Patients Presentation Of Condition Risk Health And Social Care Essay

Some of the patients that receive dental intervention have a history of depression. It is estimated that 1 in 10 US grownups have depression, harmonizing to the most current informations and statistic of Center for Disease Control and Prevention ( CDC ) , Division of Adult and Community Health1. Many of those patients have some grade of anxiousness when sitting on the dental chair that might even get down at their determination to travel to the tooth doctor. Depression and associated anxiousness negatively affect patients ‘ perceptual experience of themselves and universe around them, doing them to hold low self-esteem and self-efficacy. As a consequence, they tend to insulate themselves from society and neglect certain necessities. A great illustration is their pick to avoid traveling to the dental office and pretermiting their dental hygiene, despite their usage of antidepressant xerogenic medicines and in many instances malnutrition. Depression besides adversely impacts patients ‘ emotions towards events and results in their mundane life. For case, they might be dissatisfied with the dental intervention they are having or its outcome regardless of how good the existent intervention is. Therefore, it is of import to non merely better their unwritten hygiene but besides to take the best, most practical intervention program that will ease the process on the patients and the tooth doctor at the same clip, and will ideally take to their long-run satisfaction.SignificanceAs health care professionals, tooth doctors should hold the capableness to grok each patient ‘s societal, medical and psychological history and its affect on dental intervention and result. It is besides necessary that we are able to work as a squad with patient ‘s primary medical physician and head-shrinker to orient a intervention program that is based on a profound apprehension of patient ‘s status.AimThe purpose of this pape r is to research the consequence of depression on patients ‘ unwritten hygiene, and analyze the result of dental intervention of grownup patients with history of depression, compared to adult dental patients without depression.Patient ‘s presentation of status or hazardThe patient being discussed in this paper has a long history of depression and anxiousness. She presents with edentulous maxillary arch and partly edentulous inframaxillary arch with badly carious, diagnostic dentition. Those five painful dentitions were besides nomadic, with terrible bone recession. Her maxillary dental plate and inframaxillary RPD were sick adjustment, broken, stained and had a bad olfactory property. Patient needed full extractions and new upper jaw and inframaxillary dental plates.Clinical QuestionWill adult dental patients with a history of depression have a good unwritten hygiene result, compared to adult patients without a history of depression?LITERATURE REVIEWPICOPopulation:Adult dental patientsIntervention:Having a long history of depressionComparison:Not holding depressionResult:Improved unwritten hygieneSearch Scheme:All articles were searched utilizing PubMed. The selected articles types were: Clinical Tests, controlled clinical tests, Randomized Control Trial, Review and Systematic Review. Search consequences were farther narrowed by choosing merely worlds as theoretical accounts, English linguistic communication, and publication less than 10 old ages ago. Articles were chosen after reexamining rubrics and abstracts, and selected based on relevance to the subject and highest grade of grounds. Using the keywords â€Å" symptoms of depression, † â€Å" dental intervention † and â€Å" dental behaviour † the first article, Symptoms of depression and anxiousness in relation to dental wellness behaviour and self-perceived alveolar consonant intervention demand, was result 1 of 15 and it was selected. None of the other consequences were r elevant to the subject, so another sent of keywords were used: â€Å" depression † and â€Å" untreated dental cavities. † 6 consequences were found, but the first consequence, Depressive symptoms and untreated dental cavities in older independently, was the most relevant. And to choose a article concentrating on depression and self-pride, the undermentioned keywords were used: â€Å" Oral wellness position, † â€Å" depression, † and â€Å" self-image. † Article, Self-Liking, Self-Competence, Body Investment and Perfectionism: Associations with Oral Health Status and Oral-Health-Related Behaviours, was result 7 of 24, and it was chosen based on its relevance and strength in reply the clinical inquiry. All three articles were cross-sectional, which is a weak type of survey. Harmonizing to ADA, a cross-sectional survey is one â€Å" is the observation of a defined population at a individual point in clip or in a specified clip interval. Exposure and result are determined at the same time † ( ADA- Center for Evidence Based Dentistry ) 2. Strong association and causing can non be concluded from this type of survey ; merely weak association can be deduced. There were a really few systemic reappraisals in the hunt consequences, but none of them were relevant to the subject of this instance study. Clinical tests and cohorts were besides non found to be relevant to the subject or assist reply the clinical inquiry. Furthermore, two of the three articles were conducted outside the U.S. , although published in English. There were no comparable surveies among the hunt consequences that were done in the U.S. ( snapshots of the hunt scheme attached to the dorsum of this study ) .Article Analysis:As a consequence of the hunt scheme, three articles were selected to turn to the above-named clinical inquiry. The first 1 is titled: Symptoms of Depression and Anxiety relation to dental wellness behaviour and self-perceived alveolar consonant intervention demand. What chiefly distinguishes this survey from others is the fact that it does non merely examine dental hygiene of patients with depression, but it besides investigates how those patients assess their demand for dental intervention and dental check-ups. Part of a successful dental intervention is to be cognizant and positive of its entire necessity and positive impact on your wellness. Otherwise, patients would be given to return back to their old unwritten hygiene wonts, doing the intervention to neglect. This survey, harmonizing to the writers, is portion of the Northern Finland 1966 Birth Cohort, which randomly followed 96 % of all births in the states of Lapland and Oulu ( n=12,058 ) 3. A 1997-1998 long-run follow-up questionnaire was sent to 31 and 32-year old participants ( n=11,541 ) , and 75.3 % ( n=8,690 ) of them responded3. The questionnaire enquired about: their education-level, household income, self-perceived dental intervention and dental wellness behavior2. Research workers divided the collected informations into two chief parts based on symptoms of depression and anxiousness as determined by the depression and anxiousness subscales of Symptom Checklist-25. SCL-25 is a 25-question self-report study about the presence and grade of depressive and anxiousness symptoms over the old week3. For the intent of this instance study, merely data related to symptoms of depression is analyzed. The consequences of this survey were farther divided based on the strength of depression, depressed ( n=1,263 ) , mild symptoms ( n=657 ) , and non depressed ( n=6,702 ) 3. The per centum of down, mild symptoms of depression and non down topics describing brushing their dentitions twice a twenty-four hours was 47.9 % , 52.2 % and 55.6 % severally, and describing frequent dental check-ups one time or more in a 2-year period was 64.9 % , 65.4 % , and 69.7 % respectively3. Most interestingly, the per centum of participants who expressed self-perceived alveolar consonant intervention demand was 61.1 % , 60.4 % , and 48.4 % respectively3. After commanding for confusing factors, including gender, instruction and household income, consequences showed that there is an associated between depression and both toothbrushing twice daily and frequent dental check-ups3. As the strength of depressive symptoms addition, the frequence of tooth brushing and dental check-ups lessening. More intriguingly, this survey showed that patients who have a higher grade of depression tend to experience that they need more dental intervention, as compared to those with fewer symptoms or non-depressed. Therefore, research workers concluded in this survey that patients with depression tend to hold hapless unwritten hygiene wonts. Writers attempted to explicate this association by imputing depression to tire, psychomotor deceleration and deficiency of motive, which are all factors that hinder patients from executing day-to-day life necessities that can be every bit simple as toothbrushing. Furthermore, antidepressant medicines are known to do dry mouth, which may lend to increased dental cavities and worse unwritten wellness. In general, the consequences in this survey and the treatment provided by the writers proceed logically based on the information presented. They clearly province their hypothesis and list the collected informations in well-organized and easy to read tabular arraies. As expected, the writers do non claim 'cause and consequence relationship ‘ . They, nevertheless, claim an association between the dependant and independent variables as discussed above. This claim is justified by their informations analysis and research method, which is a cross-sectional survey. This type of survey has its ain drawbacks that we as research workers and professionals should be cognizant of, in order to avoid pulling the incorrect decisions and using them on our patients. It is important that we understand the failings and the strengths in this survey to recognize its restrictions in clinical pattern, and therefore guarantee better intervention results for patients. The chief strength in this survey is the big sample size followed in this survey, which increases the opportunities of holding a more accurate representation of the population. Another strength is this cross-sectional survey is the fact that it is portion of a postal questionnaire of a long-run prospective cohort survey, and topics were followed since birth for three decennaries. This ensures that the research workers have a better apprehension of the demographics, and societal, medical and dental history of respondents, including the development and patterned advance or declaration of diseases over the old ages. Furthermore, other surveies focus on older populations, but in this survey, research workers examined specifically 31-32 old ages old patients to do certain that they all received cost-free alveolar consonant intervention up to 18 twelvemonth of age3. This, to a certain extent, eliminates the confusing consequence of handiness to dental attention during childhood. Other conf using factors are: gender, instruction, and household income. Controling for all these variables strengthens the writers ‘ claim association between strength of depression and quality of dental hygiene. Another strength is the distinction between symptoms of anxiousness and symptoms of depression. While anxiousness is found to be associated with depression, this is non ever the instance. Anxiety and depression are different psychological diagnosings with different symptoms, which many surveies fail to divide. However, this survey avoids generalisation by sorting the consequences based on patients ‘ symptoms of depression and symptoms of anxiousness individually. Furthermore, research workers further categorized their informations based on the strength of depression and anxiousness, utilizing Symptom Checklist-25 graduated table, which is the recommended showing of psychiatric upsets in a immature grownup population3. All these categorizations of informations make the consequences more population and disease particular, and cut down generalized decisions about depression and dental hygiene. Therefore, it seems that the overall strength of this survey is that writers avoid doing generalisations by stipulating inclusive eligibility standards, commanding for confounders, and stipulating different grades of depression symptoms. This reinforces the association between depression and both tooth brushing and dental check-up frequence. On the other manus, this survey has some points of failing that are deserving adverting. First of them is the fact that this survey is cross-sectional, which ranks it low on the hierarchy of grounds. In other words, entirely based on the survey design, the grounds for the association between depression and dental hygiene is weak, and possibly ca n't be applied clinically until farther prospective cohorts, indiscriminately clinical tests, or systematic reappraisals are conducted to turn out stronger association and causing. The decisions made in this survey are based on subjective steps, as self-reported by topics in the studies. Another survey is needed to objectively analyze dental hygiene utilizing patients ‘ cavities hazard and periodontic disease. Another 2012 cross-sectional survey, entitled: Depressive Symptoms and Untreated Dental Caries in Older Independently Living South Brazilians, conducted in Brazil examined the association between depression and dental hygiene wonts among big patients4. However, in contrast to the former survey, the latter objectively assesses dental hygiene wonts utilizing the rate of untreated cavities ( DMFT index ) , presence of dental plaque, and unstimulated salivary flow rate. Another chief difference is the fact that the latter survey focused on analyzing the impact of depression on dental hygiene behaviour among the geriatric population. Research workers interviewed indiscriminately selected 390 South Brazilians, who were more than 60 old ages old ( average age of 66.83 old ages ) , with at least one tooth in their teething ( average figure of dentitions of the sample was 9.94 ) 4. Oral scrutinies were done by two accredited tooth doctors. 