Social Justice Essay -- Liberation Theology

What is social umpire and how does it relate to liberation theology? How do sin, cognize, grace, and human being freedom affect social justice? What restricts freedom and social justice? And how does all of this play a role in the Kingdom of God?Social justice is a concept of a society in which every(prenominal) human being is treated justly, without discrimination based on financial status, race, gender, ethnicity, etc. Grace is a gift from God that we dont deserve, which helps us choose the good, therefore it promotes social justice. On the other hand, sin, which can be regarded as a lack of fuck and care for others, distances us from social justice. Therefore, love and grace are essential aspects of social justice and without them there could be no social justice in the world. exit theologians, major supporters of social justice, welcome multiple elements in their beliefs that respond to major social justice issues such as unfair distribution of wealth, goods and ser vices oppression of people based on gender, race, and ethnicity and the unjustness of social structures and institutions towards the underprivileged. Lastly, the ends of Gods kingdom and the ends of social justice are one in the same Humans acting out of love to serve and give everything to those less fortunate and in need.In this idea of social justice is the belief that every human is entitled to specific political, economic, social, and human rights. However, in reality many people are stripped of these rights, leaving them without power and privilege, in other words leaving them less than human. They are bailiwick to political structures making decisions for them, which is unjust because political figures with power, acting on behalf of those without power, ... ...cial justice. Works Cited1.Haughey, John C. The Faith That Does Justice Examining the Christian Sources for Social Change. Broadway, New York Paulist Press, 1977.2.U.S. Catholic Conference. To endeavour for Justice. Washington, D.C. The Bobbs Merrill Company, Inc., 19823.Gutierrez, Gustavo. A Theology of Liberation. Maryknoll, New York Orbis Books, 1971.4.Cory, Catherine. Landry, David. Augustine of Hippo. The Christian Theological Tradition Second Edition. Upper Saddle River, New Jersey Prentice Hall, 2003.5.Boff, Leonardo. On Development and Theology. Introducing Liberation Theology. Maryknoll, New York Orbis Books, 19866.Dazet, Paul. Love Wins God Hears the Cries of the Oppressed. January 15, 2008. 7.Wolff, Edward. The Wealth Divide The Growing Gap in the United States between the Rich and the Rest.

Cassie Talaga :: essays research papers

Cassie,Do you honestly think I have no right to be angry or frustrated? For the departed 3 frickin years, Ive stayed up all nights much or less nights thinking about(predicate) you and us and, working my ass off to show you that, though in that respects blank between us, that you screw bet your life that my love is there and strong for you. I hold out what you feel when you say that you need someone and something to touch. Ive finally gotten in touch with you in a way that I can hear your voice. Just as I was saying in my last email, there forget be some fucking hard ass times, and then there leave be worse ones. This is one of those times that is going to be hard, and I believe if there was any love there for me, you wouldnt just give up. Ive always been skeptical about how you felt, thats just how I am, but then finally, in one email, subsequently I called you for the first time you said, and I quote, "...before we had our talk, I mean.. yeah.. I liked you ALOT...&q uot. But then you went on to say that you finally knew in your heart that you sincerely loved me. Im beginning to think you were just caught up in the moment. And to think, that was exactly a month ago. One frickin month ago, you said you were sure, and at present you arent. I know for a fact that love is something you cannot all of a sudden gain, or lose. It will take time as in more than a geminate weeks, but more like a couple months or years.I want you to know that, yes, Im mad. But I am alike mad about you. I feel like crying just like I did the night before you left. I had a dream a couple geezerhood ago, that ended with a phrase from no particular person saying, "Soon, your love will go through trials and tribulations, and intelligence and patience will fade as your frustration takes over but, do not falter. Persevere in your true ways, and light will shine again" I memorized that as I wrote that downward(a) after I woke up. That scared the shit out of me, becau se I spent that whole day thinking it was, in fact talk of the town about you. I see now, maybe it is.Cassie Talaga essays research papers Cassie,Do you honestly think I have no right to be angry or frustrated? For the past 3 frickin years, Ive stayed up all nights some nights thinking about you and us and, working my ass off to show you that, though theres distance between us, that you can bet your life that my love is there and strong for you. I know what you feel when you say that you need someone and something to touch. Ive finally gotten in touch with you in a way that I can hear your voice. Just as I was saying in my last email, there will be some fucking hard ass times, and then there will be worse ones. This is one of those times that is going to be hard, and I believe if there was any love there for me, you wouldnt just give up. Ive always been skeptical about how you felt, thats just how I am, but then finally, in one email, after I called you for the first time you sa id, and I quote, "...before we had our talk, I mean.. yeah.. I liked you ALOT...". But then you went on to say that you finally knew in your heart that you truly loved me. Im beginning to think you were just caught up in the moment. And to think, that was exactly a month ago. One frickin month ago, you said you were sure, and now you arent. I know for a fact that love is something you cannot all of a sudden gain, or lose. It will take time as in more than a couple weeks, but more like a couple months or years.I want you to know that, yes, Im mad. But I am also mad about you. I feel like crying just like I did the night before you left. I had a dream a couple days ago, that ended with a phrase from no particular person saying, "Soon, your love will go through trials and tribulations, and intelligence and patience will fade as your frustration takes over but, do not falter. Persevere in your true ways, and light will shine again" I memorized that as I wrote that down a fter I woke up. That scared the shit out of me, because I spent that whole day thinking it was, in fact talking about you. I see now, maybe it is.

Fighting for Equality and Freedom Essay -- American History Civil Righ

Across all nations and cultures, the enduring pursuit of equality in life seems global and timeless. Some would deliberate that their have got country has achieved a true democracy with no residual inequalities of which to speak, while others know they are at the other end of the spectrum, enduring partial laws that should not be bestowed on any human. Through the course of history many countries have fought for that democracy and all the equality that it implies. While some moot they have reached that goal, others continue to fight for the most basic human rights, even in this time of enlightenment. The journey each country takes on its road to that define may vary by origination, length, severity and outcome, but the goal seems to be the same. Looking at two such journeys through the writings of Martin Luther exp superstarnt, Jr. in his Letter from Birmingham City Jail and from an excerpt of Aung San Suu Kyis In Quest of Democracy, the underlying theme of equality is tho ughtfully penned with examples universally recognizable from each of their own perspectives, respectfully acknowledging their own histories, religions, and obstacles to illuminate the path toward that common goal of a just society despite unjust laws. In Letter from Birmingham City Jail, Kings detailed writings demonstrate his understanding of the need to painstakingly explain his position to those controlling the unequal democracy under which he was being detained at that time. Even while writing of the history of his people as slaves, King skillfully avoids coming across as just another complainer, position out the blunt truth as it was. He calls upon history to show that this never should have been in the first place, referencing the New Testament of the Bible ... ...rom worthless under unjust laws imposed by unfair rulers. Two people at different ages in their lives, different stages in their quests, of different histories and religions, one black, one Asian, one male , one female, with one goal for all. While Suu Kyi may one day be in a position to continue her fight, sadly the institution lost King too soon. Their examples, as documented in their writings, of persistence, perseverance, and grounding in what is good and just for all mankind should be followed by all, to be benefited from by all.Works CitedKing, Martin Luther, Jr. Letter from Birmingham City Jail. Reading the World Ideas that Matter. Ed. Michael Austin. New York Norton, 2007. 173-187. Print.Suu Kyi, Aung San. From In Quest of Democracy. Reading the World Ideas that Matter. Ed. Michael Austin New York Norton, 2007. 191-196. Print.

A, B, C...Not As Easy As 1, 2, 3: Are College-Bound Students Prepared?

Students that go to college to get a good job and those optimistic, broad(prenominal) achieving, civic minded that impart the promise of true greatness according to American historian and Yale graduate Neil Howe, along with his American author and Harvard graduate William Strauss, are in for quite the public check upon arriving to college and finding that they are ill-prepared for the curriculum established at a university. The educational system in the United States has seen many changes over its history as a country, and most recently, alarming news of the US slipping greatly behind in the spherical Education Race and the College Board changing college admission fee standards have drastically changed the face of higher education (Snider, Global Education Race). As it is, students already struggle tremendously to adjust to the overwhelming new aspects of a college life. With little preparation, these events only worsen the minimum forms of preparation offered. Many schools cont inue to struggle to adequately arm their students with the necessary tools needed in college. In addition, George furnishs No Child Left Behind Act of 2001 has been a turning point in the history of Americas Education. The placement and medical prognosis of all students on the same level has been argued a negative one. It is clear that the repercussions of events in history have altered the environment of contemporary education of high school students aspiring to continue onto higher education. The problem of declining University retention rates and of Americans attaining a collegiate degree can be seen as a disaster of the lack of academic preparation, largely due to state standardized testing and curriculum deficiencies. This failure was a result of several important events th... ...n. In Global Education Race, US Falls Behind. The Hechinger Report Huffington Internet Newspaper. October 2011. 12, May 2012Kirst, Michael., Aguilar, Antonio., and Bueschel, Abraham. Improving Tran sition From High School To Postsecondary Education. Policy Analysis California Education. Berkely, California.Lotkowski, VA., Robbins, SB., and Noeth, RJ. The Role of Nonacademic Factors in College Readiness and Success. Downloaded from ACT Website. 6 May 2012. Ulluci, Kerri and Spencer, Joi. Unravelling the Myths Of Accountability A Case Study of the California High School Exit Exam. Urban Review. 41.2 (2009) pages 161-173. Academic see Complete. Web. 16 May 2012United States. Dept. of Education. National Commission on Excellence in Education. A Nation at Risk The Imperative for Educational Reform. upper-case letter GPO, 1983. Print.

Primary Education in Turkey, Morocco, Egypt, Greece, and the United States :: Essays Papers

Primary Education in Turkey, Morocco, Egypt, Greece, and the United States Through issue this program I have been confronted with many images and facts about particular teaching that I go away not soon forget. The sounds of young Turkish children reciting I am a Turk, I am strong the image of six year olds in Morocco erudition to memorize the Quran before they can read or write the idea of connection schools in Egypt where students and p bents learn together to benefit and bring prosperity to the community as a whole and, fin all(prenominal)y, the idea that art is so important to Greek culture that it is one of the five major goals of primary education. These are all interesting things, they are all things I never would have expected to learn through this program, and they have made this topic and project more purposeful for me. I chose the topic of primary education not only because I am studying to be a teacher, but also because there are a lot of controversies and new ideas that are coming into American education currently, particularly the acts and ideas of No Child Left Behind, and I was curious to research how different countries were dealing with the same issues that we see in the educational system of the United States. I started my learning plan with the goals of seeing how primary education was structured in each of the countries we were visiting (Turkey, Morocco, Egypt, and Greece) both theoretically as well as how effective the actual practice of education was, to see what the situation regarding the primary education of girls was in each of the countries and what differences existed in the education of the two genders, to find out the unique solutions each country had found for their own educational system that turn to their countrys own specific challenges, to see the role that nationalism and religion played in the primary education of students in each of the countries, and finally to come to the prideful finale of the purpose of primary education in each of the countries, to use that information to help me better understand primary education, and to compare these findings to the purpose of primary education in the United States. In my project today I plan to lay out seven aspects of primary education, explain how each of these aspects is carried out in the four countries we visited, and then to speak about how each aspect influences the cultures of Turkey, Morocco, Egypt, and Greece.

Primary Education in Turkey, Morocco, Egypt, Greece, and the United States :: Essays Papers

Primary Education in Turkey, Morocco, Egypt, Greece, and the United States Throughout this program I have been confronted with many realizes and facts astir(predicate) primary breeding that I will not soon forget. The sounds of young Turkish children reciting I am a Turk, I am strong the image of six year olds in Morocco learning to memorize the Quran before they can read or write the idea of community schools in Egypt where students and parents learn together to benefit and bring prosperity to the community as a whole and, finally, the idea that art is so important to Greek culture that it is one of the quintuplet major goals of primary education. These are all interesting things, they are all things I never would have expected to learn through this program, and they have make this topic and project more meaningful for me. I chose the topic of primary education not only because I am studying to be a teacher, but also because there are a lot of controversies and new ideas that a re coming into American education currently, particularly the acts and ideas of No Child go away Behind, and I was curious to research how other countries were dealing with the same issues that we see in the educational system of the United States. I started my learning plan with the goals of eyesight how primary education was structured in each of the countries we were visiting (Turkey, Morocco, Egypt, and Greece) both theoretically as well as how effective the actual practice of education was, to see what the situation regarding the primary education of girls was in each of the countries and what differences existed in the education of the two genders, to find out the unique solutions each country had strand for their own educational system that addressed their countrys own specific challenges, to see the role that nationalism and religion played in the primary education of students in each of the countries, and finally to come to the grand finale of the purpose of primary educ ation in each of the countries, to use that information to help me better record primary education, and to compare these findings to the purpose of primary education in the United States. In my project today I plan to lay out septette aspects of primary education, explain how each of these aspects is carried out in the four countries we visited, and then to speak about how each aspect influences the cultures of Turkey, Morocco, Egypt, and Greece.

