According to Schmidt and Mandel Essay Example for Free

According to Schmidt and Mandel Essay Sepsis is an inflammatory systemic response to infection. The symptoms are produced by the host’s defense systems rather than by the invading pathogens (Schouten et al. , 2008). Sepsis is a frequent cause of admission to intensive care units (ICUs) and it is one of the leading causes of death among hospitalized patients (Alberti et al. , 2003). It is a public health concern and it continues to be a burden on the healthcare system (Ely, Kleinpell and Goyette, 2003). Despite advancing medical technology, the rate of patients in intensive care units diagnosed with sepsis is continually increasing. According to Schmidt and Mandel (2009), even when optimal treatment is provided, morbidity due to severe sepsis or septic shock is approximately 40 percent and can exceed 50 percent in the most critically ill patients. Early recognition of sepsis and sepsis-associated infections is essential to treating and controlling it from escalating to advanced stages that are associated with higher mortality rates (Lukaszewski et al. , 2008). Unlike other diseases or trauma, the initial signs and symptoms of sepsis are subtle and can easily be missed by health care practitioners. See more: Homeless satire essay Sepsis involves the activation of the coagulation cascade along with downregulation of anticoagulant systems and fibrinolysis (Schouten et al. , 2008). This cycle becomes exaggerated because inflammation induced coagulation produces further inflammation. Sepsis is associated with hypovolemia, hypotension and endothelial dysfunction. The following report will examine a patient’s course of illness during her stay in the ICU at XXXX. This paper will provide a discussion on the patient and her past Running Head: Sepsis medical history, the pathophysiology of sepsis, the clinical manifestations of sepsis, the patient’s clinical course, and finally, a summary and critique of the case management. Patient Information Mrs. E is a 73 year old female with an extensive past medical history. According to her medical chart, her history includes type II diabetes mellitus, obesity, hypothyroidism, dyslipidemia, hypoglycemia, chronic kidney disease (due to hypertension and diabetic nephropathy), hyperuricemia and gastritis. She has a history of breast and uterine cancer. As a result, she has undergone a left lumpectomy and she has had a hysterectomy. Mrs. E. is an ex-smoker and she has been diagnosed with chronic obstructive pulmonary disease (COPD). In June 2009, Mrs. E. was being investigated for transaminitis, and an MRI in the same month suggested a periampullary mass. She underwent Endoscopic Retrograde Cholangio Pancreatography (ERCP) on August 26, 2009 at Trillium Health Centre in Mississauga. The ERCP results indicated papillary fibrosis and stenosis; however no masses or stones were discovered. Mrs. E. presented to the emergency department at Trillium Health Centre on August 27, 2009 in septic shock due to an intra-abdominal source. She was then taken to the operating room for a laprotomy for cholecystitis. It was discovered during surgery that Mrs. E. had a gangrenous gallbladder. The surgery team drained a supraphrenic abscess, sutured the intestine and repaired a ventral hernia. She was then admitted to the intensive care unit (ICU) at Trillium Health Centre. During her stay in the ICU, cultures were taken on successive days that confirmed Klebsiella, pneumonia, and sepsis. She was treated with ceftriaxone and flagyl. Mrs. E’s renal function progressively worsened and her creatinine steadily rose. She developed thrombocytopenia due to sepsis. Mrs. E. began to become less responsive to furosemide treatments and was diagnosed with acute renal failure. As a result she was transferred to xxxxxx for hemodialysis. Upon arrival to xxxxxxx, Mrs. E was intubated, ventilated and sedated. On initial examination, her heart rate (HR) was 88 BPM, blood pressure (BP) was 189/59 mmHg, temperature was 36. 