Preparations Prior to Surgery

Preparations Prior to Surgery Table 6. Common adverse reactions during administration of local anaesthetics and their management 34 Box 2: Useful guidelines while administering local anesthesia 33 Box 3: Local anaesthesia in special situations: 30,31,32 Intradermal test dose is done to check for hypersensitivity to local anaesthesia. 0.5 to 1.0mL of test solution undiluted and containing no epinephrine is injected subcutaneously. The test is negative if no reaction occurs during the 30 minutes following the injection. However, regular use of test dose remains controversial as allergy to LA has been found to be exceptionally low (0.7%). (43) Many cases of reported allergy to LA have been attributed to sensitivity to preservatives used in the solution, such as sodium metabisulfite, rather than an allergy to the anaesthetic agent itself. (33) In some dermatologic procedures, often patients are averse to use of local injections for anaesthesia while use of topical anaesthesia may not be sufficient to alleviate their discomfort.. In these patients, vibration can be used to reduce the pain of injections. It may even be used as a substitute for anaesthesia by pharmacological agents in certain dermatological procedures like botulinum toxin injection, laser therapy, cautery of facial warts, incision and drainage of abcesses, etc. Their action is defined by the gate control theory of pain. The A -ÃŽ ² nerve fibers which transmit mechanoreceptor signals like touch, vibration, stimulate the inhibitory interneurons in the spinal cord which in turn reduce the amount of pain signal l transmitted by A-ÃŽ ´ and C fibers from thes kin. Thus, counter stimulation, akin to stroking or pinching the skin, can alleviate pain sensation. (44) Cold temperature in the form of ice packs or ethyl chloride sprays has also been used for these purposes (cryo analgesia) The accountability of a dermatosurgeon towards his patient who requires surgery, not only lies in performing the procedure well but, actually begins from collecting all the medical information about him, counselling him and chalking out a plan that has his best interest in mind.(45) It is prerogative to work up the patient completely before he is taken up for surgery to avoid any adverse events. The workup should include a complete history and clinical examination, relevant investigations, counseling, and documentation. 46 A detailed history of co-morbidities and concomitant medication is taken. Concurrent conditions like diabetes mellitus, cardiovascular disease, infectious diseases should be inquired upon. History regarding bleeding tendencies should also be taken. Wound healing is delayed in diabetes due to associated vasculopathy, decrease in the peripheral blood supply and increased risk of infections, hence the blood sugar levels should be monitored and brought under control before surgery. Also, these patient should be given a broad spectrum antibiotic prophylactically. 47,48 For patients with cardiovascular disease, a sublingual nitroglycerin is kept handy in case of a possible precipitation of angina. Adrenaline maybe avoided in cases of hypertension or peripheral vascular disease.49, 50 Electrosurgical procedures are avoided in patients with pacemakers.51 In pregnancy, local anaesthesia is used without adrenaline to avoid chances of uterine artery spasm. Safer antibiotics are prescribed and salicylates and NASIDS are avoided as they can interfere with the growth of the foetus. 39 A detailed drug history is imperative as certain drugs meddle with the haemostatic, inflammatory and wound healing processes. Hence, these drugs need to be stopped for a certain period, after the advice of the physician. 52History of allergy to any drugs, ingested or applied, allergy to adhesive tapes, history of keloid formation, scarring tendencies should be asked in detail. Box 4 gives the important drugs to be taken into consideration while planning a surgery Box 4: Important drug history that need to be asked for prior to a dermatosurgery Local examination of the site to be operated should be done to check the condition of the overlying skin, and to rule out any infection. The dermatosurgeon should have a thorough knowledge of the underlying vital structures so as to avoid any trauma while performing the procedure. Thorough examination also provides signs of keloidal tendency, for e.g in pre existing scars. If the lesion to be operated upon is suspected to be premalignant or malignant, then it is prudent to perform a biopsy first to confirm the findings on histopathology and then decide the next line of treatment. To prevent post –operative infections check for damaged ,infected skin, diabetes, debilitation, hypogammaglobulinaemia, severe malnutrition, long –term antibiotic therapy, corticosteroids, immunocompromised states, emotional stress, poor hygiene, etc. Counselling is an important constituent of the management of any dermatosurgical procedure. The problems and needs of the