Then and Now Essays

Then and Now Essays Then and Now Essay Then and Now Essay Now and Then Interview â€Å"Times sure have changed† is a quote that comes to mind when thinking of the different between being an adolescent today compared to being an adolescent sixty years ago. To find out more about the differences I was able to speak with a male, currently age 82, and a female age 18. I am familiar with both of these individuals one, a close friend of the family, and my cousin’s daughter was able to answer some questions for me also. These two people both grew up in the United States. The eighty-two year old lived in Kentucky as an adolescent. The eighteen year old currently resides in Arkansas. Times have changed and I learned a little about just how much in speaking with my willing participants. These two people from such different times in this country taught me quite a bit about how things are different than they were sixty years ago. When speaking with the elderly gentleman I found he spoke of his adolescents as a working time in his life. He wasn’t able to attend high school because World War II started. His father owned a saw mill and needed help making railroad ties for the government. He gave up going to school for working six days a week, 10 hour days in the saw mill, in addition to the home chores he had to do before and after work to help keep his household going. This compares drastically to the current adolescent I spoke to. Things are much different today in age than they were back then. The adolescent of today is graduating high school this month, where she was able to take medical classes along with her college prep classes. This subject works 25-30 hours per week at a local fast food restaurant, but by her own choice. One major difference between these two besides the importance of education is that the eighty-two year old did not get paid a wage to work 50 hours a week. He worked to help out his family, not to earn a wage. This gentleman was content to be given enough money to go the movies most weekends. He didn’t expect to receive a paycheck for the work he did. In speaking with the elderly individual I didn’t get a feeling that working at such a young age adversely affected his vocational identity. He worked because it was what he had to do. Working from such a young age in his home doing mandatory chores, and additionally having to work outside the home to help his father gave him a strong work ethic. Even though he is retired, this gentleman still lives alone, owns three vehicles, which he does all basic maintenance himself. Reading from the text book on page 419, the author makes it seem that working at a young age can harm an adolescent. This goes against my personal beliefs and what I found in doing these interviews, going to school and working helped both of my interview subjects, and from my own personal experience, it gave even me a better sense of responsibility and expectation for becoming an adult. From questions about school and job situations I moved into asking these individuals about the relationships they have or had with their parents. Neither subject spoke of conflicts with their parents. They both shared that their parents trust them to make correct decisions. The elderly man shared that his community was small, so his parents would warn that if he did something wrong it would get back to them. He claimed that he and his siblings knew to â€Å"just be a good citizen,† and if they did something wrong not only would their parents find out, but neighbors would correct them verbally if they were found to do something inappropriate, â€Å"it was a neighborhood kind of thing. When speaking to the current adolescent she shared that her household rules include only a curfew, dressing appropriately, not being allowed to be home alone with her boyfriend, or have him in her bedroom. Other than not being permitted to do drugs or alcohol, she said her father doesn’t place as many restrictions on her because he knows he can trust her to make good decisions. It seems both people were able to gain the trust and re spect of their parents by the time they were adolescence, keeping the conflict that can arise to a minimum. From conflicts in the home we spoke about what types of activities they do/did in their free time. This doesn’t seem to have changed much over the years. Both said they would just hang out with their friends wherever they were able to. Sixty years ago it was more outside and at Church. Today with transportation being easier things have shifted some to being â€Å"at each other’s houses, going to the mall, (we go to) Wal-Mart a lot. † Per the conversation I had with the youth of today. Though the locations are different, the time spent is similar enough. Peer selection was based on who they went to school or Church with, who was around them on a regular basis to gain that friendship with. I did notice that the current teenager shared she has had several boyfriends, where the elderly man advised he didn’t have a girlfriend until he was able to get a car of his own, which wasn’t until he was in his 20’s. This makes it appear that transportation makes dating easier. Though, he did share that walking a girl home from Church â€Å"was special. The actions are different from sixty years ago to today when adolescents spend free time with each other, but that’s to be expected with transportation and the amount of activities available increasing with technology. In closing, I found that both interview subjects were helpful in showing how the experience of being an adolescent has changed from sixty years ago to today. People still react to the environment around them. If a child is raised in a home where work is ex pected and no other option is given, they will most likely become a hard worker. Gender roles have changed and both people I spoke with mentioned something about how things are different now for women. It used to be women took care of the household, so when the eighty-two year old got married he expected his wife to stay home and take care of the house as his mother had. When she got a part time job after their kids were in school, he was upset by it, but allowed it. The young lady I spoke to provides money to her father for her vehicle payment, for her use of a cellular phone, and to help pay for their cable bill. She plans to attend college and become a teacher, which is the career she has chosen for herself. This is something she will expect any future spouse to be accepting of. Times have changed, and the roles men and women play have changed also. I learned more than I thought I would, but also found that some things haven’t changed, and I hope they never do. References Berger, K. S. (2008). The developing person through the life span, 7th edition. New York, NY: Worth, P, 416-425. Lambert, A. (2010, April 27). Telephone interview. Picklesimer, E. (2010, May 1). Telephone interview.

