Favorite Place Orlando Florida

Orlando, Florida The best place for vacation Orlando, Florida. Orlando is one of the most busy tourist locations in Florida, maybe even busier than the Miami beaches. This is because Orlando has many locations for all kinds of people, whether they are children, or adults. Orlando has many theme parks located on its famous strip, including Disneyworld, Wet n' Wild, Universal Studios, Ripley's Believe it or Not House. Sea World, and a host of other tourist locations. And out of all these places, the most interesting place to be at is Disneyworld. Many people think that Disneyworld is a place for children. This cannot be farther from the truth. Even though Disneyworld is designed for children and families, many adults can have a fun time there. Disneyworld is one of the biggest and most visited amusement parks in the world. The disneyworld in Orlando is also known as The Magic Kingdom and this is the best name for the place. Once you enter Disneyworld, you do enter into a magic kingdom. It is of no surprise that many adults have found Disneyworld to be an extremely entertaining. Even though most of the rides are meant for the children, the adults can take pleasure in being inside an architectural piece of wonderland. The Magic Kingdom is divided into many areas, and one of the most prominent, the area that comes in as soon as you enter the Magic Kingdom is the Main Street, usa. This street is made up of various architectural styles from the various states of usa, with much of the style being influence by Missouri and New England. The buildings on Main Street are built in such a way that they seem to be bigger than they actually are; the second story is smaller than the first, and the third smaller than the second is, giving the buildings a larger-than-life image. At the end of the Main Street is Cinderella's Castle, which is the trademark of the magic k ingdom. You really have to see it to appreciate its magical realm. The rest of the area is divided into different lands, such as the Frontier Land, the Adventure Land, the Land of Tomorrow, Liberty Square, and Fantasy Land. Adventureland is a paradise for children and a treat for the adults. It is made up of various foreign lands that represent the jungles of Africa, Asia, and South America. A make-belief Caribbean town square has also been built into this area to give a tropical feel to the area. This area has rides such as the Pirates of the Caribbean, Swiss Family Robinson Treehouse, and the Jungle. Cruise. Frontierland has been built in the place of the Wild West and the Rivers of America. This place has the looks of Rocky Mountains and railroads as it hosts rides such as the Big Thunder Mountain Railroad, Splash Mountain, and Tom Sawyer Island. Another area that is more popular for the children is Fantasyland. This is a colorful array of architecture that works together to represent the fantasyland of the children's minds. Includes rides such as Dumbo the Flying Elephant, Snow White's Scary Adventures, Cinderella's Golden Carrousel, and Mad Tea Party. Even though most of the rides and entertainment present inside the Magic Kingdom is meant for the kids, this does not mean that adults cannot enjoy them. The Magic Kingdom offers many packages and incentives for young couples to visit and there are more than a few freshly married people who have visited the Magic Kingdom for their honeymoon. Overall, the Magic Kingdom in Disneyworld, Orlando, Florida is a place for people of all ages and for all nationalities. It is a place one must visit at least once in their lifetime.

