Early America essays

Early America essays America. No other word in any language sparks such a passion of energy in people. Why is this? Is it because of the prosperity that the United States is associated with? Maybe, it is the idea of complete freedom. Most people in less fortunate countries dream about a life in a new land. Most often America is the land which pops into their heads. If people in less fortunate countries dream of a new life in America, why has their been a decline of patriotism? Quite possibly it is the lack of education, in the history of our fine country. People have forgotten why we live in a free country, or how our country came to be. Possibly it is the fact that since we no longer realize the overwhelming odds we faced in the revolution, or the matter of why we succeeded from Britain. People take this country for granite. Two authors, Howard Zinn, and Thomas A. Baily have not forgotten why we broke away. These men have similar opinions on the social, political, and revolutionary origins of our country. North and South America were colonized by modern European countries. The way these countries interacted was the basis for society in Colonial America. For example, Spain influenced the colonial times by introducing slavery through the Native Americans. Because of Spains introduction of slavery, it became a way of life in fifteenth, sixteenth, and seventeenth century America. Baily and Zinn both agree that Colonial America was directly influenced socially by the mixing of different cultures from the immigrants. Society was an important factor in colonial America....colonial society was not democratic and certainly not equalitarian; it was dominated by men who had money enough to make others work for them. And: Few of these men were descended from indentured servants, and practically none had themselves been of that class. Here, Zinn gives an example of how society worked....

Euphemisms for Death

Euphemisms for Death Euphemism is especially frequent, says linguist John Algeo, when we must come face to face with the less happy facts of our existence. Here we consider some of the verbal tranquilizers employed to avoid dealing head-on with death. Despite what you may have heard, people rarely die in hospitals. Unfortunately, some patients do expire there. And according to hospital records, others experience therapeutic misadventures or negative patient-care outcomes. However, such mishaps cant be nearly as disappointing as the patient who has failed to fulfill his wellness potential. Most of us, I imagine, would rather die than let down the side in this fashion. Well, perhaps not die exactly. We might be willing to pass on, like dinner guests who take a pass on dessert. Or depart, as we should after a night out. (Theyre no longer with us, our hosts will say.) Unless, of course, weve had a bit too much to drink, and then we might just end up lost or asleep. But perish the thought. In the article Communication About Death and Dying, Albert Lee Strickland and Lynne Ann DeSpelder describe how one hospital worker tiptoed around the forbidden word. One day, as a medical team was examining a patient, an intern came to the door with information about another patients death. Knowing that the word death was taboo and finding no ready substitute, the intern stood in the doorway and announced, Guess whos not going to shop at Wal-Mart anymore. Soon, this phrase became the standard way for staff members to convey the news that a patient had died.Dying, Death, and Bereavement, ed. by Inge Corless et al. Springer, 2003 Because strong taboos surround the subject of death in our culture, countless synonyms for dying have evolved over the years. Some of those synonyms, such as the gentler terms suggested above, are regarded as euphemisms. They serve as verbal tranquilizers to help us avoid dealing head on with harsh realities. Our reasons for using euphemisms are varied. We may be motivated by kindnessor at least politeness. For example, when speaking of the deceased at a funeral service, a minister is far more likely to say called home than bit the dust. And to most of us, resting in peace sounds more comforting than taking a dirt nap. (Note that the opposite of a euphemism is a dysphemism- a harsher or more offensive way of saying something.) But euphemisms arent always employed with such solicitude. A substantive negative outcome reported at a hospital may reflect a bureaucratic effort to disguise an interns blunder. Likewise, in wartime a government spokesperson may refer abstractly to collateral damage rather than announce more candidly that civilians have been killed. Euphemisms, Death and Mortality [E]uphemism cannot cancel the reality of death and mortality, says Dorothea von MÃ ¼cke in an essay on German writer Gotthold Lessing. Nonetheless, it can prevent the sudden confrontation, the accidental, unprotected encounter with death as the real, as decomposition and undifferentiation (Body and Text in the Eighteenth Century, 1994). Euphemisms serve as reminders that communication is (among other things) an ethical activity. Strickland and DeSpelder elaborate on this point: Listening carefully to how language is used provides information about the speakers attitudes, beliefs, and emotional state. Becoming aware of the metaphors, euphemisms, and other linguistic devices that people use when talking about dying and death allows for greater appreciation of the wide range of attitudes toward death and promotes flexibility in communication. Theres no doubt that euphemisms contribute to the richness of language. Used thoughtfully, they can help us avoid hurting peoples feelings. But when used cynically, euphemisms can create a haze of deceptions, a layer of lies. And this is likely to remain true long after weve bought the farm, cashed in our chips, given up the ghost, and, as now, reached the end of the line.

