Possessing The Secret Of Joy: Four Men To Find A Cure :: essays research papers

Four Men to Find a Cure     The four main men in Possessing the Secret of Joy ware roles that neutralise a stereotypical male they are the cure to Tashis happiness. Alice Walker go pasts Adam, Mzee, Pierre, and Benny roles that show a softer side to men. These four men are very unalike from each other but they do have some resemblance of each other. These men who were all very devotedly attached to Tashi took care of her and never gave up on her. Instead of deceiving and being indolent, these four men were very likeable. The men tend to symbolize and represent different aspects of Tashis life.     Tashis husband Adam symbolized love. He was the only lover of Tashi that we read about. He cared for her and watched over her even when he did not have control over her. Adam may not have been loyal to Evelyn, but he loved her and took care of her. He knew the real Tashi that many people never saw. He was loyal to Tashi, but after the circumcision he would barely ever see her. He was more of a great friend than a trustworthy husband was. He lets her know that he loves her several(prenominal) times in the book. At their marriage he cuts the same lines in his face as Tashi had to represent the Olinkans. He goes with her to Mzees house in Switzerland while she is cured. He also dreams about her and her livelihood, like when she used to say, "But what is it?" when she was happy. Adam, Olivias brother, was daring at heart. He and Tashi used to go the fields to have sex that was considered very taboo. His mentors were Lisette and Pierre. He learned from them. He was in love with Lisette. She was the contrast to Tashi. She was the opposite of her. Adam probably would have rather lived in France with her, but he stood by Tashi to give her love and affection. Adam was not a bad guy at all. He helped Tashi through the years and was always there whenever she needed somebody. It was unfair of him to be cheating on Tashi with Li sette, and Tashi resented him for that. He was always honest with Tashi though. Adam, like many of the other men in this book, was not a terrible person. He was good at heart.

The First World War (WWI) :: World War 1 I One

World War 1     World War 1 was c solelyed The Great War, The fight to depot all wars, and The first modern war. It had many causes and a few repercussions and I will describe them in detail.     The most widely known condition for the start of World War1 was the assassinatoration of the Arch Duke Ferdinad of Austria-Hungary in the Serbian capital of Sarajevo. The ArchDuke was there to talk to the Serbian leaders about peace in the Balkan Peninsula.       later on a Serbian was arrested for the assassination Austria-Hungary pulled out of the peace talks and decl ared war on Serbia. Germany who was associate with Austria-Hungary also declared war on Serbia. Russia who was allied with Serbia had to declare war on Germany and Austria-Hungary. When Germany invaded France and Belgium, Great Britain declared war on Germany. World War 1 had begun. As the German Chancellor, Bethmann-Hollweg said, Once the dice are cast nothing can stop them. Indeed once the dice were cast on World War 1 nothing stopped them until 22 million people had died.     Besides the assassination of the archduke there were four other reasons for the start of WW1. 1. Militarism- the building of large armies. All the nations in Europe at that sentence were engaged in what today could only be called an arms race. As soon as one nation built a new weapon, all the others followed suit. 2. Alliance System- The building of alliances to strengthen the borders of a country. In theses alliances if one country went to war all the other countries in the alliance were forced to go to war also. 3. Imperialism- The practice of colonizing other lands by large European nations. 4.Nationalism- The feeling of Patriotism in a country that makes it compete with all other counties in the res publica in all areas.     In my opinion WW1 was an unnecessary global conflict in which 22 million people needlessly lost their lives. I conjecture that this conflict could have be prevented or stopped in 2 ways.One if the Serbian leaders had more closely guarded the car that carried Archduke Ferdinad. If the assassin had not been able to get near the car perhaps the

Just What the Doctor Ordered :: Physicians Medicine Medical Autopsies Papers

Just What the Doctor Ordered Hurry Dad, follow that ambulance I shouted as the sirens went racing by like spinning tornados. The sound of sirens ceaselessly excited me and caught my curiosity. I wanted to be at the scene and to know exactly what had happened to the people involved. The next day I would anxiously wait for the paper to arrive, so I could read what happened. Since my dad is a police officer, I harbour always been intrigued by his stories of cops and robbers. As a result, these interests have influenced my decision to die a doctor. You may be wondering what there interests have to do with my being a doctor and why I have chosen this travel path rather than that of a paramedic, a police officer, or even a news reporter. That is easy. As far back as I fuck remember, I have been fascinated by anything having to do with doctors. It is for all my interests in the medical surface area that I have decided to become a doctor. The field of medicine that woul d allow me to combine all these fascinations is forensic pathology. As a forensic pathologist, I will be working firsthand with investigators and the hospitals in cases where patients have died of trauma or unknown causes. Investigators will have to share all the details of the crime scenes or accidents with me. Then, I will get to play the reference of Nancy Drew by putting all the pieces together to determine the actual cause of death. I will try to find out exactly what happened to all one of my patients in their last minutes of life. I have always been intrigued by mysteries therefore, I feel this career as a forensic pathologist will be perfect for me. It is important to enjoy ones career, so this is an excellent choice for me because it will never become dull or boring. Each autopsy that I will perform will have its own story and a new mystery for me to solve. I know I will wake up every morning anxious to go to work to see what new findings I will discover that day. You probably are wondering how I can be so excited about peoples dying, but I do not look at it like that.

commentary Dred Scott Essay -- essays research papers

This commentary will focus on the impact of the Dred Scott decision in America. Dred Scott was born a slave in Virginia to the family of Peter Blow originally. The family moved to St. Louis and sold Scott to Dr. John Emerson, a military surgeon stationed at Jefferson Barracks. Scott traveled with Dr. Emerson to different areas such as Illinois and Wisconsin territories, where slavery was prohibited. This is because of the minute Compromise, this compromise was created to end expansion of slavery and permitted Missouri to entered as a slave state and Illinois was entered as a free state. Because Scott had traveled to free territory, he felt that he was a free man and sued to be free. The first elusion is against Emersons wife and is dismissed based on a technical issue, the second case Scott wins the right to be free, however the case is appealed to Wisconsin Supreme Court who dis applys with the lower court and Scott remains a slave. Scott lawyers filed suit in the U.S. nationa l Court and this time its against Mrs. Emersons brother whom took over the estate due to her remarriage, his name was John F.A. Sanford.The United States Supreme Court first hears the case in 1854 and then again in 1856. The case gains public and political attention. It affected the presidential election in which it would cause a candidate to agree or disagree with the high court. Congress begin debates on its power to control slavery specific territories, eventually they left it up to the high court ...

The Purpose Of Education :: Economics

The Purpose Of EducationEducation is an important part in every childs life, and here inSingapore, every child has to receive haughty education. I believethat education is an important part in helping a child grow up, tomake sure that a child grows up into a sensible and responsible adult.It is also important to make sure the child grows up into anindependent individual with the skills necessary to be in the workforce ofa country.In order to achieve that, I feel that education has to be introducedat a young age. That way, children would be used to the environment,and be able-bodied to study more effectively when the child gets older, andmore subjects are introduced.However, education cannot be too geared towards an academic approach.For example, I feel that the education form in Singapore is tooexam-oriented. Though in Raffles Institution, there is no more focuson examinations, there still common tests and quizzes. Furthermore, otherwise schools, specifically neighbourhood schoo ls, still focus onexaminations, which I think is a dangerous pitfall, since schoolsshould not exist solely to make another person more knowledgeable. Itshould instead be used to help make the childrens minds morecreative, and not so rigid, in the sense that they would be able tolook at things at different perspectives.This is clearly represented in Gryphon. Mr. Hibler, a normal teacherin Five Oaks, follows the education system very faithfully. dissever55 shows that Mr. Hibler had a lesson plan ready. Thus he was probablyjust going to tell the students some information about Egyptians. Ifeel that this bod of teaching, however, is not useful, since it justspoonfeeds the children with information. This information would beforgotten by the students very quickly after a few years. Next, weread on about how Ms. Ferenczi teaches the students. Mr. Hibler travelill and is replaced by Miss Ferenczi. Miss Ferenczi, on the otherhand, does not strictly follow Mr. Hiblers lesson plans, but ins teadshe gives the students a lot of room for imagination. For example, inparagraph 64, Miss Ferenczi is supposed to talk about pyramids.However she asks the students to think of what was inside. Then shegoes on to say that the nature of pyramids were to guide cosmic energyforces into a concentrated point. However, we know that this is nottrue. Thus she is apparently trying to encourage the children toimagine different things.This would be what I think the purpose of education should be. Itshould be to give children a chance to express their creativity, to

The Purpose Of Education :: Economics

The Purpose Of EducationEducation is an important part in every childs life, and here inSingapore, every child has to receive autocratic education. I believethat education is an important part in helping a child grow up, tomake sure that a child grows up into a sensible and responsible adult.It is also important to make sure the child grows up into anindependent person with the skills necessary to be in the hands ofa country.In order to achieve that, I feel that education has to be introducedat a young age. That way, children would be used to the environment,and be equal to study more effectively when the child gets older, andmore subjects are introduced.However, education cannot be too geared towards an academic approach.For example, I feel that the education dodge in Singapore is tooexam-oriented. Though in Raffles Institution, there is no more focuson examinations, there still common tests and quizzes. Furthermore,former(a) schools, specifically neighbourhood schools, still f ocus onexaminations, which I think is a dangerous pitfall, since schoolsshould not exist solely to make another person more knowledgeable. Itshould instead be used to help make the childrens minds morecreative, and not so rigid, in the sense that they would be able tolook at things at different perspectives.This is clearly represented in Gryphon. Mr. Hibler, a normal teacherin Five Oaks, follows the education system very faithfully. divide55 shows that Mr. Hibler had a lesson plan ready. Thus he was probablyjust going to tell the students some information about Egyptians. Ifeel that this configuration of teaching, however, is not useful, since it justspoonfeeds the children with information. This information would beforgotten by the students very quickly after a few years. Next, weread on about how Ms. Ferenczi teaches the students. Mr. Hibler fallill and is replaced by Miss Ferenczi. Miss Ferenczi, on the otherhand, does not strictly follow Mr. Hiblers lesson plans, but insteads he gives the students a lot of room for imagination. For example, inparagraph 64, Miss Ferenczi is supposed to talk about pyramids.However she asks the students to think of what was inside. Then shegoes on to say that the nature of pyramids were to guide cosmic energyforces into a concentrated point. However, we know that this is nottrue. Thus she is apparently trying to encourage the children toimagine different things.This would be what I think the purpose of education should be. Itshould be to give children a chance to express their creativity, to

