Impact Of Assessment For Learning

Impact Of Assessment For Learning This paper considers the impact of Assessment for Learning on childrens progress in a particular strand of the Primary Maths Curriculum. It does so firstly through a review of the relevant literature, and then employs some empirical examples to illustrate how the cycle had helped to secure learning points in a particular context. The specific strand under consideration is the solving of multi-step problems, and problems involving fractions, decimals and percentages; choose and use appropriate calculation strategies at each stage, including calculator use. (DCFS 2009). Literature Review Changes in the professional framework for the teaching and assessment of Primary maths have been reflected in a constantly expanding literature. This is now so expansive, that it can only really be reviewed here through some representative examples. There are two principal sub-genres which feature here: specifically, these are official publications, and range of commercially produced texts which may be characterised as critical, professional, or vocational self-help literature. It is also the case that some generic texts on the subject of Primary Assessment for Learning may be pertinent here, although they do not relate specifically to mathematics. The official literature emphasises the holistic nature of assessment by asserting that assessment of childrens achievements and progress should be based on the expected learning outcomes identified through the learning objectives. In mathematics, assessing childrens progress in a core strand of learning should be informed by the objectives in the strand. (DCFS 2009). The fruition of this process may be visualized in the motivation and empowerment of the learners themselves, supported by Constructive feedback that identifies how childrens work and responses have led to success this, it advises, should provide a shared understanding of the achievements on which to build to make further progress. It helps children to see how the next steps take account of this success and are attainable. (DCFS 2009). There is a sense in which this acknowledges that Assessment for Learning has an importance, over and above what is revealed in outcome-based results, i.e. those from standardised tests. In other words, the latter no longer implies that it can stand as proxy for other kinds of learning. (Campbell et al. 2004: p.119) The commercially published literature is constantly being updated by texts which engage with official policy and curriculum changes, interpreting them for practitioners and parents. However, the majority of these, although they make some reference to assessment, do not do so in the terms now prescribed by the DCFS, i.e., day-to-day and periodic assessment. This is possibly because these models have only been operating in the official discourse for a relatively short period. Overall, this genre may itself be split into sub-groups, the most significant of which are the reflective or critical genre, and the vocational or self-help group. One of the most prolific authorities within this group is Sharon Clarke, whose Targeting Assessment in the Primary Classroom: Strategies for Planning, Assessment, Pupil Feedback and Target Setting (1998), Unlocking Formative Assessment: Practical Strategies for Enhancing Pupils Learning in the Primary Classroom, (2001), and Active Learning Through Forma tive Assessment (2008) straddle successive developments in the teaching and assessment of Primary mathematics. Also helpful in these areas is Hansens Primary Mathematics: Extending Knowledge in Practice (Achieving QTS Extending Knowledge in Practice) (2008), and David Clarkes Constructive Assessment in Mathematics: Practical Steps for Classroom Teachers (Key Resources in Professional Development), (1999). As Shirley Clarke indicates, the sharing of a learning intention is more complex than simply repeating what is in the teachers plan. In order for the learning intention to be shared effectively, it needs to be clear and unambiguous, so that the teacher can explain it in a way which makes sense. (2001: p.20) This may be taken as supportive of the official position: it endorses the idea that planning should draw not only on the learning outcome, but also on the prior knowledge of the students in question. If they are expected to objectively assess their own progress, they must understand the frame of reference, and be able to envisage the learning outcome, even if they havent yet attained it. This idea is also implicit in the ideas of David Clarke: as he points out, earlier approaches to assessment focussed on à ¢Ã¢â€š ¬Ã‚ ¦measuring the extent to which students possess a set of tools andà ¢Ã¢â€š ¬Ã‚ ¦the extent to which they can apply them. However, he further indicates that à ¢Ã¢â €š ¬Ã‚ ¦to be mathematically equipped, a student must also understand the nature of mathematical tools and be able to select the correct tool for a given problem-solving situation. (1999: p.11) This perspective is also endorsed in the reflections of Hansen, who argues that, à ¢Ã¢â€š ¬Ã‚ ¦it is possible to help children to learn mathematical content through effectively integrating problem-solving, reasoning and communication into mathematics lessons. (Hansen 2008: p.5) Texts such as Gardners edited collection, , Assessment and Learning, (2006), Gipps and Murphys A Fair Test? Assessment, Achievement and Equity, (1994), and Tabers Classroom-based research and evidence-based practice, (2007), go some way to bridging the gap between the official and the educational literature, specifically by looking at how policy and curriculum matters are linked by research and ideology. These are, however, not specifically devoted to Primary mathematics, and neither are they wholly accepting of the orthodoxies which pervade the official literature. Gipps and Murphy make the point that evaluating assessment is à ¢Ã¢â€š ¬Ã‚ ¦not just a question of looking at the equity in the context of assessment but also within the curriculum, as the two are intimately related. (1994: p.3) As Taber points out, practitioners are at the end of a very long and often remote supply chain when it comes to weighing the evidence on what is best practice. As they put it, à ¢Ã¢â€š ¬Ã‚ ¦teac hers are told what research has found out during their initial training, and are updatedà ¢Ã¢â€š ¬Ã‚ ¦through courses and staff development days, but largely through centralised official guidance. (2007: p.4) This is reinforced by commentators such as Rist, who argues that, We are well past the time when it is possible to argue that good research will, because it is good, influence the policy process. (2002: p.1002). These are academic but not unimportant points in terms of the overall discussion, even if they are not particularly prominent in the day to day responsibilities of the class teacher. The point is that, as reflective practitioners, we might all benefit from some awareness of what shapes the frameworks which inform our approach to teaching and learning. With regard to the current Assessment for Learning conventions, the ideas in Assessment for Learning, Beyond the black box (Assessment Reform Group, 1999), are acknowledged by the QCA to have been constructive of the whole approach. (QCA 2003: p.1). As the latter state, The study posed three questions: is there evidence that improving formative assessment raises standards?; is there evidence that there is room for improvement in the practice of assessment?; and is