5 questions Essay Example | Topics and Well Written Essays - 1000 words

5 questions - Essay Example Additionally, in 1965, Louis Pasteur discovered that silkworm was caused by a protozoan and this added more information on the prior discovery of the 1935. However, there were still limitations as the results were general instead of being particular. Koch’s discovery was so particular in his results that a particular disease is caused by a particular organism. Truly, Koch did not only isolate the causal pathogen, but he also correlated a specific pathogen to a specific disease. Again Koch provided experimental steps and guideline to prove that a bacterium caused anthrax by using a specimen of purified culture of anthrax isolated from dead animals. In the modern era, Koch’s postulates have been used to assert the causation of infectious diseases through pathogenic microorganism culture and with the aid of electronic microscopes. He was awarded a Nobel Peace prize in 1905 for his work on microbiology. 2. In 1884, Hans Christian Gram described a method of staining bacterial cells while not staining surrounding animal tissues; however, he thought the staining method he developed was faulty because not all bacteria stained. In a letter to the editor of the journal in which Gram published his findings, write your response to Grams concern. His discovery was not a faulty one in any way, it just had some limitations. To prove the reality, the stain work in some of the bacteria specimen he used. However, the failure in the other cases opened a new research question, why not in all bacteria? It has been discovered in modern science that there are almost countless bacteria, each possess a different characteristics. Some bacteria secret a chemical substance the reacts with Hans’s stained to blur vision. Now it has been discovered that the chemical mycolic acid. Mycolic acids produced by the bacteria interfere with the dye, deterring the dye to stain. The acid is a species of bacteria

Spirituality in Health Care Essay Example | Topics and Well Written Essays - 1750 words

Spirituality in Health Care - Essay Example As a means of understanding this to a more effective degree, the following analysis will discuss the role that spirituality plays in helping to address this primary task. As such, for purposes of this analysis, the author will focus specifically upon the realm of the way in which spirituality can play a role in attending to the needs of the patient, the way in which a clear delineation between a given set of beliefs and/or proselytize nation must be separated from spirituality, and the innate importance of being continually cognizant and aware/appreciative of different beliefs and the different multicultural approaches to spirituality that the patients might have. Only thorough exemplification and examination of these topics will give more effective understanding of how spirituality can be engaged within the realm of healthcare provision. The following analysis will provide a brief introduction into the topic as well as discussing the way in which three separate faiths integrate with a comparative approach to healthcare. As such, the three faiths which will be referenced are as follows: Buddhist, Shinto, and Baha’i. ... nderstood that spirituality is still a very delicate topic due to the fact that it does not exist, nor is represented, categorically among each and every patient that seeks a level of treatment (Reimer-Kirkham et al. 203). Instead, spirituality is a highly personal component of an individual’s worldview. As such, it is the ultimate role of the healthcare provider to be cognizant of this and not to seek to foster any particular type of approach to spirituality. Instead, merely listening and being aware of any needs/beliefs that the patient might represent to the healthcare provider is a preliminary and essential task. In this way, the first faith to be discussed, Buddhism, it must be understood that the Buddhist approach to healthcare provision is ultimately quite depressing with regards to the way in which care and treatment can be provided. From the Buddhist interpretation, even the highest form of care can only be viewed from the standpoint that death can merely be delayed a nd suffering itself should not necessarily be sought to be averted in and of itself due to the fact that it has an innate potential for purification and the ability to allow the individual to come to a greater appreciation for life and an escalation towards the state of nirvana. All of this of course springs from the understanding that Buddhism holds as a tacit truth that suffering is a part of life and as such should be accepted without actively seeking to diminish it. With that being said, it is of vital importance that healthcare provider is not a means anyway, or at any time, to seek to promote a particular worldview or proselytize their own belief system to the patient. This is of course due to the fact that this represents a clear breach of professionalism and an overstepping of the

Cervical Cancer Major Public Health Issue Health And Social Care Essay

Cervical Cancer Major Public Health Issue Health And Social Care Essay Introduction Cervical cancer is a major public health issue; it is the second most common cancer among women in the world, and one of leading cause of death by gynaecologic malignant tumour in developing countries. (I. Shahramian and colleagues 2011) Besides, cervical cancer is one of the most preventable and curable cancer when it is detected early, and this is due to its slow progression, since it take several years to grow from a detectable precursor lesion. This key feature provides a large window of about ten years or more for effective early detection of the precancerous lesion, and preventing its progression to invasive cancer. From this perspective, well organised prevention approaches have been applied by high income countries over the past 50 years, and have resulted in a remarkable decline in morbidity and mortality from this invasive disease. The screening program is a successful example for effective prevention from cervical cancer, it has been used in the Nordic countries (Denmark, Finland, Iceland and Sweden); this program was examined by the International Agency for Research on Cancer (IARC) in 1960s and it was found that the mortality rate in these countries fell by about three- fourth, The most drastic decrease was marked in Iceland by 84 % and this was due to the wide target age range for screening in this country.