Role Model Essay Example for Free

Role Model EssayMany seasons in animateness, we come across a tough, influential person who leaves a great and powerful impact on our lives. Maybe it is an actress, superhero, family, teacher, or just a stranger who did something that changes your thoughts and decisions about life. Fortunately, I came across to someone who supported me from the very first-class honours degree of the journey of my life. That person is my beloved mother, who taught me to walk my first steps, who introduced me to the crazy side of life, and who has always been there for me when I needed her. Ever since I could remember, she has been right beside me documentation any goal I was trying to reach, even when it was incredibly ridiculous to everybody else. When I grow old with my own children, I hope I lav be there for my kids, and make an unforgettable impact on their lives the way she did for me. I was raised by both of my parents in America after we de jure travelled from Malaysia. While my fath er worked a full time job, my mother stayed home and looked after me. At a young age, I had a capacious portion of the day with just my mother.I was never a neglected child. She taught me to always carry a smile and to look at the positives in life instead of fretting about the negatives. When I was bored, she would stop her daily chores and watch television with me. If I complained of starvation, she would immediately cook or take me out for food. When I was sick, she took fright of me and stayed up all night in case of any bad changes. If I cherished a new toy, she would nag about how hard it is to gather money but she will always end up buying it for me.I didnt realize at the time, but in my heart, she was already an unreplaceable mother. Eventually, I started to attend school regularly and my mother got a full time job in Long Island. We spent less and less time together, and our relationship began to grow apart. Fights led to more repugns up until there was a time when sh e finally broke down. She told me about all her stress, she told me she wanted things for my own good, and she told me she wanted a bright future for me so I wouldnt have to work as hard as she did just for a living.After victorious all that in, I was very grateful that my mother, who never attended college, was still trying her hardest to help support the family and gaining extra money to buy the things I ache for. I admired my mother for having the courage to speak up to me even though it was risking between us getting in a bigger fight or me understanding her. Other mothers might be yelling at their kids for coming home past midnight. Even though my mother was angry, she kept up with me.She asked me calmly for the reason and then persuades me into telling her beforehand next time. Other mothers might be throwing out their kids slump, but my mother bought me the make-up along with skincare products and taught me how to use it. Other mothers might be terrified to find out their kids dating at 16, but my mother asked me to take things behind and try to make the best decisions for myself. Other mothers might complain when their child received a failing grade on their test, but my mother employ a $50 hourly tutor for me to catch up in my class.Other mothers might nag everyday about their kids mussy room, but I never came home to a messy room before. Other mothers might be whipping their kids when they tell them they wont be able to start college in time, but my mother is proud I graduated from GED. Everyone has that one special person they look up to as a role model by finding someone who has admirable traits that you want to inquire. This could be someone youre proud of or does things that you appreciate.My mother taught me the importance of family, and self-respect. She showed me the honour of a dollar and proved thee are second chances in every corner of life. She guided me to forgiving people even when I tell myself I would never forgive someone again. My mother had demonstrated how to give back to others in need, even when you can use a little help yourself. She is the well-nigh phenomenal mother, best friend, secret-teller, chef, guidance-counselor, teacher, and role model Ill ever encounter.

John Proctor change during the course of the play Essay Example for Free

potty follow potpourri during the take to the woods of the play EssayHow does lavatory monitoring device change during the course of the play? How might this change be communicated on stage? In Act one and only(a) we first understand tush Proctor. He appears to be a very sharp and nasty man. We can see this in the way he talks to his servant, Mary warren Be you foolish Mary rabbit warren? Be you deaf? I am facial expression for you to a greater extent than I am feel for my cows If I were producing this play on the stage I would have Mary warren cowering away from hindquarters Proctor. This would give the au ease upnce an impression that he is quite a nasty man.But this all changes when he meets Abigail as she realises that he is still a powerful man even though he committed adultery with her Gah, Id almost forgot how powerful you were fundament Proctor In the same conversation he shows he has feelings for Abigail and that he is a deceitful person Oh, how you sweat ed like a stallion whenever I come near. This actors line creates a sense of a passionate family. If I were producing this on stage I would have Abigail trying to hold John while he is looking at away and checking no one is around. thus far though he has committed lechery he is still protective over is wife as he tells Abigail that she volition non speak eachthing of Elizabeth to him. He also shows that he is in denial and a liar as he denies anything ever happening between him and Abigail Aye only if we did not The language from the conversation with Abigail creates a sense of confusion with Johns personality as he does one thing and says another. Although he is a well-respected member of the community, as the audience we dont really know whether to trust him or not.He has a high expectation of Hale before he meets him and when he first meets him he is shocked by him Why, Mr. Hale Good evening to you, sir. Come in Come in. If I were producing this play then I would have J ohn looking quite flabbergasted. This would show that Mr. Hale impresses him and that he respects him. He is also deferential to him Ive heard you be a sensible man, Mr. Hale This concludes how John is respectful to his fellow villagers. He is well respected in the community and this may be why. In Act 2 we see the relationship between him and his wife, Elizabeth.The relationship in their marriage seems to be quite distant as john arrives late home. This could suggest that he stayed away longer because he wanted to stave off Elizabeth due to the fact that he has a guilty conscience What keeps you so late its almost dark In a production of this play I would have the room very dark with just a few candles on the table. There would be food on the table besides it would not look appetising, as it would have gone cold. There would be family pictures on a dresser at the side. This indicates that john is a family man, or so Elizabeth thinks. make up though there are pictures of their fa mily presented in the kitchen, this is due to their appearance in Salem. They are well respected so if they tell people that John has been untrusty then the village leave look down on them. As readers it seems that Elizabeth knows about Johns affair as they had an argument about forgiving and forgetting but John is nasty to Elizabeth and shouts at her Oh, Elizabeth, your justice would freeze beer Although he is irate with her he still wants to please her as he was unfaithful to her. He does this by complimenting her training even though he changed it so it would taste better.Johns temper also increases when he has arguments with Elizabeth. He constantly takes his anger out on Mary Warren even though she hasnt actually done anything wrong Ill whip you if you dare leave this house again This language creates a sense of him organism a bully. Mary Warren always seems to be the victim. Proctor shows he is bossy also when he orders Mary Warren to go to bed. This is what adults say to girlish children not to 18 year olds. This gives us a sense that he is treating her like a child and is disrespectful to her.Mary Warren is also much than Johns servant in the house as he tries to get her, along with himself, to overthrow the court to free Elizabeth. This also enables him to get revenge on Abigail for accusative his wife. If I were producing this play then I would have Mary trying to run away shouting that she wont do it. This would indicate that she is scared of John and doesnt feel safe near him. His anger also is shown in this Act as he rips the deputy governors warrant up.This is very disrespectful and rude to Mr. Hale, Mr. Danforth and Cheever as they are the people giving out warrants, leaving Mr. Danforth to sign them. John has destroyed legal documents that have been given out by these 3 men. John also shows that he is religious and is part of the belief of Christianity as he shouts at Mr. Hale Pontius Pilate God leave alone not let you wash your turn over of this If I were producing this play on stage I would have John with lots of anger shown on his face looking like he was going to hit Mr. Hale. Mr. Hale would turn around and start to run towards Cheever. This would indicate that John is a scary man and that getting away from him is probably the top hat thing to do.His emotions suddenly change when Elizabeth appears. He turns into a caring man when they are taking her away I will bring you home, I will bring you home soon This language shows that John can be caring, as he has forgotten about Mr. Hale and Cheever and is now concentrating on his wife. Proctor has faith that his wife never lies. She confessed that she doesnt believe in witches even though her religion says she should believe in them. At the end of act 2 John feels quite scared as he is trying to make Mary overthrow the court and she doesnt want to do it My wife will never die for meI will bring your guts into your mouth but that goodness will not die for me John character has gone from being baseless to being scared in Act 2. In Act 3 Johns attitude changes, as he becomes quite a false man. This is shown when he is in the court introducing his case to Danforth She has signed a deposition The language indicates that he is playing a court game as he has written a legal statement. When he is presenting himself he is very polite to Mr. Danforth, this is probably in his attempt to overthrow the court. He responds to questions very politely and doesnt appear violentJohn Proctor, sir, Elizabeth Proctor is my wife Even though John stays calm, Danforth constantly tries to interrogate him. This slowly increases his temper he keeps to his words without erupting with anger, as he knows this will do him more harm than good. When John speaks Danforth is constantly interrupting him, this is frustrating for him, as he cannot finish what he is saying I come not to excruciation the court, I only- The technique that Danforth uses to interrogate John s uggests by Johns reaction that it is annoying and could start an argument.If I were producing this play then I would have John change smartly so he looks professional and Danforth sat higher up than John so he looks more important. John would try to avoid looking Danforth in the eyes. This would indicate to the audience that John is a little fearful of Danforth, as he knows that he could sentence himself and his wife to death at any time. When Elizabeth Proctor was accused of witchcraft due to the poppet that was found and Abigails accusation this made John angry. In court John is sarcastic about this and tries to change the subject and make it funnyThere might also be a dragon with five legs in my house but no one has ever seen it This language also shows that John is biding time with the court. If I where producing this play then I would have John laughing, looking around the court but no one else would be laughing. This could indicate that he is scared and is trying to laugh it of or this could be so he can think of more negatives about Abigail and prove that she is lying. John is also indiscreet as he tells Danforth about how Abigail laughed during Prayer she were twice this year put out of this meetin house for jest during prayer John also shows that he is nasty as he calls Abigail a whore. Consequently this proves that John Proctor wants to seek revenge on Abigail. Even though this makes Abigail sound like the victim she is not as she is the one who is making false allegations against honest, well respected members of the community. When John is presenting his own case to spare his life he is like a hero and he is very brave. He tells Danforth what he actually thinks of him I see the boot of Lucifer, I see his dirty face, and it is my face and yours Danforth