patient are assessed, and all the options are put forward for him to decide. Patients need to have a thorough knowledge of the procedure, the complications, the follow-up, post-operative care, outcome of the surgery, must be given to the patient. All queries about the procedures duly addressed. Expected results should be explained. Any unrealistic expectations need to be put to rest then and there. Patients with unrealistic expectations should be counselled against the procedure Baseline investigations that should be done before a dermatosurgical procedure are listed in box 5. It is, however, not necessary to do the whole list of investigation prior to a minor dermatosurgical procedure. The investigations that need to be carried out should be based on the results of the clinical examination. Box 5: Investigations to be carried out prior to a dermatosurgical procedure. Complete documentation of the case is a very important part of preoperative preparation. All the relevant clinical notes, photographs should be kept as record for medicolegal reasons. A written informed consent is of paramount importance. Drugs that are prescribed before a major dermatosurgery are mentioned in box 6. However, this is again not mandatory and is based on the patient profile, nature of the surgery and surgeon’s experience Box 6: Preoperative drugs prior to a dermatosurgery Dermatosurgeon must undertake strict safety measures in order to prevent hazardous infections. As mentioned earlier hand hygiene plays a major role in preventing iatrogenic infections. Right technique of hand washing reduces contamination and prevents the transfer of infection from one man to another. Personal protective equipment (PPE) is a protective gear that comprises of mask, gloves, gowns, goggles and shoes. A high quality PPE is the only barricade between the surgeon and the infectious material. 23. All the instruments required for the surgery should be kept ready in the instruments trolley before the surgery. The surgical trolley should also have surgical drapes, adequate amount of gauze pads, cotton swabs and surgical disinfectants in place. The order of keeping the instruments on the trolley should be predetermined and kept uniform for a particular surgery so as to maintain a smooth flow of operation. Also, the emergency tray should always be ready in order to deal with any critical situation. The area to be operated upon has to be cleaned and shaved if required. Disinfection of the surgical area is done by using disinfectants like povidone iodine and methylated spirit. The cleaning of the area should always be started from the centre extending into the periphery in order to ensure minimum possible risk of contamination of the site of operation. Sterile drapes must then be used to isolate the surgical area. Excision means cutting out a tissue, an organ or a tumour. The ellipse (fusiform excision) is the mainstay and workhorse of cutaneous excisional surgery and reconstructive surgery. Proper planning of the incision should be done before the surgery is started. This results in a least noticeable and well healed scar. A well planned incision line should run parallel to the favourable lines of closure i.e. the relaxed skin tension lines (RSTL) or the lines of minimal skin tension (natural skin creases or wrinkles). [Illustration 31.4] These lines can be made obvious by pinching the skin in all direction. They can also be judged by asking the patient to smile or grimace.57,58 The incision line so planned not only makes the scar inconspicuous but it heals faster and has a higher tensile strength. Lines of maximal extensibility are typically at right angles to the RSTL. These lines are important when performing a flap grafting from an adjacent area. Incisions can also be taken along the wrinkle lines, skin folds. Another option is to make a circular incision and wait for some time to allow it to turn into an oval shape after undermining the edges. Before final closure the oval shape can be converted into an ellipse. Always respect the cosmetic units of the face. The cosmetic units of the face are chin , perioral region, cheek, periorbital region, nose, forehead, glabella, and temple. Scars restricted to single cosmetic unit hide well, than the scar crossing multiple units.58 [Illustration 31.5] Nature of the lesion removed is also an important factor. For benign lesions the surrounding normal skin excised is minimal, on the other hand for malignant lesion two factors are very important, complete excision of the tumour and to include sufficient surrounding normal looking tissue in the excision to prevent recurrences. ( 59,60) The shape of the lesion also plays important role in deciding the excision line. For oval shaped lesion the long axis of the incision line must run parallel the long axis of the lesion. This will shorten the length of the scar.[61]. When taking incisions near lips or eyes, functional considerations are very important to prevent lip retraction and ectropion respectively.