7 degrees celsius, her respiratory rate (RR) was approximately 22 bpm, and her oxygen saturation was 97%. Mrs. E. had generalized pitting edema throughout her entire body. She also presented with periods of paroxysmal atrial fibrillation and as a result was given amiodarone. The amiodarone infusion helped to bring Mrs. E back to normal sinus rhythm. On assessment, Mrs. E. had inspiratory crackles with decreased breath sounds to the left lower lobe of her lung, and ecchymosis of her upper extremities. Based on the evidence she presented with, including laboratory evidence, Mrs. E. was diagnosed by the renal physician at The Credit Valley Hospital with acute on chronic renal failure. The acute component was determined to be secondary to sepsis and hypertension perioperatively. Disease Process Pathophysiology Sepsis is a clinical condition that complicates a severe infection and is characterized by systemic inflammation and widespread tissue injury (Neviere, 2009). When coupled with acute organ dysfunction, sepsis can lead to severe life-threatening complications, including death (Lukaszewski, 2008). Individuals suffering from sepsis display signs of inflammation at tissue sites remote from the original insult such as vasodilation, increased microvascular permeability and leukocyte accumulation. During sepsis, the inflammatory response causes extensive damage to an individual’s microcirculation (Neligan, 2006). According to Schouten et al (2008), sepsis involves the activation of the coagulation cascade coupled with down-regulation of anticoagulation and fibrinolysis. An intricate link between inflammation and coagulation exists within the body (Neligan, 2006). When a pathogen is present in the bloodstream or when tissue injury occurs, an inflammatory response occurs. The response causes a stimulation of the immune system to produce interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF? ) (Neligan, 2006). These cytokines are the main catalysts of the inflammatory response and cause the release of several agents including, interleukin-8, histamine, kinins, serotonin, selectins, and neutrophils. When the above compounds are activated, local vasodilation occurs, cytotoxic chemicals are released and the invading pathogen is destroyed (Neligan, 2006). The inflammatory response can be excessive at times and causes local cellular destruction (Neligan, 2006). In septic patients, damage to their own tissues occurs throughout the body in the vasculature and endothelium. The release of the proinflammatory cytokines, specifically IL-6, causes activation of the coagulation cascade (Neligan, 2006). Coagulation can be activated by either the intrinsic or extrinsic pathway following a particular tissue damaging event (Neligan, 2006). The intrinsic pathway is the slower of the two pathways and it requires that all factors are present within the blood for clotting to occur (Marieb Hoehn, 2007). However, when blood is exposed to a factor that resides under the damaged endothelium, called tissue factor (TF), the extrinsic pathway is activated (Marieb Hoehn, 2007). The extrinsic pathway is shorter than the intrinsic pathway as it bypasses several steps of the intrinsic pathway. Each clotting pathway 6 requires ionic calcium and involves a series of procoagulants, and eventually forms a common factor X (Marieb Hoehn, 2007). Within the extrinsic pathway, tissue factor binds to activated factor VII. The complex that results activates factors IX and X (Marieb Hoehn, 2007). When factor X has been activated, it complexes with calcium ions, PF3 and factor V to form prothrombin activator (Marieb Hoehn, 2007). Prothrombin activator catalyzes the transformation of the plasma protein prothrombin to the thrombin, an active enzyme. Thrombin catalyzes the formation of fibrinogen and eventually into fibrin (Marieb Hoehn, 2007). Thrombin, in the presence of calcium ions, activates factor III in order to bind the fibrin strands closely together (Marieb Hoehn, 2007). The last step in the normal clotting cascade is fibrinolysis. Fibrinolysis is responsible for removing clots once the healing process is complete (Marieb Hoehn, 2007). Without fibrinolysis, vessels have the potential to become completely blocked because clotting occurs continuously (Marieb Hoehn, 2007). Plasmin, a digesting enzyme, is responsible for breaking clots (Marieb Hoehn, 2007). It is produced when the plasma protein plasminogen is activated. Plasminogen is incorporated into a forming clot, however it remains dormant until it is activated by an appropriate signal or tissue plasminogen activator (tPA) (Marieb Hoehn, 2007). Activated factor XII and thrombin can also activate plasminogen. In a septic patient, the fibrolytic system is inhibited (Neligan, 2006). Cytokines and thrombin stimulate the release of plasminogen-activator inhibitor-1 (PAI-1), from platelets and the endothelium (Marieb Hoehn, 2007). Thrombin is an activator of inflammation and an inhibitor of fibrinolysis. Thrombomodulin, a modulator of fibrinolysis that activates protein C, is also impaired by inflammation and endothelial injury.

