Was the Reconstruction Period a Failure

Was Reconstruction a failure? As the bloody Civil War drew to a close, the period of reconstruction began to take shape across the states. There were many questions aroused following the war regarding the physical re-building of the nation, demobilisation and most importantly what was to replace the pre-war norm of slavery? America’s position on the latter, was of course both vague, with differing opinions from the North to the South, these differences which should have been settled with the outcome of the Civil War meant the war on the battlefield had transgressed to one on a social and political level.However as Michael Les Benedict quite aptly states that ‘winning had been more important than figuring out what to do afterwards,’ which resulted in a sporadic reconstruction being forced by dissimilar motives. When looking at how successful the Reconstruction period was in America one should consider the intentions behind such Reconstructing, this poses the questi on therefore of whether the period was one of rebuilding relations between the North and the South or between the slaves and citizens?This essay will look at therefore the attempt at creating an increasingly harmonious nation with the interruption of unstoppable de facto discrimination that made reconstruction a void period. When discussing the reconstruction some decide to begin with the Emancipation Proclamation where Lincoln addressed the nation on 1st January 1863; â€Å"I do order and declare that all persons held as slaves within said designated States, and parts of States, are, and henceforward shall be free. This of course was the primary leap into the unknown, however as this was not passed through Congress and there only being a few states state’s emancipated renders 1863 as an ineffectual starting date for the Reconstruction period. However what was important during this time was the role of African American’s in the war which shaped their position in post- war America. ‘By the wars end, some 180,000 blacks had served in the Union Army. ’ Although there was severe dissatisfaction over conscription, the opportunities offered in the army was the foundation for the move towards equality.Primarily it was an opportunity for Afro-Americans to prove their capability and ability to be disciplined; this allowed them to be seen as equals, as equal as possible as the time. ‘Although slavery was still legally intact, in the summer of 1862 General Butler began substituting a system of compensated labour,’ Butler’s recognition of military status of black soldiers was an example of the positive outcome of the war, and what impact It had on integration even though ‘most of the soldiers spoke scornfully of ‘niggers’’ there was an un-admitted truth that the war could not have been won without the help of the Negros.Learning from the military integration and flowing the passing of the 13th Amendm ent in 1865 saw the true beginning of the reconstruction period and as a result there was an increase of active participation of African-Americans in society. ‘Local leaders played such a variety of roles in schools, churches, and fraternal organizations that were bridges to the larger world of politics. ’ The primary source of involvement was through the parishes however Afro-Americans were soon able to work their way further as in 1865 John S.Rock of Boston was the first black lawyer admitted to the bar of the Supreme Court, this showed that ‘slowly the North’s racial barriers began to fall. ’ This positive change not only saw the increased integration of black’s within the judicial branch, however also in the executive, ‘among the ablest were Robert B. Elliott of South Carolina and John R. Lynch of Mississippi. Both were speakers of their state House of Representatives and were members of the U. S. Congress. ’ However such was short lived due to the ever increasing violence from the Ku Klux Klan; this shows that the restoration was limited to the North.As previously mentioned the 13th Amendment was a milestone in the road to freedom or blacks, however ‘the amendment closed one question only to open a host of others. ’ This was because although freed on paper and equal under the law, Afro-Americans were not quite regarded as equal under the eyes of society. The federal government therefore set up a protective organisation; the Freedman’s Bureau which meant ‘there was a freer attitude towards supplying money for plantation equipment, clothing, and food, including salt, bacon, and other necessities for the Negros. The was a successful outcome of the Bureau, however there was obvious weaknesses within the Bureau, commenting on the organisation, a citizen expresses that ‘it would have been wise if our statesmen could have received, digested and acted upon the answers these men [ blacks] gave to their questions. ’ This suggested the nonchalant attitude the bureau had towards the emancipated slaves, rendering the establishment of a new life increasingly difficult without federal aid.Further evidence of the federals restricted willingness to give aid can be seen through their attitude as ‘for a while northerners regarded the proposed Fourteenth Amendment as an incredibly lenient settlement of the Civil War. ’ Prior to this the Civil Rights Act had been passed in 1866 which declared that ‘every race and color, without regard to any previous condition of slavery or involuntary servitude, except as a punishment for crime whereof the party shall have been duly convicted, shall have the same right. This shows that had the 14th amendment seen to be too radical then the importance of the Civil Rights Act had not been thoroughly enforced of accepted. ‘Years before the end of slavery, black abolitionist Charles L. Reason had predicted th at emancipation would impose â€Å"severe trials† upon the freedman. ’ This prediction of course was one of great clarity as during the reconstruction period there was a general neglect of emancipated slaves and a re-establishment and maintenance of white supremacy.The neglect can be seen though the inefficiency to support the released slaves and their struggle during the reconstruction period, ‘finding employment and housing, food, clothes and medicine for the flow of refugees into the Department was almost impossible. ’ There was such little prospect for a freed slave that the result was to work practically how life had been