Elizabeth Gould's 1998 study caused . The Princeton University neurobiologist demonstrated that the marmoset b... ...is is a complex issue with an array of possibilities for the future. Further investigations will have to answer some of the questions and issued raised. Sources (1)The Scientist Magazine , Human neurogenesis. Group demonstrates that adult human brains grow new cells after all. http://www.the-scientist.com/ (2)American Scientist Magazine, Depression and the Birth and Death of Brain Cells. http://www.sigmaxi.org/amsci/articles/00articles/Jacobs.html (3)National Depressive and Manic Depressive Association, Antidepressants and Brain Cell Growth. http://ndma.com/web05/web9152.htm (4) Neuroscience for Kids, New Neurons in Neocortex? New Study Says NO! http://faculty.washington.edu/chudler/newneu.html (5)National Institute of Mental Health, Learning From Songbirds About Adult Brain Generation. (6) The Scientist Magazine. http://www.the-scientist.com/

Improving Communication for People with Learning Disabilitie

learning zone CONTINUING PROFESSIONAL DEVELOPMENT Page 58 Improving communication for people with learning disabilities Page 66 Learning disabilities multiple choice questionnaire Page 67 Read Annette Martyn’s practice profile on type 2 diabetes Page 68 Guidelines on how to write a practice profile Improving communication for people with learning disabilities NS336 Godsell M, Scarborough K (2006) Improving communication for people with learning disabilities. Nursing Standard. 20, 30, 58-65. Date of acceptance: February 6 2006. Summary Patients with learning disabilities have higher healthcare risks than the general population. Similar essay: Collate Information About an Individual's Communication and the Support ProvidedHealth professionals need to develop skills that enable them to communicate effectively with this patient group. Identifying barriers to communication is the first step to reducing or removing them. Suggested strategies to improve healthcare access for patients with learning disabilities include: developing individualised health action plans, simplifying communication styles and providing accessible facilities and tailored resources. learning activities you should be able to: Understand the impact of communication on interaction between healthcare providers and patients with learning disabilities.Describe the relationship between communication and the health inequalities experienced by people with learning disabilities. Identify strategies to improve communication between health providers and patients with learning disabilities. Authors Matthew Godsell and Kim Scarborough are senior lecture rs, Faculty of Health and Social Care, University of the West of England, Bristol. Email: Matthew. [email  protected] ac. uk Introduction Learning disability is not a diagnosis but a term used to describe people with a wide range of strengths and needs.Eighty per cent of children and 60 per cent of adults with learning disabilities live with their families (Gravestock and Bouras 1997), and many people with learning disabilities exceed the expectations of families and professionals in their capacity to learn new skills and develop their talents (NHS Executive 1999). The term ‘learning disability’ says little about an individual’s strengths and needs but it does incorporate three elements that appear in most definitions (Box 1). Emerson et al (2001) state that the number of people with learning disabilities in the UK has not been determined.They estimate that in the UK there could be as many as 350,000 people with severe learning disabilities (intelligence quotie nt (IQ) 50). This means that 2 per cent of patients are likely to have a learning disability (NHS Executive 1999). The ways in which people with learning disabilities are described have changed. Terminology and related facts are listed in Box 2. NURSING STANDARD Keywords Communication; Learning disabilities nursing: attitudes These keywords are based on the subject headings from the British Nursing Index. This article has been subject to double-blind review.For related articles and author guidelines visit our online archive at www. nursing-standard. co. uk and search using the keywords. Aims and intended learning outcomes The aim of this article is to explore the impact of communication on health care for people with learning disabilities. The article discusses how cognition and communication influence interactions between healthcare providers and patients. It also examines how poor communication can contribute to health inequalities that separate people with learning disabilities f rom the rest of the population.The article explores communication strategies that can overcome or reduce barriers to effective health care. After reading this article and completing the 58 april 5 :: vol 20 no 30 :: 2006 Time out 1 Based on a figure of 2 per cent of patients having learning disabilities, it is likely that 40 per 2,000 patients registered with GP services are likely to have learning disabilities. How many patients with learning disabilities are you aware of in your practice area? List some of the reasons that might prevent people with learning disabilities from accessing local health services. Health inequalitiesAlthough people