Nottington University

January 18, 2008

Mardi Gras -Carnival Came to America by Mskittie

Filed under: NU Seminars & Classes — by nottingtonuniversity @ 7:07 pm

The history of a Mardi Gras celebration existed many years before Europeans came to the New World. Some time in the Second Century, during mid-February (usually February 15 according to the Julian calendar), Ancient Romans would observe what they called the Lupercalia, a circus-type festival which was, in many respects, quite similar to the present day Mardi Gras. This festival honored the Roman deity, Lupercus, a pastoral God associated with Faunus or the Satyr. Although Lupercus is derived from the Latin Lupus (meaning “wolf”), the original meaning of the word as it applies to Roman religion has become obscured over the passage of time. When Christianity arrived in Rome, the dignitaries of the early Church decided it would be more prudent to incorporate certain aspects of such rituals into the new faith rather than attempt to abolish them altogether. This granted a Christian interpretation to the ancient custom and the Carnival became a time of abandon and merriment which peceded the Lenten period (a symbolic Christian pentinence of 40 days commencing on Ash Wednesday and ending at Easter). During this time, there would be feasting which lasted several days and participants would indulge in voluntary madness by donning masks, clothing themselves in the likeness of spectres and generally giving themselves up to Bacchus and Venus. All aspects of pleasure were considered to be allowable during the Carnival celebration and today’s modern festivites are thought by some to be more reminiscent of the Roman Saturnalia rather than Lupercalia, or be linked to even earlier Pagan festivals.

From Rome, the celebration spread to other European countries. In medieval times, a similar-type festivity to that of the present day Mardi Gras was given by monarchs and lords prior to Lent in order to ceremoniously conscript new knights into service and hold feasts in their honor. The landed gentry would also ride through the countryside rewarding peasants with cakes (thought by some to be the origin of the King Cake), coins (perhaps the origin of present day gifts of Mardi Gras doubloons) and other trinkets. In Germany, there still remains a Carnival similar to that of the one held in New Orleans. Known as Fasching, the celebrations begin on Twelfth Night and continue until Shrove Tuesday. To a lesser degree, this festivity is still celebrated in France and Spain. A Carnival season was also celebrated in England until the Nineteenth Century, originating as a type of “renewal” festival that incorporated fertility motifs and ball games which frequently turned into riots between opposing villages, followed by feasts of pancakes and the imbibing of alcohol. The preparing and consumption of pancakes on Shrove Tuesday (also known as “Pancake Day” or “Pancake Tuesday” and occurring annually between February 2 and March 9, depending upon the date of Easter) is a still a tradition in the United Kingdom, where pancake tossing and pancake races (during which a pancake must be tossed a certain number of times) are still popular. One of the most famous of such competitions, which takes place in Olney, Buckinghamshire, is said to date from 1445. It is a race for women only and for those who have lived in the Parish for at least three months. An apron and head-covering are requisite. The course is 415 yards and the pancake must be tossed at least three times during the race. The winner receives a kiss from the Ringer of the Pancake Bell and a prayer book from the local vicar. “Shrove” is derived from the Old English word “shrive,” which means to “confess all sins.”

It is generally accepted that Mardi Gras came to America in 1699 with the French explorer, Sieur d’Iberville. The festival had been celebrated as a major holiday in Paris since the Middle Ages. Iberville sailed into the Gulf of Mexico and, from there, launched an expedition along the Mississippi River. By March 3, 1699, Iberville had set up a camp on the West Bank of the River…about 60 miles South of the present day City of New Orleans in the State of Louisiana. Since that day was the very one on which Mardi Gras was being celebrated in France, Iberville named the site Point du Mardi Gras in honor of the festival. According to some sources, however, the Mardi Gras of New Orleans began in 1827 when a group of students who had recently returned from school in Paris donned strange costumes and danced their way through the streets. The students had first experienced this revelry while taking part in celebrations they had witnessed in Paris. In this version, it is said that the inhabitants of New Orleans were swiftly captured by the enthusiasm of the youths and quickly followed suit. Other sources maintain that the Mardi Gras celebration originated with the arrival of early French settlers to the State of Louisiana. Nevertheless, it is known that from 1827 to 1833, the New Orleans’ Mardi Gras celebrations became more elaborate, culminating in an annual Mardi Gras Ball. Although the exact date of the first revelries cannot be determined, the Carnival was well-established by the middle of the Nineteenth Century when the Mystick Krewe of Comus presented its 1857 Torchlight Parade with a theme taken from “Paradise Lost” written by John Milton.

In French, “Mardi Gras” literally means “Fat Tuesday,” so named because it falls on the day before Ash Wednesday, the last day prior to Lent…a 40-day season of prayer and fasting observed by the Roman Catholic Church (and many other Christian denominations) which ends on Easter Sunday. The origin of “Fat Tuesday” is believed to have come from the ancient Pagan custom of parading a fat ox through the town streets. Such Pagan holidays were filled with excessive eating, drinking and general bawdiness prior to a period of fasting. Since the modern day Carvinal Season is sandwiched between Christmas and Lent, with Christmas Day being December 25 on the Gregorian Calendar as set by the Roman Catholic Church, this means that other Holy Days are “floating” in nature. Easter always falls on a Sunday, but it can be any Sunday from March 23 through April 25, its actual date being the Sunday which follows the first Full Moon after the Spring Equinox. Mardi Gras is always 47 days prior to this alloted Sunday (the 40 days of Lent plus seven Sundays). The beginning of the Carnival Season itself, however, is also fixed…being January 6, which is the Feast of the Ephiphany, otherwise known as Little Christmas or Twelfth Night. Since the date of Mardi Gras thus varies, the length of the Carnival Season also varies accordingly from year-to-year. The origin of the word “Carvinal” is from the Latin for “farewell to the flesh,” a time when one is expected to forego earthly pleasures prior to the restrictions of the Lenten Season, and is thought to be derived from the feasts of the Middle Ages known as carnis levamen or “solace of the flesh.”

