Stroke In Symptomatic Carotid Stenosis Health And Social Care Essay Free Essays

Purpose- The intent of this reappraisal is to look at the consequence of timing of the surgery on the hazard decrease from undergoing the process in patients that have diagnostic carotid stricture and have suffered old transeunt ischemic onslaughts or acute shots. What will be reviewed are the chief randomised control tests carried out in recent old ages and the guidelines obtained from such tests. The tests being the North American Symptomatic Carotid Endarterectomy Trial ( NASCET ) ( 2 ) the European Carotid Surgery Trial ( ECST ) ( 1 ) and a Population based survey of holds in Carotid imagination and surgery and the hazard of recurrent shot, ( the Oxfordshire survey ) ( 3 ) . We will write a custom essay sample on Stroke In Symptomatic Carotid Stenosis Health And Social Care Essay or any similar topic only for you Order Now Search methods- The writer used the University of Liverpool and Lancaster University library services to carry on the hunts every bit good as the universe broad web. Database hunts were conducted utilizing MEDLINE, PUBMED, Web of Science and OvidS. Cardinal words: shot, TIA, carotid endarterectomy, hazard, carotid stricture, timing, surgery, early Consequences: Decisions: Introduction An estimated 150,000 people have a shot with over 67,000 deceases attributed to stroke each twelvemonth in the UK. It is the 3rd most common cause of decease in England and Wales and histories for 9 per cent of all deceases in work forces and 13 per cent of deceases in adult females in the UK. It causes greater disablement than other chronic diseases and there are an estimated 300,000 people populating with moderate to terrible disablements due to shots. ( 4 ) In England shots cost the economic system A ; lb ; 7bn. This includes NHS costs, station shot attention costs and cost due to loss of productiveness and disablement ( 4 ) . A shot can be defined as either ischemic or haemorrhagic. Both cause a break in the blood supply to the encephalon and rapid development of loss of encephalon map either due to spliting of a blood vas or as in the instance of carotid arteria disease the blocking of a vas either due to plaque formation or thrombus formation. Ischaemic strokes history for 70 % of all shots. ( 5 ) Ischaemia is the deficiency of O and glucose to the tissues and so the eventual decease of the tissue. The location of the ischaemia and the loss of encephalon map can be determined by the attendant effects such as hemiparesis or unilateral paralysis, the inability to organize or understand address and the loss of ocular Fieldss typically amaurosis fugax ( a transient monocular ocular loss ) . A transeunt ischaemic onslaught ( TIA ) is frequently referred to as a mini shot and is the consequence of break of blood flow temporarily to a portion of the encephalon ( 5 ) . This impermanent break of blood flow consequences in brief neurologic disfunction that persists for less than 24 hours. If the symptoms last for longer than 24 hours it is classed as a shot. Ischaemic shots and TIA are on occasion treated with thrombolysis, the pharmacological dislocation of coagulums, physical therapy, address and linguistic communication therapy and occupational therapy. For patients shown to hold carotid artery stricture surgery is besides an option. Carotid endarterectomy ( CEA ) is a surgical process performed to forestall shots in patients who suffer from carotid arteria disease. Patients may hold diagnostic or symptomless carotid arterial stricture which is contracting of an arteria in this instance the common carotid arteria ( CCA ) . The stricture is caused by coronary artery disease and plaque formation on the interior of the arteria ( 6, 7 ) . The plaque formation normally occurs at the bifurcation of the CCA and this so causes narrowing of the lms and/or the release of emboli in to the circulation which can so come in the internal carotid arteria and so the encephalon. This can so do a transeunt ischemic onslaught or a shot. The grade of stricture of the CCA determines how high the hazard is for such an event. Patients who have suffered a TIA should be to the full assessed utilizing the ABCD2 mark to find the hazard of farther shot and should besides undergo encephalon imagination ( 8 ) . Patients with an ABCD2 mark of 4 or more and where the vascular pathology is diffident so the encephalon imagination should be carried out within 24 hours of oncoming of symptoms. Those with an ABCD2 mark of less than 4 where the vascular pathology is diffident are classed as lower hazard of farther shot and should guarantee they undergo encephalon imagination with in 1 hebdomad of the oncoming of symptoms. The ABCD2 mark is a validated tool to measure farther shot hazard in patients with TIA, based on age, blood force per unit area, clinical characteristics such as failing, diabetes, and symptom continuance. Patients believed to hold suffered an acute shot should hold encephalon imaging done within 1 hr or Oklahoman where possible if there is an indicant for thrombolysis or if they fulfil other standards set out by the guideline development group ( GDG ) , ( 9 ) . Patients who have suffered a non-disabling shot or a TIA may be appropriate for carotid endarterectomy. Campaigners who are appropriate for carotid endarterectomy should undergo specialist appraisal and imagination of their carotid arterias within a hebdomad of the oncoming of symptoms. Literature hunt and method The writer used the University of Liverpool and Lancaster University library services to carry on the hunts every bit good as the universe broad web. Database hunts were conducted utilizing MEDLINE, PUBMED, Web of Science and OvidS. Key words and footings searched included shot, TIA, carotid endarterectomy, hazard, carotid stricture, timing, surgery, early. From the hunt articles were identified by ab initio seeking the term ‘carotid endarterectomy ‘ which gave 3425 articles. This hunt was so narrowed down by adding in the term ‘timing ‘ which narrowed the hunt to merely 17 articles. From analyzing the abstracts of the 17 articles 5 were chosen for their relevancy to the rubric inquiry, day of the month and surveies carried out. I chose these articles to reexamine because they all included informations collected sing the timing of carotid endarterectomy performed after patients suffered diagnostic carotid stricture in the signifier of a non-disabling shot or TIA. The surveies chosen are ; Urgency of Carotid Endarterectomy for Secondary Stroke Prevention: Consequences From the Registry of the Canadian Stroke Network ( Study 1 ) ( 10 ) , Population-based Study of Delays in Carotid Imaging and Surgery and the Hazard of Recurrent Stroke ( Study 2 ) ( 3 ) , European Carotid Surgery Trialists ‘ Collaborative Group. Randomised test of endarterectomy for late diagnostic carotid stricture: concluding consequences of the MRC European Carotid Surgery Trial ( ECST ) ( Study 3 ) ( 1 ) , Timing of Carotid Endarterectomy in Patients with Recent Stroke ( Study 4 ) ( 11 ) , and Endarterectomy for Symptomatic Carotid Stenosis in Relation to Clinical Subgroups and Timing of Surgery ( Study 5 ) ( 12 ) . Literature Review Study 1 This survey identified patients from 12 shot Centres in Canada between 2003 and 2006. The cohort was retrospectively assembled from the patients in the register who had undergone CEA within 6 months of enduring a diagnostic event, described as a TIA or an acute ischemic shot. Patients were excluded from the survey who had suffered optic events or posterior circulation events. It besides restricted its cohort to diagnostic patients by merely including patients with known diagnostic stricture contralateral to the symptoms or ipsilateral to the country noted on neuroimaging. This was to except patients operated on for symptomless stricture. This survey showed that of all the ischemic shots and TIAs on their register that met the standards, 10213, 6270, ( 61.4 % ) received imaging and of this 1011 ( 16.1 % ) were found to hold diagnostic carotid stricture of 50-99 % . Of these patients 177 ( 17.5 % ) underwent CEA within 6 months and excepting those patients with bilateral stricture left 105 patients for the survey. 80 % of the 105 of these had terrible stricture of 70-99 % and 20 % had moderate stricture of 50-69 % . Patients were shown to go to the exigency section in a average clip of 6.7 hours of the oncoming of symptoms ( interquartile scope 1.2-31.7 ) with 71 % geting within 24hours. Of the 105 patients 38 underwent surgery within 2 hebdomads, 53 within 1 month and the staying 26 3months or subsequently. The survey showed that the patients undergoing surgery within 2 hebdomads improved significantly over the survey period – 18.2 % in 2003, 25 % in 2004, 45.5 % in 2005 and 44.8 % in 2006. Study 2 How to cite Stroke In Symptomatic Carotid Stenosis Health And Social Care Essay, Essay examples

Stroke In Symptomatic Carotid Stenosis Health And Social Care Essay Free Essays

Purpose- The intent of this reappraisal is to look at the consequence of timing of the surgery on the hazard decrease from undergoing the process in patients that have diagnostic carotid stricture and have suffered old transeunt ischemic onslaughts or acute shots. What will be reviewed are the chief randomised control tests carried out in recent old ages and the guidelines obtained from such tests. The tests being the North American Symptomatic Carotid Endarterectomy Trial ( NASCET ) ( 2 ) the European Carotid Surgery Trial ( ECST ) ( 1 ) and a Population based survey of holds in Carotid imagination and surgery and the hazard of recurrent shot, ( the Oxfordshire survey ) ( 3 ) . We will write a custom essay sample on Stroke In Symptomatic Carotid Stenosis Health And Social Care Essay or any similar topic only for you Order Now Search methods- The writer used the University of Liverpool and Lancaster University library services to carry on the hunts every bit good as the universe broad web. Database hunts were conducted utilizing MEDLINE, PUBMED, Web of Science and OvidS. Cardinal words: shot, TIA, carotid endarterectomy, hazard, carotid stricture, timing, surgery, early Consequences: Decisions: Introduction An estimated 150,000 people have a shot with over 67,000 deceases attributed to stroke each twelvemonth in the UK. It is the 3rd