To Kill A Mockingbird - How To Change Your Peers Opinon On Racism :: Free To Kill A Mockingbird Essays

If this information makes you feel uncomfortable do not further research it. It can cause mental disturbance if you are not ready for it. I know it may seem cool but I am being serious. Today I am going to compare racism in TKAMB between racism in real life situations. The main topics that I have chosen are racism in the form of bullying and racism as in the form of discrimination. In the book there are many more forms of racism as bullying than I thought there would be. They are common like when people say Nigger talk they mean talking without making sense or talking with out proper wording. There are everyday issues like while building a snowman partly out of mud Scout says as a joke †Jem I ain’t ever heard of a Nigger snowman.† Here they find paying out Negroes funny. The kids in the book tease scout and Jem because they have an annoying nature. As when Cecil Jacobs announces that Scout Finch’s daddy defends niggers and when Francis calls Scout a â€Å"Nigger lover† These terms although are nearly said in the way that saying Nigger lover is just like saying snot-nosed. While in real life bullying occurs because of many reason which can be that It makes bullies feel powerful, Because they want to impress others, Because they have an unrelated prejudice against the victim, the bully simply doesn’t know how offensive they are being, Because others have influenced them to do so, Because they have been taught this way, Because they find it a matter of amusement, Because they are forced to do so to fit in, Because they haven’t thought about what they are saying and have no previous thoughts before they open their mouths, Or they do so to get even with the bully who bullied them. Racism As in discrimination and extreme hatred In TKAMB there are many instances where the black Negroes are discriminated against or the Negroes discriminate against the white people. Situations, which occur in this book also, occur in real life. Many where racism is a tool of discrimination, situations like excluding people from social groups or from communities or not giving them equal rights. Situations in TKAMB are seen in the following instances. Where cal wants to take the children to the black church people try to oppose her. Being around Negroes is derogatory to your reputation and a punishment this is shown when talking about Boo Radley â€Å" The sheriff hadn’t the heart to but him in jail alongside Negroes†

Personal Views on Globalization and Cultural Identity Essay

The concept of the world as one community has, in recent years, turned into a growing trend not only in business but in practically all facets of activity. Globalization has, in fact, fast-tracked the integration of cultural minorities or migrants into the mainstream society of so many countries, including the United States of America. For instance, the United States today is on the verge of installing a new breed of leader. This will be made possible by the winning of South African-American candidate Barack Obama as the nation’s 44th President. This means the country has truly gone a long way. While before only â€Å"white† citizens are elected President, the U. S. now has reached a very liberal sense of nationhood. Perhaps, this is a result of decades of continuously allowing Americans to inter-marry with other nationals and its open admission into the country of migrant businessmen, workers and students. These so-called cross-boarder alternatives are attributed to globalization which is a strategy that paved the way for both weak and strong governments to open up their respective countries worldwide. In order to have a level playing field, opening up of economies resulted into privatization of main sectors of the economy such as public services and deregulation of vital businesses. But while globalization has become a norm of life, there is still a conscious effort to preserve the American culture in the same way as what the other countries are doing. Preserving the cultural heritage or identity of a nation should be taken as a continuing process and should not be left obliterated by globalization. Due to globalization, world trade has become more competitive unlike in the past where only a few countries controlled it. Today, even the previously â€Å"closed economy† of China has gained great in-roads into the world market, including the American market for that matter. Nonetheless, as emphasized by the global financial crisis, globalization has apparently just put more limit on the worldwide market and deteriorated the financial surplus. With the U. S. being a melting pot of the various cultures of the world, the impact of globalization appears more beneficial than a threat to the economy and the nation itself. These various cultures brought into the country by migrants have been successfully assimilated into the American way of life. Concrete examples are the various Asian cultures and business activities that truly helped in the growth of U. S. as a showcase for globalization. Professionals from other countries helped Americans in the delivery of modern health care while Japanese investors have awakened local manufacturers into redesigning products to fit into present needs and standards. The entry of a lot of migrants into the country, in fact, enriched American culture. It has developed the once â€Å"purist† nation into a global leader with a greatly tempered concept of supremacy. Whereas before Americans dictate the terms and conditionality in business transactions, today it has accepted and embraced fair trade practices. Maybe because in hundreds of years in dealing with other cultures, the U. S. has accepted the reality that it must co-exist with other nations and cultures. Otherwise, its very own existence could be in serious jeopardy. Its humiliating experience with the invasion of Iraq, for instance, made America learned that despite its modern technology and warfare faculties it can’t easily subdue a developing country without the cooperation of other countries and cultures. This makes globalization a positive option to prevent future tendencies of adventurism by nations like the U. S. With its failure in Iraq and the meltdown of its economy in recent months should make its leaders rethink its foreign policy, view on globalization and the need to respect the cultural identities of other civilizations. Globalization, therefore, should not be taken as an instrument to wipe out cultural identities of nations but rather it can be availed as a common bridge towards better understanding and in the process advance the cause of world peace.