Cornbread

Cornbread is a quick bread made from some type of cornmeal. There are many varieties of cornbread but all contain cornmeal and are quick breads, meaning, they are not leavened by yeast as traditional loaves. Cornbread is uniquely a product of the United States, as corn was used in North American cooking long before Europeans arrived on the continent. However, in Italy, the corn-based mush known as polenta is sometimes prepared into a fried form resembling cornbread. Although the ingredients remain the same, cornbread varies from one region to another.Cornbread was originated from Native Americans who grew corn and were well aware of its versatility and used it for breads, porridges and cakes. Once the first European settlers began to arrive to the new found land the Native Americans did not hesistate to share their knowledge and corn soon became a highly important food, long before wheat was established in the New World. The first breads settlers made with corn meal were baked in ope n hearths, sometimes on planks or other implements, and often called â€Å"ash cake. As cooking methods improved, settlers started using their sturdy cast-iron skillets to bake the breads, known by such names as journey-cake, johnny cake, hoe-cakes, dodgers, spoon bread and a variety of other appellations (Jeremy, Jackson 2003). the fact that cornbread keeps well and does not need to rise gave it a great advantage amongst other favorite foods of the early America. This was a big plus in progressive cooking. Deviations on the recipe developed rapidly, as did the consuming of cornbread, depending on what the cook had on hand that day.It also became very popular amongst both sides Civil War. When could cooked properly, it was a favorite dish. However, when supplies became scarce and the soldiers had to fend for themselves, they created â€Å"ramrod† cornbread. †(Betty Fussell, 1992) This was their ration of cornmeal, mixed with water and salt. The thick, pasty batter was then wrapped around the rifle ramrods in a spiral and cooked over their fires. It was tasteless and hard, but it served its purpose. Cornbread was an essential item and enjoyed by many people for its texture and scent.Cornbread can be fried, baked or, rarely, steamed but can be mushy, chewier and more like cornmeal pudding at times. The most common variety, however is , skillet-baked cornbread and is a traditional cuisine in the United States. In the rural Southern States heating bacon fat, lard or other oil in a heavy, well-seasoned cast iron skillet in an oven, and then pouring a batter made from cornmeal, egg and buttermilk directly into the hot grease was somewhat of a signiture in the south. The mixture is then put back in the oven to bake.The end product is usually crumbly and moist with a crunchy crust. This bread is dense, meant more as a supplement than as bread meant to be eaten alone. In addition to the skillet method, such cornbread can also be made in loaves, sticks or muffins. In some parts of the South it is crumbled into a glass of cold buttermilk and eaten with a spoon and is often served with homemade butter (Jeremy, Jackson). Johnny cakes, a deviation type of cornbread, is widespread in New England, American Midwest, American South and particularly in Rhode Island.Johnny cakes are made by pouring a batter similar to that of skillet-fried or baked cornbread, but somewhat thinner, into a skillet on the stove with hot grease. This will give and end product similar to a pancake, but still having bread qualities. The derivation of the name is unclear. Some say it may have come from ‘journey cake,’ since it was easily prepared by travelers. It has been claimed that the origin of this term is related to the Northern slang for Southern soldiers during the American Civil war, ‘Johnny Reb,’ but this claim is inconsistent with the fact that the term was in use during the 18th century† (What is Cornbread? 2008).Corn pone is a type of cornbread, made of a thick, malleable dough made of cornmeal or hominy grits, shaped by hand and then baked or fried in butter, margarine, lard or bacon grease. Corn pone has been a staple of Southern U. S. cuisine, and has been discussed by many American writers, including Mark Twain† (Betty Fussell 1992). Corn pone is traditionally formed in two to three inch oval shapes and has a crunchy or chewy texture. The term â€Å"corn pone† is sometimes used as a noun to refer to one who possesses certain rural, unsophisticated peculiarities, or as an adjective to describe particular rural, folksy or ‘hick’ characteristics.The term is sometimes intended as a pejorative, often directed at persons from rural areas of the southern and Midwestern U. S. â€Å"Hot water† or â€Å"scald meal† cornbread and is unique to the American South and is made by pouring self-rising cornmeal batter made with boiling water into a skillet of hot oil on a st ove top. The crust will turn golden brown and crunchy while the center remains crumbly and mushy. These small fried breads are soft and very rich. Sometimes, to ensure the consistency of the bread, a small amount of wheat flour is added to the batter.A thick buttermilk-based batter forms the hushpuppy. Deep-fried rather than pan-fried, these are a common accessory to fried fish and other seafood in the South. When fried properly, the hushpuppy will come out moist and light on the inside, while maintaining a crunchy and medium to dark brown crust. The name is derived from the commonly accepted story that back in the old south, the cooks would fry up left over pieces of dough and through it to the dogs telling them to â€Å"Hush, puppy. †In the United States, the different types of cornmeal used in cornbread divide the North and the South. Northerners tend to use yellow corn meal and Southerners generally prefer white. They also desire to use different flavorings for their corn breads, with the North having a preference for sweetness and adding sugar or molasses, while saltier tastes reign in the South. In Texas, a state favorite has emerged using fresh or creamed corn shredded cheese and jalapeno peppers, influenced by Mexicans.In Vermont, ground nutmeg is often added, and day-old ‘Johnny cake’ is crumbled and served with cold milk similar to cold cereal† (What is Cornbread? ). A popular Northern cornbread, referred to in the south as â€Å"Yankee Cornbread†, contains half cornmeal, half wheat four, milk, eggs, baking powder, salt and sugar. This results in a lighter and sweeter cornbread than traditionally found in the south. Cornbread has become one and the same with Southern cooking, and they do eat a lot of it. But, cornbread is an adaptable, quick bread and extremely easy to make. It is an indisputable American favorite.

