Guide to Punctuation for English Learners

Guide to Punctuation for English Learners Punctuation is used to mark the cadence, pauses, and tone in written English. In other words, punctuation helps us to understand when to pause between fully formed ideas when speaking, as well as organize our thoughts in writing. English punctuation marks include: period .comma  ,question mark ?exclamation mark !colon :semi colon ; Beginning English learners should focus on understanding the period, comma, and question mark. Intermediate to advanced student should also learn how to use colons and semi colons, as well as an occasional exclamation mark. This guide provides instruction on the basic rules of using a period, comma, colon, semicolon, question mark and exclamation point. Each type of punctuation is followed by an explanation and example sentences for reference purposes. Period Use a period to end a complete sentence. A sentence is a group of words containing a subject and predicate. In British English a period is called a full stop. Examples: He went to Detroit last week. They are going to visit. Comma There are a number of different uses for commas in English. Commas are used to: Separate a list of items. This is one of the most common uses of a comma. Notice that a comma is included before the conjunction and which comes before the final element of a list. Examples: I like reading, listening to music, taking long walks, and visiting with my friends. They would like books, magazines, DVDs, video cassettes, and other learning materials for their library. Separate phrases (clauses). This is especially true after a beginning dependent clause or a long prepositional phrase. Examples: In order to qualify for your certificate, you will need to take the TOEFL exam. Although he wanted to come, he wasnt able to attend the course. Separate two independent clauses that are connected by a conjunction such as but. Examples: They wanted to purchase a new car, but their financial situation would not allow it. Id really enjoy seeing a film this evening, and Id like to go out for a drink. Introduce a direct quote (as opposed to indirect speech i.e. He said he wanted to come ...). Examples: The boy said, My father is often away during the week on business trips. His doctor replied, If you dont stop smoking, you run the risk of a heart attack. Separate appositives (a noun, or noun phrase) or non-defining relative clauses. Examples: Bill Gates, the richest man in the world, comes from Seattle. My only sister, who is a fantastic tennis player, is in great shape. Question Mark The question mark is used at the end of a question. Examples: Where do you live? How long have they been studying? Exclamation Point The exclamation point is used at the end of a sentence to indicate great surprise. It is also used for emphasis when making a point. Be careful not to use an exclamation point too often. Examples: That ride was fantastic! I cant believe he is going to marry her! Semicolon There are two uses for a semicolon: To separate two independent clauses. One or both of the clauses are short and the ideas expressed are usually very similar. Examples: He loves studying; he cant get enough of school. What an incredible situation; it must make you nervous. To separate groups of words that are themselves separated by commas. Examples: I took a holiday and played golf, which I love; read a lot, which I needed to do; and slept late, which I hadnt done for quite a while. They plan to study German, for their travels; chemistry, for their work; and literature, for their own enjoyment. Colon A colon can be used for two purposes: To provide additional details and explanation. Examples: He had many reasons for joining the club: to get in shape, to make new friends, to lose some weight, and to get out of the house. She gave notice for the following reasons: bad pay, horrible hours, poor relations with colleagues, and her boss. To introduce a direct quote (a comma can also be used in this situation). Examples: He announced to his friends: Im getting married! She cried out: I never want to see you again!

Tobacco Advertising Essays - Tobacco, Smoking, Philip Morris, Habits

Tobacco Advertising Essays - Tobacco, Smoking, Philip Morris, Habits Tobacco Advertising Tobacco Advertising and its dangerous effects on young people. Tobacco Advertising Makes Young People Their Chief Target Everyday 3,000 children start smoking, most them between the ages of 10 and 18. These kids account for 90 percent of all new smokers. In fact, 90 percent of all adult smokers said that they first lit up as teenagers (Roberts). These statistics clearly show that young people are the prime target in the tobacco wars. The cigarette manufacturers may deny it, but advertising and promotion play a vital part in making these facts a reality (Roberts). The kings of these media ploys are Marlboro and Camel. Marlboro uses a fictional western character called The Marlboro Man, while Camel uses Joe Camel, a high-rolling, swinging cartoon character. Joe Camel, the "smooth character" from R.J. Reynolds, who is shown as a dromedary with complete style has been attacked by many Tobacco-Free Kids organizations as a major influence on the children of America. Dr. Lonnie Bristow, AMA (American Medical Association) spokesman, remarks that "to kids, cute cartoon characters mean that the product is harmless, but cigarettes are not harmless. They have to know that their ads are influencing the youth under 18 to begin smoking"(Breo). Researchers at the Medical College of Georgia report that almost as many 6-year olds recognize Joe Camel as know Mickey Mouse (Breo). That is very shocking information for any parent to hear. The industry denies that these symbols target people under 21 and claim that their advertising goal is simply to promote brand switching and loyalty. Many people disagree with this statement such as Illinois Rep. Richard Durbin who states " If we can reduce the number of young smokers, the tobacco companies will be in trouble and they know it "(Roberts). So what do the tobacco companies do to keep their industry alive and well? Seemingly, they go toward a market that is not fully aware of the harm that cigarettes are capable of. U.S. News recently featured a discussion of the smoking issue with 20 teenagers from suburban Baltimore. The group consisted of ten boys and ten girls between the ages of 15 and 17. When asked why they started smoking, they gave two contradictory reasons: They wanted to be a part of a peer group. They also wanted to reach out and rebel at the same time. " When you party, 75 to 90 percent of the kids are smoking. It makes you feel like you belong," says Devon Harris, a senior at Woodlawn High. Teens also think of smoking as a sign of independence. The more authority figures tell them not to smoke, the more likely they are to pick up the habit (Roberts). The surprising thing is that these kids know that they are being influenced by cigarette advertising. If these kids know that this advertising is manipulating them, why do they still keep smoking? The ads are everywhere, especially in teen-oriented magazines, such as Rolling Stone and Spin. The ads also fuel some of the reasons the children gave for starting. They represent rebellion, independence, acceptance and happiness. These are all the things a young person, between childhood and adolescence, needs and desires. This type of advertising, on top of peer pressure, is the mystery behind the rise in adolescent smoking. How do we stop the future of America from smoking? Here are three things that the experts recommend. Try to convince your children that smoking is not cool. Talk to your kids at a young age about the dangers of smoking. Identify family members who smoke and ask them to stop (Thomas). Children are the most valuable commodity we are given in life. Let's try to educate them while they're young to be independent thinkers and to not be swayed by the tobacco companies who are trying to take advantage of their mind and body. "Bill Clinton vs. Joe Camel." U.S. News & World Report. 2 Sep. 1996: 12. Infotrac. Online. 27 Oct. 1996. "Selling Tobacco to Kids." America. 17 Feb. 1996: 3. Infotrac. Online. 27 Oct. 1996. Roberts, Steven. " Teens on tobacco; kids smoke for reasons all their own." U.S. News 18 Apr. 1996: 38. Infotrac. Online. 27 Oct. 1996. Thomas, Roger E. "10 steps to keep the children in your practice nonsmokers." American Family Physician. Aug. 1996: 450. Infotrac. Online. 27 Oct. 1996. Breo, Dennis L. "Kicking Butts-AMA, Joe Camel and the 'Black Flag' war on tobacco." JAMA, The Journal of the American Medical Association. 29 Oct. 1993:

Success of Chick-fil-a and how it relates to management Essay

Success of Chick-fil-a and how it relates to management - Essay Example 3). Truett unveiled his entrepreneurial skills at an early age of 8 years by opening and successfully operating a stand of Coca-cola at his family’s front yard on 1929 (Cathy 1). Six years later in 1935, Truett’s family relocated to Atlanta’s downtown due to financial strains. He started a paper delivery service to his neighbors, which enhanced his customer service and relations. In 1946 Truett started a small restaurant called Dwarf Grill with the support of his brother Ben Cathy (Cathy 1). This business adventure led to the opening or a second Dwarf House in Forest Park, which unfortunately burnt to the ground leading to massive loss of profit and property. A strong Christian character and business oriented attitude prompted Truett to rebuild the burnt restaurant and started using a home-made chicken recipe for a boneless chicken breast in a sandwich (Cathy 1). This recipe was from his mother’s kitchen, and Truett called it Chick-fil-A. In 1967, the bone less chicken breast recipe attracted many loyal customers which led to the opening of Chick-fil-A first restaurant in a shopping mall in Atlanta (Cathy par. 3). Truett continued to inspire his employees by offering scholarships for further education and housing for the less fortunate teenage boys. Chick-fil-A’s customers enjoy the delicious boneless chicken at affordable prices, which has contributed to 1,605 other restaurants in a total of 39 states in America (Cathy par. 4). As the CEO of Chick-fil-A, Truett has displayed his management and leadership skills by operating the chain of restaurants for 44 years with an upsurge of sales and charity donations (Cathy 4). Employees and youths in local communities benefit from the scholarships offered by Truett to acquire the best education and skills. Management practices Effective management practices in a company ensure that stakeholders, shareholders, employees and customers achieve their personal goals. Good management practic es are directed towards the following departments in a company: human resources, company product, marketing, technology development and process controls. Customer satisfaction is significant in increasing sales while improvement of employees’ working conditions, competency and confidence ensures a high performance output. Interpersonal relations with customers Chick-fil-A chain restaurants are currently under the management of Truett Cathy’s son called Dan Cathy. Cathy is the president and Chief of Operations (COO) of Chick-fil-A restaurants across the U.S. (Zikza 3). Mr. Cathy has power and authority that allows him to sit behind a desk in a closed office and issue orders, but his charismatic character leads him to abandon his office and attend to his customers personally (Carter par. 6). He further explains that Dan Cathy shakes his customers’ hands, serves them the tasty food, clears food trays and helps in cleaning up after his customers. One of Cathyâ€℠¢s foremost and memorable activities in his restaurants is giving kids free ice cream while they are all shouting in joy (Carter par. 8). In the contemporary knowledge-driven markets, many leaders forget the strong customer relationships and services and focus all their time, energy and resources on making profits only. Businesses thrive on demand and

