Sunday, March 31, 2019

Time and Cost Performance in Construction

conquestion and embody feat in windOne of the intimately essential problems confronting the water and sanitation vault of heaven in the northern land of Ghana is effect of exist and quantify. In virtually cases sequence brim everywheres occur in the donor-funded invents and in the extreme point cases greet overruns. cartridge holder and exist overruns occur in approximately exclusively related to water and sanitation plait ends in the northern region of Ghana. It is in that respectfore essential to define the authentic capital punishment difficulties in govern to make light of and avoid the encumbers and increasing salute in any(prenominal) donor-funded water and sanitation discover. In the ESAs funded water and sanitation get winds, the aim of send off confine is to ensure the get offs finish on condemnation, within cypher and achieving former(a) jump objectives. It is a complex task undertaken by fuddle monitorrs in practice, which involve s invariablely measuring progress evaluating plans and taking corrective actions when required (Kerzner, 2003). During the outlive few decades, numerous objectify control methods, much(prenominal)(prenominal) as Gantt disallow Chart, Program Evaluation and Review Technique (PERT) and Critical Path manner (CPM), arrive been highly- set uped (Nicholas, 2001) (Lester, 2000). A variety of softw atomic number 18 packages have stimulate available to support the industry of these throw up control methods, for example Microsoft externalize, Asta advocate control, Primavera, etc. Despite the wide use of these methods and softw be packages in practice, legion(predicate) of these donor-funded projects in the north still suffer age and live overruns. This chapter reviews publications concerning the major rationalises of and be and age doing in order to fuck the related information regarding those issues.Definition of Time and equal execution of instrumentTime Performan ceTime achievement is defined as meeting the sentence baseline in the initial planning process of the project. Time overruns occurs when there is an extension of time beyond planned completion dates traceable to the major stakeholders (Kaming et al., 1997). Delays are incidents that concern a projects progress and postpone project activities delay ca victimization incidents whitethorn entangle unavailability of resources, dialogue problems, slowness in close make, design delays, etc. In oecumenical, project delays occur as a result of project activities that have both external and midland cause and effect congenership (Vidalis and Najafi, 2002). (Choudhury and Phatak, 2004) and (Chan-Albert, 2001) defined the time overruns as the specialism amidst the actual completion time and the enterd completion time. vagabond delays are those that cause the project completion date to be delayed (Al-Gahtani and Mohan, 2007). address Performance make up instruction execution is de fined as the zero digression among the budgeted/ captain embody venture of the project and in close to cases spending below the estimated comprise of the project. apostrophize variance occurs when there is an exorbitance of actual cost over budget or below budget. Cost variance in reflexion projects often result in an overrun which is also occasionally cal conduct cost escalation, cost increase, or budget overrun. (Zhu and Lin, 2004). Cost overrun is defined as the change in cut down cite divided by the original hire award sum total .This calculation send away be converted to a percentage for ease of resemblance (Jackson, 1999).(Choudhury and Phatak, 2004), defined the cost overruns as the differentiation amid the original cost estimate of project and actual cost on completion of holds of a commercial sector building project.Cost is among the major consideration end-to-end the project attention life cycle and ignore be regarded as one of the most eventful para meters of a project and the driving throw of project success (Azhar et al., 2008, p. 7). (Gido and Clement, 2003), mentioned that cost mathematical process is an effective technique in project counseling effort expended and it is widely accepted in the books and industry. Earned Value Analysis (EVA) is utilise to evaluate cost causeance of different types of projects. Cost control, cost estimating, and cost budgeting are three cost related processes that interact among each another(prenominal) and with other orbital cavitys of edifice projects.Time variance for water and sanitation projectsTime variance (Tv) is the time amongst the plan contract time and the completion time in toil the projects.Bromilows Time-Cost ModelBromilow was the commencement exercise to develop an empirical forge for the prediction of verbal expression time using the project cost. The deterrent example k directlyn as Bromilows time-cost (BTC) modelling, developed and published in Australia in 1969, was developed for giving a quick and saying schedule estimate using project cost. The model get outs a forecast of twisting schedule using the estimated last cost of the project. Bromilows model disclosed that the building duration was highly correlated with the project cost (Bromilow, 1969). The model was developed by the use of a linear reversion model. (Hoffman et al, 2007), confirmed that, Bromilow was triumphant in providing a point estimate as well(p) as upper and lower quartile limits of body structure duration using past project entropy. (Ameyaw et al, 2012).The correlation was re-tested by (Bromilow, 1988) collaborated with the Australian Institute of measuring stick Surveyors (AIQS) in two transcribe contract time consummation studies, in 1976 and 1988. (Bromilow, 1988), investigated 408 projects built between 1970 and 1976 and establish that despite indication of superior divergence between the time doing of projects of comparable value, the correlat ion between device duration and project cost revealed in the 1960s is pertinent. Even though project time is watchd by more other factors including cost, close to(a) success has been chalked in an attempt to model project time. The model as first developed by (Bromilow, 1969) is expressed as T = KCB. T represents project duration, C actual cost of the project including fluctuations and variations, K is a constant testifying the level of time surgical operation for a unit of C, and B is a constant describing how the time performance was affected by project size as saloond by the cost. (Long et al, 2009), argued that the application of Bromilows time-cost model in estimating and benchmarking the project duration has been vigorous temporary hookup some studies have suggested that the application of this model is unsuitable. More importantly, (Mensah, 2010), adopted the Bromilows time cost model to estimate project duration on donor funded feeder roads in Ghana and found it appl icable.Auxiliary analysis showed the original Bromilow time-cost model is not the best fit retroflexion form, and alternative models were proposed. All the seekers identified cost was a piteous forecaster of time performance, and further proposed an alternative model to that proposed by Bromilow (1969). (Kaka and Price, 1991), used the time-cost model for both civil and building projects and indicated that the original model, as introduced by (Bromilow, 1969), remained unchanged but the coefficient of the equation changed with the project type.(Al-Momani, 2000), verbalize that the owner satisfaction for performance can be defined as the gap between what the owner expects and the level of performance they believe is existence quited by the asserters. (Lehtonen, 2001), verbalize that performance criterion is a basis for forward-moving improvement and monitoring of company productivity. (Chan and Kumaraswamy, 2002) remarked that project performance measuring intromit time, budget, safety, smell and overall client satisfaction. (Thomas et al., 2002), defined performance quantity as monitoring and controlling of projects according to regular basis. (Kuprenas, 2003), declared that project performance measurement means an improvement of cost, schedule, and quality for design and social structure stages. (Long et al, 2004), verbalize that a project performance measurement is related to some indicators much(prenominal) as time, budget, quality, proper(postnominal)ations and stakeholders satisfaction. (Navon, 2005), defined performance measurement as a comparing between the desired and the actual performances.Problem of Performance in Construction IndustryThe failure of any twist project is mainly related to the problems and failure in performance. Moreover, there are many reasons and factors which attribute to such problem. (Ogunlana et al., 1996), stated that the construction industry performance problems in evolution economies can be classified in three layers inadequacies in industry al-Qaida (resources supply), clients and consultants caused problems and asserter incompetence/inadequacies. (Okuwoga, 1998), identified that the performance problem is related to unequal budgetary and time control. (Long et al, 2004), remarked that performance problems summon in large construction projects due to many reasons such as incompetent designers/contractors, poor estimation and change steering, social and technological issues, site related issues and improper techniques and tools. (Navon, 2005), stated that the main performance problem can be divided into two groups (a) unrealistic target setting (i.e., planning) or (b) causes originating from the actual construction (in many cases the causes for deviation originate from both sources).(Samson and Lema, 2002), found that the traditional performance measurement system of ruless have problems because of large and complex amount of information with absence of firees to aid de cision maker understand, organize and use such information to manage organizational performance. (Navon, 2005), remarked that traditional project performance control is usually generic wine (e.g., cost control techniques). It relies on manual selective information collection, which means that it is make at low frequency (normally once a month) and quite some time after the controlled event occurred (i.e., not in real-time). Moreover, manual data collection normally gives low quality data.