Child Marriage: A Human Rights Violation Essay

Child marriage is a serious form of human rights violation affecting young girls globally. It was estimated 10 million girls under the age of 18 get married every year (Bruce & Clark 2004) and according to Population Council Analysis of United Nations Country Data on Marriage (2002), more than 100 million girls will get married in the next decade if the current pattern persists. Girls who are disproportionately the most affected by this inhumane practice suffer tremendously. It is unreasonable such practice that robs away a girl’s childhood can exist, considering the devastating effects such as physical and psychological damages, severe health consequences and denial of personal development. 1.1 Physical and Psychological Damages Many young girls who are being forced into marriage face abuse and violence as their daily reality, yet most of them believe that a husband is justified in beating his wife (Jenson & Thornton 2003). For example, in Kenya, 36 percent of girls married before 18 consider the action of a husband beating his wife is acceptable as compared to 20 percent of married women (UNICEF 2005). Prolonged violence behaviours towards child brides including coercive sex, verbal abuse, slapping and beatings cause them to be emotionally affected and undergo post-traumatic stress. According to Khan and Lynch (1997), such symptoms are like feeling of hopelessness, helplessness and severe depression. Young married girls are extremely vulnerable and have little power in relation to their husbands and in-laws. They are often treated as domestic slaves to work in their in-law’s households. As much as young married girls are desperate to run away from their brutal marriages, they are often tied down with reasons that oblige them to stay. Most often than not is because of economic pressures and other social circumstances. There are those who seek for avenues to leave their spouses, there are also those who are abandoned, divorced or led into widowhood. They suffer a loss of status and ostracized by society with additional discrimination, for example being denied of property rights, as in many cultures divorced, abandoned or widowed women are often looked down upon (Tamunoimama 2012). They usually end up living in poverty as they have no financial support and bear the responsibility of raising their children on their own. The high rates of Vesico-Vaginal Fistula (VVF) amongst young married girls is one of the reasons why child marriage is linked to wife abandonment. Sexual reproductive organs of the child brides that are not fully developed cause them to endure very prolonged labour. The relentless pressure from the baby’s skull breaks the walls of the birth canal and leads to uncontrollable leakage from the bladder into the vagina. They are usually perceived as unclean and often abandoned or divorced by their spouses. In Nigeria, around 150,000 women with VVF, 80 to 90 percent of them are divorced by their husbands; in Niger Republic, VVF is the reason for 63.3 percent of all divorce cases (Tamunoimama 2012). In many countries, young girls are married off to older men of twice their age, because their parents believe that it is the best way to ensure their daughters are protected when being placed firmly under a male’s control. Influenced by negative social and religious norms, girls are married early to older men in the belief that a husband will provide a safeguard against her ‘immoral’ or ‘inappropriate’ behaviour (Senderowitz 1995). Consequently, when the girl is still young, their spouses died, leaving her with the sole responsibility on taking care her children. For some traditions, girls are not allowed to remarry and her families are also unlikely to accept her back once she has become widowed (UNICEF 2001). Even when a child bride feels able to challenge and leave her marriage, it usually takes her years to do so. Her families will cut her off from their lives because it is believed that running away from a marriage brings shame upon the family. This leaves the girl even more alone than before (The Effects of Early Marriage Cause and Effect Essay 2004). It will contribute to a lack of confidence and low self esteem in the young married girls, plunging them into poverty especially when they are under-educated and has few income-generating skills (Tamunoimama 2012). 1.2 Severe Health Consequences Girls and woman who marry early and with little or no education background often lack of knowledge and have limited awareness of their rights to negotiate safer sex, including the use of condom (Plan UK 2011). In addition to the age difference between the child bride and the husband alongside with her low economic status, it is almost impossible for her to demand fidelity or enjoy the freedom of movement. Barriers like distance, fear, expenses or the need for permission from their spouses or in -laws to access health services deteriorate the risks of maternal complications and mortality for young mothers (Tamunoimama 2012). According to UNICEF (2001), girls aged between 15 and 19 are twice as likely to die giving birth as compared to women over 20 years old; whereas for girls aged between 10 to 14, it is five times greater the risk. Young married girls face considerable physical pain associated with sexual intercourse as their sexual organs are not fully developed and matured (Alemu 2008). Pregnancy-related deaths including heavy bleeding, fistula, infection, Anaemia, and Eclampsia, are the leading cause of mortality for 15 to 19 year-old girls (married and unmarried) worldwide (Tamunoimama 2012). Fistula conditions like vesico-vaginal fistula (VVF) and recto-vaginal fistula (RVF) are permanent without surgical intervention to reseal the tissues. Many women have to endure with this condition for the rest of their lives, as such intervention may not be sought or may be hard to access (Tamunoimama 2012). WHO (2010) estimates there are two million women suffering from fistulas and for each year, there is a nother addition of 50,000 to 100,000 new cases of fistulas, many of which go untreated. Even though parents see early marriage or child marriage, as a method to protect their daughters from HIV/AIDS, future spouses may engage in unprotected sexual relations with other partners and already be infected (Tamunoimama 2012). Child brides are more vulnerable to HIV infection, due to the physiological immaturity of their sexual organs. A girl who has not reached puberty face serious risk on being infected by HIV/AIDS, because her vagina is not well lined with protective cells and her cervix may be penetrated easily (Alemu 2008). According to Clark (2004), a small scale research done in Kenya and Zambia shows that among 15 to 19 year-old girls who are sexually active, getting married increased their chances of HIV by more than 75 percent. Girls who are of lower status in society and lack of autonomy cannot have a say when to engage in sexual relations and when to bear a child, especially if it is a young virgin, she would be under pressure to become pregnant in the first year o f her marriage. 1.3 Denial of Personal Development Education is one of the largest losses a girl has to face when she is married off at a young age. Her opportunities to develop as an individual is limited as she needs to bear the burden of being a wife and a mother. Most of the child brides, who are forced to drop out of school during the preparation of marriage or at the point of union and transfer to their in-laws house, as badly as they want to return to school, they are denied of their rights to education. Older husbands and even fathers of young wives believe that the role of females are merely to stay home and undertake household and child-care duties. They fear that education undermines cultural practices and teaches the girl to reject tradition (Bayisenge 2009). The following quote illustrate well the case: â€Å"At the age of about 14 years, my father sent me to my uncle in Adagbira near Binaba so that he could let his wives â€Å"train me† for marriage. He believed that if I continued to go to school, I would be a â€Å"spoilt girl† and no man would agree to marry me. Being a â€Å"spoilt girl† meant that I would be too wise to marry back in his village where he could get my dowry.† (Interview with Ateni Adongo, Womankind,1999). Apart from that, parents of a child bride perceive education as an investment wasted because she is simply going to get married and it will only benefit her husband’s household. The child bride stand even little chance in hope that her husband and in-laws would invest their scarce resources in her education. In rural areas, secondary education is only attainable at a far distance from home, leading to a fear in parents that this may expose the girl to risks on premarital sex and unwanted pregnancy (Tamunoimama 2012). Child brides also find it difficult to return to school, because even the school itself has a policy of refusing married or pregnant girls to attain education. They believe that it will set a bad example to other students and destroy the reputation of the school for going against traditional beliefs. Besides, young married girls are unable to cope up and adapt with the school environment which includes rules, time tables and physical conditions, at the same time juggling their duties as wives and mothers. This further reduces the chances of them to enjoy the rights to education, which they require for personal development and contribution to the future well-being of their family and society. Early marriage was considered the main challenge to achieving universal primary education (MDG 2) and promoting gender equality (MDG 3) for girls and boys in rural communities (Plan Egypt 2010). It is not only a lost opportunity for the girls affected, but has a wider reach of repercussions for their own children and society (ICRW 2006). Young married girls, being denied of education are powerless in regards of deciding the size of their families, demanding the use of contraception and healthcare needs of their children. They are not well informed and knowledgeable about sexual relations, their bodies and reproduction, furthermore aggravated by the cultural silence surrounding these subjects (Tamunoimama 2012). With a low level of education and life skills, child brides face an increase of vulnerability to abuse and poor health, and therefore acute poverty and create a massive knock-on negative effect to the community. Marriage is regarded as a moment of celebration and a milestone in an adult life, but girls as young as five being married off to older men, forced to drop out of school to carry the heavy burden of being a wife and a mother is equivalent to being condemned a death sentence on their bright future. Article 16 of The Universal Declaration of Human Rights (1948) states that men and women of full age are entitled to equal rights as to marriage, during marriage and at its dissolution and marriage shall be entered into only with the free and full consent of the intending parties. Therefore child marriage is considered as a violation of human rights and must be viewed within a context of force and coercion, because valid consent of the child is absent – and also often disregarded (Kumar 2008). Early marriage or child marriage is one of the ills that have eaten deep into the marrows of the third world countries, with Niger (76.6%), Chad (71.5%) and Bangladesh (68.7%) leading the top countries with highest rates of child marriage (ICRW 2005). It is a deadly curse in the modern society, with all the consequences that come along with it, including high rate of maternal mortality and morbidity, violence and abuse, reinforce cycle of poverty and many more. It stands in direct conflict with the objectives of the Millennium Development Goals (MDGs), (Mathur & Malhotra 2003) as it threatens the achievement of the first six goals respectively, eradicating extreme poverty and hunger; achieving universal primarily education; promoting gender equality and empowering women; reducing child mortality; improving maternal health; combating HIV/AIDs, malaria and other diseases (UN 2007). In conclusion, different parties like governments, parents, schools, medias, NGOs, by and large, everyone else that is in the community should come together to trickle this challenging phenomenon and ban this from being an acceptable cultural practice. Actions to restore the rights of those already married should go hand in hand with preventive actions in protecting the rights of unmarried girls because to ensure a good start of their life, they need education instead of being trapped in a child betrothal.

