Peace-Building and Community Development in Uganda Essay

Community development is a multi-faceted activity that has different ends. It also has different requirements depending on the needs of people inside the community. Development can be achieved through sustaining small and medium businesses, ensuring education for all, managing inclusion and diversity, keeping peace and order, and creating comprehensive disaster management. Through these, a community like Uganda can be sustainable. In Uganda, the dehumanizing aspects of slavery in the South and racial discrimination in the North are more than just the beatings, but also the parting of children from their mothers, the denial of education, and the sexual abuses of slave masters (Davis, 2004). The civilization that developed in Uganda reflected the variety and contrasts found on the continent. The peoples of Uganda differ greatly in language, customs, and appearance. The geography of this huge continent also shows sharp contrasts. Along the Nile River, which flows from the tropical forests of Central Uganda through the deserts of the north, several early civilizations developed. One of the most influential regions was Sahara. Sahara’s political, economic, and cultural influence had an effect on the history of other kingdoms. Later, empires based on trade grew up in the region of Sahara (Davis, 2004). Patterns of settlement and trade were influenced by the varied climates and natural sources of the Uganda continent. The hottest and wettest regions of the continent are near the equator, in the basin of the Congo River. Heavy rainfall and warm humid air encourage the growth of lush rain forest. Near the edge of the rainforest is the savanna, an open grassland dotted with shrubs and scattered clumps of trees. The savannas provide land for farming and herding. These grasslands are also home of Uganda great herds of wild animals, gazelles, giraffes, wildebeests, zebras, lions, and elephants (Davis, 2004). Racism in Uganda has been associated with reduced spirits, lower efficiency and a greater probability to experience terrible stress and nonappearance in the major activities in a community. People who go through racism speak of having feeling of timidity or letdown and lowered levels of self-esteem. Minorities who sense that their identity and culture are not cherished may also live through lowered levels of self-confidence and self-respect and think that they have are not welcome in a neighborhood or community. This mindset may bring about a feeling of denunciation of their own values, language, and ultimately their culture, and an ensuing loss of individuality (Hooks, 1994). In Uganda, the ways of thinking of people concerning cultural miscellany of their communes differ extensively. Amongst a number of minorities, there is a devotion to a deepened insight into cultural diversity and multiculturalism. Some â€Å"mainstream† people are anxious about variations and sense antipathy towards people of color. If the person of color is suffering discrimination of any sort, he or she may feel forlorn and miserable. He or she may also attempt to evade incidents where racist activities could happen, and pretend to be unwell or be anxious of deserting their homes (Kressel, 2001). In some nations, significant segments of the population reject coexistence with minorities in equal terms. These minorities have faced discrimination in such areas as housing, education, and employment. Although no scientific proof supports racist claims, racism is widespread and has caused major problems throughout the world. Racism is most often used to justify the creation of political or economic systems that encourage or maintain the domination of one racial group over another. Such beliefs were long used to rationalize the enslavement and persecution of people viewed as inferior (Stoessinger, 2002). Throughout history there have been persecutions and atrocities that can be described as cases of genocide. The Russian pogroms (persecutions of the Jews) during the late 1800’s and early 1900’s were an example of genocide. During World War II, the Germans practiced genocide. They killed about six million European Jews. Victims of the Holocaust went through dehumanization simply to make the killing of others psychologically easy for the Nazis. Many victims of the Holocaust suffered from various experiments which eventually led to the death. Some of the experiments were things such as: sun lamp, internal irrigation, hot bath, warming by body heat, hypothermia, among others (Clemens and Purcell, 1999). In recent years a debate has raged over the question of whether opportunities for black economic advancement are more affected by race or class position. Sociologist William Wilson believes that racial discrimination has become less important than social class in influencing the life chances of black Americans (Hinkle, 2004). He says that civil rights legislation and affirmative action programs have substantially lifted the cap historically imposed on black social mobility by segregation, resulting in greater educational, income, and occupational differentiation: Blacks with good educational backgrounds and job skills rapidly moved into the American middle class; blacks with limited educations and job skills became the victims of dehumanization and welfare dependency. Now poor urban blacks find themselves relegated to all-black neighborhoods where they are further dehumanized and socially isolated from mainstream American life (Zanden, 1993). According to Maiese (2003), the United Nations defined peace-building as an interplay of â€Å"capacity building, reconciliation, and societal transformation†. For other organizations, the short-term goals are more evident; peace-building revolves around promoting peace in an immediate situation. The United Nations drew up an international convention in 1948 that made genocide a crime. On Dec. 9, 1948, the United Nations passed the Genocide Convention, which was designed to overcome the claims of Nuremberg defendants that they had violated no law. The convention made genocide a crime. The next day, the UN adopted the Universal Declaration of Human Rights. Fifty years later, in 1998, the International Criminal Tribunal for Rwanda became the first international court to pass a guilty verdict for the crime of genocide. The verdict related to crimes committed during the 1994 conflict in Rwanda (Kim, 2004). In 1999, there was already a convention, called the Geneva Spiritual Appeal, which made history in collecting in one venue the Catholics, the Jewish, the Buddhists, the Muslims, the Protestants, and the Orthodox Christians. Then again, there remain Christians, Animists, & Muslims in conflict in Nigeria; Christian-Muslim discord still abounds some parts in Asia as Indonesia and the Philippines; Buddhists and the minority population of the Hindus Tamils are at odds in Sri Lanka; and incredibly, Animists and Witches are cursing each other in Uganda (Reich, 1998). Sometimes, it is appropriate to entitle these conflicts nationalist ones, because they impact on the endeavors to build nation-states, in which the majority gets the state. More like the winning territory takes over or designs the administration. Defining such a nation is typically by linguistic or religious yardsticks. Hence, we have the Ugandans in the continent of Africa singled out as the inferiors by tongue and by faith, and Germans differ from the French by their verbal and non-verbal communication (Carter, Gwendolen, and Herz, 1991). Perhaps there’s a tendency of people growing to be defensive about their identity if they sense that it is under cordon. There is really not a single ultimate peace resolution plan that can referee the unrest. Attempts had been made like the 1999 Convention but the conflict is not exclusively attributable to spiritual diversity alone. It may be distributed among ethnic feuds, religion-based worldviews, economic modifications, and political coalitions, among several others (Carter, Gwendolen, and Herz, 1991). On having the United Nations’ enforcement of globalized paradigms, they would need to try harder. Peculiarities factor in on the extent of their reception. If the country’s fragile, they are more likely to get involved. If the country’s sturdy, they are more likely to lag behind and perform diplomatically around the edges. The key is not to establish globalized benchmarks but to develop local, internal avowals (Stoessinger, 2002). They said there is only one Bible and a million interpretations. But there is a single quotation in it that speaks of harmony: a house divided against itself cannot stand. Proclaiming a house partitioned to be a condominium cannot be expected to work out when many of the occupiers want instead to demolish the edifice entirely and put up their own, unattached houses. Speaking of houses, local religious sects could construct and ring a Peace Bell at the beginning and end of their spiritual observation. Ugandan victims could ask their municipality to formally declare their observance of the day (Kim, 2004). It would also be certainly wise for any intercontinental organizations to use workforce from countries that went through related experiences, rather then using the abstract approach brought by peacekeeping squads from Western nations to intervene in Uganda. One specific strategy possibly is to have this staff encourage the people inviting other faith traditions to join them in a prayer service for peace in Uganda (Carter, Gwendolen, and Herz, 1991). International treaties should make it easier for local organizations to get concerned in the region of Uganda where genocide is concentrated without misplacing valuable time as they wait for the pronouncement of the United Nations Security Council, the Conference on Security and Cooperation in Europe, or the Organization of African Unity (Reich, 1998). But it should always be made a point that the auxiliary time is spent on deepening interfaith commitments to dialogue and cooperation for promoting peace. In the 1990s, Jewish groups pressured those who had profited from the Holocaust to compensate Holocaust victims or their descendants. Groups that paid reparations included the German government, certain Swiss banks, and some German companies (Clemens and Purcell, 1999). In the country Uganda, Paul Rusesabagina, the hotel manager played the hero in the lives of thousands having different cultural backgrounds. In the middle of European colonization in Rwanda, Paul made an uncompromising initiative to communicate with the most relevant redeemers from the camp of Brussels’ headquarters. This way, he succeeded in playing the peacekeeper among the threatened people he hid in their hotel (Carter, Gwendolen, and Herz, 1991). The United Nations also played an indispensable role in Uganda. Led by Col. Oliver, the organization gets to know what is actually happening but not to make contingent actions and resolutions to put a stop to genocidal cases that mete out Rwanda. He stood the middleman between the U. N. superiors and the people under the wings of Paul Rusesabagina (Carter, Gwendolen, and Herz, 1991). However, it was also evident that the situation could have gone smarter if the likes of Paul Rusesabagina and Col. Oliver were given ample attention or at the very least, not ignored. Apart from the United Nations, a multitude of support and private-owned groups advocate against dehumanization and as such, campaign for a zero-dehumanized world and for a healing process to start with (Stoessinger, 2002). For instance, Interact Worldwide is an advocacy-driven virtual institution with the purpose of building support for and implement programmes, which enable marginalized people to fulfill their rights to sexual and reproductive health. Redefining Progress works with a broad array of partners to shift the economy and public policy towards sustainability; that they can measure the real state of a country’s economy, our environment, and social justice with tools like the genuine progress indicator and the ecological footprint; that they design policies to shift behavior in these three domains towards sustainability; and that they promote and create new frameworks to replace the ones that are taking us away from long-term social, economic, and environmental health. Other popular organizations include The Family Alliance to Stop Abuse and Neglect, National Down Syndrome Congress, Resources for Children of Holocaust Survivors, Amnesty International, Freedom House, Human Rights Watch, Reebok Human Rights, among many others (Carter, Gwendolen, and Herz, 1991). Prejudice provides for the safe release of hostile and aggressive impulses that are culturally tabooed within other social contexts. By channeling hostilities from within family, occupational, and other crucial settings onto permissible targets, the stability of existing social structures may be promoted. This is the well-known scapegoating mechanism, another common method to dehumanize (Zanden, 1993). In Uganda, scapegoating resulted in the inhuman treatment of Ugandan tribes like Tutsi. Bound by his duty-based ethics, Paul Rusesabagina could be pictured having utter, intrinsic moral commitments to some external source to carry out certain actions, notwithstanding his particular situation and personal goals (Carter, Gwendolen, and Herz, 1991). The ways of thinking of people concerning cultural miscellany of their communes differ extensively be it in Rwanda or in some other place in the world. Amongst a number of minorities, there is a devotion to a deepened insight into cultural diversity and multiculturalism. Some â€Å"mainstream† people are anxious about variations and sense antipathy towards people of color. If the person of color is suffering discrimination of any sort, he or she may feel forlorn and miserable. But with Paul Rusesabagina around, the people kept safe in Uganda were saved not only from the harm of genocide but from the deadly bias posed against them by the larger society that is morally wrecked and uncharitable (Carter, Gwendolen, and Herz, 1991). An inherent debate has raged over the question of whether opportunities for black economic advancement are more affected by race or class position. Some believe that racial discrimination has become less important than social class in influencing the life chances of Ugandans. Civil rights legislation and affirmative action programs have substantially lifted the cap historically imposed on black social mobility by segregation, resulting in greater educational, income, and occupational differentiation: Blacks with good educational backgrounds and job skills rapidly moved into the middle class; blacks with limited educations and job skills became the victims of dehumanization and welfare dependency. Now poor urban blacks find themselves relegated to all-black neighborhoods where they are further dehumanized and socially isolated from mainstream Ugandan life (Hooks, 1994). The risk is that when chauvinistic behaviors and attitudes are allowed to go unimpeded in any environment, a climate cultivates which sees these incidents as natural and so permits racism to become deep-rooted. Whereas not many complaints are collected every year, this should not be compared to a low frequency of racist incidence. Inadequate understanding of legislation, fear or apprehension on the part of victimized minorities to disclose racist activities or disinclination by parents to engage in legal amends are factors that may thwart the conveyance of official complaints. As well, formal treatments for grievances of racism are not constantly suitable, with arbitration usually being considered as a preferable substitute (Kim, 2004). Racism has been a steady problem in Uganda all through time. Other forms of racism are, perhaps, less obvious. The hierarchical structure, academic elitism, and the whole way of life of mainstream society are directly opposed to cultural values and world views. How all this conflict is experienced by people of color can only be explained adequately by the citizens of the society themselves; it will be different depending on their past experience and even non-existent for others, but the suppression of the values and way of life of the mainstream society will adversely affect everyone because racism against these people of color eats at the hearts of the dominating as well as the dominated people (Hinkle, 2004). Peace-building can concentrate on resolving current issues between constituents. It involves moderating by authorities or other members of the community to maintain understanding between parties. On the other hand, it is also creating a society where the constituents are educated and transformed so that they do not only know peace but also lives peace. In these terms, education plays an integral role. This creates a community which is not only dependent on intermediaries but with self-regulation of peace as well. In the end, a community filled with peace-loving citizens is a community where peace has been built (Stoessinger, 2002). Personally, if I were a member of a certain low-income urban neighborhood similar in nature in Uganda, I would offer my full knowledge of the end and the means to achieve it. As part of the will for a â€Å"sense of community,† I will take the initiative to conform to shared leadership or become servant leaders. After all, a leader providing positive reinforcement is a leader creating a positive climate and peace-loving attitude all over a community. So long as there will be provision of opportunities that allow me to exercise responsibility and creativity in our common endeavor, my active participation would include extensive information dissemination, be it online or via available physical infrastructures, and active civic participation.

