Thursday, November 28, 2019

The Life of Charles Dickens Essay Example For Students

The Life of Charles Dickens Essay The Life of Charles DickensCharles Dickens was a nineteenth-century novelist who was and still isvery popular. He was born in Landport, a region of Portsmouth, on February 7,1812 (Kyle 1). Charles Dickens was the son of John Dickens and Elizabeth Barrow. JohnDickens was a minor government official who worked in the Navy Pay Office. Through his work there, he met Elizabeth and eventually married her. By 1821,when Charles was four months old, John Dickens could no longer afford the renton his house. John Dickens loved to entertain his friends with drinks andconversation. Throughout his life, he was very short of money and in debt. Heoften had to borrow money to pay off the debt and borrow more money to pay offthe people he borrowed the money from. Later on, John Dickens was transferredagain to work in the naval dockyard at Chatman. It was here that CharlesDickens earliest and clearest memories were formed (Mankowitz 9-14). We will write a custom essay on The Life of Charles Dickens specifically for you for only $16.38 $13.9/page Order now Charles education included being taught at home by his mother,attending a Dame School at Chatman for a short time, and Wellington Academy inLondon. He was further educated by reading widely in the British Museum(Huffam). In late 1822, John was needed back at the London office, so they had tomove to London. This gave Charles opportunities to walk around the town with hisfather and take in the sights, sounds, and smells of the area. This gave himearly inspiration that he would use later on in his life when he started towrite (Mankowitz 13-14). James Lamert, the owner of a boot-blacking factory, saw the conditionsthat the Dickens family was going through. He offered Charles a job there andhe was paid six shillings a week which was reasonable at that time. Soon, hewas moved downstairs in the sweatshop-like room. Charles had been working atthe factory for less than two weeks when his father was arrested for debt. Hewas sent to debtors prison where he did work to pay off his debt. John paid forCharles lodging, but Charles had to pay for his food and everything else withthe six shillings he earned every week. The details of London and of prisonlife were imprinting themselves into Dickens memory and would one day help himin the novels he wrote. After John was in prison for three months, his motherdied leaving him enough money to get out of debtors prison (Mankowitz 20-22). Late in Charles teens, he became a court reporter. This introduced himto journalism, and he also became interested in politics. Some of his earlyshort stories and sketches, which were published in various London newspapersand magazines, were compiled in 1836 to form his first book, Sketches by Boz. This book sold well (Huffam). In 1837, he wrote another book called Posthumous Papers of the PickwickClub. It was written in monthly installments. Dickens had become the mostpopular author in England by the time the fourth installment was done. Thisperiod is now known as Dickens early period because of the interest he wasgaining for his novels. During this period, he wrote Sketches by Boz,Posthumous Papers of the Pickwick Club, Oliver Twist (1838), The Life andAdventures of Nicholas Nickleby (1839), and The Old Curiosity Shop (1841)(Huffam). In 1842, Dickens traveled to the US hoping to gain support for hisliberal political ideas. He returned to England deeply disappointed. He wrotetwo books expressing how he felt about the US. These books mainly criticizedthe US for not having a copyright law, the acceptance of slavery, and thevulgarity of the people. These books were American Notes for GeneralCirculation (1842) and The Life and Adventures of Martin Chuzzlewit (1844). .u4ec0ad1f8297e13c3cae75cb434231ee , .u4ec0ad1f8297e13c3cae75cb434231ee .postImageUrl , .u4ec0ad1f8297e13c3cae75cb434231ee .centered-text-area { min-height: 80px; position: relative; } .u4ec0ad1f8297e13c3cae75cb434231ee , .u4ec0ad1f8297e13c3cae75cb434231ee:hover , .u4ec0ad1f8297e13c3cae75cb434231ee:visited , .u4ec0ad1f8297e13c3cae75cb434231ee:active { border:0!important; } .u4ec0ad1f8297e13c3cae75cb434231ee .clearfix:after { content: ""; display: table; clear: both; } .u4ec0ad1f8297e13c3cae75cb434231ee { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u4ec0ad1f8297e13c3cae75cb434231ee:active , .u4ec0ad1f8297e13c3cae75cb434231ee:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u4ec0ad1f8297e13c3cae75cb434231ee .centered-text-area { width: 100%; position: relative ; } .u4ec0ad1f8297e13c3cae75cb434231ee .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u4ec0ad1f8297e13c3cae75cb434231ee .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u4ec0ad1f8297e13c3cae75cb434231ee .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u4ec0ad1f8297e13c3cae75cb434231ee:hover .ctaButton { background-color: #34495E!important; } .u4ec0ad1f8297e13c3cae75cb434231ee .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u4ec0ad1f8297e13c3cae75cb434231ee .u4ec0ad1f8297e13c3cae75cb434231ee-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u4ec0ad1f8297e13c3cae75cb434231ee:after { content: ""; display: block; clear: both; } READ: Breast Cancer EssayChuzzlewit was a big failure, but many critics believed it was a criticalturning point in his career because he realized that greed corrupted the humansoul. This is known as his middle period. During this period, he became moreconcerned with human life (Huffam). The first book that would start Dickens middle period would be AChristmas Carol (1843). During his middle period, he wrote two more Christmasbooks. They were The Chimes (1844) and The Cricket on the Hearth (1845). Dealings with the Firm of Dombey and Son (1848) was his next novel. In thisnovel, he tries to show the dehumanizing effects of wealth, pride, andcommercial values. He would write another novel during this period called ThePersonal History of David Copperfield in 1850. The Life Of Charles Dickens Essay Example For Students The Life Of Charles Dickens Essay INTRODUCTION This report will talk about the life of a famous author, Charles Dickens. It will tell you about his early, middle, and later years of his life. It will also talk about one of his great works of literature. In conclusion, this report will show a comparison of his work to his life. EARLY LIFECharles Dickens was born at Landport, in Portsea, on February 7, 1812. His father was a clerk in the Navy Pay-Office, and was temporarily on duty in the neighborhood when Charles was born. His name was John Dickens. He spent time in prison for debts. But, even when he was freehe lacked the money to support his family. Then, when Charles was two they moved to London. 