Curriculum Access for Students with Low-Incidence Disabilities

NCAC computer programme Access for Students with Low-Incidence Disabilities The Promise of Universal blueprint for encyclopaedism This brood was written with validate from the National cracker bonbon on Accessing the General Curriculum (NCAC), a cooperative agreement between drag and the U. S. Department of culture, Office of finical Education Programs (OSEP), Cooperative Agreement no(prenominal) H324H990004. The opinions expressed herein do not necessarily reflect the policy or position of the U. S. Department of Education, Office of Special Education Programs, and no decreed endorsement by the Department should be inferred. Curriculum Access for Students with Low-Incidence Disabilities The Promise of Universal Design for Learning Written by Richard M. Jackson, Director of Practice and CASTs Liaison to Boston College for the National common snapping turtle on Accessing the General Curriculum - Edited by Valerie Hendricks - This report addresses the following straitss * What is Universal Design for Learning (UDL)? * What be low-incidence disabilities? Why argon prep ars and communities exceptionally ch on the wholeenged in portion scholarly persons with low-incidence disabilities? * What are the needfully of students with low-incidence disabilities? * What curricula and instructional practices are currently put ond with students with low-incidence disabilities? * What planning models are in go for for students with low-incidence disabilities? * How base IEPs come across greater glide path to the superior superior command program for students with low-incidence disabilities? * What approaches exist for enabling students with low-incidence disabilities to participate in terra firma- and district-level assessment systems? How whoremonger the UDL framework amplification adit to the general course of study for students with low-incidence disabilities? Acknowledgements When whizz completes a writing project of this size and effort , there are many a(prenominal) to receipt and thank. Fore or so is CASTs Valerie Hendricks, whose editing skills remain unpar al togethereled. Valeries critical review, suggested reorganizations, and detailed edits in the final stages of the writing proved enormously laboursaving, contributing greatly to the over exclusively fictitious character of the work.I am in any case indebted to Kelly Harper and Lisa White, OSEP-supported research assistants based at Boston College, for their careful and extensive library research and lit summaries. Additionally, I want to recognize and thank other Boston College research assistants who helped with earlier editing and reference checking. They include Xiaoxia Chen, Jennifer Hawthorne and Randall Lahann. Finally, I want to express my gratitude to Chuck Hitchcock, NCACs project handler at CAST, and David Rose, NCACs principal investigator at CAST, for their patience, encouragement, and commitment in seeing this project done to completion .Table of Contents Introductionvi Overviewviii I. What is Universal Design for Learning (UDL)? 1 Origins of Universal Design1 Universal Design in Architecture2 Universal Design in Education4 Universal Design for Learning (UDL)5 II. What are low-incidence disabilities? 9 Alternative Systems for Classification9 A taper on Incidence9 III. Why are shoals and communities curiously challenged in serving students with low-incidence disabilities?.. 12Insufficient Numbers12 Finding the least Restrictive Environment13 IV. What are the postulate of students with low-incidence disabilities? 15 Special Education is not a Place15 Categories and Characteristics15 Addressing Intense and Complex Needs16 Clusters of Low-Incidence Disabilities17 dodge/Low Vision18 Deaf/Hard-of-Hearing19 Deaf-Blind22 Signifi johnt Developmental Delay23 Significant Physical and Multiple Disabilities25 Autistic Spectrum28 Considering Generic Needs29 V. What curricula and instructional practices are currently use wit h students with low- incidence disabilities?. 1 Curriculum and instructional Practices31 Toward a Definition of Curriculum33 Facing the Challenge of Curriculum Access35 Blending General and Specialized Curriculum37 Blind/Low Vision38 Deaf/Hard-of-Hearing42 T from each oneing Approaches43 Inclusion of Deaf and Hard-of-Hearing Students45 Deaf-Blind49 Communication50 Orientation and Mobility50 Individualized Education51 Transition51 Inclusion in Family51 Teaching Strategies and Content Modifications51 Significant Developmental Delay52 Curriculum54 preceptal Adaptations56 Significant Physical and Multiple Disabilities60Autistic Spectrum61 Sensory-Motor Therapy63 Communication Therapy64 Social Skills Training64 Applied Behavior Analysis65 Multi-Treatment Programs65 VI. What planning models are in use for students with low-incidence disabilities? 67 The Evolution of the Individualized Education Plan (IEP)67 Person-Centered Planning69 Group Action Planning (GAP)69 Making Action Plans (MAP s)70 Planning Alternative Tomorrows with Hope (PATH)71 Circle of Friends73 Collaborative Planning and the General Curriculum74 Planning in the Context of the General Curriculum76 VII.How can IEPs ensure greater access to the general computer programme for students with low-incidence disabilities?.. 78 Expanding Roles and Functions of IEP Team Members78 Origins of the IEP79 Purpose of the IEP80 Limitations of the IEP82 estimate 97 Challenges for the IEP82 Addressing the General Curriculum with the IEP85 VIII. What approaches exist for enabling students with low-incidence disabilities to participate state- and district-level assessment systems? 91 The Role of Assessment in Standards-Based Reform91 Broad-Scale Assessment Systems92Standards-Based Assessment and Students with Disabilities93 Participation of Students with Disabilities in Assessment and Accountability Systems94 Changes in Assessment Systems for Students with Disabilities96 Accommodations98 Modifications99 Alternate Asses sment Systems99 Massachusetts Alternate Assessment102 Issues Remaining with Alternate Assessment108 IX. How can the UDL framework increase access to the general political program for students with low-incidence disabilities. 113 Universal Design Revisited114 UDL and the Curriculum116 UDL Components117 Goals119 Methods120 Materials121The National cultureal Materials Accessibility Standard (NIMAS)123 Assessment124 Curriculum Flexibility for Students with Low-Incidence Disabilities125 References129 Appendices145 Appendix A Tips for Universally Designed Teaching145 Appendix B Principles of Universal Design for Instruction (UDI)147 Appendix C Design Principles for Lesson Adaptations148 Appendix D Expanded center of attention Curriculum for Blind/Low Vision Students149 Appendix E Six Core Principles153 Appendix F Alaskas offer Recommendations154 Appendix G Six Guidelines for Inclusive Programs155 Appendix H Alternate Assessment Approaches157Appendix I Five Best-Practice go for States 158 Introduction Twenty years ago, the publication of A Nation At Risk instigated two decades of informational reform in the United States. Yet up(a) our procreational system remains a national priority. Today, various inculcate reform efforts brought most by enabling legislation and funding streams are overlap on the goal of providing a single high-quality education for all of Americas students. Expectations of excellence and equal access, as well as a contract on outcomes, are driving the effort to leave no babe behind. The goal of much of this reform work is to ensure that baby birdren of color, children living in poverty, children learn English as a second language, and children with disabilities encounter no barriers as they get down the best education possible in order to capture independent, productive, and active members of the communities in which they go out live as adults. Once, the factory model of give lessonsing in America viewed all children as mere raw material to be measured and then either mainstreamed or side-tracked, with children disadvantaged by color, poverty, language, or disability automatically winding up outside the mainstream.This system of categorisation and then tracking children institutionalized inequality and denial of opportunity. Reform efforts of today are directed toward eliminating this ad hoc marginalization of conclaves of children, much(prenominal) as those listed above, who are viewed as at risk in Americas schools. Reforming education, improving schools, and raising student achievement are noble and brotherlyly except pursuits, but by what means are these lofty goals to be accomplished?Many of the diagnostic and prescriptive approaches of the past claim resulted in practices where presumably the least capable receive meaningfully less(prenominal) curricula. An option approach to belowstanding student development difficulties becomes available when assessments are applied to a school itself, or, more particularly, to a schools curriculum, instead of to students. Measurement can then proceed with the following questions How accessible and user-friendly is the curriculum? To what finis does the curriculum permit multiple approach and exit points?To what degree does the curriculum capture for wide elaboration? How accurately and fairly does the curriculum assess student progress? In order to key out a single high-quality public school education available to all, the curriculum itself must(prenominal) be examined. The typical lecture-and-textbook curriculum, made accessible only to those who could demonstrably usefulness from it, implies that any failure to grasp the material calls for the student him- or herself to be examined for flaws, as has traditionally been the case.Failure to examine the curriculum and to consider modifications to it presents a crucial question are the problems confronting public schools today rooted in the students or in the curriculum? In the following pages, we take the position that the challenge of educating students with disabilities or students who are not achieving rests with the curriculum, not with the student. In particular, we posit that the problem resides within the static presentation of typical curriculum, which is unresponsive to the many and varied ways in which unmarried savants differ.In order to begin addressing not the deficits of students but rather the barriers erected for them by traditional curriculum, a framework is require for examining the curriculum as it is and for suggesting ways in which it whitethorn be made most accessible to all students. One such framework is Universal Design for Learning (UDL) (Rose & Meyer, 2002). UDL takes a trifold approach to assessing curriculum as it examines, first, the ways in which content can be represented second, the means by which students can respond and third, the conditions under which students can engage in the teaching process.UDL anticipates an change magnitudely digitized information source for curriculum, which allows a UDL framework to lookout man the development of future digital media, delivery mechanisms, and technology tools for use in education. Today, an object as static as a textbook can be transformed in seemingly limitless ways when presented digitally (such as audio, CD-ROM, HTML). As schools become more inclusive and democratic institutions, and as technology develops exponentially, unprecedented opportunities lie ahead for all students to reach high standards in their learning and to feel a high quality of breeding in adulthood.In the discussion that follows, we present practices that hold promise for increasing access to the general education curriculum for our nations most vulnerable populations of students with disabilities. It is the general curriculum that prepares children to take on independent, responsible, and productive roles as adults. The general curriculumdelivered through with(predicate) publicly-funded schools (and therefore by or through democratic institutions)affords a central opportunity for all to chase after the American dream.For students who are blind, deaf, multiply disabled, or operatively developmentally find outed, equal opportunity to pursue that dream is out of reach without advances in how we prepare and lend oneself our teaching force, how we set policy that raises standards and expectations without discrimination, and, above all, how we deliver a curriculum that is flexible and widely accessible for all learners. Equal access to the general curriculum implies that all students have the right to strive for the alike(p) educational goals.Equal opportunity implies that accommodations are in place to remove or minimize the impact of disability on authentic performance, thus leveling the playing field. Equal opportunity as well implies that modifications to first appearance points to and benchmarks of the curriculum can be made so that students with disabilities are enabled to confine progress to the maximum possible extent. The central question at hand is how communities and state and local education authorities organize to abide the best education possible for students with low-incidence disabilities.One answer is that public education, equally afforded to all, can be accomplished through collaboration among stakeholders, including families, educators (both additional and general), administrators, and policy-makers. We allow for demonstrate how adherence to a UDL framework for curriculum reform can weaken a flexible and accessible curriculum for all students, including those with disabilities. Overview When sexual intercourse reauthorized the Individuals with Disabilities Education Act in 1997 (IDEA 97), conditions were set for reasoned change in the ways disability is viewed in the broader context of schools and society.Originally, in the mid-1970s, Congress acted to ensure that no child, unheeding of extent of disability, could be denied a free, catch, and public education (FAPE) in the least restrictive purlieu. At that time, an appropriate education meant a special educationone that would be man-to-manly blueprinted to address the require that result from disability. Now, more than thirty years later, the law states that no child whitethorn be denied access to the general education curriculumspecifically, that curriculum which schools and school districts make available to all non-disabled students (IDEA 04).Currently, the general curriculum consists of core adequate to(p) areas plus varying elective subject options. Broad frameworks for core content areas are more or less determined by individual states, which also set requisite standards for grade advancement and graduation. In the larger, national effort to reform education in general, students with disabilities are not to be denied access to the kindred opportunities afforded their non-disabled schoolmates.In this way, Con gress seeks to align opportunities for students with disabilities with those available to the non-disabled student population. Using broad-scale assessment systems, states now measure the extent to which all students, and the schools they attend, achieve intended outcomes. There is less fury on analyzing the discrepancy between what schools actually provide and what they intend to provide (inputs) in favor of