Tuesday, January 28, 2020

An Overview Of Meningitis

An Overview Of Meningitis Meningitis is swelling and inflammation of the protective membranes that cover brain and spinal cord. Depending on the duration of symptoms, meningitis may be classified as acute or chronic. Acute meningitis denotes the evolution of symptoms within hours to several days, while chronic meningitis has an onset and duration of weeks to months. Meningitis is mainly caused by infection with viruses, several different types of bacteria, or sometimes by a fungus, and less commonly by certain drugs. Meningitis can be life-threatening because of the inflammations proximity to the brain and spinal cord. All types of meningitis tend to cause symptoms that include fever, headache and stiff neck. Knowing whether meningitis is caused by a virus or bacterium is important because the severity of illness and the treatment differ depending on the cause. Viral meningitis, the most common form of meningitis, is less severe than bacterial meningitis. Bacterial meningitis is usually more serious than vira l meningitis and is sometimes fatal, particularly in infants and the elderly. Bacterial meningitis is a major cause of death and disability world-wide. [1] b. The etiology and risk factors Meningitis is usually caused by infection from viruses or micro-organisms. Most cases are due to infection with viruses, with bacteria, fungi, and parasites being the next most common causes. It may also result from various non-infectious causes. The etiology of bacterial meningitis varies by age group and region of the world. Worldwide, without epidemics one million cases of bacterial meningitis are estimated to occur and 200,000 of these die annually. [1] Before antibiotics were widely used, 70 percent or more of bacterial meningitis cases were fatal; with antibiotic treatment, the fatality rate has dropped to 15 percent or less. Bacterial meningitis is most common in the winter and spring. Beyond the perinatal period, three organisms, transmitted from person to person through the exchange of respiratory secretions, are responsible for most cases of bacterial meningitis: Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae. Bacterial meningitis caused by Neisseria meningitidis bacteria (meningococcal disease) can be fatal and should always be viewed as a medical emergency. About 10% of infected people die from the disease. [5] In non-fatal cases, those affected experience long-term disabilities, such as brain damage, loss of limb, or deafness. Preventing the disease through the use of meningococcal vaccine is important. Although anyone can get meningitis, pre-teens and adolescents, college freshmen who live in dormitories and travelers to countries where meningitis is always present are at an increased risk for meningococcal disease. Before the availability of effective vaccines, bacterial meningitis was most commonly diagnosed in young children. Now, as a result of the protection offered by current childhood vaccines, bacterial meningitis is more commonly diagnosed among pre-teens and young adults. As children reach their pre-teen and adolescent years, protection provided by some childhood vaccines can begin to wear off. As a result, pre-teens and adolescents are at a greater risk for catching certain diseases. Introducing vaccinations during the pre-teen years increases the level of protection during adolescence. College freshmen, especially those who live in dormitories, are at a slightly increased risk for bacterial meningitis caused by Neisseria meningitidis bacteria (meningococcal disease) compared with other persons of the same age. vaccination against bacterial meningitis caused by Neisseria meningitidis bacteria (meningococcal disease) is recommended to persons who travel to or reside in countries in which the bacterium Neisseria meningitidis is hyperendemic or epidemic, particularly if contact with the local population will be prolonged. Meningococcal meningitis, caused by Neisseria meningitidis, is primarily a disease of young children, with the incidence of cases declining in those older than 1 year of age. The disease is most common during winter and spring. In some persons, the bacteria can cause a severe blood infection called meningococcemia. N. meningitidis is classified into serogroups based on the immunological reactivity of the capsular polysaccharide. Although 13 serogroups have been identified, the three serogroups A, B and C account for over 90% of meningococcal disease. [1] Meningococcal disease differs from other leading causes of bacterial meningitis because of its potential to cause large-scale epidemics. A region of sub-Saharan Africa extending from Ethiopia in the East to The Gambia in the West and containing fifteen countries and over 260 million people is known as the à ¢Ã¢â€š ¬Ã…“meningitis beltà ¢Ã¢â€š ¬Ã‚  because of its high endemic rate of disease with superimposed, periodic, large epid emics caused by serogroup A, and to a lesser extent, serogroup C. [1] Haemophilus meningitis is most frequently caused by Haemophilus influenzae type b, also known as Hib. Before effective vaccines became available and widely used, Hib was the most frequent cause of bacterial meningitis in children 5 years of age and younger. While most children are colonized with a species of H. influenzae, only 2-15% harbour Hib. [1] The organism is acquired through the respiratory route. It adheres to the upper respiratory tract epithelial cells and colonizes the nasopharynx. Following acquisition of Hib, illness results when the organism is able to penetrate the respiratory mucosa and enters the blood stream. This is the result of a combination of factors, and subsequently the organism gains access to the cerebrospinal fluid (CSF), where infection is established and inflammation occurs. An essential virulence factor which plays a major role in determining the invasive potential of an organism is the polysaccharide capsule of Hib. Pneumococcal meningitis, caused by Streptococcus pneumoniae (pneumococci), generally strikes infants, the elderly and individuals with certain chronic medical conditions. Younger adults with anatomic or functional asplenia, haemoglobinopathies, such as sickle cell disease, or who are otherwise immunocompromised, also have an increased susceptibility to S. pneumoniae infection. S. pneumoniae, like Hib, is acquired through the respiratory route. Following the establishment of nasopharyngeal