44 out of 390 participants ( 11.3 % ) were shown to h old symptoms of depression utilizing the Geriatric Depression Scale ( GDS ) , which harmonizing to research workers has a sensitiveness of 85.4 % and specificity of 73.9 % in naming major depression symptoms4. Data collected found that 234 participants ( 60 % ) had at least one tooth diagnosed with untreated dental decay4. The average DMFT was 22.06, with a average D of 1.25, and a average F of 2.45. Furthermore, 126 participants ( 32.4 % ) had low unstimulated salivary flow4. Consequences showed that depression symptoms were associated with untreated dental decay. Writers concluded that depressive symptoms may move as forecasters of cavities in older grownup patients. In order to measure the credibleness of the decision, it is of import to analyse the strengths and failings of this survey. A major strength is commanding for major confusing external variables, including: age, gender, abode, monthly income, instruction, and prescribed medicines, and smoking wont. Controling for abode was used as a placeholder of non merely socioeconomic position, but besides H2O fluoridization, which contributes to keeping unwritten hygiene4. Another strength in this survey is the use of hierarchical attack to analyse and rank the above external variables harmonizing to their grade of association with untreated dental cavities. This is a well-organized analytical attack to sum up collected informations, and analyze the consequence of each variable individually. Harmonizing to this type of analysis, there is a important association between depression and untreated decay ( p= 0.01 ) 4. Furthermore, research workers used statistical analyses to mensurate the significance of association, including X2 trials for the dichotomous variables, and Student T trials and Mann-Whitney trials for uninterrupted variables4. All these types of analysis addition the dependability of the decisions. Despite these scientific analyses and indiscriminately selected big sample, this survey is cross-sectional, which renders the association between depression and untreated cavities weak, and no causing can be drawn from this type of survey. In add-on, even though research workers attempted to command for a comprehensive list of confusing variables, it is about impossible to nail the ground of untreated cavities to one variable, such as depression. Untreated decay is a consequence of a web factors: medical, societal, and psychological. Even though the hierarchical analysis might be an orderly method of analysing informations, it might non be inaccurate to rank the impact of each variable on untreated cavities, as that ranking might change based on different samples or different populations. Furthermore, this survey was conducted in South Brazil, and the consequences might non be applicable to a U.S. population. Another cross-sectional survey, Self-Liking, Self-Competence, Body Investment and Perfectionism: Associations with Oral Health Status and Oral-Health-Related Behaviours, aimed at tie ining self-liking and self-image to keeping one ‘s unwritten wellness position and behavior5. This survey is of import because low self-pride is a major symptom of depression, and possibly signifiers an obstruction to effectual dental intervention. The questionnaire was answered by 217 freshman dental pupils at the University of Medicine and Pharmacy Carol Davila in Romania, with a average age of 19.24 years5. The study included a 20-item self-liking/self-competence graduated table, and besides gathered information about topics ‘ age, gender, smoking wonts, unwritten wellness behaviour such as flossing, brushing and oral cavity rinse, and self-perceived dental wellness such as non-treated cavities, extracted dentitions, dental hurting, esthetics and gingival disease5. Consequences showed that topics with high self-liking and self-competence were more likely to brush their dentitions twice a twenty-four hours, floss, usage mouthrinse, and see their tooth doctors more frequently5. They were besides more likely to, as one would anticipate, hold less untreated dental cavities, less extractions and healthier gum with less hemorrhage. Furthermore, it was found that depression in mundane life was positively associated with denta l wellness. However, the association in this survey is weak due to the survey design, which is cross-sectional. Another failing in this survey is the fact that the topics are immature college pupils, who do non stand for typical patients with depression. Furthermore, the article did non concentrate on depression as a disease ; it examined â€Å" mundane life depression † instead5. In add-on, footings such as, gingival hemorrhage, untreated cavities, anxiousness, and depression might be confounding or misinterpreted by undergraduate pupils who are non dentally cognizant. For case, pupils might describe non holding untreated cavities merely because they are non experiencing any hurting. On the other manus, the comparatively big sample size, irrespective of the average age, is portion of the strength of this survey. Besides, the testers controlled for topics ‘ age, instruction and rational degree, to guarantee more accurate consequences. Synthesis of findings: Overall, based on the findings of the first article, Symptoms of Depression and Anxiety relation to dental wellness behaviour and self-perceived alveolar consonant intervention demand, one can claim that grownup dental patients with a history of depression tend to hold worse dental hygiene results, compared to those without depression. Furthermore, patients with higher grade of depression have more self-perceived alveolar consonant intervention demand, which is most likely a direct contemplation of their low self-efficacy. It is deserving analyzing in future surveies whether this increased perceptual experience of dental intervention demand could be utilized by tooth doctors as a incentive to better their patients ‘ dental hygiene behaviour. Furthermore, even though decisions made by the writers may look logical, they can non be faithfully applied in clinic, unless proven by a higher evidence-based survey design. Similarly, based on the consequences of the 2nd article, one can reason that grownup dental patients with depression tend to hold more untreated dental cavities and worse dental hygiene results, compared to patients without depression. Stronger surveies are needed to turn out the association claim made in this cross-sectional survey. And for more relevant consequences, future surveies should be conducted on a big, indiscriminately selected sample of American population. Similarly, the consequences of the 3rd article showed that patients with high self-liking and self-competence have better dental wellness behaviour. In contrast, depression is found to be associated with worse dental hygiene. This makes sense because low self-pride is one of the common features of depression. However, this survey design is weak and does non bring forth dependable consequences based on the findings. The sample of population examined in this survey, dwelling of immature college pupils, is clearly non an accurate representation of our typical dental patient with depression.Description of patient:Demographic: J.J. , 57-year-old Caucasic female. Born and raised in New York, USA. Critical marks: BP: 130/80, pulsation: 62, BMI: 24 Social and Personal History: Divorced twice. Currently lives entirely. Patient has one kid in college. Patient is on public assistance and has Medicaid. Patient studies utilizing intoxicant one time every six months. She is a tobacco user: Cigarettes, less than 10 a twenty-four hours, 6 pack-year history. History of Present Illness: Patient struggled from depression and anxiousness for many old ages. Her depression escalated after her 2nd divorce. Medicines: Pristiq, Halcion and Valium. Past Illnesss: Bulimia when she was a adolescent, stopped in 2006. Cholecystectomy many old ages ago. Carpel Tunnel surgery 3 old ages ago. Arthritis which was treated surgically in her pollex. Three episodes of Bell ‘s Palsy, unknown cause. Reappraisal of medical history and susceptibleness to chronic disease: Depression doing her susceptible to cavities, periodontic disease, Review of systems and Risk factors: Depression, anxiousness, allergic reaction to penicillin, arthritis, dry mouth, malnutrition. Hazard factors: High cavities hazard, moderate periodontal hazard, moderate-low hazard of unwritten malignant neoplastic disease, moderate intral-oral nutrition hazard factors, due to old dental plates and trouble mastication. Pertinent Family History: Father had a heard onslaught Finally, based on the findings of both articles, depression is associated with hapless dental hygiene behaviour and high cavities risk because of low self-esteem, reduced frequence of check-ups and tooth brushing, and antidepressant xerogenic medicines. Consequently, it seems that grownup dental patients with a long history of depression tend to hold worse unwritten hygiene results, compared to grownups without depression. However, there is no uncertainty that this premise can non be faithfully applied in clinic until a prospective cohort, randomized controlled test, systematic reappraisal, or meta-analysis is used to demo a strong association or causing. It is of import that dental patients understand that even though those current surveies are logical and analytical, they are simply based on questionnaires, which do non run into criterions for high grounds. There is no uncertainty that handling grownup patients with a long history of depression is by and large more complex than handling those without important medical history. Depression patients, as illustrated by the above articles, tend to hold more untreated cavities to get down with. In add-on, it might be more hard to convert depression patients about a intervention program, particularly if they need extractions or dental plates. They besides tend to be less compliant with their assignments and physician ‘s instructions. Additionally, they might be more critical of their tooth doctor ‘s work and concluding result. However, all that should non impede or deter tooth doctors from handling depression patients. Everyday at NYUCD, pupils and module are able to successfully handle patients with depression, through showing compassion, apprehension, and appropriate communicating with patient. Depression patients have more self-perceived dental intervention demands compared to p atients without depression. Therefore, this evident consciousness of their dental demand should be used by their tooth doctors to actuate them to have necessary dental intervention. Furthermore, possibly tooth doctors should work with patients ‘ head-shrinkers to increase their self-esteem and self-competency, which should take to bettering patients ‘ dental wellness behaviour, and accordingly, guaranting a long-run successful intervention. Ms. J.J. , patient reviewed in this instance study, has a long history of depression and anxiousness. She feels dying when she sees a tooth doctor. It was determined after seting a comprehensive intervention program that she needed full upper and lower dental plates, alternatively of her old lower RPD and upper full dental plate. Patient was so given two options: either to pull out the dentition and become edentulous for a few months until the new prosthetic devices are inserted, or have immediate dental plates. Patient was ab initio disquieted and get downing shouting hysterically when she thought she could non afford the immediate dental plates. However, through proper communicating and exhaustively explicating to the patient the procedure of manufacturing immediate dental plates, including the timeframe and the fiscal facets, patient was really satisfied and agreed to acquiring immediate dental plates. And presently, patient is excited about acquiring her smiling back, like she sa ys. Therefore, it is of import that we, as health care professionals, understand the complexness of depression and how it affects the result of dental intervention. The intent of this instance study is to happen out whether grownup dental patients with history of depression have improved dental hygiene result, comparison to those without depression. After analysing the findings in the articles and their decisions, it is evident that there is an association between depression and hapless unwritten hygiene, reduced frequence of check-up visits and tooth brushing, and increased cavities hazard. Therefore, big dental patients with long history of depression have hapless dental hygiene result compared to those without depression. However, it is deserving observing that future stronger surveies with big sample size are needed to be conducted in the U.S. , in order to pull dependable decisions that can be applied in our evidence-based dental medicine in clinical pattern. Depression is a complex, multifactorial disease, which requires a squad of wellness attention professionals dwelling of at least patient ‘s tooth doctor, primary attention doctor and head-shrinker to set a comprehensive, long-run effectual intervention program for the patient.