previous to the 13th Amendment just without chains or to get involved with sharecropping which resulted in the increase of Tenant farming. Planters had no desire to further economic democracy, white or black, and no confidence that freedman could farm successfully independent of whites. ’ The lack of confidence in the freed ma n bears question to what it was really the Civil War was fought for. ‘In 1861, the restoration of the Union, not emancipation, was the cause that generated the widest support for the war effort,’ this supports the evidence that there was a lack of concern for the emancipated slaves, as this was not at the forefront of Americans objectives.Quite a profound contribution to the failure of the reconstruction period was none the less than the president at the time, Andrew Jackson. Following the assassination of Lincoln was the beginning of the end for the Reconstruction period as Jacksons interpretation of reconstruction was a reflection of his southern prejudices. Jackson excluded black’s from politics, in fact excluded numerous problems from his time in office; ‘Johnson had always believed in limited government and a strict construction of the Constitution.In Congress, he had moved to reduce the salaries of government workers, voted against aid to famine-stric ken Ireland, and even opposed appropriations to pave Washington’s muddy streets. ’ This could either be described as laissez faire methods of rule or negligence. Although the Civil Rights Act did eventually get passed this was with no thanks to President Johnson, who during what was meant to be the restoration period vetoed it twice meaning its eventual passing through congress was due to an overall majority vote from his cabinet.The lack of the presidents intervention, or acceptance of the Sherman-Johnston agreement reflected the lenience accepted by the executive at the time as it was agreed that ‘the executive authority of the government of the United States not to disturb by reason of the late war so long as they live in peace and quiet. ’ This meant very liberal treatment of the ex-rebels of the Civil War. The leniency toward the de-mobilisation of the South meant it possible for ‘the same people, the same issues that had precipitated the great war to remain. This therefore making the restoration of slavery further possible, rather opposite to the original intentions of restoration, it was what Les Benedict described as the ‘death of the Confederate reconstruction. ’ ‘Laura Towne reported that the freedman would not believe that Lincoln was dead’ as he was the foundation for the emancipation of the slaves and one who had revolutionary visions at a time of prevalent discrimination. As previously mentioned, Afro-Americans were increasingly getting involved in positions and society; however this was not true to everyone and was definitely not on the increase. Cleveland County, North Carolina, counted 200 black members of biracial Methodist churches in 1860, ten in 1867, and none five years later. ’ There is a recurring trend of the laissez faire method of rule or negligence towards the Afro-Americans during the reconstruction period. Under President Ulysses S. Grant the state produced less for ms of reconstructive policies to protect the black’s from a prejudice society. ‘He had won election in 1868 by urging, â€Å"let us have peace,† and he had not intervened in the South until Klan violence had forced his hand. This shows the executives turning a blind eye towards the violence and discrimination that prevailed throughout the reconstruction period. Not only was there negligence towards imposing protection for the emancipated slaves, but there were further restrictions implemented on their freedom such as the Black Codes; Sec. 3. ‘Every negro is required to be in the regular service of some white person, or former owner, who shall be held responsible for the conduct of said Negro. ’ This shows that although black slaves were meant to have been emancipated, there was always the clause of being emancipated under the control of the white man.The fact the white man had control over the emancipated slave made freed life sometimes harder than t he days of slavery. Additionally although the 15th amendment was passed with the intention of enabling the emancipated the privilege of the vote, it was not long followed by the restrictive Jim Crow laws which had further implication into the post-Reconstruction period and into the twentieth century. The Crow laws not only made it impossible for makes to ascertain suffrage due to the Grandfather Clause, but enabled de facto segregation.The reconstruction period was not only a failure due to the legislation or lack of legislation, but the economic depression resulted in ‘the first great crisis of industrial capitalism permanently altering the nature of economic enterprise, and had profound political and ideological consequences. ’ This meant that due to economic hardship there was a decrease in sympathy towards the Negro who had nothing compared with the white man who had nothing. ‘By the end of 1874 nearly half the nation’s iron furnaces had suspended opera tion’ The reconstruction period was one that saw a plethora of legislative change, however not all for the better.There were many empty promises directed at the liberated slaves, however liberated is not the correct term to use. The emancipated slaves saw little to no improvement in their lives, and not only were the reconstruction a failure with regards improving relations between North and South; it was a failure with repairing relations between the slave and the citizen. The fact the reconstruction period was so short and its ending reverted back to previous times renders the reconstruction period a failure. There remained the underlying intentions, just lacked motivation to implement the reconstruction of the ‘United’ states.Additionally these intentions derived from a handful of just minded thinkers such as Lincoln, however there were too many, with great power who were not yet ready to accept the equality that was preached to clearly in the Declaration of I ndependence, the Emancipation Proclamation and the 13th amendment. Therefore as there was such little actual change when reflected against how much legislative change at Washington makes the Reconstruction period a failure as perception, treatment and understanding of a different race did not improve.