Meaning to Human Life Essay

Is there any meaning to human life? After listening to the first two lectures I gather what I felt to be Professor Amrbosios definitions of the hero and the saint. I took notes and after going back through and reading them it helped me to put a a couple of(prenominal) things together. He asks the question about whether or not human existence is meaningful or absurd. We live in a hostile and deadly environment so we try to find our purpose and meaning so we have some sense of security. It is a defense mechanism. Why is there so more evil in this world? We have the good and the bad.The good being our loving parents and the soldiers who put their lives at risk to defend our freedom and our lives. But hence you have the bad and the evil such as the homeless wad and the terrorist attacks and the holocaust. It is unfair how there are so many people with nothing and animated on the streets when there are just as many people who have much more then they need to survive.The hero and th e saint even off traits that can and will be inherited and passed on across different cultures and over time. The hero and the saint are metaphors that humans have used to inquisition for the meaning of life. With the hero, reality is formed and driven by the struggle of humans.They believe in honor and self-esteem along with self-fulfillment and admiration. They always run up against bad things and they believe the good guys will come in last. The Saint believes that reality is made up of our personal and loving relationships. These relationships are based more or less unconditional trust. They feel like humans really have no goal but they have a purpose. Love and gratitude define them. Some people say life is a wrong turn and its down a dead end street.Saints and heroes show us ways we can handle and participate in living every day and still asking our questions about life. The best we can do is to live the most meaningful life. realise every day count and always tell the one s you love how much you love them because you never know when it could be the last time that you are equal to(p) to tell them. Sometimes you just have to trust that our life has a purpose.

Example of Leadership Essay

From the Forbes article Leadership Lessons from Admiral Michelle Howard, The Highest Ranking Woman in marine History, written by Kathryn Dill, tells the history of the four-star admiral and Vice Chief of Naval Operations, the second highest position in the Navy, Michelle Howard and how she became the first American woman to get hold this position. It is all about her leadership. The first aspect that she points out is about innovation. She takes the example of outside companies and does not have fear to make changes. She says Theres cracking ideas out thereits having the courage to go ask people about what theyre doing thats different, and saying, I wonder how I could apply that to my organization. It is of the essence(p) to all organizations keep changing.She has an envision of the future and because of her way to manage her team, it will be always better, by experimenting and learning from those changes. Moreover, she encourages creativity and creates an environment where emplo yees can jar against personal goals and theyll strive that much harder for the professional ones. It is clear that she wants everyone to share the same vision and seek their goals, even the professional or the personal ones. Doing this, she encourages their hearts link their lives purposes. At last, she is a great example for her co-workers. She is a great leader who behaves and work in a consistent way. Furthermore, she is strong and brave. Someone who people could trust. cut back CitedDill, Kathryn. Leadership Lessons From Admiral Michelle Howard, The Highest RankingWoman In Naval History. Forbes. Forbes Magazine, 1 July 2014. Web. 23July 2014. <http//www.forbes.com/sites/kathryndill/2014/07/01/leadership-lessons-from-admiral-michelle-howard-the-highest-ranking-woman-in-naval-history/&

Administration of a Staffing System

The type of staffing organization can vary greatly from one company to another. How the staffing occasion is structured depends on the companys size, type, strategy, budget, and staffing needs. In small organizations, all staffing may be handled by the owner or general manager. In mid-sized organizations, one or more than HR generalists may be responsible for handling staffing along with a variety of HR duties. In large organizations, complex staffing departments with dedicated professionals may be created to handle extensive staffing needs.Other primaeval decisions include the option of having a centralized or decentralized staffing function (discussed previously in this course) or whether to source some or all staffing functions. The establishment of written policies and procedures to manage the staffing system is extremely important in the process. Established guidelines help to keep the staffing system in operation(p) according to the staffing strategy. When there are clear, consistent policies and procedures to follow, the intent of the staffing function is clear.This keeps everyone playing by the same rules with the same focus in mind. The selection, implementation, and administration of staffing system applied science is another important aspect. There are many types of technology available to help make the staffing function more efficient and effective. The careful consideration of staffing cogitate technology can help ease the administrative burden of this HR function. The decision to outsource some or all staffing functions, and the management of the outsourced functions is a key factor in staffing.Outsourcing some or all staffing related functions may be appropriate for some organizations. It can be a good business decision, but must be managed properly to ensure that the goals of the organization are met and the quality of staffing is maintained. Recordkeeping and reporting, auditing, addressing privacy and other legal concerns regarding sta ffing is important. One of the more or less overlooked, but most important, areas within staffing involves proper and efficient recordkeeping and reporting of activities.

Hamlet and Horatio Best Friends for Life: an Analysis of Hamlet

3 November 2009 settlement and Horatio Best Friends for Life an Analysis of Hamlet In Hamlet, two characters I believe to be important atomic number 18 Hamlet and his friend, Horatio. Horatio is the second most important character in the play. Horatio is Hamlets best friend and advisor. Horatio never keeps anything from Hamlet. In exemplify unrivaled, scene nonpareil Horatio, Bernardo, and Marcellus see the ghost of king Hamlet who was killed by his brother, Claudius. After the ghost disappears, Horatio tells Marcellus and Bernardo to reveal to Hamlet what they have seen. Let us impart what we have seen tonight Unto young Hamlet for upon my life, This spirit, dumb to us, will speak to him. (Act 1, Scene 1). Hamlet reveals to Horatio what the spirit reveled to him about Claudius. But know, thou noble youth, The serpent that did sting thy comes life Now wears his crown. (Act 1, scene 5). Horatio tells no one, of what Hamlet has told him, and he plays along with Hamlets idea of pretending to be mad or insane. I believe this exhibits that Hamlet trusts Horatio more than the other characters. I believe that Hamlet can go to Horatio for anything. There is a play tonight forrader the king. One scene of it comes near the circumstance Which I have told thee of my fathers death. I prithee, when thou seest that act afoot, Even with the very comment of thy person Observe my uncle. (Act 3, Scene 2). I believe that Horatio is able to understand Hamlet better than the other characters do. In Act five, scene two, Hamlet tells Horatio to tell his stratum to everyone. The only reason that Hamlet would tell Horatio this is if he was the only one left that could tell his story, and because Horatio is his friend.Let us face it, if we were on our deathbed, would we not indispensability our best friend to tell our story? In Act one, scene two, we spawn a glimpse of Hamlets resentment over his pay backs marriage, to his uncle, which follow hard upon the funeral of his father. Within a month, Ere yet the sale of most un properlyeous tears Had left the flushing in her galled eyes She married. O most wicked speed, to post With such dexterity to incestuous sheets It is not, nor it cannot come to good. But break, my heart, for I must hold my tongue. ( Act 1, Scene 2).In Act two, Scene one, we see a hint of Hamlets love for Ophelia. In Act two, scene two, Hamlet doubts the spirit of his father, and thinks that his father could be sexual relation the truth or telling a lie. He is not quite sure which is truth and which is false. We see that Hamlet has many questions as to what he could do to see if the ghost is telling the truth. He decides to put on a play with a scene that he has added. In Act three, scene one, we get a peek of how he seems to know everything. Let the doors be shut upon him Polonius, that he may play the fool nowhere but ins own house.Farewell. In this Act, he says things to Ophelia that I believe he does not mean, such as, Get the e to a nunnery. I believe he is saying what he says for the benefit of Polonius, Ophelias father. Polonius believes that Hamlet is mad, or insane. Your noble son is mad. Hamlet is abhorrent toward Claudius because Claudius killed his father. In act three, scene four we see Hamlets reluctance to kill his uncle, but this time he is unwilling to kill Claudius because he is praying or that is what it seems like to Hamlet.Let us face it, who in their right mind would kill someone while they are praying? However, I believe that Hamlet should have killed Claudius in this scene because if he did then the other characters that go past would not have died and his fathers spirit would be able to rest in peace. At the end of Act three, Hamlet kills Polonius believing him to be Claudius. I took thee for thy better. It was so easy for Hamlet to kill Polonius because he believed him to be Claudius. Hamlet then hides the body because he does not want anyone to know what he has done, or maybe he hides the body ecause he wants people to believe that he is insane. At the end of the play, Hamlet forces Claudius to drink from a cup of poisonous substance thus killing him. Horatio knowing that Hamlet was dying decides to drink from the cup so he would not be alone, but Hamlet stops him. Hamlet then tells Horatio to tell his story to the world. Hamlet also dies from the same poison. Throughout the play, Hamlet has been at war with Claudius because Claudius killed his father and then married his mother. At the same time, he is at a constant battle with his feelings.He asks questions that are difficult to answer or even understand, but he always comes up with an answer. Horatios part in the play is the second important part. Without Horatio, I believe that Hamlet would have killed himself, because he would not have any one to share his burden of killing his uncle. Horatio keeps helping Hamlet every chance he gets. Horatio also tries to take poison because Hamlet is dying if this is not unbowed friendship then I do not know what is. Shakspers Hamlet

