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Kurt Vonnegut Vonnegut, Kurt - Essay. Kurt Vonnegut 1922–2007. (Full name Kurt Vonnegut Jr.) American novelist, short story writer, dramatist, screenwriter, and essayist. The following entry presents an overview of slaves china Vonnegut's career through 1997. See also Kurt Vonnegut Literary Criticism (Volume 1), and Volumes 2 , 3 , 4 , 5 , 8 , 12 , 22 . Vonnegut gained a worldwide following in the late 1960s with the publication of hopkins the windhover his best-known work, Slaughter-house-Five (1969). Considered a major voice in contemporary American literature, Vonnegut populates his novels with characters searching for slaves in ancient china meaning and parens patrie, order in an inherently meaningless and disorderly universe. Known for in ancient his iconoclastic humor, Vonnegut consistently satirizes contemporary society, focusing in cars vs petrol cars, particular on the futility of warfare and the human capacity for both irrationality and in ancient china, evil. Vonnegut was born in Indianapolis, Indiana, on November 11, 1922. He was the vodafone 3g problems, third child of Kurt, an architect, and in ancient, his wife Edith (maiden name Lieber). The Concept Of Ecological Niche? Both the Vonneguts and the Liebers were formerly prosperous families who had lost their fortunes after World War I. Vonnegut entered the University of Chicago in 1940 to study biochemistry. He began writing for the student newspaper in his sophomore year, penning anti-war articles.

After Pearl Harbor, Vonnegut reversed his opinions; in March of slaves in ancient 1943 he entered the Army. Parens Patrie? He was captured in the Battle of the china, Bulge, held as part of a captive labor force in Dresden, and experienced the Allied fire-bombing of the city on , February 13, 1945. Like the protagonist in Slaughterhouse-Five , Vonnegut survived the bombing in an underground meat locker, only to be put to slaves, work by the Germans extracting corpses from the city's ruins. Upon his return home in 1945, he married Jane Marie Cox and parents behavior, enrolled at the University of Chicago, from which he graduated in 1947. In the same year, Vonnegut began working for General Electric Research Laboratory as a public relations writer. He wrote fiction in his spare time, publishing his first story in 1950, and in ancient china, was soon able to quit his job and vodafone 3g problems, write full-time. In the slaves china, 1960s Vonnegut accepted an appointment to hopkins, the Writers Workshop at the University of Iowa. He began to attract popular attention in the 1960s when his anti-war message made him a favored figure among the counter-culture; his popularity continued to increase after Slaughterhouse-Five was adapted as a film. Slaves In Ancient? He has seven children: three from his first marriage to Jane Marie Cox, three nephews adopted after the deaths of his sister and her husband, and one adopted with his second wife, Jill Krementz. Vonnegut lives in New York City.

Vonnegut's first novel, Player Piano (1952), did not attract popular or critical attention, but it established many of the traits which continue to typify the parents influence behavior, author's style. Slaves In Ancient China? The novel is futuristic and explores the relationship between changing technology and the lives of ordinary humans. His second work garnered greater critical reception. The Sirens of Titan (1959) is a science fiction parody in which all of human history is hopkins, revealed to have been manipulated by aliens to provide a space traveler with a replacement part for his ship. China? This novel, as well as the critically acclaimed Cat's Cradle (1963) and God Bless You, Mr. Rosewater (1965), exhibits Vonnegut's unique combination of black humor, wit, and pessimism. The Concept Niche Essay? Cat's Cradle is an apocalyptic satire on philosophy, religion, and technological progress while God Bless You, Mr. Rosewater concerns the idealistic attempts of an alcoholic philanthropist, Eliot Rosewater, to befriend the poor and helpless. Rosewater finds, however, that his monetary wealth cannot begin to alleviate the world's misery. Slaves In Ancient China? Like Rosewater, Vonnegut's protagonists are idealistic, ordinary people who strive in vain to understand and bring about change in a world beyond their control or comprehension. Vonnegut tempers his pessimistic, sometimes caustic commentary with compassion for his characters, suggesting that humanity's ability to love may partially compensate for destructive tendencies.

Two of Vonnegut's novels have dealt directly with World War II. In Mother Night , a spy novel, an American agent who posed as a Nazi propagandist during World War II undergoes a personality crisis when tried for crimes he committed to 3g problems, insure his covert identity. In Slaughterhouse-Five , perhaps Vonnegut's best-known work, the author confronts his personal experience as a prisoner of war who survived the Allied fire-bombing of Dresden, a city of little military or strategic value. The absurdity of this event is filtered through the china, numbed consciousness of Billy Pilgrim, a young soldier who escapes the vodafone, insanity of war through schizophrenic travels into time and space; these journeys assume realistic stature when compared to his irrational wartime experiences. Considered a classic of slaves postmodern literature, Slaughterhouse-Five is written in influence, a fragmented, non-chronological style to emphasize the confusion and slaves, absurdity of wartime life.

Vonnegut's subsequent novels have achieved popular success but have not always elicited critical praise. In 1971 he wrote his best-known play, Happy Birthday, Wanda Jane , and throughout the 1970s and on child, 1980s wrote several screenplays for television. Slaves China? Vonnegut's most recent works include Hocus Pocus (1990) and parents behavior, Timequake (1997). In both of these novels Vonnegut presents his ideas in new and china, unusual literary forms. And Downward Communication? Hocus Pocus purports to be the autobiographical manuscript of Eugene Debs Hartke, a teacher and the last American out of Vietnam, who was fired for being too pessimistic and later charged with engineering the escape of slaves china African-American inmates from a prison. Hartke writes observations about his life on pieces of paper and Vonnegut masquerades as the editor. In Timequake Vonnegut merges parts of a problematic and incomplete novel with commentary about his life and views. The result is part memoir and part political novel.

In a nutshell, observes Thomas Disch, everyone on Earth has to relive the 1990s on automatic pilot, observing but not participating in electric vs petrol cars, their lives. The book is a stew in which Vonnegut combined the best pickings from a novel that wasn't working and interspersed them with a running commentary on his own life and the state of the universe. The mix is thick and slaves china, rich: a political novel that's not a novel, a memoir that is not inclined to reveal the most private details of the writer's life, Valerie Sayers comments. Vonnegut has stated that he is retiring, and that Timequake will mark the end of his fiction-writing career. Vonnegut's first decade of the Concept Essay work did not attract much critical attention: most early discussion of his writing centered on how to classify it. Citing his futuristic settings and the paramount role of technology in his work, some critics insist that Vonnegut is a science fiction writer. Others argue that despite these elements, Vonnegut is ultimately writing about the slaves in ancient, universal human condition and that he only employs science fiction devices to create distance and irony, just as he employs satire to parents influence on child behavior, the same effect. In recent years Vonnegut has come under fire from commentators who claim that he has failed to develop stylistically and that his characters are little more than mouthpieces for in ancient his opinions.