Oil, War and U.S. Foreign Policy. Essay

The war against Iran by the Anglo-American powers has been in planning since 1990s as part of their Greater Middle East strategy. A number of sources have recently reported plans by the Iranian government to institute a Tehran oil bourse and this might be the hidden agenda behind the evident march to war by the Anglo-American powers on Iran. The oil bourse argument is a red herring which diverts the attention of people from the real geopolitical grounds which is behind the real motive for the march to the war which is a high risk game on the nuclear weapon. In 1996, two neo-conservatives, Douglas Feith and Richard Perle who later played an important role in the formulation of the Pentagon policy in the Middle East under the Bush administration authored a paper which was presented to the elected Israeli Prime Minister Benjamin Netanyahu. The advisory paper, â€Å"A Clean Break: A New Strategy for Securing the Realm†, had the intention of making Netanyahu to make â€Å"a clean break from the peace process†. Feith and Perle also demanded Netanyahu to strengthen the defense of Israel against Syria and Iraq and to attack Iran as the prop for Syria. More than a year before the declaration of the former US president George W Bush of his â€Å"shock and awe† operations against Iraq, he made his January 2002 State of the Union address which is now infamous to the Congress in which he Iran, together with North Korea and Iraq as members of the â€Å"axis of evil† trio. This occurred before anybody in Tehran had even considered establishing an oil bourse in trading oil in various currencies. According to Engdahl, the US believed that the Tehran oil bourse would be the casus belli, which would trigger the pushing of Washington down the road to the potentiality of annihilation of Iran, which seems to be based on the notion that trading on oil openly to other nations in other currencies would make Tehran set in to motion a chain of events in which buyer after buyer, nation after nation, would come to buy oil no longer in US dollars but in euros. This in turn according to an argument, would lead to a panic in selling of the US dollars on the world foreign exchange markets and also lead to the collapse of the role of the US dollar as the reserve currency, which is one of the pillars of the â€Å"US Empire†. According to Engdahl in his book, A Century of War, the creation of â€Å"petrodollar recycling† in 1974, which is a process where the by then US secretary of state Henry Kissinger was deeply involved, led to oil price hike of 400% and this was orchestrated by the Organization of Petroleum Exporting Countries (OPEC). Engdahl puts it that US dollar did not manage to become a â€Å"petrodollar† even though Kissinger emphasized the process of â€Å"recycling petrodollar†. According to the author, what Kissinger was referring to was the initiation of a new phase of global hegemony of US in which the export earnings from the petrodollar of OPEC oils lands would be recycled back to the hands of the major London and New York banks and later re-lent in the form of US dollars to other nations which are deficient in oil such as Argentina and Brazil and this led to the creation of what was soon to be known as the Latin America debt crisis. By this time, the US dollar had been a fiat issue since August 1971 following the abrogation of the Bretton Woods Treaty and refusal by the then US president Richard Nixon to redeem US dollars which were held in foreign central banks for gold. Due to the 400% increase in oil prices, nations such as Germany, France, and Japan suddenly had the reason to buy oil in their own currencies with the aim of lessening the pressure on their reserves of trade dollars which was rapidly declining. This led to the coming up of the Pentagon and US treaty partly with their secret diplomacy by Kissinger through bullying threats According to Engdahl, the US military were sent to Afghanistan for two main reasons; the first reason was to restore and control the world’s largest supplier of opium in the world while at the same time use the drugs as a geopolitical weapon against their opponents especially Russia. The control of the drug market is an essential ingredient for the liquidity of the corrupt and bankrupt Wall Street financial market. U. S. Military and CIA Interventions in the Middle-East. Blom traces the origin of the current conflict from the brutal 1980-88 war which was between Iran and Iraq. At the time of the war, Kuwait was busy stealing oil from the Iraqi territory which was worth more than $2. 4 billion of oil. Soon after the battle, United Emirates and Kuwait started to exceed the production quotas that had been established by OPEC and this led to flooding in the oil market leading to a reduction on oil prices. This led Iraq to become deeply in debt and the then president Saddam Hussein declared this policy a threat to hi country by pointing out that Iraq was loosing billions of dollars each year due to the drop in oil prices. In an attempt to offset these loses, Saddam decided to gain possession of the two Gulf islands which were blocking Iraq from ownership of Rumaila oilfield. Kuwait continued to ignore Iraq’s territorial and financial demands and the OPEC’s request to follow the quota system and this led to Iraq to form large number of troops who were posted along the Kuwait border. This led to the intervention of the US who viewed themselves as the world’s supper power. After Iraq attacked Kuwait, US came to the defense of Kuwait by declaring that their interest was in protecting nations with whom they had longstanding and deep ties while at the same time, The White House declared their concern about the buildup of troops by Iraq. According to the author, United States had an official position on the Kuwait-Iraq border dispute. This is evident from the official statement that were found by the Iraqis in some of the Kuwait intelligence files which was a memorandum concerning a meeting between the CIA Director William Webster and Kuwait state security in November 1989. in the document, there was an agreement between the Americans and Kuwait that it was of great importance to take advantage of the deteriorating economic situation in Iraq with the aim of putting pressure on Iraq’ government so as to delineate their common borders. It is evident that US was involved from the beginning and advised Kuwait to apply pressure on Iraq so as destabilize the country economically. The CIA later denied these allegations saying that it was a fabrication. Blum puts it that the US has been behind the Kurdish’ slaughter of many innocent citizens and also encouraged the Shiite Muslims in Iraq to rebel. All these were done in an attempt to incite Saddam so that he could incite a coup which would result in to the intervention of the United States. The killings in the Persian Gulf by the American soldiers have been due to a voice command from George Herbert Walker Bush according Blum. The United States started supporting Afghan Islamic fundamentalists in 1979 in their bid to fight the Soviet Union. The US continued with their support despite the kidnapping of American ambassador in the capital city of Kabul in February 1979. American intervention according to Blom had some hidden agenda. The US was using lies and tricks to gain influence of Iraq so as to control the oil prices. In both cases, the authors recognize the use the use of tricks by the US government to make the Middle East unstable. Both the authors share a common view on the idea behind the control of Middle East affairs. In both cases, the authors acknowledge the use of military force in the wars in the Middle East and in both cases, it appears that US is the main cause of all these wars. The aim of the United States according to the two authors is to take control of the rich oil nations and make sure that they continue to price and sell oil in US dollars. They both acknowledge the pretence of the US to send their military force in these countries with the aim of restoring peace while in the real sense; the US is after establishing permanent military base in places such as Iraq so that they can control the resources of these countries. Under the Bush administration, there was a severe military attack in Iraq with the aim of removing Saddam from power with the pretence that he was behind manufacturing of nuclear weapons. After the attack, it became apparently clear that such a thing never existed in Iraq. Bush was only accomplishing a war that was started by his father against Saddam who had refused to consent to the demands of the United States. The Use of Torture in Iraq and Afghanistan. A lot has been said regarding what lies behind the shocking images of torture at Abu Ghraib which were released in 2004. many American were shocked by such images and novel with the exception of one American; Alfred McCoy who had been following the operations of the Central Intelligence Agency since the early 1970s, when the agency tried unsuccessfully to stop the publication of his book, The Politics of Heroin: CIA Complicity in the Global Drug Trade. McCoy had long been conducting study on the pioneering research by the CIA in to the methods of psychological torture. He writes that the CIA had started this project in the early 1950s with their initial study on the Chinese and Soviet methods of breaking and interrogating prisoners. The author has a negative image regarding the torture policies that America has used in the last decades. The CIA’s discovery of Psychological torture had its breakthrough in the 17th century. This was in contrast to the physical approach which they saw most of the times produced unreliable information or heightened resistance. Under the new psychological paradigm introduced by the CIA, the interrogators used two essential techniques; self-inflicted pain or disorientation so as to make the victims feel responsibility of their own suffering. The first stage of psychological torture involves the use of non-violent methods to by the interrogator to disorientate the subject. After disorientating the subject, the second stage involves simple self inflicted discomforts which may be in form of standing for many hours with the arms in extended position. Although psychological torture is less brutal due to the fact that there is no touch, the torture leaves both the interrogator and the victim with deep psychological scars. Victims normally require long-term treatment in order to recover from the trauma far much more than the physical pain. On the part of the interrogator, they may suffer from dangerous expansion of ego which may eventually lead to escalating cruelty and lasting emotional problems. According to McCoy, torture was conducted by the CIA directly and also indirectly through outsourcing. The use of torture is against humanity since it involves forcing the subject to confess in criminal cases with the assumption that they are guilty prior to trail. The CIA also used this method to serve as a deterrent to other potential offenders. According to the author, torture did less in bringing any trustworthy information or truthful confession neither did it prevent other people from breaking the law in any significant way. Following the September 11 bombing of the Twin Towers in the US, the administration of the former President George W. Bush allowed US intelligence service and the military to use torture as the only means to â€Å"quickly obtain information†. They did this by creating a category of prisoners who they claimed fall outside the protection by any treaty or law obligations and are deemed to be tortured. According to the CIA, they argue that this policy which considered the most abusive approach to interrogation is the most efficient and effective quick way to get information that is accurate and useful. From McCoy’s book, he clearly puts it that torture is always not a good way of producing reliable information. The experience from Colonel John Rothrock, who was heading a combat interrogation team in Vietnam, reported that â€Å"he doesn’t know any professional intelligence officers of my generation who would think this [torture] is a good idea,† but the US under the Bush administration failed to listen and this led to death of many innocent people in the name of state security. These torture cases were concealed from the general public and the Congress when CIA was busy for the past half of the century developing and applying a sophisticated form of psychological torture which were meant to go against investigation, prohibition or prosecution and this made it very successful. Americans have found themselves have found themselves in six separate accounts of this same moral quagmire in the last 50 years period. The first was the exposure of the CIA sponsored torture which took place in South Vietnam in 1970, Iran in 1978, Brazil in 1974, Honduras in 1988, and the cases in Iran and Iraq. Each of these cases was exposed at different times and as each case fades, the agency resumes with their lethal work in the shadows. The role of torture in the geopolitics of the Middle East is to divert attention on the real issue. While the CIA was busy torturing prisoners in Afghanistan and Iraq, they were at the same time busy exporting opium to other countries. The use of torture was also a means of making sure that no information was leaked to the public. Another role that torture play is to make the subject confess to what the interrogator expects them to do. Also the use of torture by the CIA was to make people from Middle East to desist from any corporation with those who could get in to their secret conducts in these countries. An example is when McCoy was doing a research for his book in the mountains of Laos; a group of CIA machineries attempted to kill him and even threatened his translator to stop working for him. While these were happening, the CIA was secretly transporting opium using Air America helicopters to South Vietnam. Use of torture helped the American’s to exert great influence in the Middle East as those who experienced the tortures gave their experiences once they were out of the prison. The psychological damage was so much that the victims could not become normal again. This coupled with the killings of many people during the war led to weakening of these nations such that American control of oil and drugs like opium could be easy. All these acts were conducted with the aim of building an â€Å"American Empire†. Works Cited. Alfred McCoy. A Question of Torture: CIA Interrogation, from the Cold War to the War on Terror (American Empire Project).