Anaysis of the Yellow Wallpaper by Charlotte Perkins Gilman

http://www. sparknotes. com/lit/yellowwallpaper/context. html The Yellow Wallpaper, Charlotte Perkins Gilman Table of Contents Context Plot Overview Character List Analysis of Major Characters Themes, Motifs, and Symbols Important Quotations Explained Key Facts How to Cite This SparkNote Context Charlotte Perkins Gilman was best known in her time as a crusading journalist and feminist intellectual, a follower of such pioneering women’s rights advocates as Susan B. Anthony, Elizabeth Cady Stanton, and Harriet Beecher Stowe, Gilman’s great-aunt.Gilman was concerned with political inequality and social justice in general, but the primary focus of her writing was the unequal status of women within the institution of marriage. In such works as Concerning Children(1900), The Home (1904), and Human Work (1904), Gilman argued that women’s obligation to remain in the domestic sphere robbed them of the expression of their full powers of creativity and intelligence, while s imultaneously robbing society of women whose abilities suited them for professional and public life.An essential part of her analysis was that the traditional power structure of the family made no one happy—not the woman who was made into an unpaid servant, not the husband who was made into a master, and not the children who were subject to both. Her most ambitious work, Women and Economics (1898), analyzed the hidden value of women’s labor within the capitalist economy and argued, as Gilman did throughout her works, that financial independence for women could only benefit society as a whole.Today, Gilman is primarily known for one remarkable story, â€Å"The Yellow Wallpaper,† which was considered almost unprintably shocking in its time and which unnerves readers to this day. This short work of fiction, which deals with an unequal marriage and a woman destroyed by her unfulfilled desire for self-expression, deals with the same concerns and ideas as Gilmanâ€⠄¢s nonfiction but in a much more personal mode. Indeed, â€Å"The Yellow Wallpaper† draws heavily on a particularly painful episode in Gilman’s own life.In 1886, early in her first marriage and not long after the birth of her daughter, Charlotte Perkins Stetson (as she was then known) was stricken with a severe case of depression. In her 1935 autobiography, The Living of Charlotte Perkins Gilman, she describes her â€Å"utter prostration† byâ€Å"unbearable inner misery† and â€Å"ceaseless tears,† a condition only made worse by the presence of her husband and her baby. She was referred to Dr. S. Weir Mitchell, then the country’s leading specialist in nervous disorders, whose treatment in such cases was a â€Å"rest cure† of forced inactivity.Especially in the case of his female patients, Mitchell believed that depression was brought on by too much mental activity and not enough attention to domestic affairs. For Gilman, this course of treatment was a disaster. Prevented from working, she soon had a nervous breakdown. At her worst, she was reduced to crawling into closets and under beds, clutching a rag doll. Once she abandoned Mitchell’s rest cure, Gilman’s condition improved, though she claimed to feel the effects of the ordeal for the rest of her life.Leaving behind her husband and child, a scandalous decision, Charlotte Perkins Stetson (she took the name Gilman after a second marriage, to her cousin) embarked on a successful career as a journalist, lecturer, and publisher. She wrote â€Å"The Yellow Wallpaper† soon after her move to California, and in it she uses her personal experience to create a tale that is both a chilling description of one woman’s fall into madness and a potent symbolic narrative of the fate of creative women stifled by a paternalistic culture.In purely literary terms, â€Å"The Yellow Wallpaper† looks back to the tradition of the psychological horro r tale as practiced by Edgar Allan Poe. For example, Poe’sâ€Å"The Tell-Tale Heart† is also told from the point of view of an insane narrator. Going further back, Gilman also draws on the tradition of the Gothic romances of the late eighteenth century, which often featured spooky old mansions and young heroines determined to uncover their secrets.Gilman’s story is also forward-looking, however, and her moment-by-moment reporting of the narrator’s thoughts is clearly a move in the direction of the sort of stream-of-consciousness narration used by such twentieth-century writers as Virginia Woolf, James Joyce, and William Faulkner. Plot Overview The narrator begins her journal by marveling at the grandeur of the house and grounds her husband has taken for their summer vacation. She describes it in romantic terms as an aristocratic estate or even a haunted house and wonders how they were able to afford it, and why the house had been empty for so long.Her fee ling that there is â€Å"something queer† about the situation leads her into a discussion of her illness—she is suffering from â€Å"nervous depression†Ã¢â‚¬â€and of her marriage. She complains that her husband John, who is also her doctor, belittles both her illness and her thoughts and concerns in general. She contrasts his practical, rationalistic manner with her own imaginative, sensitive ways. Her treatment requires that she do almost nothing active, and she is especially forbidden from working and writing.She feels that activity, freedom, and interesting work would help her condition and reveals that she has begun her secret journal in order to â€Å"relieve her mind. † In an attempt to do so, the narrator begins describing the house. Her description is mostly positive, but disturbing elements such as the â€Å"rings and things† in the bedroom walls, and the bars on the windows, keep showing up. She is particularly disturbed by the yellow wa llpaper in the bedroom, with its strange, formless pattern, and describes it as â€Å"revolting. † Soon, however, her thoughts are interrupted by John’s approach, and she is forced to stop writing.As the first few weeks of the summer pass, the narrator becomes good at hiding her journal, and thus hiding her true thoughts from John. She continues to long for more stimulating company and activity, and she complains again about John’s patronizing, controlling ways—although she immediately returns to the wallpaper, which begins to seem not only ugly, but oddly menacing. She mentions that John is worried about her becoming fixated on it, and that he has even refused to repaper the room so as not to give in to her neurotic worries.The narrator’s imagination, however, has been aroused. She mentions that she enjoys picturing people on the walkways around the house and that John always discourages such fantasies. She also thinks back to her childhood, when she was able to work herself into a terror by imagining things in the dark. As she describes the bedroom, which she says must have been a nursery for young children, she points out that the paper is torn off the wall in spots, there are scratches and gouges in the floor, and the furniture is heavy and fixed in place.Just as she begins to see a strange sub-pattern behind the main design of the wallpaper, her writing is interrupted again, this time by John’s sister, Jennie, who is acting as housekeeper and nurse for the narrator. As the Fourth of July passes, the narrator reports that her family has just visited, leaving her more tired than ever. John threatens to send her to Weir Mitchell, the real-life physician under whose care Gilman had a nervous breakdown. The narrator is alone most of the time and says that she has become almost fond of the wallpaper and that attempting to figure out its pattern has become her primary entertainment.As her obsession grows, the sub-pattern of the wallpaper becomes clearer. It begins to resemble a woman â€Å"stooping down and creeping† behind the main pattern, which looks like the bars of a cage. Whenever the narrator tries to discuss leaving the house, John makes light of her concerns, effectively silencing her. Each time he does so, her disgusted fascination with the paper grows. Soon the wallpaper dominates the narrator’s imagination. She becomes possessive and secretive, hiding her interest in the paper and making sure no one else examines it so that she can â€Å"find it out† on her own.At one point, she startles Jennie, who had been touching the wallpaper and who mentions that she had found yellow stains on their clothes. Mistaking the narrator’s fixation for tranquility, John thinks she is improving. But she sleeps less and less and is convinced that she can smell the paper all over the house, even outside. She discovers a strange smudge mark on the paper, running all around the roo m, as if it had been rubbed by someone crawling against the wall. The sub-pattern now clearly resembles a woman who is trying to get out from behind the main pattern.The narrator sees her shaking the bars at night and creeping around during the day, when the woman is able to escape briefly. The narrator mentions that she, too, creeps around at times. She suspects that John and Jennie are aware of her obsession, and she resolves to destroy the paper once and for all, peeling much of it off during the night. The next day she manages to be alone and goes into something of a frenzy, biting and tearing at the paper in order to free the trapped woman, whom she sees struggling from inside the pattern.By the end, the narrator is hopelessly insane, convinced that there are many creeping women around and that she herself has come out of the wallpaper—that she herself is the trapped woman. She creeps endlessly around the room, smudging the wallpaper as she goes. When John breaks into th e locked room and sees the full horror of the situation, he faints in the doorway, so that the narrator has â€Å"to creep over him every time! † Character List The Narrator – A young, upper-middle-class woman, newly married and a mother, who is undergoing care for depression.The narrator—whose name may or may not be Jane—is highly imaginative and a natural storyteller, though her doctors believe she has a â€Å"slight hysterical tendency. † The story is told in the form of her secret diary, in which she records her thoughts as her obsession with the wallpaper grows. Read an in-depth analysis of The Narrator. John – The narrator’s husband and her physician. John restricts her behavior as part of her treatment. Unlike his imaginative wife, John is extremely practical, preferring facts and figures to â€Å"fancy,† at which he â€Å"scoffs openly. He seems to love his wife, but he does not understand the negative effect his treat ment has on her. Read an in-depth analysis of John. Jennie – John’s sister. Jennie acts as housekeeper for the couple. Her presence and her contentment with a domestic role intensify the narrator’s feelings of guilt over her own inability to act as a traditional wife and mother. Jennie seems, at times, to suspect that the narrator is more troubled than she lets on. Analysis of Major Characters The NarratorThe narrator of â€Å"The Yellow Wallpaper† is a paradox: as she loses touch with the outer world, she comes to a greater understanding of the inner reality of her life. This inner/outer split is crucial to understanding the nature of the narrator’s suffering. At every point, she is faced with relationships, objects, and situations that seem innocent and natural but that are actually quite bizarre and even oppressive. In a sense, the plot of â€Å"The Yellow Wallpaper† is the narrator’s attempt to avoid acknowledging the extent to wh ich her external situation stifles her inner impulses.From the beginning, we see that the narrator is an imaginative, highly expressive woman. She remembers terrifying herself with imaginary nighttime monsters as a child, and she enjoys the notion that the house they have taken is haunted. Yet as part of her â€Å"cure,† her husband forbids her to exercise her imagination in any way. Both her reason and her emotions rebel at this treatment, and she turns her imagination onto seemingly neutral objects—the house and the wallpaper—in an attempt to ignore her growing frustration.Her negative feelings color her description of her surroundings, making them seem uncanny and sinister, and she becomes fixated on the wallpaper. As the narrator sinks further into her inner fascination with the wallpaper, she becomes progressively more dissociated from her day-to-day life. This process of dissociation begins when the story does, at the very moment she decides to keep a secr et diary as â€Å"a relief to her mind. † From that point, her true thoughts are hidden from the outer world, and the narrator begins to slip into a fantasy world in which the nature of â€Å"her situation† is made clear in symbolic terms.Gilman shows us this division in the narrator’s consciousness by having the narrator puzzle over effects in the world that she herself has caused. For example, the narrator doesn’t immediately understand that the yellow stains on her clothing and the long â€Å"smootch† on the wallpaper are connected. Similarly, the narrator fights the realization that the predicament of the woman in the wallpaper is a symbolic version of her own situation. At first she even disapproves of the woman’s efforts to escape and intends to â€Å"tie her up. †When the