(whomb people) However, over the same period, developing countries have failed through using the same program to reduce the burden of the disease, and cervical cancer continues to menace the lives of thousands of women, this may be due to the lack of an effective prevention strategy. We will try in this paper to review the determinants of cervical cancer screening among Algerian women, to elucidate the salient barriers regarding screening and to highlight the principal factors influencing the individual health behaviour, for this study, we will use the Health Belief Model as a conceptual framework, we will explain the structure of the Health Belief Model (Becker) and how the different constructs of the model could predict the womens health behaviour regarding cervical neoplasm screening , finally the application of this model as a guiding framework to ground behavioural interventions and to improve attitude of women regarding cancer screening will be discussed. Epidemiology of cervical cancer/ global burden of the disease Global overview Worldwide, cervical cancer is the second most common cause of death among women (ACCP2004) with an estimate of 493,000 new cases, and 274,000 deaths occurring every year according to the statistics of the International Agency for Research on Cancer (GLOBOCAN, 2002) In 2008, 530000 new cases were diagnosed, more than 85% of the global burden were registered in developing countries (where it remains the most common cancer seen in women and it accounts for 13% of all female cancers), In the same year, the cervical cancer was responsible for 275000 deaths, about 88% of which occurred in developing countries 53000 cases in Africa, 31700 in Latin America and the Caribbean, and 159000 cases in Asia. (GLOBOCAN 2008) The figure below shows incidence of cervical cancer by country, it should be noted that data from developing countries might be underestimated as the official statistics in these countries are not reliable. http://globocan.iarc.fr/factsheets/cancers/cervix-bar.png Regional overview Algeria is a large North African country, extended from the Mediterranean Sea down to the Sahara, with about 37 million inhabitants. Algeria has a population of 11,51millions of women whose ages are 15 years and older, (WHO/ICO2010) which means that about the third of the Algerian population is at risk of developing cervical cancer. Cervical cancer is the second most common cancer among Algerian women after the breast cancer, Current estimates indicate that every year 1398 women are diagnosed with cervical cancer and 797 die from the disease (WHO/ICO2010) About 10, 5% of Algerian women are estimated harbour cervical HPV, and about 77, 1% of cervical cancers in Algeria are related to HPV 16 or 18. (WHO/ICO 2010) But we should note that even these statistics might be underestimated, The economic impact of cervical cancer is significantly heavy for the state. The treatment of a single patient returns to about 2.5 million dinars (à ¢Ã¢â‚¬Å¡Ã‚ ¬ 20,000), with this cost we we can achieve 2000 smears (smear test cost 20 à ¢Ã¢â‚¬Å¡Ã‚ ¬) and vaccinate 30 women. Natural history of cervical cancer Understanding the process of developing cervical cancer is a crucial step to design an effective program of prevention. More than 99% cases of cervical cancer are attributed to cervical HPV infection, which is a sexually transmitted disease (STD), the virus is acquired by both men and women through sexual activity, the infection is usually asymptomatic and transient. HPV is the most common STD in the world; it affects about 50% to 80% of sexually active women at least once in their lifetime ( ACCP 2004), they contract it in their teen, 20 or early 30s. There are more than 100 genotypes of HPV that have been identified, and which are numbered by order of their discovery, about 13 types can lead to invasive cervical cancer and they are known as high oncogenic risk ( 16,18,31,33,35,39,45,51,52,56,58,59,66) (WHO 2007) The two most common are 16 and 18 causing approximately 70% of all invasive cervical carcinoma (60% related to HPV 16 and 10% to HPV 18) the whom people The others types of HPV are known as low risk and they usually associated with genital warts (especially 6 and 11) which can grow in the genital part in both men and women (cervix, anus, vulva, vagina, penis, and scrotum) and they cause a significant morbidity.( WHO2007), They are very rarely associated with cervical cancer, but can lead to low grade changes in cervical cells which are very similar to those caused by high risk types. These low lesions are asymptomatic and temporary, however, in some circumstances can evolve and lead to high lesion or invasive cancer. Table: summarizes the different stages leading to cervical cancer ( ACCP2004) HPV infection Low-grade lesions High-grade lesions Invasive cancer HPV infection is extremely common among women of reproductive age. The infection can persist, lead to cervical abnormalities, or resolve on its own. Low-grade lesions are usually temporary and disappear over time. Some cases, however, progress to high-grade lesions. High-grade lesions, the precursor to cervical cancer, are significantly less common than low-grade lesions. High- grade lesions can develop from low-grade ones or directly from persistent HPV infection. Invasive cancer develops over the course of several years and is most common among women in their 50s and 60s. Source: Adapted from PATH 2000. HPV is a necessary cause but not sufficient to progress from HPV infection to invasive cervical cancer, there are other lifestyle factors that increase the probability to develop the cancer including high parity, young age at first delivery, being in polygamous marriage, women with husbands extramarital sexual relationship (D. Hammouda and colleagues 2004, 2011), long term use of oral contraception, tobacco smoking, certain dietary deficiencies, poor sanitation, multiple sex partner, low socio economic status, and living in a rural environment. In addition, co-infection with HIV, Chlamydia Trachomatis, and Herpes Simplex Virus type 2 (HSV 2)., ( whomb people) HPV was incriminated in many other anogenital cancer (anus, vulva, vagina, and penis) and cancers of the head and neck. Understanding