History of Gout Research

History of Gout Research Hyperuricemia is a biochemical defect distinguished by Serum uric acid (sUA) level greater than 6.8mg/dl (Sunkureddi et al. 2006). In majority of cases (90%), hyperuricemia arise due to reduced excretion of uric acid by kidneys, whereas in residual cases (10%), there is enlarged production of uric acid (Canella et al. 2005). . Gout is an illness that is correlated to overload synthesis, and deposition of uric acid crystals. These crystals form secondary to hyperuricemia that is a serum urate concentration greater than 0.42 mmol/L (Eggebeen et al. 2007; Chen et al. 2008). Hyperuricemia and gout are significantly high risks for kidney or bladder stones (urolithiasis).The prevalence of gout and hyperuricemia among US adults in 2007–2008 was 3.9% (Zhu et al. 2011) while 18% observed in the German population (Mikuls et al. 2007). They are highly prevalent and have treatment preposition beyond the care of inflamed joints. Gouty arthritis were amongst the initial disease to be documented in clinical entity, Identified by the Egyptians in 2640 BC (Nuki et al. 2006), podagra (acute gout stirring in the first metatarsophalangeal joint) was later on recognized by Hippocrates in the fifth century BC, who termed as ‘the unwalkable disease’. Some of Hippocrates’ outstanding clinical perception in relation to gout are potted in aphorisms, which are as accurate today as they were 2500 years ago (Hippocrates et al. 1886). Hippocrates also distinguished the connection between the disease and an unbalanced lifestyle referring to podagra as ‘arthritis of the rich’, as contrasting to rheumatism, an arthritis of the deprived people There are the four differents stages that medical professionals use to classify for the gout. The Asymptomatic gout, The Acute gout ,The Chronic goutand The Interval or intercritical goutIn asymptomatic goutthere is increase in the level of uric acid with the complaint of increase in the pain in the joints and there is no more symptoms. In acute gout this patients have too much pain in their joints and there is a swelling and assiated with the redness of joints.90% of patients have attack on their big toe. Other joints involved are ankle,midfoot heel and knee but any joints can be involved. The attack with gout can be resolved within one or two days. In the interval gout stage there is acute gouty flares and the patients has no symptoms.there is increase in the number of gouty attack if the uric acid level below 6 mg/dl .the most of patients have attack but they have never exprinced another attack of gout, Chornic gout develops because of high level of uric acid in their body for man y years.firm nodular swelling is called tophi.the tophi can occurs anywhere the most common location are antihelix and helix of ear,digits of feet and hands. (Hench et al.1936; Nakayama et al. 1984). It is estimated that the incidence and prevalence of gout and hyperuricemia in the USA are over 6 and 42 million, respectively, with a progressively increasing pattern and affecting mainly men over the age of 40 years (Lawrence et al. 2008). The rate of gout in African living in America is generally about 13% of the US population, and is double in comparison with Caucasians to develop gout. In a prospective cohort study, young men 571 Caucasian and 352 African living in America were followed for a mean duration of 29 years. The growing incidence of gout in these 2 cohorts was 5.8% and 10.9%, correspondingly. Yet, African living in America represent only 10% of the patients treated for gout.(Alvin et al2012) All the way through history gout has been linked with rich foods and extreme alcohol consumption. Because it is evidently connected with a way of life that, at least in the past, could only be afforded bythe rich, gout has been referred to as the ‘disease of kings’. In some eras gout was apparent as publicly desirable because of its occurrence among the politically and socially influential people. In his typical monograph on the history of gout (Copeman et al. 1964), Copeman refers to a comment in the London Timesin 1900, â€Å"The common cold is well named, but the gout seems right away to lift up the patient’s social status†, and to another in Punch in 1964, â€Å"In observance with the spirit of moredemocratic times, gout is becoming less upper-class and is now open to all. It is preposterous that a man should be barred from enjoying gout because he went to the wrong school.