Different Perspectives of People’s Feelings

The Killing Circle: The Deferent Perspectives on Peoples Feelings Everyday around the world many terrible, and tragic crimes take place were not everyone Is aware of every single crime. Whether It Is a robbery, a kidnapping, a murder or even a case of missing books to someone out there It matters, but to others it may not. In the novel, The Killing Circle the author Andrew Paper shows that when something bad happens it tends to only affect an individual if that person were in that situation, or has a loved one in that current situation compared to society were people would just not care at all.An example this situation in real life would be let's say a fisher men's daughter was murdered and as a father he is devastated. Now to that fisher man's family this is a tragic moment in their lives, knowing that a person that they truly, deeply cared about is now gone forever. Now to society more than half of them may not be aware of this event, or be aware and Just not care because those peo ple It may not affect them personally as It would to the fisher men's family.This novel has a similar event were random murders take place, and the mall antagonist Patrick Rush does not care about what Is happening In his city and he goes not care of what happened to those people that died, until his one and only son is kidnapped by the mysterious Sandman. Andrew Paper shows that what a person feels when losing someone close to them is completely different for what society or someone not as close may go through and develops this theme by using Patrick Rush's situation as an example.To begin, everyone knows when anything big or small happens one way to find out would be probably watching or reading the news. Although the news is a good for giving people information on recent events, it is also something that hurts the hearts f the families of which the news could be about. Andrew Paper shows that when something happens to someone close to you It Is very painful, but to someone In the media It Is something that person can exploit and use to their benefit.He uses Imagery to make the readers Imagine a scenario that which the readers can feel how both a family member may feel and someone In society. For example, Mom can Imagine. A father loses his son at the movies, the boy snatched away in the time it takes to buy hot dogs and onion rings- it's a summer weekend news editor's dream come true. (Paper, 265) This example shows the father that lost his son would be devastated, worried, and angry that it happened, but this story for the news editor is something he could potentially use as the next top story in his article.Taking it a step further it even shows that when people in the society listen to this news most may not even care and that little amount that does care will slowly start to not care as well, but the family that lost their son will never stop caring until he would return safely home. Relating this to daily life there are many examples of when news porte rs take advantage of the worst situations Just to get a better rating for their show. For example, channel 6 news was trying to get out some Information on what happened to this teen who was shot out of her mother.For a parent that just lost their daughter the last thing the parent's would want at that time would be a reporter annoying them that is why that teens mother got angry and replied † ‘K, that's good' when asked for a reaction to her daughter's shooting, but then suddenly hurled a rock at ABACA photographer Marc Jackson† (Zimmerman, Para 3). This shows that even t a situation like this the reports do anything it takes to get some good news for their viewers, even if it hurts the hearts of the poor families.Furthermore, near the end of the book as stated Patrick Rush's son goes missing, and in such cases many people in this common society would simply give up on either searching for him or already think his son would be dead. In this situation the readers c an imagine what Patrick is going through, in his state of mind he allows the reading to sense how he is feeling by saying â€Å"There's the shots of local volunteers reaching for clues, for body parts.And there's the father, his skin speckled and spongy as oatmeal, aerobically pleading for his boys safe return† (Paper, 265). This shows that the volunteers in the society are already searching for clues, and Andrew Paper specifies that the volunteers are searching for body parts meaning that the volunteers must already be assuming Patriot's son to be dead. Patrick on the other hand is feeling depressed, as if he cannot move anymore without him, as if his skin feeling like it is going to melt, begging for his son to return safe.The readers can feel hat Patrick is in pain, and clearly the volunteers helping to find the boy are not, thus proving that a what a family goes through is completely different from what others in this common society would go through. This argument could b e related to a recent tragedy that happened in Toronto where a man named Tim Bosom was fallen victim to a group of evil people that murdered him over a few vehicles.A few vehicles were recovered by the police, and a statement was given by an owner of one of the vehicles. He said â€Å"it's Just a bike,' MacDougall said. ‘It's nothing compared to what the Bosoms are going through now. They'll never get Tim back. ‘This is sad, really sad† (Casey, Para 6). Mr.. MacDougall knows that what the Bosoms are going through is very difficult, and many people in Toronto probably did not even know of this incident that occurred, and do not feel what the Bosom family is going through.Thus, this recent event helps to prove that only families can understand how it feels when you lose someone because they are so close to him, compared again to society where people Just do not have that same personal connection. Finally, Patrick shows that people that only people that are close to you actually if the main and sorrow when you are gone. Although he realizes this after his son is kidnapped, he still shows that he now understands how it feels to lose someone, and why others aside from him may not. Patrick says â€Å"Harm tends to come from when you lose ones you know the best† (Paper, 267).Here Andrew Paper uses what Patrick said to show that only when a person loses someone close to them is when that person would experience any type of emotional feelings; compared to someone that might not know that person to well and may not go through the same type of feelings that someone that was close to that person goes through. Looking outside the book, everyone in the world is scared of losing someone that is close to them; by looking online you can find millions of quotes or Just ordinary people that have shared this feeling. For example, an unknown person said â€Å"I'm always scared of losing someone close to me†¦ ND Ted up to being told ‘it'll be t ine† (Losing Someone trot Death Quotes, 4). The quote said by an anonymous source is basically saying that losing someone close to you can be really scary or even depressing Just to think about, and people around you may not feel the same as you do. This is Just one opinion of the lions of people in the world, and Andrew Paper being one is trying his hardest to prove that only if a person that loses someone close to them goes through completely different feelings than a person not as close goes through.In conclusion, Andrew Paper using this novel to help prove that the emotions somebody shares when losing someone dear to them is completely different for someone that is not close to that person. By using Patrick Rush's situation as a main example he helped to prove this thesis, and by comparing it to outside sources in this essay the readers now are totally clear on his message. Anyone would be terrified to even think about losing someone like their brother, sister, mother or f ather, or even their closest friend.What the author wanted to show is that only people close to that person that might have died or gone missing feel the pain and others do not. The real life examples of Tim Bosom, the mother that lost her daughter, and many people around the world helped to prove this thesis, and the main message Andrew was trying to get across. Everyone who was read his books will understand Andrew Peer's message, but only when the readers were to go through the same ideal or situation is when they will truly realism he importance of how feelings are different for every individual.

Barbara Corcoran Effective leadership qualities Essay

Barbara Corcoran is an American businesswoman, consultant, investor, speaker, author and TV personality. She is the owner of $5 billion business ‘The Corcoran Group’. She is known as one entrepreneur with a real story of ‘rags to riches’. Barbara was born in the year 1949 in Edgewater, New Jersey. She graduated with a degree in Education from St. Thomas Aquinas College in the year 1971. Upon graduation, she got a teaching job which she did for about a year. Barbara was never settled at teaching, so she quit and sought other jobs. However, things did not go as smooth as she had expected, as she had to quit one job after the other. By the time she was 23, she had been in and out of more than 20 jobs. It is her last trial at jobs that would ultimately change her life completely, making her one of the richest women in America. After trying different odd jobs, Barbara felt that she wanted to become her own boss. So she started a small real estate agency, dealing with brokering entry to vacant houses. However, this transformation needed money which she did not have at that moment. She asked for a loan of $1000. On one trip to see a vacant house with a client, things turned out for the best she had never imagined- the client became interested in buying the property rather than renting it. From the sale, she earned a commission of $3000 for the Corcoran-Simone partnership. This excited her, giving her the idea to transform her business into more than just the letting of vacant houses, to include even property on sale. The business began to grow, and the couple was reaping considerable profits until Barbara’s boyfriend, Simone, decided to quit the partnership after running away with Barbara’s secretary and marrying her. The division ended in 1978, when she immediately founded The Corcoran Group. When Simone withdrew his shares, he mocked Barbara that she would never make it without him. This particular incident encouraged her even the more to work hard and prove him wrong. Her determination paid, with The Corcoran Group, the first female-owned realty firm in the Big Apple, expanding to a workforce of 7 agents and over $350,000 in revenue in just her first year. Corcoran Group thrived under Barbara’s leadership, thanks in large part to her unique style. By the year 2006 when she decided to sell the company, The Corcoran Group was so big, with a staggering sales force of 850 agents and annual revenue approaching $100 million. It was sold at $66 million to NRT Inc. I chose Barbara Corcoran because her rise to the top is outstanding, thanks to her exceptional leadership skills. Barbara motivates me to push on despite my humble present- theirs is so much room up there! My vision is to grow into one of the most celebrated leaders of my time, and she fit perfectly as a person who started with nothing and turned every small thing she got into something big. Her definition of leadership is quite unique. â€Å"I never thought of it as leadership, but I knew I wanted to be loved by the people who worked for me,† Corcoran says. â€Å"I built the business exactly the way my mother built and ran her family. I wanted a replication of the big, happy family I grew up in. I wanted happy people having fun†, Barbara says (entrepreneur.com). She believes that leadership is making people feel they belong to the company like it was their family. That is how she enabled others to act, a quality discussed by Kouzes and Posner (2012). Barbara says, â€Å"I found out that the more fun I created in the company, the more creative and innovative it became,† she says. â€Å"That was the big kahuna–the fun piece. That’s what built that culture upside down and inside out. You got innovation. You got loyalty. You got people who would recruit for you.† (entrepreneur.com) She effectively encourages the heart (Kouzes and Po sner, 2012). Barbara Corcoran displays many qualities of a good leader. One unique is that she understands the value of other people she works with. Despite being the boss, Barbara respected every worker in her firm and she let them carry out their tasks with a lot of trust and space. As she says, she never knew what the firm’s revenue was, having delegated accounting duties to Esther Kaplan, the first agent she brought in. Secondly, Barbara believes in rewarding workers for their exemplary performance. She personally put colored ribbons on those workers who performed well. Her rewarding quality became even more evident when she eventually rewarded Kaplan’s hard work with a 10 percent commission in the firm, allowing her to cash in when the firm was sold. Corcoran is a leader who models the way (Kouzes & Posner, 2012). She never sat down and let her agents do all the work. She continued to make sales herself, working very hard. This encouraged her employees to develop a similar determined character. Barbara also exercised her authority very strictly. She gave all new employees a grace period of three months to make a first sale, failure to which they would leave the firm. The fifth leadership quality in Barbara is that she never let her past failure’s pull her down. In high school she scored D’s, but it never bothered her later in life. She was determined to move from one success to the other. Her undying spirit is a clear way of challenging the process (Kouzes & Posner, 2012). However, it is not all that easy for Barbara; she faces various problems as an investor in the New York realty market. While she is a popular investment consultant in the city, she admits that she has problems advising because other factors come into place. After selling her realty company, she was left with several buildings in the city; these building are her source of income, beside other investments. For instance, the values of properties have plummeted and interest rates have gone down tremendously. This gives her problems in deciding what to tell investor to do, especially because they look upon her success for guidance. References Kouzes, J. M., & Posner, B. Z. (2012). The leadership challenge: How to make extraordinary things happen in organizations. San Francisco, CA: Jossey-Bass. Hann, C. (2014). Barbara Corcoran’s Leadership Style: Rainbows and Steel-Toe Boots. Entrepreneur. Retrieved 15 August 2014, from http://www.entrepreneur.com/article/222798 Source document

Reading Is Fundamental Essay

Reading is the foundation that a child’s ability to learn is built on. The fundamentals of all learning are based on reading. Research has proven time and time again that reading to your child, even as early as pregnancy and infancy, helps to spark their curiosity to learn to read. By reading aloud during pregnancy and infancy, the ground work is being laid in the development for a child’s love of reading (Promoting Literacy). To help children develop a love of reading start by having books all around. In the words of Dr. Seuss, â€Å"The more that your read, the more things you will know. The more you learn the more places you will go. † (Dr. Seuss). An early start with teaching the concept of page turning, observing pictures, and sequencing will feed little ones curiosity. You can further spark their imagination and creative thinking skills by sharing a picture book without words. Also, reading at bed time will also help small children learn that reading is a relaxing and comforting activity. As children get older we need to make sure we don’t always make reading feel as if it is a task, but rather enjoyable. The U. S. Department of Education found that, generally the more children read for fun the higher their reading scores are in school (U. S. Department of Education, 2007). The answer to how to help children develop a love of reading mainly lies in how we as adults encourage them. Most of a child’s early learning comes from copying what they see their parents do, so if children do not see their parents read then they are not going to be compelled to read themselves. There are so many ways we can nurture a love of reading with children that in turn will help them develop in so many different ways. We read for so many different reasons and it is important that we convey those differences to our children so they can maximize the benefits they get from their own reading. Without being surrounded by people who read then it will be difficult for a child to make that vital connection between reading and enjoyment, thus hindering the development of a love of reading. Children should know books are not just purely for pleasure, but can also be used for a source of information. Once able to read then a whole world of literature opens up and as long as people write and read what is written then books will continue to provide education, information, and pleasure for all who participate. Works Cited Dr. Seuss. â€Å"I Can Read With My Eyes Wide Shut. † www. goodreads. com. Promoting Literacy. â€Å"Bonding With Your Unborn Baby Through Books. † www. earlymoments. com. U. S. Department of Education, 2007. â€Å"Facts About Children’s Literacy. † www. neg. org.