narrator finally identifies herself with the woman trapped in the wallpaper, she is able to see that other women are forced to creep and hide behind the domes tic â€Å"patterns† of their lives, and that she herself is the one in need of rescue. The horror of this story is that the narrator must lose herself to understand herself. She has untangled the pattern of her life, but she has torn herself apart in getting free of it. An odd detail at the end of the story reveals how much the narrator has sacrificed. During her final split from reality, the narrator says, â€Å"I’ve got out at last, in spite of you and Jane. Who is this Jane? Some critics claim â€Å"Jane† is a misprint for â€Å"Jennie,†the sister-in-law. It is more likely, however, that â€Å"Jane† is the name of the unnamed narrator, who has been a stranger to herself and her jailers. Now she is horribly â€Å"free† of the constraints of her marriage, her society, and her own efforts to repress her mind. John Though John seems like the obvious villain of â€Å"The Yellow Wallpaper,† the story does not allow us to see him as whol ly evil. John’s treatment of the narrator’s depression goes terribly wrong, but in all likelihood he was trying to help her, not make her worse.The real problem with John is the all-encompassing authority he has in his combined role as the narrator’s husband and doctor. John is so sure that he knows what’s best for his wife that he disregards her own opinion of the matter, forcing her to hide her true feelings. He consistently patronizes her. He calls her â€Å"a blessed little goose† and vetoes her smallest wishes, such as when he refuses to switch bedrooms so as not to overindulge her â€Å"fancies. † Further, his dry, clinical rationality renders him uniquely unsuited to understand his imaginative wife.He does not intend to harm her, but his ignorance about what she really needs ultimately proves dangerous. John knows his wife only superficially. He sees the â€Å"outer pattern† but misses the trapped, struggling woman inside. This ignorance is why John is no mere cardboard villain. He cares for his wife, but the unequal relationship in which they find themselves prevents him from truly understanding her and her problems. By treating her as a â€Å"case† or a â€Å"wife† and not as a person with a will of her own, he helps destroy her, which is the last thing he wants.That John has been destroyed by this imprisoning relationship is made clear by the story’s chilling finale. After breaking in on his insane wife, John faints in shock and goes unrecognized by his wife, who calls him â€Å"that man† and complains about having to â€Å"creep over him† as she makes her way along the wall. Themes, Motifs, and Symbols Themes The Subordination of Women in Marriage In â€Å"The Yellow Wallpaper,† Gilman uses the conventions of the psychological horror tale to critique the position of women within the institution of marriage, especially as practiced by the â€Å"respectableâ₠¬ classes of her time.When the story was first published, most readers took it as a scary tale about a woman in an extreme state of consciousness—a gripping, disturbing entertainment, but little more. After its rediscovery in the twentieth century, however, readings of the story have become more complex. For Gilman, the conventional nineteenth-century middle-class marriage, with its rigid distinction between the â€Å"domestic† functions of the female and the â€Å"active† work of the male, ensured that women remained second-class citizens.The story reveals that this gender division had the effect of keeping women in a childish state of ignorance and preventing their full development. John’s assumption of his own superior wisdom and maturity leads him to misjudge, patronize, and dominate his wife, all in the name of â€Å"helping† her. The narrator is reduced to acting like a cross, petulant child, unable to stand up for herself without seeming un reasonable or disloyal. The narrator has no say in even the smallest details of her life, and she retreats into her obsessive fantasy, the only place she can retain some control and exercise the power of her mind.The Importance of Self-Expression [pic] The mental constraints placed upon the narrator, even more so than the physical ones, are what ultimately drive her insane. She is forced to hide her anxieties and fears in order to preserve the facade of a happy marriage and to make it seem as though she is winning the fight against her depression. From the beginning, the most intolerable aspect of her treatment is the compulsory silence and idleness of the â€Å"resting cure. † She is forced to become completely passive, forbidden from exercising her mind in any way.Writing is especially off limits, and John warns her several times that she must use her self-control to rein in her imagination, which he fears will run away with her. Of course, the narrator’s eventual in sanity is a product of the repression of her imaginative power, not the expression of it. She is constantly longing for an emotional and intellectual outlet, even going so far as to keep a secret journal, which she describes more than once as a â€Å"relief† to her mind. For Gilman, a mind that is kept in a state of forced inactivity is doomed to self-destruction.The Evils of the â€Å"Resting Cure† As someone who almost was destroyed by S. Weir Mitchell’s â€Å"resting cure† for depression, it is not surprising that Gilman structured her story as an attack on this ineffective and cruel course of treatment. â€Å"The Yellow Wallpaper† is an illustration of the way a mind that is already plagued with anxiety can deteriorate and begin to prey on itself when it is forced into inactivity and kept from healthy work. To his credit, Mitchell, who is mentioned by name in the story, took Gilman’s criticism to heart and abandoned the â€Å"resting cu re. Beyond the specific technique described in the story, Gilman means to criticize any form of medical care that ignores the concerns of the patient, considering her only as a passive object of treatment. The connection between a woman’s subordination in the home and her subordination in a doctor/patient relationship is clear—John is, after all, the narrator’s husband and doctor. Gilman implies that both forms of authority can be easily abused, even when the husband or doctor means to help.All too often, the women who are the silent subjects of this authority are infantilized, or worse. Motifs Irony Almost every aspect of â€Å"The Yellow Wallpaper† is ironic in some way. Irony is a way of using words to convey multiple levels of meaning that contrast with or complicate one another. In verbal irony, words are frequently used to convey the exact opposite of their literal meaning, such as when one person responds to another’s mistake by saying †Å"nice work. † (Sarcasm—which this example embodies—is a form of verbal irony. In her journal, the narrator uses verbal irony often, especially in reference to her husband: â€Å"John laughs at me, of course, but one expects that in marriage. † Obviously, one expects no such thing, at least not in a healthy marriage. Later, she says, â€Å"I am glad my case is not serious,† at a point when it is clear that she is concerned that her case is very serious indeed. Dramatic irony occurs when there is a contrast between the reader’s knowledge and the knowledge of the characters in the work.Dramatic irony is used extensively in â€Å"The Yellow Wallpaper. † For example, when the narrator first describes the bedroom John has chosen for them, she attributes the room’s bizarre features—the â€Å"rings and things† in the walls, the nailed-down furniture, the bars on the windows, and the torn wallpaper—to the fact that it must have once been used as a nursery. Even this early in the story, the reader sees that there is an equally plausible explanation for these details: the room had been used to house an insane person.Another example is when the narrator assumes that Jennie shares her interest in the wallpaper, while it is clear that Jennie is only now noticing the source of the yellow stains on their clothing. The effect intensifies toward the end of the story, as the narrator sinks further into her fantasy and the reader remains able to see her actions from theâ€Å"outside. † By the time the narrator fully identifies with the trapped woman she sees in the wallpaper, the reader can appreciate the narrator’s experience from her point of view as well as John’s shock at what he sees when he breaks down the door to the bedroom.Situational irony refers to moments when a character’s actions have the opposite of their intended effect. For example, John’s course of tre atment backfires, worsening the depression he was trying to cure and actually driving his wife insane. Similarly, there is a deep irony in the way the narrator’s fate develops. She gains a kind of power and insight only by losing what we would call her self-control and reason. The Journal An â€Å"epistolary† work of fiction takes the form of letters between characters. â€Å"The Yellow Wallpaper† is a kind of epistolary story, in which the narrator writes to herself.Gilman uses this technique to show the narrator’s descent into madness both subjectively and objectively—that is, from both the inside and the outside. Had Gilman told her story in traditional first-person narration, reporting events from inside the narrator’s head, the reader would never know exactly what to think: a woman inside the wallpaper might seem to actually exist. Had Gilman told the story from an objective, third-person point of view, without revealing the narratorâ⠂¬â„¢s thoughts, the social and political symbolism of the story would have been obscured.As it is, the reader must decipher the ambiguity of the story, just as the narrator must attempt to decipher the bewildering story of her life and the bizarre patterns of the wallpaper. Gilman also uses the journal to give the story an intense intimacy and immediacy, especially in those moments when the narrative is interrupted by the approach of John or Jennie. These interruptions perfectly illustrate the constraints placed on the narrator by authority figures who urge her not to think about herâ€Å"condition. † Symbols The Wallpaper The Yellow Wallpaper† is driven by the narrator’s sense that the wallpaper is a text she must interpret, that it symbolizes something that affects her directly. Accordingly, the wallpaper develops its symbolism throughout the story. At first it seems merely unpleasant: it is ripped, soiled, and an â€Å"unclean yellow. † The worst part is the ostensibly formless pattern, which fascinates the narrator as she attempts to figure out how it is organized. After staring at the paper for hours, she sees a ghostly sub-pattern behind the main pattern, visible only in certain light.Eventually, the sub-pattern comes into focus as a desperate woman, constantly crawling and stooping, looking for an escape from behind the main pattern, which has come to resemble the bars of a cage. The narrator sees this cage as festooned with the heads of many women, all of whom were strangled as they tried to escape. Clearly, the wallpaper represents the structure of family, medicine, and tradition in which the narrator finds herself trapped. Wallpaper is domestic and humble, and Gilman skillfully uses this nightmarish, hideous paper as a symbol of the domestic life that traps so many women.Important Quotations Explained 1. If a physician of high standing, and one’s own husband, assures friends and relatives that there is really nothin g the matter with one but temporary nervous depression—a slight hysterical tendency—what is one to do? . . . So I take phosphates or phosphites—whichever it is, and tonics, and journeys, and air, and exercise, and am absolutely forbidden to â€Å"work† until I am well again. Personally, I disagree with their ideas . . . Explanation for Quotation 1 >> In this passage, which appears near the beginning of the story, the main elements of the narrator’s dilemma are present.The powerful, authoritative voices of her husband, her family, and the medical establishment urge her to be passive. Her own conviction, however, is that what she needs is precisely the opposite—activity and stimulation. From the outset, her opinions carry little weight. â€Å"Personally,† she disagrees with her treatment, but she has no power to change the situation. Gilman also begins to characterize the narrator here. The confusion over â€Å"phosphates or phosphites † is in character for someone who is not particularly interested in factual accuracy.And the choppy rhythm of the sentences, often broken into one-line paragraphs, helps evoke the hurried writing of the narrator in her secret journal, as well as the agitated state of her mind. Close 2. I sometimes fancy that in my condition if I had less opposition and more society and stimulus—but John says the very worst thing I can do is think about my condition, and I confess it always makes me feel bad. So I will let it alone and talk about the house. Explanation for Quotation 2 >>This section appears near the beginning of the story, and it helps characterize both the narrator’s dilemma and the narrator herself. Notably, the narrator interrupts her own train of thought by recalling John’s instructions. Gilman shows how the narrator has