Embarrassing Moment Essay

Advantages At first when I took first aid training from a local hospital, I had no idea how much helpful is this training in providing help to others. It gives you a sense of self-satisfaction when you help someone in acute emergency. But at the time of training, I didn’t realize about the importance and advantages of first aid box but after some time when I got a first aid box to keep at my home and equipped the same with all necessary items, I have a piece of mind to cope any type of emergency in my home or even if it happens with anyone in neighbor hood. If you are a person who also likes to help others, even if not others, just to provide treatment to your loved ones, you must maintain a first aid box at your home. But before you maintain a first aid box at your home, consider taking part in a first aid training course because it will train you in using various surgical instruments and medical devices properly. Usually, after you get first aid training from any hospital or organization such as Red Cross, your trainer also provides you a check-list for your first aid box. The check-list usually includes following items: * Antiseptic Wash * Gauze squares & Gauze rolls * Cotton balls & Cotton swabs * Neospirin or other triple antibiotic ointment or cream * Medical tape, hot/cold pack, small scissors * Bee sting kit, thermometer * Selection of bandages There are many other extra items which you may keep in your first aid box such as sterile water, self-adhesive tape, nail clippers, trauma shears, surgical suture, surgical suture needle, vicryl mesh, Ethicon sutures, steroid cream and sunburn treatment (aloe products) etc. Some of these items need more specific training to use them properly such trauma shears are used to cut leather jackets, seat belts and denim etc. Like wise to use surgical instruments such as surgical suture and surgical suture needle, you also need specific training to take care of large wounds or cuts. You can also make two first aid kits, one for your home and other for your. Take a small kit with you when you travel or you can name your travel kit as a mini kit. To get all these necessary items for your first aid box, you can search over the internet to find many reliable resources where you may get discounts if you order for all medical supplies at one place. The contents and equipment of the first-aid kits are not otherwise specified. Therefore, the following items are to be included in each first-aid kit and be available at every pool or spa: 1. 1 – First Aid Book 2. 1 – Box Plastic Adhesive Bandages – 1†³ x 3†³ 16/Box 3. 1 – Tweezers 4. 1 – Scissors 5. 1 – Spool Tape – 1/2†³ x 5 yards 6. 2 – Compress Bandage – 3†³ x 3†³ 7. 1 – Triangular Bandage – 40†³ 8. 1 – Small Ice Pack 9. 1 – Box Fingertip Bandage – 10/Box 10. 1 – Box Cloth Knuckle Bandage 11. 1 – Eye Dressing 12. 1 – Box Telfa Pads – 1 1/2†³ x 2†³ 12/Box 13. 1 – Roller Gauze 14. 3 – Packages Clean Wipes 15. 1 – Compact CPR Shield 16. 1 – Latex Gloves, Pair 17. 2 – Emergency Blankets Moral As well as the moral duty of employers to protect employees and members of the public,General Health and Safety Legislation covers all employers and workplaces. The Management of Health and Safety at Work Regulations 1999 These regulations place an obligation on employers to assess risks and where necessary, take action to eliminate or control the risks. The Health and Safety (First-Aid) Regulations 1981 These regulations state that, in order to provide First Aid to their employees who become injured or ill at work, employers must have adequate and appropriate equipment, facilities and personnel. Regulations apply to all workplaces, including those with less than five employees. Self-employed workers need to ensure they have adequate facilities to provide First Aid to themselves. If the self-employed person works with others on mixed premises, then joint arrangements should be made with other occupiers. It could be that one employer will take responsibility for the provision of First Aid cover for all workers on the premises. back to top Further information on First Aid at Work * Email your query now * Call our Adviceline on 0800 019 2211 First Aid at Work (external site) This site from the Health and Safety Executive provides information on all aspects of first aid at work for employers and employees across all industry sectors. Free resources from Healthy Working Lives Links below are to publications pages giving options to download these resources: * Risk Assessment Form * Risk Assessment Form – Worked Example Free First Aid guidance from the Health and Safety Executive Note – all links are to external pages on the HSE website giving options to download or order these resources: * First Aid at Work – Your questions answered INDG214 (external site) Priced First Aid guidance from the Health and Safety Executive Note – all links are to external pages on the HSE website giving options to order these resources: * Basic Advice on First Aid at Work (external site) * Electric Shock: First Aid Procedures (external site) * First Aid at Work: The Health and safety (First Aid) Regulations 1981 – Approved Code of Practice and Guidance L74 (external site) back to top