(Ling et al., 2007), remarked that architectural, engineering and construction (AEC) firms may encounter challenges managing construction projects performance in China because of unfamiliarity with this newfound operating environment. (Kim et al., 2008), stated that international construction projects performance is affected by more complex and dynamic factors than domestic projects frequently being clear to serious external uncertainties such as political, economical, social, and cultural risk s, as well as internal risks from within the project.Project Management and Performance in that respect is a strong relation between project anxiety and project performance. Management in construction industry is considered as one of the most important factors touch performance of acidifys. (Brown and Adams, 2000) canvass a new approach to the measurement of the effect of Building Project Management (BPM) on time, cost and quality outputs using 15 cases derived from UK data. The rating undertaken demonstrates that BPM as it is presently implemented in the UK fails to perform as expected in relation to the three predominant performance evaluation criteria time, cost and quality. (Lehtonen, 2001), obtained a model for performance measurement which assist both firms top management and useable buss for continuous feedback on operational activities. (Thomas et al., 2002), stated that documenting and archiving performance data could be useful for approaching reference, such as fo r settling disputes on claims, and in maintenance and repair works. (Kuprenas, 2003), remarked that quantification of the impacts of the project management processes are identified by dint of three steps of analysis comparison of summary statistics of design performance, demonstration of statistical significance of any differences and calculation of a least squares regression line of a plot of design performance measurement versus amount/application of project management as a means to specify management beguile to design degree cost performance.(Cheung et al., 2004), studied the project performance related to project managers and remarked that development of a Web-based construction Project Performance Monitoring System (PPMS) can assist project managers in exercising construction project performance indicators and can help fourth-year project management practitioners, etc., in monitoring and assessing project performance. (Pheng and Chaun, 2006), stated that while project man agement is only one of the many criteria upon which project performance is contingent, it is also arguably the most pregnant as people formulating the processes and systems who deliver the projects. (Ugwu and Haupt, 2007), stated that an adequate understanding and knowledge of performance are suitable for archiving managerial goals such as improvement of institutional transformations, and efficient decision reservation in design, itemation and construction, at divers(a) project-level interfaces, using purloin decision-support tools. (Ling et al., 2007), investigated Project Management (PM) practices adopted by Singaporean construction firms and languish the level of performance of their projects in China they identified PM practices that led to damp performance and recommended key PM practices that could be adopted by overseas construction firms in China to improve project performance. pee and Sanitation Projects and PerformanceSuccess of projects depends mainly on success o f performance. numerous previous queryes had studied performance of construction projects. (Dissanayaka and Kumaraswamy, 1999), remarked that one of the principal reasons for the construction industrys poor performance has been attributed to the inappropriateness of the chosen procurement system. (Reichelt and Lyneis, 1999), remarked three important anatomical structures underlying the dynamic of a project performance which are the work accomplishment structure, feedback effectuate on productivity and work quality and effects from upstream phases to downstream phases. (Thomas et al., 2002), identified the main performance criteria of construction projects as financial stability, progress of work, standard of quality, health and safety, resources, relationship with clients, relationship with consultants, management capabilities, claim and contractual disputes, relationship with subcontractors, reputation and amount of subcontracting. (Chan and Kumaraswamy, 2002), stated that cons truction time is increasingly important because it often serves as a of import benchmarking for assessing the performance of a project and the efficiency of the project organization.(Cheung et al., 2004), identified project performance categories such as people, cost, time, quality, safety and health, environment, client satisfaction, and communication. It was obtained by (Navon, 2005), that a control system is an important element to identify factors affecting construction project effort. For each of the project goals, one or more Project Performance Indicators (PPI) is needed. (Pheng and Chaun, 2006), obtained that human factors played an important role in find the performance of a project. (Ugwu and Haupt, 2007) remarked that both premature contractor involvement (ECI) and early supplier involvement (ESI) would minimize constructability-related performance problems including cost associated with delays, claims, wastages and rework, etc. (Ling et al., 2007), obtained that the m ost important of practices relating to scope management are controlling the quality of the contract document, excellence of reaction to perceived variations and extent of changes to the contract. It was recommended for foreign firms to adopt some of the project management practices highlighted to help them to achieve better project performance in China. tuition Technology and Water and Sanitation Projects Performance randomness technology technique is very important in the entire world. Information technology (IT) opens new visions in the businesses and industries performance of the world. The construction industry is considered as one of the industries using IT technique such as software management systems, database and communications. For many years, many processes, functions, operations were do difficulty because of absence of IT field. In addition, most of the work was done manually which ladder to more cost, time and poor performance. Furthermore, IT usage in the construction industry leads to many changes, innovations and developing in many aspects which lead utmostly to good and strong performance. thither are many benefits and relations of using IT in the construction projects such as greater use of IT correlates with better project performance, owners and contractors realize meaningful benefits, IT affects schedule compression beneficially, and overall project cost savings which lead to a success performance of project (Schwegler et al., 2001).(Nitithamyong et al., 2004), remarked that information Technology (IT) is now routinely used in the construction industry as a tool to reduce some of the problems generated by fragmentation. The use of IT improves coordination and collaboration between firms participating in a construction project, leading to better communication practices and so good performance. Its benefits include an increase in the quality of documents and the promote of the work, better financial control and communications, and simpler and faster access to common data as well as a decrease in documentation errors.(Thomas et al., 2002), proposed contractor Performance Appraisal and Reporting (PAR) system for reviewing contractor performance at an organizational level. Advancements in World Wide Web techniques provide enhanced capacities to collect compile and disseminate performance-related information to heterogeneous construction stakeholders in a timely and cost-effective manner. (Becerik, 2004), stated that the rapid advances of web-based project management and collaboration technology offer new opportunities to improve animated construction project performance. (Cheung et al., 2004) obtained framework software to measure project performance based on project performance measurement system (PPMS). The system contains four stages which are data entry, database, reportage and action. This system has eight categories to measure performance which are people, cost, time, quality, safety and health, environment, c lient satisfaction, and communication. (Goh, 2005), remarked that information technology management leads to performance improvement in the construction industries. For instance, in Singapore 2003, general administration, design, project management and site management were enhanced by using of IT. In addition, there were more advantages as quick work, good quality of work and fast access of information.Factors Affecting Performance of Managers(Ogunlana et al., 1996), recommended the need for focus effort by economy managers and construction industry associations to provide the infrastructure needed for efficient project management and performance. (Dissanayaka and Kumaraswamy, 1999), stated that the knowledge that would influence potential performance enables project managers to pay special attention to control performance more effectively. (Chan and Kumaraswamy, 2002), remarked that effective communication and fast information pitch between managers and participants help to acc elerate the building construction process and performance. (Kuprenas, 2003), studied the impact of the use of a project management based organizational structure, project manager training, frequency of design meetings, and frequency of design reports on design phase cost performance. The process of a design squad meeting frequency and the process of written reporting of design phase progress were found to be statistically solid in reducing design phase costs.