The Biblical and Historical Origins of the Problems in...

The Biblical and Historical Origins of the Problems in the Middle East The present day situation in Israel may be the most difficult political situation in world history. It dates back to thousands of years before Christ, and deals with a large number of issues including political, religious, and cultural issues. In order to understand the current day issues, we must first understand the Biblical and historical issues. In this paper, I will first explore what the later books of the old testament, specifically the books of Ezra, Nehemiah, Zechariah, and Malachi, and than talk about the modern day issues. This was an interesting part of the Bible to research, because it is the part that most people know very little†¦show more content†¦The first book that I will discuss is the book of Ezra. Ezra lived during the time several hundred years after the return of the Jews from the Babylonian exile, which would be around 400 BC. Ezra was a priest, who was an expert in the law of the Torah. The first six chapters of the Book of Ezra describe the return of the Jews from the exile in Babylon, which actually happened before Ezra was actually living. The last 6 chapters deal with the restoration of Jewish life in Israel after the exile in Babylon. In this time period, there were two restorations going on. The first dealt with the rebuilding of the city of Jerusalem, even though the Temple had already been built after the return from exile. The second dealt with the rebuilding of Jewish religious life in the postexilic period. Because he was a priest and an expert in the law, Ezra was primarily responsible for the religious rebuilding. A major problem of the time was that Jewish men were taking foreign wives, and at this time, Ezra prohibited mixed marriages. The men who had married foreign women had to abandon them. There was also a covenant renewal at this time. The second book that I will discuss is the book of Nehemiah. It isn’t known who came first of Ezra and Nehemiah, but while Ezra was the religious leader, Nehemiah was the political leader. Nehemiah began his work in Babylon around 445 BC,Show MoreRelated Palestine and Israel Essay1463 Words   |  6 Pagesonly on the battlefield but now on the streets and in homes of innocents. The war between Palestine and Israel may be able to date back to Biblical times and there seems to be no end in sight for either side. (Winder) The war in the Middle East is a great one. The cause for the fighting between both sides has changed repetitively. One of the earliest problems dates back to the bible. It is said that an angel promised the exiled slave Hagar that her son Ishmael would be the father of a countryRead Moreâ€Å"What Were the Major Reasons for the Creation of the State of Israel?3085 Words   |  13 Pagesestablished in nearly 2,000 years and was the culmination of efforts by the Jews to secure a homeland for themselves. This paper will explore the major reasons for its creation. It will be shown to be a long enduring quest that has biblical origins. Subsequently both biblical history and geography will be worthy of mention as they are integral to the question - I will furthermore suggest that the Jewish belief from the bible forms a basis for motivation for the creation of a state. Allied with this beliefRead MoreExegesis of 1samuel 172247 Words   |  9 PagesWhitelam (1998), Dutcher-Walls (2009) and Steinberg (1995) is a social scientific approach to the OT? How does this approach help us understand Judges 9 better? Introduction: The aim of social scientific criticism, as a subfield of biblical exegesis, is to study the biblical materials as a reflection of their cultural setting. The meaning and/or the social background of the text are thus more fully illumined by the exercise of sociological and anthropological methods and theories. The era of modern social-scientificRead MoreChristianity, Judaism, and Islam Paper2281 Words   |  10 Pagesitself and Judaism alone. Judaism is, of course, much older that Christianity but there are still many similarities. Whilst Jews do not consider Christ to be the Savior, they do believe him to be a prophet (Helium, Inc., 2002-2011). Another historical connection and similarity can be described by the fact that, according to Christian teachings, Jesus and many of his followers were originally Jewish