Appiah Notes on “Identity, Authenticity, Survival”

SLIDE 2- QUESTIONS OF RECOGNITION ?APPIAH quotes CHARLES TAYLOR, asserting that modern social and political life and very much based off of questions of recognition. oIn our liberal society, we see recognition as a method to acknowledge individuals and what we perceive to be their identities oWe have a notion from â€Å"ethics of authenticity† that people have the right to be acknowledged publically as what they already really are oWe deny people rights when society tells people to hide something about themselves and pretend to be something their not, such as being Jewish or gay. Discussion on recognition conflicts with the idea of an individuals authenticity and identity. oâ€Å"If what matters is my individual and authentic self, why is so much contemporary talk of identity about large categories- gender, ethnicity, nationality, race, sexuality- which seem so far from the individual. † (149) othere is a disconnect between using collective language such as this and the movement for an individual to have a â€Å"modern notion of the self† SLIDE 3-RUBRIC OF IDENTITY APPIAHT maintains TAYLOR’s defense to this phenomenon, and throughout this essay discusses features of TAYLOR’s story under three crucial rubrics- identity, authenticity, and survival. ?Identities whose recognition TAYLOR discusses are what we call collective social identities, such as religion, gender, ethnicity, race, and sexuality. APPIAHT says these identities somewhat heterogeneous or diverse because they matter differently to people who subscribe to them in different ways, but these are the major collective identities that demand recognition in North America. oHe uses the example of religion or of sexuality- both of which he says matter different to different people and are experienced in different ways at various stages of life. Connection between a persons individual identity, which is the focus of TAYLORS discussion, and these collective identities: each pe rsons identitiy is seen as having two major dimensions. †¢There is a collective dimension- intersection of collective identities †¢Also a personal dimension- consisting of other socially or morally important features, such as charm, intelligence, wit, that are not the basis of forms of collective identity (people who have these identities don’t form a social group) SLIDE 4- RUBRIC OF AUTHENTICITY Uses this rubric to acknowledge the importance and connection between the two personal and collective identities oUses quote of TAYLOR to show the â€Å"ideal of authenticity†, â€Å"there is a certain way of being that is my way. I am called upon to live my life in this way.. if I am not true to myself, I miss the point of my life. oTAYLOR justifies the politics of recognition, maintaining the oppositional aspects to authenticity that would complicate the picture because it focuses too sharply on the difference between the two levels of authenticity that the contem porary politics of recognition combine oAPPHIAT says TAYLOR/ HERDERs way of framing the issue doesn’t pay enough attention to the connection between the originality of people and nations> today the individual identity, which screams out for recognition, is likely to have what HERDER would have seen as a national identity as a component of its collective dimension. APPHIAT says being an African American is part of the authentic self he seeks to express. It is partly because he wants to express his self that he seeks recognition of an African American identity. †¢Conflicts with TRILLING in this context because recognition as an African American means social acknowledgement of that collective identity, which requires both recognizing its existence and actually demonstrating respect for it.If in seeing himself as African American, APPHIAT resists white norms, mainstream American conventions, the racism of white culture, why would he ever seek recognition from others who are white? oIrony in the ways in which this â€Å"bohemian ideal† leads authenticity to require us to reject many components of our society. oSecondly, another problem with the bohemian ideal has components of errors of philosophical anthropology. †¢It fails to see what TAYLOR recognizes as the way in which the self is dialogically constituted. Rhetoric of authenticity suggests not only that you have a way of being that is all your own, but in that developing it, you must fight against the family, organized religion, society, the school, and the state- all of the forces of convention> this point is wrong in that: †¢It is in dialogue with others understandings of who you are that develops a concept of your own identity, but also because identity is created through concepts and practices made available to a person by religion, society, school, family and the state. Dialogue shapes the identity a person develops as they grow up and what TAYLOR calls â€Å"language in a br oad sense† oOverall, APPHIAT claims that in every identity, there is a broader context that allows for a space in the other. He claims for example, African American identity is centrally shaped by American Society and its institutions, and it cant be seen as solely constructed within African-American communities. oHe claims a third problem with the standard framing of authenticity if essentialism, which seems inherent in the way questions of authenticity are normally posed.After romanticism, the idea that the self is something that one creates so that â€Å"every life should be a work of art this is his or her own greatest