El muro de Trump y su impacto ambiental

El muro de Trump y su impacto ambiental La construccià ³n de un muro a lo largo de la frontera entre Estados Unidos y Mà ©xico es una de las medidas ms controversiales propuestas por el Presidente Donald Trump. Este artà ­culo cubre informacià ³n sobre la valla que separa los dos paà ­ses, argumentos a favor y en contra de la construccià ³n del muro, en quà © consiste la Declaracià ³n de Emergencia Nacional declarada por el presidente Trump el 15 de febrero de 2019 y el impacto medioambiental que causarà ­a su construccià ³n. Puntos clave: el muro de Trump Extensià ³n de la frontera entre EE.UU. y Mà ©xico: 3.144 km (1.954 millas).Declaracià ³n Nacional de Emergencia: de dà ³nde proceden los 8.000 mil millones para su construccià ³n.Argumentos a favor: frenarà ­a migracià ³n indocumentada, drogas y posible infiltracià ³n de terroristas.Argumentos en contra: no resuelve presencia de 11 millones de indocumentados ni llegadas legales seguidas de permanencias ilegales; no afectarà ­a caminos de entrada de las drogas; alto costo e impacto a vida salvaje.Impacto medioambiental: el muro romperà ­a hbitats naturales de ms de 1.000 animales silvestres, incluyendo a 100 especies en peligro de extincià ³n. Cruzarà ­a por reservas de la biosfera, reservas naturales, santuarios de animales y parques nacionales. La frontera entre EE.UU. y Mà ©xico La frontera que separa Estados Unidos y Mà ©xico se alarga por 3.144,6 kilà ³metros (1.954 millas) desde el Golfo de Mà ©xico hasta el Pacà ­fico. En la actualidad, existe un valla de separacià ³n en 1.100 km (700 millas), la mayorà ­a se construyà ³ bajo la direccià ³n del Presidente George W. Bush como respuesta a los atentados terroristas del 11 de Septiembre del 2001. El precio de su construccià ³n fue de $2 mil millones. Por su alto costo se decidià ³ no extenderla toda la frontera. Su mantenimiento cuesta $500 millones anualmente. Adems de la valla, la frontera est protegida por la Policà ­a Fronteriza (CBP, por sus siglas en inglà ©s). Esta agencia –la cual cuenta con 20.000 agentes y un presupuesto anual de $3 mil millones- vigila la frontera a pie, a caballo, en auto y en embarcaciones con el apoyo de tecnologà ­a inteligente, como drones, cmaras, sensores y el establecimiento de retenes y controles migratorios. En el aà ±o fiscal 2018, segà ºn estadà ­sticas de la CBP, el nà ºmero de arrestados en la frontera sur tras cruzar ilegalmente el paà ­s ascendià ³ a 396.579 migrantes. A todos ellos se les aplicà ³ la polà ­tica de tolerancia cero. Argumentos a favor y en contra del muro de Trump Los defensores de la construccià ³n del muro argumentan tres razones principales. En primer lugar, frenarà ­a el ingreso de migrantes indocumentados. En la actualidad se estima que hay en el paà ­s 11 millones de migrantes sin papeles. En segundo lugar, se argumenta que si la frontera no est blindada existe un riesgo de infiltracià ³n de terroristas. Y, en tercer lugar, se afirma que la valla no es obstculo para el ingreso de drogas, lo que agravarà ­a el problema de adiccià ³n que existe en EE.UU. Segà ºn datos de los Centros de Control de Enfermedades y Prevencià ³n, ms de 33.000 estadounidenses mueren anualmente por sobredosis de opiceos. Desde otra perspectiva, se argumenta en contra del muro que este no frenarà ­a la migracià ³n indocumentada porque, por un lado, no resuelve el problema de la presencia en el paà ­s de 11 millones de migrantes y, por otro, porque la mitad de los indocumentados ingresan al paà ­s legalmente y no atravesando ilegalmente la frontera. En segundo lugar, se argumenta que no hay casos para apoyar la tesis de que los terroristas pueden ingresar ilegalmente a travà ©s de Mà ©xico. En tercer lugar, se esgrime que aproximadamente 15.000 personas de las fallecidas anualmente por consumo de opiceos tomaron medicinas que se obtienen en EE.UU. con receta. Adems, las drogas que ingresan de Mà ©xico hacia EE.UU. lo hacen por tà ºneles, en drones, compartimentos ocultos en buses o autos, o en camiones. Por lo tanto, el muro no afectarà ­a a ninguno de esos modos de transporte. Por à ºltimo, se esgrime en contra de la construccià ³n del muro su alto costo y su impacto ecolà ³gico. Costo de la construccià ³n del muro de Trump No hay consenso sobre cunto costarà ­a construir un muro que blindase los ms de 3.000 km de frontera entre Estados Unidos y Mà ©xico. Por un lado, el propio Presidente Trump estima que el precio del muro podrà ­a estar entre los $8 y $12 mil millones de dà ³lares. En el otro extremo del espectro se encuentran organizaciones como New America Foundation que estima el costo entre $27 y $40 millones. Por otro lado, la agencia de noticias Reuters tuvo acceso a un estudio de la Oficina de Contabilidad del Gobierno (GAO, por sus siglas en inglà ©s) en el cual estima que el muro costarà ­a $21,6 mil millones. El baile de