Antibody Level After Hepatitis B Vaccination in Hemodialysis

Antibody Level After Hepatitis B Vaccination in Hemodialysis ABSTRACT OBJECTIVE The objective of this study was to determine the antibody level after Hepatitis B vaccination in chronic hemodialysis patients. METHOD: All patients undergoing chronic hemodialysis (HD) at the dialysis unit of Liaquat National Hospital, fulfilling the inclusion and exclusion criteria were enrolled between April 2013 and September 2013, after taking informed consent. AntiHbs (Hepatitis B surface antibody) titers were measured. Patients were differentiated as Immune and nonimmune based on antibody titers, with levels of >10 IU/l being considered as immune and levels of RESULTS: Out of 118 patients enrolled, 103 (87.3%) had an adequate antibody response and were considered immune while only 15 patients (12.7%) had an inadequate antibody response rendering them non immune. AntiHbs titers showed no significant co-relation with gender and duration of Hemodialysis therapy (p>0.05), while age was found to have significant correlation as younger age group ( CONCLUSION: Our study showed a very good Antibody response to Hepatitis B vaccination among hemodialysis patients that correlated with age with younger age group having a better response but no correlation to gender and duration of dialysis. KEYWORDS: Hepatitis B virus, Anti-HBs antibody, Hemodialysis, Prevalence, Vaccination. INTRODUCTION Hepatitis B virus (HBV) infection is a common but avoidable disease. Hepatitis B virus (HBV) is a DNA virus that can be communicated via saliva, body fluids, semen, vaginal fluids, blood products, sexual contacts or prenatally influencing 350-400 million persons round the globe (1-3). In contrast to general population, hemodialysis patients are at higher risk of acquiring Hepatitis B Virus because of direct exposure to blood products, shared hemodialysis devices, needle pricks and hemodialysis process which involve access to blood circulation.(4) Hence, Hemodialysis patients are vulnerable to infections with Hepatitis B Virus and hepatitis C virus (HCV). The prevalence of Hepatitis B Virus in hemodialysis (HD) patients varies significantly between countries, ranging from minimal in developed countries to very high in some developing countries. Despite the fact that many steps have been taken for the prevention of HBV infection like mass vaccination programs, implementation of thoroug h blood donor screening, awareness encouragement programs of erythropoietin use and generalize availability in hemodialysis centers, Hepatitis B Virus infection remains a major concern in Hemodialysis centers majorly in developing countries (5). Patients who are on maintenance hemodialysis are considered as high-risk group, resulting in high incidence and mortality. Therefore, to vaccinate them against the virus is mandatory. Compared to a response rate of over 90% in the normal population, only 50 to 60% of those with end-stage renal disease achieve adequate antibody levels following immunization (6, 7). Various tactics have been employed to overcome the low seroconversion rate like co-administering zinc, gamma-interferon, thymopentin, interleukin-2, and levamisole as immunostimulants or adjuvants as well as changing the injection mode (intradermal versus intramuscular) or doubling the vaccine dose (7, 8). Low immune response to hepatitis B vaccination in patients on HD is noticed in several studies but has never been studied in our population. Therefore our aim is to conduct a study in our population to determine the serum Anti-Hbs levels in these patients following vaccination. MATERIAL METHODS From April 2013 to September 2013, 118 patients undergoing HD in Liaquat National Hospital and Medical College were screened for anti-HBs. A questionnaire was used to collect the demographic data and duration of HD. All patients were included in HD unit who underwent primary vaccination within last one year (four doses: recombinant HB vaccine; 40 ug, i.m, at 0, 1, 2 and 6 months). Exclusion criteria included patients on immunosuppressive drugs, malignancy or HIV positive patients. Enzyme linked immunosorbent assay (ELISA,Biokit, Spain) was used to measure Anti-HBs antibodies titers. The data was analyzed by SPSS  ® for windows ® (version 14.0 Chicago, IL, USA). A p value RESULTS We enrolled total of 118 patients on Hemodialysis who were recently vaccinated. Demographics are shown in Figure 1.Patient’s age ranged from 20-71 years. 46.6 %( N=55) were Male with mean age 53.2  ±10.02 yrs and 53.1 %( N=63) were Females with mean Age of 51.59  ±10.63 yrs. Age was found to have significant impact on Hepatitis B surface antibody titer with patients 0.05). Out of 118 patients, 15 (12.7%) were found to have Inadequate response or Non-immune, where as, 104 (87.3%) had an Adequate response and responded well to the immunization. Duration on Hemodialysis ranges from 1-4 yr with mean duration of 1.97 ±0.77 years, most of the patients had less than 3 years of Hemodialysis 97.5% (N=115/118) and only 3 patients (2.5%) were in year 4. Duration of Hemodialysis failed to show any significant impact on Hepatitis B vaccination response rate (p>0.05). DISCUSSION: An increased risk of exposure to HBV infection is observed in patients on maintenance hemodialysis (9) It has been observed that after vaccination for Hepatitis B, hemodialysis patients develop lower antibody titers compared to healthy individuals, and even if they are immunized, their antibody titers falls shortly within a year(10). The present study showed a very high response to hepatitis-B vaccination among hemodialysis patients. One hundred and four (87.6%) patients showed good antibody response after vaccination. Previous studies in hemodialysis patients have shown a variable hepatitis-B vaccination response rate, ranging from 47%-73%.