Treatment for Hypothyroidism

Treatment for Hypothyroidism Levothyroxine sodium is a synthetic thyroxine (T4) hormone, and is the mainstay of treatment for hypothyroidism and the suppression of thyroid stimulating hormone (TSH) in patients with thyroid cancer or after thyroidectomy.1 Two main properties of levothyroxine have contributed to a turbulent regulatory history. First, levothyroxine targets a narrow therapeutic range of T4 hormone and requires careful titration to a safe and effective dose.2 Second, levothyroxine is relatively unstable and its degradation is accelerated in response to environmental factors and in the presence of some inert product ingredients.3,4 Between 1991 and 1997 there were at least 10 recalls of different levothyroxine products mostly due to sub-potency or uncertain potency, comprising 150 lots and 100 million tablets.5 Although major regulatory changes were implemented to improve the quality and safety of levothyroxine products in 1997 and again in 2007,5-7 concerns persist about bioequivalence and variation in product potency.8 In a previous study of generic drug use from a nationally representative sample of commercial claims data in late 2013, we found that generic utilization of thyroid agents, mostly comprising levothyroxine, was 61%,9 despite the availability of generic preparations for >10 years. This utilization rate is markedly low given that overall generic uptake is approaching 90% in U.S.10 To encourage use of generic levothyroxine, more information is needed about the healthcare provider and patient barriers to uptake of generic preparations. We used a large electronic health records (EHR) database from a healthcare delivery system to evaluate measurable determinants of, and unexplained variation in, outpatient generic prescribing of levothyroxine. We hypothesized that both patient and provider factors contribute to generic levothyroxine prescribing and that residual variation in providers generic prescribing would persist after accounting for measurable factors. METHODS Race and ethnicity were captured by self-report during routine clinical practice in accordance with U.S. Census standards.13 We identified TSH laboratory results for each patient in the 12 months prior to the index prescription. In the case of multiple measurements, we chose the one closest to (but not after) the date that the index prescription was ordered. We also extracted information on other patient characteristics, including use of concomitant medications, insurance type, and clinical diagnoses. Insurance type was categorized as fee-for-service or preferred provider organization (FFS/PPO), health maintenance organization (HMO; including Medicare Advantage), Medicare, Medicaid, and unknown (including self-pay). For each patient, we calculated a Charlson Comorbidity Index (CCI) score based International Classification of Disease-9 encounter and problem-list diagnoses documented in the 12 months prior to the index prescription.14 We used 2010 U.S. Census block information to deter mine the median householdincome of the Census track in which patients reside as a proxy for socioeconomic status. We used information from the EHR database to characterize the index levothyroxine prescription. We classified the encounter at which the index prescription was ordered as an office or online/telephone encounter. The index prescription was classified as incident if there were no active prescriptions or pharmacy claims for this drug in the 12 months prior; otherwise it was classified as a renewal. For each patient, we quantified the duration of index prescription (recorded start date to the imputed end date, as determined by the prescribed daily dose, quantity dispensed, and number of refills). We quantified healthcare providers prescribing volume of levothyroxine by calculating the average number of levothyroxine prescriptions written per week in the three months prior to the index prescription for each patient. We also quantified healthcare providers total patient volume by calculating the average number of office encounters per week in the three months prior to the index prescription per patient. Statistical Methods We used mixed-effects multivariable logistic regression models to assess the relationship between generic prescribing of levothyroxine (dependent variable) and patient and prescription factors (level-1 predictor variables), and healthcare provider factors (level-2 predictor variables) (see Table 1). We assumed that patients with prescriptions from the same healthcare provider were more alike in their propensity to receive a generic than patients from different providers. Accordingly, we included random-effects (i.e., random intercepts) in our models for each prescribing healthcare provider of the index levothyroxine prescription (N=941). To quantify between-cluster variation, we calculated the intra-class correlation coefficient (ICC) in the absence of covariates (variance-components model) and in the presence of patient, prescription, and provider fixed-effect covariates (mixed-effects multivariable models). These models were also fitted separately by provider type (PCP and endocrin