cifras se debe, entre otros factores, a que se desconoce cul de las propuestas de muro se construirà ­a y, por lo tanto, sus caracterà ­sticas y materiales. En los ocho prototipos el material varà ­a de concreto a acero y la altura de 18 a 30 pies (5,5 a 9,1 metros). Declaracià ³n Nacional de Emergencia  ¿cul es el costo y quià ©n paga por el muro de Trump? Segà ºn la declaracià ³n de emergencia nacional del presidente Trump anunciada con fecha del 15 de febrero de 2019, podrà ­an obtenerse un mximo de $8 mil millones (8 billones) para la construccià ³n del muro. Un total de 1.375 millones de dà ³lares procederà ­an de un presupuesto autorizado por el Congreso de los Estados Unidos. La diferencia procederà ­a de fondos del Departamento del Tesoro de confiscaciones de drogas (600 millones de dà ³lares), fondos que habà ­an sido destinados a actividades del Departamento de Defensa en proyectos de lucha antidrogas y otros programas (2.500 millones de dà ³lares) y fondos destinados a proyectos de construccià ³n del Ejà ©rcito (3.600 millones de dà ³lares). Estas cantidades serà ­an suficientes para construir un muro a lo largo de toda la frontera. Segà ºn informacià ³n del gobierno, no todo el muro serà ­a de concreto sino que habrà ­a zonas de vallas metlicas. Impacto medioambiental del muro de Trump La construccià ³n de un muro por ms de 3.000 kilà ³metros tendrà ­a importantes efectos medioambientales. Una de las razones principales es una sentencia dictada en corte federal en febrero de 2018 que permite, por razones de seguridad nacional, la construccià ³n del muro fronterizo sin necesidad de respetar los preceptos de las siguientes legislaciones: Ley de Agua Potable Segura, Ley de Especies en Peligro de Extincià ³n, Ley de Agua Limpia, Ley de Aire Limpio, Ley de Eliminacià ³n de Desechos y Ley de Proteccià ³n de Tumbas Nativas Americanas y Repatriacià ³n. Ms de 2.500 cientà ­ficos estadounidenses, mexicanos y del resto del mundo, han hecho un llamado de atencià ³n sobre el impacto medioambiental del muro en un artà ­culo publicado en la revista cientà ­fica BioScience. Su opinià ³n es compartida por grupos medioambientalistas como Sierra Club. Esos expertos argumentan que el muro interrumpir los patrones de migraciones de animales, imposibilitando o limitando el acceso a sus lugares habituales de comida, bebida, apareamiento y nacimiento. En otras palabras, el muro supondrà ­a una fragmentacià ³n del hbitat animal y, posiblemente, limitarà ­a su diversidad genà ©tica. Segà ºn el Instituto de Ecologà ­a de la UNAM, ms de 800 especies se verà ­an afectadas, incluyendo al ocelote, bisonte, lobo gris mexicano, borrego cimarrà ³n, jaguar, tortuga del desierto, rana leopardo, oso negro, antà ­lope berrendo, ciervo mula, perros de la pradera, gato montà ©s, leà ³n de la montaà ±a y colibrà ­. Todo ello conducirà ­a a la reduccià ³n drstica de animales del suroeste estadounidense, de los cuales 100 ya se encuentran en peligro de extincià ³n actualmente, segà ºn datos de la Agencia de Vida Salvaje y Peces de los Estados Unidos. El muro incluso podrà ­a suponer la destruccià ³n del santuario de mariposas de mayor diversidad ubicada en Missions, Texas, y afectar negativamente, entre otros, al Refugio Nacional de la Vida Silvestre del Valle Bajo del Rà ­o Grande, al Parque Estatal Rà ­o Grande - Bentsen y los centros de la biosfera de Rancho Los Fresnos (Sonora) y Santa Ana (Texas). Este à ºltimo est ubicado en el valle del Rà ­o Grande, una de las reas con mayor diversidad ecolà ³gica en toda Norteamà ©rica. Adems, debido a la altura propuesta, el muro entre 18 y 30 pies tambià ©n afectarà ­a el movimiento de pjaros tropicales que vuelan por esas rutas en sus migraciones estacionales y de insectos. Esto tambià ©n tendrà ­a consecuencias negativas para las plantas que dependen en gran medida del movimiento de insectos y pjaros para la polinizacià ³n. Asimismo, activistas medioambientales a ambos lados de la frontera han mostrado su preocupacià ³n por la posibilidad de que el muro pueda actuar como un embalse en momentos de inundaciones, pudiendo causar una tragedia humana. Tambià ©n han puesto de manifiesto el riesgo de alterar con las obras del muro el nivel de los acuà ­feros y provocar desabastecimiento de agua. En este contexto, varias organizaciones han acudido a las cortes para intentar frenar o evitar los peores impactos ambientales que derivarà ­an de la construccià ³n del muro. Por ejemplo, el Center for Biological Diversity, en conjuncià ³n con Animal Legal Defense Fund, ha presentado en noviembre de 2018 una demanda buscando declarar inconstitucional el permiso concedido al gobierno por una corte para construir el muro sin respetar las leyes medioambientales. Esta estrategia ha sido utilizada sin à ©xito hasta el momento por otras organizaciones ecologistas. Este es un artà ­culo informativo. No es asesorà ­a legal.