most common cause of decease in England and Wales and histories for 9 per cent of all deceases in work forces and 13 per cent of deceases in adult females in the UK. It causes greater disablement than other chronic diseases and there are an estimated 300,000 people populating with moderate to terrible disablements due to shots. ( 4 ) In England shots cost the economic system A ; lb ; 7bn. This includes NHS costs, station shot attention costs and cost due to loss of productiveness and disablement ( 4 ) . A shot can be defined as either ischemic or haemorrhagic. Both cause a break in the blood supply to the encephalon and rapid development of loss of encephalon map either due to spliting of a blood vas or as in the instance of carotid arteria disease the blocking of a vas either due to plaque formation or thrombus formation. Ischaemic strokes history for 70 % of all shots. ( 5 ) Ischaemia is the deficiency of O and glucose to the tissues and so the eventual decease of the tissue. The location of the ischaemia and the loss of encephalon map can be determined by the attendant effects such as hemiparesis or unilateral paralysis, the inability to organize or understand address and the loss of ocular Fieldss typically amaurosis fugax ( a transient monocular ocular loss ) . A transeunt ischaemic onslaught ( TIA ) is frequently referred to as a mini shot and is the consequence of break of blood flow temporarily to a portion of the encephalon ( 5 ) . This impermanent break of blood flow consequences in brief neurologic disfunction that persists for less than 24 hours. If the symptoms last for longer than 24 hours it is classed as a shot. Ischaemic shots and TIA are on occasion treated with thrombolysis, the pharmacological dislocation of coagulums, physical therapy, address and linguistic communication therapy and occupational therapy. For patients shown to hold carotid artery stricture surgery is besides an option. Carotid endarterectomy ( CEA ) is a surgical process performed to forestall shots in patients who suffer from carotid arteria disease. Patients may hold diagnostic or symptomless carotid arterial stricture which is contracting of an arteria in this instance the common carotid arteria ( CCA ) . The stricture is caused by coronary artery disease and plaque formation on the interior of the arteria ( 6, 7 ) . The plaque formation normally occurs at the bifurcation of the CCA and this so causes narrowing of the lms and/or the release of emboli in to the circulation which can so come in the internal carotid arteria and so the encephalon. This can so do a transeunt ischemic onslaught or a shot. The grade of stricture of the CCA determines how high the hazard is for such an event. Patients who have suffered a TIA should be to the full assessed utilizing the ABCD2 mark to find the hazard of farther shot and should besides undergo encephalon imagination ( 8 ) . Patients with an ABCD2 mark of 4 or more and where the vascular pathology is diffident so the encephalon imagination should be carried out within 24 hours of oncoming of symptoms. Those with an ABCD2 mark of less than 4 where the vascular pathology is diffident are classed as lower hazard of farther shot and should guarantee they undergo encephalon imagination with in 1 hebdomad of the oncoming of symptoms. The ABCD2 mark is a validated tool to measure farther shot hazard in patients with TIA, based on age, blood force per unit area, clinical characteristics such as failing, diabetes, and symptom continuance. Patients believed to hold suffered an acute shot should hold encephalon imaging done within 1 hr or Oklahoman where possible if there is an indicant for thrombolysis or if they fulfil other standards set out by the guideline development group ( GDG ) , ( 9 ) . Patients who have suffered a non-disabling shot or a TIA may be appropriate for carotid endarterectomy. Campaigners who are appropriate for carotid endarterectomy should undergo specialist appraisal and imagination of their carotid arterias within a hebdomad of the oncoming of symptoms. Literature hunt and method The writer used the University of Liverpool and Lancaster University library services to carry on the hunts every bit good as the universe broad web. Database hunts were conducted utilizing MEDLINE, PUBMED, Web of Science and OvidS. Key words and footings searched included shot, TIA, carotid endarterectomy, hazard, carotid stricture, timing, surgery, early. From the hunt articles were identified by ab initio seeking the term ‘carotid endarterectomy ‘ which gave 3425 articles. This hunt was so narrowed down by adding in the term ‘timing ‘ which narrowed the hunt to merely 17 articles. From analyzing the abstracts of the 17 articles 5 were chosen for their relevancy to the rubric inquiry, day of the month and surveies carried out. I chose these articles to reexamine because they all included informations collected sing the timing of carotid endarterectomy performed after patients suffered diagnostic carotid stricture in the signifier of a non-disabling shot or TIA. The surveies chosen are ; Urgency of Carotid Endarterectomy for Secondary Stroke Prevention: Consequences From the Registry of the Canadian