Study of Recurrent UTI among Mothers in the Philippines

Study of Recurrent UTI among Mothers in the Philippines INTRODUCTION Background of Study Millions suffer, only a few understand. In Barangay Ula, Recurrent UTI is one of the leading causes of morbidity among 40 households with a prevalence of 82.5% in which a bulk of 57% comprises of mothers. Urinary tract infections (UTIs) are among the most prevailing infectious diseases with a substantial financial burden on society. An estimated 13,000 deaths annually are attributed to UTIs. The magnitude of the problem worldwide is becoming very apparent.Globally, there are an estimated 150 million urinary tract infections per annum. Nearly 20% of women who have UTI will have another, and 30% of those will have yet another, but of the last group, 80% will have recurrences. In the Philippines, UTI continues to be among the top five reasons for consultations in health facilities nationwide. It is one of the ten leading causes of morbidity in all ages with a rate of 127.84 per 100,000 population. Recurrence of UTI among these mothers is greatly affected by behaviors. In this regard, the study would like to focus on the UTI-related behaviors of mothers, in Barangay Ula, diagnosed with recurrent urinary tract infection. Review of Related Literature According to Al-badr and colleague (2013), urinary tract infections (UTIs) are one of the most common clinical bacterial infections in women, accounting for almost 25% of all infections. Around 50–60% of women will develop UTIs in their lifetimes wherein Escherichia coliis the most common organism in all patient groups, but Klebsiella, Pseudomonas, Proteus,and other organisms are more common in patients with certain risk factors for complicated urinary tract infections (Kodner and Gupton, 2010). Hooton and Gupta (2013) defined recurrent urinary tract infection as ≠¥2 infections in six months or ≠¥3 infections in one year. Most recurrences are thought to represent reinfection rather than relapse, although occasionally a persistent focus can produce relapsing infection. Recurrent uncomplicated urinary tract infection is a common presentation to urologists and family doctors. A survey data suggest that 1 in 3 women will have had a diagnosed and treated UTI by age 24 and more than half will be affected in their lifetime. In a 6-month study of college-aged women, 27% of these UTIs were found to recur once and 3% a second time (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202002/). Many women suffer from frequent UTIs. About 20 percent of young women with a first UTI will have a recurrent infection. With each UTI, the risk that a woman will continue having recurrent UTIs increases.Some women have three or more UTIs a year. However, very few women will have frequent infections throughout their lives. More typically, a woman will have a period of 1 or 2 years with frequent infections, after which recurring infections cease (http://kidney.niddk.nih.gov/kudiseases/pubs/utiadult/). In a study of college women with their first UTI, 27 percent experienced at least one culture-confirmed recurrence within the six months following the initial infection and 2.7 percent had a second recurrence during this same time period. When the first infection is caused by Escherichia coli, women appear to be more likely to develop a second UTI within six months than those with a first UTI due to another organism. In a Finnish study of women ages 17 to 82 who had E. coli cystitis, 44 percent had a recurrence within one year(http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202002/). A number of factors also appear to increase the risk of recurrent UTIs such as biological or genetic factors, behavioural risk factors and even the pelvic anatomy (http://www.uptodate.com/contents/recurrent-urinary-tract-infection-in-women). In symptomatic women, predictors of recurrent UTIs include symptoms following intercourse, signs or symptoms of pyelonephritis, and prompt resolution of symptoms with antibiotics. Nocturia and persistence of symptoms between UTI episodes are strong negative predictors for recurrent infection (http://www.aafp.org/afp/2010/0915/p638.html). According to Hooton and Gupta (2014), sexual intercourse, diaphragm-spermicide use, and a history of recurrent UTI are strong and independent risk factors for UTI. Even spermicide-coated condom use results in an increased risk of UTI. However, risk factors specific for recurrent UTI have received relatively less attention. In one large case-control study of women with and without a history of recurrent UTI, the frequency of sexual intercourse was the strongest risk factor for recurrent UTI in a multivariate analysis. Other risk factors identified were: 1) Spermicide use during the past year; 2) Having a new sex partner during the past year; 3) Having a first UTI at or before 15 years of age; and 4) Having a mother with a history of UTIs. Sexual activity can move microbes from the bowel or vaginal cavity to the urethral opening. If these microbes have special characteristics that allow them to live in the urinary tract, it is harder for the body to remove them quickly enough to prevent infection. Following sexual intercourse, most women have a significant number of bacteria in their urine, but the body normally clears them within 24 hours. However, some forms of birth control increase the risk of UTI. In some women, certain spermicides may irritate the skin, increasing the risk of bacteria invading surrounding tissues. Using a diaphragm may slow urinary flow and allow bacteria to multiply. Condom use is also associated with increased risk of UTIs, possibly because of the increased trauma that occurs to the vagina during sexual activity. Using spermicides with diaphragms and condoms can increase risk even further (http://kidney.niddk.nih.gov/kudiseases/pubs/utiadult/). According to Wilkinson and Treas (2010), perinneal care is part of routine hygiene care. When washing the perineum, it must be from front to back to prevent contaminating the urethra with any fecal material left in the anus. Fecal particles left on skin can cause skin breakdown due to enzyme activity, and may increase the risk of a urinary tract infection because of the presence of E. coli in the feces. During menstruation, it is important to change sanitary pads, tampons or menstrual cups regularly. The standard time for a sanitary pad is once every six hours, while for a tampon is once every two hours. Sanitary napkins are made of