Should Parents Lose Custody of Extremely Obese Kids? Essay -- Child Ob

In the recent decades, obesity has grown into a major health loose in the United States within young people. With 31 percent of the United States of kidskinren being obese, the United States has become the country with the grittyest rate of obesity in the world. fleshiness is not only found among adults, but it is also now found mainly among children and teenagers. The childhood is a very important period for the initiation of obesity especially in this time. Eating practices that children are taught or learn during childhood affects a person later in their life whether they know or not. triune studies have confirmed that childhood obesity in the U.S has been on a rise for years. One out of three children in the U.S are obese, most of them impertinence a higher risk of having medical, social and academic problems. childhood obesity also leads to many health problems among young people. Those problems include diabetes, high blood pressure, high cholesterol and many more others. These problems cause a rise in health care costs that their families might have to pay sooner or later. The influence of parents and the media play a big role in causing these problems to happen. Some people believe that a family with an obese child should not hiking child protection concerns if obesity is the only cause for concern (Callaghan, 2010). However, doctors should always be mindful of the possible role of abuse or neglect in contributing to obesity. The result of some research that was done on the symptoms of neglect shows a clear correlation between childhood abuse and obesity in childhood. A study of American school children has found that after controlling for socioeconomic status, those who were physically abused were more likely to be obese (Callaghan, 201... ...nment handling for a Childhood Epidemic. Washington Post. The Washington Post, 29 Nov. 2011. Web. 06 May 2012.Easterling, Kelli. Should Government Protect Obese Kids from Parents? McClatchy-Tribune Inform ation Services, 19 July 2011. Web. 06 May 2012. Hellmich, Nanci, Report maps out solutions to child obesity. USA Today n.d. MAS ULTRA-School Edition. Web. 6 May 2012. Holden, Diana. Fact Check The Cost of Obesity. CNN. Cable News Network, 09 Feb. 2010. Web. 06 May 2012.Media and Childhood Obesity. FCC.gov. Federal Communications Commission. Web. 06 May 2012. Tanner, Lindsey. Should Parents have Custody of Extremely Obese Kids? The Huffington Post. TheHuffingtonPost.com, 12 July 2011. Web. 06 May 2012.The Impact of Food Advertising on Childhood Obesity. The Impact of Food Advertising on Childhood Obesity. Web. 06 May 2012.

Othello the Tragic Hero Essay -- essays research papers

Jealously, Often this trait takes people over, controls their thoughts and persuades them to do stupid things. William Shakespeare represent this flaw extremly well in the play Othello. IN the play, Othello, is a character who seems almost perfect, but his flaw jealousy is brought out but his trusted swain Iago. This trait makes Othello the tragic hero due to the fact that he sacrifices his life in good name.When being accused of witchcraft by Barbantio ( Desdemonas father) and senators he corpse in control and courageous. Most potent, grave, and reverend signors.... Rude I am in speech And little blessed with the soft phrase of peace (1.3.91-97)This is an showcase of how he have a go at its Desdemona truly . He explains this with style, control, courage, and grace. Also in (1.3.47) it is showed that he is respected Here comes Barbantio and the valiant Moor. Iagos plot to ruin Othello starts to show up in the very beginning of the book when he angers Barbantio with the news of the Moors marriage to Desdemona ( Barbantios daughter). I am one,sir, who comes to tell you, your daughter and the Moor are making the beast with two backs.(1.1.128-131) This news angers Barbantio very much because he was not infromed of his daughters courtship to Othello and feels betrayed by Desdemona. Also he does not like the fact that Othello is of different race than he is. Another quote that shows Iago wants to ruin Othello is in Act 1 scene 1 line(s)4-42 Sblood,but youll not hear me ....To love the Moor.This quote shows Iagos hatred for Othello because he appointed Michael Cassio as his ancient and no... ...at he had killed his love. Iago winds up killing Emelia because she told Othello the truth about the handkerchief. Since Othello tires to kill Iago, but fails, he kills himself. Iago winds up going to jail to be tortured. Othello paid the ultimate price. His life.In conclusion Othello is the tragic hero because he was essentiall y perfect, except for his major flaw. Jealousy. This flaw eventually leads to his downfall, the killing of his faithful wife( at odds(p) to what he thought) and himself. This play should open everyones eyes about trusting people and having facts before you jump to conclusions. Remember jealousy is the green eyed monster that causes everyone you love pain and suffering. O, Beware, my lord, of jealousy It is the green eyed monster wich doth mockThe meat it feeds on(Iago.3.3.194-196)

How Birth Order Affects One’s Personality Essay -- Personality Psychol

How Birth Order Affects Ones Personality Everyone in the world is born with a special and unique character. Some of their personality is wrought by their surroundings as they go up as well as the factor of genetics. It is believed by some psychologists/researchers that birth order has a disposal to influence parts of the personality. Birth order isnt a simplistic 1-2-3 system that says all first borns are equally one way, all irregular barbarianren are another and last-born kids are invariably just like this or that. These are simply tendencies and general characteristics that often apply. There are dynamics with families that batch change relationships. Through your position in the family you develop your behavior pattern, way of thinking and emotional response. Your birth order supports determine your expectations, your strategies for dealing with people and your weaknesses. Reasons for be interested in Birth order is because it is one way to gain an understanding of friends, family members, boy friends, really anyone you wanted to try to scope out. Unfortunately thither arent any fortune cards or magic spells to understand family and friends. Knowing and understanding birth order can not precisely help you understand other people but yourself included. The only- child develops characteristics from having to cope with playing alone and with having to fend off adult intrusion. Only children tend to feel thwart and throw tantrums when not pleased. They love to say Leave me alone, Id rather do it myself They tend to have imaginary companions and feel as if the child within was smothered because they had to grow up so quickly. Therefore in turn allow their own children time and space. As well as always being an emotional and considerate friend that loves to listen. First borns tend to be goal setters and high achievers. Along with being perfectionists who are very responsible, organized and set people. They are rule keepers and follow all the details. The first born is an only child until the second child comes to take away the mothers attention. The only child becomes a first born feeling there is no love for him or her. In school, first-borns tend to work harder for grades than do later-borns. They often grow to be more competitive and to have higher educational and career aspirations. Any enumeration of prominent people, em... ...e effects all of the childrens personalities. Not everyones personalities match that of their birth order. Variables can affect each family situation. These variables include spacing, the finish up of the child (there are actually 12 different types of personalities due to sex coinsiding with birth- order.), the sex of the child, physical differences, disabilities, the birth order position of parents, any blending of two or more families due to death or divorce and the relationship surrounded by parents. There are many different studies that have been made dealing with birth order. Each one differs slightly from the next. Some of the studies are completely opponent each other. I have tried to compile ones that are relatively similar. sourceswww.rayid.com/main/sibling.htmJoman,(1993)Family Constellation Its effects on Personality and Social Behavior. unseasoned York Springer Pub.Co.Leman,(1998) The New Birth Order Book Why you are the way you are,Grand Rapids, Mich. F.H. RevellLederman, Sherri Phd.(2000)Birth Order, New York, New YorkWhole Family Center, Inc.Gale Encyclopedia of Psychology, 2ed. Gale convocation,2001.in association with th Gale Group and Looksmart

My Life :: essays research papers

To be given the chance to typify little league was iodine of the greatest times ofmy life. I contend little league for four years, and every year I made the in all-starteam. My surpass friend and I played on every regular season team and everyall-star team together. The final game of our career was unforgettable.It had been 4 years of great enjoyment with my best friend, Cody Smith. Wealways c utterned around in practice, exclusively when the game would start we had ahigh intensity. Cody would pitch, and I would play second base. When hewasnt pitching, I would, and he would play third base. We were the topplayers in little league, or so we thought.Our all-star team had made it to the championship of our state tournament.Before our team took the field our omnibus John Zamouski gave us a talk. Hesaid, Well men, weve came a long way. Todays the day weve allpracticed so hard for, but I want to have fun with it. Lets treat this like everyother game we have won. Youre all winners, win or lose. I want you all toknow that I feel privileged to have coached such a fine bunch of men. So letsgo out and play this game as hard as you can. What do you say, lets go haveFUN. We all got up and utter, YEA. Lets play hard. Yea As we allgot more pumped up. Who are we? N.I. As we got more loud and moreintense. Coach said, Bring it in. Win on 3. One, two, three as we all yelledtogether WIN. As I ran on to that field I recalled all the practicing I had done, and I knew Iowed most of it to my father. He started me throwing and hitting when I was to the highest degree four-years-old. As my passion grew more and more I wanted to gopractice all the time. So I would ask my father to practice with me. tear downthough my father was tired or in the middle of a good TV show he wouldpractice with me. I remembered my father sitting on an old milk crate while Ipitched to him. This made me chuckle a little because I would throw a lowwild pitch on accident that would hit him in the legs, but he kept positive.Cody was pitching a 3 hitter and I was contend well too. The score kept goingback and forth. There were a lot of errors because the field was all dirt and

Comedys Adjoining Terror: The Ponder Heart Essay -- Michael Kreyling

Comedys Adjoining Terror The shine HeartMichael Kreyling essay called, Comedys Adjoining Terror The Ponder Heart,opens with the critic force a parallel between The Ponder Heartand FaulknersIntruder in the Dust. He warns us that if we look likewise hard into the serious side of ThePonder Heart, we whitethorn lose the humor.The Ponder Heart takes place in the Beulah Hotel in Clay, Mississippi and is toldwith all the characteristics of a dramatic monologue. According to Kreyling, Edna Earleis a troubled soul that is assay for fulfillment and freedom while being trapped by the dictates of society and filling the role that society has prescribed for her. The source of comedy in The Ponder Heartis this struggle between laughter and outrage, and stability and chaos. The critic suck ups this struggle as vivification that collides with external restrictions.This releases the vital energies that exist in Weltys writing, whether she chooses to use two persons or conflicting natures in one person. Another way Kreyling illustrates this point is through the mythological personas of Apollonian and Dionysis. Edna Earle represents the Apollonian ways of living which include order, knowledge and experience. Uncle Daniel represents the Dionysian side of life as he simply does what comes naturally. He listens to spontaneous impulses that rule his life.Michael Kreyling states that there is no winner or victor in The Ponder Heart. It isbasically moribund although time continues to move on. Time is the arch enemy of EdnaEarle. Through time, she must face the point that things are changing and what wasimportant in her world is not always very important to the new social set. The critic tells us that the result of the trail, while... ...re lady bike riders, the wrong element, speeding cars, and the Peacocks.These things bring home to Edna Earle the fact that she must change to survive in lifeand one is left with serious doubts as to whether she ever will.I have to agree with M ichael Kreylingthat if one looks too deeply into The PonderHeart, one loses the sense of comedy that it first inspires. Im not sure this book should be delved into to a great extent. I prefer to see Edna Earle as a delightful, entertaining person, and although I agree with Kreylings assessment of the characters, I prefer to concentrate on the humorous side of The Ponder Heartbecause I think that was Eudora Weltys main purpose. Works CitedKreyling, Michael. Comedys Adjoining Terror The Ponder Heart. Eudora Weltys Achievement of Order. Baton Rouge Louisiana State University Press. 1980.

