Osteoarthritis and Cartilage

Question: Describe the strategies that, you as a nurse, can implement to reduce the severity and impact of the disease for the individual and their family? Answer: Osteoarthritis(OA) is also known asdegenerative joint disease, degenerative arthritisoror osteoarthrosis, is a type of abnormalities which involves joints degradation, as well as subchondral bone and articular cartilage.The purpose of the assignment is to develop an instrument so as to assess the difficulties faced by the people in their daily lives due to the Osteoarthritis of the Knee (Biological measurement of osteoarthritis, 1993). The symptoms of the disease and the strategies that I will take as a nurse are highlighted in the assignment. Pathophysiology Osteoarthritis (OA) is considered a progressive joint disease and causes disability. It can occur to people of any age especially who are 45 years and above are more likely to be affected by the disease. The Arthritis Foundation says that that more than 27 million people living in the United States are have the chances of having osteoarthritis, where the knee is more likely area to be affected area. It was also seen that the women are more prone to osteoarthritis than the men. The disease is characterized by the loss of the arterial cartilage, subchondral sclerosis of the bone, formation of osteophyte and cysts. The remodeling of the subchondral bone plays an important role in the OA Pathophysiology (14 Evaluating pain in osteoarthritis, 2005). It is often called Osteoprotegerin (OPG). As the draining down of the hyaline cartilage progresses, hypertrophic changes can occur in the synovial tissue and also the underlying bone with which can form sclerosis and osteophyte. This often lea ds to narrowing of space of the joints and joint surface become rough and irregular which ultimately causes pain, and swelling in the joint deformity (Biological measurement of osteoarthritis, 1993). Symptoms The symptoms of the disease are severe pain in the knee, with dysfunction and discomfort in the area. Thus it can be said that the pain is the initial symptom of the disease. Osteoarthritis causes pain in the knee area and reduces the motion of the person affecting the quality of life. As time passes, the condition of the knee detoriate. There is no definite treatment for the disease, and it is managed by the controlling the pain and preserving the function of the affected area (Knee taping reduces symptoms associated with osteoarthritis, 2003). The control of the life style, changes in the diet, exercises, and the use of medication and orthosis can control the pain and improve the condition to some extent. In extreme stages it can be seen that the only possible way out is knee replacement. Treatment and care by nurses It can be said that the task of the nurses is to control the pain of the knee and the joint and to promote the quality of the life of the people who are suffering from the disease. As a nurse I can help the people by guiding them and letting them know the signs and symptoms of the disease. They can be guided with education so that they can take care of themselves in case of need by doing simple exercises (Ringdahl, Erika and Pandit, 2011). The nurses instruct the patients reduce their weight and use devices that can be used to support their walking like a walker or a walking stick. I as a nurse can encourage the people in active participation to control the progress of the disease. The nurses can teach the patients exercises and the use of various aid which will help the people to keep their knees in the state of motion (gutierrez, 2013). Moreover physiotherapy can help the people to reduce the level of pain and improvements can be seen. The nurses can follow up the medication prescr ibed by the doctors and monitor the improvements and also can implement new exercises if it is necessary. References 14 Evaluating pain in osteoarthritis. (2005).Osteoarthritis and Cartilage, 13, pp.S5-S5. Biological measurement of osteoarthritis. (1993).Osteoarthritis and Cartilage, 1(1), pp.21-21. gutierrez, L. (2013). Improvement of symptoms in the generalized osteoarthritis use of zoledronic acid zola study.Osteoarthritis and Cartilage, 21, p.S293. Knee taping reduces symptoms associated with osteoarthritis. (2003).BMJ, 327(7407), pp.0-c-0. Ringdahl, Erika, and Pandit, S. (2011). Treatment of Knee Osteoarthritis.American Family Physician, 83(11), pp.1287-1292.