Stroke Network ( Study 1 ) ( 10 ) , Population-based Study of Delays in Carotid Imaging and Surgery and the Hazard of Recurrent Stroke ( Study 2 ) ( 3 ) , European Carotid Surgery Trialists ‘ Collaborative Group. Randomised test of endarterectomy for late diagnostic carotid stricture: concluding consequences of the MRC European Carotid Surgery Trial ( ECST ) ( Study 3 ) ( 1 ) , Timing of Carotid Endarterectomy in Patients with Recent Stroke ( Study 4 ) ( 11 ) , and Endarterectomy for Symptomatic Carotid Stenosis in Relation to Clinical Subgroups and Timing of Surgery ( Study 5 ) ( 12 ) . Literature Review Study 1 This survey identified patients from 12 shot Centres in Canada between 2003 and 2006. The cohort was retrospectively assembled from the patients in the register who had undergone CEA within 6 months of enduring a diagnostic event, described as a TIA or an acute ischemic shot. Patients were excluded from the survey who had suffered optic events or posterior circulation events. It besides restricted its cohort to diagnostic patients by merely including patients with known diagnostic stricture contralateral to the symptoms or ipsilateral to the country noted on neuroimaging. This was to except patients operated on for symptomless stricture. This survey showed that of all the ischemic shots and TIAs on their register that met the standards, 10213, 6270, ( 61.4 % ) received imaging and of this 1011 ( 16.1 % ) were found to hold diagnostic carotid stricture of 50-99 % . Of these patients 177 ( 17.5 % ) underwent CEA within 6 months and excepting those patients with bilateral stricture left 105 patients for the survey. 80 % of the 105 of these had terrible stricture of 70-99 % and 20 % had moderate stricture of 50-69 % . Patients were shown to go to the exigency section in a average clip of 6.7 hours of the oncoming of symptoms ( interquartile scope 1.2-31.7 ) with 71 % geting within 24hours. Of the 105 patients 38 underwent surgery within 2 hebdomads, 53 within 1 month and the staying 26 3months or subsequently. The survey showed that the patients undergoing surgery within 2 hebdomads improved significantly over the survey period – 18.2 % in 2003, 25 % in 2004, 45.5 % in 2005 and 44.8 % in 2006. Study 2 How to cite Stroke In Symptomatic Carotid Stenosis Health And Social Care Essay, Essay examples

Kashmir Conflict free essay sample

After centuries of Hindu and Buddhist rule, Muslim Moghul emperors took control of Kashmir in the 15th century, converted to population to Islam and incorporated it into the Moghul empire. Islamic Moghul rule should not be confused with modern forms of authoritarian Islamic regimes. The Moghul empire, characterized by the likes of Akbar the Great (1542-1605) embodied Enlightenment ideals of tolerance and pluralism a century before the rise of the European Enlightenment. (Moghuls left their mark on the subsequent Sufi-inspired form of Islam that dominated the subcontinent in India and Pakistan, before the rise of more  jihadist-inspired Islamist mullahs. ) Afghan invaders followed the Moghuls in the 18th century, who were themselves driven out by Sikhs from Punjab. Britain invaded in the 19th century and sold the entire Kashmir Valley for half a million rupees (or three rupees per Kashmiri) to the brutal repressive ruler of Jammu, the Hindu Gulab Singh. It was under Singh that the Kashmir Valley became part of the state of Jammu and Kashmir. We will write a custom essay sample on Kashmir Conflict or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page PARTITION amp; DISPUTE: In 1947, British rule in India ended with the creation of two new nations: the  Union of India  and the  Dominion of Pakistan, while British  suzerainty  over the 562 Indian  princely states  ended. According to the  Indian Independence Act 1947, the suzerainty of His Majesty over the Indian States lapses, and with it, all treaties and agreements in force at the date of the passing of this Act between His Majesty and the rulers of Indian States,  so the states were left to choose whether to join India or Pakistan or to remain independent. Jammu and Kashmir, the largest of the princely states, had a predominantly Muslim population, while having a Hindu ruler (Maharaja  Hari Singh. ) On partition Pakistan expected Kashmir to be annexed to it. In October 1947, Muslim revolutionaries in western Kashmir and Pakistani tribals from  Dir  entered Kashmir, intending to liberate it from  Dogra  rule. Unable to withstand the invasion, the Maharaja signed the Instrument of Accession  on 25 October 1947 that was accepted by the government of India on 27 October 1947. Kashmir Today According to a Congressional Research Service report, Relations between Pakistan and India remain deadlocked on the issue of Kashmiri sovereignty, and a separatist rebellion has been underway in the region since 1989. Tensions were extremely high in the wake of the Kargil conflict of 1999, when an incursion by Pakistani soldiers led to a bloody six-week-long battle. Tensions over Kashmir rose dangerously in fall 2001, forcing then-Secretary of State Colin Powell to de-escalate tensions in person. When a bomb exploded in the Indian Jammu and Kashmir state