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another earth essay Rhoda Williams, played by music essay writing actress Brit Marling who also co-wrote the screenplay to this movie #8216;Another Earth#8217;, has the world at research, her fingertips. She#8217;s young, pretty, smart and intellectually advanced to the point that she will be enrolling at essay, M.I.T. in the coming fall. Father? Unfortunately Rhoda#8217;s intellectual common sense didn#8217;t get the memo that it#8217;s bad to drink and essay, drive, while staring off at the sky looking at blue dots which may or may not be an alternate earth. A truly intelligent person would probably pull over to look at terrorism happens because, blue dots in essay service, the sky, but then director Mike Cahill#8217;s film would be about wireless research paper something else altogether, and it was fine the way it was. What Rhoda#8217;s drunken distracted driving has done is caused the writing service, deaths of the wife, child and unborn child of Yale music professor John Burroughs (William Mapother), and she also put him in a coma for a while but he has survived. Rhoda did four years for this senseless crime, but she was underage at the time so at research, twenty one they put her back on the street. Essay Service? Also in the four years that Rhoda was down, that alternate Earth has become crystal clear in the night sky.

At it looks to be identical to ours in every way, shape and form. But back to term on stds, Rhoda, what does this convicted felon do with her life now? What she should do is enroll in college and music writing, use this advanced intellect of her to try to make the world a better place. What she does do is track down the one day our life, extremely damaged John Burroughs, both physically and mentally, and start messing with him. In all honesty she was attempting to writing, meet with John to apologize to happens because essay for kids, him for what she had done, which we here recognize as a terribly selfish act since the music writing service, only person this apology could bring any satisfaction to is herself, but we know she thinks she has the best intentions. But Rhoda couldn#8217;t even manage to pull that off.

Instead she hangs around this extremely damaged cat, cleans his home, befriends him, and does some other things that she really probably shouldn#8217;t have done. Back to the other Earth, not only is it identical to ours in form and linda critical essays plath 1984, topography, it#8217;s also identical down the souls that inhabit it. Music Writing Service? In fact it looks as if the people on that earth and our earth have lived their lives in router paper, complete synchronicity#8230; at least until we saw each other#8230; then theoretically the synchronicity was broken. How this relates to our story is. that it is possible that Rhoda on music service the other earth didn#8217;t do what Rhoda on our earth has done, which means maybe John#8217;s family is alive on on stds Earth II. The only way to know this is to go there, which looks like this just might happen. What happens next is entirely open for discussion for anybody who has seen this movie. I enjoyed Mike Cahill#8217;s #8216;Another Earth#8217; well enough, and writing, I had been looking forward to thesis, seeing it after I had heard the description of music writing service, it a year or so ago, even though I have just gotten around to watching it. So I#8217;ll be spoiling stuff, even though I imagine anybody who has wanted to see this movie has probably seen it already.

This is a very quiet, methodical drama, with a tinge of term, Science Fiction coloring the edges, and it plays out almost as if it is a two person play. To that end both Brit Marling and William Mapother are very effective in writing, their roles, Mapother projecting the debilitating physical and emotional pain that exists almost constantly within his character, Marling displaying her characters emotional immaturity which is why she makes a number of poor decisions which compound upon one another. It#8217;s the end of the film which has most people talking, Rhoda winning an essay to go on the first trip to alternate Earth but giving her ticket to term paper on stds, John. Then we have Rhoda coming home one day to find Alternate Earth Rhoda waiting for her. What did that mean? Well I don#8217;t know, but we all have theories and music service, this is what separates #8216;Another Earth#8217; from 99.2% of the wireless router research paper, movies we see in essay writing, that it does open an audience to discuss these theories with this audience given just enough information that maybe their theories might make sense. The Synchronicity is obviously broken since Earth 1 Rhoda gave her ticket away while Earth 2 Rhoda kept hers. But is John#8217;s family dead on Earth 2? Earth 1 Rhoda wrote an essay about how she messed up so many lives, but did Earth 2 Rhoda write the same essay? I mean how else would Earth 2 Rhoda hitch a ride on the ship? Unless Earth 2 Rhoda wrote an essay about how she almost messed up a bunch of lives, which probably wouldn#8217;t have won a contest, or perhaps Earth 2 Rhoda#8217;s life went as planned, she went to M.I.T and was so academically gifted that she became an astronaut right out of college and was on the crew of thesis, that ship.

I think that#8217;s highly unlikely as well. Music? Some have noted that Earth 2 Rhoda was dressed very nice and looked successful, unlike grungy Earth 1 Rhoda, but come on#8230; Earth 2 Rhoda just caught a spaceship to linda, another planet to music essay service, meet somebody extremely special to essay for kids, her, so she#8217;s going to dress up a little, right? No, my thought is that Rhoda killed John#8217;s family on both planets. Rhoda 2 just didn#8217;t or couldn#8217;t give her ticket away. Writing? There is still a certain amount of synchronicity that is maintained, observe both doctors still communicating with each other on both earth#8217;s at happens for kids, the same time, well after we#8217;ve become aware of each other#8217;s existence. Thus with that thought, Earth 2 Rhoda still went to the party, still drank too much, still tried to drive home and probably saw the blue dot in the sky at the same time.

This is music essay going to paper, suck for John 1 when he meets with the equally miserable John 2, but maybe they can find some joy in each other. Even if his family were alive on Earth 2, then what? They have a husband and father and essay writing service, don#8217;t need another. Of course this all a discussion about free something that may or may not have happened in a movie about something that doesn#8217;t exist, but this what makes #8216;Another Earth#8217; a special movie.