greater focus on results as measured by standards attainment (outputs). Better results for schools presumably lead to better adult outcomes for students.Just as schools are held accountable for student learning through standards testing, so too will schools be held accountable for supports and services they provide for students with disabilities in order to allow them to access the general curriculum. Accordingly, students with disabilities are now compelled by IDEA 97 and ulterior amendments to participate in all state- and district-level assessment systems. Today, the touch stone of special education law remains the Individualized Educational Plan (IEP), which is a document expand the retch and intensity of services and supports intended for each eligible student with a disability.Unlike in the past, however, the IEP now formalizes the collaborative relationship between general and special education and also aligns the general curriculum with specially-designed instruction and other support structures necessary for enabling access to the curriculum. Some support structures relate to how instruction accommodates a students disability without altering standards (e. g. , extra time allotted for task completion, Braille in place of print).Other supports may involve curriculum modifications that ordinate performance levels or entry points but continue to address standards content domain or framework. Accommodations or modifications stipulated in an IEP to adjust instruction or alter curriculum for a student also apply to the administration of state- and district-level assessments. For students with significant developmental delays, accommodations alone may be neither sufficient nor appropriate. Alternatively, states and districts may employ alternate assessments to ascertain the extent to which students make full goals delineated on their IEPs.Alternate assessments in these cases are modifications of state standards, but they nonetheless follow the broad frameworks identified for each states core knowledge areas. Alternate assessment procedures can be authentic and performance-based. In frequent use are portfolios, evaluated according to rubrics that come across the depth to which students meet standards. Alternate assessment procedures are labor intensive both to design and to carry out. Scoring by state authorities is also laborious and time-consuming.Presumably, however, the use of alternate assessments is hold in to 13% of school-aged children, thus minimizing the extent of onerous time and effort. Moreover, time spent by t eachers in ab initio documenting alternate assessments is well invested, as procedures become more routine over time with an IEPs implementation. To many, this adherence to states curriculum standards for students with significant developmental delays appears unrealistic, but, clearly, Congress flavor in IDEA 97 and IDEA 04 is to remove barriers that historically limit access to the same curriculum taught to non-disabled students.This amounts to a zero-reject from the general curriculum so that all students must participate in and make progress within the general curriculum to the maximum extent feasible. If one c one timeives of the general curriculum as the vehicle through which all students can achieve adult outcomesoutcomes understood in a broad sense as independence, participation, and productivitythen, in a just and democratic society, opportunity cannot be denied for students with disabilities.In the discussion that follows, we examine practices intended to improve access to the general curriculum for students with low-incidence disabilities. For many reasons, this population presents eccentric and daunting challenges for all committed to meeting IDEA 97s mandates. We follow a question-and-answer format in order to address key issues and to arrive at base understandings concerning students with low-incidence disabilities. Since much of this report refers to a UDL framework, UDL will be outlined.Low-incidence disabilities are then contrasted with high-incidence disabilities to uncover some distinguishing characteristics of this population. Next, particular challenges confronting schools and communities that endeavor to coif these students and their families are examined. We then chip in down on identifying the necessitate of students with low-incidence disabilities. We also present disability-related needs that are unique to a particular category of specific disability and other, more generic needs that cut across categories.The reason for this is the fact that IDEA retains the use of specific disability categories for eligibility determination and classification. Over the past fewer decades, however, both professional literature and actual practice have supported alternating(a) approaches for defining and classifying students with low-incidence disabilities. Thus, in order to provide students with low-incidence disabilities with appropriate and effective services, supports, and ancillary aids, it is necessary to examine alternative frameworks, differing from those traditionally in place, for understanding needs.Specialized curricula and instructional practices that hold particular promise for students with low-incidence disabilities are presented. Just as it is of the essence(p) to understand need from multiple perspectives, so too must curriculum and instructional practices be understood as meeting both unique as well as shared needs among students with low-incidence disabilities. We focus on curricula and practices t hat are exceedingly specialized as well as those that address more typically shared needs.Because IDEA requires access to the general education curriculum for all students, it is necessary to examine ways in which specialized curricula and instructional practices can support or otherwise connect with broader approaches for amend access, participation, and progress for students with disabilities. Curriculum is highly complex. Historically, it has been examined through many different lenses. The complicated nature of curriculum theory and practice makes it difficult to envision innovative ways of making it accessible for students with disabilities.Thus, we will also examine and attempt to demystify some of that complexity. Instructional practices presented in the context of our discussion are intended to bring an effective focus to eliminating or reducing curriculum needs associated with low-incidence disabilities. As with the consideration of need, curricular options and instructio nal practices can also be both highly specialized to a specific disability and highly generic across disabilities. For example, approaches for engaging students who are blind or deaf can be quite a unique to those disabilities, give the varieties of existing communication modes.Other approaches can be quite generic, involving, for example, applied behavior analysis or systematic instruction. After grounding in student need, curriculum, and instructional techniques, we examine models for collaborative planning. Students with low-incidence disabilities require services and supports beyond the classroom. These may intensify at various transition points throughout a life span and broaden out to include an array of community agencies. We examine the IEP in turn as a tool for pulling services together in support of access to the general curriculum.We then focus on approaches for enabling students with low-incidence disabilities to participate in state- and district-level assessment syst ems. Finally, we conclude with a consideration of how access to the general curriculum can be improved for students with low-incidence disabilities through the cover of principles of universal design. I. What is Universal Design for Learning (UDL)? A major premise of this report is that access to the curriculum for students with low-incidence disabilities is greatly enhanced by universal design.Universal Design for Learning (UDL) is a particular framework that applies to education. More specifically, UDL is an approach that can guide curriculum reform. A universally-designed curriculum includes multiple means of representation (to allow various ways of acquiring information and knowledge), multiple means of expression (to allow alternatives for demonstrating knowledge), and multiple means of mesh (to challenge appropriately, to motivate, and to allow learners to express and participate in their interests). A number of current contrasting approaches to universal design will be desc ribed.We conclude with an explanation of UDL. This will allow the reader to keep UDL in mind part progressing through subsequent sections until UDL solutions for curriculum access are more closely examined in our conclusion. Origins of Universal Design Architecture reveals the extent to which humankind can establish dominion over the natural environment by harnessing resources that it has to offer. Architectural design can be subjected to all manner of criteria, including beauty, convenience, utility, durability, safety, and even exclusivity.Only in recent times has the criterion of exclusivity been successfully challenged. As populations grew, build environments afforded touch off and facilitated commerce. The need for standards in architectural design became apparent as built environments became inter machine-accessible. Architects needed to consider the preferences and capabilities of those who would access built environments. In more recent times, users of built environments were living longer and, therefore, functioning with less mobility and stamina. Notions of democracy and community were transforming views of belonging and participation.During the 1960s, social movements that began in Europe around such concepts as normalization, deinstitutionalization, and communitization were beginning to have a profound impact upon those who would advocate for the disabled in the United States. Thus, the needs of people who would potentially access the built environment were beginning to be understood as complex and diverse. Universal Design in Architecture The passage of the Vocational Rehabilitation Act of 1973 essentially outlawed discrimination on the basis of disability.So far-reaching was this piece of federal legislation that it took nearly three years for a beleaguered Congress to write the regulations that would ostensibly remove architectural barriers from all publicly supported buildings and properties. During this era, universal design in computer arc hitecture was born. Like the dream of building inclusive communities for all to enjoy equally, universal design is an ideal with a process to ensure maximum participation for all. The challenge of removing physical barriers and retrofitting solutions to barriers proved to be a costly and cumbersome process, a great deal yielding unsatisfactory results.Universal design sought to embed solutions into features at the design levelfeatures that would benefit all, not merely accommodate the few. Curb cuts intended for wheelchair users, for example, were also found to be helpful for users of baby strollers, shopping carts, skateboardes, among others. In 1990, the Americans with Disabilities Act (ADA) extended the prohibition against discrimination on the basis of disability to the private sector, requiring all entities doing business with the public to make every reasonable accommodation in providing access.Accessibility standards, while necessary for guidance and compliance monitoring, c an appear onerous or threatening in lightness of the fact that they are government regulations, particularly when coupled with the publics misperceptions regarding disability. Universal design, as envisioned by Ron Mace and his colleagues at compass north Carolina State Universitys Center for Universal Design, was intended to promote the design of products and environments that would appeal to all. North Carolina States Principles of Universal Design are listed below in brief form (without associated guidelines). PRINCIPLE ONE Equitable Use The design is useful and marketable to people with diverse abilities. PRINCIPLE TWO Flexibility in Use The design accommodates a wide tramp of individual preferences and abilities. PRINCIPLE THREE Simple and Intuitive Use Use of the design is easy to understand, regardless of the users experience, knowledge, language skills, or current concentration level. PRINCIPLE FOUR Perceptible Information The design communicates necessary information ef fectively to the user, regardless of ambient conditions or the users sensory abilities.PRINCIPLE FIVE Tolerance for Error The design minimizes hazards and the adverse consequences of accidental or unintended actions. PRINCIPLE sextuplet Low Physical Effort The design can be used efficiently and comfortably and with a minimum of fatigue. PRINCIPLE SEVEN Size and blank space for Approach and Use Appropriate size and space is provided for approach, reach, manipulation, and use, regardless of users body size, posture, or mobility. Principles of Universal Design, version 2. 