there evidence about how to improve formative assessment? This research evidence pointed to an unqualified yes as the answer to each of these questions. (QCA 2003: p.1). These are important points, as the teaching, learning and assessment frameworks which define contemporary practice are profoundly adaptive of them. Discussion/Example from Experience. A strand of the Primary curriculum where day to day and periodic assessment was found to be particularly important in the overall Assessment for Learning approach, was securing number facts, relationships and calculating. The examples used here are from Year 6 block E, especially Ma2, Written and calculator methods, and Ma2, solving numerical problems from Unit One, and focused on dealing with errors and misconceptions. One context where assessment was found to be particularly relevant was in dealing with upper school (i.e. Years 4, 5 and 6) learning of multiplication and division. The assessment process had to be multi-faceted, taking in all of the associated knowledge and skills, the errors and misconceptions which arose, and the modelling of questions to identify the origin of such problems. This may be illustrated by focusing on one example, taken from Year 6 Key Objective 2, Multiplying and dividing by powers of ten and the associative law, where commonly, the unprepared or conf used learner à ¢Ã¢â€š ¬Ã‚ ¦Misuses half understood rules about multiplying and dividing by powers of ten and the associative lawà ¢Ã¢â€š ¬Ã‚ ¦ (2009). The important thing about multiplication and division through successive addition or subtraction respectively, is that, once mastered, they can demonstrate to learners that the application of basic skills will enable them to break down seemingly complex problems into a manageable format. Multiplying or dividing a three digit number by a two digit number depends on the use of a number of skills: knowledge of number facts, i.e. times tables, place value, to quickly assess the viability of an answer, and organisational skills, i.e. being able to apply the correct steps in the appropriate order. It may also be useful to augment these with calculator use, in order to verify answers. The important point here is that day to day and periodic assessment and reflective feedback from the learners themselves was indispensable in the planning, pitching and delivery of this input. The interdependence of each step in these calculations meant that the failure to execute one step, often resulted in the failure to complete the overall objective. For example, if times tables and multiplication by 10 and 100 were not securely in place, the learner would get bogged down in the arithmetic. Conversely, the securing of one of the incremental skills involved in these calculations was a positive factor in the learners overall approach: i.e., if they knew their times tables facts, place value, or multiplication by 10 and 100 were in place, it gave them a starting point from which to analyse errors or problems. For some learners, this had the generic effect of making them realise that their long-term work in achieving these positions of strength had a positive outcome, rather than b eing an abstract, stand-alone process. This in turn made them more interested in acquiring other general mathematics skills. Looking beyond specific mathematics skills, this may also have the propensity to develop the students own capacities for self-realisation and self-motivation. As the QCA points out, à ¢Ã¢â€š ¬Ã‚ ¦In many classrooms, pupils do not perceive the structure of the learning aims that give meaning to their work. Therefore they are unable to assess their own progress. (QCA 2003: p.3) Achievement in a multi-step process such as long multiplication or division might therefore enable them to map out where they are within the overall standards. However, it was only through a combination of day to day and periodic assessment that the practitioner could be confident of planning effectively with regard to these tasks. There was no point in assembling sessions which relied on a range of skills when they were not secure, either in individual learners, or sufficiently across the cohort as a whole. In mixed ability groups, this approach was obviously the key the necessary differentiation. The logical corollary to this is that discursive feedback from the learners themselves was also important in defining the next stage of planning, i.e. what worked, what didnt, who tried which method, were there any preferences etc. The appeal of this activity also lays in its fine balance of mental and pencil and paper methods, and the way in which estimation is the necessary accompaniment to concrete calculation. Overall, these experiences may be deemed supportive of the proposals of commentators such as Clarke and Hansen, (see above) in that th ey emphasize the need for the continuous reinforcement of planning with assessment. Summary, Analysis and Reflection: Implications for Future Teaching. In summary, the conclusion of this paper is that both the literature and practical experience discussed here are mutually supportive of the need for complimentary assessment and planning. Outcome orientated results can illustrate individual and whole school performance in certain contexts, but practitioners need to be aware of assessment in a holistic way, as a daily part of their approach to teaching and learning. As the QCA expresses it, à ¢Ã¢â€š ¬Ã‚ ¦Teachers are experiencing an increased sense that pupils are working with them rather than for them. For example, pupils are asking for more questions or examples to practice applying their understanding of a topic or to repeat homework or tests if they have not met the standard and the objectives that they and the teacher have set. (QCA 2009: p.48). Whilst this dynamic sounds very positive, practitioners have new and different responsibilities within it. In terms of assessment, these can be itemised in the following waysà ¢Ã¢â€š ¬Ã ‚ ¦ Day to day: within this level of assessment, specific learning objectives should explicitly communicated, and augmented with both peer and self assessment as appropriate. Periodic: ideally, this should assemble a broader overview of progress across the subject for both learner and teacher. It is also an opportunity to interweave the national standards in a sensitive way with classroom practice. The practitioner can use the insights gained from this process to inform both long and medium term planning. Overall, it should be recognised that the ideal situation, i.e. of self-motivated, self-actuating learners, involved in their own self-assessment, is unlikely just to happen. Considered superficially, it might seem that the practitioners role in assessment has lessened, whilst the remainder has been taken up by the learners themselves. The reality is rather different: pupils will only become adequate and effective assessors of their own progress if they are provided with the appropriate support and guidance. In a sense, this facilitating role is a much more challenging and subtle one than that implied in a more top-down, didactic model. Also, there are obvious problems in considering the learner as a passive or generalised aspect of this approach: it is much more likely that there is a staggered and variegated uptake of the model, as different learners are engaged at their own pace and level. This in turn indicates that, as with all aspects of the curriculum, the social and emotional aspects of learning should be taken into consideration.