with learning disabilities are living longer, the gap that separates the health status of people with learning disabilities and the general population has increased. Cohen (2001) asserted that gross inequalities in health are politically, socially and economically unacceptable. An investigation into health inequalities by the Disability Rights Commission (Nocon 2004) found that people with learning disabilities have: An increased risk of early death compared with the rest of the population; mortality rates are particularly high for those with more severe impairments.A greater variety of healthcare needs. Many needs that are not met. High rates of unrecognised or poorly managed medical conditions including: hypertension, obesity, heart disease, abdominal pain, respiratory disease, cancer, gastrointestinal disorders, diabetes, chronic urinary tract infections, oral disease, musculoskeletal conditions, osteoporosis, thyroid disease, and visual and hearing impairments.A briefing paper produced by the NHS Service Delivery and Organisation (SDO) Research and Development Programme (NHS SDO 2004) identified barriers to appropriate and timely BOX 1 Definition of a learning disability A person with learning disabilities has: Significant reduction in the ability to understand new or complex information. Reduced ability to cope inde pendently. Impairment starting in childhood that will have a lasting effect on development. (DH 2001) access to health care within and outside services.Many people with learning disabilities find that identifying their healthcare needs is a major challenge. Proactive strategies are required to encourage people to access the full range of services that are available. Some people with learning disabilities have said that negative and unhelpful attitudes from healthcare workers have prevented them from seeking medical help (Bristol and District People First 2003). Support and encouragement are required by carers, allies and friends before people with these concerns are ready to engage with services again.People are more likely to trust service providers when they are convinced that services and practitioners have responded to their needs by improving communication skills and producing information in an accessible format. People with learning disabilities have the same right to access m ainstream services as the rest of the population (Department of Health (DH) 2001). However, mainstream services have been slow to develop the capacity and skills to meet their needs.In the document Valuing People (DH 2001) it was acknowledged that the wider NHS had failed to consider the needs of people with learning disabilities and that overcoming this source of inequality was the most important issue for the NHS to address for this patient BOX 2 Terminology and facts related to learning disabilities ‘Mental handicap’ was a term used to describe people with learning disabilities. It is no longer used in the UK. ‘Mental retardation’ is a term used internationally, however, it is not an accepted term in the UK and some may find this term offensive. Learning difficulty’ is the term used in education to define individuals who have specific learning needs, for example, dyslexia. Some people who are identified as having learning difficulty by education s ervices may also be considered to have a learning disability, but this is not necessarily the case. ‘Mild’, ‘moderate’, ‘severe’ and ‘profound’ are terms to describe different degrees of disability (Figure 1). A person with mild learning disabilities might communicate effectively, learn, live and work with little support.However, a person with profound learning disabilities will require support with activities of daily living, for example, communication, dressing, feeding, washing and mobility. A diagnosis of ‘mental illness’ is not the same as having a learning disability, but people with learning disabilities may have mental health issues as well. Not everyone with learning disabilities requires a social worker or a community nurse. People with learning disabilities may have multiple diagnoses resulting in complex health needs. People with the most profound physical or sensory impairments do not always have the most profound cognitive impairments.NURSING STANDARD april 5 :: vol 20 no 30 :: 2006 59 learning zone nursing attitudes group. The briefing paper produced by the NHS SDO (2004) provided key action points for removing barriers and improving access to health care, which included: Using specialist learning disability teams to aid adaptation of mainstream services to meet the needs of patients with learning disabilities. Developing strategies for health education and health checks for people with learning disabilities that promote timely access to health care.Families and paid carers have an important role in helping people with learning disabilities to access health care. Some people will need assistance to recognise mental health problems and to identify gradual changes in health. Time out 2 Make a list of the ways that you communicate with patients about their health, for example, through appointments and telephone calls. Take three examples from your list and consider reasons why communi cation with a person with learning disabilities might