Journal Coursework Example | Topics and Well Written Essays - 500 words - 1

Journal - Coursework Example Texting and calling ability with cell phones allows with me to connect with anyone I choose whether they are in the same town, or halfway across the world. The Internet allows me to communicate as well as share mass amounts of data such as documents with people. Social networking lets the world know what is going on with my personal world as well as keep up with everyone that I am â€Å"friends† with through the chat feature as well as news feed. Not only has technology affected me personally, but it has also had an impact on my parents and grandparents. Even though my parents and grandparents are always cautious of new technologies, after they are taught how to use them, they like the ability to constantly be in contact with the ones they love. Text messaging is especially convenient because whether I am at work or in school, I can always be in contact with them, especially if an emergency or something arises without creating a scene in class. Communication and Internet devel opment have had a enormous impact on the way information is disseminated both in the working world and in the education systems. People now have the ability to access and send files such as documents at light speed, which can in turn be read by computers and hand-held devices. It allows for collaboration with either companies or research partners.

Educational Reflection Essay Example | Topics and Well Written Essays - 1000 words

Educational Reflection - Essay Example As a function of engaging with this particular topic, the author will discuss three distinct ways in which my own personal experience with education has either made me into less of an individual or more of an individual. Through such examination, is the hope of this author that the reader will gain a more informed and relevant understanding of the manner through which education, at least in its formal context, conserve both positive and negative aspects of socialization and the degree and extent to which individuals come to represent a singularity and their approach. Finally, whereas it is true that these three distinct examples that will be discussed are contingent upon personal experience, it is the expectation and belief of this particular analyst that the issues which will be discussed are universal and invariably affect a very large number of individuals throughout society. Firstly, within my own personal experience, the level of similarity and the expectation that all knowledge should be integrated in one particular way as decreased the level of individuality that I have been able to promote my life. For instance, rather than allowing the student to explore and to understand the concepts and practices that the educational system seeks to impart in more of a natural manner, rote memorization and the necessity to understand a given topic in a particular way took away from the individuality that I might otherwise exhibit. Whereas there is most certainly a level of benefit from presenting children with a particular topic and a singular manner, the overall level of independent thinking that such an approach engenders necessarily robs the student, myself included, of a degree of experiential learning. However, one particular aspect of my own educational experience that actually contributed to the development of personality and independence was with regards to the level and degree to which my own life experience, personality, and views

Business Communication - Letter Assignment Example | Topics and Well Written Essays - 250 words

Business Communication - Letter - Assignment Example It is possible to allow women to drive while placing other measures of ensuring that they preserve their dignity and that they remain safe. We are well aware of the sensitivity of the matter at hand. However, societies do not undergo a change in a single day. The Kingdom of Saudi Arabia needs adequate time for it to undergo social and political changes that would give women more freedom. As a company, we understand the commitment of the Saudi Human Rights Commission in ensuring that women in this country get an opportunity to enjoy their human rights freely. However, we also recognize that there are relevant procedures and platforms that need to exist for the recognition of any visible social change. We hope that the Kingdom of Saudi Arabia can reconsider its position and allow women to drive while still protecting their dignity and safety. Therefore, all the stakeholders involved should critically discuss the issue at hand and develop a viable

Criminal Justice Research Paper Example | Topics and Well Written Essays - 1250 words - 1

Criminal Justice - Research Paper Example cible entry to a premise is protected under the Fourth amendment when the nature of the circumstances that led to the warrant is considered reasonable. On the mentioned case involving Steiney Richards, petitioner v. Wisconsin, Madison, police officers forcibly entered the motel room that was occupied by the petitioner on December 31 early morning in order to execute a search warrant that was intended to net illegal narcotics. Before the search warrant was granted, the magistrate who issued the warrant rejected a no- knock warrant (Karagiozis & Sgaglio 2005). The magistrate argued that the case submitted did not attain the threshold to justify the need of such a warrant and, therefore, rejected to grant the police officers a no- knock warrant. Despite the magistrate’s judicial ruling, the Madison police officers dismissed the ruling and resorted in using force where they did not disclose the purpose and their presence prior to the entry. The police officers conducted the search and identified illegal narcotics such as cocaine but there was no evidence of gun possession that was collected. The trial court dismissed all attempts from the petitioner to suppress the case after which the petitioner, Steiney Richards pleaded guilty of the felony charges. The suspect possessed illegal narcotics that comprised of cocaine with intents to deliver thus allowing the appellant court to uphold the conviction of the petitioner to a prison term. To affirm the decision, the Wisconsin Supreme court scrutinized the issues in the case and found that the entry to the petitioner’s motel room did not violate the legislation thereby upholding policies as stipulated in the Fourth Amendment. In reaffirming their decision, the supreme court, acknowledged that the police officers are invariably allowed to ignore announcing their presence by considering the nature of the search warrant especially those that involves felonious acts like drug trafficking. The petitioner argued that the