Such critics claim that Vonnegut's work after Slaughterhouse-Five has offered more or less the same style, theme, and vodafone 3g problems, message. Tom Shone, for instance, writes that all the same subjects are there, novel after novel and that Vonnegut's highly distinctive style has eclipsed Vonnegut the author. Others remain enamored of Vonnegut's distinct style, praising him for continually presenting his message in a deceptively skillful manner. In Ancient China? John Irving remarks, Vonnegut's subject has always been doomsday, and parents influence on child, nobody writes about it better. Slaves In Ancient? That he is , also so terribly funny in how he describes our own worst nightmare is, of course, another element that confuses his dumber critics. Access our Kurt Vonnegut Study Guide for Free. Player Piano (novel) 1952; also published as Utopia 14 , 1954.

The Sirens of Titan (novel) 1959. Mother Night (novel) 1962. Canary in slaves, a Cat House (short stories) 1963. Cat's Cradle (novel) 1963. God Bless You, Mr. Rosewater; or, Pearls before Swine (novel) 1965. Welcome to the Monkey House (short stories) 1968. Slaughterhouse-Five; or, The Children's Crusade: A Duty-Dance with Death (novel) 1969.

Happy Birthday, Wanda June (play) 1970. Between Time and Timbuktu; or, Prometheus-Five: A Space Fantasy (play) 1972. Breakfast of Champions; or, Goodbye, Blue Monday! (novel) 1973. Wampeters, Foma, and Granfalloons: Opinions (essays) 1974. Slapstick; or, Lonesome No More! (novel) 1976.

Jailbird (novel) 1979. Palm Sunday: An Autobiographical Collage (autobiography) 1981. Deadeye Dick (novel) 1982. Galapagos (novel) 1985. Bluebeard (novel) 1987. Hocus Pocus (novel) 1990. Fates Worse than Death (essays and speeches) 1991. Timequake (novel) 1997. George Garrett (review date 19 August 1990) SOURCE: A Long-Awaited Return, in Chicago Tribune Books , August 19, 1990, p. 6. [ In the review below, Garrett claims that in Hocus Pocus, Vonnegut returns to the high quality of his earlier works .]

Once upon a time, I, too, was a Vonnegut groupie. In that world, which every day seems a little better than this one, we waited, eager and conspiratorial, for upward the man who had written the short stories later collected in Canary in a Cat House (1961) and slaves china, the novel Player Piano (1952) to bring out Essay, his next book. We few. We happy few. There was a little wait before that marvelous and wacko novel The Sirens of Titan (1959) appeared. (The entire section is china, 1074 words.) Get Free Access to this Kurt Vonnegut Study Guide. Start your 48-hour free trial to unlock this resource and 3g problems, thousands more. Get Better Grades.

Our 30,000+ summaries will help you comprehend your required reading to ace every test, quiz, and essay. We've broken down the chapters, themes, and slaves in ancient china, characters so you can understand them on your first read-through. Access Everything From Anywhere. We have everything you need in parens patrie, one place, even if you're on china, the go. Download our handy iOS app for free.

Jay Cantor (review date 19 August 1990) SOURCE: Kurt Vonnegut: So It Still Goes, in Washington Post Book World , Vol. 20, No. 33, August 19, 1990, pp. 1-2.

[ In the following review, Cantor concludes that Hocus Pocus is a vehicle for Vonnegut to communicate his despair over humanity .] Woody Allen once observed that 80 percent of life is showing up. The other 20 percent—the part that stands between me and stardom—is making yourself likable, like George Burns, Jack Benny, Bill Cosby, or my pal (hah! don't I wish it!) Kurt Vonnegut. Parens Patrie? The amiable Vonnegut persona—a wry man who is a tad curmudgeonly, but as moral as he can honestly be—is, from slaves book to book, Vonnegut's most substantial, continuing. (The entire section is 833 words.) Get Free Access to electric vs petrol cars, this Kurt Vonnegut Study Guide. Start your 48-hour free trial to unlock this resource and thousands more. John Irving (review date 2 September 1990) SOURCE: Vonnegut in Prison and slaves, Awaiting Trial, in Los Angeles Times Book Review , September 2, 1990, pp. 4, 10. [ Irving is an and downward, acclaimed American novelist and short story writer.

In the review below, he praises Hocus Pocus as one of Vonnegut's best novels and discusses the merits of Vonnegut's writing .] The novel is the highest example of subtle interrelatedness that man has discovered. Kurt Vonnegut is in ancient china, a friend of mine. He was my teacher at the University of hopkins Iowa; he is my neighbor in slaves in ancient china, Sagaponack, Long Island—it is a three-minute. (The entire section is , 2096 words.) John Skow (review date 3 September 1990) SOURCE: And So It Went, in Time , Vol. 136, No. 10, September 3, 1990, p. Slaves In Ancient? 73. [ In the and downward communication, following review, Skow praises Vonnegut's message in Hocus Pocus, but criticizes his writing .] The knock against Kurt Vonnegut, back a couple of decades ago when he was a cult author, was that he pandered too glibly to the natural cynicism of the disaffected young.

He was too quick, it was said, to detect the smell of society's insulation burning—and to sigh So it goes—when there was nothing more in the air than, say, a harmless whiff from in ancient a distant war or the cars vs petrol cars, neighborhood toxic-waste dump. No more; his news in slaves in ancient china, Hocus Pocus is that our charred insulation no longer. (The entire section is 567 words.) Christopher Lehmann-Haupt (review date 8 September 1990) SOURCE: Familiar Characters and Tricks of Vonnegut, in The New York Times , September 8, 1990, p. ? 16. [ In the review below, Lehmann-Haupt characterizes Hocus Pocus as a contest between comedy and despair in which the latter gains the upper hand .] It should come as no surprise to Kurt Vonnegut's readers that one of the characters in slaves china, his 13th and latest novel, Hocus Pocus , is Hiroshi Matsumoto, a survivor of influence behavior Hiroshima. But what may be modestly alarming is the almost affectionate mordancy with which Matsumoto's experience is described: When the bomb was dropped, he was playing soccer during school recess.

He chased a ball into a ditch. (The entire section is 998 words.) Jay McInerney (review date 9 September 1990) SOURCE: Still Asking the slaves, Embarrassing Questions, in New York Times Book Review , September 9, 1990, p. 12. [ McInerney is an American novelist. In the following review, he discusses the balance between pessimism and humor in Vonnegut's novels, focusing on hopkins the windhover, Hocus Pocus.] For purposes of comparison with our own stodgy, inherited universe, contemporary philosophers sometimes conjure up the concept of possible worlds. They've got nothing on Kurt Vonnegut, who in slaves china, 12 previous novels has frequently resorted to Understanding the Concept of Ecological Niche Essay, other planets for slyly comparative purposes. Slaves In Ancient China? But unlike most contemporary philosophers—who fastidiously restrict themselves to vodafone, questions of linguistic and logical. (The entire section is in ancient, 1282 words.)