The world is not really there

As though the quantum physicists would ever agree There is world out here, and global thaw portends its end. Thats the truth of it entirely, really, the world was never actually in that respect, Speak the quantum physicists once again. But there is something here, Answer people same(p) Al board who take c be to notice things in the void. Indeed, they are positive that it is possible to compositionage the problem. They add The point remains that the cause of global melting Would be utterly portentous if all those who are bumming With the climate do not struggle to control anthropogenic colorhouse Gas emissions.After all, human race beings are partly, if not exclusively responsible For climate change. So, some whiz from an LDC hears Al Gore in his Movie, An Inconvenient Truth. A bomb explodes as the bomber shows his Approval skillful an LDC beach. Al Gore continues, Fortunately, it lies In their power to gradually reverse the effects of global calefacient. So, what is global heat? There is no doubt about the fact that our world Has been warming up like a teenager in warming Trying to shape up up with ways to become fit for survival. Eleven out of the retiring(a) twelve years, that is, the Bible Fighters clipping with the Quran fighters in separate words, 995 to 2006 progress to been ranked among the twelve warmest years Since 1850 ( spherical environmental Outlook 4 Environment for increase). Humans did not take for systematic records of temperature Before 1850 (Global environmental Outlook 4). How could they when they are still so helpless? How could you imagine them To keep systematic records of temperature before 1850? In any case, scientists are confident that there is something Terribly wrong with almost e genuinelything done by humans, including Their contribution to the fact that there has been a steady increase Of global surface temperature between 1995 and 2006.The evidence of global warming let ins the shrinking of or fading a way Of beautiful things like mountain glaciers in many parts of the world Thawing of permafrost the early breakup of lake as well as river ice Lengthening of growing seasons (especially mid(prenominal) to high latitude) Shifting of animal, insect and plant ranges early flowering of trees Early emergence of insects and egg laying of birds Changes in ocean currents as well as patterns of precipitation And the increasing lifetimes and intensities of tropical storms In several regions of the globe (Climate Change 2007 The Physical Science Basics).As though we care Ha The unify Nations, spreading news around the world, Stories they refer to as research For the sound judgments and the eyes of the rich Alone, theoriseing things like the following, as though anybody cares Except to say Ooh and Aah at these shocking tales Seeing that the poorest people of the world are rather dependent On a hospitable as well as changeless climate theyre dependent As always for their crop growing needs as well as gathering Of natural resources before they are snatched or stolen through invasion It is vital to chthonicstand climate change before we try to manage it Pretending that we are able to manage everything, we testament manage it (Global Environmental Outlook 4) The United Nations, our supreme council for research and no practical work Apart from research, adds Poor people are reliant on the monsoon seasons and us As you know, climate change is about to turn their lives around. Moreover, it is the poorest people of the world around Whom all our concerns rest at this time because these people Are most vulnerable to the destruction caused by natural disasters.The Asian tsunami provides evidence of this phenomenon As do bombs because they heat up things, including our minds, as no one Disagrees. Increase in drought frequency in Africa is another reason Why policymakers around the globe must consider decisions That would have a long-term impact on humanity once they fi nd The time to consider such decisions, of course they must then bind Governments in contracts to concentrate natural gas emissions knowing their contracts Exist only on papers with paper pins neatly making stacks of their contracts (Global Environmental Outlook 4). The United Nations expresses deep concern in its voice as it continues Other examples of destruction caused by climate change To the poor communities in particular who else? include The effects of Katrina in the United States and that long, crude Heat wave that was experienced by Europeans in 2003. As these examples reveal, poor people in rich societies are in any case vulnerable to the devastating Effects of global warming the rich people need not worry (Global Environmental Outlook 4) In war-torn Iraq A man is sipping tea in war-torn Iraq. Flimsy pages of his newspaper, Iraq Today, fly here and there as they stay put Nevertheless in his lap and input From the pages enters his mind as slowly As memories of the bon y lass slowlyLeave his mind memories that had tormented Him ever since the Iraq War began. Kid, She is gone, she left hand with the soldiers of the United States, The landlord of her flat had informed him. So now the man hates Everything he hears from the country where the bony lass resides. Still, out of necessity, he listens to those pages, presides Over them as though he would do something about the news on those pages If only pretend he would do something about the news on those pages. As his tea cools under those fans that dont really help him feel cooler In the head where suppressed anger and worry due to the vast dollar rustics actions stay, he chances upon a piece of news that suddenly Interests him although he did not really care whether it was hot or cold. Global warming, says the piece. A issue of the United Nations Environment Programme, Global Environmental Outlook 4, states That the effects of global warming would vary across the globe. According to the report While the Earths climate has varied throughout the prehistoric ages, the last few decades have witnessed a global climate disruption that is unprecedented over the recent millennia, a period of relative climatic stability during which civilization emerged.Some regions, particularly the Arctic, bequeath be more affected by climate change than others encompassing(prenominal) to the equator. In many regions, the agricultural sector will be particularly affected. The combination of high temperatures and decreased soil moisture projected for parts of Africa will be particularly hard to adapt to. (Global Environmental Outlook 4) I think this is what the visionary (Peace be upon him) had told us about, The man in Iraq reflects on the warning of the United Nations. He continues Reading the news report Global Environmental Outlook 4 Also describes the main responsibility that human beings must assume For global warming that, in fact, humans have placed great pressure on the Climate system with increasing anthropogenic greenhouse gas emissions. The greenhouse gas that is mainly responsible for climate change appears To be carbon dioxide, primarily originating from the consumption of Fossil fuels (Global Environmental Outlook 4). The UNEP report Further describes the environmental damage caused by humans While they were ignorant of the dangers of global warming Since the dawn of the industrial age, the concentrations of these gases have been steadily increasing in the atmosphere.The unprecedented recent rise has resulted in a current level of 380 parts per million, much higher than the pre-industrial (18th century) level of 280 ppm. Since 1987, one-year global emissions of carbon dioxide from fossil fuel combustion have risen by about one-third, and the present per capita emissions clearly illustrate large differences among regions. (Global Environmental Outlook 4) So now he understands, the man sipping tea Everything in this report describes the fee For occupying this wo rld. Moreover, it is as the Prophet (Peace be upon him) had described. It is the call of the Prophet For us to mend our ways once and for all. God is going to take account. But who is listening? Does anybody care? The man folds the account On global warming on one of the flying sheets of newspaper, Iraq Today. He decides to return home when he gets an idea, straight out of Iraq Today. He thinks Overly excited about their achievements during And after the sumptuous industrial Age, human beings did not realize That materialism and greed could even be responsible for ending Their live onence on Earth in the near future.Indeed, if climate change Is not managed through effective global policies at present, huge natural Disasters may very well finish off all life on our planet. As it is, global warming is accompanied by spells of really high temperatures That are known to destroy life through heat stress in addition to air pollution. In June 2003, Europe experienced such a spell. It ra ised temperatures Twenty to thirty pct higher than the ordinary temperatures during summer. What is more, the spell covered a huge portion of the European continent, From Germany to Italy, and from the north of Spain to Czech Republic. With social as well as economic impacts, besides its environmental impacts, The heat wave presented heavy losses to the European continent. In point of fact, thirty thousand European people lost their lives during June 2003. Forestry and agricultural production were impair forests were burned Crop cycles were disrupted nuclear reactors cooled by water from rivers Had to be closed demand for electricity could not be met And the stability of rocks was affected (Impacts of summer 2003 Heat Wave in Europe). Once they know what we go through each hour, each day They would surely become one of us, one of clay People. As he ends reflecting on climate change, heRemembers another similarity between man and man Hadnt God said, We made man out of clay? He t ries to figure out in his mind whether fire can damage clay, But then another worry enters his mind Do the industrialists Also know, We made man out of clay? In Europe The man in Iraq was happy to know that Europe had experienced significant development during the Industrial Age, Although it did not have any power over the heat wave of 2003. A construction worker in Germany, on the other hand, Understood it this way he thought It is evident that the European Union Would now play an important role in reducing greenhouse gas emissions. The heat wave of 2003 served as a warning for the entire continent To begin taking serious action against greenhouse gas emissions, While enjoying the fruits of the Industrial Age even in the twenty first century (Impacts of Summer 2003 Heat Wave). Even though he was optimistic, the construction worker Believed that he knew that politicians only tell lies to the People, the voice of the people is never heard, and democracy Is a sham. As he thought abo ut politicians suffering from all sorts Of amnesias, another fact was brought to mind simultaneously The construction worker felt delighted in the misery of othersWhen he remembered he had read somewhere that As bad as the European heat wave of 2003 was, There is no way for it to compete with the ascending average Temperatures in the Arctic. In fact, temperatures in the Arctic Are rising almost twice as rapidly as in the rest of the world (Global Environmental Outlook 4). Sea ice and glaciers in the Arctic are presently melting, While the permafrost temperatures are rising. In Siberia and Alaska, permafrost is also melting. This is expected to release methane into the Earths atmosphere From the frozen hydrates. Scientists are alive(predicate) that fiftyMillion years back, a large amount of methane was released Into the Earths atmosphere. Temperatures around that time Must have risen approximately tail fin to seven Celsius. Additionally, scientists have determined that it took app roximately One hundred and forty thousand years for the atmosphere To return to its normal state after the initial release of methane (Global Environmental Outlook 4). Perhaps, therefore reflected the construction worker The effects of global warming would remain with us For a very long period of time. Our future generations Would have to suffer because of the excessive greenhouse Gas emissions that our generation has been held responsible for. Other effects of global warming include increased changes In precipitation around the world. While wet regions are experiencing More rain, the dry areas of our world are turning more arid than before. In addition, regions like Africa with the lowest contribution to anthropogenic greenhouse gas Emissions are projected to suffer most due to these changes (Global Environmental Outlook 4). As a matter of fact, water scarcity is projected to become a dangerous Problem for the African people in the days to come (Global Environmental Outlook 4). G lobal warming is also increasing intense tropical cyclone activity, Especially in the North Atlantic (Global Environmental Outlook 4).This has been going on since 1970, and is definitely associated With increases in the surface temperatures of tropical seas. Furthermore, there is evidence of increased tropical cyclone activity In certain regions of the world where it is difficult to gather high quality data. In any case, over the past thirty five years the number of layer 4 and 5 High intense storms has almost doubled. These storms are now occurring In virtually all ocean basins. Of a certainty, our world would warm up Even more because of this activity in the deep (Global Environmental Outlook 4). As the construction reflected on the meaning of global warming For everybody in the world, the only person he thought was Insulated from its disastrous effects was himself. His family, too, Would be saved, he thought, smirking in his minds eye when those miserable two Arctic and Africa were remembered. He had to earn his daily Bread, after all. It did not really concern him that the people Of Africa suffered. He believed that the politicians with free Cups of coffee and bowls of rice unattached to them should doAll the thinking for the poor people of the world. He was lucky To be German, thats all. What concerned him about global warming was this Indeed, there exist a number of paths for us to take to help Ourselves and our fellow beings survive on the planet. As an example, with the awareness that our buildings consume Almost thirty to forty percent of energy in our world Another UNEP report, Buildings and Climate Change Status, Challenges and Opportunities, advises governments Around the world to put policies into place for the construction Of environmentally friendly or green buildings that would notExacerbate the effects of global warming. There are a variety Of choices available to modern man to use energy more expeditiously than before (Buildings and Cli mate Change). Would Herr Braun consider the alternatives? he asked Himself. After all, he was only a servant. Had he asked Herr Braun, would the latter have answered his loyal crook worker? Maybe, maybe not. The royal Herr Braun was unreachable most of the time. But the construction workers fifty-seven year old wife Should be able to guess and inform him. She was good At divining things. She would know about global warming.

Back to the Dream Time

NORTHERN UNIVERSITY OF MALAYSIA COLLEGE OF LAW, GOVERNMENT AND INTERNATIONAL STUDIES SBLE 1043(GROUP D4) TITLE BACK TO THE DREAMTIME subscriber MADAM HAZNUR NADIN BINTI HASSAN PREPARED BY TEOH BOON KHAI (219673) The two main characters in the novel Back To The Dreamtime were Richard and tomcat. This novel is talking about how a boy bring to pass the mission that given by his father who had died when he was two forms old and how a family maintain their relationship although Richard is adopted by McDonald. Richard Oenpelli McDonald was a smart, sane and filial piety boy.He has a sibling which is Judy and Tom. His mother named Sonya and his father, Oenpelli, tribal name, was died when he was two years old. He was adopted by the Joe McDonalds. However, his parents had hidden him about his mise en scene and heritage. Although Richard was Aborigines, he lived in city since he was a kid. He study in Univer dumbfoundy Of Sydney which is same with his brother, Tom. Richard was elicit i n History and he intention to wee this course in the university. Tom is Richards brother however Tom is a white man and Richard is Aborigines.Tom study in the same university with Richard which is University Of Sydney. Tom was aged than Richard exactly two month. Tom was interested in photography and he may continue his study in photography. He found it very interesting and its not usual nine to five job. The relationship this two main character was good. They went to school to school together everyday. Besides that, they used to sit and chi-chat beside the railway tracks every morning before going to school. Besides that, Richard, Tom and their sister, Judy were playing cricket in their house backyard.It was their favourite pastime on the weekend. During the carve up time in school, they and their friend, Bradley used to left the school grounds secretly to go to their favourite place at cliff. Moreover, Richard and Tom decided joined the years senior class camp which location at Alice Springs with a friend who named Bradley. The years camp was taking five days in Alice Springs. Tom volunteer himself to go to Alice Springs with Richard. The purpose they went there is to burn the tjuruga in Richards father burying ground at Uluru. At the end, they succeeded to find the burial ground and buried the tjurunga.During the trip, it had drained them physically and emotionally and they experienced it together. They helped each other during the trip. In the conclusion, I feel that the way they maintain their relationship among Richard, Tom and their family is what we have to learn. Although they dont have any relation in scientific prove, they still very respect and love each other. Nevertheless, they treat their family members very well and take care of each other. They can stay peaceful among each other. This kind of spirit and moral value is what we have to learn from.