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Ad Reinhardt Abstract Painting 19601965 Essay Research. Ad Reinhardt: Abstract Painting 1960-1965 Essay, Research Paper. Writing. Ad Reinhardt: Abstract Painting1960-65. Ad Reinhardt#8217;s painting, Abstract Painting 1960-65, is at first glance#8217; a black square canvas. The subject matter seems to be just what it is, a black painting. Free Web Site. There are no people. No event or action is taken except for the fact that Reinhardt has made the painting. The title only music writing service provides us with the paper on stds information that we are looking at an abstract painting. The only other information that the artist gives you is the time period, in which it was conceived, 1960 to 1965. In the least amount of words possible, we could describe the painting as an abstract color field. It is possible that a narrative is essay expressed through the piece, although, we can not be certain what it is.

There is nothing narrated through conventional means in any way. The composition of the painting takes place with the square of the canvas. The square is approximately 5#8242; x 5#8242;. A black frame surrounding the painting protrudes approximately 4#8243; off the canvas. There is a 1#8243; inlay between the canvas and frame. From this square, Reinhardt breaks the composition into six equal squares in three even rows. Texture is no where to be found in the painting. No visual indication of the artist#8217;s brush stroke is present.

No varnished glare is absent father thesis given off by the piece. The entire work, including the frame, is music essay writing completely matte. The squares take up the term paper on stds entire canvas in a checkerboard type arrangement. Each square is a slightly different shade of blue-black. It almost becomes impossible to see the difference between each square. The middle squares in the top and bottom rows shift more towards blue than the rest of the squares. The division of these middle squares become more obvious than the others.

When the painting is looked at from a distance, it is almost impossible to see any of the squares at all. When looking from a far, all a viewer can see is a blackish blue canvas. As you stare longer into the painting, a halo begins to form around the essay writing service corners of the canvas, creating a circle inside the square. Once you look away from the canvas, the circle is gone. With this observation in mind, we could say that the painting most definitely relies on the viewer. A viewer is required to look at the piece for its full affect. We could say that the squares in the painting are self-contained. On the other hand, the squares create a visual effect that isn#8217;t even on the canvas.

They create an experience and shape that?s completely opposite resume web site, of the paintings overall form and composition. Reinhartd#8217;s painting is abstract, expressive and analytical. We can recognize the abstractness as the idea of a black on black square. The expressive quality becomes evident when we realize that Reinhartd#8217;s hand can not be seen. The amount of self-containment and painstaking labor needed to make such a flat painting is immense. This labor can be recognized as Reinhartd#8217;s expressive nature through paint. Essay Writing. As we dig deeper, the subject matter lends itself to analyticity. The plane on which we view Ad Reinhardt#8217;s painting is much higher than first perceived. To understand the subject, the resume web site viewer most also understand Reinhardt#8217;s philosophy of essay writing painting. Reinhardt#8217;s painting goes further than the visual #8220;black square#8221;. Within this black square is the wagner critical plath 1984 end of all painting and the start of a new.

Ad Reinhardt#8217;s Abstract Painting 1960-65 (history and context) Ad Reinhardt#8217;s Abstract Painting 1960-65, was created over a span of five years. This painting, as well as many of Reinhardt#8217;s paintings is considered to be the end of painting. The nothingness of painting. In 1959 painters such as Jasper Johns, Ellsworth Kelly, Frank Stella, Joseph Albers and essay writing service, Willem de Kooning were showing exhibiting regularly and absent thesis, thought to be in their prime. Music Writing. The Museum of Modern Art in New York City was showing a Miro retrospective. The Solomon R. Guggenheim Museum had just opened in wireless research paper New York, offering a new collection a chance for artists to show work.

As the 60#8217;s came, so did a new president and a war. John F. Kennedy was to be the new president. Music Writing Service. A young, energetic, All-American male from Harvard. He gave a new image to free resume web site, the presidency and the country. The Vietnam War was beginning and the government was developing new weapons. In 1960, radar was invented and the first heat seeking missiles was tested. The Museum of Modern Art had exhibited Jean Tinguely#8217;s, Happening, a self-destroying sculpture. In 1961, the U.S. Airforce sent a chimp into space to orbit the earth.

The Civil Defense officials distributed 22 million copies of the pamphlet, family fallout shelter. In 1962-63, Andy Warhol#8217;s Campbell#8217;s Soup paintings are shown. Alber#8217;s exhibits his, Homage to service, the square. Digital marketed the first Mini-computer. John Glenn becomes the term paper first American to orbit the writing earth. 250,000 march for Civil-Rights in critical essays plath Washington, D.C. President John F. Kennedy is music writing service assassinated in Dallas, Texas. In 1964-65, U.S. On Stds. planes bomb North Vietnam. China explodes its first A-bomb.

The first U.S. combat troops land in Vietnam. 1,3500 U.S. troops were killed in Vietnam and 5,300 were wounded. In the five years during the creation of this painting, a tremendous amount of serious events took place. New work was being created. A war was killing thousands of people and technology was moving like never before. You would think that Reinhardt would have incorporated what was going on around him into is work. The opposite is true. In fact, Reinhardt believed in painting nothing; the nothing of painting. Reinhardt believed in the correction of the artist and not the enlightenment of the viewer. For Reinhardt, painting was all about the artist; the viewer was secondary if even considered.

Reinhardt had said, #8220;An artist who dedicates his life to art, burdens his art with his life and his life with his art.#8221; Reinhardt believed that art was #8220;out of time#8221;, and that there was no real placement for art in periods etc. Reinhardt writes of the music essay service 25 lines of words on art: Statement (1955), (a few examples from the text) 1. Father. Art is art, everything else is everything else. 9. Painting as #8220;not as a likeness of service anything on earth.#8221; 22. Wireless Research Paper. The most common mean to the most uncommon end. 25. The most universal path to writing service, the most unique. And vice-versa.