(11-13).Comparable good results to hepatitis-B vaccination in hemodialysis patients had also been observed in areas with intermediate endemicity (2-8%) prevalence of Hepatitis B Virus ,such as in Brazil , which approached 89.5% in one study.(14) A recent meta-analysis of 17 clinical trials showed decreased response to hepatitis-B vaccination among older dialysis patients(15) which might be attributed to age associated changes to immune status, where â€Å"older† was defined at age 50 yrs. Our patients mean age were 52.3 ±10.04 yrs correlating with Meta analysis age group, and our results are similar with older patients having less immune response.(11, 16, 17) In the present study, gender and duration of hemodialysis therapy did not have any correlation to hepatitis-B vaccination. These results are in agreement with those reported by Peces et al .(18).Dacko et al.(16) and Tele et al(14).Similarly, Roozbeh et al(19) also confirmed the same results and showed that gender did not differ between responders (immune) and non-responders (non-immune) to hepatitis-B vaccination. CONCLUSION: We report a very good response to hepatitis-B vaccination among hemodialysis patients that is neither co-relating with gender or duration of hemodialysis. This was a preliminary study in our population which only estimated the response rate against vaccination. Future studies are needed to determine the impact of nutrional status and adequacy of hemodialysis on the response rate of vaccination as previous studies has shown their influences over titer levels.

Essentialist and Post Structuralist Theories of Race and Ethnicity Essay

Identity Analysis Toward Productive Pedagogies: An Essentialist and Post Structuralist Perspective Race and ethnicity will be used to analyse the central theme of identity from an essentialist and post structuralist perspective. Definitions of race and ethnicity will be presented and distinctions made between the two categories. The character Eva from the film The Freedom Writers will be used as a medium and present an argument that race and ethnicity are social constructs but not absent of essentialist influences. Following a self reflection of my own identity the similarities between Eva and I show a congruence between essentialist perspectives of race and ethnicity to the existence of ethnic tensions and prejudice. In the context of Post structural theory it will be argued that it offers a more realistic and progressive appraisal of identity as fluid and changing through social contexts. Differences between Eva’s and my own identity serve to highlight the inequality of dominant culture over ethnic minorities. Therefore, pedagogical strategies will be examined from a post structural perspective as a means to promote inclusivity and authentic Indigenous perspectives within the classroom. Essentialist theories about ethnicity and race present these identity themes as fixed and unchangeable. Weber (1978) defines race identity as â€Å"†¦ common inherited and inheritable traits that actually derive from common descent† (p. 368 ). The character Eva from the film The Freedom Writers identities her race as â€Å"†¦ those south of the border†, or specifically Hispanic. Ethnicity from an essentialist perspective differs from race as Zagefka (2008) ascribes to the notion that â€Å"†¦ essentialist accounts of ethnicity maintain that ethnic groups have a certain ‘essence’ which determines their character† (p. 1). Therefore, essentialist ethnicity elaborates on race identity informing that behavioural traits are also biologically determined. Eva’s statement â€Å"We fight over race, pride and respect† illustrates the essentialist nature of fixed, unchangeable boundaries that exist between her group and other ethnic groups. Eva’s racial hatred of the other ethnic groups is evident through her gang affiliations and violent behaviour toward them. An essentialist perceptive would assume that Eva’s racial hatred is determined at birth but as Eva’s character develops throughout the film the essentialist perspective loses validity and Eva’s sense of identity is seen to be socially constructed. Post structural theory maintains that race and ethnicity are socially constructed presenting Eva’s identity as fluid and evolving. However, Morning (2006) concludes that â€Å"†¦ the conception of race as rooted in biological difference endures, at least in the United States today†. Therefore, ethnicity offers a more authentic analysis of Eva’s identity formation from a post structuralist perspective then the residual of essentialism that exists in relation to her racial conceptualisations. In Eva’s formative years her subjectivities about race were essentialised from her fathers’ emphasis of her origins and therefore the â€Å"†¦ need to protect your own†. The violence from other ethnic groups and the arrest of her father because of his ethnic background resulted in an intense hatred for white people. Eva â€Å"†¦ hated white people on sight†. Eva’s hatred developed over time through social contexts involving ethnic and racial violence. Eva’s changing identity is represented from a post structural perceptive through narrative and social interactions in Mrs Gurwall’s classroom. Marra (2005) states that â€Å"Narrative is a powerful means of constructing different kinds of social identity, including ethnic identity†¦. † (p. 2). Using a diary as an artefact Eva is able reflect on her own subjectivities about identity to better understand her beliefs and values (J Nailer, 2005 p. 152). Through social interactions in the classroom under the guidance of her teacher Eva’s ethnic identity is reconstructed to establish a type of class ethnicity involving students from different races. As a self reflection process my own personal identity can be examined through essentialist and post structural perspectives centred on themes of race and identity. During my childhood years race identity was represented from an essentialist perspective. I identified as a member of the white race and was educated from a white, colonial historical perspective. Instilled from an early age was the notion that being black meant being inferior. Not only did I perceive Indigenous people as those who sat in the park and got drunk but I engaged in racist language such as ‘nigger’ and ‘coon’. My prejudice is highlighted by Brickman (2009) who suggests â€Å"Indeed, for social categories based on race, increased endorsement of genetic theories (one component of psychological essentialism) has been linked to increased prejudice† (p. 2). My parents assisted in the facilitation of my racial essentialism as did many other adults and peers of my own racial group. During my formative years my identity based upon being a member of the white race assumed greater intelligence, privilege and more appropriate behaviour than Indigenous peoples. The distinction between race and ethnicity is evident when according to Chandra (2006), an ethnic group is â€Å"†¦ a named human population with myths of common ancestry, shared historical memories, one or more elements of a common culture, a link with a homeland and sense of solidarity† (p.403). This statement relates to when I left my small town and attended an affluent private college whilst undertaking university study. Although surrounded by members of the same white race I identified with an ethnic group in the context of people from my own town. The essentialist and constructiveness theories for identity are distinct yet in practice difficult to separate. Ayirtman (2007) presents constructionist perspectives as â€Å"†¦ the intersubjective formation of individual identities through confrontation and interaction with other(s)† (p.10) whilst Chandra (2006) proposes that changes in ethnicity are constrained by â€Å"descent-based† attributes. In the context of race and ethnicity both statements were appropriate to the way I constructed my own identity throughout my adult years. The immersion in multiculturalism from a large city and university institution influenced me to many different races and ethnic groups. The confrontation of cultural diversity increased fluidity in the boundaries that constituted my identity about themes of race and ethnicity. However, the recognition of cultural differences in relation to my original culture and race still left intact some relatively fixed boundaries around essentialist perspectives. It is evident that Eva and I had different life experiences yet similarities emerge between our two identities. Prominent commonalities between Eva and I relate to the essentialist perspective of race and ethnicity our childhood and adolescence years. Both Eva and I expressed prejudice toward other ethnic groups based on the biological characteristics of race and ethnicity. In relation to ethnicity and race the formative years consisted of seemingly fixed and rigid boundaries around identity groups. Juteau (1996) describes these boundaries as â€Å"†¦ monolithic and static, seen as grounded in common origin, genealogy and ancestry† (p. 57). Similar to Eva the fixed nature of my identity boundaries correlated to racial and ethnic tensions resulting sometimes in violence, in varying degrees. Despite essentialised race and ethnicity in formative years commonalities exist between Eva and me through a post structuralist perspective. Racial prejudice was socially constructed through repeated discourses of conflict between racial groups throughout childhood and adolescence. Narrative through the evolving artefact of a diary allowed both Eva and I to analyse our subjectivities about aspects of our identities and both had the experience of an excellent teacher through which effective social interactions allowed empowerment and progressive reconstruction of identity. A key difference between me and the character Eva in The Freedom Writers is that I identified with the dominant Discourse in society and Eva identified as a member of a minority ethnic group. Thomson states â€Å"A successful school student is one who has acquired much of the dominant ‘habitus’, that is, ways