Proto-Oncogenes Their Role in Cancer Article Example | Topics and Well Written Essays - 1250 words

Proto-Oncogenes Their Role in Cancer - Article Example Specific genes of chicken and rodent retroviruses were first noted to transform normal mammalian cells in culture. These cancer-causing genes (oncogenes) proved to be activated homologues of mammalian genes (proto-oncogenes), which were stolen from the host cell during viral evolution. Primary human cancers harbor similarly activated alleles of proto-oncogenes (Haber, 2006) Some of the mechanisms by which proto-oncogenes are activated in human cancers include: point mutations, gene amplification, and chromosomal translocations. These mutations are known as gain-of-function mutations because â€Å"they result in novel or altered functional properties for the encoded protein and are genetically dominant over the second normal allele†(Haber, 2006) Proto-oncogenes can be classified based either on their normal function within cells or upon sequence homology to other known proteins (National Science Teachers Association. 2001). â€Å"Proto-oncogenes that were originally identified as resident in transforming retroviruses are designated as c- indicative of the cellular origin as opposed to v- to signify original identification in retroviruses† (National Science Teachers Association. 2001). The classification listed below includes only those genes that have been highly characterized (National Science Teachers Association. 2001). Of particular interest is the ras family of proto-oncogenes. There are three homologs of this gene, H-ras, K-ras, and N-ras, and these have been detected in more human tumor types and at a higher frequency than any other oncogene (Anderson et al., 1992). They acquire transforming activity by a point mutation in their coding sequence. Invivo, activating point mutations have been observed in codons 12, 13, 61, 117, and 146 (Anderson et al., 1992).

Coffee market Assignment Example | Topics and Well Written Essays - 1000 words

Coffee market - Assignment Example For instance, in 1980s, many of the major producers of coffee had poor technological infrastructures. Therefore, cartels took this opportunity to deceive the farmers concerning the real prices of coffee in the markets. Therefore, they dictated the amount of coffee to reach the market, an aspect that affected the supply of the commodity in the market. As a result, they create an artificial demand, thereby causing an increase in the prices of the commodity. However, on the other side, they maintain a constant amount of money they purchase the coffee from the farmers. Consequently, they make huge sums of money in the expense of poor farmers. The demand in the market determines the amount of the product that producers are willing to supply. Higher prices motivate the producers to increase the amount of products to be produced. However, cartels take all the benefits emanating from higher prices of the products in the market. Therefore, many producers end up being frustrated, an aspect that affects their levels of production. This explains why rising prices of coffee since 2005 have not acted as incentives to farmers. In reaction, majority of the farmers have uprooted coffee bushes and planted fast growing crops such as fruits which are earning higher prices in the global market. Cartels are illegal in many countries because they affect the independence of the market. This is through preventing the forces of demand and supply to dictate the prices of the commodities in the market. For instance, instead of farmers benefiting from high demand in the market, these benefits end up in the pockets of few individual who does not contribute even a single cent towards the production of the commodities. These are people who distort the movement of the goods along the value chain but their presence does not benefit the producers or even the consumers. As a result, they affect the growth of the production sector in the country. In

Contract law examination Essay Example | Topics and Well Written Essays - 1500 words - 1

Contract law examination - Essay Example However, if the offeree asks for further details about the offer, the offer is not rejected and is still effective as seen in Stevenson v McLean. If the offeror makes the offer again, then the offeree can accept it. An offer also ceases to be effective when the offeree makes a counter offer to the original offeror. In Hyde v Wrench, it was held that a counter offer rejects the original offer. The offeror is not bound to accept a counter offer. However, if he accepts the counter offer, a fresh agreement is formed without any regard to the original offer. iii. Failure to fulfill a condition precedent to acceptance also terminates an offer. If the offeror has specified a definite mode of communication of acceptance which is not followed by the offeree, the offer ceases to be effective. In Manchester Diocesan Council of Education v. Commercial and General Investments Ltd, the courts ruled that an offer ceases to effective if the specified mode of communication of acceptance is not followed. An offeror has a right to revoke his offer at any time before its acceptance. For an offer and acceptance to be valid, effective communication is of paramount importance. An acceptance is not effective if it is not communicated to the offeror. In the given case, Ali sent a letter of acceptance of Yasmin’s offer to her but addressed it wrongly. Until the letter reaches Yasmin, Ali’s acceptance would not be effective as the acceptance would not have been communicated to Yasmin. Therefore, as long as the letter is in transit, Yasmin has a right to revoke her offer. The communication of revocation of offer is also very important. In this case, Yasmin notified Ali’s friend that she had revoked her offer. Assuming that Ali’s friend is a reliable third party, by the application of Dickinson v Dodds, Yasmin’s notice of revocation would be deemed to be sufficient and effective. After her revocation, she would not be bound to perform her promise when the let ter

Height and the Weight of the Mother, with structure Lab Report

Height and the Weight of the Mother, with structure - Lab Report Example The taller mother’s with an Q2 average 1.68 tend to weigh more that the mother’s with Q1 of 1.58 at 50.57Kgs. The average mother’s weighs around 58 kgs and the average BMI of 22. The age of mother’s is around 28Kgs. As the age increases, the height increases and the weight increase too. Taller mothers have a higher BMI than the shorter, thus the height of the mother has an effect on the weight of the mother and has a direct correlation with the BMI. Age does not affect the height of the mothers. There is a moderate correlation between BMI and gestation days. Mother’s with a high BMI tend to have longer gestation period. The average gestation day of a mother is 279 days and with an average of 22 BMI. The BMI effect on gestation period can be traced to weight factor; thus mother’s who have a higher BMI have a probability of having longer gestation period. Further, taller mother’s have a higher BMI; thus the probability of the taller mother’s having longer gestation period is

Art Essay Example | Topics and Well Written Essays - 500 words - 1

Art - Essay Example The painting, hauntingly striking was initially christened Der Schrei der Natur in Norwegian, or the Scream of Nature. The current Skrik, when loosely translated bestows upon it the title it is known by. Munch in a journal entry recorded sensing â€Å"an infinite scream passing through nature†, while out walking one day accompanied by friends. There are various theories about the inspiration behind the creation. Munch painted what he felt, as described in the journal entry mentioned. Another theory places the eruption of Krakatoa in 1883 behind the visual inspiration for the blood-red background, disputed by scholars who claim him to be expressive rather than descriptive in his style. Others attribute the figure’s cadaverous appearance to be caused by Munch’s probable visits to the Museum of Natural History in Florence or during the Exposition Universale in Paris where such mummified exhibits were on display. Then again, there are many who compare the environment of The Scream to that experienced by sufferers of depersonalization disorder, arguing that Munch probably suffered from the ailment. It is quite a famous painting in my opinion, instantly recognizable like the Mona Lisa. It has featured in many movies, being the inspiration behind the mask in the Scream series of films; programs as well as in the print media. Caricaturized, humored or revered, The Scream is pretty much a public figure.

Hanover-Bates Chemical Corporation Case Study Example | Topics and Well Written Essays - 500 words

Hanover-Bates Chemical Corporation - Case Study Example District 1, 2 and 7 performances got little profits as they surpassed their gross profit quote a little (Spiro, et. al, 2008). The performance of northeast district as compared to other districts is constantly low. Other districts performed better than the set target or a little low, while northeast district performed very low. The sale of the northeast district is high, but profits are low if it is accessed in comparison with northeast central (Spiro, et. al, 2008). So, in totality, northeast district is continuously performing low as compared with other districts. Jim Sprague is quite less experienced as the new sales manager of the northeast district. However, the company’s management has trust in his skills. Hank Carver, an experienced and appreciative sales representative is interested to quit his job. The northeast district has poor performance and is unable to meet the gross profit quote. The district is not capable take benefit of potential future accounts. Their sales representative pay expenses are higher as compared to other districts. The sales representatives of northeast district have elevated own selling operating expenses. Northeast district is short of paying attention to major and medium ranged accounts (Spiro, et. al, 2008). Management’s role in improving poor performance in the northeast district is very crucial. The management should support Jim in his task by appointing supporting experienced assistant. There should be a biyearly analysis of the district in comparison with other districts. There should be incentives for outclass performers to motivate sales reps. The management should be revise its standards for the poor performing districts. Jim Sprague should install a monitoring system for the evaluation of expenses related to sales representatives (Spiro, et. al, 2008). He should conduct meetings to inform the sales reps about their elevated salaries in comparison to the sales reps of other districts and

Marketing Essay Example | Topics and Well Written Essays - 1750 words - 13

Marketing - Essay Example sly existed between countries of various parts of the world and has thereby paved the way for economic development through the process of creation of internal and domestic demand for products and services of international brand, quality, design and stature. It is of considerable importance to state that the need of economic development has led to the process of opening up of economies around the world. The emergence of new and developing economies around the globe has played a catalytic role in the process of increasing the level of competition in the marketplace. So quite naturally, this has led to the process of increasing the demand for standardised and high quality goods and services in regions all over the world. In an attempt to maintain a level of standardization, the services sector all over the world has focused on implementing various new tools and strategies that considerably helps in the process of developing a significant benchmark of service delivery and retaining of authentic quality. With the growth, penetration and continuous evolution of technology, the global services sector has broadened its extension to delivering services to clients who are located in various parts of the world. It is of significant importance to state that in an attempt to do so, the services sector has increasingly embedded the technology platform as a medium of delivery in their entire service delivery model. It can be said that the Hilton Garden Inn Hotel is part of the highly popular brand of hotel chain which is trademarked by the group Hilton Worldwide. The hotel offer hospitality sector based service offerings, which are found to be falling within the category of mid-range pricing. The hotel and its esteemed services are mostly targeted consumers all over the world, who essentially form the segment of business men and leisure travellers. Talking in a more detailed manner, it can be said that the Hilton Garden Inn Hotel is a part of the independently operating chain

JFK assassination Research Paper Example | Topics and Well Written Essays - 1500 words