Vaccinating cattle against E.coli could cut human cases of infections Article

Vaccinating cattle against E.coli could cut human cases of infections by 85 percent - Article Example When the excretion from the cattle contain high percentage of the bacteria, the infection becomes significant. Nevertheless, there are vaccines, which reduce super-shedding in cattle. The findings of the study were that the vaccination of the cattle is likely to reduce human cases by approximately 85 percent. This is a strong figure supporting the adoption of the vaccine by livestock industries. Various countries like Scotland have engaged in research to establish an economic program for similar vaccination programmes. The aim of these countries is to develop more effective vaccines, which will reduce the impact of the bacterium on human life. Treating the cattle to cut down the number of human infection is justifiable, but there is need to put more effort in implementing the program and meeting the costs of the program. Public health has to be taken seriously to achieve this perspective. The hypothesis of the article was supported because nations across the world are responding positively to the implementation of the program. For instance, Scotland tackles an average of 235 culture positive cases of infections resulting from E.coli. This application continues to be extended to various nations for adoption. For example, the vaccine has been taken up in US. A version in US is not fully licensed yet the authority insists that veterinary medicines must indicate the improvement of human health. Louis, Matthews, Reeve, George, Gally, David L. Low, C. Woolhouse, Mark, McAteer, S. P. Locking, M. E. Chase-Topping, Margo, Haydon, Daniel, Allison, L. J. Hanson, G. Gunn, Joshua, and Reid, S. â€Å"Predicting the public health benefit of vaccinating cattle against Escherichia coli O157†. Proceedings of the National Academy of Sciences, 2013; DOI:

Accounting and the Public Sector - Who Measures What and Why Literature review

Accounting and the Public Sector - Who Measures What and Why - Literature review Example There has been a shift in the emphasis of the control from process and input to output control. The performance orientation is one of the major elements in the new public management concepts and the explicit standards for the performance measurement are seen to support this diffusion of new concepts. This study aims towards conducting a literature review of accountability in public sector. Catasu ´s and Gro ¨nlund (2005) have conducted research on the accountability and measurement on the Swedish Armed Forces. There is a scale down observed in the Swedish public sectors and they are aiming to create a resemblance with the other European nations. New ideologies and organizational forms are replacing the welfare state, which emphasizes on the probity, process and managerial accountability. This dismantling of the division between the private and public allows the private sector discourses to be informed to the public administrative practices. â€Å"Reinvent† is the recent ef fort taken by the government in emphasizing the role played by measurement system in enhancing the effectiveness and efficiency of the governmental operations. However, the fundamental question still remains there, that is, whether the notion of accountability and performance management, which is followed in the private sector, is applicable to the public sector. This indicates towards the fundamental differences that exist between the public and the private sector. In recent year’s advanced development system and performance enhancement methodologies were implemented in the public sector, which showed higher degree of accountability. Therefore, the main aim of the research was to conduct an analysis of the changing accountability by evaluating the changes in the measurements. Thus, the study focused at the relationship between accountability and measurement by highlighting on the measurement. Another study regarding the unintended or intended outcome of performance measureme nt in the public sector was conducted by Adcroft and Willis (2005). In this context the study highlights on the regimes of performance management that fits to the purpose of the public sector and the intended outcomes for the public services and the workers of the public sector of the performance measurement system. The key issues that are answered by the research is that content or the text of performance management in the public sector with examples specific to the higher education and healthcare; the intended outcome and the limitation of the performance management system. While most of the literatures have emphasized on the introduction of accounting system in the public sector organization of the developed countries that would lead to organizational and cultural exploration, the research scholars Ballas and Tsoukas (2004) has raised the question regarding why the accounting system are not used in public bureaucracies, which should have implemented much before. In order to find the answer of this question, the study has focused on the absence of accounting and lack of systematic measurement in a public bureaucracy. The study has explored and explained the absence of developed accounting system in the Greek National Health System and compared with the Greek political system. The paradigm of the new public management is based on the central belief that the public service organizations should not only be accountable to the fiduciary matters but should be accountable to the objectives and the efficiencies too. A cluster of administrative

Essay --

Lab Report 1 Allison M. Shaw Bio 302L Sec: 009 Thursday February 12th, 2014 Introduction: HL-60 cells were initially taken from a Caucasian female that had acute promyelocytic leukemia (Cirtain, Mittelstadt, Higgins, Pollson, 2002). These cells are good for studying cellular processes and under favorable conditions, are â€Å"immortal†. HL-60 cells have a relatively quick doubling time of no more than 48 hours, and do not experience apoptosis, which makes them â€Å"immortal† (Cirtain, et. al, 2002). The HL-60 cell line’s immortality is instrumental when it comes to finding possible treatments for patients with leukemia, which is of interest to researchers. This immortality attribute is also critical for studying mechanisms of monocyte and granulocyte differentiation (Collins, 1987). Another quality about the HL-60 cell line that is equally important is its ability to differentiate into the white blood cell line (Collins, 1987). Granulocytes and monocytes are the two most important types of differentiated cells in this experiment, although white blood cells also differentiate into macrophage-like cells and eosinophils (Collins, 1987). Compounds occurring naturally that induce HL-60 cell line differentiation include Vitamin D (Collins, 1987). Chemical inducers, such as DMSO and PMA in this experiment, can induce HL-60 cells to differentiate into cells along the myeloid path (Cirtain et al,. 2002). DMSO is studied as a control for PMA treatment conditions and is used to make PMA solution. It causes HL-60 cells to differentiate mostly into granulocytes (Cirtain et al,. 2002). The control in this experiment is cells treated with DMSO, and is done to show DMSO has no effect on PMA (Cirtain et al,. 2002). Using kinase C, PMA activates cert... ...he line. Further studies could allow researchers to gain valuable information possibly leading to cures for numerous cancer types. References: Cirtain, Mittelstadt, Higgins, Pollson. â€Å"Chapter 3.† Power Point. Cell and Molecular Biology Laboratory Manual. Great River Tech. Web. 8 Feb 2014. Cirtain, Mittelstadt, Higgins, Pollson. â€Å"Chapter 4.† Power Point. Cell and Molecular Biology Laboratory Manual. Great River Tech. Web. 8 Feb 2014. Collins, S. J. "The HL-60 Promyelocytic Leukemia Cell Line: Proliferation, Differentiation, and Cellular Oncogene Expression." The Blood Journal 70 (1987): 1233-1244. Xie, Bei, Amale Laouar, and Eliezer Huberman. "Fibronectin-mediated Cell Adhesion Is Required for Induction of 92-kDa Type IV Collagenase/Gelatinase (MMP-9) Gene Expression during Macrophage Differentiation." The Journal of Biological Chemistry (1998): 1576-1582.