creation†. Authenticity in politics should not be considered essentialist or monological. ?APPHIAT supposes that TAYLOR is content with the collective identities and this might be why he is less likely to make concessions to them. SLIDE 5- SURVIVAL RUBRIC ?TAYLOR argues that pluralism in societies will require us to modify procedural liberalism.HE agr ees that we should not accept the insistence on the uniform application of rules without exception and the suspicion of collective goals. We should not accept the insistence without the suspicion. There can be legit goals that would give up proceduralism. ?APPAHIAT acknowledges Taylors discussion of collective goals in multicultural states, but moves the focus on to say that the collective goals of society shouldn’t be that the language or practice of a culture is eventually still happening, but that there should be a desire for the language and practice to be moved on from one generation to the next.EXAMPLE- Canada paying a group of unrelated people on an island in the south pacific to carry on French Canadian culture- this doesn’t meet the need. ?In addition, there needs to be a goal to respecting the autonomy of future individuals. Sometimes children resist to practices that theyre families uphold, such as arranged marriages. In this case, the ethical principles of equal dignity that underlie liberal thinking seem to be against allowing parents to maintain their personal practices because we care about the autonomy of the children. If we create a culture that our descendants will want to hold on to- our culture will survive in them. He says we have to help children make themselves, and we have to do so according to our values because children do not begin with values of their own. He also claims that we must both appeal to and transmit values more substantial that a respect for liberal procedures. oEducation is run by government institutions on purpose for creating collective goals in social reproduction. ?APPHIAT agrees with TAYLORS objections to pure proceduralsim because of social reproduction. SLIDE 6- CONCLUSION Large collective identities that call for recognition come with notions of how a proper person of that kind behaves- there isn’t one way that a group should behave, but there are modes of behavior. These notions provide loo se norms and models which play a role in shaping the life of those who make these collective identities central to their individual identities. oCollective identities provide â€Å"scripts† which are narratives that people can use in shaping their life plans and stories. oIn telling a persons story, how a person fits into the wider story of various collectivities is important.Many identities fit each individual story into a larger narrative. oToday, it is widely agreed upon that insults to collective or individual identities are seriously wrong. oEthics of authenticity requires us to express who we really are, they further demands recognition in social life. Because there is no reason to treat people of identities badly, there should be cultural work to resist the stereotypes, to challenge insults, and to lift restrictions. oIn order to construct a life with dignity, take the collective identities and construct positive life scripts instead

Why Chinese Mothers Are Superior

In the article, â€Å"Why Chinese mothers are Superior, Chua describes her efforts to give her children what she describes as a traditional, strict â€Å"Chinese† upbringing. ] This piece was controversial. Many readers missed the supposed irony and self-deprecating humor in the title and the piece itself and instead believed that Chua was advocating the â€Å"superiority† of a particular, very strict, ethnically defined approach to parenting. In fact Chua has stated that the book was not a â€Å"how-to† manual but a self-mocking memoir. In any case, Chua defines â€Å"Chinese mother† loosely to include parents of other ethnicities who practice traditional, strict child-rearing, while also acknowledging that â€Å"Western parents come in all varieties,† and not all ethnically Chinese parents practice strict child-rearing. Chua also reported that in one study of 48 Chinese immigrant mothers, the vast majority ‘said that they believe their children can be â€Å"the best† students, that â€Å"academic achievement reflects successful parenting,† and that if children did not excel at school then there was â€Å"a problem† and parents â€Å"were not doing their job. ‘ Chua contrasts them with the view she labels â€Å"Western† – that a child’s self-esteem is paramount Amy makes it clear that the Asian kids are not born smart (For the most part, at least) It is hard work and training from the parents that shapes the children into these wonder kids. To prov e her point she lists up a number of things that her daughter were never allowed to do, such as: * Have a play date * Watch television or play computer games * Attend a school play. And so on.. Prohibitions that seems totally unreasonable for us â€Å"westerns†, as she loosely has named us. Throughout the text she covers several perspectives on parenting, which of a few I surprisingly agree on. Most of her viewpoints I deeply disagree with though and is far from my idea about proper parenting. Each time she lists up one of her perspectives, she compares the Chinese perspective with the Western perspective. She does this in a very subjective manner I think. She is very clever rhetorically. At some parts of the text, I actually caught my self being very close to getting dragged towards her side. I found it quite