cotton wool and gel. When an individual bleed into one, most of the blood gets soaked in, but at a certain point the pad gets saturated and may leak. Another consideration is that menstrual blood – once it has left the body – gets contaminated with the body’s innate organisms. When these organisms remain in a warm and moist place for a long time they tend to multiply and can lead to conditions like urinary tract infection, vaginal infections and skin rashes. Therefore changing is essential (http://health.india.com/diseases-conditions/hygiene-during-menstrual-periods-10-things-you-should-know/). General Objective At the end of the study, we will be able to describe the UTI- related behavior of mothers in Barangay Ula, Tugbok, Davao City who were diagnosed with Recurrent UTI from 2009 to 2013 in terms of personal hygiene, sexual activity and birth control method. Specific Objectives To determine the personal hygiene practices of mothers base on the following parameters: Handwashing Perineal care Type of underwear used Usage and changing of panty liners Changing of sanitary pad during menstruation To determine the sexual activity of these mothers To determine the birth control methods used by mothers Significance of the Study This study will provide a reference point on the personal hygiene practices of mothers regarding UTI. The data gathered will be used as a guide in forming future program strategies in decreasing the prevalence of Recurrent UTI in the area. The results of the study will also serve as an insight on the following parties: Barangay health care providers (doctors, nurses and midwives) to provide and disseminate proper information to BHWs and mothers about the behavioural risk factors that can cause recurrence of UTI; Barangay health workers (BHWs) as the most accessible source of information, they should be equipped with the proper and adequate information regarding the behavioural risk factors causing UTI; Mothers to assess whether their personal hygiene practices are correct. This will also, in a way, equip mothers and correct any malpractices they have. There are indeed many cases of recurrent UTI which were not prevented because the mothers have poor personal hygiene practices. Mothers should therefore be properly equipped with adequate understanding of the personal hygiene practices that can be of great importance in the prevention of UTI. Hence, this knowledge can lead to the resolution of this problem. Definition of Terms Behavioural Risk Factors – the elements that predisposes the mothers in having recurrent UTI. Recurrent UTI – Recurrent Urinary Tract Infection; the reinfection involving the urinary tract including the kidneys, ureters, bladder, and urethra. Mother – a person who has been pregnant and has already given birth regardless of her marital status. Personal Hygiene Practices – set of actions performed to care for one’s health Perineal Care an everyday hygienic practice of washing the perineum Chapter 2 Methodology Research Design Descriptive research was used in this study. The study aims to determine the Behavioural Risk Factors of Mothers diagnosed with Recurrent UTI in Purok 6, Barangay Ula, Tugbok District, Davao City. Locale of the Study The study will be conducted in Purok 6, Barangay Ula, Tugbok District, Davao City. Unit Analysis The subject of this study is a Mother diagnosed with Recurrent UTI residing in Purok 6, Barangay Ula, Tugbok District, Davao City. Sampling A total enumeration of 40 mothers will be included in the study. Variables and Measures Data Collection Procedure The testing in this study is focused on the behavioural risk factors of mothers diagnosed with Recurrent UTI, through the scheduled interview of all Mothers in Purok 6, Barangay Ula, Tugbok District, Davao City. Treatment of Data The data was analyzed using the summary statistics like means and frequency distribution. Ethical Consideration We will provide each participant with informed consent forms. Confidentiality of participants’ information and answers will be of our paramount consideration. Chapter 3 Results This section shows the results of the study. The respondents were the 40 mothers of Purok 6, Barangay Ula, Tugbok District, Davao City. Table 1. The Frequency Distribution of 40 Mothers According to Diagnosed Cases of Recurrent UTI Table 2. The Frequency Distribution of 40 Mothers According to Behavioural Risk Factors Chapter 4 Discussion Limitation of the Study The study was limited to all mothers residing in Purok 6, Barangay Ula, Tugbok, Davao City. This was limited on a scheduled interview with the participants. Diagnosed Cases of Recurrent UTI The results showed that 33 mothers were diagnosed with Recurrent UTI while 7 of them were not diagnosed at all with the infection. Behavioural Risk Factors The results showed that all of the mothers were practicing handwashing before and after doing perinneal care. It also showed that a total enumeration of 40 mothers was washing their perineum everyday in which almost all of them were doing it about 1 to times a day. They knew that it is really important to maintain cleanliness within one’s self. About 24 of the mothers were using water and soap in washing their perineum, 11 mothers were using feminine wash while 5 of the mothers were only using water for perinneal care. Out of the 40 mothers doing perinneal care, 19 were washing their perineum from front to back and the remaining 21 mothers were doing it from back to front. The type of underwear used by 28 mothers was made of cotton while 8 of them used spandex and 4 used silk underwear. 22 mothers interviewed were using panty liners in which 19 of them changes their panty liners once to thrice in a day. Of all mothers, 27 were still having their monthly menstrual period while 13 of them were already menopausal. Among the mothers who were still having menstruation, 18 of them were changing their pads at least 1 to 3 times a day, 8 mothers change 4 to 6 times in a day while only 1 mother changes her pad at least 7 times in a day. There were 29 mothers who were sexually active who all had only 1 sexual partner. 