Trends In Epidemiology Of Hiv Health And Social Care Essay

Zimbabwe has the 3rd largest HIV load in Southern Africa with an estimated 1 million grownups aged 15 and above and 150,000 kids under 15 life with HIV ( 1 ) . Harare, the state in which the capital is located, accounting for largest proportion of people populating with HIV in the state ( merely under 20 % ) and Bulawayo, the state ‘s 2nd largest metropolis accounting for the smallest proportion ( merely over 5 % ) . Zimbabwe has a generalized HIV epidemic, with exceptionally high degree of HIV prevalence in the yesteryear and significantly lower degrees at nowadays. It is estimated that between 1998 and 2010, grownup HIV prevalence has halved from 27.2 % to 14.3 % . ( 2 ) The epidemic in Zimbabwe has contracted faster than any other HIV epidemic in Eastern and Southern Africa as Figure 1 ( 1 ) below illustrates:Figure 1: HIV prevalence curves from East and Southern AfricaThe contraction in HIV prevalence is attributed to really high mortality every bit good as important alterations in sexual behavior ( 1 ) . During the economic system crisis Zimbabwe faced, the wellness system collapsed to widen that most HIV septic persons died due deficiency of antiretroviral drugs and installations for intervention of timeserving infections. In footings of behavior alteration informations from the Population Services International ( PSI ) studies conducted in 2001, 2003, 2005, 2006, and 2007 support this deci sion, particularly with respect to spouse decrease. For work forces 15-29, the proportion describing non-regular spouses fell from 32 % in 2001 to 21 % in 2003, and remained near that degree through subsequently PSI studies. For adult females 15-29, the estimations were for a decrease from 17 % to 8 % in the same period. Zimbabwe is geographically distributed into 10 states. In contrast to other states in the part, the Zimbabwean HIV epidemic is geographically rather homogeneous with similar HIV prevalence degrees across states ( Figure 2 ) . Geographic homogeneousness besides applies when HIV prevalence in rural and urban zones is compared: Rural and urban occupants have similar odds of being HIV infected ( 17.6 % in rural vs. 18.9 % in urban countries ) . There may nevertheless be important heterogeneousness in HIV prevalence at a local degree, as noted in really different degrees of HIV prevalence among Antenatal Clinic clients, with peculiarly high HIV prevalence degrees among those occupant in relocation farms, growing points, main road and boundary line towns ( 3 ) . Figure 2: Adult HIV prevalence by state in Zimbabwe Source: Zimbabwe Demographic Health Survey 2005/6. In Zimbabwe grownup HIV prevalence harmonizing to sex is significantly higher among adult females aged 15-49 ( 21 % ) than among work forces in the same age cohort ( 14.5 % ) ( 4 ) . This gender spread is even wider among immature people. Females aged 15-19 old ages have significantly higher HIV prevalence rates than work forces among the same age group ( Figure 3 ) .The differential between female and male prevalence is big besides in the age groups 20-24, 25-29 and 30-34 old ages reflecting both historical transmittal forms and important degrees of age disparate sexual relationships. The peak age for HIV infection in adult females is 30-34 old ages while for work forces it is the 40-44 old ages age group.Figure 3: HIV prevalence by age and sex in ZimbabweBeginning: 2005/6 ZDHS, Table 14.3 In 2007, an estimated 63,247 grownups acquired HIV. However, in 2009 it is estimated that this figure rose to 66,156 ( about 182 new HIV infections daily ) ( 5 ) . HIV incidence is estimated at 0.85 % in 2009. Projections into the hereafter, based on current HIV prevalence, population growing and antiretroviral therapy use indicate that the figure of freshly infected grownups will go on to turn. Heterosexual sex within unions/regular partnerships histories for the majority of beginnings of new grownup HIV infection in Zimbabwe. Other beginnings of new infections include insouciant heterosexual sex and sex work The UNAIDS Modes of Transmission ( MoT ) theoretical account was used to pattern beginnings of new infections, and overall incidence. The MoT modeling exercising confirmed that heterosexual contact remains the chief manner of transmittal in all countries of Zimbabwe, but this was represented by several different state of affairss including both insouciant and long term partnerships and miscellaneous grades of transactional sexual relationships. Nationally, the theoretical account estimates that the bulk of new infections occur among people in the general community who are non prosecuting in high hazard sexual activities. Persons in this hazard class are in discordant, monogamous relationships of at least a twelvemonth ‘s continuance but frequently longer ( 6 ) . Mother to child transmittal ( MTCT ) continues to stay a important beginning of new infections among babies. Approximately 1 in 3 babies born to HIV septic female parents are infected. HIV infection from an HIV-positive female parent to her kid during gestation, labor, bringing or breastfeeding is called mother-to-child transmittal ( MTCT ) . The per centum of babies born to HIV septic female parents who are HIV infected has remained high averaging 28.5 % between 2006 and 2009. An estimated 15,000 kids were freshly infected with HIV in 2009 ( 5 ) , the huge bulk of them through MTCT.Describe how HIV/AIDS Surveillance informations are collected and sketch the advantages and restrictions of these informations aggregation attacks.The aggregation of informations for HIV prevalence informations is really important for national HIV & A ; AIDS programmes particularly in footings of policy devising. There are several methods used but I will depict Antenatal Clinic Surveillance and Population Based Surveys sketching the advantages and restrictions of each.Antenatal Clinic SurveillanceThe chief intent of surveillance based on adult females go toing prenatal clinics is to measure tendencies in HIV prevalence over clip. However, because other informations beginnings are missing, prenatal clinic surveillance has besides been used to gauge the population degrees of HIV. This is normally based on anon. , unlinked, cross-sectional studies of pregnant adult females go toing prenatal clinics in the public wellness sector. Merely first-time attendants are included to minimise the opportunity of any adult female being included more than one time. Blood is taken routinely from pregnant adult females for diagnostic intents which include poxs, Macaca mulatta and blood grouping. After personal identifiers are removed the blood is tested for HIV. Antenatal clinic studies are normally done yearly at the same clip of the twelvemonth to obtain an estimation of the point prevalence for tha t twelvemonth. The national HIV prevalence of a state is frequently 80 % of the prevalence rate in pregnant adult females go toing prenatal clinics ( 7 ) . Advantages of Antenatal Clinic Surveillance Prenatal clinics provide ready and easy entree to a cross-section of sexually active adult females from the general population who are non utilizing contraceptive method. In generalised epidemics, HIV proving among pregnant adult females is considered a good placeholder for prevalence in the general population ( 7 ) Data for pregnant adult females will reflect the prevalence in groups that may be of higher hazard of infection because of their life agreements ( such as workers who live in inns or ground forces barracks ) if they have regular unprotected sexual contact with adult females in the general population. The restrictions of prenatal surveillance are recognized and acknowledged, and where possible, rectification factors have been developed to get the better of some of the restrictions. In states with low degrees of HIV prevalence, strategically placed lookout sites can supply an early warning for the start of an epidemic. ( 8 ) In recent old ages, many states have expanded the geographical coverage ( the figure and sample sizes of sites ) of lookout surveillance, particularly in rural countries, to better the representativeness of the samples. Restrictions of Antenatal Clinic Surveillance Most sentinel surveillance systems have limited geographical coverage, particularly in smaller and more distant rural countries. Womans go toing prenatal clinics may non be representative of all pregnant adult females because many adult females may non go to prenatal clinics or may go to private clinics. The rate of preventive usage in a state may impact the figure of pregnant adult females. The execution of prenatal clinic-based surveillance varies well between states ( 9 ) . The quality of the studies may change over clip depending on available resources. Antenatal clinic surveillance does non supply information about HIV prevalence in work forces. Because these studies are conducted among pregnant adult females, estimations for work forces are based on premises about the ratio of male-to-female prevalence that are derived from community-based surveies in the part. However, this ratio varies between states and over clip.Population-Based SurveiesThe restrictions of prenatal surveillance systems with regard to geographical coverage, under-representation of rural countries and the absence of informations for work forces have led to an involvement in including HIV proving in national population-based studies. Population-based studies can supply sensible estimations of HIV prevalence for generalised epidemics, where HIV has spread throughout the general population in a state. However, for low-level and concentrated epidemics, these studies will undervalue HIV prevalence, because HIV is concentrated in groups with bad behavior and these gro ups are normally non adequately sampled in household-based studies. Some early studies were designed for unlinked anon. testing, in which the HIV trial consequences could non be linked to persons, whereas more recent studies have incorporated linked anon. testing, in which HIV trial consequences can be linked to behavioral