1 Just before he started to toddle, he stepped into the glare of footlights. He never stepped out of it until he died. He was a good man, as men go in the bewildering world of ours, brave, transparent, tender-hearted, and honorable. Dickens was always a little too irritable because he was a little too happy. Like the over-wrought child in society, he was splendidly sociable, and in and yet sometimes quarrelsome. In all the practical relations of his life he was what the child is at a party, genuinely delighted, delightful, affectionate and happy, and in some strange way fundamentally sad and dangerously close to tears. 2 At the age of 12 Charles worked in a London factory pasting labels on bottles of shoe polish. He held the job only for a few months, but the misery of the experience remain with him all his life. 3 Dickens attended school off and on until he was 15, and then left for good. He enjoyed reading and was especially fond of adventure stories, fairy tales, and novels. He was influenced by such earlier English writers as William Shakespeare, Tobias Smollet, and Henry Fielding. However,most of the knowledge he later used as an author came from his environment around him. 4MIDDLE LIFEDickens became a newspaper writer and reporter in the late 1820s. He specialized in covering debates in Parliament, and also wrote feature articles. His work as a reporter sharpened his naturally keen ear for conversation and helped develop his skill in portraying his characters speachrealistically. It also increased his ability to observe and to write swiftly and clearly. Dickens first book, Sketches b y Boz (1836) consisted of articles he wrote for the Monthly Magazine and the London Evening Chronicles.5 On April 2, 1836 he married Catherine Hogarth. This was just a few days before the anoucement that on the 31st he would have his first work printed in The Posthumous Papers of the Pickwick Club. And this was the beginning of his career. 6 Then, at 24, Dickens became famous and was so until he died. He won his first literary fame with The Posthumous Papers of the Pickwick Club. Published in monthly parts in 1836 and 1837 the book describes the humorous adventure and misadventures of the English Countryside. After a slow start, The Pickwick Papers as the book was usually called gained a popularity seldom matched in the history of literature. 7 Then in 1837, Catherines sister Mary, died. Because of her death Dickens suffered a lot of grief. This led some scholars to believe that Dickens loved Mary more than Catherine. Catherine was a good woman but she lacked intelligence. Dickens a nd Catherine had 10 children. Then later in 1858, the couple seperated. 8 LATER LIFEHis later years was basically consisting of two main additions to his previous activites. The first was a series of public readings and lectures which he began giving it systematically. And second, he was a successive editor. Dickens had been many things in his life; he was a reporter , an actor, a conjurer, a poet, a lecturer, and a editor and he enjoyed all of those things. 9 Dickens had a remarkable mental and physical energy. He recorded all his activites in thousands of letter, many of which made delightful readings. He spent much of his later life with crowded social friends from arts and literature. He also went to the theater as often as he could, cause heloved drama. Dickens also produced and acted in small theaters to give public readings of hiswork.10 Besides doing all this after his retirement he got involved in various charities . These charities included schools for poor children and a loan society to enable the poor to prove to Australia. 11 Then about 1865 his health started to decline and he died of a stroke on June 9, 1870. 12Dickens Work The Great Expectations This story talks about a guy who is in love with a girl. It is the theme of a youths discovery of the realities of life. An unknown person provides the young hero, Pip, with money so that he can live as a gentleman. Pips pride is shattered when he learns that he loses Estella forever, the source ofhis great expectation. Only by painfully revising his values does Pip reestablish his life on a foundation of sympathy, rather than on vanity, possesions, and social position. .u8d362b414abbb16a0643df0b8d3f4850 , .u8d362b414abbb16a0643df0b8d3f4850 .postImageUrl , .u8d362b414abbb16a0643df0b8d3f4850 .centered-text-area { min-height: 80px; position: relative; } .u8d362b414abbb16a0643df0b8d3f4850 , .u8d362b414abbb16a0643df0b8d3f4850:hover , .u8d362b414abbb16a0643df0b8d3f4850:visited , .u8d362b414abbb16a0643df0b8d3f4850:active { border:0!important; } .u8d362b414abbb16a0643df0b8d3f4850 .clearfix:after { content: ""; display: table; clear: both; } .u8d362b414abbb16a0643df0b8d3f4850 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u8d362b414abbb16a0643df0b8d3f4850:active , .u8d362b414abbb16a0643df0b8d3f4850:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u8d362b414abbb16a0643df0b8d3f4850 .centered-text-area { width: 100%; position: relative ; } .u8d362b414abbb16a0643df0b8d3f4850 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u8d362b414abbb16a0643df0b8d3f4850 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u8d362b414abbb16a0643df0b8d3f4850 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u8d362b414abbb16a0643df0b8d3f4850:hover .ctaButton { background-color: #34495E!important; } .u8d362b414abbb16a0643df0b8d3f4850 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u8d362b414abbb16a0643df0b8d3f4850 .u8d362b414abbb16a0643df0b8d3f4850-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u8d362b414abbb16a0643df0b8d3f4850:after { content: ""; display: block; clear: both; } READ: What Brought Our Ancestors To America? Essay We will write a custom essay on The Life Of Charles Dickens specifically for you for only $16.38 $13.9/page Order now Conclusion His work of Great Expectation is very related with his life. It deals with the same problems he faced when he lost Catherine and how his life was before he became rich and famous. He also created scenes and descriptions of places that have longed delighted readers. Dickens was a keenobserver of life and had a great underezding of humanity, especially of young people. The warmth and humor of his personality appeared in all of his works. Perhaps in no other large body of fiction does the reader receive so strong and agreeable impression of the person behind thestory. Endnotes1. G. K. Chesterton, Charles Dickens The Last of The Great Men, American Book-Stratford Press, NY., 1942 pg.192. Ibid, pg. 21-22 3. Johnson, Edgar, His Tragedy and Triumph. Rev. ed. Viking, 1977, pg. 204. Ibid, pg. 275. World Book Encyclopedia, Random House, NY., 1990 pg. 1936. G. K. Chesterton, Charles Dickens The Last of the Great Men, American Book-Stratford Press, NY., 1942 pg. 507. World Book Encyclopedia, Random House, NY., 1990 pg. 1938. Johnson, Edgar, His Tragedy and Triumph. Rev. ed. Viking, 1977, pg. 539. G. K. Chesterton, Charles Dickens The Last of the Great Men, American Book-Stratford Press, NY., 1942 pg. 16710. World Book Encyclopedia, Random House, NY., 1990 pg.195BIBLIOGRAPHYChesterton, G.K., The Last of the Great Men American Book-Stratford Press, NY., 1942. Johnson, Edgar, His Tragedy and Triumph Rev. ed. Viking, 1977. World Book Encyclopedia, Random House, NY., 1990