† In history, gout has been well thought-out to be primarily a male disease, But actuality that women can also develop gout was first documented through the reign of Nero (AD 54–68) by Seneca, who observed, in this age, women competitor men in every kind of lasciviousness. Why require we then be astonished at considering so many of the female sex afflicted with the gout (Froster et al 1979). In the current era, although gout remains first and foremost a disease of men in middle age, it has turn out to be more and more frequent in women, predominantly after the menopause.( Hench et al.1936; Nakayama et al. 1984). The ancestral connection of gout was documented hundreds of years ago but important the exact genetic mechanisms weren’t achievable until the arrival of modern genetic tools. Gout was incorporated as an inherited disorder in the seminal work of Archibald E. Garrod in his 1931 publication on inborn errors in metabolism. Garrod well thought-out gout to be a dominantly inherited trait.(Gray et al 2012) In earlier times, attacks of gout were also seen as a prophylactic against more serious diseases. According to the writer Horace Walpole gout â€Å"prevents other illnesses and prolongs life might I treat that gout, should not I have a fever, palsy (Lewis et al. 1873),. In recent decades, however, the diet and lifestyle that predispose persons to hyperuricemia and gout have become all the time more common. The role of excess nutritional purines (derived from meat, seafood, and beer) in the progress of gout is illustrated by the difference between the incidence of gout in Asia and Europe. Traditional Asian diets, based on rice and vegetables, are small in dietary purines, and gout has been moderately rare in these cultures. In contrast, European and American diets, which are high in meat and definite sea foods, are linked with hyperuricemia and gout (Choi et al. 200; Zollner et al. 1973). Rising affluence has also led to an increase in the figure of people following a westernized diet and lifestyle, and this has been paralleled by an increase in the occurrence and incidence of gout throughout the world. Purines are machinery of nucleosides, the structure blocks of DNA and RNA. Purine nucleosides are used in the formation of other metabolically significant factors as well, such asadensosinetriphosphate, S-adeneosylmethione, and nicotineadeninedinucleotide. Given the significance of purine-containing molecules for continued existence, vertebrates, including humans, have developed robust mechanism for producing enough purine nucleosides for their metabolism using willingly available materials (such as glucose, glycine, and glutamine), as well as recycling purine nucleosides from all through the body or from the diet (Richette et al; Wilson et al. 2010). Purines can be divided into two types Endogenouspurines are manufactured within human cells. And exogenouspurines are obtained from foods. In mammals, surplus purine nucleosides are detached from the body by collapse in the liver and excretion from the kidneys. For most mammals, the purines are first transformed into the transitional uric acid, which is then metabolized by the enzymeuricaseinto the compound allantoin. Allantoin is a very soluble compound that can without difficulty pass through the bloodstream, become clean by the kidneys, and be excreted from the body. In dissimilarity to other mammals, humans and other primates lack a serviceable uricase enzyme, and can only break purines down into uric acid. The procedure of breaking down purines results in the configuration of uric acid in the humans body is not as easy to detached, because human body lack uricase, and that can build up in body tissues. The levels of uric acid in the blood depend on 2 factors. The first is the rate of uric acid synthesis in the liver. While uric acid consequences from purine degradation, its levels are influenced by both the amount of purines synthesized in the body, as well as the amounts of purines absorbed from the diet The second determinant of blood uric acid levels is the rate of uric acid excretion from the kidneys. The residual uric acid travels all the way through the intestines, where bacteria help break it down (Richette et al. 2010). Excretion has the maximum effect on blood uric acid levels, with about 90% of hyperuricemia cases attributed to impaired renal excretion (Choi et al. 