Reinhardt claimed his work was about painting and only painting. It is one day our life possible that this was his reaction to all the negative events going on in the world. His concentration on the painting as a painting and the painter was absent of politics and technology. Even the names of his paintings reflected his idea that the painting was just a painting. It seems appropriate that he would choose to music, paint this way in this time. He chooses to ignore the worlds happening and dig deeper into resume web site the meaning of painting itself. Reinhardt wanted his paintings to not reflect its surroundings: #8220;a pure abstract, non-objective, timeless, spaceless, changeless, relationless, disinterested painting- an object that is music essay writing service self conscious (no unconsciousness) ideal, transcendent, aware of terrorism essay for kids nothing but art.#8221; Reinhardt would continuously work on music essay writing, a painting, forever restoring it in the same manner he painted. The paintings were returned to his studio and absent thesis, restored to the way they where when they left. Music Service. Reinhardt#8217;s paintings are #8220;non-entertainment, not for commerce or mass-art publics, non-expressionist, not for oneself.#8221; Ad Reinhardt: Abstract Painting 1960-1965: Research. #8220;Ad Reinhardt#8217;s black paintings are often initially greeted with hostility by viewers. The balanced geometric divisions, often in router the shape of a cruciform, and music essay writing service, the subtle variations in form are at first impossible to discern.

These inert black squares have the quality of an Egyptian mirror that forces one#8217;s image back to oneself. Essay For Kids. The black paintings seem then truly to achieve Reinhardt#8217;s goal to push painting beyond its thinkable, seeable, feelable limits, to a highly physical and psychological. condition (Abstraction: Geometry: Painting).#8221; That is how Reinhardt#8217;s painting were perceived and how they#8217;re still often seen. Ad Reinhardt#8217;s Paintings, as well as the paintings of music writing service Joseph Albers, Brice Marden, John McLaughlin and other #8220;color field/minimalist painters, were often greeted with great hostility and misunderstanding. Especially when they were exhibited for the first time. Hostility seems to be a reasonable reaction to most color field painting due to frustration. The frustration of not being sure what you#8217;re seeing. You could almost feel conned by resume web site assumed simplicity of the canvas and paint. The paintings seem to writing, be nothing more than shapes of color. Many viewers of Reinhardt#8217;s paintings, even today, will blurt out essay a harsh comment in passing through the museum#8217;s contemporary wing. They#8217;re not sure if they should stare at essay writing the canvas or the critical essays on sylvia plath 1984 floor, or keep walking. When Reinhardt was working on these geometric paintings, gestural abstraction was going in full force.

Artists like De Kooning, Raushenburg, Pollack and Johns were all working in the abstract expression. The New York School of painting was at its prime. Writing Service. And as imaginable, these two genres of painting were looked at differently. Some favored gestural and others went towards the geometric abstractions. There was definitely some influence on free, both sides. Within the artists world at service that time, there was much controversy. In Abstraction: Geometry: Painting, Reinhardt#8217;s position in the New York scene as a geometric painter is brought to light with a remark by Morton Feldmen, a composer who was involved with the New York painters. #8220;The scene was not as it appeared, at least in the press. Wagner Critical Essays On Sylvia Plath. The party line was that these guys were like a fraternity of music writing gorillas with paint-filled squirt guns. It was a lot more considered and not as #8220;expressionist#8221; as it might appear. Barney [Newman] wasn#8217;t flinging any paint for Christ#8217;s sake.

He was tight, very considered, essentially geometric. He#8217;d roll over in essay one day our life his grave if he heard me say that. Essay. He thought of himself as an chemistry one day expressionist, but I think for strategic reasons. The press was more interested in and could make more hay with the expressionist angle. That?s just politics, right? He was an music service expressionist, but of a different kind.

Reinhardt was different but in a different way. (Abstraction: Geometry: Painting).#8221; In the researching of Ad Reinhardt#8217;s work, I found that his work could also be looked at in a spiritual context, although Reinhardt would have never admitted that. Reinhardt saw his paintings as nothing more than objects, pure paintings. Free Resume Web Site. In the book, The Spiritual in Art, Abstract Painting 1890-1985, Allen Watts looks at the way a viewer could possibly perceive a black Reinhardt in relation to music essay, that of Zen thought and meditation. #8220;What is form that is emptiness, what is emptiness that is form?To study a black painting by thesis Ad Reinhardt involves a process similar to Zen meditation -a deceptively similar affair that consists only in watching everything that is happening, including your own thoughts and your breathing. Granting one#8217;s vision sufficient time to perceive the resonant hues and shapes in writing service a painting by Reinhardt is paper on stds equivalent to the assumption of a meditative position. Then the painting seems to yield its essence all at once? (The Spiritual in essay service Art, Abstract Painting 1890-1985).#8221; It is possible that Reinhardt saw his work in this manner but chooses not to speak of it. I doubt that the #8220;average#8221; viewer would take Zen into consideration when looking at Reinhardt#8217;s work. Although it could be the wagner critical essays on sylvia plath way in which the work was made. Ad Reinhardt may have felt a deep connection spiritually to his work. Mark Rothko and Barnett Newman as well as many other painters welcomed the writing service spiritual into their paintings. In some cases, especially with Rothko, the spiritual was the driving force behind the painting.

In Reinhardt#8217;s case, it seems that the simple geometry and bareness of the router research paper painting is all that matters. Reinhardt released his paintings into the world as nothing. He expected no more. The rest is up to the audience to figure out, spiritual or not. Writing. Auping, Michael: Abstraction: Geometry: Painting: Albright-Knox Art Gallery. Harry. N. Abrams, Inc., New York, 1989. Daval, Jean-Luc: History of Abstract Painting: Hazan, Paris, 1989. Term On Stds. Gordon, Louis and music essay writing service, Allan: American Chronicles, Six Decades of American Life, 1920-1980.pp.382-435. Chemistry One Day. Atheneum, New York.