internalized her husband’s authority to the point that she practically hears his voice in her head, telling her what to think. Even so, she cannot help but feel the way she does, and so the move she makes at the end—focusing on the house instead of her situation—marks the beginning of her slide into obsession and madness.This mental struggle, this desperate attempt not to think about her unhappiness, makes her project her feelings onto her surroundings, especially the wallpaper, which becomes a symbolic image of â€Å"her condition. †The play on words here is typical of Gilman’s consistent use of irony throughout the story. She feels bad whenever she thinks about herâ€Å"condition,† that is, about both her depression and her condition in general within her oppressive marriage. Close 3. There are things in that paper which nobody knows but me, or ever will. Behind that outside pattern the dim shapes get clearer every day.It is always the same shape, only very numerous. And it is like a woman stooping down and creeping about behind that pattern. I don’t like it a bit . I wonder—I begin to think—I wish John would take me away from here! Explanation for Quotation 3 >> About halfway through the story, the sub-pattern of the wallpaper finally comes into focus. The narrator is being drawn further and further into her fantasy, which contains a disturbing truth about her life. Gilman’s irony is actively at work here: the â€Å"things† in the paper are both the ghostly women the narrator sees and the disturbing ideas she is coming to understand.She is simultaneously jealous of the secret (â€Å"nobody knows but me†) and frightened of what it seems to imply. Again the narrator tries to deny her growing insight (â€Å"the dim shapes get clearer every day†), but she is powerless to extricate herself. Small wonder that the woman she sees is always â€Å"stooping down and creeping about. † Like the narrator herself, she is trapped within a suffocating domestic â€Å"pattern† from which no escape is poss ible. Close 4. Life is very much more exciting now than it used to be. Explanation for Quotation 4 >>This comment comes just after the scene in which the narrator catches Jennie touching the paper and resolves that no one else is allowed to figure out the pattern. It captures one of the most distinctive qualities of â€Å"The Yellow Wallpaper†: Gilman’s bitter, sarcastic sense of humor. Now that the narrator has become hopelessly obsessed with the pattern, spending all day and all night thinking about it, life has become more interesting and she is no longer bored. Gilman manages to combine humor and dread in such moments. The comment is funny, but the reader knows that someone who would make such a joke is not well.Indeed, in the section that follows, the narrator casually mentions that she considered burning the house down in order to eliminate the smell of the wallpaper. Close 5. I don’t like to look out of the windows even—there are so many of those c reeping women, and they creep so fast. I wonder if they all come out of that wall-paper as I did? Explanation for Quotation 5 >> Important Quotations Explained 1. If a physician of high standing, and one’s own husband, assures friends and relatives that there is really nothing the matter with one but temporary nervous depression—a slight hysterical tendency—what is one to do? . . So I take phosphates or phosphites—whichever it is, and tonics, and journeys, and air, and exercise, and am absolutely forbidden to â€Å"work† until I am well again. Personally, I disagree with their ideas . . . Explanation for Quotation 1 >> In this passage, which appears near the beginning of the story, the main elements of the narrator’s dilemma are present. The powerful, authoritative voices of her husband, her family, and the medical establishment urge her to be passive. Her own conviction, however, is that what she needs is precisely the opposite—activ ity and stimulation.From the outset, her opinions carry little weight. â€Å"Personally,† she disagrees with her treatment, but she has no power to change the situation. Gilman also begins to characterize the narrator here. The confusion over â€Å"phosphates or phosphites† is in character for someone who is not particularly interested in factual accuracy. And the choppy rhythm of the sentences, often broken into one-line paragraphs, helps evoke the hurried writing of the narrator in her secret journal, as well as the agitated state of her mind. Close . I sometimes fancy that in my condition if I had less opposition and more society and stimulus—but John says the very worst thing I can do is think about my condition, and I confess it always makes me feel bad. So I will let it alone and talk about the house. Explanation for Quotation 2 >> This section appears near the beginning of the story, and it helps characterize both the narrator’s dilemma and the nar rator herself. Notably, the narrator interrupts her own train of thought by recalling John’s instructions.Gilman shows how the narrator has internalized her husband’s authority to the point that she practically hears his voice in her head, telling her what to think. Even so, she cannot help but feel the way she does, and so the move she makes at the end—focusing on the house instead of her situation—marks the beginning of her slide into obsession and madness. This mental struggle, this desperate attempt not to think about her unhappiness, makes her project her feelings onto her surroundings, especially the wallpaper, which becomes a symbolic image of â€Å"her condition. The play on words here is typical of Gilman’s consistent use of irony throughout the story. She feels bad whenever she thinks about herâ€Å"condition,† that is, about both her depression and her condition in general within her oppressive marriage. Close 3. There are things in that paper which nobody knows but me, or ever will. Behind that outside pattern the dim shapes get clearer every day. It is always the same shape, only very numerous. And it is like a woman stooping down and creeping about behind that pattern. I don’t like it a bit. I wonder—I begin to think—I wish John would take me away from here! Explanation for Quotation 3 >>About halfway through the story, the sub-pattern of the wallpaper finally comes into focus. The narrator is being drawn further and further into her fantasy, which contains a disturbing truth about her life. Gilman’s irony is actively at work here: the â€Å"things† in the paper are both the ghostly women the narrator sees and the disturbing ideas she is coming to understand. She is simultaneously jealous of the secret (â€Å"nobody knows but me†) and frightened of what it seems to imply. Again the narrator tries to deny her growing insight (â€Å"the dim shapes get clearer ever y day†), but she is powerless to extricate herself.Small wonder that the woman she sees is always â€Å"stooping down and creeping about. † Like the narrator herself, she is trapped within a suffocating domestic â€Å"pattern† from which no escape is possible. Close 4. Life is very much more exciting now than it used to be. Explanation for Quotation 4 >> This comment comes just after the scene in which the narrator catches Jennie touching the paper and resolves that no one else is allowed to figure out the pattern. It captures one of the most distinctive qualities of â€Å"The Yellow Wallpaper†: Gilman’s bitter, sarcastic sense of humor.Now that the narrator has become hopelessly obsessed with the pattern, spending all day and all night thinking about it, life has become more interesting and she is no longer bored. Gilman manages to combine humor and dread in such moments. The comment is funny, but the reader knows that someone who would make such a joke is not well. Indeed, in the section that follows, the narrator casually mentions that she considered burning the house down in order to eliminate the smell of the wallpaper. Close 5. I don’t like to look out of the windows even—there are so many of those creeping women, and they creep so fast.I wonder if they all come out of that wall-paper as I did? Explanation for Quotation 5 >> In the story’s final scene, just before John finally breaks into her room, the narrator has finished tearing off enough of the wallpaper that the woman she saw inside is now free—and the two women have become one. This passage is the exact moment of full identification, when the narrator finally makes the connection she has been avoiding, a connection that the reader has made already. The woman behind the pattern was an image of herself—she has been the one â€Å"stooping and creeping. Further, she knows that there are many women just like her, so many that she is afraid to look at them. The question she asks is poignant and complex: did they all have to struggle the way I did? Were they trapped within homes that were really prisons? Did they all have to tear their lives up at the roots in order to be free? The narrator, unable to answer these questions, leaves them for another woman—or the reader—to ponder. Key Facts title  · â€Å"The Yellow Wallpaper† author  · Charlotte Perkins Gilman type of work  · Short story genre  · Gothic horror tale; character study; socio-political allegory language  · English ime and place written  · 1892, California date of first publication  · May, 1892 publisher  · The New England Magazine narrator  · A mentally troubled young woman, possibly named Jane point of view  · As the main character’s fictional journal, the story is told in strict first-person narration, focusing exclusively on her own thoughts, feelings, and perceptions. Everything that we learn or see in the story is filtered through the narrator’s shifting consciousness, and since the narrator goes insane over the course of the story, her perception of reality is often completely at odds with that of the other characters. one  · The narrator is in a state of anxiety for much of the story, with flashes of sarcasm, anger, and desperation—a tone Gilman wants the reader to share. tense  · The story stays close to the narrator’s thoughts at the moment and is thus mostly in the present tense. setting (time)  · Late nineteenth century setting (place)  · America, in a large summer home (or possibly an old asylum), primarily in one bedroom within the house. rotagonist  · The narrator, a young upper-middle-class woman who is suffering from what is most likely postpartum depression and whose illness gives her insight into her (and other women’s) situation in society and in marriage, even as the treatment she undergoes robs her of her sanity. major conf lict  · The struggle between the narrator and her husband, who is also her doctor, over the nature and treatment of her illness leads to a conflict within the narrator’s mind between her growing understanding of her own powerlessness and her desire to repress this awareness. ising action  · The narrator decides to keep a secret journal, in which she describes her forced passivity and expresses her dislike for her bedroom wallpaper, a dislike that gradually intensifies into obsession. climax  · The narrator completely identifies herself with the woman imprisoned in the wallpaper. falling action  · The narrator, now completely identified with the woman in the wallpaper,spends her time crawling on all fours around the room. Her husband discovers her and collapses in shock, and she keeps crawling, right over his fallen body. hemes  · The subordination of women in marriage; the importance of self-expression; the evils of the â€Å"Resting Cure† motifs  · Irony; the journal symbols  · The wallpaper foreshadowing  · The discovery of the teeth marks on the bedstead foreshadows the narrator’s own insanity and suggests the narrator is not revealing everything about her behavior; the first use of the word â€Å"creepy† foreshadows the increasing desperation of the narrator’s situation and her own eventualâ€Å"creeping. † How to Cite This SparkNote Full Bibliographic Citation MLA: SparkNotes Editors. â€Å"SparkNote on The Yellow Wallpaper. † SparkNotes. com. SparkNotes LLC. 2006. Web. 2 Apr. 2013. The Chicago Manual of Style: SparkNotes Editors. â€Å"SparkNote on The Yellow Wallpaper. † SparkNotes LLC. 2006. http://www. sparknotes. com/lit/yellowwallpaper/ (accessed April 12, 2013). APA: SparkNotes Editors. (2006). SparkNote on The Yellow Wallpaper. Retrieved April 12, 2013, from http://www. sparknotes. com/lit/yellowwallpaper/ In Text Citation MLA: â€Å"Their conversation is awkward, especially when she mentions Wickham, a subject Darcy clearly wishes to avoid† (SparkNotes Editors). APA: â€Å"Their conversation is awkward, especially when she mentions Wickham, a subject Darcy clearly wishes to avoid† (SparkNotes Editors, 2006).Footnote The Chicago Manual of Style: Chicago requires the use of footnotes, rather than parenthetical citations, in conjunction with a list of works cited when dealing with literature. 1 SparkNotes Editors. â€Å"SparkNote on The Yellow Wallpaper. † SparkNotes LLC. 2006. http://www. sparknotes. com/lit/yellowwallpaper/ (accessed April 12, 2013). [pic] Please be sure to cite your sources. For more information about what plagiarism is and how to avoid it, please read our article on The Plagiarism Plague. If you have any questions regarding how to use or include references to SparkNotes in your work, please tell us.