colonization, illness results once bacteria evade the mucosal defences, thus accessing the bloodstream, and eventually reaching the meninges and CSF. The term aseptic meningitis refers loosely to all cases of meningitis in which no bacterial infection can be demonstrated. This is usually due to viruses, but it may be due to bacterial infection that has already been partially treated, with disappearance of the bacteria from the meninges, or by infection in a space adjacent to the meninges (e.g. sinusitis). Endocarditis (infection of the heart valves with spread of small clusters of bacteria through the bloodstream) may cause aseptic meningitis. Aseptic meningitis may also result from infection with spirochetes, a type of bacteria that includes Treponema pallidum (the cause of syphilis) and Borrelia burgdorferi (known for causing Lyme disease). Meningitis may be encountered in cerebral malaria (malaria infecting the brain). Fungal meningitis, e.g. due to Cryptococcus neoformans, is typically seen in people with immune deficiency such as AIDS. Amoebic meningitis, meningitis due to infection with amoebae such as Naegleria fowleri, is contracted from freshwater sources. [2] Like bacterial meningitis, viral meningitis can affect anyone but infants younger than 1 month old and people whose immune systems are weak are at higher risk for severe infection. People who are around someone with viral meningitis have a chance of becoming infected with the virus that made that person sick, but they are not likely to develop meningitis as a complication of the illness. Viral meningitis is common and often goes unreported. It is a central nervous system (CNS) infection characterized by signs and symptoms of meningeal inflammation in the absence of positive bacterial cultures. The incidence varies with season, and the clinical presentation often includes fever, headache, and stiffness of the neck accompanied by symptoms typical of the specific causal virus. Viral meningitis is usually self-limited and resolves without treatment, although case reports suggest that treatment is indicated and beneficial in certain clinical scenarios. Viruses that can cause meningitis include enteroviruses, herpes simplex virus type 2 (and less commonly type 1), varicella zoster virus (known for causing chickenpox and shingles), mumps virus, HIV, and LCMV. [3] In the absence of a lumbar puncture, viral and bacterial meningitis cannot be differentiated with certainty, and all suspected cases should therefore be referred. Lumbar puncture and analysis of cerebrospinal fluid may be done primarily to exclude bacterial meningitis, but identification of the specific viral cause is itself beneficial. Viral diagnosis informs prognosis , enhances care of the patient, reduces the use of antibiotics, decreases length of stay in hospital, and can help to prevent further spread of infection. Over the past 20 years, vaccination policies, the HIV epidemic, altered sexual behavior, and increasing travel have altered the spectrum of causative agents. [4] A parasitic cause is often assumed when there is a predominance of eosinophils in the CSF. The most common parasites implicated are Angiostrongylus cantonensis and Gnathostoma spinigerum. Tuberculosis, syphilis, cryptococcosis, and coccidiodomycosis are rare causes of eosinophilic meningitis that may need to be considered. Meningitis may occur as the result of several non-infectious causes: spread of cancer to the meninges (malignant meningitis) and certain drugs (mainly non-steroidal anti-inflammatory drugs, antibiotics and intravenous immunoglobulins). It may also be caused by several inflammatory conditions such as sarcoidosis (which is then called neurosarcoidosis), connective tissue disorders such as systemic lupus erythematosus, and certain forms of vasculitis. Epidermoid cysts and dermoid cysts may cause meningitis by releasing irritant matter into the subarachnoid space. Mollarets meningitis is a syndrome of recurring episodes of aseptic meningitis; it is now thought to be caused by herpes simplex virus type 2. Rarely, migraine may cause meningitis, but this diagnosis is usually only made when other causes have been eliminated. [2] c. Pathophisiology d. Clinical signs and symptoms Meningitis infection is characterized by a sudden onset of fever, headache, and stiff neck. It is often accompanied by other symptoms, such as nausea, vomiting, photophobia (sensitivity to light) and altered mental status. The symptoms of bacterial meningitis can appear quickly or over several days. Typically they develop within 3-7 days after exposure. Infants younger than one month old are at a higher risk for severe infection. In newborns and infants, the classic symptoms of fever, headache, and neck stiffness may be absent or difficult to notice. The infant may appear to be slow or inactive, irritable, vomiting or feeding poorly. In young children, doctors may also look at the childà ¢Ã¢â€š ¬Ã¢â€ž ¢s reflexes, which can also be a sign of meningitis. Although the early symptoms of viral meningitis and bacterial meningitis may be similar, later symptoms of bacterial meningitis can be very severe (e.g., seizures, coma). Viral meningitis is an infection of the meninges (the covering of the brain and spinal cord) that is caused by a virus. Enteroviruses, the most common cause of viral meningitis, appear most often during the summer and fall in temperate climates. Viral meningitis can affect babies, children, and adults. It is usually less severe than bacterial meningitis and normally clears up without specific treatment. The symptoms of viral meningitis are similar to those for bacterial meningitis, which can be fatal. Symptoms of viral meningitis in adults may differ from those in children. Common symptoms in infants include fever, irritability, poor eating and hard to awaken. Common symptoms in adults include high fever, severe headache, stiff neck, sensitivity to bright light, sleepiness or trouble waking up, nausea, vomiting and lack of appetite. The symptoms of viral meningitis usually last from 7 to 10 days, and people with normal immune systems usually recover completely. Symptoms of fungal meningitis are similar to symptoms of other forms of meningitis; however, they often appear more gradually. In addition to typical meningitis symptoms, like headache, fever, nausea, and stiffness of the neck, people with fungal meningitis may also experience dislike of bright lights, changes in