Twilight 14. MIND OVER MATTER

14. MIND OVER MATTER He could drive well, when he kept the speed reasonable, I had to admit. Like so many things, it seemed to be effortless to him. He barely looked at the road, yet the tires never deviated so much as a centimeter from the center of the lane. He drove one-handed, holding my hand on the seat. Sometimes he gazed into the setting sun, sometimes he glanced at me – my face, my hair blowing out the open window, our hands twined together. He had turned the radio to an oldies station, and he sang along with a song I'd never heard. He knew every line. â€Å"You like fifties music?† I asked. â€Å"Music in the fifties was good. Much better than the sixties, or the seventies, ugh!† He shuddered. â€Å"The eighties were bearable.† â€Å"Are you ever going to tell me how old you are?† I asked, tentative, not wanting to upset his buoyant humor. â€Å"Does it matter much?† His smile, to my relief, remained unclouded. â€Å"No, but I still wonder†¦Ã¢â‚¬  I grimaced. â€Å"There's nothing like an unsolved mystery to keep you up at night.† â€Å"I wonder if it will upset you,† he reflected to himself. He gazed into the sun; the minutes passed. â€Å"Try me,† I finally said. He sighed, and then looked into my eyes, seeming to forget the road completely for a time. Whatever he saw there must have encouraged him. He looked into the sun – the light of the setting orb glittered off his skin in ruby-tinged sparkles – and spoke. â€Å"I was born in Chicago in 1901.† He paused and glanced at me from the corner of his eyes. My face was carefully unsurprised, patient for the rest. He smiled a tiny smile and continued. â€Å"Carlisle found me in a hospital in the summer of 1918. I was seventeen, and dying of the Spanish influenza.† He heard my intake of breath, though it was barely audible to my own ears. He looked down into my eyes again. â€Å"I don't remember it well – it was a very long time ago, and human memories fade.† He was lost in his thoughts for a short time before he went on. â€Å"I do remember how it felt, when Carlisle saved me. It's not an easy thing, not something you could forget.† â€Å"Your parents?† â€Å"They had already died from the disease. I was alone. That was why he chose me. In all the chaos of the epidemic, no one would ever realize I was gone.† â€Å"How did he†¦ save you?† A few seconds passed before he answered. He seemed to choose his words carefully. â€Å"It was difficult. Not many of us have the restraint necessary to accomplish it. But Carlisle has always been the most humane, the most compassionate of us†¦ I don't think you could find his equal throughout all of history.† He paused. â€Å"For me, it was merely very, very painful.† I could tell from the set of his lips, he would say no more on this subject. I suppressed my curiosity, though it was far from idle. There were many things I needed to think through on this particular issue, things that were only beginning to occur to me. No doubt his quick mind had already comprehended every aspect that eluded me. His soft voice interrupted my thoughts. â€Å"He acted from loneliness. That's usually the reason behind the choice. I was the first in Carlisle's family, though he found Esme soon after. She fell from a cliff. They brought her straight to the hospital morgue, though, somehow, her heart was still beating.† â€Å"So you must be dying, then, to become†¦Ã¢â‚¬  We never said the word, and I couldn't frame it now. â€Å"No, that's just Carlisle. He would never do that to someone who had another choice.† The respect in his voice was profound whenever he spoke of his father figure. â€Å"It is easier he says, though,† he continued, â€Å"if the blood is weak.† He looked at the now-dark road, and I could feel the subject closing again. â€Å"And Emmett and Rosalie?† â€Å"Carlisle brought Rosalie to our family next. I didn't realize till much later that he was hoping she would be to me what Esme was to him – he was careful with his thoughts around me.† He rolled his eyes. â€Å"But she was never more than a sister. It was only two years later that she found Emmett. She was hunting – we were in Appalachia at the time – and found a bear about to finish him off. She carried him back to Carlisle, more than a hundred miles, afraid she wouldn't be able to do it herself. I'm only beginning to guess how difficult that journey was for her.† He threw a pointed glance in my direction, and raised our hands, still folded together, to brush my cheek with the back of his hand. â€Å"But she made it,† I encouraged, looking away from the unbearable beauty of his eyes. â€Å"Yes,† he murmured. â€Å"She saw something in his face that made her strong enough. And they've been together ever since. Sometimes they live separately from us, as a married couple. But the younger we pretend to be, the longer we can stay in any given place. Forks seemed perfect, so we all enrolled in high school.† He laughed. â€Å"I suppose we'll have to go to their wedding in a few years, again.† â€Å"Alice and Jasper?† â€Å"Alice and Jasper are two very rare creatures. They both developed a conscience, as we refer to it, with no outside guidance. Jasper belonged to another†¦ family, a very different kind of family. He became depressed, and he wandered on his own. Alice found him. Like me, she has certain gifts above and beyond the norm for our kind.† â€Å"Really?† I interrupted, fascinated. â€Å"But you said you were the only one who could hear people's thoughts.† â€Å"That's true. She knows other things. She sees things – things that might happen, things that are coming. But it's very subjective. The future isn't set in stone. Things change.† His jaw set when he said that, and his eyes darted to my face and away so quickly that I wasn't sure if I only imagined it. â€Å"What kinds of things does she see?† â€Å"She saw Jasper and knew that he was looking for her before he knew it himself. She saw Carlisle and our family, and they came together to find us. She's most sensitive to non-humans. She always sees, for example, when another group of our kind is coming near. And any threat they may pose.† â€Å"Are there a lot of†¦ your kind?† I was surprised. How many of them could walk among us undetected? â€Å"No, not many. But most won't settle in any one place. Only those like us, who've given up hunting you people† – a sly glance in my direction – â€Å"can live together with humans for any length of time. We've only found one other family like ours, in a small village in Alaska. We lived together for a time, but there were so many of us that we became too noticeable. Those of us who live†¦ differently tend to band together.† â€Å"And the others?† â€Å"Nomads, for the most part. We've all lived that way at times. It gets tedious, like anything else. But we run across the others now and then, because most of us prefer the North.† â€Å"Why is that?† We were parked in front of my house now, and he'd turned off the truck. It was very quiet and dark; there was no moon. The porch light was off so I knew my father wasn't home yet. â€Å"Did you have your eyes open this afternoon?† he teased. â€Å"Do you think I could walk down the street in the sunlight without causing traffic accidents? There's a reason why we chose the Olympic Peninsula, one of the most sunless places in the world. It's nice to be able to go outside in the day. You wouldn't believe how tired you can get of nighttime in eighty-odd years.† â€Å"So that's where the legends came from?† â€Å"Probably.† â€Å"And Alice came from another family, like Jasper?† â€Å"No, and that is a mystery. Alice doesn't remember her human life at all. And she doesn't know who created her. She awoke alone. Whoever made her walked away, and none of us understand why, or how, he could. If she hadn't had that other sense, if she hadn't seen Jasper and Carlisle and known that she would someday become one of us, she probably would have turned into a total savage.