Critical evaluation Essay Example | Topics and Well Written Essays - 250 words

Critical evaluation - Essay Example ard for the general practitioners’ support are some of the innovative ways in which access of the people with learning disabilities to the healthcare can be improved. Nevertheless, these methods’ effectiveness in providing the people with learning disabilities with improved access to healthcare needs to be examined. One strength of the article is that both primary and secondary sources have been consulted to collect the data. Another strength of the article is that it proposes a range of innovative ways in which access of the people with learning disabilities to healthcare can be improved. Yet another strength of the article is that facts and examples are supported by credible sources and references that add to the credibility of the points. One weakness of the article is that the authors were not able to study the literature covering every aspect of their model, though the authors do acknowledge this fact

Racism in the United States Research Paper Example | Topics and Well Written Essays - 1750 words

Racism in the United States - Research Paper Example All other races at one point exhibit racist tendencies towards the Caucasians and among themselves. As far as the government is concerned there is no racism as the law is quite clear that it is illegal. As compared to earlier times of slavery and periods before the 1960s (when civil rights movements were most vocal), open racism has subsided in a huge way. Its form has also changed to be more covertly and technically portrayed than before. The education system, the justice system, health sector and the corporate sector in the United States are some sectors where many feel racism still exists. Immigration issue has also played a role towards racism. Campaigns against and for immigration have on numerous occasions centered on racism. These are some of the issues that lead to the discussion as to whether racism still exists in the United States since they touch on the lives of many. Racism in the US still exists but in a more subtle way as compared to yesteryears and past centuries, and it is manifested in all races not just Caucasians versus all others. Racism puts those being discriminated against in positions of uncertainty and sheer difficulty. Racists work towards ensuring the system is water tight to prevent success of the minority groups. Minority groups are blocked from fully participating in the education system, health system, corporate sector and other realms of social development, for example, politics. These scenarios are quite well depicted in Ellison’s Battle Royal. The author here tries to portray the life of an ordinary but eloquent and learned African American back in the early 20th century. At first the story informs that the young man is optimistic that, with his talent and education, the society will accommodate him. The society here means the whites in the boy’s community, and this is clearly illustrated when he says, â€Å"I visualized myself as a potential Booker T. Washington† (Ellison 939). The state of social affairs is also deduced from humility being the key point in his speech. The story further depicts the hard position in which racism put African Americans by stating that the audiences at the battle royal were divided on whether the fighters were to look at the naked girl dancing in front of them. This scenario saw a portion of the audiences order the fighters to look at the girl while the other portion ordered them not to do so owing to the belief that it is a taboo for an African American to stare at the nakedness of a white woman. The author stated â€Å"some threatened us if we looked and others if we did not. On my right I saw one boy faint† (Ellison 940). This taboo among many others, mostly in the Southern States, was meant to distant other races from marrying the whites and as tools to harass African American men. The Southern states has such high levels of discrimination against African Americans that even after the Civil Rights marches, many still lost their lives and a gr eat deal of their properties including houses all for in the name of white women pursuance. The minority groups have for decades received promises of better lives and a bigger share of the national cake with no tangible evidence of these promises’ fulfillments. This is depicted by the fact that the gold coins are only made of brass thereby showing deception toward the African Americans. It is also clear that the African Ameri