Monday, November 25, 2019

Reasons to Study and Get a Degree in Economics

Reasons to Study and Get a Degree in Economics Economics has a reputation (but not among economists!) as a somewhat dry topic. Its a  generalization thats wrong in several ways. First of all, economics isnt a single topic, but rather many topics. Its an approach that lends itself to many different fields, from microeconomics to industrial organization, government, econometrics, game theory and dozens of other fields. You may not enjoy some of these fields, but if you are fascinated by the complexity of capitalism and would like to understand better how things work in a capitalist society, youll probably find at least one of these areas that youll really enjoy. Terrific Job Opportunities for Economics Graduates There are many opportunities for economics graduates. You are not guaranteed a good-paying job with an economics degree, but your chances are higher than in many other programs. With an economics degree, you can work in a variety of different fields from finance and banking to public policy, sales and marketing, civil service (government departments, the Federal Reserve, etc.), insurance and actuarial work. You can also go on to do further studies in economics, political science, business, or a variety of other fields. If youre certain your interest is in the business world, a business degree may also be a good fit, but an economics degree does open a lot of doors. Economics Knowledge Is Useful at a Personal Level When pursuing a degree in economics, youll learn a lot of skills and knowledge that you can apply to other jobs or to your personal life. Learning about interest rates, exchange rates, economic indicators and equity markets can help you make better decisions about investing and obtaining mortgages. As computers become more and more important in both our business and private lives, being able to use data intelligently gives you a tremendous advantage over persons with fewer skills who make a lot of decisions on impulse. Economists Understand Unintended Consequences Economics teaches students how to understand and spot secondary effects and possible unintended consequences. Most economics problems have secondary effects - the deadweight loss from taxation is one such secondary effect. A government creates a tax to pay for some needed social program, but if the taxation is careless crafted, a secondary effect of that tax may be that it changes peoples behavior, causing economic growth to slow. By learning more about economics and working on hundreds of economics problems, you will learn to spot secondary effects and unintended consequences in other areas. This can help you make better decisions about your personal life and make you more valuable to business; what are the possible secondary effects from the proposed marketing campaign? It likely wont help you get a job, but being able to spot and understand the importance of secondary effects, may help you to keep a job or earn a promotion that much faster. Economics Provides an Understanding of How the World Works You will learn more about how the world works. You will learn more about the impact decisions have on specific firms, entire industries, and on a national level. You will learn more about the impact of international trade, both good and bad. You will discover the effect government policies have on the economy and on employment; again both good and bad. It will help you make more informed decisions as both a consumer and as a voter. The country needs better-informed politicians. Economics is a very good way of improving public sector performance and  Economics gives us all the tools to think of things more clearly and to understand the implications of assumptions we may be making.