Regional Trade Agreements versus Global Trade Liberalization Annotated Bibliography

Regional Trade Agreements versus Global Trade Liberalization - Annotated Bibliography Example This journal was written on the backdrop of renewed interest in regional trade agreements, with many policymakers and scholars analyzing the benefits and drawbacks of regional trade agreements versus trade liberalization. This book discusses the proliferation of regional trading relationships in the world, particularly in Europe, Asia, and Latin America, and the resulting policy concerns on their impact on excluded countries and generally the global trading system. It has been observed that multilateral system may fracture due to the overt discrimination policies advanced by the regional blocs. The book relies on empirical analysis to explore new forms of preferential trade agreements that concentrate their trades within such regions. In a twist, the author further assesses the regional blocs on what he terms as natural or supernatural and their impacts on the global welfare. in conclusion, the book talks about complete liberalization within blocs without reduction in barriers between them pushes the trading system into the super-national sphere of too much regionalization Many reason underlie the need for regional integration among which include strategic alliances mainly for security purposes, access to a larger chunk of the international market, and lock in domestic policy reform as is with the case with Mexico and the North American Free Trade Agreement. Ensuring of fair returns among the member is also a priority of regionalism as it ensures the disparities that exist among the members do not tilt the scale in favor of any particular member. The article reviewed the theoretical and empirical literatures that have been penned down on regionalism. The regional trade agreements have been to some extent the most liked form of reciprocal form of trade liberalization in the past decade or so. The paper highlights certain aspects of regionalism that have often been forgotten by writers, and theses aspects are key

New York Times Essay Example for Free

New York Times Essay The newspaper serves as the first draft of history and is the most important source of primary documents in which historians use in order to better gauge exactly what were the concerns and motivations of a specific age. In 1900, America was celebrating a new century although there was little to celebrate. The Boar War in South Africa was taking far too long and costing far too many money and lives in what was perceived to be an invincible British Empire. A massive explosion in West Virginia killed dozens of miners and in China, the Boxer Rebellion; a Chinese nationalistic movement in which all foreigners were sought after and either expelled from the country or killed, was causing international headaches for America and President McKinley. The December 24, 1900 issue of the New York Times, the most prestigious newspaper in the country, detailed many of the aforementioned events as well as the smaller stories which never did make the history books but were vitally important for those who were involved. As 1900 was coming to a close and moving into what would be the bloodiest century in human history, the readers of that day, saw a world with no shortage of pessimistic news and depressing facts about the state of their world. In the backdrop of the Christmas season, the concern of the people of New York, as detailed in this issue of the New York Times, were detailing the hatred and strife which much of the world, and especially New York City had, in the day before Christmas.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The most important international issue of this day was the Boar War.   America would remain neutral in this war but with British soldiers deep in the heart of South Africa and fighting a war, the details commanded a position on the front page. The headline in the top left corner of page 1, â€Å"Boars Take British town,† detailed the pursuits of the British army in relation to the Boar War, which was ending its second year with no sign of victory. The war would continue from 1899-1902 and cost more lives and money than would ever have been conceived and historians marked this as the beginning of the end of the British Empire.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   There were other important issues of the day. One issue which the people of New York were talking about that day was the firing of District Attorney Garnier by then governor Theodore Roosevelt. This story was seen on page 1 of the Times as well as a detailed editorial on page 6 of the paper. Theodore Roosevelt was seen as a free thinking Progressive Reformer who had no use for patronage, nor public opinion dictating his actions. He was one of the most unique Presidents this country ever had served in the White House. These aspects came through when Governor Roosevelt, under the idea that Garnier: â€Å"that he did not acknowledge the telegram of the governor directing attention to these officers†¦ and allowed his assets to interfere with the prompt trial of election cases.†[1] In other words, Garnier’s association with Tammany, the political force of the Democratic Party in which graft and patronage ran rampant, could not be separated from the demands of this office. In the election of 1900, it was asserted that Garnier had done little or nothing to stop the election tampering which the Republicans asserted had occurred. Governor Roosevelt believed this to be the case and promptly fired Garnier.   The New York Times, in their editorial, criticized this move, through the professed to be no friend of Garnier. â€Å"We think that the people’s rights and not Garnier’s are infringed by the action of Governor Roosevelt and are forced to condemn that action as a blunder in the nature of a crime.†[2] Tammany, since the days of Boss William Tweed, had been under a suspicion of grafting politicians and Roosevelt, always the reformer, sought to free New York City from the patronage which he felt was choking the lifeblood from the city. Tammany had been a source of patronage for decades and it sometimes served as the only source of employment for immigrants who were being ignored by the establishment. However, Tammany always ran under a cloud of suspicion for corruption and the reform candidates of that age, sought to starve Tammany of patronage. It is also interesting to note that since Governor Roosevelt was causing so much trouble, for both the Democrats as well as the Republicans, that he was placed on the Republican ticket as President McKinley’s Vice President in 1900 only a few months earlier as a way to silence him. Little did they know that the assassination of President McKinley in September 1901, propel Roosevelt onto the world political stage for the next 7  ½ years.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The newspaper also details the stories which never did make the history books. There are many one or two paragraph stories which served as life changing for those involved but which were quickly forgotten in a day or two by the rest of the public. One such story is of five year old Marie Horen who went into convulsions when she drank a bottle of whiskey as she copied what she had seen her father doing. She was rushed to the J. Hood Wright Hospital where her condition was deemed serious. Another story involves nine year old Nathan Roth who was shot in the head by one who the paper deemed crazy. He was shot in the head and the bullet exited the right eye of the boy. The boy was pronounced dead and the defendant, John Galletus, a father of three and one who had attempted to shoot others, was captured and sent away.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Another negative aspect of this day in New York History was the number of fires that were reported. There was listed, sixteen fires that had occurred. One of these fires ripped through a tenement in which it was reported that there presumed to be, a number of victims but as the records of those living in these tenements were sketchy at best, it seems as though the exact count will never be known. It has been suspected that a number of these fires, especially the ones in which barns were being set ablaze, was suspected of being done by a group of sixteen years from the many notorious gangs which New York City housed.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   It was also reported that Andrew Carnegie, the steel magnate, one who had originated from Scotland and had made his fortunes in steel, donated $20,000 for the assembly of a new library at the all black Tuskegee School in which Booker T. Washington founded and led. During these last years of his life, Carnegie sought o give away millions of dollars in the construction of libraries all across the country; from the large cities in America, to the small towns. He had earned his money through the ruthless exploitation of capitalism and now sought to right his wrongs and become a philanthropist and give money to support a new school at Tuskegee. This occurred at a time when only four years later, calls of treason arose from the South when President Roosevelt invited Booker T. Washington, a leader in the African American community to lunch in order to discuss the issues of the day concerning African Americans. It was reported that the entire building would be built from the hard work of the students themselves; a practice which had been adhered to when the school was first built. This speaks to the social culture of the day and is in contrast to the arrest of Ed. Johnson, a â€Å"dark† man who was suspected of kidnapping a woman. The story states, on page 1, that Mr. Johnson had been identified by a child witness as not having been the suspect but which did little to dissuade the authorities to immediately free Mr. Johnson.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Since this issue was dated Christmas Eve, there is also a religious aspect to this day as millions of Christians in the city were set to celebrate the birth of Jesus. This aspect of loving one’s neighbor which is seen more often around Christmas time than any other, was seen in a large advertisement which detailed the Salvation Army’s feeding of the poor as well as the performance of a passion play. These plays were designed to detail the last hours of Jesus before he was hung on the cross. These plays have served as a popular and touching aspect of the Christmas Season but which have become more popular during the Easter season. In this spirit of alms giving, the New York Protestant Episcopal Society was also feeding Christmas dinner to the poor. However, with New York City containing a large Jewish population, it was stated by the prominent rabbis of the city, that the Jewish people can enjoy this Christmas season, the joy and fulfillment which their fellow New Yorkers are experiencing this Christmas season but that Jews should be careful not to blend their appreciation for the enjoyment of others, with their own sense of faith, which it was stated, â€Å"has fundamental and final differences between Judaism and Christianity.†[3]   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   1900 was an important and event-packed year. Reading the newspapers, specifically the New York Times, serves as a reminder that ever day, there occurs events, large and small, important and socially irrelevant, that occur every day and which are important to the people it affects. In a city as large as New York City, there still occurs individual interest stories like the death of nine year old Nathan Roth or the case of five year old Maggie Enloin who went into convulsions after drinking a bottle of whiskey after seeing her father do the same. These stories occur every day, in every part of the country, as well as the world. Many times, they are not reported but in this day, December 24, 1900, the editors of The New York Times, felt that the tragic death of a nine year old to street violence, or the burnings of tenements on the Lower East Side, as well as the involvements of the Boxer Rebellion, the Boar War or the issues of patronage and corruption within the Tammany machine, all fell under the definition: â€Å"All the news that is fit to print.† This day in American History as well as New York History, saw a wide array of human interest stories, coupled with heavy issues and the larger questions of: â€Å"What role will political patronage serve in the city and how much damage can Governor Roosevelt make before he assumes the Vice Presidency? Are the problems of the tenements to only being reported or sill any actions are made to help the poor and to help them rise above their circumstance? Can the deaths of innocent children be reconciled in a city who believes that it is on the cutting edge of the country’s reforms? Also, to what degree, if any, will America get involved in the issues overseas such as the Boar War and the Boxer Rebellion and how their outcomes will affect America’s relations with these countries. The December 24, 1900 issue of the New York Times, had contained within its twelve pages, a wide array of stories from all walks of life and on all levels of importance. Many of the above mentioned people are to be remembered, when they are remembered at all, in the pages of the newspaper: the first draft of history. WORKS CITED The New York Times.   December 24, 1900 (Twelve Pages) [1] Governor Roosevelt’s Error The New York Times.   December 24, 1900 pg. 6 [2] Governor Roosevelt’s Error. The New York Times.   December 24, 1900 pg. 6 [3] The New York Times.   December 24, 1900

