Thursday, August 27, 2020

Case senerio pathophysiology Essay Example | Topics and Well Written Essays - 1000 words

Case senerio pathophysiology - Essay Example Iron insufficiency sickliness results from a condition where the patient lose more red platelets more than their bodies would fabricate. Ms. A’s menorrhagia and dysmenorrheal makes her lose noteworthy measure of blood which supersedes the pace of red platelet make and accordingly causing her iron insufficiency paleness. Iron lack sickliness influences ladies more than men and it speaks to the most well-known structure or sort of weakness. This shows Ms. An is inclined to this type of frailty. The pathophysiology of iron lack weakness is portrayed considering the circumstance where the body can't produce enough red platelets in light of inadequacy of iron in the body. The loss of blood by Ms. A during her menorrhagia and dysmenorrheal, causes a huge loss of iron from her body which prompts her frailty. The research center tests additionally demonstrate that Ms. A has underneath typical hematocrit, hemoglobin level and erythrocyte check which further demonstrates that she is in all probability experiencing iron inadequacy paleness. The loss of blood from the body additionally converts into a comparable loss of iron. Ladies who experience overwhelming periods are an expanded danger of iron insufficiency weakness (Bostock 23). This is represented by Ms. ... Ms. An is unfavorably influenced by the absence of adequate oxygen as a result of her dynamic cooperation in golf. This includes a requirement for satisfactory oxygen for metabolic movement. Since Ms. An is having her periods, it is apparent that the loss of abundance blood made her have less iron for the production of hemoglobin which consolidates with oxygen and disseminates it all through the body. Ms. A’s condition is disturbed by the way that the golf competition is done in a higher height level where the measure of oxygen in much lower. This clarifies her side effects, for example, brevity of breath and exhaustion. The exhaustion is brought about by the insufficient metabolic movement in vitality creation which results from absence of adequate oxygen in blood. Consequently considering Ms. A’s side effect, clinical history and research facility tests, it is positive that she is experiencing iron inadequacy frailty and in this manner suitable medicines ought to be b egun. Contextual analysis 2 Making changes in way of life is the best way to deal with care for Mr. P. This is propelled by the way that Mr. P is experiencing issues in holding fast to the endorsed dietary limitations. The adjustments in way of life will be the significant goal for the consideration of this patient. This includes weight control, breaking point of the admission of salt, cholesterol and fat. Also, the consideration for Mr. P will be planned for guaranteeing that the measure of liquids that he takes is controlled and smoking and liquor utilize confined. Patients with side effects of congestive cardiovascular breakdown must be persuaded to make way of life changes which will permit them to decrease the compounding of their conditions (Philippe 252) notwithstanding dietary limitations, patients with CHF side effects

Saturday, August 22, 2020

Free Essays on Echoes From The Macabre

In the story â€Å"Echoes from the Macabre† composed by Daphne Du Maurier, all the characters have fascinating attributes. Out of every one of these characters, there are two that grabbed my attention. These characters are the two twin sisters that Laura met in Venice. She accepts these sisters transformed her. In the absolute starting point of the story, the two sisters appear to be puzzling. Laura and her better half, John sees the sisters gazing at them while they are eating in an eatery. Laura becomes overpowered and tails one of the sisters to the washroom. Laura discovers that one of the sisters is clairvoyant and watches the nearness of their little girl, Christine who has died. She advises Laura that her sister who is visually impaired saw Christine sitting with her and John in the café. She says that Christine is cheerful. After a significant discussion with the sister in the washroom, Laura comes back to her table to meet John and discloses to him the news. Laura is amazingly glad while John communicates sentiments of outrage. He won't accept that something like this is conceivable on the grounds that Christine is dead. They get done with eating and leave the café to go visit the city of Venice. While they are touring, John sees the sisters commonly. He feels like they are being followed. He trusts that Laura doesn't see them. He is disturbed about the thing the sisters said about Christine and thinks that its hard to accept. Laura, then again, has never been more joyful. She thinks about whether Christine is close by each second of the day. The sisters are baffling all through the whole story. The creator never makes reference to any significant insights concerning these characters. These characters are noticeable and help the plot to develop and turn out to be very fascinating all through the story. Without these characters, the story would not be engaging. Toward the finish of the story, nothing is settled with these characters. The peruser isn't sure in the event that they were coming clean about Christine.... Free Essays on Echoes From The Macabre Free Essays on Echoes From The Macabre In the story â€Å"Echoes from the Macabre† composed by Daphne Du Maurier, all the characters have fascinating characteristics. Out of every one of these characters, there are two that got my attention. These characters are the two twin sisters that Laura met in Venice. She accepts these sisters transformed her. In the absolute starting point of the story, the two sisters appear to be secretive. Laura and her better half, John sees the sisters gazing at them while they are eating in an eatery. Laura becomes overpowered and tails one of the sisters to the washroom. Laura discovers that one of the sisters is mystic and watches the nearness of their little girl, Christine who has died. She illuminates Laura that her sister who is visually impaired saw Christine sitting with her and John in the café. She says that Christine is glad. After a significant discussion with the sister in the washroom, Laura comes back to her table to meet John and reveals to him the news. Laura is very glad while John communicates sentiments of outrage. He won't accept that something like this is conceivable in light of the fact that Christine is dead. They get done with eating and leave the eatery to go visit the city of Venice. While they are touring, John sees the sisters ordinarily. He feels like they are being followed. He trusts that Laura doesn't see them. He is disturbed about the thing the sisters said about Christine and thinks that its hard to accept. Laura, then again, has never been more joyful. She thinks about whether Christine is close by each second of the day. The sisters are baffling all through the whole story. The creator never makes reference to any significant insights regarding these characters. These characters are unmistakable and help the plot to develop and turn out to be very intriguing all through the story. Without these characters, the story would not be engaging. Toward the finish of the story, nothing is settled with these characters. The peruser isn't sure in the event that they were coming clean about Christine....

Friday, August 21, 2020

Common App Prompt 2 Essay Samples - What You Need to Know

Common App Prompt 2 Essay Samples - What You Need to KnowWhen looking for Common App Prompt 2 sample essays, it is important to know that each of the five essays will be unique and offer a bit of a different type of format. However, when looking at the samples in relation to a sample Common App Prompt, this could mean several things.First, each prompt may vary slightly from the next in terms of its format and content. While the first Common App Prompt is a test that contains four exams, each of these prompts are formatted differently. For example, the final exam of the first prompt will not have the exact same questions on it as the fourth exam of the first prompt.The most common scenario is that a sample Common App Prompt will have slightly different content for each essay. This may seem a little odd at first, but once you begin to read through them, you will begin to understand how the writing samples and the prompts are formatted to vary slightly.Additionally, each of the samples will be offered in slightly different ways. While some samples will be offered in the exact same manner for each prompt, others will be slightly different in regards to how they are presented to students.While Common App Prompts are typically offered in the same way, one of the most popular samples will not be presented in the same format as other samples of the Common App Prompt. While the sample would be standardized in many ways, the prompt will be slightly different in the format of the question, the formatting used in order to read the response, and even the font that the response is delivered in.Common App Prompt samples can be given in a variety of different ways, which means that there are no two samples that are the same. One of the more popular samples for the Common App Prompt has been published several times throughout the years, so it should be easy to find in numerous places online. The same can be said for the responses that are used as well. Many students will respon d to the same samples by giving entirely new answers for each sample, but the answers that they give may be significantly different than the answers that the student would use if given a different prompt.This makes the Common App Prompt a great choice for a variety of different students in many different schools. The response options are varied enough that every student will find one that he or she enjoys responding to the most.

Monday, May 25, 2020

Covenant Theology The Relationship of the Jewish People...

Covenant theology: The relationship of the Jewish people to God and Israel In the Torah, the bond between Israel and God is negotiated in terms of a covenant, or a legal obligation. The relation of man to the Deity was also conceived of in Biblical times as a covenant concluded by God with certain men or nations, from which all laws derived their sanctity and perpetuity. God, when creating the heavens and the earth, made a covenant with them to observe the rules of day and night (Covenant, 1906, The Jewish Encyclopedia). The original covenant is often called the general, or Noahide covenant between God and humanity. This exists regardless of whether one is a gentile or Jew: Jewish law grants all non-Jews who accept these laws of civilization social and theological rights everywhere, as well as residency rights in a Jewish religious polity (Korn, n.d.). These rules of civilization include just enforcement of social laws; prohibiting blasphemy; not engaging in idolatry; not engaging in immoral sexual behavior; prohibiting murder; prohibiting theft; and not ea ting live animals (Korn, n.d.). However, there is also a special covenant between the Jewish people and God which began with Abraham and Abrahams circumcision and was renewed on Mount Sinai with Moses. Jews are obligated to adhere to the 613 commandments of Mosaic Law to honor this covenant. A covenant implies a two-way exchange in which one person owes obligations to another, based upon his or her reciprocalShow MoreRelatedJudaism and Christianity1462 Words   |  6 Pagespartition, based on different theological doctrines, evolves around the idea of the nature of human relationships with God, which in case of Judaism are based on the Law of Torah, and in Christianity stem from the belief in Jesus Christ and its cornerstone – the doctrine of Trinity. Beyond a doubt, the best illustration to the character of religious beliefs in Judaism, is â€Å"The Covenant at Sinai†, which despite being a part of Holy Scriptures in Christianity, draws a clear boundary betweenRead MoreThe Declaration Of The Requirements For The Completion Of Essay1509 Words   |  7 PagesView†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦....3 Future for Israel†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦...5 Significance†¦.................................................................................................................6 Conclusion†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.†¦Ã¢â‚¬ ¦.7 Bibliography†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦....8 ii Introduction The Abrahamic Covenant was established in Genesis 12:2-3, this is the first time God spoke to Abraham and instituted this unconditional covenant. The importance is magnifiedRead MoreUS Support for the State of Israel Essay1421 Words   |  6 Pageswith Us and Christians United for Israel in the magazine Israel 101, when it exhibits the Three Ds of anti-Semitism Delegitimization, Double Standards, and Demonization. â€Å"Delegitimization: The Jewish State has no right to exist. Israelis do not belong in the Middle East. Double Standards: Israel is condemned harshly for self-defense measures and social problems that are seen as acceptable or inevitable in other nations. Demonization: Through distortions and lies, Israel is depicted as the world’s mostRead MoreAnalysis of Christopher J. H. Wright ´s Writings on The Old and New Testament1162 Words   |  5 Pagesproclaim the Jewish lineage of Jesus by illustrating his position in the family of Abraham and by virtue of his lineage to David son of David, the son of Abraham. Wright’s comprehensive synopsis of the Old Testament shows that the history of Israel illustrates the unconditional mercy of God as he renews his covenant relationships therefore; redeeming his people. This is where Wright brings into view the missiology of the responsibility given to Israel through God’s covenant relationship. Israel does notRead MoreGod, God And The Creator Of The Earth And Living Things1010 Words   |  5 Pagesa superior power, which can be known as God. God plays a major role within many different religions. However, religions with similar beliefs can differ in numerous ways as well. For instance, both the Jewish and Christian scriptures share a few beliefs in common. Both scriptures identify the belief of one God, who is almighty and the creator of the earth and living things. Both scriptures express the understanding that the Earth is God’s domain in which God demands that all humans act according toRead MoreThe Covenant Of A Covenant1319 Words   |  6 PagesCovenant is a very important idea in both the Old and New Testament. Important covenants revealed through both Testaments are the Sinai covenant and the crucifixion of Jesus, the new covenant. A covenant includes five fundamental features which help strengthen the notion that a covenant is an eternal promise with God, not a relationship that can be broken resulting in legal repercussions. Firstly, the origin of a covenant will be discussed. Secondly, this paper will shed light on the traits of aRead MoreWorldview Analysis (Judaism) Essay example1543 Words   |  7 PagesBIBLIOGRAPHY†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦8 INTRODUCTION Judaism is the religion and culture of the Jewish people. The word â€Å"Judaism† derives from the Greek Ioudaismos, a term first used in the Intertestamental Period by Greek-speaking Jews to distinguish their religion from Hellenism. The unifying principles of Judaism are an identity by covenant with God as His â€Å"chosen people† based on the Bible (Old Testament) and a unifying expression of this relationship through prescribed tradition. Judaism and Christianity share some commonalitiesRead MoreHow God Views Covenants On The Gospels, Acts, And Revelations1740 Words   |  7 Pagesis a covenant? Webster dictionary defines a covenant as a written agreement or promise usually under seal between two or more parties especially for the performance of some action. Throughout the Old Testament the word covenant is used to remind God’s people of his steadfast and unfailing devotion to them as they navigate in a world without a visible God. As God sends his it is clear to see even more of how God values the covenants he has made with his people. This paper will talk about how God viewsRead MoreThe Jewish Community2022 Words   |  9 Pagesunderstand how the Jewish community felt when Jesus, the Christian Messiah, came and challenged the very thing that made them special. Jesus challenged the exclusive relationship they had with God and he challenged the Mosaic Laws that constitute what Judaism is. Jesus was the annoying parent that kept telling the Jews to share the love of God with the annoying adopted kid, who were the gentiles, and they were furious! To better understand this conflict, we have to understand Jewish theology and understandRead MoreWorship And Sin Can Not Coexist1233 Words   |  5 Pagescoexist. For example, before the fall, Adam and Eve did not need to acquire atonement to worship God, but instead lived in the Garden of Eden with Him. The Temple and Tabernacle were the places where man encountered God, so they served as vital religious components of Judaism. In addition to atonement, tabernacle and temple, further elements of Old Testament worship include scripture, singing, and covenant renewal/remembrance. This essay will go over Old Testament worship practices and the significance