Comedys Adjoining Terror: The Ponder Heart Essay -- Michael Kreyling

Comedys Adjoining Terror The ponder HeartMichael Kreyling essay called, Comedys Adjoining Terror The Ponder Heart,opens with the critic pull a parallel between The Ponder Heartand FaulknersIntruder in the Dust. He warns us that if we look alike hard into the serious side of ThePonder Heart, we whitethorn lose the humor.The Ponder Heart takes place in the Beulah Hotel in Clay, Mississippi and is toldwith all the characteristics of a dramatic monologue. According to Kreyling, Edna Earleis a troubled soul that is attempt for fulfillment and freedom while being trapped by the dictates of society and filling the role that society has prescribed for her. The source of comedy in The Ponder Heartis this struggle between laughter and outrage, and stability and chaos. The critic actualizes this struggle as life-time that collides with external restrictions.This releases the vital energies that exist in Weltys writing, whether she chooses to use two persons or conflicting natures in one p erson. Another way Kreyling illustrates this point is through the mythological personas of Apollonian and Dionysis. Edna Earle represents the Apollonian ways of living which include order, knowledge and experience. Uncle Daniel represents the Dionysian side of life as he simply does what comes naturally. He listens to spontaneous impulses that rule his life.Michael Kreyling states that there is no winner or victor in The Ponder Heart. It isbasically stagnant although time continues to move on. Time is the arch enemy of EdnaEarle. Through time, she must face the position that things are changing and what wasimportant in her world is not always very important to the new social set. The critic tells us that the result of the trail, while... ...re lady bike riders, the wrong element, speeding cars, and the Peacocks.These things bring home to Edna Earle the fact that she must change to survive in lifeand one is left with serious doubts as to whether she ever will.I have to agree with M ichael Kreylingthat if one looks too deeply into The PonderHeart, one loses the sense of comedy that it first inspires. Im not sure this book should be delved into to a great extent. I prefer to see Edna Earle as a delightful, entertaining person, and although I agree with Kreylings assessment of the characters, I prefer to concentrate on the humorous side of The Ponder Heartbecause I return that was Eudora Weltys main purpose. Works CitedKreyling, Michael. Comedys Adjoining Terror The Ponder Heart. Eudora Weltys Achievement of Order. Baton Rouge Louisiana State University Press. 1980.

John Wilkes Booth and the Politics of Assassination

The reading assignment from chapter 27 from our text entitled, John Wilkes booth and the Politics of Assassination written by James W. Clarke discusses the authors legal opinion that Abraham Lincolns death was brought on by political ideologies and not because of mental health issues as some thrust widely claimed. The author believes that what were accident at that period in time were the breeding grounds for kiosks drive to assassinate Lincoln.Clarke writes, political context of the assassination facts such as Lincolns unpopularity in the North as well as in the South, the vicious opposition within his cabinet and Congress along with the leaning surrounding his re-election of 1864 (306) were the true reasons behind his motives. Clarke uses examples from Booths childhood as everyone viewing him with a positive view and that view was shared by many including his friends and family. He points to his happy and health childhood as fact to his mental stability.Booths education was e xceptional and along with his aspirations of following in his fathers footsteps into acting make him a very stable and intellectual man. He was considered to have gaiety and a passion for life. Clarke goes on to discuss how at 14 Booth upset his father and soon after, 3 years, he began acting. But when he began he had very harsh reviews that were critical of his ability in acting or his inexperience. Clarke believes he took these in stride and pushed forward in earnest to make a name all his own.Because the South seemed to praise his acting abilities more than the North, some guess that this changed his attitude and he began to favor Southerner in lifestyle and beliefs that directed him to assassinate. Clark contends that although Booth did favor Southern audiences, the Northern audiences soon began to appreciate the actors abilities. Clarke asserts that women love him and men from all walks of life wanted his friendship because they saw him as a man with wit and magnetism.The aut hor maintains that this is the evidence for his motives being political kinda of being pathological. Political events of 1864 such as the Civil War and the horrors of that bloody war along with the hatred the nation felt for Lincoln motivated the actor. So this sympathy for the South and because of his passions of justice and duty gave way to Booths actions. I find this very difficult to swallow. In my eyes and from what I read, Booth was a very self centered person and a very passionate actor that helped to make him feel invincible.The proof was in Clarkes hold when over and over he kept discussing Booths physical attractiveness and popularity among women as well as men. I believe that in Booths mind the assassination was a performance and felt he would gain even more popularity by his actions. I believe Booth did have some mental issues because anyone who kills another, for whatever motives has to have some level of mental illness. Im sure that many at the time considered killin g Lincoln, notwithstanding only one person actually did the act.Charlie Manson was politically motivated when he told his followers to kill, but that didnt diminish the fact he was totally insane. The corresponding I holds true for Booth. Many can put excuses to another persons actions, and especially when that person has been dead for quite sometime, but the fact stay that murder is an abnormal act in society its against the societal norm and anyone who kills for whatever reason has mental health issues. Reference Roberts, R. & Olson, J. S. (1986). American Experiences. Glenview, Ill. Scott, Foreman.

Business Requirements Document for Baderman Island Resorts Essay

Table of ContentsRevision History31.Assumptions, Constraints, and Dependencies31.1Related Projects and Dependencies31.2Assumptions and Constraints32.Business and Customer Requirements32.1Strategic Business and Customer Requirements33.References3Revision HistoryNameDateChanges and Reason for ChangesVersionAnnamae Goodrick04/05/2014Baderman Island resort wants a qualification administration to support the three hotels on the island. 1.01.Assumptions, Constraints, and Dependencies1.1Related Projects and DependenciesThe resort has three hotels. The hotels cater to different market segments and have slightly different needs in an online substitute system. Client needs and expectations are set forth in a set of business rules outlined below.1.2Assumptions and ConstraintsIDAssumption or Constraint1.2.1The new reservation system will be proficient in achieving the begments.1.2.2Design constraints for the new reservation system are based on budget limitations and migration issues since th e resort has three different locations utilise different systems.2.Business and Customer RequirementsEnter any summary requirement information here.2.1Strategic Business and Customer RequirementsThe goal is to implement a reservation system to cloak all three of Baderman Island Resorts and assist in meeting business requirements.Priority Legend MH (Must Have) or WH (Want to Have)Status Legend (A Approved, C Cancelled, D Delayed). Req IDDateRequirementPriorityStatus2.2.104/06/2014The system would require that future guests make a reservation for a span of dates. MHA 2.2.204/06/2014Guests may reserve a type of room, but not a peculiar(prenominal) room. The specific room will be assigned to each guest at check-in.WHA2.2.304/06/2014The room descriptor will include the type and number of beds available and another(prenominal) amenitiesMHA 2.2.404/06/2014Event or conference rooms may also be reserved.MH 2.2.504/06/2014Overbooking Because there are many no-show reservations at the hot els, each hotel will allow a certain percentage of overbooking. This overbooking percentage must be available for each hotel and must be modified dynamically.MHA2.2.604/06/2014The reservation system will collect customer and payment information. Future guests will use a credit card to secure their reservation.MH A3.ReferencesEnter any references here.Req ID RelatedReference DescriptionLocationOwner3.1.1SR-bi-004Virtual Organization PortalBaderman Island ResortAnnamae Goodrick 3.1.2Oracle Websitehttp//docs.oracle.com/cd/E19636-01/819-2326/aavby/index.htmlOracle