In 1833, Bernard Xavier de Marigny de Mandeville, a wealthy plantation owner, solicited a large amount of money in order to help finance an organized Mardi Gras celebration. It was not until 1837, however, that the first Mardi Gras Parade was staged. Two years later, a description of the 1839 Parade noted that it consisted of a single float. Nonetheless, it was considered to be a great success and apparently, the crowd roared hilariously as this somewhat crude float moved through the streets of the city. Since that time, Mardi Gras in New Orleans has been an overwhelming success, continuing to grow with additional organizations participating each year.

The traditional colors of Mardi Gras are purple (symbolic of justice), green (symbolic of faith) and gold (symbolic of power). The accepted story behind the original selection of these colors originates from 1872 when the Grand Duke Alexis Romanoff of Russia visited New Orleans. It is said that the Grand Duke came to the city in pursuit of an actress named Lydia Thompson. During his stay, he was given the honor of selecting the official Mardi Gras colors by the Krewe of Rex…thus, did these colors also become the colors of the House of Romanoff. The 1892 Rex Parade theme (“Symbolism of Colors”) first gave meaning to the representation of the official Mardi Gras colors. Interestingly, the colors of Mardi Gras influenced the choice of school colors for the Lousiana arch-rival colleges, Louisiana State University and Tulane University. Whe LSU was deciding on its colors, the stores in New Orleans had stocked-up on fabrics of purple, green and gold for the upcoming Mardi Gras Season. LSU, opting for purple and gold, bought a large quantity of the available cloth. Tulane purchased much of the only remaining color…green (Tulane’s colors are green and white).

Today, Louisiana’s Mardi Gras is celebrated not only in New Orleans, but also in numerous smaller cities and towns around the State and in the neighboring Gulf Coast Region. Similar celebrations are also held in the Brazilian city of Rio de Janeiro…arguably the world’s most elaborate Carnival location with its Samba Dromo parades, which annually attract a huge number of tourists from all corners of the globe. Regardless of where the festivals take place, however, all share a common party atmosphere inherently associated with the celebrations.

As a resident,living just 60 miles from New Orleans,I have seen many Mardi Gras’ come and go.These parades span several weeks with floats being build for the next year almost before the end of the last floats last throw is thrown. With the many  parties,balls and all sorts of preparations going on over the weeks before Fat Tuesday there is a great excitement that can be felt in the very air.I love to take the children and watch the parades and holler for beads and all kinds of trinkets.I think that we have a lot more in common with people in other places than then we are aware of .I found that Sha and I share this holiday even if alittle different.It is like others I can name here.but wont yet.Maybe we just need to get to know each other better so we can focus on the similarities and not the differences.That is what Nottington is all about isn’t it ?We are making the world a lot smaller in our own way.

January 17, 2008

Holidays – Brazilian Carnival (2008, February 4 and 5) by Sha

Filed under: NU Seminars & Classes — by nottingtonuniversity @ 12:03 am
CARNIVAL ROOTS

The origins of carnival date back to the ancient Greek spring festival in honor of Dionysus, the god of wine. The Romans adopted the celebration with Bacchanalia (feasts in honor of Bacchus, the Roman equivalent to Dionysus), and Saturnalia, where slaves and their masters would exchange clothes in a day of drunken revelry. Saturnalia was later modified by the Roman Catholic Church into a festival leading up Ash Wednesday. It quickly evolved into a massive celebration of indulgences – one last gasp of music, food, alcohol, and sex before Lent – before the 40 days of personal reflection, abstinence, and fasting until Easter (not exactly what the Church probably had in mind). 40 days of purging sins, preceded by a week filled with virtually every known sin. The word itself comes from Latin, “Carne Vale” or “Farewell to the Flesh”.

BRASIL – RIO DE JANEIRO
Rio’s lavish carnival is one of the world’s most famous. Scores of spectacular floats surrounded by thousands and thousands of dancers, singers, and drummers parade through the enormous Sambódromo Stadium dressed in elaborate costumes (or, quite often, with absolutely no costume.) It is an epic event televised around the world. The origin of Brazil’s carnival goes back to a Portuguese pre-lent festivity called “entrudo”, a chaotic event where participants threw mud, water, and food at each other in a street event that often led to riots (an event quite similar to today’s Andean carnival – see Venezuelan section of this booklet). Rio’s first masquerade carnival ball (set to polkas and waltzes) was in 1840. Carnival street parades followed a decade later with horse drawn floats and military bands. The sound closely associated with the Brazilian carnival, the samba, wasn’t part of carnival until 1917. The samba is a mix of Angolan semba, European polka, African batuques, with touches of Cuban habanera and other styles. What we now know as samba is a result of the arrival of black Brazilians (primarily from Bahia) to the impoverished slums or favelas surrounding Rio following the abolition of slavery in Brazil in 1888. Today the carnival is organized by the escolas de samba (samba schools).
SAMBA SCHOOLSThe Samba schools (Escolas de samba in Portuguese) are samba clubs organised in the early half of the 20th century in Rio de Janeiro, Brazil. They are neighbourhood associations that today put on spectacular Carnival parades.
 Samba school
The most spectacular parade takes place in the Rio de Janeiro Sambadrome, with other major parades taking place in São Paulo and others cities of the southern and southeastern Brazil. These parades are sumptuous and attract tourists from all over the world.Samba schools, which started off first in Rio de Janeiro in 1928, have evolved around the centerpiece event of the Rio Carnaval. The schools parade down a lane lined with grandstands, thousands of members per school dressed in coordinated costumes, dancing a rehearsed samba routine to original music. Each school’s presentation has a central theme, such as a historical event, a famous person or a native Brazilian legend. The samba song must be developed around the theme, and the parade organised by each school must detail the theme through costumes, paintings or papier-mache sculpture.