(Navon, 2005), stated that data are collected and used for construction managers as a basis to evaluate the Project Performance Indicators (PPI) actual value to compare it with the planned value and forecast its future value based on past performance. (Pheng and Chaun, 2006), identified the importance of the working environment variables for the performance of a project manager in the tete-a-tete and public sectors according to three main groups which are job form, project characteristic and organizational related categorie s. The result revealed that working hours, physical condition of project site, complexity of project, material and supplies, project size, duration of project and time availability were viewed differently in bounds of importance by the contractors and consultants groups. team up relationship was ranked as the most important variable affecting the performance of a project manager. It is obtained that project managers experiences do not have much effect on how they perceive their working environment.Time bear upon AnalysisTime is an essential part of every plan organisations develop for performing contract work. There is a relationship between the schedule, the scope of work, and the project conditions. According to (Anabari, 2003), Time Impact Analysis is typically associated with the mannikin of the effects of a single delay. It requires a CPM schedule that is able to show the pure CPM calculation differences between a schedule that does not include a delay and one that does inc lude an activity modeling a delay. The difference for project completion between the non-impacted schedule and that of the schedule with the impact is considered to be the impact of the delay for time duration considerations.Project Cost Time RelationshipTotal project costs include both direct costs and indirect costs of performing the activities of the project. Direct costs for the project include the costs of doing work related to some specific activities of the project. Indirect costs, on the other hand, are the necessary costs of doing work which cannot be related to a particular activity, and in some cases cannot be related to a specific project (Davison, 2003),.If each activity was scheduled for the duration that resulted in the minimum direct cost in this way, the time to complete the entire project might be too long and substantial penalties associated with the late project completion might be incurred (Dlakwa and Culpin, 1990). Thus, planners perform what is called time-co st trade-off analysis to shorten the project duration. This can be done by selecting some activities on the critical path to shorten their duration. As the direct cost for the project equals the sum of the direct costs of its activities, and then the project direct cost will increase by lessen its duration. On the other hand, the indirect cost will decrease by decreasing the project duration, as the indirect cost are almost a linear function with the project duration (Al-Khalil and AL-Ghafly, 1999).Factors Affecting Cost and Time Performance(Chan and Kumaraswamy, 2002), remarked that studies in various countries appear to have contributed significantly to the body of knowledge relating to time performance in construction projects over the past three decades, while (Iyer and Jha, 2005), remarked that project performance in term of cost is studied since 1960s. These studies range from theoretical work based on experience of researcher on one end to structured research work on the o ther end. Moreover, (Pheng and Chaun, 2006), stated that there have been many past studies on project performance according to cost and time factors.(Chan and Kumaraswamy, 1996) stated that a number of unexpected problems and changes from original design arise during the construction phase, leading to problems in cost and time performance. It is found that poor site management, unforeseen ground conditions and low zip of decision making involving all project teams are the three most significant factors make delays and problems of time performance in local building works. (Okuwoga, 1998), stated that cost and time performance has been identified as general problems in the construction industry worldwide. (Dissanayaka and Kumaraswamy, 1999), remarked that project complexity, client type, experience of team and communication are highly correlated with the time performance whilst project complexity, client characteristics and contractor characteristics are highly correlated with the c ost performance. (Reichelt and Lyneis, 1999), obtained that project schedule and budget performance are controlled by the dynamic feedback process. Those processes include the rework cycle, feedback loops creating changes in productivity and quality, and effects between work phases.(Chan-Albert, 2001), identified that the best soothsayer of average construction time performance of public sector projects in Malaysia is T = 269 C 0.32. This relationship can serve as a convenient tool for both project managers and clients to predict the average time required for delivery of a construction project. (Kuprenas, 2003), stated that process of a design team meeting frequency and the process of written reporting of design phase progress were found to be statistically significant in reducing design phase costs. Otherwise, the use of project manager training and a project management based organizational structure were found to be processes that do not create a statistically significant in redu cing design phase costs.(Iyer and Jha, 2005), remarked that the factors affecting cost performance are the competence of project managers support of top management coordinating and leadership skills of project managers monitoring and feedback by the participants decision making coordination among project participants owners competence social condition, economical condition and climatic condition. Coordination among the various participants of the project was as the most considerable of all the factors having utmost influence on cost performance of projects. (Love et al., 2005), studied project time-cost performance relationships by using project scope factors for 161 construction projects that were completed in various Australian States. It was noticed that gross floor area and the number of floors in a building are key determinants of time performance in projects. Besides, the findings indicate that cost is a pitiable forecaster of time performance.(Chan and Kumaraswamy, 2002), pro posed specific technological and managerial strategies to increase speed of construction and so to invoke the construction time performance. It is remarked that effective communication, fast information transfer between project participants, the better selection and training of managers, and detailed construction programs with good available software can help to accelerate the performance. (Jouini et al., 2004) stated that managing speed in engineering, procurement and construction projects is a key factor in the competition between innovative firms. It is found that customers can consider time as a resource and, in that case, they will encourage the contractor to improve the time performance.Identifying factors that influence cost performancePrevious research has attempted to establish reasons for the difference between the tender sum and the final account. This segment identifies the factors that influence cost performance. Four factors were identified from the obtainable resear ch findings, (Morris, 1990), (Kaming et al., 1997) and (Chimwaso, 2001). These are design changes, inadequate planning, irregular weather conditions and fluctuations in the cost of building materials.To expand the research it was decided to synchronize the above list of factors with other factors gleaned from the final account reports. These were compared with the factors from the existing research findings, and a final list of 18 factors was prepared. These were then separated into two groups of seven significant factors and nine other factors, which are usually ignored, but perceived to be of equal significance (Chimwaso, 2001). measurement of Project Performance(Karim and Marosszeky, 1999), stated that performance measurement systems have been one of the primary tools used by the manufacturing sector for business process re-engineering in order to monitor the outcomes and effectiveness of carrying into action. (Brown and Adams, 2000), obtained an evaluation framework to measure the efficiency of building project management (BPM) by using conventional economic analysis tools such as time, cost and quality. (Lehtonen, 2001), stated that performance measurement systems are imminent in the construction firms. (Samson and Lema, 2002), stated that effective and efficient management of contractors organizational performance requires committal to effective performance measurement in order to evaluate, control, and improve performance today and in the future.(Tangen, 2004), obtained that performance measurement is a complex issue that normally incorporates at least three different disciplines economics, management and accounting. Measurement of performance has garnered significant interest recently among both academics and practitioners. (Tangen, 2004), remarked the choice of a suitable measurement technique depends on a number of factors, including the suggest of the measurement the level of detail required the time available for the measurement the existence of available predetermined data and the cost of measurement.(Navon, 2005), defined performance measurement as a comparison between the desired and the actual performances. For example, when a deviation is detected, the construction management analyzes the reasons for it. The reasons for deviation can be schematically divided into two groups (a) unrealistic target setting (i.e., planning) or (b) causes originating from the actual construction (in many cases the causes for deviation originate from both sources). (Navon, 2005), stated that performance measurement is needed not only to control period projects but also to update the historic database. Such updates enable better planning of future projects in terms of costs, schedules, labor allocation, etc. (Pheng and Chaun, 2006), stated that the measurement of project performance can no longer be restricted to the traditional criteria, which consist of time, cost and quality. There are other measurement criteria such as project manageme nt and products.(Cheung et al., 2004), stated that recent South Wales Public Works Department in Australia launched a Project Performance Evaluation (PPE) framework, which covers an extensive array of performance parameters. PPE parameters are communication, time, cost, quality, safety, claims and issues resolution, environment, contract relations. PPEs purpose is to broaden project performance procedures to envelop soft parameters also, such as communication and resolution of dispute. In the UK, a performance measurement tool for project referred to as the Key Performance Indicators (KPIs) was developed by the KPI working group under the UK Construction Industry Best give Programme to include time, cost, quality, client satisfaction, change orders, business performance, health and safety. The implementation steps of KPIs are as follows Decide what to measure, Collect data and encrypt the KPIs. That notwithstanding, both the PPE and KPIs are valuable tools for measuring performan ce of a project over a period of time. Anyway, it is obtained from previous study that both methods PPE and KPIs can be used for measuring of performance as the indicators are correspondent in two methods. In this study KPIs method will be used to measure performance.(Iyer and Jha, 2005), stated that measuring the performance of any construction project is a very complex process because modern construction projects are generally multidisciplinary in nature and they involve participation of designers, contractors, subcontractors, specialists, construction managers, and consultants. With the increasing size of the project, number of participants in the project also increases. The objectives or goals of all participants need not be same even in a given project. Hence to measure performance of a project witho

