Healthcare Administration Research Paper Example | Topics and Well Written Essays - 250 words

Healthcare Administration - Research Paper Example In fact, large amount of medical research breakthroughs take place in Academic Health Centers. These consequently result in clinical benefits and philanthropy towards the patients. Let us look at some of the famous Academic Health Centers in the World. 1. The Association of Academic Health Centers (AAHC) is one of the foremost associations of Academic Health Centers. It is a nonprofit organization, and consists of allopathic and osteopathic medical school. The AAHC contributes variously to the education system of the different countries. AAHC is vital for generation of newer ideas, concepts and therapies. It is responsible for original centers of innovation and benefit mankind on a large scale. 2. The Biomedical Research Centre at Bethlem Hospital, London, has majorly paced the research facilities at the institute. They’ve sought some ‘personalized medicine’ that has been a medical breakthrough in psychological medical history. 3. Centre for Rural Health, South Africa, undertakes research activities that are pertaining to the regional ailments; it was started off way back in 1980’s. However, today it has spread to a large number of countries, due to the efforts of its academic health centre. Ans 2. Telemedicine is a largely popular form of clinical medicine; to make the process of medicine audio-visual and also convenient for many to use. Telemedicine is a process of two professionals discussing the possibilities of a case over a telephonic conference. Telemedicine is of great benefit to remote communities who have scarce resources of finding adequate medical help at the right time. In fact, telemedicine is now rapidly replacing many technologies like Doctor-on-Wheels, due to its immensely beneficial results that it has cropped up with. Telemedicine can provide for accurate diagnosis as well as accurate examinations of the various techniques of medicine on a patient in a very efficient manner. In many of the

Dehumanization of the Jews Essay Example for Free

Dehumanization of the Jews Essay Dehumanization is the process of making a person less human by taking away the important things in their life and what makes them who they are; not only the material things but their ideas and morals as well. The Nazi’s dehumanized millions and millions of Jews during the Holocaust. In Elie Wiesel’s recollection of his experience in the German’s concentration camps, he explained how brutal the Nazi’s could be, how they could take a person’s life away in the matter of seconds, and how they change a person’s outlook on life entirely. The Jews were dehumanized from the very beginning of the Holocaust and only grew to be worse. Dehumanization is the process of making a person less human by taking away the important things in their life and what makes them who they are; not only the material things but their ideas and morals as well. The Nazi’s dehumanized millions and millions of Jews during the Holocaust. In Elie Wiesel’s recollection of his experience in the German’s concentration camps, he explained how brutal the Nazi’s could be, how they could take a person’s life away in the matter of seconds, and how they change a person’s outlook on life entirely. The Jews were dehumanized from the very beginning of the Holocaust and only grew to be worse. The Nazi’s didn’t make anything easy for them. The Jews endured a continuous struggle that they could do nothing about. In the beginning, it all started with the German’s forcing them out of their homes and sending them to the ghettos. The Nazi’s stripped them of their rights, took away their belongings, and removed them from their daily lives. This left them with nothing. They left behind their lives. â€Å"To live? I dont attach any importance to my life any more. Im alone,† states an early deportee, Moshe the Beadle. (pg. 5) The Jews were ridded of all sense of security. Once they arrived at the concentration camps, they were struck with another loss of â€Å"themselves. † At the camp, they received tattoos. These tattoos were a series of numbers which represented â€Å"who† they were in the concentration camps. They were known as numbers, not people, numbers. A name is sacred. A name is who you are, without it, you’re only a being. They were people with friends and family that knew them by this name, their name. It was just another way to break away the ties of humanity. In the camps, the prisoners were treated like animals. They had to work all day long. They had to eat when they were told to eat. They had do everything they were told. If anyone misbehaved they would be shot down like dogs. Wiesel asks, Was there a single place here where you were not in danger of death? † (pg. 37) A human is meant to be free, do as they please, and not live life in fear. The Jews weren’t allowed to have these luxuries anymore. They were worn down to nothing, which is exactly what Hitler was trying to do. Dehumanization was carried on throughout the Holocaust. The Nazi’s wanted the Jews gone. They made them flee their homes and their personal lives. They were left with nothing. They were given numbers in replace of their own name, the name that makes them the person they grew up as. They Jewish prisoners were treated like animals. They worked, hardly ate, hardly slept, and worked some more. If someone was to do the slightest thing wrong, they were shot down. The person they used to be is gone. The Jewish weren’t given a chance to fight for their lives. The Nazi’s made this impossible. They had to hold onto the little bit of hope left in their wounded hearts.

Analysis of Randall Jarrells The Death of the Ball Turret Gunner Essay

Analysis of Randall Jarrell's The Death of the Ball Turret Gunner Many of the great poems we read today were written in times of great distress. One of these writers was Randall Jarrell. After being born on May 6, 1914, in Nashville Tennessee, Jarrell and his parents moved to Los Angeles where his dad worked as a photographer. When Mr. and Mrs. Jarrell divorced, Randall and his younger brother returned to Nashville to live with their mother. While in Nashville, Randall attended Hume-Frogg high school. Randall showed his love for the arts while in high school by participating in dramatics and journalism. Jarrell continued his career in the arts when he wrote and edited for Vanderbilt’s humor magazine, The Vanderbilt Masquerader. After earning his graduate degree at Vanderbilt, Jarrell accepted a teaching job at the University of Texas. While teaching at Texas, Jarrell met his future wife, Mackie Langham, a fellow English teacher. In 1942, Jarrell left home to join the Army Air Corps as a flying cadet. At about this same time, Randall’s first book of poetry was being published. When Jarrell wrote home, his family often said his letters were, â€Å"confined and dreary.† When Jarrell could not quite cut it as a cadet, he switched to being a navigation control tower operator. As a control tower operator, Randall began to write about the pilots, navigators and gunners of the war. This is probably when Jarrell wrote one of his most famous poems, â€Å"The Death of the Ball Turret Gunner.† After being discharged from the army, Randall went back to teaching. Randall’s love for teaching showed by his famous quote, â€Å"if I were a rich man, I would pay money to teach.† Randall did have some psychiatric problems though. Many people thought Jarrell committed suicide when he was hit by a car on a dark road in 1965. People assumed suicide because at the time of his death Randall was in treatment for slitting his wrists in an attempt to kill himself. Most of Randall’s poetry reflects what he saw and experienced during the war. The structure that Jarrell uses in his poem, â€Å"The Death of the Ball Turret Gunner,† is quite unique. This poem consists of five uneven verses. All of these verses are combined into one stanza. The metric pattern in this poem is very hard to detect. All of the lines begin with at least two anapestic feet followed by at least one iambic foot. This poem i... ...between abortion and a gunner being killed in the belly of a plane. During an abortion, after the baby has been killed in the womb, the doctors, â€Å"wash† the dead fetus out of the mother with a hose. In the first part of the fourth line of this poem when Jarrell writes, â€Å"I woke to the black flak,† the reader heres the alliteration of the, â€Å"ck,† sound. With the repetition of this sound the reader can almost hear gunfire. Although there is no rhyme scheme to this poem, end rhyme takes place at the end of the first and fifth lines. The last thing one would analyze when explicating this poem would be the theme. Analyzing the theme of a poem consists of two things. First one would have to look at the topic of the poem. In this poem the topic is obviously the gunner getting drafted, the horrifying experiences of the gunner, and the death of the gunner. The second thing one would have to look at would be how the author feels about the topic. In this poem the author obviously feels that life is a very fragile thing. Whether you are a baby in your mother’s womb or you are a gunner in the belly of a bomber, Jarrell shows us just how fragile life is and how easily it can be taken away.

The Importance of Global Marketing Strategy

Nowadays, for many businesses, expanding means going global; it means managing to bring your products or services to more and more target markets around the world. The technology, infrastructure, and communications have developed so much that it is no longer impossible or that difficult to open up to new business markets. However, in order to be successful in this endeavor, you need to have a global marketing strategy. The way you promote your product in the United States will not have the same impact in Australia for example, or in Asia, so you need to come up with a battle plan for each culture. The amazing thing today is that you don’t need to have a very large business or be part of a corporation in order to operate in other countries or continents. All you need is for your product to be valuable, for it to be demanded; or you can create demand for it, and that could be part of your global marketing strategy. The first thing that you need to understand about it is that it definitely is not something standardized; you need to ply your product for the consumers, you need to adapt the product itself, or the way it is promoted. You can, for example, standardize your logo, thus making it recognizable around the world, but things such as packaging, promotions, commercials, and your advertising strategy have to be adjusted to the culture, economy and society they are intended for. Your global marketing strategy is only an aspect of your global strategy, and it has to take into consideration several details, such as research and development, finances, market trends, surveys and so on. First of all, you have to define your goals; think of what you are trying to achieve by going global, about the challenges and difficulties you face with a new market, or the competitors you may or may not have. Every detail of this process is important, because the clearer your objectives are, the easier it will be to find solutions and be successful on the global market. For example, depending on the countries or continents you want to reach, think of what can stay the same and what has to be adapted to that type of society. Perhaps you can keep parts of the packaging, but the way you advertise has to be different; although you’re selling the same product, how you present it can be totally different from country to country. It doesn’t matter if you have to change things drastically for each country; be glad that you have the tools and resources to adapt. The better you promote your product, the bigger the chances of success. Learn everything you can about each target and see what they respond to; that way you’ll be able to adopt an appropriate position and become â€Å"familiar† with your new customers. Today, thanks to the Internet, people know about certain products or services even if they are not currently present in their countries; you can observe whether there is a gap in the market somewhere and go to fill it, knowing that your customers are already lined up. Moreover, you can easily see how people react to similar products, or what marketing strategies function with them. Global marketing strategy is not important just because it brings your company more money and recognition, but also because it can save the company money in those places where advertising or packaging are standardized. The world already tends towards a globalization of spirit, of culture and ideas, and getting globalized products and services is just a natural step. Start working on your global strategy today and see what it can do for your business.