that HPV is the primary underlying cause of cervical cancer has focused attention on the potential of early detection of the infection through the cervical screening. Screening for cervical cancer is based on the use of the Papanicolaou cytology technic (Pap smear test) in which physicians or nurses expose the cervix by speculum and remove cells from the squamous epithelium and transformation zone to detect abnormal precancerous cells. The American College of Obstetrics and Gynaecology suggest that women should receive the first screening test 3 years after the first sexual intercourse They also recommend that women should continue receiving cytology screening yearly until the age of 30, from than they can receive it every 3 years. According to the same college, menopausal women have a lower chance to develop abnormal cervical cells; however, there is no upper age limit to stop the screening. ( Whom people) Primary prevention have focused on hygiene and reducing risks factor by reducing the number of sexual partners and encouraging the use of barrier contraceptive especially condoms,( ACCP2004) Recently a new vaccine which has the potential to protect against certain type of HPV infection (16 and 18) has been licensed to underpin the preventive program against cervical cancer. The vaccine has been used in many developed countries and shown great results in reducing the burden of the disease, but it has not been introduced in Algeria yet Pap smear as a cervical cancer screening test Algeria is one of the developing countries where cervical cancer remains a major health public issue. although the application of screening program, a large population remain under screened, the outcome are very modest and the incidence of cervical cancer is always high and this could be contributed to the lack of awareness about screening test among women and some specific cultural health beliefs barriers, not surprisingly that large proportion of the patients are diagnosed with advanced stage of the invasive cervical cancer, interestingly, even most of the health care providers have never had a pap smear.( ref risk factor ). Studies show that comprehensive cervical cancer screening is modest in low resources countries; hence a low participation in Pap smear and a low follow up when it is done the first time. It has been stated that screening program in these countries and even among minorities and aboriginal women faced many obstacles; lack of sufficient laboratory infrastructure, high cost of health care, inadequate trained health care providers, absence of providers recommendation and a lack of appropriate educational programs in these countries that indicate the risk factors of this disease, the importance of screening at early stage, and the power of the Pap smear test to detect the disease in its premalignant stage and so the possibility of full cure and prevention. (S.T. Tavafian 2012) In addition to these funds and human resources deficiencies that can hindrance an effective and organised screening intervention, there is also the lack of knowledge from the patients regarding preventable cervical cancer as well as the socio-cultural status barriers , such as embarrassment from pelvic examination that have been argued as one of leading obstacle to not receiving screening test,(S.T. Tavafian 2012) another factor is the fear of subject and the entrenched belief that cancer cannot be cured , the lack of optimal knowledge about screening practices ; this extreme fatalistic attitude about cancer among different countries lead women to consider diagnosis as a death sentence and so the avoidance of the test,(V.Thomas and colleagues 2005) there is also projects identified religious beliefs, the limited language ability as another major perceived barrier, the lack of social support, the low socio economic status and the inadequate functional health literacy. There is a study that has been conducted in Spanish among low income Latinas, that found that women with inadequate functional health literacy are 16 times less likely to receive a Pap smear test (S.T. Tavafian 2012) It has been illustrated that Individuals beliefs, ethnic background, knowledge about a particular illness are significantly interconnected with the healthcare seeking and health promotional behaviour, Al-Neggar and his colleagues concluded that some misconceptions and wrong beliefs may conduct to the poor practice of cervical cancer screening among women, despite the adequate knowledge regarding the risk factors (Al-Neggar and colleague (2010). One of theoretical models that could be used to identify the determinant of cancer screening and assess the influence of peoples beliefs on their decisions to take up cancer screening is the health belief model. According to the concepts of this model, individuals are more likely to take up screening if they are motivated enough about their health, and they regard themselves as susceptible to develop cancer, believe that effective intervention would be beneficial to reduce the susceptibility and the severity of the condition. Health belief model as a theoretical framework for predicting behaviour The health belief model is one of the theory the most commonly used in health promotion and health education, (chapter 4) it was developed in the early 1950s by a group of social psychologists to explain the widespread failure of people to adopt the disease preventive programs suggested and screening test recommended to detect and prevent the disease at its asymptomatic stage, Later it was applied to study the response of patients to diagnosed disease and their compliance with prescribed medical regimens.(Nancy and colleagues 1984) This model aims to explain the patients thoughts process behind his preventive attitude rather than his behaviour after getting the illness. The underlying concept of the model is that health behaviour and willingness of people to engage in a preventive program or to take up a screening test are determined by personal beliefs and perception of the disease in addition to the different resources available to prevent its occurrence, (chapter 4) The model provides guidelines to develop strategies for effective intervention and implementation by allowing planners to understand the reasons for not compliance with the recommended suggested preventive systems. This model assumes that individuals health behaviour is determined by five psychological factors: perceived susceptibility, perceived seriousness, ref perceived benefits and perceived barriers to effective compliance; cues to put into action, recently, there are others constructs that have been added to the model called modifying or motivating factors such as mass media initiatives, campaign, personal materials, social support, health professional and self-efficacy.