assembly and an armed band assaulted the Indian Parliament in New Delhi later that year, India mobilized 700,000 troops, threatened war, and provoked Pakistan into mobilizing its forces. American intervention compelled then-Pakistani President  Pervez Musharraf, who had been particularly instrumental in further militarizing Kashmir, provoking the Kargil war there in 1999, and facilitating Islamist terrorism subsequently, in January 2002 vowed to end the presence of terrorist entities on Pakistani soil. He promised to ban and eliminate terrorist organizations, including Jemaah Islamiyah,  Lashkar-e-Taiba  and Jaish-e-Mohammed. Musharrafs pledges, as always, proved empty. Violence in Kashmir continued. In May 2002, an attack on an Indian army base at Kolchak killed 34, most of them women and children. The attack again brought Pakistan and India to the brink of war. Like the Arab-Israeli conflict, the conflict over Kashmir remains unresolved. And like the Arab-Israeli conflict, it is the source, and perhaps the key, to peace in regions far greater than the territory in dispute CAN KASHMIR PUT AT BACK BURNER? No, it can’t be put at backburner for the improvement of relations between India and Pakistan due to following reasons: Kashmir is the main bone contention between India and Pakistan. * MOUNTAINOUS REGIONS: Both India and Pakistan claim the mountainous region of Kashmir belongs to them. * PAKISTANIS CLAIM: The Pakistanis say that Kashmir should have become part of Pakistan in 1947 because most of their populations are Muslims. * INDIANS CLAIM: India claims Kashmir because the Maharaja in Kashmir handed over various powers to India in 1947. * INDUS RIVER: Kashmir is important to India and Pakistan because the source of the Indus River is located in Kashmir and whichever country controls Kashmir will control the Indus. Kashmir also holds religious significance to both countries. * GEOGRAPHICAL IMPORTANCE OF KASHMIR Kashmir is famous for its beauty and natural scenery throughout the world. Its high snow-clad mountains, scenic spots, beautiful valleys, rivers with ice-cold water, attractive lakes and springs and ever-green fields, dense forests and beautiful health resorts, enhance its grandeur and are a source of great attraction for tourists. It is also widely known for its different kinds of agricultural products, fruit, vegetables, saffron, herbs, minerals, precious stones handicrafts like woolen carpets, shawls and finest kind of embroidery on clothes. During summer, one can enjoy the beauty of nature, trout fishing, big and small game hunting etc. ; during winter climbing mountain peaks and sports like skating and skiing on snow slopes are commonly enjoyed. In addition to the above, Pilgrimage to famous religious shrines of the Hindus and the Muslims make Kashmir a great tourist attraction. About Kashmir Sheikh Sadia great Persian poet is believed to have said, If there is any heaven on earth, it is here in Kashmir†. * IMPORTANCE OF KASHMIR TO PAKISTAN: The importance of Kashmir to Pakistan as the lifeline can be well -understood by having a look at the  map  of Pakistan. Three out of six rivers, which run through Pakistan, originates from Kashmir namely Rivers Indus, Jhelum and Chenab where as remaining three namely Rivers Ravi, Sutlej and Bias originate from India. Economically,  the waters  of the Indus, Jhelum and Chenab, which originate through Kashmir, are vital to the agricultural life of Pakistan. Assuming that Kashmir was to accede to India, the same would also apply to the other three rivers, and not only the water of the rivers which flow from India to Pakistan but also that of the rivers which flow from Kashmir into Pakistan would be denied to Pakistan. For the same very reason, Kashmir assumes added importance for Pakistan from military point of view. Without Kashmir,  Silk route  to China will be greatly endangered and there will be no link with China-a time tested ally and  friend  of Pakistan. There will be no ground defense of Pakistan if the rivers and canals of Pakistan are dried up. It was this reason that the Prime Minister of Pakistan described the strategic value of Kashmir to Pakistan in the following words in 1951[1]. â€Å"Kashmir is very important, is vital to Pakistan; to India it is what you might call a luxury; with us it is a vital necessity for our survival. Kashmir as you will see from this  map  is like a cap on the head of Pakistan. If I allow India to have this cap on our head then I am always at  the mercy  of India the strategic  position  of Kashmir is such that without it Pakistan cannot defend itself against an unscrupulous government that might come in India. Then the sacrifices of the millions will have been in vain†. * On the basis of these reasons, former president of Pakistan, Field Marshal Muhammad Ayub Khan was of the view that  Ã¢â‚¬Å"both the Kashmir and Canal water Disputes are matters of life and death to Pakistan† * INDIAN WITHOUT KASHMIR: As per the Indian’s claims, there are historical and cultural ties of the state with India of which it has all through the ages been an integral part. Mr. Gopal, a Hindu writer in his article in Indian Periodical â€Å"Carvan† published