Role of the Mother in Winnicotts Theories: An Analysis

Role of the beat in Winnicotts Theories An AnalysisHow was the role of the convey unquestionable in Winnicotts theories and what is the implication for the development of the child? Evaluate this contri only ifion in relation to thinking today.Donald Winnicott (1896-1971) an English paediatrician and psychoanalyst had a great influence in describing the object- dealings theory, focusing on individual birth with the mother and mothers role during the transition of developmental stages in the looking at of child. Winnicott builds his concepts on Kleins suggestion that the quality of infants surroundings plays a major role in their development.The object-relation theory suggests that an instinctual need is achieved by the agent called the object of instinct, who is usually the closest mortal in childs life the mother. This theory majorly focuses on the tendency to develop a self in signifi masst relations between individuals as a basis through which the individual develops. T he Object in this object relationship theory is anything/any unmatchable but oneself (Reber, 1995) the sense of self of a child is defined by the kind-hearted of a relationship that the child experiences with the object through His or Her love and affection (Mother) the object refers to a someone than oneself. There is a determining and critical impact of the quality of attachments with the object and it does non just affect the development of a child but overly the future relationships that the child has with others in the future. This development in the child is justified through the trustworthiness of messages communicated by the overseegiver. Love is considered as the main motivating squelch in human behaviour which in like manner includes development of relationships (Reber, 1995). The balance among love and affection for another and the interest in, and love for self, are formed through stirred up bonds between self and another individual/object.Winnicott (1965) postu lates the idea of primary maternal preoccupation explaining that after giving birth the mother becomes so involved and irritable to infants needfully that everything else falls apart in a secondary role.Taking the stages of separation individuation to a high research train Winnicott studies the role of mother (caregiver) in the social development of the child. He emphasizes on the wideness of the mothers ability to intuitively understand the needs of the infant at each and every point through the entire process of individuation. The child gives out certain messages and cues the mother decodes these messages and through the same provides the framework of the maturate of the child and his progress towards a proper level of functioning as an individual. A good plentiful mother defines a scenario where the mother is providing a facilitating environment where the growth of a child happens. He has purposely not used the term perfect in his statement since he believes that only a in strument delivers perfection and not a human, therefore Winnicott believes that a perfect mother is not a good enough mother.According to Winnicot, a good enough mother can identify the needs of the infant and is able to provide a good adaptation to needs. A good enough mother is one who facilitates imaginative elaboration of physical experience for an infant and allows the baby to be totally pendant on her. In case of impingements, the infant can feel going on macrocosm with the help of a good enough mother, who aids the development of a child in the transitional phases of life.Winnicott has described troika major stages of development. These are the stages of Subjective omnipotence, Objective realty and final stage of independence. The zones between these stages are a transitional experience for the child and exactly at this time, the presence of a mother is crucial. The quality of the support received by the child during the transitions stage determines the future of the child . It can decide the positive functioning or the lack of it. For Winnicott, the mother plays an grand role in the transitional experience as well as the stages of development.Subjective OmnipotenceWhen the child is newly born, the mother takes care of the Childs needs with complete indulgence, where she responds to the cries of a child almost immediately. This state is referred to as the stage of maternal preoccupancy. At such times, the mother keeps excursion her own needs and requirements to insure that she meets the requirements of her infant. She almost instantly responds when the child cries for milk. As a result to this, the infant thinks that he leave alone immediately receive diet at the very moment that he requires it. This illusion of Magical control is a very good example of subjective omnipotence (Rodman, 2003).Winnicotts theory states that the Mothers Breast is seen as the object of love during initial few weeks after birth. It is perceived so as the Mothers breast m eets the needs of the childs hunger. During this stage, the object is perceived by the infant as a part of self. Hence, a subjective agenda is developed by the infant with an illusion that the Breast is a part of the infants oneself. In the infants initial development of identity, the illusion of Being-at-one is the first step in the infants development of an identity. Here the role of the good enough mother is highlighted in the developmental process of the child (Winnicott, 1971).Object realty (Not Me/ opposite than me)Over a period of time, the child needs its independence hence, the mother distances itself according to the needs of the child. The child is provided an illusion by the mother that the breast will appear only in stances of a demand made. Post this stage, she helps the child progress through removal of omnipotence thinking and starts the process of introducing the child to the social macrocosm as a separate entity. (Winnicott, 1971)The time lapse between the childs demands and its fulfilment is increased by the mother over time. Winnicott refers to this as the trial of the mother to meet the childs needs on the spot. At this level the child experiences 2 states, one that of an introduction to independence and the other being frustration to having wait. The good enough mother is called so since she will only fail so much so that the child is left unharmed but is successful in entering the stage of transition. To cope with the failure of the mother and the Childs self frustrated rate, the child will react in the following manner He will recognize that the lapses in time are limited. Awareness will be created in his mind regarding the sense of progress. thumb sucking, which is an auto erotic simulation, will be engaged in by the child in the stage of transition. He will experience various psychological factors like memories, dreams, relieving previous experiences which can also be referred to as integration of the past, present and future. Ment al activities will be developed which will assist in deterring the child at times of frustration.At this stage the child will start having awareness of separation from mother. The mother makes the infant realize that there is a world outside of oneself which does not necessarily respond to a wish but the object of reality also teaches him that the outside world may respond negatively at times. The child stays safe in the hands of the mother all this while and the mother ensures that the child is not overprotected during this time.If the mother, due to any reason, fails to assist the child at times of transition from this stage to the stage of independence, as an adult, the child will be superficially adjusted and would fail to be passionate and unique. The child is gently ignored by the mother so that he can reach the stage of independence and experience freedom and make all while providing the child with a safe and secure environment.The Stage of IndependenceAt this stage, the nev er absolute stage of final independence is achieved. An important distinction between pure independence and never absolute independence is necessary in an individuals life to both depend on others and be dependent on others. Others company or a social circle is desired by an individual and feels the need for belongingness. A healthy headway does not support isolation or is not support by isolation but in spite of that none of us is over dependent on each other.Ones the child grows to be an individual and is separated from the mother, the holding environment acts as a safe junction through which the child can start the process of exploring the world all whilst having the knowledge that he is being provided the protection and support by the mother. For a childs healthy development, this kind of a holding environment is extremely necessary. The childs cues are recognized and worked upon by the mother whilst recognizing what he needs of the child are in respect with the holding environ ment and adapts to it accordingly.The child is provided with an environment of protection and safety through which the infant can develop from a child to adulthood. The process is supported by an optimal environment which makes sense through the fact that the good enough mother line of credits in with the childs development needs intuitively all whilst adopting both, the environment and her hand in the development of the child, the rate of which is determined by the child.The good enough mothers knows exactly regarding gradual adjustment of distance between herself and the child that this process cannot be sudden since the child would develop feeling of insecurity and no trust in others. The good enough mothers is in tune with her childs escalation towards an independent self and moves at the childs pace rather than her own. If everything works well according to the childs needs, he develops an ego and the differentiation process is continued until the child can perceive that the m other is an independent being with clarity.Winnicotts concept of reliable self and fictitious self suggests that the childs true self growth and expression is facilitated by the good mother and helps the child to be spontaneous and creative (Rodman, 2003). The true self behaves spontaneously, develops on integrity and believes that the true self is not created. The false self is similar to a mask which is worn by a person in a social club in compliance with its norms like being quiet in setting that require silence around, being respectful to elders and so on. The not good enough mother wears this mask while responding to the child and in call back the child adapts it as his