be difficult.Give an example of effective communication between a practitioner and a person with learning disabilities. Policies should address the use of technology to support communication, and the development and dissemination of accessible information. Jones (2003) suggests that managers and commissioners of services should liaise with health, social care and education agencies to ensure consistency in communication policies throughout the lives of people with learning disabilities. Communication can be broadly defined as the exchange of information between a sender and a receiver (Figure 2).Where a person has learning disabilities they may be communicating with an intention to attract a communication partner and commence a two-way dialogue. However, for some people with profound learning disabilities sending a message might be a response to their body and feelings. Their level of cognition might be such that they are unaware of possible communication partners and of how to take the communication further. This is called pre-intentional communication, in which the individual says or does things without intending to affect those around them.It is important to remember that everyone communicates and that the role of communicator and communication partner swaps from one person to the other so that a conversation can develop. The challenge for health professionals is to develop skills that enable them to interpret the messages they receive and make the messages they send understandable. Communication is not only about verbal communication; it is also about nonverbal communication, for example, the use of body language, words and pictures. CommunicationRecommendations have been made to improve communication and access to health services for people with learning disabilities. Jones (2003) states that services supporting people from birth to older age should develop communication policies. FIGURE 1 Estimated pe rcentage of people with learning disabilities according to level of severity Mild Moderate 12% Severe Profound 80% 7% 1% Augmentative and alternative communication systems Systems of communication, such as sign language, symbols and eye pointing, are known as augmentative and alternative communication systems (AACs).AACs can be used to enhance or replace customary pathways, such as speech or writing. The use of photographs of everyday objects, picture boards, line drawing and real objects are good ways to enhance communication with people with learning disabilities (American Speech-Language-Hearing Association (ASHA) 2005). You do not need to attend specialist training to be able to use AACs such as these. More formal AACs, such as Makaton (a form of sign language for people who have learning disabilities that uses keywords to enhance understanding), require preparation but learning a basic vocabulary does not require extensive training.Cognition and communication (Winterhalder 1997 ) Understanding complex information People with learning disabilities have a reduced ability to NURSING STANDARD 60 april 5 :: vol 20 no 30 :: 2006 understand new or complex information (DH 2001), and those who experience difficulties when processing information may find it hard to learn new skills. Intelligence can be quantified as a figure related to an individual’s IQ. However, it might be more useful to think about intelligence in relation to cognitive processes.Smith and Mackie (2000) describe cognitive processes as: ‘†¦the way in which our memories, perceptions, thoughts, emotions and motives guide our understanding of the world and our actions. ’ Intelligence exerts a powerful influence over the ability to process information, the capacity to learn new skills and to adapt knowledge to different situations. Intelligence is an attribute that can guide our understanding of the world, but it is not fixed or static. Teaching and learning strategies can be used to stimulate cognitive processes so that people can approach information, or potentially confusing situations, with more confidence.Similarly, complicated tasks and information can be broken down into small, simple steps so that people can approach them in stages. Attempting to understand another person’s cognitive processes can help practitioners to develop a more empathetic and person-centred approach to care, and can provide an incentive to develop the teaching and learning strategies that are best suited to the individual needs of patients. Coping independently People with learning disabilities may have a reduced ability to cope independently (DH 2001). Independence is defined according to levels of social functioning.Assessment of a patient’s strengths and needs in social functioning is a fundamental stage in developing planned care that is familiar to practitioners from all branches of nursing. Making an accurate assessment of social functioning provides val uable information about the range of activities that a person can undertake on his or her own as well as those activities where a person requires support. Some people with learning disabilities may require assistance with tasks such as washing and dressing, and many need help to have their mode of communication understood.Learning disability and development Learning disability starts before