Production Plan for Riordan Manufacturing Essay

Production Plan for Riordan Manufacturing - Essay Example A production function is a unit which represents the relationship between output variables with respect to input constraints. In mathematical terms, an effective production function is a demonstration of input-output relationship. Just as the equation shows Y= f (c1, c2, c3, c4†¦) the production output Y depends on production quantities c1, c2, c3, and c4 respectively (Khanna, 1980). To settle this relationship Riordan manufacturing will have to design an integrated production plan. Process modeling is the very first stage of an effective production plan which is done by dividing production phase in three major phases, planning phase, action phase and control phase. In the planning phase, Riordan manufacturing should include product design and order writing activities. Similarly, in the action phase the firm should include process routing, material handling, tool control, loading and scheduling as the action operations (Patil, 2008). In the last, the firm should include expediti ng and re-planning as control activities. On establishing the three production phases, an integrated relationship will be settled in the Riordan production system. Once it is settled, the relationship of production output and input will be assured. But before designing the process stage it is necessary that Riordan manufacturing set initial production objectives. Just as lowering production, inventory and shipment costs to maximize profits or improving employee skill to maximize productivity.... In the planning phase, Riordan manufacturing should include product design and order writing activities. Similarly, in the action phase the firm should include process routing, material handling, tool control, loading and scheduling as action operations (Patil, 2008). In the last, the firm should include expediting and re-planning as control activities. On establishing the three production phases, an integrated relationship will be settled in the Riordan production system. Once it is settled, the relationship of production output and input will be assured. But before designing the process stage it is necessary that Riordan manufacturing set initial production objectives. Just as lowering production, inventory and shipment costs to maximize profits or improving employee skill to maximize productivity can be set as production goals. In this forecast is also very important like forecasting sales or turnover will determine how much efficiently the new production plan is working (Patil, 2 008, pp. 242). Strategic Capacity Planning for the New Process Design For international business firms especially those which believe in supply chain principles, capacity planning is vibrantly important for such firms. Riordan, which is specializing in integrated production management must adopt the approach of integrated capacity management (Jacobs, 2006). Planning the capacities of production facilities, workmen, machinery, equipment, distribution or inventory will bring proficient results for Riordan. Once the capacity management approach is there in all sections of the firm (procurement, production, inventory, and transportation) it will have stability to control supply and demand

Technology and crimes Essay Example | Topics and Well Written Essays - 250 words

Technology and crimes - Essay Example This leads to more effective credit card and identity theft scams (Criminal Intelligence Service Canada [CISC], 2010). - Credit card skimmer devices can be placed within a point-of-sale credit card machine, and collect names and credit card numbers. These devices operate on battery power and do not require the criminal to be nearby for them to do their work; they can be picked up surreptitiously later (CISC, 2010). - GPS tracking on cell phones and other web-enabled devices, as well as cell phone call tracking, means that the police can find out where criminals are making calls from and where they are traveling (Howell, 2010). - Database analysis turns information into a map that tells cops where a specific criminal is likely to live and where they are likely to strike next; this map also shows where crime hotspots are (Logan, 2004). - Wireless networking of different departments helps with arson tracking (Logan, 2004). Arson is often not well-reported, since it is the domain of the fire department and not the police department. Networking their databases together means that if the fire department suggests a fire is suspicious, the police immediately know about it. - Dashboard cameras on police cars record how a police officer behaves during a criminal arrest or investigation of a crime scene. This way, the actions of the police officer are no longer hearsay, but instead are a matter of record. (Howell, 2010) - The installation of the Automated Fingerprint Identification System has meant that criminals picked up for minor crimes dont get away with bigger ones. It is a national database of wanted criminals that tells officers almost immediately if the person they picked up for one crime is wanted for something more serious in another jurisdiction (Howell, 2010). Criminal Intelligence Service Canada [CISC]. (2010, May 13). Technology and Crime. Criminal Intelligence Service

Massachusetts Board of Pharmacy Essay Example | Topics and Well Written Essays - 500 words

Massachusetts Board of Pharmacy - Essay Example acist who work in Massachusetts, should regulate his or her duty in such a way that they always follow and practise the required standard and ethics of the profession. The board also follows the duty of promoting, and protecting the public health and safety by implementing a proper pharmaceutical care to their citizens of Massachusetts. The function of the board involves, â€Å"The Board strives to assure consumers are receiving the highest quality prescription drug products from pharmacists who have graduated from accredited colleges of pharmacy. The Board also sets standards of quality assurance and best practices, requiring safe delivery systems in pharmacies licensed by the Board.†, says the administrative committee. More over the Massachusetts Board of Registration of Pharmacy has â€Å"The Board of Registration in Pharmacy licenses 9,902 pharmacists, 5,284 pharmacy technicians, 1,089 community/chain pharmacies, 7 nuclear pharmacies and 60 wholesale distributors in the Commonwealth† By looking at the function of the board it becomes quiet clear that the citizens of Massachusetts are at high safety and provided with full medical assistance by the board, more over there are lot of opportunities for the pharmacists who come out successfully from a strong educational background. The registration board of pharmacy of Massachusetts is found to have 9,902 pharmacists and more than five thousand pharmacy technicians are working, this clearly shows how much effort the board has put forth to implement the outcome and mission aims successfully. This would not only help the citizens to have a better and safe health, but also faith over the pharmacists. The role of a pharmacist is well defined by the board, because usually the pharmacists are considered as health professionals who should work according to supplying the exact prescription drugs to the patients. He should act according to the physician’s instructions. Becoming a pharmacist requires a basic educational

How far do the merits of selection by interview explain the fact that Essay

How far do the merits of selection by interview explain the fact that it is the most widely used method of selection - Essay Example he side of the employees who are going to give in their best and thus benefit the organization in the long run, not to forget do themselves a favor in terms of their future growth and exposure levels. However all this is easier said than done since the problems do arise from time to time and it is significant that both the organization and the employee understand that they have to co-exist for the betterment of each other. No one of these two entities could exist in vacuum and thus it is of paramount importance to understand the very same. The end result would be in terms of success both for the organization as well as the employees who are very much a part of his organization itself. Then there is the aspect of interventions which crop up every now and then and which in essence mar the real motive of hiring the best possible candidates for the job. These include references from people who are in close association with the management who are there to make decisions but end up hiring their own acquaintances and relatives. This brings a bad name to the organization and also creates a sense of animosity within the employees since they think that the relatives could have their own say by using their relationships to full effects. To this day, interviewing has remained as the cornerstone of achieving the best results envisaged when it comes to recruiting and selecting individuals best suited towards a particular job, task or duty. This is due to its very direct manner of putting the interviewer and the interviewee in close association with each other. They have an eye ball to eye ball connection where the interviewer easily gauges the amount of confidence that the interviewee possesses within him and how he copes up with the pressure of giving an interview as well. It costs thousands of dollars to hire and train employees. How do managers attract top talent that supports the corporate culture? How do they keep these employees engaged? After investing in this talent,

Drugs in sport, I'm looking at the use of EPO in Essay

Drugs in sport, I'm looking at the use of EPO in - Essay Example The paper would also briefly show the picture of what this type of behavior could do in the long run for the sports world as well as on the actions of younger generations. Any state taking part in the Olympics would be familiar with this: ``The important thing in the games is not winning but taking part. the essential thing is not conquering, but fighting well, since this is the creed of the said event (Baron, 54). But could it still be reconciled with the reality of the modern sports world? Sports now after all is not just playing some game, one could discern that it is really more than that. Thats why sports get a separate section in every major daily newspaper, stadiums are filled along with arenas around the world regularly with fans rooting and screaming their lungs out for someone or some group, they receive massive funds from schools and they occupy hours of commercial TV and radio air time (Washigton, 188). This kind of situation leads to a reward system wherein incentives are given not to a job well done or a battle well fought but to winning. Athletes and their coaches know that. Largely, as it could be associated from the above described sp orts world, this is because winning today do not just give you a shining image (if only they could be satisfied with that), but in this time and age, it is absolutely associated with unbelievably huge amount of money. Winning open the doors for athletes as well as the coaches to multimillion dollar contracts, appearance fees, and various international endorsements and exposures. Something nobody except for a few rare souls, could reject. However, the issue is not even about the abnormal financial gains these performers could acquire when they succeed, but what this drive to excel lead them to do. A conspicuous issue that arises from such situation is the use of performance enhancers in

The Pianist (2002) Movie Review Example | Topics and Well Written Essays - 1250 words

