Frederick Douglass: On Anti-Slavery Essay

Frederick Douglass—the famous icon on the context of ‘classic slave autobiography’ is considerably an eloquent writer which in essence recounts his claim to fame as that who issued the â€Å"powerlessness resulting form the social appropriation of discourse. † Born on the month of February in the year 1818 at Near Easton, Maryland, his works and admirable finesse has been recognized as the heroic act of being a slave towards being an anti-slavery leader. At age of twenty, he was able to get off the leash of slavery and pursued with his aim to thoroughly expunge the radical schema of slavery through writing articles and other forms of documentation such as The Liberator; and thoroughly escaped the wrath of slavery at age thirty in the year 1838. Further, this Garrison writer also managed to write a book under his memoir entitled Narrative of the Life of Frederick Douglass, an American slave in the midst of year 1845 and gained numerous awards and took the limelight stage due to his eloquence and intellectual fortitude as a speaker on anti-slavery movements. Not only is he good in the field of public speaking, but he also managed to take a formidable seat through lecturing and spreading out his determination to achieve â€Å"freedom† through explicitly exposing himself and truth for the purpose of campaigning for the â€Å"rights of women, and participations on Seneca Falls Convention, and advocacy in the Republican Party. † As a matter of fact, he also helped in recruiting African Americans in enlisting in the Union army—for the fight against slavery—and even advising the most influential president, Abraham Lincoln, to support him in his endeavors. All of these, in the streamline of history and of literature have nevertheless paid off worthy enough. Interview with Frederick Douglass How does it feel to be famous and world-renowned? Good day to you and to our viewers. Well, I knew you would ask me that question since in my own experience, which is perhaps the legendary question which most of my interviewers consider as the â€Å"opening remark† per se. I could not feel anything more than happiness to take it to assumption that I am considerably renowned and labeled as one of those who are legendary and has made a difference in the world or on the context of slavery. Of course, like all the other public icons and heroes as far as history and literature is concerned makes me feel that I am in one point or another a blessed individual for having been given the gift of courage and eloquence. It may be hard, in some point, since there will always be â€Å"critics who are after pulling down your reputation† for reasons which I consequently define as lame. I mean like, after all the hard work I have done and with the support of the testimonies of those who were able to witness and experience the heroic act that I have made, they always try to pull me down. I don’t know why they are utterly absurd, but I guess that is how â€Å"fame† is actually established—to be talked about and to be criticized. Nevertheless, a person would not be considered famous if his or her name does not often linger on the media, press, or on critics for that instance. (Gerteis, p. 1448) Is it true that Haitis were opposed to mixed men? We are all aware that the Haitians have always been those who are aloof amongst other people or on other race. Well, it came to a point that they specifically hate individuals with â€Å"mixed citizenship†Ã¢â‚¬â€which as you can see includes me—and therefore, I became one of those who were always stalked by these people and sometimes, whenever they get the ample chance, they get to serve their wrath against me. I never really considered it as a threat, since I always thought that every race and every culture have diverse beliefs. â€Å"These beliefs, however, are manifested by historical events or simply a tradition inculcated by their forefathers†Ã¢â‚¬â€and believe me, when tradition or belief is at stake, trying to change it is like pulling a trigger on your head. (Douglass, p. 5) Why did you decide to revolt against slavery despite the â€Å"risk† that it contains? Initially, as a boy at age 20, I was one of those who were hiding from the closet for every explosion, which I may possibly hear. But then, there was this inner sense of â€Å"hatred† which I fervently feel to be a form of evil—inequity is one—and â€Å"to treat me and my people as slaves by individuals who are humans like us, stepping on the same ground, that is reason enough not to let them do their wrong doing. † It is a disgrace to humanity and I would not want my children to experience that kind of agony in the future. (Lee, p. 51) How would you define slavery in America? â€Å"American History often stresses the point of slavery and racial discrimination. † For that certain fact, it has made black Americans hungry for freedom that their way of being heard was through the use of pen by literature, or worse, in the realm of a bloody war. Plenty of truth bares the inequity behind the perceptions of asymmetrical treatment. There is this novel which formidably shattered my world apart. Anger, Betrayal, a feeling of Invisibility – all of which horrified the pitiful young man in Ralph Ellison’s Invisible Man, which continuously puzzle readers in scouring for the Nigger’s name. Perhaps it was better way off that way then, or else the name would also dignify the unfortunate fate encountered by the man in the novel. As for the invisible man, the story of his life, though he had felt, experienced and had been a witness of the biases in color, portrayed a perfect representation of the blacks stern personality and braveness, living with their belief that all men are created equal. The mentioned outward appearance of treatment must be expunged and totally be erased in the rationality of mankind, or rather have those antagonists be called white poisonous serpents eaten with selfish pride again (Breidlid). I and my men were treated like the invisible man himself, and I believe that no one would want to live in that kind of disposition in life. Please tell me something about the Douglass-Garrison Conflict, its nature? From the founding of the American Anti-Slavery Society in the year 1833, abolitionism has been marred by constant intra-group disagreements. Within seven years, ‘the movement split itself into two camps; one was headed by William Lloyd Garrison, while the other has been spearheaded by public personalities namely, Tappans, James G. Birney, Gerrit Smith and Joshua Leavitt. ’ However, ten years after, those camp escapades, another schism occurred which eventually involved two groups which are piously clashing in perspectives with regard to the imposition of anti-slavery activities. In this point of time, the feud took place under my jurisdiction and William Lloyd Garrison’s. (Tyrone Tillery) When did you thoroughly say that you were â€Å"free† at last? My free life began sometime in September, 1838. Thus, the exultant joy resulting from this gradually fascinating status was short-lived only. In the most frustrating connotation, the moment I reached New York—just when I thought I was already away from the rage of slavery—it was surprising to realize that their power also reached the city. By then, I told myself: â€Å"no man would ever have the right to call himself slave, or assert mastery over him,† I sought refuge with the new environment where, sad as it may seem, even people same as my color would betray me over the tingle of a few dollar. (Frederick Douglass) Do you think there were also other people who suffered the same agony as that of yours? Captivating stories had been written to inspire readers instead of lingering the unfortunate fate of those who failed to survive in the war. An example for this, is a brave black American woman in the name of Fannie Lou Hamer, a woman armed with hope to eradicate a form of juxtapose deprivation against what she believed to be elements of privilege in her own very limited environment was painstakingly given to her and of her family, an implication which states that Black Americans do not allow themselves to be treated like slaves by others (Lee). Along with her bravery as indulged by other authors were The Scottsboro Boys, Joe Louis, Richard Wright and Sterling Brown. When the war has commenced, ‘children and women had to leave their homes for safety and let their fathers or any man in their family risk their lives to battle’. Guns and explosives were seen everywhere. The flag was raised symbolizing that they are ready to face the doom of death. Children were ranting and women were hearing voices. They became afraid of coming out. (Lee, p. 56) What would be your last words for the raging experience that you have had before? It was not easy; it was facing death while being alive. It seemed as if we were to lose everything that we have worked for, everything that we have sown for our children, and for the coming generations of our offspring. Our ‘economy became stagnant’, and serenity was about to be crushed into pieces. But it was a fire, ignited with hope’s flame. It was to shed blood or to be slaves; to remain free or to be chained. I now serve as a living legacy to those who enjoy the freedom the mighty indigent heroes have fought for. (Chesebrough, p. 49) Works Cited Breidlid, A. American Culture: Texts on Civilization. 1st ed. New York: Routledge, 1996. Chesebrough, David B. Frederick Douglass: Oratory from Slavery. Westport, CT: Greenwood Press, 1998. Douglass, Frederick. Narrative of the Life of Frederick Douglass. New York: Prestwick House Inc. , 2004.

