Peripheral Neuropathy among Patients Living with Diabetes

Peripheral Neuropathy among Patients Living with Diabetes Update on Foot Care: Identifying Early signs of Peripheral Neuropathy among  Patients Living with Diabetes Mellitus Bernice S. Samuel DNP  and  Susan J. Appel, PhD, APRN-BC, CCRN, FAHA Introduction Among those individuals living with diabetes, peripheral neuropathy (PNP) is a major contributor in the development of foot ulcers.1 Even though there has been a decline in recent limb amputations due to advanced management of foot ulcers, 7% of those affected with type 2 diabetes (T2D) will still develop foot ulcers.2 Diabetes-related foot ulcers not only cause further physical disability, they also reduce the quality of life and increase the risks of lower extremity amputations. 3 The CDC 4 reports that 65,700 non-traumatic lower-limb amputations were performed among people living with diabetes. While diabetes is a major cause of complications such as vasculopathies and PNP, foot ulcers are the most easily prevented complications. 5 Therefore, practitioners must be fully apprised of tools and methods used to identify early PNP and prevent foot ulcers. Practitioners should also focus on actively educating the patient and family regarding PNP. Most practitioners are familiar with the Semmes-Weinstein Monofilament testing (SWMT) as the gold standard used in primary care to assess for PNP. Mayfield and Sugarman reported the use of the SWMT as a useful tool in the primary care office for practitioners to assess patients for PNP, but indicated it is not without limitations. 6 Further interventions are needed when there is a loss of sensation detected, such as proper footwear and patient education, to prevent trauma and foot ulcers. 6 Research has shown that practitioners can continue to assess patients with diabetes using the monofilament testing as long as PNP is not present. Once PNP is noted, additional assessment and management techniques are warranted. A yearly thorough foot exam by a podiatrist has been recommended by the American Diabetes Association for those living with diabetes. 7 In addition, persons with diabetes and one or more risk factors need frequent assessments of their feet during routine office visits. 5 Patients with known risk factors for foot ulcers (e.g., poor vision, previous foot ulcers or amputation, monofilament insensitivity, and fungal infections of skin or nails) deserve special attention. 8 When practitioners have available clinical information that can help to predict the development of diabetes- related foot ulcers, patients will have better outcomes. 8 These predictors were found to be helpful in accurately targeting clients at high risks of contracting foot ulcers for preventative interventions. The use of proper footwear such as diabetes specialized shoes with proper diabetes foot insoles has been found to be a protective intervention. Pathophysiology of Foot Ulcers Diabetes related foot lesions occur as a result of two or more risk factors: PNP and peripheral arterial disease (PAD). 9 Diabetes-related PNP is a leading contributor to foot lesions. 10 The presence of PAD increases the risk for foot infections and ulcers among people living with diabetes. 11 Foot lesions are less likely to heal due to vascular insufficiency. 12 Research shows that there are three factors that leads to foot ulcers and infections: foot deformities, PNP, and minor trauma. 13 It is important to understand that the longer an individual lives with elevated blood glucose, the more likely he or she will develop PNP. 2 Long term hyperglycemia can affect the skin and delay wound healing if minor cuts or sores occur on the foot. 14 PNP According to Benbow, 14 PNP can be classified as sensory, autonomic or motor. In sensory system PNP, an individual with diabetes has no feeling of sensation on his or her feet, does not feel hot or cold temperature, and does not feel cuts or trauma to his or her feet. 14 When PNP affects the autonomic system an individual will experience a decrease in sweat, resulting in cracked or fissured skin, dilated dorsal veins and an increase in temperature of their feet. 14 When the motor system is affected by PNP, the patient will be at risk for developing foot deformities such as Charcot foot. 14 Commonly, these patients report symptoms of aches and pains with tingling in their feet when PNP is present. 