The Arterial Blood Pressure Health And Social Care Essay

Blood force per unit area refers to the measuring of force that is applied to the walls of the arterias as the bosom pumps blood through the organic structure. The force per unit area is determined by the force and the sum of blood pumped, and the size and flexibleness of the arterias. High blood force per unit area, besides known as Hypertension, is considered as above 120/80 mmHg ( PubMed Health, 2011 )PathophysiologyArterial blood force per unit area is a merchandise of cardiac end product and systemic vascular opposition. A alteration in the vascular wall thickness affects the elaboration of peripheral vascular opposition in hypertensive patients. This consequences in the contemplation of moving ridges back to the aorta and hence increasing the systolic blood force per unit area ( Medscape, 2011 ) . Although 90 % of high blood pressure instances, the cause is non truly known ( Moser, p.11 ) , harmonizing to the Australian Institute of Health and Welfare ( AIHW ) , the causes of h igh blood force per unit area are both biomedical and lifestyle oriented. Major causes include ; being overweight, dietetic salt consumption, and nutrition forms which involve low consumption of fruit and veggies and an high consumption of saturated fat ( Australian Institue of Health and Welfare,2010 ) . Although most of the clip there are no marks and symptoms, such may happen ; confusion, ear noise or buzzing, weariness, concern, irregular pulse, epistaxis, vision alterations. These marks are known as marks of complication or perilously high blood force per unit area called malignant high blood pressureNursing AppraisalAs a patient is admitted to the infirmary, it is critical to execute a nursing appraisal on admittance to garner baseline readings of the patient. The Systems Approach Framework was used to buttockss Mr Nicholas Manners from caput to toe in a mode of subjective and nonsubjective informations. The classs used are as follows ; Central Nervous System, Cardiovascular S ystem, Respiratory System, Gastrointestinal Tract, Renal System, Integumentary System and Metabolic System. CNS – patient is able to communicate-states he has a concern, assess motion of limbs, esthesis to fringes and trouble if any. CVS – HR 95, BP 160/90, assess capillary refill, patient is red in the face – assess circulation of the remainder of the organic structure including warmth and coloring material. RESP. – RR 19 beats per minute, SaO2 97 % on room air, auscultate his chest- listen for abnormalcies in the lungs as he is a tobacco user, measure his work of external respiration. GIT – farther buttocks appetency and eating wonts, auscultate for intestine sounds, buttocks and record intestine direction. RENAL – buttocks input and end product and record observations if needed, utilizing a unstable balance chart. INTEGUMENTARY – buttocks tegument for cicatrixs, waterlessness, integral and skin turgor. METABOLIC – buttocks Hb, BGL and liver map through a blood trial.Education and Psychosocial supportEducation and support that can be offered to Nicholas to help him in deriving more information and support for his Hypertension include: Dieticians which Nicholas can be referred to during his stay in infirmary, to educate him about a healthy diet and besides supply support. Social worker to supply support for Nicholas and his household if needed. Information brochures can be retreived from the infirmary, to educate Nicholas on Hypertension. Web sites such as Better Health Channel, Hypertension Education Foundation and the Heart Foundation, all provide instruction and information about support for patients about high blood pressure.Nursing DiagnosisGoalsInterventionsRationaleEvaluationIneffective wellness care related to incapableness to change life style Short term: Introduce low-sodium and low fat nutrients into Nicholas ‘ diet Refer Nicholas to a dietitian for instruction of low-sodium and low-fat nutrients. To cut down the sum of high-fat nutrients Nicholas is devouring. Nicholas ‘ diet presently consists of less high-fat nutrients. Short term: Aim to cut down blood force per unit area readings to less than 150/80 by the following GP visit in a hebdomad. Teach Nicholas to take Nicholas ain blood force per unit area daily at place and record it. To brace Nicholas ‘ blood force per unit area at a lower degree. Nicholas ‘ blood force per unit area readings have now stabilised to a lower degree. Long term: Develop a regular exercising program for Nicholas to follow. Promote Nicholas to walk for an hr each twenty-four hours. To promote Nicholas to prosecute in a healthy life style. Nicholas participates in an hr of physical activity each twenty-four hours. Long term: Aim to discontinue smoke in the following 8-12 months. Refer Nicholas to back up plans such as ‘QUIT ‘ to back up and help Nicholas in discontinuing smoke. To cut down Nicholas ‘ hazard of holding blocked arterias and therefore increasing Nicholas blood force per unit area Nicholas has now quit smokeNursing DiagnosisGoalsInterventionsRationaleEvaluationFatigue related to the effects of high blood pressure and the day-to-day life stressors. Short term: Aim to command side effects such as weariness. Educate Nicholas on the side effects, to help him in commanding them. To help Nicholas in deriving cognition of the side effects and how to command them in instance they are experienced after discharge. Nicholas is able to command his small if any side effects experienced. Short term: Aim to keep a stable degree of fluids in the organic structure. Ensure Nicholas drinks plentifulness of H2O throughout the twenty-four hours. To maintain Nicholas hydrous and cut down weariness. Record amounts utilizing a unstable balance chart if needed Nicholas ‘ weariness degrees have decreased as he is imbibing plentifulness of H2O throughout the twenty-four hours. Long term: Reduce the emphasis degrees experienced throughout the twenty-four hours. Discuss emphasis cut downing methods applicable to Nicholas. To cut down the hazard of increasing Nicholas ‘ blood force per unit area. Nicholas has reduced his emphasis degrees utilizing the methods discussed Long term: Develop a healthy feeding program to utilize one time Nicholas is discharged Refer Nicholas to a dietician to help in educating him in the importance of a healthy diet and developing a program. To cut down weariness related to an unhealthy diet. Nicholas has continued his healthy feeding program and does non endure from weariness.Nursing DiagnosisGoalsInterventionsRationaleEvaluationImbalanced nutrition related to deficient cognition of the relationship between diet and the disease Short term: Brace the instabilities of nutrition Provide Nicholas with a scope of fruits and veggies To supply Nicholas with a assortment of foods from a scope of nutrients. Nicholas ‘ diet now chiefly consists of fruit and veggies Short term: To do Nicholas ‘ cognition on the disease Provide Nicholas with information such as booklets about high blood pressure To guarantee Nicholas has a good cognition of high blood pressure Nicholas is now good educated on his disease Long term: To brace Nicholas ‘ weight within 6-8 months of discharge Refer to dietician to measure and supervise his diet and aid with his weight loss To guarantee Nicholas has the support required to run into his end Nicholas is now within a healthy weight scope for his gender, tallness and age Long term: Derive more cognition on the effects of smoke Educate Nicholas on the effects of smoking to his organic structure To guarantee he is cognizant of the harm smoke is making to his organic structure Nicholas is good informed on the effects of smokeNursing DiagnosisGoalsInterventionsRationaleEvaluationNon-compliance related to the side effects of the intervention ( Ackley & A ; Ladwig, p.315 ) Short term: Maintain stableness of side effects Monitor Nicholas and supply advice when non following instructions of intervention To guarantee Nicholas ‘ intervention continues on the right way. Nicholas ‘ side effects have decreased. Short term: Long term: Long term: Maintain conformity of intervention Educate Nicholas on hazards if intervention non followed as required To guarantee Nicholas ‘ wellness does non deteriorate Nicholas is compliant with his interventionDiagnostic TrialsDiagnostic trials that will help with the appraisal and direction of Nicholas include: Electrocardiogram ( ECG ) – This trial determines if the bosom has sustained nay harm due to untreated high blood pressure ( Cardio Connection, n.d ) . This trial assists with the direction of Nicholas ‘ high blood pressure by supplying moving ridges of the electrical current of the bosom. Urinalysis – This trial is used to test the causes of high blood pressure and expression for any harm to the kidneys as a consequence of untreated high blood pressure ( Cardio Connection, n.d ) . The trial assists with the direction to derive information about the wellness of Nicholas ‘ kidneys. Blood Glucose – This trial determines the sugar degrees in the blood and screens for secondary causes of high blood pressure and the hazard factors involved with more accelerated diseases such as diabetes. Both diabetes and high blood pressure are associated with the rapid patterned advance of arterial sclerosis and harm to the kidneys ( Cardio Connection, n.d ) . This assists in keeping a stabile sugar degree of the blood to cut down the hazard of harm to the kidneys. Serum K – This trial looks for a treatable cause of high blood force per unit area and finding the baseline degree prior to utilizing medical specialty for intervention ( Cardio Connection, n.d ) . This assists in finding a baseline to compare to if it were to promote.Hazard AppraisalUpon admittance, a hazard appraisal must be completed to find the patient ‘s hazard of holding a autumn. This appraisal besides assists the nurses in guaranting the patient has their properties or AIDSs within range to guarantee the patient ‘s safety and to diminish their hazard of hurt. The appropriate appraisal tool for Nicholas would be a Falls Risk Assessment Tool ( FRAT ) . This relates to Nicholas as he complained of giddiness and deficiency of slumber. This is needed to measure his hazard of hurt. Mention to Appendix 1 for a Falls Risk Assessment Tool.MedicinesNifedipine – Antihypertensive agent – as stated by Tiziani, 2006 Action: Besides known as Ca adversaries, these agents impede the inflow of Ca ions during depolarization of cardiac and vascular smooth musculus, doing betterment in the myocardial O supply and cardiac end product, and a decrease in myocardial work by cut downing afterload ( Tiziani, 2006 ) Use: Angina pectoris Mild to chair high blood pressure Nicholas has been prescribed this medicine to help with bracing his blood force per unit area. Interactions: Contraindicated with rifampicin May do bosom failure if used with beta-adrenoceptor-blocking agents Serum concentrations may be increased if given with Tagamet, Quinidex or Cardizem. Excessive cardiovascular depression may happen if given with inspiration anesthetics. Adverse effects: Headache, giddiness, dizziness, flushing, weariness, dizziness. Anorexia, sickness, irregularity, abdominal hurting, dry oral cavity. Muscle spasms. Nursing points/precautions: Note and study thorax hurting because thie requires stoping the drug. Patient should be advised to avoid drive or operating machinery if giddiness or dizziness is a job. Caution if used in those with aortal stricture, bosom failure, liver damage, discrepancy or Prinzmental angina, unstable angina, or recent myocardial infarction. Atorvastatin – lipid-regulating agent – as stated by Tiziani, 2006 Action: Reduce cholesterin significantly in patients with type II lipemia and hence besides significantly cut down the hazard of coronary arteria disease Use: Hypercholesterolaemia Nicholas has been prescribed this medicine to take down the entire cholesterin and low-density lipoproteins ( LDL ) Interactions: May addition plasma concentration of Lanoxin, increasing the hazard of toxicity. Caution if used with Tagamet, Aldactone or ketoconazole. Adverse effects: Headache, insomnia. Constipation, flatulency, abdominal hurting, sickness, diarrhea. Back hurting Nursing points/precautions: Liver map trial should be performed before get downing therapy and at 6 and 2 hebdomads, so twice annually. Advise patient to describe any musculus hurting, spasms, tenderness or failing, unease or febrility. Should be withheld if any status occurs that predisposes the patient to rhabdomyolysis, such as injury, sepsis, uncontrolled epilepsy or metabolic, or endocrinal instabilities.

Hunter-gather to settled community Essay

Growth of existing trade routes –Silk Roads, Mediterranean Sea, Trans-Saharan, Indian Ocean—due to innovations and technology (caravans, compass, larger ships, credit) The rise of new trade routes centering on Mesoamerica and the Andes Commercial growth due to new trading organizations (Hanseatic League), and state practices (minting of coins, paper money) and state-sponsored commercial infrastructures such as the Grand Canal of China Trans-Eurasian trade as a result of the expansion of empire (china, Byzantine Empire, Muslim caliphates, Mongols) Cross- Cultural exchanges through existing or new networks of trade and communication. The diffusion of cultural, scientific and technological traditions and new food crops, agricultural techniques, and epidemic diseases (including the Black Death) along Eastern Hemisphere trade routes Byzantine Empire, Chinese dynasties, Islamic states, Mongol Khanates, and feudalism in Europe and Japan The expansion of state systems in the Americas: Mayan city states, Mexica (â€Å"Aztecs†), Inca Technological and cultural transfer between states and empires, including tang China and the Abbasids, across the Mongol Empires,  and during the Crusades Increased agricultural and industrial production in many regions due to technological innovations (such as Chinmpa(floating plants in the water) field systems) the expansions of textile, porcelain, iron and exports from china, Persia and India Revival of urban centers, the rise of commerce and warmer temperatures between 800 and 1300; rising agricultural productivity and population, and the greater availability of labor. Varying forms of labor organization: free peasant agriculture, guild organization, several forms of coerced and unfree labor (serfdom, mit’a, slavery) The spread and diffusion of Buddhism, Christianity, Islam, and Neoconfucianism, and corresponding changes in gender relations and family structure. Intensification of existing regional trade networks, bringing prosperity and economic disruption ot the trading regions of the Indian Ocean, Mediterranean, Sahara, and overland Eurasia. European synthesis of technological developments based on knowledge developed in the classical, Islamic, and Asian worlds – resulting in new tools, ship designs, and understanding of global wind and current patterns. New transoceanic maritime reconnaissance: Zheng He in the Indian Ocean, Portuguese in West Africa, Spanish voyages across the Atlantic and Pacific, European searches for multiple routes to Asia across the North Atlantic A new global circulation of goods driven by mercantilist European monarchies, with worldwide circulation of silver from the Americas, colonial joint-stock companies, and the use of free and unfree laborers mixing African, American, and European cultures and peoples The Columbian Exchange of diseases, foods, and domesticated animals between Eastern and Western hemispheres, with subsequent population increase in Afro-Eurasia but indigenous population loss, deforestation, and soil depletion in the Americas Worldwide innovations in visual and performing arts, such as the Renaissance in Europe (with its accompanying expansion of literacy) A growing global demand for raw materials and finished products, resulting within Africa and the export of slaves to the Mediterranean, Indian Ocean, and the Americas; and a range of coerced labor in American colonial economies (indentured servitude, encomienda system) The formation of new political and economic elites as a result of imperial conquests and widening global economic opportunities, such as the Manchus in China and creole elites in Spanish America Fluctuating power of existing elites such as the nobility in Europe and daimyo in Japan, as a reult of increasingly powerful monarchs and leaders Gender and family restructuring: demographic changes in Arica resulting from the slave trades, the trade relationships of Southeast Asian women and European men, and the smaller size of European families Massive demographic changes in the Americas resulting in new ethnic and racial classifications (mestizo, mulatto, creole) Use of a variety of methods by rulers to legitimize, consolidate, and centralize power – including monumental architecture, urban design, religious ideas (European divine right, Aztec human sacrifice, Songhay promotion of Islam), differential treatment of ethnic and religious groups (Ottoman treatment of non-Muslims), recruitment of bureaucratic elites and military professionals (Ottoman devshirme, Chinese examination system, samurai), tribute collection, and tax farming Increased use of gunpowder, cannons, and armed trade to establish large  empires in both hemispheres: European trading- post empires in Africa and Asia; land empires in China, India, the Middle East, and Eurasia (Manchus, Mughals, Ottomans, Russians) Spanish, Portuguese, Dutch, French, and British maritime empires in the Americas Competition over trade routes (Caribbean piracy), state rivalries (Thirty Years War), and local resistance (samurai revolts) challenged state consolidation and expansion