Southwest’s Competititve Advantage

STRATEGY IMPLEMENTATION AND MEASUREMENT METRICS ASSIGNMENT-1 SOUTHWEST AIRLINES CASE STUDY QUESTIONS 1. How does southwestern United States Airlines get its warlike advantage? 2. How does southwesterly Airlines execute its strategy? 1. How does southwestern United States Airlines get its competitive advantage? south-west Airlines uses a Cost Leadership Strategy, however most determine strategists would agree that having a execrable price does not, in itself, constitute a competitive advantage. In fact, thinking that low prices are always a sober strategy for competition is deeply misguided.However, at times, targeting low prices can lead to a strategic instruction which delivers tremendous results. Modern competitive strategy go forth often examine firms from a resource-based view. According to this lens, competitive advantage derives from leveraging an inimi tabular array resource to deliver jimmy at a lower terms than the competitors. Price is a completely imitable reso urce. Any company can match the prices of its competitor if it so chooses. Hence, arguing that a low price is a strategic resource, or that it leads to a competitive advantage in and of itself, is illogical. southwestern Airlines has used the target pricing and utilized a marketing orientation since its infancy in 1971, regular(a) though these concepts were not fully defined back then. First, starting with the customers and the value they sought, Southwest Airlines initial target was customers traveling between cities in Texas, specific all(prenominal)y between Dallas and Houston, Dallas and San Antonio, San Antonio and Houston. While Texas is larger than many countries, it isnt so large that people cant drive from city to city.Hence initially, the most comparable alternative to Southwest, and so its prime competition, wasnt other airlines. Instead, it was the car. In uncovering the car as the competing alternative, Southwest was able to also identify the target price of its wid ening. Second, to compete with the car, Southwest Airlines had to price their service relatively similar to the cost of car travel. With this target in mind, they chose $20. While $20 is lower than the government allowable tax certainty for travel, it is also significantly higher than the price of gas alone to drive between these cities.Thus, at this $20 price, Southwest Airlines could be confident that it would capture many of the travelers that would have driven and convert them into short-hop air travelers. Third, the product was redefined to serve customers at this low price profitably. Consider what was removed from air travel and what was included instead. The table downstairs enumerates the key academic degrees Points 1 Removed Reduced reservations flexibility Reservations primarily make directly Southwest Airlines as they eschewed working with travel agents.No connections between airlines Southwest Airlines would not transfer baggage between flights. Included or Added Sim plicity in Pricing Flat rate of $20 per leg of the journey. Also trim down the cost of price management, as no yield management system was needed initially. Higher convenience in terms of on-time arrivals With a simplified fight down route between lesser used airports, Southwest was able to operate more reliably. Higher convenience in flight frequency With slur to point flights, Southwest could offer service between Houston and Dallas with the same plane roughly e really 2. hours. 2 3 No long-haul flights Southwest Airlines customers could only take Southwest between a city-pair, not across the country or even across state lines initially. This greatly reduced cost of compliance with CAB rulings, as Southwests operations were not subject to interstate commerce rulings. 4 No in-flight meals Southwest Airlines only offered peanuts and beverages. Fun Friendly flight attendants provided jokes, costumes, and made flying comfortable with warm and caring service. Faster boarding times l eading to faster flight turnarounds.More seats With one mark of service, Southwest Airlines could designate 137 seats in a 737 versus 128 in a United Airlines 737. 5 6 No seat assignments First come, first seated. No first class One-class service. 7 Does not fly into major airports or uses Use of underutilized airports that are less major airports concentrates on point close to metropolitan cities reduced to point connections costs, punctuality Use of multiple aircraft types Frequent flyer program does not use miles earned Uses fuel efficient 737s reduces maintenance and training costs found on number of trips flown reduced operating costs 9 From this list, we see a number of items which an airline would usually use to define superior value removed from Southwest Airlines offer. A Southwest customer couldnt be treated to first class, couldnt get food, couldnt book them as vary of a larger trip, couldnt book with them by an agent, and couldnt even preselect their seat. All of th ese features were exactly what defined a competitive airline at the time. And, all of these features added cost.Instead, Southwest Airlines selected a specific target customer a Texan traveling between cities in Texas and then determined what it would take to satisfy that customer. ? ? ? That customer was far more interested in travel efficiency than travel class. That customer would be glad to forgo a meal, especially in turn for a friendly flight attendant and a Dr. Pepper. That customer was trading off driving for flying, and needed flexibility in booking rather than navigating through the decisions and planning related to yield management.This service describe does not meet the wants of every customer that could have flown Southwest Airlines, merely it does describe those of the target customer. And, inclined the choice of mediocrely satisfying everyone at a high cost or highly satisfying a select few at a low but profitable price, Southwest Airlines rightly chose the latte r. As a result of tightly defining the value sought by customers (efficient and flexible travel), and the price ($20), Southwest was able to meet the needs and surpass the expectations of their target customer.Moreover, it was able to do this at a significantly lower cost than a standard airline. So can low prices deliver a competitive advantage? NO, not alone. But target pricing, where the price and benefits demanded by customer leads to a strategic focus that drives a re exposition of the product and service, can deliver a winning competitive advantage. One where a customer need is met at a cost below the price the target market is willing to pay. BALANCED SCORECARD FOR SWA 2. How does Southwest Airlines execute its strategy?Southwest Airlines is probably one of the most striking examples of a company that (a) Defined a very clear and simple key backup purpose, (b) Chose the right business modeling to support the business purpose, and (c) Consistently demonstrates the ticker va lues and behaviors derived from that key business purpose. The brand promise of Southwest Airlines is Dedication to the highest quality of Customer Service delivered with a sense of warmth, friendliness, individual pride, and Company Spirit.Every mavin employee of the company is aligned with this brand promise and in spite of the current economic turmoil in the airline industrySouthwests performance isamong the best in the industry. supply morale is exceptionally high. In 1971, Rollin King and Herb Kelleher started an airline service with one simple notion If you get your passengers to their destinations when they want to get there, on time, at the worst possible fares, and make darn sure they have a good time doing it, people will fly your airline.Southwest currently has the lowest operating-cost structure in the US domestic airline industry and consistently offers the lowest and most of all simplest fares. Southwest holds the best cumulative customer contentment record for the past 18 years. In December 2008, the airline had 35,499 employees and generated total operating revenues of $11 billion (2007 = $ 9. 8 billion, 2001 = $ 5. 3 billion) from a passenger committal factor of 71. 2% with a fleet of 537 Boeing 737s.Its stock exchange symbol is LUV, representing Southwests home at Dallas Love Field, as well as the theme of its employee and customer dealingships. The major success to their continued success seems due to their low-cost model and competitors being aware that they cannot match Southwest Airlines low prices. Southwest Airlines has the reputation of being able to force a competitor into bankruptcy. It is believed, however, that it was not simply the choice of its business model that made Southwest Airlines such(prenominal) a successful company it is the way they execute their business model through perfect strategic alignment.Southwest Airlines succeeded in defining a very simple however clear key business purpose the fact that they aim for being the only short haul, low fare, high frequency, point-to-point carrier in America leaves very little room for interpretation. What makes Southwest Airlines key business purpose such a powerful one however, is not just the very clear definition of their raison d etre, but certainly also what the company and its leaders do with it.Their simple but effective key business purpose is the main guiding principle for Southwest Airlines strategic goals, business strategy, organizational infrastructure, and last but certainly not least their company culture. The organization of Southwest Airlines is best described as an upside-down pyramid an organization very much in line with the way they want to do business. The upper management is at the sound and supports the front line employees, who are the experts.Front line employees play a major role in the yearly business planning and operational budget which for a great part is done bottom-up rather than top-down. This is the fruit of c o-founder Herb Kellehers unorthodox leadership style, in which management decisions are made by everyone in the organization, not just the head executives. The company does not put much emphasis on structure instead, employees are encouraged to think freely without constraints such as titles or official mandates. The reason for Southwest Airlines success is due to their clear key business purpose and aggregate values, and due to the way in hich they consistently execute their business model (a combination of disruptive innovation and customer intimacy) in line with their key business purpose and core values. ? ? ? The Southwest Airlines fleet consists solely of Boeing 737s It offers only economy seats (there is no business or first class). Southwest Airlines also do not offer in-flight meals, only peanuts and other snacks. Southwest is simple and direct at the goal of their service A primarily short-haul airline that flies directly from city to city, with just one type of plane th e Boeing 737 and the lowest costs.With a simple goal, Southwest has excised many of the luxuries that competitors offer, such as luxury seats this is made diaphanous by their decision to enforce a rule for passengers who cannot fit into the seats to purchase an additional seat. This rather unpopular move whereas other airlines would have suggested a more luxury class seat is simple in its purpose get passengers from point A to point B with a minimum of frills, but with a friendly smile and great personal service.While Southwest Airlines offer no frills, they do meet and exceed customer expectations when it comes to personal service. They base their model on the motto If employees are happy, satisfied, dedicated, and energetic, theyll take real good care of the customers. When the customers are happy, they come back. And that makes the shareholders happy. Southwest invests in very good relations with all their employees. Employees are either of independent labor unions or have f lexible contracts which allow employees to work longer hours (adapting the business model to the key business purpose)

Role of Nurses in Gestational Diabetes

The role of nurses in gestational diabetes. (DIABETES CARE)(Brief Article) Journal of Diabetes Nursing May 1, 2003 Assignment 2 Research studies, recently conducted in America, learn found that victuals and exercise play an important role in predisposing a woman for gestational diabetes (GD). This study comp ared the deem of insulin intercession and perinatal outcome in women with gestational diabetes under endocrinologist-based versus diabetes nurse-based metabolic management. A total of 244 participants received endocrinologist-based care and 283 participants received diabetes nurse-based care.A retrospective analysis was carried out comparing maternal characteristics, rate of insulin treatment and perinatal insulin requirements, in comparison with those who had used diet and exercise as a arbitrary factor for their diabetes. Pregnancy imposes a great amount of stress on most bodily functions and it is received that glucose metabolism is no exception. gestational Diabetes M ellitus is a type of diabetes, which occurs during pregnancy, distinct from the condition that already existed.It is defined as a glucose intolerance of variable degrees with onset or first recognition during pregnancy it will broadly develop in the latter half of the pregnancy and will improve after address (Colman, 2004). Gestational Diabetes is generally not dangerous to either mother or fetus. The disease itself is usually mild and change surface asymptotic however there is an increased incidence of foetal and perinatal complications (Guthrie & Guthrie, 2004). In addition, if an overweening amount of sugar is allowed to circulate in the mothers demarcation and then to enter the fetal circulation, potential problems for both mother and baby are serious.The mothers pancreas works extra time to produce insulin, but it is not enough to lower blood sugar levels. Glucose will then blow the placental barrier, increase work on the pancreas of the fetus, which uses insulin to co nvert the glucose into energy. The baby has more energy than is required so it converts this energy into fat stores, leave al staring in large birth weight babies and all the problems that apprize be associated with that (http//diabetes. org). At each visit to the doctor a sample of weewee is taken, this is then tested for glucose levels.Sugar in the piddle may be the first indications of Gestational Diabetes. Also, during the fifth month a glucose tolerance test is nowadays a minute test for pregnant women. A Glucose Tolerance Test is when the women provide a blood sample taken before and after consuming a glucose drink, glucose levels >9. 0mmol/l indicate Gestational Diabetes is model. even this may be performed earlier on someone who is considered as being at risk (Colman, 2004). The incidence of gestational Diabetes has increased a signifi guttert amount, among35% and 59%, over the past ten years (http//diabetes. rg). Studies wear found that the figures have shown an alarming incline in the amount of women being diagnosed with this gestational Diabetes. It is now believed that in the midst of 2 and 12% of pregnant women suffer from Gestational Diabetes (Guthrie & Guthrie, 2002). Testing has now become routine for pregnant mothers, so it is being discovered earlier in the pregnancy and as a result is now being treated much sooner. Because of this routine testing the chance of miscarriage and perinatal deviation has been greatly reduced.The survival rate of these infants has increased from less than 70% a few years ago to nearly 98% now, a figure which has only come about through care specializing in diabetes in pregnancy, routine testing of all pregnant women and the best care available (Guthrie & Guthrie, 2002). make up though gestational Diabetes is now being discovered more often and being medically entertainled a woman who has had Gestational Diabetes will have a much high schooler chance of developing diabetes afterward in lif e.If insulin was required as treatment, there is a 50% chance of diabetes within 5years, and even if the diabetes was dietetic controlled there is still a 60% chance of developing diabetes within 10-15 years (Australian Bureau of Statistics, 2007-08). With these alarming figures it is obvious that further checking of the treatment and control of gestational diabetes is necessary. From the whole number of applicants, exploreers then river basin participants into stratified samples containing those who were at risk for gestational Diabetes and those who had no known predisposing factors.Each of these strata was then further divided into halves, with one half continuing their usual daily activities and progress through the pregnancy with current medical help available. The other half of the group was required to stick to a strict regime of wellnessy diet and exercising at least once a week, more if they wish. There was an initial interview conducted between the 6-12 week period of pregnancy, during the first trimester, to come across that the required teaching is collected and any information can be supplied and ensure that is understood.The interview incorporated data from the year prior to conception and continued until 2 months following the births of the children. All participants were required to test daily their Blood Glucose Level (BGL) and withal test their urine for sugar and record their findings. While there would be an occasional increase in glucose levels during pregnancy, persistently high levels would indicate Gestational Diabetes and a Glucose Tolerance Test was conducted. Weekly follow ups were conducted to ensure all information was recorded accurately, and also permitted time for the participant to discuss any concerns that had arisen.However pregnancy requires a number of checkups, increasing towards the later trimester, so data was also collected through the ante natal clinics. After delivery another Glucose Tolerance Test was performe d to evaluate for preexisting Diabetes and it also allowed time for any complications for the newborn to arise. For the usage of this study I feel that a larger number would be required to make sure that there would be women who are at risk, have had gestational diabetes and have never suffered from this condition before, and would also allow for the inevitable elimination of some of the participants.This was a quantitative research process, there was a request to interview, assess and gather personal information on the study participants. Some participants may deem this an encroachment of privacy. To ensure that no emotional or psychological damage occurs to the participants it would be extremely important to ensure that there would be the strictest confidentiality with the information provided and that it would only be shared with those who require the data.The aim of this research is to understand whether gestational Diabetes can be avoided all together, or whether it can be t reated more effectively, providing a better health outcome for the fetus and mother. By providing conclusions, which benefit society, the principle of Beneficence can be achieved (Roberts and Taylor, 2002). An even more critical consideration is the health and well being of the participants. All women are naturally concerned that their baby will be healthy and normal a researcher must be able to ensure that no harm will come to the mother or child.The principle of non-malfeasance, makes definite that no injury will occur to either mother or fetus, that the participants are not utilise in any way and that the benefit to the community outweighs any risk that may be present (Roberts and Taylor, 2002). At all times, the participants were treated with respect, confidentiality and their physical and mental welfare was maintained. The most important point to believe here is effective communication, the participants understood exactly what was being researched, and they received accurat e information on when, where, how, wherefore and who.They were given education sessions on how to use any of the equipment that had been supplied. The equipment used were Urine dipstick and BGL machine, requiring only a undersize amount of training to make sure they were used properly. As the researcher, it is important to be precise and tripping about this information to ensure that participants show up, on time and at the right place. (Roberts and Taylor, 2002). By incorporating the interviews and research into their ante- natal care visits, which would normally take place the researchers avoided any complications arising from data collection.Participants were required to provide accurate, enlarge and correct information on their experiences for the research to be valid and have any true meanings. This requires a great amount of trust on the researcher behalf. By ensuring that the participants understood the importance of this study, for their own health as well as the wider c ommunity, it would be hoped that the participants would record precise information. For many people, being diagnosed with gestational diabetes can be upsetting. Treatment for gestational diabetes substantially reduces adverse perinatal outcomes and improves maternal quality of life.Optimal proven treatment for gestational diabetes includes review by a diabetes educator, dietitian and physician, with insulin used if glycaemic targets are not achieved with dietary control alone. Screening for gestational diabetes should be offered to all pregnant women. Maternity service providers should ensure that adequate resources are devoted to the detection and treatment of gestational diabetes.References Australian Bureau of Statistics. National Health Survey, 2007-08 http//www. abs. gov. au 10/04/10 Colman, M. 2004, Diabetes and you An owners Manual, Diabetes Australia, Melbourne. Diabetes Australia. Diabetes and Pregnancy, http//diabetes. org/gestational-diabetes 05/04/10 Guthrie, D. A. & Guthrie, R. A. , 2004, Nursing Management of Diabetes Mellitus Fifth Edition, Springer publication Company, New York. Roberts, K. L. & Taylor, B. J. , 2002, Nursing Research Processes An Australian Perspective, 2nd Ed. , Nelson Thomas Learning, Southbank, VIC. The role of nurses in gestational diabetes. DIABETES CARE, Journal of Diabetes Nursing, May 1, 2003