and, therefore, the basic teachings of Christianity will be more or less equal to those of JudaismRead MoreChristianity, Islam, And Judaism1353 Words   |  6 Pagesthe totality of individual and communal existence. It is a system of sanctification in which all is to be subsumed under God s rule. Judaism originated in the Middle East, but Jewish communities have existed at one time or another in almost all parts of the world, a result of both voluntary migrations and forced exile or expulsions. Origin The central element of Christianity is the person of Jesus Christ. Jesus of Nazareth, a Jewish rabbi, attracted a following of people who believed him to be aRead MoreComparing Christianity, Judaism, and Islam Essay1364 Words   |  6 Pagesthe totality of individual and communal existence. It is a system of sanctification in which all is to be subsumed under Gods rule. Judaism originated in the Middle East, but Jewish communities have existed at one time or another in almost all parts of the world, a result of both voluntary migrations and forced exile or expulsions. Origin The central element of Christianity is the person of Jesus Christ. Jesus of Nazareth, a Jewish rabbi, attracted a following of people who believed him toRead MoreThe Arab Israeli Conflict Between Islam And Judaism Essay1466 Words   |  6 PagesJews’ right to a state of their own†* (Uriel). They felt because the Arabs laid claim to other land in the Middle East, the Holy Lands of Palestine belonged to them. The prospective state of Israel, a Jewish safe haven, became ever more appealing as Nazi Germany reached their height of power. This created a Israeli identity, while â€Å"the state promoted seminal historical events of heroism, biblical stories, and the ideals of Zionism and pioneering as exemplifying the Israeli ethos† (Lust). By 1966 theRead MoreOrigins Of The Twin Revolutions1287 Words   |  6 PagesYevgeniya Erdyniyeva Instructor –Ibrahim Bilal History 3005 December 1, 2015 What were the origins of the â€Å"twin revolutions† and how did they combine to create what we call â€Å"modernity†? Modernity, it is a macro process of transition from traditional to modern society. â€Å"Formation of a modern political map of the world began in early 1800 in Western Europe and maybe characterized as the product of the twin revolutions.† European colonization of the New World, the economic and politicalRead MoreAncient Eastern Thought and the Old Testament Essay10692 Words   |  43 PagesAND METHODS 3 CHAPTER 2: COMPARATIVE STUDIES, SCHOLARSHIP, AND THEOLOGY 6 CHAPTER 3: SUMMARY OF THE LITERATURE OF THE ANCIENT NEAR EAST 10 CHAPTER 4: THE GODS 14 CHAPTER 5: TEMPLES AND RITUALS 19 CHAPTER 6: STATE AND FAMILY RELIGION 22 CHAPTER 7: COSMIC GEOGRAPHY 25 CHAPTER 8: COSMOLOGY AND COSMOGONY 28 CHAPTER 9: UNDERSTANDING THE PAST HUMAN ORIGINS AND ROLE 31 CHAPTER 10: UNDERSTANDING THE PAST 34 CHAPTER 11: ENCOUNTERING THE PRESENT 38 CHAPTER 12: ENCOUNTERING THE PRESENT 43 Read MoreCan Race be Biblically Defined?2399 Words   |  10 Pagesoriental was thought to be more advanced because of less body hair. What body hair had to do with intelligence is something Darwin and his supporters have yet to explain, unfortunately he died and so did the strange hypothesis he was flouting about the origins and evolution of man. We now know that intelligence has nothing to do with race or body hair or the size of one’s head for that matter but still the damage was done. The bigotry that Darwin’s theories propagated became part of the social fabric

Writing News Jane Austen May Become the Face of the 10-Pound Note

Sir Mervyn King, the outgoing governor of the Bank of England, has announced that Jane Austen may become the new face of the 10-pound note, replacing Charles Darwin who occupied this place previously. The final decision is yet to be made; it depends on Kings successor, Mark Carney, but the possibility of this change is quite high; the writer has been considered to be a candidate for a couple of years already. It should be noted that it is not the only new face we are going to see soon: this change is just a part of the new F series of banknotes, which is gradually replacing the old E series. It is also not the first piece of news from the Bank of England which has been met with certain criticism: for example, Winston Churchill will replace social reformer Elizabeth Fry on the 5-pound note, and famous economist