Thursday, November 21, 2019

Business law international Essay Example | Topics and Well Written Essays - 1000 words

Business law international - Essay Example This will be a help or support provided by the IMF to support countries which are suffering from capital flight. It stated that the IMF has allowed for an emergency finance mechanism so as to facilitate the countries which have been hit by the prevailing financial crisis. The scheme has been said to be a sppedy procedure for the approval of loans, as stated by the IMF chief Dominique Staruss-Khan and was used in the financial crisis in 1997. It is a procedure which has its legal validity and has been stated to be procedure adopted by the IMF in situations of credit crisis. It was stated that due to slump in demand in Western economies there had been cut in credit lines which had adversely affected emerging economies and due to this the IMF stated it was willing to provide assistance to countries which are in need to funding. ... Similar grants were also provided to Philippines, Thailand, Korea and Indonesia after the Asian financial crisis erupted in 1997. Another thing that needs to be pointed at this time is that in October the Permanent Peoples' Tribunal, an international organization which is an esteemed and highly regarded convened in Madrid so as deliver a judgment on the institutions that is World Bank and IMF. The evidence which had been provided was analyzed and expert witnesses were called upon and their judgments were looked into. The Tribunal issued a sentence of guilty. It was stated that the policies that had been adopted by the IMF and the World Bank infringed human rights and were found to be homicidal. The session of the Tribunal was a follow up on the pledge that had been vowed by the previous session which had taken place in Berlin in 1988 so as to assess the policies of the institution with regard to international law and the right to self determination. It had been assessed that the policies of the IMF and the World Bank are in contradiction with the constitutive treaties and the basic principles of International Law. Further it has been stated that the policies of the World Bank and the IMF can not be unfettered when they are in violation of the international law. Thus it had been stated by the Tribunal that the UN General Assembly should direct the International Court of Justice to set limitations on the competence of the IMF and the World Bank. Further it has been stated that the International Human rights should be adopted as a part of International Law to affect the policies of the IMF. In the current situation there have been put forward by the IMF

Wednesday, November 20, 2019

Academic style paper Article Example | Topics and Well Written Essays - 1750 words

Academic style paper - Article Example In addition, the agile software engineering methodology has demonstrated to be an accepted addition to the software engineering toolbox, which is capable of considerable progress in excellence for small project development teams. This report presents detailed analysis of the agile software engineering methodology. Also, this report will investigate various areas and concepts regarding agile software engineering methodology. Levy & Hazzan (2009), state that agile methodologies have established great interest among researchers and practitioners. At the present, there are various popular agile techniques for instance, feature driven development, crystal methods, adaptive software development and dynamic systems development. The widespread standard that is fundamental to agile methods highlights supportive and cooperative software development. In addition, in agile software engineering methodologies the main focus is on people as well as on the dynamics of their connections and communications, rather than on rigid software development and complicated requirements planning procedures. A main idea encouraged by the agile policy is that people for instance, customers, software developers or other users outline the foundation of the software development procedure. Furthermore, the agile software engineering methodology was devised in 2001 by a leading software practitioners group of 17 people (Levy & Hazzan, 2 009). According to Abrahamsson, Salo, & Warsta (2002), agile software engineering is additional humanistic and collaborative technique to software engineering and is also acknowledged as â€Å"agilism†, which supports â€Å"individuals and connections over procedures and tools, functioning software over extensive documentation, client collaboration in excess of agreement negotiation, and reacting to transformation over following a plan (Abrahamsson P.

Monday, November 18, 2019

Long-Term Sources of Finance Essay Example | Topics and Well Written Essays - 2000 words