mental status, confusion, hallucinations and personality changes. [5] e. Diagnosis and laboratory findings If meningitis is suspected, samples of blood or cerebrospinal fluid are collected and sent to the laboratory for testing. It is important to know the specific cause of meningitis because the severity of illness and the treatment will differ depending on the cause. In the case of bacterial meningitis, for example, antibiotics can help prevent severe illness and reduce the spread of infection from person to person. If bacteria are present, they can be grown (cultured). Growing the bacteria in the laboratory is important for confirming the presence of bacteria and for identifying the specific type of bacteria that is causing the infection. For viral meningitis, the specific causes of meningitis may be determined by tests used to identify the virus in samples collected from the patient. To confirm fungal meningitis, specific lab tests is performed, depending on the type of fungus suspected. e. Therapeutic management of disease, medical treatment, pharmacologic, dietary Bacterial meningitis can be treated with a number of effective antibiotics. It is important that treatment be started early in the course of the disease. If bacterial meningitis is suspected, initial treatment with ceftriaxone and vancomycin is recommended. Appropriate antibiotic treatment of the most common types of bacterial meningitis should reduce the risk of dying from meningitis to below 15%, although the risk is higher among the elderly. [5] There is no specific treatment for viral meningitis. Antibiotics do not help viral infections, so they are not useful in the treatment of viral meningitis. Most patients completely recover on their own within 7 to 10 days. A hospital stay may be necessary in more severe cases or for people with weak immune systems. Fungal meningitis is treated with long courses of high dose antifungal medications. This is usually given using an IV line and is done in the hospital. The length of treatment depends on the status of the immune system and the t ype of fungus that caused the infection. For people with immune systems that do not function well because of other conditions, like AIDS, diabetes, or cancer, there is often a need for longer treatment. g. Teaching self care h. Health promotion strategies to prevent Keeping up to date with recommended immunizations is the best defense. Maintaining healthy habits, like getting plenty of rest and not coming into close contact with people who are sick, can also help. There are two kinds of vaccines against Neisseria meningitidis. Meningococcal polysaccharide vaccine (Menomune) has been approved by the Food and Drug Administration (FDA) and available since 1981. Meningococcal conjugate vaccines, Menactra and Menveo, were licensed in 2005 and 2010, respectively. Each vaccine can prevent 2 of the 3 most commonly occurring strains in the US. Meningococcal vaccines cannot prevent all types of the disease, but they do protect many people who might become sick if they didnt get the vaccine. Meningococcal conjugate vaccine is routinely recommended for all 11 through 18 year olds and for certain high-risk children and adults. There are two types of pneumococcal vaccine currently available: a polysaccharide vaccine and a conjugate vaccine. The pneumococcal c onjugate vaccine, PCV7 (Prevnar) was the first pneumococcal vaccine for use in children under the age of 2 years. PCV13 (Prevnar 13), which was licensed in early 2010, replaces PCV7. [5] Pneumococcal vaccines for the prevention of disease among children who are 2 years and older and adults have been in use since 1977. Pneumovax is a 23-valent polysaccharide vaccine (PPSV) that is currently recommended for use in adults who are 65 years of age and older, for persons who are 2 years and older and at high risk for pneumococcal disease (including those with sickle cell disease, HIV infection, or other immunocompromising condition), and for persons 19-64 years of age who smoke or have asthma. The Haemophilus influenzae type b (Hib) vaccine is highly effective against bacterial meningitis caused by a type of bacteria called Haemophilus influenzae type b. The Hib vaccine can prevent pneumonia, epiglottitis, and other serious infections caused by Hib bacteria. It is recommended for all chil dren under 5 years old in the US, and it is usually given to infants starting at age 2 months. Hib vaccine can be combined with other vaccines. People with certain viral infections can sometimes develop meningitis. There are no vaccines for the most common causes of viral meningitis. Thus, the best way to prevent it is to prevent viral infections. However, that can be difficult since sometimes people can be infected with a virus and spread the virus even though they do not appear sick. Following are some steps recommended by CDC [5] to help lower the chances of becoming infected with viruses or of passing one on to someone else: Washing hands thoroughly and often, especially after changing diapers, using the toilet, or coughing or blowing nose. Cleaning contaminated surfaces, such as doorknobs or the TV remote control, with soap and water and then disinfecting them with a dilute solution of chlorine-containing bleach. Avoiding kissing or sharing a drinking glass, eating utensil, lipstick, or other such items with sick people or with others when sick. Making sure of vaccinations. Vaccinations included in the childhood vaccination schedule can protect children against some diseases that can lead to viral meningitis. These include vaccines against measles and mumps (MMR vaccine) and chickenpox (varicella-zoster vaccine). Avoiding bites from mosquitoes and other insects that carry diseases that can infect humans. Controlling mice and rats. There is little evidence that specific activities can lead to developing fungal meningitis, although avoiding exposure to environments likely to contain fungal elements is prudent. People who are immunosuppressed (for example, those with HIV infection) should try to avoid bird droppings and avoid digging and dusty activities, particularly if they live in a geographic region where fungi like Histoplasma, Coccidioides, or Blastomyces species exist. HIV-infected people cannot completely avoid exposure. Some guidelines recommend that HIV-infected people receive antifungal prophylaxis if they live in a geographic area where the incidence of fungal infections is very high.