of being in the world, as well as the cultural and symbolic capital derived from their schooling† (p. 8). An analysis of Thomson’s statement works on two levels. At the school level, and identifying as a member of the dominant culture, allowed me to be familiar with school discourse and the knowledge’s valued there in. Eva’s ethnic and racial identity immediately placed her at odds with the school discourse which restricted her acquisition of cultural capital. At the level of society I was able to exert more agency through the social influence that a familiar discourse facilitated. A seemingly natural relationship existed through identification with a common culture, language and physical race attributes. Eva’s race and ethnicity reduced the agency she could exert against the dominant culture. Her common culture and race attributes are at odds in a society where the majority race was white. The similarities and differences evident between Eva’s identity and my own identity offer invaluable understandings to develop positive, productive teacher-student interactions in the classroom. Taking a post structural approach to pedagogy teachers can be aware that their own subjectivities will influence the way they teach. (Nayler 2005). . In a multi-cultural scenario where individual students bring a variety of cultural identities into the classroom a teacher faces the challenge of facilitating inclusive pedagogical practices. Carrington advises that â€Å"†¦ the teacher facilitates a culture of respect and value for all members of the class. † (p. 113). This statement requires student interactions that involve listening to other students and being encouraged to support each other through peer assisted learning. Classroom organisation must allow students to actively participate in whole class, group collaboration, independent and problem- based learning. These student practices must be based around purposeful knowledge that engage what Thomson (2002) refers to as a student’s â€Å"†¦ virtual schoolbag† (p. 1). Through strong relationships between teacher, parent and community what students have learnt at home and in wider society can be transferred into the classroom. Therefore individual student’s â€Å"†¦ knowledge’s, narratives and interests† can be recognised and built upon with high teacher expectations of connecting them to the valued knowledge’s of the school curriculum. (Thomson, 2002). More specifically, is the need to embed Indigenous perspectives into the classroom. When embedding Indigenous studies into the classroom teachers (non-indigenous especially) need to access authentic knowledge and often admit their shortcomings in relation to skills and knowledge required to teach such units. Miller, Troy and Currell (2005) point out the risk that â€Å"as members of the dominant culture (we are all white Australian), perhaps we found it easy to revert to a knowledge base that we had naturally accepted since early childhood† (p. 61). Teachers must be critical about the resources they select to teach Indigenous studies whilst forging strong relationships with Indigenous communities. These factors will ensure that Indigenous studies are taught from an indigenous perspective and not corrupted by social, political and historical perspectives of the dominant culture of which many teachers identify with. The identity categories of race and ethnicity can be analysed from an essentialist and post structuralist perspective. The post structural perspective of race and ethnicity presents a more authentic analysis of identity as being influenced by different social contexts. Whilst the post structural perspective offers a more progressive application to Eva’s and my own identities essentialist influences are not invisible. The commonality of prejudice through race and ethnicity being essentialised offers an excellent reference point to show the usefulness of a post structural approach to productive teacher pedagogies. A post structural perspective offers the opportunity for teachers to critically reflect upon their own subjectivities in the context of their own identities. Teachers can therefore adopt pedagogical strategies that promote inclusiveness in the classroom and embrace the richness of cultural diversity, whilst linking the diverse array of knowledge’s to the value knowledge’s of the school curriculum. References 1. Marra, M (2005). Constructing Ethnicity and Leadership Through Storytelling at Work. Retrieved from http://www. mang. canterbury. ac. nz/anzca/FullPapers/06WorkCommFINALed. pdf 2. Carrington, S. (2007). Classroom relationships, pedagogy and practice in the inclusive classroom. In M. Keeffe & S. Carrington (Eds), Schools and diversity(2nd ed. ). (pp. 108-127). Sydney: Pearson Australia. 3. Miller, M. , Dunn, T. & Currell, K. (2005). Learning and the importance of knowing: Student perspectives on centralising Indigenous knowledge in their preparation as teachers. In J. Phillips & Lampert (Eds), Introductory Indigenous studies in education: The importance of knowing. (pp. 60-79). Sydney: Pearson Australia. 4. Thomson, P. (2002). Vicki and Thanh. In Schooling the rustbelt kids:Making the difference in Changing times (pp. 1-18). Crow’s Nest: Allen & Unwind. 