Explain, giving examples from the articles Essay

Explain, giving examples from the articles, what is meant by oxidation and show how oxidation reactions are used to cause explosions. Outline reasons why some explosive mixtures oxidise faster than others. [4] An element is oxidised if†¦ It gains oxygen. It loses electrons. Its oxidation state increases. Explosives such as gunpowder or black powder contain powdered carbon, sulphur and potassium nitrate. This can be ignited by a fuse where carbon and sulphur will be oxidised. Carbon will form into Carbon Dioxide and Sulphur will form into Sulphur Dioxide. > This reaction shows when a pure sample of carbon burns in air. C(s) + O2(g) i CO2(g) This is an oxidation reaction where carbon has gained oxygen and its oxidation state has increased from 0 to +4 The potassium nitrate in the gunpowder acts as an oxidiser and provides oxygen for the reaction. All the oxygen required is available almost instantly; therefore carbon and sulphur burn in a fraction of a second. > The reactants and products of this reaction are†¦ Reactants: KNO3(s) C(s) S(s) Products: CO2(g) SO2(g) N2(g) + Other solid products The volume of the reactants is very small. The products are mainly hot gases produced suddenly in a confined area. This rapid increase in pressure leads to an explosion. (132 Words) To maximise the force of the reaction, all solids involved are finely divided into powders and the proportions of reactants in the mixture are calculated very accurately. The power of the explosion is made greater by confining the reaction inside a restricted space e. g. Cannon. Fuels used in fireworks; Potassium Chloride (KClO3) and rockets; Hydrogen Peroxide (H2O2) are mixed with oxidisers to produce explosions. Some explosive mixtures oxidise faster than others if the reacting element(s) gains more oxygen and has a greater oxidation state.   Give an account of the development of chemical compounds for use in explosives. Describe the advantages of each new chemical explosive over its predecessors, and describe how the explosives were adapted to make them safer and more effective. [9] The very first discovery of an explosive chemical compound was unintended. In 1846 Dr Christian Schi nobein accidentally spilled concentrated sulphuric and nitric acids; he quickly cleaned the contaminated area with an apron made of cotton. Knowing that the apron would soon be destroyed by the acids, he rinsed it out with water and hung it up to dry in front of the fire. Moments later the cloth burst into flames. Dr Schi nobein was not aware that he had discovered â€Å"gun cotton† otherwise known as Cellulose Nitrate or Nitrocellulose. From 1860s onwards the military began investigating the possibilities of cellulose nitrate as a smoke-free gunpowder. Towards the end of the nineteenth century, black powder had been replaced as a propellant for military purposes by a smokeless powder based on cellulose nitrate. This substance catches fire very quickly and burns without lighting a fuse; produces very little smoke and creates an impulsive impact. Therefore, explosive shells were replaced by cannon balls and bullets replaced musket balls. This smokeless powder used by the British Army is called cordite and was invented in 1880s. It consists of Cellulose Trinitrate and Glycerol Trinitrate amongst other substances. This substance catches fire very easily and burns quickly. The powder was transformed into a jelly-like substance by adding an organic solvent propanone. This smokeless powder is now used worldwide as a military propellant. (253 Words) In 1847 an Italian scientist, Ascanio Sobrero was experimenting with concentrated acids. He combined together nitric, sulphuric acids with glycerine. The new substance formed was a yellowish oil. He had discovered Nitroglycerine. He experimented with a small sample and realised that was extremely unstable. Its behaviour was unpredictable. It could be detonated by the touch of a feather. Immanuel Nobel and his son Alfred Nobel from Sweden were responsible for controlling Nitroglycerine. Nobel made a deliberate explosion by mixing Nitroglycerine with (kieselguhr) which is a silica based mineral. He made a paste which could be shaped into rods. These would only explode when they are intentionally detonated. These are the very first safe high explosives. Nobel developed even safer ways to detonate these explosives. He found out that the most reliable and effective way to set off nitroglycerine was to use small quantities of gunpowder. He also invented the first percussion cap that gives out a small explosion when it is given a sharp impact. The caps were filled with a compound known as fulminate of mercury Hg(CNO)2. This substance is very sensitive that even a finger tap can cause it to detonate. This ignites the gunpowder or other explosives. In 1867 Nobel patented his dynamite. It was called Dynamite No 1. He soon realised that very effective mixtures could be made by replacing the inert kieselguhr by a substance that would itself burn or explode. He combined nitroglycerine with charcoal, barium nitrate and sulphur which led a new explosive product in 1869. It was called Dynamite No 2. This product was suitable for use in quarries and coal mines. Nobel patented another explosive product in 1875. He added 7 to 8 per cent of collodion (nitrated cellulose) to warm nitroglycerine forming a stiff jelly-like substance known as blasting gelatine. This product proved to be more powerful explosive than dynamite, because both nitroglycerine and collodion were explosive. During the Second World War, Trinitrotoluene (TNT) was developed. TNT contains nitro groups (NO2). It doesn’t react with metals therefore can be used in metal containers to produce bombs. TNT causes headaches, anaemia and skin irritation. Subsequently, workers in factories often suffered health problems. (280 Words)   Discuss, with reference to high and low explosives, the ideal features of an explosive reaction, explaining, with examples, how chemical reactions produce energy and how they cause increase in pressure. [6] Nitroglycerine is acknowledged as a high explosive. It produces a large volume of hot gas. Its decomposition only takes microseconds at a pressure of 275 000 atmospheres. Black Powder and Cellulose Nitrate are considered as low explosives. They produce a large volume of hot gas. The decomposition takes millisecond at a pressure of 6000 atmospheres. An ideal explosive reaction must take place very quickly. It must be an exothermic reaction where heat is given out. The products formed must mainly be hot gases produced in a confined space. This leads to a big rise in pressure which is the main cause of the explosion. > An equation for explosion of nitroglycerine C3H5N3O9 (l) 3CO2 (g) + 21/2H2O (g) +11/2N2 (g) + 1/4O2(g) 1 mol of liquid 7. 25 moles of gas No oxygen supply from air was needed for the reaction. The exact products are based on the actual explosion. In an oxidation reaction oxides of nitrogen such as (NO and NO2) may be produced. The amount of heat energy released from a nitroglycerine explosion is 6275 KJ kgi 1. The increase in pressure will produce greater energy from the explosion. Describe how UK methods of manufacture of propanone have changed since the beginning of the First World War. [3] Before the war propanone was manufactured by dry distillation of wood in a process that excluded air. This method was very inefficient. In 1914 a Russian chemist, Chaim Weizmann, developed a new process that produced propane by bacterial fermentation of starch in maize. This process was capable of producing 30 000 tonne. After the war propanone was manufactured from propan-2-ol by passing the vapour over a copper catalyst at 500i C and 400kPa. Propanone was produced from propene, a product of catalytic cracking of crude oil fractions. (230 Words)   Discuss how attitudes to health and safety in chemical research and industrial chemistry have changed over time. Use examples from the history of development and manufactures of explosives and medicines. [4] The discovery of cellulose nitrate was a hazard of health and safety. The discovery of nitroglycerine was another major hazard as it its behaviour was very unpredictable. Its discoverer Ascanio Sobrero was badly scarred as a result of an unexpected explosion that spattered glass fragments into his hands and face. He said â€Å"victims killed during nitroglycerine explosions† He was ashamed to be the inventor of such a deadly explosive. In Nobel’s nitroglycerine factory, there was an explosion that killed his young brother Emil and another chemist. However test on animals showed that nitroglycerine causes blood vessels of the brain and heart to flow with blood. Nitroglycerine was considered a possible treatment. Nitroglycerine is effective for treating angina pectoris; intense pain in heart. A medicine known as amyl nitrate similar to nitroglycerine are used as treatments to this day. (110 Words) OCR-AS Chemistry (Salters) Open-Book Paper (2005) 2852/01 – 1 – Name: Mohammad Ahmed Candidate No. 9023 Show preview only The above preview is unformatted text This student written piece of work is one of many that can be found in our GCSE Patterns of Behaviour section.

No topic Essay Example | Topics and Well Written Essays - 1000 words - 3

No topic - Essay Example The article emphasizes the fact that once Google launches its â€Å"Google Editions†, the online service to sell e-books, it would be in direct competition with another behemoth in the area of digital books, Amazon. The main issue analyzed here is the competition from Amazon and their pricing strategy along with the distribution channels both companies will adopt to market their services since the real winner will be the product that reaches the customer in the most convenient way possible. It is a well known fact that Amazon is the leader in the space for selling books and accessories online. It was one of the first companies to set up a website for selling books and accessories online. The success of the model pioneered by Amazon spurred many companies (Barnes and Noble, Borders etc) to enter the area of selling books online. The article clearly highlights the potential for rivalry between Google (once it launches Google Editions) and Amazon as both the companies are essentially targeting the same market i.e. the consumers of e-books. Further, the article discusses the possibility of a â€Å"price war† where each of the competitors would be going in for a â€Å"race to the bottom† in search of the consumers for their products. The Implications of this strategy would be discussed in due course. This section analyzes the case from the 4P’s of the marketing mix, namely: Price, Product, Place and Promotion. These are the cornerstones of any marketing strategy and the successful execution of these in a combination or individually would determine the success of the venture as is being undertaken by Google. The marketing mix is the â€Å"set of controllable, tactical marketing tools that the company blends to produce the response it wants in the target market.† (Kotler, 2009 63) To take the first component of the Marketing mix, the biggest advantage that Google has is its competitive pricing. Since the

Global Business Essay Example | Topics and Well Written Essays - 1750 words

Global Business - Essay Example The weaknesses and threats on the other hand arise from the external environment and the business may not have any control over such. The business must therefore implement specific policies to streamline its operations with the view of maximizing profitability based on the above. PEST analysis on the other hand investigates political, economic, social and technological factors that affect the operations of the business. Table of Contents Executive summary 2 Table of Contents 3 PEST Analysis 4 PEST analysis for the newspaper industry in developed economies 5 SWOT Analysis of The Guardian 6 Strengths 6 Weakness 7 Opportunities 7 Threats 7 Field Force Analysis for the newspaper industry in the developed world 8 The Indian Newspaper industry 9 References 10 PEST Analysis PEST analysis is a management tool that analyses the macro economic factors that affect the operations of a business in any industry and market. The tool that investigates social, economic, social and technological facto rs provides a realistic survey of any market by analyzing all the potential sources of either opportunities or threats that influence the operations of the business. Political factors are fundamental since politics influence the legal factors that influence the market. ... Such present businesses with operational challenges as the populace turn against each other thus instigating looting and massive destruction of establishments. In such a country, a business may consider seeking insurance services against political violence. This way, politics creates market for other service providers while threatening others. Similarly, social, economic and technological factors also create and destroy markets thus influences the viability of a market. Technology influences both productivity and consumption of product. The prevailing technological factors will therefore influence the consumers thus creating markets for particular products and services while threatening the viability of other markets. Such social factors as religion and cultures equally influence the consumption of certain products and services thus creating potential markets for specific products while eliminating the possibility of selling particular products in such regions. The entrepreneur must therefore employ the PEST analysis continuously to align the operations of the business and the production process to the prevailing factors thus achieving the profitability objective (Homburg, Sabine & Harley, 2009). PEST analysis for the newspaper industry in developed economies Developed economies such as the United States of America have effective democratic system implying that the markets in the countries enjoy stability and peaceful environments for operations. Besides the conducive environments, the presses in the countries enjoy a degree of freedom and independence that opens the market for any willing investor. With effective leadership, the populace enjoy myriad freedoms with the governments often

Mangin Ethics Essay Example | Topics and Well Written Essays - 500 words

Mangin Ethics - Essay Example This new incentive plan also put pressure on the service advisors, the front-desk counter people who meet the customers and advised them on the repairs to be done, based on recommendations of mechanics. Its good intentions were soon engulfed in the unethical behaviors by both the service advisors and the mechanics because they tend to mislead customers by recommending the repairs that were really unnecessary, just to meet their sales quotas of certain product item-specific parts and thereby earn commissions as well. The factors contributing to this unethical situation was its incentive plan which stokes the greed of employees to earn commissions and also the pressure of meeting the sales quotas imposed by the management of Sears to increase its profits. The ethical approach taken by Sears, Roebuck & Co. was the consequentialist approach because they did not mind how the sales quotas are met or attained by its employees as long as its objective of raising its profits is attained in a highly-competitive environment of auto repairs. Management was desperate to reverse its sales decline and therefore did not mind how to attain a better profit picture as long as it is achieved. In this regard, it is like the saying â€Å"the end justifies the means† which is actually quite Machiavellian in its nature already (Falco, 2004, p. 384). Sears response to the allegations was inadequate because it did not even issue apologies to its customers. Instead, what it did was justify its actions by claiming the repairs were done for purposes of preventive maintenance, especially on older cars. Further, it claimed some errors had been committed but only in rare instances, that the allegations of fraud was not widespread in its store chain. More damaging perhaps was it retained and merely re-designed its incentive plan by excluding the service advisors from commissions but the mechanics are still on

Characteristics and Behaviors of Effective Counse Assignment

Characteristics and Behaviors of Effective Counse - Assignment Example The new therapist had some good guiding techniques that helped make progress during the session. It is extremely important to know the major theories in counseling, but even more important still is to know when and what circumstances to apply them on. The therapist was able to figure out that the problems he was dealing with stemmed from childhood and personal experiences. This is evident of evidence-based practice, which is where rather than incorporating one theory, they apply specific techniques for intervention on a specific problem (Corey, 2009). The therapist was then able to lead the client on a guided introspection which is good in having the client understand their problems by looking at themselves. Empathy and positive encouragement were also extremely good techniques in order to build understanding with the client. This also was a good example of listening, with the therapist asking for input from the client as well as the guide and pace method (Levitt 2001). Empathy and u nderstanding help build the trust and understanding between the two. Positive encouragement is good in instilling confidence in the patient and evoking positive feelings. As a new therapist, it is a given that mistakes will be made. There were some major flaws in the first counseling session.

Supervision for Instructional Improvement Essay - 1

Supervision for Instructional Improvement - Essay Example For sometime now, Bruce Joyce and his colleagues have been saying that typical staff development â€Å"probably will not generate the amount of change necessary to affect student achievement†. Instead they advocate along with Sparks, Fullan and others---the creation of the kind of â€Å"Communities of teachers† who engage in focused, recurring cycles of instruction, assessment, and adjustment of instruction†.(Joyce and Showers 2002) â€Å"Research emphasizes that coaching is a prerequisite for the implementation of new skills strategy†( Showers, Joyce and Bennett 1987). Leaders must be aware that the provision of ongoing support is crucial to the successful attainment of an innovation. Therefore, one of the first staff development initiatives to be offered to teachers in the classroom, is peer coaching. For staff development expert Thomas Guskey, the promise of professional development has gone â€Å"largely unfulfilled†. The solution in staff develo pment is build around â€Å"collaborative exchange†, in which â€Å"teachers work together, reflect on their practice, exchange ideas, and share strategies†(Guskey 2003) Richard Stiggins writes that 2 â€Å"assessment literacy†, is so integral to the ongoing improvement of instruction in â€Å"learning teams† â€Å"Work shops†, he says â€Å"will not work†, they â€Å"do not† permit the application of and experimentation with new assessment ideas in real classrooms, and sharing that experience with other colleagues in a team effort†(Stiggins 1999).