2005). Impaired excretion is most often due to abnormality in the kidney urate carrier or organic ion transporter, both of which control the movement of uric acid out of proximal kidney tubules and into urine (Enomoto A et al. 2002). The treatment of gout consists of controlling the pain, Reducing the serum urate levels, changing unhealthy life styles, preventing the complications of chronic gout. (Schumacher et al 2008) By changing the life style because unhealthy life style will result increase hypertension,hyperlipidemia and obesity,by controlling diet of purine consumption causes significant decrease in the serum urate level but the greater decrease is seen in those patients who have stop the alcohol consumption in their diet (choi et al 2005) There are number of ways to reduced the sUA level.the best way is too control the diet,but sometime along with the drugs.sometime these drug are very effective and reduced the sUA very quickly. (choi hk et al 2008) Following drugs are also used to lower sUA level urate levels: Uricosuric agents (ii) Allopurinol and Febuxostat: Uricosuric agents:  Two drugs that belong to this group are benzbromane and probencid.these two are weal organic acid and lower the sUA level,by inhibition of tublar rebsorptionof urate in the renal tubular system and increasing uric acid in the urine. These agents are indicated when the renal execration of urate are decreased.it is contraindicated in patient with renal calculi(Alvin et al 2012). Two drugs that belong to xanthine oxidiase inhibitor are Allopurinol and Febuxostat. Xanthine oxidase inhibitor along with uricosuric agent are used to increase the urinary execration of urate .The two drugs Febuxostat and Allopurinolare used to lower the sUA level and their Xanthine oxidase xanthine oxidase is the only enzyme that break down the purine bases and catalyze the conservation of hypoxanthine to xanthine and the xanthine to uric acid .then uric acid normally excerated .this enzyme deficiency is may be due to the gentic factor, sometime more consumtion of purine food and less production of enzyme.If any drug that is metabolized by xanthine oxidased,its action is increased by Allopurinol drug llike mercaptopurine FEBUXOSTAT: Febuxostatis a urate decreasing drug and inhibitor of xanthine oxidase so that is used in the treatment of hyperuricemia and chronic gout (Grosser T et al. 2011). Febuxostat was approved by the European Medicines Agency on April 21, 2008and after one year it was approved by the U.S. Food and Drug Administration on February 16, 2009 Febuxostat lowers sUA concentrations by acting on the purine catabolism, the mechanism of action is oxidation of hypoxanthine to xanthine and xanthine to uric acid(Becker et al. 2005). . it is structurally quite different from Allopurinol, has an different mechanism of action on enzyme inhibition, and is more potent.Unlike Allopurinol, that undergoes oxidation to the active metabolite oxypurinol and interacts chemically with the molybdenum center of xanthine oxidase, Febuxostat remains unchanged and inhibits xanthine oxidase by binding in a narrow channel leading to the molybdenum center of the enzyme. By this mechanism, Febuxostat is able to inhibit both the reduced and oxidized form of xanthine oxidase to produce sustained reductions in sUA levels. (Beckar et al 2010) The capability of humans and primates to protect blood levels of uric acid (due to slow kidney filtration and lack of a uricase enzyme) was probably useful to our evolution, by increasing antioxidant capacity of the blood (Alvarez-Lario et al. 2011). Vitamin.C Humans and primates are one of the few mammals that cannot produce their own vitamin c( vit.c), and may have evolve the capability to protect uric acid to reimburse for this (Hediger MA et al. 2002). For example, blood uric acid levels in humans are in general about 6 times that of vit.c, and about ten times the levels in other mammals (Roch-Ramel F et al. 1999). Like vit.c, uric acid has a principle role in shielding high-oxygen tissues (like the brain) from spoil, and low blood uric acid levels have been linked with the succession or greater than before risk of more than a few neurological disorders, including Amyotrophic Lateral Sclerosis (Keizmann D et al. 2009), Multiple sclerosis (Rentzos M et al. 2006), and Huntingtons (Auinger P et al. 2010), Parkinsons (Andreadou E et al. 2009), and Alzheimers diseases (Kim TS et al. 2006).