26 of which were doing perinneal washing before sexual intercourse while 28 of the sexually active mothers were doing perinneal care after sexual intercourse and 26 of the said mothers were urinating before and after sexual intercourse. No mother was with catheters at the time of interview. This means that catheter is not the cause of the recurrence of UTI among the 40 mothers in the Purok. Birth control methods were used by only 18 mothers wherein 12 of them did not want to have a baby anymore while the remaining 6 were not yet ready to have a baby. The rest of the 22 mothers were not using any birth control methods because 18 of them were already menopausal and 4 of them were said to be pro-life. On the other hand, out of the 12 mothers who used family planning, 8 mothers used condoms. With these results, it revealed that many of the mothers who were diagnosed with recurrent UTI were having personal hygiene malpractices such as washing their perineum from back to front wherein it moves bacteria from the anus close to the urethra. Another was how often they change their panty liners as well as their sanitary pads in a day as the pads get contaminated with the bodies’ innate organisms. When this happens, organisms will multiply in such warm and moist environment leading to urinary tract infections. Chapter 5 Summary of Results, Conclusion and Recommendations Summary Urinary tract infections (UTIs) are among the most prevailing infectious diseases with a substantial financial burden on society. Globally, there are an estimated 150 million urinary tract infections per annum. Nearly 20% of women who have UTI will have another, and 30% of those will have yet another, but of the last group, 80% will have recurrences. In the Philippines, UTI is one of the ten leading causes of morbidity in all ages with a rate of 127.84 per 100,000 population. In Purok 6, Barangay Ula, Recurrent UTI is one of the leading causes of morbidity among 40 households with a prevalence of 82.5%. A bulk of 57% comprises of mothers. The results showed that 33 mothers were diagnosed with Recurrent UTI while 7 of them were not diagnosed at all with the infection. The results showed that all of the mothers were practicing handwashing before and after doing perinneal care. It also showed that a total enumeration of 40 mothers was washing their perineum everyday in which almost all of them were doing it about 1 to times a day. About 24 of the mothers were using water and soap in washing their perineum. The type of underwear used by 28 mothers was made of cotton. 22 mothers interviewed were using panty liners in which 19 of them changes their panty liners once to thrice in a day. Among the mothers who were still having menstruation, 18 of them were changing their pads at least 1 to 3 times a day, 8 mothers change 4 to 6 times in a day while only 1 mother changes her pad at least 7 times in a day. 26 out of 29 sexually active mothers were doing perinneal washing before sexual intercourse while 28 of the sexually active mothers were doing perinneal care after sexual intercourse and 26 of the said mothers were urinating before and after sexual intercourse. On the other hand, out of the 12 mothers who used family planning, 8 of them used condoms. With these results, it only revealed that many mothers who were diagnosed with recurrent UTI were having personal hygiene malpractices. Conclusions At the end of the study, we were able to determine the personal hygiene practices of mothers base on handwashing, perineal care, type of underwear used, usage and changing of panty liners, and changing of sanitary pad during menstruation. We were also able to determine the sexual activity of mothers associated with the prevalence of Recurrent UTI. Lastly, we were able to determine the birth control methods used by mothers that predispose them to recurrent UTI such as the use of condoms and IUDs. Recommendations To the City Health Office: conduct lectures and seminars on Recurrent UTI To the Barangay Officials: provide support on the programs on Recurrent UTI To the BHWs: attend lectures and workshops regarding Recurrent UTI

Spirit Bound Chapter Seven

â€Å"NOT WITH YOUR TEETH,† I added hastily. â€Å"Throw yourself at me. Swing your shackles. Whatever you can do.† Victor Dashkov was not a stupid man. Others might have hesitated or asked more questions. He did not. He might not know exactly what was going on, but he sensed that this was a shot at freedom. Possibly the only one he'd ever get. He was someone who had spent a large part of his life masterminding complicated plots, so he was a pro at slipping right into them. Holding his hands up as much as he could manage, he lunged at me, making a good show of trying to choke me with the chain between his cuffs. As he did, I gave a bloodcurdling shriek. In an instant, the guardians were there to stop this crazy prisoner who was senselessly attacking a poor girl. But as they reached to subdue him, I leapt up and attacked them. Even if they'd expected me to be dangerous–and they hadn't–I had so much surprise on them that they had no time to react. I almost felt bad at how unfair it was to them. I punched the first hard enough that he lost his grip on Victor and flew backward, hitting the wall near Lissa as she frantically compelled Northwood to stay calm and not call anyone in the midst of this chaos. The other guardian had slightly more time to react, but he was still slow in letting go of Victor and turning on me. I used the opening and got a punch in, forcing the two of us into a grappling match. He was big and formidable, and once he deemed me a threat, he didn't hold back. A blow to my shoulder sent shooting pain through my arm, and I responded with a swift knee in his stomach. Meanwhile, his counterpart was on his feet heading toward us. I had to end this fast, not only for my own sake but also because they would undoubtedly call for backup if given a moment's chance. I grabbed the one closest to me and pushed him as hard as I could into a wall–headfirst. He staggered, dazed, and I did it again, just as his partner reached me. That first guardian slumped to the ground, unconscious. I hated doing that, but part of my training had been learning to differentiate between incapacitating and killing. He should only have a headache. I hoped. The other guardian was very much on the offensive, however, and he and I circled each other, getting in some shots and dodging others. â€Å"I can't knock him out!† I called to Lissa. â€Å"We need him. Compel him.† Her response came through the bond. She could compel two people at the same time, but it took a lot of strength. We weren't out of this yet, and she couldn't risk burning herself out so soon. Frustration replaced fear within her. â€Å"Northwood, go to sleep,† she barked. â€Å"Right there. On your desk. You're exhausted and will sleep for hours.