Telepresence is Finally Coming of Age Essay Example | Topics and Well Written Essays - 1000 words

Telepresence is Finally Coming of Age - Essay Example Similar to face-to-face interactions, telepresence meetings allow users to view one another and the tension to stay attentive and engaged occurs. For most offices, such an innovation would prove the ideal solution (Shein 2010). Clearly, the abilities of the technology might form an experience that feels very realistic. However, users must question whether the experience is similar in quality to real human communication. As a result, prior to continuing to grow telepresence technology, an organization must take its effect on human communication and relationship quality into account. a. Apart from the travel cost savings mentioned in the case study, two less tangible advantages for applying telepresence over the travel alternative are the quality of the life of a worker and ecological footprint. These merits are not effortlessly weighted or valued. As a result, I will offer and reference conformist approximations in this research to support my answers. These kinds of innovations are only possible because of the functionality of grids, particularly telecommunications (Shein 2010). b. Levels of stress affect human health significantly. Researchers surveyed traveling businesspersons in 2000 who recorded 80% more clinical claims than those who are stationary (Shein 2010). Consequently, clinical claims can result in lost work output at the workplace. Between 60 and 90% of grievances made by patients and taken to doctors are about stress (Shein 2010). Researcher Dr. Herbert Benson says three of the most widespread symptoms, headaches, serious pain, and hypertension, account for more than half of lost incomes from absenteeism. It is logical to presume that retain workers in their homes as much as possible to prevent increases in their stress levels (Shein 2010).  

Children and violence Research Paper Example | Topics and Well Written Essays - 2000 words

Children and violence - Research Paper Example Nowadays, there is much concern on the incidents of violence among adolescents and children. This troubling and complex issue needs a deep understanding by teachers, parents, as well as other adults. Children, as young as those in preschool portray violent characteristics, possibly due to the violent surroundings they are exposed to. This presents a lot of challenges to the parents, teachers and the wider society. Thus, this essay will look into such challenges facing children, their effects and the solution to the violence crisis in the society. The rising violence rates in most American cities show that most children are being raised in conditions known as â€Å"inner-city war zones† (Garbino et.al., 1992). However, the violence problem is not limited to a particular group or community. Every child today is affected by this violence which pervades the contemporary society. Thus, a healthy progress of children in today’s world has been jeopardized. The causes as well as effects of cases of violence in the society are complex just as they are interrelated; most violence arises from social prejudice common in the society. Key among the major contributors are unemployment, racism, poverty, substance abuse, guns proliferation, abusive parenting practices, and everyday exposure to violent scenes via the media, among others (Craig, 1992). Currently, every fifth child is exposed to poverty; for the children below six years, the number is twenty five percent. The fundamental services to families with a low income have been significantly reduced in the past decade as the federal funding in America has been cut. With the disappearance of social programs and the deterioration of the economy, violence in schools, homes, and communities have escalated. The handguns proliferations have also greatly contributed to the increasing violent assaults as well as homicides that children

Australia study (social and political cultures) Essay

Australia study (social and political cultures) - Essay Example The phrase â€Å"ANZAC traditions† has its roots firmly in the First World War when the mother country called for troops from its colonies in order to fight the war. The combined forces of Australia and New Zealand were better known as the ANZACs or the Australian and New Zealand Corps. In battle the soldiers from the ANZAC division showed remarkable bravery and determination to win the war. Over time within the war years the ANZAC tradition came to denote the very characteristics that defined these soldiers namely their courage, good humour, mateship, endurance, ingenuity and larrikinism (Howe, 1995). This tradition meant that the soldiers from the ANZAC division were perceived impervious to the class and cultural differences found in British society. This phrase not only has meaning in connection to the First World War alone but can be seen as a defining moment for Australian national history. Previously Australians perceived themselves as subjects of the mother country but following the social and cultural consolidation after the First World War, the Australians begun to see themselves as a separate nation. Even today this phrase is used to indicate the nascent years of Australian nationhood (Smith, 2006). In a similar manner, the word mateship has come to symbolise Australian culture over time. As seen in the preceding phrase, the ANZAC tradition one of the defining features of the Australian soldiers was mateship (McDonald, 2009). Mateship refers to an embodiment of equality, friendship and loyalty. There has been rampant debate as to the origins of mateship as a word in common use. Some texts have inaccurately traced the origins of mateship to the early convicts who were settled in Australia when it was treated as a penal colony. However other research has conclusively proved that the word mateship emerged out of the predominantly Irish working class that was present in British society. Nineteenth century Australia

Admission Seeking Interviews Essay Example for Free

Admission Seeking Interviews Essay There are several reasons why a person would consider and actually go through with committing fraud. It could be due to a perceived pressure, for example financial problems, abuses like drugs or alcohol, pressure from superiors, or simply because the individual is a disgruntled employee who thinks the company â€Å"owes them†. Or the reason could be they want to increase their lifestyle like â€Å"keeping up with the Joneses†. Other pressures could come from superiors who coerce employees to go along with the fraud or lose their jobs. Fraudsters rationalize their misdeeds with thoughts like; they will replace the stolen asset in the near future before anyone notices, or maybe the boss is doing it so why can’t I? Higher level employees like the CEO may rationalize that stock prices will be higher if they manipulate the financial statements, after all who they are hurting? It all comes out in the wash, right? Creative accounting is all it takes and adjustments could be made in the future to remedy this year’s fraud. Individuals who do a fraudulent act typically have the opportunity to commit the fraud. It could be because of shoddy internal controls; even with good internal controls a determined person could find a way to override them. A CEO or manager may think they are high enough on the totem pole that no one would question their antics. Once a fraud has been discovered or reported the fraud examiner must do his/her homework. They must secure data and documents to determine if a fraud has actually happened. Once all the evidence has been gathered about the crime and the subjects background has been determined the fraud examiner sets up an appointment which could be a planned or spontaneous event. He/she would interview the interviewee using a variety of techniques and executing objectivity, fairness and professionalism at all times. The subject who thinks the interviewer is out to help them and does ot judge their misdeeds would be more forthcoming with information so it is important that the interviewer thanks the person periodically offers breaks and concessions lie coffee or a drink. Once it has been determined that the subject was involved through investigation and preliminary interviews the examiner would sympathize with the subject stating such things as â€Å"anyone would do that in your position†. It is important that they establish a rationalization and motive for the fraud. The fraud examiner could produce other witness’ statements to try to get the subject to reveal their motive. Once the motive or rationalization is uncovered it would be important to discover how the act took place. What opportunities did the subject have to commit the crime? Examples could be poor internal controls, management that was lax, or the fraudster was capable of outsmarting his superiors. There are many recommended methods to have a successful interview. Each case is unique and has to be handled in a different way, but the outcome is pretty much the same. The purpose to an admission seeking interview is to determine how it was done, opportunity, why it was done, rationalization, and finally what made the person do it, perceived pressure. In closing, people are complex and unique in their make-up; there is no mold or template that determines who will commit a fraud or why they may do it. Not all people that have pressures for example sole providers of a struggling family, or can rationalize a reason, or have the opportunity will commit a fraudulent act. Basically we all have to live our lives under a certain code of conduct. People who deviate from the honest worker lack morals in my opinion. It is up to the examiner to uncover the truth. The fraud triangle is a helpful tool that gives a standard of the typical fraudster. Classifying potential pressures, opportunities, or probable rationalizations and by using the techniques of a successful interviewer one should net the desired result in determining if the subject is indeed guilty or just being set up by the whistleblower for whatever reason.

Class Inequalities in Health

Class Inequalities in Health The Black Report (Black et al, 1980) was commissioned in 1977 by the Labour Secretary of State. Though there had always been a public concern about social class difference and mortality, it was the first ever review of the Health of Britains working age population. The initial purpose of the report was to measure the impact of ill health within the workforce (Macintyre, 1997). However, the report shocked the government by revealing a clear correlation between ill heath and lower social class. Conversely these inequalities have been widening rather than diminishing since the establishment of the National Health Service (NHS) (Gray, 1982). This essay is going to focus on the main factors behind class inequalities that the Black Report identified and how relevant this report is today. The Black Report identified a relationship between social class and ill health, life expectancy and infant mortality rates. The persistence of these inequalities has become the subject of continuing debate. The Black report identified four different possible explanations; artefact, social selection, cultural and material. The artefact explanation considers the existence of health inequalities as simply an artefact of the measurement system used. According to this theory any variance in health within social classes will depend on how both health and class are measured (McIntyre, 1997). However, these inequalities are often still present even when different techniques are employed when measuring social class. It is thought, if anything, that the statistics may in fact under report the extent of class and health inequalities (Kirby et al. 1997). The second explanation for these health inequalities is social selection. This theory speculates that people with ill health will generally decrease in social status while a fit and healthy person would be more likely to advance social class (Maguire, 2010). This combined effect contributes to the evident health inequalities. Within this idea a distinction between direct and indirect health selection has been made. Direct is where health alone is attributed to social mobility whereas indirect is where another quality is involved with the mobility process (Wilkinson, 1987, Platt, 2006) Few supporters of this extreme view can be found. Though ill health may have an effect on social mobility, it is often too small to account for any significant health difference (Wilkinson, 1996). Townsend and Davison (1990) also found that relatively few sick professionals experience downward occupational changes. However, as regards the social selections importance as an explanation of health inequali ties it appears to play a small but yet still significant role (Platt, 2006). The two remaining (cultural and material) explanations of health inequalities have received considerable attention. The cultural explanation proposes that members of lower social classes often choose less healthy lifestyles (smoking, eating larger quantities of fatty foods and participating in less exercise) compared to members of middle or upper class groups, thus resulting in comparatively ill health. However, similar patterns in ill health can also be found within people who follow a relatively healthy lifestyle. Though it cant be disputed that there is a correlation between a less healthy lifestyle choice and ill health, it cannot be considered the full explanation for the presence of health inequalities (Townsend and Davison, 1990, Pratt 2006) The final factor behind inequalities in health identified by the Black Report is material. This explanation highlights the role of economic factors in the distribution of ill health. Within this it is thought that members of lower social groups face material constraints and poor living conditions which prevent them from living a healthy lifestyle. These material constraints include poverty, bad housing, low income and a lack of health and educational resources. This theory coincides with Wilkinsons (1997) argument that Poverty is the most important determinant of health. The material explanation does account for a significant amount of the inequality between social classes, possibly more so than the other explanations, but once again it cannot account for all. The Black Report clearly identified many shortcomings within healthcare. It is also apparent that each of the four factors previously identified play a role in explaining the presence of these health inequalities, though some play a more significant role than others. Due to the change to a Conservative government at the time the report was published it was released quietly (only 450 copies available) with the hope it would go unnoticed (Abercrombie and Ward, 2000). This meant that it was many years until any action was taken. In 1987 the Health Education Council (HEC) commissioned the Health Divide. This report was concerned with measuring the current health inequalities and to determine what progress had been made since the Black Report was published 7 years previously. Like the Black Report the findings emphasized the link between ill health and social class and identified that the gap between social classes had widened. More recently in 1997 Labour commissioned the Acheson report (Acheson, 1998) which was an independent inquiry into health inequalities (Abercrombie and Ward, 2000). Similar to the Health Divide, the Acheson Reports findings mirrored those of the Black report. These included rates of long term illness (e.g heart disease and strokes) in 45-64 year olds being 17% in members of upper class groups compared to 48% in lower socioeconomic groups. These results once again indicate a considerable social class health inequality that is still widening (Davey et al, 1990). Also these results agreed with the fourth explanation within the Black report (material) as poverty was identified as the main cause of social inequality. It is clear that over the last thirty years social inequalities within health has been a major issue. Since these reports were issued reversing this trend of health inequalities has been a high priority on the government agenda (Abercrombie Ward, 2000). Who are committed to lower these inequalities (Department of Health, 2004). Unfortunately, even with all the actions that have been taken the gap between social groups is thought to have worsened (Sim and Mackie, 2006, Davey, 1990).