Employee relations Essay

The conviction that there exists a power im labyrinthine sense in the employment relationship which departs employers a prejudicial benefit over employees takes its existence for s everal centuries. Karl Marx known for his theories and contributions related to the employment relations field, became famous through his literatures and ever since his popularity remains.Firstly and primarily, the lives of most men and women argon subject of plow. The large majority of individuals who employment are simply employees only few are employers. Therefore, the terms and conditions in which individuals perform this work are crucial for everyone. These agreements are characterized by the relationship surrounded by employer and employee. Again, employee relations suggest notion of fairness and equity in the wages of labour. At the basic level, employee relations tend to create active group collaborationism in the place of work rather than conflicts which give to employees the impression in s ome way to be separated from employers and organisations for which they work. Employee relations take into account many factors related to a good quality of work such as remuneration of labour, bonuses, promotions as closely as the corporate culture and the work purlieu, training and development programs for employees. Recognizing the achievements and contributions made by the employee, this is an important part of employee relations, as the demands of the employees are more or less respected. Numerous scholars and authors have written lot of theories related to employment relationship field. Edwards defines Employee relation as wholly forms of economic exertion in which an employee works under the authority of an employer and receives a wage in return for his or her labour. (Edwards, 2003)However, new approaches have emerged with the influence and recognition of parcel out unions in the midst of 60s and the male breadwinner mainly consideredas industrial relationships. Accordi ng to Blyton and Turnbull, more factors to be considered wages and profit, authority and compliance ,the hire of work being a source of dignity, a living wage and social cohesion, employee voice and participation in decision making. (Blyton and Turnbull, 2004, p.7)In this essay, I go forth briefly talk about the unitary and pluralist perspectives on Employee relations. I will also discuss the applicability of the radical or Marxist perspective to the compend of employment relations.Early in the twenty century, before the advent of industrialization and globalization, industries and organisations operated in a context in which all the aspects related the work was mostly ruled by employers and the employees had no power and no right to express their views, therefore they were submitted and had to comply with the compulsory rules and regulations on them by employers. For a very tenacious time, the interests of employers have overcome the interests of employees. During the period o f post-war, the phenomenon called globalization hardly was not existent and technology had not reached its climax, these factors have not play a predominant component in the industrial world.Employees were forced to complete the entire amount of work required which included intellectual and physical effort. In return, they had limited support from employers payable to managerial styles set. By comparing the post modernization epoch and the current context of work, there has been a huge progress between relations of employees and employers. Today, a large number of factors have be taken into account, which have an impact on Employee relations such as the politico-economic frame, new legislation, globalisation, technological advances, trade union, master organisations, Training and development.Fox found two basic views expressed about the basis of relationship between management and trade unions in particular or employees in general, the unitary and pluralist. Thereafter, a radi cal or Marxist view came up as a third perspective, which was totally different and opposed from the others two frames of management. These perspectives are not essentially focused on the nature of the employment relationship but rather by conflict (Fox, 1966).The unitary view on one hand, this theory considered as one of the earliest theories. The unitary perspective takes into account the nature of work of employees as well as the technology. For the unitary, the organisation essential be a united group of individuals with single authority, loyalty structure sharing common objectives. The employers have the right to make decisions those decisions are considered as legitimate, keen-witted and are not opposable. The assumption is deep down the unitary organisation system, basic harmony and conflict is needless and exceptional. According to Howard, conflict is seen by your boss as both unnatural and unnecessary. (Howard F, 1993)Therefore, many managers see trade unions a disturban ce indoors organisation from external which contests unfair decisions for the loyalty of workers. Therefore, if conflict still pending, the management suggests it should be dealt with by their authority management coercion. As mannequin, this perspective was the case of many organisations during the 1980 in the UK while Margaret Thatcher was prime minister. This clearly demonstrates that there was a noticeable inequality and an asymmetry between the workers and the employees and the voice of the workers were not taken into consideration.The pluralist view on the other hand, Pluralist theory is deep-rooted in interests conflicts between employers and employees which co-operate in flawed labour markets. The employment relationship is perceived as a matter of negotiation between stakeholders with opposing interests, the employment outcomes depend primarily on some(prenominal) environmental factors that determine the bargaining power of each party. Pluralist view distinguishes that both employees and employers have divergences in their opinions, and following this, a power struggle or a conflict may rise within the workplace.However, pluralist view claims that it could be better for the sake of the interests of the organisation if the views of all parties in conflict could be taken in consideration and reconciled. Pluralist views was essentially founded on an convenient situation and did not take into account certain factors such as the flexibility or changes taken in the world of the industry, this due to the evolution of the technology, fast expansion of business, environmental issues. Conflict resolution is branded by the necessity to make agreed actions and institutions which attain collaborationvia comprehensive, codified negotiated settlement systems.Marxism was established through the observation of Marx recognized as one of the famous scholar who have advanced many theses opposing to capitalism. To Marx employee relations was a significant way to unde rstand the theory of capitalistic production. Marx explained how organisations were working, of how and why the history has extended, and particularly an account of the nature of capitalism. Capitalism was seen by Marx as highly inacceptable and his concern was to end up with this system through violent revolution and shape a communist society. According to Hyman, capitalism constitutes a complex of work and social relations of production. (Hyman, 197596-97) The main characteristics of the capitalist structure of employment relations are constituted as follow private ownership of the workers, the weakened minority control the ownership, mandatory method for the majority of society to sell their labour power as a product, the dominance of profit as the calculate of the economic. Although, the capitalist structure of employment relations reflects an exploitative relationship.For instance, wages remunerated to the employees consists essentially a small part of the corporal value pro duced by them, in other words wages would be minimized to a substantial level. However the rest of the gain from production is allocated to the employer as a benefit. Therefore, the capitalist environment is fundamentally being seen as a conflicting flesh relation. On the basis of the capitalist perspective on employment relations, Marxists believes that capitalist organisations are little by little dominating as prescribed in their economic status by two main opposed classes, which are the ruling class or capitalist and the workers considered as subject class. The ruling class owns and controls the mean of production, distribution and trade, in certain ways the means of political domination. Contrary to the ruling class, subject class is subordinate workers have not control on property and are subject of servitude of the bourgeoisie interests.Therefore, workers are exploited and ruled politically and socio-economically. This competition between the ruling class and the subjected class would be in argument to gain ground and impose the persistent contend, therefore fight will be obvious. The crooked distribution of power in the presence of private information and opposing between the ruling class and the workers interestsis obvious. Although, it is possible that private information and opposing interests give rise to opportunism of both parties to the employment contract in most cases, However, The Marxists believe that the negative consequences experienced by the workers are possibly more careful than consequences encountered employers because of the power of the employers based in the ownership of the organisation.The main noticeable risks related to imbalances in bargaining power are paying low wage compared to the output signal that workers have produced and the risk that could arise in the investment decisions of the organisation. As an example of imbalances in bargaining power to illustrate, we can refer to the case accept of Nike dissipated Nike has been the subject of many criticisms. It has been shown that the conditions of work were inhuman in many factories of Nike in Asia and a strict requirement of standards level needed to be achieved by all workers. How Nike has exploited its workers for financial gain with low wages. (www.stanford.edu/class/e297c/trade_environment/wheeling/hnike.html, last seen 06/02/14) This unacceptable situation is a good example to illustrates how unfairly the capitalist system operates. Therefore, all these inequalities and all of these issues within organisations have given rise to conflict.For John Kelly, The Marxist approach to industrial relations accepts that conflict exists but that at set out there is little balance between organised labour and capital, especially in an era of globalisation. (John Kelly, 1998) A big gap of power between the workers and the Employers within an organisation creates imbalance, the ruling class with more power compared to the workers rarely tend to use it. This is because the use of the excessive power usually turns into a kind of totalism in the minds of employers who want to control it.The current situation comes to be genuine, and workers must comply and accept any unfair decisions taken against them. Therefore, for the Marxist perspective, it was crucial to taste the need to settle conflicts of interests via some forms of job regulations. Contrarily to the unitary and pluralist perspectives, the Marxist perspective has go in depth in term of developing a series of elements related to industrial relations such incarnate bargaining, trade union regulations and workplace legislations. According to Flanders, industrial relations are a study of theinstitutions of job regulation. (Flanders, 1974)In order to understand why there is asymmetry of power between employees and employers, it will be relevant to look closer at the three major actors who play a significant portion, which are the collective bargaining and trade union, and th e asseverate. However, Marxism has given birth to the collective bargaining and trade unions on the basis of anxieties relating to the negotiation between management and the workforce. According to Gunnigle et al, collective bargaining gives redress the imbalance of power between individual workers and employers. ( (Gunnigle, 1995)) It is for the fundamental reason that collective bargaining is implemented in industrial relations, and basically gives an objective purely politic to collective bargaining which is the balance of power.As soon as his map is accomplished, collective bargaining is utilized principally for financial reasons. Collective bargaining allows managing in tactical way how to deal with employees fairly. The collective bargainings surgical process may also provide legitimacy to trade unions within organisations. Purcell states that this legitimacy can give trade union members a sense of belonging to the organisation. (Purcell, 1979) However, collective bargainin g has also its imperfections and disadvantages as far the capitalism is concerned. Collective bargaining may result to irrational and groundless demands which may lead to serious conflicts.Marx has modelled the historic significance of union fight unassailablely in his book The Poverty of Philosophy. Marx was not indifferent to the conditions of workers to make their lives better they were concerned on how they were struggle to unionize themselves. Marx argues that higher wages simply set up prices and strikes were a dead end. For Marx, the unions could play a political role in the real cultivated war to pay higher wages to workers. Marx argued that capitalism had operated a physical minimum, which maintained people alive, but that is a social balance of power between capital and labour.Trade unions are naturel response of workers who have been exploited by the capitalist system it gives to employees a voice. indoors the trade union the workers have the role that the management occupies this role consists to affect the demand of the union service and union memberships.The establishment of union has been encouraged since the workers are feel frustrate with the style of work or management. When there is a strong presence of union, there is a balance within the employment relations. For instance, the case of John Lewis employees, there is a strong democratic structure where partnership is also encouraged. Workers are less exploited and are less dissatisfy about the style of work. This is a good example to illustrate when we think in term of benefit of the trade unions.Marx argued about the role played by the state, which he thinks is serves only the interests of the dominant class within organisations. The state appears more as the mover of the ruling class, because it tries to maintaining its control over employees who are already exploited. Marx claimed that the state reacts as dictatorship for proletariat. The executive of the modern state is essentially a committee for managing the common affairs of the whole bourgeoisie. (Marx and Engels,1948, p.11.) Again in the instant case, we see that the state plays an adverse and inequitable role the balance of power on employers over their employees.Having critically assessed some facet of the Marxist perspective on the asymmetry of power between employees and employers, we can come to the end that this perspective leads a concept of the dictatorship of the proletariat. Marxist perspective focuses more on the structure and nature of the organisation rather than the current workplace in the society and Marxists argue that the conflict in the industrial relations is a reflection on how the society is structured. Marxism puts a particular emphasis on the instalment of interest between the employers and the employees. The Marxists considered the conflict as unavoidable and trade unions are a seeing as an alternative solution of workers to exploitation by owners.Within the Marxists perspective , employers are continued to exercise their unfair power over employees even thus the presence of trade unions which are powerless. The state is also considered as an instrument of the bourgeoisie. For the Marxist, trade unions and collective bargaining may increase but may not limit of the employers power because they are subjected to the persistence of capitalism instead of challenge it. However, The Marxist perspective is seen to be out-of-date as the entire nature of the class conflict haschanged, as a result of modern organisations, as well as its mixed economy and welfare state, which is currently more open and on a social basis mobile.ReferenceBlyton, P. &. (2004). _The Dynamics of Employee Relations Basingstoke Macmillan._Bukharin. (2003). _Imperialism and cosmea Economy._ capital of the United Kingdom & Sydney Bookmarks.Engels, M. &. (1948). _The Communist Manifesto, International Publishers.__Fox, A.(19660. Industrial Sociology And Industrial Relations (Research Paper 3, Royal Commission on Trade Unions and Employers Associations), London._Hyman, R. (1975). _Industrial Relations A Marxist Introduction._ London The Macmillan Press Ltd._http//www.stanford.edu/class/e297c/trade_environment/wheeling/hnike.html__Bukharin (2003) Imperialism and World Economy._ (n.d.). London & sydney Bookmarks.Kelly, J. (1998). _Rethinking Industrial Relations Mobilization, Collectivism and Long Waves._ London Routledge.Marx, K. (1964). _Early writings._ New York McGraw-Hill.P., E. (2003). _The employment relationship and the field of industrial relations._ oxford Backwell.Palmer, H. F. (1993). _British Industrial Relations._ London Routledge.Purcell, K. (1979). _Militancy and acquiescence amongst women workers. Burman (ed.), Fit Work for Women, London, Croom Helm.__Gunnigle, P. (1995). Collectivism and the management of industrial relations in greenfield sites, Human Ressources Journal._