in February 1950 offers following: * â€Å"India without Kashmir could cease to occupy a pivotal  position  on the political map  of Central Asia. Strategically, Kashmir is vital to the security; it has been so ever since the dawn of history. Its northern provinces give direct gateway to the North West province of Pakistan and Northern Punjab. It is India’s only window to the Central Asian Republics of USSR in the north, China  on the east and Afghanistan on the west†. Indians are also apprehensive that if Kashmir is given independence, it could set a â€Å"chain reaction† in motion of similar demands of other Indian ethnic groups and lead in turn to an extremely violent civil war in India. Similarly, Indians also quote the various elections held in Kashmir on an all India basis, which according to them have amply indicated that the Kashmiris have accepted the state as an integral – part of the India. But the ground realities are that the total boycott of State and Lok Sabha elections since 1987 and less than two percent turnout puts the very nature of these so called elections questionable. TO RESOLVE THE ISSUE: Pakistan’s Stand on Kashmir * The official  position  is that the Kashmir dispute should be resolved in the light of the UN resolutions. It continues to stress that the talks between India and Pakistan in the future should centre on securing the right of self-determination for the people of Kashmir. Pakistan has officially welcomed any  international  mediation  or a third-party role to facilitate talks. The Pakistani media subscribes to the view that  Ã¢â‚¬ËœKashmir is the core issue between India and Pakistan’  and without meaning full negotiations on the issue the situation between India and Pakistan is not likely to improve. * At the national level, Pakistan has been able to adequately handle the Kashmir situation. However, it has neither been able to provide effective assistance to the Kashmiri resistance nor has been able to resolve their differences. * At the bilateral level, a difference of approach exists between India and Pakistan. Internationally, Pakistan has achieved modest success in generating World response on the dispute and has sought favorable resolutions from such  international  bodies, like the OIC, NAM, ECO and European Community. Involvement of  international  agencies like the Amnesty  International, the Asian Watch and the Physicians for Human Rights in condemning the state sponsored atrocities in Kashmir, further strengthen the diplomatic stance of the Pakistan. Indian Stand on Kashmir: * According to the India, the state of Kashmir since its accession to India is an integral part of the union of India. The only component of the Kashmir issue legally admissible in talks between India and Pakistan over the future of the state pertains to the need for Pakistan to back away from state ‘sponsored terrorism’ in India and to ‘vacate the territories occupied illegally by Pakistan. ’ The official Indian  position  argues that the future status of the state otherwise is a domestic problem, which will entail a Punjab like  solution, within the corners of the Indian constitution and that the talks between India and Pakistan should occur in a strictly bilateral framework.

Content Management Systems essays

Content Management Systems essays A content management system (CMS) is a term used to describe a system that manages Web site content. The CMS is well known for its ability to provide templates that allow a content author to manage the creation, modification and removal of Web site content without the need to know Hypertext Markup Language (HTML). Thus, the organization is less dependent on specialized Web developer skills for Web site development and maintenance. However, the are numerous lesser known benefits such as data integration, design consistency, personalization, content syndication, automation of review, approval and publishing, and indexing, search, and retrieval that make CMS's an attractive value proposition for most Because a CMS separates the management of content from design, a Web page can more easily include content from multiple sources such as databases and files. The format management feature allows electronic and scanned paper documents to be formatted into HTML or Portable Document Format for use on the Web site. And, Web developers can more readily leverage templates and design elements to ensure consistency throughout the Web site. This also means that maintenance is less complicated because developers only need to modify templates instead of individual Web pages. Most CMS's allow different levels of access permissions to be set for separate areas of a Web site, facilitating work by areas of responsibility. Web sites are growing more complex in their needs for personalization and content syndication. More and more, companies wanted to customize Web sites to appeal to different audiences, particularly in sites for electronic commerce. In conjunction with a customer relationship management system that understands the site visitor's preferences and behavior, CMS's help to manage the personalized content that they can access. Web sites are no longer operated in a vacu...