Adam Smith has already replaced composer Edward Elgar on the 20-pound note. The latter change is somewhat notable as well; after all, he is not an Englishman, but a Scot, and thus he became the first Scot to appear on British banknotes. The decision to include Jane Austen into this pantheon can hardly be called surprising news; if you ask somebody, even a person who is not very well acquainted with British literature, to name the first British writer that comes to mind, it will most likely be Jane Austen (or Charles Dickens, but his face has already been adorning the 10-pound in the nineties); she turned into a kind of icon for British literature; even the people who have never read a single novel written by her are most likely to know their names and, sometimes, their contents: at least due to the fact that newer screen versions of them are released every now and then. Among these novels the most famous and the most characteristic is, undoubtedly, Pride and Prejudice; a brilliant depiction of early 19th century British gentry, their life, interests and aspirations. Many consider this book to be the English novel, the work of literature that is the most typical and meaningful for the nation. Although Jane Austen wasnt very well known in her lifetime, she turned out to be one of those writers to whom fame comes only posthumously. And it is quite certain that in future her prominence will only grow; the emergence and constant growth of the Janeite fan culture throughout the 20th century is a very good proof of this point. Jane Austen is one of those names that represent Great Britain in the world; which means that it is only fitting for her face to be on British money.

Brazil Case Study- Preventing AIDS - 1382 Words

Case Study – AIDS, Condoms, and Carnival MARK 4325-002 November 12, 2014 Group: Seong-eung Lee, Patricia Ortiz Mucino, Monica Romo, Brittni Johnson. 1. Comment on the Brazilian and Indian government’s strategies for the prevention of AIDS via the marketing of condoms. The strategies that the Brazilian government has implemented to prevent and combat AIDS via the marketing of condoms have been beyond successful. Chequer, a Health Ministry official said the Health Ministry would spend $300 million next year, distributing medicine and 250million condoms and bringing AIDS awareness campaigns to the urban slums, where the disease is most rampant. Brazil knows how crucial it is to combat this epidemic and the importance of doing it as soon as†¦show more content†¦In both India and Brazil women are afraid to ask their partners to practice safe sex even in a society with a high rate of infidelity. As if this was not enough in India there is a popular belief that AIDS is a Western disease and in some regions of the country the local authorities are in complete denial and ignorance in regards to this growing epidemic. All these problems are not encounter in the United States where the use of condoms is widely encourage and in growing instances dist ributed free of charge. There is also a wide range of information about AIDS and its prevention and women in the United States take charge of their sexuality and not afraid of asking their partners to practice safe sex. 3. Would the approaches described in Brazil and India work in the United States? Why or why not? We believe that the approaches described in Brazil to help the prevention of the AIDS disease would work in America because it would help people to realize that anyone having unprotected sex is at risk of getting the disease. By handing out free condoms in abundance at the country’s famous carnivals, Brazil’s Health Ministry is giving young people (including women) the opportunity to practice safe sex even if they are inebriated. Also, with the Brazilian law giving all residents the right to the best available drug treatment at no cost, the highly affected areas, such as the slums, have no reason notShow MoreRelatedA Critical Comparison Of Pneumonia1367 Words   |  6 PagesA critical comparison of pneumonia preventions taken to reduce child mortality rates in China and Brazil Pneumonia is an acute respiratory infection. It affects the alveoli sacs in the lungs, by filling them with pus instead of air (World Health Organization 2015). This infection can be transmitted in different ways, as it is spread in the form of specific viruses, bacterium or fungi; any sort of human contact