Use of Lidocaine and Sodium Thiopental for Pain Management

Use of Lidocaine and Sodium Thiopental for Pain Management Different premedication admixture with propofol to attenuate pain severityinduced by propofol injection: a double blind randomized controlled clinical trial Abstract Background and Objective Propofol has widely used due to providing pleasant anesthesia and rapid recovery. However; injection pain is one of the main side effects of a propofol that has remained as an undesirable problem. This study compares the effect of thiopental, lidocaine, fentanyl , normal saline admixture with propofol compared with only propofol on injection pain induced by propofol Materials and methods A double blind randomized controlled clinical trial was conducted on 257 patients that were randomly allocated to one of five groups to receive only 2mg/kg of Propofol type Fresenius One percent in group I, 2 cc of Lidocaine 1% in group II, 2 ml of Normal Saline 0.09% in group III, 50 mg Sodium Thiopental in Group IV and Group V were injected 100Â µg Fentanyl before injection of Propofol. Verbal Rating Scale was used for assessing pain. Results A significant decrease in pain severity during injection was achieved in group II (lidocaine ) and IV (Thiopental) compared to other groups. Fentanyl was also effective in reducing moderate pain. Conclusion: We found that Thiopental and lidocaine reduce more effectively incidence and pain severity than other groups. It seems that aforementioned drugs bee more appropriate as an alternative method to diminish propofol injection pain than others treatment in this study. Key Word: propofol, injection pain, premedication Introduction Preoperative care cause satisfaction for patient in recent years(1)Propofol is the drug that has attained popularity which has widely used owing to its fast onset time ,short-acting duration , and trivial adverse effects (2) despite these favorable attributes, the prevalence of injection pain has been reported 68-90% and has been ranked seventh among the 33 undesirable clinical problem in anesthesia(3-6). Injection pain severity was reported 5.6 Â ± 2.3 by measuring system of Visual Analog Scale , which represents unfavorable pain (7). Up to now, different ways have been studied and recommended to reduce the incidence and pain severity of Propofol injection. Among various methods, emollient of Propofol (8, 9) and using numerous drugs including Lidocaine (10), Thiopental(11) ,Alfentanil (12) and Gransytron or Ondansetron(13)can be noted. There are different emollients of Propofol in Iran such as Fresenius Propofol 1% which has a side branch of a long triglyceride (LCT) and Lipuro Pro pofol 1% which has side branches of medium and long triglyceride (MCT/LCT) ,that is assuming that later one is more effective in reducing injection pain(14). Lidocaine as a local anesthetic inhibits the beginning and conduction of nervous impulses by decreasing the penetration of nerve membrane to Na+. It prevents the membrane depolarization, effluence and conduction of potential . It’s systemic absorption is rapid via skin and phlegm (throat, respiratory system) (15).Fentanyl is a drug which usually used as a premedication, because of the rapid and short onset, intense analgesia, Stable cardiovascular hemodynamic as well as less histamine release (16). Thiopental from barbiturate family causes hypotension but has a high ability to protect nerves and control ICP (17). Ondansetron is a modern antiemetic drug which is chosen as the antagonist of Hydroxyl Triptamin type 3. This drug reduces nausea and vomiting and its complications are also very low(18). Different advantages of aforementioned drugs for pain persuaded us to use them to understand that how much they can reduce propofol injection pain and which one is more effective. Methods: A double blind randomized controlled clinical trial was performed on 257 patients, after obtaining confirmation from both Golestan University of medical science and 5th Azar hospital ethical committee approval. Signed written consent was taken from all subjects before surgery. Including criteria were patient aged between 15 to 55 years old with ASA ÃŽâ„¢, ΙΙ (American Society Anesthesiologist) that candidated for elective surgery, such as bowel obstruction, hernia, laparatomy , during 1390 to 5th Azar educational hospital in Gorgan, northeast of Iran. Alcohol consumption or taking any pain medication during 24 hours before surgery, a history of neurological disease, chronic pain syndrome, thrombofelebit, advanced systemic disease (such as advanced diabetes), and any contraindication based on injection of Propofol led to patient withdrawal from the study. Measuring patients pain using VRS (Verbal Rating Scale) from zero to three which has been developed by MC Hunter and Crirrick. Detail shown in (table 1). After patient’s entering into the operation room ,a No. 20 cannula were inserted in the biggest vein in no dominate hand. (without injection of a local anesthetic) and was connected to normal saline solution (without start of infusion). Difference between the two independent proportion formula calculated 24 samples for each group, however, considering five groups in our study, adjusted for sampling (19) was calculated, (= = 2*24 = 48 48*5= 245 ) g assume as the number of groups that 245 samples calculated. To achieve as s ame power as parametric tests we also used the efficiency power of nonparametric test, so that the sample size was multiplied by inverse 95 percent (20)which finally 260 samples was considered. Simple