Long-Term Sources of Finance - Essay Example preference equity, common equity, debt and leasing. Long-term Finances A business needs funds for capital investments such as fixed assets like plant, machinery, land, building, furniture etc. These assets must be financed with long-term financing sources. The chief financial officer (CFO) is usually responsible for making suggestions to the senior management and board of directors related to financing issues. These suggestions and recommendations carefully analyze the advantages and disadvantages of each long-term financing option. After the decision is made by the senior management and the board, the CFO is responsible for obtaining the long-term finances. The common forms of long-term finances are preferred stock, common stock, long-term debt and leasing. A firm faces need of different types of finances through its various stages of development. A firm in its start-up generally avail funds from the banks for personal loans, government agencies and personal savings. During the rapi d growth phase a firm uses internally generated funds or direct financing. The direct financing includes loans from insurance company, commercial banks or pension funds and financing by venture capitalists. The maturity phase is financed by issuing equity or debt in primary markets. The firm in its final stage finances from internal sources while making debt repayments or buying back the common stock (Weaver & Weston, 2004, p.311-312). Figure 1: Financing Sources Source: (Weaver & Weston, 2004, p.312) Sources of Long-term Finance Sources of long-term finance differ with the type and size of the firm. There are mainly two categories of financing-Equity and Debt. The equity financing consists of two types of equity instruments, one is preference stock and the second is common stock. The debt financing can take two forms, first long-term debt from financial institutions and second in the form of leasing. Each financing option is discussed as follows: Preferred Stock Preference capital is a distinctive type of long-term financing which combines the features of both debt and equity. As a hybrid security it has a fixed rate of dividend and ranks higher than the common equity in terms of claims over the firm’s earnings. The preference shareholders do not have voting rights as the common shareholders have. Advantages: The preference dividends can be omitted in case of low or zero earnings. This provides the firm greater flexibility and chance of surviving a downturn. However skipping a dividend may reflect dim view of the firm in investors’ community and may affect the share price as investors lose confidence and sell. Preference share capital is an additional source of capital which does not provide voting rights to the preference shareholders and therefore do not dilute the influence of ordinary shareholders. Fixed and limited preference dividends mean that the firms can retain or distribute common dividends in case of extra-ordinary earnings in a fisc al year. In case of limits on raising debts under the debt covenants, the preference share capital is a good alternative if a firm wants to expand raising external finance. Disadvantages: The high risk associated with capital and annual returns leads the preference shareholders to demand higher return than debt holders. The preference dividends are regarded as distribution of profits. Therefore they are not tax deductible. In comparison to this the lenders are not owners and so their interests are regarded as the expense