Effects of Longterm Imprisonment

CRJ 220 Effects of Longterm Imprisonment While the average time served in US prisons is 34 months, many inmates are serving sentences longer than this. According to a 2009 report by the Sentencing Project, 140,610 out of 2. 3 million inmates are serving a life sentence. However, with the possibility of parole, not all life sentences mean inmates spending their lives behind bars. Some inmates will return to society and face many challenges. One issue with long term imprisonment is the effect on family.While the inmates connection to his/her family may remain the same, the family moves on. Some spouses will divorce over the crime itself. The inmate now faces their long term sentence without the support of a significant other. Even those whose marriages survive the initial ordeal will encounter many more challenges along the way. Spouses are facing the prospect of spending a great period of their lives alone. The inmate knows this and will now have the added anxiety of wondering: will t hey find someone new, will they cheat?Children further complicate the matter. The child will grow up without a father or mother. At any age, the child will go through milestones that the inmate will miss: first words, first steps, first day of school, first date, graduation, marriage, grandchildren, etc. The long term inmate will likely miss one or more of these events. Young children may not remember their parent. They will likely have no relationship with the inmate. Even those who manage to form some kind of bond find it is very difficult to maintain from behind bars.The released inmate then has to be a part of a life that they were absent from for years. Another issue with long term imprisonment is employment. In five or more years, much can change. As society changes, technology advances. An inmate's prior skills, training and education may now be irrelevant. While â€Å"free† workers may face the same dilemma, they also are given time to gradually adjust to these change s and learn new skills. The inmate is thrown into these changes upon release. Even if their skills are still relevant, the inmate may lose their work skills after not using them in so ong. The long term inmate who was incarcerated at a younger age may not have had a chance to get an education or any job or skill training at all. Upon their release they may be 48 with the education of a 17 year old. Long term imprisonment may also have an effect on work ethic. Inmates have not been part of the work force for a long period of time. While some inmates are assigned jobs, not all are. Will those who don't have a diminished work ethic upon release? Will they remember how to function in a work environment?Another issue with long term imprisonment is the effect on mental health. Those sentenced to long terms may encounter psychological issues during their sentence and upon their release. Inmates may give up hope; those sentenced to life in prison give up the idea of ever gaining freedom. Th ough they may have a chance at parole, they know the chance of being released might be slim. There are inmates who commit suicide shortly after being sentenced because they can't deal with the extreme life change. Being in a prison environment for so long also can change a person.Inmates grow very accustomed to the prison lifestyle: waking up at a certain time, following a strict schedule, being watched at all times, following very strict rules. It can be difficult to adapt into being a â€Å"free† individual again: making your own decisions, knowing what to do without someone telling you what to do, giving yourself rules, etc. There are also the rules in prison versus the rules in society. Prison rules include not only the ones set by the institution itself, but also prison ‘norms' set by the inmates. These rules are very different from the ones we have in society.These rules can also change an inmate's personality. They may become more violent to protect themselves or prove their power to others, or become overly cautious and suspicious of people. These effects can carry over upon release. While some of the effects of long term imprisonment are beneficial to society and the inmate, many of the effects are harmful as well. The longer a prisoner is incarcerated, the more they will adapt to their environment and lose contact with the outside community. This adaptation can be difficult to reverse, even after release into society.