randomization allocation method was used to assign patients into five groups, so that five envelopes which containing the name of drugs was prepared and one out of five randomly selected for a patient and this approach repeated for all patients. In the first group (53 patients) 2mg/kg of Propofol type Fresenius One percent (MCT/LCT) was injected. In the second group (50 patients), 2 cc of Lidocaine 1% before use of Propofol was injected . The third group (48 patients), received 2 ml of normal saline 0.09% before the injection of Propofol .Group IV (54 patients) 50 mg Sodium Thiopental before injection of Propofol type Fresenius was injected. Group V (55 patients) also received 100Â µg Fentanyl before injection of Propofol. The place of injection is the dorsal vein of the hand. None of the patients received premedication and they were asked about the pain in injection place, 5-10 seconds after injection of 25% of anesthetic induction dose. And it was inscribed in questionnaire and after lessening the level of patients’ consciousness the rest of the anesthetics were injected. Anesthesia method were be same in all patients. The Propofol we wanted to use kept at room temperature (21 centigrade). Patients and the anesthesia nurse who filled out the questionnaires won’t know about the injected solution. And there is no chance to distinguish the solutions because they had the same color, volume and also the same shape. The first anesthesia nurse prepared the medication and injected by the second anesthesia nurse, the measure of pain and discomfort in hand examined by third anesthesia nurses and the questionnaire filled out by the fourth anesthesia nurse .To determine the relationship between premeditation and a measure of the pain Mann-Whitney and Kruskal- Walis test was used and demographic feature was also compared using ANOVA and Chi Square test with Spss 11.5. Results 257 out of a total 260 participated patients were analyzed in our study and 3 cases due to lack of condition were exclude. Characteristic of study subject including age, gender, weight and ASA physical status were presented in table2. No statistically significant difference saw in demographic characteristics of all groups and were comparable. (Table 2)(p>0.05)The overall and detailed of pain incidence shown for all groups in (table 3).Pain intensity at propofol injection in lidocaine and thiopental groups was much lower than three other groups especially in severe pain however fentanyl were also better than normal saline combined with propofol and using propofol only. No patient experienced spo2 less than 95% and heart rate lower than 50/min. No complication and adverse effect (eg, pain, allergic reaction, inflammation, edema, wheal ) were observed at the injection location 24 h after surgery. There was no conflict of interest . Discussion Pain during propofol injection causes anxiety and can interfere an appropriate anesthesia. Pain during Propofol injection mechanism is not well known yet, But it is suggested that perhaps a direct stimulating effect causes the immediate feeling of pain, or an indirect effect dependent on mediators release lead to begin pain.(15) dilatory pain (after 10 to 20 seconds) results from an indirect effect on the endothelium owing to the release of Cyanogens(21). Fat-soluble causes the increased activity of plasma’s kallikrein-kini system that leads to production of bradykinin. These interactions cause dilation and increased permeability in the peripheral veins, lead to an increase in Aqueous phase of Propofol with the endothelium and free efferent nerve endings between the media and intima of vessel wall and eventually cause pain (22). Finally we can say Propofol is a kind of drugs which stimulate skin, phlegm and inner vein wall(23). Gozal and Freeman (24-26) have debated, confined area size between the endothelium and drug is more influential than absolute drug concentration. A various method such as temperature(27) dilution(28) concurrent use of drugs(29-31) , give a variety to speed injection(32) has been used to attenuate propofol injection pain but different lidokaine dose and technique mostly use to attenuate for such pain (33)Analgesia results of Lidocaine in pain reduction following Propofol injection is not only because of it’s local analgesia but also it causes the decrease in Propofol Ph, and according to a hypothesis, Ph decrease causes Propofol moving into lipid phase and decrease Propofol in Aqueous phase and therefore lead to decreasing pain.(34, 35). In the present study, injection of Lidocaine before Propofol injection leading reduction in pain that the findings are compatible with other studies (23, 26, 36) but with the exception that their doses which were more than ours. Nevertheless controversy still exists (37) maybe for using higher dose in our study . The effect of Sodium Thiopental in pain reduction was accorded with other s tudies (8, 35, 38, 39). Fentanyl is also diminishes such pain but not as much as lidocaine and thiopental that is consistent in diminishing pain with others investigations (40-42) Conclusion This study finding shows that use of Lidocaine and Sodium Thiopental in comparison with other medications cause more reduction in pain especially in severe pains but lidocaine is more available cheaper than thiopental . Although no significant observed between some groups in pain reduction but pay attention to our founding in frequency of pain suggest using propofol with any premedication even normal saline better than injected propofol alone.