Friday, November 15, 2019

Lichen Planus Treatment Research Study

Lichen Planus Treatment Research Study Aim: Lichen planus is a chronic inflammatory mucocutaneous disease. Its treatment is often symptomatic and includes topical and systemic corticosteroids. Although corticosteroid therapy is usually successful, but because of its side effects, an alternative treatment is favorable. The aim of this study was to compare the efficacy of topical curcumin and triamcinolone on the treatment of oral lichen planus. Materials Methods:  In this study, 50 patients with the age range of 38 to 73 with oral lichen planus (OLP) were randomly divided into two groups. Each group received 0.1% triamcinolone or 5% curcumin oral paste 3 times a day for 4 weeks. Measurement of appearance score and severity of pain was done at the baseline and at the end of week 2 and 4 and recorded in the patient’s questionnaires. Results: In the evaluation of pain reduction in curcumin group, 9 patients (36%) and in triamcinolone group, 8 patients (32%) had complete remission. In the evaluation of appearance score in both groups, one patient (4%) had complete remission. No statistically significant difference was seen between two groups. Conclusion: Herbal medicines can be a suitable alternative for synthetic drugs, covering their side effects, costs and probable shortages. Clinical Significance: Application of curcumin because of its desirable anti-inflammatory effects and little side effects is suggested for the treatment of OLP. Key words: Curcumin, Lichen Planus, Triamcinolone  ­Ã‚ ­Ã‚ ­Ã‚ ­Ã‚ ­Ã‚ ­Ã‚ ­Ã‚ ­Ã‚ ­Ã‚ ­Ã‚ ­ Aim Oral lichen planus (OLP) is an immune mediated disease of unknown etiology with the mediacy of T cells (1), in which the symptoms of the patients decrease simultaneously with an increase in (CD4à ¢Ã‚ Ã‚ º) counts (2). OLP lesions can be of reticular, papular, plaque-like, bullous, erythematous (atrophic), and ulcerative forms. Ulcerative lesions are the most debilitative forms of OLP (3), which develop painful symptoms and interfere with eating, speaking, swallowing and brushing (4). Corticosteroids are usually successful for controlling the symptoms of the disease (5); but because of frequent side effects of long-term corticosteroid therapy such as: secondary candidiasis ,telangectasis, hypothalamic–pituitary–adrenal suppression (6, 7), mucocutaneous atrophy, and increased potential of systemic absorption, it may be better to avoid long-term use of them (8). Curcuma longa is a perennial plant belonging to Zingiberaceae family (9), which for its anti-inflammatory effects has been used for centuries in Indian traditional medicine (10). Its main ingredients are three curcuminoids including curcumin (the primary ingredient and the one responsible for its yellow color and anti-inflammatory effect), demethoxycurcumin and bisdemethoxycurcumin. Chainani-Wu in a systematic review (11), and others (9, 12-16) confirmed the anti-inflammatory, antioxidant, wound healing, anticarcinogenic effects and safety of curcumin. Clinical studies assessing curcuminoids have evaluated its utilization in inflammatory conditions such as rheumatoid arthritis, postsurgical inflammation, and chronic uveitis.(11) The curcuminoids, at the same time having anti-inflammatory activity, are safe even in high doses and few side effects were seen (11). Since it seems that oxidative stress may have a role in pathophysiology of OLP (17), and by noting that OLP is a chronic inflammatory disease (18), the herbs which have both anti-inflammatory and antioxidant effect concurrently, may act better in improving the disease process. Antioxidant effect of curcumin against oxidative stress was shown previously (19), Chainani-Wu et al in 2007 and 2011 assessed the efficacy of systemic administration of curcuminoids in treatment of oral lichen planus (10, 20). Efficacious results were obtained in controlling signs and symptoms of oral lichen planus, using high doses of this herb. Concerning noticeable side effects, reported by patients who consumed corticosteroids (21), chronic nature of OLP, risk of oral candidiasis upon usage of topical corticosteroids, and fewer side effects, safety and anti-inflammatory properties of curcuminoids, we aimed to clinically evaluate the efficacy of curcuminoids in treatment of oral lichen planus, compared with conventional corticosteroid therapy. Materials and methods: In this clinical trial 50 patients (36 women and 14 men) participated with age range of 38 to 73 and mean age of 50.66 years. The patients had clinical signs of OLP (atrophic and ulcerative forms) which was confirmed by clinical and histopathological examination. Patient exclusion criteria included pregnancy and lactation, current use of anticoagulants or antiplatelet agents (curcumin has inhibitory effects on platelet aggregation) (22), existing orthodontic treatment, history of gastric ulcers, duodenal ulcers, gallstones (curcumin may induce gastric irritation and stimulate gall bladder constrictions) (23), hepatic diseases (curcumin may cause hepatotoxicity in some mammals including mice and rats) (11), any existing malignancy or viral infection in mouth, receiving any topical treatment for OLP in the past 2 weeks or any systemic treatment for OLP in the past 4 weeks, consuming azathioprine, cyclosporine or receiving PUVA, UVA or UVB in the last month, a history of allergy to cort icosteroids or curcumin (6). The crushed roots of C. longa L. were purchased from drug store in Rasht city of Iran and identified by a research fellow. The grounded herbal root (1 g) was extracted with 10 ml of 96% ethanol boiling in water bath for 3 min and the least volume of solvent was added to the given aliquot. Each sample was centrifuged at 8000Ãâ€"g for 10 min, then the supernatant was filtered with a syringe filter (0.45 _m). This mixture included Curcumin, demethoxycurcumin and in less amounts, bisdemethoxycurcumin. Patients were given complete explanations on their disease and also about curcumin and triamcinolone pastes and then were asked to participate in the study by signing an informed consent and this study was registered at IRCT. ir (IRCT2001105012950N2) which is a Primary Registry in the WHO Registry Network set up. Patients were randomly divided into two groups each group including 25 patients. The sample size of 25 was based on expected and actual enrollment of study subjects over a 2-month time period. Because of feasibility reasons the enrollment was stopped at 25 subjects. A blocked randomization (block size of 6) was used. The Guilan University of Medical sciences pharmacy packaged the curcuminoids and triamcinolone in similar oral paste and generated the randomization sequence using the random number generator in Microsoft Excel (Microsoft Corp, Seattle, WA). Both participants and investigators were blinded to the treatment assignment. All the patients were examined and the age, sex, medical history, smoking, form and location of the oral lesions, duration of the disease, and type of treatments the patient had received, severity of pain and appearance score were recorded. Then patients received triamcinolone 0.1% or curcumin 5% paste for 4 weeks and asked to apply the drug 3 times a day after eating and brushing, and then they were advised to avoid eating for 20 minutes. Measurement of appearance score and severity of pain was done at the baseline and at the end of weeks 2 and 4 and recorded in the patient’s questionnaires. For determining the severity of pain, we used VAS (Visual Analogue Scale) and subjects ranked their severity of pain on a 10-cm horizontal line marked 0 to 10 which 0 indicated no pain and 10 indicated the most severe pain (24). For determining the appearance score, we also used Thongprasom criteria with the below classification: 0: no lesion, normal mucosa 1: mild white striae, no erythematous area 2: white striae with atrophic area less than 1cm ² 3: white striae with atrophic area more than 1cm ² 4: white striae with ulcerative area less than 1cm ² 5: white striae with ulcerative area more than 1cm ² (25) In this work complete remission was referred to the case in which signs or symptoms showed 100% reduction, good response was the case that signs or symptoms showed 50% or more reduction and still less than 100% and in poor responders signs or symptoms had less than 50% reduction. If the status of lesions showed no change, the case was considered as no response. Data were analyzed by SPSS 17 software, using Mann-Whitney; Fisher exact test and Spearman`s correlation analysis. P value Results: Fifty five patients participated in this study. Five patients were missed because of refusing to return for follow up visits. The remaining 50 patients consisted of 36 female and 14 male (female -to-male ratio was 2.57) with a mean age of 49.24 years and age range of 38-73 years. The curcumin group consisted of 15 women and 10 men with mean age of 49.24 years (range 38-73 years), while 21 women and 4 men with mean age of 52.08 years (range 38-73 years) formed the triamcinolone group. Mean duration of the disease before beginning the study in curcumin group was 23.96 ±15.49 months and in triamcinolone group was 28.52 ±15.72 months. 