Thursday, May 14, 2020

Unit 6 - P2 - 1251 Words

Unit 6 – P2 In sport there can be certain reasons as to why people are unable to in sport, cultural, social, historical, economic or educational. These barriers are referred to as barriers to participation. Culture barriers are linked to different nationalities, beliefs and religions. There may be rules and views on who should participate in sport. Some religions do not allow women to participate in sport altogether, others allow participation if they wear clothes that cover the whole body. In the UK is limited knowledge of sport from certain cultures. Schools often try to accommodate different cultural for example, allowing students to clothes to cover their body and separating girls from boys. There may still be an issue such as†¦show more content†¦Target groups include women, young people, over 50’s, disabled people and black or ethnic minority groups. These groups of people are the groups that generally have been the most barriers to participation. They are focused on increasing opportunities in sport as they are likely to benefit the most. Women have always had less involvement in sport than men. There may be reasons as to why women have less involvement. They may stop playing sport to focus on other thing like having children or a family. Women with family may also find it difficult due to a lack of money and time. These barriers can occur at any level of sports continuum from someone who may just want to exercise to keep fit (participation stage) but feels they can’t as the only classes available to them are mixed sex classes which they are not comfortable with. Other example, of the barriers to women may be that at the performance or excellence stage lack sponsorship, media coverage and government funding in women’s sport. This in turn means that women are unable to continue sport as a career and are limited to the level they are able to achieve as they can’t live by only playing sports and must get a job. There has been a large improvement in the amount of women involved in sport since scheme a nd government funded activities have been put in place to increase numbers of women’s only classes, competitive clubs and female teams in traditional male sport such as rugby, football andShow MoreRelatedP2 Unit 6 Travel and Tourism1912 Words   |  8 Pagesï » ¿Unit 6: Preparing for Employment in Travel Tourism Task 2: CAREER FACTFILE: JOB OPPORTUNITIES IN THE TRAVEL AND TOURISM SECTOR Job Title 1: Airline Pilot Job Title 2: Cabin Crew Job role Airline pilots are responsible for flying passengers and/or cargo on long or short-haul flights for leisure, business or commercial purposes. Air cabin crew members make sure that airline passengers have a comfortable, safe and pleasant flight. Air cabin crew member must be polite, well-spokenRead MoreReliability And Availability Evaluation Of A System Switched1625 Words   |  7 PagesRELIABILITY AND AVAILABILITY EVALUATION OF A SYSTEM SWITCHED TO ANOTHER SIMILAR, SUBSTITUTE OR DUPLICATE SYSTEM ON TOTAL FAILURE ABSTRACT A two-unit standby system is considered with two types of repair facilities. One facility repairs one unit at a time and other facility repairs both the units simultaneously. When both the units fail, if unit can be repair in short time then repair will be continued, otherwise in order to improve availability another substitute system taken from outside is usedRead MoreEssay on Work: Goal and Social Care949 Words   |  4 PagesUnit 6: Personal and Professional Development in Health and Social CareUnit 44: Vocational Experience for Health and Social CareBTEC NATIONAL HEALTH AND SOCIAL CAREExtended Diploma Student Name: Abigail bowes Group: BStudent Number: 20138903 | Unit 6 (P2, P5) half 1. Provide an up-to-date CV at the start of the course. 2. Provide an updated CV at the end of the first year. You will required to completed the following * Completed Units * Work Experience * New Skills and QualificationsRead MoreVariable costing vs Absorption costing.1134 Words   |  5 Pagescomparative insight of major differences using the examples below:- The following information is available for periods 1-6 for a company that produced a single product ($) Unit selling price10 Unit variable cost 6 Fixed costs for each period 300 Normal activity = 150 units per period, production sales are as follows:- P1 P2 P3 P4 P5 P6 Units sold150120180150 140160 Units produced150150150150170 140 There were no opening stocks for P1, actual manufacturing fixed overhead incurred was $300Read MoreAvailability Improvement For Single Unit System With Two Types Of Repair Facilities1233 Words   |  5 PagesAVAILABILITY IMPROVEMENT IN SINGLE UNIT SYSTEM WITH TWO TYPES OF REPAIR FACILITIES Gurvindar Kaur and pooja vinodiya School of Studies in Statistics Vikram University Ujjain (M.P.) Email:gkbhatti2289@gmail.com ABSTRACT This study deals with the reliability, availability, and busy period characteristics of single unit system. On failure of the system, if system can be repaired in short time then repair will be continued, otherwise in order to improve availability another substitute system taken fromRead MoreUnit 2 Assignment P2 P3 M11036 Words   |  5 PagesName: Date Submitted: Unit: 2.2 Equality, diversity and rights in health and social care I certify that the attached work is original and my own: †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ Student Signature Assessment Title: Concepts and discriminatory and discriminatory practices Lecturer: Nicky Edwards, Patricia Britto Issue Date: w/c 6th October 2014 Hand in date: 24th October 2014 Criteria 1st Referral Hand in Date 2nd Referral Hand in Date Grade Achieved Signed Dated by Lecturer P2 P3 M1 LearningRead MoreECN 5021168 Words   |  5 Pagesï » ¿ 1)  Problem 6: Suppose demand and supply are given by Qd = 60 – P and Qs = P – 20. a)  What are the equilibrium quantity and price in this market? b)  Determine the quantity demanded, the quantity supplied and the magnitude of the surplus if a price floor of $50 is imposed in this market. c)  Determine the quantity demanded, the quantity supplied and the magnitude of the shortage if a price ceiling of $32 is imposed in this market. Solution: a. For the equilibrium i) Price: Qd = Qs 60-P=P-20Read MoreOptimized Time Quantum For Dynamic Round Robin Algorithm1497 Words   |  6 Pageskeep the processor as busy as possible. . Processor Utilization = (Processor buy time) / (Processor busy time + Processor idle time) b. Throughput: The number of process computed per unit of time is Throughput. Throughput = (Number of processes completed) / (Time Unit) c. Turnaround Time (tat): The total time spent to get into the ready queue for a process is turn around time. tat = t(process completed) – t(process submitted) d. Waiting Time (wt): Time spent in readyRead MoreEssay on Competition and Unit Cost861 Words   |  4 PagesNovember 14th 2011 Price Competition and Bertrand Model Discussion Questions 1. Suppose firm 1 and firm 2 each produce the same product and face a market demand curve described by: Q = 5000 - 200P Firm 1 has a unit cost of production c1 equal to 6 whereas firm 2 has a higher unit cost of production c2 equal to 10. a. What is the Bertrand-Nash equilibrium outcome? b. What are the profits for each firm? c. Is this outcome efficient? Answer: (a) At equilibrium, assuming that if bothRead MorePressure vs. Volume Ib Chemistry Sl Full Lab Write- Up Essay1666 Words   |  7 Pagesamount of gas held at a constant temperature varies inversely with the applied pressure. In other words, when the pressure increases the volume decreases. When pressure decreases, volume increases. This can be derived from the following equation: P1 V1=P2 V2 The common use of this equation is to predict how a change in pressure or volume will alter the volume/pressure of the gas. Thus, the product of the initial volume and pressure is equal to the product of pressure and volume after a change in