Factors Affecting Selection of Brand Ambassador Essay

Factors to be considered while choosing right brand ambassador In collaboration with Claudia de Pretto, e-Luxury Specialist at IC-Agency Global companies have long understood the power and impact of associating popular personalities with their brand name and products. Most will agree that a successful brand ambassador can make or break a new product launch, or even catapult a company into a new era of exponential revenues after a long drought of fading brand clout. But these days choosing a brand ambassador isn’t what it used to be. Now, with the rapid diffusion of information made possible through the Internet, companies are seeing the dangers of making hasty decisions to link their products to public figures. In the past, reputations were not etched in stone, but were relatively stable and slow to change. Conversely, these days what goes around still comes around, only now this happens at the speed of light and travels to the ends of the world. More than just a pretty face In the watch industry, brand ambassadors have proven themselves a weighty yet worthy investment. Whether on the playing field, in the arts or simply in the world of beautiful people, brand ambassadors have measurable positive impact on a company’s bottom line. But their influence can be short-lived, and being in the public eye makes them the perfect target for increased scrutiny and attacks on their reputation. Traditional popularity life cycles have been distorted by the global reach of the Internet. What’s more, country variances in consumer opinion, rumours and scandals can be exposed and spread at a phenomenal rate. Too many variables, too little time So, given the investment, vulnerability and revenue-generating potential riding on the decision, how do watchmakers choose? Surprisingly, most brands admit to a selection process that combines a mix of networking, personal contacts and traditional market research, with a dab of ‘CEO’ feeling to finalize the decision. While this approach has produced some highly recognized success stories, companies have little information to address some tough issues: how long will this sports star’s winning streak last? What specific consumer groups emulate this model? What are this actor’s political affiliations? What stereotypes surround this individual? Selection, validation and reporting – minimizing risk and maximizing return By gathering insights on proposed ambassadors in key markets in the online arena, some visionary companies are now making more informed and successful choices. Upstream, using online strategic insights in the initial selection process generates higher quality short-lists, minimizes risk, and makes the selection process and media planning more efficient and successful. Further downstream popularity, reach, brand recall and campaign timing are confirmed through country-specific monitoring of an ambassador’s impact and reputation. Moreover, having access to a measure of a potential ambassador’s reach and clout in key markets can serve as an excellent negotiating tool. And making the right choice from the start will protect a company from the costly legal fees involved in prematurely ending a contract. Proactively influencing the conversion process The primary role of the brand ambassador is to personify the values intrinsic to the brand and evoke the dreams associated with owning the product. As such, he or she must demonstrate a trend of increasing popularity and notoriety in the markets where the advertising and promotion will be visible in order to reach the projected target groups effectively. In the pre-Internet era, the notoriety of the ambassador would be the magnet to attract a qualified target group to appropriate the brand. The conversion process would start with a prospect’s desire to purchase a certain type of product. The consumer’s ultimate choice of brand and model would then be influenced to some degree by identification with the brand ambassador. Now, the advent of online technologies has added another dimension to the equation. Whereas in the past the brand ambassador’s impact was more to confirm a specific brand or model, now it can serve to evoke awareness of the existence of a product, stimulate desire to purchase, then convert. Online, a well-chosen brand ambassador can awaken desire for a product in previously ‘uninterested’ consumers through generic searches on the ambassador’s name or associated activities. In this way, not only direct keyword searches on the brand or product lead to conversions, but non-product-related searches as well. Online, it is the ambassador’s ‘aura’ that acts as the magnet to attract a target group to desire and appropriate the product. The Internet creates propitious ‘product placement’ opportunities to build on the emotion and psychological impulse associated with emulation of the brand ambassador. By means of an innocent forum search, an overzealous fan can be diverted onto the company website and transformed into a passionate consumer with just a few clicks of the mouse. The right choice and the right management Adopting a brand ambassador in the watch industry has become more than an accepted practice. Now with mounting competition and global distribution, it’s time for proactive watchmakers to move beyond name-dropping and capitalize on their investments. By integrating online insights into the selection and validation process, marketers can advance to the next level of campaign optimization, seizing every opportunity to promote the ambassador-product association for maximum return. And with the current trend of asking the Internet public for marketing and innovative product ideas, we can expect the next generation of brand ambassadors to be chosen and promoted by online communities themselves. New game, new rules†¦ How one visionary watchmaker stays on target – Raymond Weil and Charlize Theron In collaboration with IC-Agency, a Geneva-based Internet specialist, independent watchmaker Raymond Weil is monitoring the impact of its ambassador campaigns in key markets. The agency’s proprietary technologies, IC-DemandTracker and IC-Insights, are allowing its clients to evaluate and optimize campaign effectiveness: has the product been successfully linked to the ambassador? How have popularity ratings evolved since the onset of the collaboration? Which countries are best responding to the campaign and when? For IC-Agency, this proactive management is the wave of the future for companies to fully exploit endorsement opportunities and get the best return on investment. (P. M. ) Exploiting the popularity life cycle online Online communities could help companies promote new products through a type of ‘viral marketing’. By capitalizing on interest-led online searches, entire online consumer communities can be moved to federate around an ambassador-associated product. In turn, these communities propagate the dream via their own online ‘hype’ and spread their influence via privileged personal networks. Targeting audiences already devoted to their chosen ambassador means that companies can maximize their return on investment and more quickly amortize media production costs and ambassador fees. Depending on the demographics of the target audience, marketers can use online channels such as ethnic, music, or sports communities to get their message to the most influential consumers at the most opportune time.