Zyrtec Essay Example

Zyrtec Essay Zyrtec also known as Cetirizine Hydrochloride is a second-generation anti-histamine that is generally used by children and adults to treat indoor or recurrent allergic rhinitis also known as hay fever or commonly known as allergy.[1] It is also used to treat outdoor or  Ã‚   seasonal allergic rhinitis and ‘lives’ or chronic urticaria in children over two years of age.[2]Allergies especially in children are characterized by red itchy eyes, itchy runny nose and sneezing. In the US it is the number one  Ã‚   most prescribed branded antihistamine with approximately $1,287 million sales in U.S alone.[3]CompanyThe company that manufactures and distributes Zyrtec is the renowned Pfizer U.S pharmaceutical Company. The U.S pharmaceutical giant’s guiding motto is â€Å"working together for a healthier world†.[4]   As the company puts it, it is inspired by a single goal, â€Å"your health†.   â€Å"They are dedicated to developing new safe medicines to prevent and treat the world’s most serious diseases†.[5]Therefore as the motto portrays, the company’s goal is to delight its customers though innovative and technologically advanced medicine and treat most human ailments. The major commitment that the company has is to be â€Å"the global leader in health care† by bringing change to all people across the globe.[6]The company would achieve this through provision of access to effective safe yet affordable medicines to those who need them. To also continue maintaining a leading role and to satisfy both customers and shareholders, the company is committed to remain focused on improving continually how they do business. This is done through transparency, and forging a strong relationship with its clients to enable the organization develops the abilities to listen and make appropriate decisions thereof.Charles Pfizer and Charles Errant who were cousins founded Pfizer Inc. in 1849. Ever since the company has co ntinued to evolve to keep pace with the ever changing stakeholder, customers and the society’s expectations. The two cousins who were German chemists and entrepreneurs borrowed $2,500 from Pfizer’s father and bought a red brick building in Brooklyn New York at the Williamsburg section. This building doubled up as an office, laboratory factory and warehouse.[7]Santonin was the first of the company launches. Santonin was palatable anti-parasitic drug to treat intestinal worms, which was a common ailment in America in the mid 19th century. Santonin was an instant hit and the company was officially launched following this success. Pfizer continued on producing quality products especially in the areas of painkillers and other vital drugs.[8]During the civil war of 1862 its sales soared because they ventured into domestic and cleaning agents, which also included other drugs that were in demand from the Union Army. Some of these drugs included such important drugs and cleanin g agents as iodine, morphine mercurial and camphor.By 1880 Pfizer had become America’s number one citric acid producer, which was to become its main product. This was because new drinks like coca-cola, Pepsi-cola and Dr. Ripper gained popularity and had citric acid as an ingredient. But perhaps the greatest breakthrough the company ever came of with is the production of penicillin through deep tank fermentation. Penicillin was to be known as the â€Å"real defense against bacterial infection† and there was no other drug like it before. This was a turning point not only for Pfizer as a company but for the whole human history as well, this was in 1944. [9]Pfizer would again become the leading producer of Vitamin C or Ascorbic acid in the world in 1936 and by the late 1940s it became an established leader in the production of a wider range of vitamins. By 1950, Pfizer had established one of the best sales and marketing organization in the pharmaceutical industry and by 19 51 the company underwent a major international expansion and expanded to such countries like Brazil, Canada, Cuba, Panama, Puerto Rico, England and Mexico.[10]By giving its international managers the autonomy to make decisions accelerated its growth across the globe. In 1952 the company established an agricultural division especially targeting animal health.[11]Through 1995 the company maintained its growing streak and in this particular year acquired SmithKline Beecham’s animal health business giving it the leading role in production of livestock and animals pharmaceuticals. By 1997 it was named the world’s most admired pharmaceutical company by the well-recognized Fortune Magazine.[12]This was to be followed by the breakthrough invention for erectile dysfunction drug Viagra that took the world by storm.In 1999 while celebrating its 150th anniversary it was again named the â€Å" company of the year† by Forbes Magazine and in 2000 the merger between Pfizer and Warner-Lambert created the â€Å"world’s fastest growing major pharmaceutical company†. Also, through its program of Share Card Program, it provided qualified low-income Medicare to low income Americans. [13]One of the latest innovations coming from Pfizer is a prescription medicine that enables adults cease smoking, Chantix was launched in 2006 again a first in this category and just like Viagra it took the world by storm.With such an attractive and impressive track record marketing of Zyrtec would not be a very difficult thing to do especially is the US where the company’s presence is well known and felt. To be able to understand clearly about the marketing aspect of Zyrtec it is very important to carry out a SWOT analysis that seeks to identify the strengths, weaknesses, opportunities and threats that are likely to face the organization in its quest to market the brand.StrengthsThe major strength that is easily discernable is the formidable background that th e company has created for the last 158 years. The background can be described as one of the most impressive for any organization. Through its innovativeness, creativity and solid background the company has continued to excite not only America but the whole world as well with the innovation of such first ones like penicillin in the 1920s, vitamin C in the 1950s, Viagra in the 1998s and many more life changing drugs. With such a track record the company is bound to be easily noticed.The pharmaceutical industry is a very sensitive industry because it deals with human health. A case of product backfiring would have a devastating effect on any organization. This notwithstanding, Pfizer as company because of its commitment to quality has created a â€Å"halo effect† on most of its range of products. The company is trusted by almost all its consumers and has created itself as a brand and a household name in the pharmaceutical industry.The company has established one of the best and technologically advanced laboratories that it continues to generate some of the best drugs to treat many major ailments.Another strength that the company has is its global presence where it exists in most major countries of the world. Some level of autonomy where respective managers are given a freehand to make quick decisions regarding the markets they represent characterizes its international presence. This is very important bearing in mind the dynamic world market. Pfizer’s solid base that is matched with