America Industrial Revolution

Industrial revolution has been identified as the defining force behind the tremendous economic growth witnessed in the American nation during the 19th and twentieth century (Hudson 56). Thanks to industrial revolution, the American nation improved its ability to conduct mass production both for its domestic needs and surplus for export. Just to be appreciated here is the factor that the sustainable economic development of any nation does not only depend on self-sufficiency but on its ability to conduct international business. Another important aspect of the American industrial revolution is that it led to the formalization of employment, a factor that served to mitigate human exploitation (Collier, and Kevin 21). Â  However, the American industrial revolution is blamed for compromising the sustainable competitive advantage of small scale cortege industries in the nation (Michigan State University). The revolution is also significantly blamed for compromising the cultural identity of the individual American ethnic groups (Hudson 88). This is because it led to increased social intermixing of races as well as cross-race marriages. Still, the revolution is closely attributed to an increase in environmental hazards among American communities (Hudson 91). This paper is written as a discussion on the effects of the American industrial revolution. The author takes a look at both sides of the implications of the revolution to the American people. Effects of industrial revolution to the life of the Americans There are many positive effects of the American industrial revolution to the people of America. According to available historical information, the massive industrial growth in the American nation during the 19th century is the direct result of its current superpower status in the globe. Following the emergence of the industrial revolution, the people of America enjoyed the concept of increased production in the industries, a factor that greatly improved their investment profitability (Collier, and Kevin 21). It is worth noting that the sole purpose of any investor is to ensure maximum profits. Although slaves provided cheap labor for agricultural industries in America, their productivity could not much the modernized agricultural practices that came with the industrial revolution. Another important effect of the American industrial revolution is that it led to the formalization of employment in the nation (Collier, and Kevin 21). Prior to the onset of the industrial revolution, slavery was one of the most commonly employed forms of labor for fueling the economy of America. This was a negation of the human rights since slaves were perceived as a property to their masters rather than human beings who deserved decent treatment. Nevertheless, with the coming of the industrial revolution, there came more effective and reliable machine technologies, a factor which negated the need for forced labor in the industries (Collier, and Kevin 25). This greatly improved the working conditions for the employed people of America. Still on formalization of employment is the creation of new employment opportunities for the American citizens (Michigan State University). The onset of industrial revolution brought with it new jobs for the different professional classes in the American nation. This did not only serve to improve the living standards for some members of the community but also as an encouragement for professionalism among Americans. Also, the revolution is to be thanked for the innovative development of industrial management and leadership principles as well as strategic marketing practices in America (Collier, and Kevin 27). With increased level of productivity, management and industrial leadership principles grew. Such also called for the expansionism process by the American nation in the quest to ensure sustainable market for its surplus products. According to proponents of the industrial revolution, the American industrial revolution brought with it the need for innovative approach to problem solving. It is rightly asserted that necessity is the ultimate mother of invention. Still, it is worth to acknowledge the fact that the process of industrialization has undergone many challenges. Based on this reasoning, the American industrial revolution is praised for the overall improvement of the technological and economic stand of the American nation (Collier, and Kevin 28). As per the available information, America is one of the leading influences in the international industrial product market to date. This gives its citizens a competitive advantage over those of other nations. Also, the extensive industrial revolution that marked America during the 19th and early 20th centuries are to be praised for the power control enjoyed by the nation across the globe (Michigan State University). According to available information, due to the influence of its industrial revolution, the American nation enjoys the competitive advantage of intellectual properties. Just to be underscored here is the fact that intellectual properties are found to promote the economic advantage of a nation. This is because they are protected by the law against use by other persons without providing commercial benefits to the source. Therefore, since the revolution led to establishment of numerous intellectual property rights, it served to protect the social and economic stability of the American people (Hudson 67).