Quality Of Life Thalassemia Patients Health And Social Care Essay

Thalassemia is familial upset of blood characterized by anaemia. It is the most common individual cistron upset in the universe with bulk of new instances in the development states. Thalassemia is a chronic disease in which patients can non do plenty good quality haemoglobin to prolong life. Therefore these ruddy cells break down prematurely ensuing in terrible anaemia. Epidemiology It is prevailing in the antecedently malaria endemic zones all over the universe. The planetary thalassaemia bearer frequence is about 5 % . It is widely prevailing in Bangladesh with bearer frequence of 7 % among which 4 % HbE bearers and 3 % beta thalassaemia bearers. It is estimated that 7000 new babes born with thalassaemia each twelvemonth. Thalassemia patients undergo womb-to-tomb blood transfusion and Fe chelation. WHO defines quality of life as â€Å" an person ‘s perceptual experience of their place in life in the context of the civilization and value systems in which they live and in relation to their ends, outlooks, criterions and concerns. It is a wide ranging construct affected in a complex manner by the individual ‘s physical wellness, psychological province, personal beliefs, societal relationships and their relationship to salient characteristics of their environment. â€Å" 1RationaleHemoglobin upsets are an emerging planetary wellness job. The quality of life surveies in developed states revealed important lessening in QOL due to hard and long term intervention. Though the disease is rather common in Bangladesh, there was no survey conducted on health-related quality of life ( HRQOL ) in Bangladesh and hazard indexs associated with it. There is scarceness of published research in thalassaemia in Bangladesh. A PubMed hunt with keyword ‘Thalassemia Bangladesh ‘ returned merely 13 consequences. Most diseases have a major impact on the afflicted single above and beyond mortality. Diseases that may non be deadly may be associated with considerable agony and disablement. For this ground, it is besides of import to see the impact of a disease as measured by its consequence on a individual ‘s quality of life, even though such step are non, in fact, steps of disease happening. For illustration, it is possible to analyze the extent to which patients with thalassemia rheniums compromised by the unwellness in transporting out activities of day-to-day life. Although considerable contention exists about which quality of life steps are most appropriate and valid there is general understanding that such steps can be reasonability used to be after short-run intervention plan for groups of patient. Such patients can be evaluated over a period of months to find the consequence of the intervention on their ego reported quality of life. Quality of life steps have besides been used for set uping precedences for scarce wellness attention resources. Although prioritization of wellness attention resources is frequently chiefly based on mortality informations, because many diseases are chronic and non life threatening, quality of life must besides be taken into history for this intent. Patients may put different weights on different quality of life steps depending on cultural background, instruction, and for illustration, spiritual values. As a consequence mensurating quality of life and developing valid indices that are utile for obtaining comparative informations in different patients and in different populations remain a major challenge. 2Conceptual ModelResearch QuestionWhat is the wellness related quality of life among the thalassaemia patients in the selected centres? What are the hazard indexs associated with the wellness related quality of life of thalassaemia patients?AimGeneral ObjectiveTo find the wellness related quality of life among the thalassaemia patients in selected centres and designation of the associated hazard indexs.Specific aimTo mensurate the wellness related quality of life among the thalassaemia patients in selected centres To compare the wellness related quality of life in this survey with antecedently published surveies. To happen out the hazard indexs that influences wellness related quality of life.List of variablesDependent VariablesHealth Related Quality of Life ( HRQOL )Independent VariablesSocio-demographic variables Age Sexual activity Religion Highest instruction ( in old ages ) Area of abode District of abode Highest instruction of household caput Occupation of the household caput Family income Number of siblings Number of thalassaemia among the siblings Disease and intervention related variables Type of thalassaemia Age of first diagnosing Blood group Requires blood transfusion Age of first transfusion Transfusion interval Pre-transfusion haemoglobin degree Duration since last transfusion Serum ferritin degree Type of Fe chelator Regularity of Fe chelator Splenectomy Date of splenectomy Complications i.e. Hepatitis B, C Visit to specialist physician for thalassaemia Physical scrutiny variables Height Weight Liver size Spleen size Facial alterations Composite variables Body mass index Height for age z mark BMI for age z markOperational Definition of the VariablesHealth Related Quality of Life ( HRQOL ) : Individual ‘s ability to map physically, emotionally and socially within his/her environment at a degree consistent with his or her outlook measured utilizing structured and good validated tool PedsQL. Age: Age of the respondent calculated in old ages by subtracting day of the month of birth from day of the month of interview. If day of the month of birth is non available, age in accomplished old ages is taken alternatively. Highest instruction: Highest formal instruction of the respondent calculated in figure of old ages. Area of abode: Residence of the respondent in footings of belonging to metropolis, town and small town. City is defined as the big and of import town such i.e. divisional centres. Town is defined as the population centre smaller than metropoliss i.e. territory central office. Highest instruction of household caput: Highest formal instruction of the household caput calculated in figure