ologist). Odds ratios (OR) and 95% confidence intervals (CIs) were calculated for fixed-effect covariates. We derived predicted probabilities of receiving generic levothyroxine for each fixed-effect covariate from post-hoc estimation of adjusted means, holding all other variables constant.15 We included interaction terms in the mixed-effects multivariable model to examine effect modification by provider type for patient age, sex, race/ethnicity. When interactions were present, we calculated predicted probabilities of receiving generic levothyroxine for the covariate of interest stratified by provider type. Due to multiple comparisons within models, a P-value 220 days vs. 74% for prescriptions à ¢Ã¢â‚¬ °Ã‚ ¤60 days). Patients and providers may have been more accepting of generic levothyroxine when it would be taken for longer periods of time, reflecting lower cumulative out-of-pocket drug cost. The predicted probability of receiving generic levothyroxine was also higher for renewals than incident prescriptions (83 vs. 73%) and for online/telephone encounters versus office encounters (81% vs. 72%). These factors are related, as patients with a renewal more frequently receive levothyroxine during an online/telephone encounter than those with an incident prescription, yet they remained independent predictors of generic prescribing in the multivariable model. Among patients with a renewal, 84% received generic levothyroxine prior to the index prescription and, of those, the vast majority (92%) received a renewal for generic levothyroxine. It follows that patients were less likely to have been prescribed brand levothyroxine if they were already taking a generic. In a study of 36,832 older adults (à ¢Ã¢â‚¬ °Ã‚ ¥65 years) in the U.S. initiating narrow therapeutic index drugs, of which warfarin (48%) and levothyroxine (29%) were the most prevalent, predictors of higher generic drug initiation, included older age, male sex, higher comorbidity, lower Census block median household income, and prior generic utilization. These findings from a Medicare population are overall consistent with our results.23 In our study, bivariate analyses showed that HMO and Medicare beneficiaries were more likely to receive generic levothyroxine; however, this association was mitigated in the presence of other factors in multivariable analyses. We found that provider type was an effect modifier for the relationship between patient sex and generic prescribing of levothyroxine in multivariable models. In stratified analyses, while the predicted probability of receiving generic levothyroxine from a PCP was similar among women and men (81%, each), the probability of receiving a generic from an endocrinologist was disproportionately lower for women (63% vs. 71% for men). Because lower prescribing of generic levothyroxine was observed for endocrinologists but not PCPs, this occurrence is likely driven by provider rather than patient preferences. Future studies are warranted to understand these prescribing practices among endocrinologists. The results of this study should be interpreted in the context of several limitations. The retrospective, observational nature of this study prevents causal inferences. Furthermore, rates of generic prescribing of levothyroxine may overestimate generic utilization of this drug, as some patients may not consent to generic substitution at the pharmacy. Although California has a permissive generic substitution law, patients can still refuse a substitution. In the absence of pharmacy claims, we cannot know whether a generic or branded product was actually dispensed. Nevertheless, in a previous study we showed that our algorithm used to determine brand versus generic prescribing measured by EHR data performs well in predicting actual dispensing patterns.12 Thestudy setting is a healthcare delivery system in Northern California, and we cannot know if our findings are generalizable to other parts of the U.S.; however, the organization is a mixed-payer system, and operates much like other pr ovider-based delivery systems in the nation, without a single drug formulary. As such, we are confident that our findings are relevant to other similar health systems in the U.S. This study has several strengths. We used a relative large cohort of patients from a mixed-payer healthcare delivery system over a four-year period to examine patterns in and determinants of generic prescribing of levothyroxine. We leveraged extensive information from the health systems EHR database, including disease and medication history, TSH levels, and providers levothyroxine prescribing and patient volume. To our knowledge, this is the first study to quantify variation in generic prescribing of levothyroxine between healthcare providers. The presence of residual variation between providers in generic prescribing of levothyroxine, after controlling for important measurable confounders, indicates potential unwarranted variation due to prescribing preferences. Such variation, which may also be influenced by patient beliefs and preferences, can be the target of provider interventions or patient education aimed at improving levothyroxine generic uptake.