John Leonard (review date 15 October 1990) SOURCE: Black Magic, in influence on child behavior, Nation , Vol. 251, No. Slaves In Ancient China? 12, October 15, 1990, pp. 421-25. [ In the hopkins, review below, Leonard praises Hocus Pocus and discusses Vonnegut's fatalistic message .] Hocus Pocus seems to me to be Vonnegut's best novel in years—funny and prophetic, yes, and fabulous too, as cunning as Aesop and slaves in ancient, as gloomy as Grimm; but also rich and vodafone, referential; a meditation on American history and American literature; an elegy; a keening.

How is slaves, this for a definition of high art, we are asked by the antihero, Eugene Debs Hartke: 'Making the most of the raw materials of futility?' But Hocus Pocus has been not so much reviewed as. (The entire section is 3460 words.) James Buchan (review date 20 October 1990) SOURCE: Any Old Irony, in Spectator , Vol. 266, No. 8467, October 20, 1990, pp. 31, 33. [ In the following review, Buchan states that Hocus Pocus has many elements in common with Vonnegut's earlier novels .]

This is Kurt Vonnegut's 17th novel to appear in England, so the British reader should know what to expect. It's all here in electric cars cars, Hocus Pocus , vintage Vonnegut: the short narrative units, the slaves china, repetitions as in a roundelay, the intergalactic knowingness and parents on child, the small-town good sense, the good humour, the tricks of typography, the exclamation marks as in a debutante's letter, the in ancient, diversions, the threadbare coincidences. Let me say right off. (The entire section is 1396 words.) David Streitfeld (review date 21 October 1990) SOURCE: The Wages of Rage, in Washington Post Book World , Vol.

20, No. 42, October 21, 1990, p. 15. [ In the review below, Streitfeld argues that society is the main character in Hocus Pocus and that Vonnegut's sense of dismay with America is the novel's overriding tone .] Sixty-seven years old and recipient of and downward communication as large a measure of fame as any writer in our time, Kurt Vonnegut still does what he can to enlighten the masses. He meets the public, gives lectures, talks to the press, opens himself up. Slaves In Ancient? An incident arising out of one such encounter last year, when Vonnegut spoke at a California university and gave an Understanding Niche Essay, interview to a reporter for the local paper, bears. (The entire section is 822 words.)

Ian Bell (review date 21 October 1990) SOURCE: One-Liners, in Observer Review , October 21, 1990, p. 58. [ In the following review, Bell argues that the narrative of slaves in ancient china Hocus Pocus becomes secondary to themes that Vonnegut wishes to discuss .] Here comes another of Vonnegut's exemplary tales about one man unravelling the tangle of his life and upward and downward, trying to find out What Really Happened. It is full of wit, humanity, cruelty and trite narrative devices. This time, as editor 'KV' explains, the imprisoned hero has committed his story to scraps of paper, thus allowing scope for the elliptical, the slaves, gnomic and the discursive. Often, these entries are one-sentence paragraphs. (The entire section is 495 words.)

David Montrose (review date 26 October 1990) SOURCE: Life as a Cruel Joke, in Times Literary Supplement , October 26, 1990, p. 1146. [ In the following review, Montrose characterizes Hocus Pocus as a novelized essay and praises Vonnegut's masterful style .] Hocus Pocus presents a dystopian America where the , future (2001) is like the present, only more so. Everything has worsened: the economy, the ravaging of slaves china natural resources, crime, the drugs problem, urban decay, poverty. Petrol and food are rationed. Electric Cars Vs Petrol? The rich have sold Big Business to foreigners and live off the china, proceeds. Hopkins? The only surviving American enterprises are Mafia-controlled. Nor is public property exempt. National Forests have been sold.

(The entire section is 738 words.) SOURCE: A review of Hocus Pocus , in West Coast Review of Books , Vol. Slaves In Ancient China? 15, No. 6, 1990, p. 24. [ In the following review, Lubold argues that the key to Hocus Pocus is the upward communication, way in which Vonnegut takes the concerns of today and portrays them in the extreme in his futuristic setting .] Vonnegut's new novel is about a man who has returned from slaves in ancient china Vietnam, and is now, in 2001, recalling events when he worked at a school in Upstate New York and later staged a prison break in a nearby prison. Now he awaits trial for this crime. But Hocus Pocus delivers a lot more; in fact, any plot is secondary to the author's presentation of the confusing and vodafone, bizarre reality of. (The entire section is 449 words.) Robert Phillips (review date Spring 1991) SOURCE: A review of Hocus Pocus , in The Hudson Review , Vol.

XLIV, No. 1, Spring, 1991, pp. 135-36. [ In the excerpt below, Phillips criticizes Vonnegut's style in Hocus Pocus.] In closing [ Hocus Pocus ], I was reminded of John Jay Chapman's remark: When I put down a book by slaves china, Stevenson, I swear I am hungry for something to read. Kurt Vonnegut's book left me hungry indeed; it is almost totally devoid of some standard ingredients of fiction—dialogue, form, confrontation, coherent plot. The author relies almost totally on the narrator and electric cars cars, his one point of view. Slaves In Ancient China? And the narration comes to communication, us tricked-up with unconventional lines separating passages within. (The entire section is 538 words.) James Wood (review date 15 November 1991) SOURCE: The Wrecked Generation, in Times Literary Supplement , November 15, 1991, pp.

8-9. [ In the review below, Wood discusses the role of china comedy in Fates Worse than Death.] Dreamy, hectically anecdotal, slovenly and bearish with the truth, Kurt Vonnegut's writing has always handled fact with comic negligence. It has a kind of epistemological cockiness, amassing detail only to mock its sureties. Knowledge enters his books with a hiatus, a cloudiness. Consider, for example, his fondness for place-name couplets—Genoa, Italy, or Hellertown, Pennsylvania, or Indianapolis, Indiana. He loads his sentences with all kinds of names: They were Lance Rumfoord, of Newport. (The entire section is parents influence, 1321 words.) Ross Clark (review date 16 November 1991)

SOURCE: Just a Few Quick Ones Before I Go, in The Spectator , Vol. Slaves In Ancient China? 267, No. Influence Behavior? 8523, November 16, 1991, p. 45. [ In the following review, Clark argues that Fates Worse than Death lacks coherence .] Kurt Vonnegut, German-American author of Slaughterhouse-Five , the consummate work on the bombing of Dresden, fears he will live little longer. Paying tribute to fellow Germanic writer Heinrich Boll in the preface to his latest book [ Fates Worse than Death ], he mentions that Boll died in 1974 at the age of 67.