5. Nailer, J. (2005). Understanding ourselves. In J. Austin (Ed), Culture and Identity (2nd end). (pp. 139-154). Sydney: Pearson Australia 6. Morning, A. (2006). Ethnic Classification in Global Perspective: A Cross-National Survey of the 2000 Census Round. Retrieved from http://as. nyu. edu/docs/IO/1043/Morning_2008_Ethnic_Classification_in_Global_Perspective. pdf 7. Brickman, D. (2009). The Implications of Essentialist Beliefs for Prejudice. Retrieved from http://deepblue. lib. umich. edu/bitstream/2027. 42/63752/1/dbrick_1. pdf 8. Chandra, H. (2006). What is Ethnic Identity and does it Matter. Annual Review of Political Science, 9, (pp 397-424. ) Retrieved from http://www. nyu. edu/gsas/dept/politics/faculty/chandra/ars2005. pdf 9. Juteau, D. (1996). Theorising ethnicity and ethnic communalisations at the margins: from Quebec to the world system. Nations and Nationalism, 2(1), (pp 45-66. ) Retrieved from http://onlinelibrary. wiley. com/doi/10. 1111/j. 1354-5078. 1996. 00045. x/abstract 10. Ayirtman, S. (2007). Recognition through Deliberation: Toward Deliberative Accommodation of Cultural Diversity. Retrieved from http://arts. monash. edu. au/psi/news-and-events/apsa/refereed-papers/political-theory/sayirtman. pdf 11. Zagefka, H (2008). The concept of ethnicity in social psychological research: Definitional issues. International Journal of Intercultural Relations, 33(3), (pp 228-241. ). 12. Gruwell, E (Writer), & Lagravenese, R (Director). (2006). In D. Devito, M. Shamberg, & S. Sheer (Producers), The Freedom Writers. Paramount Pictures.

Details of College Scholarship Essay Samples

Details of College Scholarship Essay Samples Introducing College Scholarship Essay Samples The cost of an essay rides on the quantity of effort the writer has to exert. The very first step to any essay writing is to choose a subject of interest. Remember that the man reading your essay would like to give out money. Possessing another man reading the essay is essential. Ensure that your essay is neatly typed, and that there's lots of white space' on the webpage. You've got a lot riding on the way in which the essay is written. You know that you are getting high-quality once you use essay writing help. Rather than being given a prompt, you may be requested to compose an essay on this issue of your choice. Type of College Scholarship Essay Samples Some scholarship programs will supply you with a list of questions to answer inside your essay. Therefore, students are advised to follow instructions provided. A scholarship is a grant that functions as an aid for a student to have the ability to attain a particular degree of education. If there are lots of scholarships that you're eligible to submit an application for, be certain to make an application for them all. If you submit the scholarship essay within the body of the email, it is going to be disqualified. Therefore, it's important to recognize key individuals to request letters of recommendation from. Typically each department has a particular deadline for every one of the scholarships they sponsor and a few departments award twice annually. If you're in need of an excellent scholarship essay, ask our writers to compose a customized scholarship essay for you. The group of essay writers covers every topic you might need. If you would like to succeed and know how to write a scholarship essay, it's also wise to become familiarized with the most frequently made mistakes. For a regular student, writing an effective scholarship essay is a true challenge. You don't need to possess the ideal writing skills to be able to be creative and compose an effective essay. Your English teacher may even be inclined to assess your essay for you. It is possible to also secure several discounts on our site which will help you to save some more money for future orders or anything you want to spend them on. The outstanding part about it's that you're not required to sign in for your purchase. This advice is also critical for essays in which you don't take a position but present an assortment of potential claims as a way to demonstrate your expertise or interest in a certain matter. Try to remember, on the exterior of the envelope, list the name of the particular scholarship you're inquiring about. The Good, the Bad and College Scholarship Essay Samples In some instances, you might find it challenging to compose because of inadequate abilities, and therefore a sample winning scholarship essays would supply the guidance you will need. Students l ead busy lives and frequently forget about an approaching deadline. Winning essays often rely on a broad range of relevant and proper evidence. With a little bit of tweaking, 1 scholarship essay can fit the requirements of several diverse contests. As you probably already know, applying for college is a great deal of work. Obtaining scholarship is just one of the greatest approaches to attain education and training to develop into a great leader. Applying for college takes quite a bit of work. College Scholarship Essay Samples Before you submit your application make certain you take the opportunity to proofread your essay from starting to end. Your application ought to be typewritten and neat. Our application essay service won't ever disillusion you and you'll be happy by our performance. It will never disillusion you and you will be pleased with our performance.