1987. LACMA: The Spiritual In Art, Abstract Painting 1890-1985: Aberville Press Pub., 1986. Essay Writing Service. Stiles/Selz: Theroies and Documents of linda wagner critical essays on sylvia 1984 Contemporary Art, a sourcebok of artists. Writings. Pp.86-91 University of California Press.


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Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy): diagnosis and essay, management. The following guidance is one day, based on the best available evidence. The full guideline ('CFS/ME: diagnosis and management of adults and music essay, children') gives details of the methods and the evidence used to develop the guidance (see section 5 for term paper, details). Shared decision-making between the person with CFS/ME and music writing, healthcare professionals should take place during diagnosis and all phases of care. Paper? The healthcare professional should: Acknowledge the essay reality and impact of the paper condition and the symptoms. Provide information about the range of interventions and essay writing, management strategies as detailed in this guideline (such as the benefits, risks and likely side effects).

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It should include: relevant symptoms and essay writing, history. plans for care and treatment, including managing setbacks/relapses. information and support needs. any education, training or employment support needs. details of the free resume web site healthcare professionals involved in care and their contact details. 1.2.1 Presenting symptoms suspicious of music essay writing service, CFS/ME. CFS/ME is recognised on clinical grounds alone. Primary healthcare professionals should be familiar with and be able to terrorism because, identify the characteristic features of CFS/ME. Healthcare professionals should consider the possibility of CFS/ME if a person has: fatigue with all of the following features: new or had a specific onset (that is, it is not lifelong) persistent and/or recurrent. unexplained by other conditions.

has resulted in a substantial reduction in activity level. characterised by post-exertional malaise and/or fatigue (typically delayed, for example by at least 24 hours, with slow recovery over several days) one or more of the following symptoms: difficulty with sleeping, such as insomnia, hypersomnia, unrefreshing sleep, a disturbed sleep–wake cycle. muscle and/or joint pain that is multi-site and without evidence of inflammation. painful lymph nodes without pathological enlargement. cognitive dysfunction, such as difficulty thinking, inability to concentrate, impairment of short-term memory, and difficulties with word-finding, planning/organising thoughts and information processing. physical or mental exertion makes symptoms worse. general malaise or 'flu-like' symptoms.

dizziness and/or nausea. palpitations in the absence of identified cardiac pathology. Healthcare professionals should be aware that the symptoms of CFS/ME fluctuate in essay writing service, severity and may change in nature over time. Signs and symptoms that can be caused by other serious conditions ('red flags') should not be attributed to CFS/ME without consideration of alternative diagnoses or comorbidities. In particular, the following features should be investigated [5] : localising/focal neurological signs. signs and symptoms of inflammatory arthritis or connective tissue disease. signs and symptoms of cardiorespiratory disease. significant weight loss. clinically significant lymphadenopathy.

1.2.2 History, examinations and investigations. A full history (including exacerbating and alleviating factors, sleep disturbance and intercurrent stressors) should be taken, and a physical examination and assessment of psychological wellbeing should be carried out. A child or young person who has symptoms suggestive of CFS/ME should be referred to a paediatrician for essay, assessment to exclude other diagnoses within 6 weeks of presentation. The following tests should usually be done: urinalysis for protein, blood and glucose. full blood count. urea and electrolytes. erythrocyte sedimentation rate or plasma viscosity.

random blood glucose. screening blood tests for gluten sensitivity. assessment of serum ferritin levels (children and young people only). Tests for serum ferritin in music service, adults should not be carried out unless a full blood count and other haematological indices suggest iron deficiency. Tests for vitamin B 12 deficiency and father, folate levels should not be carried out unless a full blood count and writing, mean cell volume show a macrocytosis. The following tests should not be done routinely to aid diagnosis: the head-up tilt test. auditory brainstem responses. Serological testing should not be carried out unless the history is paper, indicative of an infection. Music Essay Writing? Depending on the history, tests for term on stds, the following infections may be appropriate: chronic bacterial infections, such as borreliosis. chronic viral infections, such as HIV or hepatitis B or C. acute viral infections, such as infectious mononucleosis (use heterophile antibody tests) latent infections, such as toxoplasmosis, Epstein–Barr virus or cytomegalovirus.

1.2.3 Advice on music essay, symptom management before diagnosis. Advice on symptom management should not be delayed until a diagnosis is essay chemistry, established. This advice should be tailored to the specific symptoms the person has, and be aimed at minimising their impact on daily life and activities. 1.2.4 Re-assessment before diagnosis. If symptoms do not resolve as expected in a person initially suspected of having a self-limiting condition, primary healthcare professionals should listen carefully to music essay writing, the person's and wireless, their family and/or carers' concerns and music, be prepared to reassess their initial opinion. If considering the possibility of CFS/ME or another serious alternative condition, primary healthcare professionals should consider discussion with a specialist if there is uncertainty about the interpretation of signs and symptoms and whether a referral is needed. This may also enable the paper primary healthcare professional to music essay service, communicate their concerns and a sense of urgency to terrorism essay, secondary healthcare professionals if symptoms are unusual. A diagnosis should be made after other possible diagnoses have been excluded and the symptoms have persisted for: 4 months in an adult.

3 months in a child or young person; the diagnosis should be made or confirmed by a paediatrician. When a diagnosis of CFS/ME is made, healthcare professionals should provide honest, realistic information about CFS/ME and encourage cautious optimism. Most people with CFS/ME will improve over time and some people will recover and be able to resume work and music writing service, normal activities. However, others will continue to experience symptoms or relapse and free web site, some people with severe CFS/ME may remain housebound. The prognosis in children and young people is more optimistic. The diagnosis of CFS/ME should be reconsidered if none of the following key features are present: post-exertional fatigue or malaise. 1.4 General management strategies after diagnosis. There is no known pharmacological treatment or cure for essay writing service, CFS/ME.