of old ages. Family income: Monthly income of the caput of the household along with income of the other household members. Number of siblings: Number of siblings of the respondent. Number of thalassemics among the siblings: Number of siblings enduring from thalassaemia other than the respondent himself. Type of thalassaemia: Respondent or parent reported thalassemia type as diagnosed in the haemoglobin cataphoresis. The common types are Beta thalassaemia and Hb E beta thalassaemia. Age of diagnosing: The age at which thalassaemia was foremost diagnosed in the respondent. Blood group: Blood group and Rh type of the respondent. Requires blood transfusion: Weather the respondent requires blood transfusion of keeping life. Age of first transfusion: The age at which the respondent received foremost blood transfusion. Transfusion interval: Respondent or parent reported usual interval between blood transfusions. Pre-transfusion hemoglobin degree: Respondent or parent reported pre-transfusion haemoglobin degree during last 3 months. Duration since last transfusion: Duration since last blood transfusion calculated from last day of the month of transfusion as reported by respondent or parent. Serum ferritin degree: Serum ferritin degree in ng/L in last six month as reported by the respondent or parent. Type of Fe chelator: Type of Fe chelator taken by the respondent. The options are desferrioxamine, deferiporne, deferasirox or combination of these drugs. Regularity of Fe chelator: Weather the respondent takes the drugs daily or as prescribed. Splenectomy: If splenectomy was done. Date of splenectomy: Date or twelvemonth of the splenectomy as reported by respondent or parent. Complications i.e. Hepatitis B, C: Weather any complication ensuing from intervention of thalassaemia is present i.e. hepatitis B, hepatitis degree Celsius, diabetes, bosom disease, hypothyroidism and growing deceleration. Visit to specialist physician for thalassaemia: If the respondent visits specialist physician for thalassaemia and continuance since last visit to a specializer physician. Height: Height of the respondent measured in centimetre utilizing height base. Weight: Weight of the respondent measured in kg utilizing bathroom graduated table. Liver size: Size of the liver in centimetre signifier costal border along the mid costal line. Spleen size: Size of the lien in centimetre from the costal border along the axis of the spleen towards navel. Facial alterations: Facial alterations scored harmonizing to three standards i.e. bossing of the skull, giantism of zygoma, dental malformation. Each standard was scored 0-4 and amount of all standards used as the concluding mark.Review of Related LiteratureInternational PerspectiveIt is estimated that more than 300,000 kids are born with familial disease of haemoglobin each twelvemonth among which about 80 % born in low to income countries.3Regional PositionNational PerspectiveQOL A survey of hurting in the thalassaemia patient used SF-36v2 wellness study for adult/adolescent and kids were used PF-28 child wellness questionnaire.4 Iron Chelation Therapy ConformityPainThe progresss in the intervention of thalassaemia have resulted in increased life anticipation 5. The drawn-out life spans have exposed antecedently unidentified issues like bodily hurting. A survey conducted in the Thalassemia Clinical Research Network ( TRCN ) among 265 adults/adolescent and 103 kids with thalassemia 69 % of adult/adolescent reported bodily hurting with at least 28 % reported at least moderate hurting. Parent reported hurting in 56 % of kids while merely 11 % reported pain reasonably frequently. Though there was no difference in the hurting in kids with thalassaemia compared with the general population, hurting increased significantly with age. The survey besides showed that increased hurting is associated with lessening in quality of life and increased anxiousness and depression. 4 : Methodology This survey was done to happen out the wellness related quality of life of the thalassaemia patient in the selected centres in Dhaka metropolis and hazard indexs associated with it. The undermentioned methodological analysis was followed to carry on the survey.Study DesignA cross-sectional survey was designed to measure the HRQOL and associated hazard indexs. Figure 1: Conventional diagram of a cross-sectional surveyStudy PeriodThe entire survey period accounted 6 months from January 2010 to June 2010. During this period a scope of activity was undertaken get downing from title choice, protocol readying, protocol presentation, informations aggregation, informations cleansing, information analysis, study composing and printing. The clip allocated for informations aggregation by class coordinator was from 18 April 2010 to 7 May 2010. The elaborate work agenda is appended in AnnexureA -A 1.Study LocationThis survey was done on thalassaemia patients came at 3 centres in the Dhaka metropolis viz. ASHA -Thalassemia Center, Bangladesh Thalassemia Society and Thalassemia Hospital and Red Crescent Blood Center. Dhaka Shishu Hospital Thalassemia Center was planned as one of the sites in the initial protocol, but the establishment declined the research worker for informations aggregation. Therefore it was replaced with Red Crescent Blood Center with permission from research usher.Study PopulationThe survey population included all the patients coming to the survey location for outpatient audience and blood transfusion.Study SampleSampling Technique and Sample SizeA convenient sampling was done. All available instances within the informations aggregation period were included in the survey. Overall 120 instances were included in the survey.Calculation of Sample SizeEligibility CriteriaInclusion StandardsExclusion StandardsDevelopment of Research InstrumentA pretested semi structured Bangla questionnaire and checklist was used for informations aggregation. The variables were identified harmonizing to the specific aims and taking the of import variables into consideration which reveled in the literature reappraisal. Then appropriate graduated tables of measuring for these variables were identified and