with these could transmit the infection. Pneumonia accounts for 15% of all child mortalitiesRead MoreWhat Is Mass Surveillance?1255 Words   |  6 Pagesperforms mass surveillance primarily to aid in preventing terrorist plots or apprehending those who participated in acts of terrorism that have already happened; these programs arose primarily in response to the 9/11 terrorist attacks on the Twin Towers in Chicago, Illinois, United States. It can also be used to gather other foreign intelligence information too though this reason is not as heavily publicized. Has it helped? The short answer is not much. A study performed by the New America FoundationRead MoreTraces Of Nightingale s Tuberculosis Treatment And Control951 Words   |  4 PagesOrganization, 2015). Tuberculosis is caused by Mycobacterium tuberculosis bacteria and transmitted by inhaling droplets from the respiratory tract of person with an active TB (WHO, 2015). In 2013, there are 287 cases of tuberculosis in Toronto (Toronto Public Health, 2013a), 43 of these cases are from the homeless or under housed populations (TPH, 2013b) The Toronto Public Health (2015a) identified people who live and work in residential setting such as in shelter and correctional facilities alongRead MoreBan On Tobacco Advertisements By The Government Of India1444 Words   |  6 PagesBan on Tobacco Ads by the Government of India Tobacco is one of the world’s most profitable industries. The top three producers of tobacco are: China, Brazil, and India, in that order. These industries provide direct and indirect work for many people in developing countries. Thus, like any good company it wishes to expose its products to the public by investing in ads and other merchandise of its product. All companies end goal (and of course this included tobacco) is to increase the appeal andRead MoreAnalysis Of Belgrade And Cairo : Latin America And The Non Aligned Movement1651 Words   |  7 Pagesshould be to influence world opinion to such an extent that governments, however powerful, cannot regard warfare as an alternative to negotiation.† The attendees of the conference, on a public level, considered their attendance as a way of blocking/preventing outright nuclear warfare. The conference was generally intended to figure out how best â€Å"to include uncommitted countries most effectively in the solution of problems of international tension† so that they might best contribute to peace. In otherRead MoreLaboratory Techniques Employed in Blood Analysis3315 Words   |  14 Pagescell transfusions are rare because it only lasts a few hours in the bloodstream. Donated white blood cells are obtained by heamapheresis and can be stored for up to 24 hours but must be used right away. Most of the time, antibiotics are used in some cases. Platelets Platelets transfusion is needed if a person has too few platelets, those who have lymphoma, leukaemia, thrombocytopenia or those who are receiving cancer therapy. Platelets transfusion keep the level of the platelet above 10 000 to 20 000Read MoreThe Expansion Of Foreign Aid2475 Words   |  10 PagesIn the denotation of foreign aid takes many definitions in different literature, but as Tarp provided it is government transfers from donor countries to under developed or poor countries. That is intended for promoting development and reducing poverty, although there may be other aims of giving aid. As there are major trend of foreign aid and most reasonable issues that foreign aid fluctuated in different years, therefore the paper will look back the trend of foreign aid and it’s changes in globallyRead MoreAids Awareness3713 Words   |  15 PagesWhen AIDS first emerged, no-one could have predicted how the epidemic would spread across the world and how many millions of lives i t would change. There was no real idea what caused it, and consequently, no real idea how to protect against it. Now, in 2004, we know from bitter experience that AIDS is caused by the virus HIV, and that it can devastate families, communities and whole continents. We have seen the epidemic knock decades off countries national development, widen the gulf between richRead MoreThe Current Trend Of Human Population Growth1950 Words   |  8 Pagesâ€Å"Is the current trend in Human population growth a danger to our planet?