colorful and rich backgrounds enables the company to have an upper edge over its competitors.The company’s backgrounds enables it to remain ahead of the pack especially in the consumer’s mind, who would likely entrust their health and those ones of their animals to such a solid company. With such catchy and unique innovations of the Viagra, enables the company to cut down on its promotion budget because such brands automatically get headline spaces in local and international and media outlets.Zyrtec is perhaps one of the companies leading anti-histaminic drug in America. Likely, the leading role can be directly attributed not only to the effectiveness of the brand but also Pfizer’s record [F1]  as a company as well. Zyrtec being the leading antihistamine enables the company to cut down on its marketing budget and concentrate much on ensuring that the brand is well supported by making the drug better and readily available. This was to be reinforced by the over the counter authorization by the FDAIn any case the kind of marketing the company would likely to support is that one that ensures the brand does not loose the market share and not necessarily push for more sales. In marketing, brand loyalty is extremely important and Zyrtec as it is, has maintained a leading role in the U.S market. For any competitor to drive it out or to eat into it’s market would be a very daunting task.Counterfeits are one of the greatest threa ts in the pharmaceutical industries. This is because once a certain drug is counterfeited its quality of efficacy is brought into disrepute. To protect its consumers and ensure safe and effective medicines the company has continued to identify and employ innovative counterfeit proof mechanism a very good example is the Radio Frequency Identification (RFID) a first one in the industry. Such innovations ensure safety and quality are transferred to the consumers. [14]Zyrtec, when first launched was a prescription drug. This changed in November 19, 2007 when the FDA approved sales over the counter meaning one can easily buy the drug without any prescription. Undoubtedly this is likely to boost the sales as one can get prescription online and many pharmacies have continued to push it via Internet.[15]WeaknessesZyrtec is indeed a leading anti-histamine drug for the treatment of allergies in the world market. However this is bound to change it Pfizer does not do something about the side ef fects that the drug has on its patients. According to Askapatient database on a survey carried since 23/05/07 up to 9/21/2008 where 583 users of Zyrtec responded, the ratings were not very promising. Out of a scale of 1-5, Zyrtec is rated at 2.3 not a very good rating especially bearing in mind the publicity it gets in the U.S market.[16]The drug it seems is receiving negative ratings from consumers some indicating severe side effects like weight increase, low libido, panic attacks and so on. In most situations companies of Pfizer’s size are likely to ignore such comments or ratings yet it would not be business as usual. Competitors are likely to take advantage of this anomaly to penetrate the market. This is already happening with the development of Xyzal, which is using the weakness as an entry pointOpportunitiesPfizer as the manufacturer of Zyrtec has what it takes to push the allergy drug. With a well-developed network across the world makes the company the most ideal to effectively push its own brand. And the advantage that comes to fore is its various productions centers in Brazil, U.K and South Africa where it has the capacity to distribute and market Zyrtec to new markets within a very short time. Asia and Africa are a very attractive markets that it could choose to venture and establish itself as a renown brand name.With its strong base including an advanced research and development laboratory it can easily invent and role out new drugs on this particular line that would be best suitable for these areas. By riding on the crest of the good performance realized from its previous product lines, Pfizer is likely to penetrate such markets with ease as compared to other companies that are not well known in this areas. A good example of the various drugs that it can ride on includes Viagra that address erectile problems, and Chantix that enables smokers stop smoking.Pfizer also needs to utilize the online resources to propel its growth. Internet is tu rning out to be the single most important tool in the contemporary world that has the capacity to reach within a short time the target market. It is easy for the company to prescribe online and utilize powerful e-commerce organizations.However, there are certain risks that could be involved by utilizing the Internet. There’s also a great opportunity that is being through the Internet. There seems to be a great number of sites that are offering Zyrtec online. Most likely such sites are private companies that are selling the products on behalf of Pfizer, this is a great boost especially on cutting on the distribution, marketing and advertising budget.ThreatsPfizer has been in existence for over a century and a half. Its dominance in the world market has continued to attract intense competition. Zyrtec as a brand has attracted quite a formidable competition from U.C.B’s Group another global pharmaceutical giant that produces Xyzal.[17]Xyzal is a brand in the line of Zyrte c because it is anti-histamine. Xyzal is better placed to compete with Zyrtec because it has been developed in such a way that it does not have any side effects on the patients unlike Zyrtec. Xyzal was launched in 2001 and became the number one anti-histamine drug in Europe beating Zyrtec. However, Zyrtec has continued to dominate the U.S market. [18]With the claims of lack of any side effect as opposed to Zyrtec, Xyzal is likely to get into the US market and utilize its success in the European market to establish itself into the U.S market. Zyrtec’s sales were set to decline to 3% for the first quarter of 2004. This indeed is a gloomy picture for Pfizer. Another threat that would likely affect the growth of Zyrtec is the sticky issue of counterfeiting. Some factors have contributed greatly to the rise in this vice. These factors include the raise in the number of distributors in the medicine supply chain.[19] Such distributors include under regulated wholesalers, increase in the number of internet pharmacies, repackages, technology advancement enabling criminals to counterfeit easily, lack of strict legislative measures in other countries. [20]ConclusionZyrtec just like other Pfizer brands has continued to dominate the American market for some time. Pfizer as company has built quite a reputation in this market earning accolades for it innovativeness and quality products. The company has continued to dominate this particular market because of the experience and its ability to satisfy and surpass customer expectations.Zyrtec on its part is indeed a wonderful antihistamine going with its performance track record, however it stands a great risk from the competition especially Xyzal which is giving it a run for its money in the European market. Pfizer would strongly rely on its reputation to wade of any form of competition, however it is important for the company to address the complaints of the side effects from the consumers.