informations without uncovering the individuality of any person who has been tested. Advantages of Population Based Surveies: – In generalised epidemics, population-based studies can supply representative estimations of HIV prevalence for the general population every bit good as for different subgroups, such as urban and rural countries, adult females and work forces, age groups and part or state ( 8 ) . The consequences from population-based studies can be used to set the estimations obtained from sentinel surveillance systems. Population-based studies provide an chance to associate HIV position with societal, behavioral and other biomedical information, therefore enabling research workers to analyze the kineticss of the epidemic in more item. Information from this analysis could take to better plan design and planning. Restrictions of Population Based Surveys. In population-based studies, trying from families may non adequately represent high-risk and nomadic populations. In low-level or concentrated epidemics, population-based studies hence underestimate HIV prevalence. Nonresponse ( either through refusal to take part or absence from the family at the clip of the study ) can bias population-based estimations of HIV. ( Roll uping information on nonresponders can assist in the procedure of seting for nonresponse. ) Population-based studies are expensive and logistically hard to transport out and can non be conducted often. Typically, these studies are conducted every 5-10 old ages ( 8 ) .Outline the major factors doing spread of HIV/AIDS in the community where you live or work.The followers are some the factors which have been attributed to distribute of HIV in Zimbabwe Multiple Concurrent Partners ( MCP ) is by and large defined as a sexual behavior characterised by holding more than one sexual spouse in the same clip period. Zimbabwean work forces are more likely to hold multiple spouses than adult females. Harmonizing to the Zimbabwe Demographic Health Surveys 2005-6 ( ZDHS -2005-6 ) , 1 in 10 adult females and 1 in 3 work forces aged 15-49 old ages who had sex in the 12 months predating the study had sex with two or more spouses. Low and inconsistent degrees of rubber usage, particularly among married twosomes. There is by and large a low degree of rubber usage in Zimbabwe, although the more insouciant the sexual brush, the more likely that a rubber is used due to increased hazard perceptual experience. Harmonizing to the ZDHS ( 2005-6 ) , rubber usage is last amongst married twosomes and those with long-run spouses with merely 3.6 % of married adult females and 7.7 % of work forces describing utilizing rubbers the last clip they had sex with a partner or cohabiting spouse. Harmonizing to a survey by SAFAIDS about 52 % of all new infections which occurred in 2009 occurred among married people which makes the matrimony a hazard brotherhood. Low Levels of Male Circumcision: Male Circumcision is one of the best ways that has been seen to forestall HIV transmittal by about 60 % harmonizing to three surveies carried out in the different states in Africa: – Rakai, Uganda ( 10 ) ; Kisumu, Kenya ( 11 ) and Orange Farm, South Africa ( 12 ) . Male Circumcision has been seen to work through the undermentioned mechanisms: – Decrease of surface country by taking the prepuce which has seen to advance entry of HIV virus. Hardening of open glans penis therefore cut downing scratchs and hazard of HIV incursion. The removed prepuce agencies, HIV can no longer be trapped underneath therefore minimising transmittal. However male Circumcision in Zimbabwe remains low with 10.5 % of work forces aged 15-54 coverage being circumcised in the 2005/6 DHS. Such a low degree is improbable to impact overall HIV transmittal to any of import grade. In Zimbabwe, harmonizing to mathematical modeling ( Figure 4 ) , the figure of new HIV infections will drop significantly if male Circumcision services are expanded. The modeling is assuring and what needs to be done is to supply more consciousness and still negative attitudes.Figure 4: – Zimbabwe Projected New Infections Cases with Male CircumcisionAdapted from a presentation by Karin Hartzold, PSI, Zimbabwe, 2010 Age disparate sexual relationships: Surveies indicate that relationships between immature adult females and older work forces are common and tolerated in Zimbabwe as in many parts of sub-Saharan Africa and are associated with insecure sexual behavior and increased HIV hazard as informations from the 2005-6 ZDHS indicates. In such relationships rubbers use tends to be selectively and strategically and such use additions HIV hazard. High degrees of Sexually Transmitted Infections: Sexual transmitted Infections increase the hazard of HIV infection. This hazard is much higher with ulcerating infections like pox and herpes simplex. The prevalence of sexually transmitted infections in Zimbabwe is really high and this has been lending a high prevalence rate. In Zimbabwe the 2009 ANC Sentinel Surveillance Report showed that adult females with current or past venereal ulcer disease ( GUD ) had about three times the HIV prevalence of adult females without a history of GUD. Among immature ANCs aged 15-24, those with GUD had a HIV prevalence of 31 % . This is corroborated by ZDHS 2005-6 that found that work forces and adult females who reported a recent STI were significantly more likely to be HIV positive, harmonizing to the 2005/6 DHS. 40 % of adult females who reported holding had an STI or STI symptoms in the old 12 months were HIV-infected, compared to 24 % who did non describe an STI or STI symptom. For work forces, the corresponding HIV prevalence figures were 32 % and 18 % . Other factors: – though the above factors are the taking 1s in footings of distributing HIV & A ; AIDS in Zimbabwe other factors like poorness, migratory labour systems with household breaks, commercial sex workers, low position of adult females due to gender favoritism and male laterality still play a important proportion in footings of advancing HIV transmittal.

Climate change and adaptation and mitigation Essay

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Event Management Essay Example | Topics and Well Written Essays - 2250 words - 1

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Summary - Article Example In addition, authors contend in the case where a study involves large-group design there is a need to apply multifaceted approach by taking average (Miller, Besser & Vigna, 2011). This is to aggregate all findings from other researches with the intention of obtaining exact results, which is extremely hard if one utilizes one method approach. Aggregation also includes taking data of diverse and numerous subjects with the intention of producing a group mean (Miller, Besser & Vigna, 2011). Contrary to single case researchers, whose intention encompasses addressing only external validity of a study; multifaceted approach normally takes in a wide varied of replication to exhibit all essential facts. This is evident in Miller, Besser & Vigna (2011) study that extends over a period of five years. Hence, allowing a large study examined in a single and small scope though its approach is multifaceted besides having replication of numerous researches and subjects (Miller, Besser & Vigna, 2011). In this article, the author contends adopting of mixed methods approach plays a significant role in advancing beyond unclear hypothesis; hence ensure effective understanding of the highlighted aspects in a given study. This is especially in studies that involve innovation whose relaying of ideas entails to win the acceptance of the users (Wu, 2012). Wu utilized a mixed method in his research mainly because this mode of research ensures the researcher learn issues from a wider a scope. Mixed method approach utilizes both qualitative and quantitative methods of research, which in the end enables Wu effectively, evaluate all aspects concerning the subject of research (Wu 2012). According to Wu, mixed method enables a research to shift from unclear state of data or study to usefulness† and â€Å"ease of use†, which is essential in understanding varied aspects

Ethical Issue Essay Example | Topics and Well Written Essays - 1250 words

Ethical Issue - Essay Example While specialization is increasing in every area, hospitals are shuffling nurses from one unit to another with increased patient loads. Such cost effective measures compromise with the safety and quality and questions are raised on how ethical it is to do so. To make nurse staffing safe and appropriate, it was decided not to use nurse-to-patient ratios as a baseline standard for minimum safe staffing (Gallagher, Kany, Rowell, & Peterson, 1999). Nursing shortage in the United States is largely responsible for shifting nurses from one department to another. It is estimated that by 2010 there will be a shortage of about 800,000 nurses and this shortage already shows dire results (Bodley & Davis, 2003). The shortage is leading to delegation of patient care activities to nurses’ aides and unlicensed assistive personnel. Nurses do not have the managerial support or the control over their environments. Shifting nurses from unit to unit, imposing mandatory overtime, attrition in the p rofession is unlikely to abate. Psychiatric nursing is a specialized area where the availability of appropriate personnel remains a perennial problem. Patients in the mental health department need kindness and compassion during the acute phase of their illness but Nolan and Bourke (2001) point out that they were forced to live in poor social environment while they were being treated for severe mental illness. The nurses lacked the skills in interpersonal relationships. Nurses in the mental health department reported that the type of intervention had changed and there was a decreased emphasis on dynamic therapy (Nolan & Bourke). Treatment is now based on pharmacology and there was an increased use of cognitive therapies. Independent practice opportunities were lost while advanced certification and prescription authority had increased the scope