false self. New relationships are developed by the child as its false self adapting to the demands of the environment with compliance.The role of a mother in the development of a child is of high importance to decide the future identity of the child and whether it grows into a secure or insecure adult. The m other plays major role in the transition and developmental stages which is also known as the objective role.In our days the mother role plays the same significant importance in the development of the child however the society and culture have shaped this role raising a multitude of demands on women. Many mothers engage in the desire of having a fulfilled life story becoming less involved in the developmental stages of their children. Many children are too early placed in nurseries and day care centres as mothers return to work. Like Winnicott suggests, an absent mother will determine children to either grow up confused, non-passionate and psychologically affected individuals or according to the decree of self development, will grow up to be individuals who have succeeded through self development.Another issue could be represented by the option of not nursing the infants in a natural way, but feeding them with formula milk. This fact could lead to the loss of bondage, security and love between mother and child.On the other side, technology and the multitude of equipments facilitate mothers ability to crate safe and stimulating settings for their children.The quality of early parental styles and the development of the child in relationship with others is associated with maternal attachment and is entirely responsible for the development of a child into a secure adult.ReferencesChanging Minds, 2013. The good Enough Mother online available at http//changingminds.org/disciplines/psychoanalysis/concepts/good-enough_mother.htm Accessed on 21nd April 2014Phenomenological Psychology, 2009. Winnicott the false self and contemporary media celebrity. Online Available at http//phenomenologicalpsychology.com/2009/05/winnicott-the-false-self-and-contemporary-media-celebrity/ Accessed on twenty-second April 2014Reber, A. (1995). Dictionary of psychology, (2nd ed.). London Penguin books.Rodman, F. R (2003) Winnicott Biography life and work. Cambridge, Persus Books.Winnicott, D (1965) The International Psycho-Analytical Library, 641-276. London The Hogarth Press and the Institute of Psycho-Analysis.Winnicott, D (1971) Playing and reality. England Penguin books.Winchester.ac.uk, 2011. Donald Winnicotts contribution to understand children and parenting. Online available at http//www2.winchester.ac.uk/edstudies/courses/level%20one%20sem%20one/es1204w7Winnicott.htm Accessed on 22nd April 2014

Advanced Train Control System Technology

Advanced rail in go steady musical arrangement Technology1. IntroductionThe Dockland light railroad line system is one of Britains immense high-tech mechanical take away direct (ATC) establishment, now carrying over 60 million passengers. This highly developed cosmic string learn organisation has expended more rapidly than any UK railways. DLR offici in ally launched in 1987 to pay heed the existing Docklands population and helps to regenerate the Isle of Dogs atomic number 18a, with 11vehicles convoy and 15 stations. Since then the DLR net income has extended to Bank, Beckton, Lewisham, London City Airport and King George V. It has 31 km of railway and 38 station with 94 vehicles DLR Light News 2007. DLR now carries more passenger than ever before, with additional increases in demand predicted over the overture years. The outlines current 6o million passengers a year is expected to rise up to 80 million by 2009, when a further 55 cars leave behind be added to the fleet DLR Light News 2008.Passenger numbers allow rise further when the DLR assumes a national role in transporting passengers to and from the London 2012 Olympic and Paralympics Games, serving five Olympic venues. Olympic Delivery Authority (ODA)For twenty years, passengers travelling on DLR have been intrigued and puzzled by the unique trait of this network, the absence of explicate number one woods. The entire railway operates as a driverless arranging, carrying more than 200,000 people across East London every weekday. As the check outs appear to stop and start with its own harmony, the operation of the network managed and monitored 24 hour a day, 365 days a year, from the DLR Control Centre. For passenger safety, security and assistance there is a Passenger service Agent (PSA) on every DLR rail off.The DLR is operated through a electronic computerised Automatic operate on schema. Control Room staff has access to a visual overview of the entire DLR network showing on the button where apiece modernise is along the railway at any given time. The benefit of operating a network in this way is incredible. As the dust is controlled automatically it allows DLR to run many more dresss. DLR Light News 2007In the field of Automated bowed stringed instrument Control System it is imperative to know all trains position on the brass for swift and safe operation. On of the common train operating frame was fixed block system, where railway get well atomic number 18 divided in to number of blocks. These blocks only allowed one train to occupy that block. Until that block is clear, it does not permit other train to get in to that plowshargon or track and big gap used to generated mingled with two trains. To operate a numerous train service like DLR, the railway track has to be divided into many short blocks, requiring effectting up and maintenance numerous number of pointling equipment, side track and head shunt. Previously DLR operating system w as run by fixed-blocks system due to short rail way tracks, lack of side tracks and head shunts and more frequent service demand this system was later replaced by SELTRAC a Transmission-Based Automatic Train Control (TBAC) system primed on the Moving Block Principle. SELTRAC is a registered trademark of Alcatel SEL. Alcatel Canada Transport Automation1.1. carryThe sole purpose of this comprehensive study is to go behind the scene of the infrastructure of the Docklands Light Railway operating system and how this transport service has do bitate the Advanced Train Control System technology to operate and transporting thousands of people around its network in a diversely populated city with great magnitude of fast growing economy.2. Comprehensive Literature on Advanced Train Control System(ATCS), Latest System Technology on Train Operation andTop-Level Description of the Docklands Light Railway (DLR)Automatic Train Control (ATC) SystemThe First International conference on Advanced Tr ain Control, which was held in 1991 in Denver, suppliers from different countries of the world attended and demonstrated their technology, products and operating system. Burlington Northern (BN) in conjunction with Rockwell produced the first version of ATCS, known as ARES (Advanced Railroad electronic System), where they developed satellite navigation system for locating trains on the system. They tested this ARES on BNs Iron Range lines in Northern Minnesota with the purpose to blend trains tuition system with primeval commands and control businesss. During year1987 to1993, Canadian National Railways (CN) and Canadian Pacific Rail (CP) made momentous improvements in the development and testing of ATCS. A key component in recuperating safety and productivity of train operations is ATCS technology it provides better communication, more accurate development on train figurehead, train location, roadside interfaces and locomotives condition. Railways atomic number 18 part of a technological rebellion where sophisticated communications equipment and computer systems are in use to control the movement of train. A main new expansion in train operation is entropy transmission, which help the train driver and the control centre staff to pass around learning cipherly, by radio and on-board computer. Edward Furman, Network Management for ATCS Communication System 19912.1 Current Technological Expansions2.2 Advanced Train Control Systems (ATCS)Bombardier in Europe, Railway Association of Canada (RAC) and Ameri thunder mug Association of Railroads (AAR) began to explore the vi baron of a radio- ground control system that would get rid of human error in the field of train operations RAC, AAR, 1984.This development was co funded equally by these companies and several other railway companies, suppliers and consultants from Europe, Canada and the U.S. The main purpose of the project was to develop a modular computer- base train control system that will provide s afe and more proficient railway operation. ATCS is state-of-art technology, where it ensures a safe train operation service, train separation, train verifying, the safety and the reliability of all movement establishment issued to train and maintenance staff, and overly monitoring all equipment status.U.S Department of Transport, An Aid to positive Train Control, June, 1995The main goals of the ATC system are to provide mightiness to implement a system with mechanism from different suppliers, which will reduce problems related to interconnecting and interfacing components from different manufacturers.The ability for each railway to select the capabilities and character it involve to implement. interoperability.System compatibility across the railway to ensure faultless operation and interoperability between different railways.Federal Rail road Administration, 1995The Advanced Train Control Systems 5 major systemsi) Central Dispatch System (CDS) CDS manage the movement of trains al l over the railway networks and ensure safe operation without train delays and it likewise provides automatic train tracking and monitoring, status and control of the train and the field system.ii) The On-Board Locomotive System with two major sub-systemsOn-Board Computer (OBC) OBC provides automatic location tracking and automatic transmission of train movement via the info communication system.On-Board Display Terminal (OBT) On-Board Display Terminal display and provides all the necessary discipline for example certain train invigorate, speed peg downs and restrictions, train location, milepost, track geometry, type of control, track work protection, and status of switches. The display of the study can be presented in text form or in graphical form depending on type of terminals.iii) On-Board Work Vehicle System The on-board terminal allows communication between track maintenance staff, central eat up and vehicles operator via data communications system.iv) Field System roadside Interface Units (WIU) are essential equipments in the field system, which provide monitoring and control of wayside wiles for example switches, interlocking, hot-bearing detector and train defect detectors.v) Data Communication System DCS gather the various data processing systems collectively and considerably reduce juncture communications.George Achakji, March, 19922.3 Data Communication SystemData Communications System is based on 5 take aims of selective information dispensationi) Continental take aim Continental level provides the functions that are obligatory for inter-railway operations. For example, transferring waybill.ii) Railway level Railway level provides the functions which are compulsory for train operations and also for non vital instruction of train operations.iii) Regional level Regional level provides operations across dispatch regions, from one dispatch centre to another.iv) Dispatch level Dispatch level is a central control function for train con trol. It can turn over with vital or non-vital information and it is also necessitate for this level to communicating of vital information to and from trains, track forces, switches, and other wayside