Native American Art Essay Example | Topics and Well Written Essays - 250 words

Native American Art - Essay Example In addition to this unity of rhythm in both artistic products, each seemed to have an overarching, celestial quality overlaid upon the foundation rhythm. In the Friendship Dance, this is accomplished by the various vocal tones produced by the singers. The austerity of the rock arts basic geometric shapes is likewise raised to a different plain by embellishments of a more abstract nature. These include sweeping arches over the heads of characters and lines that could almost be described as suggesting movement of the figures. One difference between the two media is their feeling of accessibility. For me personally, the Friendship Dance seemed to be inviting me to come and join in some sort of festivity. The rhythm of the drums and the vocals, although foreign to my ear and understanding, sounded inviting and welcoming. On the other hand, the rock art was a wonder to behold, but seemed very cold to me. It did not make me feel as though I would ever be a part of the world that it was depicting. While I appreciated the nature of the art, I came away feeling as though you really had to be a Native American to really â€Å"get† what the rock art was all about. On the other hand, I felt that the Friendship Dance had the ability to communicate across cultural

Ink Painting In China Essay Example | Topics and Well Written Essays - 1000 words

Ink Painting In China - Essay Example China is known for its rich history in paintings, as well as, the embraced art forms. There are numerous characteristics in Chinese ink paintings that were used in the traditional mode of painting. Ink paintings in China are based on genres and themes that were acceptable in the traditional Chinese cultures. However, western educated Chinese artists changed these aspects by introducing ink paintings after returning to China. Contrary to the traditional painting in China, ink painting focused more on bringing out more vivid aspects of nature. These artists changed a lot of things, and there is no discussion of modern Chinese art can be completed without discussing Xu Beihong’s work and its influence on ink painting. Xu Beihong (195-1953) had the skill to combine modern and ancient techniques in accomplishing his best work. His works amalgamated the impressionistic utilization of color and light coupled with keen adherence to shape and structure. Xu Beihong’s works will, therefore, assist in the critical understanding of Chines ink art and why or how the western educated Chinese adapted ink painting after returning to their country, as well as, the differences between these works and traditional ink art.

Network Acquisition Essay Example | Topics and Well Written Essays - 500 words

Network Acquisition - Essay Example Therefore, for successful network acquisition, Veil (2010) asserts that one has to understand completely whether the legal name and the web presence of the company when merged. The effects of geographical distance and the inter-organizational networks on the acquisition strategies in these high technology industries will be examined via an analysis of mergers and acquisitions that occurred in the computer networking industry during the 1990s. It is during this period that the said industry encountered massive growth of entrants, innovative products, and the VC investments. The Cisco Systems, which has a dominant presence in the networking industry, acquired over 70 firms. It is, therefore, the biggest public company in terms of market capitalization (Yurov, 2008). For any successful acquisition, it is important to carry out a background check. As such, with every IT venture, customer retention and innovation would be the ultimate strength. However, threats such as the eminent rise of other companies would rise. The company’s biggest weakness would be the replication of efforts and subsequent failure brought stemming from a weak organizational structure, and poor decision making. Management experts are employed in order to achieve the company’s prosperity. While it is a merger, there’s the possibility of restructuring because of the centralization of the business. In such a state, it is instrumental to carry out hypothesis testing or questionnaires to help the management run simulations on the possible performance of the organization. Precaution has to be highlighted to avoid acquiring projects that are similar in size and competence. A more realistic concept would be to focus the acquisition activities strongly on projects involving more companies to create economies of scale. Online marketing is good when the websites of the individual companies are either merged or partnered with

The Qualities of the Real Personal Statement Example | Topics and Well Written Essays - 250 words

The Qualities of the Real - Personal Statement Example My conception of the Divine is based on the very real existence of my intellect, which has no physical form. I hold that nothing real can come out of nothingness. The reality of biological life is proof of the reality of a Creator, who was the first cause of life. He is infinite and is the cause of all finite things. He is independent and does not depend on anything for his existence. Â  It cannot be denied that good is real. There are degrees of goodness. These degrees of goodness are possible only with reference to something which is absolutely good. My conception of the Divine is that absolute good. My God is the embodiment of the highest degree of Perfection. He is removed from the senses and the body and belongs only to the mind. He is the foundation of moral values. My God is real. The existence of the unicorn and the leprechaun do not meet my criteria of real, as I can neither see them with my senses nor with my intellect. They are merely part of my imagination. They have not originated independently: they originate in my imagination. These imaginary creatures are not infinite, or perfect. They are not real. Â  