Fix my draft Essay Example | Topics and Well Written Essays - 250 words

Fix my draft - Essay Example In Cartesian dualism, the body and the mind are considered two different and distinct substances that are separable. This translates that an individual that exists independently without the effect of other beings, Jaegwon Kim. However states lack spatial location in Cartesian dualism fails to explain how any soul is causally related to its being. It has been known that the body and the soul are always connected so Cartesian Dualism needs to explain how the two are not connected in any way. Descartes tries to explain it in Descartes Dualism; he argues that the souls also referred to as an indidual’s self are purely mental substances that possess no physical characteristics therefore they create no spatial location. David Jehle interestingly disregards Jaegwon Kim’s argument in relation to substance dualism. In his way it is not possible to classify the being as a distinct entity from the soul or self. This work tries to bring out the views of three philosophers;- Kim Jeh les’ and Lowe’s, on their arguments on casual relation between the brain and the mind. In conclusion I will explain why Lowe’s NCSD is the best argument to follow in the explanation. Jaegwon Kim explains in his work, ‘the problem of interaction’, the radical disparity postulated between the brain and the mind and makes casual interaction between the two to show how each works. This concept has led to the denial of substance dualism by many philosophers. The problem of interaction however, is not well stated as an obvious argument against dualism, ( Jehle, pp. 565). Jaegwon Kim explains the reason why the problem of interaction is hard to be mentioned because, ‘it is hard to pin down exactly what is wrong with posting casual relations between substances with diverse natures and further explain in concrete terms what it is about the natures of mental and material substance that make them not fit to enter into the casual relations with each other’, Jehle,

About Alexander McQueen Essay Example | Topics and Well Written Essays - 750 words