The Biomedical Mode of Health

The biomedical model of health Introduction In health psychology it is seen that health is defined by different models. One such model is the biomedical model of health which revolves around the aspect of a healthy body. The model was introduced in the nineteenth century and has been used widely to diagnose diseases by the doctors. According to the model every disease or disorder is caused by a physical harm. In other words the diseases or disorders are caused by germs or genes which might be changing the internal environment of the body to cause the disease.Although it has been introduced in the nineteenth century, the roots of the model date back to the 17th century when Cartesian dualism existed. After its introduction the model replaced the previously famous Humoral paradigm in the twentieth century. The discovery of antibiotics proved to be a breakthrough in the approval of the model. However in the late twentieth century some of the sociologists again started questioning the in tegrity of the biomedical model of health as they considered the social wellbeing of an individual to be as important as the biological well being (Curtis 2002; Taylor 2008; Lovallo 2005; Havelka et al 2009).Biomedical Model of Health The biomedical model of health takes its roots from the Cartesian Dualism which is dated back to the seventeenth century in the times of Descartes. Cartesian Dualism revolved around the aspect that both mind and body are two separate entities irrespective of their functions. In a similar fashion the model considers physical causes to be the main reason for the disease. The model has replaced the previously followed Humoral Paradigm which was formed by the Greeks.According to this paradigm the diseases in a human body are caused by a certain abnormality in the four basic fluids of the body. In those times the four basic fluids of the body were believed to be blood, black bile, yellow bile and phlegm. The treatment of this paradigm also revolved around t he maintenance of these four basic fluids. One thing that the Humoral paradigm and biomedical model of health have in common is that both of them consider bodily factors to be the cause of the disease (Curtis 2002).The biomedical model of health revolves around certain factors which have to be present. The model states that for a person to be unhealthy they have to have some sort of biological abnormality. It also states that every disease has some specific cause which has to be diagnosed by the doctor in order to cure the patient. It also involves the process of treatment and states that the human body can be reversed back to the normal condition if the right treatment is served to the diseased person. It states that psychological and social processes do not take part in the disease causing process.Moreover it also assumes that mind and body are two different entities that have no such relation with each other and lastly the health of the whole society is dependent on the resources that are available to the medical society as a whole (Taylor 2008). The model is largely followed all over the world and its principles are also seen to be the most convincing these days. It is because of this model that researches are being conducted on the biochemical and genetic processes of the body to find out about the different diseases.Moreover all the doctors being trained these days are trained on the principles of this model as they have to learn about the internal environment of a human being so that they can treat them. In other words they have to understand the human body so that they can intervene in the process of disease that may be causing harm to the patient (Curtis 2002; Taylor & Field 2007). It has helped to carry out several projects have proved to be a breakthrough in treating various diseases occurring in the society. The Human Genome Project is an example of the advantages of this model.Human Genome Project was a project launched in the year 1990 by interna tional authorities to find out the sequencing of the human genome along with the identification of the chemical base pairs. Human genomes are the genes which contain information about the hereditary characteristics that an individual would possess. In human beings these are found in the form of genes located on the chromosomes. It is this human genome project which allowed the doctors to learn a lot about the structure of chromosomes, the proteins coded by the genes, and the number of genes in a human being.It has also made the surgeries safe and effective. Moreover it has also assisted in controlling the diseases occurring all over the world and this can be noticed in the statistics of morality in the different nations. The diseases which were previously considered to be untreatable can now be treated because of the knowledge acquired after the introduction of this model. As an example the cases of pneumonia and appendicitis can be considered which previously were untreatable. Pneu monia is a disease caused by the bacteria Pneumococcus and affects the lungs whereas appendicitis is the inflammation of the appendix.Pneumonia is a life threatening condition which could not be cured previously but nowadays it can be cured with the help of antibiotics. Appendicitis is also a lethal condition which can be cured with the help of surgery. (Taylor & Field 2007; Havelka et al 2009; Robbins et al 2005). Limitations of the Biomedical Model of Health The biomedical model of health has its own shortcomings and is termed as reductionist by the opponents. In other words it does not broaden its concept towards the factors other than genes and chemicals for example the factors relating to economic or social environment of the individual.This however is covered by the holistic approach which takes the whole situation in consideration before taking a step. Similarly another factor that is mentioned is the relation of the model to the physical causes of the diseases concerned. The opponents point out that not all the diseases are related to physical causes but some of them are caused by a multitude of the factors. An example of the heart disease atherosclerosis can be cited here in which the factors of genetics, diet, and lifestyle play a role (Curtis 2002).It is also criticized to be more related to the aspect of curing rather than preventing the disease. It is believed to be totally ignoring the aspects of social and psychological variants which do have a role in the progression of a disease. The treatment process is also related to these variants and again this model does not take into consideration these variants because of which some treatments do not go successful (Taylor 2008). Lastly, the model emphasizes on the body in particular irrespective of the role that mind plays in the health of an individual.This aspect of the model can be denied because the research these days show that the mind plays a great role in influencing the body. Some diseases may be caused because the person may be living in unstable economic conditions and these conditions are not taken into consideration by the model. An example can be cited here in the therapies that are recommended for people who are suffering from different diseases. For example the cognitive therapy recommended for patients suffering from cancer. Cognitive therapy is recommended in the treatment of certain cancers as individuals undergoing he treatment suffer from symptoms like pain, memory loss, lack of concentration, irrational behaviour and mood swings. Cognitive therapies can help in relieving all these symptoms as shown by different researches. (Curtis 2002; Scipio et al 2006). Conclusion The biomedical model of health has been questioned by many sociologists as it does not take the aspect of social well being in its definition. Health is a factor which is dependent on all the aspects of life as put down by the sociologists.Economic and social factors should also be considered wh en analyzing the health of an individual. These factors also determine the emotions of an individual and hence the person can be sociologically unfit. In other words it is not necessary for a healthy person to be sociologically fit in the current definition of the biomedical model of health. In the latter half of the twentieth century it was realized that the biomedical model of health can be applied to the ones who are diseased biologically but not the ones who are unfit by other means.This approach therefore led to the adaptation of a new approach known as holistic approach. It is seen that nowadays the biomedical model is adopted for curing purposes along with other factors of society when curing a disease (Curtis 2002; Taylor & Field 2007; Derick & Halligan 1970; Checkland et al 2008). References Lovallo, W. R. , & Lovallo, W. R. (2005). Stress & health: Biological and psychological interactions. Thousand Oaks, Calif: Sage Publications. Checkland, K. , Harrison, S. , McDonald, R . , Grant, S. , Campbell, S. , & Guthrie, B. (January 01, 2008).Biomedicine, holism and general medical practice: responses to the 2004 General Practitioner contract. Sociology of Health & Illness, 30, 5, 788-803. Havelka, M. , Lucanin, J. D. , & Lucanin, D. (January 01, 2009). Biopsychosocial model–the integrated approach to health and disease. Collegium Antropologicum, 33, 1, 303-10. Taylor, S. E. (2008). Health psychology. New York: McGraw-Hill Higher Education. Curtis, A. J. (2002). Health psychology. London: Routledge. Taylor, S. , & Field, D. (2007). Sociology of health and health care. Oxford: Blackwell Pub.Wade, Derick T, & Halligan, Peter W. (1970). Do biomedical models of illness make for good healthcare systems?. BMJ Publishing Group Ltd. Kumar, Vinay, Abul K. Abbas, Nelson Fausto, Stanley L. Robbins, and Ramzi S. Cotran. Robbins and Cotran Pathologic Basis of Disease. Philadelphia: Elsevier Saunders, 2005. Abernethy AP, Keefe FJ, McCrory DC, Scipio CD, Matchar DB. Behavioural therapies for the management of cancer pain: a systematic review. In: Flor H, Kalso E, Dostrovsky JO, editors. Proceedings of the 11th World Congress on Pain. Seattle: IASP Press; 2006. p. 789–98.

Does the Public Sector ombudsman Serve a Useful Function essays

Does the Public Sector ombudsman Serve a Useful Function essays Does the Public Sector Ombudsman serve a useful function. The Ombudsmans mission statement sums up what the office tries to achieve Helping to achieve a public service which is open, fair and accountable. The job of the Ombudsman is to investigate complaints from members of the public who feel they have been unfairly treated by certain public bodies or on his own initiative. He believes as I do, that public bodies are becoming more conscious of citizens, and as consumers of their services we have the right to be heard, to receive sufficient information, to assistance and representation, and to be given reasons and the right to be told what solutions are available to us. I believe that the office of the Ombudsman offers a very valuable service to society, with the red tape and procedures that need to be followed in some institutions and department to lodge a complaint it can be taxing in itself, let alone trying to resolve issues to closure. The office of the Ombudsman has the power to investigate all Government Departments such as, the health board, Local authorities and An Post. In its 18 years of existence the office has dealt with over 50,000 complaints. The Ombudsman is entirely independent and impartial. Impartiality requires independence and independence in turn requires statutory backing, In addition to being independent and impartial, the office must above all be effective. There are four aspects to this. First, public awareness of and access to the Ombudsman. Secondly the powers of investigation, thirdly power to propose adequate remedies and, fourth, effectiveness in securing compliance with findings or recommendations. As a tax paying resident in Ireland I believe that as users of the public services we should be able to put forward any issues or arguments before decisions adverse to them are taken, we need to be aware of remedies or avenues open to us to appeal. There is no charge for dealing...

Converting Cubic Feet to Liters

Converting Cubic Feet to Liters This example problem demonstrates how to convert cubic feet to liters. The cubic foot is the U.S.  and imperial unit of volume for a cube that has sides that are 1 foot in length. The liter is an SI or metric unit of volume. It is the volume of a cube that has sides that are 10 centimeters in length. The conversion between the two systems is fairly common, particularly if youre working with liquefied gases. Cubic Feet to Liter Conversion Problem What is this  volume  of  1 cubic foot  in liters? Many conversion factors are difficult to remember. Converting  cubic feet to liters would fall into this category. The unit-canceling method  is helpful in performing this kind of problem because it uses many easily remembered conversions that relate the original units to the final units, as follows: 1 foot 12 inches1 inch 2.54 centimeters1,000 cubic centimeters 1 liter Using these steps, you can express feet to centimeters as: Distance in cm (distance in ft) x (12 in/1 ft) x (2.54 cm/1 in)Distance in cm (distance in ft) x 30.48 cm/ft Convert these distances into volume measurements of cm3 and ft3: Cube volume (linear measurement)3, so:Volume in cm3 [(distance in feet) x 30.48 cm/ft]3Volume in cm3 (volume in ft3) x 28316.85 cm3/ft3 Convert cubic centimeters to liters: Volume in liters (volume in cm3) x (1 L/1,000 cm3)Volume in liters (volume in cm3)/1,000 L/cm3 Insert the cubic volume from the previous step: Volume in liters [(volume in ft3) x 28316.85 cm3/ft3)]/1,000 L/cm3Volume in liters (volume in ft3) x 28.317 L/ft3 Now you have your conversion factor of cubic feet to liters. Insert 1 cubic foot into the volume in ft3 part of the equation: Volume in liters (1 ft3) x 28.317 L/ft3Volume in liters 28.317 L Therefore, one cubic foot is equal to 28.317 liters of volume. Liter to Cubic Feet Example The conversion factor works the other way, too. For example, convert 0.5 liter to cubic feet. Use the conversion factor 1 cubic foot 28.317 liters: Cubic feet (0.5 liter) x (1 cubic foot / 28.317 liters) The liters cancel out on the top and bottom, leaving you with 0.5 / 28.317, and giving an answer of 0.018 cubic feet. Tips for Success The key to working the unit conversion correctly is to make certain the unwanted unit cancels out and leaves the desired unit. Its also worthwhile to keep track of significant digits. Remember there are about 28 liters in a cubic foot. If youre converting from cubic feet to liters, expect to get a larger number than you started with. If youre converting from cubic feet to liters, your final answer will be a smaller number.