Increasing Cervical Screening for BME Women in the UK

Increasing Cervical Screening for BME Women in the UK It was not until 1988 that the NHS cervical screening programme began; since then it has proved to be a successful scheme in the detection and prevention of cervical cancer saving 4500 lives per year (NHS Cervical Screening Programme 2008, Care Commission 2008). Despite the effectiveness of smear tests, evidence shows that only 80% of women with cervical cancer would have had cervical screening (Bloomfield 2007 cited in Gannon and Dowling 2008). In 2007 2,828 new cases of cervical cancer were diagnosed in the UK, and worldwide there are 493,000 cases annually (Cancer research UK 2010a, Ashford and Collymore 2005). With the prevalence of cervical cancer increasing there are concerns with the uptake of cervical screening in the UK particularly among ethnic minority of women. Evidence by Moser et al (2009) has shown there is a low uptake of cervical screening in ethnic groups of women; British women were 1.35 to 3.42 times more likely to have a cervical smear in comparison with women from an ethnic minority. Although other factors such as age and socioeconomic as demonstrated in Moser et al (2009) have an impact on the uptake of cervical screening, ethnicity seems to be a significant influence. Cervical screening is offered to women aged 25-64 years old; for women aged 25-49 screening is at 3 year intervals and for women aged 50-64 it is every 5 years (DOH 2006). Although uptake of cervical screening is lower overall in ethnic minority groups, there are differences in the uptake between ethnic groups (Luke at al 1996, Webb et al 2004). The aim of this literature review is to discover how the uptake of cervical screening can be increased amongst ethnic minority women in the UK. In doing so the literature review sets out to identify ethnic womens beliefs and attitudes towards cervical screening, identify and evaluate ethnic womens barriers to cervical screening and to evaluate the interventions used to increase the uptake of cervical screening. A literature search was conducted using the search terms cervical smears, ethnic minorities, cancer , screening , barriers, knowledge , women , prevention, interventions and UK. As individual search terms did not provide a fruitful result of papers that were relevant, these search terms were combined as follows: cervical smears + women attitudes +UK cervical cancer prevention and screening +ethnic groups, cervical screening + interventions UK, cervical cancer + ethnic minorities UK, cervical screening + barriers UK cervical screening knowledge + ethnic minorities cervical smears + ethnic minorities The combined search terms were used in the search strategies of CINAHL, MEDLINE-via PubMed, BNI, Google Scholar and PsycArticles (see Appendix 1) A total of 11 studies (Appendix 2) were found with the inclusion criteria of primary research and research published after 1990. It was important that the literature reviewed old research as it was only in 1988 that national cervical screening was introduced and the issue of cervical screening in ethnic minorities has been on-going. Hence this enabled a comparison of how ethnic minority views on cervical screening have changed over time. The exclusion criteria were primary research published outside the UK. This was due to the unfamiliarity with methods of cervical screening outside the UK. The use of electronic searching did not yield as many research as hoped for, furthermore it was very hard to find research on interventions that were tested on ethnic minority groups of women. Cervical cancer is the second most common cancer in women under age 35 in the UK (Bedford, 2009). As the name suggests cervical cancer is cancer of the cervix. The cervix (neck of the womb) is part of the female reproductive system and connects the uterus to the vagina. The cervix has many functions: during menstruation it allows the passage of blood flow and during childbirth it dilates for the baby to pass through the uterus and into the vagina (Cancer Research UK 2010b). The cells of the cervix can develop to pre-cancerous changes known as dysplasia. Dysplasia (which is abnormal cells on the cervix) can be categorised using cervical intraepithelial neoplasia (CIN) classification (see Appendix 2). For this reason it is important that women have regular smears as early detection of cervical abnormalities can initiate treatment before cancer develops (Patient UK 2010). There are two types of cervical cancers: squamous cell carcinoma and adenocarcinoma. Squamous cell carcinoma is the most common form of cervical cancer and accounts for 80- 90% of cervical cancers. Squamous cell carcinoma invades the squamous epithelium of the ectocervix (Dunleavey 2009). The other form of cervical cancer is adenocarcinoma, although less common as it accounts for only 10% in all cases it is considered to be the more severe than squamous cell carcinoma. (Dunleavy 2009, What is cervical cancer? 2011). Moreover the cervical smear is not designed to detect adenocarcinoma, however is mainly intended at detecting the early changes of squamous cell carcinoma (Poulsen 2005).As cervical cancer progresses slowly it may be asymptomatic, however as it advances the symptoms such as irregular bleeding, bleeding or pain after sexual intercourse and increased discharge may be a sign of cervical cancer Smeltzer et al (2009). According to Shiffman et al (1993) there is strong evidence to suggest that Human Papilloma Virus (HPV) causes cervical cancer, with types 16 and 18 deemed to be strongly associated with cervical cancer. Other risk factors include, smoking, number of sexual partners, age of first intercourse and use of oral contraceptives (Cancer Research UK 2009b). Internal Barriers From the literature it is apparent that internal barriers such as , beliefs, attitudes, embarrassment, and lack of knowledge have an influence on the uptake of cervical screening in ethnic minorities (Doyle 1991, Naish et al 1994, Box 1998, Thomas et al 2005, Abdullahi 2009). There seems to be a consensus about beliefs and attitudes of ethnic minority women and cervical screening. Naish et al (1994) investigated factors that deter women from attending there GP for cervical screening. A focus group of women from Turkish, Kurdish, Bengali, Chinese, Vietnamese, Punjabi and Urdu speaking women was conducted. It was found that most of the women shared fatalistic beliefs about cervical cancer. It was noted that if you have it, then that is it and it would be better if were detected early (Naish et al 1994, p.1127). Similarly a more recent study by Abdullahi et al (2009) also found Somali women had fatalistic beliefs about cervical cancer; however these beliefs stemmed from a religious view rather than a cultural view as described in Naish et al (1994). Using a purposive sample, Abdullahi et al (2009) recruited Somali women from Camden. Somali women commonly believed that cervical cancer was the will of God. This belief is further supported by participants in Box (1998) and Thomas et al (2005) study. Box (1998) aimed to seek the views and experiences of black and minority ethnic (BME) women on smear test screening for cervical cancer. The findings showed attitudes and beliefs about cervical cancer were linked with promiscuity and seen as a punishment from God. A woman in Boxs study (1998, p.7 ) stated cancer , yes it happens here, not with us we stay with our men. Therefore for some ethnic minority women there is a chance of being culturally and religiously stigmatised as a result of the belief that cervical screening is only appropriate for those who are promiscuous. For most ethnic minorities with strong religious and cultural backgrounds there is a high importance attached to how women should behave when not married. The commitment to religion in ethnic minorities especially those from a Muslim and Christian background means for most women they have to maintain their virginity until married otherwise may be exposed to social consequences (Shripinda 2010). For example in Moroccan and Turkish groups women found to have lost their virginity can be killed in what is known as honour killing (Shripinda 2010). This view is still strongly upheld. Young Pakistani, Arabic and Greek orthodox females expressed resilient views on keeping the virginal state when entering marriage (Thomas et al 2005). Thomas et als (2005) study revealed young Pakistani women suggested they would go for a cervical screening only if the screener was not from their cultural background as they feared of being found out. Likewise in Boxs study (1998), sexually active unmarried wom en were afraid their doctor or receptionist could not be trusted as to the reason why they attended the GP. The unanimity on beliefs and attitudes towards cervical cancer is not shared across all types of ethnic groups of women. Interestingly the views of African women beliefs about cervical cancer are derived from superstition (Thomas et al, 2005). The African women in Thomas et als study (2005) believed cervical cancer was a taboo and that to mention cancer might cause the cancer to manifest. Furthermore cervical cancer was seen as a taboo more than other types of cancers. The evidence above provides a strong link between ethnic minorities cultural and religious beliefs as a barrier in cervical screening. Another concern over cervical screening was the issue of embarrassment. The cervical smear test is invasive and for most ethnic women the procedure can be physically and psychologically uncomfortable (Box 1998, Abdullahi et al 2009). The issue of embarrassment is particularly important to Somali women. For them the issue of embarrassment arises from female gender mutilation (FGM). WHO (2010) explains FGM as the total or partial removal of the external female genitalia. FGM in most cultures is as result of both cultural, religious and refers to back to the ideology of maintaining premarital virginity. For some Somali women there is the anticipation of embarrassment as result of the reaction from the doctor or nurse taking the samples (Abdullahi et al 2009). Consequently Abdullahi et al (2009) brings an understanding as to how FGM acts as a deterrence for Somali women in cervical screening. These studies (Naish et al 1994, Box 1998, Thomas et al 2005, Abdullahi 2009) have the use of focus groups in common. Though this suggests the appropriate use of focus groups in the study, it has its limitations. Parahoo (2006) states the disadvantage of focus groups is that dominant personalities can control the discussions. This was evident in Naish et al (1994), where it was noted that both Turkish and Kurdish women interacted spontaneously and informally compared to the other ethnic groups of women. This can affect the credibility of the study as the views of ethnic women perhaps only reflected those from Turkish and Kurdish backgrounds and not everyone else. Furthermore focus groups are not effective compared with in-depth interview in dealing with sensitive topics. For example in Abdullahis study (2009) the issue of promiscuity was discussed with discomfort. This presents one of the prime issues within focus groups, where participants may feel less inclined to discuss sensitive issues out of fear of scrutiny and criticism from others within the group. This is reinforced by Groups Plus (2003) who states that sensitive topics are easily discussed if participants in the group all share the same problem. The lack of knowledge of cervical screening is often prevalent in ethnic minority groups. Box (1998) identifies that there were misconceptions about the purpose of screening. Similarly Abdullahi et al (2009) found that Somali women failed to recognise the importance of cervical screening. This supports a previous study by Doyle (1991) which identified ethnic minorities unawareness of both the importance and existence of cervical screening. Somali women disregarded cervical screening because there was no cervical screening in Somalia; the concept of preventative health was also unfamiliar. The concept of preventative health is unaccustomed in some cultures. Doyle (1991) suggests in the Asian communities the reliance on folk medicines meant screening was outside the traditional views of healing. The disregard towards preventative health is perhaps underpinned by religious beliefs. Thomas et al (2005) found that many ethnic groups felt it was important to turn to religion as a form of c oping emotionally. There was a consensus amongst the groups that if things are left with God he resolves the problem. Despite the lack of knowledge of cervical screening amongst ethnic groups, other groups are more knowledgeable. Guajarati women in Boxs study (1998) were the only ones aware that cervical screening is able to detect pre-cancerous cells. Thomas et al (2005) found African groups were more able to identify cervical cancer as a commonly occurring cancer within their community. However age has an influential role on the amount knowledge that is embedded. Younger African-Caribbean participants had the least knowledge about cancer as there was a perception cancer affected older people (Thomas et al 2005). It appears that Thomas et als study (2005) has a methodological weakness. In their study they aimed to describe factors that act as barriers to effective uptake of breast and cervical screening. However the sample may not be representative of the target population as the sample consisted of men. Since men do not partake in breast and cervical screening, their inclusion may have distorted the findings, therefore reduces the transferability and credibility of the study. Regardless of this, Thomas et als (2005) study shows the significance in the link between age and lack of knowledge in cervical cancer. The lack of knowledge amongst ethnic minorities perhaps was as a result of language difficulties. If they were able to communicate and comprehend information they received then this could enhance their understanding and knowledge of cervical screening. The majority of ethnic women declared that translated information in their languages was often inadequate and difficult to make sense of (Naish et al 1994, Abdullahi 2009, Thomas et al 2005, Box 1998). The translated information was not only seen as a problem, but for some ethnic minority women who were illiterate translated information was still perplexing. As a result there was a preference for being told about the cervical test in their own languages rather than reading a translated script (Box 1998). External Barriers One major external barrier that was very frequently much expressed was the gender of the GP or screener. There were conceptions that if it was male practitioners that did the screening then women are less likely to uptake cervical screening. Some women in Boxs study (1998) felt that their bodies should only be seen by their husbands and it were adamant that the smear taker should be a female. Similarly Somali women, felt that as Muslim, women having a male practitioner taking the smears is inappropriate. Abdullahi et als (2009) study is significant in identifying and providing solutions to the barriers that discourages Somali women from up taking up cervical screening. This study is commended well on its originality as mentioned by Abdullahi (2009), and this was the only study investigating barriers to cervical screening that was found that focused on the views of Somali women. Conducting a study on Somali women brings new knowledge to this area of research as the Somali community do not lend themselves to research because they are seen to be invisible compared to other Muslim ethnic minorities (Information centre about Asylum and Refugees ( ICAR) 2004).However, Naish et al (1994) found that both Kurdish and Turkish women did not mind male practitioners, as they are used to male doctors in their home countries. Nonetheless it appeared that a female practitioner