The Pros and Cons of Freelance Writing Online

The Pros and Cons of Freelance Writing Online The Pros and Cons of Freelance Writing Online The Pros and Cons of Freelance Writing Online By Guest Author Freelance writing online is often touted as a dream job. It certainly has its benefits, but it has its downfalls as well. In fact, the drawbacks to freelance writing are often the flip side to the positives of the profession. The Pros 1. Your schedule allows for a fair bit of flexibility. Because you are essentially working for yourself, the job allows you to write in just about any location: your home office, a neighborhood cafe, the beach (so long as your computer doesn’t run out of batteries and the wireless connection isn’t hampered)anywhere you want. Need a day off? No problem. There is no boss to check in with, and so long as you meet your deadlines and set time to deal with the backlog upon your return, you’re all set. 2. You have a multitude of clientsand can walk away from one if it’s not working with you. Most of us have had a boss that made our life miserable at some point in time. I used to dread going to work, and tried to plan my day around avoiding this person. Writing online allows you to work with a multitude of clients, so an occassional bad experience does not ruin your life. You also have the ability to stop working with a client if things aren’t copasetic. 3. You can make an unlimited amount of money. I’ve certainly met my share of six-figure freelancers, and those who make a decent living working part-time hours. Although there is a cap to the amount of writing you can do (and the pay per word or article you will find), publishing a book, developing a product, teaching workshops (in person or online) or speaking at live events are always options. Unlike working for a company or individual who keeps the hard-earned money you bring into the business, you are rewarded monetarily for your own innovation. 4. You are responsible for your own successes. This can be incredibly empowering and gratifying, especially over time. To see a viable, lucrative business, self-taught and self-made, develop and thrive from a simple fleeting idea there’s nothing like it. The Cons 1. Your work can take over your life, if you let it. My partner in crime works normal business hours, and his presence keeps me somewhat sane. I know this because when he’s left for business trips, I’ve found myself sitting in a pile of papers and reference materials until the week morning hours. If you allow distractions (such as the telephone or social media) to creep in while you’re working, the boundaries can become inseparable and you can find yourself whittling the night away with little to show for it. Accepting an occasional last-minute project (particularly when rush fees are provided) and having a week or two with a heavier workload than normal is one thing. However, not creating space devoid of work (and being fiercely protective of it) is a recipe for burnout. 2. You will likely have less-than-savory interactions with clients and editors. Some are simply communication problems. Having to rewrite some copy because your client didn’t explain what they wanted in the first place, for example, can sometimes be prevented by getting very specific, detailed instructions. But some people are impossible to please, it seems, or perhaps they need to find a different writer. Disorganized editors who lose things and ask for them to be resent ad nauseum, people who take your ideas and run with them (without hiring you) and general poor manners and frustrating behavior is common. 3. You have to sort through the rubble. For every client that pays you a reasonable hourly fee, there will be ten who expect you to work for pennies (or worse, for free). Perhaps due in part to the proliferation of content mills, many writers have no problem working for cheap. There is certainly money out there for freelance writing online, but you have to look for it. 4. You are responsible for your own failure. No more going into work exhausted because you stayed up late reading Harry Potter, or checking your e-mail during work hours and picking up a paycheckunless you’re prepared to see the outcome in your bottom line. Freelance writing isn’t just a dream job. It’s work. About the Author: Yael Grauer is a freelance writer and editor. She also provides proofreading and copyediting services to small businesses and creative entrepreneurs, to help spiff up their e-books, online courses and web copy. Find her at YaelWrites.com. Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Freelance Writing category, check our popular posts, or choose a related post below:What Is Irony? (With Examples)Latin Words and Expressions: All You Need to KnowHow to Address Your Elders, Your Doctor, Young Children... and Your CEO