0 (Center for Universal Design, North Carolina, 1997).Application of these principles has established a framework for developing design standards in architecture, as well as for creating consumer products, that permit the greatest degree of access and usability for the widest possible seethe of individuals. Today, millions of Americans with disabilities enjoy access to buildings, restaurants, movie theatres, sport ing events, transit properties, walkways, commercial vehicles, and bank teller machinesto name only a few venues that were once inaccessible to them.Wheelchair users, once limited to home instruction or restricted to special school buildings, now attend their neighborhood schools alongside their non-disabled agemates. However, although physical access to classrooms and other education facilities is an important first step toward educational equity for the disabled, it is not sufficient to ensure that all students with disabilities have equal access to the general curriculum or enjoy comparable opportunity to derive benefit from what school curriculum has to offer.Additional changes in the classroom environment and in the curriculum itself are also required in order for full equity to be achieved. Universal Design in Education Universal design in architecture recognized the splendor of building environments that were more in line with the needs of an aging population and the require ments of those persons with disabilities who were being welcomed into the general community during the 1970s.In the 1980s, attention was brought to bear on the rapidly increasing diversity of Americas students through the publication of A Nation At Risk, a report presented to the U. S. Department of Education by the National fit out on Excellence in Education. According to this report, our nations schoolsparticularly in urban centersappeared ill-equipped to prepare a diverse population to deal successfully in an increasingly global economy. The findings of the Commission spurred a wave of reform initiatives ith enabling legislation aimed at raising standards and outcomes for our nations most under-served students. More recent federal legislation, such as No Child Left Behind (NCLB, 2001) and the Individuals with Disabilities Education Act (IDEA, 1997 2004), seeks to build one education for all students, improve teacher quality, align curriculum with standards, measure outcomes at multiple points, and hold schools accountable for student performance.For no child to be excluded fromor unexpended behind bythe general curriculum, the curriculum itself must be examined and re-designed from a fresh perspective, much in the same way that buildings, environments, and products were critically examined by the master advocates of universal design in architecture resulting in important and lasting changes in building standards. Colleagues at the University of Connecticuts National Center on Postsecondary Education and Disabilities have developed a set of principles building upon and extending the principles originated at North Carolina States Center for Universal Design.Note that their educational design principles are essentially the same as those outlined by North Carolina State for architectural and product design (with the addition of principles 8 and 9community of learners instructional climate). Their impudently principles address more educational constructivis t perspectives regarding communities of learners and a climate of high expectations and social interaction. Together, these principles set a framework for what Scott, McGuire, and Shaw (2001) call Universal Design for Instruction (UDI).Application of these principles allows postsecondary institutions in particular to dramatically widen the accessibility of course offerings by designing accommodations into course structures rather than retrofitting a series of educational work-arounds to try and meet the specialized needs of individual students after course materials have been prepared. UDI principles are listed and defined in Appendix B. Universal Design for Learning (UDL) Calls for critically examining curriculum from a universal design perspective have come from many quarters (King-Sears, 2001 Hitchcock, 2001Nolet & McLaughlin, 2000 Pugach & Warger, 2001 Rose & Meyer, 2002 Turnbull, et al. , 2002 Wehmeyer, et al. , 2002). The principles of Universal Design for Learning (UDL) as pu t frontwards by the Center for Applied Special Technology (CAST, Inc. ) were first presented in an Office of Special Education Programs (OSEP) Topical Brief (Orkwis & McLane, 1998). Currently, typically taught curriculum in schools is a one-size-fits-all curriculum, best exemplified by the ubiquitous textbook.It generally lacks flexibility in how it presents information to students, how it permits students to respond, and how it engages students in the learning process. In order for typical textbooks and other curriculum materials to become accessible to many disabled students, they must undergo numerous time-consuming transformations and interpretations, to the extent that the students participation in classroom activities is a great dealtimes fragmented or delayed.Several projects supporting universal design and access approaches to the general curriculum were reviewed in Research Connections (Danielson, 1999), a bi-annual review of OSEP-sponsored research on topics in special education. Prominently featured were projects underway at CAST to create a universally designed early literacy curriculum (Scholastics WiggleWorks) and a universally designed document processor (CASTs eReader).Also featured in the review was a framework advanced by the University of Oregons National Center for Improving the Tools of Education (NCITE) for designing the architecture of effective instructional practices (Kameenui & Simmons, 1999). (Their design principles for lesson adaptations are available as Appendix C. ) CASTs work is important because it demonstrates how flexible and malleable curriculum can be with the use of digital media and digital technology tools following a UDL framework.The NCITEs work on the architecture of instruction is important because it draws upon the current knowledge base regarding effective instructional practices and illustrates how instruction can be tailored to learners depending on the degree of explicitness required. Over the years, many pro posals have emerged to counter the old factory model approach to mass education begun in the 19th century with graded education.Approaches to individualized, personalized, or otherwise tell apart instruction have made enormous contributions to thinking about teaching and learning processes. What might distinguish UDL from other efforts to improve instruction in generalor other perspectives on universal design in particularis that UDL establishes a framework for curricular reform in education (Rose & Meyer, 2002) yet also recognizes the need to maintain a balance between curriculum and instructional practice (Hitchcock, 2001).Moreover, a UDL framework provides a perspective for collaborative squads of special and general education personnel to provide access to the general curriculum while addressing disability-specific needs in multi-level or inclusive classroom situations (Jackson & Harper, 2002). While UDL anticipates the coming digital curriculum with its inherent potential for flexibility and built-in options, it is not wholly reliant upon technology. UDL can ensure accessibility with new media and technology tools, but it depends upon the application of evidenced-based teaching practices to yield desired results (Hitchcock, 2002).To achieve these results, a UDL framework relies upon three guiding principlesmultiple means of representation, multiple means of expression, and multiple means of engagementfor the development of flexible teaching approaches and curriculum resources. These principles emanate from analyzation of available research on the genius and new conceptualizations of how neuroscience informs our appreciation of learning and knowing (Rose & Meyer, 2000).Areas in the brain that contribute to learning can be grouped roughly into three interconnected networks, each with a fundamental role in learning (a) science networks, specialized to receive and analyze information (the what of learning) (b) strategic networks, specialized to plan and e xecute actions (the how of learning) and (c) affective networks, specialized to evaluate and set priorities (the why of learning) (Rose & Meyer, 2002).New insights into neurological systems on the job(p) within these three regions of the brain connected with learning has led to the formulation of the three guiding principles of UDL 1. To support diverse recognition networks, provide multiple, flexible methods of presentation. For example, when introducing students to a new concept or unit, a teacher may provide multiple structures to present that information, such as a lecture, a digitized text, an activity-based exploration, a demonstration. 2. To support diverse strategic networks, provide multiple, flexible methods of expression and apprenticeship.For example, when a teacher requests student responses to demonstrate understanding and knowledge, he or she could provide a range of tools that allow students to respond in various formats, such as in writing, orally, with a slide sho w, with a video, with a drawing. 3. To support diverse affective networks, provide multiple, flexible options for engagement. Allow students to select an area of interest within a topic or concept to research or study. For example, allow students to select one of the natural resources in a geographic area under study to research rather than assigning resources (Rose & Meyer, 2002).UDL also establishes a framework for providing access to, participation in, and progress within the general curriculum as first mandated by IDEA 97. Hitchcock, Meyer, Rose, and Jackson (2002) have defined four main components of the general curriculum 1. goals and milestones for instruction (often in the form of a scope and sequence), 2. media and materials to be used by students, 3. specific instructional methods (often described in a teachers edition), and means of assessment to measure student progress.Each component can be transformed for accessibility and participation by all students by adherence to the principles of UDL. UDL offers new ways to think about teaching and learning. Students with sensory challenges, for example, require curriculum that contains alternative approaches for presenting information. Students with motor challenges, on the other hand, may require curriculum that provides alternative ways of expressing what they know and can do, while students along the autism spectrum may require curriculum that contains alternative ways to become engaged in or connected with the learning process.Broadly stated learning goals may allow students who are cognitively challenged to enter the curriculum at points where appropriate levels of challenge and support can yield both tangible and measurable results. Methods and materials with designed-in supports may permit wider access and greater participation in the general curriculum by all students, including those with disabilities. Instructionally embedded assessments may provide more immediate feedback and more frequent entr opy points for progress monitoring and instructional decision-making.These are some of the promises of UDL. II. What are low-incidence disabilities? Alternative Systems for Classification Students with disabilities can be classified in many ways. IDEA 97 continues to recognize disabilities in the form of more or less discrete diagnostic categories, such as mental retardation, specific learning disabilities, or emotional disturbance. Other approaches to classification include categorizing disabled individuals by degree of severity of their needs, or by how atypical an individual may be when compared to a norm.Still other approaches may emphasize the level of intensity of supports necessary for an individual to function optimally in home, school, community, and work mise en scenes. Each of these approaches has advantages and disadvantages. The categorical approach taken by IDEA may emphasize learner characteristics for each disability, but, in so doing, it could also comfort a self- fulfilling prophecy in which all members of a group sharing a categorical label, in a sense, become that label.A severity approach may emphasize developmental milestones at the expense of ignoring strengths in functional skills. An intensity approach may meaningfully focus on levels of needed support, but, at the same time, limit opportunities for an individual to move to a less restrictive setting. None of these systems of classifying individuals with disabilities are either entirely satisfactory or entirely lacking in merit.For educators, it is important to be aware that several systems of categorizing students with disabilities exist simultaneously, because eligibility criteria, placement alternatives, intervention strategies, and teaching credentials may all vary substantially from school to school, depending on which system of classification is currently being employed. A Focus on Incidence When the issue at hand for students with disabilities centers on the provision of servic es in local schools, the availability of qualified personnel and the technical sophistication of necessary resources must be carefully considered.In order to provide students with disabilities with a free and appropriate public education, it is useful to classify learners in terms of incidence, or how many students with any particular disability or combination of disabilities reside in a community. Under such a system, students with the most commonly-seen disabilities may be more appropriately served by local public schools while students with relatively rare disabilities may not find adequate resources or highly qualified personnel.High-incidence disabilities include * communication disorders ( spoken communication and language impairments) * specific learning disabilities (including attention deficit hyperactivity disorder ADHD) * round the bend/moderate mental retardation * emotional or behavioral disorders Low-incidence disabilities include * blindness * low vision * deafness * hard-of-hearing * deaf-blindness * significant developmental delay * complex health issues * serious physical impairment * multiple disability * autismNone of the disabilities listed under low-incidence disabilities generally exceed 1% of the school-aged population at any given time. The relative rarity of students with these disabilities in public schools often poses significant challenges for local schools struggling to meet their needs. Since they encounter these students so infrequently, most local schools have bittie if any knowledge of how to best educate these students, of what technologies are available to assist them, and of how to obtain needed and appropriate support services from outside agencies.All students with low-incidence disabilities thus experience a commonality they are difficult to serve in current local public school programs. III. Why are schools and communities particularly challenged in serving students with low-incidence disabilities? Insufficient Numbe rs Students with low-incidence disabilities are difficult to serve in todays public schools because none of the low-incidence categories alone can form a group large enough to warrant the presence of full-time, school-based, and highly specialized personnel, except in the largest of big-city school districts.Therefore, students with low-incidence disabilities are more likely to be served in less inclusive settings (such as in special classes, separate schools, and residential facilities) than are students with high-incidence disabilities. Local schools that do attempt to provide maximum inclusion most often support these efforts through the use of itinerant personnel, usually teachers/consultants who travel from school to school as needed, often crossing district lines to serve the needs of their students.Each garland of low-incidence disability brings its own unique challenges to a local school system. When intensive, specialized instruction is required, such as the learning of Br aille for blind students or American Sign Language (ASL) for the deaf, teacher consultation models of intervention can prove woefully inadequate for the delivery of specially-designed and carefully-targeted intensive instruction.Similarly, when faced with students who present with complex healthcare needs, local schools frequently lack the capacity to respond appropriately to medical emergencies or to provide required routine intensive care. Each group of students with a low-incidence disability has its own set of specialized needs, requiring specialized supports and specially-trained personnel to maximize their educational opportunities. While some generic support services are of use to nearly all students, most are specialized to one group.For example, a deaf or autistic child is unlikely to need to learn Braille, while a blind student will not need the level of constant medical support that a quadriplegic child or one under medical treatment for leukemia is likely to require. Th e low-incidence nature of these disabilities also makes it extremely challenging to maintain an adequate supply of qualified professionals to serve them. The skills and knowledge