However, symptoms of terrorism happens for kids, CFS/ME should be managed as in usual clinical practice. No research evidence was found to support the experience of some people with CFS/ME that they are more intolerant of essay writing, drug treatment and have more severe adverse/side effects. However, if people with CFS/ME have concerns, healthcare professionals may consider starting drug treatment for CFS/ME symptoms at term paper a lower dose than in essay writing, usual clinical practice. The dose may be increased gradually, in agreement with the patient. Specific drug treatment for one day, children and young people with CFS/ME should be started by a paediatrician. Writing? However, prescribing may be continued in essay chemistry, primary care, depending on the preferences of the patient and their carers, and local circumstances. If a person experiences nausea as part of CFS/ME, this should be managed conventionally, including giving advice on eating little and often, snacking on essay writing, dry starchy foods and essays on sylvia plath 1984, sipping fluids. The use of anti-emetic drugs should be considered only if the nausea is severe. Although exclusion diets are not generally recommended for managing CFS/ME, many people find them helpful in managing symptoms, including bowel symptoms. If a person with CFS/ME undertakes an essay, exclusion diet or dietary manipulation, healthcare professionals should seek advice from terrorism essay for kids, a dietitian because of the risk of malnutrition. 1.4.2 Function and quality-of-life management. Healthcare professionals should provide tailored sleep management advice that includes: Explaining the role and effect of disordered sleep or sleep dysfunction in CFS/ME. Identifying the common changes in sleep patterns seen in CFS/ME that may exacerbate fatigue symptoms (such as insomnia, hypersomnia, sleep reversal, altered sleep–wake cycle and non-refreshing sleep). Providing general advice on good sleep hygiene [6] . Introducing changes to sleep patterns gradually. If sleep management strategies do not improve the music essay service person's sleep and rest, the possibility of an underlying sleep disorder or dysfunction should be considered, and interventions provided if needed. Sleep management strategies should not include encouraging daytime sleeping and naps. People with CFS/ME should be advised that excessive sleep does not generally improve physical or mental functioning, and because, excessive periods of service, daytime sleep or frequent napping may further disrupt the sleep–wake cycle. Restperiods are a component of all management strategies for CFS/ME. Healthcare professionals should advise people with CFS/ME on the role of rest, how to introduce rest periods into their daily routine, and the frequency and length appropriate for each person. Paper? This may include: Limiting the length of rest periods to 30 minutes at essay writing service a time.

Introducing 'low level' physical and terrorism for kids, cognitive activities (depending on the severity of symptoms). Using relaxation techniques (see recommendation Healthcare professionals should review the use of rest periods regularly as part of the music essay patient's management plan. Relaxation techniques appropriate to the person with CFS/ME should be offered for the management of pain, sleep problems and father, comorbid stress or anxiety. There are a number of music, different relaxation techniques (such as guided visualisation or breathing techniques) that can be incorporated into rest periods. People with CFS/ME have reported pacing to absent, be helpful in self-managing CFS/ME.

However, healthcare professionals should advise people with CFS/ME that, at present, there is insufficient research evidence on the benefits or harm of pacing. See also recommendations on managing nausea ( and service, bowel symptoms (, and use of supplements (–4). Healthcare professionals should emphasise the absent father thesis importance of a well-balanced diet in line with 'The balance of good health' [7] . They should work with the person with CFS/ME to develop strategies to minimise complications that may be caused by nausea, swallowing problems, sore throat or difficulties with buying, preparing and music writing, eating food. Healthcare professionals should emphasise the importance of eating regularly, and father thesis, including slow-release starchy foods in meals and snacks. The physiological consequences of not doing so should be explained to the person with CFS/ME. 1.4.4 Equipment to maintain independence. For people with moderate or severe CFS/ME, providing or recommending equipment and writing, adaptations (such as a wheelchair, blue badge or stairlift) should be considered as part of an overall management plan, taking into account the risks and benefits for the individual patient. This may help them to maintain their independence and improve their quality of life. Having to our life, stop their work or education is generally detrimental to people's health and well-being. Therefore, the ability of a person with CFS/ME to continue in education or work should be addressed early and reviewed regularly. Healthcare professionals should proactively advise about fitness for work and education, and recommend flexible adjustments or adaptations to work or studies to help people with CFS/ME to return to them when they are ready and service, fit enough.

This may include, with the informed consent of the person with CFS/ME, liaising with employers, education providers and support services, such as: occupational health services. disability services through Jobcentre Plus. schools, home education services and local education authorities. disability advisers in universities and colleges. For people with CFS/ME who are able to continue in or return to education or employment, healthcare professionals should ensure, with the person's informed consent, that employers, occupational health or education institutions have information on absent father thesis, the condition and the agreed management plan. Healthcare professionals should follow the guidance from the Department for Children, Schools and service, Families [8] on education for children and young people with medical needs, or equivalent statutory guidance. Healthcare professionals should work closely with social care and education services to ensure a common understanding of the goals of the person with CFS/ME.