equipments.v) Wayside/mobile level Wayside/mobile level provides both vital and non-vital processing of locomotive data, track units, and wayside devices and communications information between trains, wayside and track forces.George Achakji, Advanced railroad Electronic system, January, 19912.4 Advanced Railroad Electronics System (ARES)The exertion on ARES began in 1984, when The Rockwell International and The Burlington Northern (BN) began to study new technologies that provide automatic appointment of train speed and position. Initial tests conducted by The Rockwell International and they demonstrated that GPS could success richly track moving trains. ARES is an integrated command, control, communications, and information system which applies modern avionics technology to railway operations. Its design objectives were similar to those of ATCS, for example, safety and the efficiency of railway operations. In year of 1985, these two companies started to develop a figure system to determine the production feasibility of this conception. In the year of 1987, Burlington Northern starts their expedition with 17 locomotives, 8 switchers with ARES hardware and GPS receivers, 50 WIU (wayside interface units), two high-rail trains with GPS system on the Mesabi Iron Range 230 mile test track in Northern Minnesota. Their prototypes testing began in parallel with the existing control system in 1988 and lasted for four year and the company (BN) reported that good results were obtained. George Achakji, Advance Railroad Electronic System January 1991Advanced Railroad Electronics Systems are consists of the pursuit integrated sub-systems I) data management ii) rail operations control iii) locomotive analysis and reporting IV) on-board display v) energy management and VI) wayside interface. The ARES also has the capabilities for advanced traffic arrangement. The system provides direct dispatcher intervention in hazardous traffic situations, i.e., stopping the train by remote intervention switch which can be easily activated from the central dispatch chest of drawers.During the testing period ARES BN and Rockwell had some problem use GPS to achieve high accuracy of train position on parallel track. In an driving force to correct the problem of parallel track, BN and Rockwell explored the possible use of real-time differential GPS in terminals and also used others methods to provide more accurate positioning inputs, for example, using transponders for trains approaching switches and sidings.George Achakji, Advanced railroad Electronic system, ARES, January, 19912.5 additive Train Control System (ITCS)On of the vital communications-based train control system is Incremental Train Control System (ITCS) where the system utilize digital data link betwee n the wayside and on-board train location system and it also execute the urgency for traffic control functions. The ITCS provides enforcement of signal indications, speed limits, temporary speed restrictions, and advanced start of crossing signals. This system is developed by Harmon Industry for Amtrak in Michigan. Peter Winter, ETCS system, 1995The Incremental Train Control System consists of 3 main sectionsi) The locomotive equipment This locomotive equipment consists of On-Board Computer (OBC), display screen, GPS receiver and mobile communication package.ii) The wayside equipment This wayside equipment consists of Wayside Interface Units (WIU) and Wayside Interface Unit-servers (WIU-S) (WIU-S are the interface with the signal system), crossing signals and defect detectors.iii) The communications network This network consists of wayside local area networks (WLAN). This also use spread range radio, so it can link WIU with WIU-servers and radio frequency (RF) networks in the UHF range to link WIU-s with On-Board Computer.Incremental Train Control System is supplemented by ATC or automatic train stop systems. During its normal train operation, the train driver are accountable for observing each signal feature and control the train accordingly the speed limits and restrictions and also stop the train where a stop is necessary. ITCS is responsible for monitoring the signal system and ensure that the train is properly controlled with the speed limits, speed restrictions, and stopping, not maintain these parameters in that case ITCS will automatically apply the breaks to stop the train.Christian Tietze, ICEs On-Board Train Control and nosology System, 1994Incremental Train Control System is also known as a distributed control system, not like the ATCS architecture which is a central control system. The On-Board Computer (OBC) store the data from signal indications, track curvature, speed limits, mileposts, speed restrictions, and the locations of all the device s which are needed to communicate with the train. The OBC is also works on the train status report with the help of wayside devices. If three status reports are missed, the OBC will automatically apply the train brakes.The OBC monitors the location of the train with the help of GPS data and compared the track data base. aft(prenominal) receiving a signal indicator it determines the appropriate speed of that track. The OBC also calculates a braking outline for the train and display the necessary information on the display screen. In the forces of track crossing the OBC will calculate and issue a time to crossing (TTC) to the wayside interface units (WIU). The WIU will contemporize train start timer with the OBC and will confirm that start time.If the train speed exceeds the initial speed, the OBC will calculate and issue a new TTC to the WIU. If the OBC soothe cannot receive any confirmation that the crossing timer has been began with the correct value, in that case it will demand that train speed to be reduced. In the event of private crossings, the OBC will observe the status and monition system through update messages from the Wayside Interface Units-Server (WIU-S). If the OBC does not receive a message indicating the warning sign is active, in that case train speed will be reduced. Most of the operation manual of ITCS is very close to a conventional ATC. Christian Tietze, ICEs On-Board Train Control and nosology System, 19942.6 Positive Train Separation (PTS) SystemThe Positive Train Separation (PTS) System is a non-vital safety overlay system. PTS functions in combine with the active operation methods, signal and train control system. This PTS system was first designed for the Union Pacific/Burlington Northern Santa Fe (UP/BNSF) Railroads and state of Washington to Portland operating theater railroads. The PTS system is measured as an add-on system that enhances safety by protecting against all human errors.PTS system is centrally controlled communi cations-based system, which takes control of movement ability and speed limits of the outfit trains. It is also translucent to the train driver as long as the train is operated according to its movement ability and speed requirement. It will become apparent if the train attempt to exceed its speed limit and movement authority, PTS will issue a warning sound alarm to the train driver and the brakes will be applied if the train driver does not brought the train under control immediately.Ted Giros, Amtrak Tests Cab Signalling, July 1996The PTS system consists of 3 undermentioned segmentsI) The server This segment confirm the enforceable movement authority and speed limit, trains identification, destination for each train under the PTS control and digitally transmit this information with the help of communication network to the locomotive segment of each equipped train. It also monitors all train movements to prevent conflict.ii) Locomotive This segment is consists of an On-Board Comp uter (OBC) and a location determination System (LDS), a mobile radio and a display unit, where train staff can receive textual information. The OBC calculates and constantly updates information about authority limits and speed limits and applies breaks if the authority limits are exceeded. It also calculates the distance required to stop the train.iii) The Communication Segment Communication segment gather and transmit all information with high reliability between the server and locomotive during the train operations.Railway Age, May 19972.6.1 Positive Train Control (PTC) SystemPTS is also a centrally controlled communications-based system. Its software is written in conformance with ATCS stipulation. The purpose of the PTC design is the removal of wayside block signal systems and the management train movements, for example speed enforcement, enforcement of limits of the authority, protection of maintenance-of-way employees and work vehicles and also monitoring of highway-rail grade crossing.W Moore Ede, Communications-Based Train Control, May 1997The Positive Train Control system has 3 main sectionsI) Office Equipment The office equipments are consists of Computer-Aided Dispatching System (CAD), PTC Interface Computer (IC) and a protocol converter to interface with CAD, IC and data communication system.ii) The Data Communications System This system is consists of 3 interconnected networks a) Ground Network b) Radio Frequency link Network c) User NetworkThe ground network is consist of cluster controller(CC), base communications package(BCP), message processing nodes, microwave channels, telephone circuits, fibre-optic links and modem to connect the nodes.The Radio Frequency (RF) link is consists of base, mobile radio and radio communication channels.The User Network is consists of all application software within each field device.iii) The Field Equipments The field equipment is consists of mobile communication packages (MCPS), locomotives and wayside interfac e units (WIU). During an mite brake application in normal routing operations, the system automatically transmits an emergency message that will invalidate the limits of authority of the other trains in the surrounding area. The PTC system carries out safety critical data through digital data communication system between Interface Computer (IC) and it self for the train locations, trains planned time and devices for highway-rail grade crossing. In PTC the higher priority data message is an emergency message which occurs due to trains emergency brake application. The PTC system has designed in such a way where failure of an emergency data message will not create any unsafe condition. Railway Age, Washington may 1997PTC also uses transponders in the following critical areas a) during approaching to PTC-equipped territory, b) during the entrance of PTC territory and c) during approach to a controlled point within PTC territory. This transponder provides exact train location and routin g determination. When an equipped train passes the transponders to move towards PTC-equipped territory, the system initialize the On-Board Computer (OBC) and set the tachometer to zero for location determination. The equipped train does not enter in to the PTC territory if the OBC cannot be initialized. R Lindsey, Communication- Based train Management, May 19972.7 European Train Control System (ETCS)The European Union (EU) has adapted a railway network system to conquer the major problems in the field of technical operating system, multiplicity of signalling and train control systems. In 1991 nine foremost European railway companies of the signalling industry reached an arrangement with EU to develop a new train control system, which is now known as European train Control System (ETCS). ETCS has the ability to perform in combination with all the existing tracks and wayside equipment under the train protection and train control systems. R. Ford, 1996The ETCS is designed to congrega te wide series of running(a) requirements. The capability of ETCS are provided in three levelsa) Level 1 The new ETCS interfaces can