Monday, January 20, 2020

Graduation Speech -- Graduation Speech, Commencement Address

I rediscovered something while trying to think of my speech for tonight. History repeats itself. Everything I felt compelled to say I knew has been said before and will be said in times to come. I grew dismayed at the thought that the human race has progressed so little that the same advice has as much merit now as it did when it was first given, millenniums ago. Yet there is a simple beauty in this. It reassures us that humans will always be human; that everyone is experiencing life for the first time, no matter how many ancestors lie before them. Since we are each seeing life anew, the same truths will occur again and again. These truths have brought us to this point in history; they will carry us for the rest of our lives. Inner motivation is the force that drives us upward and onward. We all know how to rely on that force. It does not matter what degree of "success" or "achievement" we reach, so long as what we do reach is comfortable for us. Whether our motivation compels us simply to make it to school each day, or to juggle multiple outside interests with difficult class loa...

Saturday, January 11, 2020

Ernest Hemingway’s novels Essay

Ernest Hemingway is an author well known for the common themes in his novels. In his style of writing, Hemingway is able to express the themes of the novel through strong character traits and actions. The common themes in Hemingway’s novel The Sun Also and A Farewell to Arms are death and loss. The characters in these novels, and many of Hemingway’s other novels, can relate to these themes. The novels The Sun Also Rises and A Farewell to Arms share many similarities. These of course include the themes of death and loss. The common themes are supported by the war setting in A Farewell to Arms and the post-war setting in The Sun Also Rises. Both novels take place in Europe approximately in the 1920s. Jake Barnes is the main character of The Sun Also Rises and he is struggling through life after having experienced some trauma during the war. Frederic Henry, the protagonist of A Farewell to Arms must make the choice of staying in the army or abandoning his fellow troops to be with his girlfriend. Both novels explore the hardships of love, war, and death.†The wound, the break from society, and the code are subjects of Hemingway’s work† (Young 6). These three events are critical in Hemingway’s novels The Sun Also and A Farewell to Arms. â€Å"The Wound† represents just that, a wound. It can be a physical, mental, or an emotional wound always occurring in the story’s protagonist. This relates to the theme of loss because the character’s wound is always a loss they suffer. The loss can be physical, for example if the character is injured and loses a body part (which is common in the war settings Hemingway typically uses). The loss can also be emotional, for example if the main character loses a loved one and becomes depressed. In The Sun Also Rises, Jake has been injured in the war and feels like less of a man because he is â€Å"physically unable to make love to a woman† (Magnum 4). This injury leaves Jake psychologically and morally lost. In A Farewell to Arms the main character, Frederic Henry, is wounded in his leg while serving in the war as an ambulance driver in Italy. Jake and Frederic’s mental and emotional conditions lead to the next part of the Hemingway code; the break from society. The break from society is the next key element in Hemingway’s work. This disassociation with society is a result of the main character’s injury or loss. The character will separate himself from society to cope with his loss. Jake’s life has become empty and he fills his time with drinking and dancing. Jake enjoys his life by â€Å"learning to get your money’s worth and knowing when you had it.† (Magnum 4) Another break from society is shown in the story â€Å"Big Two- Hearted River† by Hemingway. The main character, Nick Adams, has experienced a loss. â€Å"Death has occurred; not literal human death, but death of the land† (Magnum 3) which has been destroyed by fire. The fire has consumed and burned all the vegetation surrounding the home where Nick grew up. Nick suffers from the shock of the devastation to the land. He had recalled so many boyhood memories of hunting and fishing on the land where he grew up. Nick goes back into the wilderness on his own to get away form the pain he has suffered. A break from society is a key aspect in Hemingway’s work that adds to the common themes among his novels. The wound and the break from society lead up to the last key element, the â€Å"Hemingway Code† (Young 8). The code is what Hemingway uses in his novels to show how the character is dealing with the wound and the break from society. For example, in The Sun Also Rises, Jake is dealing with his loss by going out and spending his money on drinks and dancing because this is the only way he can enjoy himself. He cannot fall in love so this is what he does instead to fill the missing