Limb Loss A Major Event Health And Social Care Essay

Amputation could be described as the remotion of a organic building append come along or portion by surgery or injury. If taken as a surgical step, it is utilise to command painful sensation or disease procedure in the affected portion or leg. A individual with an amputation whitethorn exist mutilated, empty and vulnerable. Traumatic amputation is a ruinous tolerate and ofttimes a h centenarian cause of baulk ( Wald 2004 ) . Further more(prenominal)(prenominal) than, reduced self-pride, social isolation, organic social organisation kitchen range jobs, and sense of stigmatisation need anyhow been associated with offshoot loss ( William et al. 2004 ) . In rough commonwealth of affairss, amputation argon ineluc tabularize. Irrespective of the cause, amputation is a mutilating surgery and it make up ones minddly affects the lives of these diligents ( De Godoy et Al. 2002 ) . Amputation of limb is a common thing in this present society.The loss of a limb distorts t he persons organic grammatical construction motion-picture show taking to the idea of non beingness a complete human being. The loss of the procedures performed with that limb renders him helpless for or sotime.Apart from loss of corporeal maps, the amputee besides loses hopes and aspirations for the here subsequently his programs and aspirations jack off shattered. on that pointfore, he loses non moreover a limb scarcely besides a portion of his universe and hereafter. A considerable figure of them remain disquieted and last roughly their interpersonal relationship in the societal, vocational, familial and married surroundings. Those few who affirm an open kind dislocation will necessitate active psychiatrical interpellation. In otherwises in whom the genial symptoms ar non so obvious, a c areful psychiatric interview is necessary to convey to the radical the interior convulsion whichmay un reduceableness aid of a head-shrinker.Limb loss is a major event that can badly continue the psychological wellness of the person concerned. Surveies show that 20-60 % of the amputees go toing determine up clinics are assessed to be clinically depressed. Persons with traumatic amputation irrespective of the age are in all likelihood to endure subsequent troubles with respect to their organic bodily structure watch, but these are bit more dramatic in the younger age groups. The psychological reactions to amputation are clearly diverse runing from terrible deterioration at ace extreme and a finding to efficaciously restart a full and active life at other terminal. In grownups the age at which an person receives the amputation is an of import factor. Surveies by Bradway JK et Al 1984 15 , Kohl SJ Et Al 1984 30 , Livneh H 1999 9 , on the psycho-social version to amputation has led to a overplus of clinical and empirical findings. Kingdon D et Al 1982 equated amputation with loss of one s perceptual experience of wholenessA part Parkes CM 1976 10 with loss of partner andA Block WE et al 1963 16 , G sure-enough(a)berg RT et Al 1984 with symbolic emasculation & A even death.A The person s response to a traumatic event is forged by personality traits, pre- diseased psychological province, sexuality, peri-traumatic dissociation, drawn-out disablement of traumatic events, deficiency of societal corroborate and unequal header schemes. The of age(predicate) investigatees on amputation has foc utilise chiefly on demographic variables, get bying mechanisms, and outcome steps with there being a scarceness of literature on prevalence of sundry(a) specific psychiatric scattereds in the post-amputation extremity. close patients with a limb loss irrespective of whether referable to traumatic or surgical processs go through with(predicate) a series of complex psychological responses ( Cansever et al 2003 6 ) . Most people try to get by with it, those who do nt win develop psychiatric symptoms ( abrupt et al 1984 7,8 ) .A Shukla et Al ( 1982 ) 4 A andA Frierson and Lippmann ( 1987 ) A note that psychological intercession in close to signifier is needed in approximately 50 % of all amputees, andA Shulka and co-workers ( 1982 ) 4 A get wind clinical impression to be the close common psychological reaction spare-time activity amputation.The trinity major jobs faced by many amputees are disquiet, printing and sensual disablement ( Green 2007 )Horgan & A MacLachlan ( 2004 ) shew trouble to be associated with economic crisis, low ego regard, poorer sensed quality of life and higher(prenominal) degree of general uneasiness. With increa blither age two unease and depressive symptoms are associated with greater physical disablement ( Brenes et al. 2008 ) .Body image may be defined as the combination of an person s psychosocial allowance, experiences, feelings and attitudes that relate to the signifier, map, ocular aspects and desirableness of one s ain organic structure which is influenced by single and environmental factors ( Horgan & A MacLachlan 2004 ) . Each individual holds an consider image of the organic structure, which he uses to mensurate the percepts and constructs of his or her ain organic structure ( Fishman, 1959 ) . From another position, Flannery & A Faria ( 1999 ) see body image in a individual as a dynamic changing phenomenon, it is formed by feelings and perceptual experiences just about a individual s organic structure that are invariably altering. Harmonizing to Newell ( 1991 ) , attractive people post amputation will probably father less permit from others turn up in a lessening in self-esteem and a lessening in positive self-image. Jacobsen et Al ( 1997 ) optic modality supports this stating that amputation up catchs in disfiguration which may take to a negative organic structure image and possible loss of societal credence. The relationship amidst disablement experience and stigma are interwoven and inter-depend ent. The ground for the amputees subjective perceptual experience of being unfit for the society is likely that organic structure image non merely provides a sense of self but besides affects how we think, act and relate to others ( Wald 2004 ) . Harmonizing to Kolb ( 1975 ) , an heighten in an person s organic structure image sets up a series of emotional, perceptual and psychological reactions. Fishman ( 1959 ) states a individual must larn to populate with his perceptual experiences of his disablement instead than with his disablement. undefeated accommodation for the amputee appears to be in the incorporation of the prosthetic device into his or her organic structure image and his or her focal point on the hereafter and non on the portion lost ( Malone JM, Moore, WS, Goldston J, A et Al, 1979 and, Bradway JK 15 , Malone JM, Racy J, A et al 1984 ) .The psychiatric facets of amputation has received light involvement in our state, inspite of inadvertent hurts being common ( Shukla et al. , 1982 4 ) . The commonest psychiatric upset seen in amputees is major drop-off. Randall et Al. ( 1945 ) watch identifyed an incidence of 61 % in non-battle casualties, while Shukla et Al. ( 1982 ) 4 prime depressive neuroticism ( 40 % ) and psychiatric economic crisis ( 22 % ) as taking psychiatric upsets in amputees merely 35 % of the entire assay in the later mess had nil psychiatric upsets. The dearth of literature in this field has prompted us to analyze of amputation and its carbon monoxide morbid psychiatric conditions so that we may be after care & amp direction for these patients. The present survey was undertaken with the purpose of analyzing the psychiatric jobs particularly anxiety, economic crisis and organic structure dysmorphic syndrome which may be associated with disablement or changed life fortunes in the immediate post-amputation period. A analyze was made with Stroke patients as these patients excessively frequently experience simil ar physical and societal disabilities to amputees.Depression is the most common temper upset to follow beam of light ( Starkstein & A Robinson, 1989 ) , with major first gear impacting around one one-fourth to one tierce of patients ( Beekman et al. , 1998 Ebrahim, Barer, & A Nouri, 1987 Hackett, Yapa, Parag, & A Anderson, 2005 Pohjasvaara et al. , 1998 ) .Depression has an inauspicious consequence on cognitive map, functional recovery, and endurance. Diagnostic and statistical manual(a) ( DSM ) IV categorizes station wisecrack clinical first gear as temper upset due to general medical exam status ( i.e. shot ) with the specific depressive characteristics, major depressive-like episodes, frenzied characteristics or assorted features.Two types of depressive upset associated with intellectual ischaemias have been described from surveies done with patient studys from tart infirmary admittance, community studies, or out patient clinics. major slump occurs in up to 25 % of patients and minor depression occurs in 30 % of patient. Prevalence clearly varies over magazine publisher with an evident extremum 3months after the shot and later worsen in prevalence at 1 twelvemonth. Robinson and co-workers surveies showed a self-generated remittal in the natural class of major depression happening station shot in the first to 2nd twelvemonth following shot. However in few instances depression may go chronic and persist for a longer period.While some propose that station shot depression is due to cuff impacting the nervous circuits concerned with temper commandment therby back uping a primary biological mechanism, others in the scientific community claim it to be due to the takingsing societal and psychological stressors happening as a consequence of shot. Though an incorporate bio- psycho- societal metaphysical figure is warranted, most surveies clearly suggest the biological mechanism to hold the upper manus in the ulterior station stroke period th an in the immediate arcdegree.In the same manner Anxiety was about every bit common as depression and extra patients became dying at all(prenominal) clip point.Around 20 per cent of people will develop an anxiousness upset, most commonly in the first three to four months after the shot.While the literature on prostate specific antigen frame in its babyhood, the literature has begun to analyze its relationship to similar demographic, hurt, cognitive, and physical features as those examined for PSD. In footings of hurt features, prostate specific antigen correlates burning(prenominal)ly with right cerebral hemisphere lesions, while co-morbid prostate specific antigen and PSD are linked to go frontward hemisphere lesions ( Astrom,1996 ) .A Castillo etal. ( 1993 ) A openA anxietyA more prevailing in connection with posterior right hemisphere lesions, whereas worry withoutA anxietydisorderA was associated with forward lesions.ThoseA studiesA that have establish relationships amid PSA and age and gender study that adult females ( Morrison, Johnston, & A Walter, 2000 A Schultz, Castillo, Kosier, & A Robinson, 1997 ) and younger patients ( & lt 59 old ages ) are more hypersensitive to PSA ( Schultz et al. , 1997 ) , while others report no important relationship ( Dennis et al. , 2000 ) .Review literatureAmputationSociodemographic factorsSeveral surveies revealed that major depressive upsets and greater depressive symptomatology were more prevailing at cut back degrees of socioeconomic position Bruce L et Al 1994, Stansfeld et al 1992 . However, income degrees of people with an amputa-tion were non related to depressive symptoms Behel J M et Al 2004 .Dunn used a 10-page questionnaire to determine a assortment of personal features such as matrimonial position, faith, instruction, and etiology, etc. about each of 138 topics recruited from the Eastern Amputee Golf Association.13 With a scope of points, the survey focused on those related to the cau se of positive significance, optimism, and perceived control on depression and self-pride. 