About Alexander McQueen - Essay Example However, he interrupted his education and ventured into fashion design. Later, in 1994, he joined Central Saint Martins College of Art and Design for a master’s degree in fashion design (Frankel, 17). Unlike many designers, McQueen’s passion for fashion started during his childhood. He had always desired to be a designer when he grew up. This was demonstrated when he used to make dresses for his elder sisters while still a young boy at Rokeby Primary School (Bremner, 117). It is during the same time that he declared his interest in design and pledged that he would be a fashion designer when he grew up. His love for clothes made him to associate with designers. It is for this reason that he left school at a tender age to advance his design interests at Savile Row Tailors; Anderson & Sheppard; Gieves & Hawkes and Angels & Bermans (Deniau, 73). His services in these premises as an apprenticeship exposed him to the challenging modern trends in fashion design. Upon graduating as a fashion designer, McQueen took several jobs in prestigious fashion companies both within the United Kingdom and Spain. Here, he got an opportunity to interact with reputable designers who later influen ced his life (Rawi, 91). For instance, after working as a Chief Designer at Givenchy, he encountered Hussein Chalayan, Pauric Sweeney and Katy England. These are some of his contemporaries who really shaped the direction of his fashion career. Had it not been for these contemporaries, he would not have achieved much. They were of a great importance to him. For instance, Katy later became his right hand lady who stood beside him and gave him the necessary assistance in whatever he was doing (Knox, 2010). As a designer, McQueen is credited for making magnificent contributions in the field of fashion design. After terminating his six-year contract at the prestigious Givenchy in 2001, he founded his own company under his name. Here, he developed the new McQueen Alexander Brands which has now revolutionized the fashion design industry (Bremner and Robertson, 11). Moreover, he brought a new idea to fashion shows when he introduced drama and extravagance as new features in catwalk. Initial ly, fashion shows were cheaper to organize and did not involve the use of drama. This necessitated him to fetch for renowned pageants to grace his shows. A t the same time, he introduced silhouettes to enable him incorporate the element of fantasy in his shows. Actually, these have become significant a component of fashion shows which are still prominent up to date. These are his legacies which will always remain in the minds of fashion lovers for a very long time (Cartner, 66). His McQueen out fits were properly designed to suit the modern man. By the year 2007, he had established boutiques in London, Las Vegas, New York, Milan and Los Angeles (Searle, 48). Hence, he managed to win the confidence of many clients who preferred his clothes to any other designer. However, this did not only include ordinary people, but celebrities like David Bowie, Nicole Kidman, Rihana, Koda Kumi, Penelope Cruz, Ayumi Hamasaki, Namie Amuro and Sarah Jessica Parker. As a result of his bright ideas, his designs are still prominent and used by people from all corners of the world. Indeed, McQueen was not made, but born a designer. After realizing his ambitions as a child, he prepared himself for it. However, could not manage to achieve anything single-handedly. First, he owes his success to his family. Had it not been for the co-operation from his parents, he would have shielded his interests for something else. This was a great source of inspiration for him (Bolton, 39). Moreover, he received

Exploring the impact of e-commerce adoption on management strategy in Research Proposal

Exploring the impact of e-commerce adoption on management strategy in Gulf Cooporation Council Countries(GCC) Enterprises - Research Proposal Example This study traces the adoption of e-commerce in SMEs in Saudi Arabia and explores what impact this phenomenon is having on management strategy. A survey of 50 managers is conducted in order to identify what has changed in their strategic thinking over the last ten years, and this is analysed in the context of GCC development potential in the next ten years. Aim. The aim of this research is to explore the impact of e-commerce on management strategy in Saudi Arabia SMEs. In particular the project will attempt to find out how far managers are reacting to the changes in the business environment that e-commerce brings, and how far they are themselves trying to drive that change or even avoid that change. Objective of the Research. The research has three objectives : To trace how far e-commerce has developed in Saudi Arabia up to December 2011. To find out what Saudi SME managers think about e-commerce at the present time To identify what impact, if any, e-commerce is now having on Saudi S ME managers’ strategies for the future. Literature Review. ... Per capita income had been $17,000 in the mid 1980s but it had dropped to only $8,200 in 2003. (Looney 2004)The old rentier state dynamics are sorely tested when such a huge change occurs, and this one reason why considerable investment is now being made in the SME sector. The Gulf Cooperation Council (GCC) consists of 6 Arab countries: Bahrain, Kuwait, Oman, Saudi Arabia, Qatar and the United Arab Emirates and is well connected with other Arab countries in the Middle East and North Africa (MENA) region. It also enjoys good relations with the United States, and plays a pivotal role in international diplomacy. Saudi Arabia is one of the more conservative members of this group, and takes a leading role in religious and cultural affairs due to its stewardship of key religious sites including Mecca Studies on the economy of Saudi Arabia have noted that there is an imbalance in the workforce, with a tendency for private businesses to recruit staff from outside the Kingdom, especially in h igh technology or specialized fields, leaving the domestic workforce ill-equipped to adapt to the changing workplace requirements. Education facilities and worker expectations are not yet well matched to the needs of the private sector. An interesting dilemma that is beginning to affect the economy is the growing number of well educated women who are now able and willing to take part in the development of the Saudi economy. E-commerce has been a part of international business for around two decades, but it has still not penetrated into all geographical areas of the world, and into all layers of society. People tend to think of the term â€Å"e-commerce† as meaning just the process of buying and selling goods online, but in fact it covers a far wider range of systems and processes than