Abnormal Uterine Bleeding (UAB) In Gynaecological Practice

Abnormal Uterine Bleeding (UAB) In Gynaecological Practice INTRODUCTION Abnormal uterine bleeding (AUB) is a common complaint in gynaecological practice, represents a major proportion of out patients attendence. One, in 20 women in UK consulted their GP for menorrhagia. [1] A menstural cycle of fewer than 21 days or more than 35 days or a menstural flow of less than two days or, more than seven days is considered abnormal. [2] AUB can be categorized as excessive menstural bleeding, irregular, bleeding intermenstural including, postcoital bleeding. [3] Different terms, used to describe AUB are: oligomenorrhea (bleeding occurs at intervals of > 35 days usually caused by, prolonged follicular phase). Polymenorrhagia, (bleeding occurs at intervals of 21 days may be caused by a luteal phase defect). Menorrhagia, (bleeding occurs at normal intervals (21 to 35 days)but with heavy flow (80 ml) or duration (7 days). Menometrorrhagia, (bleeding occurs at regular, non cyclic intervals with heavy flow (80 ml). (2) Abnormal uterine bleeding, includes both DUB bleeding from structural causes. Dysfunctional bleeding can be anovulatory, which is characterized by heavy but regular periods. (I-e, menorrhagia). Structural causes include: fibroids, polyps, endometrial carcinoma pregnancy complications. Abnormal bleeding can also results from contraceptive methods. (4) In peri postmenopause women, it is essential to exclude endometrial carcinoma. In younger women, endometrial hyperplasia anatomical anomalies: such as uterine fibroids, comprise the main pathology. (5) Perimenopause is the period, 2 8 years preceding menopause 1 year after the final menses. (WHO). However, a better practical definition is, the phase preceding the onset of menopause, generally occurring around 40-50 years of age, during which the regular cycle of a women transition to a pattern of irregular cycles. (6) A variety of methods, have been used to investigate patients with AUB, such as, endometrial cytology, transvaginal ultrasound, hysteroscopy, D C and endometrial biopsy . (7) The recommendation regarding, investigation of AUB is that women, over the age of 45, should be investigated with endometrial biopsy. Frequently, this is performed as an inpatient procedure with the biopsy being obtained by uterine curettage (D C). (5)This is the most common procedure used, to evaluate the endometrial cavity of a patient with AUB. (8) However, the value of endometrial curettage is great, in the establishment of histopathologic diagnosis. (6) The operation involves a G. A often a two day stay. Originally, the procedure was thought to have a therapeutic effect or AUB, But studies have failed to support this. This procedure is performed for diagnostic purposes, to exclude endometrial malignancy. (9) REWIEW OF LITERATURE ABNORMAL UTERINE BLEEDING Abnormal uterine bleeding (AUB) is a symptom it is not a disease, but is a common debilitating condition. Dysfunction uterine bleeding (D. U. B) is the diagnosis, given to women with AUB in whom no clear etiology can be identified. [10, 11]. An approach accurate diagnosis depend on recognizing the following types: Menorrhegia: is cyclic bleeding at normal intervals, which is excessive is larger than 7 days o and amount more than 80 ml frrom normal secretory endometrium after normal ovulation is caused by conditions affecting the uterus. (10, 11) Polymenorrhea: is cyclical bleeding which is normal in amount but which occurs at too frequent intervals of Polymenorrhegia: is cyclical bleeding which is both excessive too frequent. Eg: 9/20-12/20. It implies a disturbance in the hypothalamic pituitary ovarian uterine axis. (10) Metrorrhegia: It is bleeding of any amount whch is cyclical which occur irregularly or continuously in between normal cycles. It is caused by benign or malignant growth with ulcration. (10) Dysfunctional Uterine Bleeding continuously occurs at the extreme of reproductive (adolesence perimenopausally). The abnormalities of ovarian activity may be classified as follows. Upto 90% of cases of DUB result form menstrual cycles in which ovulation does not occur (anovulation) (Dodds). The remainder of cases arise from problems associated with ovulation such as dysfunction of the corpus luteum or prolonged progesterone secretion. (12) Anovulatory Occasionally anovulatory cycles occur in all women. Upto 90% of cases of D. U. B result from menstural cycles in which ovulation does not occur(anovulation. The remainder of cases arise from problems associated with ovulation such as dysfunction of the corpus luteum or peolonged progesterone secretion. Chronic anovulation in associated with an irregular unpredictable pattern of bleeding ranging from short cycles with scanty bleeding to prolonged period of irregular heavy loss. In anovulatory cycles, the endometrium is unable to produce factors whose sysnthesis is controlled by progesterone, eg. PGF2a (Smith et al, 1982). This may account for the painless bleeding. Anovulatory bleeding may be associated with cystic glandular hyperplasia of the endometrium. This occurs in some older women also in peripubertal girl, where unopposed oestrogen secretion occurs. Endometrial hyperplasia may cause excessive bleeding, anaemia, infertility even endometrial carcinoma. (13) Ovulatory: (idiopathic bleeding) It appears that there are a number of endometrial products, which alters the degree of vadoconstriction thus may effect the volume of menstrual blood loss. In the mid 1970s, a relationship b/w prostaglandins (PG) production menorrhegia was suggested by work showing that total endometrial PG content was proportional to menstrual loss. It appears that a shift in endometrial conversion form the vasoconstrictor PGF20( to the vasodilator PGI2 occurs. Another important factor is endothelin, which is very potent vasoconstricter, produced within the endometrial vessels. Marshs group showed reduced endothelin immunostaining in the endometrium of women with monorrhegia , implicating this peptide in the pathophysiology of increased menstural blood loss. (Marsh 996) (13) Etiology of Abnormal Uterine Bleeding Before Menarche: Malignancy, trauma sexual abuse or assault are potential causes of abnormal uterine bleeding before menarche. Child bearing years: Pregnancy is the first consideration in women of childbearing age who present with AUB. Potential causes of pregnancy related bleeding includes miscarriage, ectopic pregnancy , placenta previa, abrutio placentae trophoblastic disease. Next, iatrogenic causes of AUB should be explored. Bleeding may be induced by medication, including anticogulants, selective serotonin reuptake inhibitors, antipsychotics, cortiosteriods, hormonal medication, tamoxifen (Nolvadex). Herbal substance including ginseng, ginko, soy supplement, may cause menstrual irregularities by altering estrogen levels or clotting parameters. (14), (15) Systemic Disorders: Includes thyroid, hematologic, hepatic, adrenal, pituitary, hypothalamic conditions menstural. Irregularities are associated with both hypothroidism (23. 4% of cases) hyperthyroidism (21. 5% of cases). Coagulation Disorders: Inherited coagulopathy may be the underlying cause of AUB in 18% of white women 7% of black women with menorrhagia. Others causes include polycystic ovary syndrome or diabetes mallitis present with obesity, acne, hirsutism acanthosis nigricans. Genital tract pathology may be associated with intermenstural, postcoital and heavy menstural bleeding, Any history of abnormal Papanicolaou (Pap) smear, sexually transmitted disease, gynaecologic surgery, trauma or sexual abuse should be elicited. Uterine fibroids, endometrial polyps, adenomyosis, endometrial hyperplasia and atypia and endometrial cancer should be excluded. [14, 15] Differential Diagnosis Pregnancy complications: Threatened abortion   Incomplete abortion   Ectopic pregnancy Nonuterine bleeding: Cervical ectropion/erosion   Cervical neoplasia/polyp   Cervical or vaginal trauma   Condylomata   Atrophic vaginitis   Foreign bodies Pelvic inflammatory disease (PID): Endometritis   Tuberculosis Local factors: Endometrial polyps   Endometrial neoplasia   Adenomyosis/endometriosis   Uterine myomata (fibroids)   Intrauterine device (IUD) Uterine sarcoma Coagulation disorders: Thrombocytopenia, platelet disorders   von Willebrand disease   Leukemia   Ingestion of aspirin or anticoagulants   Iatrogenic Causes: Anticoagulants Antipsychotics Corticosteroids Herbal other supplements(ginkgo, soy) Hormone replacement intrauterine devices Oral contraceptive pills Thyroid hormone replacement PATHOPHYSIOLOGY OF ABNORMAL UTERINE BLEEDING: The hallmark of normal menstrual bleeding is the final result of fluctuations in the hypothalamic-Pituitary-Adrenal-Ovarian axis leading to predictable denudation and slough of the endometrium. Hemorrhage followed by prompt hemostasis and repair causes stabilization and regrowth of the endometrium. Physiologically, constant flow levels of estrogen prime the endometrium. Normal secretion of progesterone from the corpus luteum stabilizes the endometrium, decreases vascular fragility and supports the endometrial stroma. Patients with menorrhagia typically have an imbalance of prostaglandins levels and increased fibrinolytic activity . Specifically, women with heavy bleeding often have elevated levels of plasminogen activators compared to those with normal menstruation. [16] An intact coagulation pathway is important in regulation of menstruation. Mensturation disrupts blood vessels and in the face of normal hemostasis, the injured blood vessels are rapidly repaired . Restoration of blood vessels requires successful interaction of platelets and clotting factors. Defficiency of platelets, abnormal platelet function and an intact coagulation pathway may be associated with profound changes in the menstrual ctcle. [16]. Anovulatory D. U. B is usually due to failure of the corpus luteum to sustain the developing endometrium. The decline of inhibin levels and rise in FSH levels reflect the loss of follicular activity and competence as the perimenopausal transition occurs, [16]. Ovulatory D. U. B occurs when ovulatory cycles coexist with intracavitary lesions including polyps, endometrial cancer or fibroids which cause erractic bleeding, [16]. NATURE OF ABNORMAL UTERINE BLEEDING: The studies have shown mean menstrual blood loss to be ~ 30 ml per cycle in most societies, with loss > 60-80 ml per month being associated with an increased tendency towards iron deficiency and anaemia( Hallberg ET AL, 1996 ;Code et al, 1971). An upper limit of 60 ml may be more appropriate clinically. [17]. The duration of normal menstruation also varies greatly, with an average of 5 days and the heaviest loss usually on the first 2 days(Matsumoto at al, 1962 ; Rubin and Crosignani, 1990). Duration of flow is considered abnormal when it lasts 7 days. [17]. Abnormal uterine bleeding may involve any disturbance of regularity, frequency, duration or volume of menstrual flow and the causes may be physiological, pathological or pharmacological (Fraser and Sngertekin, 2000), [17]. MECHANISM S INVOLVED IN AUB: MENORRHAGIA: Menorrhagia is caused by certain pelvic diseases. The mechanisms by which these conditions cause excessive bleeding are poorly understood, but evidence suggest that large , thin walled and fragile surface vessels underlies the menorrhagia occurring with myomata and endometrial carcinoma. This disturbed angiogenesis is most likely a consequence of unco-ordinated release of angiogenic factors from the tumor themselves(Jane and Harris, 1998), s/a VEGF, bFGF, TGF-beta( Stewart and Nowak, 1996)[17]. The mechanism of increased blood loss with copper IUCDs is thought to be due to a combination if increased cytokine- producing endometrial leukocytes ( Sheppard, 1987), increased local fibrinolytic activity and epithelial surface erosion due to contact with the device(Shaw et al, 1979_. Release of PG and activation of mast cells and macrophages may be the underlying mechanisms. [17]. A quantitative reduction in platelets s/a in autoimmune thrombocytopenia or chronic renal failure can lead to increased menstrual loss. DYSFUCTIONAL UTERINE BLEEIDNG: Dysfunctional uterine bleeding accounts for ~50% of all cases of excessive uterine bleeding, 9Barley, 1972)[17] Anovulatory Dysfuctional Uterine Bleeding: The exact mechanisms behind anovulatory bleeding are unknown(Fraser et al, 1996) but it is known that unopposed estrogen can lead to excessive endometrial proliferation and hyperplasia with increased and dilated draining veins and suppression of spiral arterioles ( Beilby et al , 1971). Large thin walled, tortuous, superficial endometrial vessels can often be demonstrated on the surface of hyperplastic endometrium(Hamou, 1985) and increased fragility is a probable contribution to increased blood loss. Unopposed estrogen has a direct effect on the uterine blood supply by reducing vascular tone (Fraser at al, 1987) and possibly an indirect effect through inhobiting vasopressin releae( Akerlund et al, 1975) leading to vasodilation and increased blood flow. Unopposed estrogen also stimulates stromal VEGF expression which may contribute to disturbed angiogenesis ( Zhang at al, 1995 ; Smith , 1998). [17]. Ovulatory Dysfunctional Uterine Bleeding: The main defect in ovulatory DUB appears to be in the control of processes involve in the regulation of the volume of blood lost during menstrual breakdown of the endometrium, primarily the processes of vasoconstriction and haemostasis. [17] Endometrial glandular and stromal estrogen and progesterone receptor levels may be increased in the late secretory phase in women suffering from DUB (Gleeson et al, 1993 )[17] There may be some role of endothelins, which increase in at the time of normal menstruation. ( Cameron et al , 1992)[17] Reduced levels of endothelins may lead to an increase in the volume of blood lost. An increase in total PG release and disappropriate rise in PGE2 have been demonstrated in ovulatory DUB (Smith et al, 1981 ). It also has been shown that there is an increase in PGE2 and PGI2 receptors predisposing to vasodilation, in women with menorrhagia ( Adelantado et al, 1988 )[17] Prevention of platelet aggregation by PGI2 release may be an important contributing factor in ovulatory DUB ( Smith et al, 1981 ) as may increased endometrial tPA content, increased local fibrinolytic activity ( Bonner et al, 1983;Casslen et al, 1996;Gleeson et al, 1993 ) and excessive endometrial heparin like activity ( Paton et al , 1980 )[17} Endometrial lysosomal enzyme activity in women with ovulatory DUB is increased, and this activity is also observed in women with menorrhagia secondary to IUCD use (Wang , 1994 ){17 ) Matrix metaloproteinases may be important in contributing to abnormal endometrial breakdown and abnormalities of menstrual bleeding ( Salamonson et al, 2000 ){17, 18 ]. Granulated stromal lymphocytes, macrophages and othe migratory leukocytes may contribute to mechanisms of excessinve loss. [18] In DUB, delayed or incomplete endometrial repair could prolog menstrual bleeding episodes, but nothing is known about such mechanisms. [18] SIGNS AND SYMPTOMS OF ABNORMAL UTERINE BLEEDING: Frequent complaint include: heavy or prolonged menstural flow, social embarrassment, diminished quality of life, sexual compromise and alteration in life style. Pain is not a common presenting symptom unless associated with passage of large blood clots. Prolonged menstrual blood loss can be associated with anaemia. Typical complains of anaemia include fatigue, unusual desire of eating starch or dirt and headaches. Severe anaemia may cause fainting, congestive cardiac failure, exercise induced fatigue, shortness of breath. Hemorrhagic shock death are rare sequelae for DUB. [16] EVALUATION OF AUB IN PERIMENOPAUSAL WOMEN: 1.  History: History focuses on identifying the type of AUB:ovulatory, anovulatory or anatomic in order to guide treatment. Ovulatory bleeding is more common, usually cyclic, and can be associated with mid cycle pain, premenstrual symptoms and dysmenorrhea. Anovulatory bleeding occurs more frequently at the axtremes of reproductive age and in obese women. It is usually irregular and often heavy. Any history of easy bruising and tendency to bleed suggests coagulopathy. History of jaundice and hepatitis gives the evidence of liver sisease. [19] 2. Physical Examination: Physical examination includes looking for evidence of systemic disease. Pelvic and bimanual examination are done to detect disease in the genital tract. Cervical cytology analysis should be current and normal and cervical and vaginal swabs should be assesses to rule out infection. [19] 3. Laboratory tests: Beta subunit human chorionic gonadotropin for pregnancy. Complete blood count with platelet count for coagulopathy LFT, PT for liver disease. TSH for hypothyroidism and hyperthyroidism. Free testosterone for ovarian or adrenal tumor. [19] 4. Assessment of the uterine cavity: The main indications for assessment of the uterine cavity is to exclude pathology, most often seen in women over 45 years of age with anovulatory cycles. [19] A wide variety of methods are available for endometrial assessment including: Ultrasonography Endometrial Biopsy Hystroscopy Dilatation and curettage Sonohysterography Hysterosalpingography 1. Ultrasonography: Ultrasonography to look for ovarian or uterine disease. Transvaginal ultrasound is 80% sensitive and 69% specific for fibroids and polyps and is superior to transabdominal ultrasound. If possible, transvaginal ultrasound should be performed on days 4-6 of the menstrual cycle. [19] 2. Endometrial Biopsy: Endometrial biopsy is a simple office procedure that can be done by family physicians, [19]despite its convenience , cost effectiveness and safety, it is a blind endometrial sampling procedure. [20]It is a useful method to exclude malignancy in perimenopausal women. The annual incidence of endometrial cancer is 19. 5 per 100, 000 women. One in 4 cases of endometrial carcinoma occurs before menopause, so biopsy should be considered for high risk premenopausal patients, even in the presence of fibroids. Endometrial biopsy produces an adequate sample more that 85% of the time and detects 87-96% of endometrial carcinoma. [19] 3. Hysteroscopy: Hysteroscopy permits direct visualization of the cercical canal and uterine cavity, enabling observation of intrauterine abnormalities. Hysteroscopy is considered an accurate gold standard in uterine cavity evaluation. Despite the lack of adequate information about the diagnostic accuracy, it is used in many studies with and without endometrial sampling as a reference standard, [21] Hysteroscopy was reported to have sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of 94. 2, 88. 8, 96. 3 and 83. 1% respectively, in predicting normal or abnormal endometrial histopathology (Garuti et al, 2001). The highest accuracy of hysteroscopy was in diagnosing endometrial polyps, where as the worst result was in estimating hyperplasia. In a recent study the sensitivity and PPV of hysteroscopy without endometrial biopsy in diagnosing endometrial carcinoma was only 58. 8 and 20. 8 % respectively (Lo and Yuyen, 2000 ). There, since the incidence of focal lesions in patients with AUB is 46-74% (Nagele et al, 1996;Pal et al, 1997 ), it seems that the most cost effective approach is to proceed with hysteroscopy complemented by endometrial biopsy, early in the assessment of AUB. [22] 4. Dilatation Curettage: Dilatation is a common surgical procedure done on women to scrape and collect the tissue from inside the uterus. Dilatation is a widening of the cervical passage. This is done using smoothy conical and tapered, graduated metal rods of various sizes and these appropriately called the dilators, which dilates the tight cervical passage slowly. Curettage is the second part of the procedure and is done to scrape the inside contents of the uterus. For this, a sharp spoon like instrument called curette is used. The procedure is usually performed under general anaesthesia. [23, 24, 25] Indications:[23, 24, 25]s Dialtation and curettage may be done as a diagnostic or a therapeutic procedure. Diagnostic: Diagnose conditions by collecting tissue samples for biopsy. To diagnose endometrial cancer. To investigate the causes of infertility. To investigate the cause of abnormal bleeding in postmenopausal women taking HRT. Therapeutic: Treat intermenstural bleeding To remove polyps in the endometrial or inner lining of the uterus. To treat irregular and heavy bleeding. To remove an embedded IUD used for contraception. To perform abortion in the early stages of pregnancy. To evacuate spontaneous abortion product. [23, 24, 25] Preoperative procedure: It is recommended that the patient take nothing by mouth, for at least 6 hours. Pain killers and antibiotics may be prescribed before the procedure. A sedative may be useful to relieve the anxirty of srgery. The genital area may be shaved and prepared for the surgery. An enema may be administered to clear the bowels. [23] Anaesthesia: General Anaesthesia: Most D Cs are done under general anaesthesia. The procedure is normally very short and the general anesthetic can be quickly reversed, with the patient going home soon afterwards. Spinal Anaesthesia: The advantage of spinal anaesthesia is that the patient is awake but at the same time does not have any sensation below the waist. It avoids all the complications of general anaesthesia. Local Anaesthesia: Occasionally, D C s are done under local anaesthesia, if the patient is not ready for general or spinal anaesthesia. [23, 25] Procedure: The vagina and cervix are cleaned with an antibacterial solution that may be iodine or alcohol based. The cervix is visualized using an instrument that is locatedin the vagina called the speculum. Lights are so adjusted to visualize the cervix so that its upper lip can be grasped with a special curved forceps called the Vulsellum. This helps both in stabilizing and bringing the cervix down towards the vaginal opening to ease with rest of the procedure. Dilatation is next done using sequential metal round tapered dilators and the opening to the uterus is gradually widened to about the size of a large pencil. Once this dilatation has been completed, the curette is inserted into the uterine cavity and is used to gently scrape the lining of the uterus. When the surgeon feels the gritty layer of cells just above the muscle of the uterus, then he/she knows that the scrapping has gone deep enough to sample the tissue adequately. This scrapping is done throughout the uterus and the tissue is sent to histopathologist. [23, 24, 25, 26] Post operative care: There may be mild abdominal discomfort after a dilatation and curettage, if pain is severe, consult a doctor. Medication should be taken as advised by doctor. Ensure to take antibiotics. Avoid the use of any contraceptive device or sexual intercourse for a week. Use sanitary napkins during this time period. If there are any signs of infection s/a fever , pain or discharge, consult the doctor immediately. [23, 24, 25] Contraindications: If a patient is too ill to undergo surgery. If the patient is unable to move her legs apart, s/a with severe arthritis in the hips. If the patient has problem with clotting mechanism of the body. [23] Complications: Complications are usually rare: Anaesthetic Complications: Reactions to anaesthetic medications. Breathing difficulties. Surgical Complications: Perforation of the uterus. Laceration of the cervix. Scarring of the endometrium. Infection of the uterus or other pelvic organs. Hemorrhage. [23, 24, 25] 5. SONOHYSTEROGRAPHY: Sonohysterography is being used more frequently for evaluation of women with many gynaecologic conditions. In 1992, it is reported the use of sonohysterography for detecting endometrial polyp in 14 of 148 infertility patients. In 13 of the women, polyps were asymptomatic. [27]This procedure is to be done by use of saline infused through a catheter into the endometrial cavity provides slight distention and separation of cavity walls, allowing the better visualization of uterine cavity. [28] Sonohysterography not only aids in diagnosis of intrauterine pathology but also in decision regarding surgical versus medical management of patients and and directs the approach and instrumentation required when surgical treatment is warranted. [28] It can be performed in any phase of cycle but the best time is during the first phase of the cycle especially when the indication is sterility or thickened endometrium at transvaginal sonography. [28] 6. HYSTEROSALPINGOGRAPHY: Hysterosalpingography requires the use of radiations and iodinated contrast material. It is expensive and provides indirect information about the uterine cavity. One can delineate fibroids and polyps but cannot comment on endometrial thickness. [28] 7. MEGNETIC RESONANCE IMAGING: Magnetic resonance imaging , an expensive modality provides excellent images of the uterus and myometrial pathology disrupting the endometrium, however, intracavitary lesions are not well demonstrated. [28] EMBRYOLOGY OF THE FEMALE GENITAL SYETEM Although genetic sex is determined at fertilization, gender is not apparent until approximately the 12th week of embryonic life. By the 6th week embryonic life, both male and female embryos start to develop the following structures on either side of the midline. :[29, 30] Genital ridge (proliferation of coelomic epithelium ) Mesonephric (wolffian )duct (lateral to the genital ridge ). Paramesonephric ( mullerian ) duct which consists of: Upper vertical part lateral to the wolffian duct. Middle horizontal part crosses in front of the wolffian duct ( both upper and middle parts form the fallopian tubes ). Lower vertical part fuses with the similar part of the opposite side to form the uteri-vaginal canal (the upper part forms the body and cervix of the uterus while the lower part forms the upper 4/5 of the vagina ). The lower 1/5 of the vagina develops from the sino-vaginal bulbs in the posterior wall of the uro-genital sinus. [29] Origin and derivatives of the Mullerian Ducts: Mullerian ducts persists, in females to develop into the fallopian tubes, the uterus and part of the vagina. [31]. Mullarian duct grows , at first it is solid, but later it becomes canalized. It deviates more and more medially till it meets its fellow of the opposite side. The septum between the two mullerian ducts disappear. The proximal parts of the mullerian ducts form the fallopian tubes, while the distal parts meet together to form the body and cervix of the uterus and the upper 4/5th of the vagina. The stroma and muscles develop from the surrounding mesoderm. The fusion of the two mullerian ducts brings together two peritoneal folds which become the broad ligaments. [29] Ovary: Development of the ovary passes into three phases: Migration of the germ cells from the yolk sac to the posterior body wall at level of 10th thoracic level to enter the genital ridge The germ cells differentiate into oogonia then primaryoocytes and become arrested until puberty. Descent of the ovary to reach the pelvis along a ligamentous cord called the gubernaculums that is attached inferiorlyot the inguinal region. The gubernaculums becomes incorporated into the uterine wall at the point of entry of the fallopian tube and persists in the adult as the ovarian ligaments and the round ligament. [29] External Genitalia: Clitoris develops from the genital tubercle (by slight elongation ). Labia minora develops from the genital folds (by remaining separate ) Labia majora develop from the genital swelings (by enlarging greatly ). Vestibule develops from the lower most part of the urogenital sinus. [29]. ANATOMY AND HISTOLOGY OF FEMALE GENITAL TRACT Uterus: The uterus is a fibromuscular organ and is a hollow and pear shaped highly vascular organ present in the pelvis between the bladder and the rectum. It is about 8 cm long and 5 am broad, within which fetal development occurs. Uterus is usually divided into a lower cervix and an upper corpus of uterine body. 1. Cervix; The cervix is narrow region at the bottom of the uterus that leads to the vagina. It has a convex round surface with a circular or slit like opening (the external os ) into the endocervical canal, ehich is approximately 2 -3 cm in length and opens proximally into the endometrial cavity at the internal os. [30, 32, 33] Histologically, the cervical mucosa generally contains both stratified squamous  epithelium (exocervix) and mucus secreting columnar epithelium (endocervix). The mucus secreting glands are confined to the endocervix. The area where the two types of epithelia meet is called the squamocolumnar junction. [30, 34]. Cervical mucus secreted by the mucosa layer of the cervical canal serves to protect against bacteria entering the uterus from the vagina . [33]. In the cervix, the stroma is firmer, more fibrous and less cellular. [34] 2. Uterine Corpus: The body of the uterus varies in size. At birth , the cervix and corpus are approximately equal in size, in the adult women, the corpus has grown to 2-3 times the size of the cervix. The uterine corpus is divided into different regions: Isthmus: where the endocervicla canal opens into the endometrial cavity. Uterine cornu: Funnel shaped area on each side of the upper uterine body receives the insertion of the fallopian tubes. Fundus: The portion of uterus above uterine cornu. [30] Histologically, the wall of the uterus consists of the following three layers: Perimetrium: It is serous membrane that covers the outside of the uterus. Myometrium: It consists of several layers of smooth muscles and imparts the bulk of the uterine wall. Contractions of these muscles during childbirth help to force the fetus out o