The use of a flexible approach should be discussed, including home tuition and use of equipment that allows a gradual reintegration into education. Time in education should not be used as a sole marker of term, progress of CFS/ME, and education should not be the only activity a person undertakes. There should be a balance between time spent attending school or college and doing homework, and time spent on essay writing, home and social activities. If possible, and with the informed consent of the person with CFS/ME, healthcare professionals should discuss employment issues with occupational health professionals, who will communicate with the person's manager or human resources representative. If there is no access to occupational health services, the responsible clinician should liaise with the employer directly [9] . 1.4.6 Strategies that should not be used for linda 1984, CFS/ME. The following drugs should not be used for the treatment of CFS/ME: monoamine oxidase inhibitors. glucocorticoids (such as hydrocortisone) mineralocorticoids (such as fludrocortisone) The following strategies should not be offered to music essay service, people with CFS/ME: Advice to happens because for kids, undertake unsupervised, or unstructured, vigorous exercise (such as simply 'go to the gym' or 'exercise more') because this may worsen symptoms. Specialist management programmes (see section 1.6) delivered by practitioners with no experience in music writing, the condition. Although there is considerable support from patients (particularly people with severe CFS/ME) for the following strategies, healthcare professionals should be aware that there is no controlled trial evidence of benefit: Encouraging maintenance of activity levels at substantially less than full capacity to reserve energy for the body to router research paper, heal itself (sometimes known as the envelope theory). Encouraging complete rest (cognitive, physical and writing, emotional) during a setback/relapse. Strategies for managing CFS/ME should not include: Prolonged or complete rest or extended periods of terrorism happens because for kids, daytime rest in music, response to free web site, a slight increase in symptoms. An imposed rigid schedule of activity and essay, rest. 1.4.7 Complementary and supplementary therapies. There is insufficient evidence that complementary therapies are effective treatments for CFS/ME and therefore their use is not recommended. However, some people with CFS/ME choose to wireless research paper, use some of these therapies for symptom control, and music, find them helpful. There is insufficient evidence for the use of supplements – such as vitamin B 12 , vitamin C, co?enzyme Q10, magnesium, NADH (nicotinamide adenine dinucleotide) or multivitamins and minerals – for people with CFS/ME, and wireless, therefore they should not be prescribed for treating the symptoms of the condition. However, some people with CFS/ME have reported finding these helpful as a part of essay, a self-management strategy for their symptoms. People with CFS/ME who are using supplements should be advised not to exceed the happens for kids safe levels recommended by music service the Food Standards Agency [10] . Some people with CFS/ME need supplements because of a restricted dietary intake or nutritional deficiencies. Healthcare professionals should seek advice from a dietitian about any concerns.

1.5 Referral to specialist CFS/ME care. Any decision to refer a person to specialist CFS/ME care should be based on their needs, the type, duration, complexity and severity of their symptoms, and paper on stds, the presence of comorbidities. Music Writing? The decision should be made jointly by the person with CFS/ME and the healthcare professional. Referral to specialist CFS/ME care should be offered: within 6 months of presentation to people with mild CFS/ME. within 3–4 months of presentation to people with moderate CFS/ME symptoms. immediately to people with severe CFS/ME symptoms. After a patient is absent, referred to service, specialist care, an initial assessment should be done to router research, confirm the music diagnosis. If general management strategies (see section 1.4) are helpful for terrorism happens because for kids, a person with CFS/ME, these should be continued after referral to specialist CFS/ME care.

1.6.2 Cognitive behavioural therapy, graded exercise therapy and activity management programmes. Choosing and planning treatment. An individualised, person-centred programme should be offered. to people with CFS/ME. Writing? The objectives of the programme should be to: sustain or gradually extend, if possible, the person's physical, emotional and free resume, cognitive capacity. manage the physical and music service, emotional impact of terrorism for kids, their symptoms. The rationale and service, content of the different programmes, including their potential benefits and wagner critical essays on sylvia, risks, should be fully explained to music writing service, the person with CFS/ME. Healthcare professionals should explain that no single strategy will be successful for paper on stds, all patients, or during all stages of the condition. Healthcare professionals should recognise that the music writing person with CFS/ME is in charge of the aims of the programme. The choice of the programme, its components, and web site, progression throughout the programme should be mutually agreed and based on: the person's age, preferences and needs. the person's skills and abilities in essay writing service, managing their condition, and their goals (such as improvement or treatment of deterioration of symptoms, prevention of relapse or maintenance) the severity and wireless research paper, complexity of symptoms. physical and cognitive functioning. Cognitive behavioural therapy (CBT) and/or graded exercise therapy (GET) should be offered to people with mild or moderate CFS/ME and provided to those who choose these approaches, because currently these are the interventions for which there is the writing service clearest research evidence of router, benefit. If a full CBT or GET programme is inappropriate or not available, components of CBT or GET should be offered, either individually or more effectively in combination with: activity management strategies (see sleep management (see–3) relaxation techniques (see The choice of programme, its components and progression through it should be reviewed regularly, taking into account the goals and service, abilities of the person with CFS/ME, and other approaches agreed as necessary. Healthcare professionals should advise people with CFS/ME to contact them if they experience an increase in symptoms that lasts for longer than a few days after starting the wireless router research specialist programme, or if symptoms are severe or distressing. Cognitive behavioural therapy (CBT) A course of CBT should be delivered only by a healthcare professional with appropriate training in music essay writing, CBT and experience in CFS/ME, under clinical supervision. Free? The therapist should adhere closely to empirically grounded therapy protocols. CBT should be offered on a one-to-one basis if possible. CBT for a person with CFS/ME should be planned according to the usual principles of CBT, and should include: Acknowledging and validating the person's symptoms and music service, condition. Explaining the CBT approach in CFS/ME, such as the happens relationship between thoughts, feelings, behaviours and symptoms, and the distinction between causal and perpetuating factors. Discussing the person's attitudes and expectations.

Developing a supportive and collaborative therapeutic relationship. Developing a shared formulation and understanding of essay service, factors that affect CFS/ME symptoms. Agreeing therapeutic goals. Tailoring treatment to the person's needs and level of functioning. Recording and analysing patterns of activity and rest, and thoughts, feelings and behaviours (self-monitoring). Establishing a stable and maintainable activity level (baseline) followed by a gradual and for kids, mutually agreed increase in activity. Challenging thoughts and expectations that may affect symptom improvement and outcomes. Addressing complex adjustment to diagnosis and music essay writing service, acceptance of current functional limitations. Developing awareness of free resume, thoughts, expectations or beliefs and music essay writing service, defining fatigue-related cognitions and behaviour. Identifying perpetuating factors that may maintain or exacerbate CFS/ME symptoms to increase the person's self-efficacy (sense of control over symptoms).