Fight Club Essay -- essays research papers

The movie, Fight Club, has many themes dealing with some of the class-discussed vocabulary. Through a scene by scene, and dialogue-based analysis of the movie, I have found that these themes are emphasized through discussions, interactions, and non-dialogue scenes between the main character, his imaginary sidekick and the society that has had such effect on the main character. Some of these themes or topics that are shared by both the movie and the class vocabulary appear randomly, sporadically, and repeatedly throughout the movie. Most of the scenes have mainly to do with the materialism in their society and its limits on the freedom, which the characters are trying to obtain. Others deal with how they, the movie's characters, feel a sense of alienation and this alienation distorts relationships developing due to their self-determination. There is also how family interactions help to shape our development on our vertical and horizontal relationships. Then finally, hedonism and how it affects the way we treat each other and how we interact within society. All the characters in the movie deal with and dissect these themes, in all that they say and how they react to the main characters disillusionment with his life; although the main characters are mostly the ones bringing the themes to the forefront of the movie. This any man, main character dislikes his life, even to the point that he is unable to sleep. He is disillusioned with his life, unhappy and does not understand why. And in order to feel anything he has to make a lot of bad choices to under go a life transformation. This transformation originates through his interactions and dealings with Tyler Durden, his alter ego and his imaginary friend. The main character remains without a name until in the end you, as the movie watcher, are lead to realize that he (the main character) and Tyler are one in the same, almost on the level of the Trinity. However he goes without a real name because he is supposed to represent how he could and is Any Man, anybody, and everybody. But after he, Any Man, has made all these bad choices he has to run around and try to undo all the horror he has wrought. Any Man started Fight Club, which matured into Project Mayhem, which then ultimately resulted in the collapse of the institution of their society. In many ways this movie is an extreme moral movie, with the battle betwe... ...veloped enough that his subconscience allows for Tyler, his alter ego, to disappear. The Any Man feels abandoned yet again. His father abandoned him and then Tyler, the one who was helping him replace his father, left him; this Any Man was beginning to give up on all the progress he went through. He was willing in spite of all his sacrifices to go back to what he had before, his boring dull lifeless existence. The materialism that spawns from this society is the major cause of relationship development distortion, alienation, and the ultimate disillusionment of the male population within this society. In the beginning the Any Man's alienation stemmed from his distorted sense of materialism. It is this alienation that limits his sense of freedom and causes his disillusionment. This materialism is inherent in the self-determination that is prevalent in the core of this disfigured society. In order for this society to progress at all, they have to reject the controlling materialism and go through a rite of passage, that they felt they were lacking, into adulthood. In that, this rejection has to be the sacrifice of the society, the whole of society, or the whole process is pointless.