Wednesday, May 6, 2020

School Uniforms Persuasive Essay - 1470 Words

The Benefits of Uniform Adoption in Public Schools Ever wonder what it would look like to have all students wearing the same white polo shirt, black pants, and a district sweater walking in the hallway? Nowadays, public school and many districts are discussing the possibilities of enforcing the uniform policy. In most places, many private schools already require students to have their mandatory uniforms; however, there are only a few public schools adopting this mandatory school-uniform polices as one of their enrollment requirements. The reason why not all public schools participated was because people believe that they are violating the freedom of choice when enforcing this mandatory uniform policy; yet problems†¦show more content†¦Young adolescents get distracted easily compared with the mature adults. Fancy goods always attract people by their fantastic look and bring them to the fashion side. Consequently, students would pay more of their attention to the latest fashio n instead of their school work. Then the school work will not be done on time because majority of their time is spent on the fashion. Without paying attention and making great efforts, school work can only be abandoned eventually. However, like Walmsley emphasized, when public schools require their students to wear the mandatory uniform, students will not have any struggle about choosing what clothes to wear today and tomorrow. In other words, students will have more time spending on school work. Another point is that the purpose of students going to school is gaining knowledge and preparing for their future. Students learn how to dress formally as a student in school. The adoption of this district uniform could help them to prepare the way professionals dressed. The next advantage of public school uniforms can be identified as the reduction of bullying behaviors. Everyone benefits by adopting the uniform policy. It helps students to unite and share a same goal – learning. Also, by adopting theShow MoreRelatedPersuasive Essay On School Uniforms717 Words   |  3 Pages The idea of school uniforms has been a vital point within school districts for a long time now. As a parent with two kids within the school system, it is a popular trend amongst schools as both my children’s schools require for their student to wear uniform. However, more recently, students as well as parents are beginning to disagree with the enforcement with school uniforms as they believe uniforms are possibly taking away the right of self-expression for students. Although this is a valid complaintRead MorePersuasive Essay On School Uniforms723 Words   |  3 Pagesmandatory for students to wear uniforms, they have evidently been misled. Uniforms kill individ uality and creativity, are too expensive for some, and can lower both self-esteem and performance of students in school. Many critics are bringing to light the crisis of dropping individuality and creativity; we cannot afford let it plummet any further. School uniforms destroy diversity and kill courage, on top of preventing individual student expression. In addition, school uniforms provide an almost jail likeRead MoreSchool Uniforms Persuasive Essay1069 Words   |  5 Pagesmany schools around the world enforce uniforms, requiring students to wear specific clothing. School uniforms, which was first established in 16th century England, are a topic of much debate in the public school system of the United States. Many people feel that uniforms reduce competition among students and bring a sense of unity in school. People who are against school uniforms think that they prevent students from expressing themselves and inhibits creativity. Many students dislike school uniformsRead MoreSchool Uniforms Persuasive Essay1001 Words   |  5 PagesMake a Difference? If schools could automatically have more safety, a stronger sense of unity within students, and higher self esteem for every individual student at a minimal cost without transgressing any laws, or stepping over students rights it is doubtful that many would turn up their nose to all of these things. There is no difference between this situation and the benefits that school dress codes would provide. While the majority of public schools do not require uniforms, the ones that do reportRead MorePersuasive Essay On School Uniforms979 Words   |  4 PagesThe age old argument of whether or not uniforms and dress codes should be enforced in schools seems to never conclude. The issue of appropriate clothing in schools is controversial and provoking. Many argue that abolishing a student’s choice in their attire violates their freedom of expression. Students use what they wear to express themselves; their clothing gives them a sense of a unique style and identity. Others argue that pe rmitting students to wear whatever clothing they like can create unnecessaryRead MoreSchool Uniforms Persuasive Essay1127 Words   |  5 PagesAssociation (2016), an estimated 160,000 students missed school every day due to a fear of violence and harassment from their peers. Students at many schools, including my own, have become more divided. This division has resulted in bullying especially towards students that stand out from the crowd with the way they look and dress. Along with continuing the anti-bullying programs already in place, public schools should implement a school uniform in order to reduce divisions among students, which shouldRead MorePersuasive Essay On School Uniforms1422 Words   |  6 PagesCatholic elementary school, middle school, and high school. I found it easier to attend and focus on school when wearing the same clothes as everyone else. Today, tiny southern towns even to the nations largest cities, public school uniforms have become so common this year t hat in many areas, they are no longer the exception, but the rule (Lewin â€Å"Dress for Success: Public School Uniforms†). Imagine a parent’s comfort in knowing their child was being treated as an equal at school each and every dayRead MorePersuasive Essay On School Uniforms1671 Words   |  7 Pages Hari Mainali South University School Uniform â€Æ' Abstract Freedom of dress is violated by restricting on school uniform. A school and university have their own dress code which does not require a particular dress. Some researcher and scholar suggest misbehavior in the student are the result of banning uniform. But misbehavior is what they acquired in their life. Banning uniform, student can exercise their right to express themselves freely. Student will be able to focus on education and saveRead MoreSchool uniform persuasive essay2016 Words   |  9 Pagesï » ¿ School Uniforms: Agree or not? Uniforms are globally used at schools around the world, especially schools in Asia. In Asia, the policy of wearing uniform enforces strongly during school hours and whenever at schools. The policy is enforced because schools want to teach discipline to their students and prevent unanticipated troubles at school. The policy of school uniforms is not completely implemented in the United States, especially public schools. According to the US Department of Education,Read MorePersuasive Essay On School Uniforms1889 Words   |  8 Pagesfor all schools to implement school uniforms in the classroom for all students. Schools everywhere across the America are changing their policies due to changes of their dress code. Whether it be due to vulgar language, inappropriate content, or the same outfit for all students, this is becoming more popular across America. In a recent study done by Statistic Brain it has shown that twenty three percent of countries across of America have implemented a pol icy that requires school uniforms. The school

Tuesday, May 5, 2020

Business Communication Teaching and Pastoral Care of Student

Question: Discuss about theBusiness Communicationfor Teaching and Pastoral Care of Student. Answer: Introduction As being hired as a consultant to Elite Education Institute, a review needs to give on the improving the process of management and operational. The report will be prepared on giving improvements on a process of the system, teaching, pastoral care of student, communication in the work place, staff management, conflict resolution. Further, there will be outlining of the course. Finally, there will be recommendations on the acceptance of the suggestion given by the consultant. The reporting will be supported by a presentation, which will be made by report. Discussion System and Process Elite is very flexible and proved systems of courses as well as providing counseling on the personal academic for producing real results. Elite is helping the students since 25 years for fulfilling their academic goal. Elite's educational school and a summer program are offering students goods grades (Guffey and Loewy 2012). Elite is providing a variety of program and classes on that to fit the timeline as well as a goal on the bound of college and school. Elite is aiming in test preparation, academic tutorial, and consultation for getting college. Teaching Educators and counselors of Elite are keenly looking forward to the success. All the teachers have bachelors degree. Few of the faculties are in the process of getting master's degree, or Ph.D. Elite is hiring best instructors and experts in the respective field for displaying energy and enthusiasm for effectively getting engaged with the students. Elite has instructor and guide in almost every field of study. The institute has instructor and consultant in all fields of study for giving better efficiency to the students (Guffey and Loewy 2015). Student Pastoral Care Pastoral care is considered to be a more inclusive function. Pastoral care is an ancient model with emotional and spiritual support which can be seen in every culture (Fall et al., 2013). Pastoral care is nourishment for learning journey, but not a destination. Student pastoral care refers to as getting help with personal need and issues by the teacher or guide. Pastoral care of the students needs to be taken in the best possible way, because if the student is personally not cool and calm, them how will he proceed in his professional life. Teachers have responsibility to personal boding for helping them in getting over with the problems (Elite Educational Institute. 2016). Workplace Communication Workplace communication is a method of exchanging ideas, information, and knowledge, both non-verbally and verbally under the company. The company will have employees from various society, culture, and background with different norms. Also, the activities like missing deadline and activity that will be affecting negatively are standing crucial in communication. An effective workplace communication will help in ensuring that an objective of Elite is achieved. Ineffective communication will give rise to wide gap among employees, and for resulting in wastage of time, productivity, and confusion. Workplace communication is highly important because it will be giving increased efficiency and productivity. Effective workplace communication will avoid misunderstanding that causes fiction (Bhatia and Bremner 2014). Staff Management Staff management is the division of management which will have subordinate in the organization. Manager of staff will have people who will be consuming revenue for the department. Staff management will involve workforce for utilizing the human resources of the staff. Under the staff management, there is line management which will include hierarchy system in the company. Staff management is serving the line managers in the company by way of support and advisory for providing them advice on the information given. Staff managers will include will have different supervisors from accounting, customer service and human resource department. Human resource planning will be done for staffing, under the consideration of knowledge, skills, and attributes for hiring the employees of each and every department (Sigmar et al., 2012). Conflict Resolution Conflict Resolution also called for reconciliation. It is the method and technique of conceptualization which includes facilitating of peace ending in the retribution and conflict. A group of a committee will try in attempting and resolving the conflicts through active communication of information related to the conflicting motives and ideologies in the rest of the group (Conrad and Newberry 2012). Theories Outlined High Context and Low Context will be describing broad brush in the cultural differences among the societies. High context will be referred to like the groups and society in which people will be having close connections for a long period. Low context will be referring to the society in which people have huge connections but for a small time and only for a specific reason. Under this society, cultural beliefs and behavior will be needed to spell out explicitly, because the thing which will be coming in the cultural environment will know to behave. ACE model is indicating the proportion of variance in the given trait, which is heritable, versus the proportion because of the shared and unshared environment. The research will be done through SEM programs, like OpenMx the core logic of the twin designing will be same as the requirement given for the task. In Elite both the models are used to design the courses for the students (Hooker 2012). Recommendation On the basis of overall discussion some recommendations are as follows: In respect of system and process, there is more investment to be done for incorporating more academic, test and tutorial should be implemented for helping the students more. Variation needs to be done the academic division proposal and consulting services. The company should moreover try in utilizing the online service of the company. In respect of teaching, some professional and experience should be hired so that Elite will earn more profit and growth for the company. An individual need to be appointed for taking care of the pastoral of the student. An effective workplace communication will help in ensuring that an objective of Elite is achieved. So, an effective workplace communication should be maintained to maintained avoid misunderstanding. An appropriate staff management will be done with the help of human resource department. Conflict resolution can be solved with the help of theories and model related to the queries and solution. Elite should open some consulting as well as operation branches to succeed. Conclusion The report has been prepared on giving recommendations related to improvements in the process of the system, teaching, pastoral care of student, communication in the work place, staff management and conflict resolution. Finally, there are recommendations on the acceptance of the suggestion given by the consultant. Reference List Bhatia, V. and Bremner, S., 2014.The Routledge handbook of language and professional communication. Routledge. Conrad, D. and Newberry, R., 2012. Identification and instruction of important business communication skills for graduate business education.Journal of Education for Business,87(2), pp.112-120. Elite Educational Institute. (2016).Home. [online] Available at: https://www.eliteprep.com/ [Accessed 20 Oct. 2016]. Fall, L.T., Kelly, S., MacDonald, P., Primm, C. and Holmes, W., 2013. Intercultural communication apprehension and emotional intelligence in higher education: Preparing business students for career success.Business Communication Quarterly, p.1080569913501861. Guffey, M.E. and Loewy, D., 2012.Essentials of business communication. Cengage Learning. Guffey, M.E. and Loewy, D., 2015.Essentials of business communication. Nelson Education. Hooker, J., 2012. 19 Cultural Differences in Business Communication.The handbook of intercultural discourse and communication,29, p.389. Sigmar, L.S., Hynes, G.E. and Hill, K.L., 2012. Strategies for teaching social and emotional intelligence in business communication.Business Communication Quarterly,75(3), pp.301-317.

Tuesday, April 7, 2020

Baseball Magic and its Relation With Other Rituals for Luck Essays

Baseball Magic and its Relation With Other Rituals for Luck Essays Baseball Magic and its Relation With Other Rituals for Luck Paper Baseball Magic and its Relation With Other Rituals for Luck Paper The enlightening article â€Å"Baseball Magic† by George Gmelch (1992) relates the rituals practiced by ballplayers before, during, and after a baseball game with the cultural practices found in different cultures across the world. One such culture, as mentioned by Gmelch (1992), is practiced by the Trobriand Islanders who perform certain rituals in order to bring luck to their daily catch (of fish). Relating it to baseball, the two places where the Trobriand Islanders fished are associated with the three important aspects of the game: pitching, hitting, and fielding. In that sense, lagoon fishing is   associated with fielding since it uses skill rather than luck, while open-sea fishing is associated with pitching and hitting since it relies more on luck. Ballplayers practice different rituals that they assume to have brought luck upon them in the past, when they had a good game. Due to the results of each game, Gmelch (1992) claims that ballplayers would ponder on what they might have done that brought them good or bad luck, and later on, they would turn it into a ritual or cast them off as a taboo. They would also practice apparel fetishes that they believe would bring them immense luck. It has also been mentioned that according to B.F. Skinner, these attitudes and practices stem from the results of each game, wherein ballplayers would associate their performance with their daily routines (Gmelch, 1992). The article primarily relates the importance of cultural practices across the globe to the people who practice them. The game of baseball was given an example to associate the rituals importance for the players who perform them with these cultural practices. Baseball is a game of both skill and luck wherein the players would rely more on the latter rather than the former. These rituals give them strength and confidence, intensifying their skills. Similar to these ballplayers are the warriors who practice a certain ritual to provide them with better protection and courage in battle. The article also gives a detailed example of the importance of rituals for people who practice them. Certainly, these rituals intensify the attitudes like confidence and courage. However, the article could have also provided an opposing argument to the whole topic, as it could also mean that these rituals are just mere exaggerations of the ballplayers superstitious mentality about luck. These rituals may have all been their learned set of skills that provide them with the results that they want. With an opposing argument, the whole article could have further explained the importance of such rituals for players, as well as for the whole culture of baseball and its fans. Reference Gmelch, G. (2000). Baseball magic. McGraw-Hill Contemporary Learning Series. Retrieved June 8, 2009, from dushkin.com/olc/genarticle.mhtml?article=27128

Monday, March 9, 2020

Aristotles Wisdom

Aristotles Wisdom Regarding (1) the distinction between humans and animals, (2) the definition of wisdom, and (3) with what philosophy begins: I think these are all related, for Aristotle, they are all suspects of a single issue. I mean, that which enables wisdom is what is distinctive of humans, namely the capacity to derive general assumptions from experience. The results of the exercise of this capacity - that is to say, the nature of the general assumption themselves - are the contents of wisdom, by my understanding. These first two points are with what philosophy begins, then: (point 3) philosophy begins with (point 1) the distinctively human capacity to (point 2) certain thoughts.If there were not the distinction between humans and animals that Aristotle recognizes, there would not be philosophy. It is not that there is a distinction, and then the result of this distinction is philosophy. You may think that me saying this is not necessary, because it is so obvious, but I must lay it out like thi s in order to show as clearly as possible that there are not really three points Aristotle is broaching, but that he is actually explaining one thing in three parts.Detail of The School of Athens by Raffaello Sanzio...Aristotle believed philosophy to have an "ennobling effect on the philosopher, such that he or she is brought as close as possible to divine state." As you know, the common belief now days is that philosophy will provide contentment, or some kind of consolation because of a particular broadening of the mind. For a start too many philosophers' personalities are so different, yet they have fundamentally the same knowledge, which clearly means philosophical knowledge does not make for a particular reaction. A lot of those who do have the stereotypical personality trait associated with being a philosopher have had it ever before...