gap in his life. He also â€Å"gets his money’s worth† by sending pointless short telegrams to his friends, symbolizing his careless nature. A Farewell to Arms contains another example of the code. Frederic is searching for meaning in life while he is surrounded by death during the war. He chooses not to fill his life with religion or pleasure because these things are meaningless to him. Instead Frederic abandons the Italian Army to be with his girlfriend Catherine, whom he plans to marry. Loving Catherine is the only way Frederic can bring happiness to his life after facing the hardships of war. The subject’s of Hemingway’s work in A Farewell to Arms and The Sun Also Rises are similar, and can relate to the main themes of other works by Hemingway. The themes of death and loss apply to the characters of these  novels. Death occurs often during the wars which take place in both novels. Jake was wounded in a war, and Frederic is currently fighting in a war. Both have suffered a psychological loss which leaves them struggling to bring meaning to their lives. In Big Two Hearted River Nick suffers from the loss of the land. Hemingway has created all of these characters to show weaknesses which result from their losses. That is why each character suffers from the loss they experience. â€Å"Like Jake, Frederic Henry is wounded in the war and falls in love with a woman.†(Magnum 6). These characters suffer losses from the war and soon suffer losses in love. â€Å"We could have had such a damned good time together,† (Hemingway 115) Lady Ashley states afte r accepting that Jake will never be able to love her. Like Jake, Frederic loses his lover, â€Å"The arms to which Frederic must finally say farewell are those of Catherine, who dies in childbirth† ( Magnum 7) The major differences in the novels The Sun Also Rises and A Farewell to Arms do not occur in the themes of the novels but instead the character’s personalities and actions. For example Jake is considered the lost and hopeless character. He spends his time out and about with his friends touring the countryside, drinking, dancing and having a good time. He has lost all his morals and goes about freely without a care in the world. Hemingway had created Frederic as the complete opposite of Jake. He takes a stand for what he believes in and does what he thinks is right. Frederic is faced with, and overcomes, tough decisions during desperate war-filled times. Unlike Jake, he is rational and thinks out his decisions. Although theses characters have opposing personalities they will both encounter the same problem throughout the novels. Both Jake and Frederic experience hardships and internal conflict in The Sun Also and A Farewell to Arms. Jake is in conflict with himself over the love of a woman named Lady Brett Ashley. This is the woman Jake wants to fall in love with but he knows this will never be possible because of his war wound. Jake gives up his hope of finding love by introducing Lady Brett to one of his friends who she falls in love with and plans to marry. The marriage is broken off when a fight breaks out which is caused by Lady Brett’s desire to be romantic with several other men. â€Å"The novel ends right where it began,  with Brett and Jake trapped in hopeless love for each other,† (Nagel 108). Frederic’s internal conflict is similar to that of Jake’s. He is lost and confused over the love for his girlfriend, Catherine and his service in the military. After learning Catherine has become pregnant and his troops abandon him, Frederic makes the decision to desert the army and follow his heart. Frederic suffers from the most pain when Catherine dies giving birth. He realized that the love he shared, to try and bring meaning to his life, causes him even more pain when Catherine dies. The internal conflict of both Jake and Frederic leave them faced with tough decisions which affect the way they live ad love. Hemingway has used the character relationship of love and a setting with an atmosphere of war to build on his major themes. The characters were wounded in the war and suffer from the loss of loved ones. Death is used figuratively to describe the emotions and morality of Hemingway’s characters. Hemingway’s themes of death and loss are seen through his character portrayal in his novels. Work Cited Coleman, Janice. â€Å"Ernest Hemingway† The World Book Encyclopedia. Hartford, CT: Paddon Publishing, 1992. Hemingway, Ernest. A Farewell To Arms. New York, NY: Charles Scribners Sons, 1929. Hemingway, Ernest. The Sun Also Rises. New York, NY: Charles Scribners Sons, 1926. Magnum, Bryant. â€Å"Introduction to the Novels of Ernest Hemingway† Critical Survey Of Long Fiction. Salem Press Inc. 2000. Nagel, James. â€Å"Ernest Hemingway†. Dictionary of Literary Biography: Volume 9. New York: Gale Research Company, 1981. Stanton, William. 20th Century Novelists. Sacramento, CA: Bantum Books, 1984. Young, Phillip. â€Å"Ernest Hemingway† American Writers: A Collection of Literary Biographies. Volume II. New York: Charles Scribners Sons, 1974