Analyzing Modern Business Environment (Tom Peters) Essay

Analyzing Modern Business Environment (Tom Peters) - Essay Example The paper goes ahead to give suggestions on how to improve the conventional approach to long-range planning. It also explores the possibility of adopting more qualitative methods like scenario prediction in answering the managers' criticism, providing the rationale behind these ideas. The paper specifically analyses the nature of long-range planning and how it affects the operational policies of an organisation. It also appreciates the limitations of adopting the long-range approach to planning. Long-range planning is very important for the future of any organisation. Its principal tasks include understanding of the environment, defining the goals of the organisation, identifying the organisation's options, making and implementing decisions and evaluating actual performance (Collins and Porras, 1994). Long-range planning is therefore aimed at exploiting tomorrow's different and new opportunities. The traditional long-range planning has its basis on the concept of the four essential steps to planning. These steps include monitoring, forecasting, setting of goals and implementation of these goals. Long range planning is meant to help an organisation establish where it is currently, where it is going, where it wants to go, and what it has to do in order to change and head to its desired destination. The cycle of long-range planning starts by the monitoring of an organisation's selected trends. Then the process of forecasting of these trends' expected future follows. This is done by extrapolating past data by use of regression analysis or any such technique. The organisation's desired future is then defined by setting its goals in line with the expected future. The development and implementation of specific actions and policies with regard to long-range planning is aimed at reducing any disparity that may exist between the desired future and the expected future. The final phase is that of monitoring the effect of the policies and actions on the chosen trends. The nature of strategic planning and its impact on operational policies Strategic planning refers to the process of defining an organisation's direction or strategy and deciding on resource allocation in the pursuit of this strategy, including people and capital. A variety of business analysis techniques are utilised in the strategic planning process, such as SWOT analysis, PEST analysis, STEER and EPISTEL analyses (Bradford and Duncan, 2000). Strategic planning is therefore the process of formally considering the future course of an organisation (Kono, 1994). A typical strategic planning strategy is concerned with a number of issues such as what an organisation should do, for whom it should do it and how it should excel in its endeavours (Porter, 1996). Business strategic planning is mainly concerned with how to beat competition or how to avoid it altogether (Bradford and Duncan, 2000). In a number of organisations, this is seen as a process to determine where an organisation goes in the next three to five years, even though some organisations extend their plan to up to twenty years. For an organisation to determine where it goes, it must exactly know its current position. It is only when it knows its current position that it will be in a position to determine the position it wishes to get to and how to get to it. This then becomes the organisation's strategic plan (Lorenzen, 2006). It gives the general direction of the desired destination for any given organisation. Strategic

The Kite Runner Directed by Marc Forster Movie Review

The Kite Runner Directed by Marc Forster - Movie Review Example Amir also struggled at the thought that his father blames him for his mother's death during his childbirth. However, he has a kind father in the person of Baba's very close friend, Rahim Khan, who understands him and is more supportive of his interests especially in writing stories. Assef, a notorious cruel, racist, and violent older boy with sadistic tendencies, blames Amir for socializing with a Hazara, which according to him is an inferior race and should not live amongst the rich and the "true people of Afghanistan." He and his friends prepare to attack Amir at one time after the two boys watched their favorite movie, but Hassan bravely stands up to him, threatening to shoot Assef in the eye with a slingshot, and although Assef and his henchmen backed off, but he vowed to take revenge. One successful and triumphant afternoon, Amir wins the local tournament, and finally gained Baba's praise. Hassan goes to run after the last cut kite, a great trophy for Amir and saying "For you, a thousand times over." Unfortunately, that was time Assef and his gang carried out their revenge as well. Amir running to look for Hassan, after realizing it was taking him so long, soon witnessed what Assef and his friends were doing to Hassan. But cowardice took over and so he hid. The afternoon of 1975 changed all their lives forever, consequently the lives of all of Afghanistan as the Russians started to march in to their well loved country. Time passes and Amir and Hassan started totally different chapters of their lives; Hassan and Ali went to live in Hazarajat, while Amir and Baba ended up in California. Until one day, sometime after Baba's death, Amir gets a call in the United States from a familiar voice from the past. Rahim Khan is asking Amir to visit him in Pakistan. This is foreshadowing the fact that Rahim Khan knows all about Hassan, and how he is Amir's brother and how he has always known about the tragic circumstances surrounding Hassan, being raped, and what Amir d id in the hopes of getting Hassan and Ali out of his and Baba's lives. Amir finally decided to go. Enigmatically he tells Amir that "there is a way to be good again," and so he goes to rescue Sohrab, Hassan's son, who became a captive of the most notorious pedophile in Afghanistan, who happened to be Assef. After a fight that Amir almost lost if not for Sohrab finally hitting Assef in the eye with the slingshot the way his father could have done many years back, Amir felt, after so many years, that he was finally free of the guilt of the injustice he did to Hassan. He and his wife, Soraya, adopted Sohrab, and in an effort to win his heart, Amir also goes after a cut kite in one kite-flying afternoon back in the United States, and in the end Sohrab only shows a lopsided smile, but Amir accepted it with all his heart as he runs the kite for Sohrab, saying, "For you, a thousand times over." In the story, the study of religion is evident in the course of Amir's life at school. In their school, they had a mullah who taught them about Islam, lecturing them about the virtues of the zakat and the duty of the hadj; the intricacies of performing the five daily namaz prayers, and made them memorize verses from the Koran. The morning prayers were also portrayed in several scenes of the movie.

Hospitality Mangement - Destination Report - Comprehensive Report Assignment

Hospitality Mangement - Destination Report - Comprehensive Report - Assignment Example Santa Fe is the capital city of Mexico, and doubles up as the oldest capital city in the U.S. it is recognized as a chief tourist destination owing to its climate which supports multiple outdoor activities such as skiing in winter, and hiking in other seasons (â€Å"Santa Fe† n.p.). In addition, it hosts many cultural activities, and has an historic downtown which is also a tourist attraction. There are famous names originating from the region such as Antonio Lopez who is famous for playing a big role in Mexico’s gain of independence, Anna Gunn who is a popular actor on screen and stage, and Jeremy Rau Valdez who is famous for his awards and roles in television and film roles. One challenge to the tourist destination is the standoff between Hispanics and whites, who create tension with their rivalry, thus scare away tourists (Caffey, 13). The peak seasons in Santa Fe are during winter, which is around Christmas when there are much skiing and snow-related activities. The low season is experienced in summer, around March when temperatures can attain 55 degrees. The airfare and hotel rates vary similarly with season; with the rates escalating during high seasons, and being moderate during low seasons. Activities supported in Santa Fe include hiking, biking, mountaineering and skiing. There is much to see as well such as the Canyon Road which hosts most of Mexican heritage and historical sites such as the St. Francis of Assisi Basilica and the Plaza. Nightlife in this destination is mostly marked with music and live performances offered in the restaurants, clubs and bars. People convene and socialize in such places. There are numerous festivals held in Santa Fe such as the International Folk Art Market at Museum Hill, the Santa Fe Film festivals in December, and the Pueblo Winter Feast Days and Dances in January. There are hundreds of food palaces offering

Entrepreneurs Journey Case Study Example | Topics and Well Written Essays - 1000 words

Entrepreneurs Journey - Case Study Example Simi sought various interventions and methodologies to achieve to achieve her goals. This paper seeks to discuss various entrepreneurial challenges encountered in setting up a business by critically evaluating a case study. Simi’s case is a classic example of contemporary issues facing entrepreneurial endeavors that individuals face in their quests to set businesses in various regions of the world. Simi sought to establish and launch her business idea in Lagos, Nigeria her country of birth and origin. The most significant issue encountered by this entrepreneur is her gender as a woman, which bestows her added responsibility of bearing and rearing children for her family. This is compounded by her career aspirations, personal goals and dreams which she ultimately wants to achieve in a timely manner. This aspect requires appropriate and smart career planning and considerate decision making accompanied by relevant choices. Career planning should be focused the implementation of s trategic career objectives that are accommodative of an individual’s other commitments with their family. ... As a developing country, Nigeria presents myriad off challenges to any budding entrepreneur irrespective of their gender. Cultural perspectives towards women in Nigeria are totally different from those held in the United States, and Simi should have experienced a culture shock during the initial stages of her business. According to Simi, her education set her apart from a majority of women she sought to provide services to through her company. This meant that her entrepreneurial perspectives and attitudes were different from those of her potential clients she sought to recruit. This formed part of her marketing problems in a new business environment with different challenges that she had not envisaged. 2hats Network LLC was faced with operational problems in the sense that it had already started operating and functioning in the US with ongoing contracts during its intended relocation to its originally intended location. This created logistical challenges for the company, which risked losing critical contracts that were the financial lifelines of the new company. Strategic problems also bedeviled the company because of the drastic dynamism the company was bound to go through in the new business environment. Financial support for the company was entirely reliant on personal contribution because their new business environment lacked financial support for emerging entrepreneurs. Market access was another challenge that 2Hats had to contend with in its initial foray into the Nigerian market. Critical analysis of entrepreneurial activities requires both qualitative and quantitative analytical methods in order to achieve well-rounded, clear and objective inferences and solutions. There exist two approaches to a successful critical