Analysis of Anselms Ontological Argument

This premise does not state that God’s strengths as this argument is to prove his existence, not whether or not God is all-powerful, all-knowing and all-good. The second premise means this greatest possible being is either an imaginary being that one has thought of or, a being that we not only is not only thought of but also exists. The third premise and its sub premises states because existing in reality is greater than existing in thought, then the God we have thought of exists in reality or there must be a greater, or more perfect, being that does exist and that being is God. This leads to the conclusion, if you accept the premises then you accept the existence of the greatest being possible, God. This concept of God’s existence is also led with the idea that God is a necessary being, a being that is not dependent of something greater in order to exist. If God relied on another being, like how a children rely on parents to conceive them, then this being called God is not God because it would be imperfect. Therefore, there must be another to call God that meets all the requirements for perfection. One of the first popular objections was created by Gaunilo of Marmoutiers. The premise and conclusion to Gaunilo’s argument is identical to Anselm’s argument except with the replacement of the word â€Å"God† with â€Å"the Lost island† and the word â€Å"being† with â€Å"island†. As simple as that, though Gaunilo’s argument is completely absurd, Gaunilo’s reductio ad absurdum also proves to be as deductively valid as Anselm’s argument. However, this â€Å"Lost Island† could in no way exist. The absurdity and validity of â€Å"the lost island† quickly brought up questions as to how Anselm’s Argument cannot be absurd. Anselm’s argument was not proven invalid until Immanuel Kant, a german philosopher during the 18th century, proposed an objection that would be the decisive blow to the Ontological argument (Immanuel Kant. Wiki). Kant’s objection is how existence is not a predicate (Mike, screen 25). A predicate is used to describe something the subject (this being God in Anselm’s Argument) is doing. In Aselm’s Argument, Anselm premise rely on that being conceived and existing in reality is something that describes God. This rationality does not follow because to exist or conceive does not describe the subject, it only tells us whether it exist or not. Much like how fictional characters do not exist, describing cartoon for example would tell us details of what this cartoon looks like, what its habits are and common antics it goes through, but not whether it exists or not. The question of existence must fall in a separate argument that does not define the character. As there are Arguments to prove God, there are debatable arguments to disprove the God. The First version of â€Å"The Argument from Evil† goes as follow: 1. If God were to exist, then that being would be all-powerful, all-knowing, and all-good. 2. If an all-PKG existed, then there would be no evil. . There is evil. [Conclusion] Hence, there is no God (Sober, 109) The first premise is the definition of what God would be if he were to exist. That is a being that has the power to do anything, had knowledge of everything throughout the span of time and is in all ways good. The second premise is created with the first premise in mind. To expand on the second premise i t states, if God were all-powerful he could stop any form of evil from happening, if he is all knowing then he has knowledge of when evil will occur and if he is all-good then God would stop all evil from happening. If god cannot stop all evil from happening then the definition of God must be incorrect. He then must not be powerful enough to stop all evil, and/or he doesn’t know when evil until it has already occurred and/or good is not all good in that God does not wish to stop all evils. The third premise is stating the fact that there is evil in the world. The conclusion derived since that there is evil, then is what may be defined as God must be lacking in one or two of his qualities and therefore God, by definition, does not exist at all. In order for God to be compatible with evil, God must only allow the evils that would, in turn, lead to a greater amount of good and must take the route that leads to the least amount of evil to gain the greatest amount of good. The soul building defense was created in mind that evil and God co-exist in our world. The defense is that without any evil in the world, our souls would not nurture, or, understand the concept of evil. This defense does not hold true because there has been many evils in the world that seem unacceptable, even though it may have been for the purpose of soul building. God, and all-good being, would then only allow the evils that are essential in soul-building. This would only mean that evil that man commits against man. The reason for this is because anything that happens in nature exceeds soul-building essentials. Another defense is God having given us free will, humans ultimately are the causes of this evil. That is true but the common objection to this is that human do more than enough evil to ourselves, it is going too far to have God throw tornados, volcanic eruptions, and hurricanes at us too. At what point do human have such control over nature. The last defense is that God simply works in mysterious ways. Who can explain why natural events take so many lives and injure many others or why some children have to go through great deals of suffering and live through it? It is God’s way and ultimately, no matter how incomprehensible the evil is, it is for the greater good. Certainly the question to God’s existence has been pondered upon by philosophers for over a very long period of time with no progress as whether God exists or not. The ontological argument created by Anselm withstood a great deal of criticism until it was disproved by Kant over 600 years after the fact.

Resource Management Essay Example | Topics and Well Written Essays - 500 words

Resource Management - Essay Example Risk management and improving value should be the key measures to be taken by the CIO. The Cohen act also goes ahead to state the functions of a CIO which is mostly taking measurement of the performance in the company. Performance in the company can be measured according to how much it is of benefit to the company. This is a very key area in the performance management process. The CIO has to develop maintain and facilitate the IT architecture. He should come up with goals and see them through. The CIO should take performance measures to find out the viability of the set goals in regards to the losses the company has suffered and the risks apparent. These risks should be well analysed by the CIO and a plan to execute change should be formulated. Considering the various roles the CIO has to play, there are various executive decisions that will need to be made in light of the problems and risks noted. One of the problems cited was the company expenditure. The company expenditure will be keenly observed to find out which areas exactly take more than necessary. Once found the CIO should come up with way to improve on accountability and service delivery to the consumers at the very end. With a proper financial report on the expenditure in technology in any given financial year should be enough to help the stakeholders make important decisions that will directly affect the company. Communication breakdown between the management and the business units on their job descriptions cost the company a fortune and by communicating through the various channels available would be very essential in ensuring that everyone does what is expected of them. Good communication between all the ranks in the company will ensure that the company goals are properly communicated to all that it concerns and this way, the waste in the system will be easily eliminated. The

Regional human rights instruments Essay Example | Topics and Well Written Essays - 3000 words

Regional human rights instruments - Essay Example They can, however, have an ethical consequence and offer guidance to States about their responsibilities2. In Asia, the association of the 10 states of South-east Asian Nations (ASEAN) has acknowledged a regional human rights system for South-East Asia. In 2007, State leaders signed an ASEAN agreement, come into power in 2008 following endorsement by all 10 member states. The Charter offers ASEAN a bureaucratic basis that ascertains an institutional arrangement and forbids policy of course. In 2009, the ASEAN inter legislative Commission on Human Rights occurred in the 15th ASEAN meeting. The ASEAN Commission in 2010 for the protection and Promotion of the Rights of Women as well as Children (ACWC) was also acknowledged3. In Europe, the local preparations for protecting human rights are extensive. They involve the European Union, the Council of Europe, and the Organization for Cooperation and security in Europe4. All these intergovernmental organizations have their own regional human rights instruments and mechanisms. ... all over the world have built up domestic law and constitutions that mirror elementary human rights values though there is major discrepancy among States in their advances6. The federal government in Peru goes into international treaties devoid of parliamentary consent. While it cannot necessitate the provinces to apply international human rights agreements in region falling in /territorial control, provincial, federal, and territorial governments usually share their human rights schedules and the federal government gets into treaties with provincial approval1. In Peru, a dualist approach is followed. This means that global human rights treaties must be included into local legislation to have impact in domestic courts. In general, global human rights agreements are not included into local legislation, posing a challenge to their implementation within the territories and provinces. Assessing Peru’s conformity with its treaty requirements and associated jurisprudence can be hard as there are two parts to consider: jurisprudence for normal legislation and jurisprudence for the constitution of Peru and the Peru Charter of Rights and basic Freedoms7. In the ordinary legislation, the courts have argued that judges should endeavor to interpret such laws according to relevant international requirements. If the express requirements of a domestic decree are dissimilar to or conflicting with Peru’s international requirements, the former overcomes. The judiciary is therefore not bound to apply the international human rights treaty requirements of Peru, even though they will be a pertinent and important factor in the courts' explanation of the Charter8. There can be vagueness among lawyers and judges about the connection between the international human rights treaties and the