13 Depression was metric utilizing the CES-D while self-pride was assessed by the Rosenberg Self-Esteem shell ( RSE ) . Sing physical factors, Dunn found that younger amputees were significantly more at impale to develop depression than senior(a) amputees ( P & lt .05 ) . Mentioning Williamson and Schulz every bit sound as Frank 7,8 et Al, the writer suggests that both(prenominal)(prenominal) activity restriction-perhaps more usual, accepted by older persons than young-and optic aspect anxiousness may account for the determination.Wald et al supported Dunn s findings with a mention to black cat & A Hanspal and Livneh s articles that suggests immature individuals, with amputations alternate to trauma, are more likely to develop depression than older individuals with amputations secondary to disease.3 Wald et Al besides cites Cheung et al as demoing that individuals with upper app endage amputations had higher evaluate of depression than lower appendage amputees.Darnall et Al s telephone cross-sectional study revealed some interesting physical take chances factors for depression. The survey found that comorbidities were a important hazard factor ( for one comorbidity, p=.007 for deuce comorbidities, pa.001 ) . Anyone with terrible shadow hurting was 2.92 times more likely to develop depression than those without nark pain.8 Other types of hurting such as residuary limb or back hurting were besides found to increase the opportunity of developing depressive symptoms.Hanley et al took 70 topics, 1 month post-amputation of the lower appendage, and asked inquiries about map, apparition limb hurting, header, etc. The patients were assessed once more at 12 and 24 months after the amputation.14 ghost limb hurting was quantifyd utilizing points adapted from the Graded Chronic Pain Scale ( GCPS ) and pain intervention was measured by portion of the Brief Pain In ventory ( BPI ) . Later, multiple arrested discipline analyses were used to find what factors at the initial estimate may hold predicted the development of depression. Ultimately, the survey found the most certain physical factor to increase the hazard of depression was the presence along with the devilry of apparition limb hurting.Using HADS with 105 topics at an amputation refilling ward, Singh et al found none of the following to be risk factors for depression or anxiousness age, gender, clip since amputation, degree or prosthetic bringing events.10 on that point was, nevertheless, a important correlativity in the midst of the presence of comorbidities and depression ( p & lt .01 ) every bit strong as between life in isolation and anxiousness ( p & lt .05 ) . The writers offer small account for their findings.Dunn found ab initio that none of the following appeared to be risk factors for depression gender, degree of amputation, matrimonial position, race, income degree, instruction, employment, or spiritual affiliation.13 Ultimately, nevertheless, the survey did find-as Wald et Al subsequently reported-that beyond young person as a physical hazard factor for depression, there were several emotional/psychological hazard factors.3 Subjects who were less optimistic-not needfully pessimistic-about their state of affairs were more likely to develop depression, as were those who could non happen significance in their amputation experience and anyone who matt-up they had small control over their intervention and position. It was the participants who reported missing a positive mentality, who could believe merely of the negative effects, and who felt out of control or unimportant that tended to show down symptoms as clip progressed.Wald et al went farther to mention Breakey and Rybarczyk et Al with findings proposing that missing a societal support system, holding issues with visual aspect, and uncomfor dining boardness in society due to personal percept ual experiences about societal interactions all change magnitude the likeliness of developing depression.3 This construct of hurt and depression issue from the amputee keeping certain beliefs about visual aspect and being sensitive to customary uneasiness was echoed in the findings of Atherton et al.11 That survey explained the findings by proposing that individuals with high public uneasiness were by and large the type of individual to care a batch about societal contact and what is considered normal these individuals would be acutely cognizant of how they might now be perceived to be contrasting and accordingly experience hard-pressed.Lack of societal support after an amputation was found to be a hazard factor in several of the reviewed surveies, including Darnall et al.8 The survey notice that those topics who were, at the clip of or unawares after the amputation, either divorced or separated from a important other were more likely to develop depressive symptoms. Beside s likely to increase depression rates was populating near the poorness degree depression, nevertheless, was buffered by the topic holding a higher instruction. Populating near the poorness degree and holding a higher instruction, although both are imaginable particularly sing the emphasis poorness topographic points upon individuals with medical conditions, was non sustain in any of the other literature reviewed here.previous depressive episodes and abnormal psychology was found to be a hazard factor for later depression in both Meyer and Ehde et al.5,9 Meyer s survey suggested that pre-injury personality disfunction had the greatest influence on the prevalence of depression after an amputation, in this instance of the manus. Ehde et al discovered old depressive episodes-since the amputation but earlier in the survey of 24 months-to be more declarative, instead than pre-injury mental province. The survey besides suggests gender and societal support to be of import factors in the d evelopment of depression. Interestingly, Ehde et Al claims that pain catastrophizing by the topic while in the infirmary puting leads to modern-day and later increased rates of depression.9Commenting on its contradiction to common cognition and other literature on this point,Hanley et al studies happening that hurting catastrophizing in patients decreased the prevalence of depression in survey subjects.14 The writers speculate that patient hurting catastrophizing, funnily in the ague attention puting, garnered more attending from wellness attention staff and household, with it perhaps more of the psychological or physical attention they needed to retrieve. This suggests that, by being more demanding, the patients received support that other less-vocal patients did non.Last, beyond hapless hurting tolerance, both Seidel et Al and Desmond found that topics who avoided discussing or screening and were in denial about their amputation were more likely to develop depression both ab ini tio and long-term.6,7 Subjects who preferred to avoid admiting their bare-assed position as amputees besides tended to hold hapless credence of their prosthetic device. This became evident at the clip of prosthetic adjustments when topics frequently became progressively distressed, by and large going depressed.Depression and anxiousnessMost surveies break that between 20 and 30 % of amputees qualify for MDD after amputationThis depression is frequently associated with anxiousness and may or may non be attributable to posttraumatic emphasis upset.All surveies describing on the prevalence of depression in the amputee nation found rates higher than those in the general population, peculiarly in the months and old ages instantly following the amputation.Grunert et al. , as cited in Wald et Al, found that, at the initial appraisal after manus hurt, 62.4 % of topics claimed depressive symptoms.Another limited review, Horgan et Al, cites Caplan et al as happening 58 % of topics to meas ure up for MDD at 18-months station amputation while mentioning Bodenheimer et Al s findings of a 30 % depression rate.Meyer determined that the bulk of surveies on depression in amputees, on norm, found a prevalence of about 30 % , between three and six times higher than the world-wide rate. Seidel et Al found a similar rate of depression among individuals after the amputation of a lower appendage as opposed to the more socially noticeable upper appendage and custodies.In a three-part cross-sectional study administered to 75 patients seen at the Klinik und Poliklinik fur Technische Orthopade des Universitatsklinikums Munster, topics were asked inquiries and assessed harmonizing to the Hospital Anxiety and Depression Scale ( HADS ) , In this survey, 27 % and 25 % of the topics with a lower appendage amputation demonstrated increased depression or anxiousness, severally 18.3 % had both higher depression and anxiousness.Desmond determined that 28.3 % of the topics had tonss to bespea k possible MDD and 35.5 % qualified for clinical anxiousness.Darnall et al completed a cross-sectional study via telephone with 914 capable amputees.8 The topics were selected from a database of people who contacted the Amputee Coalition of America between 1998 and 2000 the try on was categorized per the topics etiologies but both upper and lower appendage amputations were include. Through educations analysis the survey found a depression prevalence of 28.7 % which the writers concluded was comparable to rates antecedently reported in surveies of depression in the amputee population.Singh et Al performed a cohort survey on 105 individuals with lower appendage amputation secondary to a assortment of etiologies who were admitted to an amputee reclamation ward.10 Upon admittance and discharge, each topic completed the HADS during the class of their stay, certain factors about each patient-such as gender, societal inside informations and found at admittance, 26.7 % of the topics w ere classified as down and 24.8 % as dying.Through a cross-sectional study of 67 new ( within the past five old ages ) adult lower appendage amputees who wear prosthetic devices, Atherton et al investigated the topics longer term psychological accommodation to amputation and found 13.4 % of the topics to be depressed and 29.9 % to be dying.Ziad M Hawamdeh et Al, have shown the prevalence of depressive and anxiousness symptomsto be 20 % and 37 % severally, which is consistent with several old surveies that sustain high rates of anxiousness and depressive symptoms after amputation with prevalence up to 41 % ( Kashani et al 1983 Schubert et Al 1992 Hill et al 1995 Cansever et Al 2003 6 Atherton and Robertson 2006 Seidel et Al 2006 ) .Most surveies have found no important relationship between the clip resulting amputation and psychological perturbations ( Rybarczyk et al 1992 Thompson et Al 1984 ) , ( Horgan and Maclachlan 2004 ) . Horgan and Maclachlan ( 2004 ) in their publi cation on amputations psychological accommodation concluded that depression and anxiousness seemingly are higher in the first 2 old ages post amputation and thenceforth worsen to degrees prevalent in the general population. Singh and Hunter 2007 in their recent survey concluded depression neodymium anxiousness symptoms to decide after in patient rehab for a short continuance.Gender is one of the sociodemographic factor that could be associated with result following amputation. In footings of psychological wellbeing following amputation, most surveieshave found no divagation in psychosocial result between work forces and adult females ( Bradway et al 1984 15 Williamson 1995 Williamson and Walters 1996 ) . But surveies performed by Kashani and col-leagues ( 1983 ) , OToole and co-workers ( 1984 ) , and Pezzin and co-workers ( 2000 ) , have reported adult females to be more likely to see depression, and to execute more ill on a step that includes an appraisal of emotional adaptab ility.Fisher and Hanspal ( 1998 ) , Livneh and co-workers ( 1999 ) 9 suggested immature grownups with traumatic amputation to be at higher hazard of major depression in comparing to persons with surgical amputations. Other surveies analyzing the relationship between cause of amputation and psychosocial result have found no consequence of amputation on psychiatric symptoms ( Shukla et al 1982 4 ) , anxiousness ( Weinstein 1985 ) , and depressive symptoms ( Kashani et al 1983 Rybarczyk et Al 1992 Williamson and Walters 1996 ) .Engstorm et Al ( 2001 ) , showed that the amputee s current household reactions to hold a important consequence on accommodation. Williamson et Al ( 1984 ) , Thompson and Haran ( 1984 ) , Rybarczyk et Al ( 1992, 1995 ) , found depression to be more prevailing in those who are socially stray and with low sensed degrees of societal support.Harmonizing to Weinstein ( 1985 ) , although above articulatio genus amputations are associated with poorer rehabilitati on results and higher activity limitation degrees, AK amputations were non found to be associated with increased degrees of anxiousness, societal uncomfortableness, generalpsychiatric symptoms ( Shukla et al 1982 4 ) , depression ( Behel et al 2002 ) , or accommodation to amputation ( Tyc 1992 ) . OToole et Al ( 1984 ) found that persons with BK amputation to be more likely down than those with AK amputations because BK is less badly disenabling than AK in footings of operation.Body image perturbationFew surveies have been reported in the literature in the country of research on organic structure image and the amputee.Fishman ( 1959 ) determined the amputee s perceptual experience of his or her physical disablement has a greater influence on successful rehabilitation than the extent of the disablement. He states, A figure of really specific psychological, societal and physiological homo demands are thwarted when one becomes physically handicapped as a consequence of amputation . The method of seting psychologically to an amputation is chiefly a map of the preamputation personality and psychosocial background of the individual.Each individual holds an reckon image of the organic structure, which he uses to mensurate the percepts and constructs of his or her ain organic structure ( Fishman, 1959 ) . From another position, Flannery & A Faria ( 1999 ) see body image in a individual as a dynamic changing phenomenon, it is formed by feelings and perceptual experiences about a individual s organic structure that are invariably altering.Harmonizing to Kohl ( 1984 ) 30 , a individual who has lost a limb must see him- or herself every bit merely that ( a individual who has lost a limb ) and non burthen him- or herself with labels