The Intel Corporation Essay Example for Free

The Intel Corporation Essay Introduction The main purpose of this case analysis is to find the issue and problem that Intel Corporation faced and how they improve their performance and solve problems. First, I will summarize the history of Intel Corporation. Second, to point out the challenge that Intel Corporation has. And, third, I will use SWOT analysis to analyze the internal strengths and weakness and external opportunities and threats of Intel Corporation. Eventually, I will give some recommendation. History of Intel Corporation Intel Corporation is a leading microprocessor producer for personal computer (PC) in the world. Intel Corporation was formed by In 1968, Robert Noyce and Gordon Moore founded Intel Corporation. After Intel Corporation founded, they recruited several employees from Fairchild Semiconductor to help them. Intel Corporation was mostly influenced by Andy Grove. He was an autocratic leader and gave everyone lots of pressure. Under his rules and management style, Intel Corporation set a good culture result in the future success. Since the dawn of the Intel Corporation, it has gained the leading position in semiconductor industry such as memory chip and microprocessor. Intel invested heavily in their RD department in order to strengthen their innovative leading position to against competitors. However, in recently years, the personal computer industry appears the negative growth rate which may harm for Intel business due to the majority business comes from personal computer. Therefore, Intel Corporation should take a consideration of downward sign to seek opportunity to exploit the blue ocean market. SWOT analysis of Intel Strength 1. Product Diversification Intel has variety products such as processors, motherboards, servers, cable modems, and solid state drive. Although Intel has dominated the market, it still put a lot of efforts on their product innovation. Diversification of Products integrated not only provides customers one-stop purchasing but also attract different field customers. 2. Technology Innovative and Strong RD Competence Intel fully understands RD is the key to allow them to lead in high tech industry. Moreover, the customers will never feel satisfaction with buying the same or few types of microprocessors. In order to satisfy various demands, Intel always spend huge amount and put a lot of efforts into their RD department which makes Intel is able to introduce new products before its competitors. Consequently, Intel can provide the choices to the demand from high-end product with high price and the low-end demand with lower price. 3. Economic of Scale Intel has almost dominated the PC, laptop, and corporate computer’s CPU which allows Intel to build up highly barriers for the new entrants because of the large economies of scale. Once Intel reaches the economies scale, they have a significant cost advantage over its competitors and that this dominant ability will make its competitors are essentially price takers, with little power to set up their own prices. Weakness 1. The Struggle of Expanding Smartphone Business Many experts claim that the smart phone will be flagship product in high tech industry for next decades. However, currently, ARM (The Architecture for the Digital World) dominates the smart phone chip market and acknowledges the first mover advantaged. As a result, it is very difficult to expand smart phone chip business for Intel and lose its competitive advantage. 2. Downward Microprocessor Demand As I mentioned before, smart phone may take some market away from PC and laptop. Currently, the demand of PC and laptop’s CPU is decline but Intel cannot take any advantages on smart phone chip. Moreover, the majority of Intel’s business comes from Microprocessor which is very risky for Intel. As long as the demand drops dramatically, it will greatly harm for Intel. Opportunities 1. Keep Innovative Competitive Advantage Technology Innovation is a key to success in rapid changing and highly competitive high tech industry. Keeps it pioneering introduction new product will develop the entry barriers and gain the competitive advantages. 2. Product Improvement Recently, Intel has launched it smart phone processor chip to compete with ARM face to face. Although, their chip works better than ARM, their chip cost more power than ARM. Therefore, it is a very good opportunity to grasp market share that if Intel improve their product based on their strong RD. Threats 1. Globally Downward of Consumer Purchasing Power Economic crisis will trigger the downward pressure on consumer purchasing ability. Laptop and personal computer is consumer product when the decreased personal income will affect the demand. Consequently, the decreased of the demand will lead to negative impact on Intel’s sales and profits. 2. The Fighting Campaign from Competitor Although Intel has become the biggest company, they still need to pay attention on their competitor-AMD. The decisions made by Intel are highly dependent upon the action of their rivals. Intel needs to closely put their eye on AMD to avoid any technology fall behind to keep their leading innovation. Recommendation Intel should strengthen their PC and sever business by using technical leadership because the PC segment still estimates to have a growing market approximately 17% worldwide. Intel can launch more marketing campaigns and put more efforts on developing new technology to exploit more business. Intel can expand products into new device. The computing landscape is changing such as smart phone, smart phones, and tablets are connecting to the internet and become more intelligent. Intel should be more aggressive to pursue opportunities to expand their business in new device categories.

Listening report: Symphony No. 89 in F major

Listening report: Symphony No. 89 in F major I thought about few of the many song I know to write a report on, but I was not sure what which song was a right one. All the songs I know are short and do not last longer than fifteen minutes. So I decided to choose a symphony from Franz Joseph Haydn because he has composed over a hundred symphonies and he is known as the â€Å"Father of Symphony†. Symphony number 89 would was a random but great choice I made to write my listening report on, because I was simply born in the year 89. My report is base on all four movements of Symphony No. 89 in F Major. The entire symphony is about nineteen minutes long and remains peaceful and pleasing in all four movements. The first movement of Symphony No. 89 in F major starts with a vivace tempo meaning playing lively and fast. In fact forte staccato chords are played followed a piano melody. For me these melodies sound very peaceful and enjoyable. Just the start of this music piece, I can simply imagine this symphony being played and people dancing on a 1800s high social class celebration. In fact, I think is the mixed of high (treble clef) keys being played throughout entire movement makes the whole movement sound pleasing and a perfect combination for a symphony and to use it as a recording for any (high loyalty social class) special occasion or event. At approximately 3 minutes and 16 seconds of the movement, the theme starts to change, and I was able to hear the drum(s) played rapidly for a couple of seconds with other instruments. This change in melody is so great to hear because of the vibrations the instruments make. This approach introduces the new theme and makes the theme sound quieter tha n the first theme. Later on recapitulation, the music stays in tonic, but the themes are being developed. The music near the end makes the movement end with mystery music in which instruments are vibrating on certain times. Movement two of Symphony No. 89 starts an andante tempo with â€Å"con moto† meaning with motion. I found out that this movement is in a siciliano style that is part of the Baroque period. The movement starts with a slow beats, and throughout the movement remains calm. This movement I characterized as being relaxing. Besides, at approximately 2 minutes and 48 seconds the melody builds into a rapid and vibrated sound. This sound change continues for two or three times and has an effect on the ending of this movement. The rest of this movement continues to be calm, smooth, and quiet, but with different types of keys. In fact, this effect The third movement of this Symphony is played with minuet tempo. The movement starts with a sound that sounds like birds singing (like they want food or something else) but with different tone and not with high (treble clef) keys. This movement also remains calm but with different melody and with greater percentage of being enjoyable and to be dance on a special event. Besides, this movement is played with the wind band alone and is followed by a solo flute during the trio. The flute makes the rest of the movement to be pleasant with whole movement music to be effective in the way that music sounds with a humorous and amusing ending. Last but not least, the fourth movement is a total impressive finale. It is a concerto that has been extended to a rondo (in the ABACA form) plus an extended coda for this symphony. This movement was written to in a vivacetempo with assaimeaning quite fast. In fact, the sound or music for this movement is also calm and quietly but with speed. The whole movement has effective dynamics that makes the music remain continues throughout the end of the movement, and with constant keys that are used to show how the music can still have an impressive and extraordinary ending. In summary, all four movements have a peaceful and quiet sound that makes Symphony No. 89 to be calm and effective but with special particular keys. It is the use of F major keys that makes the music to have high (treble clef) keys, powerful and significant melodies as well as harmonious dynamics. I personally think Haydn Symphony No. 89 is one of the best symphonies I have heard. Is obvious that this symphony is nothing compared to Beethovens symphony no. 5. I think this symphony is somewhat opposite to Beethovens Symphony No. 5. Unlike any other symphony there is, this symphony creates a peaceful environment full with stimulating melodies and tone. All four movements were great to hear, and I think I would tried to listen to this symphony again whenever I can, especially, when I need to tranquilly go to sleep/rest for a pleasurable, and satisfying dream. Family Structure and Labour Market Comparison: UK and China Family Structure and Labour Market Comparison: UK and China China and the UK are the important developing and developed country respectively. However, China has 9.6 million square kilometres of land area and the world’s biggest population, which is very different from the UK. Therefore, in terms of demography, there are many differences between the two countries. In this essay, the similarities and differences of family structure and labour market will be compared and evaluated between China and the UK. First of all, this essay will focus on the similarities between the family structure and the labour market, then analyze their differences, before suggest reasons and consequences for them. When it comes to family structure, there are two similarities between China and the UK. The first similarity is that both China and Britain’s birth rates are below the world average. According to Central Intelligence Agency (2014) China’s birth rate is 12.17†° and the UK’s is 12.22†° while the world average is 18.7†°. Another similarity is that, in terms of divorce, infidelity is the second main reason for divorce both in China and the UK. The Daily Post (2005) reveals that â€Å" the next biggest factor was infidelity, an issue for 30% of the 546 divorcees in the YouGov poll†, while Chen weihua (2006) also reports about divorce in China, which points out that 27% divorce because of infidelity and it just follows the reason of incompatibility. However, there are also two differences between China and the UK. First of all, the number of dependent children in family is different, and the UK’s tends to be bigger than China’s. According to the Office for National Statistics (2013, p.3), the UK’s average number of dependent children per family is 1.7 in 2012. In contrast to this, according to the police of family planning in China, a couple can have 1.5 children on average in the mainland. As the fact that not everyone prefers to have a child or is able to have one, the actual number is lower than that. It is easy to be discovered that China’s families have fewer children than the UK’s. The second difference is that Chinese family size is bigger than the UK’s. The ONS (2013) released that in 2013 the UK’s family size was 2.4 people per household on average. With regard to China, the number was 3.02 (The National Health and Family Planning Council, 2014). The causes of above distinctions can be divided into three aspects. To begin with, different cultures contribute to these distinctions. British aspire to independence and freedom. However, Chinese family prefer to live together. The second reason is the one-child police in China, which results in a sharp decrease in the number of children. The fact is supported by Guo (2014, cited in Howden Zhou, 2014, p.354) and Lu (2013, cited in Howden Zhou, 2014, p.354), who estimated that â€Å"the 1CP prevented 400 million births between 1979 and 2009, almost 25 per cent of China’s present population.† Finally, different pension modes impact on the family structure of China and the UK. As British social security system is very sound, the elderly need not to live with their children to contain the living standards. Conversely, Chinese elderly people are supported by families. It limits the independence of the elderly and brings pressure on young couples, which in turn make them t end to have fewer children to reduce this stress. There comes to be some consequences of these differences. First of all, the decrease in the number of children helps to promote the position of Chinese women. Gender plays a significant role in traditional Chinese family structure, as the male have more discourse power in the family. However, Fong (2002, cited in Feng et al., 2014, p.21) indicates that the circumstance transforms when the only child is a daughter. There is no other choice for only-daughter Chinese families and they have to cultivate the only daughters the same as sons, which makes a contribution to equality between sexes in both personal development and marital relations. On the other hand, it also brings drawbacks. Only children are usually spoiled, unlike the UK’s families, most Chinese families will meet all the requirements of the only child. As a consequence, only children often behave selfish and lack of self-care ability, which is very harmful to their long-term development. Lastly, Chinese are easy to worry about the future, whereas British need not to think much about the old age. Chinese face to strong pressure of life and have to work hard to improve their living standards, Having considered family structure, now I will move on to labour market. In aspect of labour market, the similarities come to be two. Firstly, in China and Britain, personal income tax additional rates are the same. According to GOV.UK (2014), the income tax additional rate is 45% from 6 April 2014 to 5 April 2015. Although China and the UK’s personal income tax thresholds are different, both of their additional rates are 45%. Furthermore, the second similarity is approximate social security rates for employees. In China it is 11% while in the UK it comes to be 12%, which is very close to China’s. In addition to the similarities, there are two differences. Initially, China has a bigger labour force population than the UK. According to Casale and Zhu (2013), at the beginning of 2012, China had 764 million population in employment. With regard to the UK, the number of employment was 30.79 million (ONS,2014). Another difference is protection for workers. There is little workers’ hurt in the UK, whereas China has many reports about hurt and injustice for workers. For example, since January 23, 2010 to November 5, 2010, Foxconn, the worlds biggest contract electronics supplier, had occurred 14 suicide incidents, which shocked the whole China, and some media outlets said that pressure was to blame. Two reasons for these differences will be analysed. The main reasons for these distinctions are due to the different population and socio-economic development status. Initially, one of the main reasons is different population. The total population of Chinese mainland was about 1.34 billion, whereas the UK’s population was 64.1 million (ONS, 2014). Enormous population disparities lead to a huge difference in labor market scales between the two countries. A further reason comes to be different social and economic development status. The UK is a mature developed country whereas China is a developing country with many aspects imperfect. Economic profits are focused on while workers’ rights, which should be taken into consideration, are ignored. These differences in labour market also bring three different influences on people’s lives in the two countries. One of the effects is the different labour cost. China’s labour cost is obviously lower than the UK’s. British are reluctant to do physical labour. For example, in China, if a customer buy the floor, the shop usually is responsible for free installation, when it comes to the UK, the installation fees may be more expensive than the floor itself. Another influence on employees is working hours. Chinese people tend to work for longer time than British, as supported by Organization for Economic Co-operation and Development (2013), who resealed that Chinese worked 2209 hours per year on average in 2009, while in the same year the British annual working time was 1651 hours. The fierce competition makes Chinese work hard under great stress. The last impact is gender discrimination and it becomes a problem in China that female candidates are treated unfairly. As recruiters have bigger options, if they can choose a man, they will not select a woman, because women may need maternity leave in the future. In this essay, the similarities and differences of family structure and labour market are indicated between China and the UK. These differences are caused by many aspects, which vary in societies, economy, culture and laws. By analyzing these differences, some disadvantages in China’s development have been discovered. In terms of one- child police and labour protected, much work should be done to reduce the negative effects and protect the interests of vulnerable groups.