Cross Cultural Awareness for the International Manager Essay

Cross Cultural Awareness for the International Manager - Essay Example It runs an Internet filtered search engine that caters mostly to school-age children of ages 7 to 12. This search engine filters effectively the restricted sites from the children and promotes wholesome Internet surfing suitable to its young consumers. It aims to release an English-language Internet filtered search engine, a more advanced and more scrutinizing system (when compared to competitors Google and Yahoo) where it can be made available to the Chinese English-speaking children and adults, in accordance to the strict regulations of the government. Since it is a more efficient filter as compared to its competitors, it also features a Chinese counterpart site for its bilingual target public. It needs bilingual speakers and writers who would be able to man a new center that would be built in the country. China, or the People's Republic of China if the official name has to be used, has a total area of 9,596,960 sq km, slightly smaller when compared to the United States of America. The country is found in Eastern Asia, surrounded by Mongolia on its north, Central Asia countries on its west, South and Southeast Asia countries on its south and the East China, Yellow and South China Seas and the Korea Bay in its east With a total population of 1.3 billion people (July 2006 est.),... It also has a wide variation of dialects with each region having their own such as Yue or Cantonese (Hongkong area), Wu or Shanghaiese (Shanghai area), Minbei (Fuzhou area), Minnan or Hokkien-Taiwanese (Taiwan area), Xiang, Gan, Hakka dialects and other dialects of the ethnic tribes. Standard Chinese or Mandarin (Putonghua, based on the Beijing dialect) is the official language in China as mandated by the government. The population growth is estimated to be 0.59% by 2006. Those below 14 years old make up 20.8% of the population, 15-64 years old has 71.4% and those 65 years old and over are 7.7%. Adding to the variety of the country is the religious adherence of the population to Taoism, Confucianism, Buddhism, Christianity, and Islam despite the discouragement of the state for religious practices and its push for atheism in 2002. In 221 BC, China was first united under the Qin or Ch'in Dynasty which the British based its current English name (its local name is Zhonghua Renmin Gongheguo). Its last reigning dynasty, the Manchu, was replaced by a republic in January 1, 1912. The Communist Party took over in October 1, 1949, officially making it the People's Republic of China. For centuries China stood as a leading civilization even as the Roman Empire crumbled, exceeding the rest of the world's foremost civilizations and contributing important discoveries and inventions in arts and sciences. But in the 19th and early 20th centuries, the country was beset by civil unrest, major famines, military defeats, and foreign occupation (The World Factbok, 2006). After the devastation brought about the Second World War, the Communists under the command of Mao Zedong established an autocratic socialist system that

See the file Essay Example | Topics and Well Written Essays - 1750 words

See the file - Essay Example This paper provides an insightful analysis of the thoughts of Descartes and Bentham regarding whether we should eat animals or not As mentioned earlier, Descartes argued that animals do not feeling pain even though they act as if they do. They are like machines, which can be used at anytime for any purpose. Unlike human beings, animals do not feel pain at all. This implies that when they are killed for consumption, they do not feel any pain for it. For this reason, animals can be used as food, just like the vegetables and the fruits. The fact that animal kept and domesticated just like plants implies that they can be used by human beings for food (Warren 164) . Their necks can be cut off the same way the plant tips are cut and they do not complain. In of support of the reasoning that the animals should be eaten, Descartes argues that animals do not have rights, unlike the human beings. The same way the plants are used they should be used to provide food for the human beings who are far much superior to them. Human beings do feel pain especially when they are cut. This, according to Descartes, is unlike to happen to the animal (Pickering and Norman 513). Animals should be treated like the machines since they are like the objects; the same way we use a tractor to plough. Moreover, he argues that anything that feels pain should be pitied. Human beings are emotional beings; if the animals were feeling pain they would be pitied. According to him, it would be so remorseful to see the animals go through the painful state of being slaughtered. Since them do not feel any of these they should be killed according the human being’s wish. It can be so remorseful to see a fellow human being slaughter unlike an animal. The cry of the fellow human being can make another human being feel sad or cry as a result. If animals were emotional, they would cry if they see a human being slaughter a fellow animal. Animals should be eaten as they eat one another, this show that they