The Drivers of Chinese Businesses Strategy for Expansion into Nigeria Dissertation

The Drivers of Chinese Businesses Strategy for Expansion into Nigeria - Dissertation Example The political and economic hardships that faced China at that time qualified it to be an implausible partner of development. Moreover, subsequent to the policies of Deng Xiaoping of the 1970s and1980s, Chinese spectacular innovation and intensification, industrial attendant and demands of market expansion, plunged it into inevitable contact with the African continent (Utomi 2012:1). Its fresh extended presence provided a relationship viewed by several stakeholders as a substitute and replica of Western partnerships. In fact, the augmenting presence of China in Africa, and particularly in Nigeria has elicited a lot of issues concerning the rising relation’s model. A national discussion across sectors upon that relationship would be a practice which is healthy and may impel additional scrutiny (Taylor 2012: 111). In point of fact, viewpoints in Nigeria are far from forming a balance between the motives of China, the budding rivalry with Western associates or renewed collaboration possibilities between new and old partners. The focus of this proposal is the drivers of Chinese business strategy for expansion into Nigeria. The study is grounded on cross-examining the officials of the Nigerian government, business people, and the private sector. The broad purpose of this research proposal is to explore the drivers of Chinese business strategy for expansion into Nigeria. In this scenario, China uses clever tactics to create room for expanding business operations in Nigeria. On the other hand, Nigeria benefits when the Chinese involve themselves in foreign direct investment. In comparison to Nigeria’s conventional Western business partners, China seems to have better terms, thus gaining more ground in Nigeria.

Management and leadership Development Essay Example | Topics and Well Written Essays - 2250 words

Management and leadership Development - Essay Example 17). Current cultural diversity in global business entities have as well played very essential role in enhancing the experienced impediments in the application of conventional leadership and management theories in contemporary profit making organisations(Hernandez, 2008, p.121). By referring to modern increasing competition and changes in global and local market, global institutions has the role of coming up with efficient means of training and educating their leaders on the most effective means of complying with international management and leadership standards(Hersey and Blanchard, 1993, p.41). Hawksmoor Restaurants is one the other hand rated as one of the most successful multinational corporation in United Kingdom. Despite having huge number of sales and profitability, Hawksmoor Restaurants is among the commonly preferred restaurants company in United Kingdom (Hawksmoor Restaurants, 2012, p. 5). A part from having its headquarters and numerous branches in United Kingdom, Hawksmoo r Restaurants has instituted various outlets in other parts of the world (Gutierrez and Tania, 2007, p. 67). Compared to other proficient local and international restaurants, Hawksmoor Restaurants is among the finest United Kingdom companies in offering fair deals to its staffs. In spite of getting free meals, the company’s employees, are also given competitive wages depending on their performances and skills. The aim of treating its employees fairly is to motivate them as well as enhance their professionals, individual leaders, and management development (Hannum, Jennifer and Claire 2012, p. 79). Compared to its competitors, Hawksmoor Restaurants is also known for paying its employees fairly and in accordance to their skills and competence. Regardless of employing skilled and competent employees, the company is as well known for employing youthful managers (Martineau, 2007, p. 309). Effective employment of both modern and conventional leadership and management theories has a s well been very helpful in facilitating the success of Hawksmoor Restaurants in local and global market (Pulley and Wakefield, 2001, p. 439). To understand the importance and relevant of effective application of leadership and management theories in business entities, the subsequent essay will expound on how Hawksmoor Restaurants has been employing these theories in developing the efficiency of its managers and leaders (Hannum and Claire, 2012, p. 1719). The success of Hawksmoor Restaurants in local and international market can largely be linked to effective and consistent application of Great Man Leadership and Development Theory. Great Man Theory is based on the perception that, leaders are unique and special people in the society. As described in this theory, leaders are born with innate leadership traits. The use of the term man was intentional as it aims at describing the manner in which a leader is supposed to be firm and composed (Reed, 2005, p. 176). As explained in this th eory, although a leader is born with inmate skills and competence, training is very essential in facilitating the development of the identified leadership traits. By referring to the contents in Great Man Theory, Hawksmoor Restaurants have adopted mechanisms that are aimed at identifying and developing leadership traits among its leaders.