Why We Shouldn’t Write Essays

For many students, pen essays are non exactly our number one choice. Unfortunately, writing essays in High School is like the fog in Daly City- its inevitable. Writing essays in skill class on the new(prenominal) hand, is like a fortunate day quickly covered by fog. Its somewhat expected, yet still disappointing, and surprising at the same season. Were most expected to write essays in our position class, so writing an essay in any other subject such as Science makes us hate writing essays even more. In general, writing essays interfere with our personal responsibilities, and our activities outside of school.The main problem students have with writing essays is not knowing how to manage their time well. Often times, we procrastinate because we elect to do other things instead. Given a 1-2 week time period to complete an essay seems like a lot of time until procrastination satiates over. Writers block, and distractions are a huge contribution to procrastinating as well. Somet imes you just dont know where to start when you write an essay, or your ideas and words may not flow together. Youll see over, and over again but it just doesnt sound right.As a result, you become discouraged and leave it to do later. Instead of trying to write your essay, you get deflect by your phone, favorite show, or computer. This easily makes later become the night before its due, and by then were struggling to cram in on the whole of the other cookery we have to do still. Nowadays, teachers give so much homework. Its really important that we use our time wisely, or we wont finish what we need to get through on time. Doing an essay on top of homework can be very time consuming, and sometimes we just dont have the time.Some may say, You have all the time in the World, but in reality its the time you have later school, and how you use that time. Most students in High School have after school activities such as Club meetings, sports, dance, etc. If you have practice 2-3 hou rs after school, by the time you get home youll most likely be too tired and lazy to start, or finish your essay. Having a significant other requires you to dedicate your time to them, depending on how serious your relationship is. Dedicating all your time to our boyfriend, or girlfriend can be a huge distraction when youre writing an essay. For example, you may be constantly calling, or texting each other which wont eudaemonia you at the end. By the time youre done talking to him/her, chances are youd either say your essay for later, or not finish it at all. Maybe youre not the type to procrastinate, but you have committed to other responsibilities in addition to your school work such as babysitting your little brother, or crime syndicate businesss.This can make it difficult to complete an essay because youre trying to do too many things at once. If you pick up your sibling from school, still having to take bus home, youre not left with a lot of time once you get home to do ever ything you need to do. Washing the dishes is a common chore done by teenagers everyday which doesnt exactly take 5-10 minutes to do, particularly with a big family. With that being said, the time taken out of when you do your homework can be very crucial. After writing many essays, youd think it would only get easier, and sometimes it does.Other times, most times, it only gets harder. Writers block can especially discourage students from writing an essay. This leads to distractions, which then turns into procrastination. For some, they might just not have the time due to other responsibilities, or activities. Writing an essay in a Science class doesnt appeal to many students simply because essays are expected in an English class. What we do expect, and are used to in a Science class are research papers, and worksheets.

How Can 1984 Be Read and Interpreted Differently?

How can a text be read and interpreted differently by two different refs? 1984by George Orwell (1949) is a political sassy written with the purpose of warning reviewers of the dangers of totalistic government. The book can be read and interpreted very differently by two different readers, peculiarly when they were born in a different time. In this essay the viewpoint of two Western readers, one from 1950 and the other from 2012 will be compared to look at the possible difference they could experience in interpreting the story.First of all, the fear of creation watched and controlled is more recognizable for a reader in 1950. During World War II, the media was controlled by the Nazis. Radios for example, all transmitted positive news for Germany. In order to ensure nobody secretly listened to something else, houses were checked regularly. That was not only to see if people listened to an illegal radio-channel but also to see if they were hiding Jews. When they were founded guilt y, they were send to a concentration camp immediately. In the book this is compared with Thought horror and the Ministry of Love.P 21 theyll shoot me in the back of the neck i dont care down with big brother they always should you in the back of the neck i dont care down with big brother This is a quote from Winstons diary. Even writing something in his own private diary, in his own house is a crime since he didnt obey Big Brother, the Partys leader. The fact that he scribbled it down so quickly and full of mistakes shows the fear being caught and watched. Second of all, the concern of totalitarian governments was more relevant immediately after World War II.The reader in 1950 could easily recognize the similarities between the totalitarian government of Hitler and the totalitarian government described in 1984. Before World War II Germany was in an economic downturn. Hitler was a magnificent speaker who offered a reason for this occurring he blamed the Jews. No one wants to hear th at the problem with their country are their own so the German accepted this as an answer. In Oceana the same happened P 13 The hate had started. As usual, the face of Emmanuel Goldstein, the enemy of the people, had flashed onto the screen. The leaders of The Party use the same way to gain power as Hitler did, so readers from 1950 are likely to . For readers in 1950 this is all fresh and easily recognizable and therefore more relevant than for readers from 2012. Lastly, the fear of being spied on and eavesdropped by telescreens and secret microphones was more substantialistic to a reader from 1950. That is because around 1950 more and more people started to own a television and therefore it became a real possibility that everybodys house would have a telescreen one day. Nowadays this fear has become a reality, only in a different way.The government is able to control and check a lot of things through cameras and social media and there is little privacy. But to a reader from 2012 th is is not strange or frightening, it is absolutely normal. For this reason you could say the actual fear is not realistic because a reader from 2012 doesnt have to fear it anymore. To conclude, the fear a reader could experience while reading the book in 1950 is more realistic, more relevant and easier recognizable than the fear possibly experienced by a reader in 2012. Therefore, 1984 can be read and interpreted differently by two different readers who were born in a different time.

Inverse Proportion of Physical Fitness and Awareness Program

Although aw areness of the importance of bodily seaworthiness has increased in the United States, the average level of an Ameri plunders fittingness has decreased. In short, intimately everyday citizens are out of shape. This is parti anyy due to the more modern and easier lives that most Americans lead compared to Americans of earlier time periods. If Americans wish to prevail in dependable health, then their daily regiments must be changed.Among adolescents and teenagers, thesame numbers are noticeable. Nearly fifty portion of American youth fourth-twelvemonth twelvethrough and through twenty-one are not vigorously vigorouson a regular basis. Only nineteen percent ofall in high spirits school students are forciblely activefor more than twenty minutes or more, fivedays a week, mainly in physical program lineclass (Physical occupation and HealthAdolescents and Teenagers, par. 5-8).These numbers are a significant drop from previous studies of earlier decades. When physical fitness reform was stressed in schools during the fifties, the government administered some(prenominal) test to get an exact figure on American childrens level of fitness. The United States office of Education discovered that in one year fifty-six of 108,000 public schools had strengthened their physical preparation programs. These modifications were noticed. Between 1964 and 1965, 11,000 boys and girls who took the Youth Fitness test had higher mean scores in every circumstance and at all ages than the results recorded from the previous decades tests (Van Dalen 520-521).Although modern, well-designed school-based interventions directed at increasing physical activeness in physical education classes buzz off been shown to be effective, only twenty five percent of high school students enroll in physical education class daily. In 1991, forty-one percent of all high school students enrolled in physical activity. That means that in only ten years, the daily level of physical activi ty amongst teens has been cut almost in half (Physical Activity and Health Adolescents and Teens, par. 9-10). Not even the best school based interventions directed at increasing physical activity can actually amend a students level of fitness if they arent participathing in class to begin with.Over 60 percent of adults do notengage in the recommended amount ofactivity. In fact, over twenty five percentof American adults are not active at all(Physical Activity and Health Adults, par. 6-8)Concerning the history of physical fitness awareness, physical activity for better health and well- cosmos has been an important theme passim much of western hemispherical, American history. Since the beginning of awareness, public health recommendations have evolved greatly. They started with emphasizing vigorous activity for cardio-respiratory fitness. The same recommendations are still given, but straight it is thought to be better to include the options of moderate levels of activity for nu merous health benefits (Historical Background and Evolution of Physical Activity Recommendations, par. 1-2).One of the first qualify fields of medicinal drug in the fitness world was sports medicine. Physicians associated with professional sports teams initially practiced sports medicine, but with interest in amateur sports and physical fitness programs in the 1970s and 1980s the field grew rapidly. Sports medicine still continues to be a fast-growing division of specified medicine that has to revolutionize the understanding of exercise and the systems reply to the stress of exercise (Sports Medicine, par.1)These physicians and doctors are not uncovering these earth-shattering discoveries on their own. The American Council on Exercise (ACE) is very active in fitness research (The in store(predicate) of Fitness, par. 2). The official government committee to support physical fitness is The Presidents Council on Physical Fitness and Sports (PCPFS) is extremely birdcall in the edu cation of the public. PCPFS has been fighting its ever-toughening crusade against laziness since the era of President Kennedy, who founded the Council (Van Dalen, p. 520-521). There are also many Internet websites (e.g. efitness.com, emedicine.com, nutricise.com) that provide easily handy information to the public.Because of groups alike ACE and PCFS, the awareness of the benefits to physical fitness are being broadcasted everywhere it is just a matter of time until every American understands the value of being physically fit. When that time comes, experts say more people leave exercise to achieve better health instead of just to improve appearance. Also, exercise will become a vital part of disease management. In the future, adventure workouts such as hiking and mountain climbing will switch over traditional treadwheel and weight training workout. Sports specific training such as golf and tennis exercises will become more mainstream. It is also express that exercise programs adapt towards older adults such as water-based fitness will increase in popularity (The Future of Fitness, par. 3-4, 6-7).Inverse Proportion of Physical Fitness and consciousness ProgramAlthough awareness of the importance of physical fitness has increased in the United States, the average level of an Americans fitness has decreased. In short, most everyday citizens are out of shape. This is partially due to the more modern and easier lives that most Americans lead compared to Americans of earlier time periods. If Americans wish to stay in good health, then their daily regiments must be changed.Among adolescents and teenagers, thesame numbers are noticeable. Nearly fiftypercent of American youth aged twelvethrough twenty-one are not vigorously activeon a regular basis. Only nineteen percent ofall high school students are physically activefor more than twenty minutes or more, fivedays a week, mainly in physical educationclass (Physical Activity and HealthAdolescents and Teenagers, par. 5-8).These numbers are a significant drop from previous studies of earlier decades. When physical fitness reform was stressed in schools during the fifties, the government administered several test to get an exact figure on American childrens level of fitness. The United States office of Education discovered that in one year fifty-six of 108,000 public schools had strengthened their physical education programs. These modifications were noticed. Between 1964 and 1965, 11,000 boys and girls who took the Youth Fitness test had higher mean scores in every event and at all ages than the results recorded from the previous decades tests (Van Dalen 520-521).Although modern, well-designed school-based interventions directed at increasing physical activity in physical education classes have been shown to be effective, only twenty five percent of high school students enroll in physical education class daily. In 1991, forty-one percent of all high school students enrolled in physical activ ity. That means that in only ten years, the daily level of physical activity amongst teens has been cut almost in half (Physical Activity and Health Adolescents and Teens, par. 9-10). Not even the best school based interventions directed at increasing physical activity can actually improve a students level of fitness if they arent participathing in class to begin with.Over sixty percent of adults do notengage in the recommended amount ofactivity. In fact, over twenty five percentof American adults are not active at all(Physical Activity and Health Adults, par. 6-8)Concerning the history of physical fitness awareness, physical activity for better health and well-being has been an important theme throughout much of western hemispherical, American history. Since the beginning of awareness, public health recommendations have evolved greatly. They started with emphasizing vigorous activity for cardio-respiratory fitness. The same recommendations are still given, but now it is thought to be better to include the options of moderate levels of activity for numerous health benefits (Historical Background and Evolution of Physical Activity Recommendations, par. 1-2).One of the first specified fields of medicine in the fitness world was sports medicine. Physicians associated with professional sports teams initially practiced sports medicine, but with interest in amateur sports and physical fitness programs in the 1970s and 1980s the field grew rapidly. Sports medicine still continues to be a fast-growing division of specified medicine that has to revolutionize the understanding of exercise and the bodys reaction to the stress of exercise (Sports Medicine, par.1)These physicians and doctors are not uncovering these earth-shattering discoveries on their own. The American Council on Exercise (ACE) is very active in fitness research (The Future of Fitness, par. 2). The official government committee to support physical fitness is The Presidents Council on Physical Fitness and Sports (PCPFS) is extremely vocal in the education of the public. PCPFS has been fighting its ever-toughening crusade against laziness since the era of President Kennedy, who founded the Council (Van Dalen, p. 520-521). There are also many Internet websites (e.g. efitness.com, emedicine.com, nutricise.com) that provide easily accessible information to the public.Because of groups like ACE and PCFS, the awareness of the benefits to physical fitness are being broadcasted everywhere it is just a matter of time until every American understands the value of being physically fit. When that time comes, experts say more people will exercise to achieve better health instead of just to improve appearance. Also, exercise will become a vital part of disease management. In the future, adventure workouts such as hiking and mountain climbing will replace traditional treadmill and weight training workout. Sports specific training such as golf and tennis exercises will become more mainstream. It is also said that exercise programs geared towards older adults such as water-based fitness will increase in popularity (The Future of Fitness, par. 3-4, 6-7).