† There was so much to think through, so much I still wanted to ask. But, to my great embarrassment, my stomach growled. I'd been so intrigued, I hadn't even noticed I was hungry. I realized now that I was ravenous. â€Å"I'm sorry, I'm keeping you from dinner.† â€Å"I'm fine, really.† â€Å"I've never spent much time around anyone who eats food. I forget.† â€Å"I want to stay with you.† It was easier to say in the darkness, knowing as I spoke how my voice would betray me, my hopeless addiction to him. â€Å"Can't I come in?† he asked. â€Å"Would you like to?† I couldn't picture it, this godlike creature sitting in my father's shabby kitchen chair. â€Å"Yes, if it's all right.† I heard the door close quietly, and almost simultaneously he was outside my door, opening it for me. â€Å"Very human,† I complimented him. â€Å"It's definitely resurfacing.† He walked beside me in the night, so quietly I had to peek at him constantly to be sure he was still there. In the darkness he looked much more normal. Still pale, still dreamlike in his beauty, but no longer the fantastic sparkling creature of our sunlit afternoon. He reached the door ahead of me and opened it for me. I paused halfway through the frame. â€Å"The door was unlocked?† â€Å"No, I used the key from under the eave.† I stepped inside, flicked on the porch light, and turned to look at him with my eyebrows raised. I was sure I'd never used that key in front of him. â€Å"I was curious about you.† â€Å"You spied on me?† But somehow I couldn't infuse my voice with the proper outrage. I was flattered. He was unrepentant. â€Å"What else is there to do at night?† I let it go for the moment and went down the hall to the kitchen. He was there before me, needing no guide. He sat in the very chair I'd tried to picture him in. His beauty lit up the kitchen. It was a moment before I could look away. I concentrated on getting my dinner, taking last night's lasagna from the fridge, placing a square on a plate, heating it in the microwave. It revolved, filling the kitchen with the smell of tomatoes and oregano. I didn't take my eyes from the plate of food as I spoke. â€Å"How often?† I asked casually. â€Å"Hmmm?† He sounded as if I had pulled him from some other train of thought. I still didn't turn around. â€Å"How often did you come here?† â€Å"I come here almost every night.† I whirled, stunned. â€Å"Why?† â€Å"You're interesting when you sleep.† He spoke matter-of-factly. â€Å"You talk.† â€Å"No!† I gasped, heat flooding my face all the way to my hairline. I gripped the kitchen counter for support. I knew I talked in my sleep, of course; my mother teased me about it. I hadn't thought it was something I needed to worry about here, though. His expression shifted instantly to chagrin. â€Å"Are you very angry with me?† â€Å"That depends!† I felt and sounded like I'd had the breath knocked out of me. He waited. â€Å"On?† he urged. â€Å"What you heard!† I wailed. Instantly, silently, he was at my side, taking my hands carefully in his. â€Å"Don't be upset!† he pleaded. He dropped his face to the level of my eyes, holding my gaze. I was embarrassed. I tried to look away. â€Å"You miss your mother,† he whispered. â€Å"You worry about her. And when it rains, the sound makes you restless. You used to talk about home a lot, but it's less often now. Once you said, ‘It's too green.'† He laughed softly, hoping, I could see, not to offend me further. â€Å"Anything else?† I demanded. He knew what I was getting at. â€Å"You did say my name,† he admitted. I sighed in defeat. â€Å"A lot?† â€Å"How much do you mean by ‘a lot,' exactly?† â€Å"Oh no!† I hung my head. He pulled me against his chest, softly, naturally. â€Å"Don't be self-conscious,† he whispered in my ear. â€Å"If I could dream at all, it would be about you. And I'm not ashamed of it.† Then we both heard the sound of tires on the brick driveway, saw the headlights flash through the front windows, down the hall to us. I stiffened in his arms. â€Å"Should your father know I'm here?† he asked. â€Å"I'm not sure†¦Ã¢â‚¬  I tried to think it through quickly. â€Å"Another time then†¦Ã¢â‚¬  And I was alone. â€Å"Edward!† I hissed. I heard a ghostly chuckle, then nothing else. My father's key turned in the door. â€Å"Bella?† he called. It had bothered me before; who else would it be? Suddenly he didn't seem so far off base. â€Å"In here.† I hoped he couldn't hear the hysterical edge to my voice. I grabbed my dinner from the microwave and sat at the table as he walked in. His footsteps sounded so noisy after my day with Edward. â€Å"Can you get me some of that? I'm bushed.† He stepped on the heels of his boots to take them off, holding the back of Edward's chair for support. I took my food with me, scarfing it down as I got his dinner. It burned my tongue. I filled two glasses with milk while his lasagna was heating, and gulped mine to put out the fire. As I set the glass down, I noticed the milk trembling and realized my hand was shaking. Charlie sat in the chair, and the contrast between him and its former occupant was comical. â€Å"Thanks,† he said as I placed his food on the table. â€Å"How was your day?† I asked. The words were rushed; I was dying to escape to my room. â€Å"Good. The fish were biting†¦ how about you? Did you get everything done that you wanted to?† â€Å"Not really – it was too nice out to stay indoors.† I took another big bite. â€Å"It was a nice day,† he agreed. What an understatement, I thought to myself. Finished with the last bite of lasagna, I lifted my glass and chugged the remains of my milk. Charlie surprised me by being observant. â€Å"In a hurry?† â€Å"Yeah, I'm tired. I'm going to bed early.† â€Å"You look kinda keyed up,† he noted. Why, oh why, did this have to be his night to pay attention? â€Å"Do I?† was all I could manage in response. I quickly scrubbed my dishes clean in the sink, and placed them upside down on a dish towel to dry. â€Å"It's Saturday,† he mused. I didn't respond. â€Å"No plans tonight?† he asked suddenly. â€Å"No, Dad, I just want to get some sleep.† â€Å"None of the boys in town your type, eh?† He was suspicious, but trying to play it cool. â€Å"No, none of the boys have caught my eye yet.† I was careful not to over-emphasize the word boys in my quest to be truthful with Charlie. â€Å"I thought maybe that Mike Newton†¦ you said he was friendly.† â€Å"He's Just a friend, Dad.† â€Å"Well, you're too good for them all, anyway. Wait till you get to college to start looking.† Every father's dream, that his daughter will be out of the house before the hormones kick in. â€Å"Sounds like a good idea to me,† I agreed as I headed up the stairs. â€Å"‘Night, honey,† he called after me. No doubt he would be listening carefully all evening, waiting for me to try to sneak out. â€Å"See you in the morning, Dad.† See you creeping into my room tonight at midnight to check on me. I worked to make my tread sound slow and tired as I walked up the stairs to my room. I shut the door loud enough for him to hear, and then sprinted on my tiptoes to the window. I threw it open and leaned out into the night. My eyes scanned the darkness, the impenetrable shadows of the trees. â€Å"Edward?† I whispered, feeling completely idiotic. The quiet, laughing response came from behind me. â€Å"Yes?† I whirled, one hand flying to my throat in surprise. He lay, smiling hugely, across my bed, his hands behind his head, his feet dangling off the end, the picture of ease. â€Å"Oh!† I breathed, sinking unsteadily to the floor. â€Å"I'm sorry.† He pressed his lips together, trying to hide his amusement. â€Å"Just give me a minute to restart my heart.