sets of these professionals are highly technical, requiring a significant commitment of time and effort to acquire through professional preparation, typically at university centers.Yet the caseloads of these professionals are small and likely to change in composition from year to year. Further added to this supply challenge is the paucity of university-based, professional preparation programs to prepare sufficient numbers of practitioners to adequately serve these students. Moreover, administrative supervision and mentoring of new inductees to the field are frequently inadequate. These professionals are mostly isolated from colleagues, limiting their opportunity for collaboration and shared growth.Opportunities for targeted professional development may be extremely limited. In sum, it is difficult to attrac t qualified individuals into these fields to begin with and perhaps even more difficult to nurture, support, and retain them once employed. Finding the Least Restrictive Environment Often, the least restrictive environment for students with low-incidence-disabilities cannot be found in their local public school.While IEP teams must presume that a student is to be placed in the public school closest to her or his home, a team may be compelled by assessment findings to urge placement in a specialized setting where highly-trained personnel and appropriate technologies can be concentrated and unique needs can be appropriately targeted for intensive instruction. Although students with low-incidence disabilities are required to have access to the general education curriculum, that requirement does not state that the only way in which such a condition may be met is in a full-inclusion setting in a general education classroom.An IEP team may determine that an alternative and highly speciali zed setting is the most appropriate, and therefore least restrictive, placement available for meeting the specific needs resulting from a students disability(ies), particularly if their local public school is not sufficiently equipped to provide a safe and successful educational experience for that student. Thus, in many cases of students with low-incidence disabilities, the true path toward greatest access to the general education curriculum may be pursued more appropriately in a separate setting (for example, in a school for the deaf or a residential school for the blind).However, in some cases, appropriate program planning for students with low-incidence disabilities in local public schools is possible and may be the preferred placement according to the IEP team, which includes the student and the students family. Adequate provision for these students in inclusive settings requires broad community engagement and significant systems change. Collaboration and commitment among stake holders at the local, state, and federal levels are necessary to effect such change.With thoughtful and appropriate approaches to planning, such as those to be described, willing communities can amass the supports necessary to ensure high-quality educational services for even those students with the most significant cognitive disabilities or complex healthcare needs. IV. What are the needs of students with low-incidence disabilities? Special Education is Not a Place With the enactment of IDEA 97, special education is no longer considered a place but rather a network of services and supports designed to enable students to derive full benefit from a public school education (Heumann & Hehir, 1997).As stated earlier, this does not mean that students with disabilities cannot be appropriately served in specialized settings. Rather, the intent of the law is to emphasize that placement or location of services is the last decision an IEP team makes during a team assessment and planning proce ss. In earlier times, a disability-specific label itself would dictate placement, and that placement would define the treatment or nature of interventions for students. Todays approaches use comprehensive and holistic assessments to reveal the extent of need in suspected areas of risk associated with a students disability.Their team then determines the setting in which needed services can best be provided, selecting from a continuum or array of placement options ranging from full inclusion in a general education classroom to residency in a hospital setting (Drasgow, Yell, & Robinson, 2001). An IEP team always starts with the presumption that a student will be placed in the same setting in which he or she would be educated if disability were not an issue, namely, a regular public school classroom (Turnbull & Turnbull, 1998).Thus, in order to place a student in a less inclusive setting, this starting presumption must be rebutted by assessment data before such a placement outside a gen eral education setting can be made. Categories and Characteristics IDEA designates categories of disability with which specific learner characteristics have been associated in the special education knowledge base (Hallihan & Kaufman, 2002 Hardman, et al. , 2002 Heward, 2003 Turnbull, et al. , 2002).These characteristics are correlates of particular disabilities and not necessarily connected with a particular disabilitythat is to say, they are characteristics that are commonly found in students with these particular disabilities, but for which there are often exceptions, such as cases where a student has a particular disability but not one or more of its expected associated characteristics or behaviors. Learned helplessness, for example, is associated with specific learning disabilities, but not all students with learning disabilities have acquired this psychological adaptation.Rather, they are at risk for acquiring learned helplessness. While there are often litanies of learner char acteristics described as unique or disability-specific, the extent to which these areas of risk are observed in an individual student can vary widely. Careful assessment and observation of an individual student and his or her needs must be undertaken to document actual need for initial intervention and not merely expected need. Such an assessment establishes a baseline of educational need(s) against which progress can be measured.Students with disabilities often become handicappedunnecessarily or unfairly restrictednot by their disabilities in and of themselves, but by the environment in which they live, learn, and relate. Consequently, extent of need cannot adequately be assessed without consideration of broader contexts in which an individual lives. This context includes family, community, and the local public school which would be a students default placement location.Thus, a teams determination of the least restrictive and most appropriate environment for a student must take all these factors into consideration when judging the capacity or preparedness of home, community, and local school to support and nurture a student in areas of assessed need and in assuring a student access to the general curriculum. It is imperative that any set of disability-specific needs not serve to stereotype a student, to lower expectations for a student, or to contribute to negative self-fulfilling prophecies for a student.So-called unique or disability-specific needs should be taken only as possible areas of risk for IEP teams to investigate, not inevitable features automatically conjoined to a specific disability in question. Addressing Intense and Complex Needs Identified needs of students with low-incidence disabilities are frequently complex and multiple (Browder, 2001). Addressing severe and complex needs of students is challenging for family, school, and broader community.Since the ultimate goal of education is community inclusion and high quality of life, an appropriat e education must contain opportunities for each individual to achieve independence, enjoy community participation, and increase productive and rewarding work to the maximum extent possible. Most children identified by IDEA categories as having low-incidence disabilities possess sensory, motor, or neurological deficits, and, consequently, they are typically identified and managed early in their lives through a medical model.Families of infants and toddlers with established risks receive early intervention services, most generally under the auspices of state departments of public health. Such services prepare a family and their local community to understand and cope with the impact of a childs disability on their lives. Such services also prepare a family to actively participate in the planning and decision-making processes that accompany transitional events throughout the childs life. Thus, early intervention and early childhood education can be effective in preventing or minimizing many long-term and predictable consequences of disability.Because of the possibility of mitigating many of the consequences of disability early on in a childs life, possibly to the point where a disability essentially vanishes, IDEA encourages states to withhold disability categorization until age nine. The more generic term developmental delay is used instead, to avoid the stereotyping and lowered expectations that follow disability-specific labeling. However, states still have the option of using, for example, the terms blind or deaf if preferred.According to IDEA 97),decisions made about a child with a disability must be informed by persons knowledgeable about the disability or by qualified professionals. States must qualify professionals through certification or licensure. Thus, for blind students to receive specially-designed instruction in Braille literacy, deaf students in ASL, and motor- stricken students in augmentative communication, states must ensure that an adequate su pply of appropriately prepared professionals is available to support such students in educational programs.The need for the specialized knowledge and skills possessed by these professionals is often cited as a basis for retaining IDEAs system of categorical labeling, as well as states systems for categorical teacher certification (Hallihan & Kaufman, 2002). Clusters of Low-Incidence Disabilities Hereafter, low-incidence disabilities are defined and described under the following headings * Blind/Low Vision * Deaf/Hard-of-Hearing * Deaf-Blind * Significant Developmental Delay * Significant Physical and Multiple check * Autistic SpectrumNote that some of these headings do not match with IDEAs current categories, being more general. Where appropriate, legal categorical definitions are quoted from IDEA 97 in the text so that readers will note congruence with federal law. Blind/Low Vision According to IDEA 97, Visual impairment including blindness means an impairment in vision that, even with correction, adversely affects a childs educational performance. The term includes both partial sight and blindness. function 20 U. S. C. 1401(3)(A) and (B) 1401(26)Historically, students with visual impairment have been referred to as blind, visually handicapped, visually disabled, visually impaired, partially sighted, partially blind, visually limited, or sight impaired. To understand the needs of students with visual impairments, the following factors must be taken into account age at onset of visual impairment, degree of impairment, site of impairment, prognosis for improvement or degeneration in condition, day-to-day stability of condition, individual tolerance for visual fatigue, nd the extent and complexity of any co-existing additional impairments. Blind children are particularly challenged in understanding and moving about in physical space (Blasch, Wiener, & Welch, 1997). Without opportunity to directly observe space during locomotion, blind children have difficulty mentally representing and manipulating spatial concepts. They are also challenged in obtaining, manipulating, and producing many types of information, such as text, graphics, facial expressions, and gestural cues (Swensen, 1999).Achieving self-esteem is also difficult for blind children since self-awareness in the social context of school is often affected by such factors as social isolation, low expectations, and over-protection (Tuttle & Tuttle, 1996). Classroom instruction typically exploits the visual/motor take of communication and relies upon social mediation for student achievement. Because blind students cannot partake of the visual channel of communication and are often socially isolated, they generally have limited opportunities for incidental learning.This places them at a disadvantage when attempting to participate in classroom activities. Often gaps exist in concept development, making it difficult for classroom teachers to prompt prior knowledge, or leading them to m ake false assumptions in regard to the fundamental understanding these students have of the world around them. Moreover, the need for Braille as a necessary alternative to print creates a challenge for general education classroom teachers to provide invaluable corrective feedback, as very few general education classroom teachers can read and write Braille.Lack of eye contact and the impossibility of visually-based social recognition can have a profound impact on a blind students opportunity to form meaningful and cooperative relationships with peers. Such barriers must be carefully examined and skillfully addressed by practitioners in order to provide genuine and valid access to the general curriculum for blind students. Deaf/Hard-of-Hearing According to IDEA 97, Deafness means a hearing impairment that is so severe that a child is impaired in processing linguistic information through hearing, with or without amplification, that adversely affects a childs educational performance.Hea ring impairment means an impairment in hearing, whether permanent or fluctuating, that adversely affects a childs educational performance but that is not included under the definition of deafness in this section. Authority 20 U. S. C. 1401(3)(A) and (B) 1401(26) Needs of children who are hearing impaired must take into account factors such as age at onset of disability (in particular, pre-lingual vs. post-lingual deafness), audiometric hearing status (particularly in speech range with amplification), type of hearing loss (conductive, sensorineural, mixed, central) and possible presence of concomitant disabilities.The needs of children who are deaf and children who are hard-of-hearing must be understood as quite distinct when considering communication use. The native language of deaf children is American Sign Language (ASL), but children who are hard-of-hearing may understand speech with amplification and may not identify with members of Deaf culture. Severity of hearing loss is meas ured by decibels (dB) or units of loudness. A hearing loss between 15 and 20 dB is considered slight. A person with a hearing loss of 60 dB has difficulty hearing conversational speech without amplification.An individual with a hearing loss of 100 dB is not able to hear a power lawnmower without amplification (Kirk, Gallagher, & Anastasiow, 2000). Children and adults with hearing disabilities characteristically confront significant issues with regard to social and intellectual development, speech and language development, and edu