The Growing College Gap

At first glance, Tamara Drauts article seems to state a fact that most individuals already know its hard to get into college. Looking further into her claim, Draut reveals the struggles that low-income high school students applying to a four-year college or university face. Specific whollyy, the article talks about enrollment gaps between class and melt due to financial issues and the increase of high school students applying to colleges and universities across the people. In addition, Draut begins her article by explaining the divergent outcomes that occur from specific levels of upbringing.First, she shows the lifetime economic gains that different degree, ranging from high school to PhD, testament make. Second, she explains the different qualities of life that each education level will face. Specifically, Draut explains that those who cannot get into a higher education program will not have the opportunity to have a higher paying job. I especially agree with one aspect of Dra uts argument in which she states that not enough college worthy students are getting to attend the schools that they want to and should be attending.I agree with another part of Drauts argument should make all college degree seeking Americans fight against the injustice of government aid programs providing aid on merit based performance only. This is not to say that I discord with money being surrendered to students who study hard and make sacrifices in order to obtain their secondary education, I disagree with more money abandoned to merit based programs instead of students who come from low income backgrounds.Aid programs do not take into consideration that many low income students come from inner cities, where secondary education is at the bottom of hierarchical education scale and these students lack the crucial knowledge that being taught at the more prestiges high schools of the suburbs where fondness and upper class students attend. The later portion of Drauts article tal ks about the issues that stem from the nations lack of financial aid. Since the loan/grant system has deteriorated, the friendly gap between Caucasian and ethnic students has increased.Over 570,000 students could not go to a public university solely because of financial reasons. This has caused the enrollment in conjunction colleges to increase rapidly- 44% of all under downs go to a community college. Also, 40% of young adults surveyed said that they either had to delay their education or go to a less expensive school because of financial issues/student loans. Draut provided an example in her article by putting an image stating I sure hope social security is around when Im 65.Ill need to finish paying off my college loans(Draut,383) The struggle to get into and maintain an education at a four-year college or university causes a social-rift among socioeconomic classes instead of solely on race/ethnicity. If low- income students are able to make it through a four-year program at on e of the nations most prestigious schools, they are more likely, according to statistical data, to have a higher wage premium in comparison to high-income students that graduate from the same academic institution.

Optimism and Health Benefits Essay

veritable(a) the darkest night will end and the sun will rise. This quote from Victor Hugo is a perfect sheath of optimism. When someone is optimistic, they have a disposition or drawency to look on the much affirmatory side of events or conditions and to expect the most favorable takings. Optimism is simply a mental game. The brain drive out interpret situations or events as being optimized nub that some factors may non be amply comprehendible, yet having confidence that the present moment is in an optimist state. This understanding, although criticized by counter views such as pessimism, realism, and idealism, leads to a state of mind that believes everything is as it should be. With optimism, someone contains hopefulness and confidence about the future or the successful outcome of something. Not only does optimism give someone confidence, it also provides many health benefits and a instinct of answer in life. Is your glass half empty, or half full? This saying is a co mmon set phrase that illustrates optimism versus pessimism an optimist is said to see the glass half full, and a pessimist sees the glass as half empty.Winston Churchill provides another crotchety understanding of this idea The optimist sees opportunity in every danger the pessimist sees danger in every opportunity, The delineate characteristic of pessimists is that they endure to believe bad events will last a long sentence, will damp everything they do, and ar their own fault. The optimists, who are confronted with the same problems of the world, think about misfortune in the opposite way. They tend to believe defeat is just a temporary setback. Provoked by a bad situation, they savvy is as a challenge to try harder. If the thoughts that run through ones head are mostly negative, their mentality on life is more likely to be pessimistic. There is nothing wagerer in life than having a peace of mind that no matter what the troubles are that life may bring, everything will b e okay and that life has so much to offer. Unfortunately this peace of mind does not happen over-night, it takes years of trials and experiences to be able to see the bright side of any given situation. spate are not automatically born with optimism they have to experience negative circumstances in pronounce to find the strength to be optimistic in general. Without hardships, optimism would not grow. Optimism often starts with egotism-talk.These endless streams of unspoken thoughts squeeze out either be positive, or negative. Optimism does not mean that one keeps their head in the sand and sack lifes less unpleasant situations, it just means that the approach to the unpleasantness is in a more positive and productive way. With this approach to any given situation, extend can be reduced. Often times people upset themselves over something minute, causing a lack of sleep, unhealthy eating habits, antagonistic mood, etc. What they do not know is that with a simple thought of, I can do this, or It will be okay, their whole stream of thoughts eventually start following that positive pattern, ever-changing their whole mood, reducing stress, and increasing their chances of overcoming obstacles. Not only does an optimistic view reduce stress, it also decreases the risks of cardiovascular disease, hypertension, and infections.Optimism itself, not just its association with happiness, lowers anxiety, thus causing less hostility, and has the potential to lower the risk of a stroke. U.S. questioners followed more than 97,000 women for about eight years. Measures of optimism and cynical hostility were strongly associated with these outcomes Optimists had a lower incidence of meat disease and total mortality. Conversely, cynical hostility, which is a lack of confidence and increased bitterness, was associated with both higher general mortality and cancer-related effects. Along with positive health benefits, optimism also gives someone a sense of purpose. American p sychologist, Salvatore Maddi, co-author of Resilience at Work How to Succeed No Matter What Life Throws at You, extensively examine what makes executives tough in the face of work-related stress.He found that the healthiest of executives shared three characteristics a feeling of commitment, a sense of control in their lives, and an acceptance of lifes stressful moments as challenges rather than threats. This research confirms that having a sense of commitment to a purpose does not merely give someone meaning it makes them more resistant to the impact of stressful living. This view on optimism can increase ones chances of succeeding their goals or dreams, and not allowing negative situations to hinder their attitude. With hopefulness that their goals will be achieved, their motivation is amplified as well. Optimism is a way of life that is not learned automatically, it takes time and effort to completely change ones mindset. This mindset has many positive effects. A firm confidence in ones self develops, and they have self-assurance that no matter what life throws at them, it is completely possible to overcome those obstacles.Optimists tend to believe that defeat is not their fault circumstances, bad luck, or other people bring it about. such people are unfazed by defeat. Optimism not only gives one confidence, but also provides a unlimited number of health benefits. With an optimistic attitude, depression can be reversed. Although it takes time to get out of a slump, just the start of positive self-talk can remove one out of despair. Positive self-talk also reduces stress and the chance of cardiovascular disease, hypertension, and strokes. A sense of purpose also develops with someone who acquires an optimistic mentality. A sense of purpose does not only give someone meaning, it helps them to overcome the stresses that life brings. Optimism merely starts with a simple I will be okay. It takes small steps, but it is completely possible for one to change the ir outlook on life and not let circumstances defeat ones life.

“a Contemporary View on Health Care System in Bangladesh.”