Medieval Childbirth and Baptism

Medieval Childbirth and Baptism The concept of childhood in the middle ages and the importance of the child in medieval society is not to be overlooked in history. It is fairly clear from the laws designed specifically for the care of children that childhood was recognized as a distinct phase of development and that, contrary to modern folklore, children were not treated as nor expected to behave as adults. Laws regarding the rights of orphans are among the pieces of evidence we have that children had value in society, as well. It is difficult to imagine that in a society where so much value was placed on children, and so much hope was invested in a couples ability to produce children, children would regularly suffer from a lack of attention or affection. Yet this is the charge that has often been made against medieval families. While there have been- and continue to be- cases of child abuse and neglect in western society, to take individual incidents as indicative of an entire culture would be an irresponsible approach to history. Instead, let us look at how society in general regarded the treatment of children. As we take a closer look at childbirth and baptism, well see that, in most families, children were warmly and happily welcomed into the medieval world. Childbirth in the Middle Ages Because the foremost reason for marriage at any level of medieval society was to produce children, the birth of a baby was usually a cause for joy. Yet there was also an element of anxiety. While the childbirth mortality rate is probably not as high as folklore would have it,   there was still a possibility of complications, including birth defects or a breech birth, as well as the death of mother or child or both. And even under the best of circumstances, there was no effective anesthetic to eradicate the pain. The lying-in room was almost exclusively the province of women; a male physician would only be called in when surgery was necessary.  Under ordinary circumstances, the mother- be she peasant, town-dweller, or noblewoman- would be attended by midwives. A midwife would usually have more than a decade of experience, and she would be accompanied by assistants whom she was training. In addition, female relatives and friends of the mother would frequently be present in the birthing room, offering support and good will, while the father was left outside with little more to do but pray for a safe delivery. The presence of so many bodies could raise the temperature of a room already made warm by the presence of a fire, which was used to heat water for bathing both mother and child. In the homes of the nobility, gentry, and wealthy townspeople, the birthing room would usually be freshly-swept and provided with clean rushes; the best coverlets were put on the bed and the place was turned out for display. Sources indicate that some mothers may have given birth in a sitting or squatting position.  To ease the pain and to hasten the process of childbirth, the midwife might rub the mothers belly with ointment. Birth was usually expected within 20 contractions; if it took longer, everyone in the household might try to help it along by opening cupboards and drawers, unlocking chests, untying knots, or even shooting an arrow into the air. All of these acts were symbolic of opening the womb. If all went well, the midwife would tie off and cut the umbilical cord and help the baby take its first breath, clearing its mouth and throat of any mucus. She would then bathe the child in warm water or, in more affluent homes, in milk or wine;  Ã¢â‚¬â€¹she might also use salt, olive oil, or rose petals. Trotula of Salerno, a 12th-century female physician, recommended washing the tongue with hot water to assure the child would speak properly.  It was not uncommon to rub honey on the palate to give the baby an appetite. The infant would then be swaddled snugly in linen strips so that his limbs might grow straight and strong, and laid in a cradle in a dark corner, where his eyes would be protected from bright light. It would soon be time for the next phase in his very young life: Baptism. Medieval Baptism The primary purpose of  baptism  was to wash away original sin and drive all evil from the newborn child. So important was this  sacrament  to the Catholic Church that the usual opposition to women performing sacerdotal duties was overcome for fear an infant might die unbaptized. Midwives were authorized to perform the rite if the child was unlikely to survive and there was no man nearby to do it. If the mother died in childbirth, the midwife was supposed to cut her open and extract the baby so that she could baptize it. Baptism had another significance: it welcomed a new Christian soul into the community. The rite conferred a name on the infant that would identify him throughout his life, however short it might be. The official ceremony in the church would establish lifelong ties to his godparents, who were not supposed to be related to their godchild through any blood or marriage link. Thus, from the very beginning of his life, the medieval child had a relationship to the community beyond that defined by kinship. The role of godparents was mainly spiritual: they were to teach their godchild his prayers and instruct him in faith and morals. The relationship was considered as close as a blood link, and marriage to ones godchild was prohibited.  Because godparents were expected to bestow gifts on their godchild, there was some temptation to designate many godparents, so the number had been limited by the Church to three: a godmother and two godfathers for a son; a godfather and two godmothers for a daughter. Great care was taken when selecting prospective godparents; they might be chosen from among the parents employers, guild members, friends, neighbors, or lay clergy. No one from a family that the parents hoped or planned to marry the child into would be asked. Generally, at least one of the godparents would be of a higher social status than the parent. A child was usually baptized on the day he was born. The mother would stay at home, not only to recuperate, but because the Church generally followed the Jewish custom of keeping women from holy places for several weeks after giving birth. The father would assemble the godparents, and together with the midwife they would all bring the child to the church. This procession would frequently include friends and relatives, and could be quite festive. The priest would meet the baptismal party at the church door. Here he would ask if the child had been baptized yet and whether it was a boy or a girl. Next he would bless the baby, put salt in its mouth to represent the reception of wisdom, and exorcise any demons. Then he would test the godparents knowledge of the prayers they were expected to teach the child: the  Pater Noster,  Credo, and  Ave Maria. Now the party entered the church and proceeded to the  baptismal font. The priest would anoint the child, immerse him in the font, and name him. One of the godparents would raise the baby up from the water and wrap him in a christening gown. The gown, or crysom, was made of white linen and might be decorated with seed pearls; less wealthy families might use a borrowed one. The last part of the ceremony took place at the altar, where the godparents made the profession of faith for the child. The participants would then all return to the parents house for a feast. The entire procedure of baptism mustnt have been a pleasant one for the newborn. Removed from the comfort of its home (not to mention its mothers breast) and carried out into the cold, cruel world, having salt shoved into its mouth, immersed in water that could be dangerously cold in winter all this must have been a jarring experience. But for the family, the godparents, friends, and even the community at large, the ceremony heralded the arrival of a new member of society. From the trappings that went with it, it was an occasion that appears to have been a welcome one. Sources: Hanawalt, Barbara,  Growing Up in Medieval London  (Oxford University Press, 1993). Gies, Frances, and Gies, Joseph,  Marriage and the Family in the Middle Ages  (Harper Row, 1987). Hanawalt, Barbara, The Ties that Bound: Peasant Families in Medieval England (Oxford University Press, 1986).