21 patients had atrophic lesions (42% or 9 patients in curcumin group and 12 patients in triamcinolone group) and 29 patients had ulcerative lesions (58% or 16 patients in curcumin group and 13 patients in triamcinolone group). All the individuals complained of pain. Mean severity of pain in curcumin group was 5.84 ±2.01 (VAS) and in triamcinolone gro up was 5.47  ±3.12 (VAS) (table 1). The buccal mucosa was the most common site for OLP followed by the gingiva, tongue, palate, labial mucosa and floor of the mouth (table 2). Mean VAS score in curcumin group was 5.84 ±2.01 at the baseline which decreased to 3.08 ±2.01 and 2.64 ±2.98 at second and third follow-ups . Mean VAS scores in triamcinolone group was 5.47 ±3.12 at the baseline which declined to 1.90 ±1.58 and 1.76 ±1.78 at second and third visits . Mean Thongprasom scores in curcumin group was 3.88 ±0.78 at the baseline and decreased to 3.28 ±1.36 and 2.64 ±1.29 at second and third visits. Mean Thongprasom scores in triamcinolone group was 3.95 ±1.07 at the baseline, decreased to 3.38 ±1.07 and 2.95 ±0.97 at second and third visits . In the evaluation of pain reduction in curcumin group, 9 patients (36%) had complete remission, 4 patients (16%) had good response, 6 patients (24%) had poor response and 6 patients (24) showed no response to the treatment. In triamcinolone group, 8 patients (32%) had complete remission, 8 patients (32%) had good response, 4 patients (16%) had poor response and 5 patients (20) showed no response to the treatment. There is no significant differences between two groups in each of the follow up visits ( Mann- Whitney ; P>0.05 ; power of analysis =0.74). (Table 3). In the evaluation of appearance score in curcumin group, 1 patient (4%) had complete remission, 6 patients (24%) had good response, 12 patients (48%) had poor response and 6 patients (24) showed no response to the treatment. In triamcinolone group, 1 patient (4%) had complete remission, 2 patients (8%) had good response, 12 patients (48%) had poor response and 10 patients (40) showed no response to the treatment. Two groups had no significant differences ( Fisher exact test ; P>0.05) (Table 3). Using Spearmans correlation analysis, there was no meaningful relation between mean severity of pain and mean appearance score in both groups with age, sex and duration of the disease. (p > 0.05). At the end of the study in curcumin group, few patients complained of burning sensation, itching, mild swelling and xerostomia, which was disappeared at the enf of first week of drug consumption. Most of the patients also complained about undesirable yellow color of the drug particularly on the gingiva. In triamcinolone group, only one patient complained about burning sensation in the first week of applying the drug, and one patient complained about mucosal desquamation in the entire duration of treatment. Discussion Oral lichen planus, is an chronic autoimmune, mucocutaneous condition, which commonly involves oral mucosa. This lesion can cause oral discomfort and even in some cases, transform into squamous cell carcinoma. Therefore, OLP is considered to be a potentially harmful and malignant disease and attracts many attentions of clinicians.(26) Most of the previous studies, assessed the effect of corticosteroids (4, 6, 27) and one immunosuppressive drug were compared and in all of them the results in both participating groups were the same and also successful; but since topical use of corticosteroids may lead to oral candidiasis and other side effects and also considering the chronic nature of OLP, it would be better to find an alternative for these types of treatment. Also it has been reported that tacrolimus and pimecrolimus may increase the risk of malignancy in patients using these drugs topically for their cutaneous psoriasis. These medicines should be used in limited situations and their consumption in human is advised to be in minimal doses and limited duration (3, 28-31). In current study we used curcumin, which its safety, anti-inflammatory and antioxidant effects have been confirmed in many studies (9, 11-16). Clinical efficacy of curcumin is compared with topical corticosteroid, which is the standard treatment for OLP. It was concluded that in addition to effectiveness of curcumin in the treatment of OLP, its effects are similar to topical corticosteroid, and can be an alternative for it. Chainani-Wu et al. in 2007 (10) used curcumin for the treatment of OLP in placebo controlled study. Curcuminoids were prescribed as tablets, at dose of 2000mg/day for 7 weeks. They concluded that systemic administration of curcumin wasn’t a successful treatment in managing OLP lesions. Systemic administration of curcumin in Chainani-wu’s study is different with topical administration in present study, which increases the topical efficacy of the drug. Chainani-Wu et al. Administered a primary dose of systemic prednisone (60 mg/day for the first 1 week) in both groups that was not done in our study which could affect the final result. Long periods of observation not only could interfere with patient compliance in less subject retention until the end of study, but also can affect treatment outcomes, as they concluded to design next studies in shorter periods of follow-ups. In the present study, last observation session was at week 4. Chainani-Wu et al. in 2011.(20) used higher dose of cucrumin in treatmen of OLP. They implemented systemic curcumin, with a dose of 6000mg/d. This dose is higher than the one in their previous study (2000 mg/d). Interestingly, they found curcumin efficacious in controlling signs and symptoms of oral lichen planus. It was well tolerated by the patients and safety was confirmed at this dose. Observation period was reduced to two weeks, which our study is more harmonious with, compared to 7 weeks of their previous study. Sample size of the present study is similar to this study, as they enrolled 20 patients. Concerning their findings, erythema, mucositis, ulceration of the OLP patients were significantly reduced, after using curcuminoids. The other thing we can add about current study was the little difference between two groups in patients’ responses to the reduction of pain and appearance score (There was no statistically significant difference between two groups (P>0.05)). The number of patients responding to the reduction of appearance score in curcumin group were more than triamcinolone group (76% in curcumin group versus 60% in triamcinolone group); but the number of patients with reduction in severity of pain in triamcinolone group were more than curcumin group (80% in triamcinolone group versus 76% in curcumin group). This difference may be explained as: _ Some of the patients complained of burning sensation while applying the curcumin that might affect the pain and burning sensation during the treatment. _ Half of the patients which didn’t respond to pain reduction by applying the curcumin, had the same problem with triamcinolone paste in their history, this might be due to the topical form of the drugs, because the same patients didn’t have any problem with corticosteroid mouthrinse. At the end of the study, we asked the patients of curcumin group if they had used corticosteroid in orabase or mouthrinse, to compare the efficacy of them with curcumin. 20 patients (80%) preferred triamcinolone in orabase to curcumin. seven patients (35%) had only problems with undesirable yellowish color of curcumin particularly on gingival or other exposed areas. The other 13 patients (65%) had experienced burning sensation while applying curcumin. Larger sample size, using the drug in the form of mouthrinse and using the novel curcumin derivatives (curcumin-carboxy derivative, and curcumin protein conjugate) that improve the biological activity of natural curcumin (32), may be used in future studies. Conclusion: Corticosteroids as conventional therapy of this chronic disease, may lead to noticeable side effects and develop other conditions like oral candidiasis. Herbal medicines can be a suitable alternative for these synthetic drugs, covering their side effects, costs and probable shortages. Topical curcumin can be suggested for the treatment of OLP. It is recommended that a larger sample size and using the drug in the form of mouthrinse may be used in future studies. Clinical Significance: Application of curcumin because of its desirable anti-inflammatory effects and little side effects is suggested for the treatment of