still had more favour compared to that of a male practitioner. From the evidence the preference for a female doctor is not only due to cultural or religious views but also due to the lack of understanding and insensitivity that male doctors display towards ethnic women having cervical smears. This is particularly demonstrated in Box et als study (1998, p.7) where a women stated the doctor was cross with me when I asked for the forceps (speculum) to be warmed, how would he feel if it was him? However Thomas et al (2005) suggests that this poor relationship between practitioners and patients was due to poor communication skills. In Thomas et als (2005) study BME women identified that the attitudes portrayed by their GP was very discouraging and at times it felt as if their GPs did not want them to be there. Moreover the issue of racism is problematic for ethnic minority women. For example in Box (1998) some of the Asian women were cited as being treated coldly by the smear taker because of their race. Health advocates noticed BME women were treate d less favourably than white women and when smears were taken they were provided with less comfort (Box 1998). Childcare issues also play an influential part in preventing ethnic women in up taking cervical smears. Naish et al (1994) found with many women, having children in the same room was very distracting. This view was also supported by Somali women who indicated the lack of childcare facilities was a barrier in attending cervical screening (Abdullahi et al 2009). There is a link between the perceived lack of sterility of equipment and the uptake of cervical screening. The views expressed by some ethnic women were that the speculum was not hygienic and that this could be a cause of cervical cancer instead of the association with HPV (Box 1998). One woman expressed the following concern; the cancer might be there [in the clinic] you never know they need to cover it with water, wash it all away Ive never seen them do that (Box 1998 , p.g 9). The view is also reiterated in Naish et als (1994) study, where Chinese women were adamant that the use of unsterile equipment could induce infections. This demonstrates how important the lack of knowledge amongst ethnic minorities can affect the uptake of cervical smears. Interventions that increase cervical screening Interventions that increase cervical screening such as health promotion, education, invitations, psychological interventions and media interventions are examined below. Kernohan (1996) investigated the effectiveness of community-based intervention to improve knowledge on the uptake of breast and cervical screening. The sample consisting of 1000 women from different ethnic backgrounds were involved in a health promotion intervention. The study focused on Bradfords main minority ethnic women (South Asian) and was concerned with the impact of health education programmes on the knowledge of cervical screening in South Asian women. Compared to the other ethnic groups South Asian women had the lowest level of knowledge on cervical smears, however their knowledge had considerably improved from 35.8% to 68.7% after the intervention. Kernohan (1996) study is noteworthy for depicting a positive correlation between health promotion and knowledge of cervical screening. However as this study was a pilot study this area of research would require further work in order to provide robust evidence. Furthermore kernohan (1996) did not look at the impact of increased k nowledge on the subsequent rate of uptake. Evidence from Abdullahi et al (2009) and Naish et al (1994) suggest that addressing barriers which deter women from having cervical smears can be used as interventions to increase cervical smear rates. The lack of knowledge of cervical screening is an apparent barrier in most ethnic women and a proposed solution would be to increase the levels of knowledge of cervical screening. Abdullahi et al (2009) suggests that education about the purpose of cervical screening is key to encouraging Somali women to attend for cervical screening. However, suggesting such solutions to overcome barriers to cervical screening without trial may be futile, since without some testing the solutions there remains a gap in understanding the impact of the intervention suggested by Abdullahi et al (2009). More importantly Sabates and Feinstein (2006) investigated the role of education on the uptake of preventative health care, in this case cervical screening. Sabates and Feinstein (2006) suggest that educational effects on the uptake of preventative health results in raising the awareness of and the importance of having a regular health check and therefore the inclination to uptake preventative health checks. The study found that women enrolled in courses or training leading to qualifications had a positive impact on the probability of the uptake of cervical smears. Sabates and Feinsteins (2006) study provides further support to the socio-economic determinants of the uptake of screening. However, the effectiveness of this particular intervention is limited as women within ethnic minorities tend to not achieve the accolades of adult learning as a result of cultural demands. According to YWCA (2011) some black minority ethnic women are missing from the school register and are pulled out of school as a result of family duties to marital commitment. A systematic review conducted by Forbes et al (2009) reviewed interventions targeted at women to encourage the uptake of cervical screening. It concluded that invitation letters and educational materials were the most effective types of interventions. However evidence from Stein et al (2002) suggests that invitation letters were not effective. Stein et al (2006) investigated the effectiveness of three methods of inviting women with a long history of non -attendance to undergo cervical screening. The methods of invitation were a telephone call from a nurse, a letter from a well-known celebrity and letter from the local NHS Cervical Screening Commissioner. A telephone call and a letter from a celebrity were ineffective. A letter from the commissioner resulted in a small increase in the uptake of cervical screening this was not statistically significant. Although Stein et al (2006) findings contradict that of Forbes et al (2009), this does not nullify the results of Forbes et als (2009) study. The findings from Stein et al (2005) highlight one of the limitations of doing a single study. Egger et al (2001) argues a single study often fails to detect a statistically significance between interventions when in fact such difference may exists, therefore are more likely to produce false negative results. Moreover, in the hierarchy of evidence for interventions, systematic reviews are at the top as they are more likely to produce a strong and less-biased synthesis of findings that to show whether the intervention has an effective outcome (Melnyk and Fineout-Overholt 2010) . For this reason Forbes et al (2009) has a more valuable contribution towards knowledge on the interventions that increase the uptake of cervical screening. The NHS cervical screening programme (2011) highlights that encouraging women through reminders such as invitation letters is exceptionally important; this may not be as effective in motivating ethnic minority women to attend cervical screening. Some ethnic minority women are more likely to ignore invitation letters if translation is unavailable ( Naish et al 1994). On the other hand, there is a link between planning when, where and how of making an appointment and the success rate in uptake of cervical screening. This is referred to as implementation intentions the initiation of behaviour is determined if the conditions when, where and how are planned (Bartholomew et al 2011).This was demonstrated by Sheeran and Orbell (2000) who tested the concept of implementation intentions as a method to increase non-attendance in cervical screening. It was found that the participants who produced implementation intentions were much more likely to attend for a cervical smear test compared to th e control group. This demonstrates how empowering women to have more control on the choices in arranging their appointments can significantly encourage the uptake of cervical screening. This supports Abdullahi et al s (2009) study where it was identified that inconvenient appointment times were also considered to be a barrier. Consequently the use of implementation intention as an intervention is noteworthy of encouraging ethnic women to uptake cervical screening. Furthermore, an area of research that would increase existing knowledge is to investigate implementation intentions on ethnic minority women and subsequent uptake of cervical smears, in order to provide strong evidence for such intervention. The media has potentially an important role on the uptake of cervical screening. Howe et al (2002) investigated the impact of a television soap opera on the NHS cervical screening programme. Using a retrospective analysis on information of the NHS cervical screening databases, during the 6 month of the storyline, the number of smears performed in women whose previous smears were compared to women who had smears taken previously that year. The storyline involved a character that missed her regular screening appointments; later she was diagnosed with cervical cancer and 6 weeks later she died. Howe et al (2002) found that there were substantial increases in the number of cervical smears- from 65 714 in 2001, to 79,712 in 2002, 19 weeks after the storyline. This demonstrates a significant link between the effects of media in motivating women to take up cervical screening. In support is the impact of a celebrity profile on uptake of cervical screening. The media coverage of Jade Goody fr om diagnosis of cervical cancer till death has been an influential motive for some women to uptake cervical screening. Parkers (2010) reports that, since the media coverage of Jade Goodys case, figures from NHS Rotherham showed an 80% improvement rate in the uptake of cervical screening. Discussion From reviewing the literature it is apparent that increasing the uptake of cervical screening amongst ethnic minority women poses a challenging problem. Ethnic minority women are faced with internal and external barriers that play an important role on their non- attendance for cervical screening. It appears the internal and external barriers are interrelated. For instance the issue of embarrassment may arise as a result of being screened by a male practitioner, as well as FGM particularly in the case of Somali women as stated earlier. Moreover the culturally sensitive issues such as the loss of virginity still pays a price tag in many cultures and the stigmatisation attached towards it means some young ethnic minority women might feel reluctant to take up cervical smears. Needless to say the extent to which a barrier act as a deterrent to the uptake of cervical screening is very much culturally dependent. Women from African cultures see cervical cancer as a taboo, where as in Asian cultures cervical cancer is perceived as a disease for those who are promiscuous. Additionally, the cultural attitudes and beliefs may be a stronger barrier than child care issues for some ethnic minority women, whilst the sterility of equipment may have a stronger influence than the issue of embarrassment. The lack of knowledge was the most common barrier that was revealed and it appears this has not changed over the years amongst ethnic minority groups ( Box 1998, Thomas et al 2005 , Abdullahi et al 2009). From evaluating the interventions, it remains substantial that socioeconomic factors (lack of knowledge and education) are predictors in determining ethnic minority women attendance for cervical screening. For this reason, it would be beneficial for communities where ethnic minorities are prevalent to have health promotion projects that produce the awareness of cervical screening (kernohan 1996). There was sufficient evidence to suggest language difficulties as an important factor in deterring ethnic minority women from the uptake of cervical screening. Though research has not tested the effect of bilingual services as an intervention to increase cervical screening, an area in practice that needs room for improvement is the use bilingual services and bilingual interpreters in the cervical screening recall system. Forbes et al (2009) research supports the use of invitation letters as an intervention to improve the uptake of cervical screening and currently still remains the most popular intervention used. Therefore a recommendation for practice would be for invitation letters to be printed in the languages of ethnic minorities. What was interesting and surprising, was the issue of racism as a barrier to the uptake of cervical screening. The ethnic minority often experience health inequalities as a result of racism, karlsen (2007) reports racism can lead to differences in treatment and access to health promoting resources for the ethnic minority. This was reflected in Box (1998) where Asian women expressed their concerns of being treated coldly and treated indecently as a result of their race. This area highlights the need for a change within the health services offered to ethnicity minorities in the UK. More importantly a contribution to research would be to tackle racism as an intervention to encourage ethnic minority women in the uptake of cervical screening (Szczepura 2005). Furthermore training needs to be put in place for health professionals to understand and embrace the forms of cultural and religious beliefs amongst ethnic minorities in order to reduce prejudice and discriminatory practices. This would be particularly important to women from ethnic minorities where FGM is seen as a custom practice. Denniston et al (2001) states FGM continues to take place in many cultures around the world; health practitioners and screeners need to be taught to take a sensitive and a considerable approach when screening women with FGM. Sheeran and Orbells study (2000) makes a positive contribution towards the issue of improving the uptake of cervical screening in women from ethnic minority groups. The use of implementation intentions seemed to have an effect on women in their attendance for cervical screening. Implementation intentions would be advantageous for some ethnic minority women. Planning when, where and how an appointment would address some of the barriers identified, including the gender of the screener, ensuring that a bilingual interpreter was present, so if needed information given could be clarified. Thomas et al (2005) implies that the planning of an appointment for ethnic minority groups, especially for those with religious festivals is important. Ethnic women given the chance to decide when their appointment should take place would eradicate inconveniences such as being invited for screening during Ramadan. However further research would be necessary to establish the effectiveness as well as the c ost-effectiveness of using implementation intentions amongst ethnic minority women and the uptake of cervical screening. To conclude, this literature review examined how to increase the uptake of cervical screening amongst ethnic minority women in the UK. The evidence discussed in this review has explored the internal barriers and external barriers that deter ethnic women in the uptake of cervical screening. It is hard to change peoples behaviour because of what we believe in and how this has shaped our social norms and values. Therefore to increase the uptake of cervical screening amongst ethnic minority groups remains complex and inconclusive. With the evidence examined in this review, the interventions (health promotion, education, implementation intentions, invitation letters and the media) to improve the attendance and uptake of cervical screening noticeably have an influential impact in encourag