An analysis of the childrens aid society and its contributions to the community Essay

Evaluation of Children’s Aid Society Mission Statement The Children’s Aid Society is a 501Â ©3 children’s services agency that helps children in poverty to succeed and thrive. They do this by providing comprehensive support to children and their families living in high needs New York City neighborhoods (website). This organization has developed services that ensure children have access to programs that promote health and wellness as well as social-emotional development skills. They also strive to make sure that children attend college. The Form 990 on page 2 does not provide any further detailed information. With the available information from the mission statement on the website, as well as Form 990 part I and III, it is difficult to evaluate this nonprofit organization’s mission. The quality and the quantity of the available information from the website, and Form 990 is difficult to evaluate because the mission statement was not stated in the annual report. The Children’s Aid Society provides information about its programs on their website. The Form 990 and the annual report are very similar because it is almost the same information. They provide numbers about how many people they serve and the impact the programs have on the children and families. The website and the annual report 2013 both mention this information. Effectiveness From the information obtained, the website provides the effectiveness of the programs from the website, the annual report and the Form 990. The programmatic goals state how many children receive service from various programs. The website provides the number of children served by the organization. The Children’s Aid Society has three major programs that include Early Childhood (0-5), School Age (5-13), and Adolescence (14-18). Early Childhood- The program’s goals are preparing young children for school success through physical, social, emotional, and cognitive development. The core services they provide are Early Head Start for children ages 0-3, and Head Start and Early Learn Day Care for ages 3-5. School Age- The program’s goal is to promote physical, social, and emotional well-being as key factors for high school graduation and college success. This program serves to engage children, families, schools, and communities through a focus on academics, services, support, and opportunities. The core services include out-of-school time programs in Children’s Aid Community Centers and schools, summer camps, athletics, and the national center for community schools that provide assistance to developing a community school model nationally and internationally. Adolescence-The goals of this program are to enhance young people’s physical, social, and emotional competencies as well as improving their academic performance and preparing them for successful careers and gaining financial independence. According to the Form 990, the core services that the organization provides are the Carrera adolescent pregnancy prevention program, which meets the top-tier evidence of effectiveness standards by the coalition for evidence-based policy. The EXCEL college support program assists young people to enter and complete college. The HOPE Leadership Academy provides wrap-around support and develops leadership through a peer education model. They also provide teen employment services such as AmeriCorps internships and the summer youth employment program. Efficiency From the information obtained from the three sources, it is very difficult to determine whether these programs have been efficient in the programs that they administer. After looking into the Form 990, there is no available information about the total costs per person in the programs provided. The three most expensive programs are school age, adolescence, and early childhood. School-age- The total cost of this program is $18,843,068. In Form 990 on page 2, the organization mentions that its goal is promoting physical, social and emotional well-being. However, they do not mention any specific programs. In the annual report, it states that they provide health services to about 4,000 children through school-based health clinics. They do not provide costs for each child served by the school-based health clinics. The annual report also states that the Office of Client Advocacy helped 345 clients avoid eviction. There is no information on the program information in Form 990, pg 2. Adolescence- The total cost of this program is $15,402, 365. In Form 990, page 2 mentions Carrera-Adolescent Prevention Program but does not provide any further information on the number of people served and the costs. The annual report also does not state how many adolescents were served and at what cost. However, the annual report states that the program reduced teen pregnancy by 50 percent. The EXCEL college support program does not provide information on the number of students served as well as how much it costs. The annual report states that more than 90 percent of EXCEL students graduate high school and go on to college. There is no information on how many students are in the program. The quality and the quantity of available information is not very satisfying because