Narrative Essay :: Personal Narrative

David The chaos from my teenage sister’s birthday party was deafening. Somehow through the noise, I registered that the phone was ringing. Jumping up, my sister answered it in hopes of hearing her boyfriend’s voice. A look of concern and confusion crossed her face as she handed me the phone. She mouthed the word "David" as I placed the receiver to my ear. Immediately I began fighting off a panic I could not yet explain. Dead. David. Crying and screaming assaulted my senses. "He's dead. He's dead," were all I could hear. I wondered briefly if this was someone’s idea of a cruel joke. But, within moments, the cold reality of this life changing nightmare set in. How could something like this happen to someone I was so close to? I had just talked to him that morning. We were supposed to meet up later to hang out like always. My heart hurt; I couldn’t breathe. It was like I was stuck in a bad movie and I couldn’t turn it off. The tears just wouldn’t stop. I had to see for myself. I slipped my shoes on, grabbed my keys, and rushed to my car. The drive to David’s house was agonizing. I could barely see the road through my tears. The whole drive my mind was racing, trying to grasp the reality of what just happened. Once I got there and saw the ambulances, the policemen, and the look in his family’s eyes it hit me like a ton of bricks. He was really gone and not coming back. I've never seen a body bag with a real body in it. Not in real life and not with one of my friends inside. But there he was surrounded by detectives as the Emergency medical technicians were loading him into the ambulance. I'll never be able to erase that image from my mind and believe me, I have tried. David was a close friend of mine. We had known each other since elementary school. He was the one that could make me laugh nonstop and without even trying to. I could always depend on him to lift my spirits. He had the most amazing caramel eyes that seemed liked they stared into your soul.