OManjos Last Waltz Essay -- Creative Writing Narrative Essays

O'Manjo's Last Waltz It was another long week, and I was looking forward to the usual summer rituals of mowing lawns and hammering a few nails into any place they seemed to fit. I usually closed the auto parts store at 5:30 and stayed doing paperwork for another hour or so, but not on Fridays. Fridays were the finish line of a usually marathon week of complaining customers and dissatisfied employees. At 5:31, the place would be empty, dark, and eager for an echo. The old man knew this ritual, and when he came on Fridays, he usually blew in the door around 5:15. He had been coming in every week for about a year. We didn't know Joe's last name, we only knew him as "Old Man Joe." We call him "O'Mango," and he didn't seem to know the difference. His hearing was the least of his problems. He peppered his weekly visits over different weekdays, but it was always Fridays that he waited until 5:15. He makes the usual remarks every time he sits his old, marshmallow behind down at the counter. "Well, boy?" He'd ask. "What the hell are you looking at?" "I'm looking at the ugliest, most disgusting, onriest son-of-a-bitch I've ever seen!" Was my usual reply. "That's right, and don't forget it!" He would hold his dry, cracked hands in fists and shake them at me. "Keep it up, boy, and I'll whoop your scrawny little but right here and now." At some time in O'Mango's life, he was a prizefighter. His nose looked like it had taken more than its share of beatings, so I tended to believe the story. All the talk was, of course, our way of greeting each other. If he did intend to come after me, I'd most likely have him pushed out the door before he could get his oxygen tank over his shoulder. O'Manjo didn't really need ... ...opened. The neighbors didn't want money for them; they were just trying to sort things through, and knew Joe well enough to guess at our credit arrangement. They said Joe died peacefully in his sleep, without pain. I wondered if he just laid in bed listening to that tape over and over like it was some kind of drug and he was a junky. This didn't seem wrong to me. At least I'd know that he died happy. I imagined him waking up in heaven wearing his best dance shoes, and bouncing across the ballroom floor. There will always be another customer to fill Joe's stool and fire remarks at us, but none will replace Joe. When I think about it, I kind of feel guilty that he paid me ten dollars a month to be his friend. It was not a difficult job, but was merely human interaction that somehow becomes precious when it's lost. I just pray O'Manjo got his money's worth.

Learning institutions in America before public education

In the early part of American history, education was not for everyone. The masses usually came from agricultural communities were planting and harvesting crops were more important than education. On the other side of the fence, were the wealthy families, the businessmen, the landed and the politicians who were able to enjoy the benefits of education. The kind of education that the poor got was a few weeks of schooling during winter where teachers were not trained and school houses were decrepit and materials were lacking. The lessons were limited to basic skills to enable the children to write their names and count hens. The public education system that we presently have is a far cry from what has been in the past century. We owe the present form of education we have to Horace Mann, who campaigned for and worked to bring about social reforms and give each American the right to free education. Mann through his enthusiasm and devotion secured within his own state public support for schools. He encouraged businessmen to support building public schools since he believed that educating the masses would lead to greater economic progress. It goes to say that having a literate nation would spell more skilled and competent workers who would be the backbone of the factories at that time. More so, when the masses were given the right to vote, a growing awareness of the government’s obligations to its people came to light, the clamor for free education was strongest at this period. Mann faced a few difficulties in the form of opposition from prominent politicians and wealthy businessman and the clergy for education would be an equalizing factor between the rich and the poor and most especially because public schools would be competing with private and sectarian schools. Horace Mann also advocated public education for the masses as a means of bringing equality to the society. He argued that pubic schools made it possible for all citizens to exercise their right to free education without the encumbrances of religion or financial burdens. The individual could go to school without having to believe in something that is opposed to his cultural background and everyone could at least finish high school without the need to apply for loans or maintain a scholarship. The poor could concentrate on learning and in some ways to prepare for their future. Furthermore, Mann was able to integrate the schools in his state to a system that became the basis for the public education system in the country. He also advocated the establishment of normal schools to train teachers; he was against corporal punishment and instead focused and emphasized better teaching methods. Thus education gained the attention and funding that it never before had, and was established as one of the institutions of society. By the latter part of Mann’s life, the number of elementary and secondary schools had increased dramatically all over the country, but he did not stop there. He went on to work on changing higher educational system wherein the poor had the opportunity to be admitted to colleges until his death. Thus the door to educational advancement and success was opened to the masses. Â   Â  