† Yes. The current trend in Human population growth is a serious issue, and, as of late,   it has been the focus of numerous scientific debates and studies. Why is it a danger to our planet? Recent studies from various scientific sources show that since the late eighteenth century (after the beginning of the industrial revolution), the human population had set itself on an explosively exponential growth rate, catapulting out ofRead MoreWorld Aids Day Report8605 Words   |  35 PagesWorld AIDS Day Report | 2012 Results 1 Foreword T he sun finds a way to shine into even the deepest parts of the forest. It is a metaphor for all of us who are working to restore hope and dignity around the world. In the history of the AIDS response there have been, and still exist, many obstacles to overcome but our path is clear—we work together to get results for all people. To the millions who have come together with compassion and determination, on this World AIDS Day we

Proper Paragraphing Free Essays

PJgQP. BR PARAGRAPHING V^ 1. Remember to always indent your paragraph. We will write a custom essay sample on Proper Paragraphing or any similar topic only for you Order Now 2. Begin with a topic sentence which makes a general statement about what is to follow in your paragraph. This topic sentence controls and limits what can be discussed in the remainder of the paragraph. 3. After you have chosen a good topic sentence, you need to develop the idea into a well-organized paragraph. One way to do this is to use very specific examples that support whatever statement is made in the topic examples in each paragraph. efoutfxuj te, asJcad -fo use, mofc) 4. Every example needs to be followed with an explanation. f how the example helps illustrate the point of vour paragraph. It is never wise to just list the examples and not provide any explanation. sentence. It is wise for you to use at least three . 5 End the paragraph with a sentence that summarizes and concludes the paragraph or the point you are trying to make in your paragraph. This sentence is referred to as a concluding sentence. It signals to the reader that you have said all you are going to say abou t the topic you are examining in the paragraph. ^^ 6. 7. Remember that a paragraph deals with one main idea and ne topic – not a series of unrelated events and/or topics. As always, you need to be careful about spelling and grammar. IN REVIEW: †¢ a paragraph should be about one topic only. When you need to change topics, create a new paragraph. †¢ your topic sentence should tell your reader exactly what your paragraph is going to be about †¢ each example you use (and you generally will be asked to use at least three examples per paragraph) needs to be backed up by a clear explanation †¢ you must end your paragraph with a concluding sentence †¢ always indent your paragraph and check your spelling ^J and grammar. i i ‘t i a r; PARAGRAPH OUTLINE w TOPIC SENTENCE: POINT #1: EVIDENCE (INCLUDE CONTEXT FOR QUOTATION); EXPLANATION (HOW DOES EVIDENCE PROVE POINT? ): ^; POINT#2i EVIDENCE: EXPLANATION: POINT # 3: w EVIDENCE: EXPLANATION: CONCLUDING SENTE NCE (RELATE WHAT YOU HAVE PROVEN TO TOPIC SENTENCE): r) o ENGLISH – grade 9 and 10 Rubric ~ PARAGRAPH EVALUATION w LR Absent â€Å"V /3 ~ m ^ k -W,  «Ã¢â‚¬ Ã¢â‚¬ ¢* LI Limited L2 Some L3 Considerable L4 Thorough †¢ ,-* Knowledge Clear, focused interesting ideas 0-2 2. 5-3 3. 5-4. 5 5-6. 5 7-7. 5 -Ideas support topic entence -Understanding of topic Thinking (Inquiry) 0-3 -Insights, support -Logical coherent argument -Ideas are interrelated -Relevant evidence to 3. 5-4 4. 5-5. 5 6-7. 5 8-9 support ideas w Communication 0-3 3. 5-4 4. 5-5. 5 6-7. 5 8-9 -Style -Coherence – Purpose is clear -Appropriate and effective use of language -Flow of ideas -Precise, clear choice of words Application 0-1. 5 -Unity, organization -Command of paragraph form (topic/conclusion) -Grammar,spelling,punctuation -Smooth transitions w 2. 5-3 3. 5 4-4. 5 -Requires no editing/error-frce How to cite Proper Paragraphing, Papers

SLEEP APNEA Essay Example For Students