JFK assassination - Research Paper Example The sheer emotion and rawness of the coverage appealed to people’s senses that brought the people closer to the news. It was also by no means dismissible that at the heart of the breaking news were America’s affable and media-savvy president and the grief-stricken first family devastated by a tragedy. Overnight, the mostly newspaper-reading and radio-listening nation has turned their attention to their television sets to get a blow-by-blow update of the latest news. Merriman Smith, a United Press International (UPI) newsman, was riding in the presidential press pool car just behind JFK’s limousine on that fateful day in Dallas when they heard three loud shots. The second and third sound made it unmistakable that they came from gunshots. Smith immediately grabbed hold of the car’s radio phone and contacted the UPI headquarters to deliver the news update. Cronkite, inside the CBS studio in New York, was just informed of the president’s assassination coming across through the UPI teletype machine. As Cronkite’s news team breaks the station’s regular programming to deliver the assassination news unsure of the president’s condition, Smith was in Parkland Hospital with more breaking story. Smith informs UPI that President Kennedy has died at 1:00pm. Breaking the soap opera slot, Cronkite emotionally delivers the news.2 Smith rushed to the office and fed the whole world with the news through the five bells that rang on the recipient UPI machine to indicate the urgency and weight of the message. Walter Cronkite was a close confidant of Smith’s. He knew exactly what Smith meant by the message fed to the world in such a short span of time. Cronkite took to the television immediately, putting a break to the ongoing programs. He had to go on audio, as the available camera was slow at loading images. Cronkite became the most trusted person in America at that time.3 From the time of

Analysis of Two Pictures by Dorothea Lange Essay Example for Free

Analysis of Two Pictures by Dorothea Lange Essay Dorothea Lange is one of the America’s most renowned documentary photographers. Yet her works can not be considered as â€Å"purely† documental. Lnge’s ability to demonstrate the inner world of her heroes and her masterful photographic techniques placed her works in the middle between photography and art. In this paper I will attempt to review and analyze two Lange’s photographs: â€Å"Human Erosion in California† (â€Å"Migrant Mother†) and â€Å"Child and Her Mother†. I am going to analyze them in terms of style, symbolism and influence on future Lange’s career and development of the art of photography. â€Å"Human Erosion in California† and â€Å"Child and Her Mother† are separated with the period of three years being made in 1936 and 1939 respectively. This was a time when Lange was about forty and her talent flourished reaching its highpoint. At that time she made her name as a social critic, as her matter of primary concern was the fate of poor and dispossessed people . â€Å"Human Erosion in California† is probably her most famous picture touching this theme. More broadly, Lange was interested in the people as they are and people in different situations. The â€Å"Child and Her Mother† is more a psychological than social work, or, better to say, a work on human psychology in a stagnating society. Here Lange could apply her experience she received working with Maynard Dixon and in the portrait studio to develop her own original style . The picture that later became known as â€Å"Human Erosion in California† or â€Å"Migrant Mother† was originally made in California in 1936. This picture that became almost an iconic vision of the Great Depression depicts Florence Owens Thompson, a Cherokee woman whose husband died in 1932 leaving her with five children and expecting the sixth child. Describing their meeting Lange wrote: I did not ask her name or her history. She told me her age, that she was 32. She said that they had been living on frozen vegetables from the surrounding fields and birds that the children killed. She had just sold the tires from her car to buy food. Lange has made several pictures of the same model to find the best perspective. The most famous of the pictures she made demonstrates a prematurely aged woman sitting in a camp with two underage children cuddling to their mother. The woman looks both tensed and tired. Her look can not be called desperate, she rather seems to be disappointed and desolated. A woman can not afford herself to become frustrated as she has to care of the babies. Despite of all her grieves she looks strong and decisive. This picture places a model in the centre while the details of the background are unimportant. Much later Thompson told that Langer promised her not to publish the picture and to send her a copy, yet she did neither. Officially the picture was made for the government and Lange never received royalties for it, but this work was a landmark that contributed greatly to her success. 20 000 pounds of food arrived to the camp where the picture was made after publication of the picture, but Thompson has not received any since she had already moved in search of work . Durden observes that many of Lange’s pictures â€Å"focus on the expressive potential of the body’s gesture† . This is true for the â€Å"Migrant Mother†, but this feature of Lange’s work can be most obviously illustrated by the â€Å"Child and Her Mother†. The picture was made in 1939 in the Yakima Valley near Washington. It is less famous than the â€Å"Migrant Mother†, yet not less brilliant as it presents another aspect of Lange’s talent. â€Å"Child and Her Mother† is a socio-psychological work combining the view of a teenage frustration with social blunders. From the artistic point of view Lange used a different composition in this picture. In contrast to static â€Å"Migrant Mother† this photograph presents movement and tensed rhythm. A child, who can also be perceived as a young girl downcasts her eyes linking against the wire fence while carefully observed by her mother. Both stand on a sandy desert land burned by sun, but the mother attempts to cover her eyes while the daughter keeps them open. It appears that the girl is trying to escape the life that her mother has lived in order to overcome sadness and poverty . Lange’s work in the times of the Great Depression are not unique. Not less famous are, for example, works of Arthur Rothstein. Yet Lange is distinguished by her profound sympathetic understanding not of the social phenomena, but of the people suffering from it. This is a kind of â€Å"female view† of the Great Depression as an event that revealed the hidden sides of people’s characters. For this reason Lange’s pictures would hardly be lost in the stream of her contemporaries’ works. Works Cited: 1. Partridge, Elizabeth. Restless Spirit: The Life and Work of Dorothea Lange. Puffin, 1991; 2. Meltzer, Milton. Dorothea Lange: A Photographers Life. Syracuse University Press; 1st Syracuse University Press Ed edition, 2000; 3. Durden, Mark. Dorothea Lange. Phaidon Press, 2006; 4. Spirn, Anne Winston. Daring to Look: Dorothea Langes Photographs and Reports from the Field. University Of Chicago Press, 2008; 5. Maksel, Rebecca. â€Å"Migrant Madonna†. Smithsonian magazine, March 2002. http://www. smithsonianmag. com/arts-culture/Migrant_Madonna. html retrieved April 27, 2009.

Huge Inflammatory Myofibroblastic Tumor in Teenager

Huge Inflammatory Myofibroblastic Tumor in Teenager Abstract Background: Inflammatory myofibroblastic tumor (IMT) is a rare benign neoplasm. The huge IMT of chest is even rarely observed and there is few literatures described the disease. Case presentation: A 17-year-old girl who suffered from a dry cough with right chest pain. Contrast-enhanced CT showed a huge heterogeneous mass with calcified plaques. A surgical management strategy was successfully undertaken. Increasing physician awareness of this entity should facilitate recognition of its clinical characteristics and laboratory findings. Conclusions: This case suggests that a rarely huge and surgically treated IMT in a teenager and concerned with the radioclinical, histopathological, therapeutic aspects of this disease. Keywords Inflammatory myofibroblastic tumor, Lung, Surgery Background Inflammatory myofibroblastic tumor (IMT) is a rare benign tumor that often affects children. It has been first described by Brunn in 1939 [1] and it accounts for 0.71% of all lung tumors. [2, 3]. The origin of the IMT is unknown, but recent studies have shown that it is a true tumor rather than a reaction process [4]. Different terms used to describe IMT include inflammatory pseudotumor, cellular inflammatory pseudotumor, plasma cell granuloma and inflammatory fibrosarcoma. This lesion consists of inflammatory cells and myofibroblastic spindle cells [5, 6]. We report a case with a rarely huge and surgically treated IMT in a teenager and concerned with the radioclinical, histopathological, therapeutic aspects of this disease. Case presentation A 17-year-old girl was referred to our hospital with a 15 days history of right chest and cough without sputum. She denied the following symptoms including the presence ofhoarseness, hemoptysis, anddyspnea. Her medical history and family history were uneventful. Physical examination revealed normal breath sounds in both of the lung fields. The results of laboratory examinations, including arterial blood gases, hematology tests and biochemistry tests, were within normal limits. Her Pulmonary function tests and cardiovascular examination revealed normal performance. Contrast-enhanced chest computed tomography (CT) showed an 18Ãâ€"16Ãâ€"15 cm heterogeneous mass with calcified plaques invading the entire right hemithorax and mediastinal shift to the left (Fig 1A, 1B). However, the patient refused to have the bronchoscopic examination and fine-needle biopsy of the mass. As diagnosis was not established through imaging, surgery was scheduled. Under general anesthesia with selective intub ation, a huge mass (measuring 20Ãâ€"17Ãâ€"17 cm and weighing 2010g) with inferior vena cava and right pericardium invasion was found and the right middle and lower lobes bronchus appeared encased by the mass. At last, the neoplasm was completely excised. The patient underwent a right middle and lower lobectomy, inferior vena cava angioplasty and partial resection of pericardium. Mediastinal lymph node dissection was also accomplished. The feeding vessels of the mass were ligated and the mass was removed without tumor spillage or capsular injury. After that, reexpansion of the right upper lobe was observed and a chest tube was placed to drain the pleural cavity. A postoperative roentgenogram of the chest showed that the mediastinum had returned to its normal position and the right lung was well expanded. Microscopic examination revealed a proliferation of regular spindle cells arrayed in fascicles, admixed with lymphocytes, plasma cells and eosinophils. Additional immunohistochemis try with anaplastic lymphoma kinase (ALK)-1 and smooth muscle actin (SMA) revealed positive and the translocation of the ALK gene was found by fluorescence in situ hybridisation (FISH). The results for desmin, S-100, CD99, CD34, Myogenin, EMA and pankeratin were negative. Ki-67 proliferative activity was 8%. Based on these data, the diagnosis of inflammatory myofibroblastic tumor was retained. Histologic diagnosis showed a negative bronchial margin and lymph nodes free of malignancy. The patient made an uneventful postoperative recovery and was followed up for two months without evidence of recurrence to date. Conclusions Inflammatory myofibroblastic tumor (IMT) is a rare massforming lesion characterized by fibroblastic or myofibroblastic spindle cell proliferation with varying degrees of inflammatory cell infiltration. The World Health Organization (WHO) classified IMT as a distinct entity in 1994 [7]. However, the huge inflammatory myofibroblastic tumor of chest is even rarely observed and there is few literatures described the disease (Table). The cause of IMT tumors is unclear, but an immunological response to an infectious agent or noninfectious agent remains possible [8]. Whereas some reporters demonstrated that IMT tumors are true neoplasms and some believe the IMT tumors to be a low-grade sarcoma with inflammatory cells as it has a potential for local recurrence, infiltration, multicentricity, and rarely metastases [9]. Also, ALK positivity is detected in 36% to 60% of cases and the presence of chromosomal aberrations in these tumors suggests that IMT is a neoplastic proliferation of clonal or igin [10]. In our case, there was no evidence of infection or inflammatory response and no history of trauma in her chest. The tumor was single and circumscribed, and movable. The IMT affects both sexes, at any ages, with a slight predominance in children and young adults [4, 11]. Most patients are asymptomatic and the tumor is discovered incidentally on a chest X-ray performed for another reason [4, 11].From the table, all of the four patients were young adults and were referred to the hospital with a common symptom of cough. In our patient, the tumor was discovered at an early age and the only symptoms were dry cough and right chest pain. Radiological aspects are capricious. Chest radiographs are the most generally performed imaging study to evaluate the neoplasm. Most patients have a mass or a pulmonary nodule, generally measuring 1 to 6 cm in diameter [12]. On CT scans, these tumors shows typically heterogenous attenuating enhancement [6]. Sometimes the tumor can extend towards the hilum, mediastinum, pleura or diaphragm [1, 3]. As recorded in the table, all the sizes of masses were huge and two of them were observed the invasion of the mediastinal or the chest wall. There is also a word of caution in our case that the representative calcifications were observed in the centure of heterogeneous mass and it invaded the inferior vena cava and right pericardium. Microscopically the IMT tumor consists of spindle shaped cells that are mixed with a chronic inflammatory component that consists of plasma cells, lymphocytes, and occasional histiocytes. Immunohistochemistry for ALK discovered cytogenetic abnormalities on chromosome 2p23 is relatively specific for IMF tumor among the spectrum of fibroblastic-myofibroblastic tumors and other potential mesenchymal mimics of IMF tumor [13]. The recent WHO classification of soft tissue tumors recognizes 3 basic variants of IMT: (1) loosely organized myofibroblasts in an edematous myxoid background with plasma cells, lymphocytes, eosinophils, and blood vessels, resembling nodular fasciitis; (2) dense aggregates of spindle cells arrayed in a variable myxoid and collagenized background and admixed with a distinctive inflammatory infiltrate, diffuse clusters of plasma cells, and lymphoid nodules, resembling fibrous histiocytoma or fibromatosis; and (3) collagen sheets with scattered plasma cells and eosinop hils resembling a scar or desmoid tumor [14]. The differential diagnosis of IMT is follicular dendritic cell tumor and inflammatory pseudotumor. Follicular dendritic cell sarcoma (FDCS), which was first reported by Monda et al. in 1986, is a rare neoplastic proliferation that exhibits the morphological and immunophenotypic features of FDCS that are among the accessory cells of the lymphoid system. The tumor cells exhibited positive immunohistochemical staining for vimentin, CD21 and CD35 as well as negative staining for ALK-1 and SMA. Inflammatory pseudotumors are benign tumors commonly found in the lung and they are characterized by proliferation of spindle cells (fibroblasts and myoblasts), with variable numbers of mitoses, and inflammatory cells infiltration, particularly plasma cells. More recently, the presence of anaplastic lymphoma kinase (ALK 1) staining in some cases has been postulated to be of value in the confirmation of IMT and in its distinction from other entities. A series of studies found the translocation of th e ALK gene by fluorescence in situ hybridisation (FISH) in IMT (16). In our case, the mass was spindle cell lesion with severe atypism and some mitosis. As shown in Fig 2 (A, B, C), ganglion-like cells were present and the immunohistochemistry result for ALK-1 shows strong positivity of tumor cytoplasm and translocation of the ALK gene. Based on these findings, her tumor may be very aggressive. Despite IMT is a benign tumor, it is considered by some authors as a low grade tumor because of malignant features such as local invasiveness, recurrence or malignant transformation. Complete surgical resection is the appropriate treatment for IMT. Cerfolio and colleagues reported an excellent prognosis in patients undergoing complete resection of pulmonary IMT, with a 5-year survival rate of 91.3%. However, a 60% recurrence rate in those receiving incomplete resection has been reported in the same study [15]. Corticosteroid monotherapy may result in rapid resolution of the disease and sustained remission (17, 18). Non-steroidal anti-inflammatory agents (NSAIDs) as solitary therapy may be extremely efficacious and anecdotal response to chemotherapy has also been reported (19). As the literature reviewed in the table, three patients had the operations by a standard posterolateral thoracotomy. Among them, two patients had the lobectomy and the other had the complete resection with two through fourth ribs. The patient whose neoplasm invaded superior vena cava, heart atrium and right pulmonary vein underwent chemotherapy with bleomicin, etoposide and cisplatin. After two cycles of chemotherapy, the tumorslightly reduced in size and the patient only survived for 12 months. In summary, inflammatory myofibroblastic tumor is a rare benign tumor. Because of its local invasiveness and its tendency to recur, IMT tumor can be confused with malignant lesions. Because the treatment of IMT tumor is conservative surgery, preoperative recognition is important to avoid radiation therapy, and intensive multi-agent chemotherapy that would be appropriate treatments for soft tissue sarcomas. Clinical and radiological presentation is variable and nonspecific and the diagnosis is rarely made before chirurgical management. Also, because the tumor with cellular atypia, ganglion-like cells, ALK and SMA reactivity has a more aggressive clinical behavior, a careful follow-up is required. Figure legend Figure 1: CT features of the case. A and B: Contrast-enhanced CT showed a huge heterogeneous mass with calcified plaques. Figure 2: Histological and immunoistochemical features. A: Hematoxylin-eosin staining demonstrating spindle cells sprinkled, with a predominance of plasma cells and lymphocytes. (X400) B: Immunohistochemical staining showing strong reactivity for anaplastic lymphoma kinase (ALK)-1(X400) C: Immunohistochemical staining showing strong reactivity for smooth muscle actin (SMA) (X400) 1