† He sat up slowly, so as not to startle me again. Then he leaned forward and reached out with his long arms to pick me up, gripping the tops of my arms like I was a toddler. He sat me on the bed beside him. â€Å"Why don't you sit with me,† he suggested, putting a cold hand on mine. â€Å"How's the heart?† â€Å"You tell me – I'm sure you hear it better than I do.† I felt his quiet laughter shake the bed. We sat there for a moment in silence, both listening to my heartbeat slow. I thought about having Edward in my room, with my father in the house. â€Å"Can I have a minute to be human?† I asked. â€Å"Certainly.† He gestured with one hand that I should proceed. â€Å"Stay,† I said, trying to look severe. â€Å"Yes, ma'am.† And he made a show of becoming a statue on the edge of my bed. I hopped up, grabbing my pajamas from off the floor, my bag of toiletries off the desk. I left the light off and slipped out, closing the door. I could hear the sound from the TV rising up the stairs. I banged the bathroom door loudly, so Charlie wouldn't come up to bother me. I meant to hurry. I brushed my teeth fiercely, trying to be thorough and speedy, removing all traces of lasagna. But the hot water of the shower couldn't be rushed. It unknotted the muscles in my back, calmed my pulse. The familiar smell of my shampoo made me feel like I might be the same person I had been this morning. I tried not to think of Edward, sitting in my room, waiting, because then I had to start all over with the calming process. Finally, I couldn't delay anymore. I shut off the water, toweling hastily, rushing again. I pulled on my holey t-shirt and gray sweatpants. Too late to regret not packing the Victoria's Secret silk pajamas my mother got me two birthdays ago, which still had the tags on them in a drawer somewhere back home. I rubbed the towel through my hair again, and then yanked the brush through it quickly. I threw the towel in the hamper, flung my brush and toothpaste into my bag. Then I dashed down the stairs so Charlie could see that I was in my pajamas, with wet hair. â€Å"‘Night, Dad.† â€Å"‘Night, Bella.† He did look startled by my appearance. Maybe that would keep him from checking on me tonight. I took the stairs two at a time, trying to be quiet, and flew into my room, closing the door tightly behind me. Edward hadn't moved a fraction of an inch, a carving of Adonis perched on my faded quilt. I smiled, and his lips twitched, the statue coming to life. His eyes appraised me, taking in the damp hair, the tattered shirt. He raised one eyebrow. â€Å"Nice.† I grimaced. â€Å"No, it looks good on you.† â€Å"Thanks,† I whispered. I went back to his side, sitting cross-legged beside him. I looked at the lines in the wooden floor. â€Å"What was all that for?† â€Å"Charlie thinks I'm sneaking out.† â€Å"Oh.† He contemplated that. â€Å"Why?† As if he couldn't know Charlie's mind much more clearly than I could guess. â€Å"Apparently, I look a little overexcited.† He lifted my chin, examining my face. â€Å"You look very warm, actually.† He bent his face slowly to mine, laying his cool cheek against my skin. I held perfectly still. â€Å"Mmmmmm†¦Ã¢â‚¬  he breathed. It was very difficult, while he was touching me, to frame a coherent question. It took me a minute of scattered concentration to begin. â€Å"It seems to be†¦ much easier for you, now, to be close to me.† â€Å"Does it seem that way to you?† he murmured, his nose gliding to the corner of my jaw. I felt his hand, lighter than a moth's wing, brushing my damp hair back, so that his lips could touch the hollow beneath my ear. â€Å"Much, much easier,† I said, trying to exhale. â€Å"Hmm.† â€Å"So I was wondering†¦Ã¢â‚¬  I began again, but his fingers were slowly tracing my collarbone, and I lost my train of thought. â€Å"Yes?† he breathed. â€Å"Why is that,† my voice shook, embarrassing me, â€Å"do you think?† I felt the tremor of his breath on my neck as he laughed. â€Å"Mind over matter.† I pulled back; as I moved, he froze – and I could no longer hear the sound of his breathing. We stared cautiously at each other for a moment, and then, as his clenched jaw gradually relaxed, his expression became puzzled. â€Å"Did I do something wrong?† â€Å"No – the opposite. You're driving me crazy,† I explained. He considered that briefly, and when he spoke, he sounded pleased. â€Å"Really?† A triumphant smile slowly lit his face. â€Å"Would you like a round of applause?† I asked sarcastically. He grinned. â€Å"I'm just pleasantly surprised,† he clarified. â€Å"In the last hundred years or so,† his voice was teasing, â€Å"I never imagined anything like this. I didn't believe I would ever find someone I wanted to be with†¦ in another way than my brothers and sisters. And then to find, even though it's all new to me, that I'm good at it†¦ at being with you†¦Ã¢â‚¬  â€Å"You're good at everything,† I pointed out. He shrugged, allowing that, and we both laughed in whispers. â€Å"But how can it be so easy now?† I pressed. â€Å"This afternoon†¦Ã¢â‚¬  â€Å"It's not easy,† he sighed. â€Å"But this afternoon, I was still†¦ undecided. I am sorry about that, it was unforgivable for me to behave so.† â€Å"Not unforgivable,† I disagreed. â€Å"Thank you.† He smiled. â€Å"You see,† he continued, looking down now, â€Å"I wasn't sure if I was strong enough†¦Ã¢â‚¬  He picked up one of my hands and pressed it lightly to his face. â€Å"And while there was still that possibility that I might be†¦ overcome† – he breathed in the scent at my wrist – â€Å"I was†¦ susceptible. Until I made up my mind that I was strong enough, that there was no possibility at all that I would†¦ that I ever could†¦Ã¢â‚¬  I'd never seen him struggle so hard for words. It was so†¦ human. â€Å"So there's no possibility now?† â€Å"Mind over matter,† he repeated, smiling, his teeth bright even in the darkness. â€Å"Wow, that was easy,† I said. He threw back his head and laughed, quietly as a whisper, but still exuberantly. â€Å"Easy for you!† he amended, touching my nose with his fingertip. And then his face was abruptly serious. â€Å"I'm trying,† he whispered, his voice pained. â€Å"If it gets to be†¦ too much, I'm fairly sure I'll be able to leave.† I scowled. I didn't like the talk of leaving. â€Å"And it will be harder tomorrow,† he continued. â€Å"I've had the scent of you in my head all day, and I've grown amazingly desensitized. If I'm away from you for any length of time, I'll have to start over again. Not quite from scratch, though, I think.† â€Å"Don't go away, then,† I responded, unable to hide the longing in my voice. â€Å"That suits me,† he replied, his face relaxing into a gentle smile. â€Å"Bring on the shackles – I'm your prisoner.† But his long hands formed manacles around my wrists as he spoke. He laughed his quiet, musical laugh. He'd laughed more tonight than I'd ever heard in all the time I'd spent with him. â€Å"You seem more†¦ optimistic than usual,† I observed. â€Å"I haven't seen you like this before.† â€Å"Isn't it supposed to be like this?† He smiled. â€Å"The glory of first love, and all that. It's incredible, isn't it, the difference between reading about something, seeing it in the pictures, and experiencing it?† â€Å"Very different,† I agreed. â€Å"More forceful than I'd imagined.† â€Å"For example† – his words flowed swiftly now, I had to concentrate to catch it all – â€Å"the emotion of jealousy. I've read about it a hundred thousand times, seen actors portray it in a thousand different plays and movies. I believed I understood that one pretty clearly. But it shocked me†¦Ã¢â‚¬  He grimaced. â€Å"Do you remember the day that Mike asked you to the dance?† I nodded, though I remembered that day for a different reason. â€Å"The day you started talking to me again.