amusing to feel the power of pathos, but at the same time a bit daunting. According to Amy, the main difference between Chinese parents and Western parents is the way they see their children. Western parents believe that respecting their children’s choices, their individuality and always encouraging them to pursue their true passions is the way. In contrast, Chinese parents believe that preparing their children for the future, and.. Why Chinese Mothers Are Superior Children all over the world are raised in hundreds of different ways. Some parents strive to get a successful child, some are more casual, and some parents even relive their youth through their kids. China is on the running course with the rest of the world, and when it comes to creating masterminds, China is way ahead of everyone else. Should we follow, or should we simply go on the way we always have? In the article â€Å"Why Chinese Mothers Are Superior† by Amy Chua, we’re informed about the differences between the western way of raising children and the Chinese way.She is a Chinese mother herself, and from her perspective she explains how she has raised her children by excluding them from every social activity, both within school, but also during their extracurricular.Her opinions are pretty clear, and she doesn’t hesitate to express how much she thinks her way of raising children is better than the western way. She explains that not all Chinese mothers are l ike her â€Å"Conversely, I know some mothers of Chinese heritage, almost always born in the West, who are not Chinese mothers, by choice or otherwise†1.Throughout the article, she states that the western way of raising children is not as good as the Chinese, and even though some western parents think they’re strict towards their children, it’s nothing compared to the Chinese idea of strict â€Å"†¦even when Western parents think they’re being strict, they usually don’t come close to being Chinese mothers. (†¦ ) my Western friends who consider themselves strict make their children practice their instruments for 30 minutes every day. An hour at most.For a Chinese mother, the first hour is the easy part. It’s hours two and three that though†2. This proves that she truly thinks that she, and the rest of the hardworking Chinese mothers, are superior. Throughout the article, she also resorts to studies, that have examined the opi nions of 50 western women and 48 immigrated Chinese women, all mothers. â€Å"Almost 70% of the Western mothers said either that â€Å"stressing academic success is not good for children† or that â€Å"parents need to foster the idea, that learning is fun†Ã¢â‚¬ 3.The opinion of the Chinese mothers was a whole different story, though â€Å"By contrast, roughly 0% of the Chinese mothers felt the same way†4. Dragging these studies into her article doesn’t only make her reliable, she also argues very well for her case. The fact that she is a professor at Yale Law School also backs up her reliance. Being a professor for future lawyers usually requires being good at arguing, which she certainly is.In her article, she has included stories and experiences from her own life, in which she was also raised the Chinese way: Play to be the best, or don’t play at all. The first experience she explains is how her father used to call her names when she was disres pectful towards her mother â€Å"†¦ when I was extremely disrespectful to my mother, my father angrily called me â€Å"garbage†Ã¢â‚¬ 5, but she also states that she was never negatively affected by his name-calling â€Å"I felt terrible and deeply ashamed of what I had done.But it didn’t damage my self-esteem or anything like that†6. Throughout the article, she uses humor even though she seems to be a strict lady, that doesn’t waste time messing around â€Å"One guest named Marcy got so upset she broke down in tears and had to leave early. My friend Susan, the host, tried to rehabilitate me with the remaining guests†7. This shows that she does, even though it might be a bit hard to detect, have a sense of humor. She is pretty subjective in this article, since she assumes that every Chinese child is an A-class student.This is, though a bit of a paradox, since she in the start of the article wrote that not all Chinese mothers are the same â₠¬Å"If a Chinese child gets a B – which would never happen – there would be a screaming, hair-tearing explosion. †8. She is convinced, that a Chinese parent can treat their child in any way they want to, calling them names and forcing them to do things, they don’t want to do, whereas western parents can’t be critic at all or demand anything of their child without ruining the self-esteem of their child â€Å"Chinese mothers can say to their daughters â€Å"Hey fatty – Lose some weight.