The Union of American Federation of Labor

Early american workers dealt with many problems. These problems ranged from child labor to unemployment. The workers also tried to set up groups, called unions, that they could call their own. The owners of the companies they worked for could not give the workers what they deserved because of their unions. Many unions also helped shape our modern US history by helping the people come together as a whole. One such union was the American Federation of Labor (A. F. of L. ). The unions of the A. F. of L. laced great emphasis on written collective agreements, including the closed shop, in which only union members are permitted to work. The A. F. of L. unions also insisted that members pay relatively high dues, and many of them established insurance and strike benefits. They became known to be job consciousness rather than class consciousness. The start of the A. F. of L. started with the beliefs of one man. That man was Samuel Gompers. He believed in organizing skilled workers ofd the same craft, build unions of plumbers, or carpenters, or cigar makers. By establishing these unions, a labor movement started to unfold. He split the American unions from the class struggle, and made it a partner to the US and not an enemy as people thought unions were. Gompers made unions respectable to the people. Child Labor The A. F. of L. was a pioneer in restricting child labor. The A. F. of L. would have a law passed by the Congress but the Supreme court would say Congress over stepped its powers. Even though this slowed the progress of child labor laws, it did not stop Gompers from trying to start the laws. The A. F. of L. held a conference in 1922 in which any union who wished to see the abolition of child labor was invited. The council worked for the restriction of child labor by writing an amendment that did not get enough votes to pass. It was not until the 1930†³s that some forms of restriction come about. Unemployment The depression in the 1930†³s gave way to massive unemployment. In 1929, 3. 2% of the workers could not find work. In 1933, it rose to over 24. 9% of the workers not being able to find work. The A. F. of L. ecognized the problem of unemployment even before it became a problem in the 1930†³s. The A. F. of L. had a plan for meeting unemployment: (1) establishment of a national employment service by Congress; (2) census of unemployment to be included in the census to be taken in 1930; and (3) regularization of employment by management to provide stable work. The plan also represented the following program as a means for relieving unemployment: (1) shorter work hours to be introduced in industry, with the five days week and vacations with pay; (2) stabilization of employment. With the effort of the A. F. of L. , unemployment was greatly reduced, but not completely and jobs for workers became easier to attain and keep. Education The A. F. of L. has always supported the education of children and the free public school. They liked the idea of â€Å"enactments that will enforce the education of children. † They supported free textbooks to the school children and the establishment of part time classes for the education of minors who were employed. Federal aid to the A. F of L. eant four items: (1) able to pay the teachers; (2) aid to protect the health of the student; (3) scholarships to help those in need to further education; and (4) support in a school building program. Extra funds would be distributed based on need. In 1920, the Workers† Education Bureau was established with the help of the A. F. of L. The bureau was to promote and assist educational work done by the unions. The bureau became an important and very functional part of the A. F. of L. Merger of AFL and CIO The A. F. of L. and the C. I. O (another strong union) saw that unions would be better able to serve their members and the community if a labor unity was reached. Talks soon started with the help of President Roosevelt but were soon halted by both sides in 1939. Talks did not resume until 1942 where an agreement was negotiated. The agreement was signed by three members of both unions who were put in charge of the agreement. But the major leaders of both unions accused the other of raiding They said that talks could not go farther until they agreed that neither side would raid and the war was over. Year after year, very little progress was made, but enough to keep the talks going. Serious negotiations were not made until 1947. Closer cooperation between both groups slowly began with the help of local groups affiliated with the two unions. In 1954, both sides agreed to the no-raiding policy. The new A. F. L-C. I. O spent time examining their differences standing in the way of finalizing their unity. In 1955, all differences were sorted out and on February 9, the Merger Agreement was signed. On this day, the American Federation of Labor finished its seventy-five years of existence. The Union of American Federation of Labor Early american workers dealt with many problems. These problems ranged from child labor to unemployment. The workers also tried to set up groups, called unions, that they could call their own. The owners of the companies they worked for could not give the workers what they deserved because of their unions. Many unions also helped shape our modern US history by helping the people come together as a whole. One such union was the American Federation of Labor (A. F. of L. ). The unions of the A. F. of L. laced great emphasis on written collective agreements, including the closed shop, in which only union members are permitted to work. The A. F. of L. unions also insisted that members pay relatively high dues, and many of them established insurance and strike benefits. They became known to be job consciousness rather than class consciousness. The start of the A. F. of L. started with the beliefs of one man. That man was Samuel Gompers. He believed in organizing skilled workers ofd the same craft, build unions of plumbers, or carpenters, or cigar makers. By establishing these unions, a labor movement started to unfold. He split the American unions from the class struggle, and made it a partner to the US and not an enemy as people thought unions were. Gompers made unions respectable to the people. Child Labor The A. F. of L. was a pioneer in restricting child labor. The A. F. of L. would have a law passed by the Congress but the Supreme court would say Congress over stepped its powers. Even though this slowed the progress of child labor laws, it did not stop Gompers from trying to start the laws. The A. F. of L. held a conference in 1922 in which any union who wished to see the abolition of child labor was invited. The council worked for the restriction of child labor by writing an amendment that did not get enough votes to pass. It was not until the 1930†³s that some forms of restriction come about. Unemployment The depression in the 1930†³s gave way to massive unemployment. In 1929, 3. 