† Out of the corner of my eye, I saw Northwood slump, his head hitting the desk with a thump. Everyone who worked here would have a concussion by the time we were through. I threw myself at the guardian then, using my full weight to get him within Lissa's line of sight. She pushed her way into our fight. He glanced at her in surprise, and that was all she needed. â€Å"Stop!† He didn't respond as quickly as Northwood, but he did hesitate. This guy was more resistant. â€Å"Stop fighting!† she repeated more forcefully, intensifying her will. Strong or not, he couldn't stand against that much spirit. His arms fell to his sides, and he stopped wrestling me. I stepped back to catch my breath, straightening my wig back into place. â€Å"Holding this one's going to be hard,† Lissa told me. â€Å"Hard as in five minutes or five hours?† â€Å"Somewhere in the middle.† â€Å"Then let's move. Get Victor's key from him.† She demanded the guardian give her the key for the shackles. He told us the other guardian had it. Sure enough, I frisked the unconscious body–he was breathing steadily, thank God–and retrieved the key. Now I turned my full attention on Victor. Once the fight had started, he'd stepped out of the way and simply observed quietly while all sorts of new possibilities undoubtedly formed in his twisted mind. I approached and put on my â€Å"scary face† as I held up the key. â€Å"I'm going to unlock your cuffs now,† I told him, in a voice both sweet and menacing. â€Å"You're going to do exactly what we tell you to do. You're not going to run, start a fight, or in any way interfere with our plans.† â€Å"Oh? Are you using compulsion nowadays too, Rose?† he asked dryly. â€Å"I don't need it.† I unlocked the shackles. â€Å"I can render you unconscious as easily as that guy and drag you out. Makes no difference to me.† The heavy cuffs and chains fell to the floor. That sly, smug look stayed on his face, but his hands gently touched each wrist. I noticed then that there were welts and bruises on them. Those shackles weren't meant for comfort, but I refused to feel sorry for him. He glanced back up at us. â€Å"How charming,† he mused. â€Å"Out of all the people who would attempt to rescue me, I never would have expected you two†¦ and yet, in retrospect, you're probably the most capable.† â€Å"We don't need your running commentary, Hannibal,† I snapped. â€Å"And don't use the word rescue. It makes it sound like you're some wrongfully imprisoned hero.† He arched an eyebrow, like he believed that might indeed be the case. Instead of disputing me, he nodded toward Bradley, who had actually slept through the fight. In his drugged state, Lissa's compulsion had been more than enough to knock him out. â€Å"Give him to me,† said Victor. â€Å"What?† I exclaimed. â€Å"We don't have time for this!† â€Å"And I have no strength for whatever you have in mind,† hissed Victor. That pleasant and all-knowing mask vanished, replaced by one vicious and desperate. â€Å"Imprisonment involves more than bars, Rose. They starve us of food and blood, trying to keep us weak. Walking here is the only exercise I get, and that's effort enough. Unless you really do plan on dragging me out of here, give me blood!† Lissa interrupted any response I could make. â€Å"Be fast.† I stared at her in astonishment. I'd been about to deny Victor, but through the bond I felt an odd mix of feelings from her. Compassion and†¦ understanding. Oh, she still hated him, absolutely. But she also knew what it was like to live on limited blood. Mercifully, Victor was fast. His mouth was at the human's neck practically before Lissa finished speaking. Dazed or no, feeling teeth in his neck was enough to wake Bradley up. He woke with a start, his face soon moving into the delight feeders took from vampire endorphins. A short burst of blood was all Victor would need, but when Bradley's eyes started to go wide in surprise, I realized Victor was taking more than a quick drink. I leapt forward and jerked Victor away from the scattered feeder. â€Å"What the hell are you doing?† I demanded, shaking Victor hard. It was something I'd wanted to do for a long time. â€Å"Did you think you could drain him and become Strigoi right in front of us?† â€Å"Hardly,† said Victor, wincing at the grip I had on him. â€Å"That's not what he was doing,† said Lissa. â€Å"He just lost control for a second.† His bloodlust satisfied, Victor's smooth demeanor had returned. â€Å"Ah, Vasilisa. Always so understanding.† â€Å"Don't make any assumptions,† she growled. I shot glares at both of them. â€Å"We have to go. Now.† I turned to the compelled guardian. â€Å"Take us to the room where they monitor all security footage.† He didn't respond to me, and with a sigh, I looked expectantly at Lissa. She repeated my question, and he immediately began to leave the room. My adrenaline was running high from the fight, and I was anxious to finish all of this and get us out of here. Through the bond, I sensed her nervousness. She might have defended Victor's need for blood, but as we walked, she kept as far away from him as possible. The stark realization of who he was and what we were doing was creeping up on her. I wished I could comfort her, but there was no time. We followed the guardian–Lissa asked his name; it was Giovanni–through more halls and security checkpoints. The route he led us on went around the prison's edge, not through the cells. I held my breath almost the entire time, terrified we'd run into someone. Too many other factors were working against us; we didn't need that too. Our luck held, though, and we ran into no one–again probably a result of doing this near the end of the night and not passing through a high-security zone. Lissa and Mia had gotten the Court guardian to erase the security footage there too, but I hadn't witnessed it. Now, when Giovanni led us into the prison's surveillance room, I couldn't help a small gasp. Monitors covered the walls, and consoles with complex buttons and switches sat in front of them. Computer-covered desks were everywhere. I felt like this room had the power to blast off into space. Everything in the prison was in view: each cell, several halls, and even the warden's office, where Eddie sat making small talk with Theo. Two other guardians were in here, and I wondered if they'd seen us in the halls. But no–they were too fixated on something else: a camera that had been turned to face a blank wall. It was the one I'd adjusted in the feeding room. They were leaning toward it, and one of them was saying how they should call someone to check down there. Then they both looked up and noticed us. â€Å"Help her subdue them,† Lissa ordered Giovanni. Again, there was hesitation. We would have been better off with a â€Å"helper† with a weaker will, but Lissa had had no idea when she chose him. Like before, he eventually sprang into action. Also like before, surprise went a long way in subduing these two guardians. I was a stranger–immediately raising their guard–but still appeared as human. Giovanni was their coworker; they didn't expect an attack from him. That didn't make them easy to take down, though. Having backup went a long way, and Giovanni was good at his job. We rendered one guardian unconscious pretty quickly, Giovanni using a choke hold to briefly cut off the guy's air until he collapsed. The other guard kept his distance from us, and I noticed his eyes continually shifting toward one of the walls. It had a fire extinguisher, a light switch, and a round silver button. â€Å"That's an alarm!