The 17th and 18th centuries were a time of great political change in Research Paper

The 17th and 18th centuries were a time of great political change in Europe - Research Paper Example To begin with, Hobbes being a scholar, his main aim was to place politics on a scientific grip, hence employing a strict logical method to his work. In contrast, Machiavelli having worked as one of the civil servants of Florentine Republic drew his conclusions, after observing how people behaved instead of how they should behave in an intangible and hypothetical world2. It is this methodology difference, which leads to differing political views of these two authors. Hobbes, writing Leviathan immediately after the end of civil war and unfruitful tries at republicanism in Europe, held less estimation of the nature of human beings that Machiavelli. According to Hobbes, if two individuals have desire of a certain thing, which they cannot enjoy at the same time, then they become enemies3. Hobbes argued that, people living in such state were continuously at war, and they could not differentiate between right and wrong. The two lived a life that was poor, solitary, short, brutish, and nasty. Resulting from his reductionist methodology, taking societal analysis to a position of human nature, he made his conclusion with a main realist assumption (anarchy). In such a state, every individual has his or her natural right for protection against injury or harm4. Therefore, Hobbes’s arguments purports that there must be fundamental laws to avoid the state of war. On contrary, Machiavelli does not reflect a theoretical state of nature like Hobbes. Howev er, Machiavelli argues, â€Å"there is no secret hand, which brings human activities into natural harmony†. Another factor differentiating these two political theorists is their diverging views about governance. According to Hobbes, it was the speculation on how a society functions without set rules. Hobbes felt that individuals would simply be doing things according to their own interests. Regarding how people should act, Hobbes makes

Cultural Exploration Term Paper Example | Topics and Well Written Essays - 2250 words