Then he adds, sorrowfully but proudly: 'One year short of my age now, and I smoke as much as he did'. Therein lies the reason for. (The entire section is china, 692 words.) Valentine Cunningham (review date 22 December 1991) SOURCE: So It Still Goes with the the Concept Essay, Sermonettist, in Observer Review , December 22, 1991, p. 43.

[ In the following review of Fates Worse than Death, Cunningham praises Vonnegut's wit in addressing the problems of modern American society .] Kurt Vonnegut is the conscience of slaves in ancient china Middle America. Cars Cars? The fates picked out an ordinary GI kid prisoner-of-war, one of us, one man out of the whole US, to in ancient, endure and miraculously survive the upward and downward, fire-bombing of in ancient Dresden. Of Ecological Niche Essay? Thus Vonnegut became a unique witness against slaves in ancient the human awfulness Dresden symbolised. He chose to do his testifying by playing Huck Finn, a Holy Fool, a zany and practical joker with a canny touch for. (The entire section is parens patrie, 665 words.) Thomas M. Disch (review date 21 September 1997) SOURCE: Novelist on the Half Shell, in Washington Post Book World , September 21, 1997, p. X01. [ In the following review, Disch argues that Timequake discloses much information about Vonnegut himself .] Timequake is a novel by, and starring, Kurt Vonnegut.

His co-star, and virtually the only other character in the book, is his alter ego, Kilgore Trout, who figured in in ancient china, two earlier Vonnegut novels, God Bless You, Mr. Rosewater (1965) and Breakfast of Champions (1973). Trout has also published his own novel, Venus on upward and downward communication, the Half Shell (1975), but since it was written, without Vonnegut's consent, by Philip Jose Farmer, that book cannot. (The entire section is in ancient, 860 words.) Valerie Sayers (review date 28 September 1997) SOURCE: Vonnegut Stew, in The New York Times , September 28, 1997. [ In the following review, Sayers describes Timequake as a mix of novel and vodafone 3g problems, memoir .] Like so many of my peers, I began reading Kurt Vonnegut while the slaves china, Vietnam War was raging. By the time I discovered his great World War II novel, Slaughterhouse-Five , the earth had shifted under my feet.

Vonnegut, satirist and electric, tragedian, seemed like a literary elder bearing witness. (Some elder; he was in his 40's then.) And I knew I was embarking on a lifelong relationship. Vonnegut thought the big thoughts—about war and death and how we ought to treat one another—and regarded them not only as. (The entire section is in ancient, 961 words.) Kurt Vonnegut Homework Help Questions. In this, Vonnegut's first published short story, which appeared in 1950, a good-hearted professor develops the psychic ability to hopkins, destroy weapons even from a great distance away. He goes into. It would be helpful to china, your argument if you could find some references in parens patrie, Kurt Vonnegut's novel to the German V2 rockets which were described as Hitler's secret weapon. Here is an excerpt from. Dear Abby: I have been in love with my childhood sweetheart, Catherine, all of in ancient my life. She does not know that I still love her.

I am in parents behavior, the Army and I just found out slaves, she is electric cars vs petrol cars, getting married next. The notion of the irrationality of groups is present in china, many (or most or even all) of Vonnegut's works, from Slaughterhouse-Five to Hocus Pocus. Groups often believe in things that are both. Kurt Vonnegut's short story All the parens patrie, King's Horses is in ancient, a satire in which, as literary critic Northrop Frye observes, irony is militant. And, in this story, the militant irony is also a.

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Analysis of Arthur Young#8217;s Travels in in ancient china, France. DEPARTMENT OF GOVERNMENT, HISTORY AND JUSTICE CAMPBELL UNIVERSITY ANALYSIS OF ARTHUR YOUNG’S TRAVELS IN FRANCE BY DANIELLE KING Submitted to Professor Ocana in partial fulfillment of the requirements for , Western Civilization 112 November 3, 2010 Arthur Young was born on September 11, 1741 in Bradfield, a village in Suffolk, England. After he dropped out of slaves china school and acquired a job in a mercantile house, for which he was not suited for, Young began his writing career at parents on child, the age of seventeen. He was much more inclined to write than work in a more commercial capacity as he later became a great English agriculture writer. Slaves. Although Young was such a fantastic agriculture writer he is most known for his social and vodafone political writings.

Young was not very successful with the land from the start; however, after inheriting the land around his home after the death of his mother and through a series of failed farming attempts elsewhere in England, he began to learn quite a lot about agriculture. From this point Young began to write several books and journals about agriculture in slaves, and around England and his popularity grew tremendously. After having made quite a name for himself in the world of agriculture, Young began to travel outside of England. Young first went to Ireland in 1776 and published his findings there four years later with Tour in Ireland. Young’s most popular excursion was to France, which he first visited in 1787. Young explored the country in parens patrie, great detail learning a good deal from the people and the land.

Young meticulously documented the condition of the soil and other agricultural data as well as his opinions as to the political and social reasons for Frances’ agricultural failure. This information was published in 1792 split into two volumes titled Travels in France. He begins by in ancient china giving the reader an cars vs petrol understanding of how the kingdom was organized. Young says that the slaves in ancient china, kingdom was broken into generalities with an intendant appointed to cars, govern them. The generalities were broken down further into elections which were governed by “sub-de-legue”; this position was appointed by the intendant. Needless to say, the intendant held a vast amount of slaves power particularly with regards to taxation. According to Young these intendants could “exempt, change, add, or diminish” taxes on parents on child a whim. (Young) With this type of control it is easy to see why befriending the intendant might be advantageous. It was known that the friends and in ancient china family, even very distant relatives could benefit financially from electric a connection to the intendant.

Naturally people without this connection were very upset as, since taxes still had to be paid to the kingdom, they were the ones to shoulder this financial burden. There were exemptions allowed for the intendants, sub-de-legues, nobility, clergy, and the friends and family of these people. The poor of the kingdom felt as though the slaves, people with the most economic resources were exempted from paying taxes because they were fortunate enough to have those resources. The second issue Young uncovers while traveling in Frances is the kingdoms’ unequal and 3g problems unfairly harsh penal code. Young uses, as an example, the slaves in ancient, laws for salt smugglers. Taken from his Travels in France were eight extremely strict regulations covering the offenders accused of of Ecological Essay smuggling salt.

The first law mentioned says that if five or more armed salt smugglers are gathered together in Provence they will be fined and slaves in ancient spend nine years in jail. If these same people were anywhere else in , the kingdom they would be put to slaves china, death. The next law says that if less than five but more than one armed smugglers are gathered together they get a second chance. The first time they are caught meeting, they will be fined and sentenced to three years in jail. The second time they will be killed. The third rule discusses unarmed smugglers that have some sort of transportation to move the salt. This could be in the way of animals and or carts while traveling on land or a boat if the smuggler is on the water. At this point the punishments become slightly less severe with the first offence being only the fine of the previous law without the time in jail. However, if that fine is not paid then the electric cars, same three years time will be served. With this law as well, the smuggler would have a second chance although the second offence carried a much stiffer penalty. In most of the kingdom a heaver fine was required as well as nine years jail time.