there should be detailed information on the exact costs of each major program within the program. Early Childhood- The total cost of this program is $11,612,396. According to the Form 990 page 2, the organization mentions the Early Head Start program. The program provides numbers on its website stating that each family receives a minimum of 32 home visits a year for 90 minutes each. However, it does not state the number of families served. The 2013 annual report does not contain any specific numbers about the program. The quality and quantity of available information are not satisfying because there are no exact costs of how much program costs. According to the nonprofit’s annual report, the management and general administration costs increased to $7,378 in 2012 compared to $6,546 in 2011. This organization increased its expenses, which means that they are spending money on ways to increase mission impact and evaluate programs that may or may not work. The costs of the programs from the Form 990 do not match the financial statement in the annual report. In Form 990, it states larger expanses and is not specific about where the money went. In the annual report, the expenses are more specific but the costs seem to be smaller in Form 990. This shows that the organization is not efficient in its programs. It also shows that they may not have provided other essential information. Governance The Form 990 claims that the Children’s Aid Society has a governing body where the organization documents all meetings. It also states that the committees have the authority to represent the organization on behalf of the governing body. This organization also has different policies. The two main policies that it has based on Form 990 are the whistleblower policy and the written document retention and destruction policy. The Form 990 states that the organization consists of 31 Board Members. These members also have the power to elect other members to the governing body. The Children’s Aid Society has executive centrality governance. Finances The organizations current total revenue is $117,154,454 and its current total expense is $121,692,560. This organization is running a deficit rather than a surplus. The organization is losing its revenue stream and its assets will not cover it for a long time. The organization is fiscally unsustainable. The organization has net unrestricted assets total of $258,063,545 and its restricted assets is a total of $13,848,823. According to the Form 990, the organization received a total of $31,966,571 in contributions and grants. However, it only spent $31,966,571 on fundraising expenses. After dividing the expenses by costs, a total cost of raising a dollar was .09, which is very low. The salary of the Chief Executive Officer is $408,431.00 and it is too much. The average salary according to www.payscale.com states that the average salary is $100,000 for a Chief Executive Officer of a nonprofit organization. After calculating the organization’s program expanse it came up to be .88 ratio from dividing its total program service expenses by its total functional expenses. After analyzing the Children’s Aid Society, I determined that this organization is not worthy of a significant contribution because it is not transparent in providing information to the public. Even though it has a high mission impact in helping children get out of poverty, financially it is starting to become unsustainable in its assets and revenues. This shows that the organization is mismanaging its finances spending. This organization does not earn the seal of approval because the potential donor wants to donate to an organization that is impact-oriented and achieves results cost-effectively, which this organization does not achieve.

Biography of Fences Playwright August Wilson

Award-winning playwright August Wilson had no shortage of fans during his life, but his writing enjoyed renewed interest after a film adaptation of his play â€Å"Fences† opened in theaters on Christmas Day 2016. The critically acclaimed film not only earned kudos for stars Viola Davis and Denzel Washington, who also directed, but exposed new audiences to Wilson’s work as well. In each of his plays, Wilson shined a spotlight on the lives of the working class African Americans overlooked in society. With this biography, learn how Wilson’s upbringing influenced his major works. Early Years August Wilson was born April 27, 1945, in Pittsburgh’s Hill District, a poor black neighborhood. At birth, he bore his baker father’s name, Frederick August Kittel. His father was a German immigrant, known for his drinking and temper, and his mother, Daisy Wilson, was African American. She taught her son to stand up to injustice. His parents divorced, however, and the playwright would later change his surname to his mother’s, for she was his primary caregiver. His father did not have a consistent role in his life and died in 1965. Wilson experienced fierce racism attending a succession of nearly all-white schools, and the alienation he felt as a result eventually led him to drop out of high school at 15. Leaving school did not mean Wilson had given up on his education. He decided to educate himself by regularly visiting his local library and voraciously