† exclaimed Victor, just as the guardian lunged for it. Giovanni and I tackled him at the same time, stopping the guy just before his hand could brush the button and send a legion of guards down on us. A blow to the head knocked this guardian out too. With each person I took out in this prison break, a knot of guilt and nausea twisted tighter and tighter in my stomach. Guardians were the good guys, and I couldn't help but keep thinking I was fighting on the side of evil. Now that we were left to ourselves, Lissa knew the next step. â€Å"Giovanni, disable all the cameras and erase the last hour's worth of footage.† There was a greater hesitation on his part this time. Getting him to fight his friends had required a lot of forceful compulsion on her part. She was keeping her control but growing weary, and it was only going to get harder making him obey our commands. â€Å"Do it,† growled Victor, coming to stand beside Lissa. She flinched at his proximity, but as his gaze joined hers, Giovanni complied with the order and began flipping switches on the consoles. Victor couldn't match Lissa's power by a long shot, but his small burst of compulsion had strengthened hers. One by one, the monitors went black, and then Giovanni typed in a few commands on the computer that stored digital footage from the cameras. Red error lights were flashing on the consoles, but there was no one here now to fix them. â€Å"Even if he erases it, there are those who might be able to recover it from the hard drive,† noted Victor. â€Å"It's a chance we'll have to take,† I said irritably. â€Å"Reprogramming or whatever isn't really in my skill set.† Victor rolled his eyes. â€Å"Perhaps, but destruction certainly is.† It took me a moment to get what he meant, but then it clicked. With a sigh, I grabbed the fire extinguisher from the wall and beat the computer to a pulp until it was nothing more than a pile of plastic and metal fragments. Lissa winced at each blow and kept glancing at the door. â€Å"I hope that's soundproof,† she muttered. â€Å"It looks sturdy,† I said confidently. â€Å"And now it's time to go.† Lissa ordered Giovanni to return us to the warden's office at the front of the prison. He complied, leading us back through the maze we'd gone through earlier. His codes and security card got us through each checkpoint. â€Å"I don't suppose you can compel Theo into letting us walk out?† I asked Lissa. Her mouth was set in a grim line. She shook her head. â€Å"I don't even know how much longer I can hold Giovanni. I've never used someone as a puppet before.† â€Å"It's okay,† I said, trying to reassure both of us. â€Å"We're almost done with this.† But we were going to have another fight on our hands. After beating up half the Strigoi in Russia, I still felt good about my own strength, but that guilty feeling wouldn't leave me. And if we ran into a dozen guardians, even my strength wasn't going to hold. I'd lost my bearings from the blueprint, but it turned out that Giovanni's route back to the main office was taking us through a block of cells after all. Another sign read overhead WARNING–NOW ENTERING PRISONER AREA (PSYCHIATRIC). â€Å"Psychiatric?† I asked in surprise. â€Å"Of course,† murmured Victor. â€Å"Where else do you think they send prisoners with mental problems?† â€Å"To hospitals,† I responded, holding back a joke about all criminals having mental problems. â€Å"Well, that's not always–â€Å" â€Å"Stop!† Lissa interrupted him and came to an abrupt halt before the door. The rest of us nearly walked into her. She jerked away, taking several steps back. â€Å"What's wrong?† I asked. She turned to Giovanni. â€Å"Find another way to the office.† â€Å"This is the fastest way,† he argued. Lissa slowly shook her head. â€Å"I don't care. Find another, one where we won't run into others.† He frowned, but her compulsion held. He abruptly turned, and we scurried to keep up. â€Å"What's wrong?† I repeated. Lissa's mind was too tangled for me to pull out her reasoning. She grimaced. â€Å"I felt spirit auras behind there.† â€Å"What? How many?† â€Å"At least two. I don't know if they sensed me or not.† If not for Giovanni's clip and the urgency pressing on us, I would have come to a stop. â€Å"Spirit users†¦Ã¢â‚¬  Lissa had looked so long and hard for others like her. Who'd have thought we'd find them here? Actually†¦ maybe we should have expected this. We knew spirit users danced with insanity. Why wouldn't they end up in a place like this? And considering the trouble we'd gone through to learn about the prison, it was no wonder these spirit users had remained hidden. I doubted anyone working here even knew what they were. Lissa and I exchanged brief glances. I knew how badly she wanted to investigate this, but now wasn't the time. Victor already looked too interested in what we'd said, so Lissa's next words were in my head: I'm pretty sure any spirit users would see through my charms. We can't risk our real descriptions being discovered–even if they came from people who are allegedly crazy. I nodded my understanding, pushing aside curiosity and even regret. We'd have to check into this another time–say, like, the next time we decided to break into a maximum-security prison. We finally reached Theo's office without further incident, though my heart pounded furiously the entire way as my brain kept telling me, Go! Go! Go! Theo and Eddie were chatting Court politics when our group entered. Eddie immediately leapt up and went for Theo, recognizing it was time to go. He had Theo in a choke hold as efficiently as Giovanni had managed earlier, and I was glad someone else was doing this dirty work besides me. Unfortunately, Theo managed a good yelp before passing out and falling to the ground. Immediately, the two guardians who had escorted us in earlier charged the office. Eddie and I jumped into the fray, and Lissa and Victor got Giovanni in on it too. To make things more difficult, just after we subdued one of the guardians, Giovanni broke out of the compulsion and began fighting against us. Worse, he ran to the wall where I discovered–too late–there was another silver alarm button. He slammed his fist against it, and a piercing wail filled the air. â€Å"Shit!