Reflection on Self Development in Mental Health Nursing

Reflection on Self Development in Mental Health Nursing The Nurse Association (ANA) (2003) defines nursing as the promotion, protection and improvement of health and abilities, stopping of illness and injury, relief of suffering through identification, medical care and support in the care of individuals, families, societies and citizenry (Nancy, 2001 p.2).Generally nursing is liable to the society for providing quality, economical as well as improving the care rendered. Hence, nurses are responsible for their patients standard of health. The area of practice I would like to develop in this regard is mental health. The World health Organisation (WHO) (2009) defines mental health as a state of well-being where all individual notices his or her own potential, can cope with normal stressful events of life, can be fruitful and productive, and is able to contribute meaningfully to his or her society. For a person to live happily and meaningfully in life, mental health is important as well as physical health. Inadequate mental health can interfere with keeping meaningful relationships, having a sense of fulfilment in ones self, work and ability to perform in daily activities of life. Mental illness can obstruct ones interest in sleep, food and sexual contact. How we cope with life situations, the way we think and feel can be defined as mental health. By description mental health could be defined as a state of well-being which enables one to be fruitful, being able to live in peace with other people, adjusts to alteration and been able to handle difficult situations. Health conditions marked by alteration or abnormalities in mood, thinking or behaviour (or a mixture of the three) that causes discomfort or impair functioning is known as mental disorder. Giving a lot of definition without going into thorough details is difficult. One huge reason that is partly responsible for the difficulty in defining mental health, mental disorder and mental illness is the differentiation between mental and physical health which is largely pretended. Our ability to think, feel and respond is governed by our brain. The brain needs constant supply of oxygen and nutrients like any other organ in the body because it can also be damaged by thyroid issues, tumours and physical trauma. Mental health and physical health are interweaved (Linda, 2010, p.334). STRENGTHS AND WEAKNESSES ANALYSIS OF MY CURRENT KNOWLEDGE BASE ON MENTAL HEALTH My main tool as a mental health nurse is caring for the elderly living with dementia. As a mental health nurse I show compassion for the people I am dealing with by showing care towards them. Regrettably, there is still some stigma attached to mental illness. Combating this and helping the individuals and their families deal with it is the key part of my job. The danger of violence is often associated with this branch of nursing and one of the special skills required is to spot a build-up of tension and defuse it. Dealing with the behaviour and human mind is not an exact science. The job of helping people back to mental health is every bit as valuable and satisfying as caring for those with a physical illness. Showing professional compassion in my field of practice as a mental health nurse is a very important strength that I possess. For true care to take place feeling compassionate and empathetic towards a stranger is a must; a good feedback feeling is set into motion by doing this. Feelings are important in a humans life. I will say compassion is strength because it is a very important ingredient in nursing profession. Compassion is more than just showing pity or concern; and some dictionary definitions indicate that compassion is part of caring because it involves suffering with the person (Moya, 1992 p 5). As a mental health nurse, it is my duty to understand how to care for the elderly with dementia because their cognitive and affective states are conflicting. Now my experience with the elderly does not appear to me differently put myself into the private world of my patient and this is what empathy and care requires. Moya (1992, p 8) suggested that though as mortals we may find true empathy hard to practice because true empathy is only possible among archangels. My weakness on my current knowledge based on this area unfortunately is lack of Confidence which is evident in certain instances. Public speaking, presentation and demonstration of procedures to nursing assistance plague me. It is one thing to be nonchalant and laid back when speaking with your family and friends, but in a professional environment the whole mood and interpretation of things changes. It all comes down to one thing, the amount of self -esteem that i have and i am willing to exert. CLEAR STATEMENT FOR PERSONAL KNOWLEDGE Snow (1991, pp. 195-197) identifies compassion as pain, sorrow or grief for someone else. Emotions help me focus my moral actions. From my personal knowledge as a mental health nurse, compassion should be totally added in my concept of care. Furthermore the role of a Registered nurse is to improve the health and well-being of the people. My aim in focus is to strive for moral height because I have the opportunity as a nurse to give attention to the pain and suffering of my patients (Ferrel, 2005, p. 86), with a workable process in leadership and putting more compassion in practice. Putting compassion into nursing care is really not an easy task as it involves a lot of work. How this will be achieved is by involving in a compassion program for qualified nurses; going into wards that are already selected for excellence in compassion. In addition getting myself in an NHS Lothian centre for compassionate care which is also called the beacon ward where patients can be asked what we the nurses are doing right and tell us how can improve health (2008) puts it as bottling the magic formula and sharing it. The beacon ward will involve me using an all about me sheet which patients will fill when admitted. This form is not about their medical conditions; about how they will love to be addressed and who is important to them. This gives me an opportunity to look at people values and beliefs. DEVELOPING KNOWLEGDE IN THIS AREA My professional role and expectation from my clients as a mental health nurse is to win trust and establish contact with my clients. They find it difficult to gain trust and build good relationships with professionals in this field. In achieving this, competence is needed. What is competence? Spencer Spencer (1993) describe competency as the ability to realize organizational goals. It involves skills, attitudes and knowledge. These soft skills are vital in this area of practice. Developing my knowledge in mental nursing will enable me be a better nurse and gain a higher level of competency. Registered mental health nurses are regularly faced with clients who stay away from care. They involve patients with severe personality and behavioural disorders, older people living with dementia. Nursing and Midwifery Council (2002) Professional code of conducts describes situations where my professional role as a nurse is needed to be put into practice as regards competence. Throughout my year of practice I must keep my knowledge and skills up to date. Taking part in learning activities that will develop my performance and competence. In order to practice competently and professionally i must possess the knowledge, skills and abilities needed for lawful effective and safe practice without supervision. I must know the things that I am capable of doing and only accept those procedures and practice that I am competent at. If an area of practice is above my level of competence or outside my area of specialty I should call for help and supervision from a competent practitioner except otherwise. SMART CHART DETAILING HOW I WOULD ACHIEVE MY GOALS My goals, when adequately structured can be achieved in a means elaborated below using a SMART CHART. Extension (2008) stressed that SMART goals will enable one achieve relevant actions and goal; they further explained SMART is an acronym for goals that are: Specific, Measurable (Mutual, Motivated), Attainable, Relevant/Realistic, and within a specific Timeline. Clearly stated, my goals are: Improvement in the area of my level of competence as a mental health nurse Ability to win patient trust Develop my level of confidence Broaden my level of knowledge in mental nursing S My goals are limited to my area of improvement and strengths particularly related to my area of specialization which makes it specific M These goals serve as a driving force to my striving for excellence in mental health nursing A A right move in attaining or achieving these goals is by the embarking on my current programme in the University which has boosted my assurance of being a figure head in the nursing profession. R My goals are still in line with my first degree and profession hence its relevance in to my career and to the improvement of patient status. The Nursing and Midwifery Council has embarked on nurses self-development training programmes which my goals conform to. T Putting into utmost consideration my level of adaptation to the health system of the UK and my academic pursuit, my goals are already being actualized and is an on-going process of development till my career is over because learning is a continuous process and knowledge is acquired on a daily process.