13 Foot Deformities According to Abad Safdar, 13 foot deformities are the second causative factor that leads to foot ulcers among people living with diabetes. People affected by neuropathy have decreased sensation in their feet, and are more prone to foot deformities. 13 These foot deformities affect the muscles and bones of the foot leading to bony protrusions that put the individual at increased risk for ulceration especially when PNP is present. 13 The correlation of PNP and foot deformities was examined by Soyupek, Ceceli, Suslu, Yorgancioglu, 15 utilizing x-rays. Their study showed that the patients with PNP commonly also have foot deformities such as pes planus, pes cavus, tendon calcifications and osteoporosis. 15 Patients living with type 1 diabetes are particularly at risk for developing Charcot neuropathy that causes destruction of the bones of the foot. 16The resultant bone thinning causes the bones to be fragile and leads to foot deformities. 16 Foot Trauma Abad Safar 13 identify foot trauma as the third factor that can lead to foot ulcers. Foot ulceration occurs when there is breaking of the skin, which leads to impaired healing of the lesion. 12 People affected by PNP have sensory loss of their feet and are unable to identify foot pain, trauma, calluses or injury to their feet. 13 Wearing ill-fitting shoes, calluses, onychomycosis, and foot infections that are not treated are all causes of foot trauma leading to ulceration. Once ulceration occurs due to trauma, the wound becomes infected. Testing Tuning Fork and Neurothesiometer A study by Kà ¤stenbauer, Sauseng, Brath, Abrahamian, Irsigler 17 investigated the effectiveness of the Rydel-Seiffer tuning fork in helping with the detection of diabetes-related neuropathy and compared its ability with that of the electronic neurothesiometer. In this study a 128-Hz tuning fork and a neurothesiometer were used at the bedside. 17 The results of the study showed that vibration perception threshold (VPT) was normal in 1917 individuals and abnormal in about 105 individuals when the tuning fork was used. 17 The participants who had abnormal results were older and also had elevated A1c results. The researchers used the neurothesiometer and the results showed that VPT was 2.5 times higher among patients who had an abnormal tuning fork test. 17 The researchers concluded that the tuning fork had a higher sensitivity and a better predictive value in diagnosing PNP at the bedside. 17 The tuning fork is a reliable instrument in helping to detect PNP in the outpatient setting. It is an appropriate clinical tool that practitioners can utilize either at the bedside or in primary care. Neurometer A double-blinded study by Nather and et al. 18 showed that there were other testing methods that were superior in comparison to the SWMT in detecting PNP. One useful tool was neurometer testing. The neurometer measures readings from rapid current perception threshold (R-CPT) which is derived from the lowest strength of stimulus that the patient could perceive. 18 Three different rates of current signals at levels measuring between 0 and 10 mA were applied by the neurometer to the big toe and ankle. 18 Neurometer testing was found to be highly sensitive as compared to the SWMT. Sensory neuropathy was detected with better accuracy when using the neurometer testing at the big toe and ankle sites in comparison to the SWMT. 18 Studies show that the neurometer is an effective tool that practitioners can use to detect PNP. Temperature guided avoidance therapy Research shows that the best intervention in the prevention of foot ulcers was foot temperature guided avoidance therapy (TGAT). 19 A study by Lavery et al. 20 sought to evaluate the effectiveness of infrared temperature monitoring among individuals at a high risk for diabetes related ulceration and amputations. Patients were placed in a usual therapy group or an enhanced therapy group. 20 The enhanced therapy group had additional tasks such as such as the use of a handheld infrared skin thermometer to measure the temperatures on the bottom of their feet twice a day. 20Participants contacted a nurse if they noted a difference in temperature >4 °F between the left and right foot. 20 The results of the study showed that the enhanced therapy group had notably fewer diabetes related foot complications. 