Friday, January 3, 2020

All Quiet on the Western Front A Movie To Make You Think...

All Quiet on the Western Front was never written to be like the movies we watch today. When people go to see a movie about war, they typically expect watch a story jam packed with action from start to finish. All Quiet on the Western Front, also has this kind of battle from beginning to end, but was never intended to tell the common sci-fi adventure of which it could be associated to. It is made to speak against the terrible conditions which men had to face in world war won. The movie shows us, that even though there were so many casualties in the aftermath of World War One, there are some things in the world worse than death. The opening of the movie tells how the film is not an accusation, a confession, or an adventure, and the†¦show more content†¦Himmelstoss comes off as this amazing person who trains his recruits to the bone to get them ready for the war. The irony falls when we learn how pointless his training really is. Then we meet Kat. He looks much more rela xed and easy-going than Himmelstoss. In fact you may wonder at first how Kat hasn’t been killed yet, since he lacks the discipline needed to supposedly succeed in the war. We later on find out that Himmelstoss is the one who should have been killed since he knows nothing of what the war is like. When the Kaiser pins a medal on the surprisingly, for once not crying, corporal Himmelstoss we see how clueless the people, in the upper ranks, are about the fighting, and they really can’t be blamed since the warfare used in World War One was so alien to everybody. Basically, only those who chose to relax about it actually understood what was going on. Today, what keeps people entertained for a continuous amount of time, is a story with a little adventure. All Quiet on the Western Front, makes clear that it is not a story of adventure, from the very beginning. This is no more evident than at the end of the movie. Adventure stories do not necessarily have a happy ending, but they do have a good ending. Now, good does represent a state of mind, but the ending of a war movie is exciting to say the least. Paul may die at the end of the movie, but his death is quite boring. Towards the endShow MoreRelatedPsychological Effects Of War In Saving Private Ryan, And All Quiet On The Western Front1109 Words   |  5 PagesRyan and the book â€Å"All Quiet on the Western Front.† In the movie Saving Private Ryan, a battalion led by Caption Miller is ordered to reach a man named Private James Ryan, whose brothers had been killed in action (KIA) and has been requested to return back to the states. 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