(V.Thomas and collegues 2005) Copier le tableau Articulation of cervical cancer screening behaviour to the HBM framework In this section; I will try through the constructs of the Health Belief Model to explain the relationship between womens belief and health behaviour in Algeria Perceived susceptibility: personal risk or susceptibility is referred to the personal belief about the likelihood of contracting a disease (S.T. Tavafian 2012), it is one of the most powerful factor that influence people to adopt a healthy behaviour, the greater the perceived risk, the greater the likelihood of engaging in behaviours to decrease the risk( chapter4). For screening program, woman will be interested to take up a smear test if she is aware enough of the possibility to get cervical cancer by contracting HPV infection, and that she is exposed to this risk as long as she is sexually active. The HBM predicts that women are more likely to comply with cervical cancer screening recommendation if they believe that they have risk factor of cervical cancer (Glanz et and colleagues 2008), and vice versa, the belief of not being at risk for cervical cancer or HPV infection preclude (deter, empeche) women to engage in such program, And this is why most virgin women in Algeria underestimate the necessity( believe the futility) of smear test as they think they are protected from the risk of HPV infection because they are not married. Or in other words , because there is no sexual intercourse, virgin woman does not perceive her vulnerability to cervical cancer, although studies show that HPV has been found in some female virgins, which means that the virus does not always need penetrating sex to be transmitted, And that it may be spread through non penetrating sexual contact; and even within married women, the concept that HPV infection is related to multiple sex partner make them b elieve they are safe from the risk since they have one partner, ignoring the husband sexual behaviour, as many men in Algeria have extramarital sexual relationship underground that the wife unawares, and so she doesnt see herself as susceptible to the risk. Another worrying factor is that youngest women consider cancer to be an elderly disease, while older women according to cervical screening age limit might think that they are no longer at risk ref( V.Thomas 2005), and so there is a wrong perceive of susceptibility. Perceived severity: refers to the seriousness of the disease as assessed by the patient, it is usually based on medical information or personal knowledge from television, radio or leaflets, or it may come from the belief of a person about the consequences that would create a particular disease whatever clinical such as death, disability, or social like family life and social relations (chapter4), (S.T. Tavafian 2012), For screening test, if women believe that cervical neoplasm is a severe disease that would lead to serious difficulties for her and her family, she will view prevention as a priority and so she is more likely to receive a Pap smear test. Also having knowledge about Pap smear test and its importance to detect the invasive disease at early stage will motivate her to receive one, because many women realise the severity of cervical cancer but lack knowledge of screening program, and available service. Despite the recognition that cervical cancer is a serious issue, most of women in Algeria believe that there is no treatment, which make them see screening test as futile and this perhaps reflects the religious beliefs and the cultural background that may influence their attitude, Algeria population as most of Muslims agree that illness, recovery and death are all determined from God, so The majority believe that screening would not prolong their lives and when the time of death comes no one can push it away( K,Salman2011) Another point is that the fear from possibility of identification abnormal cells would necessarily lead to other investigations often influence the willingness of the women to attend, especially when there is no one to watch the children during the screening and the lack of significant support. (chapter4) In Algeria, as in many other Arabic countries, cancer screening is usually recommended for diagnostic purposes rather than being used as a tool for secondary prevention ( K,Salman2011) most of women consider the absence of visible symptoms as a sign of good health hence they do not seek health care unless the disease manifests itself and starts to disable her daily activities, and so the cancer is often diagnosed at its advanced stage. Perceived benefits is about the persons opinion on how much may new behaviour decrease the risk of a particular disease, the HBM predicts that most people have tendency to adopt new behaviour which is seen as a healthy behaviour when they believe the capability of this new behaviour to decrease their risk of developing a disease (Glanz and Colleagues 2008) Perceived benefits play a major role in the adoption of secondary preventive interventions such as screening, for example, if women believe that Pap smear is important for early detection of the precancerous lesions and prevention of cancer that will motivate them to participate in secondary prevention practice by seeking checks up and periodic screening. Therefore women are not expected to engage in any screening program unless they perceive that this program is potentially beneficial to reduce the risk, and so health care providers should explain to the patient the ability of screening test to detect changes in cervix before they develop to cancer, which make treatment easier and prevention effective. Perceived barriers: relate to the individuals vision of the obstacles he will face if he decides to adopt a new behaviour. In order to undertake a recommended behaviour, a person needs to believe that the benefits expected from it outweigh the outcomes of his old behaviour; this enables him to