Traditional Values :: Personal Narrative

Traditional Values Traditional values can sometimes sway us to do wrong things parallel to our own personal beliefs. People, places, and things shape these values and cause us to surrender to situations that neither influence nor hold our interest. This is a scary concept: What if one of these situations put our life or someone else’s life in danger? This is a question that crossed my mind when I thought about conformity in my life. One memory in particular involves my football team. As did Langston Hughes in his experience with conformity, I too felt pressure from my peers to do something I didn’t want to do. During my sophomore year, my teammates wanted to take part in hazing a younger freshman football player. They asked me to help them take all of his equipment out of his locker, find him, and beat him up. This went against my personal beliefs. In no way did I want to take part in something that had to do with the humiliation of another teammate. Also, when I was younger, I had to go through the same thing, and it hurt me deeply. Then and now, I looked at my own embarrassment as something I don’t ever want to see someone else go through. Before I gave my answer to my teammates, other consequences rolled through my head; hazing is illegal, and if convicted, the offender would be prosecuted to the fullest extent of the law. I was doing well both on and off the field, so why mess it up? So I devised a plan. I would agree to help my teammates, but I would also agree to help the young freshman find his equipment and help him elude a vicious beat-down. â€Å"Well are you gonna help us or not?† the quarterback of my team impatiently asked.â€Å"Yeah sure†¦Ã¢â‚¬  I said, â€Å"Just let me take care of everything ‘cause I really don’t like this kid.† He looked at me and smiled. â€Å"There you go, Taylor!† He turned to the posse of football players, â€Å"We got a sophomore that’s stepp’n up!† It was like I killed two birds with one stone and saved both my butt and the kid’s in one throw.

Students, faculty struggle with plagiarism in Internet era

In the postmodern society we have today, Internet-access Is a natural part of the everyday life. Not only have the Internet almost taken over people's lives, but apparently also their schoolwork and education. Due to the easy access to everything on the Internet, faculty at schools have trouble find-inning a dividing line, between what is cheating and what is not. An example of this was seen in a chemistry-class at the University of Wisconsin, where 42 students were accused of plagiarism. While all the students protested, none of the students seemed to know the seriousness of the situ-tool.This leads to the question: when Is something plagiarism? And what can one do to fix the cheating? Journalist, Todd Effeminately wrote the text â€Å"U students, faculty struggle with plagiarism in In-tern era† in 2010, and it was published in â€Å"the Capital Times†- newspaper. The sender of the art-clue, want to Inform the reader of the present Issue: plagiarism. The sender simply wants to notify the reader that plagiarism Is Illegal and wrong. This leads to the unknowing students, who tempt to take the short cut and use other people's work.The scary thing is that most students don't see the series- scenes of this problem – they simply don't consider it cheating. As Donald McCabe, professor at Rutgers University and co-founder of the International Center for Academic Integrity, explains it: â€Å"You're almost to the 50-50 mark right now, where almost half the students we survey don't see this as ‘moderate' or ‘serious' cheating. And the number that's growing Is the half who don't con-slider It cheating. † This quotation-use by the writer, appeals to the readers pathos: how come so many students don't see this wrongdoing?What have society done wrong to make this happen? Not only does Effeminately appeal to pathos, but he also appeals to ethos, which strengthens his reliability. HIS ethos Increases, with both the use of statistics and experts to comment on the Issue, for an example: â€Å"Donald McCabe, has been researching academic misconduct for 20 years, and he says Logos is also a penetrating form of appeal. It is used throughout the entire text, when Effeminately tries to convince the reader that plagiarism is an increasing crime.Because, of course plagiarism is wrong, and he proves it by referring to the majorities opinion: â€Å"most me to agree with the notion that plagiarism – taking the work of others and presenting It as your own – Is wrong†. Another appeal to logos Is his use of connectives in the text. Connectives make him look sure of his case, for an example when he uses â€Å"of course† in the end his contention: â€Å"Students who cheat are nothing new on college campuses, of course†. All of the examples above are all signs of hidden argumentation.Hidden problem, and agree with him at the same time. With the use of hidden argumentation, the reader is influence d in the wanted direction, most likely without ensign any form of manipulation. The signs of hidden argumentation is seen in the text, when the writer refers to experts, the majority of people's opinions and if the writer is general-sizing, which is all seen in this text. The way of the composition makes the text very floating – there is a good balance between claim and evidence in the argumentation.At the same time there is a perfect comprehensive use of experts to support the argumentation. Because of the formal and high-flown language used in the article, it is to conclude that the target roof for the text must be most suitable for the academic educated people. At the same time it is not unthinkable that the text also is meant for college-students around the world. Because of the theme and the conclusion in the text, you must assume that the text's purr-pose is to enlighten the students about the serious matter of the problem: plagiarism.One of the scary things to think ab out is the fact that young students cheat because they have doubt in themselves. Either, they don't realism how smart they are, or maybe they are Just scared of hard work and failure? In reality, the main reason why students cheat is because they: â€Å"didn't think they could accomplish what they wanted to any other way'. But is the goal really accomplished, when it is accomplished with fraud? Plagiarism is so common that some people even write papers in ex-change for money.As it is told in the article: â€Å"Professor Donald Downs (†¦ ) met a man who â€Å"told me he felt like he had taken my courses. † A puzzled Downs asked the man what he meant. â€Å"He told me, ‘Vive written about 20 papers for your In conclusion, what can one do to fix the cheating? According to the article the main season to fix cheating is by talking about it, even though the topic is sensitive: ;legalism is a very difficult conversation to have because nobody quite wants to talk about it,† (†¦ You can't work on this issue unless you talk about it. † The important thing is to enlighten students about this issue, because if the students really speak the truth: then how can it be considered cheating, if they truly don't know what plagiarism is? Enlighten is also the main purpose of this article: enlighten the world about plagiarism. Set a stop to plagiarism and accomplish your goals by yourself.