Causes of the Rwanda Genocide

Causes of the Rwanda race murderhttp//www.y all begain as a loving economic standing s between deuce groups in Rwanda terminate up cosmos the reason why 800000 hatful ended up losing their lives this competitiveness didnt nonwithstanding start with the Rwandan racial extermination in 1994, this battle has been here ever since the colonisation of Rwanda.Throughout the 1800s among an otherwise(prenominal) categories Rwanda had two chief(prenominal) categories for race that lived in that respect, stoolly there were the Hutus and the Tutsis, but this had nothing to do with cultural grouping whatsoever, these different categories were inclined onto another by the economical point in of which they were in, if you had a large come up of cattle you were regarded as a Tutsi and if you had a small amount of cattle you would past be regarded as a Hutu there were interactions among these two categories good de al and unmatched could easily move from existence a Hutu to being a Tutsi vice versa, this was done either by marriage or by the accomplishment of cattle or the nurture there of (Roseberg, 2014) so then the term Hutu or Tutsi had no bases of which clan one telephone lineated from or whether they were original raise in Rwanda or not, and then generally speaking being a Tutsi held a gameer strata in society (UN, 2014). This was all up until the white homophile came with his one political orientation and human classification this was all before the white men came to Africa the Rwandan people had their proclaim system of running things but the white man came and he had the Bible and they had the land. They then dress notion of Christianity into their minds and when the Rwandans got the hang of the white mans system the white man had the land and Rwandans were left with notions that caused them hat sneak awaying. (Sugirtharajah, 2006)Among these systems of how Rwanda ope rated the Rwandans had their own myths and believes of how humanity came to be (Mamdani, 2002, 79) firstly they believed in the sacral nature and the origin of human settlement in Rwanda that claimed monarchy originated from a heavenly king nkuba means thunder and that nkuba had two sons namely Kigwa and Tutsi and a daughter Nyampundu, the Rwandans believed that the nkuba a massiveside his married woman Nyagasani lived in the heavens above and that one day these troika siblings pull down from the heavens and landed on the Rwandan Hill and as Kigwa married his sis their descendants were to be the Abanyinginya clan and as Tutsi their brother married on one of his nieces his descendants were the Abeega clan and these was to be the reason for the intermarriage among these two royal families(Mamdani, 2002, 79)The second myth was to be based on the cordial differences of the three groups. The myth claimed that the three sons namely Gatwa, Ga chanteyu and Gatutsi went to God and asked for social abilities and the Gatutsi was granted anger, Gahutu given disobedience and labour and the Gatwa was given the faculty, gluttony (Mamdani, 2002, 79)The third one claimed the first king of the earth Kigwa tested his three sons abilities by better-looking them milk to keep guide overnight, Gatwa was found to have drank the whole milk, Gahutu to have spilled his milk but the Gatutsi to have kept his milk intacked and that is why the Gatutsi was put in higher possible than the the two other brothers so that he give the axe ensure that their bad traits be kept in clink (Mamdani, 2002, 80).And it is in every one of these examples that the Tutsis and the Hutus all came from the same family notwithstanding though other were put in ad effective of power over the other but this was until the rival colonists arrived in Rwanda with their idea that the Tutsis were to be deemed better than the Hutus because they coiffure from elsewhere (Mamdani, 2002, 80).During the era of the trans-Atlantio slave trade the racialized understanding of Africa was that there were three Africas, southern Africa Africa proper where there was no form of civilization and where slaves were found, uniting Africa European Africa that had some form of civilization as a issuing of the influence that Europe had on it and east Africa that was influenced by Asia, but as Africa was explored even further they found that this ideology became even less apt because they found forms of civilization where there had not been an European influence and this was then that they claimed this influence was not completely without European influence because these erosive people were the descendants of Canaan (Mamdani, 2002, 80), that were given the curse of ham.The curse of ham was given to Canaans children after his father ham had seen Noah who was Canaans Grandfather drunk and naked in the stupor. This curse was given to playact that Canaans descendants shall be born ugly and macabre, they de part have their hair twisted into kinks and their eyes will have red eyes and they will go naked and their male members shamefully stretch and they shall form subject to slavery (Mamdani, 2002, 81), this myth fitted in so suddenly with Rwanda people they twain illustrated difference that arose from brothers so therefrom humans(Mamdani, 2002, 80) paradox is that black people were to be regarded as slaves by this biblical curse a servant of servants shall he be(Mamdani, 2002, 81), by this curse the coloniser entangle it highly Christian of them so enslave black people even though they were part of humanity (Mamdani, 2002, 81).But this believe of black having to be subjected to bad and all that is not to be liked does not nevertheless exist in Christianity, it is in every human being that the is a distinction from bad and good and it is in or so case that black is always seen as the bad side, darkness is to be evil and dead to be the good of things it is by this Manichean Alleg ory that colour can be deemed as a form of identifying what is good and what is bad, this allegory does only compare one from the other but it weighs it against another so there is to be degrees of which one can be deemed to be bad and so to be good, it was by this allegory that complex concepts are just to be put into black and white, bad and good, darkness and light. Because of the skin pigmentation difference that was found within the Hutus and the Tutsis the Manichean allegory was quick to take course and the Hutus being darker were to be deemed as the darkness the bad of things and the Tutsis as the more igniter ones as the light, the ones to be in power and generally the more shining and to be regarded as foreigners in the Rwandan society and put in position of power and called the Hamitic people and the Hutus to be the Negros that are to be slaves to the Tutsis and therefore stemma victim under their regime (Mamdani, 200282)All of these factors wouldnt have caused the genoc ide to be what it was if only it wasnt instituted into the Rwandan society and this took prescribe when the Belgians arrived in Rwanda and put a minority power over a majority amount of Hutus.Rwanda was generally place full of magical beauty that was tacked away in the heart of Africa, Rwanda was among others an inspiration for the some writing material regard Gorillas (Meredith,2002 485) it was a place of tourism attraction and as such its economy was just on the bone, between the 1956 and 1989 inflation rates were low, there was a high number of schoo enrolment and health facility were of good standards, their main exportation being coffee almost every house hold that was in the rural areas was involved in coffee production (Meredith, 2002486) even though they were these highly positive aspects to Rwanda the politics of the country were still being ran by the Hamitic hypothesis and for this reason the Tutsis were being recognised as the enemy of the country(Meredith, 2002486) be cause they were been give tongue to not to originate from but this notion was not the reason why they were annihilateed these was just a long standing ethnic ideology that has long been standing but has commonly been the scapegoat at the dispose of both the Tutsis and the Hutus whenever there is a crisis at hand, like in 1972 when Captain Michel Micombero a Tutsi, had rounded up all Hutus with any form of pedagogy and had them killed as a form of reducing the Hutu uprising (Meredith, 2002 488).It seems as if though whenever the Rwandans are doing badly in the country they claim that there is up rise of the other ethnic group that wants to have their own power oblige onto others.Even though Rwanda was a place of beauty and all, during the time that professorship Kayibanda was the leader the government was about to collapse because of the great disagreements that were among the government (Meredith,2002488). Among the other issues the most highlighted was that President Kayibanda favoured the southern Hutu clan more than he favoured the other Hutu clans of Rwanda because he himself was from the south of Rwanda( Meredith, 2002489). So when the Tutsis that were exiled into neighbouring countries formed insurgent groups called the inyenzi that had a resole intention of restoring the Tutsi monarchy attacked a military camp and were heading for the countrys capital Kayibanda took this act as his opportunity to crush the Tutsi opposition(opposition (Meredith, 2002 487) and send out his hate speeches of how the Tutsis wanted to run Rwanda once more (Meredith, 2002 488)When his claims of terrorism by the Tutsis and his hate campaign did not work he got thrown into cast out by his fellow Hutu man from the southern of Rwanda and Kayibanda died allegedly from starving (Meredith, 2002489), he was succeeded by the very same man that put him into jail (Meredith, 2002 490) and during most of his years of power which was during the 1970s and 1980s the Tutsi factor was no t of brilliance to him (Meredith,2002490) up until he himself needed a scapegoat to divert to.The killings that took place and the reasons for these killsOn the 6th of April 1994 Habyarimanas plane was shot down (Meredith, 2002 507) although not known by which clan, the Hutu extremists and the RDF accused each other. Because of Habyarimana had signed the Arusha Accords making the hut hold on Rwanda week and allowing Tutsi participation (Rosenberg,2014), the Hutu extremists were heavily upset and therefore they took into action the plans that have been put into place for years which was the extermination of the Tutsi (Meredith, 2002507).The victims that were be killed were not only to be Tutsis but too Hutus that were either will to help Tutsis or that were standing in the way of the Hutu extremists that were willing to kill the Hutus lists of victims were properly prepared for both the opposition and every Tutsis name and addresses and they were tracked down and killed in their ho mes (Meredith, 2002 503-507). So because of the Hamitic hypothesis the Tutsis had an element that do them distinct and the oppositions was just a mere minority (Girard, 1986 17).Certain forms of media was also used as a method of not only identifying the people that were to be killed by radio broadcasts (Meredith, 2002 507) but it was also used to pass on the propaganda of the whole genocide, it also continued the Hutus of the ways of which they are pass judgment to behave as proper Hutus through the ten curbments that clearly express that a hutu shall not have any form of mercy for a tutsi or any intermarriage between them(Gisenyi, 1990,4) it is paradoxical that they did not command them not to have sexual intercourses with them and that may be the reason why so many woman like Jane were raped and witnessed other being raped and killed (Nowrojee,1996). Through media the ten hutu commandments gained obedience from even pastors for they ignored the watchwords Ten Commandments an d churches because the hotspots for these killings(Rwembeho, 2007)BibliographyJennifer Rosenberg, 2014, Rwanda Genocide, http// , picture access 26 whitethorn 2014.United Nations, 2014, Rwanda A Brief History of the Country, http//, Date access 26 May 2014.Sugirtharajah, R. (2006) Voices from the Margin INTERPRETING THE record book IN THE THIRD WORLD, New York Orbis Books, p25).Mamdani, M. (2002) When victims become killers colonialism, nativism, and the genocide in Rwanda, Chapter Three, p76-87.Meredith, M., (2006) The grave are not yet full in The State of Africa A History of Fifty of Independence, London Free Press.Girard, R., (1986) Steriotypes of Persecution in The Scapegoat. Baltimore The John Hopkins University press.Gisenyi Information, (1990), Kangura consequent 06.Nowrojee, B., (1996) Shattered Lives Sexual Violence during the Rwandan Genoci de and its Aftermath, United States of America.Rwembeho, S., (2007), Rwanda When Churches Became Killing Fields, http//, Date accessed 28 May 2014.Da Silva, S., (2007), Revisiting the Rwandan Genocide, http//, Date accessed 28 May 2014. 1 Page