Causes of Stalking and Experiences

Causes of Stalking and Experiences Stalking is an issue that affects 1.5 million people each year. While women are commonly the general target, men can become victims of stalkers as well. Stalkers share similar traits, each of which fuel what they do. Oftentimes a stalkers motives are as easily profiled as their traits. Stalkers commonly share similar personality characteristics as well as reasons for doing what they do (Michele, 2002). Stalking has been around since the beginning of time. Men and women alike have been accused of such a crime because they either cant get it out of their head that the other person does not want to have anything to do with them, or they are just obsessed with a stranger. It is just recent that the UK Government has decided to make stalking a crime in it self. This type of crime was labelled as harassment, annoyance, or domestic violence. It wasnt until the 80s and 90s that stalking cases were brought to the attention of the media and high political policy makers (Michele, 2002). Discussion Many stalkers are loners. Because of the lack of other relationships, they become severely attached to the idea of possessing a relationship with the person who they are stalking (Paul, 2000). In many cases, the lack of ability to form relationships starts at a young age. Some stalkers are neglected by their parents, and in turn are unable to form attachments with other people later on in life. This causes them to be extremely lonely, which is a main characteristic of a stalker. This lack of personal relationships, combined with a low self-esteem creates a feeling of worthlessness (Michele, 2002). They feel like without a connection with the person they are stalking, they have no purpose in life. This is one reason for most celebrity stalking. The idea of establishing a connection with a person of high status becomes appealing, because these stalkers believe that they will acquire a higher level of importance. When this does not happen, stalkers can often become extremely angry, even violent toward that person. Frustration builds up, and they do not know how to deal with the situation. This can sometimes lead to stalker related deaths. A common characteristic shared by most stalkers is their lack of anxiety, and even shame in a stalking scenario (Paul, 2000). In most situations, a person would be absolutely beyond embarrassed to be caught snooping around in another persons personal belongings. Rummaging through someones garbage in order to find personal information would be so inappropriate that the average person would not even consider it. Beyond that, if they were, in fact, caught in the act, most people would be completely mortified. Stalkers, on the other hand, do not think this way. No action is too out of line. Stalkers see it as an attempt to gain the love of the person that they are stalking. These people seem to be immune to anxiety and discomfort, and in turn they have no trouble continuing in their pursuit. Some of the tasks that are carried out by stalkers are quite difficult. Stalkers need way more intelligence than one would assume that they have. But although many of them have mental disorders, most stalkers are much smarter than the average person. Obtaining information about a person is not usually the easiest task, but stalkers may go as far as changing jobs in order to do so. Stalkers sometimes learn how to tap into phone conversations, hack into computers, and spend thousands of dollars to find a particular person, or information about that person. Psychologists have long puzzled over the way in which individuals may act differently in identical situations, resulting in various strands of personality theory to have emerged within the realm of psychology each attempting to explain personality traits at various levels , these being experimental, psychometric and clinical (Michele, 2000). Butt (2004) notes how Eysencks theory although presented as a clinical approach to understanding individual difference, was fundamentally rooted within the psychometric tradition which emerged from within the mainstream paradigm in the early twentieth century. Most famously to appear from this era was the Likert scale- a graded style response questionnaire which had been engineered for attitude measurement. For Eysenck however psychometric testing aided the process of assessing and predicting individual levels and likelihood of extroversion or neuroticism by reducing dimensions of personality ranging on a bipolar scale from unstable to stable to either being classified as a typical extrovert or introvert. According to Eysneck the reduction of variables in personality traits to either extroversion or neuroticism could be biologically explained by differences in the cortical and autonomic arousal systems . According to Eysnecks Personality Inventory individuals who were perceived with introspective, quiet, reserved and generally unsociable traits were classified as having a high N score whilst those who appeared optimistic, talkative, sociable and outgoing were prescribed a high E score. This lies in contrast to Eysencks model of a fixed personality which appears to be unaffected by external circumstance . In addition, Salmons re- working and application of theories in the context of educational learning has shown how her intervention of the Salmon Line provides a basis for facilitating change (Jens, 2008). Salmons intentions in developing the Salmon Line were aimed at providing a tool that could stretch beyond diagnostic mo del and assist the learning process. The success of technique has been attributed to the ways in which behaviour change and learning is enhanced through eliciting pupils and teachers experiences and identifying areas of conflict and collaboration. The approach is rich in subjective experience captivating the diversity that exists amongst individuals and allowing for reflexivity in its approach. In summary for PCT theorists, differences in personality is viewed as a reflection of the complex ways in which individuals build constructions of their world rather than a simply reflection of innate biological forces. Having contrasted Eysnecks theory with others people shall now explore to what use and purposes such theories can apply as well as their validity in either upholding an agency-structure dualistic approach or seeking to dissolve it (Jens, 2008). Stalkers often also possess the ability to manipulate friends and family members of the person who they are stalking (Thomas, 2003). They will find ways to trick the people into giving away information about the person they are harassing. This involves a higher level of intelligence than that of an average person. Often, people who stalk celebrities suffer from a condition called erotomania, which is also known as de Clerambaults syndrome. Stalkers fall deeply in love with a person and in their own mind, that person is in love with them as well. Stalkers will watch the actions of the person very closely, and even if they have never met the person before in their life, they believe that that person is in love with them as well. Stalkers may dream up an entire relationship, such as Margaret Ray did when she told people that she was David Lettermans wife. Not only did she claim to be married to Letterman, but one day she showed up at his house carrying a baby which she demanded was his (Letterman stalker killed by train in apparent suicide)(Thomas, 2003). Sometimes people will stalk celebrities simply because they desire the fame and status of those people. Michael Lewittes article Serial Celebrity Daters describes the lives of Lisa Chiafullo and Jennifer Young-two girls who are obsessed with being obsessed (Joseph, 2001). Each of these girls began dating the stars at young ages. While Jennifer grew up in luxury in Beverly Hills, Lisa was on welfare and in bad financial shape. While Jennifer enjoyed the high life and luxury of dating celebrities, Lisa sometimes counted on meals, shelter and money from celebrities to keep her head above water. The desire is summed up perfectly by Lisa (Joseph, 2001). She always wanted to be somebody so if she couldnt be somebody; she wanted to date someone who was. This type of thinking is what causes many fans to turn into fanatics. They obsessed over people simply because of whom they are and how famous they are. Stalking is not only limited to celebrities, however average people are in danger of being stalked just as well (Thomas, 2003). In the case of simple obsession stalkers, victims arent chosen based on celebrity status or popularity, rather their past relationships with the stalker. Simple obsession stalkers harass people who they have been involved with in previous relationships, most of the time; the victim puts an end to the relationship, which seems to be tragic to the stalker. Suddenly, the stalker feels that his or her life has been destroyed, and that they simply cannot live without having that person back. The reasoning behind the stalking is that they feel like they have no self worth in the world and that its a necessity to have the person back in order to regain their identity and power that they once had. The person falls into a deep state of denial, refusing to accept the idea that they will have to go on in life without that person. Stalking is not always based on positive feelings and desire to by love. Some people stalk to seek revenge or simply out of pure hatred for a person. Sometimes stalking can occur in the workplace. A large number of murders due to stalking are carried out by people who have recently been fired from a job and who want to get revenge on the person who fired them. Psychotherapists sometimes become targets of stalking as well. They are severely harassed by former patients of theirs. Dissatisfaction, anger, and hatred are a few reasons that can fuel stalkers to harass and sometimes abuse- or even kill their victims (Thomas, 2003). Taking charge and admitting there is a domestic abuse problem is the key to starting to take back ones life, but the legal system must also be utilized to ensure individual rights are preserved and protected (Joseph, 2001). While great strides have been made in recent years to strengthen laws and educate judges on how to address domestic violence cases effectively, there is still work to be done. Some domestic violence cases have languished in district circuit courts for years. Because there are weak justices and numerous loop holes in the written law, there are criminals who will return to society un-rehabilitated seeking revenge or to target another to abuse. The feminist movement during the 1970s fundamentally changed societys attitude towards domestic violence (Logan, 2006). Women who formerly had been battered and abused developed services for domestic violence victims. They also lobbied for government support of these services and raised awareness of domestic violence. Since then, numerous changes have taken place to address the problem of domestic violence. Class action lawsuits and civil-damage suits forced law enforcement agencies to revise their policies and adapt processes to better address domestic violence. Domestic violence incidents were, in many states, established as crimes against the state, resulting in the victim no longer having to press charges. Law enforcement officers today are often trained on how to respond to domestic violence incidents. The medical community also felt the need to act in response to domestic violence. In Delaware, for example, the Delaware Coalition against Domestic Violence together with Delaware s medical community and the Domestic Violence Coordinating Council (DVCC) developed a manual for healthcare providers addressing how to respond to domestic violence (Stephen, 2002). The DVCC also trains hospitals and clinics, police officers, prosecutors, judicial officers, court personnel, executives, faith-based personnel, social workers, advocates, probation officers, and therapists throughout the First State on domestic violence. While most laws pertaining to domestic violence are on the state level, the federal government also responded to domestic violence. For example, it is a federal offence to travel from one state to another to commit domestic violence or to force an intimate partner to cross state lines in an attempt to commit domestic violence. Additionally, the federal government passed interstate stalking legislation making it a federal offence to cross state lines in an attempt to stalk a victim, and also barred offenders from carrying and owning weapons. The Violence against Women Act (VAWA) further protects victims of domestic violence and provides funding for services. VAWA also requires that the victim, if so desired, be heard at a bail hearing with regard to the danger posed by the defendant. VAWA also stipulates that the victim be reimbursed for costs occurred to the victim in obtaining a restraining order and other costs connected to a domestic violence conviction. Another important aspect o f VAWA is the ability for battered and abused spouses and children of citizens and lawful permanent residents to self-petition for independent legal residency. Before VAWA, immigrant victims had to fear deportation when leaving an abusive relationship (Logan, 2006). Since the late 1970s, states took an active role in domestic violence prevention. About a third of domestic violence outreach and services are funded from state level (Stephen, 2002). Most states have laws that allow prosecutors to charge abusers without having to involve the victim. Many times victims are no longer are required to testify against their abusers. In 1997, a total of seven states and the nations capital had mandatory arrest laws on the books that required law enforcement to make an arrest if there is evidence of an assault. Even more states encouraged such arrests. A 1984 study showed that arresting abusers lowered the re-arrest rate within the next 6 months for domestic violence to 10%. However, more studies are needed to replicate these findings (Stephen, 2002). According to the study, most intimate partner abuse is not reported to law enforcement, making it difficult to know exactly how many men and women are abused. Only about 20 percent of all rapes, 25 percent of physical assaults, and 50% of stalking incidents against women were reported to law enforcement. The number of victimizations of men by intimate partners reported to police is even smaller. A general belief that the police cannot help or would not do anything keeps victims from reporting abuse or stalking incidents (Stephen, 2002). Many positions related to domestic violence are held by social workers. Social workers often help clients build s support system by referring them to resources they need and by helping them gain access to such services. Social workers may also be involved in crisis and long term counselling to help victims make significant decisions. Additionally, social workers may develop and co-lead support groups for victims, lobby on a national or state level for funding, and perform advocacy work. Advocacy work may include fund raising, training, explaining domestic violence, speaking to the media about domestic violence, developing materials to give to battered women, and community education. These are only a few of the essential functions performed by social workers in the domestic violence field. In 1993, following the murder of a woman by her ex-lover, who violently harassed her in breach of a protection order before killing her , the New South Wales Parliament responded by enacting a separate offence of Stalking which is now part of the Crimes Act. Stalking is conduct that is harassing or threatening, directed at a person with the intention to cause intimidation or fear. It is a form of non-physical violence, causing psychological and emotional abuse (Logan, 2006). The awakening of concern about this type of behaviour was caused by its prevalence in domestic violence cases. Firstly, the nature of the offence of stalking makes