†By contrast, Western parents have to tiptoe around the issue, talking in terms of â€Å"health† and never mention the f-word, and their kids still end up in therapy for eating disorders and negative self-image†9. In the modern world, it’s all about stepping up and making a name for yourself, no matter if you’re on Wall Street or a part of the underground music revolution. Many years ago, China’s economy was a wreck, peopl e starved and you had to be the best to survive.Call it Darwinism, but these people had to fight to be something, and I think this is how this Chinese way of raising children was created, and we learned from Amy’s article, that Chinese children are still raised this way. If a young child is brilliant at for example an instrument and a video is posted on Youtube and it goes viral and people hear about it, they sometimes ask â€Å"Is the kid Asian? †. Then people laugh, but it’s funny because it’s true!The Chinese, not to speak of rest of Asia, has conquered a big part of the market for manufactured products, and everywhere you go you see the stamp â€Å"Made In China†. No wonder if everyone in China raise their children like Amy does. When all this is said, I think children should be allowed to be children. It’s healthy for them to create social bands, but if they’re cut out from all social activity by their parents, they will automati cally become the outcast in their class.This is why we on American high schools always see white and black kids hang out together, but the Asians are usually for themselves. It’s natural to make boundaries for your child, the child should know the difference between right and wrong, but should definitely not learn that socializing is wrong. Maybe Amy didn’t get damaged in the process of being perfected by her parents, but I’m sure not every Chinese child is like her. We keep talking about leaving a better planet for our children – But how about leaving better children for our planet? Why chinese mothers are superior â€Å"Nothing is fun until you’re good at it.† That statement is the essence of the Chinese way of parenting. Studies show, that Chinese parents spend about 10 times as long as Western parents on academic activities with their children on a daily basis. But the question is, will all that discipline and those high expectations really create content and successful adults or does it in fact create children who will eventually resent their parents?The article was brought in The Wall Street Journal in 2011 and it is written by Amy Chua’s and from her point of view. She is a professor and a mother of two. She believes in the Chinese way of parenting – that discipline and expecting nothing less but perfection from your children, will eventually create happy and successful adults. In the article she argues for the reason why the Chinese upbringing is successful. She is married to a Westerner and therefore she has recognized three big differences in the Chinese and Western parental mind-sets.Amy believes these three differences to be the reason why Chinese children have a tendency to perform better at school. First of all, she thinks that Western parents are too concerned with their children’s self-esteem. As she says it: â€Å"Western parents are concerned about their children’s psyches. Chinese parents aren’t. They assume strength, not fragility, and as a result they behave very differently.† This statement is somewhat true. Western parents have a tendency to tiptoe around an issue; because they are petrified they might hurt their child’s feelings or damage their child’s self-esteem.If you expect your children to be fragile, they most likely will become fragile. If you on the other hand expect strength, and that they can handle the truth without getting a damaged self-esteem, they will be strong. But as always there must be moderation in all things. Amy Chua says: â€Å"That’s why the soluti on to substandard performance is always to excoriate, punish and shame the child. The Chinese parent believes that their child will be strong enough to take the shaming and to improve from it.†Punishing your children for a disappointing performance at school by castigating the child is very far from the Western parental mind-set. If you are disappointed in your children, it is better to be honest with them and tell them you know they can do better and what you expect of them in the future. It is unnecessary to lambast your children. It seems, that in Amy Chua’s mind respect and fear is the same thing, which in my mind seems hopelessly out of date.You should not fear your parents; instead they should be the ones in whom you could always seek comfort and support. Amy Chua has a completely different mind-set on where children are in the social hierarchy, which is the next big difference between Chinese and Western upbringing.Amy Chua believes that the second big difference between Chinese and Western upbringing is, that Chinese parents believe their kids owe them everything. In this part she uses her husband as an example of what a Westerners view is: â€Å"It’s parents who foist life on their kids, so it’s the parents’ responsibility to provide for them. Kids don’t owe their parents anything.†This is an opinion most Westerners share. It is a culture difference. It is  not only the Chinese culture, but also the Muslim, Jewish etc. that have this type of social hierarchy, where it is the older you are, and the higher status you have. Amy Chua may exaggerate when she says Chinese children owe their parents everything, but a lot of Westerners could learn to show more respect towards the elderly people. We could learn something from each other’s way of parenting, even though they are opposite of each other.In the next part Amy Chua points out the last big difference between the two very different ways of parent ing. â€Å"Third, Chinese parents believe that they know what is best for their children and therefore override all of their children’s own desires and preferences.