2% of the workers could not find work. In 1933, it rose to over 24. 9% of the workers not being able to find work. The A. F. of L. ecognized the problem of unemployment even before it became a problem in the 1930†³s. The A. F. of L. had a plan for meeting unemployment: (1) establishment of a national employment service by Congress; (2) census of unemployment to be included in the census to be taken in 1930; and (3) regularization of employment by management to provide stable work. The plan also represented the following program as a means for relieving unemployment: (1) shorter work hours to be introduced in industry, with the five days week and vacations with pay; (2) stabilization of employment. With the effort of the A. F. of L. , unemployment was greatly reduced, but not completely and jobs for workers became easier to attain and keep. Education The A. F. of L. has always supported the education of children and the free public school. They liked the idea of â€Å"enactments that will enforce the education of children. † They supported free textbooks to the school children and the establishment of part time classes for the education of minors who were employed. Federal aid to the A. F of L. eant four items: (1) able to pay the teachers; (2) aid to protect the health of the student; (3) scholarships to help those in need to further education; and (4) support in a school building program. Extra funds would be distributed based on need. In 1920, the Workers† Education Bureau was established with the help of the A. F. of L. The bureau was to promote and assist educational work done by the unions. The bureau became an important and very functional part of the A. F. of L. Merger of AFL and CIO The A. F. of L. and the C. I. O (another strong union) saw that unions would be better able to serve their members and the community if a labor unity was reached. Talks soon started with the help of President Roosevelt but were soon halted by both sides in 1939. Talks did not resume until 1942 where an agreement was negotiated. The agreement was signed by three members of both unions who were put in charge of the agreement. But the major leaders of both unions accused the other of raiding They said that talks could not go farther until they agreed that neither side would raid and the war was over. Year after year, very little progress was made, but enough to keep the talks going. Serious negotiations were not made until 1947. Closer cooperation between both groups slowly began with the help of local groups affiliated with the two unions. In 1954, both sides agreed to the no-raiding policy. The new A. F. L-C. I. O spent time examining their differences standing in the way of finalizing their unity. In 1955, all differences were sorted out and on February 9, the Merger Agreement was signed. On this day, the American Federation of Labor finished its seventy-five years of existence.

The One Thing to Do for Article Review Apa

The One Thing to Do for Article Review Apa Article submission is affordable to small small business owners through an exceptional subscription model that permits an author to submit an unlimited number of articles without needing to factor in the cost of each and every guide. An outline may also help you write your article quicker and so conserve time, and all of us recognize that time is vital in any sort of business. Maybe, there are a number of points that will need to get revised. It's crucial, as a number of the readers may wish to first read the article under review or might want to compare and make opinions of their very own other than that which is established in the review essay. Ideally it doesn't only give credit to the author of the write-up to reviewed, but in addition gives the readers an opportunity to have a look at the article which is being reviewed. When identifying the report, it is vital that the writer selects an article that talks about a topic they are conversant with. Tell the reader the reason you selected that distinct article to examine. The critique section of the essay is organized into three major components, the coming of the field where the post belongs and the wide troubles. The total reference for the report is put in proper format following your title. The introduction should also include things like article main theme and the author's most important claim. The debut of the article review essay needs to be catchy and inform the readers about the topic which they are likely to discuss. Reviewing journal articles is the perfect way to find out more about a particular subject of interest and how research is conducted. Teachers instruct that in the event the student strays from the focus than their writing is going to be weakened. When a student, you get a good deal of writing assignments, you learn to write, and ultimately, you're going to learn how to compose your graduate paper. Students in IS 369 will be supplied a lecture in the UMBC library about ways to find and download articles. What's Really Ha ppening with Article Review Apa Generally, the body of your review ought to be written in two or three paragraphs. To satisfy the high standards of academic writing, you have to read more information and instruction about how to compose a review on the guide. A review ought to be built by certain criteria. Even a technical review needs to be kept to the facts which people wish to know. If you're interested the best way to do a journal article review, you should be prepared to carry out research and expand your knowledge on the subject. Article reviews play an essential role in scholarship. The article ought to be in a refereed journal or superior excellent conference proceedings. In the conclusion, discuss whether it is successful in advancing the field of study it is examining. An article review is a part of writing where you summarize and assess another individual's article. It is a piece of writing where you summarize and assess someone else's article. Thus, it should not merely focus on discussing what the article is about, but should reveal your personal ideas and opinions on the article. A superb article review implies that the writer reads the article several times to come up with a comprehensive comprehension of the content and its most important points. Our editors help them put out a superior quality article the very first time through. People who have not ever written an article before are discovering it isn't that hard. You're able to discover a lot of journal articles to think of a great critique or review. All of us that write content for our marketing and advertising articles niche can occasionally get stuck'' or do not understand how to begin developing a great informative article. Please share the info contained within the write-up. Take notes on just what the aim of the post is, and whether the info presented is relevant. If you would like to read the entire article, for instance, click the link provided and you'll be carried to the page on the Excess Voice site where I've published the entire item.