Art & the Pregnant Form Essay Example | Topics and Well Written Essays - 2500 words

Art & the Pregnant Form - Essay Example Through the years, the way in which the pregnant form has been represented, misrepresented and ignored has been a growing theme, coming into full flower in the modern art world in a variety of media. What is painted or sculpted and how this is done reveals much about the prevailing attitudes of the time period in which the art work was created. From the fully clothed, questionable nature of early artists’ renditions of pregnant women to the fully nude and exposed form of today’s pregnant sculptures, the art of the pregnant form has definitely advanced into the worldview. To gain an understanding of how this change came about, it is necessary to learn more about some of the artists that have participated in this centuries long debate about how best to portray the multiple aspects of the pregnant woman – her impending motherhood, her swelling form, her newfound tenderness. Among these artists are Jan van Eyck, Gustav Klimt, Egon Schiele, Lucien Freud, Marc Quinn an d Ron Mueck. By looking at how these artists portrayed pregnant women as well as their motivations in doing so, we can begin to gain an understanding of how the cultural attitude toward pregnancy and the female form has changed. Jan van Eyck is the earliest of these painters, having painted his â€Å"Giovanni Arnolfini and His Wife† in 1434. This painting has been largely acknowledged primarily due to the various examples of symbolism contained in the painting as well as for its unique perspective. However, left mostly out of the conversation is the idea that Arnolfini’s wife is pregnant. Closer inspection indicates that Jeanne de Chanany is not actually pregnant but is instead wearing the voluminous clothing popular for the early Renaissance period. â€Å"Although many modern viewers mistakenly assume Giovanna is pregnant, art historians familiar with 15th century painting point out

Preschool Observation Essay Example for Free

Preschool Observation Essay There is growth and development in a child if he or she shows the necessary skills or milestones for his or her age. This essay is a case study of a pre-school child. An observation was done to determine whether the child has matured intellectually, emotionally and physically with her age. The child, who is two years and nine months old, was observed while she was in her play room with her mother one hour before her bed time. Below is an account of the observation. The child is kneeling on the floor and is opening a box of toys. She places blocks and cubes on the floor. Her mother joins to play with her. When her mother asks her what she is taking out of the box, she answers, â€Å"Toys. † After emptying the box, she chooses blocks with colors yellow, orange and red and she starts to form objects out of it. First, she lines up the longer orange blocks. Then, she stacks these blocks together by putting shorter blocks which are colored yellow and red on top of the orange blocks. The resulting object is like a train. Afterwards, she disassembles it and creates another object which looks like a phone and she pretends to talk to someone else with it. Next, she takes the red and orange blocks and forms a square using three longer blocks supported by one longer block and two shorter blocks underneath. The shape is not recognized by her mother so she asks her, to which she replies â€Å"toys. † Then she tries to tell a story as she makes gestures and actions and she tries to explain but only the words â€Å"she,† â€Å"ride,† and â€Å"ice cream† are intelligible. After explaining, she says, â€Å"Look at this†¦ These are toys†¦ Place this here† as she places a cube on top of the object. After a few minutes, a cat’s cry is heard from another room. She recognizes it and says â€Å"Cat†¦ Cat meow. † A little later, she gets a cloth and wipes her nose. Her mother asks what is wrong and she says, â€Å"Mommy, nose† to probably mean that she has a running nose. After a while, she counts from one to ten the blocks she formed into an object. Then, her mother asks her the color of a block and she answers â€Å"red† but she cannot recognize the colors pink and blue when she was asked. After that, her mother asks how old she is and she quickly answers â€Å"Two† and shows her two fingers. By and by, she sees a picture book, which is an atlas for children, on the shelf. She points at it and articulates