20 The TGAT is an effective method in the detection of PNP where practitioners can assist patients in identifying sensory loss so that foot ulcers and complications can be prevented. Scales for Neuropathy Symptoms The Diabetes Neuropathy Symptom (DNS) score is a valuable tool that can be used to screen for and identify PNP. 21 The scoring is based upon symptoms such as ataxic walking, neuropathic pain, paraesthesia, and/or numbness. The DNS criteria are scored with 1 point each and there is a total of 4 points that can be given. 21 Presence of PNP is present with a score of 1, or more. 21 Similarly, the Diabetic Neuropathy Examination (DNE) is another valuable scoring system that helps to identify PNP. This scoring system consists of a total of eight items: two of the items describe the person’s muscle strength; one item addresses reflexes of the tendon and the other five items address sensation. 21 There is a total of 16 points that can be scored with this system. Any score above 3 points is considered to be abnormal and is PNP. 21 Treatment Educating patients Educational interventions are an important tool in reducing foot ulcers. A randomized controlled trial by Gershater and et al. 22 was designed to investigate the effectiveness of patients learning in groups versus learning on their own with information that is provided to them. The authors sought to understand what types of learning would decrease the incidence of foot ulcers. The study results showed that about 42% of the patients got foot ulcers. 22 Some of the reasons for ulcer development were: stress- related plantar ulcer and trauma. 22 The study showed that education in group sessions among patients who are at increased risk for foot ulcers did not have an effect on whether they would develop ulcers of the foot. 22 It was concluded that sessions conducted within a group educational method may be suitable for patients who have a low risk of getting foot ulcers. The authors of the study suggests that it is important to educate practitioners involved in the patient’s medic al care and also their caregivers regarding improved foot care such as footwear and signs of foot problems. Implications for Practice The conclusive results show the best methods to identify PNP and to prevent foot ulcers was the TGAT, the neurothesiometer and the tuning fork. The TGAT method shows that patients can complete this task at home and alert their practitioner about the results. The TGAT is valuable in showing the results of further neuropathy or damage if patients have a prior history of insensitivity to the SWMT. The SWMT is valuable for practitioners to use in the office setting as this is an inexpensive test. The SWMT is not valid once neuropathy is diagnosed. The practitioner should consider the use of the TGAT at this point and teach the patient how to use an infrared sensitive skin thermometer. The patient should be advised to keep a log book and if the temperature on the designated site is >4 °F, he or she will need to reduce the number of steps taken in the following days and contact their practitioner. The tuning fork was also validated as being highly sensitive in diagnosing PNP and is a goo d test for practitioners to use at the bedside. Certain clinical information about the patient is valuable in predicting future foot ulcers. These predictors were high A1c levels, poor vision, prior history of foot ulcer and/or amputation, monofilament insensitivity, tinea pedis and onychomycosis. The practitioner needs to be aware of these predictors and educate the patient about foot care. Practitioners need to increase monitoring of the patient’s foot at every office visit when these predictors are identified. Education is an important criterion in managing PNP. Patients need to be educated about PNP, foot ulcers, proper fitting shoes and the signs of foot infections. This review of the evidence- based literature revealed that basic SWMT is useful in predicting neuropathy but is not useful in preventing ulcers once neuropathy is diagnosed. There is a common misconception among practitioners that SWMT can be used even when neuropathy is diagnosed. The re-education of practitioners is important with the introduction of new testing methods such as TGAT once neuropathy is already diagnosed. This best practice will help to prevent ulcers among persons affected by diabetes and