The role of culture in the economic development of countries Essay

Introduction: The role of culture in the economic development of countries is often overlooked by economists, yet it can significantly affect a country’s economic development. Culture generates assets, such as skills, products, expression, and insight that contribute to the social and economic well being of the community. I will show the benefit of culture’s impact on economic development through tourism, social capital, and corporate governance. In contrast, culture can produce negative outcomes in economic development. Cultural issues, such as gender inequality, lack of social capital, and diminishing cultural heritages, contribute to a downgrading economy. To understand culture’s impact on a country’s economic development, it is important to understand what culture is: a system of values and norms that are shared among a group of people and that when taken together constitute a design for living (Hill 98). Furthermore, it is about the way the people live, and how the quality of their lives can be improved. It shapes â€Å"the way things are done† and our understanding of why this should be so. Culture is concerned with identity, aspiration, symbolic exchange, coordination, and structures and practices that serve relational ends, such as ethnicity, rituals, heritage, norms, meanings, and beliefs. It is not a set of primitive wonders permanently embedded within national, religious, or other groups, but rather a set of contested attributes, constantly changing, both shaping and being shaped by social and economic aspects of human interaction. Economic development is fundamentally about enhancing the factors of productive capacity, such as land, labor, capital, and technology, of a national, state, or local economy, as stated by the U.S. Economic Development Administration. Economic development influences growth and restructuring of an economy to enhance economic well-being. We experience economic growth when our standard of living is rising. Rather than being a simplistic process, economic development typically is a range of influences aimed at achieving objectives like creating jobs and wealth and improving the quality of life. It incorporates coordinated initiatives targeted at expanding infrastructure and increasing the volume and/or quality of goods and services produced by a community. A common measure of economic development is a country’s gross national ... ...Business Today. 3rd Ed. New York: McGraw-Hill/Irwin, 2004. Kaufmann, Daniel, Aart Kraay, and Pablo Zoido-Lobaton. Governance Matters. The World Bank Development Research Group Macroeconomics and Growth and World Bank Institute Governance, Regulation and Finance, October 1999. Organization for Economic Co-operation and Development. Improving Business Behavior: Why we need Corporate Governance. Oct. 2004. OECD. The National Conference of State Legislatures. Cultural Policy Working Group. Investing In Culture: Innovations In State Policy. The National Conference of State Legislatures: 2003. â€Å"Tourism sector plays key role in economic development.† Economics. Radio the Voice of Vietnam. 2004 United Nations. Office of the Special Adviser on Gender Issues and Advancement of Women. Gender Mainstreaming. United Nations: Oct. 2004 United States. Department of Commerce. Economic Development Administration. United States: May 2002. Woolcock, Michael, and Deepa Narayan. Social Capital: Implications for Development Theory, Research, and Policy. World Bank, Jan 1999. World Bank. Gender and Development Group. Gender Equality and the Millennium Development Goals. 4 April 2003 The role of culture in the economic development of countries Essay Introduction: The role of culture in the economic development of countries is often overlooked by economists, yet it can significantly affect a country’s economic development. Culture generates assets, such as skills, products, expression, and insight that contribute to the social and economic well being of the community. I will show the benefit of culture’s impact on economic development through tourism, social capital, and corporate governance. In contrast, culture can produce negative outcomes in economic development. Cultural issues, such as gender inequality, lack of social capital, and diminishing cultural heritages, contribute to a downgrading economy. To understand culture’s impact on a country’s economic development, it is important to understand what culture is: a system of values and norms that are shared among a group of people and that when taken together constitute a design for living (Hill 98). Furthermore, it is about the way the people live, and how the quality of their lives can be improved. It shapes â€Å"the way things are done† and our understanding of why this should be so. Culture is concerned with identity, aspiration, symbolic exchange, coordination, and structures and practices that serve relational ends, such as ethnicity, rituals, heritage, norms, meanings, and beliefs. It is not a set of primitive wonders permanently embedded within national, religious, or other groups, but rather a set of contested attributes, constantly changing, both shaping and being shaped by social and economic aspects of human interaction. Economic development is fundamentally about enhancing the factors of productive capacity, such as land, labor, capital, and technology, of a national, state, or local economy, as stated by the U.S. Economic Development Administration. Economic development influences growth and restructuring of an economy to enhance economic well-being. We experience economic growth when our standard of living is rising. Rather than being a simplistic process, economic development typically is a range of influences aimed at achieving objectives like creating jobs and wealth and improving the quality of life. It incorporates coordinated initiatives targeted at expanding infrastructure and increasing the volume and/or quality of goods and services produced by a community. A common measure of economic development is a country’s gross national ... ...Business Today. 3rd Ed. New York: McGraw-Hill/Irwin, 2004. Kaufmann, Daniel, Aart Kraay, and Pablo Zoido-Lobaton. Governance Matters. The World Bank Development Research Group Macroeconomics and Growth and World Bank Institute Governance, Regulation and Finance, October 1999. Organization for Economic Co-operation and Development. Improving Business Behavior: Why we need Corporate Governance. Oct. 2004. OECD. The National Conference of State Legislatures. Cultural Policy Working Group. Investing In Culture: Innovations In State Policy. The National Conference of State Legislatures: 2003. â€Å"Tourism sector plays key role in economic development.† Economics. Radio the Voice of Vietnam. 2004 United Nations. Office of the Special Adviser on Gender Issues and Advancement of Women. Gender Mainstreaming. United Nations: Oct. 2004 United States. Department of Commerce. Economic Development Administration. United States: May 2002. Woolcock, Michael, and Deepa Narayan. Social Capital: Implications for Development Theory, Research, and Policy. World Bank, Jan 1999. World Bank. Gender and Development Group. Gender Equality and the Millennium Development Goals. 4 April 2003

Autism Involvement in Society Essay

My cousin is my age, he is a freshman in high school to be exact. He loves to plays video games, He hates homework. He is a great student, gets all A’s in his classes and hangs out with friends. He is very good at playing the bass (stringed instrument), although he cant keep his concentration very long. You see my cousin has autism. He shows great courage in the face of adversity. Vijay Barona was diagnosed with autism when he was three years old. And he hasn’t haven’t had the easiest time with it. Autism is known as a complex developmental disability. Experts believe that Autism presents itself during the first three years of a person’s life. The condition is the result of a neurological disorder that has an effect on normal brain function, affecting development of the person’s communication and social interaction skills. â€Å"I had great trouble in school’ says Vijay ‘ concentration was the hardest part† He talked about how school work became harder to do as he got older. My parents did help me through it. They got a teacher to come to my house when I was little for some extra help in coping with autism. Vijay had lived in Atlanta, Georgia till he was 9, the moved up into Indianapolis, Indiana. What made this even more challenging? â€Å"Moving up north made this adversity more challenging for me.† Being a new kid at a different school is hard for anyone to go through. â€Å"I always knew something was wrong with me, I was different from the other kids and they never really liked me either† says Vijay. Being as I am now has made me realize how much I had gone through to get where I am now. I was bullied in school. Just because I had autism, and just because I was different. I didn’t act like the other kids or think in the same way as they did. That’s when I knew that I didn’t fit in. Did you ever feel like giving up? â€Å"Yes I always wanted to move back to Georgia,† said Vijay. â€Å"No one really knew about it except my sister. I never talked to anybody about what was going on in my life.† Did this ever stop? He did have a girl in the same grade a while back stick up for him. She really helped him get through bulling. â€Å"It gained me confidence to actually do something about it, Eventually its stopped.†

Jawahar Lal Chaudhry

Sunita Jawahar  Lal Chaudhry&Associates are in practice since 1998.the firm was started by CA Sunita Juneja and her father Mr. Jawahar Lal Chaudhry who is an advocate of income tax department. At first they started their office in their house but now they have their main office in Krishna market, rajpura.CA Sunita Juneja is in practice since 1998.she joined her father Mr. Jawahar Lal Chaudhry who was an advocate and now these both are running the firm fomore than 18 years. As we know that Partners are the founders of the firms and the name are associated to them only they are the main parties who issues or signs any report and all the inquiry is made by them in our firm. In our firm Mrs Sunita Juneja and Mr. Jawaharlal Chaudhary are the two partners who started the firm. The firm represents the combination of specialized skills, which offers sound financial advice and proper services. They have the good customer relation and all the work is been completed by them on time. There is proper management for handling of the work and proper managing because of which no confusion is being created. There is proper infrastructure and various departments for proper handling of the work. Both the partners of the firm have the good experience and as a result there is goodwill of them in the market. All the work carried here is according to the rules and regulations which are passed by the government .They audit various good firms in Rajpura .Some of them are alcon cables, aneja plywood etc. 1.2 About the projectStudy of internal auditing as a tool for companies performance was completely a new project idea which I got through the Chitkara University. As we all know auditing is the most important part of the company as it maintains the system of the internal control to attain the objectives and moreover for the smooth running of the company auditing is necessary.Internal audit is a consultant activity which designs to add some value in the organization. Basically internal auditing is the integral part in the companies. They provide various services to the companies like prevention of the fraud. As we all know that many frauds are taking place for example like misuse of company credit cards etc. So internal auditing keeps the check on the financial resources so that there is no misuse of the company resources.It is also helps to monitor the internal controls by designing the proper credit policy so that there is no bad debt. Internal audit also consists of the operational audit which means that to look that whether the organization is operating at maximum efficiency or not For the proper working of the organization and for the sound financial system there should be proper check on the organization which can be done through internal auditing. 2.2) Report on internship 2.1) About the firm I did my internship under chartered accountant Sunita Jawaharlal Chaudhary and associates in rajpura.All of my fellow worker were cooperative and were ready to help each other. There was proper management structure. The infrastructure of the firm was also quite good. There was proper working of computers and equipments were used according to the latest technology. By working under the chartered accountant firm not only gives us additional knowledge but also helped me to apply my academic knowledge into the practical world. It is one of the reputed firm in the rajpura and also audit good firms in rajpura.