Roberts Frosty Woods - Stopping by Woods on a Snowy Evening :: Stopping Woods Snowy Evening

Robert's Frosty Woods The mood of Robert Frost's "Stopping by Woods on a Snowy Evening" is artfully set by saying "the only other sound's the sweep / of easy wind and downy flake" (11-12). These lines convey they beautiful tranquillity of solitude. Many critics argue that the dark woods of the poem symbolize death. It is equally as valid to say that the poet is describing the joy experiencing a peaceful moment to him; the relaxing mood of the poem as well as the realization that the traveler must move on provide evidence contrary to the interpretation that the woods symbolize death. A relaxing calming mood prevails in "Stopping by Woods on a Snowy Evening". The only reference to sound is "the sweep / of easy wind and downy flake" (11-12). There is complete silence with the exception of this beautiful sound; there is no loud cacophony to imply the violence of death. The prevailing visual imagery is of a lovely wintry scene; at one point the woods are described as "lovely, dark, and deep" (16). This visual scene further contributes to the restful feel of the poem. The persona's only companion is his horse; this adds a solitary feel to the poem which when combined with the vivid imagery show the peacefulness of a moment alone. The title "Stopping by Woods on a Snowy Evening" implies that this is a visit to the woods as opposed to a final resting-place. If this were the final destination, the title "Stopping in the Woods" or "Stopping at the Woods" would be more appropriate. Because the "horse must think it queer / to stop without a farmhouse near," (5-6) there must be some continuation to the journey; otherwise it would not seem odd to the horse to stop. The final lines "and miles to go before I sleep, / and miles to go before I sleep" (18-19) provide further evidence that there will be more to this journey; the depicted scene is only a resting-place. Poetry interpretation in inherently personal due to the abstract nature of poetic language; what may be a valid interpretation for one reader might be completely meaningless to another.

The Deceived Invisible Man :: Ralph Ellison, Invisible Man

In the Invisible Man, by Ralph Ellison, our main character struggles to find his place in society. Throughout the novel, he finds himself in "power-struggles". At the beginning of the novel, we see the narrator as a student in an African-American college. He plays a large role in the school as an upstanding student. Later, we see the Invisible Man once again as an important member of an organization known as the Brotherhood. In both situations he is working, indirectly, to have a place in a changing world of homogony. In each circumstance he finds himself deceived in a "white man's world". The Invisible man originally wanted to graduate from his college to be a professor, perhaps even the president of the college. His dream and life as he knew it was crushed when he was expelled from school for taking a white alumni to a black neighborhood where he should not have gone. The president of the college reprimands him for not having enough common sense to show the white man what he "wanted" to see. Dr. Bledsoe, the president, believes that it is necessary to lie to the white man. He calls The Invisible man a "nigger". By this act, Bledsoe is stating that he feels superior. Dr. Bledsoe promises the Invisible Man letters of recommendation to white businessmen in New York. He finds that in truth the letters are mocking him and stating that he will never be invited back to the college again. Bledsoe masks his "respect" for the white man, signing the letter, "Respectfully, I am your humble servant". This power struggle between the white man, the powerful black man, and the black citizen is a twisted circle of trying to please the "other". The Invisible man meets a character named Brother Jack. He is a member of the Brotherhood, an organization desiring peace between races. It can be said that the Brotherhood represents American communism. Brother Jack is the head of power. Once the invisible man finds his place as a political figure in the Brotherhood he is successful. He is a strong speaker and the public loves him. He receives a note warning him that he was moving too fast and that it is a "white man's world". In the end, he discovers that it was Brother Jack, the very man fighting for equality, who was responsible for the letter.

Leadership Styles :: essays research papers

The style of leadership that would be the most comfortable for me would be delegation. One of the first signs of good supervision is effective delegation. Delegation is when supervisors give responsibility and authority to subordinates to complete a task, and let the subordinates figure out how the task can be accomplished. Effective delegation develops people who are ultimately more fulfilled and productive. Managers become more fulfilled and productive themselves as they learn to count on their staffs and are freed up to attend to more strategic issues. Delegating is a critical skill for supervisors. Delegating involves working with an employee to establish goals, granting them sufficient authority and responsibility to achieve the goals, often giving them substantial freedom in deciding how the goals will be achieved, remaining available as a resource to help them achieve the goals, assessing their performance, addressing performance issues and/or rewarding their performance. Ultimately, the supervisor retains responsibility for the attainment of the goals, but chooses to achieve the goals by delegating to someone else. True delegation means giving up a little of what we would like to hold onto while keeping what we might prefer to give up. Participative style of leadership would be least comfortable for me. A participative leader, rather than making decisions, looks to involve other staff in the process. Often however, as it is up to the manager to decide how much influence others are given, this style can only work well, when both managers and staff understand and are in agreement about which tasks are important. The staffs expertise, experience and intuition need to be encouraged, not stifled, if challenging situations are to be negotiated. The goal of the participative leader is to persuade followers to share their values and connect with their vision. It appears to me, to be obvious that most large organizations, the federal government, the military, etc., require leaders and followers that possess the same core Leadership Styles :: essays research papers The style of leadership that would be the most comfortable for me would be delegation. One of the first signs of good supervision is effective delegation. Delegation is when supervisors give responsibility and authority to subordinates to complete a task, and let the subordinates figure out how the task can be accomplished. Effective delegation develops people who are ultimately more fulfilled and productive. Managers become more fulfilled and productive themselves as they learn to count on their staffs and are freed up to attend to more strategic issues. Delegating is a critical skill for supervisors. Delegating involves working with an employee to establish goals, granting them sufficient authority and responsibility to achieve the goals, often giving them substantial freedom in deciding how the goals will be achieved, remaining available as a resource to help them achieve the goals, assessing their performance, addressing performance issues and/or rewarding their performance. Ultimately, the supervisor retains responsibility for the attainment of the goals, but chooses to achieve the goals by delegating to someone else. True delegation means giving up a little of what we would like to hold onto while keeping what we might prefer to give up. Participative style of leadership would be least comfortable for me. A participative leader, rather than making decisions, looks to involve other staff in the process. Often however, as it is up to the manager to decide how much influence others are given, this style can only work well, when both managers and staff understand and are in agreement about which tasks are important. The staffs expertise, experience and intuition need to be encouraged, not stifled, if challenging situations are to be negotiated. The goal of the participative leader is to persuade followers to share their values and connect with their vision. It appears to me, to be obvious that most large organizations, the federal government, the military, etc., require leaders and followers that possess the same core