Organisations have different forms ranging from sole trader to large Essay

Organisations have different forms ranging from sole trader to large multinational corporations. Choose an organization of your choice and complete the followin - Essay Example The Coca-Cola is one of the most celebrated brands among all the world-class products and industries. The title, trademark and logo of this giant organisation are thought to be the symbol of reliance and confidence. Introduced in May 1886 in Atlanta, Georgia, Coca-Cola company has become very much popular among the people of various age groups and socioeconomic classes all over the globe. Right now, it is at the top in respect of sales among the soft drinks, mineral water and food products of the globe. During the last many decades, the organisation has been the sponsor of mega events and grand ceremonies including Olympic Games, World Cups, G-8 conferences and other domestic, national and international ceremonies. An international organisation makes its plans and devises its strategy for the people of the whole world without discrimination; so it always maintains a universal thoughtfulness and a global vision while manufacturing and selling its products. The products of a multinational organisation are welcomed and well-known at divergent parts of the world, which enhances its popularity and unconditionally supports the company in respect of its sales volume and sound reputation. A global product always paves the way towards innovative ideas in manufacturing and marketing, which is also beneficial for the local brands to improve their quality and present their products to the customers in a refined way. An international brand contains its offices, outlets and factories everywhere on the Earth, where it hires the services of the people as its employees in every country, which is highly supportive in respect of introducing new products and presenting novel ideas in a refined way.. The multinational brand has wide range of its consumers, which not only results in the manufacturing of new tastes, but the brilliant brains existing everywhere as the employees of the company do not let the rival brands beat their company. A

How can usability improve the mobile-commerce channels Coursework

How can usability improve the mobile-commerce channels - Coursework Example Many people are using mobile phones for commercial purposes such as internet shopping. The fact that a great portion of the world population uses mobile phones has made mobile commerce a very useful technology which is worth developing. The launch of smart phones has also made this technology popular by moving it from systems that use SMS to those that use actual applications. This paper will discuss analyze the issue on the basis of different mobile commerce channels, which are business domains where mobile commerce has been implemented. Mobile ticketing: With mobile commerce in wide use, one of the benefits is mobile ticketing. One can attain a device such as a mobile phone. The process, in countries where it is applicable, has been made possible for those customers with mobile phones that can access the web they get their tickets online. It is still possible for mobile users who use gadgets that cannot access the web. SMS and MMS are used. A company may, for example, be using SIM (subscriber identity mobile) tool kit or USSD to give a purchase menu. A subscriber identity mobile kit is a platform that utilizes use of RF (radio frequencies. According to computer science and its application, CSA 2012, by Sang-Soo Yeo and others, a security chip is used. It receives instructions from the user and if the frequency is to be transmitted back to the SIM card, it is transmitted to the phone. If there is information to be processed, it is transmitted to the security chip, worked on and result forwarded automatically to the SIM that was used to request the service. For this case our expected result could is a ticket. The ticket comes as a secured message, either SMS or MMS image. The customer will enter their specifications here from choices given and send their request to the company’s server. If the customer has enough credit in an account linked to the mobile number, the server will be able to deduct an exact amount to the value of the ticket purchased, and t hen automatically send a confirmation text message to the customer. The confirmation SMS entails details of the product bought, for this case the ticket specifications, the date and time of purchase, and a unique code that identifies the ticket and can be manually entered. This is for a phone that is only SMS enabled and cannot execute MMS or WAP outputs. If mms or can output barcode images, a ticket recognition image is sent alongside the confirmation text message. With these considerations of type of phone used, usability, being the ease of use, is enhanced. Reading MMS or SMS is a very easy task. It is also easy during initial purchasing since the USSD code guide the users by giving options. In the future, there should be assistive technology for people with various disability problems. With better accessibility by all, the idea will have an expanded market. Lessons on the website on how to use this service should be easy to access. According to world statistics, done by Jupiter Research, mobile ticketing has been used in purchase of bus tickets, railway transport tickets, and movie and entertainment tickets. In March 2011, 250 million people were purchasing this tickets using mobile. It was estimated that by the year 2015 750 million people will be able to purchase tickets on mobile. MOBILE MONEY TRANSFER: Mobile banking is a growing field worldwide. It is a surprise

Laura Mericer Cosmetics Research Proposal Example | Topics and Well Written Essays - 500 words

Laura Mericer Cosmetics - Research Proposal Example It was 1996 when Mericer developed an own line which was designed to suit women of all the ages and all skin types. The specificity of her products is that their color themes are based on classic palette and usually don’t follow the seasonal trends – according to Laura’s vision classics is always in fashion. Currently Laura’s products are available in more than six hundred stores of twenty four countries all over the world, and the line has developed and grown to include skincare, bath, body, and fragrance lines. The founder of the line spends much time traveling, making public appearances at such stores as Neiman Marcus and Henri Bendel among others. She spends most of the free time in New York City or Paris. Currently among her clients are Cameron Diaz, Oprah Winfrey, Julia Roberts, and Mariah Carey to name a few. All of Laura’s artists were gaining experience through backstage access, editorial work or television before joining her team. She hires only experienced and creative individuals in order to provide clients with the best qualified service and the brand with those to continue the tradition of excellence. The preference is always given to diversified people experienced in cosmetics industry and with a successful track record. The images presented by the artist are those carrying confidence in oneself combined with lightness and some shades of glamour.

Musicians who are known as heroic figures Essay Example | Topics and Well Written Essays - 250 words

Musicians who are known as heroic figures - Essay Example One can almost draw the over-commercialization of this genre back to Jackson, shaping pop music into what it has become today. It truly is impossible to negate the intense influence he has had. At the same time, no one has conveyed social and political ideas using music quite as powerful as Dylan. He led in an age of prodigious songwriters. Dylan’s influence comes through his lyrics, hard-hitting poetry merged with beautiful music. He is a giant in the modern music’s history. The Beatles transformed pop music on a level that no one else has ever been able to. They are perhaps the most well known musicians in the world and their legacy is undoubtedly certain to last for several decades to come. Elvis, on the other hand, formed rock and roll music. He commanded high-energy music to the foreground. According to the Rock and Roll Hall of Fame, â€Å"he rose from humble circumstances to launch the rock and roll revolution with his commanding voice and charismatic stage presence.† He carried this music and made it part of popular culture that it has been one of the greatest part of our culture

The performance management (PM) approach and the High performance Work Assignment

The performance management (PM) approach and the High performance Work (HPW) approach - Assignment Example These activities are carried out by leaders and managers in organisations to help in improving the activities and the performance of the organisation. We think that performance management for employees in trying to set goals, monitor the employee’s achievement of the goals of the organisation, sharing the feedback of performance of employees with them and evaluating the performance with them. Organisational performance is composed of the output of an organisation while comparing it against the inputs that were deployed to the organisation to achieve those results. The output can be measured by the organisation in terms of profits and growth of the organisation. Performance can be measured by several dimensions; the financial performance or the shareholder returns the level of customer service in the organisation, the social responsibility of the organisation in the society and its clients and the stewardship of the employees. Organisations use statistical evidence to be able t o determine the progress to define the objectives in the organisation (Hoverstadt 2011, p67). Organizational performance is measured in terms indicators of efficiency, effectiveness, relevance to shareholders and the financial viability. These indicators are used by the human resources to evaluate the performance of the employees and the organization (Ed Barrows 2010, p98). Performance management is composed of two types of the management system. One of them is where an analyst views the performance of a firm as a whole, and will monitor the effectiveness of how managers and other executives achieve their set goals. On the other hand, performance management may be viewed as a system to monitor the performance of employees and how they help them in achieving their goals; hence ensuring that organizations perform much better. This type of management will differ from the objectives to how they will be applied. This will include; planning of the work to be done, the setting of the goals , and offering feedback to the employees about their performance (Hoverstadt 2011, p45). Employees work best when the work they are given is planned well, delegated well, and objectives of the work are clearly set. This will motivate employees to do their job and be able to achieve the goals without any problem. When the executives plan and set goals and objectives better in performance management, it creates a predictable system for better performance. By doing this, the employees assume their consequences of work performance and bear the responsibility too. Giving results back to the employees about their work is done on an annual review. This enables employees to change their past mistakes and ensure that they will perform better in the next year. Employees get to benefit from the consistent models of performance evaluation; this is because the employees will get enough time to address their issues. Performance management also provides employees with opportunities to grow themsel ves in their fields of interest. This means that employees will be given opportunities to perform their duties better and at the same time pair the unskilled employees with the more skilled employees. This model enables employees to perfect their skills and hence improve the performance of the organizations (Ed Barrows 2010,