Topology :: Math Mathmatics

Topology Topology is a modern branch of geometry. It has been called qualitative geometry because instead of thinking about the traditional characteristics of an object (like angles, length, etc.), topologists study features that can’t be altered by stretching, twisting or shrinking the object. After any alteration all points in the object that were connected must still be connected and all points separated by a hole must remain separated. Topology also attempts to explain objects that cannot exist in three dimensions using mathematical equations, since it is nearly impossible to imagine such objects within our frame of reference. The dimension of an object can be thought of in two ways: intrinsic and extrinsic. The perception of a â€Å"creature† occupying, say a line, is one-dimensional, since he can only move in one dimension. However, we draw a line on a plane, so extrinsically it is two-dimensional (1). So how do objects occupying the same dimension diff er topologically? A doughnut shaped object, called a torus, and a sphere are topologically different. Both of these objects are extrinsically two-dimensional, since we only deal with the surfaces of the object. There is no â€Å"inside.† The reason for the topological difference is the hole in the middle of the torus. No permitted alterations (stretching, twisting, shrinking) can be made to the sphere that will transform into a torus. Topology emerged out of Euler’s work on graph theory in the early 1700’s. Leonhard Euler was born on April 15, 1707 in Switzerland. His father was a minister and wanted his son to follow in his footsteps. He sent his son to the University of Basel in 1720, when Leonhard was only 14. It was here that his interest and natural capabilities in mathematics really began to show. After completing his studies and showing very promising mathematical talent, Euler moved to St. Petersburg, Russia to teach mathematics, at the age of only 19. He remained in Russia for several years (4). And it was here that he made contributions to mathematics that would later be seen as the first steps towards topology. Graph theory studies how points are connected without giving any regard to the distance between them or the actual shape of the line connecting them.

The Role of Estrogen in Sexual Differentiation :: Biology Essays Research Papers

The Role of Estrogen in Sexual Differentiation Most, if not all, species with two sexes exhibit sexually dimorphic behavior and physical characteristics. These dimorphisms can be attributed to differences in the brain, such as size or function of structure, and these brain structures can be affected by the hormones circulated throughout the organism. It has been held that the sexual dimorphisms rely only on the presence or absence of androgen, namely, testosterone, during the critical period of development for an organism; however, new research suggests that the presence of estrogen, specifically estradiol, has an active role in sexual differentiation. Several sexual dimorphic structures in the brain have been observed in laboratory experiments. The corpus callosum in male rats is much larger than that in female rats, and this size difference is uncorrelated with total brain weight. These findings led many to investigate the relationship between human male and female corpus callosa. A paper published by de Lacoste-Utamsing and Holloway stated that the splenium of the callosum is larger in women than in men, but their finding has since been challenged by several reports stating that there exists no sexual dimorphism. Analysis done from 1982-1994 reveals a small difference of corpus callosum size in favor of males, but it is hypothesized that age, handedness, overall brain size and weight, and incorrect statistics were not taken into account. (3) There has also been controversy in the research involving the brain region INAH-3 in humans. The heterosexual male INAH-3 is larger than that of heterosexual females; the INAH-3 in homosexual males is on the average smaller than that of heterosexual males and approximately the same size of heterosexual females. The general population has attempted to use this fact as an explanation of the biological basis of homosexuality, though the differences in structure may not be causally related to the sexual orientation of the man. Because we can only observe behaviors when doing experiments with lab animals, the data cannot firmly establish a basis for sexual orientation. The traditional view on sexual differentiation is that organizational effects from hormones which occur during neonatal development are the master plan for the organisms sex and corresponding behaviors and characteristics. Exposure to androgen, namely, testosterone, would result in a male organism, while exposure to neither androgen nor estrogen would result in the default sex: female. Characteristics resulting from organizational effects include formation of genitalia and traits such as aggression. The Role of Estrogen in Sexual Differentiation :: Biology Essays Research Papers The Role of Estrogen in Sexual Differentiation Most, if not all, species with two sexes exhibit sexually dimorphic behavior and physical characteristics. These dimorphisms can be attributed to differences in the brain, such as size or function of structure, and these brain structures can be affected by the hormones circulated throughout the organism. It has been held that the sexual dimorphisms rely only on the presence or absence of androgen, namely, testosterone, during the critical period of development for an organism; however, new research suggests that the presence of estrogen, specifically estradiol, has an active role in sexual differentiation. Several sexual dimorphic structures in the brain have been observed in laboratory experiments. The corpus callosum in male rats is much larger than that in female rats, and this size difference is uncorrelated with total brain weight. These findings led many to investigate the relationship between human male and female corpus callosa. A paper published by de Lacoste-Utamsing and Holloway stated that the splenium of the callosum is larger in women than in men, but their finding has since been challenged by several reports stating that there exists no sexual dimorphism. Analysis done from 1982-1994 reveals a small difference of corpus callosum size in favor of males, but it is hypothesized that age, handedness, overall brain size and weight, and incorrect statistics were not taken into account. (3) There has also been controversy in the research involving the brain region INAH-3 in humans. The heterosexual male INAH-3 is larger than that of heterosexual females; the INAH-3 in homosexual males is on the average smaller than that of heterosexual males and approximately the same size of heterosexual females. The general population has attempted to use this fact as an explanation of the biological basis of homosexuality, though the differences in structure may not be causally related to the sexual orientation of the man. Because we can only observe behaviors when doing experiments with lab animals, the data cannot firmly establish a basis for sexual orientation. The traditional view on sexual differentiation is that organizational effects from hormones which occur during neonatal development are the master plan for the organisms sex and corresponding behaviors and characteristics. Exposure to androgen, namely, testosterone, would result in a male organism, while exposure to neither androgen nor estrogen would result in the default sex: female. Characteristics resulting from organizational effects include formation of genitalia and traits such as aggression.

Great Expectations, Little Dorrit Essay -- Great Expectations Essays

Charles Dickens used his own personal experiences and views to create the setting in his novels, as it is seen in Great Expectations, Little Dorrit, and Bleak House. The role of the setting in each book is to create the mood and support the characters. (Davis 350) In Dickens’ novels the setting helps the reader better understand the time period and the problems the people of London faced with the political and social structure in place at the time. It also gives insight into the lives of the people through the intricate detail. Many times in Dickens novels, the setting becomes a character itself and without it the story would be incomplete. Dickens attention to detail is part of what makes his novels so unique and original. In order to see the influence Dickens’ experiences had in his books, first one must know a little of his history. Charles Dickens was born on February 7, 1812 to John and Elizabeth Dickens. (Kaplan 18) During most of his childhood they lived in London and this is where most of his settings come from. John Dickens had a hard time living within his means and when Charles was 12 his father was sent to the debtors’ prison, known as the Marshalsea. (Kaplan 39) While John was in prison Elizabeth and their other children lived at the Marshalsea with him, but Charles was sent to work in a factory to help support the family and pay off his father’s debt. (Kaplan 41) This time in Charles’ life would always be a haunting memory for him and it influenced many of his stories. After a year John’s mother died, leaving him enough money to pay off his debts and he was released from the Marshalsea. Even after his father’s release from prison, Dickens mother made him continue to work at the factory. This time caused him to be b... ...d distinct. Many of the settings in Great Expectations and Little Dorrit come from Dickens’ childhood experiences, such as the dock yard, the Marshalsea and working in the factory. He paints vivid pictures with words to show the reader exactly how he saw things. Bleak House shows his strong beliefs and views about the political system of England during this time. He uses the story to show exactly how unorganized and corrupt the political system was at the time. These novels are great examples of how the setting plays a role in the story, by creating the mood and helping the reader better see into the lives of the people living during that time. The major role the setting plays in these stories is the insight into the beliefs of the author and the experiences he had growing up in and around London in the nineteenth century, as it is portrayed by him in his works. Great Expectations, Little Dorrit Essay -- Great Expectations Essays Charles Dickens used his own personal experiences and views to create the setting in his novels, as it is seen in Great Expectations, Little Dorrit, and Bleak House. The role of the setting in each book is to create the mood and support the characters. (Davis 350) In Dickens’ novels the setting helps the reader better understand the time period and the problems the people of London faced with the political and social structure in place at the time. It also gives insight into the lives of the people through the intricate detail. Many times in Dickens novels, the setting becomes a character itself and without it the story would be incomplete. Dickens attention to detail is part of what makes his novels so unique and original. In order to see the influence Dickens’ experiences had in his books, first one must know a little of his history. Charles Dickens was born on February 7, 1812 to John and Elizabeth Dickens. (Kaplan 18) During most of his childhood they lived in London and this is where most of his settings come from. John Dickens had a hard time living within his means and when Charles was 12 his father was sent to the debtors’ prison, known as the Marshalsea. (Kaplan 39) While John was in prison Elizabeth and their other children lived at the Marshalsea with him, but Charles was sent to work in a factory to help support the family and pay off his father’s debt. (Kaplan 41) This time in Charles’ life would always be a haunting memory for him and it influenced many of his stories. After a year John’s mother died, leaving him enough money to pay off his debts and he was released from the Marshalsea. Even after his father’s release from prison, Dickens mother made him continue to work at the factory. This time caused him to be b... ...d distinct. Many of the settings in Great Expectations and Little Dorrit come from Dickens’ childhood experiences, such as the dock yard, the Marshalsea and working in the factory. He paints vivid pictures with words to show the reader exactly how he saw things. Bleak House shows his strong beliefs and views about the political system of England during this time. He uses the story to show exactly how unorganized and corrupt the political system was at the time. These novels are great examples of how the setting plays a role in the story, by creating the mood and helping the reader better see into the lives of the people living during that time. The major role the setting plays in these stories is the insight into the beliefs of the author and the experiences he had growing up in and around London in the nineteenth century, as it is portrayed by him in his works.