Friday, February 21, 2020

History Essay Example | Topics and Well Written Essays - 500 words - 21

History - Essay Example Stephen Kinzer in book â€Å"Overthrow† argues that America could have avoided most of these violent military confrontations spending billions of dollars and causing bloodshed and pain by more patient and effective use of diplomacy and its tools of persuasion. â€Å"Modern history makes it eminently clear that when United States engages with oppressive and threatening regimes, using combinations of incentives, threats, punishments and rewards, those regimes slowly becomes less dangerous† (p.320). This statement sums up what the US has to understand if they truly want peace on earth rather than using the military might to overthrow the other countries governments. The author cites the examples of China, the former Soviet Union, South Korea, South Africa as the success stories of effective diplomatic strategy. At the same time one look at the countries that US militarily intervened like, Philippines, Afghanistan, North Korea, Vietnam, Iran and Iraq the results were terribly wrong. In Iran for example in the early 1951, US at the request of the British, removed a fully functional democratic government only to install a dictator. And in Iraq several decades later they did exactly opposite. Both have not worked. Iran became a completely anti-american country with religious leaders as head of state that looks to oppose any American ideas at the world level. Iraq is still smoldering from the chaos of war with violent reactions every now and then. The resentment against US is ever increasing with strong Anti-US propaganda. The author argues that in most of these cases diplomatic and political approaches would have been far more effective. More often than not, the think tank of the US gets impatient and jumps to the conclusion that a â€Å"regime change† is the only answer. What do they do?. They forcefully invade the country with their military might and advanced weaponry, remove the leader of that country and hand its power to someone who will dance to their tunes.

Wednesday, February 5, 2020

Post War Era, 1946-1954 - Written Assignment Essay

Post War Era, 1946-1954 - Written Assignment - Essay Example ype, represents a fusion of jazz, blues, and boogie-woogie in a swinging upbeat designed to offer some comic relief in substance and rhythm, meaningfully and emphatically conveyed through percussions. Hoochie Coochie Man, on the contrary, features a more relaxed tempo and appears to have much inclination to romantic subjects with some degree of sophistication. In his performance, Muddy Waters was able to deliver a content peculiar with the black culture during post-war era. The need to tone down and experience soothing transition readily builds within the atmosphere and though the jazz level of the song leans towards neoclassicism, it is still one that could do justice to an unpopular struggle of uniqueness in which notes and succession remain unpredictable though artfully crafted to encourage slow yet sensational moves in response. As rendered through percussive selection, the music in Hoochie Coochie Man had been arranged to appropriately coincide with the overall composition such that it forms a trend in classic blues that was later to influence the modern rhythm and blues with flexible style and confidence. Choo Choo Ch’ Boogie seeks compatibility with those whose mood is up for raving and dancing in quick-paced steps and boogie fashion. An audience under rock and roll framework would most likely acquire fondness to blend with it, having a nature similar to the original preference. While Choo Choo Ch’ Boogie would normally target to have frolicking listeners, Hoochie Coochie Man is equivalently expected to play in front of a somewhat nostalgic or maudlin crowd hoping to be mildly stirred as thoughts dissolve into the blues with a little troubled lightness. It enables its audience to drift into a dimension of soul while maintaining a significant awareness of the reality. Being a mood music of its kind, either Choo Choo Ch’ Boogie or Hoochie Coochie Man brings about an attitude which each audience might not know they’d be taken into on the process. As