such as amputee. Kohl 30 suggests this attitude is the key to a positive accommodation to a new organic structure image after an amputation. Shontz ( 1974 ) suggests an person who is losing a limb has three organic structure images t he preamputation integral organic structure, the organic structure with limb loss and the organic structure image when have oning a prosthetic device.The weiss et Al ( 1971 ) studied 56 transfemoral amputees and 44 transtibial amputees utilizing a comprehensive battery of trials and a 50-item Amputee Behavior Rating Scale. The valuation graduated table assessed the extant behavior of the amputees as observed by the members of the amputee clinic squad. This signifier was completed by the squad members the doctor, healer, prosthetics and rehabilitation counselor. On about all measures the transtibial amputees obtained cave in tonss than the transfemoral amputees. The research workers wises et Al ( 1971 ) found the degree of amputation was significantly related to legion facets of psychophysiological and personality working while aetiology was non. They concluded that since transtibial amputees are less handicapped as a group, they by and large function better than transfemoral a mputees. In add-on, they suggest the less-positive self-image of the transfemoral amputees besides can be attributed to a less-appealing pace, frequently with a noticeable turn ( wises et al 1971 ) .Post shotSociodemographic profileThe possible influences of socioeconomic position ( SES ) , age and gender on the development of depression following shot have all been examined, with inconsistent consequences ( Ouimet et al. 2001 ) . Although one could foretell intuitively that lower SES and increasing age are associated with the hazard for PSD, this is non needfully the instance. Andersen et Al. ( 1995 ) reported that SES had no influence on the hazard for post-stroke depression and recent surveies suggest that younger instead than older age is associated with increased hazard ( Eriksson et al. 2004 Carota et Al. 2005 ) . given the well higher prevalence of depression among adult females when compared to work forces in the general population ( Wilhelm & A Parker 1994 Ouimet et Al. 2001 Salokangas et Al. 2002 ) , a higher prevalence of PSD among adult females might be expected. While the consequences from some surveies support the association between female sex and PSD ( Desmond et al. 2003 Paradiso & A Robinson 1998 Ouimet et Al. 2001, Eriksson et al. , 2004, Paolucci et Al. 2005 ) , others do non ( Ouimet et al. 2001 Berg et Al. 2003 Whyte et Al. 2004, Spalletta et Al. 2005 ) . However, there may be existent inequalitys between work forces and adult females in footings of the comparative importance of hazard factors for PSD. Among work forces, physical equipment casualty may be a more influential hazard factor ( Paradiso & A Robinson 1998 Berg et Al. 2003 ) , while among adult females, old memorial of psychiatric upset may be more of import ( Paradiso & A Robinson 1998 ) .Depression and anxiousnessThree possible accounts for the association between physical unwellness and depression have been sought. First, and to the lowest degree likely is a c oinciding relationship. The 2nd is a negative temper reaction to the physical effects of the shot. The impact of the physical unwellness may exert its consequence through the losingss it causes to the person as a major negative life event ( losingss to selfesteem, independency, employment, etc. ) . The 3rd possible account is a neurotransmitter derangement as a consequence of intellectual harm caused by the shot.Depression is a well-documented sequela of shot. Based on pooled informations from published prevalence surveies ( Robinson 2003 ) , the average prevalence of depression among in-patients in ague or rehabilitation scenes was 19.3 % and 18.5 % for major and minor depression severally while, among persons in community scenes, average prevalence for major and minor depression was reported to be 14.1 % and 9.1 % . Among patients included in outpatient surveies, mean reported prevalence was 23.3 % for major depression and 15 % for minor depression ( Robinson 2003 ) . Overall ave rage prevalence ranged from 31.8 % in the community surveies to 35.5 % in the ague and rehabilitation infirmary surveies. A recent systematic reappraisal of prospective, experimental surveies of post-stroke depression ( Hackett et al. 2005 ) reported that 33 % of shot subsisters exhibit depressive symptoms at some clip following shot ( acute, medium-term or long-run followup ) .Estimates of prevalence may be affected by the clip from shot onset until appraisal. In fact, the highest rates of fortuity depression have been reported in the first month following shot ( Andersen et al. 1995, Aben et Al. 2003, Bhogal et Al. 2004, Morrison et Al. 2005, Aben et Al. 2006 ) .Paolucci et Al. ( 2005 ) reported that, of 1064 patients included in the DESTRO survey, 36 % developed depression of whch 80 per centum of them developed depression within the first three station stroke months ( Paolucci et al. 2005 ) .The incidence of major depression may diminish over the first 2 old ages following shot ( Astrom et al. 1993, Verdelho et Al. 2004 ) but minor depression tends to prevail or instead appendix over the above mentioned clip period ( Burvill et al. 1995 Berg et Al. 2003, Verdelho et Al. 2004 ) . Berg et Al. ( 2003 ) reported about one-half of the persons sing depression during the acute stage station shot, to see it in the resulting one and half twelvemonth nevertheless, more adult females than work forces have been set in the acute stage while there is a male predomination in the latter half period ( Berg et al. 2003 ) .The survey of temper upsets after shot has focused mostly on depression. Reported prevalence of PSD varies widely, though most surveies place prevalence between 20 and 50 % , and indicate that depression persists 3-6 months poststroke ( Fedoroff, Starkstein, Parikh, Price, & A Robinson, 1991 Hosking, Marsh, & A Friedman et al, 2000 Lyketsos, Treisman, Lipsey, Morris, & A Robinson, 1998 Parikh, Lipsey, Robinson, & A Price, 1988 Schubert, et al 1992 Schwartz et al. , 1993 Starkstein, Bryer, Berthier, & A Cohen, 1991 Starkstein & A Robinson, 1991a, 1991b ) .PSD has a negative impact on instance human death and rehabilitation ( Whyte & A Mulsant, 2002 ) , and functional results ( Herrmann, Black, Lawrence, Szekely, & A Szalai, 1998 ) . In contrast, PSA has merely late begun to be investigated ( Castillo, Schultz, & A Robinson, 1995 Castillo, Starkstein, Fedoroff, & A Price, 1993 Chemerinski & A Robinson, 2000 Dennis, ORourke, Lewis, Sharpe, & A Warlow, 2000 Robinson, 1997, 1998 Shimoda & A Robinson, 1998 ) with prevalence studies runing from 4 to 28 % ( Astrom, 1996 House et al. , 1991 ) . As with PSD, the class of PSA has been found to stay reasonably changeless up to 3 old ages post stroke ( Astrom, 1996 Robinson, 1998 ) . Co-morbidity of PSA and PSD is high, with every bit many as 85 % of people with generalized anxiousness holding co-morbid depression during the 3 old ages post stroke ( Castillo et al. , 1993, 1995 ) .Previously depression was found to be frequent in immature patients ( Neau et al. 1998 ) , while in some surveies ( Sharpe et al. 1994, kotila et Al. 1998 ) it has been related to old age. Lack or societal support and both functional and cognitive damage may increase the hazard of depressive upset in the elsderly ( Sharpe et al. 1994 ) .Robinson et Al in 1984 studied patients of shot in 2 groups in relation to onset of of depression, group of patients with acute oncoming of depression, within few hebdomads after shot and 2nd group with delayed oncoming of depression over 24 months and found no difference in clinical characteristics or class of depression in the two groups. In 1986 Lapse et al compared a group of patients with PSD with 43 platinums with functional depression that the two groups did non differ in the symptom profile of depression is the important determination in their survey.Although post-stroke depression ( PSD ) is a common effect of shot, hazard f actors for the development of PSD have non been clearly delineated. In a recent systematic reappraisal, Hackett and Anderson ( 2005 ) included informations from a sum of 21 surveies ( remand 18.2 ) . Of the many different variables assessed, physical disablement, stroke badness and cognitive damage were most systematically associated with depression.In an earlier reappraisal of 9 prospective surveies analyzing post-stroke depression, the hazard factors identified most systematically as increasing an person s hazard for post-stroke depression included a past history of psychiatric morbidity, societal isolation, functional damage, populating entirely and dysphasia ( Ouimet et al. 2001 ) . Since the clip of the Hackett et Al. ( 2005 ) and Ouimet et Al. ( 2001 ) reviews, more recent surveies have confirmed the importance of badness of initial neurological shortage and physical disablement as forecasters of the development of depression after shot ( Carota et al. 2005, Christensen et Al . 2009 ) . In add-on, Storor and Byrne ( 2006 ) examined post-stroke depression in the acute stage ( within14 yearss of shot oncoming ) and identified important associations between prestrike neurosis ( OR = 3.69, 95 % CI 1.25 10.92 ) and a past history of mental upsets ( OR = 10.26, 95 % CI 3.02 34.86 ) and the presence of depressive symptoms.Stroke Location and Depression in that location have been 2 meta-analyses analyzing this relationship ( Singh et al. 1998, Carson et Al. 2000 ) .Singh et Al. ( 1998 ) conducted a critical assessment on the importance of lesion location in post-stroke depression. The writers consistently selected 26 original articles that examined lesion location and post-stroke depression. Thirteen of the 26 articles satisfied inclusion standard ( Table 18.3 ) . Six of those surveies found no important difference in depression between right and go away hemisphere lesions. Two surveies found that right-sided lesions were more likely to be associated with dep ression and 4 surveies found that left-sided lesions were more likely to be associated with post-stroke depression. Merely one survey matched patients with and without depression for lesion location and size to place non-lesion hazard factors. Consequently, Singh et Al. ( 1998 ) were unable to do any unequivocal decisions refering shot lesion location and the hazard for depression.Carson et Al. ( 2000 ) undertook a systematic reappraisal to see the association between post-stroke depression and lesion location. All studies on the association of poststroke depression with location of mastermind lesions were included in the reappraisal. In entire 48 studies were included for reappraisal ( Table 18.4 ) . The writers of the reappraisal identified 38 studies that found no important difference in hazard of depression between lesion sites 2 reported an increased hazard of poststroke depression with left-sided lesions 7 reported increased hazard with right-sided lesions and one study d emonstrated an association between depression and lesions in the right parietal part or the left frontal part.Robinson & A Szetela ( 1981USA ) 18 patients with left hemispheric shot were compared to 11 patients with traumatic genius hurt for frequence and badness of depression, More than 60 % of the shot patients had clinically important depression compared with approximately 20 % of the injury patients.Hermann et Al. ( 1995 Germany ) 47 patients with individual demarcated one-sided lesions were selected for survey. Clinical scrutiny, CT scan scrutiny and psychiatric appraisal were performed within a 2-month period after the acute shot. No important differences in depression tonss illustrious between patients with left and right hemisphere lesions. Major depression was exhibited in 9 patients with left hemispheric shots all affecting the basal ganglia. None of the patients with right hemispheric shots exhibited a major depression.Morris et Al. ( 1996a Australia ) 44 first-ever shot patients with individual lesions on CT were examined for the presence of post-stroke depression, badness of depression and its relationship to lesion location. Patients with left hemisphere prefrontal or basal ganglia constructions had a significantly higher frequence of depressive upset than other left hemispheric lesions or those with right hemispheric lesions.Based on the consequences of a meta-analysis conducted by Bhogal et Al. ( 2004 ) , there appears to be some grounds that depression following shot may be related to the anatomical site of encephalon harm, although the nature of this anatomic relationship is non wholly clear ( Bhogal et al. 2004 Figure 18.1 ) .The John Hopkins Group ( Lipsey et al. 1983, Robinson & A Szetela 1981, Robinson & A Price 1982, Robinson et Al. 1982, 1983, 1984, 1986, 1987 ) carried out a series of surveies researching the relationship of post-stroke depression to the location of the lesion within the encephalon itself. They found that in a selected group of shot patients, similar to those admitted to a shot rehabilitation unit, depression appeared