overcome the perceived barriers and to adopt the new behaviour (chapter4) For example, if woman believes that benefits of undergoing a screening test outweigh the obstacles that she may face, she is more likely to obtain Pap test. Previous studies have showed that women who perceived the Pap smear testing as a painful and embarrassing process were less likely to obtain cervical cancer screening, in the same studies women reported many cause that deter them to take the action, such as a negative previous experience, included pain, bleeding, or being faced with inexperienced practitioner who didnt explain the procedure to them during taking the sample, language difficulties was another barrier due the perceive that she will be unable to communicate properly with the health care provider, and to build a trusting relationship. Even those who appreciated the necessity of the screening, the fear of the test process was a great obstacle for them, as most of women find it uncomfortable, and perceive the metal speculum as a painful instrument. (Abdullah 2009) Shyness is another major hindrance that may deter screening process, and It is very common for women to refuse to reveal her body parts to undergo a physical exam or a medical procedures especially when the health provider is a man, and even the discussion about a sensitive health issue like marital relationship, sexual activity and reproductively is regarded as very private, and shouldnt be disclosed to other people , especially men, and even husband may sometimes not be involved in his wifes health issue if it is related to her reproductive organs.( K,Salman2011) Cues to action: are the ensemble of events, things, people that motivate a person to change his behaviour, and this can be mass media such as television, radio, advice from a family or friends, leaflets, information brochure, campaigns, recommendation from health provider,(chapter4) Women are more likely to take up a pap test if she receives enough information about the benefits of the test from her GP or Gynaecologist, if she receives advice from another woman who had the test, if she is encouraged by a member of her family especially the husband or if she knows someone in her entourage with a history of cancer, all those factors are susceptible to reduce the perceived barriers to cancer screening. Perceived self-efficacy: it refers to the belief of the person in his own ability to adopt the behaviour required, because people generally dont engage in doing something unless they believe they are able to achieve it. (Chapter 4) Modifying factors: in addition to what it has been already said, There are other factors that seem to influence the willingness of women to take up the test such as inadequate knowledge about the screening, lack of trusting relationship with the health provide , lack of confidence in the importance of the test, high cost of the test, fear of the result of the test and superstition that talking about cancer would bring it, some stigmata imposed by the community and even sometimes the family that cervical cancer is related to promiscuity, Perception of the Pap smear as a threat for the womans virginity, some fatalistic attitude that illness, recovery and death are relating to gods will and that screening test is futile, Low socioeconomic status, lack of social support, poverty, lack of health insurance (J.Hatcher and colleagues 2011), childhood sexual abuse, obesity, low levels of education, child care, lack of transportation. Cervical cancer screening- promotion interventions based on HBM Today, the HBM is used by many researchers to guideline the development of strategies for effective health intervention, In this section, I will try to summarise some finding from the different interventions based HBM that push me to suggest this model to improve womens behaviour in Algeria. The health belief model has been used by several study, alone or combined with other health promotion models to and to improve belief and behaviours among women regarding the screening program, an example of this study, has been conducted in Iran, in 2010, this study showed that the HBM has formed the basis for an interventional program to improve behaviour among Iranian women,(S.Tavafian2012),The study was conducted with 70 volunteers- aged between 16 and 54 years, and they had never received Pap test, the participants were divided into many small groups, and each group underwent a session of 2 hour training. For the data collection tool, a self-administered multi-choice questionnaire was developed based on the concepts of the HBM. The personal belief and health practice of all the women were assessed pre intervention and four months later, the findings reported that health education based on HBM construct was effective, and could promote the participants knowledge and improve the d ifferent components of the model (perceived susceptibility, severity, benefits, and barriers).The training program that has been used enhanced the willingness of women to practice the screening test significantly. The study concluded to the fact that education program based on HBM constructs can change womens health beliefs, enhance their knowledge about the cervical cancer and the screening test, and motivate them to adopt a new behaviours. (S.Tavafian2012) Another study in Somali was about an educational programme about the purpose of the screening test, to encourage Somalis to undertake the test. The participants praised the initiative and suggested that such information should be provided in a community setting, because it would help women to perceive the value of the test, and to overcome the different fatalistic barriers to screening. further, Participants suggested improving the awareness of screening among women via mass media: TV, radio, video, DVDs, CDs and audiotapes (Abdullahi , 2009), Health promotion (ACCP 2004)( review the title) There is a lack of information regarding health promotion models that have been used to influence health behaviour among women in Algeria, and even there is no description how the intervention methods were selected, Alliance for Cervical Cancer Prevention (ACCP) consists of five international health organizations who share all the same goal to prevent cervical cancer in limited-resource countries.it aims through its projects to implement an effective prevention strategies to