SLEEP APNEA Essay SLEEP APNEAWhat is Sleep Apnea?The Greek word apnea literally means without breath. There are three types of sleep apnea: obstructive, central, and mixed; of the three, Obstructive Sleep Apnea (OSA) is the most common. Despite the difference in the root cause of each type, in all three, people with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer. Obstructive sleep apnea is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep. In central sleep apnea, the airway is not blocked but the brain fails to signal the muscles to breathe. Mixed sleep apnea is a combination of the two. With each apnea event, the brain briefly awakes sleep apnea victims from sleep in order for them to resume breathing, therefore sleep is extremely fragmented and of poor quality. Sleep apnea is very common and affects more than twelve million Amer icans. Risk factors include being male, overweight, and over the age of forty, but sleep apnea can strike anyone at any age, even children. Yet still because of the lack of awareness by the public and healthcare professionals, the vast majority remain undiagnosed and therefore untreated, despite the fact that this serious disorder can have significant consequences. Untreated, sleep apnea can cause high blood pressure and other cardiovascular diseases, memory problems, weight gain, impotency, and headaches. Moreover, untreated sleep apnea may be responsible for job impairment and motor vehicle crashes. Fortunately, sleep apnea can be diagnosed and treated. Several treatment options exist, and research into additional options continues. How is Sleep Apnea treated? There is currently no proven drug therapy for sleep apnea. However, there are 4 basic approaches to treatment, which are not mutually exclusive: 1. Modification of circumstances which may be causing sleep apnea or making it worse. This would include weight loss, avoidance of alcohol and sedative drugs, trying to sleep only on your side and stopping smoking. It would also help to improve nasal breathing if this problem exists; sometimes this can be done with some simple medication and occasionally it requires an operation. Finally it is important to avoid sleep deprivation. 2. Use Continuous Positive Airway Pressure (CPAP) in the upper airway to support and hold the airway open. This involves wearing a close fitting mask over the nose, which is attached to a supply of continuously flowing air via a flexible plastic hose from a medical air pump that sits on the floor or bedside table. The flow of air into the mask creates a dilating pressure that is transmitted from the mask through the nose into the upper airway. This positive pressure dilates the upper airway so the breathing is not interrupted. When a sleep apnea patient no longer has obstructed breaths they are able to sleep continuously and hence th eir quality of sleep improves dramatically. An added benefit is that when the upper airway is dilated sufficiently there shouldnt be any further snoring. The amount of airflow and hence the amount of pressure is determined by your doctor. To date this has been the most successful and well-studied treatment for sleep apnea. This type of treatment almost always works regardless of the underlying cause of the sleep apnea. It is usually well tolerated and does not have any serious side effects. The treatment is not covered by the provincial health care plan, but is covered by some third party insurance companies 3. One of the reasons for the upper airway to become narrowed at night is because the tongue falls posteriorly, especially in the supine position. Since the tongue is attached to mandible this can be a significant problem in people with retrognathia and/or a very large tongue. It is possible to use a dental splint at night that effectively prevents the jaw and tongue from moving back when someone lies down and goes to sleep. There has been less experience with this type of treatment compared to CPAP. Since the upper airway can be narrowed for different reasons, this approach may not work for all patients. The splint may put some strain on the temporal mandibular joint, causing some discomfort. There are now many types of dental splints available but few have been extensively studied so that we are not able to predict the rate or degree of success with this type of treatment yet. It would be important to have follow-up investigations to ensure the sleep apnea is adequately treated if this type of treatment is selected. Patients should consult with dentists or orthodontists that are knowledgeable about sleep apnea. 