CHAPTER 1 Introduction 1. 0 origin and background of the pass over The writing A Contemporary view on wellness Cargon System in Bangladesh is the expiry of Internship Program which is a precondition for acquiring MBA level. Only curriculum activities be not enough for use the real business environment, so it is necessary to get the better k straight off takege astir(predicate) the real scenario. The inform is a requirement of the internship program for my MBA Degree. give experienceion of Internship/ Dissertation started on 20th December two hundred9 and ended on 12th February 2010.My internship supervisor at Inter topic Islamic University Chittagong, Dhaka Campus, Mr. R M Nasrullah Zaidi assigned me the worldation of my report. The reason behind choosing this topic is getting a clear picture of the wellness sector of Bangladesh. works on this topic gives me an opportunity to chthonianstand the Problem and prospect of wellness flush placement in Bangladesh. In t odays orb of globalization Thiland is seeking to encourage wellness tourist to its pastoral down the stairs(a) the banner of Thailand Centre of Excellent Health C are of Asia, India is grammatical construction an e-wellness industry and Singapore is building infirmarys abroad.When scenarios are like that where the health sector of Bangladesh ? Here we try to get a idea more or less what is the real scenario of various tie in issues like regain to health-relate knowledge and technology, the provision of new hospital and aliened health institution and the availableness of health professionals. 1. 1 objectives of the report The objective of my study carve up into deuce instalments 1. 1. 1 Primary Objective The autochthonic objective of this report is to meet the requirements of the course, OCP 5900, Internship. 1. 1. 2 Secondary ObjectiveThe secondary objectives are * To confer a clear picture of matter health senario. * To know well-nigh list and contentedness of existi ng hospital & clinic * To know al intimately manpower supply capacity and requirement * To know about Morbidity and its rate * To know about Available alternative or traditional medical checkup trade system. * To know about health education of mass plurality * To know about governing social structure- health system * To know about demographic structure of population * To know about role of different institution in respect of Health Care 1. methodology I withdraw aforethought(ip) to accomplish the task in quadruplet stages Step 1 readiness of the work Step 2 selective information collection Step 3 Analysis and interpretation of entropy Step 4 Drawing conclusions and recommendations The first-class honours degree stage is the most important stage. I have allocated enormous time for this stage. I am show on thorough and detailed planning. formulation includes detailed methodology and scheduling of the re importanting three stages. I am likewise emphasizing on documen ting detailed planning which would serve as a road map and performance measure for the whole report.The second stage is the info collection stage. I have planned to collect data in three main phases. * Collect data from internet, different books and medical journals. * Conduct interviews with selected re exhibitatives from different take of health professionals. This phase actually concentrates on clarification and elaboration of data peaceful from the first phase. * Conduct interviews and communicate with health providers who are in the front line. This phase actually concentrates on accumulating data for the overall scenario. The third stage is the analysis and interpretation of data.In this stage I would use just about statistical and graphical analysis tools to interpret the relationship among different variables and factors. The fourth stage is the stage for draft copy conclusions and prescribing recommendations. In this stage the results from the previous stage would be u sed to draw conclusions about different aspects of refer matters within the constitution and prescribe some recommendation for future improvement. The project is base on devil prime and secondary information. Primary Source * Informal discussion with employees of UHL. Observation while working in different desks * Interview with health trade providers. Secondary Sources * Official Web Site of UHL * Annual Reports of Ministry of Health * Various Manuals and Brochures of DG Health * Different publications of WHO. 1. 3 scope This report solely deals with the health related information of Bangladesh. Here we try to accumulate information from various topics that have role with the health system of a country. The project is based on both main(a) and secondary information. Health system is a very vast area to work gravitational constants of issues are related here.Here we make some major incision to discuss like national health circumstance, health kick preservation system, fa cility based health assist, leading public health problems and health education. 1. 4 limitations 1. The major limitation faced in preparing this report is the enormous number of parameters that have relationship to the health veneration system of a country. 2. Less availability of data at all tiers of service providing especially in the private sector. 3. Less accessibility to data due to shortage of time and proper arrangement and at the same time the authenticity of data not beyond questions. 4.Health sector requires few specified technical knowhow for better down the stairsstanding. Being a non medical background some time face some problem to understand technical terminology and ofttimes needed explanation and further study. CHAPTER 2 Bangladesh National Health Status 2. 0Location and Geography Bangladesh was emerged as an self-sufficient and sovereign country in 1971 following a nine calendar months war of liberation. The country is wizard of the largest deltas of the wo rld with a total area of 147,570 sq km. Being a low-lying country it stretches latitudinal between 20? 34 and 26? 38 north and hugeitudinally between 88? 01 and 92? 1 east. It is for the most part surrounded by Indian Territory (West Bengal, Tripura, Assam and Meghalaya), except for a small strip in the southeast screen by Myanmar. Bay of Bengal lies on the south. The standard time of the country is GMT +6 hrs. 2. 1History Bangladesh has a superb history and rich heritage. Once it was known as Sonar Bangla or the Golden Bengal. The territory now constituting Bangladesh was under the Muslim blueprint for over five and a fractional centuries from 1201 to 1757 AD. Subsequently, it came under the British rule following the defeat of the sovereign ruler, Nawab Sirajuddaula, at the battle of Plessey on 23 June 1757.The British command over the Indian subcontinent including this land for nearly 190 days from 1757 to 1947. During that extent, Bangladesh was a part of the British In dian provinces of Bengal and Assam. With the termination of British rule in August 1947, the sub-continent was partiti angiotensin- exchangeing enzymed into India and Pakistan. Bangladesh was a part of Pakistan and was called East Pakistan. 2. 2Physiography With about half of its surface below the 10 m contour line, Bangladesh is located at the lowermost reaches of three correctly river systems -the Ganges-Padma river system, Brahmaputra-Jamuna river system and Surma-Meghna river system.Coinciding with the division of the country based on altitude the land can be divided into three major categories of physical units Tertiary hills, Pleistocene uplands and Recent plains (formed in recent epoch). The heavy monsoon pelting coupled with the low altitude of major parts of the country makes floods an annual phenomenon in Bangladesh. Quaternary (began about 2 million years ago and extends to the present) sediments, deposited mainly by the Ganges, Brahmaputra (Jamuna) and Meghna rivers and their numerous distributaries, cover about three-quarters of Bangladesh.The physiography and the drainage pattern of the vast alluvial plains in the central, northern and western regions have g iodine under considerable alterations in recent times. In the context of physiography, Bangladesh may be classified into three perspicuous regions (a) floodplains, (b) terraces and (c) hills, each having distinguishing characteristics of its own. The physiography of the country has been divided into 24 sub-regions and 54 units. 2. 3Climate Bangladesh has a tropical monsoon-type climate, with a bitter and rainy summer and a dry winter.January is the coolest month with temperatures averaging near 260 C (780 F) and April is the w weaponest with temperatures from 330 to 360 C (910 to 960 F). The climate is one of the wettest in the world. or so places receive more than 1,525 mm of rain a year, and areas near the hills receive 5,080 mm). Most rains occur during the monsoon (June-September) an d little in winter ( nary(prenominal)ember-February). Bangladesh has warm temperatures doneout the year, with relatively little variation from month to month. January tends to be the coolest month and may the warmest.In Dhaka, the average January temperature is about 19C (about 66F), and the average May temperature is about 29C (about 84F). 2. 4 face From the administrative point of view, Bangladesh is divided into 6 Divisions, 64 soils, 6 City Corporations, 308 Municipalities, 482 Upazilas and 4498 pairings. The sise administrative divisions are namely, Dhaka, Chittagong, Rajshahi, Khulna, Barisal and Sylhet. The country is governed by the Parliamentary Democracy and it has a unitary National Parliament, nameBangladesh Jatiya Sangsad. on that point are 40 Ministries and 12 Divisions.The Ministry of Health Family Welfare is one of largest ministries in the country. At the national direct, the Ministry oHealth Family Welfare (MOHFW) is responsible for policy, planning and d ecision reservation atmacro level. on a lower floor MOHFW, there are four Directorates, namely , Directorate cosmopolitan of HealthServices, Directorate world-wide of Family Planning, Directorate of Nursing Services and Directorate of dose Administration. Beside, there are a separate National Nutrition Proje(NNP)and Construction, Maintanance and Management unit of measurement (CMMU). . 5Economy Bangladesh has an agrarian economy, although the divide of agriculture to GDP has beendecreasing over the last few years. Yet it dominates the economy accommodating major artless labour force. From foodstuffing point of view, Bangladesh has been following a mixed economy that operates on free market principles. The GDP of Bangladesh is 6. 21% and per capitincome is US$ 599. The principal industries of the country include readymade garments,textiles, chemical fertilizers, pharmaceuticals, tea processing, sugar, leather goods etc.Theprincipal mineral includes Natural gas, Coal, white clay, glass sand etc. 2. 6Communication The transport system of Bangladesh consists of roads, railways, inland waterways, two sea ports, maritime shipping and civil aviation catering for both domestic and world-wide traffic. Presentlythere are about 21,000 km of paved roads 2,706 route-kilometres of railways (BG-884km and MG -1,822 km) 3,800 km of perennial waterways which increases to 6,000 km durinthe monsoon, 2 seaports (Chittagong and Chalna) and 3 international (Dhaka, Chittagong andSylhet) and 8 domestic airports. . 7Religion and Culture The majority (about 88%) of the people are Muslim. Over 98% of the people speak in Bangla. English, however is widely spoken. Bangladesh is heir to a rich cultural legacy. In two thousand or more years of its chequered history, many illustrious dynasties of kings and Sultans ruled the country and have left their mark in the shape of magnificent cities and monuments. The people of Bangladesh are very simple and friendly. A beautiful communal harmony among the different religions has ensured a very congenial atmosphere.More than 75% of the population lives in rural areas. Urbanization has, however, been rapid in the last few decades. 2. 8 universe of discourse and Demography Bangladesh is now Asias fifth and worlds one-eighth populous country with an estimated population of about 146 million. Density of population is around 979 per square kilometer, the highest in the world. farming(prenominal) population comprises about 76% while urban constitutes about 24%. Adult literacy rate is 54% ( two hundred6). Census of 2001 reveals that 43 per cent of the population is below 15 years of age.This young age structure constitutes built-in population momentum. Also urban population is increasing quite fast. Though Bangladesh has made elevate in trim back poverty and per capita income has been creeping up, a substantial number of population are poor. move on made in improving Bangladeshs Human Development Index (HDI) has rigid her among the medium-ranking HDI countries. Strong policy interventions led to persisting reduction in the annual growth rate of population from the level of 2. 33 % in 1981 to 1. 54 in 2001 and further to 1. 48 (2007). The TotalFartility Rate (TFR) also went protrude from 3. 4 in 1993-94 to 2. 