† â€Å"I was surprised by the flare of resentment, almost fury, that I felt – I didn't recognize what it was at first. I was even more aggravated than usual that I couldn't know what you were thinking, why you refused him. Was it simply for your friend's sake? Was there someone else? I knew I had no right to care either way. I tried not to care. â€Å"And then the line started forming,† he chuckled. I scowled in the darkness. â€Å"I waited, unreasonably anxious to hear what you would say to them, to watch your expressions. I couldn't deny the relief I felt, watching the annoyance on your face. But I couldn't be sure. â€Å"That was the first night I came here. I wrestled all night, while watching you sleep, with the chasm between what I knew was right, moral, ethical, and what I wanted. I knew that if I continued to ignore you as I should, or if I left for a few years, till you were gone, that someday you would say yes to Mike, or someone like him. It made me angry. â€Å"And then,† he whispered, â€Å"as you were sleeping, you said my name. You spoke so clearly, at first I thought you'd woken. But you rolled over restlessly and mumbled my name once more, and sighed. The feeling that coursed through me then was unnerving, staggering. And I knew I couldn't ignore you any longer.† He was silent for a moment, probably listening to the suddenly uneven pounding of my heart. â€Å"But jealousy†¦ it's a strange thing. So much more powerful than I would have thought. And irrational! Just now, when Charlie asked you about that vile Mike Newton†¦Ã¢â‚¬  He shook his head angrily. â€Å"I should have known you'd be listening,† I groaned. â€Å"Of course.† â€Å"That made you feel jealous, though, really?† â€Å"I'm new at this; you're resurrecting the human in me, and everything feels stronger because it's fresh.† â€Å"But honestly,† I teased, â€Å"for that to bother you, after I have to hear that Rosalie – Rosalie, the incarnation of pure beauty, Rosalie – was meant for you. Emmett or no Emmett, how can I compete with that?† â€Å"There's no competition.† His teeth gleamed. He drew my trapped hands around his back, holding me to his chest. I kept as still as I could, even breathing with caution. â€Å"I know there's no competition,† I mumbled into his cold skin. â€Å"That's the problem.† â€Å"Of course Rosalie is beautiful in her way, but even if she wasn't like a sister to me, even if Emmett didn't belong with her, she could never have one tenth, no, one hundredth of the attraction you hold for me.† He was serious now, thoughtful. â€Å"For almost ninety years I've walked among my kind, and yours†¦ all the time thinking I was complete in myself, not realizing what I was seeking. And not finding anything, because you weren't alive yet.† â€Å"It hardly seems fair,† I whispered, my face still resting on his chest, listening to his breath come and go. â€Å"I haven't had to wait at all. Why should I get off so easily?† â€Å"You're right,† he agreed with amusement. â€Å"I should make this harder for you, definitely.† He freed one of his hands, released my wrist, only to gather it carefully into his other hand. He stroked my wet hair softly, from the top of my head to my waist. â€Å"You only have to risk your life every second you spend with me, that's surely not much. You only have to turn your back on nature, on humanity†¦ what's that worth?† â€Å"Very little – I don't feel deprived of anything.† â€Å"Not yet.† And his voice was abruptly full of ancient grief. I tried to pull back, to look in his face, but his hand locked my wrists in an unbreakable hold. â€Å"What -† I started to ask, when his body became alert. I froze, but he suddenly released my hands, and disappeared. I narrowly avoided falling on my face. â€Å"Lie down!† he hissed. I couldn't tell where he spoke from in the darkness. I rolled under my quilt, balling up on my side, the way I usually slept. I heard the door crack open, as Charlie peeked in to make sure I was where I was supposed to be. I breathed evenly, exaggerating the movement. A long minute passed. I listened, not sure if I'd heard the door close. Then Edward's cool arm was around me, under the covers, his lips at my ear. â€Å"You are a terrible actress – I'd say that career path is out for you.† â€Å"Darn it,† I muttered. My heart was crashing in my chest. He hummed a melody I didn't recognize; it sounded like a lullaby. He paused. â€Å"Should I sing you to sleep?† â€Å"Right,† I laughed. â€Å"Like I could sleep with you here!† â€Å"You do it all the time,† he reminded me. â€Å"But I didn't know you were here,† I replied icily. â€Å"So if you don't want to sleep†¦Ã¢â‚¬  he suggested, ignoring my tone. My breath caught. â€Å"If I don't want to sleep†¦ ?† He chuckled. â€Å"What do you want to do then?† I couldn't answer at first. â€Å"I'm not sure,† I finally said. â€Å"Tell me when you decide.† I could feel his cool breath on my neck, feel his nose sliding along my jaw, inhaling. â€Å"I thought you were desensitized.† â€Å"Just because I'm resisting the wine doesn't mean I can't appreciate the bouquet,† he whispered. â€Å"You have a very floral smell, like lavender†¦ or freesia,† he noted. â€Å"It's mouthwatering.† â€Å"Yeah, it's an off day when I don't get somebody telling me how edible I smell.† He chuckled, and then sighed. â€Å"I've decided what I want to do,† I told him. â€Å"I want to hear more about you.† â€Å"Ask me anything.† I sifted through my questions for the most vital. â€Å"Why do you do it?† I said. â€Å"I still don't understand how you can work so hard to resist what you†¦ are. Please don't misunderstand, of course I'm glad that you do. I just don't see why you would bother in the first place.† He hesitated before answering. â€Å"That's a good question, and you are not the first one to ask it. The others – the majority of our kind who are quite content with our lot – they, too, wonder at how we live. But you see, just because we've been†¦ dealt a certain hand†¦ it doesn't mean that we can't choose to rise above – to conquer the boundaries of a destiny that none of us wanted. To try to retain whatever essential humanity we can.† I lay unmoving, locked in awed silence. â€Å"Did you fall asleep?† he whispered after a few minutes. â€Å"No.† â€Å"Is that all you were curious about?† I rolled my eyes. â€Å"Not quite.† â€Å"What else do you want to know?† â€Å"Why can you read minds – why only you? And Alice, seeing the future†¦ why does that happen?† I felt him shrug in the darkness. â€Å"We don't really know. Carlisle has a theory†¦ he believes that we all bring something of our strongest human traits with us into the next life, where they are intensified – like our minds, and our senses. He thinks that I must have already been very sensitive to the thoughts of those around me. And that Alice had some precognition, wherever she was.† â€Å"What did he bring into the next life, and the others?† â€Å"Carlisle brought his compassion. Esme brought her ability to love passionately. Emmett brought his strength, Rosalie her†¦ tenacity. Or you could call it pigheadedness.† he chuckled. â€Å"Jasper is very interesting. He was quite charismatic in his first life, able to influence those around him to see things his way. Now he is able to manipulate the emotions of those around him – calm down a room of angry people, for example, or excite a lethargic crowd, conversely. It's a very subtle gift.† I considered the impossibilities he described, trying to take it in. He waited patiently while I thought. â€Å"So where did it all start? I mean, Carlisle changed you, and then someone must have changed him, and so on†¦Ã¢â‚¬  â€Å"Well, where did you come from? Evolution? Creation? Couldn't we have evolved in the same way as other species, predator and prey? Or, if you don't believe that all this world could have just happened on its own, which is hard for me to accept myself, is it so hard to believe that the same force that created the delicate angelfish with the shark, the baby seal and the killer whale, could create both our kinds together?