Cultural Exploration - Term Paper Example These cultural patterns, which include beliefs, values, norms and social practices, do affect the quality of communication that takes place as the people from these different cultures interact. The result is either an enhanced quality of communication or a total breakdown in communication. To avoid this breakdown in communication, and to enhance the quality of communication between the different parties, it is very important for the two people who are communicating to be aware of the various attributes of the other culture. This way, mistakes that can be avoided and that can cause a breakdown in communication are identified. The cultural patterns of the two cultures might either lead to a competent intercultural communication or problems as far as the communication is concerned. This paper is going to examine the cultural patterns of two cultures and how the interplay between these patterns affects the intercultural communication of people from these cultures. The first culture is that of the writer, Southeastern Georgia Caucasian, and that of Chinese. Throughout this paper, the writer will be guided by one major objective. This will be the exploration of the various potential effects of the cultural patterns of Southeastern Georgia Caucasian and Chinese on intercultural communication between the two. To achieve the major objective, the writer will be guided by several specific objectives. It is through the address of these specific objectives that the writer will have effectively dealt with the major one. These specific ones are as follows: 1. An analysis of cultural value orientations of southeastern Georgia Caucasian and Chinese using the globe taxonomy approach 2. An analysis of verbal communication norms of the two cultures 3. An analysis of non-verbal communication norms of the two cultures 4. An analysis of relational communication norms of the two cultures The writer will not merely describe the cultural patterns of the two cultures picked. Rather, this will be a comprehensive analysis of the effects that the interplay between this set of pattern has on intercultural communication. Does it make it more productive or does it make it less productive and problematic 1: Cultural Value Orientations of Georgian and Chinese Cultures This analysis will be conducted using the GLOBE cultural taxonomy approach. This approach identifies nine dimensions of culture that are regarded important or ideal in a particular culture. These nine dimensions are a description of what people actually do, or what Millet (1) refers to as cultural practices. They also identify cultural values or what is regarded as ideal practice or conduct in the society under examination (Millet: 1). Power Distance Dimension Power distance dimension describes the degrees to which members of the society that are less powerful both "expect and accept that power is distributed unequally" (Leadlay & Jomy: 38). It is a fact that in any one society, there are differences in the distribution of power, resulting in powerful individuals and less powerful ones. But the differences between the societies occur because, to some, as much as the power

Globalization of North America, South America and the Caribbean Essay Example for Free

Globalization of North America, South America and the Caribbean Essay Globalization is the result of a development of an increasingly integrated global economy marked especially by free trade, free flow of capital, and the tapping of cheaper foreign labor markets (http://www. merriam-webster. com/dictionary/globalization). Not everyone is a proponent of globalization. This is especially true for North America. Although the textbook says North Americans have become a highly affluent society by means of transforming the environment and by extending their global, economic, cultural and political reach, the fact remains, that many citizens of North America are not wealth by any stretch of the imagination. The same can also be said about Latin America. The affluence has spread so unevenly, particularly in the United States, that many of the previously middle class have lost their homes and many are now living in tent cities. Recent college graduates are finding it very difficult to obtain employment in their chosen field. Many people have been unemployed long enough that their unemployment benefits have run out. These people are considered to be not actively seeking employment – this is hardly a fair opinion to form. Much of this can be accounted to work being outsourced, mainly to places like Mexico, or even as far as India. â€Å"Multinational corporations are often accused of social injustice, unfair working conditions (including slave labor wages and poor living and working conditions), as well as a lack of concern for the environment, mismanagement of natural resources, and ecological damage. † http://www. manufacturing. net/articles/2010/06/the-pros-and-cons-of-globalization. However, there are some benefits of globalization. Some people argue that money is now able to flow freely across boundaries that were once limited. An article found in Forbes Magazine explained how Sony could sell a Playstation game console or TV just as easily in the United States as Tokyo. The same goes for Apple with its iPhones and other tech toys. (http://www. forbes.com/sites/panosmourdoukoutas/2011/09/10/the-good-the-bad-and-the-ugly-side-of-globalization/). The textbook points out how uneven development is in Latin America. Frustrated workers, whether highly skilled or low skilled look to emigration as their only hope. Migrants frequently relocate to the United States, Europe and Japan looking for work. Remittances are sent back to their native countries, which results in billions of dollars annually directed to Latin America.

Keys to a Good Education for Children Essays -- Education

The key and initial forces/factors that help children receive a good education are parents’ support, the child’s confidence, and the drive to learn. In The Joy of Reading and Writing: Superman and Me, Sherman Alexie demonstrates each characteristic, strives through obstacles and shines through it all. According to therapist, Anna Robinson, the first and key factor in children receiving a good education is parents’ support. Anna discovers that when children come into her office, one key initial common thing the children posse is lack of hearing their parents encourage what they are doing and not pushing them enough. For example, in The Joy of Reading and Writing: Superman and Me, Alexie’s dad doesn’t say anything but encourages Alexie with by collecting books from everywhere. Alexie taught himself how to read first by â€Å"reading† Superman comic books. Now the word reading has parentheses around it because Alexie looks at the pictures and assumes what Superman is doing and saying. â€Å"I look at the narrative above the picture. I cannot read the words†¦.. Aloud, I pretend to read t...