Each samba school rehearses all year round for this event and all its members take part in the rehearsals, whether experts or not. It is a place where people who always wanted to write a song, play a percussion instrument or choreograph a dance will have their opportunity. Unlike the Rose Parade, which has largely been taken over by high-budget professionals, the samba parade is the work of neighbourhood communities working together. Much more than musical groups, they are in fact, neighborhood associations that cater for a variety of community needs (such as educational and health care resources) in a country with grinding poverty and poor social safety net.

Parade components

First is the front line (the comissão de frente), which consists of around ten people who have to introduce the samba school’s theme. Other than that, there is no rule concerning the order of the different elements of a samba school. Its main components are:

  • The master of ceremonies and flag bearer: a couple, sometimes dressed in royal eighteenth or nineteenth-century attire, who dance in a graceful, composed manner. The flag bearer displays the flag of the samba school. The rich costumes that the couple wear are a mark of the intense dialogues between cultures provided by the Carnival in Rio.
  • The Baianas (ala de baianas), which may include over one hundred older Afro-Brazilian women stereotypically dressed to represent the women from Bahia who sold goods in the streets of Rio during the 19th century.
  • The drum section (bateria) which consists of a few hundred men playing in rows. Instruments include a variety of drums, tambourines, and rattles.

BRASIL – SALVADOR, BAHIA

Salvador da Bahia was Brazil’s first center of government (from 1549 to 1763), and remains its musical capital. For centuries, Bahia was home of the Portuguese sugar industry and slave trade. As a result, today Salvador is the largest center of African culture in the Americas. Amidst the colonial architecture and cobblestone streets, there is an unmistakable beat of Bahian drumming. You can hear it in the stereo speakers and boom boxes blasting the latest Axê pop music. It becomes overwhelming when the large percussion ensembles (with literally hundreds of drummers) called “blocos Afros” take to the streets for carnival. It was a movement launched a half century ago by the group, Filhos de Gandhi (Sons of Gandhi). Today, there are countless blocos Afros that have taken on a new mission as part of the “negritude” movement to re-establish Black Pride. Olodum, Ara Ketu, Ilê Aiyé, Timbalada and the all women’s drumming mega-group Dida all electrify Salvador every February during carnival. Olodum’s Billy Arquimimo explains, “We started Olodum 20 years ago because at that time, black people used to be ashamed of their skin. We thought it was necessary to do something to re-establish Black Pride, and to redevelop African culture here in Bahia.”

Like Rio, the city of Salvador is famous for its carnival. For both cities, it is an enormous festival leading up to Lent. That is where the similarities end. Rio is famous for its Samba schools, elaborate costumes (or at times no costumes), and a huge parade held at the Sambódromo Stadium. Salvador is Brazil’s street carnival. It lasts for weeks. The music begins daily as early as noon and runs until 7 or 8 the next morning.

Bahian superstar Carlinhos Brown explains, “We play, not for money, but to celebrate happiness. Our carnival is a street carnival. It is for everyone, not just for those with money.” In addition to the Blocos Afros, artists like Carlinhos Brown and Daniela Mercury perform on huge trucks, packed with loudspeakers called “trio elétricos“. Trio elétrico in Salvador, BahiaThese are the big tractor-trailer trucks packed with huge speakers. The tradition began in 1950 when two Bahian musicians, Dodo and Osmar, performed with their electric trio aboard a 1929 Ford pickup truck.. Even though there are regularly 20-40 band members atop 18 wheeler mega-trucks today, the name “trio electrico” still sticks. Bahia’s carnival is perhaps the world’s largest public festivity, attracting crowds of three million that dance through the night in Salvador’s historic colonial streets.
A PERSONAL POINT OF VIEW
I really only like Carnival because it’s a long holiday that I don’t (usually) have to work and can travel or can enjoy the empty and super calm city. Carnival has never been my “thing” as for most of the Brazilians who live all year long just waiting for this moment of the year. There is a motto in our country that says “that the year in Brazil only effectively starts after the Carnival”, so as you can imagine, 2008 hasn’t started yet…..
Fortunately, this is not true for everybody. As in every part of the world, we have hard working citizens and those who aren’t…. In fact Brazilian people are known as very outgoing, friendly, easy going and one of the sociological reasons for these facts is the African influence in our colonization whose roots are also the carnival’s ones.
From now on, on TV, all I can see on the news, local programs are the Carnival’s preparations, I, personally, get tired and bored… but hey that’s my country… and after Feb 5th…. 2008 will begin! LOL
Bibliography:
Images from:

January 14, 2008

Strokes and Living with them by Mskittie

Filed under: NU Seminars & Classes — by nottingtonuniversity @ 8:10 pm
  1. STROKES AND LIVING WITH THEM
  2. We are going to look at stokes and how they effect the victim and family and what we can do when someone we love has a stroke.We have an important part to play in the treatment and recovery of those who have had a stroke.It is up to us whether these people recover and live a full life,as much as it is their own.
    My sister had s stroke 3 years ago and is just now getting the care she needs and a hold on life.Her family aided her to the point of making her a victim and more disabled.The fear of losing her to the stroke and hurting her prevented him from doing the therapy she needed at home and he would not let her do anything for herself.All she was taught in therapy was lost with lack of use and she found herself unable to even care for her basic needs.Now after all this time she is finally getting the help she needed.We can only hope it is not to late.
    I cared for her for a year and it was during this time that she finally was able to start caring for herself and now can do much for her family too.I pray she will continue on the path so she can walk and even run one day.She will have surgery this week we pray all will be well.
  3. Rehabilitation works best when stroke survivors and their families work together as a team. For this reason, both stroke survivors and family members are encouraged to read all parts of the booklet.
  4. What is a Stroke?
  5. A stroke is a type of brain injury. Symptoms depend on the part of the brain that is affected. People who survive a stroke often have weakness on one side of the body or trouble with moving, talking, or thinking.
  6. Most strokes are ischemic (is-KEE-mic) strokes. These are caused by reduced blood flow to the brain when blood vessels are blocked by a clot or become too narrow for blood to get through. Brain cells in the area die from lack of oxygen. In another type of stroke, called hemorrhagic (hem-or-AJ-ic) stroke, the blood vessel isn’t blocked; it bursts, and blood leaks into the brain, causing damage.
  7. Strokes are more common in older people. Almost three-fourths of all strokes occur in people 65 years of age or over. However, a person of any age can have a stroke.
  8. A person may also have a transient ischemic attack (TIA). This has the same symptoms as a stroke, but only lasts for a few hours or a day and does not cause permanent brain damage. A TIA is not a stroke but it is an important warning signal. The person needs treatment to help prevent an actual stroke in the future.
  9. A stroke may be frightening to both the patient and family. It helps to remember that stroke survivors usually have at least some spontaneous recovery or natural healing and often recover further with rehabilitation.
  10. Recovering From Stroke
  11. The process of recovering from a stroke usually includes treatment, spontaneous recovery, rehabilitation, and the return to community living. Because stroke survivors often have complex rehabilitation needs, progress and recovery are different for each person.
  12. Treatment for stroke begins in a hospital with “acute care.” This first step includes helping the patient survive, preventing another stroke, and taking care of any other medical problems.
  13. Spontaneous recovery happens naturally to most people. Soon after the stroke, some abilities that have been lost usually start to come back. This process is quickest during the first few weeks, but it sometimes continues for a long time.
  14. Rehabilitation is another part of treatment. It helps the person keep abilities and gain back lost abilities to become more independent. It usually begins while the patient is still in acute care. For many patients, it continues afterward, either as a formal rehabilitation program or as individual rehabilitation services. Many decisions about rehabilitation are made by the patient, family, and hospital staff before discharge from acute care.
  15. The last stage in stroke recovery begins with the person’s return to community living after acute care or rehabilitation. This stage can last for a lifetime as the stroke survivor and family learn to live with the effects of the stroke. This may include doing common tasks in new ways or making up for damage to or limits of one part of the body by greater activity of another. For example, a stroke survivor can wear shoes with velcro closures instead of laces or may learn to write with the opposite hand.
  16. What Happens During Acute Care
  17. * The main purposes of acute care are to:
    * Make sure the patient’s condition is caused by a stroke and not by some other medical problem.
    * Determine the type and location of the stroke and how serious it is.
    * Prevent or treat complications such as bowel or bladder problems or pressure ulcers (bed sores).
    * Prevent another stroke.
    * Encourage the patient to move and perform self-care tasks, such as eating and getting out of bed, as early as medically possible. This is the first step in rehabilitation.
  18. Stroke survivors and family members may find the hospital experience confusing. Hospital staff are there to help, and it is important to ask questions and talk about concerns.
  19. Before acute care ends, the patient and family with the hospital staff decide what the next step will be. For many patients, the next step will be to continue rehabilitation.
  20. Preventing Another Stroke
  21. People who have had a stroke have an increased risk of another stroke, especially during the first year after the original stroke. The risk of another stroke goes up with older age, high blood pressure (hypertension), high cholesterol, diabetes, obesity, having had a transient ischemic attack (TIA), heart disease, cigarette smoking, heavy alcohol use, and drug abuse. While some risk factors for stroke (such as age) cannot be changed, the risk factors for the others can be reduced through use of medicines or changes in lifestyle.
  22. Patients and families should ask for guidance from their doctor or nurse about preventing another stroke. They need to work together to make healthy changes in the patient’s lifestyle. Patients and families should also learn the warning signs of a TIA (such as weakness on one side of the body and slurred speech) and see a doctor immediately if these happen.
  23. How Stroke Affects People
  24. Effects on the Body, Mind, and Feelings
  25. Each stroke is different depending on the part of the brain injured, how bad the injury is, and the person’s general health. Some of the effects of stroke are:
  26. Weakness (hemiparesis–hem-ee-par-EE-sis) or paralysis (hemiplegia–hem-ee-PLEE-ja) on one side of the body.
    This may affect the whole side or just the arm or the leg. The weakness or paralysis is on the side of the body opposite the side of the brain injured by the stroke. For example, if the stroke injured the left side of the brain, the weakness or paralysis will be on the right side of the body.
  27. Problems with balance or coordination.
    These can make it hard for the person to sit, stand, or walk, even if muscles are strong enough.
  28. Problems using language (aphasia and dysarthria).
    A person with aphasia (a-FAY-zha) may have trouble understanding speech or writing. Or, the person may understand but may not be able to think of the words to speak or write. A person with dysarthria (dis-AR-three-a) knows the right words but has trouble saying them clearly.
  29. Being unaware of or ignoring things on one side of the body (bodily neglect or inattention).
    Often, the person will not turn to look toward the weaker side or even eat food from the half of the plate on that side.
  30. Pain, numbness, or odd sensations.
    These can make it hard for the person to relax and feel comfortable.
  31. Problems with memory, thinking, attention, or learning (cognitive problems).
    A person may have trouble with many mental activities or just a few. For example, the person may have trouble following directions, may get confused if something in a room is moved, or may not be able to keep track of the date or time.
  32. Being unaware of the effects of the stroke.
    The person may show poor judgment by trying to do things that are unsafe as a result of the stroke.
  33. Trouble swallowing (dysphagia–dis-FAY-ja).
    This can make it hard for the person to get enough food. Also, care must sometimes be taken to prevent the person from breathing in food (aspiration–as-per-AY-shun) while trying to swallow it.
  34. Problems with bowel or bladder control.
    These problems can be helped with the use of portable urinals, bedpans, and other toileting devices.
  35. Getting tired very quickly.