Separation, Divorce & Annulment

SEPARATION, DIVORCE & ANNULMENT Introduction When two people are in a relationship they are usually in it forever. Unfortunately, it isn’t always the case and as you will learn in this unit, there are many things that could potentially be blamed for the breakdown of such relationships. This topic takes you into the world of divorce which is never an easy thing for any couple and if there are children involved (and there usually are); it makes the experience even worse. Some couples split amicably while for others the parting can drag on in what could seem like forever where the accusations and blame is often hurled from one party to another.In many countries, there has been a shift towards ‘no fault’ divorce. A no fault divorce is divorce in which the dissolution of a marriage does not require fault of either party to be shown, or the requirement of any evidentiary proceedings to take place. So either party may request a divorce despite the objections of the other party. No fault divorce systems are where the law provides for only one ground for divorce – this is that the marriage has broken down irretrievably (see example, s30(1) Family Law Act, Fiji).This does not necessarily mean that both parties to the marriage were equally blameless for the breakdown in the relationship but it does recognise that both may have contributed to that breakdown and that blame and accusation can aggravate what is likely to already be an unhappy and often bitter situation. Accusations and recriminations do not help this and may be particularly damaging for any children of the marriage, who, despite whatever the feelings of their parents, still need to have a mother and father.While marriage remains an important cornerstone for the stability of society and social ordering, the law allows divorce and provides a framework both for that divorce and for the consequences of that change of status especially as regards any children of the marriage and any prop erty interests which have arisen due to the marriage. 1. Ground s for Di v or c e Grounds for divorce are statutorily provided for throughout the region. They include: i. adultery ii. desertion iii. refusal to consummate iv. cruelty v. habitual drunkenness or habitual intoxication vi. onvictions for various criminal acts vii. failure to financially support the petitioner viii. failure to comply with a decree for the restitution of conjugal rights ix. being of unsound mine x. living apart for five years from the respondent with no intention of cohabiting xi. Presumed dead. LW310 Family law 4. 6 In Tuvalu, unless one party to a marriage has wilfully refused to consummate it, or the marriage was induced by fraud, duress or mistake, the sole ground for divorce is that the marriage has broken down completely (Matrimonial Proceedings Act [Cap 21] (Tuvalu) section 9).Evidence which may be accepted by the court to show that the marriage has broken down includes adultery, desertion, cruelty, being of unsound mind or if, in the circumstances, it would be unreasonable to expect one party to continue in the marriage. Whatever the evidence, however, the court must determine whether or not the marriage has completely broken down. A more restrictive approach is taken by Nauru where the court must find that the marriage has broken down irretrievably and it may only do so on one of four grounds.These grounds are desertion, separation for two years with consent of both parties or separation for five years and certain behaviour. These grounds need to be proved or parties need to fulfil strict conditions. The conditions relate to: †¢ living apart, †¢ attendance at court each month for six months after presentation of the petition, †¢ consistent and voluntary statements requesting the marriage to be dissolved and †¢ attempts by the court to promote reconciliation (Matrimonial Causes Act 1973 (Nauru) ss 10 and 12).Tonga prescribes eight matrimonial offences alth ough, with consent, the parties may also divorce after two years of separation. READ s 3 Divorce Act [Cap 29] (Tonga) There are only three grounds for dissolution of marriage in Tokelau – adultery, cruelty and three years of living apart (Divorce Regulations 1987 Reg 3). In Kiribati, fault grounds predominate. I-Kiribati parties may divorce if the court finds that their temperaments are incompatible (Native Divorce Act [Cap 60] s 4).However, the Matrimonial Causes Act 1950 (UK) which applies to other races in Kiribati and to foreigners in Solomon Islands, reinforces the fault based position by insisting on the blameless character of the petitioner and the fault of the respondent. In Fiji, the Family Law Act provides only one ground for divorce and that is irretrievable breakdown (s 30). This marks a shift to ‘no fault’ divorce, although often one of the various ‘matrimonial offences’ which may be relied on as a grounds for divorce elsewhere may have contributed to the irretrievable breakdown of the marriage – for example, adultery by one of the spouses.However a variety of lesser ‘fault’ may have led to the irretrievable breakdown of the marriage. What the court is looking for is evidence of conduct which makes it impossible for the two parties to continue to live as husband and wife in close proximity to each other and sharing the same home, resources and living space. I. Adultery Adultery is one of the most common grounds of divorce where it is still necessary to show fault.For the purposes of obtaining a divorce on the ground of adultery in fault based jurisdictions, a petitioner must prove that the respondent engaged in voluntary sexual intercourse with another person of the opposite sex during the subsistence of the marriage (Coffey v Coffey [1989] P 169). All jurisdictions except for Fiji, Nauru and Tuvalu list adultery as a ground for divorce. READ s3 (1) (a) Divorce Act [Cap 29] (Tonga) In Tuvalu adu ltery, if proved, is prescribed as evidence which a court may accept as causing the marriage to completely break down.READ s 9(a) Matrimonial Proceedings Act [Cap 21] (Tuvalu) The fact of adultery must be proved to the satisfaction of the court although the required standard of proof is unclear. In Elisara v Elisara [1994] WSSC 14 the proof consisted of testimony of the petitioner and her sister that they had found the co-respondent â€Å"half dressed inside the matrimonial home† as well as the respondent’s admission. Chief Justice Sapolu recited the facts as follows; „The petitioner, the wife, and the respondent, the husband, are a married couple having been married on 5 January 1980.In the first quarter of 1993, the petitioner was under suspicion that her husband, the respondent, was having an affair with the co-respondent. The respondent was director of the Department of Lands and Environment until near the end of 1992. The co-respondent was a secretary in the same department. Due to her suspicions, the petitioner and her cousins kept watch of the respondent? s whereabouts on the nights that the petitioner and the respondent were not together. Then one night in the beginning of April 1993, the petitioner asked the respondent to drop her off at her family at Savalalo.Not very long after the petitioner was dropped off, she headed back with her sister and cousins to their matrimonial home at Waivaseuta. When they arrived at Vaivase-uta the lights downstairs of the matrimonial home were on but not the lights upstairs. The respondent came out of the house and asked the petitioner as to why she was there. The petitioner gave the excuse that she was there to look for a parcel. She searched every bedroom in the house and found the co-respondent in one of the bedrooms half-naked. She told the respondent this is the last time you will see me again in this house and then left.The petitioner? s sister also testified that she saw the co-respondent ha lf dressed inside the matrimonial home at Vaivase-uta on the same night. LW310 Family law 4. 8 In his evidence, the respondent admits having committed adultery with the co-respondent. He says he has never denied to his wife, the petitioner, that he had committed adultery with the co-respondent. The corespondent did not appear to give evidence. On this evidence, I find that the ground of adultery alleged in the petition had been established. Accordingly a decree is granted to dissolve the marriage of the petitioner to the respondent.?However, in Bhagmati & Another v Ishri Prasad [1974] 20 FLR 75, the Court dismissed an appeal by a wife against an order for dissolution of the marriage on the basis that admissions made by her were not voluntary. Mr. Justice Bodilly stated that: ‘The Court must have sufficient evidence before it to be reasonably satisfied. I think that it is clear that a court would not be reasonably satisfied upon a mere balance of probability, on the other hand I do not think that the standard of proof required is as high as that in criminal cases, namely beyond any reasonable doubt. It lies somewhere between the two?. READ THE CASE NOWProving adultery can be difficult and may depend on circumstantial evidence. Read the case of Sugar v Fatafeti [1993] TOSC 2 for an illustration of this. A fraudulent secret understanding between the parties – collusion – is also one of the discretionary bars available to some courts in the region. READ s 11 (2) Divorce Act [Cap 29] (Tonga) Condonation or connivance may also act as a bar to the relief sought by the petitioner, whilst forgiveness by the petitioner provides the respondent with a defence in the Marshall Islands, provided that the forgiving party is treated with â€Å"conjugal kindness† (26 MIRC 1 s17).See the Vanuatu case of Ilaisa v Ilaisa [1998] VUSC 16 where the question of condonation is considered. Adulterers must be joined as co-respondents in proceedings for divorce on the basis of adultery in most jurisdictions unless they are excused by the Court on special grounds. See Cook Islands Matrimonial Proceedings Act 1963 (NZ) s 22; Samoa Divorce and Matrimonial Causes Ordinance 1961 s 11; Kiribati and Solomon Islands Matrimonial Causes Act 1950 (UK) s 3 and Vanuatu Matrimonial Causes Act [Cap 192] s17. In Niue this is at the discretion of the court ((NZ) Niue Act 1966 s537.READ s 11 Divorce and Matrimonial Causes Ordinance, 1961 (Samoa) Proceedings against co-respondents may be dismissed by the Court if there is insufficient evidence against them. See for example, Samoa s. 10. LW310 Family law 4. 9 READ s 6 Divorce Act [Cap 29] (Tonga) In some countries petitioners have a right to claim damages against corespondents. See for example, Vanuatu, Solomon Islands and Kiribati. The Solomon Island and Vanuatu Acts provide that a petitioner relying on adultery as a ground for divorce may claim damages from any person.The amount of damages which may be clai med against co-respondents is prescribed in Tonga. READ s. 13 Divorce Act, 1927 (Tonga) In Cook Islands, Vanuatu and Tonga the courts may direct the manner in which such damages are to be paid or applied and the sex of the petitioner or respondent is irrelevant. However, only petitioner husbands in the Solomon Islands and non i-Kiribati in Kiribati may claim damages in adultery cases. The categorisation and amount of such damages, which are not specified in the Acts, (except in Tonga) has been the subject of some judicial concern.In Tonga where the amount claimed is specified, the court found in ‘Afa v Tali & Sika [1990] Tonga LR 185 that the maximum amount of damages should only be awarded where it was shown on the balance of probabilities that the conduct of the co-respondent brought about the breakdown of the marriage by, for example, seducing or enticing away the respondent. Further, damages were to be based on- (a) The actual value of the wife (sic) (in terms of money and companionship); and (b) Compensation for injury to feelings, honour and family life. Damages are measured as compensation and not to punish or make an example of the Co-respondent.This idea of damages as compensation rather than punishment was elaborated further in Lamatau v Mau [1991] TOSC 3. It has been indicated however that the award of damages is becoming less common and that the courts are reluctant to allow a change of claim to include damages – see Mamata v „Akolo [2001] TOSC 47. The Vanuatu case of Banga v Waiwo is further illustrative of the difficulties faced by courts in the region when interpreting legislation derived from colonial sources whilst attempting at the same time to acknowledge custom law and respond to local social conditions.This matter originated in the Senior Magistrates Court where the petitioner gave evidence that customary meetings had been held with regard to the marital dispute. As a result of these meetings the chiefs decided that the husband was to pay 20,000 vatu to the co-respondent’s husband and the co-respondent was to pay the wife 5,000 vatu and two pieces of calico. The petitioner was also to pay the co-respondent 5,000 vatu because she had â€Å"insulted† the co-respondent. Having refused to accept this decision, the petitioner approached the Court for a divorce and claimed 100,000 vatu damages against the co-respondent.The solicitor for the co-respondent argued that the sum claimed was excessive and amounted to punitive damages. Reference was made to the Matrimonial Causes Act 1965 (UK) on which the Vanuatu Act is based. In the UK, it was argued, damages are awarded on a compensatory basis only and this should also be the approach of the law in Vanuatu. The amount awarded by the Chiefs, namely 5,000 vatu, was submitted as being appropriate as compensation â€Å"for the loss of the Husband (sic). â€Å"On behalf of the petitioner it was submitted that section 17 (1) of the Act should be in terpreted according to the intention of Parliament. That section states that; †¢ A petitioner may on a petition for divorce claim damages from any person on the ground of adultery with the respondent. † †¢ It was also contended that â€Å"adultery is a serious offence in Vanuatu communities and that punitive damages are often given for adultery which show clearly that Vanuatu local circumstances are different from those of the United Kingdom.The Senior Magistrate (then) considered the issue of the interpretation of section 17 of the Act and referred to the rules in Heydon? s case (1584) as restated in Re Macmillion v Dent (1907) 1 Ch 120, Brett v Brett (1826) 2 D and s 8 of the Vanuatu Interpretation Act CAP 132. In determining the intention of parliament the Senior Magistrate found circumstances in Vanuatu to be quite different from those in the United Kingdom and the Acts themselves to differ in important respects. Unlike the position in the UK Act, which allows o nly a petitioning husband to claim damages, the Vanuatu Act is not so limited.In comparing the UK and Vanuatu jurisdictions, it was noted that in Vanuatu the law recognises civil, religious and custom marriages and customary law, pursuant to Article 95(3) of the Constitution. Further, because adultery is considered a serious offence on the basis of custom, ‘any damages claimed by the Petitioner against the Co-Respondent should be awarded in accordance with customary law. ’ The Senior Magistrate did not categorise the type of damages to be awarded. He found in favour of the petitioner with regard to the amount of damages, however, stating that, „†¦ 00,000 Vatu damages claimed against the Co-Respondent is not excessive and it should be awarded to the Petitioner in accordance with customary law. ’ The matter then went on appeal to the Supreme Court of the Republic of Vanuatu where Chief Justice Vaudin d’Imecourt held that, whilst exemplary damages could be awarded in an appropriate case, no evidence justifying such an award had been presented to the court. His Honour considered that custom law only LW310 Family law 4. 11 applied where no other law was in force. The Court also found that custom law is not uniform in Vanuatu and; Although it is conceivable that there might not be a need for strict rules regarding the obtaining of evidence of a particular custom if and when the need arises to establish a particular custom, evidence must, nevertheless, be obtained and a clear custom must be established. ’ READ Waiwo v Waiwo [1996] VUMC 1 and Banga v Waiwo [1996] VUSC 5 In Solomon Islands and Kiribati where UK Acts still apply, damages for adultery may be claimed by petitioner husbands. Where damages are not available the court may order an adulterer to pay costs. S t u d y T a s k 1 CONSIDER THE FOLLOWING QUESTIONSAdultery and Divorce 1. Do you think it is sufficient for the petitioner to simply show that the respondent ha s committed adultery OR that the respondent has committed adultery AND ALSO that the petitioner finds it intolerable to live with the respondent? 2. If it is sufficient only to show that the respondent has committed adultery is one incident of adultery sufficient? 3. To what extent should the court investigate the claim? If the petitioner files an affidavit stating he or she believes the respondent to have to have committed adultery is that sufficient? . What does adultery as a ground for divorce which is frequently relied on tells us a) about marriage b) about people? 5. Should it make any difference to a divorce petition if the petitioner has also committed adultery? 