† â€Å"Let me get this straight – I'm the baby seal, right?† â€Å"Right.† He laughed, and something touched my hair – his lips? I wanted to turn toward him, to see if it was really his lips against my hair. But I had to be good; I didn't want to make this any harder for him than it already was. â€Å"Are you ready to sleep?† he asked, interrupting the short silence. â€Å"Or do you have any more questions?† â€Å"Only a million or two.† â€Å"We have tomorrow, and the next day, and the next†¦Ã¢â‚¬  he reminded me. I smiled, euphoric at the thought. â€Å"Are you sure you won't vanish in the morning?† I wanted this to be certain. â€Å"You are mythical, after all.† â€Å"I won't leave you.† His voice had the seal of a promise in it. â€Å"One more, then, tonight†¦Ã¢â‚¬  And I blushed. The darkness was no help – I'm sure he could feel the sudden warmth under my skin. â€Å"What is it?† â€Å"No, forget it. I changed my mind.† â€Å"Bella, you can ask me anything.† I didn't answer, and he groaned. â€Å"I keep thinking it will get less frustrating, not hearing your thoughts. But it just gets worse and worse.† â€Å"I'm glad you can't read my thoughts. It's bad enough that you eavesdrop on my sleep-talking.† â€Å"Please?† His voice was so persuasive, so impossible to resist. I shook my head. â€Å"If you don't tell me, I'll just assume it's something much worse than it is,† he threatened darkly. â€Å"Please?† Again, that pleading voice. â€Å"Well,† I began, glad that he couldn't see my face. â€Å"Yes?† â€Å"You said that Rosalie and Emmett will get married soon†¦ Is that†¦ marriage†¦ the same as it is for humans?† He laughed in earnest now, understanding. â€Å"Is that what you're getting at?† I fidgeted, unable to answer. â€Å"Yes, I suppose it is much the same,† he said. â€Å"I told you, most of those human desires are there, just hidden behind more powerful desires.† â€Å"Oh,† was all I could say. â€Å"Was there a purpose behind your curiosity?† â€Å"Well, I did wonder†¦ about you and me†¦ someday†¦Ã¢â‚¬  He was instantly serious, I could tell by the sudden stillness of his body. I froze, too, reacting automatically. â€Å"I don't think that†¦ that†¦ would be possible for us.† â€Å"Because it would be too hard for you, if I were that†¦ close?† â€Å"That's certainly a problem. But that's not what I was thinking of. It's just that you are so soft, so fragile. I have to mind my actions every moment that we're together so that I don't hurt you. I could kill you quite easily, Bella, simply by accident.† His voice had become just a soft murmur. He moved his icy palm to rest it against my cheek. â€Å"If I was too hasty†¦ if for one second I wasn't paying enough attention, I could reach out, meaning to touch your face, and crush your skull by mistake. You don't realize how incredibly breakable you are. I can never, never afford to lose any kind of control when I'm with you.† He waited for me to respond, growing anxious when I didn't. â€Å"Are you scared?† he asked. I waited for a minute to answer, so the words would be true. â€Å"No. I'm fine.† He seemed to deliberate for a moment. â€Å"I'm curious now, though,† he said, his voice light again. â€Å"Have you ever†¦ ?† He trailed off suggestively. â€Å"Of course not.† I flushed. â€Å"I told you I've never felt like this about anyone before, not even close.† â€Å"I know. It's just that I know other people's thoughts. I know love and lust don't always keep the same company.† â€Å"They do for me. Now, anyway, that they exist for me at all,† I sighed. â€Å"That's nice. We have that one thing in common, at least.† He sounded satisfied. â€Å"Your human instincts†¦Ã¢â‚¬  I began. He waited. â€Å"Well, do you find me attractive, in that way, at all?† He laughed and lightly rumpled my nearly dry hair. â€Å"I may not be a human, but I am a man,† he assured me. I yawned involuntarily. â€Å"I've answered your questions, now you should sleep,† he insisted. â€Å"I'm not sure if I can.† â€Å"Do you want me to leave?† â€Å"No!† I said too loudly. He laughed, and then began to hum that same, unfamiliar lullaby; the voice of an archangel, soft in my ear. More tired than I realized, exhausted from the long day of mental and emotional stress like I'd never felt before, I drifted to sleep in his cold arms.

Sannu’s Story

Unit 8. Case Study 1. Sannu’s Story Sannu has contracted Leprosy. As a sixteen year old teenager, it is hard to pin point when he was infected since Leprosy has a long incubation period. As a small boy traveling barefoot along trails in his village, Sannu’s body has already adapted to his living conditions. Sannu’s feet are tough and calloused. As Sannu ages, so does his Leprosy infection progress. The infection will cause neuropathy in his extremities which will lead to many injuries to his feet and hands. The wounds acquired will be infected for weeks or even months without treatment.The neuropathy caused by the Leprosy infection is characterized by causing a decrease in sensation in the extremities, muscle weakness, and numbness. Sannu’s feet that have been toughened by his environment and life style have been further injured due to lack of sensation and medical treatment. In an attempt to keep his feet clean to aide the healing of his infections, Sannu is more than likely maintaining a sedentary life style. This life style along with the progression of the Leprosy infection will weaken Sannu’s muscles. A feature common to all forms of Leprosy is nerve infection.Nerve damage appears to result from the multiplication of bacilli within Schwann cells and damage to the perineurium. Most of the deformities occurring from Leprosy are in fact due to trauma or a secondary infection. In a Leprosy infection one of the first symptoms are anesthesia to heat and cold. Leprosy affects the peripheral nervous system by attacking the myelin sheath surrounding the axons which affects the reliability and speed of nerve impulses. In other words, the nerve fibers are no longer insulated and nerve impulses cannot be conducted efficiently.There are different types of sensory receptors located throughout the body and are designed based on a selective stimulus response. The appropriate receptive field is stimulated within a sensory receptor produci ng a response. In Sannu’s condition this action is delayed or absent due to the damage of his free nerve endings. Free nerve endings detect pain, temperature, and touch as well as tickle and itch. Sannu’s encapsulated nerve endings are also damaged. Encapsulated nerve endings detect pressure, vibration, and touch sensations.When Dianna performed the tests to check Sannu’s Achilles tendon and Babinski’s reflex, she was evaluating his somatic senses. Somatic senses involve sensations such as touch, pressure, and pain as well as temperature perception. These are all affected in Leprosy infection. In Sannu’s case he has also lost the sensations of touch, pressure, and pain in his feet and hands due to the affects of leprosy on his nociceptors, mechanoreceptors, proprioceptors, and exteroceptors. These sensations are also present in the sensory receptors free nerve endings and encapsulated nerve endings.Sannu’s interoceptors would not be affected in a Leprosy infection because interoceptors pertain to the body’s internal environment. Mycobacterium leprae grow best in relatively cool areas of the body such as: the skin, peripheral nerves, the mucosa of the upper respiratory tract as well as the chamber of the eye and in severe untreated cases the