Free Essays on Abortion Ethics

On the question of abortion being moral, the answer is clearly that terminating a fetus' life under certain circumstances is not only moral, but it is also our responsibility to terminate it if the quality of life is in question for the fetus. A second major reason is that to declare abortion immoral would mean that we would have to consider the factor of how the conception came about. This cannot and should not be done. Quality is a major factor in the question of the morality of abortion. When parents decide to keep or not keep a baby the issue of adoption does not play into this. The reason for this is that once the baby is born that the parents may change their mind if they want to keep it. Parents must decide at the onset of the pregnancy to decide if they can in good conscience bring a child into the world, if the answer is yes, then people should proceed with the pregnancy and then determine whether they want to give the child up for adoption. It is a parent's moral responsibi lity to make sure that the environments, which the child will be brought into, will be healthy and supportive. It is a far greater crime to treat a child poorly for eighteen years then it is to terminate a fetus that cannot think, feel or is aware of its existence. On the second point of making the way that conception occurred a non-factor I am not saying that having the babies of rapists or in cases of incest is okay. Still, for the argument that abortion is immoral, you must argue that the action is immoral, not the child. The child cannot be either at this point. If we are then talking about the act of abortion then, who is there to determine right and wrong. A court of law should have no place in this decision. The primary interests in this pregnancy should make the decision themselves. This would normally be the parent of the fetus. The action in the case of rape is defiantly immoral, but the fetus is not. To say that the abortion is moral because the... Free Essays on Abortion Ethics Free Essays on Abortion Ethics On the question of abortion being moral, the answer is clearly that terminating a fetus' life under certain circumstances is not only moral, but it is also our responsibility to terminate it if the quality of life is in question for the fetus. A second major reason is that to declare abortion immoral would mean that we would have to consider the factor of how the conception came about. This cannot and should not be done. Quality is a major factor in the question of the morality of abortion. When parents decide to keep or not keep a baby the issue of adoption does not play into this. The reason for this is that once the baby is born that the parents may change their mind if they want to keep it. Parents must decide at the onset of the pregnancy to decide if they can in good conscience bring a child into the world, if the answer is yes, then people should proceed with the pregnancy and then determine whether they want to give the child up for adoption. It is a parent's moral responsibi lity to make sure that the environments, which the child will be brought into, will be healthy and supportive. It is a far greater crime to treat a child poorly for eighteen years then it is to terminate a fetus that cannot think, feel or is aware of its existence. On the second point of making the way that conception occurred a non-factor I am not saying that having the babies of rapists or in cases of incest is okay. Still, for the argument that abortion is immoral, you must argue that the action is immoral, not the child. The child cannot be either at this point. If we are then talking about the act of abortion then, who is there to determine right and wrong. A court of law should have no place in this decision. The primary interests in this pregnancy should make the decision themselves. This would normally be the parent of the fetus. The action in the case of rape is defiantly immoral, but the fetus is not. To say that the abortion is moral because the...

Jan Brueghel the elder- Looking at his flowers essays

Jan Brueghel the elder- Looking at his flowers essays The artist I am going to look at is Jan Brueghel the elder. Brueghel was, born in Brussels. As the most talented son of Pieter Brueghel the elder, he devoted his early career to flower painting and still lifes and his suave renderings earned him the nickname Velvet Brueghel. Brueghel achieved fame for his beautifully detailed landscapes, peopled with biblical and mythology figures. He also painted landscape settings for numerous portraits, notably the Flemish master Peter Paul Rubens. Jans best works include The battle of Arbela and Bowl with jewels. Jan Brueghels work falls into the renaissance period. Brueghel followed in the footsteps of Hieronymus Bosch , just like his father, Pieter Brueghel. Bosch was an artist who was far more original, and less dependent on traditional Flemish paintings. All his pictures were wildly unconventional. The Garden of Earthly Delights (1510-1515? Prado), an elaborate fantasy of sin and redemption, shows an imaginary, surreal world where the past, present, and future unfold in nightmarish images. Such extreme originality led to the art of Pieter Brueghel the Elder, well on in the 16th century. Brueghel demonstrates the powerful influence of Bosch in its phantasm imagery. At a time when many of his contemporaries were imitating Italian solutions, Brueghel continued an allegiance to the earlier style of Netherlandish and Flemish painters in his own paintings and engravings, which often are illustrations for folk proverbs. Comparing Jan Brueghels painting with Georgia OKeefes work it was fascinating to see how different and independent each of the artists style of work is, although they are of the same subject matter. It can be described as a tapestry, which leads the eye around the piece but I find this can also be confusing. Whilst analyzing this piece, I noticed that the ...

The Great Irish Famine Was a Turning Point in History

The Great Irish Famine Was a Turning Point in History In the early 1800s, the impoverished and rapidly-growing rural population of Ireland had become almost totally dependent on one crop. Only the potato could produce enough food to sustain families farming the tiny plots of land the Irish peasants had been forced onto by British landlords. The lowly potato was an agricultural marvel, but staking the lives of an entire population on it was enormously risky. Sporadic potato crop failures had plagued Ireland in the 1700s and early 1800s. In the mid-1840s, a blight caused by a fungus struck potato plants across all of Ireland. The failure of essentially the entire potato crop for several years led to unprecedented disaster. Both Ireland and America would be changed forever. The Irish Potato Famine The Irish Potato Famine, which in Ireland became known as The Great Hunger, was a turning point in Irish history. It changed Irish society forever, most strikingly by greatly reducing the population. In 1841, Irelands population was more than eight million. It has been estimated that at least one million died of starvation and disease in the late 1840s, and at least another one million immigrated during the famine. Famine hardened resentment toward the British who ruled Ireland. Nationalist movements in Ireland, which had always ended in failure, would now have a powerful new component: sympathetic Irish immigrants living in America. Scientific Causes The botanical cause of the Great Famine was a virulent fungus (Phytophthora infestans), spread by the wind, that first appeared on the leaves of potato plants in September and October of 1845. The diseased plants withered with shocking speed. When the potatoes were dug up for harvest, they were found to be rotting. Poor farmers discovered the potatoes they could normally store and use as provisions for six months had turned inedible. Modern potato farmers spray plants to prevent blight. But in the 1840s, the blight was not well understood, and unfounded theories spread as rumors. Panic set in. The failure of the potato harvest in 1845 was repeated the following year, and again in 1847. Social Causes In the early 1800s, a large part of the Irish population lived as impoverished tenant farmers, generally in debt to British landlords. The need to survive on small plots of rented land created the perilous situation where vast numbers of people depended on the potato crop for survival. Historians have long noted that while Irish peasants were forced to subsist on potatoes, other crops were being grown in Ireland, and food was exported for market in England and elsewhere. Beef cattle raised in Ireland were also exported for English tables. British Government Reaction The response of the British government to the calamity in Ireland has long been a focus of controversy. Government relief efforts were launched, but they were largely ineffective. More modern commentators have noted that economic doctrine in 1840s Britain generally accepted that poor people were bound to suffer and government intervention was not warranted. The issue of English culpability in the catastrophe in Ireland made headlines in the 1990s, during commemorations marking the 150th anniversary of the Great Famine. Britains then-Prime Minister Tony Blair expressed regret over Englands role during commemorations of the 150th anniversary of the famine. The New York Times reported at the time that Mr. Blair stopped short of making a full apology on behalf of his country. Devastation It is impossible to determine precise numbers of the dead from starvation and disease during the Potato Famine. Many victims were buried in mass graves, their names unrecorded. It has been estimated that at least half a million Irish tenants were evicted during the famine years. In some places, particularly in the west of Ireland, entire communities simply ceased to exist. The residents either died, were driven off the land, or chose to find a better life in America. Leaving Ireland Irish immigration to America proceeded at a modest pace in the decades before the Great Famine. It has been estimated that only 5,000 Irish immigrants per year arrived in the United States prior to 1830. The Great Famine increased those numbers astronomically. Documented arrivals during the famine years are well over half a million. It is assumed that many more arrived undocumented, perhaps by landing first in Canada and walking into the United States. By 1850, the population of New York City was said to be 26 percent Irish. An article titled Ireland in America in the New York Times on April 2, 1852, recounted the continuing arrivals: On Sunday last three thousand emigrants arrived at this port. On Monday there were over two thousand. On Tuesday over five thousand arrived. On Wednesday the number was over two thousand. Thus in four days twelve thousand persons were landed for the first time upon American shores. A population greater than that of some of the largest and most flourishing villages of this State was thus added to the City of New York within ninety-six hours. Irish in a New World The flood of Irish into the United States had a profound effect, especially in urban centers where the Irish exerted political influence and got involved in municipal government, most notably in the police and fire departments. In the Civil War, entire regiments were composed of Irish troops, such as those of New Yorks famed Irish Brigade. In 1858, the Irish community in New York City had demonstrated that it was in America to stay. Led by a politically powerful immigrant, Archbishop John Hughes, the Irish began building the largest church in New York City. They called it St. Patricks Cathedral, and it would replace a modest cathedral, also named for Irelands patron saint, in lower Manhattan. Construction was halted during the Civil War, but the enormous cathedral was finally finished in 1878. Thirty years after the Great Famine, the twin spires of St. Patricks dominated the skyline of New York City. And on the docks of lower Manhattan, the Irish kept arriving. Source Ireland in America. The New York TImes, April 2, 1852. Lyall, Sarah. Past as Prologue: Blair Faults Britain in Irish Potato Blight. The New York Times, June 3, 1997.