A Study or Research on Depression and Anxiety Essay

I. Introduction ‘’ Anna† had been suffering from depression and anxiety attack since adolescence. Her depression started when her parents broke up while her anxiety attacks started her mother started working in Cebu, leaving Anna her psychological problems, but when she was 17, Anna did the ultimate act giving in to her depression, she committed to suicide by hanging. This true story brings home the reality of the problems of depression and anxiety that could afflict individuals regardless of age, status, race, social standing or gender, and the intensity and severity of the pain they bring that could be lead to the ultimate act of suicide. Even the great Sir Winston Churchill suffered from depression in his lifestyle. Severe depression marked by prolonged and very deep sorrow and lowered self-esteem, and anxiety, a serious state of deep worry and panic, affect a large number of individuals today. Shimberg (1991) identifies depression as â€Å" the most common biological disorder seen in psychiatry today that nobody can escape because people are either directly affected by it or try to cope with a  family member who is affected with depression† Aside from the ever-present danger and risk of suicide, depression and anxiety rob affected persons with loss of happiness and well being that could lead to physical, psychological and well social ailments. Many are prevented from going to school from finding or maintaining lucrative jobs, and from enjoying social activities with family and friends. All of these negative effects and fatal impact on depression and anxiety make this study highly significant. This aims to show that depression and anxiety when left undetected o untreated would lead to suicide among teenagers and adults alike. The second part of this study will present the salient facts about depression, its types, causes, risk factors, effects and dangers from suicide, as well as therapy and preventive measures to stop afflicted individuals from committing self-destruction. The next part will present all the facts about anxiety, the different types or manifestations, cause, risk factors, effects, dangers of suicide and also therapy and preventive measures.  The least part will focus on suicide. -the types and methods, the statistics of suicide due to depression and anxiety and the preventive measures that must be done by those nearest to the afflicted people with suicidal tendencies. II. Depression A.Definition Depression can be defined and described in various ways. Kyes and Hofling (1980) define it as a pathologic state, brought on the feelings of loss and/ or guilt and characterized by sadness and lowering of self-esteem. ¹It may also be simply defined as a brain disorder that affects thoughts, moods, feelings, behavior and physical health. More specifically, depression is best defined in terms of its attributes, or the observable signs, symptoms and charges it brings to an afflicted person. These include: (1) a marked alteration in mood such as sadness, loneliness and apathy; (2) a negative self-concept associated with self-reproaches and self-blame; (3) Regressive and self-punitive wishes such as the desires to escape, hide, or die; (4) vegetative changes including anorexia, insomnia, loss of libido ; and (5) change in activity level including retardation or agitation. ³ B.Types of Depression Today, psychiatrists categorize depression into the different types based on their characteristics. The first type termed Major depressive episode is marked by symptoms that appear without any cause that can be pinpointed. It prevents the person from doing normal daily activities and may be isolated (occur once) or recurrent. The second type called Manic episode is marked by dominating abnormal euphoria (extreme happy agitated state) or irritability. The third is Mixed episode marked by alternating mood, between mania depression for at least one week. This episode also goes by the name manic depression or bipolar disorder. The fourth and last in this group of psychiatric categories is Dysthymic disorder marked by the affected individual can still perform normal activities.⠁ ´ The reaction states in the depression are also classified in terms of state or intensity of impairment and disturbance. Neurotic depressive reaction is identified as a state of depression of neurotic intensity wherein realty testing is largely unimpaired and physiologic disturbances are mild. On the other hand, Psychotic depressive reaction is that state depression of psychotic intensity in which realities testing severely impaired and physiologic disturbances (vegetative signs) are usually conspicuous. The third state called Reactive depression is a depressive state which the precipitating stress can be clearly discerned and seen to be of some magnitude. The fourth state called Unipolar depression is a condition characterized by recurrent episodes of depression, usually of psychotic intensity, without episodes of mania.⠁ µ Another type of depression is called Seasonal Affective Disorder or SAD. This is a pattern of major depression related to seasonal changes which might be caused by decreased levels of sunlight and increased melatonin (mood-controlling hormone) in the brain.⠁ ¶ Unlike SAD which can be explained by a biochemical cause the cause of depression and its various types and states difficult to pinpoint. Scientists and experts believe that a combination of factors such as genetic vulnerability, environmental factors, stress, physical illness, or neurotransmitter imbalances in the brain could lead to depression. The known causes of depression are inherited vulnerability; environmental triggers; medications; illnesses; personality; alcohol; nicotine; and drug abuse; and diet.⠁ ¶ Inherited vulnerability as cause of depression means that having a family history of depression increases the risk of developing depression. A person who has a parent or relative with this condition is in danger of getting bogged down with depression. Researchers have isolated several genes involved in bipolar depression, although not all with this negative heredity trait develops the problem. It has been clarified that there are other factors that can lead t depression and one of these are environmental triggers such as stressful life events including loss or death of a loved one, divorce, break up of a relationship, loss of a job, financial worries, and sickness or loss of health or independence.⠁ · Although depression just like stress, is a part of life, when the depression starts to control a person’s life for over two weeks and leads to passive behavior prolonged sorrow, lack of appetites and a loss of the general zest for living, then he or she has shifted from simply being depressed to suffering from depression. This type of depression caused by a situation, specific event or life changing situation is called reactive or situational depression.⠁ ¸ In addition to inherited vulnerability, environmental triggers and stressful  events or situations, personality traits can also be cause of depression having low self-esteem, being too dependent, self critical, pessimistic and negative, and being easily overcome by stress can make a person prone to depression.⠁ ¹ Also, medications and illnesses, as well as habits such as drinking alcohol, smoking and drug abuse as well as poor dietary habits can also cause depression. Prolonged use of certain medications such as beta blocker propanolol or Inderal, some blood pressure medicines and drugs for treating arthritis and Parkinson’s disease may cause depression. Sometimes, steroid medications such as Prednisone and oral contraceptives, and anti-cancer medicines can also being on depression. Those chronically sick from heart disease are also greater risk for suffering from full blown depression. This connection between heart disease and hypothyroidism has been established by studies. ¹Ã¢  ° Studies also found that contrary to previous beliefs, people did not turn to alcohol, nicotine or drugs to get comfort from depression but it is these substances that make them prone to depression and anxiety disorders. Studies found that about 30% of depressives and 60% of bipolar depressives abuse alcohol and drugs. Moreover other bad habits such as not eating well and lack of foliate and Vitamin B-12 may also result in depressive symptoms. ¹Ã‚ ¹ With the various cause of depression cited above and one might ask what the risk factors are and who are at risk for depression. Shimberg (1991) point to stages in life that might trigger the problem including forced retirement; being left behind by children who get married or leave for school; becoming an adolescent. These life stages and occurrences individuals at the risk for depression. Childhood depression and post depression are forms of depression that often do not get recognized. ¹Ã‚ ² Moreover, according to Kyes (1980), some research had indicated that depression and bipolar disorders might earlier by experts. This indication is linked to increase in the adolescent suicide rate in recent years. ¹Ã‚ ³ Experts also warn that outside of those already mentioned as at risk for  depression because of the altered stage in life, families of those who are depressed at most at risk for depression. The reason for this is the destruction that depression cause on the depressed and all family members round them: damage to relationships, end to careers, lost dreams and chaos and torment for the family. So mothers of depressed children become depressed, and children of depressed parents also become more likely to get depressed. ¹Ã¢  ´ In terms of age, race, status, gender and other factors, experts point out that depression can affect all ages and all races, but typically the first episode occurs between the ages of 25 and 44. Although older people are no more at risk than other age groups, depression are higher among single individuals and those not in long-term relations- among divorced people and those who live alone. Women are more prone to major depression, dysthemia and seasonal affective disorder. It is said that one out of four women will experience some type of depression so women are at 25% higher risk, although both genders have about the same risk for bipolar depression.  ¹Ã¢  µ More important than knowing the risk factors causes of depression is knowledge of preventive measures and the signs and symptoms of depression so that its negative effects and serious impact can be avoided. When left untreated and undetected, depression can result only in the worst consequences of disability, dependency and even suicide. Statistics reveals that as high as 70 percent (70%) of people who committed suicide may have some form of depression. ¹Ã¢  ¶ D.Effects and Dangers of Suicide Indeed, the impact of depression is severe because it negatively affects all aspects of health and depresses thinking, moods, feelings and behavior, as well as weakens physical health. The depressed person loses interest in normal day to day activities and experience lack of pleasures in activities previously enjoyed. This loss of happiness is called anhedonia; it erases all the enjoyment previously experienced in life. Hence, the depressed person feels very sad, helpless and hopeless and suffers from crying spells.  These effects last for a long time.  ¹Ã¢  · In addition to the above major affects of depression, the afflicted individual also suffers from disturbed sleep; marked less or gain in weight; agitation or slowed body movements; fatigue; diminished self-esteem; persistent thoughts of death and suicide; impaired thinking or concentration and loss of libido or interest in sex. Depressed individuals either sleep too much or suffer from insomnia. They may wake up in the middle of the night or at dawn and not fall asleep again. They often become agitated, irritable and easily gets angered at little things. On the opposite extremes, they become robot like, moving slowly and speaking in a monotone. They feel fatigued and weary, filled with guilt and feelings of worthlessness. Because of these, they think of suicide and not death, unable to make the right decisions and forgetting things. They lose interest in sexual relations. It is when they become overwhelmed that depressed individuals commit suicide. ¹Ã¢  ¸ A study by Cassidy, Flamegon and Spellman (1957) found that 58% of depressed individuals were psychologically affected, often saying that they had nothing to look forward to, were afraid to be alone, could not remember anything, had black moods and blind rages, felt all mixed up, very unhappy or simply brooded around the house. Some (18%) felt that their head was heavy, pressured in the throat or had headaches. Some left a pain in the head like a balloon about to burst urinated frequently and had upset stomach. A few (11%) felt tired, exhausted or jumpy. They confessed to inability to do work, lack of strength and trembling like a leaf. A small number (2%) experience a mixture of medical and psychological problems such as getting scared and not being able to breath, suffering from stiff necks and loss of power, feeling a weakness in their arms. ¹Ã¢  ¹ In the major form of depression, depressed persons become so fatigued that they sleep throughout the day and night. They are unable to work or do simple chores due to exaggerated sadness and lack of lethargy that cannot overcome. Compounding their depressive feelings are those of worthlessness, excessive guilt and receiving thoughts of suicide affected by the lifetime  of these major depressive effects are 5-12 out of 100 men and 10-26 of women. The American Psychological association (APA, 1994) also point slowly increasing severity of the problem. Maj. Et al. (1992) state that about 75% of those who suffer from a depressive episode may suffer it again within five years . ²Ã¢  ° People who suffer from bipolar disorder or manic depression marked by alternating moods of depression and mania are affected differently. In this period of a manic episode, they become restless and feel energetic even with only three hours of sleep. They become very talkative, with racing thoughts and flighty ideas. They easily get distracted and increase their social work, school or sexual activities. They also become excessively involved in pleasurable activities that could lead to painful consequences such as uncontrollable buying sprees, sexual indiscretions or foolish business investments. All these can affect their work and social relationships. ²Ã‚ ¹ Less marked affects can be seen in the people with dysthemia or chronic low-level depression. While they may also suffer from disturbed sleep, energy and self-esteem, they are not debilitated; those who suffer from it often lack self-confidence or motivation and remain in abusive relationships. ²Ã‚ ² E.Therapy and Prevention Because depression especially major episodes can lead to suicide, treatment measures must be followed starting with techniques including giving of tranquilizing drugs for mania or antidepressant drugs for depressions, electroconvulsive therapy, milieu therapy, occupational and recreational therapies, and supportive psychotherapy. In addition to these, the most important treatment objective is to change whatever underlying personality problems are causing the depression through psychoanalysis or psychotherapy. ²Ã‚ ³ Three specific forms of psychotherapy that can effectively treat depression are cognitive therapy, behavior therapy and interpersonal psychotherapy.  These are combinations of one of the recommended such as tricyclics or selective serotonin reuptake inhabitations can effectively treat the condition. Other specified forms of treatment are electroconvulsive therapy and phototherapy for seasonal depression. ²Ã¢  ´ The type of treatment given to a depressed person depends on the physiological symptoms that can be observed including disturbance of sleep or loss of the desire to eat. In such cases, anti depressant medications that act to increase the amount of nor epinephrine, serotonin or both available in the synapses. These substances identified as neurotransmitters are found in decreased amounts in depression. Antidepressants that have been found effective are tricyclic antidepressants, monoamine oxidate (MAO) inhibitions and selective serotonin reuptake inhabitations (SSRIS). The SSRIS are preferred because of fewer side effects and they are better tolerated for longer treatment. One example is Prozac. For those suffering from bipolar depression, lithium is usually given in all cases where these medications are used; care should be taken to prevent patients from using them in suicide attempts. ²Ã¢  µ The need to prevent depressed individuals from suicide attempts cannot be overemphasized. Statistics reveals that about 15% of the population experiences major depression and some point in life, putting them at risk for suicide. This danger increases due to the fact that depression is often not diagnosed, or when diagnosed, it is not treated adequately. Physicians need to always assess the risk of suicide by direct questioning because patients often fail to put their thoughts into words if they are not encouraged to do so. When such specific plans of suicide are discovered and if significant risk factors exist such as a past record of suicide attempts, deep hopelessness, accompanying medical illness, substance abuse, or social isolation and loneliness, the patient or depressed individual must be referred right away to a mental health specialist. The physicians should try to dig deeper with hope and empathy in dealing with the depressed patient, and become sensitive to hidden feelings denial a [atient who shows signs of anxiety, panic or agitation is at significantly increased risk of suicide. Almost 15% of patients with untreated depression will commit suicide but  majority of these will have asked for help within a month of their suicide. ²Ã¢  ¶ Because of the ever present danger and risk of suicide among depressive individuals, therapy and treatment should be implemented with clear steps for preventive measures. These include providing a safe environment to protect them from self-injury or suicide; providing a structured environment to encourage the patients to engage in daily and recreational activities ; to reactivate their interests away from personal concerns ; and to motivate them for the treatment and introduce psychotherapy and occupational therapy always, the doctors and caregivers should aim at building trust through one-to-one relationships, showing interest and giving positive support to help build the patients ego and self-esteem. They have to help provide adequate nutrition, sleep and exercise for the patients. ²Ã¢  · IV. Anxiety A. Definition Aside from and often occurring with depression are feelings of anxiety, best described as â€Å" an abnormal and overwhelming signs such as sweating, tension, and increased pulse ; by doubt concerning the reality of the threat ; and by self-doubt concerning one’s capacity to cope with it.  ²Ã¢  ¸ It must be pointed out that anxiety is a normal and useful feeling when it warns of possible danger, but uncontrollable anxiety becomes a disorder when the affected person becomes bombarded with intense, frequent and continuous false alarms. These false alarms may result in dysfunctional avoidance behavior such as refusal to leave the house for fear of a panic attack. Such anxiety disorders are reported as most frequently occurring type of mental disorders in the general population as reported by the American Psychological Association (1994). About 5% of the population suffers from acute or chronic anxiety, with women twice more likely to be affected. More than two percent (2%) of Americans for example have generalized anxiety disorder and are persistently axioms and disturbed. They become excessively and unrealistically worried about life circumstances. About a third of the populations also have at least one irrational or unreasonable fear or phobia. ²Ã¢  ¸ Such exaggerated worry often goes together with depression, which experts think is also caused by imbalance of neurotransmitters. As opposed to normal worry that encourages people to plan and prepare for the future, and to get financial security for the family and the future, anxiety disorders lead to feelings of apprehension, nervousness and nagging uneasiness that resemble a heart attack, accompanied by fast heartbeat, palpitations, seating and dizziness. People with anxiety disorders may also suffer from headaches, insomnia and relentless fatigue. ²Ã¢  ¹ B.Types of Anxiety Anxiety disorders are usually classified as generalized or free floating anxiety; phobic anxiety; or panic attacks. Free floating anxiety refers to morbid states of anxiety that are relatively persistent and generalized. On the other hand, phobic anxiety refers to directed of focused anxiety which is an unreasonable and unfounded fear of an object or situation that leads to avoidance situation. Such phobias are of three main categories. The first are phobias of specific objects or situations such as fear of thunder, spiders, etc. The second are social phobias connected to social situations such as speaking or eating in public; while the third is agoraphobia, anxiety of leaving ones home or familiar surroundings and being in crowded place. The last major category of anxiety disorders, panic attacks, refer t brief but very intense attacks of anxiety. ³Ã¢  ° Such panic attacks are or panic disorders are distinguished from real panic because the intense fear and feelings of doom or terror are not justified by the situation. These attacks are accompanied by shortness of breath, dizziness, heart palpitations, trembling, chest pains and even fear dying or going crazy. ³Ã‚ ¹ In the related disorder called agoraphobia mentioned earlier, the fear is connected to inability to escape such as from crowded grocery stores, elevators, a bridge, or a train, car or bus. The investigating factor is fear of having a panic attack in a public place; hence the afflicted person  avoids leaving home altogether. A similar anxiety disorder is obsessive- compulsive Disorder which is characterized by recurring obsessions and compulsions that lead to severe distress that interfere with life. Obsessions are persisting thoughts or ideas like the notion of a terrible accident about to happen to a loved one or that underwear is filled with germs compulsions and intentional behaviors or mental acts performed to act on an obsession, often as a magical technique to world off the obsessive threat, such as taking a bath over or washing the hands repeatedly. Those with OCD give in to irresistible acts that they perform repeatedly even if they know are irrational. ³Ã‚ ² One type anxiety disorder that has become common is Post- traumatic Stress Disorder or PTSD. This is marked by flashbacks and recurrent thoughts of a psychologically distressing experience outside the range of usual human experience such as seeing someone killed; being tortured; being raped; or losing one’s home in tsunami or natural disaster. The signs include nightmares, flashbacks, lessened responsiveness to the world, and psychological numbness. ³Ã‚ ³ C.Causes and Risk Factors of Anxiety Whether anxiety is generalized or free-floating, phobic, obsessive- compulsive or caused by traumatic stress or panic attack, it is often exaggerated worry that goes together with depression. Hence, like depression, it is also caused by an imbalance in neurotransmitters as experts believe. ³Ã¢  ´ Also, like depression, anxiety disorders can be traced to several root causes including genetic vulnerability, and environmental factors. Family studies have shown that genetic factors. Family studies have shown that genetic factors and heredity contribute to anxiety disorders such as panic, simple phobia and obsessive-compulsive. People suffering from anxiety disorders have family members with anxiety and mood disorders. This generic vulnerability is believed to be due to mechanisms involving the neurotransmitters epinephrine and norepinephrine. Obsessive- compulsive  syndromes, for example, have been found to be the result of imbalance among neurotransmitter systems. As for environment, growing eyes in a home with pathologically anxious parents or family members give a significant environmental risk for anxiety disorders. ³Ã¢  µ One group of anxiety disorders, the phobias, can be traced to traumatic or painful roots. Psychiatrists believe that they often result from one single incident that was very frightening, painful or traumatic enough to leave a scar in the unconscious mind, one famous example was Rita Hayworthis phobia for riding elevators. A famous actress, she was once trapped in a lift in a tall building in Madrid when all of sudden, it plunged 20 floors down before the emergency brakes worked. After this event, she developed a phobia for elevators and moved only ride escalators or go to the event of walking up to a destination. She confessed that even thinking above riding an elevator would make her feel cold; she had developed claustrophobia. ³Ã¢  ¶ However, experts also point out that phobias maybe caused by a series of disturbing experiences or situations. This series of unpleasant, frightening events can deeply ingrain the fear in a person’s subconscious mind. One example is the case of famous Mike Douglas who developed acrophobia or fear of flying. At the first, he saw gasoline pawing out of the gas tanks of a B-24 Liberator he had to ride on a assignment. Although the plane did not burn the sight of gasoline hitting the airplane’s wings terrified him. On another tour, the plane he rode on lost an engine and they had to crash-land. Douglas had to be carried from the wreckage and since these two experiences, he had developed from the wreckage and since these two experiences, he had developed acrophobia. ³Ã¢  · In addition to different types of phobias, teenagers can develop anxieties because of difficulties connected with their struggles with issues of freedom and separation from parents, and the need to establish their personal identity. Teenagers often experience fear, ambivalence, and confusion about assuming the role of adults, and these may result in deep emotional conflicts and anxieties. High degree of anxiety among teenagers may be indicated by their overly passive, compliant and conforming  behaviors. ³Ã¢  ¸ Oftentimes, anxiety is caused by exaggerated concerns with the possibility of being physically or emotionally hurt in the future. For example, a student suffering from anxiety would experience continual thoughts of failing in a coming test and everyone thinking that he is stupid. ³Ã¢  ¹ D.Effects of anxiety and Dangers of Suicide Like depression, anxiety has harmful effects on the affected individual. They might feel apprehensive and nervous, troubled by nagging and constant uneasiness about the future. Attacks of anxiety are similar to a heart attack accompanied by rapid heartbeat, palpitations, sweating and dizziness. Anxious people also from headaches, insomnia, and relentless fatigue. When left untreated, anxiety disorders increase the risk for hypertension and heart disease.