Concept Map Tuberculosis

Schiffman, George. (07, 2011). Tuberculosis. Retrieved from http://www. medicinenet. com/tuberculosis/page4. htm Tuberculosis. (01, 2013). Retrieved from http://www. mayoclinic. com/health/tuberculosis/DS00372/DSECTION=treatments-and-drugs Vyas, Jatin M. (11, 2012). Pulmonary Tuberculosis. Retrieved from http://www. ncbi. nlm. nih. gov/pubmedhealth/PMH0001141/ Schiffman, George. (07, 2011).Tuberculosis. Retrieved from http://www. medicinenet. com/tuberculosis/page4. htm Tuberculosis. (01, 2013). Retrieved from http://www. mayoclinic. com/health/tuberculosis/DS00372/DSECTION=treatments-and-drugs Vyas, Jatin M. (11, 2012). Pulmonary Tuberculosis. Retrieved from http://www. ncbi. nlm. nih. gov/pubmedhealth/PMH0001141/ IMPLEMENTATION -Assess respiratory rate every 10-15 minutes Continuously note chest movement and use of accessory muscles during respiration -Auscultate breath sounds and note any areas with adventitious sounds, especially wet crackles -Document any respiratory secretions such as sputum: amount, character, and consistency -Keep patient in high Fowler’s position to allow optimum breathing -Check for obstructions or accumulation of sputum -Ask patient level of discomfort/pain on a scale of 1-10 -Record medication administrations and if therapeutic effects are occurring -Describe procedures and treatment expectations Encourage patient to follow drug regimens IMPLEMENTATION -Assess respiratory rate every 10-15 minutes -Continuously note chest movement and use of accessory muscles during respiration -Auscultate breath sounds and note any areas with adventitious sounds, especially wet crackles -Document any respiratory secretions such as sputum: amount, character, and consistency -Keep patient in high Fowler’s position to allow optimum breathing -Check for obstructions or accumulation of sputum -Ask patient level of discomfort/pain on a scale of 1-10 Record medication administrations and if therapeutic effects are occurring -Describe procedur es and treatment expectations -Encourage patient to follow drug regimens PLANNING -Goals include treating any abnormal results such as dyspnea, abnormal breath sounds, irritability, and reducing or eliminating sputum levels -Give patient therapeutic effects regarding abnormalities found with little or no side effects -Help patient in making lifestyle changes that include making a safer work and home environment and getting the people who have the most contact with the patient treatment PLANNING Goals include treating any abnormal results such as dyspnea, abnormal breath sounds, irritability, and reducing or eliminating sputum levels -Give patient therapeutic effects regarding abnormalities found with little or no side effects -Help patient in making lifestyle changes that include making a safer work and home environment and getting the people who have the most contact with the patient treatment TUBERCULOSIS TUBERCULOSIS DIAGNOSIS Ineffective airway clearance related to poor cough ef fort as evidenced by abnormal breath sounds and dyspnea -Risk for infection related to settled secretions as evidenced by wet adventitious lung sounds such as crackles, and excessive sputum -Deficient knowledge related to condition, treatment plan, self-care and discharge needs as evidenced by questions/requests for information, statements about the problem, and the development of preventable complications DIAGNOSIS -Ineffective airway clearance related to poor cough effort as evidenced by abnormal breath sounds and dyspnea -Risk for infection related to settled ecretions as evidenced by wet adventitious lung sounds such as crackles, and excessive sputum -Deficient knowledge related to condition, treatment plan, self-care and discharge needs as evidenced by questions/requests for information, statements about the problem, and the development of preventable complications ASSESSMENT -Check for vitals; check for abnormal breath sounds, especially for wet crackles on inspiration -Assess for dyspnea, if using accessory muscles for respirations, or if the pt has elevated shoulders -Assess level, color, and consistency of any sputum Check for restlessness, irritability, or anxiousness -Report history of the patient, any existing illnesses such as pneumonia, cancer, family hx, workplace, home life, and lifestyle ASSESSMENT -Check for vitals; check for abnormal breath sounds, especially for wet crackles on inspiration -Assess for dyspnea, if using accessory muscles for respirations, or if the pt has elevated shoulders -Assess level, color, and consistency of any sputum -Check for restlessness, irritability, or anxiousness Report history of the patient, any existing illnesses such as pneumonia, cancer, family hx, workplace, home life, and lifestyle NURSING PROCESS NURSING PROCESS EVALUATION -Assess if medication and procedures are performing therapeutic effects -Check for levels of discomfort/pain on a scale of 1-10, make sure vitals and lab results are within normal ra nges -Check if patient’s secretion amount diminished or stopped -Assess if patient’s restlessness and irritability was alleviated -Check if patient is continuously taking prescribed medications to prevent spread of disease EVALUATION Assess if medication and procedures are performing therapeutic effects -Check for levels of discomfort/pain on a scale of 1-10, make sure vitals and lab results are within normal ranges -Check if patient’s secretion amount diminished or stopped -Assess if patient’s restlessness and irritability was alleviated -Check if patient is continuously taking prescribed medications to prevent spread of disease ETIOLOGY -Caused by the bacteria Mycobacterium tuberculosis (M. uberculosis) by breathing in air droplets from a cough or sneeze of an infected person, resulting in primary TB -Risk factors include those who life with others who have active TB, poor or homeless people, elderly, infants, nursing home residents, prison inmates, alc oholics, IV drug users, those with malnutrition, working in health care, workers in refugee camps -Factors that elevate chances include diabetes, kidney disease, cancer, chemotherapy, and certain types of drugs ETIOLOGY Caused by the bacteria Mycobacterium tuberculosis (M. tuberculosis) by breathing in air droplets from a cough or sneeze of an infected person, resulting in primary TB -Risk factors include those who life with others who have active TB, poor or homeless people, elderly, infants, nursing home residents, prison inmates, alcoholics, IV drug users, those with malnutrition, working in health care, workers in refugee camps -Factors that elevate chances include diabetes, kidney disease, cancer, chemotherapy, and certain types of drugsPATHOGENESIS -Droplets of fluid containing tubercle bacilli are released into the air and are taken into the nasal passages and lungs of a susceptible person nearby -Once inhaled, tubercle bacilli reach alveoli where macrophages take them up; ba cilli then multiply and spread through lymph vessels into the lymph nodes and finally to distant organs; can remain ‘alive’ or become ‘inactive’ -Immune system responds which causes damage to the tissues; cells attack the bacilli, thus killing the infectionPATHOGENESIS -Droplets of fluid containing tubercle bacilli are released into the air and are taken into the nasal passages and lungs of a susceptible person nearby -Once inhaled, tubercle bacilli reach alveoli where macrophages take them up; bacilli then multiply and spread through lymph vessels into the lymph nodes and finally to distant organs; can remain ‘alive’ or become ‘inactive’ -Immune system responds which causes damage to the tissues; cells attack the bacilli, thus killing the infectionSIGNS/SYMPTOMS -Common symptoms include unintentional weight loss, fatigue, fever, night sweats, chills, loss of appetite -Cough persisting three weeks or more, coughing up blood or sput um, or chest pain when breathing or coughing -If spread, TB of the spine leads to back pain and TB of the kidneys cause blood in the urine SIGNS/SYMPTOMS Common symptoms include unintentional weight loss, fatigue, fever, night sweats, chills, loss of appetite -Cough persisting three weeks or more, coughing up blood or sputum, or chest pain when breathing or coughing -If spread, TB of the spine leads to back pain and TB of the kidneys cause blood in the urine COMPLICATIONS -Medicines for TB can cause side effects such as liver problems, changes in vision, orange/brown colored tears or urine, rash -TB of the bones: joint destruction -TB of the brain: meningitis; swelling TB of liver or kidneys: impaired filtering of waste -TB of the heart: inflammation; fluid collections; impaired pumping abilities; cardiac tamponade COMPLICATIONS -Medicines for TB can cause side effects such as liver problems, changes in vision, orange/brown colored tears or urine, rash -TB of the bones: joint destru ction -TB of the brain: meningitis; swelling -TB of liver or kidneys: impaired filtering of waste -TB of the heart: inflammation; fluid collections; impaired pumping abilities; cardiac tamponade TREATMENT/MANAGEMENT Patient recommended to stay in isolation and on bed rest until no longer contagious -Inactive TB: antibiotic called isoniazid (INH) is prescribed for six to twelve months; not prescribed to pregnant women; can cause liver damage and peripheral neuropathy -Active TB: INH is also prescribed along with rifampin, ethambutol, pyrazinamide; may also receive streptomycin; may be taken from months to years -Drug resistant TB: everything with active TB with several other drugs; longer treatment; may require surgery to remove damaged lung tissue TREATMENT/MANAGEMENT Patient recommended to stay in isolation and on bed rest until no longer contagious -Inactive TB: antibiotic called isoniazid (INH) is prescribed for six to twelve months; not prescribed to pregnant women; can cause li ver damage and peripheral neuropathy -Active TB: INH is also prescribed along with rifampin, ethambutol, pyrazinamide; may also receive streptomycin; may be taken from months to years -Drug resistant TB: everything with active TB with several other drugs; longer treatment; may require surgery to remove damaged lung tissue