Tuesday, January 28, 2020

Tradition and the Individual Talent Analysis

Tradition and the Individual Talent Analysis Tradition and the Individual Talent was originally published across two instalments of the Egoist in 1919 and later, in 1920, became part of T.S. Eliots full length book of essays on poetry and criticism, The Sacred Wood. Literary modernism is visible throughout the essay in the self-consciousness Eliot writes of with regards to writing poetry. The Waste Land, like much literature of the modernist era breaks away from traditional ways of writing and uses Eliots own understanding of tradition, literary allusion, in a unique way. This essay will be focusing on the arguments made by Eliot, with regards to literary tradition, in Tradition and the Individual Talent and how The Waste Land relates to those arguments. Eliot begins Tradition and the Individual Talent by arguing it is the poets treatment of their position within the historic context of literature that demonstrates talent. The essay asserts that the poet should use their knowledge of the writers of the past to influence their work. He states that we shall often find that not only the best, but the most individual part of his work may be those in which the dead poets, his ancestors, assert their immortality most vigorously. Eliot explains that to write with tradition in mind does not mean imitating, as this would lead to repetition and novelty is better than repetition. He defines tradition as something only to be gained by the labour of knowing literature of the past and by being critically aware of what techniques and content is of value. The poet should be aware of the simultaneous order of literary tradition, dating back to the classics. Tradition is the accumulated wisdom and experience of literature through the ages and is, according to Eliot, essential for great achievements within poetry. Eliot argues that no writer or piece of literature has value or significance when isolated from the literary cannon. In order to judge a work of art or literature it must be compared to works of the past. He believes that tradition is constantly changing due to adding new work to the literary cannon. He suggests that the author should conform to literary tradition and be informed by the past, but that by doing so the work of the author modifies the work they have been informed by. It is important for the poet to be aware of their own position within the present but also their relevance in relation to literature of the past. The modern author adds meaning to the traditional text by incorporating its influence into their work. Eliot acknowledges that the new work of art, when original, modifies the literary tradition in a small way. The relationship between past and present is not one-way, the present can alter the past, just as the past informs the present. Eliot then acknowledges that knowledge of the past as a whole would be impossible. In order to gain a good sense of tradition one must critically examine the past, focusing on works of art that are considered to be of high value. He explains that the definition of a sense of tradition is to be critically aware of trends and techniques which became typical of a particular age, movement or even author, and to have the ability to recognise deviation from this. An author with a good sense of tradition should also be aware that the main literary trends do not come, solely, from the most recognised poets, but they must be aware of trends set by poets of lesser recognition. Although the work of present poets is compared and contrasted to poets of the past, it does not determine whether the work of the present is better than the work of the past. Standards and principles are recognised to have changed. The comparison is made in order to analyse the new work, creating a deeper understanding of the text. It is only through this comparison the traditional and the individual elements can be determined. Eliot claims that art never improves. He argues that, despite changes in thinking, great writers such as Shakespeare and Homer remain relevant. He recognises that artists work with different materials and their art is a product of different eras, therefore it would be impossible to measure a qualitative improvement in any school of art. Eliot is aware that questions will be asked about the great level of knowledge that would be required of any one poet in order to meet his understanding of tradition. The essay will be criticised on the basis that there are great poets who did not have the level of education that Eliot is claiming is required. Eliot goes on to argue that it should be the duty of every poet to build their knowledge of the past for the duration of their career. He believes that it is knowledge of tradition that encourages and strengthens the poets ability to write great work. Eliot recognises that, at the start of a poets career, individuality will assert itself, but he notes that it is the sign of an immature poet and that as they continue to write one should lose the sense of the poets personality within the work they create. The poet should become objective with maturity. This therefore makes it irrelevant who wrote the poem under analysis, the relevance lies in the poems delivery of literary tradition. Eliot notes the necessity of the poet experiencing new situations and emotions without any changes being visible in their poetic voice. He states the more perfect the artist, the more completely separate in him will be the man who suffers and the mind which creates. He notes that the personality of the poet should not be expressed in their work but should remain unchanged by external factors. Eliot expresses that poetry may be formed from singular or various feelings, emotions or a combination of the two. He argues that poetry is in fact the organisation of emotions and feelings rather than inspiration. He believes that the quality of the poetry is not determined by the intensity of feelings or emotions but the intensity of the process of creating and ordering those feelings as part of poetic composition. The more pressure involved in the creative process the better the quality of the end product. Eliot goes on to note the difference between personal emotions of the poet and the emotion of poetry itself. While personal emotions may be simple, the expression of these emotions may be complex. While it is not the role of the poet to express new emotions, the poet should express ordinary emotions in new ways. Eliot then goes on to reject Wordsworths theory of poetry that is has its origin in emotions recollected in tranquillity. He believes that the composition of poetry does not require emotion, recollection or tranquillity, but that original poetry results from concentration on experiences. He also argues that this concentration should not be deliberate but passive. Poetry should be an escape from the poet, not a reflection of them. Eliot is not denying the poet personality but is declaring that the impersonality required to create good poetry can only be achieved when the poet surrenders themselves to the poetry they create. In part three of the essay, Eliot concludes that the poet is only capable of surrendering themselves to their work if they have acquired a good sense of tradition. And he is not likely to know what is to be done unless he lives in what is not merely the present, but the present moment of the past, unless he is conscious, not of what is dead, but of what is already living. By this he means that the poet should be conscious not only of their position within the literary cannon of the past but also where they belong in the literature of the present and how their poetry is relevant as a statement of the world in which it is created. The arguments made by Eliot suggest he is of the didactic school of poetic literary theory, believing that poetry should educate as well as entertain. Tradition and the Individual Talent sets out rules to be a great poet. Although he does not go to the extreme of being a neo-Classical critic, his theories do bear some resembalance in that he speaks of the classics being as relevant to poetry now as ever. This suggests that Eliot believes alluding to classical poets can improve the quality of the poetry. While Tradition and the Individual Talent does argue for originality it does so in a way that relies upon literature of the past. This still fits with the understanding of literary modernity as suggested by Ezra Pounds statement Make it new as, rather than making something completely original, Eliot is suggesting you take the traditional and make that new by attributing new meanings to what has been expressed. Eliot does not allow for the expression of new emotions. The arguments Eliot makes for the absence of the individuals experiences within their poetry is limiting the originality and uniqueness of poetry. While Eliot allows for originality in the way in which poets react and respond to the literary and historic tradition, he limits free expression of the self. Whilst the poet often takes influence from the past there should be unlimited freedom for expressing new ideas and emotions relating to the new material and the world in which they live. The ideas expressed in Tradition and the Individual discourages poets who are less well educated and therefore could discourage naturally talented poets from creating truly unique poems. Overall the essay is flawed not in the expression of Eliots arguments but in the rigidity of rules he places on a creative process, which should be free from rules and allowing for complete creative freedom. In Tradition and the Individual Talent, Eliot stated that the most individual parts of [the authors] work may be those in which the dead poetsassert their immortality most vigorously. When placing this alongside his argument that the experienced and mature poets converse with literary tradition in their work, it is hardly surprising that The Waste Land is full of literary allusions. The way Eliot alludes to literary tradition is in itself a source of originality, fitting with his arguments, however, emotions, personality and the personal experience of T.S. Eliot are disguised within The Waste Land. These aspects become clear when studied from a biographical perspective. The Waste Land is often read as an attempt to put the ideas of Tradition and the Individual Talent into practice, but the remaining part of this essay will focus on how Eliot fails to separate his personal experiences from the creative process. The Waste Land was written in 1922 during a period when T. S. Eliot was under orders from his physician to take three months rest. It is generally believed that this was due to a nervous breakdown. As a result of this Eliot was treated for neurasthenia[1] under the care of Dr. Vittoz in Lausanne, Switzerland. Because the majority of The Waste Land was composed during the period of Eliots treatment, the poem can be viewed as representative of Eliots psychological condition and his healing. It is due to this that Eliots emotions and personality are visible in the themes, structure, language and even grammar of the poem. This is something which Tradition and the Individual Talent claims should be absent in the work of a great poet. It is perhaps due to Eliots belief that poetry is not a turning loose of emotion, but an escape from emotion; it is not the expression of personality, but an escape from personality there have been relatively few critics to study Eliots poetry alongside biographical examinations of the poet. Lyndall Gordon states that the more that is known of Eliots biographical life the clearer it seems that the impersonal faà §ade of his poetry-the multiple faces and voices-masks an often quite literal reworking of personal experience.[2] Eliot claimed that Tiresias is the most important personage in the poem, uniting all the rest it is therefore likely that Tiresias, as the main consciousness of The Waste Land, represents Eliot in his struggle to gain brain control. Tiresias fits Vittozs understanding of the neurasthenic as living very little in the present and his thoughts always turn to the past or the future.[3] Tiresias figured in this sense can be understood as throbbing between two lives (l. 218) where the lives represent the two different aspects of his mind, the conscious and the subjective. Tiresias can be assigned the role of the characterisation of Eliots illness as the positive driving force of inspiration within the poem. Eliot himself wrote on the theory of the impact of illness on art in a positive light: it is a commonplace that some forms of illness are extremely favourable, not only to religious illumination, but to artistic and literary composition.[4] Eliot took a rest break in Margate in October 1921 which proved unsuccessful: On Margate Sands. I can connect Nothing with Nothing. (l. 300-302) This demonstrates the symptom of hopelessness. There are no connections to be found between the speakers thoughts. The conscious and subjective aspects of the mind are unable to communicate with one another. There are multiple references in the poem to blindness, deafness, muteness and difficulties with the sensation of touch. Vittoz has stated that the neurasthenic often looks without seeing and listen[s] without hearing (p. 44). The narrator, whether it is considered to be Tiresias, Eliot or another refers to all of these issues: I could not Speak, and my eyes failed, I was neither Living nor dead, and I knew nothing, Looking into the heart of the light, the silence.'(l. 38-41) It is the neurasthenic condition that could be preventing the speaker from connecting emotions to senses which results in further hopelessness. This is followed by a quotation from Tristran and Isolde, Oed und leer das Meer (Desolate and empty the sea) which again furthers the state of despair associated with neurasthenia. Along with the narrator and Tiresias there appears to be another character who, as Vittoz would describe, looks without seeing and listen[s] without hearing: My nerves a bad to-night. Yes, bad. Stay with me. Speak to me. Why do you never speak. Speak. What are you thinking of? What thinking? What? I never know what you are thinking. Think. (l. 110-113) The reference to nerves in line 110 should be attributed to insomnia, another symptom of neurasthenia. This furthers the argument that Eliots neurasthenia has impacted the poem greatly. Here we also see a lack of control in Eliots writing, he writes the question Why do you never speak without a question mark and the incomplete sentence What thinking? There is a severe lack of control in the poem so any semblance of narrative becomes blurred along with the sense of time, characters and their voices. The poem does seem to progress towards a sense of peace. It is in this way that it can be understood as Eliots process of recovery. In order to progress from this state of confusion Eliot must go through Vittozs therapy in order to reach the point of shantih. Vitozz wrote that several times a day the patient should repeat ideas of calm three times, this can explain the closing line Shantishantishanti (l. 434). In the manuscript version this movement can also be seen from the poem beginning with the horror, the horror to ending with the words still and quiet. In What the Thunder Said the tone of the poem begins to find its direction, or demonstrates the narrator approaching brain control. DA Damyata: The boat responded Gaily, the hand expert with sail and oar The sea was calm, your heart would have responded Gaily, when invited, beating obedient To controlling hands (l. 418-423) At this point in the poem Eliot is approaching a point of recovery. The poem has moved from the uncontrolled nature of neurasthenia to a calmer state of mind thanks to controlling hands. When linked to Vittozs technique of placing his hands on his patients temple in order to feel brain activity this passage is clearly in appreciation of his therapy. He spent time in the mountains recovering the symptoms of insomnia, hopelessness and confusion, In the mountains, there you feel free./I read, much of the night, and go south in winter (l. 17-18). These repeated references to symptoms, treatments and Eliots own experience of recovery certainly suggest neurasthenia is central to The Waste Land. This argument does not dispute the understanding of The Waste Land as a reflection on modern society. T.S. Eliots neurasthenia was a product of the financially focused post World War Britain in which he lived. The Waste Land can be seen as reflective of the sensibility of the time in Britain, struggling between the wars and trying to gain control, the poem could therefore be understood as diagnosing the society in which he lived. Whichever interpretation one believes, The Waste Land was composed as a result of T.S. Eliots mental health problems, whether it be an awareness of neurasthenia in order to diagnose society with or the expression of his internal struggle. This is clear through the fragmented nature of the text. The unannounced changes in speaker, time and location are as a result of Eliots mental state and yet have been studied in great depth without considering the biographical aspects of the context of the poem. The reason for neglecting this way of reading the text is lik ely to be a result of Eliots own arguments in Tradition and the Individual Talent, that The emotion of art is impersonal. The emotion of The Waste Land however is very personal to the poet, T.S. Eliot. [1] The symptoms of neurasthenia were notoriously vague-they included headaches, noises in the ear, bad dreams, insomnia, flushing, and fidgetiness, flying neuralgia, spinal irritation, impotence and hopelessness. Gold, M. K. 2000. The Expert Hand and the Obedient Heart: Dr. Vittoz, TS Eliot, and the Therapeutic Possibilities of The Waste Land. Journal of Modern Literature, 23 (3), pp. 519533. [2]Lyndall Gordon, Eliots Early Years (Oxford University Press, 1977), p. 2. [3] Roger Vittoz, Treatment of Neurasthenia by Means of Brain Control, trans H.B. Brooke (London: Longmans, Green and Co., 1921). P. 19. [4] Eliot, T. S. and Kermode, F. 1975. Selected prose of T.S. Eliot. New York: Harcourt Brace Jovanovich. pP. 237.

Monday, January 20, 2020

Shakespeares Sonnet 116 :: William Shakespeare

LET ME NOT TO THE MARRIAGE OF TRUE MINDS By: William Shakespeare Let me not to the marriage of true minds (Sonnet 116) by William Shakespeare is about love in its most ideal form. It is praising the glories of lovers who have come to each other freely, and enter into a relationship based on trust and understanding. "Let me not" the poem begins in the imperative mood. Its action is semantic and aims to delineate the allowable parameters of love and its goal appears to be air-tightness. The love I have in mind could be like a seamark or navigational guide to sailors, it is a north star. Like that star, it exceeds all narrow comprehension. Its height alone is sufficient to guide us. The poem's ideal is unwavering faith, and it purports to perform its own ideal. Odd then, isn't it, how much of the argument proceeds by means of negation: "let me not," "love is not," "O no," and so forth. Perhaps the poet is less confident than he appears to be. The first four lines reveal the poet's pleasure in love that is constant and strong. ?Which alter when it alteration finds." The following lines proclaim that true love is indeed an "ever fixed mark" which will survive any crisis. In lines 7-8, the poet claims that we may be able to measure love to some degree, but this does not mean we fully understand it. Love's actual worth cannot be known it remains a mystery. The remaining lines of the third quatrain (9-12), reaffirm the perfect nature of love that is unshakeable throughout time and remains so "even to the edge of doom", or death. In the final couplet, the poet declares that, if he is mistaken about the constant, unmovable nature of perfect love, then he must take back all his writings on love, truth, and faith. Moreover, he adds that, if he has in fact judged love inappropriately, no man has ever really loved, in the ideal sense that the poet professes. In the sonnet, the chief pause in sense is after the twelfth line. Seventy-five per cent of the words are monosyllables. Only three contain more syllables than two, none belong in any degree to the vocabulary of 'poetic' diction. There is nothing to remark about the rhyming except the happy blending of open and closed vowels, and nothing to say about the harmony except to point out how the fluttering accents in the quatrains give place in the couplet to the emphatic march of the almost unrelieved iambic feet.