adulthood, affects people of all ages and has a lasting effect on development (DH 2001). A majority of younger people with learning disabilities are living in the community with their parents or carers. Older people with learning disabilities also live in the community but they may have periods of institutional care. Some people will have frequent contact with health services and others have irregular contact. People with learning disabilities are not a homogeneous group. Their perceptions of nurses, NURSING STANDARDFIGURE 2 A model for communication Person communicating: we take turns in this ro le of sender of information. Depending on the person’s cognitive ability, this may be intentional or pre-intentional communication Communication barriers: can be present in the environment as well as being caused by the communicator and communication partner Communication partner: we take turns in this role of the person who receives the information sent, makes sense of it and responds appropriately doctors, health centres, clinics and hospitals will have been shaped by their formative experiences with staff and services.Providing encouragement for people with learning disabilities to attend health checks and to make use of healthcare services can involve changing their perceptions of health professionals. Some people with learning disabilities have not received the treatment they need because they are reluctant to engage with services where they have had bad experiences in the past. To encourage people with learning disabilities to make effective use of healthcare services t hroughout their lives, practitioners need to use their communication skills to initiate and maintain positive relationships. Time out 3Think about the last time you communicated with a person with learning disabilities, or someone who has communication difficulties. Refer to the list you made in Time out 2 about the communication systems you use in your workplace. What are the main barriers to communicating about health with a person who has learning disabilities? How do you remove or reduce barriers to communication? Which environmental factors impede communication? Identify any barriers that you had not previously considered. april 5 :: vol 20 no 30 :: 2006 61 learning zone nursing attitudes Barriers to communicationThere are barriers to communication which can be identified in relation to the person with learning disabilities, the health professional and the environment (Box 3). When barriers have been identified, health professionals can start to think about ways of reducing or removing them. Health professionals exchange information by using terminology that reflects their specialised knowledge. Patients and other people who are not involved in the day-to-day delivery of health care BOX 3 Barriers to communication The person with learning disabilities may: Have limited understanding.Have limited vocabulary or difficulty speaking. Have sensory impairments that limit ability to hear requests or instructions. Have poor understanding of health and healthy living. Be scared of people in uniforms. Be stressed because of illness. Not like new places. Have difficulty waiting and may not understand the concept of time or queuing. Have limited literacy and numeracy skills to read health advice and information, for example, instructions, letters, dosages. Expect contact with nurses to be unpleasant because of previous experiences. The nurse may: Be rushed because of heavy workload.Have biases and assumptions about people with learning disabilities. Have poor listeni ng and attending skills. Be unable to understand augmentative and alternative communication systems. Have limited knowledge of the individual. Have insufficient time to develop a good relationship with the individual or carer. Not use visual aids to support understanding. Use technical jargon and/or long words. Provide written information without thinking of the patient’s ability to read it. Provide information about the next appointment in a way the patient will not understand or remember.The environment may: Be crowded. Busy. Uncomfortable. Have strange smells and noises. Bring back bad memories. Have limited physical access, for example, no hoists. Include unhelpful people. Have poor signage, relying on literacy skills and good sensory abilities. Have no area to sit quietly with limited sensory stimulation while waiting. Be filled with machines and instruments that a person with learning disabilities may not understand. may find it difficult to comprehend the terms and ide as they encounter in healthcare settings. They can find it hard to follow advice or instructions.This could result in patients making inappropriate decisions or exposing themselves to unnecessary risks. For example, patients with learning disabilities who take their own medication may be at risk of overdosing or taking an ineffectual dose, particularly if the route and dosage of a newly prescribed medicine has not been explained clearly and/or recorded in an accessible format. Time out 4 Consider the list of potential barriers to communication and categorise them according to: Barriers that have been addressed for patients with learning disabilities using the services you work in.Barriers that can be remedied