† I yelled. Lissa's skills weren't in physical fighting, and Victor wasn't much better. It was all on me and Eddie to finish these last two–and we had to do it fast. The second of the escort guardians went down, and then it was just us and Giovanni. He got a good hit in on me–one that knocked my head against the wall. It wasn't good enough to make me pass out, but the world spun and black and white spots danced before my eyes. It froze me up for a moment, but then Eddie was on him, and Giovanni was soon no longer a threat. Eddie took my arm to steady me, and then the four of us immediately ran out of the room. I glanced back at the unconscious bodies, again hating myself for it. There was no time for guilt, though. We had to get out. Now. Every guardian in this prison would be here in less than a minute. Our group ran to the front doors, only to discover them locked from the inside. Eddie swore and told us to wait. He ran back to Theo's office and returned with one of the security cards that Giovanni had often swiped at the doors. Sure enough, this one let us out, and we made a mad dash for the rental car. We piled in, and I was glad Victor kept up with all of us and made none of his annoying comments. Eddie stepped on the gas and headed back toward the way we'd come in. I sat beside him in the front. â€Å"I guarantee the gate guy's going to know about the alarm,† I warned. Our original hope had been to simply leave and tell him there'd been a paperwork mix-up after all. â€Å"Yup,† Eddie agreed, face hard. Sure enough, the guardian stepped out of his gatehouse, arms waving. â€Å"Is that a gun?† I exclaimed. â€Å"I'm not stopping to find out.† Eddie pushed hard on the gas, and when the guardian realized we were coming through regardless, he jumped out of the way. We crashed through the wooden arm that blocked the road, leaving it a mess of splinters. â€Å"Bud's gonna keep our deposit,† I said. Behind us, I heard the sounds of gunshots. Eddie swore again, but as we sped away, the shots grew fainter, and soon, we were out of range. He exhaled. â€Å"If those had hit our tires or windows, we'd have had a lot more to worry about than a deposit.† â€Å"They're going to send people after us,† said Victor from the backseat. Once again, Lissa had moved as far from him as she could. â€Å"Trucks are probably leaving right now.† â€Å"You don't think we guessed that?† I snapped. I knew he was trying to be helpful, but he was the last person I wanted to hear from at the moment. Even as I spoke, I peered back and saw the dark shapes of two vehicles speeding down the road after us. They were gaining quickly, leaving no question that the SUVs would soon catch up to our little compact car. I looked at our GPS. â€Å"We need to turn soon,† I warned Eddie, not that he needed my advice. We'd mapped out an escape route beforehand, one that took lots and lots of twisty turns on these remote back roads. Fortunately, there were a lot of them. Eddie made a hard left and then almost an immediate right. Still, the pursuing vehicles stayed with us in the rearview mirror. It wasn't until a few turns later that the road behind us stayed clear. Tense silence filled the car as we waited for the guardians to catch up. They didn't. We'd made too many confusing turns, but it took nearly ten minutes for me to accept that we might have actually pulled this off. â€Å"I think we lost them,† said Eddie, the wonder in his voice matching my feelings. His face was still lined with worry, his hands gripping the wheel hard. â€Å"We won't lose them until we clear Fairbanks,† I said. â€Å"I'm sure they'll search it, and it's not that big.† â€Å"Where are we going?† asked Victor. â€Å"If I'm allowed to ask.† I squirmed around in my seat so that I could look him in the eye. â€Å"That's what you're going to tell us. As hard as it is to believe, we didn't do all that just because we missed your pleasant company.† â€Å"That is hard to believe.† I narrowed my eyes. â€Å"We want to find your brother. Robert Doru.† I had the satisfaction of momentarily catching Victor off guard. Then his sly look returned. â€Å"Of course. This is a follow-up to Abe Mazur's request, isn't it? I should have known he wouldn't take no for an answer. Of course, I never would have guessed you were in league with him.† Victor apparently didn't know I was actually in the familial league with Abe, and I wasn't about to enlighten him. â€Å"Irrelevant,† I said coldly. â€Å"Now, you're going to take us to Robert. Where is he?† â€Å"You forget, Rose,† mused Victor. â€Å"You aren't the one with compulsion here.† â€Å"No, but I am the one who can tie you up by the side of the road and make an anonymous call back to the prison with your whereabouts.† â€Å"How do I know you won't get what you want from me and then turn me back in anyway?† he asked. â€Å"I have no reason to trust you.† â€Å"You're right. I sure as hell wouldn't trust me. But if things work out, there's a chance we might let you go afterward.† No, there really wasn't. â€Å"Is this something you want to gamble on? You'll never get another opportunity like this, and you know it.† Victor had no witty quip for that. Score another one for me. â€Å"So,† I continued, â€Å"are you going to take us to him or not?† Thoughts I couldn't read churned behind his eyes. No doubt he was scheming about how he could work this to his advantage, probably figuring out how to escape us before we even reached Robert. It was what I would have done. â€Å"Las Vegas,† Victor said at last. â€Å"We need to go to Las Vegas.†

How Has Classical Music Changed the World - 1724 Words