Saturday, March 30, 2019

Contemporary issues in health and social care

Contemporary issues in toilsomelyness and sociable cautiousnessThis report covers galore(postnominal) argonas in health commission and the responsibility of meadia.This foc holds on the aspect that media adds a study role in Health and cordial fretfulness. Also exclusive responsibility too should be adhered too. therefore when divulging and feeling or rangeting any thing on the toilet media, each psyche ahs to be knowledgably taking in the responsibility of such(prenominal) issues because great damage atomic number 50 be ca apply to society. So intellectuality is the more or less cardinal component part in this plus each and e precise one should be responsible.excuse how specifyation relating to affectionate and health circumspection gives to raise to issues of concern to the habitualHow describeing related in health and complaisant forethought in that respect are more ways to recording information in the word. that relating to the tike informati on is give care health care, companionable, Adult, War related wise mass be categorized .because all the information man focus is on some sectors. In the society, social and health care information is important. Because its ac think put togethers are on the publicly in society. Ex some(prenominal) information coming to To be care of some diseases. This is directly pith in the public society. Need to be account the grouch it in genuinely secure and accurate way and also need to has consider as below attribute if the bare-ass or information.Trust of entropy (Ex data in the based on the news need to be true. before publishing have to check that sauce )/ Quality real information sauces as its comingSecurity of the informationEffectiveness git be categorized its Danger information, General advice..etcRelated society like adult, child, related executeers..wiseCurrent situation in pastoral (Ex consider the country weather some disease is growing need to be inform in public ly its carefulness)Consider the approval and the validation from related professionals sine qua non to be publishDifferent technique for presenting information in mediaIn the media of presenting information is apply several ways. Television, internet, radio, newspapers, Public publicizing, posters, banner and cut pops..Etc. based on these methods to be used some have a Audio and visual image some methods have only visualization or audio technique.tecghniq should be depend on the using media type. At the information presenting wise poop be used as fallowing technique.(Figure 1.0 Media and technique plunder used to peasant information)MediaMethodsTechnique put advancing be usedTVAdvertisement use Visual and Sounds ,NewsColors ,Graphics, VideosRadioOnly Audio news or advertisement, NewsWith beneficials, Time of peasantNewspapersNewspaper Article, Newspaper AdvertisementHeadings loafer used, fonts expressive style and Graphics, photosBanners and cutouts and postersVisual imag es with informationGraphics, words development Team penisOrganized the caimans, Publicly do advisedVideo, Sounds, using postersInternetGoogle Adds, Emails, use community sitesVideo, Words, images, soundsDifferent ways of presenting informationCan be present information in unlike ways as above display media and methods as presenting and technique washbowl be used in the fulfill it. Finally analysis thy way of peasant as information on related social and health care sector,Friendly TV advertisementNews wiseWarning (Ex some diseases spread in such subject field dont do it)Video ( using small TV program) roll an large Banners and cutout in the Public placesPresentation wise in the seminars through with(predicate) the Email chasm painUsing cinemas and Drama and entertainment wayUsing newspapers articlePublic health care reportsHow to crook attitude and demeanour of potIn the volume behaviours and attitude are different put we are going to present in the health and social care r elated information we substructure manage their attitude and behavior in one direction. But need to be maintaining on the Media type, presentation format, and style of presentation, content on the presentation, Understandability Visual aspects and sounds. Because people attitude and behaviors hindquarters be change using visualization and sounds. Its directly effective in the human sense. Finally update their knowledge in the related topics using presentation we can improve the attitude and behavior.Analyze how issues of concern in health and social care are presented in the mediaWhen analyzing how issues concerning health and social care are presented in the media the good and the bad are presented in media today .People have got engrossed to media today ascribable to the improvement of mass media and technology.Reliability and validity of Media information on health and social careHealth care and social care are systems built round the society, combining mechanism for health f inancing and service provision.Media can play a strong advocacy role by transferring the focus of health issues from indivuals to policy listrs and executives whose decisions model health policy programmers and budgets. olibanumly with media spreading rapidly over the dry land, the global village concept has comportn over the introduction and people are more interconnected than before.The mass media, particularly the new media have collectively a wide reach. Generally, they also have a high level of creditability, and the information they carry is generally accepted by their audience. In the health area too, the media have a strong influence on peoples knowledge, attitudes and practicers.However while news about health issues should be of raise to everyone, we must remember that journalism has its feature needs and parameters. The reader should wait in mind the fact that diarist work out for interesting stories, stories that make headlines, that convey the different and the usual. But this might not coincide with the ingredients of sound public policy, or be in accordance with the actual sum of money of health issues.The health sectors and social care units have information to apply to the society, information which is important and relevant to the health of the population. But government interpretive programs that act with the media are at a disadvantage. If the spokes instinct gives good news, most of the sentence it is dis turn overd by the people. thence the communication with the media has to be accurate and clear. So the spokesperson should be a trained person, rather than a novice who cannot handle the media.The fact is that both sides need each other. The health ministry needs the journalist to spread the news, which is often very vital to the public.The most important grammatical constituent here is that both parties the health ministry and the journalist, have to be professional, and the most important two factors are that their likenessship are trust and transparent.The media have been used to market health behavior, which targets the indivuals and also it informs about health pretends to the masses. But most know about it, that the major determines of health are both in the social and physical environment. And the power of the media can be used very effectively to make environmental healthier.For example the successful public judicial proceeding against the tobacco industry. Today, as a result of years of lobbying and informing the public about it, about the tobacco hazard, its consumption world wide is declining. The curtilage n is that the mass media together with political science have carried on the labor very effectively with accurate information. thusly new media technology as stated above constantly evolves around providing better health care. But studies have revealed that excessive use of new media technology, best exemplified by computers, contains a possible risk of gaining various controv ert impacts on health.Type of information influence Attitude and behavior of people health and social careFor this particular section I wish to take examples from the sex education area, as it has a great impact on the attitude and behavior of young people. The targeted audience is the younger generation of our world.Young people can be exposed to a wide range of attitudes, behaviors and beliefs in relation to sex and sex activity. These sometimes appear contradictory and confusing.For example, some health messages tenseness the risk and danger associated with sexual activities and media coverage promotes the idea that being sexually active makes a person more attractive and matire.Beause sex and sexual practice are very sensitive subjects, young people and sex educators can have strong realizes on what attitudes people should hold, and what moral frame work should govern peoples behavior- these too can sometimes be at odds. hence young people get information about sex and sexua lity from a wide range of sources including each other, through the media including advertising, television and magazines, as well as leaflets, books and web sites which are intended to be a source of information. It is important to provide information which correct mistaken beliefs. With out correct information young people can put themselves at greater risks.When taking the above scenario into consideration, this involves peoples thoughts, feelings and behaviors which are influenced by the actual, imagined or implied straw man of others. At this point the media plays a major role. It is a must to entertain in mind that people are prone to social influence even when no other person is present, in such moorage watching television or reading effects.So when writing articles or doing television documentaries related to health and social care, the authorities that put these forward should be well knowledgeable. As they deal with the masses.Analysis what builds the attitude and depo rtment of people, for health care and social careThere are hardly a(prenominal) factors that contributes to this factor of attitude and behavior which think overs on the way that people look at these issues.The physiological needsSafety and security needThe people in elderly homes, childrens home or under health risk need and highly require safety and security. So adverse media publications can hinder their security plus fear may a uprising in them.the love a belonging needAt this point the elders at social care units long for a sense of belonging as loneliness over comes them. This issue arises to many problems within the service person and the elder. They have the strong need to be belonged to a community.Esteem need.Thus people in elders homes or in childrens homes can have an unfavorable position complex and some such articles or media publications can increase this as responsible citizens its in the hands of society to make these people they are needed in our society.So when we take the above facts into consideration we can see that cultures of certain countries along with social norms play a major effect. A culture provides individuals with a set of embedded customary understandings that they usage in fashioning their actions, and makes society possible by providing a common frame work of thinking. Thus along with this goes the norms of social rules that specify attach and inappropriate behavior in a given situation. So thus these contribute a lot and play a major effect in health and social care.Research and analyze range of different perspectives on one particular(prenominal) issues relating to social and health care study issues in health and social care ScopeThe major issues that encompass health and social care issues are the cultural, social and psychological issues. This can be considered highly intricate. Thus diversity is seen as a very broad concept, embracing for example culture, beliefs, disability, gender and race and ethnicity as we ll as undeserved and marginalized population. Diversity also extends to the wide Varity of settings in which care takes place and the multidisciplinary nature of professional practice.Summary of different perspective occidental health care faces a number of challenges, including an aging population and rise in chronically diseases, in which in turn causes a loading on the sector and the rising health care expenditures.Attitude relating to the specific issues in local anaesthetic areaAttitudes mean the positive or negative approach towards a view of a person, place, thing or event. Thus people posses an objective towards the introduced thing and a question arises within them whether to arrogate or not.Thus in the case of local areas or villages, there are many clans and beliefs and ideas that each of these groups posses. Thus they too have their own views and ideas on their health conditions. In many countrified areas the conditions of health and sanitisation lies at a very poor standard, and there are people who dont want to change their views.Most people living in rural areas dont want to change their ways of medication and though the world is mournful forward with new techniques and information, there is a set of people who wants to be in the olden times. Who has a strong belief, on orals and witch crafty. So with this the effect, the spreading of sicknesses and diseases are more. How much NGOS and many organizations integrate towards the rural village, the in habitants dont want to change their ways of thinking. It is not with all but a few who want to live within their idea frame.This is all due to the illiterates people. Thus to over come this scenario the people have to be change state on the ways of taking medicine and facing situations.Also the social care units are seen as something bad. They dont believe in the benefits of these units. Also they believe that it is a social come down to keep an aged person in a social care unit, thus little not icing the care there is sometimes much better what they provide at home. prize current thinking on the chosen issues and its likely influence on the development of health and social careHow the local attitude reflect on the national levelAs discussed above many local issues are the reasons of many international issues. When people are unable to cipher or eradicate or minimize the spreading of an epidemic it reflects globally. Thus causing a major damage to health, physical, economic and international aspects. Thus then the revenues of NGOS,a countries economy and WHO have to spend a vast get on eradicating these sickness when it could have been able to be plucked from pip root level.So in order to eradicate and make the nations relax and bring good health practice each and every soul should and must contribute towards this factor.The best example that I can inverted comma from the reason past is dengue which is a high risk health issue. But the people still have not recognized t he individual responsibility towards the spreading of it. They bestow the blame on health organizations and thus each year the death toll increases. The saddest part in this is many young lives victims of this.We have to concentrate on the fact that the national and world productivity decreases very badly when disease start to spread. So the social responsibility too should pay a vast role in this factor.Evaluate the validity of public attitudes and behaviors related in to specific issueshealth care is the area of educating people about health .This encompasses a vast area when related to health such as environmental health, physical health, social health, emotional health, intellectual and spiritual health. This is the principal by whom individuals and groups of people learn to behave in a manner conducive to the promotion, maintenance or restoration of health. As there are many health definitions, there are multiple definitions of health education.Thus the joint committee of healt h education and promotion terminology of 2001 defined health education as nay combination of planned education based on sound theories that provides individuals ,groups and communities the opportunity to acquire information and skills needed to make quality health care and social care.ConclusionIn conclusion this is an over view and an insight to global health issues and how media can reflect or take it in to the masses. Thus the responsibility of the masses too is important in this issue. Each and every one should be responsible plus the attitudes count a lot. The local health issues and attitudes contribute to the international arena. Thus globally major issues do occur due to attitudes of local people. So authorities should know to educate the people, in health care and thus in media publication. What I strongly believe is that the young should be educated on media, and not to always consider the validity and reliability of media publications.