Actuellement Is a French False Cognate

Mistakes will always be made in French, and now you can learn from them. French and English have hundreds of cognates, which are words that look alike or are pronounced the same in both languages. There are true cognates (similar meanings), false cognates (different meanings) and semi-false cognates (some similar, some different meanings). The French adverb actuellement looks an awful lot like the English word actually, but looks can be deceiving.  Its really the  case of a  false cognate, because these two words mean completely different things: Actuellement means at the present time and should be translated as right now or currently.  Actually means in fact and should be translated as  en fait,  Ãƒ   vrai dire  or vraiment. Still, many people have not assimilated this lesson, and  actuellement  is mistakenly used to mean actually so often that  you  have to read the sentence two or three times to decide what the person actually means. How to Remember Which Is Which If you need a memory device, keep this in mind: Actualità ©Ã‚  refers to a  current event.  If you can remember this, you shouldnt have trouble remembering that actuellement and actually are false cognates with different meanings. Or you can remember the etymology. The root word of actually is actual, which means real or true. (Depending on the context, actual can be translated as  rà ©el,  vrai,  và ©ritable,  positif, or  concret.)  By extension then, actually means in fact. Meanwhile, the French root word for actuellement is the French adjective actuel, which means current or present. So actuellement  naturally refers to time as well and, by extension, means currently or right now. Examples of Correct Usage Je travaille actuellement. (I am currently working.)Le problà ¨me actuel (The current/present problem)Actually, I dont know him. (En fait, je ne le connais pas.)The actual value (La valeur rà ©elle)

The Bible By Throngs Of God Inspired Men - 1833 Words

It is important to define the meaning of the word metanarrative in order to grasp the importance of the concept itself. The word â€Å"metanarrative† is defined in the New World Encyclopedia as.†A grand narrative or metanarrative is one that claims to explain various events in history, gives meaning by connecting disperse events and phenomena by appealing to some kind of universal knowledge or schema.† In other words, the Biblical metanarrative is a grand narrative with a cohesive message being told throughout the whole Bible. The Bible is composed of over 60 different books written by throngs of God-inspired men in different times with various themes and messages that are told in each book. In spite of this fact, there is a clear, all-important message that is at the heart of the entirety of the books. The story is one of creation, fall, redemption, and restoration. To comprehend this concept is crucial in and of itself, but a proper understanding of this Biblical metanarrative is integral to living as a disciple of Christianity. It is essential to the Christian walk. A Christian or as my Dad would say â€Å"Little Christ† is an individual who claims to devote his or her full life to Jesus Christ. He is the author and hero of the narrative of life and is seated at the heart of all knowledge and schema. Genesis 1:1 sets into motion the first component of the Biblical metanarrative, Creation, with the first verse in the Bible, and it states, â€Å"In the beginning God created the HeavensShow MoreRelatedEssay on Communicating Leadership1922 Words   |  8 Pagesgo, press agents, bodyguards, loyal assistants, and throngs of eager admirers follow in their wake. In the Bible, Matthew depicts Jesus as a true leader, a king in fact, however one who broke stereotypes. Jesus had undeniable power and he was not concerned about a powerful image. The Word of Matthew 13:54-55 tells us, â€Å"Where did this man get his wisdom and these miraculous powers? They asked. Isn’t this the carpenter’s son?† (The Student Bible, 1992). What is a traditional leader, or what is a transformationalRead MorePolitical and Religious Motivations in Dante Alighieri’s Divine Comedia 3036 Words   |  12 Pagesconflict of faith. Many have suggested that he wrote the text to share his per spective of Christianity with the world. However, beyond religious implications, Dante sought just as equally, if not more so, to share his political philosophy and the agony inspired by some of the political occurrences in his life with the world. It is important, then, to consider the following question: to what extent is Dante’s Inferno a politically motivated text rather than a religious one? Alighieri’s epic, particularlyRead MoreThe Wedding - Original Writing5028 Words   |  21 Pageswho knows exactly what he wants to say. â€Å"You know how easily topics can go astray in those group discussions.