quickly. Barriers that need planning to be reduced or removed. Barriers that require financial investment to be reduced or overcome. Discuss this list with your colleagues. Identify strategies for removing barriers and improving communication. Good practice in communication In South Warwickshire, health passports have been developed for people with learning disabilities (Leamington Spa Today 2005). These provide detailed information about an individual’s health, strengths and needs so that practitioners can provide patient-centred care.They are used to improve communication across a range of healthcare providers. Having an alert system incorporated into patient notes which provides individual communication needs could be beneficial, especially where staff do not know individual patients. Health practitioners may use and be involved in developing health action plans. These are plans specific to individuals and are developed to meet their access needs. Health action plans are a way of overcoming some of the barriers to high quality health care (DH 2001).Plans are produced by a group of people including the patient. They encourage the development of a shared understanding about an individual’s health needs. Where training in health action plann ing has been provided for GP surgeries, improvements have been shown in the health of patients with learning disabilities (Smith et al 2004). There are benefits to having a lead person to deal with learning disability issues. In primary healthcare services, a lead person takes an interest in learning disability issues, collates information, NURSING STANDARD 62 april 5 :: vol 20 no 30 :: 2006 ives support and advice to health staff and develops links with specialist services for people with learning disabilities and other agencies (NHS Executive 1999). Time out 5 Does your organisation have a lead person who is involved in initiatives such as joint communication policies and the development and sharing of accessible health information? If yes, find out how he or she is supporting your team to develop skills in communicating with people who have learning disabilities. If no, how might developing this role benefit your team and improve access to health care for patients with learning d isabilities?To improve communication with people with learning disabilities, more time should be allocated to appointments so that there is more time for them to express themselves and understand any information they have received (DH 1999). This is particularly the case if AACs are being used. Reception staff are often aware of people who have difficulties using services. Supporting these key staff to develop effective communication skills and flexibility can improve access to health services (NHS Executive 1999).For example, if staff in reception are aware that someone finds it difficult to wait in a queue, they may offer that person the first appointment. Several resources have been developed by trusts to improve communication. Some examples of these include: Hambleton and Richmondshire Primary Care Trust (PCT), in partnership with Mencap, has developed an accessible ‘Choose and Book’ guide for hospital appointments that uses a combination of pictures and words to ex plain how patients can make choices about hospitals and appointments.Bristol South West PCT, as part of its ‘Expert Patient Programme’, has developed plans that help prepare people with learning disabilities for a visit to the doctor. The Health Facilitation Team at Gloucestershire Partnership NHS Trust (2004) has produced a ‘traffic light assessment’ that conveys information about individuals on admission to hospital. This ensures that important information is clearly communicated to health professionals. Camden PCT (2005) has used this work to develop an online resource. Although people may appear to have limited communication skills, they should not be ignored.These patients should be addressed directly and NURSING STANDARD the information they receive should be provided in a simple way without being patronising. Effective communication often depends on how the information is delivered. Practitioners may have to talk to carers, but they should not forget to address the person with learning disabilities. Practitioners should examine their beliefs about people with learning disabilities and avoid making assumptions about an individual’s strengths and needs. This will help to make health assessments more accurate (DH 1999).It is useful to invite a speaker with learning disabilities to talk to healthcare staff about living with a learning disability and his or her experiences of accessing health services. Time out 6 What beliefs and values do you think society holds about people with learning disabilities? Some examples of negative beliefs and values are that people with learning disabilities: Have a poor quality of life. Have higher pain thresholds. Are dangerous and promiscuous. Will not understand anything. Should not get married or have children. Cannot care for their children. Need institutional care. Cannot work.Are like children not adults. What are your feelings about these statements? How might the presence of any or al l of these beliefs influence the care given to a person with learning disabilities? People