HOW HAS CLASSICAL MUSIC CHANGED THE WORLD How has classical music changed the world we live in? The world we live in has changed but Classical music has remained the same. Classical music isn’t really prevalent in today’s society. Classical music doesn’t appeal to this generation. Classical music is more appreciated by older generations. Classical Music is not as popular today as it used to be. It has been around for hundreds of years and it is the oldest type of music out there. Classical music is very complex in nature. Classical music has grown distant from the culture we live in. The rest of the world changed but classical music has remained the same. Classical music hasn’t kept up with the world, so the world has been leaving it†¦show more content†¦Listening to classical music stimulates the creative pathways in the human brain. Classical music has been found to reduce tension and enhance brain power and specific types of intelligence su ch as verbal ability and spatial-temporal reasoning. Because of this, Classical music has been found to be extremely beneficial for pregnant women. Studies have shown that babies listening to classical music in the womb could benefit the baby by raising their intelligence and mental development. Not only is classical music a calming method for both mother and child, the music can help to prepare an unborn infants ears and brain for the outside world. Mothers can play the classical music for their baby by placing earphones around her belly. This theory of letting babies listen to the classical music by classical music genius Mozart in the womb became known as the â€Å"The Mozart Theory.† During the 1990s, several research papers and popular books wrote about â€Å"The Mozart Theory,† which came to be called the â€Å"Mozart Effect†: an observed temporary, small elevation of scores on certain tests as a result of listening to Mozarts music. The Mozart effect h as been the subject of much research in recent years, after it was found that listening to Mozart’s music may increase specific types of intelligence. The approach has been popularized in a book by Don Campbell, and is based on an experiment suggesting that listening to Mozart temporarilyShow MoreRelatedSimilarities Between Music And Classical Music921 Words   |  4 Pagesfrom the Classical Era. Classical music originated in Ancient Egypt but as time went by in became less popular. 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We saw huge changes in styles between each musical era. From 1750 until the present day, there have been three major musical eras: classical, romantic, and modern. All three of these eras have brought new and innovative ideas to the world, but they are all drastically different stylistically, philosophicallyRead MoreMusic And Its Influence On Music Essay854 Words   |  4 Pagesquestion? Music, the idea of using sounds for thoughts. Cultivated music can be defined in many different ways, although it is defines as being music that comes from another country, it is also defined as music that is consciously well put together. The word culture is almost visible. However, the term â€Å"cultivated† brings a deep contrast to that of â€Å"vernacular†. Vernacular can be defined as music of the present place. It will be safe to say that cultivated music carries over into Vernacular music. CultivatedRead MoreMusic Is The Reason Why Music1463 Words   |  6 Pagesbenefit of learning music is that it has the ability to change the perspective of the listener. â€Å"Music is not only able to affect your mood -- listening to particularly happy or sad music can even change the way we perceive the world, according to researchers from the University of Groningen† (U of G 1). Music has a way of affecting those who are listening in a certain way, people choosing a song based on how they feel at that very moment. Although there are many genres of music, they all fall underRead MoreWestern Art Music : A Constant State Of Flux Since Its Creation1426 Words   |  6 PagesWestern art music has been in a constant state of flux since its creation. Evolving due to generations constantly contributing and evolving music in order to express what they believe music is and express how they feel. This love and dedication towards music has been unparalleled and unwavering for hundreds of years from sacred medi eval music to modern day pop hits. Western Art music began taking the shape that we know today after the fall of Rome with Medieval music. Almost all music from that timeRead MoreModern Music After World War II1041 Words   |  5 PagesResearch Paper: Iannis Xenakis Iannis Xenakis (1922-2001) was a French composer who revolutionized modern music after World War II. He was the founder of stochastic music and composed works that include: Metastaseis, Diamorphosis, Pithoprakta, and Nuits . In his works he utilized mathematical concepts such as statistics, Brownian motion, Gauss’s law, set theory, game theory, as well as music techniques such as sound mass, and glissandos. Iannis Xenakis was born on May 29th, 1922 to Greek parentsRead MoreClassical Music Essay1701 Words   |  7 PagesMusic is such an amazing and wonderful thing. There are so many different possibilities when it comes to music. One of the fascinating things about music is that there is always room for improvement. Composers are making better and better music everyday. Music is always changing and composers are creating new never before heard pieces constantly. There is such a wide range of music that it is almost impossible for someone to not like at least one kind of music. The combination of keys and instrumentsRead MoreMy Point Of View 20th Century1110 Words   |  5 PagesBut it’s the best for the most part. Western culture refers to the culture of any country that is a part of the western world. The western country is always democratic has neo-liberal capitalist economy. Has a separation of church and state, and high livings standards with materialistic society? The USA, UK, France are examples of western countries. Western culture is also a music type and lifestyle that come from the western countries. Best it boosted the economy, increase technology, creates a foundation

Essay On 12 Years A Slave - 1170 Words