Anthrax Vaccine Trials for Pediatrics

splenic fever Vaccine Trials for paediatricsAnthrax is a serious infectious infirmity caused by Bacillus Anthracis, a gram positive bacterium that forms spores. A spore is a cell that is dormant but may come to life-time with the right conditions and become active. These spores can contaminate bulk like in 2001 when letters containing Anthrax spores were universe mailed in a bioterrorist onslaught and make them severely ill. (White, 2012) Anthrax generally comes from soil and animals. A somebody can become infect if they come in contact with and infected animal or animal product. Once they are infected past they can start to show the first symptoms of inhalation. Anthrax starts off with wintry or flu symptoms and can include a sore throat, mild-mannered fever and muscle aches. As time goes by symptoms include cough, government agency discomfort, shortness of breath, tiredness, and muscle aches. It also affects the GI system. Patients may experience nausea, privation of a ppetite, bloody diarrhea, and fever, followed by bad stomach pain. In the 2001 bioterrorist onrush, five people were killed and seventeen were infected. (White, 2012) The purpose for this paper is to discuss the ethical dilemma on running test trials of the Anthrax vaccination prior to administering it on pediatric patients. When it comes to the Anthrax vaccine the difficulty arises because there are no clinical test trials done on pediatric patients. This brings the ethical issue of protection of patients in query. (ANA, 2008) The reasons being that there are many a(prenominal) hurdles on beginning the process of making sure that children are safe during clinical test trials if it further goes into the trial process, as well as many separate ethical dilemmas that revolve around the process itself. Parents are wondering(a) enough just about their children receiving certain vaccines like MMR and Varicella to have their children go through clinical test trials for Anthrax and setting them at danger for unknown side effects. Otherwise like Nicola Klein, postor of Kaiser Permanente Vaccine regard Center stated, upgrades must go through a lot in advance they can actually approve their child to be involved in any type of clinical trial. They will be informed with a large amount of information regarding risks, benefits and any other type of outcome. (White, 2012) Since children are non responsible for their own clinical decision making the parent would be responsible for making this informed decision regarding their children. A nurses righteousness would be to make sure that the parent of the child involved is presented with the ideal information regarding the trial. The parent would then have the right to refuse interest in any clinical trial they do not flavour would be beneficial to them or their child. Michael Anderson, Vice president and Chief medical checkup officer of UH Case Medical Center and representing the American Academy of Pediatri cs states, It is unethical not to conduct pediatric trials. Failure to examine the vaccine in children would deprive us of valuable data necessary to remedy childrens lives. (White, 2012) According to Robert Skip Nelson, senior Pediatric Ethicist in the office of Pediatric Therapeutics of the Food and Drug Administration, it has to meet three germane(predicate) principles before going into clinical trial runs. (White, 2012) First the children should not be enrolled in a clinical trial if the scientific or frequent health objective can be achieved by enrolling adults. Second, absent direct therapeutic benefit to the children enrolled the risks to them must be low-or no more than a minor increase over minimal a risk, which itself is defined as no greater than the risk that they face in ordinary activities. Lastly, children should not be placed at a disadvantage after being enrolled in a clinical trial, either through motion-picture show or to excessive risk for by failing to get necessary health care. (White, 2012) A study done in San Francisco, California named Dark duck soup that found that if there were a release of Anthrax spores on the city 7.6 million people would be affected and a quarter of a million of that population would be children. (White, 2012) If there were to be an Anthrax epizootic there would be a treatment for it. The treatment consists of a cardinal day antibiotic fare and once the regimen is finished the someone is in need for vaccination to prevent another outbreak. The antibiotic regimen alone is not sufficient enough. It is only a temporary fix. The problem is children enrolled in a prevent anthrax trial will not receive direct medical benefits and by benefits they mean knowledge about how best to protect children from anthrax. If trials do go into effect the question is would health care officials be able to gain the trust of the parents. It would be the employment of the health care officials to keep parents well informed with all minded(p) information regarding the trials including and not limited to potential risks, benefits and other consequences of the vaccine as predicted from use in adults. The parents must be actively engaged on reporting outcomes and be committed to the goals of the research. Because we are unsure that an Anthrax attack would even happen, it is unclear as to how much of a risk research subjects should be exposed to or whether vaccinations would be better, or more cost effective than an antibiotic regimen. Furthermore the Presidential Commission of study of Bioethical issues cerebrate that no testing should be considered unless the risk to kids is minimal. They feel that it will put the child at high risk. Also, there is not a aspect that a sufficient number of American parents are going to stigma up their kids for the safety testing of an Anthrax antidote. They also feel that the exposure the Anthrax is farther down the list then some of the other obstacles a child may face for example, obesity, bullying, and suicide.ReferencesAmerican Nurses Association. Code of morality for Nurses with Interpretative Statements. Accesses November, 2008 athttp// for Disease Control and Prevention. (2006). Anthrax What you need to know. Emergency Preparedness and Response. Retrieved from http//, Ross. (2012). Anthrax Vaccine Trials for Children preventive or Premature? Bioethics Forum blog. Retrieved from http//*.html

Friday, March 29, 2019

Baló-like Lesion With Psoriasis and Autoimmune Thyroiditis

Bal-like Lesion With Psoriasis and Auto tolerant ThyroiditisBAL-LIKE LESION ASSOCIATED WITH PSORIASIS AND CHRONIC AUTOIMMUNE THYROIDITISAuthorsCorina Roman-Filip1, Aurelian Ungureanu2, Ileana Prvariu3AbstractVariants of ten-fold induration are seldom encountered in clinical practice, whatevertimes with close prognosis or possibly serious disability. These pathologies are characterized by unpredictable demyelinating lesions such as Bal-type lesions or tumefactive lesions. The mechanism behind these lesions still trunk a debate, since genetic and immune factors are incriminated. We expose a outcome of multiple sclerosis variant with remarkably good outcome in association with autoimmune thyroiditis and psoriasis. This concomitant process questions the possibility of shared immune pathogenesis regarding the activation of T jock 17 cells lineage and mitochondrial oxidative stress. The imagistic sort of the free-base lesions raises discussions on a possible radiologic diagnosis. Keywords Bal-type lesions tumefactive lesions psoriasis autoimmune thyroiditis T helper 17 cellsIntroductionPathologist Jzsef Bal described a event form of demyelinating sickness, leukoencephalitis periaxialis concentrica, virtuousally named Bals concentric sclerosis (BCS). Nowadays, this is defined as a variant of multiple sclerosis. The intensive use of magnetic ring showed an increasing number of different types of demyelinating lesions. Some of these are specific, but a large variety is under debate regarding the classification. Tumefactive demyelinating lesions (pseudotumoral) can sometimes present a degree of concentricity and can be easily mistaken for a genuine Bal lesion, or at least a Bal-like demyelinating lesion. Historically, the variants of multiple sclerosis were regarded as serious disabling inflammatory damages of the central tense system, but recent works have demonstrated that the course of the disease may be more variable, at least regarding BCS. Imagistic studies can pick out to a better appreciation on the prognosis of BCS and its association with early(a) types of demyelinating lesions 1. The pathological mechanism behind it still remains a debate, although hotshot can find similarities with multiple sclerosis (MS) and even overlapping lesions of these conditions. miscue reportWe present the case of a 40-year-old woman admitted for mild incoordination of the go forth arm and speech impairment. The patients medical history is constructive for psoriasis (since 2002) and autoimmune thyroiditis under treatment with levothyroxine 50 ug/day (since 2010). Magnetic ringing imaging (MRI) studies revealed FLAIR and T2 weight down inhomogeneous hyperintense lesions with concentric enhanced and non-enhanced lesions on T1 with gadolinium contrast (fig 1ab). The lesion was characterized as atypical demyelinating with 22.5/21.6 mm in size, with belatedly concentric enhancement and without mass effect. Additionally, two demyelinating peri ventricular enhancing lesions were found (fig 1def). A biochemistry panel, antinuclear antibodies, anti-ds desoxyribonucleic acid antibodies, ANCA antibodies, anti Ro antibodies and anti-Borrelia antibodies were negative. Slight pleocytosis (16 cells/mm3 with 75% monocytes) was detected in the cerebrospinal silver together with present oligoclonal bands and normal proteins. Serum myelin oligodendrocyte glycoprotein antibodies, myelin introductory protein antibodies, IgG anti-aquaporin 4 antibodies were negative. Moreover, a high serum titre of anti-thyroperoxidase antibodies (60.73 IU/mL normalDiscussionThe association of the pathologies described may seem incidental. However, fast research evidence shows the implication of Thelper17 cells (Th17) and Interleukin 17 (Il17) in the autoimmune pathways of MS, autoimmune endocrinopathy and psoriasis 2,3. BCS type lesions and MS lesions may both be present simultaneously in the same patient, and Bal-like lesions may change over time i nto the classic appearance of MS lesions 4. The lesions are characteristic, with sound of demyelination, surrounded by uncomplete demyelinated regions, reflecting the concentricity within the lesion. The lesion type is classified as MS pattern triad with oligodendrocyte loss, microglial activation and loss of myelin-associated glycoprotein 4. Studies of 7 Tesla MRI support the microvascular pathology associated to inflammation, which seems to be concordant with pattern III lesions 5. These studies are sustained by identifying ding 3 mutation in a patient with BCS phenotype and a family history of Notch 3 mutation carriers and CADASIL. Mitochondrial respiratory chain disturbance and the expression of some molecules probably tend to precondition hypoxic tissue to inflammation, such as mitochondrial horniness shock protein 70 6. Furthermore, new cellular biology studies of cancer found that hsp70 can mediate the Th17 differentiation 1. We consider that the simultaneity with the a utoimmune endocrinopathy and psoriasis may be more than incidental and raises the hypothesis of probable linkage of the proinflammatory and autoimmune role of Th17 cells lineage with mitochondrial oxidative stress.Compliance with Ethical Standards fight of Interest The authors declare that they have no conflict of interest sensible consent was obtained from all individual participants included in the studyFig. 1 a. T1 gadolinium installment showing a frontal demyelinating lesion with concentric enhancing rings (arrow) b. T2 weighted image with concentric rings of demyelination and myelinated regions (arrow) c. DWI sequence with distribution restriction in the active lesion d. T1 gadolinium enhancement of periventricular lesion (arrowhead) e. Enhancing periventricular lesion in the occipital lobe (arrowhead) f. Coronal T2 small demyelinating lesion (arrowhead) with enhancement on T1 (not shown)Fig. 2 a. T1 gadolinium sequence showing a significant improvement six months later (arr ow) b. T2 weighted image showing the demyelinating lesion markedly decreased (arrow) c. DWI d, e, f. Improvement of demyelinating lesionsReferencesHardy TA,Miller DH (2014) Bals concentric sclerosis. Lancet Neurol 13(7)740-6. inside 10.1016/S1474-4422(14)70052-3.Kottke T, Sanchez-Perez L, Diaz RM, Thompson J, Chong H, Harrington K, Calderwood SK, Pulido J, Georgopoulos N, Selby P, Melcher A, Vile R (2007) Induction of hsp70-Mediated Th17 Autoimmunity raise Be Exploited as Immunotherapy for Metastatic Prostate Cancer. Cancer reticuloendothelial system 67(24)11970-11979.Bossowski A, Moniuszko M, Dabrowska M, Rusak M, Jeznach M, Bodzenta-ukaszyk A, Bossowska A (2013) Role of Th17 cells and IL-17, IL-23 cytokines in pathogenesis of autoimmune thyroid disease in children. Thyroid Research 6(Suppl 2)A8.doi10.1186/1756-6614-6-S2-A8.Stadelmann C, Ludwin S, Tabira T, Guseo A, Lucchinetti CF, Leel-Ossy L, Ordinario AT, Brck W, Lassmann H (2005) Tissue preconditioning may excuse concentric le sions in Bals type of multiple sclerosis. Brain 128(Pt 5)979-87. doi10.1093/brain/awh457.Berghoff M, Schlamann MU, Maderwald S, Grams AE, Kaps M, Ladd ME, Gizewski ER (2013) 7 Tesla MRI demonstrates vascular pathology in Balos concentric sclerosis. Mult Scler 19(1)120-122. doi 10.1177/1352458512445302.Chitnis T, Hollmann TJ (2012) CADASIL mutation and Balo concentric sclerosis a link amidst demyelination and ischemia? Neurology 78(3)221-3. doi 10.1212/WNL.0b013e31823fcd3c.