with learning disabilities can have additional physical or sensory impairments that should be considered. They are also more likely to have more mental health needs than the general population (DH 2001). Where a patient has additional impairments or health issues these need to be considered during communication. The healthcare environment should be adapted to accommodate people with physical or sensory impairments.Time out 7 In your work place: Do you have a private area to talk to a person who has a large wheelchair? Do you have rooms where glare is controlled and the environment is suitable for people with limited vision? Do you consider the needs of interpreters/ carers and ensure they fully understand information before they pass it on? april 5 :: vol 20 no 30 :: 2006 63 learning zone nursing attitudes Accessible information Accessible information comes in many forms, such as videos, CDs, DVDs and audiotapes. Pamphlets can be produced with accessible information about the services offered.Written information needs to be in plain language, with short sentences and one subject per sentence. Photographs, drawings, symbols and other visual information can be used to support written information. It is important to keep pages uncluttered on plain backgrounds so that text does not detract from graphics. Letters should be large, 16-18 point type size, and fonts that do not have serifs, such as Arial and Comic Sans, should be used. Graphic text, underlining and italics should be kept to a minimum because they can impede readability. Many trusts are now producing resources to enhance accessibility.Some of these include: The United Bristol Healthcare NHS Trust has produced a leaflet called ‘You are coming to the Bristol Royal Infirmary about your heart’, TABLE 1 Using terminology that is easy to understand Health issue Common words that are used Epilepsy Investigat ions EEG (electroencephalogram) Strategies or words that improve understanding Find out more about This word would have to be used, but a photograph of someone having an EEG may help understanding Medicine tablets to help control your epilepsy Having two or more seizures straight after each other or whatever describes status for the individual Taking your medication as we have agreed Things that might make you have a seizure Not being able to have a poo for three days Things you feel in your head and body that make you think you will have a seizure Having a fit or turn, whichever word the person uses which uses pictures and words to introduce some of the staff and explain what happens when patients are admitted to the cardiology department.The Learning Disability Partnership Board in Surrey has developed ‘The Hospital Communication Book’ that combines words, pictures, signs and symbols. Trafford North and South PCTs have produced a toolkit for people with learning disab ilities called ‘Cancer and You’ (Provan 2004). Contact your local Community Learning Disability Team or People First organisation for information about local resources. Simplifying conversation When talking to people with learning disabilities, use approaches similar to those used for written text. Plain language, the use of keywords, short sentences and one subject per sentence should be used. Give people time to process what is being said and to formulate a reply.Use openended questions to assess a person’s understanding and rephrase the question if necessary, as repeating the same question rarely improves understanding. When information is presented during a consultation it is important to check that the person with learning disabilities has understood it. If there is insufficient time during the initial consultation, it may be necessary to make a further appointment to check what the person has understood and retained. For an individual who processes informat ion slowly this might be essential to ensure an accurate assessment and the effective implementation of a treatment plan. Examples of terms that are easier to understand are presented in Table 1.Such terms are only beneficial if the person understands them so, for example, ‘constipation’ could be described as ‘not being able to have a poo’, but the health practitioner needs to know whether the person uses this term to describe defecation. Anti-epileptic drugs Status epilepticus Drug compliance Triggers Constipation Aura Time out 8 Think of four common illnesses that are likely to make a person visit your service. Write these in the first column of a table (see Table 1). Identify the language you use when discussing these illnesses and record these words or phrases in column two. These might be medical terms, health terms or long words. Now spend some time identifying words that are easier to understand and record them in the third column. NURSING STANDARD S eizure 64 april 5 :: vol 20 no 30 :: 2006 ConclusionPeople with learning disabilities may have communication difficulties that have restricted their access to health care and prevented them from receiving the information required to maintain their health. In addition to learning disability, they are more likely to have complex healthcare needs leading to multiple diagnoses. Steps towards better health for people with learning disabilities can be made by