† Caleb made his way over to a wicker rocker covered with a handmade quilt, pulled it near the opened window and sat down. He placed his Bible on the windowsill and waited for Samuel to begin. â€Å"I lay awake half the night thinking about the disorder we are beginning to see within the group. I ve been talking to some of the original members and we feel it s the time for some changes.† AaronRead MoreMass Media and Evangelization in the Church8919 Words   |  36 Pagesessentially an interpersonal, inter-group relationship, between God and people, and among the people themselves through sharing and communication, bringing about a greater solidarity among all, universal human fellowship and one world community.† Not only God and men meet each other but also men themselves meet one another as individuals and groups within the reality of the world in the course of history with its trends and events where men are, where history is made, and where the society is being shaped

Illegal Immigrants And The United States Essay - 1527 Words

Illegal immigrants have been present in every country ever since governments have been established. Even in the time when Christopher Columbus first set foot on North America, there were already Natives living on the continent. The British immigrants that first established the Thirteen Colonies brought disease and famine with them. Many Natives died from the diseases that the British brought with them. If there had been a federal government in place, the settlers would have been considered illegal immigrants. Many of the Natives were treated unfairly and most likely would have wished to send the British back to whence they came. Alas, this could not be done. Although not entirely in a diplomatic fashion, a treaty was made between the Native Americans and the immigrants that came into their land. Like the government at the beginning of the formation of the United States, the government compromised. Because the U.S. is seen as a melting pot of cultures and ideas, there are a few processes by which citizens of another country may become citizens of this one. These processes may include things such as a Citizenship test or marriage to a U.S. citizen. These processes were put into place to allow accountability of every person in the country. When people come illegally, things become difficult. Things are easier for the majority of people whe everyone can be accounted for. Other deterrents have also been put in place to keep illegal immigrants out. Between the United States andShow MoreRelatedIllegal Immigrants : The United States1392 Words   |  6 PagesJoseph Lema Professor Ferrell English 1470 19 Oct 2017 Illegal Immigration Illegal immigrants are coming into the United States at an alarming rate and it is affecting the United States in negative ways. Immigrants are drawn to America to escape poverty, corrupt government, crime, severe danger, drugs, or persecution in their own countries. Immigrants that come to the United States of America are supposed to apply for a Visa when they first arrive. To get a Visa, the peopleRead MoreIllegal Immigrants And The United States1303 Words   |  6 PagesAs history has shown, millions of immigrants have flocked to the United States in attempts to find a better life. The complexity of immigration is much greater now than it was in the early 1900’s. Most immigrants arriving on boats to Ellis Isle would have only been denied if they were deemed to be a criminal or with disease. Individuals must now endure an extensive application process to obtain a green card or visa. Without one of these documents, the person is considered to be here illegally. To dayRead MoreIllegal Immigrants And The United States1248 Words   |  5 Pagesa half million unauthorized immigrants in the United States in 2014. The population has remained stable for five years, and currently makes up three and half percent of the nation’s population. In the United States Labor Force, there were eight million unauthorized immigrants either working or looking for work in 2014. Is it ethical to employ illegal immigrants? According to the Pew Research Center, Currently, â€Å"49% of US citizens agree with the statement â€Å"immigrants today strengthen the countryRead MoreIllegal Immigrants And The United States1418 Words   |  6 PagesAn illegal immigrant, who works for their keep in an unknown country, contributes to taxes, stays out of trouble, and just wants a better life in a foreign country, on unknown land should be recognized for their contribution to that particular society. An illegal immigrant is a person who migrates to a different country i n a way that is in violation of the immigrant laws of that country. Immigration has been a divided topic for many years in America- illegal immigrants are sometimes seen as a burdenRead MoreIllegal Immigrants And The United States Essay1594 Words   |  7 