    Becoming tired very quickly may limit the person’s participation and performance in a rehabilitation program.
  36. Sudden bursts of emotion, such as laughing, crying, or anger.
    These emotions may indicate that the person needs help, understanding, and support in adjusting to the effects of the stroke.
  37. Depression.
    This is common in people who have had strokes. It can begin soon after the stroke or many weeks later, and family members often notice it first.
  38. Depression After Stroke
  39. It is normal for a stroke survivor to feel sad over the problems caused by stroke. However, some people experience a major depressive disorder, which should be diagnosed and treated as soon as possible. A person with a major depressive disorder has a number of symptoms nearly every day, all day, for at least 2 weeks. These always include at least one of the following:
  40. * Feeling sad, blue, or down in the dumps.
    * Loss of interest in things that the person used to enjoy.
  41. A person may also have other physical or psychological symptoms, including:
  42. * Feeling slowed down or restless and unable to sit still.
    * Feeling worthless or guilty.
    * Increase or decrease in appetite or weight.
    * Problems concentrating, thinking, remembering, or making decisions.
    * Trouble sleeping or sleeping too much.
    * Loss of energy or feeling tired all of the time.
    * Headaches.
    * Other aches and pains.
    * Digestive problems.
    * Sexual problems.
    * Feeling pessimistic or hopeless.
    * Being anxious or worried.
    * Thoughts of death or suicide.
  43. If a stroke survivor has symptoms of depression, especially thoughts of death or suicide, professional help is needed right away. Once the depression is properly treated, these thoughts will go away. Depression can be treated with medication, psychotherapy, or both. If it is not treated, it can cause needless suffering and also makes it harder to recover from the stroke.
  44. Disabilities After Stroke
  45. A “disability” is difficulty doing something that is a normal part of daily life. People who have had a stroke may have trouble with many activities that were easy before, such as walking, talking, and taking care of “activities of daily living” (ADLs). These include basic tasks such as bathing, dressing, eating, and using the toilet, as well as more complex tasks called “instrumental activities of daily living” (IADLs), such as housekeeping, using the telephone, driving, and writing checks.Some disabilities are obvious right after the stroke. Others may not be noticed until the person is back home and is trying to do something for the first time since the stroke.
  46. Deciding About Rehabilitation
  47. Deciding About RehabilitationSome people do not need rehabilitation after a stroke because the stroke was mild or they have fully recovered. Others may be too disabled to participate. However, many patients can be helped by rehabilitation. Hospital staff will help the patient and family decide about rehabilitation and choose the right services or program.
  48. Types of Rehabilitation Programs
    There are several kinds of rehabilitation programs:
  49. Hospital programs.
    These programs can be provided by special rehabilitation hospitals or by rehabilitation units in acute care hospitals. Complete rehabilitation services are available. The patient stays in the hospital during rehabilitation. An organized team of specially trained professionals provides the therapy. Hospital programs are usually more intense than other programs and require more effort from the patient.
  50. Nursing facility (nursing home) programs.
    As in hospital programs, the person stays at the facility during rehabilitation. Nursing facility programs are very different from each other, so it is important to get specific information about each one. Some provide a complete range of rehabilitation services; others provide only limited services.
  51. Outpatient programs.
    Outpatient programs allow a patient who lives at home to get a full range of services by visiting a hospital outpatient department, outpatient rehabilitation facility, or day hospital program.
  52. Home-based programs.
    The patient can live at home and receive rehabilitation services from visiting professionals. An important advantage of home programs is that patients learn skills in the same place where they will use them.
  53. Individual Rehabilitation Services
  54. Many stroke survivors do not need a complete range of rehabilitation services. Instead, they may need an individual type of service, such as regular physical therapy or speech therapy. These services are available from outpatient and home care programs.
  55. Choosing a Rehabilitation Program
  56. The doctor and other hospital staff will provide information and advice about rehabilitation programs, but the patient and family make the final choice. Hospital staff know the patient’s disabilities and medical condition. They should also be familiar with the rehabilitation programs in the community and should be able to answer questions about them. The patient and family may have a preference about whether the patient lives at home or at a rehabilitation facility. They may have reasons for preferring one program over another. Their concerns are important and should be discussed with hospital staff.
  57. Things To Consider When Choosing a Rehabilitation Program
  58. * Does the program provide the services the patient needs?
    * Does it match the patient’s abilities or is it too demanding or not demanding enough?
    * What kind of standing does it have in the community for the quality of the program?
    * Is it certified and does its staff have good credentials?
    * Is it located where family members can easily visit?
    * Does it actively involve the patient and family members in rehabilitation decisions?
    * Does it encourage family members to participate in some rehabilitation sessions and practice with the patient?
    * How well are its costs covered by insurance or Medicare?
    * If it is an outpatient or home program, is there someone living at home who can provide care?
    * If it is an outpatient program, is transportation available?
  59. A person may start rehabilitation in one program and later transfer to another. For example, some patients who get tired quickly may start out in a less intense rehabilitation program. After they build up their strength, they are able to transfer to a more intense program.
  60. When Rehabilitation Is Not Recommended
  61. Some families and patients may be disappointed if the doctor does not recommend rehabilitation. However, a person may be unconscious or too disabled to benefit. For example, a person who is unable to learn may be better helped by maintenance care at home or in a nursing facility. A person who is, at first, too weak for rehabilitation may benefit from a gradual recovery period at home or in a nursing facility. This person can consider rehabilitation at a later time. It is important to remember that:
  62. * Hospital staff are responsible for helping plan the best way to care for the patient after discharge from acute care. They can also provide or arrange for needed social services and family education.
    * This is not the only chance to participate in rehabilitation. People who are too disabled at first may recover enough to enter rehabilitation later.
  63. What Happens During Rehabilitation?
  64. In hospital or nursing facility rehabilitation programs, the patient may spend several hours a day in activities such as physical therapy, occupational therapy, speech therapy, recreational therapy, group activities, and patient and family education. It is important to maintain skills that help recovery. Part of the time is spent relearning skills (such as walking and speaking) that the person had before the stroke. Part of it is spent learning new ways to do things that can no longer be done the old way (for example, using one hand for tasks that usually need both hands).
  65. Setting Rehabilitation Goals
  66. The goals of rehabilitation depend on the effects of the stroke, what the patient was able to do before the stroke, and the patient’s wishes. Working together, goals are set by the patient, family, and rehabilitation program staff. Sometimes, a person may need to repeat steps in striving to reach goals.
  67. If goals are too high, the patient will not be able to reach them. If they are too low, the patient may not get all the services that would help. If they do not match the patient’s interests, the patient may not want to work at them. Therefore, it is important for goals to be realistic. To help achieve realistic goals, the patient and family should tell program staff about things that the patient wants to be able to do.