6. Is the adultery of a woman more serious than that of a man? If yes why? 7. If the ground for divorce is irretrievable breakdown or final breakdown of a marriage and the matrimonial fault relied on is adultery, should this be viewed more gravely than other matrimonial offences such as cruelty, habitual drunkenness, or desertion? . Could adultery be claimed as the ground for divorce even if in fact it is not this but other factors which have led to the irretrievable breakdown of the marriage? 9. To what extent should the law of divorce be used to punish adultery? 10. What is the advantage/disadvantage of joining a co-respondent to adultery in a divorce action? 11. Should a petitioner be able to claim damages from more than one corespondent? What are damages for in such cases? 12.Would it make any difference if the respondent had promised to marry the coLW310 Family law 4. 12 respondent? 13. Should a co-respondent ask if the respondent is married before having intercourse with him or her? 14. Should it make a difference – in law – if the co-respondent is married or not? 15. Is adultery a) unlawful b) immoral c) a fact which may be evidence of the breakdown of a marriage? 16. Should any consideration be given to the fact that there are children born from the adulterous union? II. De sertionIn Tuvalu and Nauru the sole ground upon which a petition for divorce may be presented is that the marriage has â€Å"completely broken down† (Matrimonial Proceedings Act Tuvalu s 9(1) and â€Å"broken down irretrievably†(Matrimonial Causes Act 1973 s 8 Nauru) respectively. In Tuvalu, desertion â€Å"without reasonable cause† (s. 9(2)(b) may be accepted as evidence of marriage breakdown whilst in Nauru it is one of the grounds which, if proved, can lead to a finding that the marriage has broken down irretrievably. (s 9 (1)(a)(ii) Desertion is not a ground for divorce in Tokelau.READ ss 9(1) and 9 (2)(b) Matrimonial Proceedings Act [Cap 21] (Tuvalu) The applicable provisions in Kiribati, (Native Divorce Ordinance s 4(b) and Matrimonial Causes Act (UK) 1950 s 1(b)) Niue ((NZ) Niue Act 1966 s 534(3)(c)) Solomon Islands (The Islanders Divorce Act [Cap 48] S5(1)(b) and Matrimonial Causes Act 1950 (UK. ) s 1(b)) and Vanuatu ( Matrimonial Causes Act [Cap 192] s 5(a)(ii)) state that the respondent must have deserted the petitioner without just cause (the wording in the Kiribati and Solomon Islands legislation is â€Å"without cause†) for at least three years.In the Cook Islands and Nauru the period is two years prior to filing the petition ( Matrimonial Proceedings Act, 1963 (NZ) s 21 (c) and Matrimonial Causes Act 1973 ss 9(1)(ii), 12 (3). 54) Wilful desertion is statutorily provided for in Cook Islands (Matrimonial Proceedings Act, 1963 (NZ) s 21 (c)); Marshall Islands (26 MIRC 1 s 15 (c)); Samoa (Divorce and Matrimonial Causes Ordinance 1961 s 7(1)(b)) and Tonga (The Divorce Act [Cap 29] s 3(1)(c)). LW310 Family law 4. 13The Marshall Islands Act prescribes a period of not less than one year before wilful desertion may be alleged, Samoa prescribes three years and the other jurisdictions prescribe two years. READ s 7(1) (b) Divorce and Matrimonial Causes Ordinance, 1961(Samoa) There appears to be no difference in law between wilful desertion and desertion as in all cases the burden is on the petitioner to show that throughout the statutory period the desertion subsisted without cause. A distinction can be made however between desertion and constructive desertion.Facts presented to the court must show that the respondent intended to leave the marriage and that the desertion was against the will of the petitioner. If the behaviour of one party to the marriage causes the other to leave the matrimonial home then constructive desertion may be argued. Cook Islands also allow desertion to continue notwithstanding that during the period of the desertion the deserting party becomes â€Å"incapable of forming or having an intention to continue the desertion† (Matrimonial Proceedings Act, 1963 (NZ) s 24)A review of desertion as a ground for divorce can be found in the Solomon Island case of Kikolo v Aberam [2002] SBHC 28. In the Fiji case of Kistamma v Sarojini [1977] 23 FLR 86, desertion was not made out because the respondent was found to have made a genuine offer to return to the marriage. See also Ledua v Uluiborotu [1994] FJHC 182 and compare Peck v Peck [1993] FJHC 34 There may be some confusion between desertion as a ground for divorce and separation. This was considered in the case of Peck v Peck [1993] FJHC 34 III. Failure to Consummate the MarriageThe issue as to whether or not the marriage has been consummated is dealt with in some jurisdictions as a ground for divorce and in others as rendering the marriage voidable. The latter approach is taken by Cook Islands (Matrimonial Proceedings Act, 1963(NZ) s 18 (2)(a)); Nauru (Matrimonial Causes Act 1973 s 22 (e)); Samoa (Divorce and Matrimonial Causes Ordinance 1961 s 9(3)(a)); Solomon Islands (The Islanders Divorce Act [Cap 48] s13 (1)(a) and Matrimonial Causes Act 1950 (UK. ) s 8 (1)(a)) and Vanuatu (Matrimonial Causes Act [Cap 192] s 2(1)(a)).In Fiji, if a party was incapable of consummating, the marriage used to be rendered voidabl e (Matrimonial Causes Act [Cap 51] s 9(1) (a)) 70 whilst wilful and persistent refusal to consummate was a ground for divorce (Matrimonial Causes Act [Cap 51] s 14(c)). The new Family Law Act abolishes this ground for divorce. Inability of failure to consummate may however lead to the irretrievable breakdown of the marriage. In Tuvalu the term â€Å"voidable† is not used but wilful refusal to consummate provides an entitlement to divorce (Matrimonial Proceedings Act [Cap 21] s 8).LW310 Family law 4. 14 The Marshall Islands legislation provides that:- ‘A decree annulling a marriage may be rendered on any ground existing at the time of the marriage which makes the marriage illegal and void or voidable. A court may, however, refuse to annul a marriage which has been ratified and confirmed by voluntary cohabitation after the obstacle to the validity of the marriage has ceased, unless the public interest requires that the marriage be annulled. (26 MIRC 1 s 12)?In Kiribati it is a ground for divorce if the respondent has either wilfully refused or is incapable of consummating the marriage (Native Divorce Act [Cap 60] s 4(d)) whilst in Tonga the section is much wider and provides that if:- †¦ the respondent at the time of the marriage is and continues to be incapable of consummating the marriage by reason either of some structural defect in the organs of generation which is incurable and renders complete intercourse impracticable or of some incurable mental or moral disability resulting in an invincible repugnance to sexual intercourse with the petitioner. Divorce Act [Cap 29] s3 (1) (e)) The petitioner has grounds for the marriage to be dissolved. In the region, only Tokelau does not provide for failure to consummate as either a ground for divorce or as possibly rendering a marriage voidable. IV. Cruelty Whilst cruelty is not mentioned specifically in the legislation of Cook Islands, Nauru, Niue and Tonga it is a ground for divorce elsewhere in the region in Kiribati Marshall Islands and Samoa. In Vanuatu, such cruelty must be â€Å"persistent†.A clear consideration of what may amount to cruelty was considered in the case of Kong v Kong [1999] VUSC 41. See also the approach taken in the Marshall Islands where; „the guilt of either party toward the other of such cruel treatment, neglect or personal indignities, whether or not amounting to physical cruelty, as to render the life of the other burdensome and intolerable and their further living together unsupportable? (26 MIRC 1 s 15(b)81) †¦is a ground for divorce.The scope of the cruelty is extended by the Regulations in Tokelau which specify that the cruelty can be directed to the applicant or â€Å"a child of the applicant† (Tokelau Divorce Regulations 1987 Reg. 3). The applicable provisions in Cook Islands, Niue and Samoa require that the respondent be not only habitually cruel but a â€Å"habitual drunkard† as well ((NZ) Matrimonial Proceedin gs Act, 1963 s 21 (e); (NZ) Niue Act 1966 s 534 (3)(d); Divorce and Matrimonial Causes Ordinance 1961 s 7(1)(c)83). LW310 Family law 4. 5 In the Solomon Islands case of Elaine Bui v Anthony Makasi [1993] SBHC 3, the applicant succeeded in obtaining a divorce on the ground of cruelty. Justice Palmer held that it was not necessary to find physical violence and considered four specific allegations. Three of the allegations involved assaults and threats against the petitioner whilst the respondent was drunk and the fourth allegation involved an assault on the eldest child of the parties. READ THE CASE NOW V. Criminal ConvictionsIn the Cook Islands, Samoa, and the Solomon Islands and for non i-Kiribati only a respondent husband can be guilty of rape, sodomy or bestiality and sued for divorce by his wife. (Cook Islands Matrimonial Proceedings Act, 1963(NZ) s 21(1)(h);Kiribati Matrimonial Causes Act 1950 (UK) s 1; Samoa Divorce and Matrimonial Causes Ordinance 1961 s 7(1)(k), Solomon Islan ds The Islanders Divorce Act (Cap 48) s 5 (1) and Matrimonial Causes Act 1950 (UK. ) s 1) In Vanuatu, a wife may divorce her husband if he has been â€Å"convicted of rape or an unnatural offence† (Matrimonial Causes Act [Cap 192] s5).Incest, attempted rape or assault with intent to rape a child of the either party provides a ground for divorce in the Cook Islands Matrimonial Proceedings Act 1963 (NZ) s 21(1) (g) and Niue (Niue Act 1966 (NZ) s 543(f)) as does sexual intercourse or attempted sexual intercourse with the child. Husbands in Niue who commit rape or buggery(s 543(g) or either party to a marriage in the Cook Islands, Samoa or Niue who is convicted of murder may also be divorced.Other criminal convictions which provide a ground for divorce are those which result in various periods of imprisonment including for a life sentence, seven years and five years. (E. g. Marshall Islands 26 MIRC 1 s 15(e) stipulates imprisonment for life or for three years or more; see also: S amoa Divorce and Matrimonial Causes Ordinance 1961 s 7(1)(l) and Tonga The Divorce Act, 1927 s 3 (1)(a)). Serious offences against the petitioner are also specifically provided as a ground for divorce in three jurisdictions.In three of these, offences against a child of the parties are included: Cook Islands (Matrimonial Proceedings Act, 1963(NZ) s 21(1) (f); Niue (Niue Act 1966 (NZ) s 534 (3) (e)) and Samoa (Divorce and Matrimonial Causes Ordinance 1961 s 7 (d)) READ s 7(d) Divorce and Matrimonial Causes Ordinance, 1961(Samoa) VI. Drunkenness In the jurisdictions where drunkenness is a ground for divorce, such as Cook Islands (Matrimonial Proceedings Act 1963(NZ) s 21(1) (f)) Samoa (Divorce and Matrimonial Causes Ordinance 1961) s 7(1) (d)) and Niue (Niue Act 1966 (NZ) s 534 (3) (e)) the legislation is not uniform although the CookIslands, Niuean and LW310 Family law 4. 16 Samoan Acts are in very similar terms. As noted above these Acts link drunkenness and cruelty. They also link other behaviour with drunkenness along the lines of traditional gender roles in marriages, as illustrated by the Samoan provision which states; that the respondent has for three years or more been a habitual drunkard and has either habitually left his wife without sufficient means of support or habitually been guilty of cruelty toward her; or, being the petitioner? wife has for a like period been a habitual drunkard and has habitually neglected her domestic duties and rendered herself unfit to discharge them. (Divorce and Matrimonial Causes Ordinance 1961) s 7(1) (c)) In the Cook Islands and Niue, the relevant section is in similar terms with a three year time period for a husband who is a habitual drunkard or drug addict and who either leaves his wife without means of support or who is habitually cruel to her. (Cook Islands Matrimonial Proceedings Act, 1963(NZ) s 21(1) (e); Niue, Niue Act 1966 (NZ) s 534(3) (d)).A wife must be similarly addicted and either habitually neglect her do mestic duties and have been unfit to discharge them or be habitually guilty of cruelty towards the husband. (Cook Islands Matrimonial Proceedings Act, 1963 (NZ) s 21 (e)(i)which prescribes a period of two years following amendment by the Cook Islands Amendment Act1982; Niue Niue Act 1966 (NZ) s 534(3) (d)(i)). In the Marshall Islands the time period is reduced to not less than one year.The applicable section requires â€Å"habitual intemperance in the use of intoxicating liquor or drugs† (26 MIRC 1 s 15(d)). Obviously the time restrictions are used to bar applications for divorce after one or several episodes involving excessive use of alcohol or other drugs. VII. Failure to Maintain In Niue and in Samoa a petitioner wife may only rely on insufficient means of support if the respondent husband is a habitual drunkard or addict (Niue Act 1966 (NZ) s 534(3) (d) (i) and Divorce and Matrimonial Causes Ordinance (1961) s 7(1) (c) (Samoa)).The equivalent provision in Marshall Island s targets the â€Å"wilful neglect by the husband to provide suitable support for his wife when able to do so or when failure to do so is because of his idleness, profligacy or dissipation† (26 MIRC 1 S15 (I)). VIII. Presumed Dead In the Cook Islands it is a ground for divorce if the respondent can be presumed dead on reasonable grounds. (Matrimonial Proceedings Act, 1963 (NZ) s 19) Separate provision is made for this in Samoa where five years absence is required (Divorce and Matrimonial Causes Ordinance (1961) s 8) and in Nauru, Marshall LW310 Family law 4. 7 Islands and Vanuatu the period is seven years (26 MIRC 1 s 29; Matrimonial Causes Act 1973 s 29; Matrimonial Causes Act (Cap 192) s13). The United Kingdom legislation applying in Kiribati and Solomon Islands also makes separate provision for a decree of presumption of death and dissolution of marriage after seven years of absence (Kiribati Matrimonial Causes Act 1950 (UK) s 16; Solomon Islands Matrimonial Causes Act 195 0 (UK. ) s 16). IX. Unsound Mind or InsanityIn the Cook Islands a marriage is rendered voidable if at the time of the marriage either party was a â€Å"mental defective† (Matrimonial Proceedings Act, 1963 (NZ) s 18 (2) (b)). Insanity, provided that it has existed for three or more years may provide grounds for divorce in one country (see Marshall Islands 26 MIRC 1 s15 (f)) but other jurisdictions refer to the â€Å"unsound mind† of the respondent to divorce proceedings. The length of time that a person has been of unsound mind, possibility of recovery and proof of the condition are material.Some jurisdictions require that the respondent be under care and treatment continuously for five years prior to the presentation of the petition for divorce (e. g. Cook Islands Matrimonial Proceedings Act, 1963(NZ) s 21(1)(l); Kiribati Native Divorce Ordinance [Cap 60] s 4(e);Kiribati Matrimonial Causes Act 1950 (UK) s 1(d); Niue, Niue Act 1966 (NZ) s 534(3)(k); Samoa Divorce and Ma trimonial Causes Ordinance (1961) s 7(f), (g); Solomon Islands The Islanders Divorce Act [Cap 48] s 5 (1)(d) and Matrimonial Causes Act 1950 (UK. s 1 (d); Tonga The Divorce Act, 1927 s 3 (1)(d); Vanuatu Matrimonial Causes Act [Cap 192] s 5 (a)(iv)). Samoa extends its provision to cover the possibility of a confinement in another country (Divorce and Matrimonial Causes Ordinance (1961) s 7(1) (g)). The Cook Islands, Niue and Samoa also cover the possibilities of respondents being of unsound mind intermittently and continuously for a number of years (Matrimonial Proceedings Act, 1963 (NZ) s 21(1) (j), (k); Niue Act 1966 (NZ) s 534(i) (j); Divorce and Matrimonial Causes Ordinance (1961) s7 (f) & (g)).Respondents must be either â€Å"unlikely to recover† (Cook Islands, Niue, Samoa, Tuvalu) or â€Å"incurably of unsound mind† (Kiribati, Solomon Islands, Tonga and Vanuatu). Reference may be made to applicable Mental Health legislation (Kiribati, Niue, Samoa, Solomon Islands and Tuvalu). There is no reference to insanity or unsound minds in Nauru or Tokelau. READ s 7 Divorce and Matrimonial Causes Ordinance, 1961(Samoa) X. Marital Breakdown – Living Apart The legislation in Marshall Islands, Nauru and Tonga provides a â€Å"catch all† provision in identical terms dealing with the behaviour of the respondent generally.The provisions require that the petitioner â€Å"cannot reasonably be LW310 Family law 4. 