Analyzing an important futer goal Assignment Example | Topics and Well Written Essays - 250 words

Analyzing an important futer goal - Assignment Example This sector is well developed, and there is a lot of market for its products. The government also has incentives for swine farmers and this endeared me to it considering that it is very easy start as long as one has a piece of land then he can quickly start it (Bensoussan and Fleisher 54). Some of the steps required to attain the goals entails reading content on swine farming, and this can take about one day. Looking for the market for the products, and this can involve 20 minute search on the internet. Setting up the structure that will host the swine can take about five hours. Ordering for its feeds from suppliers will take about one hour. It will also take approximately two hours to get the initial swine stock delivered to the pig sty. The venture will require a lot of sacrifices in terms of finances. I will have to forgo the money spent on entertainment so that I can direct it to

Business Strategy in Kellogg Company Term Paper

Business Strategy in Kellogg Company - Term Paper Example The main external environment that necessitates firms to develop strategies include the general environment which entails demographic, economic, political/legal, socio-cultural, technological, global and physical trends, the interplay of the industry environment that often impact on the relationship between its customers and suppliers and competitors environment and analysis (Ireland, Hoskisson, & Hitt, 2008:59). Business strategy is a key plan of action for companies after the assessment of the above market factors and business environment and is often aimed at positioning the company, influencing the market balance and exploiting changes in the industry. This paper examines business strategies that have been employed by Kellogg Company and the reasons why such strategies have proved to be successful to the firm. Kellogg Company Business Strategy Kellogg Company is the leading producer of cereal and convenience foods such as cookies, toaster pastries, cereal bars, fruits snacks, fro zen watts, and veggie foods in the world. Kellogg Company manufactures its products in more than seventeen countries and markets them across the world (Kellogg Company, 2012). The core reason for the establishment of Kellogg Company was for the Company to produce high quality, nutritious and great tasting food. The company has made tremendous growth and this can be evidenced by its ever-expanding market share and increased profits. The success can be attributed to the existence of key business strategies that ensures the growth of Kellogg Company amidst increased competition and entry of other players and dynamics of the market. Key Terms Kellogg Vision To be the food company of choice Mission statement To drive sustainable growth through the power of our people and brands by better serving the needs of our consumers, customers and communities. Objectives Encourage and support of among all sectors of the population Use of resources to run and sponsor community programmes for its con sumers and public Increase the association between Kellogg and physical activity Use the cereal packs to communicate the ‘balance’ message to consumers Introduce food labeling that would enable consumers to make decisions about the right balance of food Goals Remain consumer centric Product innovation Priority to win Continuous efficiency improvements Core Competence Baking The Vision and Mission Statements Business strategies of firms can be evaluated based on the design and definition of their vision and mission statements. This is because of the crucial role that vision and mission statement play in current business environment as they convey the aspirations of the organizations. Kellogg Company has exploited this concept and has formulated a vision and mission statements that focuses on sustainable growth of the company, social responsibility, its stakeholders (people) and its brands. Whereas the vision statement of Kellogg Co

Introduction to Philosophy (not quite sure about what the title is) Essay

Introduction to Philosophy (not quite sure about what the title is) - Essay Example Nevertheless, can not you see that while doing so, you give up one of the previous aspects of your individuality, namely moral autonomy? Please consider this: if you believe that God gave you free will and He must want you to use it all the time, especially while making ethical decisions, but by sending this letters He practically deprives you of this ability. In other words, by commanding you He substitutes your will with His. It is quite obvious that in this situation you lose your value as an autonomous human being with independent reasoning! (2) - I see that you are a young and promising student of Philosophy, good for you, - he replied. - Nevertheless, I adhere to nihilistic views and would like to use this chance as I chase you to collect the sample of you blood to present my position. You see, I comply with what your Philosophy would call Expressivism. As you may guess from the very name, this approach towards morality puts emphasis on the action of expression rather than action of judgment. You see, ordinary people do not receive letters from God Himself think about the world in the categories of right and wrong, claiming that there is no other option. Contrary to that, I simply express my opinion about something, not necessarily claiming it to be good or bad. Let is consider the situation that we are having at the moment. You make taking samples of other people blood sound horrible! On the other hand, I retain a position that does not claim that it is good, I just note that it is necessary for my question, you know . You may be thinking that I am a crazy maniac who approves of killing people, but please refrain from such kind of thinking. It is my strongest belief that strict moral knowledge that you think you have is in fact impossible. Indeed, if one develops a broad understanding of the world, one will be able to see that it is not possible to gain any knowledge in the realm of Ethics which would

Compose a report on management performance characteristics Essay

Compose a report on management performance characteristics - Essay Example I studied the essentialities of the skill in detail, considering the context of the role of the Head of MLT. I plan to develop my communication skills through a number of interventions, over a period of time. Nurturing my communication skills shall take place through simulation games, skill improvement exercises, understanding the 7Cs of communication and taking part in cross-cultural communication training. These evaluation and diagnostic tools would facilitate in furthering my skills and contribute towards the success of my career. Management has been my favourite subject since my childhood. After completing my undergraduate course, I wish to study Masters In Business Administration, under the discipline of Marketing Management. During this undergraduate course, I also happened to learn about the prospects offered by Information Technology and could cognise that it is a flourishing industry. Under this context, I set the role of Manager of a Marketing Leadership Team in a multinational software organisation as my career goal. This job involves understanding the markets, facilitating transformations that improve the efficiency of marketing function in the entire organisation, by increasing its impact on the prospective customers, giving due consideration to the job satisfaction of the marketing team and managing the lower level marketing leaders. The job description depicts that my aim is not easy to embrace and is a step-by-step process, where I need to attain the eligibility and highlight myself as the most qualified and appropriate candidate at every instance. Advancement in this direction should be a planned self-development exercise that instils new skills and boosts the existing ones to the desired intensity. Along with the educational background and experience, I need to recognise my internal capabilities and shoulder the responsibility of developing my management and leadership skills too, in order to attain that position and efficiently manage

Explaining a concept Essay Example | Topics and Well Written Essays - 750 words

Explaining a concept - Essay Example Perennialism can be understood to be the â€Å"conservative† approach in that it argues that the same tried and true methods and subject matter should continue to be taught to the next generation of students do the fact that it is both tried and true and has informed the preceding generations. On the other hand, progressivism takes the more â€Å"liberal† approach in positing that individuality, progress, and change are key cornerstones of a truly great education (Labaree 281). As a means of providing an explanation for the concept of progressivism, this brief paper will to approach this particular educational approach in a way which will seek to shed light on whether such a concept is in fact the best concept to engage students with and to provide a higher degree of educational success and interaction. The progressivist concept of education places a high degree of emphasis upon the experience of the individual as well as the changing ways in which new material and old material alike can help to better hone the quality of education that the student is able to achieve. At its core, the concept engenders the belief that individuals will most benefit by studying those materials which most directly impact upon their own lives. Although such an approach is most certainly less concrete than that of the perennialist’s approach to education, it nonetheless is able to take into account the transforming needs that our society and the world in general is placing upon the educational system and the individual student. A secondary component of the concept is the understanding that it is necessarily a more visual concept than that of the perennialist’s approach. This is mainly due to the fact that the perennialist’s approach hinges upon the primary data sources and methods of learning that have been in existence since the dawn of knowledge. However, the fact of the matter is that these rather stodgy and non-visual means to engage the pupil have

Critically assess Wildavskys theory of the two presidencies Essay

Critically assess Wildavskys theory of the two presidencies - Essay Example The papers will critically asses Wildavsky’s theory with regard to the presidencies of President Franklin, D. Roosevelt, President George W. Bush and President Bill Clinton to establish whether foreign and domestic policies operate as dichotomies or they operate in reciprocity. The American politics has always been characterized by critical analysis of the policies adopted by presidents and how these policies impact on the values, beliefs and perception of the American people. The way the Americans perceive the policies usually determine the popularity of presidents and whether they will only rule for one term or two terms. A retrospective analysis on the approaches taken by American presidents reveals that there exists a dichotomy in relation to how American presidents shuffle their political cards in their bid to push forwards certain agendas that they deem important for the American nation. The Dichotomy is clearly brought out in Wildavsky’s theory of Two Presidencie s.