  68. Rehabilitation Goals
  69. * Being able to walk, at least with a walker or cane, is a realistic goal for most stroke survivors.
    * Being able to take care of oneself with some special equipment is a realistic goal for most.
    * Being able to drive a car is a realistic goal for some.
    * Having a job can be a realistic goal for some people who were working before the stroke. For some, the old job may not be possible but another job or a volunteer activity may be.
  70. Reaching treatment goals does not mean the end of recovery. It just means that the stroke survivor and family are ready to continue recovery on their own.
  71. Rehabilitation Specialists
  72. Because every stroke is different, treatment will be different for each person. Rehabilitation is provided by several types of specially trained professionals. A person may work with any or all of these:
  73. Physician.
    All patients in stroke rehabilitation have a physician in charge of their care. Several kinds of doctors with rehabilitation experience may have this role. These include family physicians and internists (primary care doctors), geriatricians (specialists in working with older patients), neurologists (specialists in the brain and nervous system), and physiatrists (specialists in physical medicine and rehabilitation).
    Rehabilitation nurse.
  74. Rehabilitation nurses specialize in nursing care for people with disabilities. They provide direct care, educate patients and families, and help the doctor to coordinate care.
    Physical therapist.
  75. Physical therapists evaluate and treat problems with moving, balance, and coordination. They provide training and exercises to improve walking, getting in and out of a bed or chair, and moving around without losing balance. They teach family members how to help with exercises for the patient and how to help the patient move or walk, if needed.
  76. Occupational therapist.
    Occupational therapists provide exercises and practice to help patients do things they could do before the stroke such as eating, bathing, dressing, writing, or cooking. The old way of doing an activity sometimes is no longer possible, so the therapist teaches a new technique.
  77. Speech-language pathologist.
    Speech-language pathologists help patients get back language skills and learn other ways to communicate. Teaching families how to improve communication is very important. Speech-language pathologists also work with patients who have swallowing problems (dysphagia).
  78. Social worker.
    Social workers help patients and families make decisions about rehabilitation and plan the return to the home or a new living place. They help the family answer questions about insurance and other financial issues and can arrange for a variety of support services. They may also provide or arrange for patient and family counseling to help cope with any emotional problems.
  79. Psychologist.
    Psychologists are concerned with the mental and emotional health of patients. They use interviews and tests to identify and understand problems. They may also treat thinking or memory problems or may provide advice to other professionals about patients with these problems.
    Therapeutic recreation specialist.
  80. These therapists help patients return to activities that they enjoyed before the stroke such as playing cards, gardening, bowling, or community activities. Recreational therapy helps the rehabilitation process and encourages the patient to practice skills.
    Other professionals.
  81. Other professionals may also help with the patient’s treatment. An orthotist may make special braces to support weak ankles and feet. A urologist may help with bladder problems. Other physician specialists may help with medical or emotional problems. Dietitians make sure that the patient has a healthy diet during rehabilitation. They also educate the family about proper diet after the patient leaves the program. Vocational counselors may help patients go back to work or school.
  82. Rehabilitation professionals, the patient, and the family are vitally important partners in rehabilitation. They must all work together for rehabilitation to succeed.
  83. Rehabilitation Team
  84. In many programs, a special rehabilitation team with a team leader is organized for each patient. The patient, family, and rehabilitation professionals are all members. The team has regular meetings to discuss the progress of treatment. Using a team approach often helps everyone work together to meet goals.
  85. Getting the Most Out of Rehabilitation
  86. What the Patient Can Do
  87. If you are a stroke survivor in rehabilitation, keep in mind that you are the most important person in your treatment. You should have a major say in decisions about your care. This is hard for many stroke patients. You may sometimes feel tempted to sit back and let the program staff take charge. If you need extra time to think or have trouble talking, you may find that others are going ahead and making decisions without waiting. Try not to let this happen.
  88. * Make sure others understand that you want to help make decisions about your care.
    * Bring your questions and concerns to program staff.
    * State your wishes and opinions on matters that affect you.
    * Speak up if you feel that anyone is “talking down” to you; or, if people start talking about you as if you are not there.
    * Remember that you have the right to see your medical records.
  89. To be a partner in your care, you need to be well informed about your treatment and how well you are doing. It may help to record important information about your treatment and progress and write down any questions you have.
  90. If you have speech problems, making your wishes known is hard. The speech-language pathologist can help you to communicate with other staff members, and family members may also help to communicate your ideas and needs.
  91. Most patients find that rehabilitation is hard work. They need to maintain abilities at the same time they are working to regain abilities. It is normal to feel tired and discouraged at times because things that used to be easy before the stroke are now difficult. The important thing is to notice the progress you make and take pride in each achievement.
  92. How the Family Can Help
  93. If you are a family member of a stroke survivor, here are some things you can do:
  94. * Support the patient’s efforts to participate in rehabilitation decisions.
    * Visit and talk with the patient. You can relax together while playing cards, watching television, listening to the radio, or playing a board game.
    * How the Family Can HelpIf the patient has trouble communicating (aphasia), ask the speech-language pathologist how you can help.
    * Participate in education offered for stroke survivors and their families. Learn as much as you can and how you can help.
    * Ask to attend some of the rehabilitation sessions. This is a good way to learn how rehabilitation works and how to help.
    * Encourage and help the patient to practice skills learned in rehabilitation.
    * Make sure that the program staff suggests activities that fit the patient’s needs and interests.
    * Find out what the patient can do alone, what the patient can do with help, and what the patient can’t do. Then avoid doing things for the patient that the patient is able to do. Each time the patient does them, his or her ability and confidence will grow.
    * Take care of yourself by eating well, getting enough rest, and taking time to do things that you enjoy.
  95. To gain more control over the rehabilitation process, keep important information where you can find it. One suggestion is to keep a notebook with the patient. Some things to include are provided in the sample that follows.
  96. Sample Pages for Patient Notebook
  97. Discharge Planning
  98. Discharge planning begins early during rehabilitation. It involves the patient, family, and rehabilitation staff. The purpose of discharge planning is to help maintain the benefits of rehabilitation after the patient has been discharged from the program. Patients are usually discharged from rehabilitation soon after their goals have been reached.
  99. Some of the things discharge planning can include are to:
  100. * Make sure that the stroke survivor has a safe place to live after discharge.
    * Decide what care, assistance, or special equipment will be needed.
    * Arrange for more rehabilitation services or for other services in the home (such as visits by a home health aide).
    * Choose the health care provider who will monitor the person’s health and medical needs.
    * Determine the caregivers who will work as a partner with the patient to provide daily care and assistance at home, and teach them the skills they will need.