providing encouragement and support to attend regular health screening and reviews, and by developing a range of strategies to improve communication between practitioners and individuals with learning disabilities NS RECOMMENDED RESOURCES British Institute of Learning Disabilities (2001) Factsheet No. 005 Communication. www. bild. org. uk/pdf/factsheets/communication. pdf (Last accessed: March 10 2006. British Institute of Learning Disabilities (2005) Your Good Health (a set of 12 illustrated booklets). www. bild. org. uk/publication s/your_very_good_health_details. htm (Last accessed: March 10 2006. ) Communication Matters (updates 2005) What is AAC? www. communicationmatters. org. uk (Last accessed: March 10 2006. ) Communication Matters (updated 2005) How to be a good listener. www. communicationmatters. org. uk (Last accessed: March 10 2006. ) Department of Health. www. dh. gov. uk (Last accessed: March 10 2006. ) Foundation for People with Learning Disabilities (2004) Communication and people with learning disabilities. www. learningdisabilities. org. uk/page. cfm? agecode=ISSICMMT (Last accessed: March 10 2006. ) Foundation for People with Learning Disabilities (2005) Patients with learning disabilities in South Warwickshire have been given a new type of passport to help with their medical appointments. www. learningdisabilities. org. uk/profilenews. cfm? pagecode=ISSICOLN&are acode=ld_communication_news&id=7231 (Last accessed: March 10 2006. ) MENCAP (2003) You and your health: a basic guide to being heal thy. www. mencap. org. uk/download/you_and_your_health. pdf (Last accessed: March 10 2006. ) Plymouth Hospitals NHS Trust (2005) Living with cancer. www. learningdisabilitycancer. nhs. uk/ (Last accessed: March 10 2006. ) Time out 9Complete a SWOT analysis (strengths, weaknesses, opportunities and threats) of your skills and knowledge when communicating with and supporting access to health care for people with learning disabilities. Time out 10 Now that you have completed this article, you might like to consider writing a practice profile. Guidelines are on page 68. References American Speech-LanguageHearing Association (2005) Introduction to Augmentative and Alternative Communication. www. asha. org/public/ speech/disorders/acc_primer. htm (Last accessed: March 9 2006. ) Bristol and District People First (2003) We are People First. (Film) People First, Bristol. Camden PCT (2005) What You Need to Know About Me in Hospital. www. camden. gov. k/ (Last accessed: March 17 2006. ) Cohen J (2001) Countries’ health performance. The Lancet. 358, 9285, 929. Department of Health (1999) Facing the Facts: Services for People with Learning Disabilities: A Policy Impact Study of Social Care and Health Services. The Stationery Office, London. Department of Health (2001) Valuing People: A New Strategy for Learning Disability for the 21st Century. The Stationery Office, London. Emerson E, Hatton C, Felce D, Murphy G (2001) Learning Disabilities: The Fundamental Facts. Foundation for People with Learning Disabilities, London. Gloucestershire Partnership NHS Trust (2004) Traffic light assessment. Unpublished document.Gloucestershire Partnership NHS Trust, Gloucester. Gravestock S, Bouras N (1997) Emotional disorders. In Holt G, Bouras N (Eds) Mental Health in Learning Disabilities: A Training Pack for Staff Working with People who have a Dual Diagnosis of Mental Health Needs and Learning Disabilities. Second edition. Pavilion Publishing, Brighton, 17-26. Jones J (2003) Th e Communication Gap. www. learningdisabilities. org. uk /page. cfm? pagecode= FBFMCHTP04 (Last accessed: March 10 2006. ) Leamington Spa Today (2005) Patients with learning disabilities in South Warwickshire have been given a new type of passport to help with their medical appointments. Leamington Spa Today. January 19, 2005.NHS Executive (1999) Once a Day One or More People with Learning Disabilities are Likely to be in Contact with Your Primary Healthcare Team. How Can You Help Them? Department of Health, Leeds. NHS Service Delivery and Organisation (SDO) Research and Development Programme (2004) Access to Health Care for People with Learning Disabilities. Briefing paper. NHS SDO, London. Nocon A (2004) Background Evidence for the DRC’s Formal Investigation into Health Inequalities Experienced by People with Learning Disabilities or Mental Health Problems. Disability Rights Commission, Stratford upon Avon. Provan K (2004) Cancer and You: Toolkit for Working with People with Learning Disabilities. www. cancerandyou. info/docs/ FullToolkitNov04. pdf (Last accessed: March 9 2006. Smith ER, Mackie DM (2000) Social Psychology. Second edition. Psychology Press, Hove. Smith C, Giraud-Saunders A, McIntosh B (2004) Healthy Lives: Health Action Planning in a Person Centred Way; Including Health in Person Centred Planning. www. valuingpeople. gov. uk/ HealthHealthyLives. htm (Last accessed March 10 2006. ) Winterhalder R (1997) An overview of learning disabilities. In Holt G, Bouras N (Eds) Mental Health in Learning Disabilities: A Training Pack for Staff Working with People who have a Dual Diagnosis of Mental Health Needs and Learning Disabilities. Second edition. Pavilion Publishing, Brighton, 1-6. NURSING STANDARD april 5 :: vol 20 no 30 :: 2006 65