minimise the burden of the cervical cancer .unfortunately ,Algeria has not been included in this initiative, through my review of this manual , I would suggest it as an approach to improve womens health is Algeria and to promote health service delivery. Many method of diagnostic, screening and treatment are currently used. And each of them has strengths and limitations, this method should be reviewed to pick up the most appropriate for the patient, for the screening for example the Pap smear test is the most commonly used, this test requires multiple and regular visit from the client, which can be a barrier for the woman to attend it, The ACCP suggest some alternative approach with better sensitivity and specificity such as Human papillomavirus (HPV) DNA testing, or visual screening, a low cost method with an immediate result. As a health care facility, they suggest to combine the treatment of precancerous lesions to the screening process, and propose some effective and safe methods that should be performed by physician and not physician. These treatment methods allow cure and histological verification at the same time, it has been shown that this initiative was praised by women and providers as well, and it has a great result to lower rate morbidity. The combination of both effective screening approach and treatment would overcome the limitation. Facility womens access to precancer treatment services, through selecting a program to link screening services to precancer treatment services. This would increase the effectiveness and encourage woman to follow up. Achieving widespread screening coverage of the target population by selection of well-organised prevention approach. And this may include the policymakers and authorities who should encourage the investment in cervical cancer prevention Planning an effective prevention intervention: Planning a prevention program requires a coordination between a multidisciplinary management team, that include clinical, administrative, and training specialists. To achieve the programs objective, the team members should follow a participatory process which includes also the perspective of lay people who are concerned by the outcome of this program, and this will allow achieving a high screening coverage with satisfactory result. Improving health services and laboratory infrastructures: delivery services should be accessible, acceptable, affordable, and reliable to satisfy the client and ensure a high coverage of the population target Training: Ensuring Performance to Standard Ensure to qualify a competent staff and health provider, to attract client to use the facilities available and this would happen by training session that enable provider to confidently offer reliable services Providing Information and Counselling to Address Community and Client Needs Women target group should be informed enough the benefits of screening and availability of prevention services to increase the effectiveness of the program, and this could happen by direct contact between woman and health worker or through mass media and campaign, Social network interventions, mailed invitation letter for screening and reminders, information brochure which are very popular to spread information about health topics. It has been stated that direct provider contact is more effective to increase the use of prevention services as the individual counselling will address concerns and emotional need and should be more convincing Overview of screening, treatment and Palliative Care services of cervical cancer Cervical cancer screening services, cervical cancer treatment, and palliative care services should be continuously linked to ensure the effectiveness of the program

Marriage practices

In the Cooper Eskimos area, the prospective son-in-law worked as a servant for the girl's father for a period of three or four years, generally before she reached puberty. Bride service among the Cooper Eskimos was often Supplemental, and sometimes replaced by payments of valuable articles† (Dams, Divide Demographic Aspects of Central Eskimos Marriage Practices. American Ethnologist, Volvo. 2. No 3 (Gauge 1975). Up. 409-413. Http//www. ASTOR. Org/page/info/about/policies/ terms. Jsp). The three major groups of Eskimos were first designated as tribes by members of the fifth Thule Expedition and these three groups are Guilt, Entitles, and Cooper.Information from Nineteenth and early twentieth century describes that each of the tribal units are relatively discreet. With trade routes that intersect in Central Artic Contract between different tribes is most likely very short. There was intermarriages between Mackenzie Eskimos woman marrying into the Cooper Eskimo tribes. There have also been cases of intermarriages between Flimflamming Eskimos and Entails Eskimos and there also hostility between these two groups also. The Entitles had four cases of polygamy compared to two cases of polyandry. However, the census said otherwise.The Census shows there were three cases of polygamy to two cases of polyandry. â€Å"Rasmussen (1931 : 195) believed that two woman would be more compatible in sharing a husband than two men in sharing a wife. This explanation begs the question of the nature of Eskimo personality. † ( Dams, David. Demographic Aspects of Central Eskimos Marriage Practices. American Ethnologist. Volvo. 2 No. 3 (Gauge. 1975). Up 409-413. Http://www. ASTOR. Org/ page/ info/ about/ politics/ terms. ]SP). The Jewish ethnic traditions has some marriage practices that differ from other traditions. The Mishap's generally are observant and religious.According to Zionist ideology, ethnic intermarriages is a means of creating a single, unified cultures among Jews in Israel ( Risen 1982). Migrate couples were less educated than those of the mixed couples. They usually married with in the Shaken tradition. In the Shaken community the ones who were less educated, married Migrate would Join the next generation. The group of Shaken education is relatively higher than it probably would be if they didn't do the mixed marriages. Education plays a large role in whether they marry into the Shaken or less economically advantaged Mishap's.Patterns of intermarriage are thus challenging concepts of race and ethnicity and are leading to complex views of ethnic and racial boundaries (Harris and Simi 2002; Hiroshima 2003; Roquefort and Brunets 