The Mind of the Mad Analysis of Hamlet - Free Essay Example

Sample details Pages: 5 Words: 1540 Downloads: 6 Date added: 2017/09/20 Category Literature Essay Type Argumentative essay Tags: Hamlet Essay William Shakespeare Essay Did you like this example? The Mind of The Mad What is it to be mad? Is it related to something of biological background? Or is it to do with the complex breakdown of one’s emotions? Or is it both? These questions are important to keep in mind when understanding whether Hamlet is truly mad or feigning madness as part of his ‘plan’ in which Shakespeare builds up throughout the play. This relates to the second aspect which must also be looked at when comprehending the fictional play Hamlet. This aspect is the certain ‘key’ events that take place, and how they not only provide a basis for, but also shape and mould the emotions of the character Hamlet. When Hamlet is first introduced into the story, his dark mood can be perceived as an inveterate shape of mind which can be traced to his father’s passing. Shakespeare uses many statements, such as, ‘Together with all forms, moods, shapes of grief, That can denote me truly’, to convey the dark mind of Ha mlet. George Wilson Knight believes that Hamlets grief for his father’s death and his mother’s ‘quick forgetfulness’, both contribute, ‘if not wholly’, to Hamlet’s fragile state of mind, and that they are an important basis to Hamlet’s madness. The madness of Hamlet is first introduced when he learns of his father’s ghost, who has been taken by death, and discovers his uncle as the murderer, who now wears the crown. One can see the scene with the ghost as a phantasmagoria which Shakespeare uses to ‘play’ with the storyline. Is this ghost truly Hamlet’s father or is it a shade of the Devil? The answer for this is left completely up to the discretion of the reader. Shakespeare does however litter the text with clues that can justify either side of the Arcanum. One such comment is by the guard Marcellus when Hamlet leaves with the spirit. He says, ‘Something is rotten in the state of Denmark. à ¢â‚¬â„¢ Hamlet’s madness can be seen in many scenes; however it still cannot be labelled as ‘real’ or not. During Hamlet’s talk with Polonius after the King and Queen leave, in which he acts quite fractious, he begins with the insult of ‘Fishmonger’. This can either be seen as a comical input by Shakespeare, as there are many throughout Hamlet, or as a hint to Hamlet’s madness. In this conversation Polonius attempts to elicit the reason behind Hamlet’s attitude, and to find duplicity in his behaviour. Hamlets conversation at this point can be identified to be a duplicity as it can be seen that he drops many hints of his knowledge. An example of this is when Hamlet quizzes Polonius of his honesty and says, ‘Ay, sir. To be honest, as this world goes, is to be one man picked out of ten thousand. ’ This purely relates to his treacherous uncle Claudius, and also opens the question, is one of the reasons behind Hamlets madness to do with Hamlet’s ‘denied’ access to the throne? The fact that Hamlet states ‘Ay, sir, but ‘while the grass grows’ – the proverb is something musty’ to Rosencratz and Guildenstern in reference to his ‘desire’ for advancement leaves this question open. Is this purely for comical relief? Or is this his madness and a darker greed that had not been illumined yet? The relationship between Hamlet and Ophelia is a very complex one in Hamlet, and in which Shakespeare uses many plot elements to manipulate. When first understanding this relationship, one must be aware of the hints placed throughout the play of the relationship between the two characters before the start of the book. These hints indicate Hamlet was deeply in love with Ophelia and that he wrote her many love letters. However, when the play reaches the stage when Hamlet first interacts with Ophelia, the emotions one can derive from it are much diff erent to the emotion we know as love. In this scene Ophelia is used by The King and Polonius as a bait for Hamlet, while Ophelia’s wishes remain uncorrupted as she wishes to give back to Hamlet the letters he gave her, stating that, ‘And with them words of so sweet breath composed as made the things more rich. Their perfume lost. This gives the reader a feeling of Hamlets attitude towards Ophelia. However the reason for this is left completely up to the reader. Hamlet begins this conversation with, what seems, talking to himself. He then notices Ophelia and begins to talk to her. He denies the letters that Ophelia claimed he gave her. This is also left ‘open’ by Shakespeare, in the sense that the