English questionnaire was drafted. After necessary rectification and tuning the English questionnaire was translated into Bangla. Th e questionnaire was so reviewed by research usher and co-workers of the research worker. The PedsQL Core scales 6-11 by James W. Varni was used for appraisal of quality of life with due permission from the writer. The tool consists of 4 ( four ) graduated tables for different age group i.e. Young grownup ( 18-25 ) , adolescent ( 13-18 ) , kid ( 8-12 ) , immature kid ( 5-7 ) . The interlingual rendition of the instrument was carried out harmonizing to the lingual guideline sent by the writer. The purpose was to develop a questionnaire which is conceptually tantamount to the original version, every bit good as clear and easy to understand. The interlingual rendition procedure consisted of three stairss – Forward Translation Backward Translation Patient Testing In each measure a interlingual rendition study was prepared and sent to writer. For interlingual rendition of the PedsQL to Bangla, the research worker appointed two transcribers viz. Dr. Jenny Roslin D'costa and Dr. Tareq Salahuddin and himself acted as the undertaking director for the interlingual rendition procedure as stipulated in the lingual proof guideline. Each the transcriber was given the 4 ( Young grownup, adolescent, kid, immature kid ) original PedsQL graduated tables for different age group along with the lingual proof guideline. They were asked to interpret independently. After completion of the interlingual rendition a meeting was arranged on 16.04.2010 for rapprochement of the interlingual renditions. The undertaking director went through all 4 graduated tables one by one. There was no major dissension among the transcribers. They agreed to alter some of the words with equivalent word and rephrased some of the instructions and inquiries. Both the transcriber translated â€Å" walk more than one block † literally. The undertaking director pointed that actual interlingual rendition of western block will transport no significance in Bangla and among the mark population. Therefore he suggested it to be replaced with Bangla equivalent. He quoted Wikipedia mention below to explicate the significance of block. hypertext transfer protocol: //en.wikipedia.org/wiki/City_block â€Å" Since the spacing of streets in grid programs varies so widely among metropoliss, or even within metropoliss, it is hard to generalise about the size of a metropolis block. However, as mention points, the standard block in Manhattan is about 264 by 900 pess ( 80 m A- 270 m ) ; and in some U.S. metropoliss criterion blocks are every bit broad as 660 pess ( 200 m ) . The blocks in cardinal Melbourne, Australia, are 660 by 330 pess ( 200 m A- 100 m ) , formed by dividing the square blocks in an original grid with a narrow street down the center. † The transcriber discussed the issue and replaced block with â€Å" walking more than 100 paces † which is frequently used in Bangla to intend â€Å" walk a short distance † . After alteration of all four graduated tables ( Young grownup, adolescent, kid, immature kid ) version -1 of each paperss was prepared. Dr. Md. Rajib Hossain was appointed for the backward interlingual rendition of Bangla VersionA aˆ‘A 1 of the PedsQL graduated tables ( Young grownup, adolescent, kid, immature kid ) and research worker himself acted as the undertaking director. He was besides given the lingual proof guideline and asked non to entree the original graduated tables from cyberspace. After completion of the interlingual rendition a meeting was arranged on 17.04.2010 to compare his interlingual rendition with the original graduated tables. The consequence of the treatment in the meeting is documented in the undermentioned subdivision. The rubric contrary translated as â€Å" list † alternatively of â€Å" stock list † . This is due to non holding a similar word Bangla word. The closest interlingual rendition was synonymous to â€Å" name † and Dr. Hossain accepted it. In the Young Adult Report, Teen Report and Child Report â€Å" walking more than one block † , which was changed to â€Å" walking more than 100 paces † in forward interlingual rendition due to cultural differences was rearward translated same. Dr. Hossain besides agreed on the alterations made. The point 8 â€Å" I have low energy † was reverse translated as â€Å" I feel weak † . Therefore the interlingual rendition in version 1 was updated in version 2 which literally translates to â€Å" I have low energy † . In the emotion subdivision, point 4 â€Å" I worry what will go on to me † translated back as â€Å" I get dying about my hereafter † but it was decided to maintain the current Bangla interlingual rendition. In â€Å" how I get along with others † point 5, there is non actual interlingual rendition of â€Å" equal † hence the contrary interlingual rendition was â€Å" others of my age † which was acceptabl e. The other differences were considered as normal lexical fluctuations. In Young Child Report, â€Å" a batch of job † in the direction subdivision was back translated â€Å" large job † . In the reply options â€Å" a batch † was translated as â€Å" many times † . The difference was due to weak backward interlingual rendition. â€Å" Functioning † in the subdivision rubrics had no actual Bangla word, which was reflected in each of the subdivision rubric. The difference was acceptable. In the first subdivision â€Å" Physical operation † , foremost 6 points was translated as interrogative get downing with â€Å" Do you † . Therefore sentence building was altered to repair it. The other differences in all the graduated tables were considered normal lexical difference transporting the same significance of the original graduated table. The alterations were incorporated in version-1 of the translated graduated table and the version 2 is produced. In the patient proving measure, the research worker found that in the Likert graduated table ( 0-4 ) , patients did non understand the difference of â€Å" frequently † and â€Å" about ever † clearly. Therefore he suggested interlingual rendition of these two points to be modified which retranslate as â€Å" frequently † and â€Å" ever † . However the writer of the tool expressed his concern that altering â€Å" about ever † to â€Å" ever † will cut down your responses at that terminal of the graduated table. He advised to return to â€Å" about ever † which will be helpful in comparing the research worker ‘s findings with other published informations on the PedsQL utilizing a one-sample t-test. The writer suggested utilizing cognitive questioning method to get the better of this issue. The survey questionnaire was besides pretested along with the PedsQL graduated tables. Entire 37 points were included in the concluding questionnaire after necessary all right tuning.Datas Collection PlanThe PedsQL Generic mark tool has 4 graduated tables for different age group of 5-7, 8-12, 13-18 and 18-25 old ages. The sale for 5-7 old ages is interviewer administered while remainders are designed to be self administered. However the research worker communicated the writer of the tool about the low literacy rate which may cut down the pertinence of the ego administered tool. The writer provided a Cognitive Interviewing Guideline, which was applied for questioning all the tools.Data Processing and Analysis PlanAfter aggregation, informations were checked exhaustively for consistence and completeness. Datas were cleaned and edited manually. Statistical Package for Social Science ( SPSS ) version 16.0 for Windowss was used to analyse the information. Descriptive statistics were compu ted for the demographic variables. Chi-square analysis was carried out to measure the important association of qualitative informations. Datas were presented by tabular arraies and graphs.Quality AssuranceStudy RestrictionsPurposive samplingEthical IssuesThe survey was done through aggregation of informations utilizing questionnaire and neither any intercession nor any invasive process was be undertaken. However, prior to induction of the survey ethical clearance was taken from NIPSOM ethical commission. Before induction of the interview a brief debut on the purpose and aim of the survey was presented to the respondents. They were informed about their full right to take part or decline to take part in the survey. The research worker besides assured the respondents that there was no invasive process included in the survey and all the findings of the survey will be used to steer the service suppliers and policy shapers for the betterment of thalassaemia intervention. A complete confid ence was given to them that all information provided by them will be kept confidential and their names or anything which can place them will non be published or exposed anyplace. Their engagement and part will be acknowledged with due regard. After completion of these processs the interview was started with their due permission. : Consequences This cross sectional survey was conducted among 108 thalassaemia patients in three thalassaemia intervention centre in Dhaka metropolis. The information was analyzed utilizing appropriate descriptive and illative statistical processs and presented in this chapter utilizing tabular arraies and graphs, harmonizing to specific aims where applicable. The determination is organized under the undermentioned subdivisions4.1 Socio-demographic features of the respondents4.2Socio-demographic features of the respondentsData was collected on socio-demographic position of the respondents which is shown in the tabular array xx.xx.Age of the respondentsThe age of the respondent was usually distributed ( One sample Kolmogorov Smirnov Test, P =0.28 ) with average 13.28 old ages and standard divergence A ±5.19 old ages. There was no important difference of quality of life in one manner ANOVA ( F=1.68, p=0.18 ) among the PedsQL age groups.Table 1: Age distribution of respondents harmonizing to PedsQL age groupsAge groupFrequencyPercentage5-7 old ages 17 15.7 8-12 old ages 44 40.7 13-17 old ages 25 23.1 18-25 old ages 22 20.4 Entire 108 100.0AgeSexual activityReligionHighest instruction ( in old ages )Area of abodeDistrict of abodeHighest instruction of household caputOccupation of the household caputFamily incomeNumber of siblingsNumber of thalassaemia among the siblingsCorrelation analysis and additive and ordinal logistic arrested development were used to pattern forecaster of hurting. Forecasters important in initial analysis, commanding for age, sex, and state, thalassemia diagnosing, regular transfusion, bone denseness, pre-transfusion haemoglobin degree. Partial correlativity, commanding for age and sex, was used to measure the consequence of hurting on quality of life. : DiscussionDiscussion12

The Divine Power Of Womanhood Hawthorne s Re Branding...

The Divine Power of Womanhood: Hawthorne’s Re-branding of Femininity Women in Puritan society, as in many other societies throughout time, were repressed. In Nathaniel Hawthorne’s The Scarlet Letter it is womanhood, not women themselves, that is being repressed within Puritan society. On the surface, this is because of its traditional religious association with sin. However, Hawthorne depicts femininity and womanhood as having divine power and influence, [as in, they] ? are a God-approved force leading people towards moral good. This is shown through his depiction of women deprived of womanhood as morally corrupt, the way in which Hester’s feminine qualities inspire forgiveness, and in Hester’s belief in the power of a woman to change Puritan society. Hawthorne does this in order to subvert those traditional religious ideas about femininity, instead suggesting that the reason womanhood is repressed lies in the fear the Puritans have of womanly power destro ying their patriarchal society. Hawthorne depicts the unfeminine women in Puritan society as being morally corrupt, thus proving that feminine influence is necessary for morality. In Puritan society, femininity and womanhood are repressed, as they are considered sinful. Hawthorne emphasizes this by showing how Puritans blame womanhood for Hester’s sin: â€Å"she would become the general symbol at which the preacher or moralist might point, and in which they might vivify and embody their image’s of women’s frailty and sinful