A Preprocessing Framework for Underwater Image Denoising Essay Example for Free

A Preprocessing Framework for Underwater Image Denoising Essay Abstract A major obstacle to underwater operations using cameras comes from the light absorption and scattering by the marine environment, which limits the visibility distance up to a few meters in coastal waters. The preprocessing methods concentrate on contrast equalization to deal with nonuniform lighting caused by the back scattering. Some adaptive smoothing methods like anisotropic filtering as a lengthy computation time and the fact that diffusion constants must be manually tuned, wavelet filtering is faster and automatic. An adaptive smoothing method helps to address the remaining sources of noise and can significantly improve edge detection. In the proposed approach, wavelet filtering method is used in which the diffusion constant is tuned automatically. Keywords: underwater image, preprocessing, edge detection, wavelet filtering, denoising. I. INTRODUCTION The underwater images usually suffers from non-uniform lighting, low contrast, blur and diminished colors. A few problems pertaining to underwater images are light absorption and the inherent structure of the sea, and also the effects of colour in underwater images. Reflection of the light varies greatly depending on the structure of the sea. Another main concern is related to the water that bends the light either to make crinkle patterns or to diffuse it. Most importantly, the quality of the water controls and influences the filtering properties of the water such as sprinkle of the dust in water. The reflected amount of light  is partly polarised horizontally and partly enters the water vertically. Light attenuation limits the visibility distance at about twenty meters in clear water and five meters or less in turbid water. Forward scattering generally leads to blur of the image features, backscattering generally limits the contrast of the images. The amount of light is reduced wh en we go deeper, colors drop off depending on their wavelengths. The blue color travels across the longest in the water due to its shortest  wavelength. Current preprocessing methods typically only concentrate on local contrast equalization in order to deal with the nonuniform lighting caused by the back scattering. II. UNDERWATER DEGRADATION A major difficulty to process underwater images comes from light attenuation. Light attenuation limits the visibility distance, at about twenty meters in clear water and five meters or less in turbid water. The light attenuation process is caused by the absorption (which removes light energy) and scattering (which changes the direction of light path). Absorption and scattering effects are due to the water itself and to other components such as dissolved organic matter or small observable floating particles. Dealing with this difficulty, underwater imaging faces to many problems: first the rapid attenuation of light requires attaching a light source to the vehicle providing the necessary lighting. Unfortunately, artificial lights tend to illuminate the scene in a non uniform fashion producing a bright spot in the center of the image and poorly illuminated area surrounding. Then the distance between the camera and the scene usually induced prominent blue or green color (the wavelength corresponding to the red color disappears in only few meters). Then, the floating particles highly variable in kind and concentration, increase absorption and scattering effects: they blur image features (forward scattering), modify colors and produce bright artifacts known as â€Å"marine snow†. At last the non stability of the  underwater vehicle affects once again image  contrast. To test the accuracy of the preprocessing algorithms, three steps are followed. 1) First an original image is converted into grayscale image. 2)  Second salt and pepper noise added to the grayscale image. 3) Third wavelet filtering is applied to denoise the image. Grayscale images are distinct from one-bit bi-tonal black-and-white images, which in the context of computer imaging are images with only the two colors, black, and white. Grayscale images have many shades of gray in between. Grayscale images are also called monochromatic, denoting the presence of only one (mono) color (chrome). Grayscale images are often the result of measuring the intensity of light at each pixel in a single band of the electromagnetic spectrum and in such cases they are monochromatic proper when only a given frequency is captured. Salt and pepper noise is a form of noise typically seen on images. It represents itself as randomly occurring white and black  pixels. An image containing salt-and-pepper noise will have dark pixels in bright regions and bright pixels in dark regions. This type of noise can be caused by analog-to-digital converter errors, bit errors in transmission. Wavelet filtering gives very good results compared to other denoising methods because, unlike other methods, it does not assume that the coefficients are independent. III. A PREPROCESSING ALGORITHM The algorithm proposed corrects each underwater perturbations sequentially.  addressed in the algorithm. However, contrast equalization also corrects the effect of the exponential light attenuation with distance. B. Bilateral Filtering Bilateral filtering smooth the images while preserving edges by means of a nonlinear combination of nearby image values. The idea underlying bilateral filtering is to do in the range of an image what traditional filters do in its domain. Two pixels can close to one another, occupy nearby spatial location (i.e) have nearby values. Closeness refers to vicinity in the domain, similarity to vicinity in the range. Traditional filtering is a domain filtering, and enforces closeness by weighing pixel values with coefficients that fall off with distance. The range filtering, this averages image values with weights that decay with dissimilarity. Range filters are nonlinear because their weights depend on image intensity or color. Computationally, they are no more complex than standard nonseparable  filters. So the combination of both domain and range filtering is known as bilateral filtering. A. Contrast equalization Contrast stretching often called normalization is a simple image enhancement technique that attempts to improve the contrast in an image by ‘stretching’ the range of intensity values. Many well-known techniques are known to help correcting the lighting disparities in underwater images. As the contrast is non uniform, a global color histogram equalization of the image will not suffice and local methods must be considered. Among all the methods they reviewed, Garcia, Nicosevici and Cufi [2] constated the empirical best results of the illuminationreflectance model on underwater images. The low-pass version of the image is typically computed with a Gaussian filter having a large standard deviation. This method is theoretically relevant backscattering, which is responsible for most of the contrast disparities, is indeed a slowly varying spatial function. Backscattering is the predominant noise, hence it is sensible for it to be the first noise Anisotropic filtering Anisotropic filter is used to smoothing the image. Anisotropic filtering allows us to simplify image features to improve image segmentation. This filter smooths the image in homogeneous area but preserves edges and enhance them. It is used to smooth textures and reduce artifacts by deleting small edges amplified by homomorphic filtering. This filter removes or attenuates unwanted artifacts and  remaining noise. The anisotropic diffusion algorithm is used to reduce noise and prepare the segmentation step. It allows to smooth image in homogeneous areas but it preserves and even enhances the edges in the image. Here the algorithm follow which is proposed by Perona and Malik [5]. This algorithm is automatic so it uses constant parameters selected manually. The previous step of wavelet filtering is very important to obtain good results with anisotropic filtering. It is the association of wavelet filtering and anisotropic filtering which gives such results. Anisotropic algorithm is  usually used as long as result is not satisfactory. In our case few times only loop set to constant value, to preserve a short computation time. For this denoising filter choose a nearly symmetric orthogonal wavelet bases with a bivariate shrinkage exploiting interscale dependency. Wavelet filtering gives very good results compared to other denoising methods because, unlike other methods, it does not assume that the coefficients are independent. Indeed wavelet coefficients in natural image have significant dependencies. Moreover the computation time is very short. IV. EXPERIMENTAL SETUP AND EVALUATION To estimate the quality of reconstructed image, Mean Squared Error and Peak Signal to Noise Ratio are calculated for the original and the reconstructed images. Performance of different filters are tested by calculating the PSNR and MSE values. The size of the images taken is 256256 pixels. The Mean Square Error (MSE) and the Peak Signal to Noise Ratio (PSNR) are the two error metrics used to compare image compression quality. The MSE represents the cumulative squared error between the compressed and the original image, whereas PSNR represents a measure of the peak error. The lower the value of MSE, the lower the error. In Table 1, the original and reconstructed images are shown. In table 2, PSNR and MSE values are calculated for all underwater images. PSNR value obtained for denoised images is higher, when compare with salt and pepper noise added images. MSE value obtained for the denoised images has lower the error when compared with salt and pepper noise added images. e D. Wavelet filtering Thresholding is a simple non-linear technique, which operates on one wavelet coefficient at a time. In its most basic form, each coefficient is thresholded by comparing against threshold, if the coefficient is smaller than threshold, set to zero; otherwise it is kept or modified. Replacing the small noisy coefficients by zero and inverse wavelet transform on the result may lead to reconstruction with the essential signal characteristics and with the less noise. A simple denoising algorithm that uses the wavelet transform consist of the following three steps, (1) calculate the wavelet  transform of the noisy image (2) Modify the noisy detail wavelet coefficients according to some rule (3) compute the inverse transform using the modified coefficients. Multiresolution decompositions have shown significant advantages in image denoising. best denoised image. In clearly, the comparisons of PSNR and MSE values are shown in Fig -1a and Fig -1b. V. CONCLUSION In this paper a novel underwater preprocessing algorithm is present. This algorithm is automatic, requires no  parameter adjustment and no a priori knowledge of the acquisition conditions. This is because functions evaluate their parameters or use pre-adjusted defaults values. This algorithm is fast. Many adjustments can still be done to improve the whole pre-processing algorithms. Inverse filtering gives good results but generally requires a priori knowledge on the environment. Filtering used in this paper needs no parameters adjustment so it can be used systematically on underwater images before every pre-processing algorithms. REFERENCES [1] Arnold-Bos, J. P. Malkasse and Gilles Kervern,(2005) â€Å"Towards a model-free denoising of underwater optical image,† IEEE OCEANS 05 EUROPE,Vol.1, pp.234256. [2] Caefer, Charlene E.; Silverman, Jerry. Mooney,JonathanM,(2000) â€Å"Optimisation of point target tracking filters†. IEEE Trans. Aerosp. Electron. Syst., pages 15-25. [3] R. Garcia, T. Nicosevici, and X. Cufi. (2002) â€Å"On the way to solve lighting problems in underwater imaging†. In Proceedings of the IEEE Oceans 2002, pages 1018–1024. [4] James C. Church, Yixin Chen, and Stephen V., (2008) â€Å"A Spatial Median Filter for Noise Removal in Digital Images†, page(s):618 – 623. [45 Jenny Rajan and M.R Kaimal., (2006) â€Å"Image Denoising Using Wavelet Embedded anisotropic Diffusion†, Appeared in the Proceedings of IEEE International Conference on Visual Information Engineering, page(s): 589 – 593. [6] Z. Liu, Y. Yu, K. Zhang, and H. Huang.,(2001) â€Å"Underwater image transmission and blurred image restoration†. SPIE Journal of Optical Engineering, 40(6):1125–1131. [7] P. Perona and J.Malik, (1990) â€Å"Scale space and edge detection using anisotropic diffusion,† IEEE Trans on Pattern Analysis and Machine Intelligence, pp.629-639. [8] Schechner, Y and Karpel, N., (2004) â€Å"Clear Underwater Vision†. Proceedings of the IEEE CVPR, Vol. 1, pp. 536-543. [9] Stephane Bazeille, Isabelle, Luc jaulin and Jean-Phillipe Malkasse, (2006) â€Å"Automatic Underwater image PreProcessing†, cmm’06 characterisation du milieu marine page(s): 16-19. [10] Yongjian Yu and Scott T. Acton, (2002) Speckle Reducing Anisotropic Diffusion, IEEE Transactions on Image Processing, page(s): 1260-1270, No. 11, Vol.11.