Nowadays, Food Has Become Easier to Prepare Essay Example for Free

Nowadays, Food Has Become Easier to Prepare Essay Nowadays, Food Has Become Easier to Prepare. Has This Change Improved the Way People Live? Use Specific Reasons and Examples to Support Your Answer. By annicat Man, through the ages, has undergone many changes, from a period when he hunted for his food to the present era when man is dependent on preprocessed foods. During this period not only has man changed his mode of eating but his whole lifestyle as well. In pursuit of more in this competitive world, man no longer has time as he once had. He is caught in a race against the clock. A person who finishes more n lesser time is considered more efficient. This pressure to do more in less time has affected his eating habits as well and, as a result, man no longer has time to cook food. Early mans only objective was to seek food to sustain him and his family. Nowadays finding food has taken a back seat to other priorities, such as career and education. Food is no longer of that importance. This is not an encouraging trend. People are too dependent on preprocessed or precooked food, which no longer has the freshness it once had. Such foods loose their mineral and vitamin content and re not as healthy as fresh food. That is why the number of diseases is also rising. People have also shifted to high calorie content food like French fries, pizzas, and ice cream, etc. , which is causing obesity, fatigue, etc. As man is becoming busy and too involved in his busy schedule, he has no time even to take care of his own personal needs. Furthermore, cooking is an art which is dying out. People once enjoyed cooking . It was a means of eliminating stress and tension. People were once able to relax during this time and reflect on their lives. People may tend to argue that by sing precooked and preprocessed food they are efficiently using time and can use this precious time saved for other purposes. But is it really worth it? This is a question whose answer can invite much speculation about whether by saving this little time we are inviting lots of other problems, which could easily be avoided. It is actually making our lives not simpler but more complicated. We have lost many of the simpler things in our lives, like the simple acts of selecting our evening meal, preparing it, and enjoying it with our loved ones, and we are worse off for it.