therefore improve the quality of their life. References Meaney, B. (2012). Diabetic foot care: Prevention is better than cure. Journal Of Renal Care, 3890-98. doi:http://dx.doi.org/10.1111/j.1755-6686.2012.00276.x Eddy, J., Price, T. (2009). Diabetic foot care: Tips and tools to streamline your approach. Journal Of Family Practice, 58(12), 646-653 Dorresteijn, J., Kriegsman, D., Valk, D. (2011). Complex interventions for preventing diabetic foot ulceration. The Cochrane Library. Retrieved from http://www.thecochranelibrary.com Centers for Disease Control and Prevention (2012). Diabetes data and trend. Retrieved from: http://www.cdc.gov/diabetes/statistics/prev/national/figraceethsex.htm Broersma, A. (2004). Preventing amputations in patients with Diabetes and Chronic kidney disease. Nephrology Nursing Journal, 31(1), 53-64. Mayfield, J. A., Sugarman, J. R. (2000). The use of the Semmes-Weinstein Monofilament and other threshold tests for preventing foot ulceration and amputation in persons with diabetes. Journal Of Family Practice, 49(11), S17-S29. American Diabetes Association. (2013). Standards of Medical Care in Diabetes. Diabetes care. Retrieved from http://care.diabetesjournals.org/content/36/Supplement_1/S11.full Boyko, E.J., Ahroni , J.H., Cohen, V., Nelson, K.M., Heagerty, P.J. (2006). Prediction of diabetic foot ulcer occurrence using commonly available clinical information: The Seattle Diabetic Foot Study. Diabetes Care, 29(6):1202-7. Retrieved from: http://care.diabetesjournals.org/content/29/6/1202.full.pdf+html Bakker, K., Apelqvist, J., . Schaper, N. C. (2012). Practical guidelines on the management and prevention of the diabetic foot 2011. Diabetes/metabolism Research and Reviews, 28, 225-231. doi:10.1002/dmrr.2253 Bakker, K., Apelqvist, J., . Schaper, N. C. (2012). Practical guidelines on the management and prevention of the diabetic foot 2011. Diabetes/metabolism Research and Reviews, 28, 225-231. doi:10.1002/dmrr.2253 Jarrett, L. (2013). Prevention and management of neuropathic diabetic foot ulcers. Nursing Standard, 28(7), 55-65. Nagoba, B., Gandhi, R., Wadher, B., Rao, A., Hartalkar, A., Selkar, S. (2010). A simple and effective approach for the treatment of diabetic foot ulcers with different Wagner grades. International Wound Journal, 7(3), 153-158. doi:http://dx.doi.org/10.1111/j.1742- 481X.2010.00666.x Abad, C., . Safdar, N. (2012). From Ulcer to Infection: An Update on Clinical Practice and Adjunctive Treatments of Diabetic Foot Ulcers. Curr Infect Dis Re, 14:540–550. DOI 10.1007/s11908-012-0283-3 Benbow, M. (2012). Diabetic foot ulcers. Journal Of Community Nursing, 26(5), 16 Soyupek, F., Ceceli, E., Suslu, F., Yorgancioglu, R. (2007). Neurologic and radiologic abnormalities of the foot in diabetic patients. Journal Of Back Musculoskeletal Rehabilitation, 20(2/3), 55-60 Holt, P. (2013). Assessment and management of patients with diabetic foot ulcers. Nursing Standard, 27(27), 49-55 Kà ¤stenbauer, T., Sauseng, S., Brath, H., Abrahamian, H., Irsigler, K. (2004). The value of the Rydel-Seiffer tuning fork as a predictor of diabetic polyneuropathy compared with a neurothesiometer. Diabetic Medicine, 21(6), 563-567. Nather, A., Keng, W., Aziz, Z., Ong, C., McFeng, B., Lin. C. (2011). Assessment of sensory neuropathy in patients with diabetic foot problems. Diabetic Foot Ankle.2(10). Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/22396819 19. Arad, Y., Fonseca, V., Peters, A., Vinik, A.( 2011). Beyond the monofilament for the insensate diabetic foot: a systematic review of randomized trials to prevent the occurrence of plantar foot ulcers in patients with diabetes. Diabetes Care, 34(4):1041-6. doi: 10.2337/dc10-1666. Lavery, L., Higgins, K., Lanctot, D., Constantinides, G., Zamorano, R., Armstrong, D., Kyriacos, A., Agrawal, M. (2004). Home Monitoring of Foot Skin Temperatures to Prevent Ulceration. Diabetes Care, 27 (11):2642-2647. Meijer, J.W., Bosma, E., Lefrandt, J., Links, T., Smit, A., Stewart, R., Van Der Hoeven, J. (2003). Clinical Diagnosis of Diabetic Polyneuropathy With the Diabetic Neuropathy Symptom and Diabetic Neuropathy Examination Scores Diabetes Care, 26(3), 697-701. Retrieved from: http://care.diabetesjournals.org/ Gershater, M., Pilhammar, E., Apelqvist, J., Alm-Roijer, C,. (2011). Patient education for the prevention of diabetic foot ulcers. European Diabetes Nursing, 8(3), 102-107b. Retrieved from: http://dx.doi.org/10.1002/edn.189