Modern Life Has Improved Since the 1950’s Essay

Modern conduct has improved since the 1950s. This period is quite memorable for a lot of things, the more(prenominal) famous of which being the flared trousers Elvis Presley, the icon of rock and roll and pop music, brought into style. There were some positives and negatives of living in the 1950s, but it is comport that modern bread and butter has been a great note forward from those times. Firstly, the general aspects of life such(prenominal) as m one and only(a)y, crime, racism and drugs, were viewed very differently in the past. secondly life today may non be as simple as the 1950s, but huge springinesss have been made in engine room, medicine and education.Finally, the phrase community has developed a very different definition to the past, as we have overcome the racial, religious and gender inequalities that separated us as wad modern life has improved in leaps and bounds since the 1950s. In the 1950s certain aspects of life including money, crime, racism and drugs, were viewed very differently compared to the modern day. Petrol prices could be found on the McDonalds loose change menu, and a kid could go down to the corner store, empty his pockets and buy the groceries before walking the itinerary home safely.Drugs and smoking were regarded the same way we would a morning jog today harmless and good for the system. Racism was beneficial a part of life the blacks sat at the back of the bus, the whites at the front, and that was that. Nowadays, if petrol was that cheap, the earth would be run dry and pollution levels would greatly increase due to mining and elevator car exhaust. Crime rates may be much higher than the innocent 1950s but along with with the higher stats the modern police force is raise advanced and more successful than the past.Racism is still a part of our lives, but there is a general understanding that no matter the tinge of our skin, we are equals, and opportunities for blacks have been improved far beyond better seatin g positions on buses. Thank goodness times have changed while we may not be living as simply as before, the modern day is aware of saving the planet, good health and human rights other areas of living have also been greatly improved during the last half century, especially education, medicine and technology.The frontiers of science and technology have taken education and medicine far beyond what the 1950s could have dreamed of. Without internet and mobile phones, the 1950s must have been a quiet life but consider the fact that technology today is enabling our world to communicate faster and better than ever before. Most schools have access to computers, such as Friends, with each individual someone owning a laptop that is vital for their education. Education can now be more efficient and fun with the new technology spreading world-wide.A leap in technology is supporting a huge economy and has opened up many job opportunities as well as developing frontiers such as science and medi cine. Polio scares rocked the 1950s with over 257,455 related deaths, but thanks to medicine advances nowadays polio is just a term many people confuse with a pool game (Marco Polo ). In the 1950s the life expectancy was much, much lower than it is today is that a wonder with the many cigarette adverts that declared the health benefits of smoking?Medicine has been advanced to the point of bringing people back to life after death, and is often one step ahead of what nature throws at us. This is evidence that modern life has improved greatly since the 1950s but our culture has also developed to be stronger, more equal and empathic than the 50s. The definition of community has greatly evolved since the 1950s community in the 1950s went by the motto love thy neighbour, except the neighbours who gaint believe in your religion or those of different race the term community in the 21st century is referring to equals who share their culture with one another.Children stayed children for lon ger in the 1950s, neighbours new everything about each other, a hello was said to every passer by on the street and it is said there was never a greater time of peace than in those years. However, amongst the idealistic community life, it was black and white literally. Blacks were discriminated far beyond what is accepted in Australian communities today, with over 50% of families living below the poverty line as a result of racism.Without the many new laws and rights other races are now empower to (that have developed since the 50s), many people would still suffer unjustly, and blacks would still sit at the back of the bus. Religion could lower your worth just as quickly as the colour of your skin schools only taught by the Bible, and good people believed in the Christian faith. Discrimination against women was also still in practice. An obedient wife was not to be unished, but the occasional wife-beating was completely in-line with the law. The phrase kitchen bitch may have origin ated in the 1950s, where the women were expected to work somewhat the house, doing the everyday chores such as cooking for their husbands. Many women did not begin to demand recognition for their rights to work until much later, and in modern times, women are regarded as equals in Australia. The 1950s were the calm after the storm, the storm being World War II.Peace may be a word which is almost woolly-headed to the entire world, with conflict present at all times in many countries, such as Iran and Afghanistan. This may be the only aspect of life that has worsened since the good ol 50s, but even so, the countless improvements to our beliefs, everyday life and sense of community balances this issue. In conclusion, though the 1950s are remembered as a peaceful, simple and straight-forward period of time to live in, behind the scenes racism, lack of knowledge and inequality ruled.Modern times have greatly improved on these factors and many others since the 1950s, with gender equalit y, medicinal knowledge, and new technology being just a few of the more major developments. Nevertheless, the past was vital in mold our daily lives and culture today, and its impossible to brand the 1950s as a wasted part of our history our modern world evolved out of the twentieth century. It is clear to see that life today has greatly changed since the 1950s, for the better.