â€Å"Book†¦ Read book. † Her mother gives her the book. She starts to turn the pages one by one and she recognizes pictures of a cow, earth, water, stars, bird, fish, and a dog especially when her mother points out a picture and asks her the names for those pictures. Her mother also teaches her the names of a few of the pictures such as a whale and a bear. She is quick to remember the image of a bear because when she was near the end of the book, she suddenly asks, â€Å"Where bear? † and she turns back the pages of the book to find it. She exclaims, â€Å"It’s here! † when she found it. Her mother tries to help her turn the pages of the book but she exclaims, â€Å"Wait! † and continues to turn the pages on her own. There was a time when she mentions the word â€Å"heavy† referring to the heavy pages of the book. She pretends to read the words written on paper and looks at the pictures most of the time. Furthermore, she turns back to the pages she has already seen again and again. She also recognizes pictures of babies because when her mother asked her what can be seen on the page with baby pictures, she responds, â€Å"Baby. † Her mother then asks her how many babies there are and she accurately counts from one to three. Since it was almost her bedtime, her mother tells her to go to sleep, she says, â€Å"Wait. No sleep† but yawns. Then, she stands up, says â€Å"Me sleep,† goes to the door of her bedroom and opens it. Once inside the bedroom, her mother undresses her and dresses her up for sleeping. While dressing up, she tries to help by lifting her arms to fit to the sleeves of the shirt and lifting her legs to put on the pajamas. After that she says, â€Å"Mommy, milk. † So, her mother gets her milk, gives it to her and she drinks it from a cup. Based on the observation, the child displays the common developmental milestones of a two to three-year old preschool in terms of her cognitive, socio-emotional and motor skills. These are enumerated below: Primarily, the child exhibits the following cognitive skills of most two-year old children: (1) uses more than 100 words; (2) likes to take things apart; (3) uses 2 to 3 word sentences; (4) refers to self as â€Å"me†; (5) verbalizes desires; (6) enjoys looking at one book over and over; (7) points to body parts (Powell Smith); (8) recognizes familiar pictures; and (9) asks for items by name (Developmental Checklist). Moreover, she demonstrates what other three-year children can do such as: (1) naming pictures of a book; (2) naming at least one color; and (3) knowing and telling her age (Goodbye Babyhood). Aside from these skills, it is observed that she can recognize animal sounds and she can already count from numbers one to ten. Furthermore, the child demonstrates the following socio-emotional skills: (1) shows awareness of parental approval; (2) displays independence to do things on her own; and (3) likes to imitate adult activities such as talking on the phone (Miss Independent). In addition to this, she can already perform motor skills such as: (1) opening a box; (2) building or stacking up small blocks; (3) using toys appropriately; (4) using a cup well; (4) dresses up with help (Miss Independent); and (5) turning pages of a book two to three at a time (Developmental Checklist). In conclusion, the preschool child who has been observed is on the right track in the growth milestones children of her age range develop. She has progressed in her cognitive, socio-emotional and motor skills as a two-year old child. Works Cited â€Å"Developmental Checklist for Infants and Toddlers. † Jacksonville Medicine. March 2000. University of Florida, Jacksonville Early Intervention Program for Infants and Toddlers. 11 March 2009. http://www. dcmsonline. org/jax-medicine/2000journals/march2000/EIPchecklist. htm â€Å"Goodbye Babyhood, Hello Childhood. † Kids Growth. 8 May 2007. Maternal and Child Health Bureau U. S. Department of Health and Human Services. 3 April 2009. http://www. kidsgrowth.com/resources/articledetail. cfm? id=321 â€Å"Miss Independent. † Kids Growth. 8 May 2007. Maternal and Child Health Bureau U. S. Department of Health and Human Services. 3 April 2009. http://www. kidsgrowth. com/resources/articledetail. cfm? id=320 Powell, J. and Smith, Charles. â€Å"Developmental milestones: A guide for parents the 2nd year. † National Network for Child Care. (1994). Kansas State University Cooperative Extension. 11 March 2009. http://www. nncc. org/Child. Dev/mile2. html