The Crucible’ by Arthur Miller: A Summary

?Ben O'Connor Mr. Richards English 10 January 11th, 2009 -Crucible Essay- The Crucible written by Arthur Miller was a story in which takes place in a town called Salem, Massachusets. This story was directed towards the topic of the witch trials of 1692 and how the people were effected by the deaths and horrific torture treatments. The Crucible portrayed the perfect description of how the time of witch trials were so curropt and unfair. In this time if someone were to blame another person of something then the person blamed would immediatly be guilty and thrown in Jail or hung. Is Salem many people tried accusing people of different crimes so that they could gain power aswell as land. Thomas Putnam was greedy for land because more land meant more power. Thomas Putnam had giles killed because he wanted his land, so he simply acused him of something which would result in his death from â€Å"pressing†. Also in the text a woman named Abigail Williams loves a man named John Proctor however John is married, so Abigail accuses Johns wife Elizabeth of being in the precense of the devil. This in the mind of Abigail this will bring her and John closer togather however it only makes things worse. As many will see this time in Salem was a very terrible time and from 1692 to 2010 we have come a long way in our nation wide governmental system. In this time period there were many people accusing others of crimes so they could gain land, covet their neighbors wifes, or husbands, and much more. A man named Thomas Putnam was a greedy man and was hungry for land. Putnam rode to the farm of Giles Corey and told him that a section of GIles property was his. Of course Giles objected to this statement, and Putnam rode off. Thomas Putnam then accused Giles of a crime that would have him killed. Giles is brought in and he states â€Å"Thomas Putnam is reaching out for land. † pg. 84. however no one believes this statement and GIles is soon killed by the torture treatment called â€Å"pressing†. Fair trials in this town are completly absent and when someone is accused of something serious the odds of them being successful are very slim. During the time period of the witch trials there were not only aqusations dealing with peoples land but there was also conflicts with peoples relationships. Abigail Williams was a women who loved John Proctor however John was married to a women allready named Elizabeth. Abigail tries to seperate John and Elizabeth by accusing Elizabeth of being in the presence of the devil. Mary Warren a close person to Elizabeth and John and she states â€Å"But i said I never see no sign of you ever sent your spirit out to hurt no one, and seeing I do live closley with you, they dismissed it†. g. 59. Even with this strong statement with a women who lives with John and Elizabeth, it is still not enough evidence to keep Elizabeth safe. Abigail desperatly wants Elizabeth gone and out of the way so that she can have John, so she brings along many other women to help her cause and this shows great evidence that Elizabeth is guilty even though she isnt. Abagail's wishes go unanswered, because John ends up being exicuted due to Abigail's actions. Mrs. Putnam was a women who had 7 babies, 6 of which died extremly young. She has only one daughter living and she feels that it doesnt make sense that this many children could die all around the same age, around the same time. Mrs Putnam was sad, however grows angry and searches desperatly to put the blame on someone. â€Å"I knew it! Goody Osbourne were midwife to me three times. I begged you, Thomas, did I not ? I begged him not to call Osbourne because I feared her. My babaies always shriveled in her hands. â€Å". Goody Osbourne is desperate to place the blame on someones sholders, so she is going around and blaming everone she knows. What she did back then which was blame others for her pain i believe still exists for individuals today. Today when an individual has an issue many of them pass the blame to someone els so that they can feel better. The time of the witch trials must have been a horrible time in history, especiall for the innocent victims in the town. The way that the government ran in that time period compared to now have completly changed. In trials now there must be more evidence, and trials are longer for thought process, and time to gather evidence. In 1692 it was as simple as if you were acused of something then you were automatically looked at as bad and guilty and you would soon be thrown in jail or exicuted. The witch trials were a terrible time in history, and many great people died simply because of peoples jealousy, or their greed for land. After this time period America learned a great lesson, that all American Citzens have the full rights to a fair trial. With out fair trials, and strict rules there would be complete a narchy.