Case Study: Fractured Hand

Case Study: Fractured Hand Introduction The reflective framework chosen for this case study is that of Peters (1991). This framework has been used and favourable evaluated within education (Bell and Gillett, 1996). Peters’ (1991) reflective framework incorporates a guideline called DATA comprising four steps; Describe Analyse Theorize Action The first step is the description of an aspect of practice the clinician wants to change. Identification would be made of the context and the reason the clinician wants to change the practice and their feelings about this. Analysis involves identification of the factors that lead to and the assumptions that support the present approach. This includes analysis of beliefs, rules and motives supporting the present approach (Imel, 1992). Theorizing is the next step which looks at the theories for developing a new approach building on the theories that were identified that were supporting the present approach. The final step is the action putting the new theories (if appropriate) into practice to ensure that such cases continue to be managed appropriately in the future. â€Å"Success of this process would occur only through additional thought and reflection† (Murray, 2006). DATA Description Patient presentation At 11 am a 64 year old lady presented to the Accident and Emergency Department with a painful right wrist following a fall. We shall call her Betty but, in order to protect confidentiality, that was not her real name. She had been brought to the department by car by her husband. Patient assessment History Betty was seen by the triage nurse and subsequent upon waiting her turn was allocated a cubicle. I saw her at 11.20 hours. An understanding of the pathophysiology of fracture is important if important aspects of the patient’s history are not to be missed. Firstly taking an adequate history of the accident, including details of the mechanism of the fall, will help the clinician to decide whether the amount of force applied to the bone would be of the degree that would be expected to cause that particular fracture. Secondly there may be underling osteoporosis leading to fracture with minimal trauma. There may be factors in the history suggestive of osteoporosis e.g. use of systemic steroids (Angeli, 2006) or early menopause without subsequent hormone replacement therapy. A fracture which occurs after only minimal trauma and from a standing height or less, the degree of trauma being that which would not normally be expected to fracture healthy bone, may be what is known as a fragility fracture. This occurs where a bone is weakened by a pathological process , (Majid and Kingsnorth, 1998) such as osteo porosis. In distinction a pathological fracture occurs because of metastatic bone disease. Thirdly not just the mechanism of the fall but the reason for the fall needs to be considered. Betty had slipped on some ice when walking outside to her car. In the absence of such a clear history other factors in the history should be considered; for instance â€Å"funny turns,† visual problems, cerebrovascular accidents, or non accidental injury. It is important to directly enquire about that last aspect. Examination On inspection Betty’s right wrist was swollen. The skin was intact. There was some distortion of the normal contour of the arm typical of a â€Å"dinner folk† deformity. The distal part of the radius was angulated dorsally, the wrist supinated and the hand deviated towards the thumb. On palpation the distal radius was markedly tender. There was no crepitus. Betty was unable to use her right arm at all. The radial and ulnar pulses were readily palpable and there was good capillary refill in the hand. Sensation in the radial, ulnar and median nerve dermatomes was normal as were finger and thumb movements. The preliminary diagnosis of Colles fracture was made with some degree of confidence since the patient was a 64 year old female who had fallen on an outstretched and had classic examination findings of such a common injury. Investigations For a completely confident diagnosis a plain X ray was required. For an X ray of a suspected fractured limb the following are requirements (Majid and Kingsnorth, 1998); The X ray should be in two different planes at right angles. The X ray should involve the joint above and below the suspected fracture site. In this case the wrist and the elbow. Diagnosis X ray examination of Betty’s arm revealed a transverse extra articular fracture of the distal radius within one inch of the wrist joint. The distal radial fragment was displaced dorsally. A Colles fracture could now be diagnosed with confidence. Management Analgesia was given by intra muscular injections of morphine 10 mg and stemetil 12.5 mg. The arm had been temporarily immobilised with a splint and elevated to prevent further injury and swelling prior to the X ray examination. Arrangements were made for prompt reduction of the fracture. The displaced fracture was reduced and manipulated and then immobilised. Betty chose to have a general anaesthetic for this procedure. To disimpact the fracture Betty’s hand was pulled distally whilst her wrist was hyper extended. Once disimpaction had been achieved the wrist was manipulated so that it was flexed with some ulnar deviation and pronation. In this position it was immobilised by a plaster cast which extended from just distal to the elbow to the metacarpophalangeal joints. These joints (and therefore the plaster) were at the site of the transverse skin crease across the palm. When the plaster had been applied Betty could move her elbow joint and her fingers and thumb. A check X ray confirmed the bone ends to be in a satisfactory position. Post operative instruction Betty was advised to wear her right arm in a sling and to move her shoulder, elbow and her fingers and thumb to prevent stiffness in these joints. Complications of immobilisation in fracture are joint stiffness and tissueand especially muscle, atrophy. An important and serious complication is Sudek’s atrophy which probably occurs due to neurological and microvascular compromise. Better was instructed to contact the hospital if her fingers became painful, swollen, cold or discoloured. This could indicate that the plaster was too tight and impeding the circulation. Rarely carpal tunnel syndrome can occur due to pressure on the median nerve at the wrist. Betty was then discharged once she had recovered fully from the anaesthetic and was able to walk around. Betty asked if she could drive and this was allowed following evidence that driving is safe with a right Colles plaster (Blair, 2002). A further review was arranged for one week. Betty was advised th at the fracture would most likely heal in four to six weeks. Once the fracture had healed by six weeks the plaster was removed and physiotherapy was advised. DATA Analysis On analysis of the case presentation it is apparent that the well known clinical features of a fracture were present; Pain Tenderness Swelling Immobility Deformity as were the five classical features of a Colles fracture, often called the â€Å"dinner fork deformity† (GP Notebook, 2006); Dorsal displacement of distal fragment Distal fragment dorsally angulated Hand deviated towards the thumb Wrist joint supinated Proximal impaction The absence of crepitus might be explained by the fact of the fracture being impacted. A fracture of the distal radius is one of the commonest fractures in adults (Majid and Kingsnorth, 1998). The Colles fracture was first described by Collees in 1814 (GP Notebook 2006) and is a transverse fracture across the distal radius within one inch of the wrist joint with dorsal displacement and angulation of the distal part of the radius. Sometimes a Colles fracture is associated with a fracture of the ulnar styloid (GP Notebook, 2006) and this must be sought on X ray. A Galeazzi fracture (GP Notebook, 2006) is a distal radial fracture associated with a dislocation of the distal