In Provence, a smuggler could expect to china, go to jail for five years without the fine. In Dauphine, however, the second offence would take away a smuggler’s freedom for the rest of vodafone 3g problems his life. The next law covers unarmed smugglers without transportation. This is the least severe of the punishments for in ancient, males having only a small fine for the first offence. Electric. If the slaves, smuggler does not have the money to parens patrie, pay the fine they are flogged and branded. The second time they are caught is not much worse with a fine and six years jail time. The fifth law sets the punishments for women; it is very interesting that are given three chances and not given jail time for in ancient china, either offence. Parens Patrie. The first time they are sentenced with a very small fine and in ancient china the second time a slightly larger fine. The husband is responsible for the fine. The third time they are flogged and permanently put out of the kingdom.

The next law says that the child smugglers are treated the same as the parens patrie, women with both parents held liable for the fine. After the common people of the kingdom, the nobles are mentioned. If nobles are caught, their titles and estates are taken away from them. No fine or jail time is necessary for the same crime that common people could be put to death for. The last law in this excerpt discusses what Young thinks is the salt or revenue employee that smuggles on the side. This person would be sentenced to death. If this employee steals or transports the stolen salt they would be hung. This is the in ancient china, only law listed that describes a particular kind of vodafone death showing how important they felt this crime was. The final major issue Arthur Young found with the French during his journey through the kingdom was with the lack of justice in the court system. In his words the justice that was administered was “partial”, “venal”, and “infamous”. (Young) He goes on to say that after conversing with numerous men in several different areas around France all of slaves in ancient them felt as if the electric cars, legal system needed serious reform, as equal justice under the law was completely impossible due to widespread corruption.

Young found that as two parties stood before the judge the winner of the dispute would be whichever party could bribe the judge more. Shockingly, this bribe did not always have to be monetary; it could also be the “beauty of a handsome wife” (Young) The only way justice would be served was if two conditions were both meet; neither party could have any connection to the judge (or anyone else in power) and neither party could have something of value to offer the judge, be it money, land, or women. If either of these conditions was not met, the party that knew the judge or had the available resources would be victorious. Furthermore, the judges had the authority to in ancient china, originate decrees. Not surprisingly, they did this without the hopkins, permission of the King.

As it turns out, these “parliaments” had configured a judicial system where they made the in ancient china, laws and then turned around and punished people for breaking these laws. Young had uncovered what he described as “a horrible system of tyranny”. Young’s main points of unbalanced taxes, unforgiving penal codes, and electric cars the deceitful legal system help to bring into focus his feelings of why the French were doomed for in ancient china, a revolution. He does a wonderful job of Niche really capturing the feeling of the typical Frenchmen at the time. Although he arrived in in ancient china, the kingdom to evaluate the conditions of the soil and other aspects of the farming environment, he seemed to leave with a thorough understanding of vodafone 3g problems French society in the late 1780’s. The only bias shown in the piece might be in that Young only makes note of the thoughts, fears, and slaves in ancient complaints of the working class citizens. From the reading, it is difficult to get a sense of how the hopkins the windhover, people in power felt about day-to-day life. Because of in ancient china this one-sided account, any reader would automatically find themselves cheering for the “little people” and suppressing a growing detestation for persons of authority. The principle value of Arthur Young’s Travels in France is that the people of this day and age studying the French Revolution have an excellent report of some of the events leading up to it. Electric Cars. Young goes deeper into the major concerns of the day than the average textbook can. The reader truly gets the opportunity to feel the slaves in ancient china, pain of the local townspeople.

Textbooks try to hit the highlights of history, which sticks mainly to important kings and parents influence on child behavior key politicians, where in pieces like Young’s, readers get to understand the plight of the average Joe. Bibliography Stead, David. Slaves China. Arthur Young. EH. Net Encyclopedia 2003. Electric. http://eh. net /encyclopedia/article/stead. young Young, Arthur. Arthur Young’s Travels in slaves in ancient, France During the parens patrie, Years 1787, 1788, 1789.

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Attention-Deficit/Hyperactivity Disorder: Presentation and Management in the Haitian American Child. A case study of a young Haitian American is presented that is illustrative of cultural issues that influence care of those with attention-deficit/hyperactivity disorder (ADHD). Medications are the preferred treatment for ADHD and can be combined with psychological intervention. However, many Haitians and Haitian Americans see psychoactive medications as leading to substance abuse or mental illness. Efficacious psychosocial treatments include contingency management, parent training, and behavior therapy; cognitive-behavioral treatment has not been helpful. Complementary and alternative medicine might have appeal; primary care physicians can help families to in ancient china, assess such treatments and not to upward and downward, be enticed by expensive ones of little benefit. A determinant of the treatment a family pursues is their perception of the cause of the ADHD behaviors.

While there is no term for ADHD in china the Haitian-Creole language, in the Haitian culture the behaviors consistent with the diagnosis might be interpreted as indicating a poorly raised child whose behavior could be modified by parental discipline, an intentionally bad child, or a psychically victimized child suffering from an #x0201c;unnatural#x0201d; condition. #x0201c;Natural#x0201d; ailments are attributed to natural forces (e.g., wind, temperature), while #x0201c;unnatural#x0201d; ones are attributed to bad spirits or punishment by God. Families may #x0201c;lift their feet#x0201d; ( Leve pye nou : to see a Hougan or voodoo priest) to determine the unnatural cause. Haitian Americans often combine therapeutic foods that are considered cold in nature, natural sedatives and vodafone 3g problems purgatives from in ancient china, herbal medicine, religious treatments, and vodafone 3g problems Western medicine. Immigrants often lack support of extended families in an environment not supportive of their interpretation of child behaviors and traditionally accepted parental disciplinary style. Slaves In Ancient China! Stigma, language, cultural conceptions, concerns about governmental agencies, and physician bias can all be barriers to upward and downward communication, care for immigrant families. Primary care and behavioral integration are useful in managing families from other cultures. More than ever in the United States, it is nearly impossible to find a medical practice with a patient population that does not include cultural and ethnic diversity. While this reality is broadly recognized, clinicians and patients often face challenges in communicating with one another regarding health concerns. These challenges may be due in part to cultural differences in understanding and interpreting illness.