Pagesand illegal immigrants originate to the United States. From all around a world, individuals want to arise toward America for an improved existence for them and their families. America is a freedom-oriented country, where everybody has right how to live their life in their own conditions. I myself, I remain immigrant as well. I came to U.S.A. 5 years ago. American culture remains actual diverse somewhat from other cultures. In this country, we all get the liberty to live our life. The United StatesRead MoreIllegal Immigrants And The United States1256 Words   |  6 PagesAn immigrant is a person who legally comes to a country to take up a permanent residence. An illegal immigrant is a person who does come to a country withou t following the established legal procedures of the destination country and who resides in that country without the proper identifications for example: visas, or other documents. Illegal immigrants are sometimes referred to as illegal aliens or undocumented workers. Emigration and immigration are two sides of the same basic act of human migrationRead MoreIllegal Immigrants And The United States1490 Words   |  6 PagesThe United States of America constantly boasts about its homeland security system and the 1.6 million dollar budget it grants to immigrant and border control. However, in the past decade the number of illegal immigrants in the US has risen from around 4 million to 11.6 million. Its insane that the United States is spending the extremely generous sum of 1.6 million dollars on border control out of its 3.8 trillion dollar budget, and is seeing no return! Currently, about 3.5 million illegal immigrantsRead MoreIllegal Immigrants And The United States1848 Words   |  8 Pagesof the United States immigration has reliably transformed into a bit of our nation s fabric which began many years earlier. Just to wind up one of the most sizzling subjects in the United States and as of late with its essential center being illegal immigrants. Illegal immigrants are individuals who enters a country without the administration s authorization. In 2008, the Center for Immigration Studies assessed that there are more than 11 million illegal immigrants in the United States which areRead MoreIllegal Immigrants : The United States1174 Words   |  5 PagesEach year about 2.5 million Illegal immigrants attempt to cross the border, only about 100,000 and less make it through. Illegal immigrants come to America for a better life. They have gradually increased over time since the 1800’s. Illegal immigrants can come from all parts of the world, but most them come from spanish speaking countries (South and Central America). Most Americans believe illegal immigra nts are a problem to the U.S.. Also, Illegal immigrants are believed to be bringing crime, butRead MoreIllegal Immigrants in the United States613 Words   |  3 Pages It has been estimated that there are 8.3 million workers in the United States who are illegal immigrants. There have been certain proposed policy responses that vary from more restrictive border and workplace enforcement to the legalization of workers who are already here. Using the U.S. Applied General Equilibrium, it’s possible to weigh in the impact on such factors like public revenues and expenditures, the occupational mix and total employment of U.S. workers, the amount of capital

A review of the production of Blood Brothers Essay Example For Students

A review of the production of Blood Brothers Essay In year 10 we went to see the musical Blood Brothers by Willy Russell. We saw the play at the New Wimbledon Theatre on the 2nd of November 2006. It is a story about two twin brothers who are separated at birth but find each other again at aged 7. It shows the standard of living between the upper and working class of Liverpool in the 1960s onwards. The many characters in the play are: Mrs Johnstone (the working class mum), Mickey (working class twin), Sammy (brother of Mickey), Mr and Mrs Lyons (upper class parents) Eddie (upper class twin), Linda (friend of both twins) and the Narrator who helps tell the story throughout the play. It has many unexpected surprises along the way to keep in you interested. In the play the playwrite Willy Russell explored many themes and issues: class and expectations, unemployment and crime, superstition, loyalty and trust. The twins were altered by their different upbringings. Both went to separate schools, Eddie to a boarding school and Mickey to a state school. Eddies attire at school was a very strict uniform, tie up to the top button, socks to his knees, shoes polished and overall looking very smart. Mickeys uniform was scruffy and dirty the total opposite of Eddies. They were treated differently by society by a policeman. Both of the brothers were throwing stones when a policeman caught them and took them home. He had a drink at the Lyons