⠁ ´Ã¢  ° In the case of phobias, the extreme fright results in physical changes including quickening of heartbeat and responses, dilation of the pupils, and pouring of large amounts of energy producing adrenalin.⠁ ´Ã‚ ¹ This response is called the Flight or Fight response and is commonly known to become harmful to health when prolonged. In the case of teenagers, those suffering from anxiety often become preoccupied with physical complaints and feelings. They experience disturbed interpersonal relationships and become plagued and bothered by unrealistic fears. Because they cannot express their fears and anxiety, they may act out their feelings through dysfunctional behaviors like aggression, juvenile or drugs, and truancy. But the worse impact of anxiety is suicide.⠁ ´Ã‚ ² Indeed, the danger of suicide due to anxiety cannot be ignored. A study conducted in Sweden involving 3000 patients suffering from anxiety disorders found that before they reached 70 years old, one third or about 1000 died because of suicide. Hence, anxiety disorders predisposed affected people to commit suicide. ⠁ ´Ã‚ ³ E.Therapy and Prevention To relieve suffering and prevent suicide, proper management of anxiety attacks, treatment techniques and preventive measures must be followed by the afflicted individual and those who care for them. Persons affected by anxiety can learn the techniques of muscle relaxation and biofeedback. They have to take prescribed anti-anxiety medications such as benzodiazepines, selective serotonin reuptake inhibitions (SSRIs) and buspirone (bulpar) to help relieve anxiety symptoms.⠁ ´Ã‚ ³ According to western (1996), benzodiazepines are useful for short-term treatment of anxiety symptoms. The earliest medicine of this type was valium but this has since been replaced by alprazolen or xanax which is more effective in treating panic symptoms. These medications increase the activity of GABA neurotransmitters that inhibits activation throughout the nervous system. Hence, anxiety is reduced by increasing inhibitory neurotransmitters. In the case of panic disorder, psychiatrists prescribe antidepressant medications for faster relief of anxiety.⠁ ´Ã¢  µ In addition to medications which can be habit forming, those suffering from phobias can turn to other techniques to combat phobias. Trudy weirs man, director of the Phobia Workshop in New York suggests an eight-step plan to fight phobias. The plan includes the following steps; â€Å"(1) accepting the phobia; (2) Realizing that phobia cannot kill; (3) Not running and focusing instead on the present situation; (4) Making a chart of feelings and thoughts during a phobic situation; (5) Relaxation using the tighten-relax method; (6) Keeping in touch with reality to divert attention such us opening mail; (7) Belief in one’s own ability to function with fear levels; (8) Seeking professional help when all else fails’’ ⠁ ´Ã¢  ¶ However, it must be pointed out that the anxious individuals need all the help they can get. Those who come in contact with the, especially parents,  teacher and guidance counselors must be careful and be very cautious with teenagers rather the ignore behavior that often signs of serious disturbance and anxiety. For example, a teenager was suspended from school because of tribal rebellion, truancy and drug use. In the absence of social support from school officials and friends, the teenager overdosed on a bottle of pills in an attempt to commit suicide. The treatment revealed problems of depression.⠁ ´Ã¢  · People who come in control with anxious or depressed individuals must be aware of suicidal wishes that are expressed. Such suicidal wishes are extreme expressions of the desire to escape the suffering they imagine in the future and the burdens they believe they are placing on their families. In order to lighten the burden of suffering, hopelessness and mistaken ideas of the facility of their lives, the guidance counselor, teacher or psychiatrist must help the anxious person to examine their reasoning and think about alternative solutions to their problem. They must be guide in correcting their mistaken ideas about things that make them feel hopeless burden that add to their family’s sufferings once they recognize that there is a hope or alternative way, they will be motivated and forget about suicidal thought.⠁ ´Ã¢  ¸ Indeed, the need to correctly assess those people who are in danger of committing suicide and to follow the strategies to prevent them from putting into action suicidal thoughts cannot be overemphasized. School Nurses especially need to be vigilant in diagnosing teenagers with suicidal tendencies. The signs and symptoms of emotionally disturbed teenagers include the following. Social isolation related to inability to engage in personal relationships; Potential for self-directed violence related to suicidal behavior; Anxiety related to situational or maturational crisis; IV. Suicide A.Methods and types of suicide Mass media have successfully raised the awareness of people about the various methods and types of suicide. Some intentionally cause their own death directly by using firearms, knives, or poison while others hang themselves. There are also those who commit suicide indirectly by continuous intake of harmful substances such as alcohol, drugs or tobacco, though most people are aware only of direct suicide. Other types of suicide that have become well-publicized are euthanasia (doctor assisted suicide) and teen age suicide. The issue of teenage suicide has raised to the forefront with the case of the teenager committing suicide in a Pampanga mall recently. B.Statistics of Suicide Gelman (1994) cited in Smith (1992) reported that in the United States of America alone, about 30,000 people die from suicide every. Belluck (1998) cited in Smith (1992) reported that suicide ranked as the 8th leading cause of death among young people in the 15-24 age range. Among adolescents, there has been a marked increase in suicide rate since 1950. ⠁ ´Ã¢  ¹ In addition, statistics reveal that for every successful suicide, there are 5-10 attempted suicides. Moreover, women are reported to make more suicide attempts than men, but four times as many men actually commit suicide. Suicide cases have been increasing in both the teenage and elderly age group.⠁ µÃ¢  ° Furthermore, out of the estimated 30,000 people who actually committed suicide in the United States, 10-50 percent or about half suffer from major depression. For depressed people, the most dangerous time for suicide is when they are already to come out and recover the depression. When they are severely depressed, they are weakened and emotionally paralyzed so that they could not act on the impulse to kill themselves.⠁ µÃ‚ ¹ Just like depression, the anxiety disorders also predispose people to suicide and place them at risk for untimely death. As stated earlier, a study conducted in Sweden found that of more than 3000 impatient who have been  diagnosed with anxiety disorders, about one third or 1000 deaths before age 70 were due to suicide. Aside from those suffering from depression and anxiety disorders, those suffering from schizophrenia and personality disorders also die from suicide. Suicide is the primary cause of death among schizophrenics who are often faced with alienation and homelessness. Those with personality disorders are also prone to suicide because of the chaos and social problems they encounter in life. C.Preventive Measures In order to prevent individuals afflicted with depression, anxiety and other disorders from committing suicide, careful assessment of their status has to he made. Those near to them must recognize the level to depression or anxiety and the potential for suicide. Also, the presence of suicide ideation or thoughts of suicide have to be determined. The behaviors of these afflicted individuals have to be observed closely to note any clues to possible suicide. Most of the time, the person concerned will talk about suicide plans. Hence, it is important that a anxious individuals from self-destructive acts. Care must be taken especially at times when the patients depression in lifting. Support and care must be established so that the afflicted persons will know that those around them are concerned about their welfare. At all times, the depressed and anxious must be encouraged to express their feelings and anger. Relevant questions must be asked such as: â€Å"Do you wish your well dead?†, etc. All concerned should recognize such continued desire to commit suicide. More importantly, those around afflicted individuals should help increase their self-esteem by focusing on their strengths and success a structured schedule and involvement in activities with others should be helpful, as well as a structured plan to use to cope with future suicidal thoughts. The client should be helped to plan for continued professional help to relieve depression and anxiety in order to fully prevent suicide. In the case of teenagers, those educators, social workers, psychiatrists and others near them should help prevent teenage suicide by taking note of the risk factors and signs of suicide. These signs include changes in their behavior, anger,  irritability, depression, sadness, withdrawal, changes in eating and sleeping habits, and preoccupation with death are the other signs of suicidal tendencies. Those young people who are contemplating suicide often report headaches, stomach aches and ailments and also talk about killing themselves. IV. Conclusion In the end, public health workers and care givers could not be less vigilant in assessing suicide risks and in implementing measures to prevent suicide among others people suffering from depression, anxiety disorders and others disorders and severe stress. This is especially there in hospitals and health agencies. For example, a patient who had undergone mastectomy became quiet and withdrawn after a mastectomy operation upon learning that confirmation of cure would take months, she refused to eat and eaten jumped out of a window. Those who are most prone to depression and anxiety leading to suicide are those with chronic or incurable disease with loss or severe damage to body parts, and those with other concerns in addition to illness such as death of loved one, loss of property, divorce, separation and other overwhelming problems. The severity of depression and anxiety will depend on the evens catastrophe, or critical incident that has occurred. Whatever the case, the caregivers must always be aware of the damage from suicide. In conclusion, those concerned with individuals who are likely to commit suicide have to be aware of points at which to repeat suicide assessments. These individuals at a time prior/ before sustained therapentic response; first 6 months after hospital discharge; in presence of a new, painful, or disabling medical condition; in the presence of anxiety, panic or substances abuse; at evidence of relapse or recurring symptoms; at times of major stresses, losses, threats or shame inducing events; with comorleid personality disorders; or coming out of acute risk factors. Suicide, as what statistics has shown in recent years, have been increasing at a fat rate and is becoming more common especially among the young; but, it could be prevented with prompt and appropriate intervention. Depression  and anxiety, the most common causes of suicide, when left unchecked and untreated could lead to suicide among teenagers and adults alike. Hence, it is important for all who come in contact with depressed and anxious individuals to encourage them to undergo therapy and treatment.