Explaining a concept Essay Example | Topics and Well Written Essays - 750 words

Explaining a concept - Essay Example Perennialism can be understood to be the â€Å"conservative† approach in that it argues that the same tried and true methods and subject matter should continue to be taught to the next generation of students do the fact that it is both tried and true and has informed the preceding generations. On the other hand, progressivism takes the more â€Å"liberal† approach in positing that individuality, progress, and change are key cornerstones of a truly great education (Labaree 281). As a means of providing an explanation for the concept of progressivism, this brief paper will to approach this particular educational approach in a way which will seek to shed light on whether such a concept is in fact the best concept to engage students with and to provide a higher degree of educational success and interaction. The progressivist concept of education places a high degree of emphasis upon the experience of the individual as well as the changing ways in which new material and old material alike can help to better hone the quality of education that the student is able to achieve. At its core, the concept engenders the belief that individuals will most benefit by studying those materials which most directly impact upon their own lives. Although such an approach is most certainly less concrete than that of the perennialist’s approach to education, it nonetheless is able to take into account the transforming needs that our society and the world in general is placing upon the educational system and the individual student. A secondary component of the concept is the understanding that it is necessarily a more visual concept than that of the perennialist’s approach. This is mainly due to the fact that the perennialist’s approach hinges upon the primary data sources and methods of learning that have been in existence since the dawn of knowledge. However, the fact of the matter is that these rather stodgy and non-visual means to engage the pupil have

Peer Evaluations in Enhancing Written and Oral Communication Essay Example for Free

Peer Evaluations in Enhancing Written and Oral Communication Essay Communicative practices such as writing and reading are important components in the facilitation of education and learning. For educators, they must realize the relative importance of these communication practices for they are vital in the enhancement of learning. One way to address this is by creating peer review mechanisms. Though such may prove to be an important component in the facilitation of education, there are cultural impediments that continue to surround the facilitation of peer evaluations. â€Å"When we deal with English-as-a-second-language students, cultural factors may influence both the operation and outcomes of peer response groups. † (Nelson, 1997, p. 78) By being constantly aware of these issues, one can create effective peer evaluation mechanism that is free from cultural bias and prejudice. A collective action and approach must be created by instructors and teachers to address such problem. â€Å"To maintain the group cohesion and harmonious interpersonal communications interpersonal relations valued by collectivist cultures, collectivists use indirect means of communicating messages that may otherwise be disruptive to the group. † (Nelson, 1997, p. 82) Thus, giving of vital information is an important tool and component in the overall facilitation of peer evaluations in enhancing communication practices. â€Å"By being informed of cultural differences in communication, they may be better able to interpret the feedback they receive from the English-as-the-second-language students and also better able to provide these students with effective feedback. † (Nelson, 1997, p. 83) Enhancing the Writing Skills Effectiveness in writing is one facet that students must acquire in school as it is vital in the overall communication process not only in the educational sector but in different aspects of society. By enhancing such skills, an international student can be fit and remained at level with native speakers of the language. The main barrier and impediment in such scenario is the lack of expertise in the local and native language. The study of Koffolt and Holt showcases several important mechanisms that can improve writing skills of international students. The article seeks to showcase how teachers can be a vital part in the overall facilitation of efficient writing among students. By doing these, students can get the development in the realm of writing. â€Å"Teachers who play a more active role in guiding their students through the entire writing process of gathering ideas, organizing, drafting, and revising can help students produce writing that is thoughtful, coherent, and polished. † (Koffolt and Holt, 1997, p. 53) By providing several important measures that a teacher must consider is an important process to guide students in the overall facilitation of improving writing capabilities. One important method is by creating feedbacks on writing works by international students. By doing this, the student can actively assess his/her standing as far as competency in writing is concerned. The creation of a feedback system â€Å"gives them the opportunity to correct deficiencies in content, language and style. † (Koffolt and Holt, 1997, p. 54) For the part of instructors, there must be an active collaboration with an international student as far as writing is concerned. The instructor must recognize the relative challenges that an international student may face during the course of writing. That is why it is essential for the teacher to actively create writing strategies that will help improve the overall capacity of the student to write. However, the teacher must recognize that the process of such endeavor is not easy. â€Å"Writing is seldom a linear activity, and it is common for writers to go back and forth among different steps of the writing process as they complete a major writing task. † (Koffolt and Holt, 1997, p. 56)

Major Depressive Disorder

Major Depressive Disorder Major Depressive Disorder Preface Today, there are so many people suffering from so many diseases. Likewise, so many people started to feel depressed without a reason. Maybe there should be a reason but most people fail to find it and live their life as it goes by. Now, depressive disorder has become one of major diseases. Boys, girls, teenagers, 20s, 30s, 40s, most people regardless of their age are suffering from major depressive disorder. Because of this, suicidal rate has been increased far more than ever. Maybe, because of technological revolution, many people started to feel as if they are alone, for people talk through internet, telephone, and so on, they do not feel as if somebody is beside them. Because of this, I wanted to research on ‘major depressive disorder to figure out what are causing this and what are some ways to prevent this. Symptoms and Signs Major depression is a serious illness that affects a persons family and personal relationships, work or school life, sleeping and eating habits, and general health. Its impact on functioning and well-being has been equated to that of chronic medical conditions such as diabetes. A person suffering a major depressive episode usually exhibits a very low mood, which pervades all aspects of life, and an inability to experience pleasure in activities that formerly were enjoyed. Depressed people may be preoccupied with, or ruminate over, thoughts and feelings of worthlessness, inappropriate guilt or regret, helplessness, hopelessness, and self-hatred. In severe cases, depressed people may have symptoms of psychosis. These symptoms include delusions or, less commonly, hallucinations, usually of an unpleasant nature. Other symptoms of depression include poor concentration and memory (especially in those with melancholic or psychotic features), withdrawal from social situations and activities, reduced sex drive, and thoughts of death or suicide. Insomnia is common among the depressed. In the typical pattern, a person wakes very early and is unable to get back to sleep. Hypersomnia, or oversleeping, is less common. Appetite often decreases, with resulting weight loss, although increased appetite and weight gain occasionally occur. The person may report multiple physical symptoms such as fatigue, headaches, or digestive problems; physical complaints are the most common presenting problem in developing countries, according to the World Health Organizations criteria for depression. Family and friends may notice that the persons behavior is either agitated or lethargic. Depressed children often display an irritable rather than a depressed mood, and show varying symptoms depending on age and situation. Most exhibit a loss of interest in school and a decline in academic performance. They may be described as clingy, demanding, dependent, or insecure. Diagnosis may be delayed or missed when symptoms are interpreted as normal moodiness. Depression may also coincide with attention-deficit hyperactivity disorder (ADHD), complicating the diagnosis and treatment of both. Older depressed persons may have cognitive symptoms of recent onset, such as forgetfulness, and a more noticeable slowing of movements. Depression often coexists with physical disorders common among the elderly, such as stroke, other cardiovascular diseases, Parkinsons disease, and chronic obstructive pulmonary disease. Causes The biopsychosocial model proposes that biological, psychological, and social factors all play a role to varying degrees in causing depression. The diathesis-stress model posits that depression results when a preexisting vulnerability, or diathesis, is activated by stressful life events. The preexisting vulnerability can be either genetic, implying an interaction between nature and nurture, or schematic, resulting from views of the world learned in childhood. These interactive models have gained empirical support. For example, researchers in New Zealand took a prospective approach to studying depression, by documenting over time how depression emerged among an initially normal cohort of people. The researchers concluded that variation among the serotonin transporter (5-HTT) gene affects the chances that people who have dealt with very stressful life events will go on to experience depression. Specifically, depression may follow such events, but seems more likely to appear in people w ith one or two short alleles of the 5-HTT gene. A Swedish study estimated the heritability of depression—the degree to which individual differences in occurrence are associated with genetic differences—to be approximately 40% for women and 30% for men, and evolutionary psychologists have proposed that the genetic basis for depression lies deep in the history of naturally selected adaptations. A substance-induced mood disorder resembling major depression has been causally linked to long-term drug use or abuse, or to withdrawal from certain sedative and hypnotic drugs. Biological Monoamine hypothesis Most antidepressant medications increase the levels of one or more of the monoamines—the neurotransmitters serotonin, norepinephrine and dopamine—in the synaptic cleft between neurons in the brain. Some medications affect the monoamine receptors directly. Serotonin is hypothesized to help regulate other neurotransmitter systems; decreased serotonin activity may allow these systems to act in unusual and erratic ways. According to this permissive hypothesis, depression arises when low serotonin levels promote low levels of norepinephrine, another monoamine neurotransmitter. Some antidepressants enhance the levels of norepinephrine directly, whereas others raise the levels of dopamine, a third monoamine neurotransmitter. These observations gave rise to the monoamine hypothesis of depression. In its contemporary formulation, the monoamine hypothesis postulates that a deficiency of certain neurotransmitters is responsible for the corresponding features of depression: Norepinephrine may be related to alertness and energy as well as anxiety, attention, and interest in life; lack of serotonin to anxiety, obsessions, and compulsions; and dopamine to attention, motivation, pleasure, and reward, as well as interest in life. The proponents of thi s theory recommend the choice of an antidepressant with mechanism of action that impacts the most prominent symptoms. Anxious and irritable patients should be treated with SSRIs or norepinephrine reuptake inhibitors, and those experiencing a loss of energy and enjoyment of life with norepinephrine- and dopamine-enhancing drugs. Schematic of a synapse between an axon of one neuron and a dendrite of another. Synapses are specialized gaps between neurons. Electrical impulses arriving at the axon terminal trigger release of packets of chemical messengers (neurotransmitters), which diffuse across the synaptic cleft to receptors on the adjacent dendrite temporarily affecting the likelihood that an electrical impulse will be triggered in the latter neuron. Once released the neurotransmitter is rapidly metabolised or pumped back into a neuron. Antidepressants influence the overall balance of these processes.In the past two decades, research has revealed multiple limitations of the monoamine hypothesis, and its explanatory inadequacy has been criticized within the psychiatric community. Intensive investigation has failed to find convincing evidence of a primary dysfunction of a specific monoamine system in patients with major depressive disorders. The medications tianeptine and opipramol have long been known to have antidepressant properties despite the fact that the former is a serotonin reuptake enhancer and the latter has no effect on the monoamine system. Experiments with pharmacological agents that cause depletion of monoamines have shown that this depletion does not cause depression in healthy people nor does it worsen symptoms in depressed patients—although an intact monoamine system is necessary for antidepressants to achieve therapeutic effectiveness. According to an essay published by the Public Library of Science (PLoS), the monoamine hypothesis, already limited, has been further oversimplified when presented to the general public as a mass marketing tool. Other theories MRI scans of patients with depression have reported a number of differences in brain structure compared to those without the illness. Although there is some inconsistency in the results, meta-analyses have shown there is evidence for smaller hippocampal volumes and increased numbers of hyperintensive lesions. Hyperintensities have been associated with patients with a late age of onset, and have led to the development of the theory of vascular depression. There may be a link between depression and neurogenesis of the hippocampus, a center for both mood and memory. Loss of hippocampal neurons is found in some depressed individuals and correlates with impaired memory and dysthymic mood. Drugs may increase serotonin levels in the brain, stimulating neurogenesis and thus increasing the total mass of the hippocampus. This increase may help to restore mood and memory. Similar relationships have been observed between depression and an area of the anterior cingulate cortex implicated in the modulation of emotional behavior. One of the neurotrophins responsible for neurogenesis is the brain-derived neurotrophic factor (BDNF). The level of BDNF in the blood plasma of depressed subjects is drastically reduced (more than threefold) as compared to the norm. Antidepressant treatment increases the blood level of BDNF. Although decreased plasma BDNF levels have been found in many other disorders, there is some evidence that BDNF is involved in the ca use of depression and the mechanism of action of antidepressants. Major depression may also be caused in part by an overactive hypothalamic-pituitary-adrenal axis (HPA axis) that is similar to the neuro-endocrine response to stress. Investigations reveal increased levels of the hormone cortisol and enlarged pituitary and adrenal glands, suggesting disturbances of the endocrine system may play a role in some psychiatric disorders, including major depression. Oversecretion of corticotropin-releasing hormone from the hypothalamus is thought to drive this, and is implicated in the cognitive and arousal symptoms. Depression may be related to the same brain mechanisms that control the cycles of sleep and wakefulness.Depression may be related to abnormalities in the circadian rhythm, or biological clock. For example, the REM stage of sleep, the one in which dreaming occurs, may be quick to arrive and intense in depressed people. REM sleep depends on decreased serotonin levels in the brain stem, and is impaired by compounds, such as antidepressants, that increase serotoninergic tone in brain stem structures. Overall, the serotonergic system is least active during sleep and most active during wakefulness. Prolonged wakefulness due to sleep deprivation activates serotonergic neurons, leading to processes similar to the therapeutic effect of antidepressants, such as the selective serotonin reuptake inhibitors (SSRIs). Depressed individuals can exhibit a significant lift in mood after a night of sleep deprivation. SSRIs may directly depend on the increase of central serotonergic neurotransmission fo r their therapeutic effect, the same system that impacts cycles of sleep and wakefulness. Research on the effects of light therapy on treating seasonal affective disorder suggests that light deprivation is related to decreased activity in the serotonergic system and to abnormalities in the sleep cycle, particularly insomnia. Exposure to light also targets the serotonergic system, providing more support for the important role this system may play in depression. Sleep deprivation and light therapy both target the same brain neurotransmitter system and brain areas as antidepressant drugs, and are now used clinically to treat depression. Light therapy, sleep deprivation and sleep time displacement (sleep phase advance therapy) are being used in combination quickly to interrupt a deep depression in hospitalized patients. The hormone estrogen has been implicated in depressive disorders due to the increase in risk of depressive episodes after puberty, the antenatal period, and reduced rates after menopause. Conversely, the premenstrual and postpartum periods of low estrogen levels are also associated with increased risk. The use of estrogen has been under-researched, and although some small trials show promise in its use to prevent or treat depression, the evidence for its effectiveness is not strong. Estrogen replacement therapy has been shown to be beneficial in improving mood in perimenopause, but it is unclear if it is merely the menopausal symptoms that are being reversed. Other research has explored potential roles of molecules necessary for overall cellular functioning: cytokines and essential nutrients. The symptoms of major depressive disorder are nearly identical to those of sickness behavior, the response of the body when the immune system is fighting an infection. This raises the possility that depression can result from a maladaptive manifestation of sickness behavior as a result of abnormalities in circulating cytokines. Deficiencies in certain essential dietary nutrients, particularly vitamin B12 and folic acid, have been associated with depression; other agents such as the elements copper and magnesium, and vitamin A have also been implicated. Prevention A 2008 meta-analysis found that behavioral interventions, such as interpersonal therapy, are effective at preventing new onset depression. Because such interventions appear to be most effective when delivered to individuals or small groups, it has been suggested that they may be able to reach their large target audience most efficiently through the Internet. However, an earlier meta-analysis found preventive programs with a competence-enhancing component to be superior to behaviorally oriented programs overall, and found behavioral programs to be particularly unhelpful for older people, for whom social support programs were uniquely beneficial. Additionally, the programs that best prevented depression comprised more than eight sessions, each lasting between 60 and 90 minutes; were provided by a combination of lay and professional workers; had a high-quality research design; reported attrition rates; and had a well-defined intervention. The Coping with Depression course (CWD) is claim ed to be the most successful of psychoeducational interventions for the treatment and prevention of depression (both for its adaptability to various populations and its results), with a risk reduction of 38% in major depression and an efficacy as a treatment comparing favorably to other psychotherapies. References http://en.wikipedia.org/wiki/Depressive_disorder#Prevention