Ben and Jerry's Homemade Case Study Example | Topics and Well Written Essays - 500 words

Ben and Jerry's Homemade - Case Study Example It is interesting to inquire how the earning of Yocream International was lesser (9.4) than that of Ben and Jerry’s (19.8) although both sold on the same price line (1.8). The above analysis reveals that other companies were earning higher than Ben and Jerry’s and their shareholders were profiting better than the shareholders of Ben & Jerry’s. 2. Do you think that, in general, it is possible for a for-profit company to be committed to â€Å"improve the quality of life of a broad community† and still maximize shareholder value? Why or why not? In general, it is not possible for a for-profit company to be committed to improve the quality of life of a broad community and still maximize shareholder value because approach towards the community and overall society is different. The traditional business approach has been money-minded. Companies strive to reduce costs and increase profits. This is a simplistic view of business and profit-making. Not only simple but it is conservative as well. In old times, it used to depend on company proprietors whether to spend their hard-earned money on personal pursuits or on the community welfare. Improving the quality of life was not counted to be relied on the shoulders of private sector. It used to be the responsibility of the government. If I were Henry Morgan, I would recommend the Board to decide in favor of the takeover offers being made. Shareholders’ profit-earning interests cannot be ignored at the cost of playing a greater role of attending to the needs of social, economic, and environmental concerns. No doubt, providing a canopy to the social values through such efforts as providing demand for harvestable tropical rainforest products sounds nice and caters to deep human welfare emotions, but the primary job of a listed company is to earn profit for the shareholders. Community welfare needs to be a secondary thought. 4. If you are thinking about starting a new business, would social consciousness

Reporting Requirements Memo Essay Example | Topics and Well Written Essays - 1250 words

Reporting Requirements Memo - Essay Example The memo ends with the comparison of the accounting reporting practices of the two entities. Reporting requirements for private sector, not-for-profit organizations under Financial Accounting Standard Board guidance The Financial Accounting Standard Board has specific accounting reporting requirements for all types and kinds of health care organizations. This also includes the private sector not for profit nursing homes. The Financial Accounting Standard Board have issued several standards especially for private not for profit nursing homes. Few of the standards that have been introduced are â€Å"Accounting for Contributions Received and Contributions Made,† â€Å"Financial Statements of Not-for-Profit Organizations† and â€Å"Accounting for Certain Investments Held by Not-for-Profit Organizations†. The American Institute of Certified Public Accountants’ (AICPA’s) accounting and audit guide for Health Care Organizations have made these statements m andatory. Both AICPA and FASB promote the accrual method of accounting. An accrual method accounting gives a complete, accurate and meaningful report about the financial condition of the organization. The accounting period should span for one year. A private sector not for profit nursing home’s financial statements should have a balance sheet, a statement of operations, cash flow statements and statements showing changes in net asset. If the not for profit organization decides to invest in financial assets the transactions that involves financial instruments have to be recognized on the settlement date. Any transactions that involve a third party have to be measured at fair value. For investments in debt securities, the securities that are not held up to the maturity period are recorded at fair value with subsequent changes in net assets and net income. The organization can invest in debt bonds at amortized rate without any restriction. The debt security should be measured at fair value and any changes in net income should be recorded. The principles for investment in equities are that the shares that are quoted in the active market should be recorded at the fair price and the resulting change in the net assets should also be recorded. Unquoted equities can be measured at the actual market price (Carmichael & Rosenfield, 2003). Investments in mutual funds will also be considered as equity investments. Derivatives that involve hedging characteristics should be measured at fair price. A private nonprofit organization should be very careful in selecting the methods it wants to use to measure its investments so that its relationships with its benefactors are not compromised. It should successfully incorporate the unrealized losses and gains in its financial statements. Transaction costs that arise due to purchasing of financial instruments should be capitalized and will be measured at the amortized cost. At the end of each accounting period the organization has to check for assets that are impaired. If there is any such asset its carrying amount should be reduced to the highest of the amount the organization expects to generate by selling the asset or the present value of the expected future cash flow of the financial instrument. Accounts receivable will be treated in the same way as debt securities. But receivables that are not due for a minimum of one year and are without market rates