house and advised docking Eddies pocket money for a while as a punishment. Whereas at the Johnstons he told Mickey off and saying that its not a joke throwing stones and that he could be fined next time. The policeman only treated them both differently because of their background, purely because of their money. Mrs Johnstone worked for Mrs Lyons as a cleaner, which also shows the class and status of the two families. Mickey ended up being involved in crime because of his family and background. Sammy was involved in crime already and dragged Mickey in it to help him, as he knew he was unemployed and looking for and job for money to support his family. From the shoes on the table to Mrs Lyons and Mrs Johnstone swearing on the bible, superstition had a huge effect on the lives of the main characters. Mrs Lyons wasnt superstitious at the beginning of the play at the shoes on the table song, but as the play carried on she began to feel more and more paranoid and guilty of what was going to happen in the future. She felt this, as she believed the superstition that twins will die if separated. This helped her to become guilty which ate away at her and in time she becomes mentally ill because of this. The lives of the brothers were based on a lie. They were twins more than friends of what they thought they were. Towards the end of the play Mrs Lyons tapped Mickey on the shoulder and showed him Linda and Eddie standing and talking together. This planted a seed in his head thinking that they were having an affair, which they werent. This made Mickey distrust Eddie and Linda even though they were being loyal to him. Mrs Lyons didnt trust Mrs Johnstone as she made her swear on the bible when she gave away her unborn child, so she couldnt go back on her word. Mrs Lyons betrayed her husbands trust, Mr Lyons, as she lied and said that Eddie was his son. There were four couples in the play, Mr and Mrs Lyons, Mrs Johnstone and Mrs Lyons, Mickey and Eddie and Mickey and Linda with none of them trusting each other. There was a break down in families no matter what class and status you had. Lots of different drama forms and styles of theatre were used in the production. .u92f2eacf4a3182e43655f67a8ba2c2e2 , .u92f2eacf4a3182e43655f67a8ba2c2e2 .postImageUrl , .u92f2eacf4a3182e43655f67a8ba2c2e2 .centered-text-area { min-height: 80px; position: relative; } .u92f2eacf4a3182e43655f67a8ba2c2e2 , .u92f2eacf4a3182e43655f67a8ba2c2e2:hover , .u92f2eacf4a3182e43655f67a8ba2c2e2:visited , .u92f2eacf4a3182e43655f67a8ba2c2e2:active { border:0!important; } .u92f2eacf4a3182e43655f67a8ba2c2e2 .clearfix:after { content: ""; display: table; clear: both; } .u92f2eacf4a3182e43655f67a8ba2c2e2 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u92f2eacf4a3182e43655f67a8ba2c2e2:active , .u92f2eacf4a3182e43655f67a8ba2c2e2:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u92f2eacf4a3182e43655f67a8ba2c2e2 .centered-text-area { width: 100%; position: relative ; } .u92f2eacf4a3182e43655f67a8ba2c2e2 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u92f2eacf4a3182e43655f67a8ba2c2e2 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u92f2eacf4a3182e43655f67a8ba2c2e2 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u92f2eacf4a3182e43655f67a8ba2c2e2:hover .ctaButton { background-color: #34495E!important; } .u92f2eacf4a3182e43655f67a8ba2c2e2 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u92f2eacf4a3182e43655f67a8ba2c2e2 .u92f2eacf4a3182e43655f67a8ba2c2e2-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u92f2eacf4a3182e43655f67a8ba2c2e2:after { content: ""; display: block; clear: both; } READ: Jane Eyre EssayThese included naturalistic acting, musical drama, direct address and physical theatre. Naturalistic acting is very realistic and believable. An example of this being used on the play is the drug scene between Linda and Mickey in the kitchen. Musical drama is the songs and music used throughout the production. The song Marilyn Monroe was used to help tell the story, changing the meaning of dancing to fit what was happening. Direct address was when the Narrator spoke lines directly to the audience to either help the play proceed or explain what was happening. Physical theatre was used in the bus ride scene and also at the fun fair. People represented a rollercoaster using their voices and bodies and the same for the bus. At the start of the musical we saw the end. It made you ask yourself questions about what was happening? Who are the people lying down? Why is the music so sad and emotional? It was effective as it made you very inquisitive and intrigued to find out more. The actors communicated who they were to the audience through song, voice, outfits, body language and the interaction with each other. The actress playing Linda changed what she was doing to show how old she was and how she felt about life. She went from an