Sunday, January 12, 2020

An Assessment of Nhif Utilization in Kiwanja Market

AN ASSESSMENT OF THE UTILIZATION OF NHIF BY RESIDENTS OF KIWANJA MARKET, KAHAWA WEST LOCATION, KASARANI DIVISION IN NAIROBI. Presented by: Ann Mwangi Registration number: I30/2160/2006 A research proposal submitted in partial fulfillment of the requirements for the award of the degree of Bachelor of Science (nursing and public health) in the school of health sciences of Kenyatta University. February, 2010. DECLARATION STUDENT’S DECLARATION This proposal is my original work and has not been presented for any academic award in any other University or college. Signature†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ Date†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. Name: Ann Mwangi Registration number: I30/2160/2006 SUPERVISOR’S DECLARATION This proposal has been submitted for review with my approval as a university supervisor. Signature †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. Date†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. Name: Mrs. Makworo Department: Nursing sciences. ABBREVIATIONS AND ACRONYMS NHIF National Hospital Insurance Fund MOH Ministry of Health CAP Chapter HMOs Health Management Organization UNICEF United Nations Children’s Fund KIPPRA Kenya institute for public policy research activities and analysis OPERATIONAL DEFINITIONS Health care- Goods and services used as inputs to produce health. In some analyses one’s own time and knowledge used to maintain and promote health are considered in additional to conventional inputs. Used synonymously with Medicare in this study. Health maintenance organization (HMOs) –It is a managed care plan that integrates financing and delivery of a comprehensive set of health care services to an enrolled population. HMOs may contract with or directly employ health care providers. Social insurance – It’s a government insurance programme in which eligibility and premiums are not determined by the practices common to private insurance contracts. Premiums are often subsidized and there is typically redistribution from some segments of the population to others. Health care financing- Refers to paying or funding of health care services provided or to be provided. It is not Medicare per se that consumers want but health itself. Medicare demand is a derived demand for an input that is used to produce health. Health care consumers do not merely purchase passively from the market, but instead produce it, spending time on health improving efforts in addition to purchasing Medicare input. ABSTRACT The National Hospital insurance Fund (NHIF) is an important aspect of healthcare financing through social health insurance in Kenya. It was established by the government of Kenya (GoK) in 1966 as a social insurance fund. At its inception, the NHIF was meant to assist GoK employees to gain access to higher quality private hospitals, thereby relieving congestion in the free public hospitals. The NHIF has mainly focused on the formal sector employees in the past around four decades. This has left those employed in the informal sector. This study is attempts to analyze and understand the demand for social health insurance of the informal sector workers in Kiwanja market by assessing their perceptions and knowledge of and concerns regarding National Hospital Insurance Fund. It will serve to explore how more informal sector workers could be integrated into the NHIF scheme. The research design to be used will be a descriptive cross-sectional study. The area of study is Kiwanja market in Kahawa west location. The study population will include Kiwanja residents above 18 years of age, and employed in the informal sector. The sample size will be 76 as determined using a standard statistical formula and the respondents selected through cluster sampling. A structured questionnaire will be used to collect data. Pretesting of the data collection tool will be done in Kihunguro area in Ruiru. The data collected will be entered, coded and keyed into variables using SPSS version 12- computer software and excel computer packages. Quantitative data will be analyzed using SPSS version 10 computer software. Presentation of quantitive information will be done using statistical packages (graphs, charts, tables and pie charts). The findings, conclusions and recommendations of this study will be very important in formulating awareness campaigns and educational materials that will enable the residents of Kiwanja in the informal sector of employment to realize the significance of NHIF programmes in financing their healthcare. TABLE OF CONTENTS DECLARATIONii ABBREVIATIONS AND ACRONYMSiii OPERATIONAL DEFINITIONSiv ABSTRACTv CHAPTER ONE1 1. 0 INTRODUCTION1 1. 1Background to the study1 1. 2Statement of the problem4 1. 3Justification of the study5 1. 4 Research questions5 1. 5 Objectives of the study6 1. 5. 1 Broad objective6 1. 5. 2 Specific objectives6 1. 6 Research assumptions6 1. 7Significance of the study6 CHAPTER TWO7 2. 0 LITERATURE REVIEW7 2. 1 Social health insurance7 2. 2 Healthcare financing through health insurance in Kenya9 2. 2. 1 The National Hospital Insurance Fund (NHIF). 10 2. 2. 2 Membership to NHIF10 . 2. 3 Mode of Payment11 2. 2. 4 Benefits and cover11 2. 2. 5 How to access benefits11 2. 2. 6 Accredited hospitals12 2. 2. 7 Milestones12 2. 2. 8 The future of NHIF12 2. 3 Factors influencing utilization of social health insurance services. 13 2. 3. 1 Feasibility analyses of social health insurance14 CHAPTER THREE20 3. 0 RESEARCH METHODOLOGY20 3. 1 Research design20 3. 2 Study area20 3. 3 Stud y population20 3. 4 Inclusion and exclusion criteria20 3. 4. 1 Inclusion criteria20 3. 4. 5 Exclusion criteria20 3. 5 Sampling technique and sample size21 3. 5. 1 Sample size determination21 . 5. 2 Sampling technique22 3. 6 Data collection procedures22 3. 6. 1 Research instruments22 3. 6. 2 Pre testing22 3. 6. 3 Data collection process22 3. 7 Data management23 3. 8 Limitations of the study23 3. 9 Ethical considerations23 REFERENCES24 WORK PLAN FOR THE STUDY. 26 BUDGET27 APPENDICES28 INSTRUMENT FOR DATA COLLECTION (QUESTIONNAIRE)28 CONSENT FORM31 MAP OF STUDY AREA32 CHAPTER ONE 1. 0 INTRODUCTION 1. 1Background to the study The concept of National Hospital insurance Fund (NHIF) is an important aspect of healthcare financing through social health insurance in Kenya. In a developing country like Egypt, the Health Insurance Organization (HIO) is prominent among many health institutions involved in health financing and provision, and a key player in the country’s health sector reform programme. It was established in 1964 as the institution in Egypt responsible for social health insurance, providing compulsory health insurance to workers in the formal sector (Abd et al. , 1997). One of the overall goals of the Government of Kenya is to promote and improve the health status of all Kenyans by making health services more effective, accessible, and affordable. Therefore health policy in the country revolves around two critical issues, namely: how to deliver a basic package of quality health services, and how to finance and manage those services in a way that guarantees their availability, accessibility and affordability to those in most need most health care (Kimani, Muthaka, and Manda, 2004). On achieving independence in 1963, the Government of Kenya (GoK) committed itself to providing â€Å"free† health services as part of its development strategy to alleviate poverty and improve the welfare and productivity of the nation (GoK press, 1965). This pledge was honored in 1964 with the discontinuation of the pre-independence user fees, and the introduction of free outpatient services and hospitalization for all children in the public health facilities. Services in the public health facilities remained free for all except those in employment whose expenses were met by their employers (Owino, W. and Were, M. , 1998). Through financial support from the central government, strategies were developed to expand the health infrastructure and support the entire health system. The GoK established NHIF in 1966 as a social insurance fund. At its inception, the NHIF was meant to assist GoK employees to gain access to higher quality private hospitals, thereby relieving congestion in the free public hospitals. The NHIF has mainly focused on the formal sector employees in the past around four decades. This has left those employed in the informal sector. Structural reforms and poor economic growth have increasingly pushed labor into the informal and small scale agriculture sectors where livelihoods are often insecure and incomes are low and uncertain (Kimani, Muthaka, and Manda, 2004). As a way of reaching out to those in the informal sector and the poor, the government plans to transform the current NHIF to National Social Health Insurance Fund (NSHIF). The aim is to ensure equity and access to healthcare services by the poor and those in the informal sector, who have been left out for the last forty years that the NHIF has been in existence. It is also expected that the new scheme will increase healthcare services utilization, which has suffered under cost sharing, by extending benefit package to also cover outpatient care. The current cost sharing will be replaced by pre-paid contribution into the new scheme (Kimani, Muthaka, and Manda, 2004). The principal choices for financing a health care system are: general revenues, social insurance funding, and private insurance financing and out of pocket payments. General revenue financing here refers to a system of revenue collection through a broad based tax. All or portion of this tax may be dedicated to the health care system . general revenues may be raised at the federal, state, provincial, or local levels. According to the United Nations system of national account, 1993, Annex IV par. 4. 111, an insurance programme is designated as a social insurance programme if at least one of the following three conditions is met: a) Participation in the programme is compulsory either by law or by conditions of employment. b) The programme is operated on behalf of a group and is restricted to group members. c) An employer makes a contribution to the programme on behalf of the employee. National Hospital Insurance Fund (NHIF) is therefore a social insurance financing in Kenya. NHIF’s core function is to collect contributions from all Kenyans earning an income of over Ksh 1000 ($12) and pay hospital benefits out of the contributions to members and their declared dependants (spouse and children) Whilst ensuring that Kenyans of all walks of life have access to quality and affordable healthcare, NHIF operates under the social principle that â€Å"the rich should support the poor, the healthy should support the sick and the young should support the old. 2. Statement of the problem The GoK established NHIF in 1966 as a social insurance fund. At its nception, the NHIF was meant to assist GoK employees to gain access to higher quality private hospitals, thereby relieving congestion in the free public hospitals. The NHIF has mainly focused on the formal sector employees in the past around four decades. This has left those employed in the informal sector (Republic of Kenya, 2003a). There exists an information gap on informal sector Kenyans utilization of NHI F services, in instances where studies focus on informal sector employees, NHIF is a social health insurance and an important aspect healthcare financing in Kenya that is often neglected or not fully explored. Majority of studies carried out; focus on utilization of NHIF services across general Kenyan population irrespective of the employment sector. This has led to formulation of healthcare financing programmes that do not address the specific needs of Kenyans in the informal sector. More so, tools of analysis by most relevant studies are limited to univariate and bivariate analysis falling short of examining the net effect of selected background and intermediate factors negatively impacting healthcare accessibility and utilizations by workers in the informal sector of employment. The study is designed to assess the level of knowledge and utilization of NHIF in Kiwanja market because it is an area whose majority of residents are in the informal sector of employment. 3. Justification of the study Taking into considerations the existing information gap on utilization of NHIF services by informal sector employees, it is important to undertake this study in Kiwanja market to establish the awareness level and its use. Kiwanja market is a densely populated area behind Kenyatta University. Majority of Kiwanja residents are in the informal sector. The study is designed to identify the potential hindrances of utilization of NHIF services in Kiwanja residents in the informal sector and ways of how to remove them. The study seeks to explain and provide a systematic body of knowledge that can be explored for appropriate policy formulation, to act as an eye opener and reminder to both the NHIF management team, and other stakeholders to raise the utilization of NHIF services by the informal sector in Kenya. Knowledge deficit regarding NHIF benefits and use to finance health care contributes greatly to the high mortality and morbidity rates due to poor health seeking behavior (Inke et al. 2004). Provision of information and raising awareness on NHIF benefits and use will reduce significantly the number of pregnant women delivering at home due to lack of funds to pay for hospital delivery. 1. 4 Research questions The research questions for the study will be: a) How informed are the members of Kiwanja market about NHIF benefits? b) Wha t percentage of Kiwanja market residents use NHIF services and are in the informal sector? 1. 5 Objectives of the study 1. 5. 1 Broad objective To assess the awareness on NHIF benefits and utilization of NHIF services by Kiwanja market residents. . 5. 2 Specific objectives a) To find out the knowledge level of Kiwanja residents about NHIF. b) To determine the number of Kiwanja residents who are NHIF beneficiaries. 1. 6 Research assumptions The residents of Kiwanja market are knowledgeable about health care financing, they are aware about NHIF benefits but they do not use it because they think it is only meant to benefit those people in the formal employment sector. 7. Significance of the study This study aims at finding out if Kiwanja residents utilize NHIF services. In addressing the objectives, the study will identify the level of utilization of NHIF services, factors influencing its utilization and come up with ways of addressing any shortcomings that will be identified and help in improving NHIF services utilization. The findings, conclusions and recommendations of this study will be important in formulating awareness campaigns and educational materials that will enable the residents of Kiwanja in the informal sector of employment to realize the significance of NHIF programmes in financing their healthcare. This study attempts to find out the awareness on NHIF benefits and use by residents of Kiwanja market. It will therefore benefit the residents of Kiwanja and empower them to acquire their human right of health care. CHAPTER TWO 2. 0 LITERATURE REVIEW 2. 