Online Education Essay Example | Topics and Well Written Essays - 1250 words

Online Education - Essay Example This paper approves that the student responses published on the online message boards give the students a chance to share their views and ideas. The students can choose to have a virtual social life by forming online communities and groups. Considering the fact that the students pursuing online courses hail from diverse locations, belong to different age groups, have variegated professional backgrounds and are more diverse in their interests and affiliations, the online education certainly offers a more full bodied and enlightening academic environment to its students as compared to the regular classrooms. The online education system is also fast gearing up to the challenges imposed by the current job market. A number of online institutions do offer placement services to their students and many online courses are actively collaborating with the leading corporate concerns to upgrade and customize their courses so as to make their students more sought after and competitive in the real world. This essay makes a conclusion that with the ensuing advances in the telecommunication technology and the changing face of the society the world over, the online education system is expected to become more popular. It is the only way of taking education to each and every eligible aspirant. Definitely the standard modes of education are going to stay, but the real future of the world lies in the online dissemination of knowledge and facts

Symbolism in the Short Story Assignment Example | Topics and Well Written Essays - 250 words

Symbolism in the Short Story - Assignment Example It does catch fire from the sun making it burn up and from its ash, it is reborn. In the short story, the mission of Phoenix is to obtain the Medicine for the sake of the grandson. She is strong and persistent as she walks. She is a symbolic of phoenix (Chengges, 2009). The description in the story about Phoenix Jackson is indicative of phoenix. She is described as having golden color under her skin, and her hair is tied in a red flag and eyes are blue due to age. It symbolizes her age and compares it with the bird, which matures to old age. In the whole novel, there is close reference to time and age. Another symbolism emerging is the appearance of birds. She is being likened to a bird, together with her grandson. In the initial introduction of the story, she is carrying a small stick, hitting ground with it and making some noise like a chirping bird. She is also overprotective of her son like the one a bird watches over her young ones. The incidences occurring in the hospital after her arrival is symbolic of phoenix. She becomes numb, losing the ability to talk. The care team is perplexed and asks if the grandson is dead. The words bring her back to her sense and her face glitters, just as phoenix does. She starts to walk down the stairs, indicating a new life (Ma, 2010). Essentially, the whole plot is all symbolic of the legend bird phoenix. Her behavior, description appearance, and all she does rotate around the symbolic bird. She is so caring to her grandson and can travel to any distance for his sake. Her journey portrays her as a selfless person. Her aim is just to help. She undergoes so many difficulties in aiding her grandson, just like the phoenix bird (Welty& Sarcone,