Configuring Files, NTFS, and Backups Assignment

Configuring Files, NTFS, and Backups - Assignment Example Security breaches possibly caused by human actions, which could be malicious, accidental, or through improper installation, operation or configuration. This paper presents guidelines that should be adopted to ensure efficient management and security of any information and communication technology network. These guidelines are written with keeping in mind of a less experienced IT network managers, to assist them in understanding and dealing with the risks they face. Upon implementation, these guidelines will go a long way in easing with problems of network insecurity. Network security policy guidelines are the practices and rules followed by an institution to protect its information resources. These polices must be documented, developed, reviewed, implemented and evaluated to ensure the integrity of the network. Hence, the need for these policies by an institution is never overemphasized (Avolio & Fallin, 2007). Program policies. It tackles overall Network security goals and it should be applied to all IT resources inside an institution. The institution’s management must instruct policy development to guarantee that the policies address the Network security requirements of all systems operating within the institution. System-specific policies. It addresses the Network security matters and requirements of a particular system. Corporate facilities may have several sets of system-specific policies that address security from the very common (access control) to the particular (system authorizations that reflect the isolation of duties among a team of employees). Create an approval procedure to include legal and human resources specialists, regulatory specialists and procedure and policy experts. Allow maximum time for the review and respond to every comment whether you accept it or not. Institution once developed its network security policy; next step is to document these policies. Each department is responsible to protect its networks,

IB economics internal assessment portfolio Essay

IB economics internal assessment portfolio - Essay Example However, the proportion of investment to GDP remains relatively unchanged, during the period of higher economic growth. The service sector in China is growing exponentially, which is not accounted for while calculating the GDP and the sector plays a crucial role in Chinese economy. Consistently high investment rate in China implies high rates of domestic saving which are exceptional not only by international standards, but more particularly for an economy at China's level of per capita GDP. Gross domestic product is the total value of new goods and services produced in a given year within the borders of a country, regardless of by whom. It is "gross" in the sense that it does not deduct depreciation of previously produced capital, in contrast to Net domestic product. There is two ways of calculating GDP, i.e., Income approach and expenditure approach. The income approach takes into account the income earned by the citizen. Sometime it is more important than GDP if a country has much foreign direct investment and many foreigners work in the country. Although about 70% of its population lives in the rural area, China's economic growth depends very much on the rapid expansion of manufacturing and service sector rather than on the agriculture, except for the earlier phase of the 1980s. The value added of industrial sector has accounted for 45% of China's GDP, while that of agriculture only about 10% and still declines. This gives rise to growing rural urban income disparity. The inequality within China has had mainly spatial dimensions, in terms of growing income and consumption inequality between rural and urban areas as well as across regions. Aggregate demand curve is the graph of quantity demanded as a function of price, normally downward sloping, straight or curved, and drawn with quantity on the horizontal axis and price on the vertical axis. In macro economy, aggregate demand curve indicates the various quantities of goods and services that purchasers are willing to buy at different price levels. The aggregate is negatively related to price. The inverse relationship between price and the amount demanded of a specific commodity, reflects the fact that consumers turn to substitutes when a price increase makes a good more expensive. The aggregate demand curve is downward sloping because of wealth effect on the consumption, interest rate effect on investment and the exchange rate effect on the net export. The aggregate supply curve reflects how the price is determined given the aggregate demand to aggregate capacity. The short-run aggregate supply curve indicates the various quantities of goods and services that firms wil l supply at different price levels during the period immediately following a change in the price level. The aggregate supply curve is upward sloping because with an increase in output the price or inflation rate will increase. Changes in aggregate demand cause the curve to shift outward (to the right) or inward (to the left). Changes in aggregate supply cause the curve to shift outward (down) or inward (up). Meanwhile increase in output also indicates the increase in employment and thus the decrease in unemployment rate. The unemployment is an important problem of micro economic theory which is calculated by the ratio of unemployment to the total labour force. There is a significant relation between