1 Social health insurance The concept of health insurance was first proposed in 1694 by Hugh the Elder Chamberlen from the Peter Chamberlen family. In the late 19th century, â€Å"accident insurance† began to be available, which operated much like modern disability insurance. This payment model continued until the start of the 20th century in some jurisdictions (like California), where all laws regulating health insurance actually referred to disability insurance. During the 1920s, individual hospitals began offering services to individuals on a pre-paid basis, eventually leading to the development of Blue Cross organizations. The predecessors of today's Health Maintenance Organizations (HMOs) originated beginning in 1929, through the 1930s and on during World War II (Weber, 1994). A health insurance scheme is social when it subsidizes the poor, the elderly and the sick, and when it promotes equity and access to everyone and not for profit. The core values in social health insurance embody a concern for the plight of the poor. In social insurance financing, health services are paid for through contributions to a health fund. The most common basis for contributions is payroll, with both the employer and the employee paying a percentage of the salary. In general, membership to a social health insurance schemes is mandatory, although it can be voluntary to certain groups such as the self-employed. The health fund is usually independent of the government but works within a tight framework of regulations. Premiums are linked to the average cost of treatment for the group as a whole, not to the expected cost of care for the individual (Conn , 1998). While there is no universally accepted definition of what â€Å"social insurance† is, Kraushaar and Akumu (1993) outline some broad characteristics, which are generally agreed upon. These are: a) Coverage is generally compulsory by law ) Eligibility for benefits is derived from contributions having been made to the programme c) The benefits for one individual are not usually directly related to contributions made by that individual but often those benefits aim to redistribute income between different income groups. This redistribution is usually from the rich to the lower income groups or from those with few to those with many dependants. Equity of benefits regardless of payment is the rule. d) There is generally a plan or the financing of benefits that is designed to be adequate in the long term. ) Governments manage nearly all such social insurance organizations. f) Revenues go fully and unchallenged to health and are not controlled by the treasury in a given country. Conn and Walford (1998) explain the rationale for health insurance in a low-income country with the following three arguments: a) Attracting additional money for health. This is so because health insurance is perceived as an additional source of money for healthcare. Consumers are more enthusiastic about paying for health insurance than paying general taxation as benefits are specific and visible. ) Getting better value for money because consumers are more able and prefer to pay regular, affordable premiums rather than paying fees for treatment when they are ill. c) Improving the quality and targeting of healthcare. Historically, HMOs tended to use the term â€Å"health plan†, while commercial insurance companies used the term †Å"health insurance†. A health plan can also refer to a subscription-based medical care arrangement offered through HMOs, preferred provider organizations, or point of service plans. These plans are similar to pre-paid dental, pre-paid legal and pre-paid vision plans. Pre-paid health plans typically pay for a fixed number of services. The services offered are usually at the discretion of a utilization review nurse who is often contracted through the managed care entity providing the subscription health plan. This determination may be made either prior to or after hospital admission (Weber, 1994) 2. 2 Healthcare financing through health insurance in Kenya Health insurance in Kenya has been provided by both private and public systems. The main objectives of the he health systems have been to insure Kenyans against health risks that they may encounter in future. Health insurance is considered private when the third party (insurer) is a profit organization (Republic of Kenya, 2003a). In private insurance, people pay premiums related to expected cost of providing services to them. Therefore people who are in high health risk groups pay more, and those at low risks pay less. Cross-subsidy between people with different risks of ill health is limited. Membership is usually voluntary. Public health insurance in Kenya is provided by the National Hospital Insurance Fund (Kimani, Muthaka, and Manda, 2004). 2. 2. The National Hospital Insurance Fund (NHIF). The NHIF was established in 1966 under chapter (CAP) 255 of the Laws of Kenya to be run by an Advisory Council appointed by the Minister of Health. The NHIF was established in 1966 under CAP 255 of the Laws of Kenya to be run by an Advisory Council appointed by the Minister of Health. It catered for salaried employees earning Kshs. 1, 000 and above per month, making a monthly contribution of Kshs. 20/= . In 1972 an amendment was made to incorporate voluntary members (self-employed) at a monthly contribution of Kshs. 0/=. In 1998, Cap 255 was repealed and replaced by the NHIF Act No. 9 of 1998 which transformed the fund to a State Corporation managed by an all inclusive Board representing various stakeholders and interest groups (Republic of Kenya, 2003a). 2. 2. 2 Membership to NHIF Membership to NHIF is open to all Kenyans aged 18 years and above earning a monthly income of kshs. 1000 or an average yearly income of kshs. 12, 000. There is no upper ceiling for the age. 2. 2. 3 Mode of Payment Employers effect deductions and remit to the fund by cheque or cash, and E-banking. Members in the informal sector pay in any of the NHIF offices Kshs. 160 per month for informal sector members. Members in the informal sector pay in any of the NHIF offices. All payments should be received by the 9th of the following month. For retirees/self employed persons payment for the year may be paid upfront; quarterly, semi-annually and/or annually. 2. 2. 4 Benefits and cover a) It covers all admission cases with few exceptions such as circumcision with no medical checkup required. b) Covers member, spouse and children under the age of 18 year. ) Children over 18 yrs and in learning institutions are also covered d) It covers for 180 days of hospitalization in a year. NHIF pay a daily rebate which ranges from Ksh. 400/= to Ksh. 2, 200/= Foreign claims. The number of other spouses is not limited and depends on the ability to pay for them. 2. 2. 5 How to access benefits Through presentation of the following to hospital on admission: Current NHIF Card- both manilla and photo card , Certificate of Contributions Paid (CCP) receipt and the national Identity card. The accredited hospitals deduct the daily rebate X number of days of hospitalization from the incurred bill. While for the contracted hospitals under category A, the entire bill is made by the Fund, the Fund reimburses member for costs incurred to the extent of the daily rebate if for one reason or another he /she is unable to use the card in Hospital. All claims should be received within 90 days after hospitalization. 2. 2. 6 Accredited hospitals Four hundred and fifteen health care providers have been enlisted across the country to provide services to NHIF beneficiaries under various contracts. Accreditation by NHIF is based on certain set standards and criteria for purpose of NHIF benefits. Quality Assurance and Standards Department consistently monitors the quality of services. 2. 2. 7 Milestones Increased rebates up to a maximum of 2,200 depending on hospital accreditation. It has an extensive branch network with 27 branches, satellite and window offices. It offers decentralized services, computerized operations and services and has a quality assurance and standards department in place. 2. 2. 8 The future of NHIF NHIF in future will use magnetic stripe card in hospitals to access benefits, introduction of diversified product lines, and further expansion of branch network. The ministry of health has designed a mandatory social health insurance scheme which seeks to transform the NHIF into a National Social Health Insurance Fund (NSHIF) to provide health insurance cover to both outpatients and inpatients. The main objective of the fund is to facilitate the provision of accessible, affordable and quality healthcare services to all its members irrespective of their age, economic or social status (Republic of Kenya, 2003c). 2. 3 Factors influencing utilization of social health insurance services. In most economically advanced countries, adequate social security laws are basically taken for granted. However, it often took many decades for social security systems to benefit all or major parts of the population in those countries. In the area of social health protection, for example, it took Japan 36 years to move from the enactment of the first health insurance law to the final law establishing nation-wide social health insurance. In the United Kingdom, a similar time period was needed to achieve its universal tax-based system (Inke et. al. 2004) Social Health Insurance (SHI) is not a widely adopted health financing mechanism in Africa. While there are many countries that operate a health insurance scheme for civil servants and/or private sector employees only some of these include features of a SHI, its appeal to cover larger parts of the population has been growing. Countries including Ghana, Nigeria and Rwanda have passed SHI laws. Earlier on, Kenya investigated the feasibility of SHI and Lesotho and Swaziland are doing so now. One distinct feature is that it does not call exclusively on public finance, but instead spreads the responsibility of health care financing among households and the private sector as well. From that point of view, tax-based systems in Africa are particularly challenged: the overall tax base may need to be strengthened, tax compliance may require improvement, and then a sufficient allocation towards health would have to be called for. Still, social health insurance is not a panacea either. It requires that an important organizational apparatus be put in place and that many actors in society shoulder critical responsibilities, such as the willingness and ability to contribute to the SHI scheme and then to comply with its regulations, thereby accepting a certain degree of financial solidarity (Kimani Muthaka ,and Manda, 2004). Aiming at universal health coverage for its 9. 5 million populations, Rwanda has spearheaded the development of a number of schemes that together constitute its SHI system. The three most important ones are the Rwandaise d'assurance maladie (RAMA), the Medical Military Insurance (MMI) and the Assurances Maladies Communautaires (AMCs). The RAMA social health insurance is compulsory for government employees and voluntary for private sector employees. Its contribution rate is 15% of basic salary (shared equally etween employee and employer). MMI covers all military personnel, who pay a contribution rate of 22. 5% of basic salary (5% paid by employee and 17. 5% by government). AMCs are community-based health insurance schemes whose members are mainly rural dwellers and informal sector workers in both rural and urban areas. They make up the majority of the population; by the end of 2007 about 5. 7 million Rwandans were covered by AMCs. Members usually contribute 1000 Rwandan Francs (1. 5 US$) per person per year which is matched by the government (Stilglitz, J. E. , 2000) 2. 3. 1 Feasibility analyses of social health insurance Since 2002, the WHO has been involved in technical advisory work especially on assessing the feasibility of SHI in Kenya, Lesotho and Swaziland in collaboration with national experts from those countries. In each country we analyzed the financial, organizational and political feasibility. Below we present some of the highlights of this work that should help us in formulating general guidance (Inke et. al. 2004) In Kenya, one basic financial scenario was that of gradual implementation of universal health coverage: coverage by a possible National Social Health Insurance Fund (NSHIF) would reach 62% of the population after 10 years, with further expansion in the second decade of SHI implementation. An important feature is that such a scenario would only be conceivable with sizable government subsidies. Without such subsidies, access to health car e among low-income households would be jeopardized, as the contributions From formal sector employees and civil servants would be insufficient to cross-subsidize the needed health care of the poor. External donors' financial support, however, could alleviate this extra financial burden on government. In fact, a variant of the basic scenario assumes that external donors would finance the provision of antiretroviral therapy, which would reduce the required government subsidies by about 20%. As far as the organizational aspects are concerned, it was studied whether the existing National Hospital Insurance Fund, a mandatory hospital insurance scheme for the formal sector with a small part of voluntary insurance for informal sector workers, might be transformed into the NSHIF. The latter would then be governed by a Board of Trustees with representatives from civil society. It is also interesting to note that the proposed NSHIF would include a Department of Fraud and Investigation in order to check the fund's financial activities. Civil society groups and enterprises such as the Post Office would also be given a role, especially in the collection of contributions from households in the informal sector (Inke et. al. , 2004) Concerning its political feasibility, consultations were held with a great number of stakeholders and interest groups, and most were supportive of the proposed NSHIF. Only Kenya's private Health Maintenance Organizations were very critical and had doubts about NSHIF feasibility. Finally, in 2004, the Kenyan Parliament passed a law on the NSHIF. However, President Kibaki judged it still needed amendments and returned it to Parliament for further debate that is still ongoing. Nonetheless, with a long-term vision, the existing National Hospital Insurance Fund is undertaking a number of institutional changes to increase membership and extend benefits so as to be better prepared should SHI take off (Inke et al. 2004) Factors which influence the use of NHIF services in Kenya include: ignorance, socio-economic factors, cultural factors, and demographic factors. Services information availability and accessibility also determines the utilization of social health insurance. Owino and Were (1998), in their study of enhancing healthcare among the vulnerable groups in Kenya ,found out that higher levels of awareness on health insurance, was associated with gre ater use of social insurance and thus better healthcare among the vulnerable people. In another study , a poverty survey by the UNICEF and overseas development Agency in 1995/96,it was found that user fees in Kenya made visits to government facilities prohibitively costly as the poor were required to make payments to reach the registration table, instead of using social insurance rebates. Worse, after the