Thursday, March 28, 2019

Dwight D Eisenhower Essay -- essays research papers

Dwights Early LifeDwight D. Eisenhower was the third watchword of David and Ida Stover Eisenhower. He was born in 1890 in Denison, Texas, and named David Dwight Eisenhower, although he was known as Dwight David by many. In 1891, the family moved to Abilene, Kansas, where Eisenhower was brought up. He was the third of seven sons. He and his older br opposites were all called Ike by their family, Eisenhower was known as Little Ike. In his high shoal years, he was known to excel in sports payable to his active nature. After he graduated, Eisenhower wanted to attend college, only when his family could non afford the tuition. Dwight and his brother planned to switch off between exercise and college every year in order to pay for each others tuition and allow them to both complete their education. In 1910, Eisenhower set up that he could get a free college education at linked States Military Academy at West Point, New York. The prerequisite for obtaining much(prenominal) involved passing a difficult exam. While Eisenhower had no trustworthy plans to be a soldier, he still prepared well for the free-enterprise(a) West Point entrance exam and won an appointment to the school in 1911.The Coming of a Commander in Chief unnoticeable to him at the time, Eisenhower would later lead many military forces though the public life of both world wars, winning decisive victories and helping push the States forward even before his own presidency. When the unify States entered World warfare I in 1917, Eisenhower was promoted in the army and assigned to training barter for new cadets. He desperately wanted to see action during the war, and utilise for an overseas assignment. His own skill would prevent him from participating in affair during that war. Higher officers saw the ability that he had as an organizer and trainer, and localise him in command of Camp Colt at Gettysburg, Pennsylvania, instead of granting his overseas request. unitary of the armys first tank c orps was being form there, and Eisenhower trained the fighting unit. In the October of 1918 he finally got orders to take his units overseas, to France, but the war ended before he could leave America. Although disappointed at having missed combat, Eisenhower was recognized by his superiors for his efforts during the war. He was awarded the Distinguished Service thenar following the submission of German forces. After gaining much respect in the military field for his accompli... ...ho was true to his country, as there were few measure in his life where he was not actively serving The United States. Helping our nation though two harsh wars as a trainer and commander, and attempting to tackle issues of great proportions during his presidency showed the strength, determination, and the great efforts put forrader by this man to help shape the U.S. into the country that it is today.1. Joann P. Krieg. Dwight D. Eisenhower Soldier, President, Statesman. Greenwood Press. Westport, Conn. 1987.2. Clarefield, Gerard. Security with Solvency Dwight D. Eisenhower and the organization of the American Military Establishment. Westport, CT, Praeger, 1999. 3. Divine, Robert A. Eisenhower and the Cold War. New York, Oxford University Press, 1981. 4. Broadwater, Jeff. Eisenhower and the Anti-Communist Crusade. Chapel Hill, University of North Carolina Press, 1992. 5. (Document) Beasley, Charles A. consort and Eisenhower A Comparative Study of the Soldier Turned Political Leader. Carlisle Barracks, PA, military War College, March 1991. 6. (Periodical) Barclay, C. N. Dwight David Eisenhower 1890-1969 A Tribute to the Supreme Allied Commander, 1942-45. array Quarterly 98

Hhv-8 :: essays research papers

Human Herpes Virus-8 (HHV-8) and Kaposis Sarcoma (KS)Human herpes computer virus (HHV-8) poses a challenging task for researchers determining its role in Kaposis sarcoma (KS). People with KS are distinguished by their placement in intravenous feeding categories. The first category consists of elderly males of Mediterranean or Eastern European Jewish descent. The second category consists of individuals of all ages from Africa. Neither one of these categories is associated with insubordinate deficiency or known environmental constituents. The last two categories are associated with organ transplants or HIV-1. In all forms of KS males are predominantly affected.Kaposis Sarcomas are known to harbor cells known as spindle cause cells (SC). The spindle shaped cells are associated with abnormal blood vessel cultivation and blood leakage. Although, the SC is the most frequently encountered cell in KS tumors it is heart-to-heart if they are neoplastic cells or hyperproliferating cell s or an altered cell generate by cytokines (INF-&61543).Although, it is easy to believe that all cells in a tumor are neoplastic, evidence suggests otherwise. There are three characteristics that are innovate in all KS cells whether they are neoplastic or not. The first is absence of a histologically distinguishable neoplastic cell. The second is the lack of wonted(prenominal) chromosomal abnormalities. The last is a combination of three features angiogenesis, inflammation, and proliferation.The one factor that brings the four categories of people infected with KS is HHV-8 found in KS tissues. Although, HHV-8 is thought to be connected to KS, HHV-8 itself has very low risk factor for KS development. Most reports on KS indicate a 2% to 10% preponderance of HHV-8 in the world, only if in the U.S. there is thought to be a 5% prevalence among men according to a 1970s baseline incidence of KS. In relation to HIV-1 incidence of KS increases by a factor of 20,000 to 50,000 times with the carriage of HHV-8.It is postulated that HIV-1 infections promote HHV-8 replication indirectly by suppression of host tolerant systems. KS is thought to begin with micro-vascular lesions mediated by different environmental factors for all(prenominal) of the four categories of KS. One of these factors is abnormal cytokine production in HIV-1 associated KS, this includes an increase in inflammatory cytokines, such as IFN &61543, TNF &61537, and IL-7 that are enhanced by Tat of HIV-1. Tat which is essential for HIV-1 replication is released and taken up by other cells, where it inhibits T-cell proliferation and promotes abnormal cytokine production, adhesion, and growth.

Wednesday, March 27, 2019

The Path of Shelleys Winged Thoughts :: Writing Poetry Papers

The Path of Shelleys Winged Thoughts physical composition much of his poetry on the Continent, away from England where his readership lived, and dying only tercet years after the composition of much of his best work, Percy Bysshe Shelley had little check into over the contagion of his poetry. At the time of its initial publication, Ode to the West cheat appeared as part of a larger volume, entitled Prometheus Unbound, also the construct of its signature, featured numbers which overshadowed Ode to the West hook. Following Shelleys untimely death, his wife, bloody shame Shelley, dedicated herself to organizing and publishing Shelleys work, and is largely responsible for the transmission of Shelleys work that occurred posthumously.Piecing together a publication and composition history is in particular befitting for Percy Bysshe Shelleys Ode to the West Wind, for the theme of transmission of lyric and thoughts is enlace conspicuously within the lines of the poem itself. In the final stanza of the poem, the poet beseeches the West Wind, a natural and divine life-force, to Drive my dead thoughts over the universe/ worry withered leaves to quicken a new birth (lines 63-64) Shelley continues to address transmission in the next tercet, writing Scatter, as from an unextinguished hearth,/ Ashes and sparks, my words among mankind (lines 66-67). These imperatives stop over Shelleys lofty expectations for the dissemination of his words however, when the actual path his words followed is analyse, great disparity emerges between the ways in which Shelley envisioned his poem entering the world, and the way it actually reached an audience. While to sidereal day Ode to the West Wind is widely known, and respected as one of Shelleys best poems, during the a few(prenominal) years the poem and poet lived simultaneously, Shelleys visions for the transmission of Ode to the West Wind were limited, and boasted no divine intervention.Shelleys notebooks and preserved manuscr ipts provide much information round the composition history behind Ode to the West Wind. In mid-October, 1819, Shelley walked along the river Arno, fixed near Florence, watched the autumn wind rustle and sweep the leaves strewn about the ground, and draw inspiration for the composition of Ode to the West Wind. Shelleys own note include with the published version of the poem states, This poem was conceivedone a day when that tempestuous wind, whose temperature is at once mild and animating, was collecting the va streams which pour down the autumnal rains. (Wu, 859) His notebooks show the meticulous level of observation with which Shelley studied this scene one page of preliminary notes contains a drawing of a

How Does the Tell Tale Heart Fulfil Your Expectations of A Gothic Essay

How Does the Tell Tale Heart Fulfil Your Expectations of A Gothic recital?From a gothic story such as the tell record heart, by Edgar Allan Poe, Iexpect numerous amounts of gory deaths, intense disbelief, abhorrenthorror, plently of fear and espically paranoia. They should alsocontain a variety of literacy techniques including imagery, sentencestructure, punctation and repititation in my essay I will be focusingon the amounts of death, horror, fear, suspense and the amount ofliteracy techniques used throughout the story.Edgar Allan Poe uses a lot of suspense in the Tell Tale Heart. Toincrease the effect the suspense he incorprates it with literacytechniques. wizard example of mixing literacty techniques with suspenseis when Edgar Allan Poe uses imagery to descirbe the man creeping intothe senile mans bedroom when the old man wakes up.I had my head in, and was about to unresolved the lantern, when my thumbslipped upon the tin fastening, and the old man sprang up in bed, shout ou t out --Whos there?I kept quite still and tell nothing. For a whole hour, I did not mo...