2002). Jews can trace their roots in Israel past their grandparent's generation. In Israel context, the assimilation hypothesis suggest that the greater contact of educated Migrate with Shamanism has led to the erosion of their Migrate ethnic consciousness, more frequent intermarriages, the consequent concentratio n of Migrate ethnicity in the lower classes (Ben-Rafael 1982).A well-off educated Migrate would marry a poorly educated Shaken. Jews consider marriages to be the ideal state of personal existence, when you have a woman without a man and a man without a wife they consider it to be incomplete. Their engagement of marriage was usually brought about by a third person, which was also known as a match-maker. Although the marriages were the concerns of their parents, the children were not forced into marriage over their objections.When they are at the ceremony for marriage, the groom is given the ring and says his declaration, the bride does not have to respond, and she Just accepts the ring from the groom and then closes her hand to show that she accepts. Then the bride and groom drink a glass of wine together. After the ceremony is over the groom steps on glass, the broken pieces of glass is supposed to tell them how many years the marriage will last between the couple. The Jews and Eski mos had some things that each culture's did for their marriage practices that were alike and some that were different.In the Jew culture they married off the girls at a very young age. The parents usually had their children's marriages arranged by a matchmaker. They had confidence that the matchmakers would bring a proper spouse for their daughter to marry. Back then the father could marry off his daughter between the ages of three and twelve years of age, which was known to be called cetacean (little one). Which was completely subject to her father's authority and could arrange the marriage without daughter's approval. The marriages without the daughter's saying â€Å"l want this one†, was considered effective gal marriages.Now the daughters have a say if they want to marry the guy that's picked out for them. If it's not who they want then they go out and find who they want. The Eskimos parents also made marriage arrangements for their daughters. Their marriages were sought through kinship. They were also married off at a young age, married before they had their first menstrual period and began bearing children three to four years later. The men in the two cultures were not able to marry the girls till they could prove they could support them and have a home for them.The Eskimo sys were forced with different sets of requirements, they were not old enough for marriage till they proved themselves capable as hunter and providers. Also had to be able to build a snow house or hunt large game unassisted, he was not considered mature enough to take on and support a wife if he couldn't do them. After they proved those steps then before marriage they had to Join the father in laws house hold. During the trial marriage period they worked for the father in laws for three to four years or until the young couple was mature enough to establish a separate house hold.In the Jews culture the young men Just had to be able to provide a home for their soon to be wife's. O nce the marriages were completely arranged the wedding plans began. The two cultures to me seem to actually have a lot of common marriage practices. Kind of shocking how closely they do things even being two separate cultures. I feel that the children should be able to have a say into who they marry and spend the rest of their lives with. The two cultures that were described in this paper lead to finding regarding the marriage practices of the Jews and Eskimos.

An Analysis of the Operations Strategy and Management...

An Analysis of the Operations Strategy and Management Decisions in Lego Group between 2004 and 2009 Summary By 2004 Lego was in considerable trouble; it had made a loss of approximately  £200m; sales fell by 40%. One reason for this was lack of success in moving into new markets, such as computer games and clothing. However, a major cause for the financial woe was due to issues in the supply chain; costs were not being squeezed out, and the increase in specialised LEGO models had led to an explosion in the total number of unique bricks; each requiring expensive moulding, production and inventory. LEGO rightly decided to address this supply chain cost issue, and turned to Flextronics, a company with considerable experience in†¦show more content†¦18 3 M.Sc. Management BSMP27 1 Analysis for the Period to 2004 Operationally, LEGO manufactured a wide range of products (many of which were ephemeral, with a life of 12-18 months), sought to supply retailers large and small in the countries it served, and strived to provide short delivery times. Since demand fluctuations could reach 30%, LEGO had to maintain stocks of products, both completed and work in progress (WIP), in order to meet the customer needs for flexibility and quick delivery. The characteristics of the LEGO operations process in place can be shown in a 4Vs typology diagram: Low VOLUME High High VARIETY Low High VARIATION IN DEMAND Low High VISIBILITY Low At that time, the performance winners for LEGO were speed (of delivery), and flexibility (wide range of products, volume and delivery adjustments at short notice). Cost, dependability and quality were not as vital. To achieve these objectives, LEGO had made several operational decisions: Speed: †¢ Maintain multiple distribution centres, close to key markets: 5 in Europe, 1 in USA †¢ Maintain high stock levels, of finished product, and components so products could be assembled quickly. Flexibility: †¢ Supply retailers both large and small, from relatively close distribution centres †¢ Frequent, small, orders accepted †¢ Introduce new products to the range, and discontinue oldShow MoreRelatedAnalysis Of The Toy Industry, Making The Threat Of New Entrants1222 Words   |  5 PagesAnalysis External Threat of New Entrants There are many barriers to new organizations in the toy industry, making the threat of new entrants low. Lego and other big toy companies like Mattel benefit from economies of scale. An economy of scale is achieved by lower costs through large volume production (Textbook glossary). 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