payments, the patients were asked to provide paper for record purposes. These costs could have been covered less difficultly by NHIF or more so NSHIF were they well informed of the benefits and the ease of membership. The study by Mwabu and Wang’ombe (1995) showed that the introduction of outpatient fees in Kenya’s public hospitals reduced the demand by a large proportion, and concluded that introduction of fees, or any upward revisions should be preceded by investments to raise quality of services and a well worked system of health insurance. The people should then be well sensitized on the benefits of joining into health insurance schemes. Huber (1993) did a systematic assessment of outpatients requiring exemptions, based on data from surveys in three districts in Kenya. The calculation was based on information on the household’s ability to pay. The study established the criteria for determining ability to pay on the assumption that households do not need to pay more than 5% of their annual incomes on healthcare from their pocket fees. As a result, households with cumulative health expenditures greater than 5% were assumed to qualify for the exemptions. The main conclusion from the study was that, it is not possible to tell who cannot pay fees by personal characteristics and so all people of the entire population should be enlightened on social insurance schemes such as NHIF and be encouraged to be members even when they are self employed. In a study carried out in Kenya (coast province) by Inke Mathaue (2007), on assessment affecting health services demand: extending social health insurance to informal sector in Kenya. Inke found out that, in the sum mix of the demand-side determinants can be addressed with a well designed strategy, focusing on awareness raising and information, improvement of insurance design features and setting differentiated and affordable contribution rates. In another study done by Mwangi W. M. and Mwabu, G. M (2006) on health care financing in Kenya: simulation of welfare effects of user fee, they found out that the introduction of user selective contribution charges would improve social insurance programmes such as the NHIF. The National Hospital Insurance Fund is the most important health insurance program in Kenya. Membership is compulsory for all civil servants. As of 1990, contribution levels proved insufficient to meet hospital costs and the government was planning to broker private health insurance policies. The government is continually improving and upgrading existing health facilities and opening new ones. Private health institutions account for 60% of total medical equipment and supplies (import value). Kenya also has a well-developed pharmaceutical industry that can produce most medications recommended by the World Health Organization (republic of Kenya, 1999) In order to increase the utilization of NHIF services, we need to raise the awareness on NHIF benefits to the people of Kiwanja market majority of who are struggling to pay for healthcare from their pockets. This study therefore, sets out to assess the utilization of NHIF services and identify factors that hinder its use by Kiwanja residents. The Government of Kenya has addressed the issue of inequalities and poor performance in a number of policy documents. The efforts made under the First Health Sector Plan (1999-2004) did not contribute towards improving Kenya’s health status. In 2005, the Second Health Sector Strategic Plan was implemented. This will run until 2010. In order to improve the funding of the healthcare system and to give more Kenyans access to better healthcare, the Ministry of Health is planning to introduce a National Social Health Insurance Fund (NSHIF). This is a social insurance scheme to which everyone will contribute, without exception. CHAPTER THREE 3. 0 RESEARCH METHODOLOGY 3. 1 Research design The study will be a cross-sectional descriptive study which will assess the awareness of the residents of Kiwanja market on NHIF services and benefits. 3. 2 Study area The research will be carried out in Kiwanja market which is located behind Kenyatta University, approximately 2 kilometers from the Nairobi –Thika dual carriage highway. 3. 3 Study population The study population will include Kiwanja market residents who are in the informal sector employment, who have attained the age of 18 years and earn an income of at least one thousand shillings per month. Kiwanja market has a total population of approximately 28,000 and about 5600 households as per the records in the chief’s office of Kahawa west location. 3. 4 Inclusion and exclusion criteria 3. 4. 1 Inclusion criteria The study will include Kiwanja market residents, who are self employed or employed in the informal sector. The respondents to be included must have attained the age of 18 years and consented to be used as respondents in the study. 3. 4. 5 Exclusion criteria The study will exclude students of Kenyatta University residing in Kiwanja market, residents under 18 years of age, and those who will decline to give consent. 3. 5 Sampling technique and sample size 3. 5. 1 Sample size determination The sample size will be determined by using the standard sample size calculation formula by Mugenda and Mugenda, 2003. nf = [pic](Mugenda & Mugenda, 2003) Where: nf =desired sample size (If the target population is 10,000) =the proportion of the target population estimated to be in the informal sector taken as 50% z =Standard normal deviation which is 1. 96 at 99 % level of confidence q=1 – p=1-0. 5=0. 5 d=Degree of accuracy desired is 0. 08 (Fischer et al, 1998) n=the desired sample size (when the target population is ;10,000) N=the population of Kiwanja resident households which is 5600 n =1. 962 ? 0. 5 ? 0. 5 0. 082 =76. 64 nf= 5600=75. 60 therefore sample size=76 1+ (5600/76. 64) 3. 5. 2 Sampling technique Cluster sampling technique will be used till an adequate sample size is achieved. Kiwanja market area will be divided into four clusters of approximately 1400 households each. There will be cluster A, B, C, and D. cluster A will be on the eastern part of the safaricom booster, cluster B will be on the western part of the safaricom booster while clusters C and D will be north and south of the booster respectively. Each cluster will contribute 25% of the sample size thus 19 respondents will be issued with the questionnaires. 3. 6 Data collection procedures 3. 6. 1 Research instruments A structured questionnaire will be used to collect data during the study. 3. 6. 2 Pre testing Pre testing of the study tool will be done at Kihunguro area in Ruiru town. 10% of the sample size will be used to test the data collection tool. 3. 6. 3 Data collection process A structured questionnaire will be issued to the respondents after an informed consent is given. The first respondent per cluster will be identified through simple random sampling technique and the next subjects will be selected by snowball sampling until a sample of 19 is obtained. Field editing will be done to the raw data obtained. . 3. 7 Data management Data categorization and coding will be carried out during preparation of the questionnaires. The data collected will be entered, coded and keyed into variables using SPSS version 12- computer software and excel computer packages. Quantitive data will be analyzed using SPSS version 10 computer software. Presentation of quantitive information will be done using statistical packages (graphs, charts, tables and pie charts). 3. 8 Limitations of the study Time will be limiting factor as the time frame for the study is short compared to the workload that will be involved in the study. Due to inadequate time and limited resources, it will be impossible for the study to be carried out in the entire Kahawa west location. This therefore will make generalization impossible because of using only one locality for the study. The researcher will also be disadvantaged in terms of personnel in that the researcher will be the only one carrying out the study with no assistants involved. 3. 9 Ethical considerations The researcher will ensure the following ethical considerations: i. Introductory letter from Kenyatta University, Department of Nursing Sciences. ii. Letter of authorization from chief of Kahawa west location.. iii. All respondents will give informed consent before being interviewed. iv. Confidentiality will be maintained. The researcher will provide feedback to the gatekeepers in the community (chief) and Kenyatta University, Department of Nursing Sciences REFERENCES 1. Abd El Fattah, H. I. Saleh, E. Ezzat, S. El-Sahaty, M. El Adawy, A. K. Nandakuma, C. Connor, H. Salah(1997). The health insurance organization of Egypt: An analytical review and strategy for reform. Technical report No 43. Bethesda, MD: Partnerships for health reform project, Abt Associates Inc. 2. Arrow, K. J. (1963). †Uncertainty and the welfare economics of medical care. † American Economic review. 3. Inke Mathauer, Guy, C, Doetinchem, O. , Joses, K, Laurent, M. (2004). Social health insurance: how feasible is its expansion in the African region, ISS, Rotterdam. 4. Kraushaar, D. (1994). † Health insurance: what is it, how it works. † Financing districts Health Services international workshop 5. Kraushaar. & O. Akumu (1993). â€Å"Financial sustainability of health programmes: the role of the national hospital insurance fund. † Nairobi: Government of Kenya. 6. Manda, Kimani. D. , (2004) Healthcare financing through health insurance in Kenya: the shift to a national social health insurance fund. Kenya Institute for Public Policy Research Activities and Analysis (KIPPRA), Nairobi, Kenya. . Republic of Kenya (2003a). The National Social Health Insurance Strategy. Prepared by the Task Force on the Establishment of Mandatory National Social Health Insurance. 8. Republic of Kenya (1999). Kenya Gazette supplement, Acts, 1999. The national hospital insurance fund Act, 1998. Nairobi: government printer. 9. Republic of Kenya, (1997). Econom ic survey. Nairobi: government printer. 10. Shaw, P. (1998) Financing healthcare in the sub-Saharan Africa through user fees and insurance. World bank 11. Stliglitz, J. E. (2000). Economics of the public sector (third edition). W. W. Norton 12. World Bank (1993). World development report 1993: investing in health. Oxford university press. 13. Techlink International (1999). A renewed NHIF: final report manual. WORK PLAN FOR THE STUDY. |Task | Months | | | |January |February |March |April | | | | | | | | | | | | |Preparation, and approval of proposal |Wk 1 | |Purchasing stationery |500 | |Transport |1500 | |Proposal preparation |2,000 | |Data collection |3,000 | |Data processing and analysis |2,000 | |Lunch |1500 | |miscellaneous |1500 | |Total |12,000 | APPENDICES INSTRUMENT FOR DATA COLLECTION (QUESTIONNAIRE) Instructions Please tick ( ) in the brackets representing the most appropriate response. Additional informational can also be given in the provide spaces or at the back of the questionnaire. 1 a) How old are you? (In complete years) 18-24years ( ) 25-34 years ( ) 35-44years ( ) 44years and above ( ) b) What is your gender? Male ( ) female ( ) 2. What is your highest level education? Never gone to school ( ) primary school ( ) secondary ( ) post secondary education ( ) 3. What is your religion? Christian ( ) Muslim ( ) Baha’i ( ) other (please specify)†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 4. What is your marital status? Single ( ) married ( ) divorced ( ) separated ( ) single parent ( ) widowed ( ) other (please specify)†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ †¦Ã¢â‚¬ ¦.. 5 a) what is your main occupation? Self employed ( ) civil servant ( ) ? 6. Have you ever heard about NHIF? YES ( ) NO ( ) b) How many dependants do you have? †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 7. IF Yes in question 6 above, where did you hear about it? ) Heard from a friend b) I am a beneficiary or a member if NHIF c) My parents are members of NHIF d) At my place of work 8. Are you a National Hospital Insurance Fund member or beneficiary? Yes ( ) No ( ) 9. If yes in question 9 above how do you rate NHIF services in the scale below out of ten:0-3 poor ( ) 3-5 below average ( ) 5-7 good ( ) 7-10 very good ( ) 10. If no in number 9 above, please tick as appropriate the reason why you are not member or beneficiary of NHIF a) I have never heard about NHIF b) I do not know the benefits of NHIF c) There is no branch of NHIF in Kiwanja market d) I am not employed in the formal sector. 11. If you are a beneficiary of NHIF, would you like to be a member? Yes ( ) no ( ) 12 If no in number 11 above, please as appropriate the reason why. a) I am not employed in the formal sector. b) There is no branch of NHIF in Kiwanja market. c) I have to think about it first and consult my husband about it. d) The monthly contribution is too much for me. 13. If yes in number 11 above, how many beneficiaries will benefit from your cover? None ( ) my spouse ( ) my children ( ) my parents ( ) other†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 14. Do you think that NHIF services will ease your burden of financing healthcare for you and your family and significant others? Yes ( ) no ( ) 15. Would like to be an NHIF member? Yes ( ) no ( ) 16. If yes in the above no. 15 do you know what requirements for becoming a member are? Yes ( ) no ( ) 17. If no in number 16 above, why? a) Because I have just learnt about NHIF now. b) Because I have never had a chance of accessing information about NHIF membership before. c) Because I have always thought NHIF is for those in the formal sector. d) I would like some brochures from NHIF on benefits, cover, and how to contribute to the insurance scheme. 18. If you are a member of NHIF have you ever used their services? Yes ( ) no ( ) 19. If no in the above question 18, why? ) I have never been hospitalized. b) None of my beneficiaries have been hospitalized. c) I did not know how to place my claim of cover. d) The process of accessing benefits is too long for me. 20. If yes in the above question 18, where did you use it? a) In a government facility. b) In a mission hospital. c) In a private hospital. d) In a referral h ospital such as Kenyatta National Hospital. e) Other (please specify)†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 20 if yes in question 18 above how did you find NHIF services? a) Average b) Good c) Very good d) Excellent Thank you very much for being a respondent and for your much cooperation. CONSENT FORM Researcher’s confirmation. I am Ann Mwangi, a Kenyatta university student pursuing a Bachelor’s of science degree in Nursing and Public Health. I am carrying out a study on utilization of NHIF services in Kiwanja market, Kahawa west location in Kasarani Division. I kindly request your permission to interview you. Confidentiality will be guaranteed. Your names will not be required. Signature of researcher†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. Date†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. Respondent’s consent I have been fully informed about the nature of the study and I hereby give my consent to any information which is required of me. Signature of respondent†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Date†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. MAP OF STUDY AREA [pic] ———————– Kiwanja Market