meet the terms with the existing system. ETCS can also provide a basic Automatic Train Protection (ATP) capability combination with the conventional wayside signals.B) Level 2 This level has the option of speed data display for automatic train speed control. New Cab signalling system is also been added up to ATP capability. But still the trains can be driven by wayside signals equipment and it can also determine the train location with help of tracks fixed equipments and track circuits.c) Level 3 Train location and train lawfulness detection can be utilize with the help of transponders on the track (same as in ATCS). This system eliminates the need of track circuits and other detection techniques. In this level, the system incessantly provides an update of train location and also transmits the signalling information to all trains to ensure a safe sep aration. Level 3 ETCS is also undefended of moving block signalling to maximize line capacity. One of the main goals behind the ETCS design is to develop common display units which can be easily understood by the all drivers across the boundaries of different European countries. The ETCS operates frequency range in 900 MHZ using data radio transmission called Euradio. This Euradio transmit encoded data in digital form with vital safety signalling standards. Each operational train does constant radio contact with a central computer. This central computer is responsible for controlling the trains movement and safe separation. R.Ford, Railway Technology International, 19962.7.1 Train a Grande Vitesse (TGV) Train Control SystemTGV (train grande vitesse) is French high-speed train, which has no wayside signals. SNCF (French National Railways) has determined that for a safe train operation track side signals, cab signalling system and on- board equipment with reliable advance informatio n (road status) are vital to the operator. These requirements led to the development of an ATC system. There are two generations of ATC systems are in use on the TGV network system. Both these systems are significant for dogging link between the train and the track. George Achakji, TGV System Development, 1992TVM 300 is the first generation TVM. This TVM uses wired logic and has the following performance levels at speed of 270 km/h with 5 min headway on the SE Line (in 1981) and at speed of 300 km/h with 4 min headway on the Atlantic Line (in 1989). George Achakji, TGV System Development, 1992TVM 430 is the second generation TVM This TVM is a fully-digitized system and it also design to companionable with all versions ground equipment. The TVM 430 is designed to have the following performance levels at speed of 320 km/h with 3 min headway on the North Line and a mixed traffic with 2.5 min headway in the Channel Link which connects Paris -London-Brussels operation route. The TVM 430 based on a real-time, fault-tolerant architecture. To establish the safety requirements and all other techniques are based either on the intrinsic features of certain components, or on hardware or functional dismissal. George Achakji, TGV System Development, 1992The TGV has an on-board data transmission network called TORNAD. It has the facility to communicate between 18 computers (single-unit) and 36 multi-unit computers. The TORNAD has the following main functions controlling, monitoring, and regulating of equipment and carrying out the information exchanges for operation and maintenance. George Achakji, TGV System Development, 1992TGV has built with an automatic braking system. It stops the train when the driver exceeds the speed limit. During operation period, the brakes are monitored in the region of once a minute, and their status is indicated to the train drivers OBC screen. If the train driver exceeds the maximum speed limit which is permitted by the system, than the automa tic train stop system instigate an emergency braking action George Achakji, TGV System Development, 19922.7.2 Advanced Control SystemAdvance control system for train communication is an incorporated command, control and communication system. It is also known as ASTREE system. It was developed by the Socit National des Chemins de Fer (SNCF), for train operations and for the railway network management. The ASTREE system offers computerized real-time control of train movement, with the help of radio telephone communication between a central control and onboard microprocessors. This system provides train position and location modification, ground-train transmission (known as data and voice transmission), switch control, monitoring and interlocking, automatic vehicle identification, train consist acquisition, and train integrity checking.36ASTREE system does not put any strong command for safety requested from the communications mechanism because in this system every train is equipped wi th location and communication capability equipment. During the train operation the trains location can be adjust with passive microwave tags (same as the ATCS track transponders, SNCF has new identification tags, capability to read train speed at 400km/h) through an on-board interrogator and the train constantly knows its own position and speed limit according to authority restrictions.George Achakji, High-Speed Train, TGV system Development, March 1992.2.7.3 German InterCity Express (ICE) SystemThe German InterCity Express (ICE) System is one of the state of-art train operation system set with locomotive at each train coaches. This system implements a sophisticated integrated data transmission system network, which imposes with traction control and also interacts with the each coaches control system. ICE System network uses fibre-optic cable to transmit data for trains diagnostic systems, real-time processing, and block maintenance and also for on-board passenger information and am usement. Using of fibre-optic is the best method for train-bus communication, because it is technically more effective and much more economical. Christian Tietze, ICEs Onboard Train Control and Diagnostics System, 1994ICEs electronic control and watch devices are divided into 4 subsystem levelsI) Train operation level Train engineers inputs resolute command during train operation from Automatic Train Control (ATC) wayside and Automatic Train Protection ATP) devices.ii) Train control level This level handles trains automatic driving and braking and traction effort with the help of closed-loop control.iii) Vehicle control level The vehicle control level has resulting redundancy for the train bus fibre-optic interface and the train control, for example, power car (locomotive) and the train coach. Central diagnosis device on the locomotive called the David monitors and stores all functions and malfunctions. It also checks trains equipment at the beginning of operation. The train contro ller unit on the trailer coaches called the Zeus. Zeus controls diagnosis and co-ordinates functions for each car. After receiving data from the train levels, it distributes this information to the subsystem level.iii) Subsystem level The subsystem level includes propulsion control, brake control, auxiliary control, door control, and air conditioning control devices of the train.Christian Tietze, ICEs Onboard Train Control and Diagnostics System, 19942.8 Intermittent Cab Signalling (ICS)Cab signalling technology has been available and in use for many years. In 1979 it was first established on the Swedish State Railway (SJ X2000) for high-speed train operations. Its function has been proven both in European and North American railways. In the recent years, supplementary developments were undertaken by various railway companies. In U.S.A, Amtrak has tested an intermittent cab signalling system for the future advanced civil speed enforcement system (ACSES). In their signalling design, the system can operates independently and it can also be integrated with existing train control systems. It has the capabilities for enforcement of train speed limits and the automatic stop command by applying the trains breaking system (calculates and compares by trains on-board computer). This system also uses separate passive radio frequency transponders to provide the required data to a passing train. Ted Giras, Amtrak Tests Cab Signalling, July 19962.9 Docklands Light Railway (DLR) System OverviewThe Dockland light Railway (DLR) system outline is shown in Figure 1-1. The system comprises existing connection from Bank (BAN) to Canary Wharf (CAW), Tower Gateway (TOG), Stratford (STR) and Lewisham (LEW), Beckton (BEC), as well as a new line to the King George V (KGV) station. This automated system consists of approximately 27 km of double track, except between station Bowchurch (BOC) and Stratford, where section of single track exist. There are two manual deports, which are locat ed at Poplar (POP) and Beckton (BEC).Alcatel Canada provided SELTRAC system, a transmission based signalling system for DLR.Conventional signalling follows the fixed block principle, where tracks are divided into section (blocks) of a prearranged length. A train is only authorized to carry on into a block when that block and the next are clear of traffic. To achieve the closer headway and system flexibility demanded by urban transit, shorter and more numerous blocks are needed in affixed block system.An adaptation of the system known as SELTRAC was developed and implemented by SELC. The technology was expanded to permit fully driverless operation in high capacity (i.e. passenger) application for the cities of Vancouver, Toronto and Detroit for Light rapid transit systems. Over the years these systems have demonstrated high availability and topping operating flexibility. SELTRAC has provided several operation modes including fully automatic known as Automatic train Operation Functio n (driverless) and Automatic Train Protection function (ATP) Manual.SELTRAC is based on the moving block principle, in which the safe separation behind the proceeding train is dynamically calculated based on the actual operating speeds, breaking curves and locations of the trains on guide way. This dynamic method allows shorter headways to be achieved without impinging on safety principles.With the SELTRAC system, all DLR Automatic Train Operation (ATO), Automatic Train Protection (ATP), and Automatic Train Supervision (ATS) function are performed with a minimum of wayside hardware. Checked-redundant centralised computers are in continues cyclic nonpartisan communication with vehicle-borne, checked-redundant microprocessor control component.DLR major departure from conventional signalling is the centralisation of route

South African Public Hospitals Health And Social Care Essay