Crooklyn

Afro American Film & Achieves Crooklyn â€Å"Crooklyn† is a black feature film made in 1994. It was written by Spike Lee, along with his brother Cinque Lee and sister Joie Lee. This is not your typical â€Å"Spike Lee Joint. † It’s not, in your face, or edgy, and does not address any racial, controversial, or sexual issues. The film shows the lighter side of Spike Lee because it is actually a family film. Crooklyn is semi autobiographical because it is loosely based on the childhood of Spike and his brothers and sister. The film shows them growing up in the lower middle class, racially mixed Bedford-Stuyvesant section of Brooklyn during the 1970s, showing the good times and the bad times. It’s not the typical Brooklyn film with gangs, violence, and drugs backed by rap and hip-hop beats. The family is very believable. The father, Woody Carmichael, played by Delroy Lindo, is a struggling jazz musician who would rather stay true to his art form and produce pure jazz, even though he is not making any money, than play guitar for a few rock groups to bring in an income. The mother, Carolyn Carmichael, played by Alfre Woodard, is a school teacher taking care of the house and the children, struggling to pay all the bills with her sole income. The children, four brothers: Clinton (Carlton Williams), Wendell (Sharif Rashed), Nate (Christopher Knowings), Joseph (Tse-Mach Washington), and one sister, Troy (Zelda Harris), are growing up and doing what kids normally do: learning, playing, and getting into trouble. Crooklyn† starts with recreated Brooklyn neighborhood, showing kids at play on the street, playing games reminiscent of a simpler time like hop scotch, double dutch, skully, stick ball, and steal the bacon. Then it moves onto the typical family scene, with the Carmichael family setting the table to eat dinner. Lee does a good job of showing them as a genuine family, complete with spats and squabbles between the siblings and parents. In the scene that follows, which was most likely one of Lee's family memories, Carolyn asks the children to cl ean the kitchen before she comes home from work. When she comes home and finds a dirty kitchen, she rouses all the children from their beds, marches them down to the kitchen, and makes them clean it up, showing her as a mother and disciplinarian. When Clifton says he'd rather have a father than a mother any day, Carolyn chases him around the table, making the scene even more hilarious. At first the film seems to be a recollection of old memories with no real plot as more neighborhood scenes are shown. We see the real â€Å"danger† in the neighborhood. Spike Lee makes a funny cameo as Snuffy, along with Right-Hand Man, as the neighborhood glue sniffers. They â€Å"terrorize† the neighborhood, stealing money so they can get more glue. We also see some altercations between the Carmichael family and their neighbor Tony Eyes, played by David Patrick Kelly, who keeps a filthy house and throws trash on their steps. Carolyn also throws Woody out the house after an argument over him bouncing checks turns into a family fight, involving everyone, even the children. These scenes, as well as the others that follow seem like real memories, even though the Lees said the film should not be interpreted as an autobiography. As â€Å"Crooklyn† went on, I began to see Troy more and more. Troy is seen with her friends, shoplifting from the stores, and spending a lot of time in front of the bathroom mirror, wishing she had breasts. Gradually I realized that the film was mainly about her, and that I was supposed to be seeing the film through her eyes. Troy goes to stay down south with her Aunt Song, played by Frances Foster, and cousin Viola, played by Patriece Nielson, for a few weeks over the summer. Troy hates the experience because Aunt Song, who is very religious, finds something wrong with everything she does, makes fun of her, and seems like she is trying to take Troy's black identity away. Aunt Song also seems to love her dog more than her adopted daughter. When the film switched from the streets of Brooklyn to the South, I noticed something was wrong with the picture. At first I thought something was wrong with my laptop. Then I thought the video must have messed up. So I disregarded it and kept watching the movie. But