    * Help the stroke survivor explore employment opportunities, volunteer activities, and driving a car (if able and interested).
    * Discuss any sexual concerns the stroke survivor or husband/wife may have. Many people who have had strokes enjoy active sex lives.
  101. Preparing a Living Place
  102. Many stroke survivors can return to their own homes after rehabilitation. Others need to live in a place with professional staff such as a nursing home or assisted living facility. An assisted living facility can provide residential living with a full range of services and staff. The choice usually depends on the person’s needs for care and whether caregivers are available in the home. The stroke survivor needs a living place that supports continuing recovery.
  103. It is important to choose a living place that is safe. If the person needs a new place to live, a social worker can help find the best place.
  104. During discharge planning, program staff will ask about the home and may also visit it. They may suggest changes to make it safer. These might include changing rooms around so that a stroke survivor can stay on one floor, moving scatter rugs or small pieces of furniture that could cause falls, and putting grab bars and seats in tubs and showers.
  105. It is a good idea for the stroke survivor to go home for a trial visit before discharge. This will help identify problems that need to be discussed or corrected before the patient returns.
  106. Deciding About Special Equipment
  107. Even after rehabilitation, some stroke survivors have trouble walking, balancing, or performing certain activities of daily living. Special equipment can sometimes help. Here are some examples:
  108. Cane.
    Many people who have had strokes use a cane when walking. For people with balancing problems, special canes with three or four “feet” are available.
  109. Walker.
    A walker provides more support than a cane. Several designs are available for people who can only use one hand and for different problems with walking or balance.
  110. Ankle-foot orthotic devices (braces).
    Braces help a person to walk by keeping the ankle and foot in the correct position and providing support for the knee.
  111. Wheelchair.
    Some people will need a wheelchair. Wheelchairs come in many different designs. They can be customized to fit the user’s needs and abilities. Find out which features are most important for the stroke survivor.
  112. Aids for bathing, dressing, and eating.
    Some of these are safety devices such as grab bars and nonskid tub and floor mats. Others make it easier to do things with one hand. Examples are velcro fasteners on clothes and placemats that won’t slide on the table.
  113. Communication aids.
    These range from small computers to homemade communication boards. The stroke survivor, family, and rehabilitation program staff should decide together what special equipment is needed. Program staff can help in making the best choices. Medicare or health insurance will often help pay for the equipment.
  114. Preparing Caregivers
  115. Caregivers who help stroke survivors at home are usually family members such as a husband or wife or an adult son or daughter. They may also be friends or even professional home health aides. Usually, one person is the main caregiver, while others help from time to time. An important part of discharge planning is to make sure that caregivers understand the safety, physical, and emotional needs of the stroke survivor, and that they will be available to provide needed care.
  116. Since every stroke is different, people have different needs for help from caregivers. Here are some of the things caregivers may do:
  117. * Keep notes on discharge plans and instructions and ask about anything that is not clear.
    * Help to make sure that the stroke survivor takes all prescribed medicines and follows suggestions from program staff about diet, exercise, rest, and other health practices.
    * Encourage and help the person to practice skills learned in rehabilitation.
    * Help the person solve problems and discover new ways to do things.
    * Help the person with activities performed before the stroke. These could include using tools, buttoning a shirt, household tasks, and leisure or social activities.
    * Help with personal care, if the person cannot manage alone.
    * Help with communication, if the person has speech problems. Include the stroke survivor in conversations even when the person cannot actively participate.
    * Arrange for needed community services.
    * Stand up for the rights of the stroke survivor.
  118. If you expect to be a caregiver, think carefully about this role ahead of time. Are you prepared to work with the patient on stroke recovery? Talk it over with other people who will share the caregiving job with you. What are the stroke survivor’s needs? Who can best help meet each of them? Who will be the main caregiver? Does caregiving need to be scheduled around the caregivers’ jobs or other activities? There is time during discharge planning to talk with program staff about caregiving and to develop a workable plan.
  119. Going Home
  120. Adjusting to the Change
  121. Going home to the old home or a new one is a big adjustment. For the stroke survivor, it may be hard to transfer the skills learned during rehabilitation to a new location. Also, more problems caused by the stroke may appear as the person tries to go back to old activities. During this time, the stroke survivor and family learn how the stroke will affect daily life and can make the necessary adjustments.
  122. These adjustments are a physical and emotional challenge for the main caregiver as well as the stroke survivor. The caregiver has many new responsibilities and may not have time for some favorite activities. The caregiver needs support, understanding, and some time to rest. Caregiving that falls too heavily on one person can be very stressful. Even when family members and friends are nearby and willing to help, conflicts over caregiving can cause stress.
  123. A stroke is always stressful for the family, but it is especially hard if one family member is the only caregiver. Much time may be required to meet the needs of the stroke survivor. Therefore, the caregiver needs as much support as possible from others. Working together eases the stress on everyone.
  124. Tips for Reducing Stress
  125. The following tips for reducing stress are for both caregivers and stroke survivors.
  126. * Take stroke recovery and caregiving one day at a time and be hopeful.
    * Remember that adjusting to the effects of stroke takes time. Appreciate each small gain as you discover better ways of doing things.
    * Caregiving is learned. Expect that knowledge and skills will grow with experience.
    * Experiment. Until you find what works for you, try new ways of doing activities of daily living, communicating with each other, scheduling the day, and organizing your social life.
    * Plan for “breaks” so that you are not together all the time. This is a good way for family and friends to help on occasion. You can also plan activities that get both of you out of the house.
    * Ask family members and friends to help in specific ways and commit to certain times to help. This gives others a chance to help in useful ways.
    * Read about the experiences of other people in similar situations. Your public library has life stories by people who have had a stroke as well as books for caregivers.
    * Join or start a support group for stroke survivors or caregivers. You can work on problems together and develop new friendships.
    * Be kind to each other. If you sometimes feel irritated, this is natural and you don’t need to blame yourself. But don’t “take it out” on the other person. It often helps to talk about these feelings with a friend, rehabilitation professional, or support group.
    * Plan and enjoy new experiences and don’t look back. Avoid comparing life as it is now with how it was before the stroke.
  127. Follow-up Appointments
  128. After a stroke survivor returns to the community, regular follow-up appointments are usually scheduled with the doctor and sometimes with rehabilitation professionals. The purpose of follow-up is to check on the stroke survivor’s medical condition and ability to use the skills learned in rehabilitation. It is also important to check on how well the stroke survivor and family are adjusting. The stroke survivor and caregiver can be prepared for these visits with a list of questions or concerns.
  129. I hope this information is helpful and informative.Bless you all.
  130. Comment by mskitte — January 14, 2008 @ 4:13 pm |Edit This