Tuesday, March 26, 2019

Racism In America :: essays research papers

There is surely no rural argona in the world that holds "racism" in greater horror than does the coupled States. Compared to other kinds of offenses, it is thought to be somehow more(prenominal) reprehensible. The press and general confine become so used to tales of murder, rape, robbery, and arson, that any(prenominal) but the closely spectacular crimes are shrugged off as part of the inevitable caryopsis of the Statesn life. "Racism" is never shrugged off. For example, when a colour Georgetown Law direct student reported earlier this year that black students are non as qualified as White students, it set off a booming, bailiwick controversy about "racism." If the student had merely murdered someone he would have attracted far less attention and criticism.Racism is, indeed, the national obsession. Universities are on full alert for it, newspapers and politicians denounce it, churches preach against it, America is said to be racked with it, but j ust what is racism?Dictionaries are not much help in understanding what is meant by the word. They usu ally narrow down it as the belief that ones own ethnic stock is superior to others, or as the belief that culture and behavior are rooted in race. When Americans speak of racism they mean a great deal more than this. Nevertheless, the dictionary definition of racism is a clue to understanding what Americans do mean. A peculiarly American meaning derives from the current dogma that all ethnic stocks are equal. Despite clear evidence to the contrary, all races have been declared to be equally talented and hard- working, and anyone who questions the dogma is thought to be not merely wrong but evil.The dogma has logical consequences that are profoundly important. If blacks, for example, are equal to Whites in every way, what accounts for their poverty, criminality, and dissipation? Since any theory of racial differences has been outlawed, the only possible explanation for black ill i s White racism. And since blacks are markedly poor, crime-prone, and dissipated, America must be racked with distributive racism. Nothing else could be keeping them in such an abject state. completely public discourse on race today is locked into this rigid logic. each explanation for black failure that does not depend on White wickedness threatens to veer off into the forbidden territory of racial differences. Thus, raze if todays Whites can find in their hearts no desire to crush blacks, yesterdays Whites must have oppressed them.

Influence of Religion on Society during the Fifteenth and Sixteenth Cen

Influence of Religion on Society during the Fifteenth and ordinal Centuries The undeniable power, force, and influence of religion stand out throughout history. However, agree to J. Michael Allen and James B. Allen in World History from 1500, in the ordinal and 16th centuries, religion was exceptionally important, because it had a great influence on everything from political relation to brotherly order and family relationships (16). Hundreds of years may separate these two period periods and the modern world, but the same positive do of religion such as unity, credentials, and a social order are still staple ideals in todays world. This is also true for the negative effects such as the conflicts that result in war and bloodshed, the separation of social classes, and the corruption throughout the church, especially the recent sex scandal in the Catholic church. In order to appreciate the impacts of religion during the fifteenth and sixteenth centuries the positive and negative effects of this era must be understood. During the fifteenth and sixteenth centuries, religion gave mint a sense of belonging. Belonging to a church was important during this time because it gave people a sense of security and support. This was important because it made it much easier to deal with everyday problems and issues. For instance, diseases and death were super common during this time period, because of the lack of medicine and technology. So, religion played an extremely important role in giving people a direct light to pray for support, health, and help. People also had a sense of phantasmal protection in everyday life and also in the afterlife. With a sense of protection, they lived a life with less fear of d... ...o this period, giving people the background of such problems. Works CitedAllen, Michael J., and James B. Allen. World History from 1500. radical York Harper Collins, 1993. Conquest of Paradise. Dir. Ridley Scott. Perf. Gerald Despardieu, Armand Assante, and Sigorney Weaver. Bravo Special Presentation. programme Film. HSS-212-003. Fall Semester. family 12, 2002.Conquistadors. Dir. David Wallace. Narr. Michael Wood. Maya Vision. PBS Presentation, 7 Aug. 2001. phase Film. HSS-212-003. Fall Semester. September 19, 2002.Joan of Arc. Written by Micahel Alexander Miller and Ronald Parker . Dir. Christian Duguay. Perf. Leelee Sobieski, Chad Willett, Peter Strauss and Peter OToole. Class Movie. HSS-212-003. Fall Semester. 2002Mary, Queen of Scots. Nar. Star Jones. A&E Special Presentation. Class Movie. HSS-212-003. Fall Semester. September 26, 2002.

Monday, March 25, 2019

Characters Contribute to the Dramatic Effect of Alan Bennetts Talking Heads :: essays research papers

Talking heads by Alan Bennett is a collection of soliloquys in which the audience are showed into the keep of a grapheme and given an brainwave into the records personality and situation. Peoples lives are portrayed in ludicrous ways divergence the audience feeling sympathy and guilt for the character in laughing at their misfortune.In the land a confirmation in the breadstuff Alan Bennett shows us a life of a actually unconfident man who distillery lives with his mum. whole wheat flour is a middle-aged man with a history of kookie mental health problems, living with his set about in Leeds. He is an utterly stereotypical Guardian reader he wears flares, avoids deodorant, is environmentally conscious, equivalents date and walnut bread, and is very anti-Thatcher. It is likewise hinted that he is a crush homosexual. His life is dramatically disrupted when his catch, who he is effectively married to, meets her quondam(a) flame weenie Turnbull after 52 years. Turnb ull is bigoted, right-wing, and racist the opposite of whole meal flour notwithstanding he is also well-dressed and well off. grahams father presumably died in hospital Graham refers to doctors wheeling him into the theatre. Graham becomes increasingly envious as Mr Turnbull takes an ever-growing flirt with on Mrs Whittakers life, to the extent he proposes marriage concurrently suggesting Graham moves turn up of the house to a hostel. But Mr Turnbull is hiding a secret, and when Graham finds knocked out(p) he gets the courage to confronts his mother with the information, restoring the status quo and his cozy life but destroying her hopes of happiness in the process. It seems like Graham has been bad traumatized as he will not leave his mothers sight which is very unhealthy for a 52 year old to be doing. This play is not single based on graham and his relationship with his mother but it is also based on the different emotions shown within the monologue such as fear which Graham shows a lot of as he is evermore scared for his mother so this causes him to treat her like a child. on that point is also much anger shown towards the man that his mother is in a relationship with not only because he doesn?t trust him ,but because he wants to be the only man in his mothers life as he has been sic kingly close with his mother since a being a young child and she is always saying to Graham ?Characters Contribute to the outstanding Effect of Alan Bennetts Talking Heads essays research papersTalking heads by Alan Bennett is a collection of monologues in which the audience are showed into the life of a character and given an insight into the characters personality and situation. Peoples lives are portrayed in comic ways leaving the audience feeling sympathy and guilt for the character in laughing at their misfortune.In the play a Chip in the Sugar Alan Bennett shows us a life of a very unconfident man who still lives with his mum. Graham is a middle-aged ma n with a history of mild mental health problems, living with his mother in Leeds. He is an absolutely stereotypical Guardian reader he wears flares, avoids deodorant, is environmentally conscious, likes date and walnut bread, and is very anti-Thatcher. It is also hinted that he is a closet homosexual. His life is dramatically disrupted when his mother, who he is effectively married to, meets her old flame Frank Turnbull after 52 years. Turnbull is bigoted, right-wing, and racist the opposite of Graham but he is also well-dressed and well off. Grahams father presumably died in hospital Graham refers to doctors wheeling him into the theatre. Graham becomes increasingly jealous as Mr Turnbull takes an ever-growing hold on Mrs Whittakers life, to the extent he proposes marriage simultaneously suggesting Graham moves out of the house to a hostel. But Mr Turnbull is hiding a secret, and when Graham finds out he gets the courage to confronts his mother with the information, restoring the status quo and his comfortable life but destroying her hopes of happiness in the process. It seems like Graham has been seriously traumatized as he will not leave his mothers sight which is very unhealthy for a 52 year old to be doing. This play is not only based on graham and his relationship with his mother but it is also based on the different emotions shown within the monologue such as fear which Graham shows a lot of as he is constantly scared for his mother so this causes him to treat her like a child. There is also much anger shown towards the man that his mother is in a relationship with not only because he doesn?t trust him ,but because he wants to be the only man in his mothers life as he has been sic kingly close with his mother since a being a young child and she is always saying to Graham ?

Analysis of Woman to Man by Judith Wright Essay -- Judith Wright Woman

Analysis of Woman to Man by Judith Wright I was slightly compound when I read this poem at get-go, plainly it became apparent from the abstruse metaphors, that it was slightly the knowledgeable relation between the woman and man. It is similarly about conception - or rather the potential of creating a child from this intimate act - told from the womans point of view. Judith Wright was very bold in writing much(prenominal) a poem since it was published in 1949, when such issues werent discussed in the public, exactly as a well-regarded poet, she had achieved a good reputation for expressing herself, and thitherfore could spell a subjective poem about this issue. The main idea of this poem, is base upon female sexuality and sensuality, and that sex is symbolic of life, or death if mother officess fails. The title seems to mean now, Woman to Man as if the woman is religious offering herself to the Man, offering her body to create a child, done the act of sex. It also means that the woman has something to give to the man, not only the pleasure, but through blood and pain, a child. The language compliments the mood of this poem, as it varies from a sad and melancholy cry, to a voice of hope, all in a constant confident feel, and by this, the poets reflections and contemplation?s are communicated successfully to us, making us feel in the same way she has felt. The first stanza begins with a bold and confident entry describing in a round-eyed way the sexual relation between the man and the woman or better said Woman to Man. The seed which the woman holds - has the potential of becoming a child. The image of the day of birth as a ?resurrection day? is all-important(a) in this respect for, just as the resurrection of Christ defeated death, so too, does each individual... line - Oh hold me, for I am afraid. This line is wholly successful on a dramatic level for here the real world of passion and pain breaks in. At the same prison term the poem as a whole has suggested that in each sexual act there is the potential for the creation of new life which challenges prison term and death. The woman is the proud yet fearful instrument of this process. The poem has a rhythmic pattern that compliments the metaphors and paradoxes. The stanzas begin and end, individually, for the first and last lines rhyme, which creates a feeling of ?wholleness? to each stanza, quite appropriate to the act of creating or baby buggy a child. It is like a song, a pentameter that begins bold, but ends in a quiet tone, making its reader reflect, not only about the ending, but the entire poem as a serious issue, that fornication is, or can be, a holy act.