50 Common Chinese Proverbs

50 Common Chinese Proverbs Chinese proverbs (è « ºÃ¨ ªÅ¾, ynyÃ… ­) are popular sayings taken from literature, history, and famous people such as philosophers. The expressions are often used colloquially as statements of wisdom or advice. There are hundreds of Chinese proverbs addressing all aspects of life, from education and work to personal goals and relationships. Key Takeaways: Chinese Proverbs Chinese proverbs are common sayings that express popular wisdom or advice.Some Chinese proverbs are taken from works of literature or philosophy. Books and Reading After three days without reading, talk becomes flavorless. - Reading helps people to stay in touch with interesting ideas. A book is like a garden carried in the pocket. - Reading helps people to grow intellectually. A closed mind is like a closed book; just a block of wood. - You cannot learn if you have a closed mind. Its better to be without a book than to believe a book entirely. - It is important to think critically rather than believe everything you read. A single conversation with a wise man is worth a month’s study of books. - Wisdom is sometimes more important than knowledge. Education and Wisdom If a son is uneducated, his dad is to blame. - Fathers are responsible for their childrens education. A jade stone is useless before it is processed; a man is good for nothing until he is educated. - Education is what turns people into productive human beings. Learning  is a weightless treasure you can always carry easily. - Unlike material goods, your education is something you always take with you. Teachers  open the door. You enter by yourself. - Education is not a passive process; to learn, you must desire to learn. True knowledge is when one knows the limitations of one’s knowledge. - It is important to recognize the limits of your education. Children and Family Vicious as a  tigress  can be, she never eats her own cubs. - A mother never hurts her children, even if she is strict. Govern a  family  as you would cook a small fish- very gently. - Do not be harsh in how you treat your family. To understand your parents love you must raise children yourself. - Only parents know what it is like to raise children. A child’s life is like a piece of paper on which every person leaves a mark. - Children are very impressionable. Giving your son a skill is better than giving him 1,000 pieces of gold. - It is better to support your child with education than money. Fear One cannot refuse to eat just because there is a chance of being choked. - You cannot let fear stop you from living your life. Clear conscience never fears midnight knocking. - If you live according to your conscience, you wont be troubled by guilt. Once bitten by a snake, he/she is scared all his/her life at the mere sight of a rope. - Trauma causes people to fear things that they have no reason to fear. Friendship With true friends, even water drunk together is sweet enough. - True friends only need each others company to enjoy themselves. Do not use a hatchet to remove a fly from your friends forehead. - Be gentle when criticizing your friends. Happiness If you want happiness for a lifetime; help someone else. - Happiness comes through helping others. A smile will gain you 10 more years of life. - Staying positive will improve your health. One joy scatters a hundred griefs. - It only takes a small amount of happiness to bring great relief. Better the cottage where one is merry than the palace where one weeps. - It is better to be poor and happy than rich and miserable. We count our miseries carefully, and accept our blessings without much thought. - We often take our blessings for granted. Patience You wont help shoots grow by pulling them up higher. - Some things happen slowly and there is nothing you can do to speed them up. A dish of carrot hastily cooked may still have soil uncleaned off the vegetable. - Take your time and do things properly rather than rushing and making mistakes. A journey of a thousand miles begins with a single step. - Big goals are achieved through many small actions. Patience  is a bitter plant, but its fruit is sweet. - It is not easy to be patient, but patience will reward you. If you are patient in one moment of  anger, you will escape a hundred days of sorrow. - Keeping a cool head will help you avoid trouble. Personal Development A fall into a ditch makes you wiser. - Mistakes are opportunities to learn. Be not afraid of growing slowly, be afraid only of standing still. - Slow growth is better than stagnation. Before preparing to improve the world, first look around your own  home  three times. - Work on improving yourself before trying to improve others. A man grows most tired while standing still. - It is better to remain active than do nothing. When the winds of change blow, some people build walls and others build windmills. - Personal challenges can be opportunities for growth. The more you sweat in practice, the less you bleed in battle. - Preparing for challenges in advance will make it easier for you to meet them. All things are difficult before they are easy. - Nothing is easy the first time you do it. Better a diamond with a flaw than a pebble without one. - It is better to be ambitious and sometimes fail than to never try to do anything at all. Precautions Bad things never walk alone. - Troubles always come with other troubles. There are always ears on the other side of the wall. - Be careful about what you say; other people are always listening. When you are poor, neighbors close by will not come; once you become rich, youll be surprised by visits from (alleged) relatives afar. - When you have something people want, everyone will try to be your friend. Teamwork   Behind an able man, there are always other able men. - No one accomplishes anything alone. Three humble shoemakers brainstorming will make a great statesman. - Teamwork allows people to do much more than any one person could do on their own. Only when all contribute their firewood can they build up a strong fire. - It takes a group of people to build something that will last. Time An inch of time is an inch of gold but you cant buy that inch of time with an inch of gold. - Time equals money but money does not equal time. Age and time do not wait for people. - If you wait to get started, life will go on without you. The best time to plant a tree was 20 years ago. The second best time is today. - It is best to start a project as soon as you can. Do everything at the right time, and one day will seem like three. - Keeping an organized schedule will make you more productive. Persistence An ant may well destroy a whole dam. - What seems like a small amount of work adds up over time. A man who cannot  tolerate  small misfortunes can never accomplish great things. - You must learn to deal with setbacks if you want to achieve big goals.

Management research project Paper Example | Topics and Well Written Essays - 3500 words

Management project - Research Paper Example The paper will critically evaluate how human resource in the bank incorporates strategies and policies to better handle and nurture diversity within its workforce. Research Objectives The broad objective of the study is to find out how OCBC handle the issue of its diverse workforce. The three specific objectives of the study are: To establish how diverse the workforce in OCBC is. To find out the existing strategies and policies employed by the human resource management regarding diverse workforce To examine the challenges brought about by a diverse workforce Research Question How diverse is the OCBC workforce in Singapore? What are the existing strategies and policies used by the human resource management in handling diversity in its employees? What are the challenges brought about by a diverse workforce Research Methodology Both qualitative and quantitative research design will be utilized as they will cover the broad aspects of the study and enable a concrete conclusion and recomme ndation to be drawn. The tool used to collect data includes both primary and secondary sources. Questionnaires as well as interview guides will be distributed to OCBC employees and the human resource department respectively as they are the target population. Data will be analyzed using SPSS and presented descriptively using tables, charts and graphs. Random and careful biased sampling will be used to arrive at the desired sample Literature Review It has been argued that human or workforce is the most important asset that dictates the future of any organization, OCBC Bank in Singapore not being an exception. According to Boxall & Purcell, 2008 workplace diversity has been defined severally but one definition adopted is; variety of differences and uniqueness among and between individuals within an organization. The concept entails issues relating to of age, sex, religion, ability, disability, race, ethnic groups, color, nationality and even sex orientation, educational background, job title to mention but a few. If the HR have in place best strategies and policies to nurture diversity, the results are better as it helps in increasing adaptability, widening service range, more effective way of executing duties as well as bring a diverse ideas that can yield the desired satisfaction to customers hence propelling the organization to greater heights (Katharine, et al 1995). On the other hand, there are challenges brought about by a diverse workforce and this include resistance to change, hindrance on implementation of diversity in place of work polices, difficulties in sharing information Company background OCBC is the longest operating bank in Singapore having been established in 1912. Today, OCBC has been ranked by world analysts as the second largest financial services group in Southeast Asia, most highly-rated bank and one of the world’s strongest bank ( OCBC Annual Report 2010). OCBC provides financial services

The property and financial difficulties of a divorced couple Case Study

The property and financial difficulties of a divorced couple - Case Study Example Divorce has always been a complex and controversial subject for couples. For the most part, the issues concerning property, pension or children complicate relationships and adversely impinge on families including the children. The case of Jenny and Ted is not different compared to others who had to deal with the issue of property during or after the divorce is filed. However, if amicable settlement is not reached by the couple, the laws in the United Kingdom with regards family, divorce and property are very clear on this issue.First the Matrimonial Causes Act 1973 sets out the foundation for divorce and is also the major law England and Wales which stipulates the creation of ancillary relief -the financial payment to a marriage party after a couple files for a divorce, nullity of marriage or separation. The claimant of the ancillary relief should present her claim (in this case, Jenny) to a court in England or Wales in order for the court to resolve pecuniary issues which arise from the divorce. 1This is specified in Section 23 & 24 of the Matrimonial Causes Act 1973 which states that the court is empowered to create financial and property provision orders when a couple is granted a divorce. This provision indicates that a party to a marriage shall pay, in forms of securities, bonds or share, or in unsecured lump sums, the other party. Section 24 of the aforementioned act likewise gives the courts in England and Wales the power to order the sale of property which is intended for ancillary relief. The courts in England and Wales have been given this authority since 1970's which bestow them the powers to transfer ownership of property and order a party to make payments to the other party. This authority requires that the courts must assess whether the pecuniary relationship between the couple must be ordered immediately ceased or terminated. 2Payment to the other party in a marriage is ordered by the court in a form of maintenance or in a form of a clean break order which bars the litigant from making further claims in a form of ancillary relief. This payment is also referred to as maintenance orders which can be given to the other party on 'nominal basis' or specific terms. However, the court can review this order any time so as to match the ongoing adjustments in financial ability of the parties who filed for a divorce. The terms and particular dates and arrangements for maintenance orders are usually specified by the courts (Kempton & Theobold 2001). Other various orders which the court can create on their discretion and ones which are contextually related to the family law include Property Adjustment Order in which the courts are given a wide discretion on how the property will be divided and in what shares. The court also has the power to order the auction of the matrimonial home of the couple. Furthermore, a variety of options are open to the courts of England and Wales in order to settle dispute on property. These factors are listed on Section 25 of the Matrimonial Causes Act 1973 so that the courts may serve well and judiciously the interest of both parties in a marriage or serve the best interest of the children. The possible orders that courts can make are in fact limitless and they are created in specific circumstances (Kempton & Theobold 2001). The idea of fair and equal distribution of property has its precedence on the landmark cases decided by courts of England and Wales or the House of Lords. One such case is the famous White v White 2001 in which the House of Lords ordered a controversial redistribution of the couple's finances and property after the divorce. Lord Nicholls, a member of the House has set precedence in his speech which would later on specify the acts with regards division of assets. Nicholls stated in his speech that in all cases, judges must practice judiciousness and ensure their provisional judgment (on assets distribution) regarding the "yardstick of equality of division". This does not mean

Helicobacter pylori (Microbiology CS3) Case Study

Helicobacter pylori (Microbiology CS3) - Case Study Example It is also believed to be the etiologic agent for peptic ulcers, gastritis and other gastric disorders (Mobley, Mendz and Hazell, 2001). H. pylori produces several key enzymes that enable it to survive in the host. The enzyme, urease, catalyses the breakdown of urea, which is abundantly available in the stomach, into ammonia and bicarbonate (Helicobacter Foundation, 2006). The resulting ammonia surrounds the bacteria, proving a basic (low pH) environment that protects the bacteria from stomach acid. Another enzyme, superoxide dismutase, protects the bacteria from being killed by macrophages and polymorhonuclear leukocytes by breaking down the dismutase produced by them (Mobley, Mendz and Hazell, 2001). Catalase protects the bacteria from hydrogen peroxide produced by phagocytes (Mobley, Mendz and Hazell). According to the Centers for Disease Control and Prevention, H. pylori infection afflicts almost two-thirds of the entire population of the world (CDC, 2005). Developing countries have a higher incidence of H. pylori infection than developed countries (Mobley, Mendz and Hazell, 2001). The infection is more prevalent among lower socio-economic groups and in older adults (CDC, 2005). In the US, Hispanics and African Americans are found to be the most affected (CDC, 2005). The rate of acquisition of the infection differs greatly, both within and across countries (Mobley, Mendz and Hazell, 2001). The bacteria first adhere to the mucin in the epithelial cells of the gastric mucosa (Mobley, Mendz and Hazell, 2001). By altering the rheological properties of the mucus gel, the bacteria coats the lining of the stomach wall (Celli et al. 2009). It then generates a cloud of ammonia around itself to achieve low pH for protection from stomach acid. The ammonia is produced by the hydrolysis of urea. The bacteria also produces phospholipase A that degrades cell membranes by breaking down phospholipids (Mobley,