Learning Notes Essay

|STAGE 1 | |CONTENT STANDARD: The learner understand the different types and forms of drama, the features ,elements and conventions which distinguish | |them from narratives thereby leading him/her to produced a reaction paper. | |PERFORMANCE STANDARD: The learner writes a meaningful reaction paper on a drama presentation. | |ESSENTIAL UNDERSTANDING: The learner exhibits understanding and appreciation of drama by making sense of and reacting to the different issues| |presented in it.. | |ESSENTIAL QUESTION: How does one show appreciation of Philippine Drama? | |Learners will know: | |Types of Drama | |Forms of drama | |Drama conventions | |Expressions showing agreement and disagreement | | | |Learners will be able to: | |Explain types of drama | |Distinguish various forms of drama. | |Apply various graphic organizers to illustrate key concepts in a drama. | |Perform an array of reading techniques to concretize and unlock drama concept. | |Respond in various ways to express understanding of drama. | |Relate how drama mirrors real life. | |Deduce authentic experiences that can be incorporated in a drama. | |Analyze descriptions, dialogs and actions to discover, articulate, and justify characters in a drama. | |Draw insights on main and sub issues presented in a drama. | | | |STAGE 2 | |Product Performance Task: A meaningful reaction paper on a drama presentation. | | | |Evidence at the level of understanding: The learners should be able to demonstrate understanding by covering the six (6) facets of | |understanding. | |Explanation-Explain how the playwright justifies the actions, feelings, and attitudes of the character. | |Describe characters, and situation to show how drama reflects culture. | | Interpretation- interpret the series of connected events in a drama plot. Using events line | |Application-Apply role playing strategies in delivering dialogs between the protagonist and antagonist in the play | |Perspective- Develop perspective by evaluating a drama presentation. | |Empathy-assume role in Critiquing a drama presentation. | |Self-knowledge- self-assess one’s strengths and weaknesses in presenting assessment of a drama presentation. | |Evidence at the level of performance: Performance assessment of an original extended dialog for drama presentation based on the following | |criteria: | |1. Focus/Theme | |2. Accuracy | |3. Language | |4. Unity | |5. Coherence | |6. Style | | | |STAGE 3 | |TEACHING LEARNING SEQUENCE | |A. EXPLORE- At this stage, the teacher should be able to do the following: | |Make the learners aware of the desired result that is, for him/her to demonstrate understanding of understanding of the different types and | |forms of Philippine drama as well as the features, elements, and conventions which distinguish them from narratives | |Introduce the Essential Question (EQ), â€Å"How does one show appreciation of Philippine drama? † with the learners. Make them answer the questions| |as exhaustively as possible and cue them into the big ideas by activating their prior knowledge or past experiences. | |Use non-formative assessment procedure to check/evaluate learners’ readiness and competence on the prerequisite skills to the tasks at hand. | |Inform the learners of how they will be assessed. Their major output after the lesson is a meaningful reaction paper on a drama presentation. | |Likewise explain the rubrics. | |Activities |Materials |Date |Remarks | |1. Life is a drama TG. P. 4 |Types of Drama listed on a manila |August 15,2011 | | | |paper. | | | |2. Illustrate it TG. P. 4 |1. Manila paper |August 16,2011 | | | |2. Pentel pen/ pencil | | | | |3. crayons | | | |Note: | |1. Pre-test is given to students. To test their prior knowledge. | |2. Ask the EQ-essential Question | |3. Clarify expectation | |4. Hook and engage interest. | |5. Give the essential understanding. | | | | | | | | | | | | | | | | | | | |STAGE 3 | |TEACHING LEARNING SEQUENCE | |B. FIRM UP- At this stage, the teacher should be able to do the following: | |Make the learners enhance their knowledge of the different types and forms of Philippine drama, as well as the features, elements and | |conventions which distinguishes them from narratives. | |Highlight the grammar item by providing sufficient examples of word/phrase showing agreement or disagreement. | |Provide the learners with activities that are motivating and challenging | |Maximize learners’ participation in various tasks from controlled practice to free association phase of learning | |Provide feedback to check for understanding. | |Activities |Materials |Date |Remarks | |1. Which one are you TG. P. 6 |1. A copy of the words â€Å"JOLOGs and | | | | |â€Å"CONOS† | | | |2. A day for a play TG. P6 | | | | |- Read and write words in the play |2. A photocopy of the Drama- â€Å"Call | | | |that shows AGREEMENT and |Me Flory† by Wilfrido Ma. Guerrero | | | |DISAGREEMENT. | | | | |3. Lexicon TG. P6 | | | | |- Write the meaning of the phrases. |3. Manila Paper with the Phrases | | | | |taken from the play. | | | |4. Simple Recall TG. P7 | | | | |- Comprehension Questions |4. Manila paper with the | | | | |comprehension questions. | | | |5. Agree or Disagree TG. P9 | | | | |- Expressing agreement and |5. Manila Paper with two column A | | | |Disagreement |and B Agreement and Disagreement. | | | | | | | | |6. In my opinion TG. P10. |6. Various topics written on a | | | |- Choose one topic then write an |Manila paper. | | | |opinion paragraph stressing their | | | | |greatest argument for agreeing or | | | | |disagreeing. | | | | | | | | | |Note: Discuss and explain | | | | |expressions on agreement and |Outline of the topic | | | |disagreement. | | | | | | | | | | | | | | |STAGE 3 | |TEACHING LEARNING SEQUENCE | |C. DEEPEN- At this stage, the teacher should be able to do the following: | |Provide learners with thought – provoking questions that will make them reflect, revisit, rethink, and revise earlier assumptions about the | |types and forms of Philippine drama, the features, elements, and conventions that distinguish them from narrative. | |Enable learners to apply the grammar items learned by giving them activities within the confines of higher order thinking skills. | |Address the learners’ uniqueness, their strengths and weaknesses by providing them with differentiated instruction as needed. | |Provide them with meaningful and challenging activities that will reinforce what they have learned. | |Engage them in meaningful self-evaluation. | |Give feedback. | |Activities |Materials |Date |Remarks | |1. Curtailed Freedom TG. P. 11 | 1. Topic on specific reality or | | | |- Have them agree or disagree†¦ |game show. | | | | | | | | |2. Mock Election TG. P11 | | | | |-Write and express their ideas | | | | | |2. â€Å"Written issue on a manila | | | | |paper- â€Å"Are you in favor of using | | | |3. Drama Inventory TG. P12 |the Filipino language during | | | |- Complete the table after |English time? † | | | |watching/listening to various drama| | | | |media. |3. Written CHART on a manila paper | | | | |as guide to the activity. | | | |4. Airing Feedback TG. P12. | | | | |- Role play any situation | | | | | | | | | | | | | | | |4. Rubrics | | | |Notes: | | | |1. Discuss the Elements of Drama | |2. types of drama | |3. drama conventions | | | | | | | | | | | |D. TRANSFER- At this stage, the teacher should be able to do the following: | |Have the learners make independent application of the various processes (drama review, play reaction paper production, critiquing an original | |extended drama script, ect) they have learned. | |Make them do independent performance or project using varied and complex assessment procedure. | |Harness the learners’ growing proficiency by letting them establish the interface among the activities they have performed. | |Have them see the connections between tasks and the world. | | | |Activities |Materials |Date |Remarks | |1. Drama Review TG. P13 | 1.evaluation Chart | | | |- Complete the evaluation chart | | | | |after watching a scene in a drama | | | | |or play. | | | | | | | | | |2. DRP (Drama Reaction Paper) TG. | | | | |P13 | | | | |- evaluate the strength and |2. List of criteria written on a | | | |weaknesses of a play or drama. |manila paper | | | | | | | | | | | | | |References: | | | | |Laarni- A Dream by Loreto | | | | |Paras-Sulit | | | | | | | | | |Call Me Flory, by Wilfrido Ma. | | | | |Guerrero | | | | |The World is an Apple | | | | | | | | | | |Prepared by | | | |FERDINAND A. SANGAO | |Subject Teacher Noted: | |NORA D. DALAPNAS | |Head Teacher In Charge | | | | | | |