testes and eventually other vital organs. Leprosy affects the exteroceptors of the external surface of the body. Nociceptors are the receptors of pain and are located in all tissues of the body with an exception of the brain.Proprioceptors do no adapt very much, this is why Sannu still feels pain in his leg that has been amputated. Sannu’s pain is slow pain. Slow pain is referring to pain that is chronic, burning, aching, or throbbing. The peripheral receptors activated during a stimulus are the nociceptors. Like other cutaneous and subcutaneous receptors, Nociceptors transduce a variety of stimuli into receptor potentials. Also, like other somatic sensory receptors, N ociceptors arise from cell bodies in dorsal root ganglia that send one axonal process to the periphery and the other into the spinal cord or brain stem.Peripheral Nociceptors terminate at the site of free nerve endings. Nociceptors are located in the entire body except for the brain. The loss of myelination causes impulses to misfire. Without the myelin sheath the impulses are slower and misdirected. Sannu had little sensation to his extremities because of the process related to his Leprosy infection. Phantom limb pain is a result of neuroplasticity (new neural links can be made), or the brain region that once was responsible for controlling the amputated limb is taken over by an adjacent area of the brain.The phantom limb pain is enhanced by referred sensations, so that stimuli applied to other body parts can be sensed from the phantom limb. In patients with Leprosy, phantom limb pain will not occur with only the amputation of fingers, toes, hands, or feet. Phantom limbs and phanto m limb pain will only occur when the amputation is taken up to the stump of that limb. The representation of Sannu’s amputated leg on the somatosensory map will involve referred sensations because of remapping of somatosensory areas in the brain. The activity of the somatosensory map in the brain leads to conscious experience of body image and somatic sensations.After Sannu’s amputation it is possible for him to initially experience some effects on his balance and equilibrium. This is because after amputation Sannu may still have confused senses of his missing leg. With the introduction of a prosthesis, Sannu’s brain will connect to the prosthetic device causing his brain to remember how to function as if the original leg were still there. The initial sensory loss that Sannu experienced was due to interference of the sensory pathway transmission. Leprosy affects the skin and peripheral nerves which are closest to the exterior of the body where the sensory recept ors are located.Leprosy infection is caused by mycobacterium leprae and mycobacterium lepromatosis. Both forms affect the peripheral nervous system by attacking the Schwann cells, destroying the myelin. At the site of the Schwann cell, the bacteria multiply and cause damage of the nerve architecture and cause secondary inflammation. This disease process results in desensitizing sensory receptors. This is why when Sannu cut his foot, he did not feel the pain, nor the infection that followed. Due to his location in a remote village and lack of medical care, his infection resulted in an amputation.The receptors that should have sensed the initial injury to Sannu’s foot are the exteroceptors. Exteroceptors are responsible for responding to stimulus from outside the body such as touch, pressure, pain, and temperature. After Sannu’s amputation he began experiencing phantom limb sensations. This is considered as a form of neuropathic pain. It is presumed to be a response by t he peripheral nervous system and the central nervous system of an injury. The process of reorganizing occurs from retained nerves from the amputated limb, spinal cord, thalamus, and cerebral cortex.After an amputation the area of the brain that is responsible for processing the sensations from the missing limb are taken over by areas that neighbored the missing limb. It is believed that around 95% of people are naturally immune to Leprosy. Recent research suggests that there is a defect in cell-mediated immunity that causes susceptibility to Leprosy. The area of DNA responsible for that variable is also found in Parkinson’s disease. It is speculated the two disorders are linked somehow at the biochemical level. Research has shown that susceptibility to the disease was linked to region q25 on the long arm of chromosome 6.Further study indicated that the Leprosy susceptibility gene lies within a region shared by two genes for Parkinson’s disease. Resources The Merk Manua l of Diagnosis and Therapy â€Å"Infectious Diseases caused by Mycobacteria† 2004 International Journal of Leprosy and other Mycobacterial Diseases â€Å"Linkage of Leprosy Susceptibility to Parkinson’s Disease Genes† June 2004 www. who. ch/program [email  protected] nl www. encyclopedia. com www. ncbi. nlm. nih. gov/pubmed/15372437 en. wikipedia. org/wiki/proprioception rarediseases. about. com. lepercolonies. thalidomide May 16 2009 pubmed. gov Muscle Nerve October 30 2004

Essay on Why Students Should Go to School - 765 Words

Why should students go to school? There are several reasons why kids need to go to school but to me, the top three reasons are getting an education helps you go farther in life, it’s required by the state that you go till you reach a certain age, and it will help you learn social skills and help you be comfortable to talking to people. Although students may not like going to school, it benefits them in the long run. It is important for students to go to school to get an education. Even though some students may not like to go to school it is required that they go. Even though students may not realize it but they also learn social skills by making friends and talking in front of people. It’s significant for students to go to school so†¦show more content†¦If you ever went into a business where you had to do a presentation on a piece of work you’ve been working on or if you came up with a new idea that you thought could help your business, you would most likely have to present the informati on in front of your boss and coworkers. Having social skills could play a big role in your presentation because if you was not comfortable talking in front of a crowd, then you could either: freeze up while talking, talk too fast cause you’re so nervous and want to get the presentation over with, your face could turn red, etc. But, if you had social skills and were use to talking in front of a group of people then you will be comfortable presenting your project with no worries. Also by socializing students can make friends. By making friends school could also be more enjoyable. You will have friends to eat lunch with; friends to hang out with on the weekends and you will have friends in your classes so they will be less boring. If you went to a school where you didn’t have any friends or where you didn’t like anyone, then you will not enjoy the activities you may do in class and you may want to change schools to find kids that you do like and will enjoy being ar ound. By having social skills it will help you talk to people and make friends. Students may not like going to school but, it is for the best. By going to school students can get an education and get a job or go to college andShow MoreRelatedEssay On School Uniforms1388 Words   |  6 PagesStevens Miss. Windish English II 16 October 2017 Dress for Success Many schools have decided that having school uniforms is the best for their students. Other schools don’t want to limit the student’s freedom of speech. Schools can’t decide which is the best - have uniforms or not. 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