Electronic money challenges and solutions Essay

Electronic money challenges and solutions - Essay Example As Bill Gate, the founder of Microsoft puts it: E-payment or electronic payment is a technique of making transactions over the internet or some other electronic system. The transaction takes place in the form of secure data transfer from one end to the other. The greatest advantage of an e-payment based transaction is the speed with which the transaction gets completed. Other benefits include the ease with which the transaction can be completed; the users do not have to be physically present to make these transactions and in fact, both buyers and sellers can meet in the electronic market to make electronic transactions using electronic money. There are various forms of e-payment systems that are in use nowadays. These include credit cards, debit cards, online transfers, wire transfers, e-money like Pay Pal, and other modes through which people make payments over the web. Most of these systems are based on a ID and password system to protect against unauthorized usage. With an increase in the magnitude of online applications and systems, there is a growing threat of security issues, vulnerabilities and exposure on the use of electronic transmission, and internet based systems. This has been a concern for companies, individuals, government and law enforcement agencies. Doing transactions online means making payments for the goods and services that are purchased; this leads to a need for developing a mechanism to make these 'e-payments'. This further translates into developing and implementing a security process to ensure that these transactions are carried out keeping the confidentiality, integrity and availability of the systems intact. An e-transaction is as susceptible to fraud as any other transaction, if not more. The fraudsters are many in the electronic world, are dispersed all round the globe, have update knowledge and expertise about the systems and computers, and are attacking to gain access to, and in many cases, to use the identity, fun ds and communication of a person in illegal, unethical and undesired way. 2.1 Security Issues for E-Money and E-Payment Systems Security of electronic money refers to establishing the confidentiality, integrity and availability of information when it is passed through the electronic system. Some security requirements for an electronic money transfer system are outlined below (British Standards, 2006, p.3): Confidentiality - ensuring that information is accessible only to those authorized to have access to it. Integrity - safeguarding the accuracy and completeness of information and processing methods Availability - ensuring that authorized users have access to information and associates assets when required Authenticity - information should be available to sender and recipient, who must prove their identities to each other Non-repudiation - assurance/ proof that the transmitted message was indeed received (ECD, 2007). 3. Key Challenges and Recommendations for Electronic Payment Systems A description of specific risks and challenges of online transactions is provided below. 3.1 Privacy and

Evaluation of a Business Code of Ethics Essay Example | Topics and Well Written Essays - 1250 words

Evaluation of a Business Code of Ethics - Essay Example And to manufacture them in a socially responsible way† (IKEA Services, 2004). Locally and globally the company does not hesitate to declare its devotion to values like trust, integrity and honesty. Another plausible statement can be found in IKEA’s Code of Conduct, the IWAY Standard (IKEA Supply, 2008). It is firmly stated there that â€Å"we can do good business while being a good business†. Thus, within the business environment and activities of the company one can find ethical messages like â€Å"better living† and â€Å"socially responsible way† while in its ethical code (the IWAY) the message is about being and doing a good business. The IWAY is based on international conventions and declarations like the United Nations Universal Declaration of Human Rights (1948), the Fundamental Principles of Rights at Work, ILO declaration (1998), the Rio Declaration on Sustainable Development (1992) and the Ten Principles of the United Nations Global Compact (2000). Marcoux (2008) agrees that a â€Å"common approach in international business ethics is to refer to or to construct lists of norms that ought to guide transnational business conduct†. ... ) diversifies these principles by adding the features of a duty-driven ethical system to the code of ethics Following IKEA’s business operating network structure the IWAY is a Code of IKEA directly with its suppliers (contractors). It is about what a supplier should do in the right way. Suppliers are responsible for communicating the content of the IKEA code of conduct to sub-contractors and workers. Relations to applicable law and regulations are at the core center of the subject. Workers or as Ikea familiarly calls them â€Å"co-workers† and managers are not directly addressed. Trade unions are only mentioned, while nothing is related to civil groups and voluntary organization and to religious topics. The development of a company’s code of ethics can be motivated by the sole requirement of life and human experience or by personal moral values and national cultural traditions. Working in favor of social responsibility can be a basic value in the behavior of grou ps and individuals. Prior to the current state of affairs Friedman in his article â€Å"The Social Responsibility of Business Is to Increase Its Profits† (1970) rigorously raises a discussion on the topic of the "social responsibili ­ties of business". He argues that social responsibilities are of the individuals and not of the business. There he reminds about his book â€Å"Capitalism and Freedom† (1962), where the author postulates that "there is one and only one social responsibility of business–to use its resources and engage in activities designed to increase its profits". Amazingly contrasting to this position appear IKEA’s guiding principles for working in the interest of the child, the worker and the environment. Implementation of a Code of Conduct may be driven by international agreements and by

Electronic money challenges and solutions Essay

Electronic money challenges and solutions - Essay Example As Bill Gate, the founder of Microsoft puts it: E-payment or electronic payment is a technique of making transactions over the internet or some other electronic system. The transaction takes place in the form of secure data transfer from one end to the other. The greatest advantage of an e-payment based transaction is the speed with which the transaction gets completed. Other benefits include the ease with which the transaction can be completed; the users do not have to be physically present to make these transactions and in fact, both buyers and sellers can meet in the electronic market to make electronic transactions using electronic money. There are various forms of e-payment systems that are in use nowadays. These include credit cards, debit cards, online transfers, wire transfers, e-money like Pay Pal, and other modes through which people make payments over the web. Most of these systems are based on a ID and password system to protect against unauthorized usage. With an increase in the magnitude of online applications and systems, there is a growing threat of security issues, vulnerabilities and exposure on the use of electronic transmission, and internet based systems. This has been a concern for companies, individuals, government and law enforcement agencies. Doing transactions online means making payments for the goods and services that are purchased; this leads to a need for developing a mechanism to make these 'e-payments'. This further translates into developing and implementing a security process to ensure that these transactions are carried out keeping the confidentiality, integrity and availability of the systems intact. An e-transaction is as susceptible to fraud as any other transaction, if not more. The fraudsters are many in the electronic world, are dispersed all round the globe, have update knowledge and expertise about the systems and computers, and are attacking to gain access to, and in many cases, to use the identity, fun ds and communication of a person in illegal, unethical and undesired way. 2.1 Security Issues for E-Money and E-Payment Systems Security of electronic money refers to establishing the confidentiality, integrity and availability of information when it is passed through the electronic system. Some security requirements for an electronic money transfer system are outlined below (British Standards, 2006, p.3): Confidentiality - ensuring that information is accessible only to those authorized to have access to it. Integrity - safeguarding the accuracy and completeness of information and processing methods Availability - ensuring that authorized users have access to information and associates assets when required Authenticity - information should be available to sender and recipient, who must prove their identities to each other Non-repudiation - assurance/ proof that the transmitted message was indeed received (ECD, 2007). 3. Key Challenges and Recommendations for Electronic Payment Systems A description of specific risks and challenges of online transactions is provided below. 3.1 Privacy and

An equal opportunity of Homosexuality through history Essay

An equal opportunity of Homosexuality through history - Essay Example isms, the homosexual community is often described as marginalised and vulnerable since they are at high risk of coping with psychosocial problems in relation to both actual and anticipated reactions of fear from the people around them. The homosexuals may be also prone to harassment, physical and verbal attacks, and the risk of being exposed to having an HIV infection, and STD particularly for the male homosexuals (Clermont & Durand, 1997, p.8). This paper seeks to discuss an issue concerning homosexuality particularly with regard to the health and social care of homosexuals. Furthermore, this seeks to evaluate the impact of historical and contemporary beliefs of homosexuality from an anti-heterosexist perspective. Empirical studies on homosexuality only began in the late 20th century regardless of the number of case studies and theoretical writings conducted particularly with regard to its treatment (Morin, 1977, p.630). Contemporary beliefs on gays and lesbians were greatly changed and influenced due to the pioneering studies that centered on homosexuality. Among the most influential of these pioneering studies were probably those of Martin, Kinsey, and Pomeroy whose works have demonstrated the extensive presence of homosexual behaviour contrary to what most people previously believed in (1948 cited in Morin, 1977, p.630). In the early times, most psychologists and psychiatrists believed that homosexuality is associated to a mental disorder (McConaghy, 1993, p.127). Other scholars considered it as a symptom of emotional disorder while others regard it as one of the severe disorders of intelligence and personality (Hooker, 1957; Curran, et al., 1980 cited in McConaghy, 1993, p.127). These beliefs, however, may imply a liberal approach or attitude toward homosexuality considering that its long history of moral and legal beliefs was perceived to be as unnatural and criminal. Above all, its existence in traditional societies is usually cited as the common