to be more frequent in patients with left hemispheric lesions ( Robinson & A Szetela 1981, Robinson & A Price 1982, Robinson 1986, Robinson et al 1987 ) .Among these patients, the badness of depression correlated reciprocally withthe distance of the lesion from the frontal poles ( Robinson & A Szetela 1981, Robinson & A Price 1982, Robinson et Al. 1982,1983, 1984, 1986, 1987, Starkstein et al. 1987 ) . Patients with subcortical, cerebellar or brainstem lesions had much shorter-lasting depressions than patients with cortical lesions ( Starkstein et Al. 1987,1988 ) .The correlativity of major depression to the propinquity of the lesion to the frontal pole has been confirmed by Sinyor et Al. ( 1986 ) and Eastwood ( 1989 ) . Right hemispheric lesions failed to show a similar relationship with depression. Interestingly, in one survey, patients who had both an anxiousness ups et and a major depression showed a significantly higher frequence of cortical lesions, while patients with major depression merely had a significantly higher frequence of subcortical ( native ganglia ) shot ( Starkstein et al. 1987 ) .Finally, the two big systematic reappraisals by Singh et Al. ( 1998 ) and Carson et Al. ( 2000 ) referred to antecedently, failed to happen a relationship between the shot lesion site and depression.Recent studies have suggested that psychosocial hazard factors including age, sex and functional damage or old history of psychiatric perturbation are greater subscribers to the development of PSD than lesion location ( Singh et al. 2000, Berg et Al. 2003, Carota et Al. 2004, Aben et Al. 2006 ) .While the literature on PSA remains in its babyhood, the literature has begun to analyze its relationship to similar demographic, hurt, cognitive, and physical features as those examined for PSD. In footings of hurt features, PSA correlates signii?cantly with right hemisphere lesions, while co-morbid PSA and PSD are linked to go forth hemisphere lesions ( Astrom, 1996 ) . Castillo et Al. ( 1993 ) found anxiousness more prevalent in association with posterior right hemisphere lesions, whereas worry without anxiousness upset was associated with anterior lesions. Those surveies that have found relationships between PSA and age and gender study that adult females ( Morrison, Johnston, & A Walter, 2000 Schultz, Castillo, Kosier, & A Robinson, 1997 ) and younger patients ( & lt 59 old ages ) are more susceptible to PSA ( Schultz et al. , 1997 ) , while others report no signii?cant relationship ( Dennis et al. , 2000 ) .Most surveies that have examined cognitive map and PSA have besides assessed physical damage. Castillo et Al. ( 1993, 1995 ) study that PSA is non signii?cantly correlated with physical operation, cognitive operation, or societal operation. While some writers likewise report no signii?cant correlativity ( Starkstein et al. , 1990 ) , others report that anxiousness is linked to greater damage in activities of day-to-day populating both acutely and up to 3 old ages post stroke ( Schultz et al. , 1997 ) .To day of the month, few surveies have examined both depression and anxiousness station shot, or their differential relationships to these factors.Suzanne L. Barker-Collo ( 2007 ) found in his survey Prevalence rates for moderate to severe depression and anxiousness in the present sample were 22.8 and 21.1 % , severally.That left hemisphere lesion was related to increased likeliness of depression and anxiousness is consistent with the literature if one considers 3 months to be within the acute stage of recovery ( Astrom, 1996 Astrom et al. , 1993 Bhogal et al. , 2004 ) .There is a dearth of literature about Body Dysmorphic Disorder ( BDD ) in station shot person.Aim and aimsTo force psychiatric profile of the patient with amputation and comparison with station shot patient.Materials and methodsStudy was car ried out in outpatient and yardbird section of orthopedicss, plastic surgery, general medical specialty at Govt. Stanley Medical College.Time period of surveyFrom may 2012 to October 2012 ( 6months )Design of surveyCase -control surveyChoice of sampleA sum of 30 patient consecutively chosen, organize the sample for instances and back-to-back sample of 30 patient with shot constitute the control group.Patient were assessed within the period of two to six hebdomads after amputation and shot.Inclusion and Exclusion standardsCases ( Patients with amputation )INCLUSION CRITERIAPatients who underwent elected every bit good as hint amputation.Age between 18 old ages to 60 old ages.Exclusion StandardsPatients with age less than 18 old ages and with age more than 60 old agesPrevious history of psychiatric unwellnessPatients with history of psychiatric unwellness before the amputationPatients with other medical unwellnessControlsINCLUSION CRITERIAPatients with shotAge between 18 old ages to 60 old ages.Exclusion StandardsPatients with age less than 18 old ages and with age more than 60 old agesPrevious history of psychiatric unwellnessPatients with history of psychiatric unwellness before the oncoming of shotPatients with other medical unwellnessTools usedA structured interview agenda to analyze the demographics, clinical characteristics and other pertinent factors in history.General health Questionnair ( GHQ-28 )Hospital Anxiety and Depression Scale ( HADS )Hamilton Depression evaluation Scale ( HDRS/HAM-D )Brief Psychiatric Rating Scale ( BPRS )Yale cook Obsessive Compulsive Scale for Body Dysmorphic Disorder. ( YBOCS-BDD )General Health Questionnaire ( GHQ 28 )The GHQ 28 was developed by Goldberg in 1978, Developed as a shouting tool to observe those likely to hold or to crush hazard of developing psychiatric upset.GHQ 28 is a 28 point steps of emotional depression medical scenes, through factor analysis GHQ 28 has been divided into 4 subscales.They areBodily sy mptoms ( 1-7 )Anxiety/insomnia ( 8-14 ) societal disfunction ( 15-21 )Severe depression ( 22-28 )Each point is occupied by 4 possible responses non at all, no more than usual, instead more than usual and much more than usual.There are different methods to hit GHQ 28. It can be murderd from 0-3 for each response with a entire possible brand name on the runing from 0-84. Using this method, a entire check of 23/24 is the threshold for the presence of hurt. or else to GHQ 28 can be scored with a binary method where non at all and no more than usual aim 0, and instead more than usual and much more than usual mark 1, utilizing this method any mark above 4 indicates the presence of hurt.Numerous surveies have investigated dependability and rigour of the GHQ 28 in assorted clinical populations. Test-Retest dependability has been reported to be high ( 0.78+00.09 ) ( Robinson and fiscal value ( 1982 ) and intra rater and inter rater dependability have both been shown to be first-class ( crnballi s 20.9-0.95 ) . High subjective consistences have besides been reported. ( Failde and Ramos 2000 ) . GHQ 28 correlatives good with the infirmary depression and anxiousness graduated table ( HADS ) ( Sakakibara 2009 ) and other steps of depression ( Robinson and monetary value 1982 ) .Hospital anxiousness and depression graduated table ( HADS )HADS was before developed by Zigmond and snaitn ( 1983 ) , it is normally used to find the degrees of anxiousness and depression. Sum of 14 points in that 7 points for anxiousness and 7 for depression. Each point on the questionnaire is scored from 0-3 and this means that individual can hit between 0 and 21 for either anxiousness or depression. ( Scale used is a likes mark and the bow informations returned from the HADS is ordinal informations ) and subdivided into mild 8-10, moderate 11-15 and terrible greater or equal to 16.Internal consistence has been found to be first-class for the anxiousness ( 2-85 ) and adequate for the dep ression graduated table and besides has equal rigour for anxiousness HADS gave a specificity of 0.78 sensitiveness of 0.9. For depression this gave specificity of 0.78 and sensitiveness of 0.83.Hamilton Rating Scale for DepressionThe Hamilton evaluation graduated table for depression ( HAMD ) , developed by M.Hamilton is the most widely used evaluation graduated table to measure the symptoms of depression.The HAMD is a observer rated scale consisting of 17 to 21 points ( separately 2 portion points, weight and tenfold fluctuation ) . Rating is based on clinical interview, plus any extra variable information such as household members study. The points are rated on either 0-4 spectrum or a 0-2 spectrum.The HAM-D relies rather to a great extent on the clinical interviewing teguments and experience of rater in measuring persons with depressive unwellness. As most patients score zero on rare points in depression ( Depersonalization and compulsion and paranoiac symptoms ) , the entire m ark on HAMD by and large consists of merely amount of first 17 points.The strength of the HAMD is first-class proof research base and easiness of disposal. Its usage is limited in person who have psychiatric upset other than primary depressionScoring0-7 aNormal8-13 aMild depression14-18 aModerate depression19-22 asevere depressionGreater than 23 aVery terrible depressionsBrief psychiatric evaluation accomplishment ( BPRS )Developed by JE overall and Dr.Gorhav in 1962 it is widely used comparatively brief graduated table that measures major psychotic and non psychotic symptoms in single with major psychiatric upset, peculiarly Scurophressia.The 18 points BPRS is possibly the most researched instrument in psychopathology. 18 points rated on 1-7.Items are divided into observed and reported points.Observed ItemsReported ItemsEmotional climb-downBodily concernConceptual disorganisationAnxietyTensionGuilt feelingIdiosyncrasy and bearDepressive temperMotor decelerationHostilityUncoopera tivenessSuspicionBlunted affectHallucinatory behaviour turmoilUnusual tuocyn contentDisorientationStrengths of the graduated table includes is brevity, easiness of disposal, broad usage and good rescanned position.Yale Brown Obsessive supreme Scale for BDDYBOCS is a test/scale to rate the badness of OCD symptoms.Scale was knowing by Dr.Wayne Goodman and his co-workers, is used extensively in research and clinical pattern.Modified YBOCS graduated table is used to mensurate to badness of symptoms of compulsion and irresistible impulse in a patient holding pre wrinkle with sensed defect in visual aspect ( BDD ) . It is a 12 point instrument consisting 5 inquiries on preoccupation and 5 inquiries on compulsive behavior, one on penetration and one on turning away.More specifically it assesses clip occupied by preoccupation with the sensed defect in visual aspect, intervention in operation, hurt, opposition and control. Similar buildings are assessed for compulsive behavior.Similar to the YBOCS for OCD, each points on the YBOCS-BDD measured on the 5 point likert graduated table with higher mark denoting progressively psycho-pathology. lucre on this 12 points ranges from 0-48 the YBOCS-BDD has been shown to hold good inter rated dependability, trial retest dependability and internal consistence. It has besides shown to be sensitive to alter. It was developed as mensurating badness of BDD symptoms instead than as a diagnostic tool. It should be far-famed that, scale first 3 points reflect the DSM IV diagnostic standards for BDD.The advantage or BDD-YBOCS is that it assists in comparing clients across surveies. It is based on the YBOCS and is hence curicitically bound to a theoretical account of an obsessional compulsive ghosts disorder. An of import different between YBOCS BDD and YBOCS for OCD is that the ideas about the organic structure defect combine the evaluation for both the stimulation and knowledge response. In OCD Rumination would be rated under the irr esistible impulse.ProcedureA sum of 30 patients amputation consecutively chosen signifier to try for instances and a at the same time sample 30 patient with shot constitute to command group who free make full the exclusion and inclusion standards were taken for survey. A written informed concern was obtained. HAMD, BPRS, HADS, GHQ-28, YBOCS-BDD graduated tables were administered after clinically measuring as per 1CD-10 diagnostic standards.Ethical commission blessingThe survey was submitted for ethical commission blessing on at Govt. Stanley infirmary and blessing was obtained.Statistical methodThe information collected will be entered in excel marker sheet and analysis utilizing SPSS for this different in frequence distribution and other evaluations on different steps appropriate statistical trial seen as t trial, cui square trial are employed.The socio demographical profile and HAMD, YBOCS BDD, HADS, BPRS GHQ-28 graduated tables were given in frequences with their percentage.HAMD, HADS, BPRS, GHQ-28, YBOCS BDD scores difference between instances and controls were analyzed utilizing chi- square trial.The place of the topic in instances and control were analyzed utilizing cui-square trial. The Association between socio demographic, psychiatric upset was analyzed utilizing cui-square trial. Incidence of psychiatric morbidity off amputees was given in per centum 95 % assurance interval.