it inappropriate to prosecute under the current law of criminal assault. Related to this is the severe impact that stalking behaviour inflicts on its victims. The current law of assault is simply not broad enough to deal with the complexities that arise from an offence such as stalking. Assault is an act, which intentionally or recklessly causes another to apprehend immediate and unlawful personal violence, charged under s61 of the Crimes Act. At the essence of the offence of assault is a requirement that the threat created by the offender must cause a fear of imminent violence in the victim. Stalking involves instances where a person does not explicitly threaten their victim but silently follows them around or sits outside their dwelling. When placed in this context, such behaviour is dangerous beyond its immediate significance. Although, it is difficult to charge this as assault since it is not sufficient that the threat raises apprehension that violence will be inflicted at some time in the future. The inability to prosecute an offence that is of a similar nature to stalking under the law of assault was apparent in the case of Knight. Knight had made a series of phone calls threatening to kill or injure those involved his prior conviction, including a policeman, a magistrate and to a judge who later dismissed his appeal (Logan, 2006). On appeal to the Court of Criminal Appeal, his conviction for these offences was quashed on the basis that the requirement of a threat of immediate violence was not satisfied. Even though his behaviour caused fear and was dangerous, it fell short of the necessary accuses and hence could not be sanctioned under the law of criminal assault (Paul, 2000). Alternatively, the case of Ireland demonstrates an instance where an offence with characteristics that can be likened to stalking was successfully prosecuted under assault. The accused had proceeded to harass a woman whom he had a prior social relationship with, by making both silent and abusive phone calls, frequenting her place of work and home and taking photographs of the victim and her family. While fearful of personal violence the victim was also diagnosed with suffering a severe depressive illness. The offenders behaviour amounted to assault. This reasoning was founded on the fact that the victims fear of the caller arriving at her door could be seen as imminent since he may be making the calls in close proximity to her home and able to arrive at her door within minutes. However the legal reasoning in this case, has been criticised for being rather artificial by stretching assault beyond its natural legal meaning. As shown in Knight, most stalking cases are not suitable for pr osecution under the elements of criminal assault. The main area of assault also poses difficulty for the prosecution of stalking. It is constituted by intention to either affect an unlawful contact or to create an apprehension of imminent unlawful contact in the mind of the victim (Larry, 2000). Despite that the common law of assault is now more accommodating to the offence of stalking, through developing an interpretation of harm to include psychiatric as well as physical injury (Logan, 2006). It is still difficult to prove the imminence requirement in both of most stalking cases where the threat of harm is protracted rather than immediate (Sandra, 2007). Therefore, there is more rationale in treating stalking as a separate offence with its own specific elements rather than distorting the elements of assault to accommodate for the manifestations of stalking. The wide-ranging and severe impact of stalking further necessitates the need for a separate offence of stalking to deal with this crime. The psychological responses caused by stalking such as anxiety, fear, paranoia and often symptoms of post- traumatic stress disorder have been acknowledged in a study as emotions induced by stalkers. This research has found that 94% of victims have made changes to lifestyle patterns such as temporary or permanent relocation, changing personal contact information and even identities. Perhaps more compelling is that victims of a recent psychopathological study indicated that they might have coped better with more tangible damage of physical assault than with a stalkers constant intrusion and menace (Paul, 2000). Furthermore, stalking is often a precursor to severe and fatal physical violence as demonstrated in the case of Thomas v Burk. In this instance the applicant had been in a previous relationship with the complainant. After they separated, the complainant experienced many incidents of stalking such as receiving harassing telephone calls at work and being followed on a vacation trip. These incidents eventually escalated to physical abuse when on one occasion, the applicant stroked the complainant with such force across the face with an open hand that it caused injury to her eye. This is one of many cases that reflect the statistic that 80% of women who report being stalked by an intimate partner are eventually physically assaulted (Sandra, 2007). It therefore becomes apparent that there is a need to take preventative action. Such as prosecuting this behaviour under an offence of stalking at its early stage, rather than waiting until the situation amplifies and the victim is physically a ssaulted and only then taking action by prosecuting for assault. Sexual Harassment is defined as a continuum of behaviours that intimidate, demean, humiliate or coerce (Diane, 2006). These behaviours range from the subtle forms that can accumulate into a hostile working, learning, or worshipping environment to the most severe forms of stalking, assault or rape. For many businesses, preventing sexual harassment, and defending its managerial employees from sexual harassment charges, has become key goals of legal decision making. In contrast, many scholars complain that sexual harassment in education remains a forgotten secret, with educators and administrators refusing to admit the problem exist in their schools, or accept their legal and ethical responsibilities to deal with it. Previously stalking behaviour has been prosecuted as offensive conduct under s4 of the Summary Offences Act. An artificial reasoning was drawn by the courts that stalking was offensive from the fact that it was continued or repeated. While offensive conduct carries a light maximum penalty of three months this may be satisfactory for minor instances of stalking but it is a clearly an inappropriate reflection of the magnitude of behaviour that amounts to intimidation and harassment. The protracted nature of stalking and the serious implications on its victims necessitates the need for a specific offence of stalking with its own appropriate penalty in order to capture the severity of the offence. This is arguably more effective than collapsing this offence into the category of offensive conduct or treating it as criminal assault. The offender would then, also have to bear the stigma of being labelled a stalker (Larry, 2000). In 2006 study on sexual harassment at colleges and universities, it was reported that 62% of female college students and 61% of male college students report having been sexually harassed at their university, with 80% of the reported harassment being peer-to-peer. Fifty-one percent of male college students admit to sexually harassing someone in college, with 22% admitting to harassing someone often or occasionally (Diane, 2006). Thirty-one percent of female college students admitted to harassing someone in college. Sexual harassment can occur in a variety of circumstances. The harasser can be anyone, such as a supervisor, a client, a co-worker, a teacher or professor, a student, a friend, or a stranger. The victim does not have to be the person directly harassed but can be anyone who finds the behaviour offensive and is affected by it. While adverse effects on the victim are common, this does not have to be the case for the behaviour to be unlawful. The victim can be a male or female. The harasser can be male or female. The harasser does not have to be of the opposite sex. The harasser may be completely unaware that his or her behaviour is offensive or constitutes sexual harassment or may be completely unaware that his or her actions could be unlawful. There are however, some instances where a criminal sanction may not constitute an effective strategy of deterring further stalking even though the impact on the victim is traumatic. This mainly applies to the category of stalkers classified as erotomaniacs who are mentally ill. It would be more appropriate to deal with these stalkers through the mental health system as they are impervious to judicial sanctions and thus require assertive psychiatric management. The inefficacy of using stalking legislation to punish a perpetrator who has a psychiatric condition was illustrated in the case of Strong v The Queen. The appellant had been sentenced to imprisonment for the offence of stalking a female contrary to s562ABof the Crimes Act 1900(NSW) (Paul, 2000). Whilst serving his sentence in prison, the accused began writing sexually suggestive letters to another female with whom he had no prior relationship. After his release, he continued with his stalking behaviour by following and watchin g her and subsequently moved to live opposite her home. This conduct became the basis of another substantive charge of stalking for which he was again imprisoned. On appeal of this conviction the issue was raised that he had been diagnosed with suffering symptoms of psychosis. The Criminal Court of Appeal agreed that in cases such as this, the offenders condition should be managed under mental health legislation rather than sanctioned under the criminal law. This case demonstrates the inability of the criminal law to deter psychiatrically ill stalkers as the rate of recidivism of people in this category suggests. However, it is important to note that the majority population of stalkers are from the intimate category of non- psychotic ex partners and are not mentally ill at the time of committing the offence. Courts can issue an Apprehended Domestic Violence Order under s562AE of the Crimes Act 1900(NSW) or an Apprehended Personal Violence Order under s562AI of the Crimes Act 1900(NSW). Unfortunately this method of dealing with stalking offences is often criticised for having little effect on serious obsessive behaviours exhibited by some offenders. A recent study has shown that after issuance of an apprehended violence order, stalking and physical violence was reduced in the first six months only to reoccur in over half the cases of women who undertook the study. This shows that these orders are an inappropriate long-term prevention tool. Helen Katzen reported in her study that of the 22,556 apprehended violence orders granted in New South Wales in 1998, 9,647 breaches were recorded by the police (Joseph, 2001). The ease with which these orders are breached and the fact that they are not taken seriously is reflected in the case of Long field v Glover. The appellant had been in a relation ship with the complainant. When the relationship ended she obtained an apprehended domestic violence order, which prohibited the appellant contacting her. He disregarded this order and persisted calling her at home and at work, making threatening statements such as I control your life (Michele, 2002). Similarly in the case of R v Powell, the appellant had broken into the victims premises in breach of an apprehended violence order and maliciously wounded her by stabbing her twice in the back. Both these cases demonstrate the inability of these orders to deter offenders which highlights how inefficient a mechanism they, are for dealing with such behaviour. Furthermore, apprehended violence orders were found in many cases to be aggravating factors, which exacerbate the likelihood of violence (Paul, 2000). This was exemplified in the case of Igbinoba v Commissioner of New South Wales Police Service, where a court issuance of an apprehended domestic violence order aroused further anger in the defendant towards the complainant, which resulted in a threat being made towards her that he was going to get her (Paul, 2000). Shortly after receiving the order, the defendant started a campaign of harassment against her and physically assaulted her. Recent research shows that incarceration has a sobering effect on stalkers and allows them to adjust their lives. This supports the idea that a more preventative approach would be to immediately prosecute this behaviour under an offence of stalking with a prison sentence, rather than wait for breach of an order to occur by which time the situation may have escalated to a degree of violence. While, it is impractical to contain all stalking offences by criminalising them, it is also inefficient for the court to proceed with prosecuting minor nuisances under the stalking legislation. Many of these cases would not lead to any conviction due to the lack of the requisite intent necessary to prove the offence. In 1998, two example cases were given by the model criminal code committee where stalking legislation was used inappropriately (Joseph, 2001). In the first case a fourteen year old girl had stalked her teacher, by following him around school and singing a mocking song about the teacher. In the later case Yugoslavian parents had stalked their teenage daughters because they had moved away from home in violation of family traditions. These stalking incidents are more commonly known as conformist who is the stalking falls within the acceptable range of social behaviour rather than criminal stalking. Neither of these cases led to convictions. In circumstances such as these, a pplicants are more likely to succeed in obtaining apprehended violence orders since they would only be required to prove on the balance of probabilities, that they are in fear of the other person and that these fears could culminate into an act of personal violence or harassing conduct (Sandra, 2007). With advances in technology people see new and scary ways criminals commit crimes. With the introduction of cell phones and scanners years ago, criminals could listen to police radio traffic and see where and how we police were responding. No need for look outs, technology became the look out. Now in the computer age people see crimes from identity theft and hacking into computers to steal personal and corporate confidential information to cyber stalking and sexual predating to cell phone cloning. Criminals have a whole new playground and the playground as technology advances (Lorraine, 2008). But technology is not just for criminals. Law enforcement agencies are using technology to make police work more effective and efficient. Also police and communities are also using technology to make their communities safer. Cyber stalking is described as the procedure or offense of deliberately and constantly irritating another person in situation that would cause a sensible person to panic harm or death because of articulated or obscured fears is a comparatively latest trouble. Annoying others over the Internet is a little that usually happens, but the word constantly placed in front of that report can make a huge distinction. If someone is causing a nescience that interferes with ones professional or individual life it is measured stalking. Catching the criminals of computer is the tough part. There are Computer Crime Stopper groups, hackers turned excellent, whose only intention and job is to track down and catch criminals of computer (Keith, 2002). Activity of tracking computer is a hard thing to do, particularly over the Internet. There is no track left for the criminal to be followed through. Generally the only things crime-stoppers have to go on are the IP addresses and telecommunication lines to trace to find the source of the signal, but the performer is generally long gone through the time authorities arrive. Anticipation is a vital part in defending the computers of these days. Through secure servers, which are particular c