Case Report: Topiramate Induced Myopia

Case Report: Topiramate Induced Myopia G.Srinivasagopalan Gopalsamy, Murali Mohan Mohan, Sudhakar Sankar Tamilnadu, India Abstract Topiramate (sulfamate-substituted monosaccharide) is a broad spectrum newer anti-convulsant. It is also used in prophylaxis of migraine, cluster headache, bipolar affective disorder, post traumatic stress disorder, post herpetic neuralgia , relapse prevention in alcohol dependence syndrome, add on treatment for antipsychotic induced weight gain. Acute Myopia and angle closure glaucoma are some of the rare side effects of topiramate. This case highlights the development of myopia in a middle aged patient with alcohol dependence syndrome while he was on topiramate therapy. Keywords: Topiramate, alcohol dependence syndrome, angle closure glaucoma, myopia. INTRODUCTION Topiramate is a sulfamate substituted monosaccharide, a broad spectrum anticonvulsant acting on voltage dependent sodium channels, enhancement of gamma amino butyric acid (GABA), decrease in glutamate and inhibition of carbonic anhydrase. We (the psychiatrists) use topiramate to treat migraine, cluster headache, bipolar affective disorder, post traumatic stress disorder, post herpetic neuralgia , relapse prevention in alcohol dependence syndrome, add on treatment for antipsychotic induced weight gain1. Some of the rare side effects of topiramate are acute myopia and angle closure glaucoma. We report a case of topiramate induced transient myopia in a patient who had been started on topiramate for relapse prevention in alcohol dependence syndrome. CASE REPORT A 35 year old married male, lower middle socio economic status from rural background, working in a private company presented to the outpatient services of our department of psychiatry with 10 years history of alcohol use amounting to dependence and two weeks history of blurred vision and headache. Patient was diagnosed as a case of alcohol dependence syndrome – uncomplicated withdrawal state (F10.30) as per International Classification of Diseases (ICD) ‑10 criteria. He was admitted for detoxification and on eliciting history; it was found that he had been commenced on oral topiramate 50 mg/day 3 weeks previously by a private psychiatrist for his alcohol use. The patient had no history of hypertension, diabetes or glaucoma, he had never worn glasses and there was no history of injury to eyes or head and no history of withdrawal seizures. He was referred to department of ophthalmology for blurred vision. Ophthalmic opinion on the day of admission suggested refractive err ors bilaterally with left eye myopia of -2.5 diopters and right eye myopia of -3.5 diopters with shallow anterior chamber and normal pupils and lens on slit lamp examination and normal intra ocular pressure on tonometry. After this ophthalmologic report, topiramate was stopped immediately by us thinking that it could have induced myopia. Other routine investigations were normal and detoxification with oral lorazepam and thiamine supplementation continued along with motivation enhancement sessions by psychologist. Patient reported gradual clinical improvement in his vision. Repeat ophthalmologic consultation on the 7th day of admission showed significant improvement in visual acuity and refraction with left eye myopia of 0.75 diopters and right eye myopia of 0.75 diopters .Because of our early intervention, angle closure glaucoma was averted in our case. DISCUSSION The most frequently reported side effects for Topiramote are dizziness, mental slowing, somnolence, ataxia, impaired concentration and confusion2. Most of these are transient and observed during the initial weeks of therapy and can be reduced by slow titration of the dose. Anorexia and mild weight loss has been observed during the therapy. Metabolic acidosis, and nephrolithiasis are the other reported side effects. WHO Causality Assessment3 suggests abnormal vision, acute secondary angle closure glaucoma, acute myopia and suprachoroidal effusions are complications of Topiramate therapy. This case highlights and aims to raise awareness that topiramate can cause acute myopia and angle closure glaucoma. Both are reversible with immediate discontinuation of the drug4. Various authors have also reported these serious complications due to topiramate[4][5][6]. The mechanism for topiramate induced angle closure glaucoma is by ciliochoroidal effusion with forward displacement of the lens â₠¬â€œ iris diaphragm and anterior chamber shallowing, resulting in acute myopia and angle closure glaucoma4]. Topiramate’s weak carbonic anhydrase inhibitor activity and prostaglandin mediated effects have also been postulated as possible mechanisms7. Acute myopia up to -9.0 diopters can occur in a matter of hours after starting topiramate, but might take weeks to fully resolve. Whenever a case of myopia with angle closure glaucoma and a shallow anterior chamber is encountered, ciliochoroidal effusion syndrome induced by drugs should be considered in the differential diagnosis. Drug induced myopia has also been associated with promethazine, spironolactone, tetracycline, corticosteroids etc.5. Pupils should not be dilated to prevent further angle closure and possible rise in pressure. Paediatric and developmentally delayed patients who have been started on topiramate should be closely monitored during the first 2 weeks of treatment. It is important for the clinician to educate the patients about this serious adverse effect while prescribing topiramate and advise them to report immediately in the event of visual disturbance. REFERENCES 1V. Shivakumar, N. Jayaram, N. P. Rao, and G. Venkatasubramanian, Successful Use of Add on Topiramate for Antipsychotic Induced Weight Gain, Indian J Psychol Med, 34 (2012), 85-6. 2Y. Mikaeloff, A. de Saint-Martin, J. Mancini, S. Peudenier, J. M. Pedespan, L. Vallee, J. Motte, M. Bourgeois, A. Arzimanoglou, O. Dulac, and C. Chiron, Topiramate: Efficacy and Tolerability in Children According to Epilepsy Syndromes, Epilepsy Res, 53 (2003), 225-32. 3S. A. Zaki, Adverse Drug Reaction and Causality Assessment Scales, Lung India, 28 (2011), 152-3. 4J. E. Craig, T. J. Ong, D. L. Louis, and J. M. Wells, Mechanism of Topiramate-Induced Acute-Onset Myopia and Angle Closure Glaucoma, Am J Ophthalmol, 137 (2004), 193-5. 5T. C. Chen, C. W. Chao, and J. A. Sorkin, Topiramate Induced Myopic Shift and Angle Closure Glaucoma, Br J Ophthalmol, 87 (2003), 648-9. 6H. A. Sen, H. S. OHalloran, and W. B. Lee, Case Reports and Small Case Series: Topiramate-Induced Acute Myopia and Retinal Striae, Arch Ophthalmol, 119 (2001), 775-7. 7C. M. Desai, S. J. Ramchandani, S. G. Bhopale, and S. S. Ramchandani, Acute Myopia and Angle Closure Caused by Topiramate, a Drug Used for Prophylaxis of Migraine, Indian J Ophthalmol, 54 (2006), 195-7.