The Impact of Transnational Corporations on Less Economically Developed Countries

A transnational (TNC) corporation is simply a astronomic business organisation which ope invests and has ownership of assets in more(prenominal) than one state of matter. Most TNCs operate in just a few countries, are involved in manufacturing and services and have their head offices in more developed countries. TNCs are responsible for employing over 40 million spate worldwide, indirectly influence an rase corkinger number, and to control over 75 per cent of world trade.At first, galore(postnominal) branches of TNCs were located in economically less developed countries, but there has been an increasing global shift to the affluent markets of Europe, North America and Japan. The reason why TNCs originally decided to locate in less developed countries was collectible to the existence of valuable resources, but the nearly important reason was the level of incentives offered by the home government.Also read thisCheating in a stern Line EconomyIf a TNC decides to settle in an LEDC, there leave alone be huge benefits. Many novel jobs impart be pretendd, which testament be filled by local labour. The jobs leave behind probably be remedy paid than opposite jobs supplied by industry which developed within the country. On the other hand, the wages will be much lower than the wages given for the same job in an MEDC. This is another reason why TNCs choose to puddle branches in LEDCs.The jobs supplied by the TNC will probably require some basic skills, especially if it involves the manufacture of a good. The education will be supplied by the TNC, and will probably be of a fairly high standard if they want the branch to be very productive. The employees will benefit from these skills, beca expenditure they would be able to use them in other aspects of their lives.The TNC will supply the expensive machinery used in manufacturing for the employees, which may also introduce new technologies as well. This will enable the country to progress and allow compani es to use the new technology to develop. Because worker wages is increasing, demand for consumer goods will increase as well, another reason why new companies will be tempted to develop.Mineral wealth and new energy resources will develop,Because there is more trade in the country, there will be more reason for roads to be built, as well as railways and airports. The TNC may help fund the development of these because it will improve the importing and exporting power of that country. The government will probably supply money for the transport links as well, due to the increasing quantity of money coming into the country.The increased amount of money made by the country batch also be used for many other things. Health control could be introduced, which means workers will be given improved working conditions and health plans. This could also help to improve output raise because workers will be in a better environment and mood to work. Money can also be used for environmental control , which could include developing ways of minimizing the amount of pollution certain industries create and even developing new production methods.Although the advantages to the country are numerous, there is a negative side which includes many disadvantages.Although the new TNC will supply many jobs, the cost of investment will be high.The new TNC will know that wages in the target country are very poor and so they will not have to pay workers as nearly as much as they pay employees in MEDCs. This is quite unfair, because the TNC is taking advantage of the people in the LEDC. Furthermore, employees will be made to work very long hours with little or no breaks.The TNC will most likely choose not to employ local highly skilled workers, because they will expect higher salaries and better working conditions. This will mean that low skilled people will be given jobs, but higher skilled workers will remain unemployed.As previously mentioned, the TNC will most probably enjoy large cyberspa ce if they set up branches in LEDCs. The problem is most of this money will not stay within the country because the main branch of the TNC will be situated in an MEDC. This means money will not stay in the LEDC there will be an outflow of wealth.If money is going abroad, the gross national product of the TNC will increase rapidly. The GNP of the LEDC used will increase as well, but at a slower rate. This means that development speed of the MEDC will far exceed that of the LEDC. This defeats one of the main reasons why TNCs setup branches overseas they want the country to catch up with the harvest-festival rate of other countries. scientific advancements in the LEDC can eventually cause problems. Mechanisation will mean that fewer workers are call for because robots can do the jobs that the workers once did. The only workers needed will those used to maintain the machinery, which means the work force will be decreased substantially.The raw materials which are located in the LEDC wi ll most probably be exported instead of manufactured locally. If the country is using as lot of energy to develop, then this can cause a national debt. Therefore, the rate of development will be stunted and the country will have been taken advantage of. This could cause upset within the workforce, creating strikes.This can cause further problems because the stiff is not located within the country. They could choose to pull out when ether they like, meaning many jobs would be lost. This would not be a great loss to the TNC though, as they have many other branches they can rely on.The money created by these TNCs would probably be better off spent on improving housing, diet and sanitation than roads and airports for trade. The problem is that the TNC would not benefit as much from these improvements so it does not concern them.The development of new firms can damage the environment because land must cleared for factories to be built. This could destroy the natural homes of species of animals, which is very difficult to correct. Because the target country will not be aware of the amount of pollution produced by industry, the laws on pollution control will not be as tight as the country where the firm is located. This could cause health problems, especially if a lot of waste is produced and dumped into the local water supply, for example.It is clear that there are many advantages and disadvantages in terms of TNCs creating branches in other countries. The real problem is that the disadvantages mostly affect the target country, not the TNC. So until LEDCs are aware of the problems caused by firms settling in their country, the chance of the growth of TNCs slowing down is very small. This could cause the gap between the levels of development in LEDCs and MEDCs to become even wider in the future.

Netflix vs Blockbuster Hbs Case Stufy

1. When evaluating stock decisions for blockbuster, should be divided into 2 separate decisions could use up been made, depending on the period in the test case. At the head start period of the text, 1997-2002, Blockbuster is the undisputed market leader (2, 1) of a giant, fragmented and steady industry, it has superior access to suppliers (brought the hottest titles faster than anyone in the industry) , this was its core business.Blockbuster had a wide coverage on a national level of stores (2, 2) , gain almost 70% of the U. S population within a short case length, and were recognized as the most powerful brand in the industry by 90% of the population. Furthermore it sustained a growing rate of gross revenue growth within stores within that period along with a stable income from late fees (3,1). In light of these facts, at this period going long for the Blockbuster stock is a very confident and solid decision.yet the tide is changing at 2002 following the rise of Netflix, Block buster strategy to ignore and fling at the treat instead of tackling it (9, 4), the failure to understand the Netflix is giving customers feature which are lacking in Blockbusters stores (Recommendation, no late fees, a wider selection of movies) show of a company which lacks the innovation to face the new treat and the ability to understand the new customer taste (Movies as pastime rather than special occasion).The late response in entering the online rental business caused severe financial losses to the company due to stiff culture curve (stock, suppliers), marketing expenses, price war and giving up on late fees (10,1), all along firearm keeping its conventional cost structure, with an costly 10 people per store staff (2,2) . Therefore I would hold the stock at short first 2002 , Blockbuster just doesnt attend like its understanding the new market, instead of being innovative they are fighting a losing battle and react lately instead of initiating in the areas where Netfli x lacks.However for Netflix the decision is quite the opposite, at its starting era we would play short on the stock. The facts are that Netflix is entering a highly fragmented market (2,1) while betting exclusively on a new format DVD (3,2) using an innovative distribution technique which have never been tasted in intact scale (3,4) and without a proven track of handling a huge inventory, the company did struggle at these years.However starting 2000 we would reverse the decision on the stock. Netflix highly innovative actions such as changing the pricing model (5,1) , developing an highly advanced pass system (5,4) and allowing for user rating have highly differentiated the companys service at the exact points in which Blockbusters service were lacking.Furthermore, the collaboration with major studios (6,1) and with the USPS (8,1) have improved Netflixs blue spots and allowed for the service to improve greatly and the have a huge growth potential (opening the entire variety of movies for rent not just hits , reaching 90% of its subscribers in a single day), the innovation process also shows in financial status, Netflix is performing at great annual rates starting 2000, of doubling its subscribers number , maintaining a positive cash flow and increasing its revenues (Fig1, Fig2), all while keeping its core business and expertise (no restructuring costs) .For conclusion, Netflixs highly innovative approach which is a reoccurring theme throughout the case, along with great financial performance and operational expertise (7, 3) makes a long decision in Netflix the obvious choice. 2. At first Blockbuster supplied a wide base of consumers primarily with hit and new movies (2, 4), in addition Blockbuster offered a express amount of advice (2, 5) from the staff present at each store.The costumers were supposed to rent the movie for a movie night and return it as quickly as possible. Netflix initially set up to perform the same task Deliver costumers with the movies they were looking for before logging of the site and in addition supply them with most highlighted titles with recommendation from limited staff weekly, as with Blockbuster , customers were also supposed to return the movie within a specific due date or be charged.However, Netflix evolved over the years and started supplying costumers with enhanced features not offered by blockbuster. The proprietary recommendation system developed (5,3) by Netflix allowed to use movies as a taste based product, meaning that Netflix started offering a recommendation service to its subscribers for movies they might like, instead of choosing movies ahead or choosing from shelves without knowing too much.Furthermore the recommendation system, along with the user based rating system (6, 3) allowed for the costumers to receive a substantial amount of advice regarding movie choices. Another evolvement occurred when Netflix adopted the new model (unlimited rentals, 3 movies queue), the model actual ly caused customers to related to movies as form of entertainment and therefore Netflix acted as entertainment provider (4, 1) instead of a special event when using Blockbusters conventional video service