Addressing any over-vigilance to symptoms and related checking or reassurance-seeking behaviours by providing physiological explanations of symptoms and using refocusing/distraction techniques. Problem solving using activity management and resume, homework tasks to test out essay writing alternative thoughts or beliefs, such as undertaking pleasure and mastery tasks (tasks that are enjoyable and give a sense of resume, accomplishment). Building on existing assertion and communication skills to set appropriate limits on activity. Managing sleep problems, for example by addressing any unhelpful beliefs about sleep, behavioural approaches to sleep disturbance, stress management, and/or relaxation training (see recommendations–6). Treating any associated or comorbid anxiety, depression or mood disorder according to NICE clinical guidelines on these conditions (see section 6). Offering information on service, managing setbacks/relapses (see section 1.7). GET should be delivered only by a suitably trained GET therapist with experience in CFS/ME, under appropriate clinical supervision. GET should be offered on a one-to-one basis if possible. People with mild or moderate CFS/ME should be offered GET that includes planned increases in the duration of essay chemistry one day our life, physical activity. The intensity should then be increased when appropriate, leading to aerobic exercise (that is, exercise that increases the pulse rate). GET should be based on the person's current level of activities (such as physical activity, daily routines, sleep patterns and frequency of setbacks/relapses) and emotional factors, vocational or educational factors and individual goals (details of service, these may be obtained from an activity diary). The programme should also include sleep and relaxation strategies (see recommendations–6). When planning GET, the healthcare professional should: Undertake an activity analysis to father, ensure that the person with CFS/ME is not in a 'boom and bust' cycle before they increase the time spent in music, exercise. Discuss with the person the ultimate goals that are important and relevant to them. This might be, for example, a twice-daily short walk to the shops, a return to wireless router, a previous active hobby such as cycling or gardening, or, for people with severe CFS/ME, sitting up in bed to essay service, eat a meal. Recognise that it can take weeks, months or even years to router research, achieve goals, and ensure that this is music essay, taken into free, account in service, the therapy structure (for example, by resume web site setting short- and medium-term goals).

Explain symptoms and the benefits of exercise in a physiological context. When starting GET, the healthcare professional should: Assess the person's current daily activities to determine their baseline. Agree with them a level of additional low-intensity exercise that is music essay service, sustainable, independent of daily fluctuations in symptoms, and chemistry one day, does not lead to 'boom and bust' cycles. This may be sitting up in music, bed or brushing hair, for example, for people with severe CFS/ME, or gentle stretches or a slow walk. Encourage them to undertake this exercise for at router least 5 days out of 7, or build up to music essay writing service, this level if and when possible. Advise them that this level of exercise may mildly increase symptoms for a few days (for example, a mild to moderate increase in stiffness and fatigue), explain why this may occur and discuss strategies to mitigate it.

Offer information on the management of setbacks/relapses (see section 1.7). Progressing with GET. When the low-intensity exercise can be sustained for 5 days out of 7 (usually accompanied by a reduction in research, perceived exertion), the duration should be reviewed and increased, if appropriate, by music essay writing service up to 20%. For example, a 5-minute walk becomes 6 minutes, or a person with severe CFS/ME sits up in bed for a longer period, or walks to another room more often. The aim is to reach 30 minutes of low-intensity exercise. When the critical 1984 duration of low-intensity exercise has reached 30 minutes, the intensity of the writing exercise may be increased gradually up to an aerobic heart rate zone, as assessed individually by free web site a healthcare professional. A rate of writing, 50–70% maximum heart rate is recommended. Exercise intensity should be measured using a heart rate monitor, so that the person knows they are within their target heart rate zone. If agreed GET goals are met, exercise duration and intensity may be increased further if appropriate, if other daily activities can also be sustained, and in agreement with the terrorism for kids person with CFS/ME. After completing a GET programme, the healthcare professional and the person with CFS/ME should continue working together to develop and build on strategies to maintain exercise. Support should be available, if needed, to enable the person to reinforce the learning and lifestyle changes made and continue GET beyond discharge. Activity management is a goal-oriented and person-centred approach tailored to the needs of the person with CFS/ME. It should include: Understanding that activities have physical, emotional and essay writing, cognitive components, and identifying these components. Keeping a diary that records cognitive and because essay, physical activity, daytime rest and essay service, sleep. Web Site? This will help to set baseline levels of service, activity (a stable and sustainable range of functioning), identify patterns of over- and underactivity, and develop an activity/exercise strategy. Establishing a baseline; specific activities may need to be increased or decreased while this is happening. Gradually increasing activity above the baseline in agreement with the person. Planning daily activities to allow for research paper, a balance and variety of different types of music essay writing service, activity, rest and sleep. This may include making a weekly activity schedule. Spreading out difficult or demanding tasks over the day or week.

Splitting activities into wagner critical essays on sylvia plath, small achievable tasks according to the person's level of ability/functioning, followed by music essay gradual increases in free resume web site, the complexity of the tasks. Monitoring, regulating and planning activities to avoid a 'boom and bust' cycle. Goal setting, planning and prioritising activities. Explaining the role of rest in CFS/ME and helping the person work out essay writing how to build in rest periods and achieve a productive day (see recommendations–6). Regularly reviewing activity levels and goals.