The Conflict, Climax and Resolution in Oedipus Rex Essays -- Oedipus t

The Conflict, Climax and Resolution in Oedipus Rex  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚        Ã‚  Ã‚   Sophocles’ tragic drama, Oedipus Rex, presents a main conflict and lesser conflicts and their resolution after a climax.    In Oedipus Tyrannus: Tragic Heroism and the Limits of Knowledge, Charles Segal had the protagonist fares well in the first series of tests, but does poorly in the second series:    The first three tests are, respectively, Oedipus’ meetings with Creon, Teiresias, and then Creon again. In each case he is pursuing the killer as someone whom he assumes is other than himself. . . . The second series begins with Jocasta and continues with the Corinthian messenger and Laius’ herdsman. Now Oedipus is pursuing the killer as possibly the same as himself. . . . In this set his goal shifts gradually from uncovering the murderer to discovering his own parents. The confidence and power that he demonstrated in the first series of encounters gradually erode into anger, loss of control, and fear (72).    With each of the six encounters the main conflict of the drama builds – an inner conflict within the protagonist which involves his own mastery or hubris – and humility or modesty before the the gods.Thomas Van Nortwick in The Meaning of a Masculine Life describes Oedipus’ tragic flaw:    As ruler, he is a father to Thebes and its citizens, and like a father he will take care of his â€Å"children.† We see already the supreme self-confidence and ease of command in Oedipus, who can address not only other people’s children as his own, but also be a father to men older than he is. But beyond even this there is, in the sretched posture of the citizens, the hint of prostration before a deity. We are â€Å"clinging to your altars,† says the prie... ...homas Woodard. Englewood Cliffs, NJ: Prentice-Hall, Inc., 1966.    Ehrenberg, Victor. â€Å"Sophoclean Rulers: Oedipus.† In Twentieth Century Interpretations of Oedipus Rex, edited by Michael J. O’Brien. Englewood Cliffs, NJ: Prentice-Hall, Inc., 1968.    Jevons, Frank B.   â€Å"In Sophoclean Tragedy, Humans Create Their Own Fate.† In Readings on Sophocles, edited by Don Nardo. San Diego, CA: Greenhaven Press, 1997.    Segal, Charles. Oedipus Tyrannus: Tragic Heroism and the Limits of Knowledge. New York: Twayne Publishers, 1993.    Sophocles. Oedipus Rex. Transl. by F. Storr. no pag. http://etext.lib.virginia.edu/etcbin/browse-mixed new?tag=public&images=images/modeng&data=/texts/english/modeng/parsed&part=0&id=SopOedi    Van Nortwick, Thomas.   Oedipus: The Meaning of a Masculine Life. Norman, OK: University of Oklahoma Press, 1998.   

The Odyssey :: essays research papers

The Odyssey   Ã‚  Ã‚  Ã‚  Ã‚  The Odyssey is one of the two great epic poems written by the ancient Greek poet Homer. Due to its antiquity, it is not known when or where it was first written, nevertheless, the approximate date and place is 700 BC Greece. Later publications are widespread as the text is transcribed in modern English with no deviation from the original story.   Ã‚  Ã‚  Ã‚  Ã‚  The story is set in the lands and seas in close proximity to Greece changing by books as Odysseus, the protagonist hero, recounts of his many fated adventures and misfortunes in a series of flashbacks. Odysseus, a survivor of the bloody Trojan War that left many Greek heroes dead and a city plundered, yearns to return Ithaca and his wife Penelope, who is solicited by countless suitors, yet due to an accidental grievance done to the God of Sea, Poseidon, Odysseus is plagued by misfortunes and spend nearly ten years traveling the seas searching a path home.   Ã‚  Ã‚  Ã‚  Ã‚  The Odyssey is written in the third person omniscient perspective, perhaps the only voice capable of integrating Homer’s usage of the Gods and the supernatural. This perspective shifts as necessary to give the reader a full understanding of Odysseus’ journeys. In fact, without incorporating the supernatural forces, there would be no way of understanding why Odysseus is met with such inhospitality from certain Gods or constructing a majestic recount of the actions in the plot.   Ã‚  Ã‚  Ã‚  Ã‚  Odysseus is the classic Greek hero by all standards. He is a hardened warrior who has fought against the Trojans, a dutiful husband who would journey years to return home, a cunning wayfarer who fares well with any host hostile or amicable, and a mortal in bipolar relation with the Gods. He may be the protagonist, yet as a mortal, he is only a servant to the Greek Gods. Poseidon has a bitter grudge against Odysseus for blinding the Cyclopes Polyphemus, yet Homer balances Odysseus’ fate by giving him the aid of the Goddess Athena. Thus, Odysseus’ fortunes and misfortunes are all the deeds and misdeeds of the Gods, and the protagonist is subject to his fate as determined by the supernatural. Homer’s implications about the life and fate of a man could be easily recapitulated as uncontrollable. Though the Greek Gods do not exist, man’s fortunes and misfortunes still contain unexplainable entropy, leaving mortals with no precise knowledge or grasp of their future yet mortals do have an unfailing sense of hope, just as Odysseus is determined to return home despite his foes and hardships.

How Does Hughes Create An Effective Description of a Windy Day?

Hughes uses a variety of poetic techniques to create an effective description of a windy day. He uses a lot of figurative language, such as metaphor, simile and personification. Hughes also creates the effect of a windy day using structural techniques such as enjambement, and the sound technique onomatopoeia. He often uses interesting lexis to help our imaginations. Hughes uses a lot of figurative language in this poem. One particularly effective technique is metaphor. He starts the poem with the metaphor – â€Å"This house has been far out at sea all night† This is very effective because it creates a very strong picture in your mind. â€Å"Far out† suggests isolation, and a mention of night suggests danger and fear. Another effective example of metaphor is â€Å"The skyline a grimace†. This suggests that the whole view and landscape is grotesquely distorted. A grimace means to pull a strange face, so this makes it an example of personification. The mental image is very clear too. Simile is another example of figurative language use by Hughes in this particular poem.What is the difference between a figurative and a literal analogy? â€Å"Flexing like the lens of a mad eye† This suggests that the view is constantly moving with the wind and the movement in my mind is visualised as everything bending, swaying and generally looking contorted. Similes are used throughout Hughes's poem. Another magnificent example of a simile is â€Å"Rang like some fine green goblet† This makes the house seem very delicate, as a glass will shatter if it resonates at a certain pitch. Glass is brittle anyway, so using this particular material as a simile would automatically suggest fragility. Another example of simile is â€Å"Black gull bent like an iron bar slowly†. This suggests that the gull is fighting against the wind's strength with all it's might. The mental picture it puts into my mind is very clear, and it makes me think that the wind is very powerful. Personification is a type of figurative language, giving an inanimate object humane characteristics. An example of personification occurs in line 13 of the poem: â€Å"The fields quivering, the skyline a grimace† The fields are ‘quivering' which suggests that they are afraid of the wind, and are shaking and ducking down to avoid the devastation that the wind can cause. In actual fact, the wind makes the grass bend over. Hughes uses structural techniques in his poetry, and enjambement is the one that probably stands out the most.