Strategies to Prevent the Spread of Tuberculosis

Strategies to Prevent the Spread of Tuberculosis To address the problem of Tuberculosis (TB) within East London Tuberculosis (TB) is caused by Mycobacterium tuberculosis. People who have infected sputum can transmit the disease to others. Since it is a notifiable disease accurate figures are available. There are about 7000 cases of TB annually in the UK mostly in the large cities especially London (Health Protection Agency figures). The number of cases has increased by 25% in the last ten years (Department of Health figures). Issues Paucity of evidence will mean some decisions on strategy will encompass consensus decisions. Often it is not one single measure that is effective on its own. Those born abroad or homeless are at disproportionately high risk of getting TB. They must not be seen as being victimised if they are screened in preference to other people. The stigma associated with TB is counter productive to the programme. Potential patients are reluctant to seek investigation. Tannahill’s (1985) three overlapping spheres of health promotion; health education, prevention and health protection, will be incorporated into the programme. Prevention Primary This involves changing the environment, behaviour or both. Immunization is the crux here together with health education. The later involves knowledge, changing attitudes and behaviour (Donaldson, 2003). Secondary This involves early detection of TB and prompt treatment. It is necessary to screen asymptomatic individuals. TB fulfils the WHO screening test requirements (Wilson, 1968). Tertiary Rehabilitation needs to be effective and visible. If the community can see the care and curative treatment the stigma of the illness will lessen and more people come for screening. Programme development Since doctors and nurses do not empower but the community empowers itself (Bright, 1997) it is important that the community has control over the way the programme is set up and run. The issues need to be ranked in order of importance (Ewles, 2003). The programme design is one of health promotion and disease prevention. The Healthcare Commission assesses how well the NHS meets the standards set by the Department of Health document ‘Standards for Better Health’ (2004). These standards include taking into account and implementing nationally agreed guidelines. It is therefore assumed, at least for the purpose of this work, that the NICE guidelines are implemented. The chosen program will be supplementary and complimentary to the implementation of the NICE guidelines. A force field analysis can help to determine the helping and hindering aspects the project is likely to encounter and may be valuable at an early stage in planning the project. It will be beneficial to look at ways of promoting the helping forces and lessening the unfavourable ones. The rationale of the study This is based on the policy on TB. The purpose behind this is that the sooner TB is detected the easier it is to treat and the less the risk of transmission to other people. Aims and objectives These are constructed from areas relevant to the NICE guidelines. There are two aspects to the programme and these are both directly obtained from the objectives of the NICE guidelines (2006). The whole purpose of the NICE guideline is diagnosis and treatment (this is stated in the title of the guideline). Those who may be infectious to others require detection and treatment from the purpose of the own health interests and also in order to lessen the chance of transmission. Treatment needs to be effective. The NICE guideline recognises the advent of drug resistance with failure of treatment and remaining risk of transmission. Following directly on from these two points respectively there are two parts to the objectives of this programme: Diagnosis Each case of sputum positive TB detected will be looked at to see if the diagnosis could have been made sooner. A group will assess the prior opportunities for earlier diagnosis and why those opportunities were missed. For instance was it a problem with the patient, the medical care, administration, resources. Each case will be classed to see if there was an element of sub standard care. Information thus obtained from the cases will be amalgamated to see if there can be any â€Å"lessens learnt† or whether targeting of resources in one particular aspect might help. Treatment This consists of two parts (the cases concerned will be a subset of group one except for those cases diagnosed outside of the area): Incomplete treatment Each case where directly observed treatment was not completed will be looked at to see what factors might have enhanced compliance. Drug resistance Each drug resistant case will be looked at to see whether there were potentially avoidable factors in the development of resistance. Target group, The appropriate target groups for the different parts of the study are: 1. Diagnosis All the sputum positive cases that are diagnosed in the area within the first six months. 2a) Incomplete treatment All the cases who were on directly observed treatment and failed to complete it. They may be being treated somewhere else but if this cannot be confirmed they are classed as failure of treatment. Six months would be the time frame Those complying with and still on their treatment at the six month point would not be classed as failure to give treatment. 2b) Drug resistance All diagnosed cases of drug resistant TB diagnosed within the six months. Since health inequalities are associated with social class (Black report, 1980) and material deprivation (Townsend, 1987) these groups will feature prominently in the cases. A study in London (Story, 2006) found that 321 of 1941 (17%) of cases of TB there were in people who were homeless, drug abusers or ex prisoners. These three factors were independently associated with poor treatment compliance. Of poor treatment compliance 38% of the patients were in one of these groups and 44% of smear positive and drug resistant cases were in one of these groups. Setting and needs assessment An integral aspect of this project involves identifying ways to change behaviour of those at risk of acquiring or having TB. The Health Belief Model (Becker, 1974) explains people will weigh up the benefits and risks of making a change and the Theory of Reasoned Action (Ajzen 1980) adds in the influences of family and friends. To facilitate the change Ewles (2003) recommends; Working with the community Facilitating healthier choices Relating to individuals Dealing with resistance When working with the community advocacy is a useful way of gaining representation from groups, and indeed individuals, whose views are difficult to obtain. Perhaps they do not speak English, perhaps they are homeless or abuse drugs. The advocates may be non-medical but have some things in common with the group they are representing. It is vitally important to make healthier choices more attractive to people. This will encourage them to present for screening, investigation or vaccination. Whilst this may be relatively easy for an ethnic minority community it is particularly challenging for the drug abuser or homeless person. Empathy with the problematic group and really understanding their views, motives and behaviour is inherent in this project. In identifying whether diagnosis could have been made earlier or treatment completed the people involved in investigating aspects of the cases will need to include the groups of people from whom the index case arose. This will involve people from local ethnic groups, prisoners, drug addicts and homeless people. Most importantly of all it will involve the patients themselves. For instance, although much useful information will be gleaned from meetings with the above groups of people to try and evaluate the reasons why a particularly individual did not present themselves for screening or did not respond to a request to be screened or did not have a baby vaccinated it is going to be extremely valuable to discuss with the person concerned what factors led to the diagnosis being made at the time it was rather than earlier. Much valuable insight may be gained from this process or there again it might not. In a programme of this nature it is important to keep an open mind to whether somethi ng is going to work or not hence the importance of building in an appropriate method of evaluation at the design stage of the study. It is too late to add on the choice of statistical analysis once the data has been collected because it might not have been collected in an appropriate way. Resources To be comprehensive the resources will need to include; Primary and secondary care, with consent issues handled at the time of diagnosis and treatment so that only patients willing to participate will be interviewed. A prior plan will need to be formulated in agreement with the ethics committee about what level of investigation can take and mechanisms of anonymising information. Patient confidentiality is of utmost importance. Patients attending genitourinary medicine clinics will often wish to remain anonymous. However this attendance is an opportunity for screening would provide useful information to the programme. If the group set up to look into the issues of potential for earlier diagnosis and treatment failures are from the same local community they may well know the index case. This issue needs to be discussed at community level to find effective ways of making the process anonymous and gaining community confidence. It is difficult to envisage at this stage where the source of funding will come for such a project. Perhaps the best scenario would be to run it at a loss as academic research perhaps involving students for higher degrees and then present the results of a pilot study to then try and gain some central funding to pursue the project on a wider scale. The worst scenario would be that it never becomes more than a research project. Much will depend on its evaluation results and perceived value partly as a result of its marketing. Aagencies, consumers and stake holders The stake holders are those with an interest in the project and seeing how it is run. The stake holders are many and really encompass all groups primary and secondary care, groups outside of healthcare, and community groups. They all need an awareness of the programme. Some will be more directly involved than others and the degree of involvement will alter as the programme progresses. Budget plan, A costing plan and a template are discussed in detail in a Costing report (2006) for implementation of the NICE guidelines. If feedback from this programme results in earlier diagnosis and in more effective treatment there will be less transmission and less drug resistance. Costings are set out in the NICE documentation and so the relevant calculations can be made for cost savings based in estimates of the results of the programme. The costs incurred will be of setting up the relevant community groups and analysing the cases. This will incur staffing costs and administration costs and likely costs for travel and other community member and patient related costs. Policy evaluation It is important to have a comprehensive programme of evaluation the features of which will shortly be outlined. There are three main purposes to the policy evaluation: Can we identify aspects where significantly earlier diagnosis could have been made? If so what are these and what are the resource and practical implications of implementing them? The same question could be asked of avoiding incomplete directly observed treatment and of avoiding drug resistance. If question one is answered in the affirmative can funding be secured for the project? If question one is answered in the affirmative can the actions identified as valuable in that section be set up? If so this would represent effective feedback. How evaluation will be carried out Clinical and statistical significance must be distinguished. The former is arbitrarily chosen as one month for speed of diagnosis. The relevant evaluation will be by qualitative methods of analysis. It will however be useful to compare the percentage where there was an avoidable factor in later diagnosis, treatment failure or development of resistance over a time scale say a number of years to see if the whole systems approach is actually improving with regard to diagnosis or treatment. References/resources Ajzen I Fishbein M 1980 Understanding attitudes and predicting social behaviour. Englewood Cliffs. Prentice Hall. Becker MH 1974 The health belief model and personal health behaviour. New Jersey. Slack. Black Report 1980 Dept of Health and Social Security Inequalities in Health: report of a research working group. London HMSO Bright JS 1997 Health promotion in clinical practice Bailliere Tindall London Costing report. 2006 NICE clinical guideline no. 33 Implementing NICE guidance in England Department of Health Donaldson LJ Donaldson RJ 2003 Essential Public Health 2nd ed Petroc Press Berkshire Ewles L Simnett I 2003 Promoting health, a practical guide. London. Bailliere Tindall. Government’s TB Action plan for England 2005 Health protection Agency www.hpa.org.uk/infections/topics_az/tb/menu.htm accessed 4.5.06 NICE guidelines 2006 Clinical guideline 33 Tuberculosis Clinical diagnosis and management of tuberculosis, and measures for its prevention and control. www.nice.org.uk/CG033 accessed 10 May 2006 Standards for better health 2004 Department of health. Stopping Tuberculosis in England Department of Health 2004 Story A Murad S Roberts W et al 2006 Contribution of homelessness, problem drug use and prison to tuberculosis in London. Tannahill A 1985 What is health promotion? Health Education Journal 44:167-8 Townsend P Phillimore P Beattie A 1987 Deprivation and health: inequality and the North. Beckenham. Croom Helm Whitehead M Tones K 1991 Avoiding the pitfalls. London. Health Education Authority. Wilson JMG Jungner G 1968 The principles and practice of screening for disease. Public Health Papers 34 Geneva. WHO.