Traumatic Experiences Faced by Tina Essay Example for Free

Traumatic Experiences Faced by Tina Essay 1.1 Traumatic experiences As a result of her mother’s commitment to her marriage, Tina may experience a wide range of traumatic experiences. As a teenage girl she is predisposed to being violated by the ‘step’ male relatives that she’s living with. In this sense, she faces emotional, physical and psychological abuse at the hands of extended family (Finkerlhor Browne; 1985). The type of foreseen traumatic experiences is mostly aggravated by Tina’s profile and situation in the family. Being a step daughter, whose mother constantly wants to make an effort to embrace the union places her in a disadvantaged angle where either one of her step family members may find her either as a threat or an accessory that can be utilised to his advantage. Looking at this scenario, one cannot rule out the huge possibility being of a sexual nature, this is due to the contemporary social behaviour within family units, where children have become ‘accessories’ to utilise for adults pleasure. Tina’s mother and her new union could be the beginning of Tina’s worst nightmare. A chain of traumatic events could arise from just one form of abuse, for arguments sake let’s take sexual abuse and unpack it to its worst possible chain of events. After being sexually abused by either one of her step family members, Tina’s could contract a sexually transmitted disease; she could fall pregnant and maybe be forced to go through an abortion because of fear of stigma and lack of support from her mother and extended family. Alternatively, Tina could end up deciding to commit suicide due to feeling trapped, alone and depressed. 1.2 1.2.1 Effects of Child Abuse Child abuse has been conceptualised by a lot of scholars in various ways, this has either distorted or diminished the intensity of its effects in children. I feel that how one conceptualises child abuse should capture the exact effects and aggravated meaning it holds for its sufferers. This is a broad concept that when narrowed gives birth to various other concepts that encompass children’s victimization. Hence, for the purpose of Tina’s case, I have adopted the meaning that was captured in a study conducted within the Nigerian region. This not only gives Tina’s story relevance but it also engages with the same factors that affect an African teenager within the boundaries of a family unit is subjected to. Hence Akhilomen sees child abuse as ‘an intentional or neglectful physical or emotional injury imposed on a child’ (2006). As mentioned above, Tina could be perceived as a threat or an outsider by either one of her ‘step’ family members and that could lead to emotional and physical abuse such as neglect, she could be rejected and side-lined by her family members. As culture dictates, women are expected to leave their ‘a bustard† child with their families when they start new families, Tina is then automatically subjected to such unspoken discrimination within the family. She may be at a disadvantage of favourism of the brother because he is the husband’s son; this making it an emotional injury and also the possibility of verbal and physical abuse arises. Children who suffer abuse within families are said to show certain behavioural traits in society or any other groups they were initially involved in before the abuse. Suffering from the above-mentioned forms of abuse could raise feelings of sadness, anger, betrayal, unworthiness and children will soon be withdrawn from social scene (Finkerlhor Browne; 1985). 1.2.2 Effects of Sexual abuse â€Å"The National Centre on Child Abuse and Neglect (NCCAN) describes sexual abuse as contacts or interactions between a child and an adult when the child is being used for the sexual stimulation of the adult† (Kempe Kempe; 1987 in Schoeman; 2013: 63). This conceptualisation finds relevance in Tina’s case as she is used for her step brother’s stimulation and benefit for sexual pleasure. Sexual abuse has four traumatic impacts in a child’s life; these are discussed from a clinical and socio-cultural view. Finkelhor and Browne (1985) came up with a conceptualization that could be used in research and treatment of sexual abuse victims. This is targeting people in pastoral roles away from the family unit where children are exposed to these stressors; in this case Tina confiding in her teacher is the first step to acknowledging teachers as social activists. These are labelled as the four traumagenic dynamics and they are impacts that alter children’s cognitive and emotional orientation to the world and create trauma by distorting children’s self-concept, world view and effective capacities (1985). †¢ Traumatic sexualisation Refers to a process in which a child’s sexuality is shaped in a developmentally inappropriate and interpersonally dysfunctional fashion as a result of sexual abuse. This stage consists of feelings towards the offender; it affects the ‘trust’ aspect of the relationship as this case is an intra-familial encounter. This is where more behavioural signs are seen, Tina will feel a disruption in her normal mental functioning. She will seem sad, confused and eventually she will withdraw from her ‘normal’ self. This is the first sign that people close to her will be able to notice a disruption in her life. †¢ Powerlessness Powerlessness impairs a child sense of efficacy, a reaction to this stage will be fear and anxiety and total loss of control in situations that resemble the abuse (Finkerlhor Browne; 1985) (Schoeman; 2012-2014). As noted in the scenario, Tina already feels like going back home is like being in a trapped hole where she has no control over what happens to her. She fears for her life, she feels more like an object to her brother than a family member †¢ Betrayal This refers to a stage in a victim’s life where a number of reactions are noted, during this stage, they suffer feelings of grief and depression. This is coupled with feelings of hostility and anger in young girls of Tina’s age. Distrust may manifest itself in isolation and fear and resentment of males which at a later stage affects their ability to engage in healthy heterosexual relationships (Finkerlhor Browne; 1985). Tina’s feelings towards her mother; as the person that subjected her to this; she feels †¢ Stigmatization Lastly, given the feelings her mother has towards Tina and their previous experience with her father, Tina will most definitely be stigmatised by the family and initially her mother as she has dismissed her attempts to report the case. This will affect Tina’s ability to trust and depend on her mother as she has deliberately failed to protect her (Schoeman; 2012-2014). She will have feelings of resentment towards her mother as she will feel she subjected her to this; by constantly forcing her to make effort to accept her new family. This is validated by my initial statement about cultural expectations with bustard children; Tina will not get support from anyone in her circle of family as her mother will be accused of bringing this misfortune to herself. These negative connotations will not only affect the mother but Tina as well as these feelings are associated with suicide attempts and other self-destruction behaviours. 1.3 Maslow’s Hierarchy of needs Fig 1.3.1 [pic] †¢ Safety Needs Tina’s sexual abuse has distorted her normal view and perception of the world and the people in it. This has ‘burst her safety bubble’ she no longer feels safe in anyone’s company because her mother, being the one person to protect her has failed to do so. This has crashed her emotional and psychological link to the mother and world she looks up to. †¢ Love/Belonging Feelings of powerlessness and betrayal have left her feeling that she does not belong anywhere in the world. People whose love needs have been destroyed lose their sense of being worthy and belonging to society and hence the sky rocketing statistics of suicide amongst teenagers of Tina’s age (McLeod; 2007). Tina may feel that her mother’s pressure to make an effort to the family has caused her all this pain and trauma and she may conclude that she does not love her or she chooses her new family instead of her. This eventually leads to rejection and feelings of worthlessness. This will affect her ability to engage in healthy heterosexual intimate relationships as she grows older, her ability to establish and maintain friendships will also be affected as she loses trust in people. †¢ Esteem Needs A child whose esteem needs have been destroyed will find difficulty perceiving herself as a normal worthy and valued individual. It affects person from obtaining a higher level of self-esteem or self-respect (McLeod; 2007).Children who are sexually abused usually turn to worse measures to deal with the inadequacy they feel inside. SECTION 2 2.1 Counselling versus Support for Learning Problems †¢ Counselling Defined as a facilitative process where the counsellor uses specific skills to help young people help themselves more effectively (Gillis; 1997). This facilitative process entails giving ‘common sense’ advice and it extends the teacher-learner, parent-child relationship. Counselling is a more emotional than logical process of problem solving, in this sense, the counsellor has to be more aware of the children’s’ perspective of things and be able to come up with an interactive plan to help that child cope and solve the problem at hand. Counselling provides the child with a chance for growth and change. In this instance, Tina needs her teachers, peer educators and mostly her mother to help her find a way to address and deal with the abuse in her life. †¢ Counselling versus Learning Problem âž ¢ Conceptualization: Learning problems refer to the difficulty faced by children in partaking to academic/educational activities. These may be unpacked as limitations to comprehension of study content as well as reading and writing (Schoeman; 2012-14). This is characterised by the inability to engage in class activities or carry out academic tasks like other children, these are then regarded as learning problems which; given the availability of professional help, the teachers may have to intervene and help. Counselling is a facilitative process where the counsellor uses specific skills to help young people help themselves more effectively (Gillis; 1997). This facilitative process entails giving ‘common sense’ advice and it extends the teacher-learner, parent-child relationship. Counselling is a more emotional than logical process of problem solving, in this sense, the counsellor has to be more aware of the children’s’ perspective of things and be able to come up with an interactive plan to help that child cope and solve the problem at hand. âž ¢ Order/Method of Practice The approach or method of addressing these two roles differs regarding the needs of the child as well expectation of performance from the person in the pastoral role. Counselling entails the use of emotional relations into facilitation to helping the children become better problem solvers. There are certain skills that are required from the person who takes on the counselling role. This then dictates the order or manner in which the counsellor can create a condusive environment for the children. In these one may include the categories for counselling responses. These are namely; evaluating, interpreting, supporting/reassuring, questioning/probing, advice, communication, verbal and non-verbal responses and silence. These are all broken down to give a scope of the ‘know how’ of counselling. Learning support is a different ball game when it comes to going about it. Here the teacher has to take into consideration the state of being of the child, have full understanding of the problem and its dynamics. Schoeman (2012-2014) provides a list of guidelines that teachers are to follow in order to effectively assist children with learning problems. These guidelines are as follows: keep sessions short, meet regularly with the learner, sessions should be highly structured, keep anxiety levels at minimum, focus on specific issues being addressed and keep morale high. 2.2 Trauma and its Effects on Tina’s life Trauma implies intense emotional wounding that may comprise of bodily wounds, it entails the wounding of a person’s emotion, spirit, will to live, beliefs about themselves and the world, dignity and sense of security (Matsakis; 1996 in Schoeman; 2012-2014). It refers to â€Å"any negative event that causes an individual to re-experience an earlier traumatic event so that the current event somehow becomes as traumatic as, or at least strongly reminiscent of, the earlier event must itself be regarded as traumatic† (Urman, Funk Elliot; 2001:403-4). The trauma suffered by Tina is unpacked to various stages of response and feelings, amongst these, one has noticed recurring processes as to those described for the purposes of sexual abuse, and as a result, this section will only address the retaliation feelings from Tina. In this sense, Tina’s story will be addressed according to Lewis’ three traumatic phases of response (1995:15-16). These are namely the impact phase, the recoil phase and the re-integration phase. †¢ Impact Phase This stage can last from a few seconds to days immediately after the trauma, Matsakis continues to state that the victim may appear emotionally disorientated, confused irrational and disorganised (1996:34-5). At this point Tina will need comfort and reassurance from her adult figures and pastoral actors such as her teachers. At this stage assurance, comfort and love are the key things she needs from people around her. †¢ Recoil Phase According to Lewis, this is the reality phase (1995:15). Tina will experience feelings of sadness, guilt and anger. At this point in her life, Tina will have developed feelings of post-traumatic stress resulting from a constant reminder or reality and flashbacks from her sexual incident. †¢ Re-integration This phase holds Tina captivated in her own mental and psychological body as she eventually assimilates this horrible experience as part of her life. She however slowly learns to reintegrate herself with people, this is her body’s way of trying to heal and overcome the traumatic experience. Here she will show enthusiasm to reconnect with people the way she did before the trauma (Lewis; 1999:16). 2.3 Parental Involvement versus Parental Counselling It has been established that children who suffer any form of abuse need the support of their elderly people to overcome the effects of the traumatic experiences. Amongst the people who can provide this form of support are parents and teachers. As a result it is important to note the angle in which parents can be included in the programs for assisting children. âž ¢ Parental Counselling This form of support is addressed to the parents as primary caregivers to the children with learning difficulties. In this support programme parents are taught how to handle and give support to their children as a form of partnership with the teachers in managing the problem a child may be facing. The focal point lies in this form of problem being intrinsic and more emotional for both the parent and child. In some cases parents suffer from ignorance and fail to understand or even identify the problem (Schoeman; 2012-2014). It is in this sense that parental counselling becomes useful. âž ¢ Parental Involvement Parental involvement need not only to be for the formal meetings with the school authorities but Schoeman (2012-2014) notes that parents should be involved in all that involves their children within the school. Amongst these activities; school learning and intervention programmes, they should be involved in teaching their children in particular skills that can be useful to their development. Their involvement in cultural and sport activities not only benefits the child but the entire school benefits from an involved parent. 2.4 Tina’s Intervention It is important for school teachers to be familiar with the mandated reporting laws and know to what agency they should report suspected sexual abuse (most often, Child Protective Services). To prevent Tina from feeling betrayed after she has confided sexual abuse, teachers must first get approval from the child to get the authorities and other institutions involved to resolve the matter. Remedial intervention comprises of six principles of practice (Schoeman; 2012-2014). In these the teacher will have to design a detailed and proper planned learning strategy for Tina. Tina needs patience as a result; I find it relevant to employ attention to basic skill, motivation and evaluation principles into practice. In this I feel helping Tina will require more time in between school breaks and maybe after classes to establish a proper workable strategy for individual treatment. The first step to reporting this incident will be to alert the school support system and the governing body of this situation. This will happen with Tina’s consent. The school governing body and committee will then summon Tina’s mother to school to make her aware of the problem as well as of Tina’s attempts to report the abuse. After this meeting, a decision to further report the police will be tabled and a decision will be reached to act in the benefit of the victim. After the formalities have been dealt with, Tina and her mother will be taken to a community wellness centre for children and get counselling as they have to get help with living beyond this abuse. Tina will continue to get remedial treatment in class until she shows signs of reintegration. Reference list Akhilomen, D.O (2006) Addressing Child Abuse in Southern Nigeria: The role of the Church. Studies in World Christianity, Vol 12(3) pp235-248. Available at http://muse.jhu.edu/login?auth=0type=summaryurl=journals/studies_in_world_ch.. [Date Accessed 10th August 2013] Finkelhor, D Browne, A ( 1985) The Traumatic Impact of Child Sexual Abuse: A conceptualisation. American Journal of Orthopsychiatry, Vol 55(4). Available at http://univerityofnewhemisphere.ac.za. [Date Accessed 10th August 2013] Harley, K., Barasa, F., Bertram, C., Mattson, E. Pillay, S (2000) â€Å"The real and the ideal†: Teacher roles and competencies in South African policy and practice. International Journal of Education Development Vol 20(2000) pp 287-304. Available at http://ukzn.ac.za.[Date Accessed 10th August 2013] McLeod, S. A. (2007). Maslows Hierarchy of Needs Simply Psychology. Retrieved from http://www.simplypsychology.org/maslow.html Schoeman, S (ed) (2012-2014) The educator in a pastoral role. University of South Africa