The importance of slaves in ancient china, cultural issues on mental health care was highlighted in 2000 in the first-ever Surgeon General's report on mental health. 1 National efforts at education in cultural competency have taken root in various ways in electric cars cars medical centers, practice groups, teaching institutions, and community health centers. Attention-deficit/hyperactivity disorder (ADHD) is one of the most commonly diagnosed chronic mental conditions of childhood. Slaves China! ADHD has a large genetic component to its etiology, 2, 3 and alterations in the noradrenergic and dopamine systems lead to dysfunction in higher cortical processing related to attention, alertness, and electric cars vs petrol executive functions (e.g., planning, working memory, abstract reasoning, mental flexibility). 4. ADHD has been reported in all continents of the world. Slaves! Prevalence studies for many countries do not exist; however, studies have been conducted in China, Thailand, Israel, Turkey, Brazil, India, Puerto Rico, and Mexico. Upward And Downward! 5 Although the signs and symptoms of ADHD are basically the same in these diverse countries, they each represent a different ethno-socio-cultural context in slaves which the communication condition is interpreted and responded to slaves in ancient, by patients, their families, caring professionals, and others. The Windhover! 6 Several recent studies demonstrate that in 40#x00025; to 70#x00025; of children, ADHD persists into adulthood. 7, 8. Although ADHD has been well established as a condition in children worldwide, the subtler question of how the interpretation of china, symptoms and behaviors varies between locales remains elusive.

Studies describing the interpretation of ADHD symptoms in and downward communication different cultures are extremely limited. African American parents have been shown to be more unsure of the potential causes and treatments of ADHD and less likely to connect the school system to ADHD issues than white parents. 9 In another school-based study, white children with ADHD were twice as likely as African American children to receive evaluation, diagnosis, and treatment, and the threshold of china, parental recognition and seeking of services contributed to this discrepancy. 10 In a third study, African American children were identified with ADHD symptoms at higher rates than white children. 11 Compared to white teachers, African American teachers rated children as presenting more ADHD symptoms. 12 A similar study compared Hispanic teachers' and non-Hispanic white teachers' assessments of hopkins the windhover, hyperactive-inattentive behaviors portrayed in standardized tapes of white and Hispanic children. Hispanic teachers were more likely than white teachers to score Hispanic students above the in ancient china clinical cutoffs for ADHD. 13 Whether such discrepancies are due to ethnic differences in behavior, limitations in the cross-cultural validity of diagnostic measures, or bias in and downward communication raters' assessments of behavior is uncertain. More than 2 million Haitian Americans reside in the United States, and this cultural group has a presence in every state.

The following case study of a young Haitian American illustrates the cultural issues that can influence the care of a person with ADHD and the difficulties that can result from culturally based disagreement or inadequate communication between medical professionals, educators, social service personnel, and families. Mr. A is a 25-year-old man with a history of ADHD. He was an overactive child from early infancy, and his parents initially attributed his exuberant behavior to the natural tendencies of his sex. Mr. A's parents tried their best to keep his behavior under control by corralling him in his crib, verbally disciplining him, and occasionally spanking him. From when Mr. A was 3 years of age, his parents became increasingly aware of china, his hyperactivity, impulsivity, and inability to follow directions. Throughout his pre-school years, he was repeatedly suspended from school and on child was forced to move from one school to the next. In his community, he developed a reputation for being mal #x000e9;lev#x000e9; #x02014;a French term for #x0201c;badly reared,#x0201d; which in turn reflected negatively on in ancient his parents within their extended family and community.

At age 5, Mr. Vodafone! A was diagnosed by a specialist as having ADHD. His parents accepted counseling to help manage their son's condition, but declined the use of medication. In Ancient! Later, during his elementary school years, another clinical assessment confirmed the diagnosis of influence on child, ADHD. This time, Mr. A's mother accepted the use of medication, but stopped it and refused to consider any other medication when side effects placed Mr.

A into a #x0201c;zombie-like#x0201d; state that included sluggishness, difficulty sleeping, and loss of appetite. When Mr. A's parents halted his medication, school staff registered their concern with the Department of slaves in ancient china, Social Services by filing a child neglect report. Mr. A's parents were evaluated for social services; however, these services included no interpreter, nor economic or social support. His parents were placed on the defensive all the time and began to feel threatened, stating that #x0201c;the focus was no longer on #x0005b;Mr. A's#x0005d; condition, but on our parental abilities.#x0201d; As a result, to attend to Mr. A and coordinate his care, his mother stopped working outside the the windhover home. Unable to navigate the different agencies that had become involved with their family, and in ancient believing a more disciplinary and controlled environment might help, Mr.

A's parents first sent him to Haiti to live with grandparents and parens patrie 1 year later sent him to a Haitian boarding school. Neither environment had an effect on his behavior. Two years later, when he returned to live with his parents in the United States, his father built his own life around a tight schedule to tutor, mentor, and supervise Mr. A's school activities. Mr. A eventually graduated from high school, but was unfocused and performed poorly in the classroom. After graduation, Mr. A participated in several training programs but has yet to china, complete one. He continues to parens patrie, be hyperactive and unfocused. At work, he is known as a #x0201c;good guy#x0201d; who regularly jumps to defend coworkers, a behavior that often costs him his own employment.

His parents are finally convinced that medication would be beneficial, but Mr. China! A refuses to take medications and denies his disorder. WHAT DIAGNOSTIC STRATEGIES ARE USEFUL IN PRIMARY CARE PRACTICE TO CONFIRM THE DIAGNOSIS OF ADHD? Table 1 lists the DSM-IV criteria for the 3 subtypes of and downward, ADHD. These are (1) predominantly inattentive (has at least 6 of 9 inattention behaviors), (2) predominantly hyperactive-impulsive (has at least 6 of 9 hyperactive-impulsive behaviors), and (3) combined (has at least 6 of 9 for both inattention and hyperactive-impulsive behaviors). Due to their ability to slaves china, function with ADHD during adolescence, children with the inattentive subtype of ADHD tend to parents influence on child, be the easiest group to manage and are the least likely to have recurring problems; however, they often are the hardest to diagnose.

Hyperactivity behaviors often start by a child's fourth birthday, peak around age 7 to china, 8 years, and decrease greatly by adolescence. Impulsive behaviors follow the same early course, but rather than declining in adolescence, remain a problem for life. 7, 14, 15 Impulsive behaviors in adolescence may result in problem drinking and drug use, and impulsive spending in adulthood. In contrast to hyperactivity and impulsivity, inattention often does not become evident until age 8 or 9 years, but, like impulsivity, then remains a problem for life. By DSM-IV criteria, the onset of symptoms must occur before the age of 7 years, persist for at least 6 months, be present in more than 1 setting (e.g., school, home, after-school program), and be excessive for the development level of the child. In addition, an individual's behaviors should affect at least 1 aspect of life, such as the school, family, or work environment. As with Mr. A, ADHD commonly disrupts daily functioning and development in multiple areas.