The Pianist (2002) - Movie Review Example In order to determine the film’s value, analysis will be focused on three of the film’s pivotal elements: directing, acting and music. It is through these elements wherein one will find that the film is a work of Polanski above all. It reflected his style, his genius, faults and failures and everything in between in his attempt to recreate the life and the sensibility of a martyred musician. The movie itself, its treatment of the story and the actor’s portrayal, presented the director’s interpretation of Wladyslaw’s experience in surviving the holocaust. Everytime he faced death, Szpilman survived because he was assimilated to the Polish society, he had friends, he had help, and he had his talents. The Jewish Police pushed him off the vehicle because he was a genius. Then the Nazi soldier towards the end of the film helped him live because he was talented. The case would have been otherwise, had the Pianist been an ordinary Jewish who is not assimilated in the Polish society. For instance, the set design for the film was entrusted to Allan Starski and Anna Sheppard, set design and costume designer, respectively. Both of them worked for Steven Spielberg’s opus, Schindler’s List, of the same theme: the Jewish experience under the Nazi atrocities. These two designers was able to reconstruct an era in their design that enabled the desired effect – the progression of horror in such peaceful city. The sequencing of streets, the film color tones, costumes, they highlighted the threats, the establishment of the ghetto, the indiscriminate killing, mass deportation and systematic extermination of Jews. With the help of these designers, Polanski was able to superbly recreate not only the period but the accuracy of the systematic deterioration of the Jewish plight in Poland during the Nazi occupation: from the building of the

Goodbye Pork Pie Hat by Charles Mingus disscusion paper Essay

Goodbye Pork Pie Hat by Charles Mingus disscusion paper - Essay Example Berndt (52) further notes that Jazz involves vitality and spontaneity of musical production which involves improvisation. Berndt also holds that Jazz contains â€Å"a manner of phrasing and sonority that mirrors the Jazz musician’ individuality (73). Holding a similar view, Berndt (63) noted that Jazz music originated in the Southern United States among the African-American communities, combining European music and African music. According to Shipton (23) Jazz music started developing in 1880 during the Atlantic slave trade which brought Africans to the U.S. Shipton (34) holds that the Jazz music, therefore, early Jazz had rhythms that reflected the African speech pattern was characterized by the pentatonic scale which led to the blue notes that commonly characterize Jazz. Focusing on Jazz music, this paper provides an in-depth analysis of â€Å"Goodbye Porkpie Hat,† a historic jazz style. The paper will focus on discussing general characteristics of the historic jazz style and the individual stylistic characteristic for which the performer is known. The paper also focuses on one piece that features a notable performance while providing observations from listening to such apiece. The paper concludes with an overview of the aforementioned issues while highlighting the significance of the piece and performer of the Jazz music featured. Before, discussing the aforementioned issues it is important to examine the jazz music featured. Goodbye Porkpie Hat, which was later renamed Theme in memory of Lester Young is music piece or a jazz standard, which was composed by Charles Mingus. The jazz standard recorded in 1959, by his sextet, and released on the album of â€Å"Mingus Ah Um.† He wrote it as in memory of Lester Young, a saxophonist, who passed on before the recording was done and was reputed for wearing a broad-rimmed of pork pie hat. Good-bye porkpie Hat is Mingus widely known musical composition and many jazz fusion and Jazz artists have r ecorded his music. For instance, Mitchell Joni added lyrics to the songs for his album Mingus, which was recorded jointly with Mingus in the months prior to his death. Besides, Kirk Rahsaaan also composed some lyrics to the song, which was included in his album, of The Return of 500lb Man. â€Å"Goodbye porkpie Hat† is a ballad composed for a saxophonist Lester Young, and it is named after young’s reputable signature headwear. The melody is beautiful and haunting plays in Octaves or in unison by tenor saxophonists Booker Ervin and Handy John except for one note, where they play the dissonant interval of either a minor second or ninth (Artist Direct 1). Ideally, the single dissonance resembles wince, and it is perhaps a subtle nod to the pained life of Young. Charles Mingus was an influential Jazz double bassist composer as well as bandleader. His musical compositions had a hot soulful feel of hard bop and credits to black gospel music and free jazz, Third stream and cl assical music (Open Culture 1). Yet he avoided categorization, thus forging his own unique music brand, which fused traditions with the unexplored jazz realms (Open Culture 2). Mingus emphasized on collective improvisations, which is similar to old New Orleans jazz while paying much attention to the interactions of each band member with the group. He recruited band members on not only skills but also their personalities. Besides, Mingus receives credit for the double bass

The use of structure and agency and its effect on Globalization Essay

The use of structure and agency and its effect on Globalization - Essay Example This paper aims at relating the discussion on structure and agency with that of globalization, in order to comprehend this complex process in a more logical way. Greater emphasis is placed on the contribution of ideas in the dynamic relationship between agents and the environment in which they exist. Sociologists have spent two centuries on the issue of structure and agency. Yet they have gone no further than Marx's true statement "men make history, but not in circumstances of their own choosing". One of the main issues in sociology has always centered around the debate of the effect of individualism and holism on human thought and endeavors. Agency refers to the capability of individuals to act independently and to make their own free choices. Structure refers to those factors such as social class, religion, gender, ethnicity, customs, etc. which seem to confine or regulate the possibilities that individuals have. The debate over whether social structures determine individual behavior or do individuals themselves play a role in defining their own destiny has lead to much befuddlement. A strategic-relational approach as developed by Hay (2001) will be adopted in this paper to answer some of the questions raised by the relationship between structure and agency in opposition to much of the existing literature on this subject matter. This approach suggests that the distinction between structure and agency is strictly analytical. Over time it has been argued by many noted sociologists that structures exist before agents; however the view developed in this paper is that structures can only be said to exist by merit of their intermediation of human conduct - structures comprise both the medium and condition of human agency. In essence neither agents nor structures are real, since neither has an existence in isolation from the other - their existence is relational and truly based on sound reasoning. Structure and agency are the flip sides of the same coin. Structure and agency, although analytically dissociable, are essentially entirely intertwined. Agents are conceived as witting, reflexive and strategic. They act purposefully in an effort to realize their aims and preferences. However, they may also act intuitively or out of habit. Even so, when acting habitually they are assumed to be able to deliver their aims and their motivations explicitly. They are presumed to make all their decisions based on the immediate and long-term consequences of their actions, whether intuitively or more intentionally. Though actors are conceptualized as intentional and strategic, their preferences are not assumed to be fixated nor are their preferences solely based on the circumstances in which they find themselves. Different actors in similar physical settings and circumstances will opt for different interests and preferences, just as the same actors will review, revise and reform their perceived interests and preferences over time as the circumstances and situation changes. This may lead one to think that the context or circumstances in which the actors find themselves is irrelevant. However this is far from truth. The key to the tie-up between structure

Decision making software Essay Example for Free

Decision making software Essay QUESTION 1 Life Orientation is an umbrella term which encompasses all the work that teachers should be doing with learners and include school guidance, counselling and life skills. QUESTION 2 Acceptance is concerned with all aspects of learning. QUESTION 3 Three (3) different types of thought developments can be differentiated. QUESTION 4 An intensive, extended career education programme helps learners to gain knowledge of who they are. QUESTION 5 Lindhard and Oosthuizen differentiate between the following principles of decision making, namely: aims and value; information; solution and decision making. QUESTION 6 A facilitative process is where the individual looks at his/her own interests. QUESTION 7 Assessment should only focus on the learner’s intellectual abilities. QUESTION 8 Observation is an exploratory technique that should be part of every educator’s role. QUESTION 9 The implication of the structured interview is that the interviewer and the learner encounter each other as equal partners. QUESTION 10 Individual counselling is predominantly used as a mode of counselling in school settings. QUESTION 11 In the teaching of Life Skills education the learner is the centre. ETH203Q/101 13 QUESTION 12 In educational support the content should be presented in such a way that the learners themselves achieve personalization. QUESTION 13 Study methods and reading skills are categorized as personal skills. QUESTION 14 Compiling a budget and writing a CV are categorized as survival skills. QUESTION 15 Imagining are dependent upon the senses and is a precondition for learning. QUESTION 16 The learner is able to transcend reality and enter a world of â€Å"nonreality† through the process of personalization. QUESTION 17 The composite interview method is made up of the best elements from the direct and indirect interviews. QUESTION 18 The three main considerations governing a career choice are job description, working conditions and job opportunities. QUESTION 19 In the decision making process the delaying decider is the â€Å"whatever will be, will be† type. QUESTION 20 During observation the learner is always the object. (20)