International personality Assignment Example | Topics and Well Written Essays - 500 words

International personality - Assignment Example a lady, and the challenges she experienced as a young black girl in her upbringing have really contributed to the kind heart that Oprah Winfrey exhibits (Hanson, 2009). At her talk show, Oprah Winfrey addresses very many challenges, especially social, that affect either a huge population or a selected minority. The direct effects of the show on various people can be said to be overwhelming. This is because Oprah Winfrey is surrounded by a team of in-house experts, or guest experts, in various fields who normally provide their expert advice or understanding of the issues at hand. According to Garson (2011), as a successful entrepreneur, Oprah Winfrey has not left out the community that is needy. Her various acts of kindness has left no option but for her to be tagged as a philanthropist. She has been involved in several charity programs, as well as in the general commitment to raising the values of living for the less-fortunate in the community and the world over. Berkley and Economy (2008) say that her influence and success has impacted positively to the citizens all over the world thus making her one happy woman who is so much admired. While reading the articles about Oprah Winfrey, they really encourage someone and despite several cultural inclinations, it encourages someone and gives them hope .They show one that success is something that is brewed and it normally comes with several responsibilities. These responsibilities are normally a way that someone uses to bless the community around them. This human right is not limited to any extent, as long as the right does not infringe on the people’s rights. In any liberal country, the citizens of that nation practice freedom of speech in a manner that is indulgent. This means that they can talk about sensitive issues even the ones that touch directly on the government and even the powerful people. The freedom of speech in these liberal and democratic nations cannot pause as a security threat to the ones