The diagnostic differential for many of the behaviors found in ADHD includes emotional and behavioral problems (e.g., depression, anxiety disorders including obsessive-compulsive disorder and slaves posttraumatic stress disorder, conduct disorder) developmental problems (e.g., learning disabilities, mental retardation, conditions such as fragile X syndrome), and medical conditions (e.g., sensory deficits, seizures, fetal alcohol syndrome, thyroid disorders). For recent immigrants, these conditions may present at an age beyond that commonly encountered by American clinicians. Environmental concerns and experiences can also lead to behaviors mimicking ADHD and can be particularly difficult to define in recent immigrants. 16, 17 These include culturally different parenting approaches, parental psychopathology, stressful home environment, lack of experience with the American school environment, inadequate language skills, and child abuse or neglect. 18 A substantial number of individuals with ADHD will also have comorbid psychiatric conditions (e.g., depression, oppositional defiant disorder, learning disabilities).

A variety of rating scales are available and helpful in evaluating children (see; however, most of these have been validated in referral populations rather than primary care settings and may not be generalizable to immigrant populations. These scales include ones for use by clinicians, parents, and teachers. Also, collecting information from other settings (e.g., summer programs, after-school programs) may provide additional helpful insight, particularly if the rater is from a background similar to the patient, but not a family member. For older patients who do not recall enough about their childhood, clinicians should have them speak to and downward communication, relatives to gather their childhood histories. China! For example, clues to , onset before age 7 years might include being held back or suspended in early school years, old report cards indicating behavior problems, or stories of being difficult to control. Scales for slaves adults (e.g., the Wender Utah Rating Scale, 19 also available in electric cars French 20 ; the Copeland Symptom Checklist for Attention Deficit Disorders 21 ; the Conners Adult ADHD Rating Scale 22 ) can be useful, but yield large numbers of false positives and cannot be relied on for diagnosis without supportive evidence from clinical assessment. 23.

Treatment approaches to ADHD include an array of psychotropic medications, behavioral and psychological treatments, and complementary and alternative medicine approaches. Slaves In Ancient China! Medications are generally the preferred treatment modality and can be combined with behavioral or psychological interventions, especially in children with behavioral problems or comorbid psychiatric conditions. Stimulant medications and psychosocial treatment have been the Understanding the Concept Essay major foci of in ancient, clinical research; however, the duration of , most randomized trials has been 3 months or less, and in ancient china thus the literature on long-term treatment is sparse. In general, studies suggest that stimulants and psychosocial treatments are efficacious. 24, 25 They also indicate that treatment with stimulants is superior to psychosocial treatment. 26. Short-term trials of stimulants support their efficacy, with response rates in the 70#x00025;-to-90#x00025; range. Hopkins! 27 Methyl-phenidate and dextroamphetamine are the most studied stimulants.

While there are longer-acting stimulants, these do not appear to provide any improvement in slaves in ancient china efficacy. Studies have found that stimulants improve the defining symptoms of ADHD and associated aggression. 3g Problems! However, there are not consistent findings that improvement in symptoms leads to improvement in academic achievement or social skills. Slaves In Ancient China! 28, 29. Aside from studies suggesting the efficacy of hopkins, using stimulants, there are also studies of antidepressants showing that tricyclic antidepressants (e.g., imipramine, desipramine, nortriptyline) produce improvements over placebo. On Child Behavior! 30 The primary concern regarding their use is the in ancient risk of cardiac side effects, especially in overdose. Atomoxetine also has proven efficacy for the windhover ADHD 31, 32 ; it is the only medication approved by the U.S. Food and Drug Administration for use in in ancient adult ADHD, is not a controlled medication, and might be particularly useful when possible comorbid substance abuse is a concern. On Child Behavior! 33 However, it does have a new black-box warning regarding the potential for severe liver injury, based on 2 reports (1 of a teenager and 1 of an adult). Psychosocial treatments of ADHD with demonstrated efficacy include behavioral strategies such as contingency management (e.g., point/token reward systems, timeout, response cost) that is slaves in ancient china, conducted in the classroom, parent training (parent is taught child management skills), and clinical behavior therapy (parent, teacher, or both are taught to cars vs petrol cars, use contingency management procedures).

34 In contrast, cognitive-behavioral treatment (e.g., self-monitoring, self-instruction, problem-solving strategies, self-reinforcement) has not been found to be helpful in children with ADHD. 35, 36. Complementary and alternative medicine strategies are very commonly used and might have particular appeal to families from other cultures. 37 Such therapies include special diets and in ancient china supplements, megavitamins, applied kinesiology, and biofeedback; however, their benefits have not been demonstrated in clinical trials. 38 Diet, including reducing sugar, affects behavior in less than 1#x00025; of children. 39 One role in which the primary care physician can be helpful is to vodafone 3g problems, help families assess alternative treatments and not be enticed by expensive treatments of little benefit.

The treatment of ADHD should be viewed as involving 3 stages of therapy: initiation and titration, maintenance, and in ancient termination. 40 During the initial phase of on child, treatment, patients and families should be educated regarding ADHD ( Table 2 for examples of parental activities that may be helpful), therapeutic goals should be established with the slaves patient and electric cars vs petrol family, and in ancient treatment should be initiated. Influence On Child! If medications available in short- and slaves in ancient long-acting forms are selected, initial titration can best be accomplished using short-acting forms, observing for response and side effects. This can be followed by switching to longer-acting forms if desired. Electric Cars! Starting and adjusting medications on in ancient a weekend provides opportunity for parents to observe effects and side effects directly. During the parens patrie maintenance phase, ongoing family education, dosage adjustment, and slaves china monitoring of growth, efficacy, and side effects are appropriate. The duration and approach to termination should be individualized, with regular discussions with patients and families to Understanding the Concept Niche Essay, support adherence to slaves in ancient, treatment rather than unsupervised treatment termination. Stimulant medications and hopkins the windhover atomoxetine may be stopped at slaves once, while other medications (e.g., tricyclic antidepressants) may need to be tapered. Trials off therapy, for hopkins the windhover instance during school holidays, may help determine if medications are still beneficial. In summary, although there are a range of slaves in ancient, treatment modalities that have been tried in of Ecological Essay the treatment of ADHD in children, the management approach that has proved most effective includes stimulants and psychosocial treatments focused on behavioral strategies. Slaves In Ancient China! Of note, in the Concept one large study funded by the National Institute of Mental Health, there was no difference in response to treatment between ethnic groups (Latino, African American, and white).

41. ADHD AND ITS CARE FROM A HAITIAN PERSPECTIVE. While there is no corresponding term for ADHD in the Haitian-Creole language, in the Haitian culture the behaviors consistent with the diagnosis of ADHD might be interpreted as indicating the following: Among Haitians, the interpretation of in ancient china, ADHD-related behaviors varies widely from , family to family depending on in ancient china religious affiliations, level of education, and experience with school and primary care systems. Stigma, language, cultural conceptions, concerns about governmental agencies, and physician and teacher bias can all serve as barriers to care for immigrant families ( Table 3 ). An important determinant of the treatment or other intervention strategy a family pursues is their perception of the cause of the ADHD behaviors.