Influenza Vaccination for Pregnant Health Care Workers

Influenza Vaccination for Pregnant Health Care Workers Jee Hae Kim Introduction A certain pregnant nurse was fired because of refusing to get a flu shot in Pennsylvania in December, 2013 (Murphy, 2013). Getting a flu shot is the one of the biggest issues for health care professionals who are especially pregnant health care workers. However, vaccination still remains the most effective way for preventing severe influenza illness. According Center for Disease Control and Prevention (CDC) and American College of Obstetricians and Gynecologists (ACOG), seasonal flu vaccination is recommended for all pregnant women (Goldfarb, Panda, Wylie Riley, 2011). But, why do they hesitate to get a flu shot? Current vaccination rate Flu vaccination rate for pregnant women is still low in the US. In 2005, the US achieved just 16% influenza vaccination coverage of pregnant women, and it is estimated that less than 10% of pregnant women who are at highest risk of influenza receive the vaccine (Broughton, Beigi, Switzer, Raker Anderson, 2009). Even with increased morbidity during pregnancy from seasonal influenza, only 11% of pregnant women were vaccinated during the 2008 through 2009 flu season (Dlugacz, Fleischer, Carney, Copperman, Ahmed, Ross Silverman, 2012). In addition, influenza vaccination rates have remained substantially below 50% for Health Care Personnel (HCP). Within the population of HCP, nurses have been shown to have lower influenza vaccination rates than physicians (Clark, Cowan Wortley, 2009). Although the rate is getting increase little by little, it is still low compared to physicians’ vaccination rate. Barriers for vaccination According to a certain survey, 58.3% of patients reported feeling scared about seasonal flu infection during their pregnancy (Goldfarb, et al., 2011). What are the main causes they are afraid of getting a flu shot? One of those reasons is that they have a fear uncertainly because they do not know specifically how safe flu vaccine is while they are pregnant. In addition, they do not know as well about how dangerous unvaccinated status is during pregnancy. Vaccinated nurses demonstrated greater knowledge about influenza and risk factors for influenza, while unvaccinated nurses believed they were not at risk (Clark, et al., 2009). These facts show that knowledge about safety of vaccine is one of the most important keys to decide whether they get a flu shot or not. Vaccine declination was associated with less knowledge about influenza, lower perceived susceptibility, and beliefs that the vaccine is not efficacious of safe (Eppes, Cameron, Gracia Grobman, 2013). Furthermore, health care workers in the obstetric field also have limited knowledge about the epidemiology of influenza infection and most of them do not consider influenza as a potentially serious disease (Broughton, et al., 2009). Political, social and economic backgrounds The states role is to reduce morbidity and mortality by nosocomial inflammation of influenza and maintenance of a reasonable health care workforce and to show that mandatory influenza vaccination is sensibly related to reducing the flu budget (Ottenberg, Poland, Jacobson, Koenig Tilburt, 2011). It can be one of the political reasons for getting a flu shot for health care workers and government forces them to vaccinate. In addition, we can concern about economic aspect. The commerce legislation can make the federal government regulate activity essentially that affects inter-state commerce, including parts of the health care industry which is related to the management infectious disease and prevention. With the public health service act, health and human services department in the US has organized the national vaccine plan, the national vaccine advisory committee, and the national vaccine injury compensation program (Ottenberg, et al., 2011). Through these mechanisms, the commerce legislation permitted the federal government to control, strengthen, or potentially obligate the vaccination of health care workers against influenza and ensure fair movement to arbitrate complaints related to vaccination (Ottenberg, et al., 2011). It shows that mandatory vaccination can lead saving budget for government because they do not have to pay for the treatment of the secondary infection for people due to influenza . Ethical concerns There are also possible ethical arguments underlying mandatory vaccination. Hospitals are enforcing health care workers to vaccinate for two primary reasons. The one is for supporting of the professional duty of health care workers to benefit for patients individually and to ‘Do No Harm’ and another is for meeting the shared obligations of hospitals and health care workers to protect the public health with infectious disease which is preventable (Ottenberg, et al., 2011). In these situations, we can think about the important questions such as â€Å"What are the obligations of health care workers to their patients?† or â€Å"Is it proper for patients to expect health care workers to get a flu shot because of influenza?† Possible solutions I suggest some solutions to promote vaccination for pregnant health care workers. First of all, the convenience of influenza vaccination is strongly needed such as using mobile vaccination carts. Instead of fixed date or time for vaccination, health care workers can have it depending on their schedules. Secondly, provision of free vaccination and peer vaccination is another good method for promoting vaccination. For example, some pregnant nurses who are already vaccinated could be a good model for other pregnant nurses who are not vaccinated yet. Thirdly, incentive programs also can be a great way for health care workers. If they can get extra pay, the rate of vaccination can be raised. Lastly, education about safety of vaccination for pregnant health care workers is the most effective method. Indeed, I had concerned about wearing a mask while they are working without vaccination, but this could be not a perfect prevention of pandemic influenza. Instead of this, it would be better to persuade them who refuse vaccination and to emphasize again about the safety of vaccination during pregnancy. Safety of vaccination during pregnancy There are already several studies to prove safety of vaccination during pregnancy. According to CDC, studies of a lot of pregnant women in scientific view have checked the safety of vaccination during pregnancy. These studies did not show any evidence of danger to pregnant women, even to the unborn fetus and to newborns of vaccinated women (CDC, 2013). In addition, the Food and Drug Administration’s (FDA) and CDC’s periodic monitoring of side effects’ occurrence has not raised safety concerns (CDC, 2013). Rumors and fears should not be an obstacle to promoting patient safety and public health. The implementation of mandatory vaccination should solve the ambiguous concerns and misconceptions of vaccine safety as well. Rates of serious side effects’ occurrence following vaccination, such as Guillain-Barrà © syndrome, are vanishingly low as no higher than 1 in 1,000,000 (CDC, 2013). Conclusion Among several solutions as I mentioned above, I guess the best way to promote the flu-vaccination rate for pregnant health care providers is education. An effective educational strategy should focus on known misconceptions and knowledge gaps. Furthermore, the influence of health care workers on patient vaccination coverage should not be underestimated. It has been shown that health care workers’ recommendations have positive effects on the likelihood of patients to be vaccinated (Broughton, et al., 2009). According to an article, women whose maternity care provider has recommended the vaccine are much more likely to receive it than those whose providers did not (Broughton, et al., 2009). It shows that how critical education affect not only pregnant health care workers, but also pregnant patients. I insist that health care workers should be vaccinated because reducing the transmission of preventable diseases cannot prevent any harm in the clinical care area. Health care worker vaccination of influenza is consistent with a collective professional accountability to treat all patients moderately and to use appropriate precautions against preventable harms. With mandatory health care worker vaccination, health care organizations should make sure that vaccination is an informed procedure. Health care workers should also get the information clearly about benefits and risks related to influenza vaccination and that vaccines are offered handily. Reference Broughton, D. E., Beigi, R. H., Switzer, G. E., Raker, C. A., Anderson, B. L. (2009). Obstetric health care workers’ attitudes and beliefs regarding influenza vaccination in pregnancy. Obstetrics Gynecology, 114(5), 981-987. Center for Disease Control (2013, September 3). Seasonal Flu Vaccine Safety and Pregnant Women. Retrieved March 17, 2014 from: http://www.cdc.gov/flu/protect/vaccine/qa_vacpregnant.htm Clark, S. J., Cowan, A. E., Wortley, P. M. (2009). Influenza vaccination attitudes and practices among US registered nurses. American Journal of Infection Control, 37(7), 551-556. Danzon, P. M., Pereira, N. S., Tejwani, S. S. (2005). Vaccine supply: a cross-national perspective. Health Affairs, 24(3), 706-717. Dlugacz, Y., Fleischer, A., Carney, M. T., Copperman, N., Ahmed, I., Ross, Z., Silverman, R. A. (2012). 2009 H1N1 vaccination by pregnant women during the 2009-10 H1N1 influenza pandemic. American journal of obstetrics and gynecology, 206(4), 339-e1. Eppes, C., Wu, A., You, W., Cameron, K. A., Garcia, P., Grobman, W. (2013). Barriers to influenza vaccination among pregnant women. Vaccine, 31(27), 2874-2878. Goldfarb, I., Panda, B., Wylie, B., Riley, L. (2011). Uptake of influenza vaccine in pregnant women during the 2009 H1N1 influenza pandemic. American journal of obstetrics and gynecology, 204(6), S112-S115. Murphy Carrie (2013, Dec 23). Pregnant Nurse Wrongfully Fired For Refusing Flu Shot Because Of Miscarriage Concerns. Mommish.com. Retrieved March 21, 2014, from http://www.mommyish.com/2013/12/23/pregnant-nurse-wrongfully-fired-refusing-flu-shot. Ottenberg, A. L., Wu, J. T., Poland, G. A., Jacobson, R. M., Koenig, B. A., Tilburt, J. C. (2011). Vaccinating health care workers against influenza: the ethical and legal rationale for a mandate.American journal of public health,101(2), 212.