The United Nations In The Cold War Era Politics Essay

The United Nations In The Cold War Era Politics Essay After the end of world war two the world called for the revision of the League of Nations especially after it had been casted in a negative light by the Soviet Union after they were evicted for attacking Finland in 1940 (Chung TK).The new international order became known as the United Nations and the Charter was signed in 1945 and allowed five states to be given veto power in the upper chamber of the UN known as the Security Council. The five states were China, US, the Soviet Union, France and Great Britain. Following world war two, the Security Council was given the task of determining if there is a breach of peace, a threat to peace or an act of aggression towards another country and to decide what course of action to take (The United Nations and the Cold War Collective Security). However, with mounting tensions between the US and the Soviet Union, the UN would face an uphill battle as it attempted to establish itself through the Cold war era. The Cold war era refers to the time period in which the Cold War took place. This era began in 1947 after the introduction of the Truman Doctrine and the Marshal Plan by President Truman (Chung TK). This was a time of tremendous turmoil between the communist nations lead by the Soviet Union and the democratic nations lead by the United States. The Cold War did not imply the same notions that previous wars had in terms of battles; this was a time of political conflict, military tension, and economic competition (Chung TK). The Cold War is marked by several different events of conflict such as the nuclear arms race, the space race and the rise of the Berlin Wall. The conflicts are deep rooted in conflicting ideology in terms of government, economy and the existence of a rivalry that is derived from those conflicting ideologies. The United States and the Soviet Union had two utterly different governments (Chung TK). The US which is democratic believes in free press, the right to assembl e and the right to elect government officials. The Soviet Union which is Communist, believes in a totalitarian form of government in which there is no election of officials, there is no right to assemble or freedom of press. They also had conflicting ideas about the global economy. The US wanted to open up trade to all nations however the Soviets wanted to shield themselves from international commerce. They felt the influence of the West would topple their totalitarian government (Chung TK). The Soviet Nation was ravaged after the Second World War and needed aid, however the Marshall plan required that nations applying for aid turn over their economic records and the Soviet Nation saw that as a threat to their privacy (Chung TK). The world was divided on two sides and the world began to see the need for a peacekeeping body. The founders of the UN had envisioned that the organization would act to prevent conflicts between nations and make future wars impossible. However, the outbreak of the Cold War made peacekeeping agreements extremely difficult because it divided the world into hostile camps (Peace: The Role of the United Nations). Up until the end of the Cold War, the UN only intervened in the majority of cases if the conflict involved two or more Nations. This is known as the principle of non-interference. The principle of State sovereignty was adhered to more than it is today which meant that individual nations were independent and could handle their own conflicts with other nations without the UNs intrusion (The United Nations and the Cold War Collective Security). With the onset of the Cold war, the seat on the UNs Security Council was more or less used as another power cushion. The purpose of the Security Council was to keep peace and because they were not able to do that amongst their own seat holding states, the UN was rendered insignificant or irrelevant (The United Nations and the Cold War Collective Security). The issue is that under this model of appointing five seats to the Security Council with decision making power- it assumes that all of those Nations are peaceful or peace loving nations and war is caused by occasional outbursts by a bad nation that is ill-advised (The United Nations and the Cold War Collective Security). If this were true it would imply that the world will always be more or less, a peaceful place because the superpowers could keep everything in cooperation. The dark side of this which was demonstrated through irony by the Cold war era is that if the superpowers cannot agree, there is no hope for conflict resoluti on (The United Nations and the Cold War Collective Security). This opens up the door to a difficult question: what can the world do in that situation? During the Cold war era, a separate incident regarding the Korean War brought forth the same situation. Communist North Korea, aided by the Soviet Union and China behind closed doors launched a blatant attack on democratic South Korea (The United Nations and the Cold War Collective Security). The UN condemned North Korea at the persuasion of the US and UN and US soldiers were sent to Korea to fight. Basically, South Korea was supported in the name of the United Nations. In essence, the Security Council Resolution on Korea gave the United States international authority on decision making (The United Nations and the Cold War Collective Security). This compromised the symbol and reputation of the United Nations. The Soviet Union was initially boycotting the Security Council because of the Korean Resolution but then it returned to its seat once they realized the United States was using the United Nations as a platform for to show the world that since the UN was agreeing with them, they were correct (The United Nations and the Cold War Collective Security). Once they returned, the ability for the Security Council to make a decision was virtually impossible because even the Council was used and split in to two sides. Also because the Secretary- General actively sided with South Korea on the issue, as he is legally allowed to do, he committed political suicide because he lost all credibility in the eyes of Moscow and the Soviet Union (Mingst and Karns). The United Nations is supposed to be neutral and act as a negotiating body of power through the collective efforts of world nations. All of the Secretary Generals have been careful to not take an outright side on an issue anymore so that the United Nations is not weakened (Mingst and Karns). The conflicts of the Cold war continued until about 1991 when the Soviet Union was dissolved and became Russia and the Berlin Wall came down in 1989. In the early years following the establishment of the United Nations, it struggled tremendously to gain credibility and become a true international diplomatic body of power (Mingst and Karns). The failure of the League of Nations did not do much to help it. The United Nations has evolved significantly to face the growing obstacles in the world and adapt to changing times (Weiss et al). The peacekeeping aspect of the UN was born at the time when Cold War rivalries paralyzed the Security Council regularly (The United Nations Peacekeeping). They were limited to maintaining ceasefires and stabilizing situations on the ground so that the governments could resolve the conflict through talks and negotiation efforts. By the end of the Cold war, the UN peacekeeping task force was changed dramatically (United Nations Peacekeeping). They expanded in the peacekeeping approach by making sure complex peace plans were implemented and followed through on. They also began to focus on human rights by monitoring and disarmament (The United Nations Peacekeeping). Over the next few decades, the United Nations created many different programs that are supposed to reduce all factors leading to outbreaks of conflict, as much as possible. These programs did not only focus on peace keepers, who intervene after a conflict has erupted, but also on economic and social development, human rights, and the struggle to end world poverty and hunger (Mingst and Karns). All of these United Nations programs contribute directly or indirectly to the prevention of conflicts and thus to peace on earth (Mingst and Karns). It is certainly true that, in the last 50 years, not everyone in the world has known peace, but it is gradually gaining ground. The dream of peace in the world is becoming less and less utopian and more and more attainable (Peace: The Role of the United Nations). In conclusion, since the failure of the League of Nations after world war two, the world saw the dire need for an international peacekeeping body as it attempted to rebuild whole nations devastated by the war. Thus, the United Nations was formed. However, in the infant stages of the United Nations, it was thrown into the spotlight because of the increasing hostility between the democratic United States and the communist Soviet Union. It was used as a political tactic by the United States to further its agenda and began to cause more conflict and strife between the sides. As a result, the realization that occurred was that if the worlds superpowers are not at peace, there is essentially no hope for peace. As a result of that, the UN evolved after the cold war and has begun laying the foundation for peace in different nations and attempts to keep the superpowers out of major problems to avoid another cold war type situation and maintain peace (Weiss et al). The battle was uphill to sin ce the creation of the UN charter and still continues to be today as well with all of the political strife and religious conflict that exists.

The Americans with Disabilities Act of 1990 Essay examples -- Disabili

The path to enacting the Americans with Disabilities Act (ADA) is the history of the disability rights movement and its struggle to attain a better chance for equality not unlike other minority groups. The Disability community came to realize that the problem they were fighting was discrimination. The Disability community came face to face with some of the same problems and challenges that every individual who is in the minority faces. However, a disabled individual was not considered to be in a minority therefore could not be afforded the protections under the Civil Rights Act. A growing sense of unrest or change in mood galvanized and empowered the Disability community to fight for its civil rights. Federal laws that were enacted prior to the ADA gave precedent for giving disabled individuals rights as a minority group under the Civil Right Act of 1964 such as the Rehabilitation Act of 1973 and the Fair Housing Act of 1988. The 60’s, 70’s and 80’s was a p eriod of growth for the Disability movement building its way to comprehensive disability rights legislation in incremental steps. President Franklin D. Roosevelt created the Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) programs to assist the aged and people with disabilities. The thinking concerning programs like SSI and SSDI near the time of enactment of the ADA was that these programs created â€Å"disincentives† for the disabled to enter into the workforce (NCD). In fact in administrations beginning with President Nixon’s administration programs were targeted such as these for deregulation. President Nixon vetoed the Rehabilitation Act in 1972 and signed a weaker version of the Rehabilitation Act in 1973. It took until 1978 in the ... ....com/ps/i.do?id=GALE%7CCX2687400149&v=2.1&u=cuny_baruch&it=r&p=GVRL&sw=w&asid=8cf19a43ddef5ea2cb064ded30e16f8e Gale Document Number: GALE|CX2687400149 â€Å"H.R. 2273--101st Congress: Americans with Disabilities Act of 1990.† www.GovTrack.us. 1989. December 1, 2013 http://www.govtrack.us/congress/bills/101/hr2273 â€Å"S. 933--101st Congress: Americans with Disabilities Act of 1990.† www.GovTrack.us. 1989. December 1, 2013 http://www.govtrack.us/congress/bills/101/s933 United States. Congress. House. Committee on Education and Labor. Legislative History of Public Law 101-336, the Americans With Disabilities Act: Prepared for the Committee On Education And Labor, U.S. House of Representatives, One Hundred First Congress, Second Session. Washington: U.S. G.P.O., 1990. The Disability Rights Movement: From Charity to Confrontation By Doris Zames Fleischer, Frieda Zames