Whether the cause is natural or unnatural is extremely important in the Haitian belief system. Parents On Child! #x0201c;Natural#x0201d; ailments are often attributed to slaves, natural forces (heat/cold, gas, wind, temperature), while #x0201c;unnatural#x0201d; ailments are attributed to bad spirits or punishment inflicted by God. These are treated using either natural remedies or religious intervention. 42 Such belief systems can influence a family's acceptance of parents behavior, a physician's diagnosis of ADHD and their adherence to Western medical treatments. In the United States, as in many other countries, the china diagnosis of ADHD is mainly a medical one and involves pediatric and family medicine providers, social workers, and psychologists. However, for most of the population in Haiti, a child would not be brought to a primary care physician for and downward communication care of a behavioral problem. Doctors are generally seen only for physical illness and emergency care; access to primary care is limited and slaves in ancient china generally available only to the most affluent. ADHD manifesting as a negative behavior usually is handled by parents, extended family, and school teachers through verbal or corporal discipline.

Verbal discipline includes preaching to the child, comparing the child to parens patrie, others, begging the child to behave, and humiliating the in ancient china child. Corporal discipline and punishment can be inflicted by any member of the electric cars family, neighbors, and schoolteachers, all of whom are given full authority to slaves in ancient, educate and #x0201c;correct#x0201d; the child. Immigration adds a complex dimension to hopkins the windhover, raising children. New families find themselves devoid of the support of the in ancient china extended family, in an environment that is not supportive of their interpretation of child behaviors and traditionally accepted parental disciplinary style. Like many Haitian American parents living in the United States faced with similar circumstances, Mr.

A's parents chose to send him back to and downward communication, Haiti with the hope that a more authoritative parenting style, the enforcement of in ancient china, discipline in school (schoolteachers are very respected), and removal of the upward communication interference of the American social worker would offer a better environment for rearing their child. Mr. A went to live with his grandmother first and slaves in ancient then off to and downward, a boarding school, a setting seen by many Haitian parents as the slaves china ultimate answer to upward and downward, a child with behavioral problems. There are many beliefs among Haitian Americans surrounding the use of medication. Many in slaves in ancient the Haitian American community see the use of psychoactive medications as a gateway to substance abuse or mental illness. Therefore, even parents who agree to allow their children to try them will most likely have low thresholds for terminating medication and be unsupported by family members, friends, neighbors, and even religious leaders. Understanding Of Ecological Essay! Mr.

A's parents received much unsolicited advice, and some friends wanted them to slaves in ancient china, #x0201c;lift their feet#x0201d; ( Leve pye nou : to see a Hougan or voodoo priest) who might be able to determine the unnatural but real cause of their son's problem. Being transnational and having access to both native Haitian medicine and Western medicine, Haitian Americans routinely combine therapeutic foods that are considered cold in nature, natural sedatives and purgatives from influence, traditional herbal medicine, religious treatments, and Western medicine to treat illness. Examples of folk treatments for ADHD include mint tea, sweetsop (apple custard), or leaf teas (usually hot drinks); tizanne (usually cold drinks) of slaves china, lettuce or other refreshing vegetables; and vodafone 3g problems baths with boiled leaves ( bain de feuille ), which are often used as natural sedatives. While it may be difficult to establish trust with Haitian families initially, such trust in the doctor-patient relationship is essential in obtaining their participation in the development of a treatment plan to which they will adhere. Clinicians should work to disarm or to gain acceptance with parents and family members. It may be helpful to slaves in ancient china, learn a few words of Creole or tidbits of upward and downward, Haitian history, to be respectful of combining benign natural remedies with conventional Western medicine, and to find ways to show respect for the family's heritage. Engaging families in supportive behavioral management approaches (see Table 2 ) can give them a sense of slaves, control and involvement that will help build adherence to other treatments recommended. Cultural sensitivity is essential in dealing with not only vodafone, Haitian patients but also patients from various cultural and ethnic backgrounds. One definition of cultural competency is #x0201c;a set of slaves china, congruent attitudes, behaviors, and communication policies that come together in a system, agency, or amongst professionals and slaves in ancient enables them to work effectively in cross-cultural situations.#x0201d; 43 Haitians, like most immigrant patients, need sympathetic advice and vodafone help from their physicians, as they often feel governmental agencies such as the local department of slaves china, social services place a great deal of pressure on parens patrie them to either medicate their children or move their children to other school systems.

In direct contrast, it is also important not to slaves china, #x0201c;overemphasize#x0201d; a patient's culture when considering a diagnosis and treatment. While many of the Understanding the Concept of Ecological Niche Essay barriers listed above may be relevant for some patients, culture is only one factor in their understanding of their illness. Educational, social, economic, and slaves in ancient individual factors may also hold relevance. Because the interface of psychiatric disorders#x02014;in this case ADHD#x02014;and culture is complex, it is a useful context for examining the integration of psychiatric and primary care. While there are a number of 3g problems, models of such primary care and slaves china behavioral integration, one, called #x0201c;primary mental health care,#x0201d; 44#x02013;47 is particularly useful in managing families from other cultures. The goal of , this approach is to resolve problems within the primary care service context: #x0201c;primary mental health#x0201d; is designed to support the ongoing behavioral health interventions of the primary care provider. This model of behavioral health care is consistent with the philosophy, service goals, and health care strategies of slaves in ancient china, primary care. This approach involves making psychiatric consultative services available to primary care providers and allows for behavioral health and primary care comanagement of patients who require more concentrated services, but nevertheless can be managed in primary care. Influence On Child Behavior! Both consultative and condensed specialty treatment services are delivered as first-line interventions for primary care patients who have behavioral health needs.

In summary, there are several options for assisting Mr. A and his family and other Haitian children and adults with ADHD: Drug names: atomoxetine (Strattera), desipramine (Norpramin and others), dextroamphetamine (Dexedrine, Dextrostat, and others), imipramine (Tofranil and others), methylphenidate (Metadate, Ritalin, and others), nortriptyline (Pamelor, Aventyl, and others). The authors acknowledge Jean-Robert Boisrond, Coordinator of the Haitian Health Institute at china Boston Medical Center, Boston, Mass., for upward and downward communication assistance in preparation of the case and for commitment to the special needs of the Haitian people. Cultural Currents presents clinical experience derived from the practices of clinicians caring for patients and families whose cultural backgrounds are outside of the slaves in ancient mainstream of society. At times, those very clinicians will be in the position to provide rich insights afforded by their own unique cultural backgrounds. These case reports and commentaries provide knowledge and strategies helpful in vodafone the clinical encounter with patients from other cultures.

This article is based on a Grand Rounds presented at the Department of Family Medicine, Boston Medical Center, Boston, Mass., on Sept. 16, 2003. The authors received no direct support related to slaves, this article. Dr. Culpepper has been a consultant for Eli Lilly. Drs.

Prudent, Johnson, and Carroll report no financial or other relationship relevant to vodafone, the subject of in ancient, this article.