reader may believe that Hamlet did in fact give letters of a very affectionate nature to Ophelia, or that Hamlet never gave her letters, and that he’s denial is truthful. It is however commonly believed that Hamlet did in fact write Ophelia letters which, as mentioned before, Shakespeare uses to establish a history of Hamlet and Ophelia’s relationship. This being the case, why would Hamlet deny giving these letters? In the argument that Hamlet is truly mad by this stage, it is believed that he truly has no idea that he ever gave letters to Ophelia. However to argue the fact that Hamlet isn’t really mad, it is believed that to maintain his illusive madness he must end his relationship with Ophelia, nd break all ties with her for his madness to look convincing. This is another example of Shakespeare ‘playing’ with the madness of Hamlet, and to keep the reader guessing. It is also interesting to briefly look outside the text of Hamlet, and into other Shakespearian plays, where he depicts madness to a similar level. The Character Lear, from King Lear, also suffers from a similar, brought on, madness. This argument of whether the madness is real or not can also be asked of the character Lear. Does he really go insane from the flagitious actions of his two daughters? Or is he faking it as part of a big scheme to get revenge? Like Hamlet, Shakespeare leaves many plot clues that point ‘both ways’. Shakespeare plays with Lear’s madness in a similar way he does with Hamlet, and through this, creates many different ‘ways to travel’ when deciding what one believes in. It is important to note that Hamlet is a tragedy, and holds many of the characteristics tragedies held in the renaissance. Tragedies feature the main character being brought to ruin and grief and usually, but not always, result in death of the main character and others. In Hamlet we see that Hamlet is either brought to ruin through the fate of his father and the actions of his mother, or by his own ‘selfish’ and colluding attitude. The madness that he suffers after this could be the final element that pushes him to ruin. However many could also argue that the fate and actions of h is father and mother alone brought him to this ruin, and that he solely concentrates on revenge now by feigning madness. A tragedian named Catherine Belsey believes that the readers of today read tragedies from ‘ he present, to produce for it a meaning intelligible from our own place in history. ’ This interesting point must be taken into account when asking the play questions such as these. From a look at today’s beliefs, many readers tend to justify the main character and brand him as a ‘good’ character or heroine. However it is interesting to ‘turn’ the text Hamlet around. When doing this one can still see Hamlet as the main character, however one can also see him as a villain, bringing ruin and chaos to Denmark through the actions of his ‘madness’. In this sense, one can see the incredible flexibility Shakespeare has when moulding the story. From the evidence mentioned before, the capricious text of Shakespeare can be turned on all angles. This is due to how he plays with Hamlet’s madness, and uses it to make readers question its own authenticity. Because of this, the very revenge that Hamlet has planned can be questioned. Are his actions brought on by madness and no other motivation, or is it planned, and will it save Denmark or break it? These questions prove that to answer a question such as this, many things must be taken into account. Hamlet is an extraordinary text in this sense, and whichever way one ‘turns’ it, a new direction in its plot is found. Bibliography Belsey, Catherine, The Subject of Tragedy. Methuen and Co Ltd, England, 1985. Coyle, Martin and Peck, John, How to Study a Shakespeare Play. Macmillan Education Ltd, England, 1985. Palmer, Christopher, The Mysteriousness of Hamlet. Published in Meridian, La Trobe University Press, Australia. Shakespeare, William, Hamlet. This Edition) The Penguin Group, England, 1980. Shakespeare, William, King Lear. (This E dition) The Penguin Group, England, 1972. Wilson Knight, George, The Wheel of Fire. Oxford University Press, England, 1930. [ 1 ]. W. Shakespeare, Hamlet, P. 15, L. 82. [ 2 ]. G. Wilson Knight, The Wheel of Fire, P. 18. [ 3 ]. W. Shakespeare, Hamlet, P. 31, L. 90. [ 4 ]. W. Shakespeare, Hamlet, P. 50, L. 179. [ 5 ]. W. Shakespeare, Hamlet, P. 82, L. 350. [ 6 ]. W. Shakespeare, Hamlet, P. 67, L. 98. [ 7 ]. C. Belsey, The Subject of Tragedy, P. 2. Don’t waste time! Our writers will create an original "The Mind of the Mad: Analysis of Hamlet" essay for you Create order