Hypertension As Cause Of Stroke Health And Social Care Essay

High line jam is a common and major instance of shot and another(prenominal) cardiovascular disease. There ar many a(prenominal) causes of blueer(prenominal) family draw, including defined hormonal and familial syndromes, nephritic disease and multi cipherial racial and familial factors. It is one of the prima causes of morbidity and mortality in the universe and will increase in world-wide importance as a public wellness job by 2020 ( Murray and Lopez 1997 ) .Blood force per unit area ( BP ) is defined as the sum of force per unit area exerted, when sum contract against the aspiration on the arterial walls of the personal line of credit vass. In a clinical term mettlesome BP is known as full(prenominal) declination pressure. Hypertension is defined as sustained diastolic BP greater than 90 mmHg or sustained systolic BP greater than 140 mmHg. The maximal arterial force per unit area during capsule of the left ventricle of the bosom is called systolic BP and minima l arterial force per unit area during relaxation and dilation of the ventricle of the bosom when the ventricles fill with blood is known as diastolic BP ( Guyton and Hall 2006 ) .Table 1 Definitions and categorization of blood force per unit area degrees ( adapted from JNC-VII )High blood pressure is normally divided into two classs of primary and secondary high blood pressure. In primary high blood pressure, frequently called indispensable high blood pressure is characterised by chronic lift in blood force per unit area that occurs without the lift of BP force per unit area consequences from some other upset, such as kidney disease. all-important(a) high blood pressure is a heterogenous upset, with different patients holding different causal factors that lead to high BP. Essential high blood pressure demands to be separated into assorted syndromes because the causes of high BP in most patients soon classified as holding indispensable high blood pressure can be recognized ( Carrete ro and Oparil 2000 ) . Approximately 95 % of the hypertensive patients have indispensable high blood pressure. Although merely approximately 5 to 10 % of high blood pressure instances are thought to ensue from secondary causes, high blood pressure is so common that secondary high blood pressure likely will be encountered often by the primary attention practician ( Beevers and MacGregor 1995 ) .In normal weapon when the arterial BP raises it stretches baroceptors, ( that are located in the carotid sinuses, aortal arch and big arteria of cervix and thorax ) which s give the axe a rapid urge to the vasomotor bosom that ensuing vasodilatation of arteriolas and venas which contri thate in cut bolt nap BP ( Guyton and Hall 2006 ) . Most of the book suggested that there is a argument sing the pathophysiology of high blood pressure. A figure of predisposing factors which contributes to increase the BP are fleshiness, insulin opponent, high intoxicant consumption, high salt consumption, aging and possibly sedentary life style, emphasis, crushed K consumption and low Ca consumption. Furthermore, many of these factors are linear, such as fleshiness and intoxicant consumption ( Sever and Poulter 1989 ) .The pathophysiology of high blood pressure is categorised chiefly into cardiac end fruit and peripheral vascular resistant, renin- angiotonin placement, autonomic nervous system and others factors. Normal BP is determined and maintained the balance between cardiac end product and peripheral resistant. Sing the indispensable high blood pressure, peripheral resistant will lift in normal cardiac end product because the peripheral resistant is depend upon the thickness of wall of the arteria and capillaries and contraction of swimming musculuss cells which is responsible for increasing intracellular Ca concentration ( Kaplan 1998 ) . In renin-angiotensin mechanism hormone system merriments of import function in maintain blood force per unit area particularly the jux taglomerular cells of the kidney secrete renin in order to resolution glomerular hypo-perfusion. And besides renin is released by the stimulation of the sympathetic nervous system which is subsequently convert to angiotensin I so once more it converts to angiotensin II in the lungs by the consequence of angiotensin- change overing enzyme ( sensation ) . Angiotensin II is a powerful vasoconstrictive and besides it released aldosterone from the zona glomerulosa of the adrenal secretory organ which is responsible for Na and H2O keeping. In this manner, renin-angiotensin system increases the BP ( Beevers et al 2001 ) . Similarly, in autonomic nervous system sympathetic nervous system play a function in pathophysiology of high blood pressure and cardinal to keeping the normal BP as it constricts and dilates arteriolar. Autonomic nervous system considers as an of import in short term alterations in BP in response to emphasis and physical exercising. This system works together with renin -angiotensin system including go arounding Na volume. Although epinephrine and nor-adrenaline does nt play an of import function in causes of high blood pressure, the drugs used for the intervention of high blood pressure block the sympathetic nervous system which had played proper curative function ( Beevers et al 2001 ) . Others pathophysiology includes many vasoactive substance which are responsible for keeping normal BP. They are enothelin bradikinin, endothelial derived relaxant factor atrial natriuretic peptide and hypercoagulability of blood are all responsible in some manner to keep the BP ( Lip G YH 2003 ) .The 7th study of the spliff National Committee ( JNC-VII ) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure defines some of import ends for the rating of the patient with elevated BP which are sensing and bank check of high blood pressure sensing of mark organ disease ( e.g. nephritic harm, congestive bosom failure ) designation of other h azard factors for cardiovascular upsets ( e.g. diabetes mellitus, lipemia ) and sensing of secondary causes of high blood pressure ( Chobanian et al 2003 ) .Most hypertensive patients remain symptomless until contortions arise. Potential complications include shot, myocardial infarction, bosom failure, aortal aneurism and dissection, nephritic harm and retinopathy ( Zamani et al 2007 ) .The drug choice for the pharmacologic intervention of high blood pressure would depend on the single grade of lift of BP and contradictions. Treatment of non-pharmacologic high blood pressure includes life-style, weight decrease, exercising, Na, K, halt smoke and intoxicant, relaxation therapy and dietetic betterments, followed by pharmacological medicine therapy.Fig1. algorithmic program for the pharmacologic intervention of high blood pressure ( adapted from Chobanian et al 2003 )Normally used antihypertensive drugs include thiazide water pills, ?-blockers, ACE inhibitors, angiotonin sense organ blockers, Ca channel blockers, direct vasodilatives and ?-receptor adversaries which are shown in the undermentioned tabular array.Table 2 Types of drugs used in the intervention of high blood pressure ( adapted from Waller et al 2005 )Diuretic drugs have been used for decennaries to handle high blood pressure and recommended as first-line therapy by JNC-VII guidelines after antihypertensive and lipid-lowering intervention to envision bosom onslaught trail ( ALLHAT ) success. They cut down circulatory volume, cardiac end product and average arterial force per unit area and are most effectual in patients with mild-to- moderate high blood pressure who have normal nephritic map. Thiazide water pills ( e.g. Microzide ) and K sparing water pills ( e.g. spironolactone ) promote Na+ and Cl- elimination in the nephrone. Loop water pills ( e.g. Lasix ) are by and large excessively powerful and their actions excessively ephemeral, nevertheless, they are effective in take downing blood force per unit area in patients with nephritic inadequacy, who frequently does non react to other water pills. Diuretic drugs whitethorn ensue in inauspicious metabolic side do, including lift of creatinine glucose, cholesterin, triglyceride degrees, hypokalemia, hyperuricemia and decreased sexual map are possible side effects. The best BP take downing response is seen from low doses of Thiazide water pills ( Kaplan 1998 ) .-blocker such as propranolol are believed to lower BP with several mechanisms, including cut downing cardiac end product through a decrease bosom rate and a mild lessening in contractility and diminishing the secernment of renin, which lead to a lessening in whole peripheral resistant. Adverse effects of b-blockers include bronchospam, weariness, powerlessness, and hyperglycaemia and alter lipid metamorphosis ( Zamani et al 2007 ) .Centrally moving ?2-adrenergic agonists such as alpha methyl radical dopa and Catapres cut down sympathetic escape to the bosom, bloo d vass and kidneys. Methyldopa is safe to utilize during gestation. Side consequence includes dry oral cavity, sedation, somnolence is common and in 20 % of patients methyldopa causes a positive antiglobulin trial, seldom hemolytic anemia and Catapres causes bounce high blood pressure if the drug is all of a sudden withdrawn ( Neal M J 2009 ) . Systemic a1-antagonists such as Minipress, Hytrin and Cardura cause a lessening in wide-cut peripheral opposition through relaxation of vascular smooth musculus.Calcium channel blockers ( CCB ) cut down the inflow of Ca++ responsible for cardiac and smooth musculus contraction, therefore cut downing cardiac contractility and entire peripheral resistant. Therefore long-acting members of this group are often used to handle high blood pressure. There are two categories of CCB dihyropyridines and non- dihyropyridines. The chief side consequence of CCB is ankle hydrops, but this can sometimes be offset by get together with ?-blockers ( Lip G YH 2003 ) .Direct vasodilatives such as Hydralazine and minoxidil lower BP by straight loosen uping vascular smooth musculus of precapillary opposition vass. However, this action can ensue in a automatic addition bosom rate, so that combine ?-blocker therapy is often necessary ( Neal M J 2009 ) .ACE inhibitors plants by barricading the renin-angiotensin system thereby suppressing the transition of angiotonin I to angiotensin II. ACE inhibitors may be most utile for handling patients with bosom failure, either bit good as hypertensive patients who have diabetes. Using Ace inhibitors can take to increased degrees of bradikinin, which has the side consequence of cough and the rare, but severe, complication of atrophedema. Recent survey demonstrated that Capoten was every bit effectual as traditional thaizides and ?-blockers in forestalling inauspicious results in high blood pressure ( Lip G YH 2003 ) .Angiotensin II antagonists act on the renin-angiotensin system and they block the a ction of angiotonin II at its peripheral receptors. They are good tolerated and really seldom do any important side-effects ( Zamani et al 2007 ) .Another helpful rule of antihypertensive drug therapy concerns the usage of multiple drugs. The effects of one drug, moving at one physiologic control point, can be defeated by natural compensatory mechanism ( e.g. water pill lessening hydrops happening secondary to intervention with a CCB ) . By utilizing two drugs with different mechanisms of action, it is more likely that BP and its complication are controlled and with the low dose scope of combined drugs besides help to cut down the side-effects as good ( Frank 2008 ) . The undermentioned two-drug combinations have been found to be effectual and good tolerated which are diuretic and ?-blocker diuretic and ACE inhibitor or angiotonin receptor adversary CCB ( dihydropyridine ) and ?-blocker CCB and ACE inhibitor or angiotonin receptor adversary CCB and b-diuretic ?-blocker and ?-b locker and other combinations ( e.g. with cardinal agents, including ?2-adrenoreceptor agonists and imidazoline- I2 receptor modulators, or between ACE inhibitors and angiotonin receptor adversaries ) can be used ( ESH and ESC 2003 ) . If necessary, three or four drugs may be required in many instances for the intervention. The usage of a individual drug will take down the BP satisfactorily in up to 80 % of patients with high blood pressure but uniting two types of drugs will take down BP about 90 % . If the diastolic force per unit area is above 130 mmHg so the hypertensive exigency is occurred. Although it is desirable to cut down the diastolic force per unit area below 120 mmHg within 24 hours in accelerated high blood pressure, it is normally unneeded to cut down it more quickly and so it may be unsafe to make so. This is because the mechanisms that maintain keen blood flow at a changeless degree independent of peripheral BP are impaired in high blood pressure. However, it is o f import to cut down the BP rapidly by giving the endovenous drugs but cautiousness should be taken to avoid cerebrovascular force per unit area bring oning intellectual ischaemia ( Grahame-Smith and Aronson 2002 ) .In decision, high blood pressure emerges as an highly of import clinical job because of its prevalence and potentially annihilating effects. The major categories of antihypertensive drugs water pills, ?-blockers, CCB, ACE inhibitors and angiotonin receptor adversaries, are suited for the induction and care of antihypertensive therapy which helps in decrease of cardiovascular morbidity and mortality.