conspiracy Afri house Public Hospitals heartyness And Social C ar EssayThe words crisis and wellness sustainment follow each other in sentences so often in South Africa that most citizens have grown numb to the association. Clinicians, wellness managers and public health experts have been talking about a crisis in access to health vexation for more than half a century, and the advent of democracy has not jutting the situation.South Africas inability to adequately respond to its many crises is also the result of a national healthc atomic number 18 system designed to provide treatment rather than prevention. The oer-dependence on hospital-based c atomic number 18 in South Africa not only makes the healthc ar system pricey and inefficient, yet also precludes more-needed investments in primary and preventative handle. Health minister Dr Aaron Motsoaledi honestly conceded that the public health system faces very serious ch each(prenominal)enges(Philip 2009).In this review I de scribe the crisis in childcare and its consequences for the health of children, qualify the underlying reasons for the crisis, examine current interventions and explore some medium and longer term solutions.How severe is the crisis?It is not surprising that the publics perception of health serve are often determined by stories about the care offered to children move all overed in the media. For instance, in one week in May 2010, two stories dominated immaturespaper and media headlines in Gauteng. One was the death of seven newborn infants and the infection of 16 others as a result of a virulent infection (subsequently identified as a norovirus) acquired by the infants at the Charlotte Maxexe Johannesburg Academic Hospital. At Natalspruit Hospital in Ekhuruleni, 10 children sympatheticly succumbed to a nosocomial (hospital acquired) infection (Bodibe 2010).These types of events, with large flecks of children acquiring infections in hospitals are not uncommon, although only a f raction grabs the headlines. Outbreaks occur at regular intervals at hospitals throughout the outlandish. An outbreak of Klebsiella infection was responsible for 110 babies last at Mahatma Gandhi Hospital in Durban, according to the organisation Voice that threatened a class action case against the Department of Health. The national health subdivision itself has identified infection supremacy as one of six key areas that needed improvement in the public health sector (Department of Health 2010). curt health care at several(prenominal) Eastern Cape hospitals left more than 140 children dead in one of South Africas patheticest districts within the low three months of 2008 (Thom 2008). A toil team investigating these deaths in the Ukhahlamba district concluded that they were not the result to any particular disease outbreak or exposure to contaminated water as initially suspected, but rather that the health dish available was hopelessly defective. (Report on childhood deaths, Ukhahlamba District, Eastern Cape)The Ukhahlamba line of work team, comprising of three experienced public sector paediatricians, painted a grim picture of Empilisweni Hospital childrens shield where most of the deaths occurred. Problems identified includedThe structure and layout of the physiological facility was inappropriate no nurses station or work surfaces, no separation of clean and dirty areas and no play or stimulation facilities,The ward and cubicles were overcrowded and no provision existed for lodger mothers, who paid R30 to sleep on the floor following to their children,There were grossly inadequate service no oxygen and suction points, too few electrical sockets, no basins or showers and too few toilets in the persevering ablutions, and an unacceptable ward kitchen,Extremely hold clinical equipment,Staffing deployment and revolution did not promote effective care, with few nurses dedicated to the childrens ward and doctors changing wards every two months, leav ing the ward devoid of experienced someonenel,There were limited policy documents and no protocols or access to appropriate clinical reference material or guidelines,Clinical practices were ineffective or dangerous, particularly regarding infection control and the preparation and distribution of infant feeds and medicines,Not a single hospital record included details about the prescribing or administration of infant feeds. liquified management was badly documented. Three of the children appeared to have died from fluid overload due to inappropriate and unregulated fluid administration,The majority of the children were never weighed, their nutritional status was not assessed nor their HIV status established.The task teams audit of 45 of the deaths revealed that most of the deaths occurred within the first 48 hours of admission to hospital and were in infants who were self-referred. The dominant diagnoses were diarrhoeal disease, pneumonia and malnutrition. The task team concluded t hat These deaths are more likely the result of poor care of a vulnerable impoverished community with high rates of malnutrition among the infants and poor utilisation of the available health services.The pathetic situation described at Empilisweni Hospital is not unique and similar abject conditions can be make at many of the paediatric wards at the 401 hospitals in the country. While objective evidence to support this contention does not exist, paediatric practitioners in many provinces and settings would quick acknowledge the veracity of the claim.The explanation offered by different investigations of adverse events occurring at public hospitals countrywide is remarkably similar. Uniformly, there is a combination of overcrowded wards, under catering, overwhelming workloads, a breakdown of hygiene and infection control procedures, and management mischance with a lack of auditing or monitoring systems to identify and respond to problems at an earlier stage. change magnitude child deathrateWhat is not contentious is that South Africa is one of only 12 countries where childhood mortality increased from 1990 to 2006 (Childrens Institute 2010), with a doubling of deaths in children under the age of five years in this period (from approximately 56 to 100 deaths per 1000 live births). The 2010 UNICEF State of the Worlds Children estimates South Africas under 5 death rate to be 67 per 1000 for 2008 (UNICEF 2009). This high rate ranks South Africa 141st out of 193 countries. The national statistic also hides marked inter bucolic variations from about 39 per 1 000 in the Western Cape to 111 per 1 000 in the Free State (McKerrow 2010). A single disease HIV- is largely responsible for the increased mortality.Countries with a similar economic profile (Gross National Income GNI) as South Africa such(prenominal)(prenominal) as Brazil and Turkey boast about quaternion-fold lower under 5 mortality rates (U5MR). South Africas high U5MR is even more disconcerting when co mpared to poorer countries such as Sri Lanka and Vietnam. These two countries U5MRs are roughly five times lower (15 and 14 per 1,000 respectively) despite having a GNI less than one half to a deuce-ace of South Africas (UNICEF 2009, World Bank 2010). disdain being classified as a high middle income country, South Africa has high levels of infectious diseases such as diarrhoea, pneumonia, HIV, tuberculosis and parasitic infections normally found in poorer countries. Similarly, there has been little succeeder in reducing undernutrition in children a quarter of South Africas children are stunted (short). Further, as a result of increased urbanisation and economic development, the country is also experiencing increasing levels of traumatic injuries and chronic diseases of lifestyle such as obesity, diabetes and cardiovascular disease that are more typical of better resourced countries. These diseases mainly shanghai adult populations but are increasingly being identified in childre n.The worsening in child health has occurred despite significant improvement in childrens access to water, sanitation and primary health services. near 3000 new clinics have been built or upgraded since 1994, health care is provided for free to children under 5 years and pregnant women (Saloojee 2005), and the child social support grant is reaching 10.5 jillion children (more than half of all children in the country) (Dlamini 2011). These achievements have been marred by several shortcomings. many new clinics and the district health systems are not yet adequately functional because of a lack of personnel and finances, poor administration, and expanding demands. Public ordinal health care (academic hospital) services have severely eroded.Characterising the crisisThe World Health Organization, in 2000, ranked South Africas health care system as the 57th highest in cost, 73rd in responsiveness, 175th in overall performance, and 182nd by overall level of health (out of 191 member nat ions included in the study) (World Health Organization 2000). What explains this dismal rating? Despite high national expenditure on health, inequalities in health spending, inefficiencies in the health system and a lack of leadership and accountability contribute to South Africas poor child health outcomes.Hospitals operate within a nonadaptive health systemPoor hospital care is but one mark of a dysfunctional health system that comprises blotches of independent services rather than a coherent, co-operative approach to delivering health care. just about primary health care services for children are only offered during office hours, with some clinics restricting new patients access to services by early afternoon a waste of available and expensive human resources. Some clinics lack basic diagnostic tests and medication. Consequently, many hospital emergency rooms are flooded with children with relatively minor ailments because their caregivers choose not to queue for hours at poorl y managed local clinics, or prefer accessing health services after returning from work.The referral system in which patients are referred from clinics to district, regional or tertiary hospitals according to how serious their health problems are has disintegrated in many parts of the country. Children who require more specialised care often cannot get it every because they get stuck within a dysfunctional system or because there is no space for them at the next level of care. Transport to secondary and tertiary level hospitals is problematic, resulting in delays or non-arrival, increasing the severity of the disease and treatment be when the child does arrive.District hospital services are the most dysfunctional (Coovadia 2009), with patients often by-passing this level of care in settings where access to secondary (regional) or tertiary care (specialist) services are available. Despite cut-backs in reckons, tertiary care settings continue to attempt to provide first-class service s, which although commendable, may result in over-investigation and treatment, and denial of essential care to children who reside outside their immediate catchment areas (because the hospital is full). changing health environmentSome of the increasing stress faced by the public hospitals may be attributed to the changing health environment in which they operate. twain factors are most responsible for the change rapid urbanisation and the back up epidemic. Urban, township hospitals are particularly affected by the burden of increased patient loads, and barely coping with the demand.Although a national strategic plan for HIV/AIDS exists, the ability to use the plan is constrained by the enormous demands on human and fiscal resources demanded for its implementation. The budget allocated to HIV/AIDS has increased from R4.3 billion in 2008 to an estimated R11.4 billion in 2010 (13% of the total health budget) (Mukotsanjera 2009). New initiatives aimed at fortify the HIV/AIDS respons e, include a national HIV counselling and testing campaign and the decentralization of antiretroviral treatment from hospitals to clinics with nurses now providing the drugs. About a third of children at most South African hospitals are HIV infected. HIV-positive children are hospitalised more frequently than HIV-negative children (17% compared to 4.7% hospitalised in the 12 months prior to the study) (Shisana 2010). Children with AIDS tend to be sicker and often require longer admissions despite suffering from the kindred spectrum of illnesses as ordinary children.Greater numbers of patients, higher disease acuity levels and complications, and slower convalescence rates all impact on limited resources. High mortality rates take an emotional toll on doctors and nurses. Hospital paediatrics, which has always been a popular and rewarding choice for newly qualified doctors because of modern medicines ability to quickly restore desperately ill children to health has now become much mo re about chronic care delivery because of the high number of HIV infected children in the wards, many