18 expected to live with the respondent† because of that behaviour (Marshall Islands 26 MIRC 1 s 9(1) (a); Nauru Matrimonial Causes Act 1973 s 9(1) (a) (i); Tonga The Divorce Act, 1927 s 3 (1) (g)). The parties are treated as living apart in Nauru unless they are living with each other in the same household although they may live together for a period or periods not exceeding six months, in an attempt to reconcile, without prejudice.In wider terms, the Tuvalu Act allows parties to divorce on proof that the marriage has broken down where â€Å"in the circumstances it would be unreasonable to expect one party to continue in the marriage relationship with the other†. READ s 9(2) Matrimonial Proceedings Act, (Cap21)(Tuvalu) When a party asks for a divorce on the ground that petitioner and spouse are living apart, is this just another way of claiming that petitioner has been deserted or is this a different ground? Some answer to that question might be provided in the case of Ng Lam v Ng Lam from Samoa.READ the Ng Lam case now XI. Incompatible Temperaments Kiribati is the only jurisdiction to allow divorce on the basis that the temperaments of the parties are incompatible (Native Divorce Ordinance [Cap 60] s 4(j). This is a significant departure from other jurisdictions and is clearly a no fault ground for divorce. The closest comparison is the provision in Tuvalu relating to â€Å"circumstances† as described in the preceding paragraph. However in Fiji, incompatibility of temperament might be a cause of the irretrievable breakdown of the marriage.XII. Disease Whilst the contraction of disease may render a marriage voidable in most jurisdictions it can be used as a ground for divorce in others. Kiribati prescribes â€Å"venereal disease† as a ground for divorce if certified as such by â€Å"a medical officer†(Native Divorce Ordinance [Cap 60] s 4(g)) whereas Tonga specifies affliction with â€Å"an incurable disease capable of being transferred to the petitioner by contagion of infection† (The Divorce Act [Cap 29] s 3 (1) (d)).The Marshall Islands prescribes leprosy as a ground for divorce (26 MIRC 1 s 15(g)) XIII. Other Grounds The Marshall Islands lists â€Å"neglect† or â€Å"personal indignities† as grounds for divorce if this renders the life of the other party â€Å"burdensome and intolerable† and the married life â€Å"unsupportable† (26 MIRC 1 s 15(b)). Kiribati has the additional grounds of epilepsy (Native Divorce Ordinan ce [Cap 60] s 4(f)); duress or mistake (s 4(h)) and parties within prohibited degrees of LW310 Family law 4. 9 consanguinity or affinity (s 4(i)) as grounds for divorce. Other jurisdictions categorise such issues as rendering a marriage void or voidable (e. g. Cook Islands Matrimonial Proceedings Act, 1963(NZ) s 7(1) (a) (ii); Niue Niue Act 1966(NZ) s 515). Similarly, the Tongan Act states that it is a ground for divorce if a respondent has a former spouse still living (s 3 (1)(b)), whereas this situation renders a marriage void in Cook Islands, Nauru, Solomon Islands, Samoa and Fiji.The Cook Islands and Niue provide that a husband can file for a divorce if without his consent his wife has been â€Å"artificially inseminated with the semen of some man† other than himself (Matrimonial Proceedings Act, 1963 (NZ) s 21(1)(b) and Niue Act 1966 (NZ) s 534(3)(b)). A marriage is rendered voidable in Cook Islands (Matrimonial Proceedings Act, 1963 (NZ) s 18 (2) (d) and IN Vanuatu (Mat rimonial Causes Act (Cap 192) s 2 (1) (d)) if a wife is pregnant at the time of her marriage by some person other than the petitioner.The Cook Islands takes this situation further by providing for dissolution where a woman other than the petitioner wife is pregnant by the respondent (Matrimonial Proceedings Act, 1963 (NZ) s 18 (2) (d)) 2. Cus tomar y Di vor c e The divorce laws of the region are governed by written legislation – much of it introduced under colonial administration and now therefore, quite out of date. Where marriages may be entered into according to custom then customary divorce applies. This occurs in Vanuatu and Solomon Islands. Customary divorce also has some problems.Consider the two cases below. Both are from Melanesia. In all other respects, the two cases are very different. As you read To? ofilu v Oimae, a case from Solomon Islands, and the Wagi Non case from Papua New Guinea, consider what differences, if any, there are between the customary law of div orce and the statutory law of divorce. Consider also the attitudes of the two judges towards custom. READ To? ofilu v Oimai now And, when you have finished that case READ Application of Wagi Non 3. RECOGNITION OF FOREIGN DIVORCE DECREESAs Pacific people acquire greater mobility and come into contact with people of other nationalities and who are domicile in other countries it is not unusual that marriages and divorces occur outside the region or in a different jurisdiction. It is therefore important to know what recognition is given by domestic law to these decrees. LW310 Family law 4. 20 In Nauru, the Recognition of Foreign Divorces, Legal Separations and Nullity of Marriages Act 1973 provides guidelines for judicial recognition of foreign orders or decrees. The following sections give the grounds for recognition and the exceptions from recognition respectively:- . 4 (1) The validity of a foreign divorce, legal separation, annulment of marriage or declaration of invalidity of marri age shall be recognised if, at the date of the institution of the proceedings in the country in which it was obtained – (a) either spouse was habitually resident in that country, (b) either spouse was a national of that country; or (c) the proceedings by means of which it was obtained were held in the exercise in that country of a jurisdiction similar to any jurisdiction conferred in the Family Court in respect of proceedings in Nauru by section 44 of the Matrimonial Causes Act 1973. 2) In relation to a country the law of which uses the concept of domicile as a ground of jurisdiction in matters of divorce, legal separation or nullity of marriage, paragraph (a) of the preceding section shall have the effect as if the reference to habitual residence included a reference to domicile within the meaning of that law. (3) In relation to a country comprising territories in which different systems of law are in force in matters of divorce or legal separation, the preceding provisions of this section, except those relating to nationality, shall have effect as if each territory were a separate country†. s. 9 (1) Recognition by virtue of this Act of the validity of a divorce, legal separation, annulment of marriage or declaration of invalidity of marriage obtained outside Nauru may be refused if, and only if – (a) it was obtained by one spouse – (i) without such steps having been taken for giving notice of the proceedings to the other spouse as, having regard to the nature of the proceedings and all the circumstances, should reasonably have been taken, or ii) without the other spouse having been given, for any reason other than lack of notice, such opportunity to take part in the proceedings as, having regard to the matters aforesaid, he should reasonably have been given: or (b) its recognition would manifestly be contrary to public policy. (2) Nothing in this Act shall be construed as requiring the recognition of any findings of fault made in a ny proceedings for divorce, legal separation or annulment or of any maintenance, custody or other ancillary order made in any such proceedings. LW310 Family law 4. 21 READ the following case Meleisea v Meleisea [1994] WSSC 24 Where legislation does not deal with the recognition of foreign decree, courts must have recourse to the common law. The case example above shows how this may occur in practice. It also highlights possible evidentiary problems when dealing with overseas decrees. 4. Divorce: Marital Agreements, Collaborative Law, Mediation and Family Arbitration Litigation has for a long time been the traditional battlefield for disputing parties within the Family Law.The financial and emotional cost of litigation in the Family Courts is an issue that has often prompted debate over the years. When parties engage themselves in long, drawn out disputes, the strain is not just felt financially, the children will often be victims, courts are clogged with an overflow of cases and the public will end up bearing the burden of resources spent. The time has come for courts to begin utilising different forms of resolving disputes within the courts and one such mechanism is arbitration or alternative dispute resolution (ADR).Dispute resolution is not a new concept to the South Pacific as most societies are familiar with one form or another. ‘Most Pacific societies are familiar with the ideas of â€Å"alternative dispute resolution† without necessarily being familiar with the term. As Vanuatu Chief Justice Lunabek informed a conference on conflict resolution held in Vila in 2000: â€Å"ADR is not a new concept to Pacific Island jurisdictions and, in particular, to Vanuatu. It is, in fact, consistent with traditional methods of dispute resolution that predated the introduction of the formalised system of justice. The resolution of conflict is described as being â€Å"deeply embedded in the culture† in many societies, so that its structures remained unobtrusive.? (Graham Hassal, „Alternative Dispute Resolution in Pacific Island Countries? [2005] 9 (2) Journal of South Pacific Law) In jurisdictions that utilise ADR in the Family Court, there are different processes currently available and these include: i. Counseling This can be likened to a sort of therapeutic process that is aimed at examining the underlying conflict between parties and with the goal of assisting with reconciliation.Parties are encouraged to sort out their differences rather than opting to go to court. In Fiji, one of the key strategies in the Family Law Act to provide support to troubled families is to make available within the Family Court an on-site counseling service. There is statutory requirement under s. 11 of the LW310 Family law 4. 22 Act for the Director of Counseling to „advertise the existence and availability of the counseling and welfare facilities of the respective Family Division? and as far as practicable, to make those facilities available to those seeking such services.The Act provides for three different types of counseling and these are marriage reconciliation, family and child counseling and financial and property conciliation. (See also the Family Protection Act, Vanuatu) Child counseling is an important component because the focus is on the parents coming to an agreement about issues pertaining to the child (ren) and this is done with the belief that the best judges of the children’s best interest are the parents and not the court. Section 50 and 51 of the Family Law Act, Fiji make provisions for child counseling.This is where a parenting plan may be drawn up by the parents. Some issues that the plan will address is where and with whom the child is to reside (focus will be on the effect of relocating a child from a familiar environment), the issue of contact between the child and the non-custodial parent and other persons, the maintenance of a child and any other aspect of parental responsibili ty towards the child. ii. Negotiation (including round table conferences and collaborative law) This seems to be the most common form of dispute resolution in family law.The simplest example of negotiation is where separated parties have discussions with each other to determine if they can resolve some or all of their issues. This is very similar to counselling where parties may be focused on what type of parenting arrangement they will agree to. Parties may choose to conduct negotiations on their own or if this proves too difficult then they may engage the services of their lawyers who will negotiate on their behalf. The latter form is now known as round table conference. A round table conference is one where parties and lawyers meet together, generally at one of the lawyers offices, to undertake settlement discussions. One or both lawyers will initiate the meeting. The conference can be used to resolve any type of legal issues, such as those about parenting and property and financ es. Lawyers need to come to the meeting prepared with all relevant information, such as valuation of properties and superannuation entitlements, where there is property dispute. If a dispute is complex, a series of round table conferences may be needed.? Alexander Harland et al, Family Law Principles (1st ed. 2011) A more complex form of negotiation is known as collaborative law which aims to resolve matters without recourse to litigation. Parties who choose to participate in this type of negotiation must sign an agreement that commits each of them to the process and this agreement includes an undertaking that parties will not resort to litigation. If one party wishes to opt for litigation then the disputing parties’ lawyers must be changed as they had originally signed the agreement on litigation.This is one drawback of this option. ‘Collaborative law may be appropriate where:  ¦ Parties in low conflict are motivated to work together with the assistance of their lawy ers to resolve their dispute, without going to court;  ¦ Parties are committed to negotiating a settlement outcome;  ¦ Parties may have substantial assets, and then can involve their accountant and financial advisors in the negotiation process.? (Alexander Harland et al, Family Law Principles (1st ed. 2011) This form of negotiation first began in the United States and Canada and is today used in Australia. ii. Mediation Mediation is a process where a third party enters the dispute as a sort of referee and to facilitate the discussion between disputing parties. This third party may be someone from the community, the family court, a counsellor, and even lawyers. The Family Court of Fiji operates according to simple, appropriate and effective procedures, offers counseling and mediation support services. „Mediation may be appropriate where:  ¦ Parties are able to negotiate with assistance and want to work towards settlements; Both parties are able to negotiate during the pro cess and are not prevented from doing so by an overwhelming power imbalance, due to family violence, mental health problems, cultural factors or other issues (or the process can be structured in an appropriate way; for example, shuttle mediation in separate rooms and each party has a lawyer representative during the mediation).? (Alexander Harland et al, Family Law Principles (1st ed. 2011) iv. Conciliation This process is not one aimed at getting the parties back together.Rather it is designed to allow for the disputing parties to settle issues regarding the settlement of matrimonial property. ‘The conciliator will be a qualified lawyer who will receive training in conciliation and alternative dispute resolution skills. They will discuss who will live in the matrimonial home or whether it should be sold; whether payments are to made to the Bank for loans; how much maintenance is to be paid for the children or the other spouse if relevant; how income once going into one family will be shared between two homes; their various financial commitments to the Bank or other debtors and any other financial matters.? Imrana Jalal (2009) in Narawa-Daurewa U, The Family Law Act of Fiji, 2003: A Brief Review of Provisions in the Act; The Impact on the Family (with Emphasis on Women? s Access to Justice) (LLM thesis, University of the South Pacific, 2010) Again the idea of this type of service in the Family Courts is to ensure that parties are the best judges and should try to resolve the issues themselves rather than litigating. v. Arbitration Arbitration is again another means of trying to resolve disputes by means of a third party involvement.The difference between arbitration and mediation is that with the latter you always have the choice of backing out or not accepting the options being offered by the other party (spouse). In arbitration, although the arbitrator cannot grant a divorce, they do have power over how property distribution and custody and access issu es are resolved. An upside to arbitration is that parties are able to keep matters out of court and private and it is also more cost effective. The downside is that for jurisdictions that offer arbitration processes in family law the order made by the arbitrator is not binding until registered in court.See for example, the Family Law Act of Australia. Conclusion Arbitration should be advanced as a desirable alternative to litigation. A revision of the family legislation in countries of the South Pacific is necessary at this time in light of the ever-increasing use of arbitration and the developments of the law in this area. Alternative dispute resolution is being used in other areas of law as a means of resolving disputes without litigating and so it begs the question, why is the family law being left behind? . Conc lus ion There are various models of divorce law evident in the USP region which can provide comparisons for reformers. Tuvalu, Kiribati, Nauru and Tuvalu have partial no fault systems and the remainder are largely fault based. Some, however, have retained the concept of matrimonial fault whilst allowing divorce after a relatively short period of separation. Those laws which focus on â€Å"fault† do so because this was the approach of colonial law prior to independence.This has also led, in two countries, to the application of different matrimonial laws to people in the same jurisdiction on the basis of race rather than relying on the domicile or residence of the petitioners. The legislation also reflects a time and culture when the roles of men and women were largely unquestioned and family life was designed for the procreation of children, the passing of inheritance to ones offspring and the restriction of sexual activity to the parties of the marriage exclusively. This is reflected most dramatically in some of the ‘failure to maintain’ grounds.In Samoa, alcoholic husbands must be sure to financially support their wives or face the possibility of divorce while alcoholic wives must determine the nature of their domestic duties and carry them out without neglect. Niue and the Cook Islands alert husbands to the possibility of wives being artificially inseminated with semen which is not theirs, whilst husbands in the Cook Islands and Vanuatu may opt out of a marriage if their wives, at the time of marriage and without their knowledge, were pregnant by a person other than themselves. Wives in the Cook Islands also have redress if their husband has fathered a