Good evening, and welcome to tonight’s episode of ‘Fact to Fiction’, where we review the latest hollywood blockbuster on how they turn fact into fiction. As always, I’m your host, Zodie Bolic. On tonight’s show, we will be analysing the portrayal of Solomon Northup in the movie ‘!2 Years A Slave’, based on Northup’s besting selling memoir of the same name. In ‘12 Years A Slave’, Solomon Northup, a 33 year old free black man, is kidnapped and forced into slavery. Northup, an accomplished violinist is drawn to Washington by the promise of money and employment by two men, latter to be his kidnappers. Though he protests his freedom, he passed from owner to owner before finally a canadian abolisher by the name of Samuel Bass helps him regain†¦show more content†¦Northrup says in his biography, ‘They proposed to engage my services for a short period, stating, at the same time, I was just such a person as their business required’ (Northup, 1853). While the movie portrays Northrup as definitely being drugged, he was unsure if he actually was, though he did feel sick and nauseous (Northup, 1853). The movie was also mostly correct in their portrayal of Northup’s life during his time in slavery. As the movie shows, Northup did attempt to escape while he was travelling on the slave ship, though the other slave, Robert, did not die after being stabbed by the sailor, instead he died of smallpox (History vs Hollywood, 2017). However, the movie does get the little things right, for example, how slaves names would be changed (Northup’s name was changed to Platt Hamilton) and how females slaves and their children would be separated after they were sold (History vs Hollywood, 2017)(West, 2014). Dr Emily West, associate professor of history from the University of Reading in the USA, says ‘I have never seen a film represent slavery so accurately’ (West, 2014). Down to the fact that christian slave owners would often use the bible to justify their slave owning and that slaves leaving their owner’s properties had to wear written passes around their necks s ignifying they weren’t runaway slaves, the movie ‘12 Years A Slave’ gets a lot right (West, 2014). However, there are some minor errors. ForShow MoreRelated12 Year a Slave Essay1620 Words   |  7 PagesTwelve Years A Slave Essay During a time of cruel punishment and harsh conditions of life as a slave in the 19th century South, there was a book that shed a light on the life of a slave unparalleled in past as well as in modern literature. That book was entitled Twelve Years a Slave by Solomon Northup. Northup was born a freeman that was obtained from his father after being freed by the Northup family due to loyal service. Growing up in the free state of New York, Solomon was allowed an educationRead More12 Years a Slave Essay701 Words   |  3 Pages12 Years a Slave Author: Solomon Northup Forwarded By: Steve McQueen History 1301 October 7, 2013 The main idea of the book was to share with the reader and give a deeper understanding of what occurrences happened during the darkest periods in American history. The author shares his life during his twelve years, on a personal level, to be able to connect with his readers and show his perspective on his experiences during his time held captive as a slave. When taught about slaveryRead More12 Years a Slave Essay examples1699 Words   |  7 Pages(McQueen). Unfortunately at this point for Mr. Northop it would do no good for him to speak up, in fact, it did more harm than good. In the film 12 Years A Slave, the audience encounters the horrible kidnapping, based on a true story, of a free black man named Solomon Northop. This film is by no means easy to watch but it accurately portrays the life of slaves, and free blacks, who were caught up in the gruesome world of slavery. The history of Slavery in the American South is not a secret. African AmericanRead More12 Years a Slave and Fruitvale Station Essay1389 Words   |  6 PagesThrough analysis of present day motion pictures that stem from American history such as â€Å"12 Years A Slave† and â€Å"Fruitvale Station† reveals some of the legal and ethical concerns that are prominent today can be revealed: Historically law has been altered but the integrity of the law s till remains in question. Literature Review Let’s start with some of the issues that were brought about in the film â€Å"12 Years A Slave†. After viewing the movie twice, not only did it show that slavery was prominent (1841)Read More12 Years a Slave movie-analysis Essay1093 Words   |  5 Pages12 Years a Slave The movie  «12 Years a slave » is based on the book  «12 Years a Slave » by Soloman Northup. Its his life story of how he got lured in a trap and kidnapped in 1841. Its about how he was sold into slavery in the south, and what happened during those 12 years a slave . The movie was released in 2013, but the book was first published in 1853. The setting of the movie was in the US, mostly in the states New York and Louisiana. The film was directed by Steve McQueen, hes also knownRead MoreEssay about Book Review 12 Years a Slave774 Words   |  4 PagesShaTaylor Moore March 11, 2013 History 1301 -02 Twelve Years a Slave: Solomon Northup Book Review Solomon Northup was a free African American man from Minerva, New York. In the novel Twelve Years a Salve, Northup composed a narrative about his life as a free man, and also his life as a slave. In the year of 1814 Northup was kidnapped and taken deep South, to the rugged life of slavery. After 12 years of being thrown into the slavery against his will, he rightfully regained his freedom inRead MoreIs the Movie Twelve Years a Slave a Good Movie of Its Genre? Essay1273 Words   |  6 Pagesand most movie characters. This essay will focus on the slavery drama movie Twelve Years a Slave to show how this movie gives the audience the sense of how both the slaves and the society lived during slavery eras. Likewise, how the slaves and society are different from what the audience expect any slavery movie to be by comparing many aspects and ways used to portray them as slavery drama movies. Above all, this essay will categorize the movie Twelve Years a Slave as a good movie of its genre be causeRead MoreSummary Of Gabriel Garcia Mà ¡rquezs Of Love And Other Demons749 Words   |  3 PagesInquisition. Sierva Marà ­a is the only child born to an old noble family whose mother hated her the moment she was born, and whose father shy and afraid of life. She was raised by the Marquis’s African slaves where she learned their culture by being fluent in their many languages and dances. She lived with the slaves and while she did inherit many physical attributes from her noble father, she identified and was accepted by the African culture. All this started to go wrong for her when she was bitten by aRead MoreThe Problem Of Human Trafficking1080 Words   |  5 PagesThe Source Awakens When I found out about my first essay, I was not ready to begin my research. I honestly did not want to think about it but the due date was inevitable. 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