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January 8, 2008

The Seven Chakras

Filed under: NU Seminars & Classes — by nottingtonuniversity @ 5:19 pm
  1. ~*~*~*~*~*~*~*~*~ The seven Chakras ~*~*~*~*~*~*~*~*~*~*~*~*
  2. My apologies to Sha who has been waiting too long for this course to begin. Sorry hun.
    The 7 Chakras have their origin from ancient India and Hindi. The word “chakra” originates from a Sanskrit word meaning wheel, or sometimes, wheel of life.
    A Chakra is an energy point in your body. The seven Chakra’s, and their color association are as follows:
  3. One ~ Root chakra, red
    Two ~ Sacral Chakra, orange
    Three ~ Solar Plexus Chakra, yellow
    Four ~ Heart Chakra, green
    Five ~ Throat Chakra, blue
    Six ~ Brow Chakra, indigo
    Seven ~ Crown Chakra, violet.
  4. Chakras are associated with much more than color. They have connections to emotions, physical problems, they store information ~ many things. For the sake of simplicity, I’ll be looking at each Chakra and it’s own associations. the first Chakra I’ll be looking at is the Root Chakra.
    I really do hope to have that up soon!
  5. Comment by nottingtonuniversity — January 8, 2008 @ 2:17 am |Edit This

January 2, 2008

Seminars and classes.

Filed under: NU Seminars & Classes — by nottingtonuniversity @ 4:47 pm

This is where residents can post their seminars and classes for NU. The actual class description will be posted in the schedule but I thought splitting the two up with make it clearer for our students.

Gaia

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