Analysis on Automobile Industry Essay

Globalization had indeed left its impact on the automobile industry. Now foreign auto dealers were facing lesser restrictions to operate in overseas markets. Michael E. Porter in his book â€Å"Techniques for analyzing industries and competitors† dealt with five competitive forces that shaped all industries. This helped to analyze the intensity of competition which had an impact on the profitability of an industry. The US automobile industry was considered as a force to reckon with from the days of craft production and hence would serve as a standard use case to identify Porter’s five forces. With low level of entry barriers, the Big was facing increasing competition from foreign players like Toyota and Honda. The relationship among Porter’s five forces in the US automobile industry, detailed below clearly proved its’ competitive nature. 1. Threat of New Entrants – The existing loyalty to major brands, incentives for using a particular buyer, higher fixed costs, scarcity of resources, high costs of switching companies, and government regulations constituted the barriers to entry which in turn reduced the competition in an industry. The success of foreign car manufacturers like the Honda Motor Co. had disproved the general belief that the Big Three were invincible. The only factors expected to retard the growing significance of foreign auto dealers were the loyalty to American made vehicles and the after-sale services offered. 2. Power of Suppliers – The presence of very few suppliers of a particular product, and the absence of any substitutes for the product supplied reflected the pressure exerted by the supplier. Sometimes the product was extremely important to the auto-maker and the alternatives proved to be very costly. In such cases the suppliers were in a better position to dictate terms. A lot of suppliers depended on automakers to buy their products. But if the automaker decided to change suppliers it would badly affect the supplier’s role in auto manufacturing. 3. Power of Buyers – Small number of buyers, purchases of large volumes, prevalence of alternative options, and price sensitive customers were some of the factors that determined the extent of influence of the buyers in any industry. American consumers were driven towards foreign cars mainly because most of the auto-makers sourced their key auto-parts from different suppliers. But this raised doubts on the reliability of the vehicle itself. 4. Availability of Substitutes – If substitutes were available offering similar services, the likelihood of buyers switching over to another competitor depended mainly on the cost. The cost of the automobiles along with their operating costs was driving customers to look for alternative transportation options. The rising gasoline price was bound to influence the buyers. 5. Competitive Rivalry – The presence of many players of about the same size, little differentiation between competitors, and a very mature industry with very little growth were the features of a highly competitive industry. Higher the competition in the industry lower would be the profit margin. To remain ahead in competition, auto-makers were tempted to offer value added services to the customers incurring more costs. Easyfinance options and long term warranties were offered to lure the customers. But these measures cut into the profit margins. Thus the US automobile industry in the face of global competition from foreign firms was offering better deals to cater to diverse needs of customers SWOT Analysis An analysis of the fortunes of Ford, a global leader in the automotive industry based in Michigan, wielding significant influence since the inception of global automobile industry, would serve as a classic example to diagnose the strengths, weaknesses, opportunities and threats existing for auto-makers. Strengths †¢ Ford owned a vast array of brand names, which had world wide recognition and respect. Ford, Lincoln, Mercury, Mazda, Volvo, Jaguar, Land-Rover, Aston Martin were the famous vehicle brand names owned by the company. Ford Credit, Genuine Parts & Service and Motorcraft were its’ automotive service brands. †¢ Huge size of the business operations allowed Ford to reap the benefits of economies of scale. As of 2005, Ford’s distribution network spread over 200 markets across six continents, supported by an employee base totaling 300,000 and 108 plants worldwide. †¢ Business diversification initiatives of past decades helped Ford to focus on financing sector in addition to manufacturing, with the help of its subsidiaries. Most of the vehicles sold to dealers and distributors were financed by Ford Credit at wholesale rate. The diverse product line was another positive outcome of business diversification. As of 2005, Ford was the second biggest player in US with a total market share of 18. 2%. In Europe, the market share stood at 10. 8%. Weakness Ford’s large size could pose serious impediment to its efforts to adjust to the dynamics of global automobile market. Unlike its Japanese counterparts, Ford had to ride on heavy incentives to boost sales of models, which failed to catch the attention of consumers. Financial Constraints prevented Ford from channeling investments towards the manufacture of new models. Failure to control plant capacity also cut down the profit margin. Opportunities The opening up of Asian markets, wherein lied the potential for growth in commercial vehicle sales, offered a big opportunity to Ford in the near future. The big size and extended global reach, which some identified as a weakness, was helping Ford to become a major player in these markets. Meanwhile in the US, consumers in the higher income category were expected to spend more on high-end models more frequently. The growing trend in energy prices23 was paving the way for a huge market for full and medium sized SUVs and hybrid vehicles with better fuel economy. Despite losing the first mover advantage to Japanese auto-makers, Ford was making headway in this growing market. And in order to leverage on its brand image, efforts were on to differentiate brand identities to the potential consumers. By this initiative, Ford was trying to cut down its incentives. To check capacity issues, Ford made plans to close 10 plants and 30,000 jobs by 2008. Its ultimate aim was to boost capacity utilization to 95% from the current level of 72%. Threats The main threat to Ford’s market dominance came from Japanese auto-makers, particularly Toyota, whose products were of high quality. Ford was losing out customers, who went for higher quality vehicles from Japanese auto-makers, despite absence of incentives. The negative ratings given by most of the credit rating agencies in 2005 also demanded attention as the decision reflected concerns over Ford’s cash flow and profitability, declining market share, excess industry capacity, industry pricing pressure and rising health care costs.