Roaring Twenties Essay -- American History 1920s

The Roaring Twenties The decade of 1920-1929 was a time of great change, reform, improvement, adjustment and alteration of everything Americans had come to rely on. In other words everything changed. Not one part of common life was unaffected. Exciting new events happened in sports, entertainment, science, politics, communication and transportation. It was the age of prohibition, it was the age of prosperity, and it was the age of downfall. The twenties were the age of everything. It has been called the decade of enjoyment, employment, and for some, disappointment. The 20's were a decade to remember and it had an impact on the people living through it. During the 1920s the United States was in an economic high point. Following World War I people had more money to spend due to the wartime boom in the economy. People were able to buy products on credit, and pay small installments later. This process allowed people more freedom to purchase items, such as refrigerators, radios, and cars, when previously they had not been able to. The 1920s got its reputation as the â€Å"Roaring Twenties† from the economy in part because the economy was booming, and people were purchasing products on credit and stocks on margin. All this exchange of currency created a boom era or a â€Å"Roaring† period of time. In sports, athletes were being identified as heroes for the first time in history. This was the time of great athletes such as Babe Ruth. American Football reached the professional leagu...

Graduation Speech -- Graduation Speech, Commencement Address

Fellow graduates, honored guests, faculty, administration: Minna-san, Konbanwa Dobri Vecher Buenos Noches Bon Soir Good evening. We, of Cedar Community College, are many nations. We are men and women, husbands and wives, parents. We are young and not-so-young. Behind the face of every graduate, and just as distinct, is a different story, a different reason, and a different use for the education for which we have assembled this evening to recognize. We serve to enrich the campus community, as we are not just a cross-section of this nation, but of the world. Displayed in the Brier Hall cafeteria are 50 national flags to signify our cultural heritage here at Cedar. Yet regardless of our diverse origins, we come here bound by a common thread: to acknowledge to ourselves and to others that we met and overcame the challenges needed to achieve this milestone. This great gift of education we entitle ourselves better prepares us for challenges yet ahead. There isn't one among us who hasn't made sacrifices, or know of someone who made them on our behalf, so we could be here thi...

American Government Assignment

The United States, once chauvinist in its beliefs may see the dawn of a new era on 2008 – two female presidential candidates battling it out for the position of Commander in Chief.   Condoleezza Rice and Hillary Clinton are considered two likely candidates for the 2008 Presidential Election.The country calls for total equality between men and women, however this equal treatment has never crossed over into such a position of power.Besides the biological differences between men and women, it is said that the style of leadership displays some differences as well.   According to Maryann Kimoto, reporter for the USCD Guardian, â€Å"One study of the religious leadership style of female pastors noted that women were more likely to base decisions on the aggregated advice of a group, while men tended to see themselves or their higher-ups as the authoritative voice.†(Kimoto, 2005, p. 1)   Based upon this data, it would seem that a female president would be more likely to t ake into account the opinions of others, rather than making decisions based upon selfish judgment.In a poll commissioned by Hearst Newspaper, the overall results state that the United States is ready for a female to assume the office of President – 64% of the people polled supported this belief.   (Fulcher, 2006, n.a.)   According to this poll 53% of people polled in 2005 believed that Senator Hillary Clinton should run for President in 2008 and when asked again in 2006 the percentage supporting Clinton held strong, only dropping 2%.The poll also stated that there is a growing support for Condoleezza Rice; therefore, proving that yet another female candidate could become a contender. (Fulcher, 2006, n.a.)  Ã‚   Over all, the poll suggested that 64% of those polled believed that the United States is ready for a female Commander in Chief.Personally, I feel that the United States is ready for drastic change and when taking into account the results of the recent elections t he voting public proved such, as the Democrats regained control of the House.Polls are suggesting that the chauvinistic attitude once rampant in the United Stats has softened, approximately 64% of those polled, as stated above.   Though I believe the country is ready for the female leader the candidates will face the remaining 36% against such a change.Our society is changing drastically.   For example, a society once dead against allowing gays to legally wed, is softening in the more liberal states.  Ã‚   The public opinion has changed and the country is ready for drastic change; therefore, I believe that the United States can handle a female President.