4. A surgical operation on the back of the throat to remove redundant soft tissue in an attempt to increase the size of the upper airway can be performed. It usually involves removal of the part of the soft palate that hangs down in the back of th e throat, as well as the tonsils if present, and other soft tissue if it is felt to be excessive. The operation is referred to as an uvulopalatopharyngoplasty (UPPP) and was initially described as an operation to improve heavy snoring. It is usually quite successful at decreasing the loudness of snoring but is not always successful at improving sleep apnea. There is currently no method that is widely available to predict which patients stand to benefit from this surgery. It is likely going to be less successful for patients with retrognathia. The surgery should not be considered as an option for patients with severe sleep apnea. Like dental appliances there should be some follow-up after surgery to ensure there has been a significant improvement in the severity of the sleep apnea. This surgery can be performed traditionally under general anesthesia in a hospital operating theatre. Short-term results suggest a 50% chance of improvement (defined as a 50% reduction in the AHI). Longer term studies suggest that some patients relapse and their sleep apnea is no longer controlled. Part of the reason for this may be weight gain. More recently this type of surgery is being offered to patients in an outpatient setting using local anesthesia and laser assistance. While this looks like a promising treatment for snoring there are no well-controlled, long-term studies that can demonstrate a role for it in patients suffering from significant sleep apnea. One would expect the results might be similar to the standard UPPP. Currently neither type of operation should be considered as an option for treatment unless patients are unable or unwilling to tolerate CPAP. Who should be treated? In most circumstances treatment should be reserved for those patients with particularly troublesome symptoms. What is troublesome for one patient may not be to another so that only general rules can be stated. Sometimes the patient with sleep apnea may not be the best person to decide whether th eir symptoms are severe or significant. Many patients with sleep apnea have had the problem for several years so they may have lost their proper perception of what a normal night of sleep feels like, or how sleepy during the day they really are. The most important symptom and indeed what often finally brings people to medical attention is daytime sleepiness. Falling asleep at work or school, an inability to concentrate doing normal tasks, unable to watch TV or to read are all common reasons for treatment. Unrefreshing sleep or just always having to fight the urge to sleep are good reasons to treat this disorder. Sometimes it affects someones mood and personality. If sleepiness affects the ability of anyone to operate a motor vehicle or power machinery then obviously treatment is mandatory. A minority of patients have severe sleep apnea (frequent events and/or events long enough to allow a significant drop in the oxygen level). A very few of these people may not have a lot of obvious symptoms (although in general the worse the sleep apnea is at night the more pronounced are the daytime symptoms). Your doctor will take all of this information into consideration as well as your other medical history before recommending therapy and which therapy in particular. The Evaluation Process An evaluation at the Sleep Disorders Center begins with an initial consultation with the director of the Center. In many instances, one visit is sufficient for a diagnosis to be made and a treatment plan formulated. For some patients, however, more extensive testing is required. If an all-night sleep study is required, it is performed at our laboratory in The Presbyterian Hospital /Columbia-Presbyterian Medical Center. The all-night sleep study is a safe and completely painless technique by which physiological functions in sleep are measured. Patients spend one or more nights in a private and comfortable laboratory during which a series of measurements are taken with sophisticated moni toring devices. Patients arrive at the laboratory in the evening and leave the following morning; it is usually not necessary to miss a day of work. In the course of your night at the sleep laboratory, over 1000 pages of data are collected, along with a complete video-tape record. This data is thoroughly reviewed by our expert staff and when necessary, by additional consultants. 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