Standard Procedure For Male Circumcision Health And Social Care Essay

In a combined survey from the USA and Kenya, the safety of big male Circumcision in the latter state was reviewed, peculiarly with the purported association between this process and a lower incidence of HIV and other sexually-transmitted infections. It was found that safe and acceptable grownup male Circumcision services could be delivered in developing states should this be advocated as a public wellness step. Aim To develop a standard process for male Circumcision in a resource-poor medical scene and prospectively measure the result in a randomized, controlled test with the incidence of human immunodeficiency virus ( HIV ) as the chief result, as surveies suggest that Circumcision is associated with a lower incidence of HIV and other sexually familial infections in bad populations. SUBJECTS AND METHODS Healthy, uncircumcised, HIV-seronegative work forces aged 18-24 old ages from Kisumu District, Kenya, were offered engagement in a clinical test utilizing a standard Circumcision process based on ‘usual ‘ medical processs in Western Kenya. The followup included visits at 3, 8 and 30 yearss after Circumcision, with extra visits if necessary. Healing, satisfaction and recommencement of activities were assessed at these visits and 3 months from randomisation. Consequence Overall, 17 ( 3.5 % ) of the 479 Circumcisions were associated with inauspicious events judged decidedly, likely or perchance related to the process. The most common inauspicious events were wound infections ( 1.3 % ) , shed blooding ( 0.8 % ) , and delayed lesion healing or sutura line break ( 0.8 % ) . After 30 yearss, 99 % of participants reported being really satisfied with the process ; ?aˆS23 % reported holding had sex and 15 % reported that their spouses had expressed an sentiment, all of whom were really satisfied with the result. About 96 % of the work forces resumed normal general activities within the first hebdomad after the process. Decision Safe and acceptable grownup male Circumcision services can be delivered in developing states should male Circumcision finally be advocated as a public-health step. Abbreviations STI sexually transmitted infection KES Kenya shilling. Introduction Top of page Abstraction Introduction SUBJECTS AND METHODS Consequence Discussion Recognitions Conflict OF Interest Mentions Of African work forces, ?aˆS62 % are circumcised [ 1 ] ; more African work forces are seeking clinical Circumcision to better hygiene, to cut down the hazard of sexually transmitted infections ( STIs ) , to look more ‘urban ‘ , or to be more like others [ 2-6 ] . Epidemiologic surveies suggest that male Circumcision is associated with a ?aˆS50 % decrease in the hazard of HIV infection, and with a lower hazard of ulcerative STI [ 4,7-10 ] . Male Circumcision eliminates the venereal jobs of balanoposthitis, phimosis and paraphimosis, well reduces penial carcinoma rates and, in one survey, reduced the cervical malignant neoplastic disease hazard in female spouses [ 3 ] . Despite increased involvement among medical governments and greater credence among African work forces, there are significant concerns about urging male Circumcision as a public-health step. These reserves include the deficiency of informations from randomized, controlled clinical tests demoing that Circumcision decreases the hazard of STIs and HIV. Considerable anecdotal grounds, including studies based on medical record reappraisal, suggests that Circumcision in traditional scenes exposes immature work forces to an inordinate hazard of complications [ 11-15 ] . Very few informations on Circumcision results are available from African clinical scenes. One survey from Tanzania found that infant Circumcision utilizing the Plastibell technique resulted in a 2 % complication rate [ 16 ] , comparable to reported rates in developed states [ 17 ] . We are carry oning a prospective, randomized controlled clinical test of grownup male Circumcision to measure its impact on the incidence of HIV among 18-24-year-old work forces in Kisumu District, Kenya. One of import aim was to develop a standard Circumcision process that would be applicable to resource-poor medical scenes. A 2nd aim was to find the inauspicious event rates associated with this process. Thus the intents of this study are to: ( I ) describe the proficient facets of the standard process ; ( two ) outline the processs for monitoring and sorting inauspicious events ; and ( three ) to depict results and inauspicious events associated with the first 479 Circumcisions. SUBJECTS AND METHODS Top of page Abstraction Introduction SUBJECTS AND METHODS Consequence Discussion Recognitions Conflict OF Interest Mentions Uncircumcised, HIV-seronegative work forces aged 18-24 old ages shacking within Kisumu District, Kenya, were offered admittance to the test. After supplying written, informed consent, participants were randomized every bit to either Circumcision or delayed Circumcision after a 2-year followup ( the control group ) . Exclusion standards included: any medical indicant for Circumcision ( e.g. important phimosis, recurrent balanitis, paraphimosis, or extended venereal warts ) , history of a hemorrhage upset, keloid formation, or other status that might unduly increase the hazards of elected surgery. Work force in both weaponries of the test were given extended reding about the decrease in hazard of STI/HIV, including the proviso of limitless supplies of free rubbers. This survey was approved by institutional reappraisal boards at the Universities of Nairobi, Illinois at Chicago, Manitoba, Washington, and RTI International. A Data Safety and Monitoring Board reports to the USA National Institute of Allergy and Infectious Diseases. For Circumcision, a standard process was based on ‘usual ‘ medical Circumcision processs in Western Kenya [ 18 ] . One Medical Officer ( medical physician ) and two Clinical Military officers ( Kenyan paramedicals who conduct medical audiences and selected surgical processs ) were trained in techniques and inside informations of the process. All instruments and supplies were purchased from providers in Western Kenya. The genital organ were prepared with a povidone-iodine solution and draped in unfertile manner. A dorsal nervus block was applied utilizing 2 % Lidocaine, with extra anesthetic administered circumferentially about the penial base ( maximal 10 milliliter ) . The foreskin was grasped at the 3 and 9 o'clock places utilizing two mosquito clinchs, so pulled over the glans. The scratch was outlined with a taging pen analogue to and 1 centimeter proximal to the coronal sulcus. The mosquito clinchs were so used to draw the foreskin over the glans while a Kocher clinch was applied below the planned scratch, taking attention to avoid wounding the glans. The foreskin was excised by cutting above the Kocher clinch, which was so removed. Shed blooding vass were ligated utilizing 3/0 field intestine. The lesion was irrigated with physiological saline. The tegument and mucosal scratchs were aligned utilizing 3/0 chromic perpendicular mattress suturas at the 12, 3 and 9 o'clock places, and a horizontal mattress sutura at the 6 o'clock ( frenulum ) place. The four initial suturas were tagged with mosquito clinchs to supply grip during the balance of the closing. Four extra perpendicular mattress suturas were placed halfway between the initial suturas, with simple suturas so placed to jump between the mattress suturas. The lesion was covered utilizing a Vaseline gauze dressing. Each patient was given verbal and written instructions, including vesture and bathing patterns, and instructed to urinate often to minimise hard-ons. They were given Datrils, 1 g three times daily as needed for 5 yearss, and tramadol hydrochloride, 100 milligram at bedtime as needed for two darks. Participants were strongly counselled to abstain from sex for at least a month. Follow-up visits were scheduled for 3, 8 and 30 yearss after surgery. Patients were instructed to return to the clinic if there was shed blooding, infection or inordinate hurting. At each visit the lesion was checked, and standard inquiries assessed activities of day-to-day life, possible inauspicious events, and the participants ‘ satisfaction. Additional elaborate ratings were conducted at 1, 3, 6, 12, 18 and 24 months from randomisation. Regular instance conferences reviewed all processs and results. Adverse events were categorized by badness and relatedness to the survey. Severity classs were mild, moderate and terrible. Relatedness to the process was classified as: ( 1 ) decidedly unrelated, clearly explained by another cause ; ( 2 ) perchance related, probably explained by other causes ; ( 3 ) likely related, most likely explained by the Circumcision ; and ( 4 ) decidedly related, a clear complication. Patient satisfaction was analysed at ?aˆS30 and 90 yearss after surgery as ( 1 ) really satisfied, ( 2 ) slightly satisfied, ( 3 ) slightly disgruntled, or ( 4 ) really disgruntled. We evaluated whether patients had resumed work and sexual activities and, if so, whether their sexual spouses had expressed an sentiment about their Circumcision position. The critical end points and definitions were determined before get downing the survey. Datas were collected prospectively and entered on site, and evaluated for quality and consistence continuously. Consequence Top of page Abstraction Introduction SUBJECTS AND METHODS Consequence Discussion Recognitions Conflict OF Interest Mentions Between 4 February 2002 and 11 March 2004, 2160 work forces were screened, including 47 % who agreed to take part. Of these, 505 were randomized to Circumcision, including 479 ( 95 % ) who had the process. The balance either declined after randomisation or deferred Circumcision until subsequently. The average age of circumcised participants was 21 old ages and 96 % were of Luo cultural beginning ; 89 % had completed primary school, 53 % had completed secondary school and & A ; gt ; 90 % were single. Almost half classified themselves as unskilled workers and about a one-fourth were pupils. Merely 37 % reported regular employment. The median ( scope ) continuance of Circumcision was 30 ( 18-63 ) min ; Fig. 1 shows the continuance for each consecutive group with clip ( Cochran-Mantel-Haenszel rank correlativity statistic, chi-square 149.4, 1 d.f. , P & A ; lt ; 0.001 ) . Figure 1. Box-and-whisker secret plan comparing process continuance with the figure of Circumcisions. For each group of Circumcisions, the line in the box indicates the median ( 50th percentile ) , and the upper and lower bounds of the box the interquartile scope ( 25-75th percentiles ) . The mistake bars indicate the 10th and 90th percentiles. Valuess above the 90th or below the tenth percentiles are plotted as points. For all 479 Circumcisions, the median ( scope ) continuance was 30 ( 18-63 ) min ; the average continuance was 38 min for the first 100, 30 min for the 2nd 100, 30 min for the 3rd, 28 min for the 4th and 26 min for processs 401-479 ( Cochran-Mantel-Haenszel rank correlativity P & A ; lt ; 0.001 ) . Of the 479 Circumcisions, 17 ( 3.5 % ) were associated with 18 inauspicious events considered decidedly, likely or perchance related, including six wound infections ( 1.3 % ) , four bleeds ( 0.8 % ) , four delayed healing or disrupted lesions ( 0.8 % ) , two with inordinate puffiness ( 0.4 % ) , one anesthetic reaction, and one participant who reported erectile disfunction. Of the 18 inauspicious events, none was classified as terrible, 11 were moderate ( necessitating extra intervention, e.g. drainage of an infection or revising a sutura to command indecent hemorrhage ) , and seven were mild ( necessitating minimum extra intervention ) . Fourteen inauspicious events were considered decidedly related ( including most infections and shed blooding jobs, plus the anesthetic reaction ) , one was considered likely related ( an infection off from the lesion that represented a reaction to the dressing tape ) , and three perchance related ( including diminished erectile map reported, folliculitis at the pubic base, and a pubic abscess in one participant each ) . Overall, nine of 18 inauspicious events were considered to be both moderate and definitely/probably procedure-related, happening after eight of 479 processs ( 1.7 % ) . The decorative consequences were first-class, with no demand for alterations or secondary processs. There were no instances of extra preputial tegument remotion, unequal preputial tegument remotion, penial tortuosity, cheloid, other hapless decorative or functional results. At this analysis, 411 of 479 participants were evaluated at ?aˆS30 yearss after surgery ; 99 % reported being really satisfied, 23 % reported holding had sex since the Circumcision, and 15 % of these work forces reported that their female spouse had expressed an sentiment about the process, all of whom were really satisfied with the result. In all, 321 work forces had appraisals at ?aˆS90 yearss from surgery, when 65 % reported holding resumed sexual intercourse, and 54 % of their sex spouses had expressed an sentiment about the process. Of these spouses, 95 % were really satisfied with the result, 4 % were slightly satisfied and 2 % were slightly disgruntled. None was really disgruntled. At 30 yearss after surgery, 98 % of work forces who were employed reported holding returned to work, 91 % within a hebdomad of the process and 97 % within 2 hebdomads. At this visit, all work forces reported holding resumed normal general activities, 96 % within the first hebdomad and another 3 % during the 2nd hebdomad after surgery. Discussion Top of page Abstraction Introduction SUBJECTS AND METHODS Consequence Discussion Recognitions Conflict OF Interest Mentions We developed a Circumcision process that was implemented efficaciously in an African medical scene. All instruments and supplies were purchased locally and local clinicians performed all processs. The standard method was based on medical processs used in eastern Africa [ 18 ] . To avoid trust on a engineering that is non widely available in developing states, we did non utilize electrocautery. Nevertheless, the overall inauspicious event rate was comparable to reported rates from the developed universe. Postoperative lesion infection ( 1.3 % ) and shed blooding ( 0.8 % ) were the most common inauspicious events, as would be predicted. The huge bulk of participants and their spouses who expressed sentiments were really satisfied at 30 and 90 yearss after surgery. This is one of the largest series of big male Circumcisions and it is alone in that results were monitored prospectively. Participants were followed utilizing a strict protocol. We used simple definitions that may turn out utile for other surgical tests, particularly surveies measuring Circumcision as a public-health step. The average clip to finish a Circumcision was 30 min ; runing continuance decreased from a median of 38 min for the first 100 processs to 26 min for processs 401-479 ( P & A ; lt ; 0.001 ) . This is of import, because if Circumcision were recommended as a public-health step for forestalling HIV, so it would be necessary to finish processs within an acceptable period in resource-poor states. The instruments and supplies were modest and all were obtained locally. In Kisumu the cost of supplies is 1500 Kenya shillings ( KES ) per process at our installation ( ? US $ 20 ) . In the Kisumu community, charges for Circumcision scope from 1000 KES ( US $ 13 ) at the authorities infirmary to 5800 KES ( US $ 77 ) at the taking private infirmary. Therefore, this survey suggests that our standard Circumcision method is consistent with bing pattern in Kenya and is likely to turn out practical within the underdeveloped universe. We besides showed that it is possible to obtain consequences that are tantamount to series of big male Circumcisions from the developed universe. The present survey has some advantages ; it represents a big series of big male Circumcisions and one of really few studies of surveies designed to supply an optimal prospective appraisal of results. We used strict definitions for events. The Circumcision process and resources were based on local medical pattern and resource handiness. All instruments and supplies were obtained locally, and clinicians trained and working in their ain community completed all processs. Therefore, our consequences should be straight applicable to similar clinical scenes in other countries. Two of the three clinicians were Clinical Military officers, the cell of professionals likely to execute most Circumcisions in sub-Saharan Africa. An of import lesson was that clear patient instructions are critical for lesion attention after surgery. Young work forces in many developing state scenes may miss easy entree to H2O and have trouble in keeping hygiene. Their timeserving employment forms frequently require high degrees of physical activity that can interrupt wound mending. Instruction manuals, both verbal and written in autochthonal linguistic communications, can help patients to restrict the possible effects of such lifestyle challenges. A determination that requires further attending is that 23 % of work forces reportedly resumed sexual activities before their 30-day follow-up visit, despite intensive reding to the contrary. Fortunately, merely one adult male reported holding had sexual intercourse at one of the early visits, and that was 19 yearss after the process. If work forces resume sexual contact before their scratchs are to the full healed, there is the danger of increased hazard of infection with HIV or other STIs. Once the test is complete, we will prove whether circumcised work forces have a higher incidence of HIV/STI than uncircumcised controls during this 1-month period after randomisation. Effective guidance of immature work forces is disputing, but developing effectual ways to advocate against sexual contact while the surgical lesion is mending will be important if male Circumcision is to be introduced as an intercession to forestall HIV. The present survey has of import restrictions ; the work forces were circumcised in a carefully designed, controlled research undertaking, with thorough preparation of clinicians, careful choice of healthy patients and uninterrupted monitoring of the result. It will be necessary to demo similar results in less strict scenes. The followup was short, but we will obtain more informations on sexual map. Most significantly, we need to find, through the test, whether grownup male Circumcision is effectual in cut downing the incidence of HIV. In decision, we developed a standard process for grownup male Circumcision that proved suited for resource-poor clinical scenes. The inauspicious event rate compares favorably with rates reported from developed states. Participants had first-class clinical results, acceptable morbidity and first-class patient satisfaction. They returned to work and to normal general activities really rapidly. These findings suggest that it should be possible to present grownup male Circumcision services with acceptable complication rates in developing states. Recognitions Top of page Abstraction Introduction SUBJECTS AND METHODS Consequence Discussion Recognitions Conflict OF Interest Mentions We particularly thank the immature work forces in Kisumu who have so enthusiastically participated in the survey. We acknowledge the aid and indefatigable support provided by Dr J. Otieno. We greatly appreciate the tireless attempts of the UNIM undertaking staff. This survey was funded by grants from the National Institute of Allergy and Infections Diseases, National Institutes of Health, Bethesda, Maryland USA, Grant No. AI150440, and the Canadian Institutes of Health Research ( CIHR ) , Grant No. HCT 44180. S. Moses is the receiver of a CIHR research worker award. 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