Chrétien De Troyes †Perceval Essay

Chretien De Troyes’ Arthurian Romances are one of the best and most brilliant works of medieval literature. Originally, in Old French, modern translations are widely available. In fact, even today, years later, they continue to be an invaluable asset to both literature and human history. Chretien De Troyes works include four complete poems – Erec et Enide, Cliges, Yvain and Lancelot, and the fifth, last, unfinished one called Perceval, le Conte du Graal (Perceval, the story of the Grail). Erec is the tale of one of Arthur’s knights, who after several trials finally understands his loved for his betrothed, Enide [3]. Several other Arthurian knights including Kay, Lancelot and Gawain too are mentioned in the text. â€Å"The court of Arthur is filled with magnificent things and people, led by the fabulous Arthur himself. The knights pursue games of chance and test of strength; when they’re not doing that, they’re wooing women [3]. † The next romance, Cliges too uses Arthur’s magnificent court as its backdrop [3]. † Both Cliges and Yvain have love triangles and adventure. Lancelot, though is almost all about a hero rescuing his lover, the beautiful Guinevere [3]. And lastly, Chretien’s unfinished piece: Perceval, and the Holy Grail. Before studying the text of the work, it is important to understand the time it was written in. Little is known about Troyes life, but most believe he lived somewhere in the 1100’s. It is also known that he was in close association with his patroness Countess Marie de Champagne. This time has a great influence on the subjects and stories of his work, and other works of Arthurian Literature. The eleventh and twelfth centuries were a time of ‘renaisance’ in Europe. Europe had been gripped in the Dark Ages for years, but this is when barbarism was slowly rooted out, to be replaced by missionaries and churches. Social activites too took a new turn. Several universities and centres were set up. In fact, towns were planned, with proper structure and organization. Culture also took a newe dimension altogether. This is when Arthurian literautre was born. With the concept of castles and romances, chivalry and battle, courtly love, stories were dramatized and preserved; written in the form of poems or essays. This is exactly why Arthurian literature deals with princes, knights, castles, adventure and battle. Similarly, Troyes work too reflects much of the world of the renaissance. Perceval is believed to be the first account of the Holy Grail; but Troyes died before completing the masterpiece. In quest for a complete poem, many attempted to write an ending to it. Of these, four versions are widely known, and accepted. The first continuation is called the Pseudo-Wauchier Continuation, the second is attributed to Wauchier de Danain, the third by Gerbert, and the fourth is Manessier’s continuation, the only one with a true ending. But despite the efforts to write continuations, the original incomplete version in itself has its own charm, aura, and mysteriousness. Perceval is the Grail knight or one of the Grail knights in numerous medieval and modern stories of the Grail quest [2]. † Perceval is a bright and spirited young man brought up in the woods, by his mother. His mother raises him in the forest of Wales, away from civilization to protect him from the horrors of war and battle. One day, Perceval sees some knights in the woods. It is here that his interest in chilvalry and knighthood is aroused. His mother objects vehemently, fearing to lose him like her other sons, but Perceval insists, and heads out for King Arthur’s court. The Holy Grail was the most sought after treasure. In fact, all of Arthur’s knights were in quest of it. At Arthur’s court, the king’s senschal (steward) Sir Kay mocks him. A jester at the castle prophecizes that Perceval will be a great knight. Perceval rides away, and comes across another castle, where he decides to stay. Here he is trained under Gornemant. Gournemant teaches Perceval all the tactics and strategies of combat, and later, advises him not to be impolite or ask too many questions anywhere. Now Perceval leaves, looking for his mother. On his journey, he comes across yet another castle, where he meets and falls in love with the beautiful Blancheflor. Blancheflor is Gornemant’s niece, and her followers are weakened by hunger and famine. She tells Perceval of the intentions of Anguingueron, the seneschal of the evil knight Clamadeu of the Isles. He intends to attack them. Perceval, touched, commits himself to Blacheflor, and promises to help her. Perceval defeats Anguingueron and his men the next day. Clamadeu waits, hoping that eventually starvation would kill Blanchflor and her men, but luckily, a ship full of food arrives. Eventually, Clamadeu is forced to battle against Perceval; he begs for mercy after Perceval defeats him. Perceval sends both Anguingueron and Clamadeu to Arthur’s court. At the court, Arthur and his wife learn of Perceval’s heroism and courage in battle. But Perceval has to continue on his journey. He has to find his mother. At a river, he comes across the Fisher King, who offers him lodging for a night. In the castle, Perceval sees the fisherman lying there already. Perceval witnesses a strange procession, in which odd and peculiar things are being carried from one chamber to another. A squire enters carrying a sword with engraved blade, another squire enters carrying a white lance on whose tip blood oozed and flowed down onto the squire’s hand. Perceval refrains from asking about this lance, recalling Gornemant’s admonishment. More squires bring in candelabras. A maiden brings in a grail held in both hands [for Chretien, it is a serving dish], and the room becomes brightly illuminated [presumably because of the contents of the grail]. Another brings in a silver carving platter. The grail is made of gold and set with precious stones-it and the platter are carried to another chamber. Perceval fails to ask who is being served by the grail. They dine at an ivory table. The grail returns borne in the opposite direction. Later that night, the Fisher King excuses himself and has to be carried off to his bedroom, and Perceval again fails to ask what ails him. The next morning, Perceval discovers that the hall is deserted and everyone has left [1]. † Outside the castle, he comes across a maiden. She tells him that had he asked about the grail, or the platter, it would have brought the king great relief, and may even have cured him. She also informs him that his mother is dead. Later that day, Perceval is warned against the ‘haughty knight of the Heath. ’ But he challenges him, and defeats him. The haughty knight and his maiden set out for Arthur’s court. On their way, they come across King Arthur and his men, who are ironically looking for Perceval. But the king does not recognize Perceval by face. He releases the ‘haughty knight’ from imprisonment, and hands him over to his nephew Gawain. Later, Perceval too is wandering around Arthur’s camp. Arthur’s men find him asleep on a horse, but Perceval soon defeats them, including the arrogant Kay. The king asks Gawain to deal with the fiery Perceval, and not through combat. They soon become friends. But now Perceval is consumed by curiosity. He wants to know who was served by the grail and the silver platter, and why the lance bled. Here Chretien relates the tale of Gawain. Later, he continues with Perceval’s story. He has been wandering for years. He goes to see a hermit, and tells him of his wandering, and the grail. The hermit reminds him of how his mother died of sorrow, and that he was being made to repent her death. The hermit believes that the man served by the grail is Perceval’s uncle. Perceval agrees to repent for his sins. Gawain’s tale again picks up from hereon. Gawain’s story is in contrast to that of Perceval. Gawain is more professional, and less naive in battle. He also finds his long lost mother and grandmother, and his sister, about whom he had never known. The narrative breaks off shortly. Even though the story ends abruptly, one does arrive to the conclusion that Perceval is indeed, a good knight. Literally speaking, he has all the valous and heroism of a great warrior and an honorable knight. He is brilliant in battle, being able to defeat the best of warriors, fighting everyone and anyone who challenges him. But apart from the literal sense, Perceval continues to be one of the most famous and mysterious knights in medieval literature. The most important fact behind this is that many can, till today, relate to him. Throughout the text, we see him as confident and brave, but never evil. In a deeper, emtional sense, Perceval is not just a good knight. He is a good man. Many critics believe that Perceval, apart from being an Arthurian romance is also one of the earliest works on spirituality, and what we call ‘existentialism. ’ This is clearly evident from the ending of the original text. Perceval commits himself to spending a life similar to that of the hermit, in search of spirtual enlightenment and communion with God. Chretien’s writings and works are very popular. In fact, that can be estimated by looking at the number of languages his works have been translated into. In fact, it is not just the translations. Chretien’s works also provided inspiration and ideas to many fine works of literature. Chretien’s story was also the inspiration for one of the greatest romances of the Middle Ages, Wolfram von Eschenbach’s Parzival (c. 1200-1210) [4]. † Chretien has also been called the creator of the modern novel, and is believed to have reinvented the lost genre of narrative romance. Many of his works seem theatrical, as if they are meant to be performed on stage, rather than being read on paper. Perceval, like other works of Arthurian romances has the strong element of romance, drama and tragedy. Arthurian romances though were heavily dependent on one common theme – of battle. No Arthurian romance was complete without battle or warfare. The spirit and art of war, honor, courage, manhood, combat and duels were all cardinal to the stories. The male protagonists were brave men of honor. Another important aspect was the romance. All these themes of blended together created one of the most cherished style of literature called ‘medieval literature. ’ Even though Arthurian romance and literature was famous with the works of Geoffrey of Monmouth and the Lais of Marie de France, but it was the work of Chretein De Troyes that brought the genre back into full swing. Medieval literature did suffer a setback, and was in the background for a considerable time, but was revived again especially after Lord Tennyson’s poem Idyll’s of the King. These adventurous stories have formed the basis of innumerable books and movies. The reason again, remains that even centuries later, they continue to arouse our interest. We can still relate to the heroic characters, their strengths, their weaknesses and the general human condition, which has remain unchanged through centuries.

50 Tips on How to Write Good

50 Tips on How to Write Good 50 Tips on How to Write Good 50 Tips on How to Write Good By Mark Nichol The contents of this post are an alphabetical arrangement of two lists that have been circulating among writers and editors for many years. In case you have missed out all this time, I’m sharing here the wit and wisdom of the late New York Times language maven William Safire and advertising executive and copywriter Frank LaPosta Visco. 1. A writer must not shift your point of view. 2. Always pick on the correct idiom. 3. Analogies in writing are like feathers on a snake. 4. Always be sure to finish what 5. Avoid alliteration. Always. 6. Avoid archaeic spellings. 7. Avoid clichà ©s like the plague. (They’re old hat.) 8. Avoid trendy locutions that sound flaky. 9. Be more or less specific. 10. Comparisons are as bad as clichà ©s. 11. Contractions aren’t necessary. 12. Do not use hyperbole; not one in a million can do it effectively. 13. Don’t indulge in sesquipedalian lexicological constructions. 14. Don’t never use no double negatives. 15. Don’t overuse exclamation marks!! 16. Don’t repeat yourself, or say again what you have said before. 17. Don’t use commas, that, are not, necessary. 18. Don’t be redundant; don’t use more words than necessary; it’s highly superfluous. 19. Eliminate quotations. As Ralph Waldo Emerson once said, â€Å"I hate quotations. Tell me what you know.† 20. Employ the vernacular. 21. Eschew ampersands abbreviations, etc. 22. Eschew obfuscation. 23. Even if a mixed metaphor sings, it should be derailed. 24. Everyone should be careful to use a singular pronoun with singular nouns in their writing. 25. Exaggeration is a billion times worse than understatement. 26. Foreign words and phrases are not apropos. 27. Go around the barn at high noon to avoid colloquialisms. 28. Hopefully, you will use words correctly, irregardless of how others use them. 29. If any word is improper at the end of a sentence, a linking verb is. 30. If you reread your work, you can find on rereading a great deal of repetition can be avoided by rereading and editing. 31. It behooves you to avoid archaic expressions. 32. It is wrong to ever split an infinitive. 33. Never use a big word when a diminutive alternative would suffice. 34. No sentence fragments. 35. One should never generalize. 36. One-word sentences? Eliminate. 37. Parenthetical remarks (however relevant) are unnecessary. 38. Parenthetical words however must be enclosed in commas. 39. Place pronouns as close as possible, especially in long sentences, as of ten or more words, to their antecedents. 40. Placing a comma between subject and predicate, is not correct. 41. Poofread carefully to see if you any words out. 42. Prepositions are not words to end sentences with. 43. Profanity sucks. 44. Subject and verb always has to agree. 45. Take the bull by the hand and avoid mixing metaphors. 46. The adverb always follows the verb. 47. The passive voice is to be avoided. 48. Understatement is always best. 49. Use the apostrophe in it’s proper place and omit it when its not needed. 50. Use youre spell chekker to avoid mispeling and to catch typograhpical errers. 51. Who needs rhetorical questions? 52. Writing carefully, dangling participles must be avoided. Oh, and let me add one tip: If your article consists of a list and the title refers to the number of items in the list, count the number of items in the list carefully. Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Writing Basics category, check our popular posts, or choose a related post below:20 Computer Terms You Should KnowDeck the HallsTitled versus Entitled