Offering information on the management of setbacks/relapses (see section 1.7). 1.6.3 Pharmacological interventions for symptom control. If chronic pain is a predominant feature, healthcare professionals should consider referral to a pain management clinic. Prescribing of low-dose tricyclic antidepressants, specifically amitriptyline, should be considered for people with CFS/ME who have poor sleep or pain. Tricyclic antidepressants should not be offered to people who are already taking selective serotonin reuptake inhibitors (SSRIs) because of the potential for serious adverse interactions. Melatonin may be considered for free, children and music essay writing service, young people with CFS/ME who have sleep difficulties, but only under specialist supervision because it is not licensed in the UK. 1.7 Management of setbacks/relapses. 1.7.1 Preparing for a setback/relapse. People with CFS/ME should be advised that setbacks/relapses are to resume, be expected as part of CFS/ME. Healthcare professionals and people with CFS/ME should develop a plan for managing setbacks/relapses, so that skills, strategies, resources and support are readily available and accessible when needed. This plan may be shared with the person's carers, if they agree. Setbacks/relapses may be triggered by factors such as unexpected/unplanned activities, poor sleep, infection or stress. Healthcare professionals, in discussion with the person with CFS/ME, should try to service, identify the cause(s) of a setback/relapse, but it should be recognised that this may not always be possible. When managing a setback/relapse, the terrorism because essay management plan should be reviewed. Healthcare professionals should discuss and agree an appropriate course of service, action with the person with CFS/ME, taking into account: the person's experience. possible causes of the setback/relapse, if known. the nature of the because for kids symptoms.

the severity and duration of the setback/relapse. the current management plan. When managing setbacks, healthcare professionals should put strategies in place that: Include relaxation and breathing techniques. Maintain activity and exercise levels if possible, by alternating activities with breaks and pacing activities, as appropriate. Involve talking to families and carers, if appropriate. Recognise distressing thoughts about setbacks/relapses such as 'this means I'll never get better', but encourage optimism.

Involve reconsidering and revising the levels and types of music essay service, symptom control. In some setbacks/relapses, it may be necessary to reduce, or even stop some activities and increase the frequency and/or duration of rest periods to stabilise symptoms and re-establish a baseline activity level. This should be discussed and agreed with the router research paper person with CFS/ME. People with CFS/ME should be advised to music writing, minimise daytime sleep periods. However, healthcare professionals should recognise that this is not always possible, depending on the severity of a person's symptoms and the setback. After a setback/relapse, healthcare professionals should review the person's activity levels to chemistry one day, re-establish a baseline and review the management plan. A gradual return, when possible, to previous exercise and functional routines should be encouraged. Activity should be increased gradually. Healthcare professionals should advise on:

Slowly decreasing the service frequency and duration of rest periods. Continuing the use of relaxation techniques, even when the person with CFS/ME is one day, beginning to feel better. After a setback, healthcare professionals and people with CFS/ME should review the experience to determine, if possible, whether triggers can be managed in the future, and put strategies in place to do this. Regular, structured review should be undertaken for essay writing service, all people with CFS/ME. The review should include, if appropriate: Assessing improvement or deterioration in absent father thesis, symptoms.

Assessing any adverse or unwanted effects of therapy. Considering the need to repeat investigations (for children and essay, young people, repeating investigations should be considered if there is free web site, no improvement after 1 year). Reviewing the diagnosis, especially if signs and symptoms change (see recommendation Considering referral to specialist CFS/ME care. Reviewing equipment needs. Assessing any additional support needs (see sections 1.1 and 1.4). The timing of the reviews should depend on the severity and complexity of symptoms, the effectiveness of any interventions, and essay writing service, the needs of the person with CFS/ME. 1.9 Key principles of care for people with severe CFS/ME. Management of linda critical plath, severe CFS/ME is difficult and complex and healthcare professionals should recognise that specialist expertise is needed when planning and providing care for people with severe CFS/ME. Diagnosis, investigations, management and essay, follow-up care for people with severe CFS/ME should be supervised or supported by a specialist in CFS/ME. People with severe CFS/ME may need to use community services at times. These services may include nursing, occupational therapy, dietetics, respite care, psychology and physiotherapy (see the 'National service framework for paper on stds, long-term conditions' [11] ). The input of different professionals should be coordinated by music essay service a named professional. People with severe CFS/ME should be offered a summary record of every consultation because of linda wagner critical essays on sylvia plath, their cognitive difficulties. Most people with CFS/ME will not need hospital admission. However, there may be circumstances when a planned admission should be considered.

The decision to admit should be made with the essay service person with CFS/ME and their family, and be based on linda wagner critical on sylvia 1984, an informed consideration of the benefits and music writing, disadvantages. For example, a planned admission may be useful if assessment of a management plan and investigations would require frequent visits to the hospital. When making decisions about prolonged bed rest, healthcare professionals should seek advice from term paper, a specialist experienced in the care of people with severe CFS/ME. The significant physical and psychological risks associated with prolonged bed rest should be taken into account. Healthcare professionals working with people with severe CFS/ME who are in music, bed most (or all) of the time, should explain the associated risks (such as postural hypotension, deep venous thrombosis, osteoporosis, pressure sores and deconditioning) and monitor these. People with severe CFS/ME should be offered an individually tailored activity management programme (see recommendation as the absent father thesis core therapeutic strategy, which may: be delivered at home, or using telephone or email if appropriate. incorporate the elements of recommendation and draw on the principles of CBT and GET (see recommendations–21). An activity management programme should be reviewed regularly and frequently. [4] Available from the Department of Health (England; this framework includes an exemplar pathway for music essay writing, CFS/ME) and NHS Wales. [5] Follow 'Referral guidelines for suspected cancer' (NICE clinical guideline 27) or other NICE guidelines as the symptoms indicate.

[6] For general advice on sleep hygiene, see the NHS Direct website. [7] Food Standards Agency (2006) 'The balance of good health'. London: Foods Standards Agency. [9] NHS Plus has produced guidance on thesis, the occupational aspects of the management of CFS/ME (search for 'chronic fatigue syndrome'). NICE [year]. All rights reserved.

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