radio-ulnar joint and is important to diagnose (also by means of an X ray) since it requires open fixation to promote adequate healing. Another injury also caused by a fall on the outstretched hand and which it is important not to miss is a fractured scaphoid (Hodgkinson, 1994). This is clinically characterised by tenderness in the â€Å"anatomical snuff box† which is that area on the back of the hand found by hyperextension of the thumb. If present this fracture mandates appropriate immobilisation to reduce the risk of subsequent disabling avascular necrosis. Other injuries can occur following a fall on the outstretched hand, such as fractures to the clavicle, humerus and other parts of the radius hence the need for the wide area of vi ew on X ray examination. Although the presentation was a typical one there was not a mechanism in place to arrange suitable follow up for Betty to see if measures were necessary to protect her from subsequent osteporotic hip fracture. This problem is not an uncommon one in accident and emergency departments as found by a systematic review of 35 studies showing that those individuals with fragility fractures seldom received investigation or treatment of osteoporosis (Giangregorio, 2006). The writer feels that such action would be important since Colless fracture is common and hip fracture a devasting condition. The writer feels that quite simple steps could be put in place to arrange appropriate follow up. An analysis of why Colles fractures are commoner in women than in men needs to consider the full picture. For instance initially it might be assumed that because postmenopausal women are lacking in oestrogen and therefore predisposed to osteoporosis that is the only reason. However research has shown that women have more falls than men and they are more likely, when they fall, to fall forwards onto the outstretched hand (O’Neill, 1994). There is an assumption that the risk assessment for likelihood of subsequent hip fracture will be dealt by someone else. The accident and emergency department does need to concentrate on the acute problem. However hip fracture will necessitate subsequent accident and emergency department involvement. Preventative measures may be a neglected but important aspect of the accident and emergency role despite resources being an ever restraining factor. DATA Theorizing Fracture healing is affected by general and local factors (Majid and Kingsnorth, 1998). The general factors include the patient’s age, wellbeing, nutritional and endocrinological state. With regard to the local factors a compound fracture (i.e. a fracture which involves breach of the overlying skin) incorporates a risk of infection which will prejudice healing. Local factors affecting healing include the site of the fracture, proximity of bone ends and adequacy of blood supply. The pathophysiology of fracture healing consists of three stages (Majid and Kingsnorth, 1998); Inflammatory phase Repair phase Remodelling phase In the inflammatory phase haematoma contains osteoclasts which remove dead bone. Over two weeks granulation tissue forms which contains osteoblasts which form new bone. In the reparative phase the granulation tissue becomes fibrocartilagenous callus. The callus gradually turns into bone during the consolidation phase. Remodelling occurs as the bone adapts under the influence of the stresses placed upon it. Delayed union occurs when healing requires an excessive duration and non union when there is a failure to heal. Factors associated with poor union include a poor blood supply or displaced bone ends. Treatment is aimed at reducing this risk by optimising the position of the fragments and immobilising them. To develop a new approach to the prophylaxis of hip fracture will require multidisciplinary agreement with the formulation of guideline for information giving to both patient and general practitioner. Ideally an appointment would be generated for the bone mineral density scanning and reporting and advising. A mechanism of patient information will be required in parallel. DATA Actions proposed Treatment plan The aims of the proposed action were to achieve; Healing of the bone, and Preservation of function of the arm and wrist joint. There was more than minimal displacement of the fractured bone therefore manipulation was required. During manipulation it was important to pull the hand in order to disimpact the fracture. Manipulation then involved a reversal of the position that was present making up the dinner fork deformity. Management If the fracture is displaced this may, if left untreated, lead to breach of the overlying skin and convert a closed fracture to an open one with the subsequent increased infection risk. An unreduced displaced fracture may compromise the blood supply distally. Correctly to lessen these risks Betty’s fracture was reduced promptly. The treatment consisted of (GP Note book, 2006); Disimpaction Manipulation Immobilisation Rehabilitation in order to preserve function The aim of immobilisation was to allow the fracture to heal without movement of the bone ends but to facilitate as much movement of the unaffected joints as possible. An understanding of the pathophysiology of fracture helps to determine what the risk is for subsequent fracture. If this risk is high it will be advantageous to give some prophylactic treatment to lessen this risk. The fractures with greater morbidity are hip fractures and vertebral fractures and a radial fracture may be an â€Å"early warning† sign of an unacceptable risk of fracture with a more serious consequence. Bone mineral density measurements may be indicated in the near future. If this is outside the normal range and taken in conjunction with the present fracture there may be a need to consider prophylactic measures against osteoporosis and further fracture. A Colles fracture is associated with subsequent hip fracture but the association is greater in men than in women according to a metanalysis (Haentjens, 2003). Nonetheless it may be prudent to advise Betty to check with her general practitioner whether she now falls into the category of the local guideline for measuring bone mineral density. Woman with a Colles fracture within ten years of the menopause had an eight fold increase incidence of hip fracture compared with the rest of the population but the increased risk diminished by age 70 in a study by Wigderowitz (2000). In this study bone mineral density was lower in women who had a Colles fracture that in the general population but after age 66 there was no significant difference. The paper concluded women of 65 and under presenting with a Colles fracture should undergo bone mineral density testing. Bone mineral density checking though not an exact predictor of subsequent fracture is a worthwhile measurement in diagnosing osteoporo sis (Small, 2005). Treatments are available and might be considered if osteoporosis is confirmed (McCarus, 2006). Guidelines are also available (SIGN, 2003). Oestrogen does protect bone from osteoporosis but is no longer recommended as first line prophylaxis in view of recent studies showing concern about the association with cardiovascular adverse events (Sicat, 2004). Other options include raloxifene, a selective oestrogen receptor modulator which reduces spinal but not hip fractures and biphsophonates e.g. alendronate which does reduce hip fracture incidence (British National Formulary, 2006). Action on prophylaxis would likely most easily and consistently be arranged via computerisation of letter of appointment and information to the patient following discharge. This would necessitate no increased time or resources within the department but would cover all at risk patients. References Angeli A Guglielmi G Dovio A et al 2006 High prevalence of asymptomatic vertebral fractures in post-menopausal women receiving chronic glucocorticoid therapy: A cross-sectional outpatient study. 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