Wordplay Functions In Literature And Literary Theory English Language Essay

Wordplay Functions In Literature And Literary Theory English Language Essay Abstract: Wordplay occupies a significant position in several important conceptions and theories of literature, principally because it has both a performative and a critical function in relation to language and cognition. This article describes the various uses and understandings of wordplay and their origins in its (Whose?) unique flexibility, which involves an interaction between a semiotic deficit and a semantic surplus. Furthermore, the article illustrates different methods of incorporating theories of wordplay into literature and literary theory, and finally, it demonstrates the ways in which the use of wordplay often leads to the use of metaphors and figurative language. Introduction Puns and wordplay occupy a significant position in literature as well as in various ways of reflecting on and conceptualizing literature. They can be used to produce and perform a poetic function with language and they can be used critically, which entails considering them from a distance(?) as utterances that undermine meaning and sense and that ultimately accomplish a deconstructive performance. A dictionary definition of the word pun illustrates that both homonymy (when two words with unrelated meanings have the same form) and polysemy (when one word form has two or more, related, meanings) can properly be used to form puns: a play on words, sometimes on different senses of the same word and sometimes on the similar sense or sound of different words (American Heritage College Dictionary 1997, Third Edition). However, this definition could also be extended to embrace the term wordplay, mainly because pun seems to cover only single words.  [1]  So a more precise definition of pu n might be a play on words, sometimes on different senses of the same expression and sometimes on the similar senses or sounds of different words (This is between inverted commas. Where is the citation?). The various uses and understandings of wordplay originate from a flexibility which this article attempts to identify and describe from both a historical and a contemporary perspective. Wordplay involves an interaction between a semiotic deficit and a semantic surplus and is therefore primarily understood and used in two different ways in literature and literary theory. Literary scholar Geoffrey Hartman succinctly articulated this interaction in an essay titled The Voice of the Shuttle: Language from the Point of View of Literature (1970) I dont know which system of citation the author is using. If it is APA, this citation is wrong: You can define a pun as two meanings competing for the same phonemic space or as one sound bringing forth semantic twins, but, however you look at it, its a crowded situation (1970: 347). The semiotic deficit is caused by one sign or expression signifying at least two meanings. The semantic surplus, on the other hand, refers to the cognitive event happenin g in the individual (in literature, the reader) experiencing the play on words. The article describes these two features of wordplay with the help of a few examples of wordplay in literature and literary theory, and it also demonstrates that the use of puns and wordplay often leads to the use of metaphor and figurative language or a semantic surplus like Hartmans twins. Furthermore, the article presents an argument for distinguishing between exploring the intention behind the use of wordplay and exploring wordplay itself. In the previous paragraph, the author talked about an essay by Hartman. Is he/she still referring to that essay when he/she talks about the article? Paranomasia and traductio In the beginning was the pun (1957: 65), writes Samuel Beckett in his novel Murphy from 1938 The citation is wrong, according to APA standards, but although puns and wordplay as such may have been with us from the very beginning (of what?) Beckett is paraphrasing the Bible), actual descriptions of wordplay do not appear until the rhetorical studies of Cicero and Quintilian. Parts of Platos Cratylus do; however, bear a superficial resemblance to wordplay because Socrates makes fun of etymological argumentation, showing the reader how language can lead to sophistic blind alleys and dead ends, which can be deceptive to those who are not familiar with the well-known schism between the world of ideas and the world of phenomena. Moreover, in Phaedrus, Socrates argues that in the written word there is necessarily much which is not serious (277E) It wasnt written by Socrates, but by Plato. It is this argumentation which Jacques Derrida later criticizes in Platos Pharmacy (1998) the system of citation does not seem to be consistent. Names of books are alternatively written in bold type, without inverted commas, or in normal type, with inverted commas, in which Derrida attempts to demonstrate the erosion of Platos argumentation through the two-sidedness and ambiguity of the word pharmakon and through the way Plato plays on the multiple meanings of this word. Writing is both a remedy and a poison, producing both science and magic. Platos antidote to sophism is episteme, or, in Derridas view, mental or epistemological repression. Derridas text demonstrates an interesting and intimate connection between writing, wordplay, oblivion and memory, but since this is a perspective a bit outside the framework of this article I will carry on a more historical view..  [2]   Over time, wordplay has been linked to the rhetorical terms of traductio and adnominatio. The anonymous Rhetoric to Herennius (Rhetorica ad Herennium), written in the period 86-82 BC and ascribed to Cicero until the fifteenth century, states that [t]ransplacement [traductio] makes it possible for the same word to be frequently reintroduced, not only without offence to good taste, but even so as to render the style more elegant (1954: 279) The work of Derrida was not cited like this. Traductio is classified below figures of diction and is compared to other figures of repetition. Common to these figures is an elegance which the ear can distinguish more easily than words can explain. (1954: 281). Identifying wordplay as traductio, however, may not entirely correspond with the understanding we have of wordplay today, although the lack of explanatory words within this rhetorical figure is comparable to the above-mentioned thesis. Today, we would perhaps rather characterize wordplay as adn ominatio [called paranomasia in the English translation]. The Rhetoric to Herennius states that wordplays should be used in moderation because they reveal the speakers labour and compromise his ethos: Such endeavours, indeed, seem more suitable for a speech of entertainment that for use in an actual cause. Hence the speakers credibility, impressiveness, and seriousness are lessened by crowding these figures together. Furthermore, apart from destroying the speakers authority, such a style gives offence because these figures have grace and elegance, but not impressiveness and beauty. (1954: 309) I have indented this, according to APA norms. Wordplay must therefore be used economically so as not to seem childish or to monopolize the listeners attention. In addition, the author of the Rhetoric points to the fact that one very quickly becomes too clever by half if the frequency of paronomasia is too high. In Quintilians treatise on rhetoric, The Orators Education (Institutio Oratoria), wordplay is reckoned among figures of speech (9.13). Another style of citation. Quintilian divides these into two types, the first of which concerns innovations in language, while the second concerns the arrangement of the words. The first type is, according to Quintilian, more grammatically based, while the latter is more rhetorically based, but with indistinct limits. At the same time, the first one protects the speaker against stereotypical language. Wordplay belongs to what Quintilian refers to as figures which depend on their sound; other figures depend on alteration, addition, subtraction or succession. Quintilian treats wordplay immediately following the chapter on addition and subtraction, thereby suggesting its status as something which neither subtracts nor adds. Otherwise his conception of wordplay is similar to that of the Rhetorica ad Herennium: wordplay should be used with cautiousness and only if it to some extent strengthens a point, in which case it can have a convincing effect.  [3]   What we can learn by reading these passages on wordplay in Quintillian and the Rhetorica ad Herennium is that ever since the beginning of literary studies our understanding of wordplay has oscillated between at least two different extremes: traductio and adnominatio / paranomasia, or, one could say, between an outer understanding concerned with the context and an inner understanding mostly concerned with language itself. This could also be one of the main reasons why literary theory has tended to describe puns and wordplay in two ways: either as magical (iconic) language use or as critical language use. Magical language use has much in common with wordplay as a rhetorical figure, and thus also with the way wordplay was used in antiquity and in the romantic era, between which periods the literature of Shakespeare creates an important link. For instance, it is quite remarkable that at first Shakespeare was admonished for his plays on words. In Germany, the Enlightenment poet and transl ator of Shakespeare, C.M. Wieland citation?, also complains about the wisecracks. He calls them albern (silly) and ekelhaft (disgusting). When A.W. Schlegel citation?, on the other hand, gets hold of Shakespeares texts, he is much more attentive to and respectful of the latters excesses in language. Schlegel is in debt to Herder citation?, who is one of the first in Germany to appreciate the poetry in Shakespeares works (their rhythm, melody and other more formal qualities) (cf. Larson (1989)). We cant carry out this comparison, because the works have not been properly cited. By using the rather odd term magical language, this article aims to carry on colloquial a German tradition of treating wordplay as Sprachmagie. Walter Benjamin, for instance, construes language as magical or self-endorsing citation?.  [4]  Critical language use, however, is more comparable to the use of wordplay and the discussion of wit in the Age of Enlightenment, and thus more generally to humour, including, for instance, the joke and the anecdote (whereas in relation to magical language use, wordplay should be regarded as akin to the riddle, the rebus and the mystery). Much literary theory may therefore have adopted these two ways of dealing with and understanding wordplay: it is treated as exceptionally poetic and almost magical precisely because it is untranslatable, or as something which can be used in a general critique of language in which this untranslatableness is used as an argument for the arbitrariness of the relationship between signifià © and signifiant .citation ?The words were not coined by the author of this paper. Wordplay as part of language criticism The work of the linguist Ferdinand de Saussure citation may be seen as a prism for the two understandings of wordplay throughout the twentieth century. On the one hand, there is the scholar Saussure, who later became famous for his hypothesis of the arbitrary relationship between signifià © and signifiant and for his statement that language only contains differences without positive terms. On the other hand, there is the other Saussure, who, besides his more official scholarship, occupies himself with anagrams in Latin texts (cf. Starobinski 1979). In his private scholarship Saussure considers the sign highly motivated, which stands in contrast to his thesis of the arbitrariness of the sign in his official scholarship. Saussures remarkable occupation with language alternates between an almost desperate confidence in language and a growing distrust of its epistemological value. The discussion in the last part of this article will be based on this distrust, orienting it toward Nietzsc he and Freud, since they represent two of the most predominant views on language and thus wordplay in several important literary theories of the twentieth century, not least Russian Formalism and deconstruction. Franz Fà ¼rst (1979) wrongly cited, according to APA norms mentions that wordplay changes character during the nineteenth century. First, the romantic age idealizes it, changing its characteristics. Wordplay is not only connected to wit, but also to in my free translation from Bernhardis Sprachlehre (1801-1803) citation the eternal consonance of the universe through its heterogeneous homogeneity.  [5]  The coherence between sound and meaning was therefore at first considered deeper than might be expected, but the coherence, as the future would show, also had another side displaying a quite different function of wordplay. Fà ¼rst explains: Aus einer à ¤hnlichen Bemà ¼hung um die Wiederherstellung der engen Wort-Ding-Beziehung, jedoch mit karikaturistischer Absicht, entstand eine neue Technik des Wortspiels, die von Brentano und ihm folgend von Heine und Nietzsche verwendet wurde. Diese Technik verzichtet auf das Urwort und begnà ¼gt sich mit der Wortentstellung, der Karikatur eines ehemals organisch-sinnvollen Wortes zur Bezeichnung einer entstellten Wirklichkeit. (1979: 49) We need a translation of this. In Fà ¼rsts view, from pointing out a deeper coherence, wordplay now stands at the service of a distorted reality. It becomes an example of the play of falseness and designates a disfigured reality, especially concerning epistemological questions. The connection with this deeper coherence is therefore eliminated from language and discarded. For example, wordplay and other rhetorical figures which build upon likeness, like the metaphor, are denigrated in Nietzsches work from 1873, On Truth and Lie in an Extra-Moral Sense citation , when he proclaims that the truth is only [a] mobile army of metaphors, metonyms, and anthropomorphisms in short, a sum of human relations which have been enhanced, transposed, and embellished poetically and rhetorically (1982: 46-47). Martin Stingelin points out that Nietzsches wordplay gewinnt (à ¢Ã¢â€š ¬Ã‚ ¦) seine reflexive Qualità ¤t gerade durch Entstellung (1988: 348) Translation, citation. Precisely because everything is rhetoric anyway, we must turn the sting of language against itself. In this connection, wordplay is the least convincing example of false resemblances made by language and can therefore participate reflectively and ironically in such an Enstellung (distortion). The failure to convince should indicate, and thereby ironically convince us, that there is something inherently wrong with language and the epistemological cognition it attends to for us. Besides Nietzsches critique, we also find Freuds general distrust of language in the beginning of the twentieth century. Most relevant to wordplay is his work The Joke and Its Relation to the Unconscious. Date, citation.With this as a starting point, it is possible to make some more general remarks about the fundamental importance of the relationship between wordplay and metaphor in the different ways in which wordplay is understood and used in twentieth-century literary theory. Freud believes that play on words is nothing but condensation without substitute-formation; condensation is still the overriding category. A tendency to parsimony predominates in all these techniques. Everything seems to be a matter of economy, as Hamlet says (Thrift, thrift, Horatio!) Speech marks (2003: 32). Freuds interest in wordplay therefore goes by way of the joke, which is primarily characterized by economization and condensation.  [6]  A substitution is omitted; in other words, wordplay is not a translation of something unconscious, but a translation which more precisely takes place in language. This is also one of the definitions that Walter Redfern arrives at (1997: 265). Redferns study of wordplay is without doubt the most comprehensive yet in a literary context, but the many metaphorical classifications for instance, ubiquity, equality, fissiparity, double-talk, intoxication (2000: 4) or bastard, a melting-pot, a hotchpotch, a potlatch, potluck (2000: 217) are char acteristic of the relationship between wordplay and metaphor. Wordplay therefore has to do with something fundamentally poetic in language, or as Roman Jakobson puts it, poetry is precisely characterized by being untranslatable: In poetry, verbal equations become a constructive principle of the text. Syntactic and morphological categories, roots, and affixes, phonemes and their components (distinctive features) in short, any constituents of the verbal code are confronted, juxtaposed, brought into contiguous relation according to the principle of similarity and contrast and carry their own autonomous signification. Phonemic similarity is sensed as semantic relationship. The pun, or to use a more erudite and perhaps more precise term paronomasia, reigns over poetic art, and whether its rule is absolute or limited, poetry by definition is untranslatable. (1987: 434) If wordplay may be characterized as a translation in language, metaphor may be considered a translation with language, and each time this inner translation or untranslatability of a pun or wordplay is translated, words for this translation are lacking. Arguably, this is exactly where metaphor helps, like a Band-Aid for a small wound. For this lack or deficit of words produces a poetic surplus which is precisely able to express itself in metaphors and figurative language in general. The latter is an attempt to explain the translation or translate it to something more comprehensible. Whereas the metaphor gives the sense of an effective blend between two semantic fields which together create a third one, wordplay gives a very different impression. The third place which the wordplay creates in its expression is not intellectually comprehensible, but rather inscribed in the form of its own manifestation, a distinctive blend of sound and sense. The incomprehensibleness is an argument for both of its general understandings, partly according to a view which considers language something which can reveal the nonsense of a truth (language criticism) and partly according to a certain kind of nonsensical truth, the idea that language contains m ore than we are aware of (magical language use). Consequently, it is not so odd that metaphor is useful for describing wordplay: metaphor creates a convergence between several semantic fields by covering up the differences between them and in so doing often makes poetry happen. Wordplay, on the other hand, fixes the difference in the mind, thus maintaining the convergence in its very expression. Take, for instance, the literary example of Shakespeares Sonnet CXXXII: THINE eyes I love, and they, as pitying me, Knowing thy heart torment me with disdain, Have put on black and loving mourners be, Looking with pretty ruth upon my pain. And truly not the morning sun of heaven Better becomes the grey cheeks of the east, Nor that full star that ushers in the even, Doth half that glory to the sober west, As those two mourning eyes become thy face: O! let it then as well beseem thy heart To mourn for me since mourning doth thee grace, And suit thy pity like in every part.   Ã‚  Ã‚  Ã‚  Then will I swear beauty herself is black,   Ã‚  Ã‚  Ã‚  And all they foul that thy complexion lack. The sonnet is replete with wordplay and puns, especially on the words I and eye, and morning and mourning no inverted commas here?, but also and perhaps less importantly on the words ruth and truth. Appropriately, the sonnet contains two instances of the word I, punningly mirroring the two eyes. But an expression and a metaphor like the grey cheeks of the east would simply not emerge without the existence of the pun between morning and mourning. The poem develops and invents a vocabulary and uses expressions which would simply not exist or appear without the puns and plays on words. It actually manages to connect blackness with beauty because of the pun between mourning and morning which also connects the sun with the full star and in this manner with the night. Hence, everything that the I in the sonnet lays eyes on is polluted by a look of mourning and pity. The connection mentioned above causes most scholars to describe wordplay as a potential metaphor; even Freud (especially read in the perspective of Jacques Lacan citation  [7]  ) indicates that we should understand wordplay this way. However, no one has shown that metaphor is a potential wordplay. The question must be whether the connection goes both ways or if wordplay simply is a more initial metaphor? In any case, following Lakoff and Johnsons now classic theory (1980), it is easy to suspect that so-called dead metaphors can be played on more easily than other words for example, the word leg, which is used in connection with chairs, tables and human beings, or words like root or rose, which function in countless contexts. The ambiguity is most severe in connection with some of the key examples provided by Lakoff and Johnson, such as our value-laden and metaphorical organization of space in up and down, in and out, and so forth. The reason for this is probably not that these e xpressions are metaphorical, but rather that they belong to the trite vocabulary which often activates wordplay makes it alert, as Redfern citation writes. In other words, a revitalizing process in language takes place between wordplay and metaphor. Wordplay is not more original than metaphor, nor is the reverse true, for that matter. Experience has shown that wordplay has a tendency to generate metaphors when we attempt describe what they exactly mean and that dead metaphors have a tendency to generate wordplay. Regarding the latter, the same applies to dead language in general, such as hackneyed proverbs, phrases and clichà ©s. Along with the dead metaphors, these expressions make up an un-sensed language which often activates wordplay. The more remarkable of these two relations is without doubt the first one, which I will therefore focus on. The relation between wordplay and metaphor outlined above corresponds with the one that Maureen Quilligan (1992) identifies between wordplay and allegory. Below, we will examine Quilligans understanding of their connection. Wordplay and allegory Quilligan tries to redefine allegory as a genre in which wordplay plays a central part due to its ambiguousness, or as Quilligan writes, [a] sensitivity to the polysemy in words is the basic component of the genre of allegory (1992: 33). Quilligan sees wordplay as initiating the unfolding of the relationship of the text to itself. The text comments on itself, not discursively, but narratively. In this way an author does the same thing with allegory as the literary critic, but the difference is that the author makes commentary on that is, enacts an allegoresis of his own text, which is due to the fact that language is self-reflexive. But this self-reflexivity is only brought about through the reader, who therefore constantly plays an important role in Quilligans reading and re-evaluation of allegory. Self-reflexivity is, however, potentially inscribed in the text through certain traces, especially through polysemy, which expresses itself on the most fundamental literal level specif ically, in the sounds of the words and it is in this respect that wordplay enters the picture alongside allegory. Quilligan uses Quintilian to differentiate between allegory and allegoresis. Allegoresis is literary interpretation or critique of a text, and it was this concept that Quintilian was referring to when he wrote that allegory means one thing at the linguistic level and another at the semantic level; in other words, as a figure, allegory could retain a separation between several semantic levels for a long time for example, between a literal and a figurative level. However, the other which the word allegory points towards with its allos is not someone floating somewhere above the text, but the possibility of an otherness, a polysemy, says Quilligan, on the page and in the text. The allegory designates the fact that language can mean numerous things at once. This very redefinition causes Quilligan to turn towards wordplay. Besides, Quilligan wants to escape from a vertical understanding of allegory such as it has been inherited from Dante, who organized his Divine Comedy according to the Bible, which he believed had four layers of meaning. Quilligan suggests that allegory works horizontally, so that the meaning is increased serially by connecting the verbal surface before moving to another level for example, beyond or above the literal level. And this other level which she refers to has to be located in the reader, who will gradually become aware of the way he or she creates the meaning of the text. Out of this awareness comes a consciousness, not just of how the text is read, but also of the human response to the narrative. Self-reflexivity occurs, and, finally, out of this a relation is established to the other (allos) towards which the allegory leads its reader through the allegoresis. This sensation of the real meaning can be called sacred. Quilligan aims to grasp allegory in its pure form before it becomes allegoresis. Through her readings, she tries to identify a more undetermined conception of allegory on a linguistic level before it gets determined by and in the reader. Quilligan could have used Quintilians definition of allegory as a continued metaphor (III, 2001, 8:6: 44) to establish a relation between allegory, metaphor and wordplay. In my view she thus misses something essential in the contiguous relationship between wordplay, allegory and allegoresis, and this is the making of metaphors. The relation between wordplay and metaphor constitutes a more intimate bond than that between wordplay and allegory, or, as James Brown puts it: The pun is the first step away from the transparent word, the first step towards the achievement of symbolic metaphor (1956:18). But this does not mean that wordplay is some sort of metaphor, as Brown seems to suggest. More accurately, it would be reasonable to suggest that wordplay gives rise to creative language usage, including metaphors and figurative language use in general. This very use is an attempt to translate the relative untranslatability of wordplay, and thereby to satisfy a natural human desire for understanding. Russian formalism vs. deconstruction By treating the text as described above, Quilligan can read several texts in a new and constructive manner inspired by the way that early literary works such as The Faerie Queene way of writing titles deal with language. But it is principally Quilligans starting point and to a lesser degree her treatment of the text that I aim to pinpoint with my focus on wordplay. This article does not claim that the twentieth century should only be understood in the light of wordplay, but rather that in some periods wordplay was used with very specific intentions, and that it offers an understanding of language which several literary theories benefit from. Wordplay stands out particularly in two twentieth-century literary theories namely, Russian formalism and literary deconstruction in the wake of Jacques Derrida citation but it is used in very different ways in these theories. In Russian formalism, wordplay involves a revitalization of language,  [8]  parallel to the concept of skaz,  [9]  which refers to an illusion of a kind of orality or even realism in literary language. In contrast, in deconstruction, wordplay is often tied to writings influence on language in general to a grammatology, to borrow Derridas term. From a deconstructive perspective, wordplay deals with the inadvertent or unintended in the intended (cf. Gordon C.F. Bearn 1995a: 2), or with absence in presence; the exact opposite is true in Russian formalism, which deals with puns and wordplay as a form of oral presence in writing, likening this to a kind of absence. Here, as in other cases, wordplay is involved in a fundamental shift in perspective between a semiotic deficit and a semantic surplus in what may be called a constructive and deconstructive construction of meaning. An example of this problematic is a book by Howard Felperin citation problems with the symptomatic title Beyond Deconstruction. The Uses and Abuses of Literary Theory. In this book, Felperin differentiates between what he calls the enactment and counter-enactment of wordplay, emphasizing counter-enactment at the expense of enactment: If the figures of enactment, of speaking in effect in Shakespeares phrase, work cumulatively to integrate the jigsaw puzzle of language into concrete replica of the sensory world, the pun is precisely that piece of language which will fit into several positions in the puzzle and thereby confound attempts to reconstruct the puzzle into a map or picture with any unique or privileged reliability or fidelity of reference. Whereas metaphor and onamatopeia attempt to bridge the precipitate fissures between signs and their meaning, paronomasia [or wordplay; Felperin does not make a distinction] effectively destabilizes further whatever conventional stability the relation between sign and meaning may be thought to possess. (1985: 185) (My addition) In Felperins view, wordplay turns our understanding of things upside down in respect to both language in general and certain overall views of life and so forth. This is the reason why wordplay has been disliked for so many years. Felperin analyses Shakespeare and finds that wordplay is at the disposal of language in various ways in Shakespeares work, precisely in the form of a counter-enactment. However, what he seems to forget is that not only does wordplay oppose similarities, but it also conveys likeness for instance, in the wordplay between eye and I, which may underlie a much deeper understanding of the sonnets and of subjectivity in Shakespeares works in general (cf. Fineman 1988). Arguing against the theory of enactment, Felperin criticizes, among other things, Russian formalism as a theory founded on metaphor (which from Felperins deconstructive perspective is the wrong foundation when it comes to an ontology of language): The Russian formalists, for example, like the Elizabethans, see language as aboriginally poetic, and similarly identify its performative potential in the storehouse of metaphor that lies buried within it (1985: 180). Only Shakespeare escapes this sort of criticism, which appears typical of the period and untenable. Metaphor almost seems like a dark, anthropomorphic enemy in such a deconstructive point of view. Furthermore, Felperin of course makes considerable efforts to define wordplay as a matter