2 (2007). The CPR (any method) increased from 44. 6% in 1993-94 to 58. 1% in 2004, but again fell down to 55. 8% in 2007. Life expectancy at birth has continuously been rising, and is now 65 years (2007) from the level of 58 (1994). Reversing past trends, women now live longer than men. The country, however, is over burdened with about two million new faces every year creating extra pressure on food, shelter, education, health, employment, etc. , and thus making the anticipated economic growth difficult. . 9Health Status Since independence Bangladesh has made significant progress in health outcomes. Infant and Child mortality rate rates have been markedly reduced. The underfive mortality r ate in Bangladesh declined from 151 deaths per thousand live births in 1991 to 65 deaths/1000 live births in 2007 and during the same period infant mortality rate reduced from 94 deaths per 1000 live births to 52. EPI coverage extended its reach from 54% in 1991 to 87. 2% in 2006. The MMR reduced from 574/100,000 live births in 1991 to 290 in 2007.Deliveries attended by skilled birth attendants increased from only 5% in 1990 to 20% in 2006. The prevalence of malaria dropped from 42 cases /100,000 in 2001 to 34 in 2005. Bangladesh has also achieved significant success in halting and reversing the break of tuberculosis (TB). Detection of TB by the Directly Observed Treatment Short-course (DOTS) has more than doubled between 2002 and 2007, from 34 to 92%. The boffo handling of tuberculosis has progressed from 84% in 2002 to 91% in 2007. Polio and leprosy are virtually eliminated. human immunodeficiency virus prevalence is even very low.Development of countrywide network of health ca re infrastructure in public sector is remarkable. However, availability of drugs at the health facilities, deployment of adequate health professionals along with maintenance of the health care facilities remain as crucial issues, impacting on optimum economic consumption of public health facilities 2. 10Nutrition Status in that respect has been considerable progress in reducing malnutrition and micro nutrient deficiencies in Bangladesh. According to BDHS, percentage of U5 tightly fitting (6-59 months) has reduced to 46. (2007) from 67 (1990) and that of U5 stunted (24-59 months) from 54. 6 (1996) to 36. 2 (2007). Percentage of children 1-5 years receiving vitamin-A supplements in last six months has increased from 73. 3 (1999-00) to 88. 3 (2007). The rate of night blindness has reduced to 0. 04 per 1000 people (IPHN, HKI 2006). However, in spite of efforts taken by the government, high rates of malnutrition and micronutrient deficiencies along with gender discrimination remain v iridity in Bangladesh. 2. 11Urban Health ServiceThe urban areas provide a contrasting picture of availability of different facilities and service for secondary and tertiary level health care, while primary health care facilities and operate for the urban population at large and the urban poor in particular are inadequate. Rapid influx of migrants and increased numbers of people living in urban slums in large cities are creating continuous pressure on urban health care service delivery. Since the launching of two urban primary health care projects, the work have been delivered by the city corporations and municipalities by contracted nongovernmental organizations in the projects area.Rest of the urban areas and function are being covered by MOHFWs facilities. Moreover, 35 urban dispensaries under the DGHS are providing out-of-door patient services including EPI and MCH to the urban population. 2. 12Organizational Setup of MOHFW The Ministry of Health & Family Welfare is one of largest ministries in the country. At the national level, the ministry of Health & Family Welfare (MOH&FW) is responsible for policy, planning and decision making at macro level. 2. 12. 1Executing Authorities of MOHFWUnder MOHFW, there are four Directorates habitual or Directorates, e. g. , Directorate General of Health Services, Directorate General of Family Planning, Directorate of Nursing Services and Directorate of Drug Administration. 2. 13Directorate General of health Services (DGHS) The Directorate General of Health Services (DGHS) is entrusted for the implementation of the policy decisions of the Ministry of Health and Family Welfare (MOHFW) as regards health service delivery to all the people under the jurisdiction of the Government of the Peoples Republic of Bangladesh.It provides technical guidance to the ministry. DGHS carries out its activities through with(predicate) different directors, line directors, project directors, institution heads, district and upazila healt h managers and union health staffs. 2. 14Health, Nutrition universe of discourse field Program (HNPSP) The constitution Bangladesh mandates for basic health care services for its people as one of the fundamental responsibilities of the state. Towards this goal, the government has taken different endeavors to extend health facilities to the population.The broader policy document of the Government of Bangladesh that shapes rush of health care is the Poverty Reduction Strategy Paper (PRSP) although the current government has indicated that it leave behind go for Five Year Plan. The Government of Bangladesh is running a program through which the health care services are provided to the people from the grass root to the central level. The program is entitled Health, Nutrition and Population Sector Program for the period of July 2003 through June 2010 (HNPSP 2003-2010).The Ministry of Health and Family Welfare (MOHFW) designed the Program Implementation Plan (PIP) in accordance with the PRSP to implement its sector wide program popularly known as Health, Nutrition and Population Sector Program (HNPSP). The HNPSP covers 38 Operational Plans (OP) to be implemented by 38 Line Directors and 14 Projects/Programs. The Government has recently decided to continue HNPSP until 2011. The details of the program are well documented in the form of Program Implementation Plan (PIP) duly endorsed at the highest policy level of the government, the Executive commission for National Economic Council (ECNEC).The Implementing Agency of the program is Ministry of Health and Family Welfare (MOHFW) with its attached departments. The financial involvement is estimated to be around Taka 324,503 million which includes contributions for GOB (Government of Bangladesh) and DPs (Development Partners). 2. 15Priority Objectives and Goal One of the important goals of PRSP and HNPSP is attainment of Millennium Development Goals (MDGs). The health sector is specially striving for attainment of h ealth related MDGs.The priority objectives of HNPSP are (i) reducing MMR (ii) reducing TFR (iii) reducing malnutrition (iv)reducing infant and under-five mortality (v) reducing the burden of TB and other indispositions and (vi) prevention and obligate of nontransmissible diseases including injuries. The commitment of the government targets towards reaching the goal of sustainable improvement in health, nutrition and family planning status of the people by the end of the program period. It may be mentioned here that HNPSP deals with health care service delivery of the public sector.Nevertheless, it strives to maintain a strong co carrying out and coordination with the efforts of the Private Sector as well so as to ensure the overall well-being of every citizen of the country. Of the 38 OPs, 7 are under MOHFW, 19 under Directorate General of Health Services (DGHS), 9 under Directorate General of Family Planning (DGFP), 1 under Directorate of Nursing Services (DNS), 1 under Director ate of Drug Administration (DDA) and 1 under National impart of Population Research and Training (NIPORT) and.Of the 14 projects/programs, 1 is under MOHFW, 9 under DGHS, 1 under DGFP, 2 under DNS and 1 under NIPORT. The Health bulletin 2009 is an attempt of Management Information System (MIS) of DGHS to provide an overview of the current health profiles of Bangladesh. CHAPTER 3 Health care delivery systems of Bangladesh Distribution of public health care services and facilities follows similar pattern of administrative tiers, viz. national (mostly capital-based in Dhaka), regional (in divisions), district, upazila, union and ward. The country has 7 divisions, 64 districts, 482 upazillas and 4,498 unions.As the Ministry of health and family Welfare deploys health workforce according to the older ward system, which divides each union into 3 wards. Therefore, number of MOHFW wards is 13,494. Primary health care (PHC), which includes family planning services in the urban area (city c orporations and municipalities), is provided by Ministry of Local Government and in rest of the country by Ministry of Health and Family Welfare (MOHFW) provides health care service. Provision of secondary and tertiary care, in both urban divisional directorates with necessary staff. and rural areas, is the sole responsibility of MOHFW.The MOHFW delivers its services through two separate executing authorities, viz. Directorate General of Health Services (DGHS) and Directorate General of Family Planning (DGFP). The names explain their functions. PHC services of both DGHS and DGFP begin at the ward level through a set of community health staffs, at least one in each ward (Table). To supervise these field staffs, there is one assistant health tester (for DGHS) and one family planning inspector (for DGFP) at union level. There are several hundred non- rear community facilities to provide outpatient services (1466 for DGHS and 3500 for DGFP).Besides DGFP also operates additional 97 mate rnal and child welfare centers (MCWCs) (union 23 upazila 12 district 62), 471 MCH-FP clinics (upazila 407 district 64), 177 NGO clinics (upazila 68 district 104 national 05), 08 model clinics (national 02 regional 06) and organizes 30,000 makeshift beam clinics per month. The public sector hospital care in Bangladesh is mainly provided by DGHS. Primary level hospital care Secondary level hospital care Tertiary level hospital care Begins through Upazila Health Complex (31 to 50 Bed) existing in 418 upazilas. The district hospitals (50 to 375 neck), one each district, provide secondary level hospital care in several specialty areas. The regional hospital are multidisciplinary tertiary care hospitals (250 to 1700 beds) mostly affiliated with learn bes. At the national level, there are postgraduate and specialized hospitals (100 to 600 beds) 3. 0Divisional level health organization At the divisional level, there is a divisional Director for Health. S/he is the head of a Divisiona l Directors supervise the activities of the civil Surgeons. 3. 1District level health organizationAt the district level, Civil Surgeon is the health manager. S/he has own administrative office supported by various categories of staff. There is either a Sadar Hospital or a General Hospital in each district head quarter. The Hospital provides services under the management of Civil Surgeon with a view to render out-patient, in-patient, emergency, laboratory and image services to the people. The in-patient services internal medicine, general surgery, obstetrics and gynecology and other common specialist clinical services. It is the secondary level referral facility of health services of Bangladesh.Currently there are 59 Sadar district hospitals and 2 General hospitals in the country each having 100-250 bed. 3. 2Upazila level health organization Upazila Health Complex (UHC) is another(prenominal) fixed service delivery point next to district level hospital. It provides the first level r eferral services to the population. In each UHC, there are posts for 9 (nine) doctors including one Upazila Health and Family Planning Officer (UHFPO). UHFPO is the master(prenominal) Health Officer of upazila and also Head of the UHC. Other doctors of UHC are Junior Consultants-4, Resident aesculapian Officer-1, suspensor Surgeons (MO)-2 and Dental Surgeon-1.There are 418 Upazila Health Complexes (UHC) in the country of which 153 are 50bed and rests are 31-bed. UHC provides out-patient, in-patient and emergency services, limited symptomatic and imaging services, emergency obstetric care, contraceptive services and dental care. 3. 