of whom are re-admitted regularly because of recurrent infections. In recent years, young doctors have been dissuaded from selecting primary care disciplines, such as paediatrics, and have moved instead to pursuing specialities where contact with patients is limited, such as radiology, for affright of acquiring HIV from work-related accidents such as needle-stick injuries. The availability of highly active antiretroviral therapy to increasing number of children nationally, though still limited to fewer than half of all eligible children, has the potential to return paediatrics to its previous status as a rewarding and fulfilling specialty.InequityInequities and inequalities abound in South African health care spending generally, and specifically regarding childrens health. Of the R192 billion pass on health care in 2008/09, 58% was pass in the underground sector (Day 2010). Alth ough this sector only provides care to an estimated 15% of children, two-thirds of the countrys paediatricians service their needs (Colleges of Medicine of South Africa 2009). Furthermore, of the R90 billion provincial public health sector budget, about 14% is exhausted on central (tertiary) hospital services (Day 2010), which primarily benefits children residing in urban settings and wealthier provinces such as the Western Cape and Gauteng. Similarly, marked inequities exist in the number of health professionals available to children in different provinces with, for grammatical case, one paediatrician servicing approximately 8,600 children in the Western Cape, but 200,000 children in Limpopo (Colleges of Medicine of South Africa 2009). This differential exists among most categories of health professionals.The current health system claims to provide universal coverage to children. Yet, from a resourcing, service delivery and quality perspective, the availability and level of serv ice is inequitable with many patients and communities experiencing substantial difficulty in accessing the public health system. Rural and black communities remain most disadvantaged.Apartheid age differentials continue in present day health care. Thus, for instance, while the formerly whites only Charlotte Maxexe Johannesburg Academic Hospital now mainly serves a black urban population, its resources including ward facilities, staff-patient ratios and overall budget still show a clear positive bias when compared to the resources available to the Chris Hani Baragwanath Hospital located in Soweto (a former black hospital) (von Holdt 2007). Nationally, the most stressed hospitals are those with the lowest resources per bed. The least(prenominal) stressed hospitals continue to be those with previous reputations as high-quality institutions (mostly previously whites only hospitals) that provide them with a kind of social capital (von Holdt 2007). wariness capacity crisisThe battle for the control of hospitalsSouth Africa has embraced the concept of health services delivered within a three-tiered national health system framework national, provincial and district. Provinces are charged with the responsibility of providing secondary or tertiary hospital services, with district services having responsibility for district hospitals and clinics. Existing legislature allows hospital chief executive officers (CEOs) considerable powers in the running of their own hospitals.However, there is a dysfunctional relationship amid hospitals and provincial head offices, which often assume authoritarian and bureaucratic control over strategic, operational and detailed processes at hospitals but are unable to deliver on these. There is a blurred and ambiguous venue of power and decision-making authority between hospitals and head offices (von Holdt 2007). Hospital managers are disempowered, cannot take full accountability for their institutions and are mostly unable to decide on matters such as staff numbers and appointments, drawing up their own budgets or playing any role in the procurement of goods and services.The structural relationship between province and institution is a disincentive for managerial innovation, giving rise to a hospital management culture in which administration of rules and regulations is more definitive than managing people and operations or solving problems, and where incompetence is intimately tolerated. Hospital managers lack of control undermines management accountability and promotes subservience to the central authority. The role of provincial health departments should really be about controlling policy regarding training, job grading and accountability.Silos of managementMost South African hospitals have essentially the same management structure where authority is fragmented into separate and parallel silos. Thus, doctors are managed within a silo of clinicians, nurses within a nursing silo, and support staff by a mesh of separate silos for cleaners, porters, clerks, etc. The senior managers in the institutions have wide spheres of responsibility but with little authority to make decisions or implement them (von Holdt 2007).As an example, a clinical department such as paediatrics is headed by a senior or principal paediatric specialist who has no control over the nurses in the paediatric department. In the wards, nursing managers are responsible for effective ward functioning, but have little control over ward support staff such as cleaners or clerks. A senior clinical executive (superintendent) has responsibility for the paediatric (and other) departments, but can exercise little substantial authority over it because power lies within each of the silos (doctors, nurses, support workers). As a result, the clinical executive has to attempt to carry off with all parties.Doctors and nurses do not determine budgets, or monitor and control costs. In essence, those responsible for using resources have no influence on their budgetary allocation, while those responsible for the budget assume no responsibility for the services that the budget supports. Most clinical heads have no idea what their budgets are and costs are not disaggregated within the institution to individual units or wards.Thus, what should be managed as an integrated operational unit (for example, a ward or clinical department) operates instead in a fragmented fashion with little clear accountability. In this circumstance all parties are disempowered, and relationships oscillate between diplomacy, persuasion, negotiation, angry confrontation, heraldic dealing and withdrawal. In the process few problems are definitively resolved, with negative consequences for patient care. Where institutional stress is high, the fragmented silo structures generate the fault lines along which conflict and managerial failure manifest (von Holdt 2007).Financial crisisInsufficient expenditure on health, hospitals and child healthBetwee n 1998 and 2006, South African annual public per capita health expenditure remained nigh constant in real terms (i.e. accounting for inflation), although spendingin the public sector increased by 16.7% annually between 2006 and 2009 (National Treasury 2009). Nevertheless, the smooth increases in expenditure have not kept pace with population growth, or the greatly increased burden of disease (Cullinan 2009). In 2009 the country spent 8.9% of the gross national product (GDP) on health (Day 2010), and easily met the World Health Organisations (WHO) informal recommendation that so-called developing countries spend at least 5% of their GDP on health (World Health Organization 2003). However only 3.7% of GDP was spent in the public sector, with 5.2% of GDP expended in the private sector (Day 2010). In per capita terms R9605 was spent per private medical scheme beneficiary in 2009, while the public sector spent R2206 per uninsured person (Day 2010).Although the health of mothers and chi ldren has been a priority in giving medication policy since 1994, including in the latest 10 Point Plan for Health (Department of Health 2010), it has not translated into movements in fiscal and resource allocation. Children comprise nearly 40% of the population (Statistics South Africa 2009), but it is unlikely that a similar proportion of the health budget is spent on child health. No reliable data exist, as government departmental budgets do not specifically delineate expenditure on children, easily allowing this constituency to be short-changed or cut.Poor fiscal disciplineA lack of accountability extends throughout the health service, and includes the lack of fiscal discipline. Provincial departments of health collectively overspent their budgets by more than R7.5bn in 2009/10 (Engelbrecht 2010). Provincial departments frequently fail to budget adequately, resulting in the freezing of posts and the restriction of basic service provision (e.g. act child immunisation services were seriously disrupted in the Free State province in 2009 Kok D 2009). Every year, budgetary indiscipline results in critical shortages of drugs, food supplies and equipment in many provinces, particularly during the last financial quarter from January to March, and during April when new budgetary allocations are being released.Stock-outs of pharmaceutical agents, medical supplies such as disinfectants or gloves or radiological material, and food or infant formula, may annoy staff but may have devastating consequences for patients, including death. Most of these stock-outs are the result of suppliers terminating contracts because of failure of defrayment of accounts. In Gauteng, medical suppliers are currently owed more than half a billion rand by the Auckland Park medical exam Supplies Depot, the central unit from which medicines are distributed to provincial hospitals and clinics. The largest amounts owed by the depot are to two pharmaceutical companies (some R130 million) (Bat eman 2011).A recent embarrassing occurrence is the return of R813 million to Treasury at the end of the past financial year by the health department because of unspent funds (Bateman 2011). Most of the money was budgeted to revive collapsed and plain infrastructure at hospitals. This function belongs to the Department of Public Works, and hospitals have little influence on the functioning of this separate department a further example of fragmented services. Treasury has nevertheless allocated funds for the revival or construction of five academic hospitals by 2015, mainly through public private partnerships. These are Chris Hani Baragwanath in Soweto, Dr George Mukhari in Pretoria, King Edward VIII in Durban and Nelson Mandela in Mthatha, as well as a new tertiary hospital for Limpopo.Provincial health departments are beginning to show modest success in rooting out fraud and corruption, but their efforts have revealed widespread swindling costing tax reconcileers billions of rands , much of it late systemic (Bateman 2011). The bulk of endemic corruption involves dishonest service providers with links to key health department officials, looting via ghost and treble payments loaded onto payment systems. In the Eastern Cape an external audit of anomalies in four health department supplier databases revealed R35 million in duplicate or multiple payments in 2010 (Bateman 2011). Some 107 suppliers had the same bank account number, 4 496 had the same animal(prenominal) address and 165 suppliers shared the same telephone number. Less advanced fraud involved the bribing of district ambulance service directors to transport private patients.Theft of equipment, medication and food is pervasive, aggravating existing bottlenecks in supply chain management. Almost R120 000 worth of infant formula destined for malnourished babies or infants of HIV-positive mothers was stolen in the Eastern Cape in 2010 for which three foreign national businessmen and four health departmen t officials were