The History of the Antidepressant Prozac

The History of the Antidepressant Prozac Prozac is the registered trademarked name for fluoxetine hydrochloride, one of the worlds most widely prescribed antidepressants. It was the first product in a major class of drugs for depression called selective serotonin reuptake inhibitors- or SSRIs. The drugs history dates to the early 1970s when the role of serotonin in depression began to emerge, according to David T. Wong, K.W. Perry, and F.P. Bymaster, in their September 2005 article, The Discovery of Fluoxetine Hydrochloride (Prozac), published in the journal Nature Reviews: Drug Discovery. They add: These studies led to the discovery and development of the selective serotonin-reuptake inhibitor fluoxetine hydrochloride (Prozac; Eli Lilly), which was approved for the treatment of depression by the U.S. FDA in 1987. Prozac was first introduced to the U.S. market in January 1988 and  gained its most prescribed status within two years. The Invention of Prozac The story of Prozac began when biochemist Ray W. Fuller came to work at Eli Lilly in 1963, according to the Science History Institute: In his research Fuller had used rats treated with chloroamphetamine, which inhibited the production of serotonin, to measure the effects of other drugs on serotonin levels. Fuller believed that this method would forward research on brain chemistry. Two other scientists, Bryan Molloy and Wong- who coauthored the article previously mentioned in the introduction- joined Fuller in his work at Eli Lilly. In 1971 both Molloy and Wong attended a lecture on neurotransmission given by Solomon Snyder, a researcher from Johns Hopkins University, the institute notes. Snyder had ground up rat brains, separated out the nerve endings, and created an extract of nerve endings that worked in the same way as living nerve cells. Wong then used this technique to test the effects of various compounds, one of which was found to block the reuptake of serotonin with no side effects. The compound, fluoxetine, became the drug that was eventually named Prozac. Interestingly, Eli Lilly first tested Prozac as a treatment for high blood  pressure and then as an anti-obesity agent, noted Anna Moore in a 2007 article in The Guardian, a British newspaper. Eventually, after further studies by Fuller, Malloy, and Wong, Eli Lilly sought and received FDA approval (in December 1987) and the next month began to market Prozac as happiness in a blister pack, Moore noted. Skyrocketing Sales Sales of the drug took off: By the end of 1988, 2.5 million prescriptions for it were dispensed in America, according to Siddhartha Mukherjee in his article, Post-Prozac Nation: The Science and History of Treating Depression, published in The New York Times Magazine in April 2002, a year when the number of Prozac prescriptions had risen to more than 33 million annually. Though other antidepressants have taken over the top spots, Prozac was still the sixth-most popular such drug in the U.S. with 24.5 million annual prescriptions in 2015, according to Tim Hrenchir in his article, 10 Most-Prescribed Antidepressant Medications, published in July 2018 on NewsMax Health. How It Works Prozac works by increasing brain levels of serotonin, a neurotransmitter that is thought to influence sleep, appetite, aggression, and mood. Neurotransmitters are chemicals that carry messages between nerve cells. They’re secreted by one cell and picked up by receptor proteins on the surface of another. A neurotransmitter is either destroyed or retrieved into the cell that made it after the message has been delivered. This process is known as reuptake.   The effect of serotonin is amplified when reuptake is inhibited. Although its  not entirely known why increasing neurotransmitter levels reduces the severity of a depression, it may be that increased levels of serotonin cause changes in the brains concentration of neurotransmitter-binding receptors. This might make the brain physically more capable of feeling good. Since its introduction in the U.S., Prozac has met with mixed reviews by scientists, patients, and doctors, and has provoked its share of debate. Controversy and Clinical Trials In her 1994 book  Ã¢â‚¬Å"Prozac Nation,†Ã‚  Elizabeth Wurtzel wrote of a nearly transcendental experience after she started taking the drug, moving from an absence of affect, absence of feeling, absence of response, absence of interest and a â€Å"suicidal reverie† to a generally blissful state. Indeed, Wurtzels book helped the antidepressant gain even greater popularity. Peter Kramer in his 1993 book, Listening to Prozac coined the term better than well in describing how patients felt after taking the drug. But others began to question the effectiveness of Prozac, such as psychologist Irving Kirsch who wrote an article in 1998 in the journal Prevention Treatment titled, â€Å"Listening to Prozac but Hearing Placebo,† where he argued that antidepressants, including Prozac, were much less effective than was generally believed. In 2010, he published a book with the same argument called â€Å"The Emperor’s New Drugs: Exploding the Antidepressant Myth.† Clinical trials were conducted that both supported and questioned the efficacy of Prozac. For example, Jay C. Fournier, et al., in a 2010 article published in the JAMA, called Antidepressant Drug Effects and Depression Severity: A Patient-Level Meta-analysis, evaluated patient data from six trials and found that all antidepressants, including fluoxetine hydrochloride, exhibited minimal efficacy in mild to moderate depression. Conversely, in a 2009  systematic review of the literature, the National Institute of Care and Clinical Excellence found that strong evidence existed for the efficacy of SSRIs, including Prozac. Backlash and Continued Use PBS on the People and Discoveries section of its website notes that reports also emerged that some patients felt more suicidal when they were on Prozac. Other negative references to Prozac also began to emerge in society, PBS notes: Lawyers began to defend murder suspects by saying that whatever they did, it was under the influence of a drug Prozac. In all, there were backlashes against Prozac, and later backlashes against the backlashes. The drug eventually settled into the middle of the pack of antidepressants. As noted, Prozac is no longer the most prescribed antidepressant, but it continues to hold a place in the pharmacists formulary, as PBS describes it: It is today one of the dozen or so drugs in the U.S. that continue to be prescribed to millions for antidepression.

Economic dissertation3 Essay Example | Topics and Well Written Essays - 3000 words

Economic dissertation3 - Essay Example The EU has progressively liberalized textile and clothing imports under quotas to a present level of only 25% of total imports.(Heagreaves,2004)(Smook, 2005) Though the barriers to the entry into the EU market has increased considerably in terms of quality, innovation, lead-time and design, the benefits of ‘Chinese imports without quota’ remains attractive. If the top importers of textile apparel into the whole world EU is assessed, China ranks in the first place, but only accounts for 19.9% of the market. The growth of China with increased penetration of EU will possibly assist in sustaining competitiveness in China, which will make it less reliant on US market. (Smook, 2005) The globalization, of China, in the phasing-out quota, will produce new challenges in the competitiveness, since quotas imposed were generally based on historical exports to those countries and bilateral relationships. Countries for which quotas provided a shield against their low competitive ability will lose out, and countries like China can only go forward through greater competitiveness. China joined the WTO late, at a stage when the 10- year quota phase-out (MFA) was already in progress and as a result, a number of textile and apparel items were quota free overnight. And simultaneously, with joining the WTO, the Chinese Government was actively engaged in new political and economic reform. Large investment in the manufacturing industry increased exports, and the start of the phasing-out of State Owned Enterprises (SOE’s) increased unemployment. This resulted in the increase in production and exports. Overall Chinese textile and apparel imports to the US alone grew by 117% in 2002, and another 75% by August 2003 in some quota categories (Heagreaves, 2004) (Smook, 2005) The massive and growing population of China provides for low cost of labour which can be a great advantage in achieving low cost production. The

How did Tommy Douglas lead the province of Saskatchewan to adopt his Research Paper

How did Tommy Douglas lead the province of Saskatchewan to adopt his vision of a health care model - Research Paper Example This was the reason for young Douglas to visualize a health care system, which should be free for all. (Tommy Douglas Research Institute, 2009) Young Tommy started preaching at the Baptist church in Saskatchewan, on Sundays, as the church offered him a permanent ministry in 1930. Thus began his career as a politician and motivator. Being persisted by his family Pastor Woodsworth, Tommy joined Saskatchewan farmer labor party, while being elected to Provincial legislature in 1934 and thereafter a CCF Member of Parliament, during 1934-35. He began his political career as labor MP for next 9 years; during the hard times, which saw economic depression and world war. Under Tommy’s leadership, CCF gained power in Saskatchewan, on 15th June 1944 and Tommy Douglas became the premier of this province, which continued for five full terms, as head of Social Democratic Government.(Reb, 2009) This paved the way for bringing several reforms, which included bills for free health care. CCF under the leadership of Douglas created new government departments like Labor, Cooperatives and Social Welfare, along with bringing legislations that provided free medical, hospital and dental services to pensioners, while everyone had free access to hospitals for treatment of cancer, TB and mental diseases. In 1947, a bill was introduced which allowed every one in Saskatchewan being able to avail hospital facilities at an annual fee of 5 dollars. ((Tommy Douglas Research Institute, 2009) Being introduced by CCF under Tommy Douglas, in 1960, the act for providing government paid medical services was passed during 1962 in Saskatchewan. Doctors went on strike against this act, while government recruited medicos from UK. However, the most important factor for making the act successful was the charismatic personality of Tommy Douglas. He had already set an