3Union level health organization There are four types of static health facilities in the union level. These are Rural Health Centers (RHC, 10-bed hospital), Union Sub-centers (USC), Union Health and Family Welfare Centers (UHFWC) and Community Clinics (CC). There are 22 RHCs, in each of these, there are sanctioned posts of 20 staffs.RHC provides both ou t-patient and inpatient services. In an USC, there is sanctioned posts for one medical officer, one medical assistant, one pharmacist and one MLSS. Number of USC is 1,362 that for UHFWC is 87. Under HPSP, Government planned for establishing one Community Clinic for every 6000 rural populations. Number of CCs so far built is 11,883. But, these were not made functional. of late Government has decided to start the CCs again. The total number of CCs will be clxxx00. The existing UHCs and Union level facilities will also provide services of CCs in the respective communities.So,13,500 additional CCs will be required. The main health workforce in the union level is the domiciliary staff called health assistants. They are placed in each ward, which is the lowest and smallest administrative unit of the health sector. They visit the homes of the local people for providing primary health care services and collection of routine health data. The health assistants routinely organize air clinic s for immunization services. Besides there are other small to large hospitals and special purpose hospitals spread across the country both in rural as well as in urban areas.Under the DGHS, there are altogether 40 teaching/training institutes and 589 small to large hospitals. In Family Planning sector, there are one national inquiry-cum-training institute, two hospital-based training centers, and 32 other training centers (national 12 regional 20). Nearly six hundred health managers under DGHS and a similar number under DGFP, from national to upazila levels, play roles in administering the health and family planning services (1,17). This figure does not include the institute and clinic/hospital heads. CHAPTER 4Facility Based Health Services Hospital service is one of the important activities of health sector, which is the most visible health service also. This chapter of the Health Bulletin 2009 will provide an overview of the hospitals and their bed capacity as well as utilizatio n based on the information from January through December of 2008. 4. 0Hospitals by bed capacity There are 585 hospitals ranging from 10 beds to 1,700 beds under DGHS currently. All of these hospitals provide a total of 37,090 beds. The sidestep below gives a detail profile. No. f hospitals by bed capacity and total beds under DGHS Sl. No. Bed capacity No. of hospitals in this type Total beds 1 1700 beds 1 1700 2 1010 beds 1 1010 3 900 beds 1 900 4 800 beds 1 800 5 600 beds 5 three hundred0 6 500 beds 3 1500 7 414 beds 1 414 8 375 beds 1 375 9 250 beds 19 4750 10 200 beds 2 four hundred 11 150 beds 3 450 12 100 beds 53 5300 13 80 beds 1 80 14 56 beds 1 56 15 50 beds 158 7900 16 31 beds 271 8401 17 30 beds 1 30 8 25 beds 1 25 19 20 beds 43 860 20 10 beds 22 220 Total = 589 3817138171 Type of hospitals Following list gives an overview of the type of hospitals currently in operation under DGHS Type of hospitals No. of hospitals Total bed capacity high institute hospital 7 2014 Dental college hospital 1 20 Hospital for alternative medicine 2 200 medical examination college hospital 14 8685 Mental hospital, Pabna 1 500 Shekh Abu Naser Specialized Hospital 1 250 Narayanganj 200 bed Hospital 1 200 Specialized Health center (Asthma Burn unit) 2 150 Sarkari karmochari hospital 1 100 Chest hospital 12 566 Infectious disease hospital 5 180 Leprosy hospital 3 130 District Level Hospital 60 8100 50 bed hospital(Tongi, Saidpur) 2 100 100 bed hospital (Narsingdi) 1 100 25 bed hospital (Jhenidah) 1 25 Bangladesh korea moitree hospital 1 20 Upazila health complex 421 15958 Health complex (31 bed) 3 93 20 bed hospital 28 560 10 bed hospital 22 220 Postgraduate prove Hospitals all are national level hospitals and are located in Dhaka) Total = 7 No. of beds Total Revenue Develop. Proposed Beds will Increase 1. Nationa l launch of Chest Disease and Hospital (NIDCH) 600 600 0 0 0 2. National appoint of Cardiovascular Disease (NICVD) 414 250 164 0 0 3. National Institute of Traumatology and Rehabilitation (NITOR) 500 500 0 0 0 4 National Institute of Cancer Research and Hospital (NICRH) 50 50 0 250 200 5 National Institute of Ophthalmology (NIO) 250 250 0 0 6.National Institute of Kidney Disease and Hospital (NIKDU) 100 0 100 0 0 7. National Institute of Mental Health (NIMHR) 100 50 50 0 Total = 2014 1700 314 250 200 checkup College Hospitals of Teaching Hospitals of equivalent level (Regional hospitals and are used as undergraduate and postgraduate teaching hospitals). Division District Name of hospital (Total = 17) No. of beds Beds Revenue Develop. Proposed Bed will increase Barisal Barisal Sher-e-Bangla medical College Hospital 00 600 0 1000 400 Chittagong Chittagong Chittagong medical examination College Hospital 1010 10 10 0 0 0 Comilla Comilla aesculapian College Hospital 250 250 0 500 250 Dhaka Dhaka Dhaka Medical College Hospital 1700 1700 0 2000 300 Sir Salimullh Medical College Hospital 600 600 0 0 0 Shahid Suhrawardy Hospital, Dhaka 375 375 0 0 0 Homoeopathic Degree College Hospital 100 100 0 0 0 Unani Ayurvadic College Hospital 100 100 0 0 0 Dental College and Hospital, Dhaka 20 20 0 200 180 Faridpur Faridpur Medical College Hospital 250 250 0 0 0 Mymensingh Mymensingh Medical College Hospital 800 800 0 1000 200 Khulna Khulna Medical College Hospital 250 250 0 500 250 Rajshahi Bogra SZR Medical College Hospital 500 500 0 0 0 Dinajpur Dinajpur Medical College Hospital 250 250 0 500 250 Rajshahi Rajshahi Medical College Hospital 600 600 0 0 0 rangpur lime Rangpur Medical College Hospital 600 600 0 1000 400 Sylhet Sylhet MAG Osmani Medical College Hospital 900 900 0 100 0 100 Total = 8905 8905 0 7700 2330 Specialized Centers under DGHS with bed capacity (Year 2008) Division District Name of hospital (Total = 2) No. of beds Beds Revenue Develop. Proposed Bed will increase Dhaka Dhaka 1. National Asthma Center at NIDCH 100 0 100 0 0 2. Burn Unit 50 0 50 200 150 Total = 150 0 150 200 150 4. 1BSMMU Bangabandhu Sheikh Mujib Medical University (BSMMU) is the premier Postgraduate Medical Institution of the country. It bears the heritage to Institute of Postgraduate Medical Research (IPGMR)which was established in December 1965.In the year 1998 the Government converted IPGMR into a Medical University for expanding the facilities for higher medical education and research in the country. It has an enviable reputation for providing high quality postgraduate education in different specialties. The university has strong link with other professional bodies at home and abroad. The university is expanding cursorily and a t present, the university has many departments fit with modern technology for service, teaching and research. Besides education, the university plays the vital role of promoting research activities in various discipline of medicine. Since its inception, the university has also been delivering general and specialized clinical service as a tertiary level healthcare center.The university provides patient care services on various disciplines like Psychiatry, somatogenetic medicine, Pediatrics, Neonatology, Pediatric neurology, Pediatric surgery, Clinical pathology, Dermatology, Colorectal surgery, Nephrology, Urology, Neurology, Neuro-Surgery, Internal Medicine, Gastroenterology, Hepatology, Ophthalmology, ENT, Obstetrics gynecology, Surgery, Hepatobiliary Surgery, dentistry, and blood transfusion services. It provides different treatment services like Intensive Care, Lithotripsy, Pain management and diagnostic services like radiology, endoscopy, CT stare MRI and a one-stop laborat ory service. BSMMU runs Institute of Nuclear Medicine (INM). INM is a joint project of Bangladesh nuclear Energy Commission and BSMMU. The INM has modern diagnostic and therapeutic facilities including computerized ultrasonography, gamma camera and a well equipped radioimmunoassay (RIA) laboratory.This is considered to be the best center for noninvasive diagnoses. 4. 2SmilingSun libertyProgram (SSFP) The Smiling Sun Franchise Program is a project funded by the United States Agency for International Development (USAID). It is intended to equilibrize the wide network of healthcare facilities set up by the Government of Bangladesh resorting to an innovative approach to health care franchising. SSFP is committed to improve the quality of life of all Bangladeshis by providing superior, friendly and affordable health services in a sustainable manner. To achieve relevant health outcomes, SSFP is jointly working with partnering NGOs to convert the existing network into a viable social heal th system.SSFP objective is to strengthen partnering organizations quality of care while helping them to enhance their financial sustainability, thus enabling them to continue serving an important segment of the Bangladeshi society, including the poorest of the poor. Currently 29 NGOs are providing health care services to women, children and through 319 static and 8,500 satellite clinics in 61 districts of Bangladesh. 34 clinics of this network are providing Emergency Obstetric Care (EmOC) services. This network will continue to expand the volume and types of quality health care under ESD provided to the able-to-pay customers as well as underserved and poor clients. 4. 3Urban Primary Health Care Project (UPHCP-II) About 35 million people representing close to 25 percent of the population of Bangladesh live in urban areas, a large proportion of whom are slum dwellers.The health knowledge of the urban slum dwellers and their access to essential basic health services are low. Children living in urban slums are deprived of education and health care, and vulnerable to violence, revilement and exploitation. On the other hand, high rate of mortality and morbidity exists among women who remain neglected in call of meeting their basic health needs and ensuring their rights. The Government of Bangladesh is committed to put in place strategies to plough the issues of improving the health status of the urban population. This is to be done through improved access to and utilization of efficient, effective and sustainable Primary Health Care Services.The provision of public health services in urban areas is the responsibility of Local Government Bodies by dint of City Corporation Ordinance of 1983 and Pouroshova Ordinance of 1977. For primary health care services delivery, the public sector works in partnership with NGOs and the local government institutions such as the City Corporations and Pouroshovas. The health service delivery mechanism in urban areas involves div ers(prenominal) roles of the government (MOLGRD&C and MOHFW), NGOs and the private sector. CHAPTER 5 Leading Public Health Problems 5. 0Communicable disease The prevention and control of communicable diseases represent a significant challenge to those providing health-care services in Bangladesh.Sound knowledge on the disease epidemiology is a must for the health service providers in various levels. The Bangladesh population is namely affected by diarrheal diseases, cholera, hepatitis A & E, Malaria, Mycobacterial Disease like Tuberculosis and Leprosy, Dengue, Japanese encephalitis, Nipah virus infection, etc. Crowding, poor access to safe water, inadequate hygiene and toilet facilities, and unsafe food preparation and handling practices are associated with transmission. cholera is endemic Bangladesh, between 800 and 1000 cases are usually being recorded daily at the hospital of the ICCDR, B in Dhaka. Hepatitis A and E levels are usually high in the country.Malaria risk exists pas sim the year in Bangladesh. Thirteen out of 64 administrative districts are high malaria endemic areas. 98% of all malaria cases reported are from these districts, which are mainly located in the border areas of India and Myanmar. Tuberculosis still remains as a major public health problem, which ranks Bangladesh fifth among the high-TB burden countries in the world. The present revised National Tuberculosis Programme (NTP) was launched and field implementation of DOTS (Directly Observed Treatment short course) was started in 1993. Kala Azar or Leishmaniasis or is endemic in Bangladesh and has an incidence of 175 per 100,000 per annum.It is caused by a phylum Protozoa which is transmitted from the bite of infected sandfly and may present in cutaneous or splanchnic forms (particularly common in Bangladesh). Filariasis is a mosquito borne parasitic disease causality urogenital organs, breast, etc. with long arm disability. In Bangladesh, it is endemic in 23 districts, mostly the borde ring ones. About 20 million people are already infected, most of whom are incapacitated. Leprosy has been a major health problem in Bangladesh for a long time. Bangladesh was considered a high endemic country and was listed among ten countries with high case load (1992). Leprosy situation has changed globally after 1981 when the Multi Drugs Treatment (MDT) were introduced.Hepatitis A virus infection is common in Bangladesh with a prevalence of about 2% to 7%. Prevalence of hepatitis C virus infection is less than 1%. Sporadic volcanic eruption is often seen caused by hepatitis E virus infection but presence of hepatitis D infection is not exactly known. Polio free status prevailed from 2001 until now (June 2009) except a small window period in 2006 when 18 cases of child polio were seen in boarder areas of Bangladesh. it is assumed that these cases were imported from India. Dengue febrility/Dengue hemorrhagic fever (DF/ DHF) is a viral disease transmitted by the Aedes aegypty mosqu ito. It is on the increase in South East Asia. Bangladesh reported 100, 000 cases in 2005.However case fatality rate (CFR) remained