when it showed a scene from Brooklyn, the picture was fine. Then when it went back to the south, the picture was distorted again. I later learned that this was done on purpose. Lee shot the scenes down south in wide screen without anamorphically adjusting the image. This was supposed to show that the south was a weird, warped place where Troy felt lost and alienated. Now that I know why the picture was warped, I understand its significance, but I, like most people, was confused because idid not get it when I was watching the film. When Troy returns home, she learns a tragedy has struck her family. Her mother is sick in the hospital. Later the family finds out that Carolyn has cancer. All of Troy's brothers break down and cry, but Troy doesn't shed a tear. In the scene that follows, the family is preparing for their mother’s funeral. Troy doesn't want to go, but after her father talks to her she agrees to go. After the funeral, everyone gathers in the house for a celebration of Carolyn's life. Troy is sitting on a couch, and Clifton goes over comforts his sister the best way he knows how. The takes her hand and intertwines their fingers. It’s the first time we see Clifton show any real compassion for his sister in the whole film. Its a real moment between a brother and sister, and shows they are on their way to reconciliation. In the next scene, Troy is having a nightmare. When she wakes up, she hears her mother and father arguing, so she runs down the stairs to find them. But when she gets to the kitchen calling for her mother, she just sees her father yelling, trying to kill a rat. Her father tells her that her mother is gone. Troy runs to the bathroom and throws up, and it finally hits her that her mother is gone. She says to father, â€Å"Mommy was in a lot of pain, wasn't she? †, to which he replies â€Å"Yes she was. † Troy says, â€Å"Then it’s good she died, so she wouldn't have to suffer. † I think Troy already knew it would happen, but she also knew that it was for the best. In the next scene, we see Troy combing her little brother's hair, assuming the role of her mother. â€Å"Crooklyn† is a great movie, with a strong message of family. It’s not a cheap family movie with the generic happy ending. It was raw, showing real life, and real issues. The children still have much growing up to do, and life is out there waiting for them. Spike Lee did a great job with this movie. I give a lot of credit to Spike, Joie, and Cinque for writing a great film. But no matter how great a movie is, it still has some flaws. One thing I noticed was there was no real direction or plot line in this film. It was mainly a lot of events going one after the other. Kind of like organized chaos. Another thing was that the film relied too much on the music. There was a song in almost every scene of â€Å"Crooklyn. † It was like memories put to music. While they do help you connect with the movie, I think that you wouldn't get the same effect if you were to watch the film again with only half or none of the music in it. The cast of the â€Å"Crooklyn† was excellent. Alfre Woodard and Delroy Lindo did an outstanding job of portraying the parents. But the best acting would go to Zelda Harris. Not once did I see her act in the whole film. She really made me believe that she was Troy. The children all acted like real siblings as well. The film also celebrates the black culture of the 1970's with everything from the afros, clothing, tv shows, the neighborhood, and music. The songs were personally chosen by Spike himself, and fit the movie perfectly. I also like the direction Lee chose for this movie. Most films about Brooklyn show the stereotypes: violence, drugs, gangs, and angry black people. Spike showed the real side of Brooklyn, with caring people and family. I also like this movie because it showed me the way Brooklyn was before me. Spike's version of Brooklyn is very different from the Brooklyn I grew up in, but there are also some of the same characteristics in each. The worst thing in his neighborhood were glue sniffers and little kids causing trouble. My neighborhood is different from his, and we face more problems but its nice to relate. It good to know that even back then, people faced some of the same problems we do now, and do some of the things we still do now as well. I enjoyed â€Å"Crooklyn† and would recommend the movie to anyone.