Descriptive Essay - A Slimy Situation - 865 Words

A Slimy Situation â€Å"I’ll be right over!† I excitedly told Carly over the phone. â€Å"Mom I’m going to Carly’s to make slime!† I yelled from my room. BOOM BOOM BOOM BOOM. Four stomps boomed from the ceiling, my queue to go upstairs. â€Å"Coming!† I screamed. I bounded up the stairs into my mom’s room. â€Å"I’m going to Carly’s.† I repeated. â€Å"Ok† she advised, â€Å"Bring your brother’s bike and be home by 6:30.† â€Å"Ok, thank you, bye Mom, love you!† I hollered, already down the hall towards the door. I scooped up the ingredients to make the slime, put it in my backpack, and ran out to get my bike. I opened the garage door and scooted my brother’s big blue bike onto the driveway. I hopped on and was on my way the half mile to Carly’s house. I was SO excited to†¦show more content†¦Next, I grabbed a mixing utensil and went to town on the mixture. Once I finished mixing, Carly was already behind me with some pink food coloring. She lightly squeezed the container, bright red liquid came bursting forth from the bottle. Carly missed the bowl and got some on the counter, but there was already shaving cream everywhere so, I didn’t say anything. After I stirred the slime again, I put a pinch of corn starch and some contact solution into the mixture. It was now time for my favorite part, the glitter! We poured a ton of glitter into the pink slime. Then, we mixed it and then kneaded it to fine dough. Finally, it was time to play. Carly and I squished, squashed, and scrunched our pink glitter slime. â€Å"Cassidy, catch.† She told me, and I did. We threw our slime around for about 5 minutes. Until Carly chucked the slime at me and instead of landing in my hands, it hit the ceiling. Carly and I couldn’t stop laughing. We laughed until the slime fell down. When it did it was surprisingly as hard as a rock. â€Å"Why is it so hard?† I asked Carly â€Å"Oh† She surprised turned to laughter again â€Å"We added to much corn starch. Now the slime is hard!† Then we started laughing again, passing the pink glittering rock around like before. We were having so much fun, I didn’t notice the clock. 6:27! â€Å"Oh no!† I frantically started packing my stuff. â€Å"I have to be home at 6:30. â€Å"Sorry Carly, thanks for making slime with me. Bye,Show MoreRelatedThe Rhetorical Analysis Of Mary Crow Dog And Graduation By Maya Angelou1640 Words   |  7 PagesThe rhetorical situation helps the audience understand all aspects of which the rhetor writes. When an audience understands the rhetorical situation, they are able to make a judgment on whether they believe the author to be credible or not, or their writing to be effective or not. Mary Crow Dog and Maya Angelou are both effective rhetors because their rhetorical situations work together to make their essays compelling. â€Å"Civilize Them with a Stick† by Mary Crow Dog and â€Å"Graduation† by Maya AngelouRead MoreEdgar Allan Poes Use of Descriptive Language in The Pit and the Pendulum1609 Words   |  7 PagesEdgar Allan Poes Use of Descriptive Language in The Pit and the Pendulum Edgar Allan Poe has been known for writing stories of mystery and horror. He has composed poems dealing with the occult. He favors those themes and ideas that people shy away from, death, pain, suffering, torture, terror, and fear. His gothic stories burn fright into the hearts of the reader or leave them with a sense of remorse for Poes poor and unfortunate characters. Not many people have ever thought aboutRead MoreEssay on Teaching: Grammatical Number and Notes21041 Words   |  85 Pagesrelationship between two events do future time clauses represent? Future time clauses are used to show the time relationship between two events or situations. Using the connecting words  when, after,  or  before  shows when each event occurred. Review the Meaning and Use notes on page 144. * When using  if  clauses to show a cause and effect situation, is the  if  clause associated with the cause, or the effect? The  if  clause represents the cause of the scenario. Review the Meaning and Use notes onRead MoreIgbo Dictionary129408 Words   |  518 Pagesillustrated the meaning and use of words; the great majority of the examples are due to him. Their merit is that they are not translations from English, but natural Igbo sentences elicited only by the stimulus of the word they illustrate. The short essays which appear from time to time (e.g. under otà ¹tà ¹, à ²Ã¯â‚¬ ¤gbanÌ„je) on aspects of culture are also his work, as are the sketches which served as basis for the illustrations, a large number of new words, and various features of the arrangement. When he had