† To explain the reasoning behind this statement, Amy tells a story from her own life, when her  daughter refused to play a piano piece because it was too hard. But Amy made her do it and in the end she did it and performed it perfectly. To a certain degree, it is okay for parents to make their children do something they do  not want to, because it takes practice.What you have to be careful about is keeping them away from the things they want to do. If they have a desire to something, not allowing them will only enhance that desire, and in the end that might cause some kind of drastic reaction from their part. Once again it is a really big difference between the Chinese and the Western mind-set. Western parents usually encourage their children to pursue their desires and support their decisions, whereas the Chinese parents believe they know what is best for their children.The fact that Western parents allow their children to do what they want with their lives, makes the Chinese parents think that Chinese parents care more about their children, because they won’t let them turn out badly. On the other hand, Westerners think that Chinese parents are callous people, who do not let their children be children. Amy think’s that is a misunderstanding on both sides, because as she says: â€Å"All decent parents want to do what is best for their children. The Chinese just have a totally different idea of how to do that.† Amy respects both ways of parenting, but it is oblivious throughout the article that Amy Chua believes the Chinese way of parenting is the right way to go.Amy Chua’s views on parenting might be slightly provoking to a lot of people, but she argues well for the reasoning behind it. In the article it seems that there are no consequences of the Chine se parental mind-set. But there always is. There is a possibility that Amy Chua’s way of parenting might cause her children to resent her at some point, when they realize that not every parent is like that. Also undermining the creative subjects like gym and drama is not the way to go.A lot of studies show the importance of creativity in a child’s life and exercise is crucial for children as well. It is also important to remember that the social intelligence is just as important as  the logical one, and maybe more. When the children are going to job interviews etc. it is very important to be socially qualified, and they won’t learn that by being kept away from sleepovers, play dates and so on. There are definitely consequences of the Chinese way of upbringing that Amy describes, just as well as there is of the Western way.Even though Amy is an advocate of the Chinese way of parenting, she does not glorify it. She uses humour and exaggeration to engage the read er for example: â€Å"If a Chinese child gets a B – which would never happen – there would first be a screaming, hair-tearing explosion.† She amplifies a lot in the examples she uses in order to emphasize just how different Western and Chinese parents are. An article is not engaging if it only consists of statistics and surveys. But like Amy does use those statistics and surveys to back up her own story. By doing that, the story becomes more believable. As readers we are much more interested to hear a personal story that is part of a greater hole.Amy also engages the reader by making a bold headline: â€Å"Why Chinese Mothers Are Superior†. When we read that we instantly feel a desire to know why and which arguments she has for making such a statement.The article ends with a summary of the contrast between the Western and Chinese parental mind-set. Both are very positive, but still very different. In that way Amy enlightens how both ways of parenting can be equally as good. The message of the article is that we should learn from each other’s way of parenting, and just because one environment is different, does not mean it is not equally as loving and nurturing as the other.

Catalogue of Abuse in Nhs Care Homes - 1352 Words

‘Anna Walker and David Behan, Inspectors of the Health and Social Care Commission recently launched an audit of all services for England for people with Learning Disabilities.’ The above action comes after it was revealed that NHS staff abused adults with learning difficulties which included, among many other things, such abuse as a deaf and blind man being tied up for 16 hours a day; withdrawal of food; being locked in rooms, cold showers, over reliance on medication; misuse of funds and sexual abuse. Investigations, in part, prompted by Mencap (who say that there are about 1.5 million people with learning disabilities and around 2,500 of these people live in NHS care homes), uncovered widespread abuse and a lack of understanding of†¦show more content†¦Obviously this situation needs to be put right immediately but there are a couple of issues highlighted by this report that need to be looked at more carefully. Firstly, a member of staff being jailed for the rape of a woman in one of these units with a second member of staff receiving a suspended sentence for a previous sex offence against the same woman is the correct course of action. However, the reason given for the prosecution was that the woman was deemed to have too low a mental age to have given consent in either incident and I take issue with this because there is no real clarity and a limited lesson to be learned by those people charged with the care of people with learning disabilities. In the first instance, nobody employed to take care of a patient or a resident should be engaging in any kind of sexual contact with any person they are caring for; regardless of the patient/residents ability to give consent. Secondly, does this mean that the woman in the case will not be allowed to have a fulfilling relationship with anyone else, will she be allowed to vote, will she be allowed to have any say in decisions about her life? 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