Wednesday, November 13, 2019

Fodorian Naturalistic Semantics and Double Disjunctivitis :: Philosophy

Fodorian Naturalistic Semantics and Double Disjunctivitis ABSTRACT: Direct Informational Semantics, according to which [X]s represent (express/mean) X if ‘Xs cause [X]s’ is a law, and Fodorian naturalistic semantics both suffer from double disjunctivitis. I argue that robustness, properly construed, characterizes both represented properties and representing symbols: two or more properties normally regarded as non-disjunctive may each be nomologically connected to a non-disjunctive symbol, and two or more non-disjunctive symbols may each be nomologically connected to a property. This kind of robustness bifurcates the so-called disjunction problem into a Represented-Disjunction Problem, of which Fodor was aware, and a Representer-Disjunction Problem, of which he was on the whole oblivious. Fodor fails to solve these problems: his solution to the former, the Asymmetric Dependence Condition, presupposes a successful solution to the latter, while possible responses that Fodor might make to the latter either beg the former or cannot be met or else flout the Naturalistic Requirement and the Atomistic Requirement. Even setting the Representer-Disjunction Problem aside, the Represented-Disjunction Problem does not get solved, because the robustness involving phonological/orthographic sequences (tokens and types) guarantees that nothing can meet the Asymmetrical Dependence Condition. Indeed there is a serious problem of individuating phonological/orthographic tokens and types in a manner that satisfies Fodor’s expectations. This is made manifest by the presence of orthographic tokens embedded in larger tokens. I. Fodor’s Naturalization Proposal and the Represented-Disjunction Problem The specific task which the naturalization project is designed to accomplish is to construct an information-based semantic theory that articulates (I) an atomistic and (II) naturalistic — i.e., in non-intentional, non-semantic terms — sufficient condition for a syntactically primitive predicate to express a property. (1) For convenience (I) will be referred to as the Atomistic Requirement and (II) as the Naturalistic Requirement. Now if Direct Informational Semantics were correct, "tamarao" would express the disjunctive property tamarao or thump because, under certain conditions, a thump and a tamarao are each sufficient for its tokening. Thus a tokening of a symbol would be ipso facto true. There would be no accounting for the fact that meaning is robust:’ "cow" tokens get caused in all sorts of ways, and they all mean cow for all that’. (2) I shall refer to this problem (3) as the Represented-Disjunction Problem, considering that it figures on the repres ented side. Fodor proposes to solve the Represented-Disjunction Problem without abandoning the main thrust of the information-theoretic account. His proposal (FP) is that "X" means X if: (4)