Is Is a Flat World? Essay

Freidman summarizes the three globalizations that direct occurred in the introduction. The graduation one in 1492-1800, reservation the cosmos to a medium size. south one in 1800 to 2000 make the human race to a size sm all(a)(prenominal) and threesome one commencement ceremonying in 2000 making the origination tied(p) after all these years of developing technology do to effect an integrate and mat conception. Freidmans 10 events and forces starting in Nov. 9, 1989 with Berlin beleaguers dropping down hint how the world get suavetened so fast. He mentions in these 10 events the Netscape minute of arc offering the dot-com and connecting volume in a expression never in advance.This enable Indian engineers which years back when the world wasnt widend didnt had the opportunity to deal in a position with an Ameri put forward to be enlisted for outsourcing. With these events the world suddenly began outsourcing, offshoring, open-sourcing, insourcing, supply-chaining and communicate community and connecting them, showing the world a whole new idea that we ar alimentation in a globalize world. The final event he called it the steroids which is the wireless access that enables you to connect with every soulfulness you want from anywhere with any device.Which is turnaround to what Ghemawat says, People be getting more than connected tho they arent connecting (pg. 58 Ghemawat, 2005). The situation is that people are disbursal time chatting with family and friends that meeting someone to start a jejune world. It is true that non everyone has the access to technology, exactly is a detail that each day more people get connected and collaborating to this than ever before in historys life, this is the first step for a globalize world.Americans had become lazier in innovating probably because they never ruling that globalization would be knocking in their front doors. This is not a show Freidman says, is already happening and the soone st you engineer for this the soonest you will be dowery of this vapidtened world. Why the World Isnt Flat by Pankaj Ghemawat is just the mated as everything Freidman tells, making an exaggeration to all this presumption of the world macrocosm flat. In the article he states facts proving we are far away from a fully globalized world.He evidences this by stating, 90% of all resound calls, web traffic and investment is global. Freidmans 10 forces seem persuasive but Ghemawats The 10 Percent supposal proved him wrong. In these presumptions it shows that immigration, phone calls, chair investment, and others tiret even pass off the 10% in levels of internationalization across industries. Patents and portfolio investment barely exceeds the 10% and profession hardly beats the 20%. plane with trades being the highest you cannot corroborate a globalize world with that percentage shown.For Ghemawat all of this flat world that Freidman says contains an exaggeration maybe in orde r to sell books and that we in fact are more cautious and privilege to be in a protectionism world. Although study revolutions as the Internet has improved the way we globally integrate, the barrier where globalizations principles speech communication, geography and distance doesnt affaire is still not functioning at all. Russias local service Yandex lacing up Google because they dont take up the ability to understand the complexities of the Russian language proves that we are not living in a globalize world.He overly states that there is a fear of becoming a globalize world as tendency is supporting more protectionism and that globalization may be incompatible fleck Freidmans posture is mentioning that a flat world involves everyone around, as a video-conference with the undefiled supply chain of the company and unlike employees all at once. You need to renounce protectionism and a fear of being globalized and astute youre in a flat world when your office has eight con trastive clocks.Ghemawat mentions that people like Friedman are describing globalization, as a world that doesnt exists. The verity is for Freidman that people dont endure but we are actually living a globalization that is shown by stating a fact that China graduates twice students with bachelors degree than US. America is falling behind he says, but the truth is that everyone is falling behind if they dont realize that the world is becoming more flat and less round. The World is high-pitched by Richard Florida mentions that the world is more plow and less flat as Freidman says.He refers spiky with a map as the different peaks around the world and how they arent constant but significantly different that you cannot call it a flat world as Freidman. There had been a return in countries with the major cities but they are going away their other cities behind this go of globalization. Florida says this spiky globalization in expectant countries like China are intemperate their production, innovation in their rural regions leaving the urban outside of this making them have conflicts.Instead of a flatter world is becoming a spiky world with peaks dispersed all around it but in an inconsistent way. Instead of ski lift spikes, there needs to be valleys to have equality in their peaks for a flat world to come and hes arguing why Freidman left this rift between the poor and rich behind. besides the article by Matt Taibbi Flathead for the sassy York Press, says he is not surprised nearly what Freidman says because he always continues to fail his metaphors in this case the world being flat. joust in favor of the exaggerations Ghemawat said rough Freidman and the harrowing the world is as Florida. I believe that Freidman exaggerated of the world being flat but also I believe this is just what we need in order to have a motive and not getting stuck in the acedia and comfort. Maybe this fear of globalization people have, is because they know that theyre livi ng in a globalize world where they can be left behind if they dont realize the fact that directly the world is becoming more flat and less round or spiky.