energetic tomboy, to a sexy teenager, to a stressed out mum. Her body language told us that she had grown up by the way she tense and stood right up. He voice was a lot lower and deeper. The Narrator in the play represented the little voice in the back of your mind, your conscience. I felt scared, insecure and timid when the Narrator was on stage as it felt that he would be able to read my mind and so my guard will fall. The fact that he was always watching everyone and often from the shadows gave the impression that he was sly and scheming like a fox ready to pounce on his prey. His voice was very strong and confident; it gave the effect that he was all knowing and wise. He had a very harsh Liverpudlian accent, which supports my thought that he was conscience the characters in the play were all from Liverpool. He wore a black suit with a shirt underneath which he didnt change from throughout the musical. It was a lot different from the other characters in the play. I think it was important that he dressed individually as he wasnt part of the production as a main character in the story line. It also helped the audience not to get confused. As well as the performances by the actors, the design and staging of the production also highlighted the themes and helped to communicate the status and class of the characters to the audience. The costumes of Mickey and Eddie were very contrasting. When they were younger Mickey was relaxed as a child whereas Eddie was very constricted, as he didnt mess about and have fun with the other little boys his age. This showed through their clothes. Eddie wore his knee-high socks and polished shoes whereas Mickey wore Sammys scruffy old big jumper. This told us that Mickeys family couldnt afford to buy new clothes for him so he had his older brothers hand-me-downs. Eddie on the other hand could afford new clothes and dressed smartly because he had the money to do so. The same goes for the mothers, Mrs Johnstone and Mrs Lyons. Mrs Johnstone wears a floral apron whereas Mrs Lyons wears a smart tailored suit. Her outfit kept changing throughout the musical as her character had the money to keep on buying new outfits. She wore jewellery and had her hair styled which she could afford to have done everyday. .ubbfa3ceb845ec8ec87736f0eae595a8b , .ubbfa3ceb845ec8ec87736f0eae595a8b .postImageUrl , .ubbfa3ceb845ec8ec87736f0eae595a8b .centered-text-area { min-height: 80px; position: relative; } .ubbfa3ceb845ec8ec87736f0eae595a8b , .ubbfa3ceb845ec8ec87736f0eae595a8b:hover , .ubbfa3ceb845ec8ec87736f0eae595a8b:visited , .ubbfa3ceb845ec8ec87736f0eae595a8b:active { border:0!important; } .ubbfa3ceb845ec8ec87736f0eae595a8b .clearfix:after { content: ""; display: table; clear: both; } .ubbfa3ceb845ec8ec87736f0eae595a8b { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .ubbfa3ceb845ec8ec87736f0eae595a8b:active , .ubbfa3ceb845ec8ec87736f0eae595a8b:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .ubbfa3ceb845ec8ec87736f0eae595a8b .centered-text-area { width: 100%; position: relative ; } .ubbfa3ceb845ec8ec87736f0eae595a8b .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .ubbfa3ceb845ec8ec87736f0eae595a8b .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .ubbfa3ceb845ec8ec87736f0eae595a8b .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .ubbfa3ceb845ec8ec87736f0eae595a8b:hover .ctaButton { background-color: #34495E!important; } .ubbfa3ceb845ec8ec87736f0eae595a8b .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .ubbfa3ceb845ec8ec87736f0eae595a8b .ubbfa3ceb845ec8ec87736f0eae595a8b-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .ubbfa3ceb845ec8ec87736f0eae595a8b:after { content: ""; display: block; clear: both; } READ: Catcher In The Rye - Symbolism EssayMrs Johnstone kept her outfit the same all through the production, as her character wouldnt have been able to buy new outfits all the time. Her floral apron however represented that she was a mum who always put her children first before herself. Lindas costume effectively communicated the different stages of Lindas life. Her outfits went from a bright yellow dress to high heels and a miniskirt to a dull baggy jumper and jeans. At the different stages of her life her clothes showed the changed, her emotions and what she was going through at the time. For example when she had a child, she was worried that she couldnt support her daughter financially as her husband, Mickey, didnt have a job so there was no income coming in. At this point she was wearing baggy jumpers and jeans, which represented her feelings. Nothing was going for her anymore and her drive and charisma had gone. Other actors changed their outfits aswell, like the milkman who took of his hat, then turned into a doctor. There was also a teacher at both of the brothers schools, who just took off his coat and rolled up his sleeves to change between the two.