reading the offerings there. A self-taught education proved fruitful for Wilson, who would earn a high school diploma due to his efforts. Alternatively, he learned important life lessons by listening to the stories of the African Americans, mostly retirees and blue-collar workers, in the Hill District. A Writer Gets His Start By 20, Wilson decided that he would be a poet, but three years later he developed an interest in theater. In 1968, he and his friend Rob Penny started the Black Horizons on the Hill Theater. Lacking a place to perform, the theater company staged its productions at elementary schools and sold tickets for just 50 cents by herding in passersby outside just before the shows started. Wilson’s interest in theater waned, and it wasn’t until he moved to St. Paul, Minn., in 1978 and began adapting Native American folktales into childrens plays that he renewed his interest in the craft. In his new city, he began to recall his old life in the Hill District by chronicling the experiences of the residents there in a play, which developed into â€Å"Jitney.† But Wilson’s first play staged professionally was â€Å"Black Bart and the Sacred Hills,† which he wrote by piecing together several of his old poems.    Lloyd Richards, the first black Broadway director and dean of the Yale School of Drama, helped Wilson refine his plays and directed six of them. Richards was artistic director of Yale Repertory Theater and head of the Eugene ONeill Playwrights Conference in Connecticut to which Wilson would submit the work that made him a star, â€Å"Ma Rainey’s Black Bottom.† Richards gave Wilson guidance on the play and it opened at the Yale Repertory Theatre in 1984. The New York Times described the play as â€Å"a searing inside account of what white racism does to its victims.† Set in 1927, the play details the rocky relationship between a blues singer and a trumpet player. In 1984, â€Å"Fences† premiered. It takes place in the 1950s and chronicles the tensions between a former Negro leagues baseball player working as a garbage man and the son who also dreams of an athletic career. For that play, Wilson received the Tony Award and the Pulitzer Prize. The playwright followed up â€Å"Fences† with â€Å"Joe Turners Come and Gone,† which takes place in a boardinghouse in 1911. Among Wilson’s other key works is The Piano Lesson, the story of siblings fighting over a family piano in 1936. He received his second Pulitzer for that 1990 play. Wilson also wrote Two Trains Running, Seven Guitars, King Hedley II, Gem of the Ocean and Radio Golf, his last play. Most of his plays had Broadway debuts and many were commercial successes. Fences, for example, boasted earnings of $11 million in one year, a record at that time for a nonmusical Broadway production. A number of celebrities starred in his works. Whoopi Goldberg acted in a revival of Ma Raineys Black Bottom in 2003, while Charles S. Dutton starred in both the original and the revival. Other famous actors who’ve appeared in Wilson productions include S. Epatha Merkerson, Angela Bassett, Phylicia Rashad, Courtney B. Vance, Laurence Fishburne and Viola Davis. In total, Wilson received seven New York Drama Critics Circle awards for his plays. Art for Social Change Each of Wilson’s works describes the struggles of the black underclass, be they sanitation workers, domestics, drivers or criminals. Through his dramas, which span different decades of the 20th century, the voiceless have a voice. The plays expose the personal turmoil the marginalized endure because their humanity all too often goes unrecognized by their employers, by strangers, by family members and America overall. While his plays tell the stories of an impoverished black community, there’s a universal appeal to them as well. One can relate to Wilson’s characters in the same way one can relate to the protagonists of Arthur Miller’s works. But Wilson’s plays stand out for their emotional gravitas and lyricism. The playwright didn’t want to gloss over the legacy of slavery and Jim Crow and their impact on his character’s lives. He believed that art was political but didn’t consider  his own plays to be explicitly political. I think my plays offer (white Americans) a different way to look at black Americans, he told The Paris Review  in 1999. For instance, in ‘Fences they see a garbage man, a person they dont really look at, although they see a garbage man every day. By looking at Troys life, white people find out that the content of this black garbage mans life is affected by the same things - love, honor, beauty, betrayal, duty. Recognizing that these things are as much part of his life as theirs can affect how they think about and deal with black people in their lives.† Illness and Death Wilson died of liver cancer on Oct. 2, 2005, at the age of 60 in a Seattle hospital. He had not announced that he was suffering from the disease until a month before his death. His third wife, costume designer Constanza Romero, three daughters (one with Romero and two with his first wife) and several siblings survived him. After he succumbed to cancer, the playwright continued to receive honors. The Virginia Theater on Broadway announced that it would bear Wilson’s name. Its new marquee went up two weeks after his death.