Burden Invasive Pneumococcal Disease Health And Social Care Essay

strep pneumoniae claims 1 million child grumbles every(pre no.inal) twelvemonth worldwide ( 1 ) . nigh 90 % of deceases occur in ontogenesis states. For every 1 slang that dies of pneumonia in a certain state, to a greater extent than 2000 kids cut of pneumonia in developing states ( 2 ) .The SAARC states general ar in the z champion with last incidence of pneumococcal sickness ( 1 ) solely no watch over has try to happen out the same. The child fatality rate rates ( & lt 5 ) argon laid-back in the part runing from 17/ super C for Srilanka to 149/1000 for Afghanistan. Pneumonia claims 11 % of U5 child deceases in India, Maldives, Bangladesh and Pakistan 23 % of U5 child deceases in Afghanistan and 19 % in Bhutan with grimest in Srilanka 6 % . ( 3 ) . Pneumonia is the taking display case of U5 decease in Pakistan ( 4 ) but tho 50 % receive antibiotic preventive ( 5 ) . The Million Death sight account that pneumonia accounted for 27A6 % deceases out of ideal 1226 0 deceases in kids from 1-59 months ( 6 ) .S. pneumoniae is one of the study causes of fatal pneumonias in kids ( 7 ) . excessively pneumonia S.pn is excessively known to do meningitis which is an an opposite(prenominal)(prenominal) fatal status for kids. Many much indispositions atomic number 18 to the name of S.pn like acute accent otitis media, joint gushs and bacteraemia etc. Estimates of pneumococcal indisposition hitch atomic number 18 needed so as to use the resources for kid endurance.In Bangladesh, the theoretical account predicts a pneumococcal unsoundness incidence of 3351 vitrines per 100,000 kids younger than 5 mature periods. A cosmos- put, active- watch, active-case comprehend subject ara measured an invading pneumococcal unsoundness rate of 447 representatives per 100,000 kids younger than 5 experienced elds ( 8 ) . Unfortunately the grounds for estimation of pneumococcal affection in low/middle income states is little(prenominal)(preno minal). The institutionalise of pneumococcal disease is steepest in kids and the period population in both more and less developed states. The intervention of pneumococcal infections is complicated by the world-wide outgrowth of adversary to penicillin and other antibiotics ( 9 ) .The pneumococcal conjugate vaccinums argon stabilising but the effectivity of these vaccinums is dependent upon the pneumococcal disease load and serotype coverage of the vaccinum. ( 10 )AimThe primary aims of this systematic reappraisal areTo cognize the load of invasive pneumococcal disease.To find the demand for debut of pneumococcal conjugate vaccinum in the immunisation agenda.MethodsWe performed a systematic hunt of the create publications and in any event tried to beguile learning about the unpublished writings from assorted research workers of the part.Beginnings of DatasThe hunts were latest as of January 2013 and we identified articles with schooling on pneumococcal invasive diseas e among kids & lt 5 obsolete ages of age. We searched 3 Databases Pubmed, Embase and The Cochrane library. The mention lists of the obtained articles were removedther searched for surveies. Non face articles were non include. The hunt inside knowledges are minded(p) in the appendix I. Searching were by with(p) by 2 writers ( NJ, HK ) . HK helped in obtaining wide of the checker textual matter articles.Definitions UsedSAARC states South Asiatic Association for Regional Co-Operation includes Afghanistan, Pakistan, India, Nepal, Bhutan, Bangladesh, Srilanka and Maldives.Burden of pneumococcal disease We engender defined load of pneumococcal disease as the predict of prescribed pneumococcal isolates from the surmise population.PneumoniaSymptoms coughing or hard external respiration, and attach external respiration & gt 50 breaths per scrap for infant aged deuce months to less than one twelvemonth, take a respiration & gt 40 per minute for kid aged one to five agein g ages, and no thorax indrawing, stridor or risk marks. ( 11 )Severe pneumoniaSymptoms cough or hard sweet-breathed plus any general danger mark or chest indrawing or stridor in a unagitated kid. usual danger marks for kids aged two months to five grizzly ages unable to shine up or suckle pukes everything paroxysms lethargy or unconscious mind ( 11 ) .Clinical diagnosing of meningitis is more straightforward than that of pneumonia. The definition of pneumonia is ground on the incorporate direction of childhood infections ( IMCI ) attack, which includes other ague lower respiratory folder infections and deficiencies specificity. In add-on, aetiologic diagnosing of bacterial pathogens is easier in CSF than in blood.Meningitis ( 11 )Suspected both individual with sudden oncoming of feverishness ( & gt 38.5 AC rectal or & gt 38.0 AC axillary ) and one of the downstairsmentioned marks cervix stiffness, modify consciousness or other meningeal mark.Probable A suspected ins tance with cerebrospinal fluid ( CSF ) scrutiny demoing at least one of the followers doubtful visual aspect leucocytosis ( & gt 100 cells/mm3 ) leucocytosis ( 10-100 cells/ mm3 ) AND each an elevated protein ( & gt 100 mg/dl ) or decreased glucose ( & lt 40 mg/dl ) .Confirmed A instance that is laboratory-confirmed by turning ( i.e. culturing ) or placing ( i.e. by Gram discoloration or antigen sensing methods ) a bacterial pathogen ( Hib, Diplococcus pneumoniae or meningococcus ) in the CSF or from the blood, in a kid with a clinical syndrome consistent with bacterial meningitis ( WHO, 2003 ) .Non Pneumonia Non Meningitis All infections other than pneumonia and meningitis watch been categorise under this header.Invasive Pneumococcal disease When Diplococcus pneumoniae has been identified from one of the otherwise unimaginative sites of the organic structure like blood, CSF, pleural fluid etc either by cultivation or by LAT/PCR or other technique.The surveies where the defi ned instances see round other parametric quantities or if on that point were any(prenominal) other standards no stew was made to standardise them.Inclusion standardsSurveies prospective/ retroactive with kids & lt 5years of age as /or quite a little of the studied population.Surveies through with(p) in infirmary or familiarity scene.Surveies with possible informations usable on S.pneumoniae isolated from kids & lt 5 old ages of age.Surveies with at least 12 months of surveillance were include in order to baffle the better of the seasonal nature of pneumococcal diseases.Surveies conducted in SAARC states.The inclusion was reconciled by 2 writers ( NJ, KK ) and choice appraisal was make by 2 writers ( NJ, KK ) . Discrepancies, if any, were resolved by intervention with 3rd writer ( MS ) and the finding of fact was considered concluding.If the exact information was non available we have contacted the writers and tried to decide the disagreements The surveies which have commented merely on pneumococcal serotypes & A /or antibiotic opposition have been excluded from pooled synopsis. We excluded instance studies, columns, vaccinum surveies, literature reappraisals and the surveies in which nasopharyngeal aspirates, pharynx swabs or oropharyngeal swabs were the lone samples to find the causative existenceness.Data aggregation and directionThree writers ( BE AK, SS ) absorbed informations individu in solely(a)y from the included surveies in a predesigned tabular array that included survey design, puting, no. of suspected instances, no. civilization samples taken & amp positive civilizations obtained, and no. positive civilizations for Diplococcus pneumoniae.The information from infirmary ground surveies and population ground surveies were crocheted individually. To decide the disagreements sing the abstracted informations treatment with the other referees were done and consensus was reached. Sing some losing informations the writers were co ntacted and if the disagreements were non resolved they were non taken up for pooled analysis.The participation based surveies available merely endow information about pneumococcal pneumonia instances in the confederacy.Datas analysisData analysis was done utilizing CMA V2 by 4 writers ( NJ, MS, KK, and AA ) . The similar surveies were pooled unneurotic. fill in assemblage analysis for finding the IPD load in India was done and in addition sub- conclave analysis for finding IPD in kids & lt 5 old ages was done.The lodge based surveies, infirmary based prospective and retrospective surveies have alike been examine individually.ConsequencesDatas reviewedWe represent 700 published articles through electronics and manual searching. After rubric and abstract testing 40 full text articles were retrieved and 21 surveies ( 8, 12-31 ) were included for the reappraisal and 19 were excluded ( 32-50 ) ( flesh 1 )Community based surveies were non available from Afghanistan, India, N epal, Bhutan & A Srilanka. Because the life conditions are about same and there is in addition geographic similarity we have considered the surveies from Bangladesh and Pakistan as representative of the SAARC states.Similarly there were no infirmary based surveies from Afghanistan and Bhutan so we have taken the surveies from remainder of the states and generalized them for these states.We have included a sum of 21 surveies for this systematic reappraisal & A mentioned in tabular array I. The inclusion was dogged by 3 writers ( MS, NJ, KK ) and quality mug was done by 3 writers ( MS, NJ, KK ) . The surveies with mark of 6 or more were considered to be good quality grounds.Hospital Based future SurveiesSAARC statesWe identified 15 infirmary based prospective surveies ( 12-19, 22, 24-27, 29, 31 ) from assorted SAARC states and analyzed them for finding the invasive pneumococcal disease load in kids populating in these states and besides did a subgroup analysis for kids less than 5 old ages of age.These surveies exhibition that 3.5 % ( 95 % CI 1.9-6.4 ) of kids admitted to infirmaries with diagnosing of invasive diseases like repelling pneumonia or meningitis or sepsis are delinquent to S. pn ( human body 3 ) . Eight surveies ( 13, 15, 16, 18, 24-27 ) shew that 1.5 % ( 95 % CI 0.6-3.4 ) of kids admitted as terrific pneumonia have S. pn as the causative being ( Fig 5 ) . Ten surveies ( 12, 14, 16, 17, 19, 22, 24, 26, 27, 29 ) of the included surveies show that 7.6 % ( 95 % CI 4.1-13.7 ) of kids with likely or confirmed meningitis have S.pn as a causative being ( trope 7 ) . S.pn is one of the study bacteriums doing 20 % ( 95 % CI 12.9-29.9 ) of invasive bacterial diseases ( human body 4 ) . 11 % ( 95 % CI 6.5-17.9 ) of impish bacterial pneumonia are caused by S.pn ( anatomy 6 ) . S.pn has been an aetiologic agent in 33.1 % ( 95 % CI 23.1-44.8 ) instances of bacterial meningitis ( form 8 ) .Children less than 5 old ages of ageOut of the 15 surveie s merely 11 surveies ( 13, 15, 17, 18, 22, 24-27, 29, 31 ) have authorise information on invasive pneumococcal disease in kids less 5 old ages of age. The surveies show that S.pn causes 2.7 % ( 95 % CI 1.1-6.2 ) hospitalizations collectable to all invasive disease in kids & lt 5 old ages of age ( fig 9 ) . Merely 7 surveies ( 13, 15, 18, 24-27 ) had clear information on pneumococcal pneumonia in kids & lt 5 old ages of age and showed that 1.5 % ( 95 % CI 0.5-4.3 ) of noble pneumonias are cod to S.pn ( fig 11 ) . Similarly 6 surveies ( 17, 22, 24, 26, 29 ) showed that S.pn is the being responsible for 7.1 % ( 95 % CI 2.6-17.5 ) meningitis instances in the age group ( fig 13 ) .S.pn remains the major(ip) bacterial cause of all invasive diseases in kids U5 old ages of age doing 19.2 % ( 95 % CI 11.5-30.3 ) of invasive bacterial diseases ( fig 10 ) . 10.8 % ( 95 % CI 6.4-17.6 ) dreaded bacterial pneumonias are cod to S.pn ( fig 12 ) and 35.1 % ( 95 % CI 22.1-50.8 ) of pyogenic meningitis is due to S.pn. ( fig 14 ) .BharatWe found 9 surveies from India ( 12-19, 22 ) which showed that S.pn causes 7.9 % ( 95 % CI 3.8-15.7 ) of invasive diseases in kids ( fig 15 ) . S.pn has been an aetiologic agent in 3.9 % ( 95 % CI 1.2-11.7 ) kids with tremendous pneumonia ( fig 17 ) and is besides a major bacterial cause of pneumonia in kids doing 14 % ( 95 % CI 5.8-30.1 ) of bacterial pneumonias ( fig 18 ) . S.pn has been a causative agent in 10.4 % ( 95 % CI 5.8-18.1 ) of kids with meningitis ( fig 19 ) and once more a major bacterial cause of pyogenic meningitis ( fig 20 ) . The hospital prevalence of S.pn in Indian kids is more than that of all other SAARC states.Children less than 5 old ages of ageFive surveies ( 13, 15, 17, 18, 22 ) gave clear information on pneumococcal diseases in kids under 5 twelvemonth of age in India. The image does non alter in this age group of Indian kids where S.pn is regular in 8.2 % ( 95 % CI 4.1-16.6 ) of all hospitalized kids with s uspected invasive bacterial disease ( fig 21 ) and S.pn becomes a major bacterial cause of invasive bacterial diseases with 21.2 % ( 95 % CI 9.4-41.0 ) of all invasive bacterial diseases are due to S.pn ( fig22 ) . 5.4 % ( 95 % CI 2-14.1 ) of terrible pneumonias in infirmary wards are due to S. pn ( fig 23 ) & A 16.5 % ( 95 % CI 12.8-16.2 ) meningitis in kids less than 5 old ages describing to infirmaries are due to pneumococcus. In 13.6 % ( 95 % CI 5.5-29.8 ) of all bacterial pneumonia ( fig 24 ) & A 39.3 % ( 95 % CI 27.5-52.6 ) of pyogenic meningitis ( fig 26 ) S.pn has been isolated and is a major cause of these diseases in India.Hospital Based retrospective SurveiesTwo infirmary based retrospective surveies ( 21, 28 ) from India were included in this reappraisal. The pooling of these surveies together showed that 15.5 % ( 95 % CI 0.5-88 ) of invasive pneumococcal disease instances amongst the entire admitted patients with invasive bacterial diseases ( Fig 27 ) . The assurance intervals for this group are broad because one survey ( 21 ) which is merely on bacterial meningitis and has a little sample size with comparatively more proportion of pneumococcal isolates.Population Based SurveiesFour surveies ( 8, 20, 23, 30 ) from the SAARC states were included in the reappraisal. These surveies are from Pakistan and Bangladesh. These surveies merely hold forth the kids under 5 old ages of age. These surveies show that approximately 13.4 % ( 95 % CI 6.7-25 ) of all invasive bacterial diseases in community are due to S. pn ( fig 29 )Inference of all the analysisThe impression from the population based surveies ( 13.4 % ) is comparable to that from the infirmary based prospective surveies ( 19 % ) and besides to those obtained from retrospective surveies ( 15.5 % ) . The pneumococcal disease prevalence in SAARC states varies between 13 % 19 % of all invasive bacterial diseases.DiscussionOur findings show that S. pn is prevailing in 19 % of all hospitalizations in kids of SAARC states and is hence one of the major cause of concern every bit far as child health is concerned. Pooling the Indian surveies we found that pneumococcal diseases are 25 % of all invasive bacterial diseases in kids of India. These figures might be an underestimation of the current state of affairs as the surveies debate merely hospitalized instances, the milder signifiers may travel unreported. S.pn is a major bacterial cause for terrible pneumonia and besides for pyogenic meningitis in kids of this part. The community based surveies besides show that in 13 % of bacterial instances were due to S.pn but once more these surveies besides discussed the terrible diseases merely and did non describe the milder signifiers.The consequences of our reappraisal are comparable to other reappraisals ( 1 ) which showed high prevalence of pneumococcal diseases in India. The consequences of community based surveies show that __ % of all bacterial invasive diseases in community ar e due to pneumococcus which is comparable to the consequence from the infirmary based prospective surveies.An unpublished information from one site of a multicentric test ( ISPOT survey ) from India showed that approx 38 % of kids with terrible pneumonia ( Radiologically confirmed ) had S. pn isolated from the nasopharyngeal aspirates or pharynx swabs. The survey besides showed that unrehearsed amoxicillin administered at plate was impelling in handling terrible pneumonia. The No Shots survey from Pakistan ( 51 ) concluded that place intervention with high dose extempore Amoxil in instances of terrible pneumonia is tantamount(predicate) to WHO recommendations of hospitalizations and i/v antibiotics. Similarly in another(prenominal) survey from Pakistan showed that local wellness workers were able to handle terrible pneumonia instances at place with high dosage Amoxil ( 52 ) .Survey from Bangladesh ( 53 ) reports the rhinal passenger car rate of 47 % and besides reports the ear ly colonisation in rural population. The survey besides reports that 69 % of invasive strains were resistant to cotrimoxazole.The ANSORP survey reported 41 % non-susceptible strains to penincillin in Srilanka and approximately 4 % in India ( 54 ) . The IBIS survey ( 16 ) reported 60 % opposition to chloramphenicol, Principen, trimethoprim-sulfamethoxazole, or Erythrocin with 32 % isolates resistant to more than 3 antimicrobic drugs. Kunango et Al ( 55 ) reported that out of 150 clinical isolates from invasive pneumococcal infections, merely 11 ( 7.3 % ) isolates were comparatively repellent to penicillin, although 64 were immune to one or more antibiotics in particular cotrimoxazole, Achromycin and Chloromycetin. In the ISCAP test ( 56 ) the opposition form of S. pneumoniae to assorted antibiotics was cotrimoxazole 66.3 % , chloramphenicol 9.0 % , oxacillin 15.9 % and erythromycin 2.8 % .So the antibiotic opposition becomes another menace.In India, the most plebeian serogroups c olonising the nasopharynx of kids are 6, 14, 19, and 15 ( 38, 57 ) . IBIS survey ( 16 ) studies serotype 1,6 and 19 to be the most common serotypes isolated from either blood or CSF samples of the kids with invasive disease. Rijal et Al ( 49 ) found that serotypes 1,5 & A 4 were most commonly isolated from the patients of IPD and besides reported that 52 % of isolates were immune to cotrimoxazole.DecisionThe systematic reappraisal concludes that S. pneumoniae is a major bacterial cause of invasive bacterial diseases in kids of SAARC states. The outgrowth of immune strains of Diplococcus pneumoniae are indicating towards the demand for revisiting the intervention recommendations and besides do a call for explicating load steps to decrease the prevalence of invasive pneumococcal diseases. The usage of antibiotic which is less immune and easy to administrate should be considered. Pneumococcal conjugate vaccinum, after cognizing the normal serotypes and there coverage, should be con sidered by the constitution shapers.Conflict of Interests None stated percentage of the Funding Agency The reappraisal was back up and funded by ICMR, New Delhi. The support chest did non interfere with the reappraisal procedure or the consequences.Recognitions We would wish to thank Dr. Samir K Saha ( ICDDR, Bangladesh ) , Dr. Z.A. Bhutta & A Dr S.Q. Nizami ( AKU, Karachi, Pakistan ) for supplying us with their publications on pneumonia we would besides wish to thank Dr. Kay Dickerson of John Hopkins University U.S. for assisting us with the statistical methods.