arrested. Eight nurses at Mthathas Nelson Mandela Academic Hospital were arrested for allegedly stealing R200 000 worth of medicines (Bateman 2011).In KwaZulu-Natal, a report to the finance portfolio committee revealed 24 high priority cases involving irregularities, supply chain and human resource mismanagement, overtime fraud, corruption, nepotism, misconduct and negligence, amounting to nearly R1 billion. Among others, the former health MEC, Peggy Nkonyeni faced charges of irregular tender awards amounting to several million rands (Bateman 2011).Ten health department officials in Mpumalanga, including its chief financial officer, appeared before a disciplinary tribunal on charges of corruption. Three separate probes unveil massive fraud and corruption in the department, including irregularities with tender procedures and the buying of unnecessary hospital equipment. Perversely, Sibongile Manana, the health MEC, was removed from her post by the provincial Premier , and given the Sports, Recreation, arts and Culture portfolio. The Premier justified this decision by claiming that the reshuffle of his executive council was to rectify instances of mismanagement and wrongdoing uncovered by a series of rhetorical audits (Bateman 2011).Human resources crisisStaff shortagesStaff shortages are a critical problem in most public hospitals, and are the result of underfunding as well as a national shortage of professional skills. Almost 43 % of health posts in the public sector countrywide are vacant, and more concerning appear to be increasing (up from 33% in 2009 and 27% in 2005) (Lloyd 2010). Some institutions are running with less than half the staff they need, with more than two-thirds of professional nurse posts and over 80% of medical practitioner posts in Limpopo unfilled (Lloyd 2010). Shortages of support workers such as cleaners and porters exacerbate the problem, since nurses and doctors end up performing unskilled but essential functions.Sh ortages of nurses in particular are generating a healthcare crisis in South African public hospitals (von Holdt 2007). Nurses have a wide scope of practice, and bear the brunt of increased patient-loads, staff shortages and management failures. Ironically, a number of nursing colleges were closed down in the late 1990s as part of governments cost-cutting measures while government made it very difficult for foreign doctors to practice in the country. The situation is now being addressed with recognition of the need for both more nurses and doctors to be trained. However, the constricted resources available limit a speedy or meaningful response and considerable investment in new facilities and trainers is required over the next decade to address the current deficit.Throughout the country, doctors and nurses constantly make decisions about which patients to save and which to withhold treatment from based on available staff and physical resources, rather than medical criteria. Because o f the pressure on beds, children are sometimes denied admission to hospitals, not referred appropriately or discharged prematurely, thus facing the danger of deterioration, regress or death.Conditions of serviceUnderstaffing and vacant professional posts and are the result of a number of factors, and vary in different locations. They include failure to establish new posts despite the increased demand for services, frozen posts because of insufficient funding being available and lack of suitably qualified staff. This lack may be because of evoke or push factors. Pull factors attract staff away from the public service and include emigration and movement to the more lucrative private sector. promote factors such as poor salaries, the inability of hospitals to satisfy the simple creature comforts of staff, particularly in rural or township settings, and a dazzling disrespect by hospital administrators of the professional status of staff induce staff to leave the public service. The high death rate of health workers from AIDS has further exacerbated the skills crisis.The Occupational Specific Dispensation was a measure introduced to specifically address the poor salaries paid to nurses and doctors. Although the intervention has been successful in retaining some staff in public sector hospitals and even enticing private sector nurses and doctors back, this financial incentive was insufficient to prevent national strikes by both doctors in 2009 and the full health sector in 2010. Much of the dissent and unhappiness related to conditions of service, rather than the declared dispute about the size of the annual increase of the pay package. The long and bruising six-week strike was a sad indictment of the poor levels of professionalism of health workers, with wards full of newborn and young infants in many hospitals being tumble-down instantly and completely with no interim plans for their feeding or care. This necessitated emergency evacuations or alternative arr angements by practitioners who were willing to place their little patients needs in a higher place those of the strike action, and by concerned members of the public. Undoubtedly, many hundreds of childrens lives were lost during this industrial action but the details of these deaths and any consequent punitive action has been conveniently ignored in an attempt to placate further strike action by the responsible parties.Aberrant staff behaviourAbsenteeism among health workers is rife, even at well run institutions such Durbans Addington Hospital (Cullinan 2006). This is mostly due to stress, but nurses moonlighting in private hospitals to supplement their state salaries is also a factor. At hospitals where management was weak, such as Cecilia Makiwane Hospital in East London or Prince Mshiyeni in Durban, nurses also turned up late, left early, and often neglected patient care such as regular monitoring of vital signs (Cullinan 2006). Hospital managers ability to take disciplinary a ction is severely limited by the centralised record of provincial health bureaucracies. In many provinces, the provincial head of health is the only person able to dismiss staff.Hospitalised children are the most vulnerable, since they cannot demand services or advocate for their own needs. Thus missed feeds, failure to receive prescribed medication timeously or missed doses, inattention to monitoring vital signs and delays in responding to sudden clinical deterioration are daily occurrences in childrens wards countrywide.Service delivery crisisInadequate patient careThere is a crisis of caring at hospital throughout the country. Evidence of poor service delivery at hospitals is disputed, ignored, and mostly tolerated by readily accepting the excuse of low staff morale, staff or resource shortages and no money (Saloojee 2010). The caring ethos that characterises the health profession has eroded to the degree that most patients are grateful for any acts of kindness say to them. Man y patients can recount how their most basic needs, such

Prostitution Should be Legalized :: essays research papers

During the 1700s, New York and Boston women began soliciting their bodies to soldiers stati hotshotd in the large cities. These women were mostly European immigrants who were looking for money to support themselves. Prostitution rose in these cities due to speedy urbanization, and an expansion of the male population.So, you may be thinking, prostitution is illegal and evil, right? Well, you are correct, but in my opinion, only by the standards of which you have been living in, which is that prostitution is illegal, and therefore, risky business.In my hometown of Elko, Nevada, population thirty-five thousand, prostitution is legal. People who hear of this tend to think there are scantily clad women on all(prenominal) street corner. I, however, have never seen a slander, or havent noticed her if I did, because they are only allowed, by law, to do their business in a whorehouse that is in a small section of the town. These brothels are brightly painted, and there are almost n o windows in the building. Unlike prostitution that is run in the cities, brothels in my town are run by a management of three or more people, not one pimp. As the customer gets buzzed in to the building, the management checks his identification to make sure he is at a legal age. The customer can then choose between any of the ladies line up. The prostitute and customer go into a room, and negotiate a price, which is overheard by the management. The amount is anywhere from one hundred to three hundred dollars, the house receiving half. The prostitute receives the other half of the profit. In illegal prostitution, the female usually receives anywhere from six to fifteen percent of the profit off a customer. If she were to make one hundred dollars, she would only get around six to fifteen dollars off it. The pimp would get the rest.Here are another three reasons that prostitution should be legal in the United States. A law was passed in 1986, requiring legal prostitutes to engage in a sexually transmitted disease test any two weeks at the Northeastern Nevada Regional Hospital. If a prostitute is found with a sexually transmitted disease, she is quarantined, until the disease is cured. If the disease cannot be cured, then she is no longer allowed to work, and is put into a home.

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Our tax dollars at work - a Border Patrol Agent at Burger KingPerhaps its a bit radical, perhaps a bit nave, but I believe that the Immigration and Naturalization overhaul and the Border Patrol are institutions which are no longer practical, useful, or necessary in this country. First of all, what are they really accomplishing? The Border Patrol is specifically designed to keep illegal or undocumented aliens from coming into the US. Is it working? Hardly. Oh sure, they catch a few Mexicans running the desert now and then, but the numbers that are apprehended dont come close to the numbers of those that make it through. And what about immigrants from other countries? Are our resources able to track those that fly in or arrive by boat? According to the Arizona Republic article Dying to Work, The INS strategy of blockading popular border routes with high-tech gizmos and nigh 10,000 agents has yet to measurably cut the flow of illegal immigrants. In fact, it is estimated that there co uld be as many as 8 million illegal immigrants in the US today.Would it be so bad to just let them in? Over 1100 Mexican nationals have died since 1997 just trying to get to El Norte. Is property them out really worth all the expense of the Anti-Immigration agencies and the death toll involved? I would like to examine some of the issues believed to be a bother in this situationImmigrants are taking American jobs. While in the case of educated immigrants taking skilled jobs this may be true, the numbers in this situation are very small. In fact, one problem that faces many immigrants coming to this country for work is that skills or certifications that they may have had in their inhabitancy country wont transfer to professional jobs here, or the language barrier prevents them from performing professional jobs. A good example of this is with Seini from Tonga. In her blank space country she was a nurse, but in the US could only be a nurses aide. Her husband Simi went from being a t eacher in Tonga to a warehouse worker. Of more concern to Americans seems to be the throngs of unskilled laborers coming from Third World countries. These immigrants come to the US primarily to seek employment, true, but in general the jobs they take are those that are low paying and undesirable to Americans. In speaking with the owner of Hoe-Down Landscaping Services, I was told that in 8 geezerhood of business he had not had a single white American apply for a job.