Do My Homework: No Longer a Mystery

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Who is Sidney Poitier - 555 Words

Sidney Poitier Sidney Poitier is an African American actor who helped break the color barrier through acting. He proved that anyone could improve any skill if they tried, no matter what the color of skin was. Sidney Poitier was born on Febuary 20, 1927, in Miami, Florida. Although he barely survived the first months of his life due to premature birth, his family loved him very much. However, his family was very poor, and his family was very big, so it was hard to take care of the newborn baby. Once he was seven, Poitiers family decided to move to Cat Island in the Bahamas so they could earn money working on his fathers tomato farm together. There, he started school at the age of ten in a one-roomed schoolhouse. Between working at his fathers farm and trying to get an education, he only got about two years of school before he had to stop at the age of twelve to help his family through a crisis at the farm. Once he got to his teen years, he started causing trouble. During his mid-teen years, Poitiers parents finally decided to send him back to Florida to stay with his older brother. Poitier then stayed with his brother until he was sixteen, when he experienced much racisim, such as ridicule and rejection from high paying jobs and good shcools. Once Poitier stopped living with his brother he applied for several lowly jobs, including washing dishes and mopping the floors after resteraunts closed. Because he no longer lived with his brother and wasnt earningShow MoreRelatedThes View Of Reality1500 Words   |  6 PagesDirector, Sidney Poitier was born on February 20, 1924, in Miami, Florida to Reginald and Evelyn Poitier. On this day he was born, â€Å"two and a half months prematurely while his Bahamian parents were on vacation in Miami (Biography.com). However, â€Å"as soon as he was strong enough, Poitier left the United States with his parents for the Bahamas† (Biography.com). 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In the early years of motion pictures, African American actors were usually relegated to roles of servants, butlers, comedian and maids and that was very common in the majority of films thatRead MorePersonal Essay On Mass Whos Comming To Diner896 Words   |  4 PagesHonestly, in regard with my feelings from watching it, I don’t have much to say about â€Å"GUESS WHO’S COMING TO DINNER?†, because the main message the director: Stanley Kramer, script writer: William Rose and actors: Spencer Tracy, Sidney Poitier, and Katharine Hepburn, and features Hepburns niece Katharine Houghton are trying to convey; (the racism and interracial marriage in the USA) are truly distant to me personally. In my country of origin and furthermore, in our national history, we never experiencedRead MoreRepresentation of Race in Cinema1917 Words   |  8 Pagesdirector, writer and diplomat Sidney Poitier for his role in the 1963 film â€Å"Lilies of Field†1. 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She was born in the United States but her Asian face leaded to a discrimination by Caucasian (Anna May Wong - BiographyRead MoreAnalysis Of The Film Six Degrees Of Separation1567 Words   |  7 Pagesalludes to Sidney Poitier and a double-sided Kandinsky throughout the film to separate Paul from the rich, white community to which he is trying to belong. To gain the trust of wealthy white couples such as the Kittredges, Paul pretends to be the son of prominent black actor Sidney Poitier. The whites of Fifth Avenue are immediately enthralled by Paul`s fictitious stories of his time with Poitier. Poitier, however, only had daughters, revealing that the â€Å"liberal† who supported Sidney Poitier were ignorantRead MoreComparing Relationships, Stereotypes, and Identity Of Characters in Four Films1 858 Words   |  7 Pagesï » ¿Comparing Relationships, Stereotypes and Identity of Characters in Four Films Four films were viewed, all featuring central characters who had to overcome various obstacles to form successful relationships. The films were very different from one another in terms of cinematography and plot. In each instance, however, characters experienced emotional growth as they formed relationships and, in the process, learned more about themselves. The overarching theme of the four films could be that of unlikelyRead MoreEssay on Masculinity and Race1594 Words   |  7 Pagesbecause they have different cultural features that are alienating to our perception, but they have become an enemy to be feared not so much for his cunning but for his martial arts. This new masculinity was first and foremost introduced by Bruce Lee, who shot a handful movies that have influenced literally every production from either Asia or America since then. His masculinity did not depend on fancy equipment like James Bond ´s or heavy artillery like those of Cowboys and Rambo, he depended solely