Matrimonial Rights of Women Essay Example for Free

Matrimonial Rights of Women Essay Islamic law is a very great jurisprudence worldwide, Islamic law is defined as the law according to the Muslim faith and as interpreted from the Quran also known as Sharia law. The sacred law of Islam is an all-embracing body of religious duties, the totality of Allahs commands that regulate the life of every Muslim in all its aspects. Important feature of Muslim law is the fact that there is no clear separation of Mosque (is a place of worship for followers of Islam) and state. Under Islamic law, the religion of Islam and the government are one. Islamic law is controlled, ruled and regulated by the Islamic religion; a theocracy. Islamic law purports to regulate all public and private behavior including personal hygiene, diet, sexual conduct, and child rearing. Islamic law now prevails in countries all over the Middle East and elsewhere covering 20 per cent of the worlds population. Despite its relative inflexibility, in some ways, Islamic law is superior to other systems of law, such as the preference given to arbitration in civil disputes. Islamic law composed of following elements * Sharia: * Quran * Sunnah of Prophet Muhammad (generally known as Hadith) * Sunnah, literally means path. * The Sunnah of Prophet Muhammad consists of his sayings, actions, approval and disapprovals. * ?Fiqh: * Collection of juridical opinions given by various jurists as they pondered over the day-to-day application of Sharia * ?Fatwa: * Legal opinions (typically non-binding) issued by qualified jurists. * Usually provided as an answer to a specific question. Sharia is based on wisdom and achieving people’s welfare in this life and the afterlife. Sharia is all about justice, mercy, wisdom, and good. Thus, any ruling that replaces justice with injustice, mercy with its opposite, common good with mischief, or wisdom with nonsense is a ruling that does not belong to the Sharia even it is claimed to be so according to some interpretations. The main criticism on Islamic law from the western society is â€Å"Islamic law discriminates women’s rights†. Western society has identified so many women’s right violating incidents occurred in the countries which practices Islamic law or the countries which identify themselves as an Islamic republic. For example the following incidents could be recognized as the discriminatory aspect of Islamic law. Traditionally, the Muslim woman marries at a young age to a man of her fathers choice. A husband is entitled to divorce any time, even against his wifes will, by merely declaring verbally that this is his intention.Although the image of the egalitarian woman is slowly developing within some more secular Arab states, it remains largely confined to urban centers and upper-class circles. Ritual sexual mutilation of females is still common in rural areas of Egypt, Libya, Oman and Yemen. According to the UN, utilization of Arab womens capabilities through political and economic participation remains the lowest in the world in quantitative terms†¦.In some countries with elected national assemblies, women are still denied the right to vote or hold office. And one in every two Arab women can neither read nor write. Wife-beating is a relatively common practice in Arab countries, and abused women have little recourse. As the State Department has noted regarding Jordan (and most of the Arab world): Wife beating is technically grounds for divorce, but the husband may seek to demonstrate that he has authority from the Quran to correct an irreligious or disobedient wife by striking her. Abstraction of all above issues points out that most of the restriction on Muslim women connected with their marital life. A patriarchy family system has been formed through Islamic norms and values. however Islamic legal experts and scholars denies the above statement and they strongly argue that Islamic law grants much wider rights to women’s especially in case of marriage life the Islamic women enjoys much wider rights other than non Islamic women’s. Now let’s analyze myths and facts regarding the matrimonial rights provided under the Islamic law. First of all let’s see how Islamic laws treat gender equality. â€Å"And women shall have rights similar to the rights upon them in a just and equitable manner; but men have a degree over them† (Holy Quran2:228). Interpretation given for the above verse by Islamic scholars is the rights of the wives in relation to their husbands are equal to their obligations toward their husbands but men in their obligations toward their wives stand a step further The â€Å"step further† of which the Quran speaks is not a position of greater rank or nobility. The â€Å"step† the Quran makes reference to is the obligatory duty given to the man in the care of the woman; it is not a degree of superiority. Allah ordained men with the responsibility to preserve and solely sustain women. The â€Å"step further† is in no way a form of dominance or preferment. The Quran consistently makes reference to equity, parity, and equilibrium among the genders. It disposes of genders and makes no distinction whatsoever between the superiority or inferiority of men and women. On the contrary, it is the piety of a person that distinguishes him or her by ranks or degrees, not gender or lineage. As stated in this verse â€Å"step further† husband duty bound to maintain his wife, Now let’s see how does Shariah law ensures the Right to Maintenance of a wife. The duty to maintain a wife is the sole responsibility of a husband under Islamic Law. This can be seen in the Quran where it states that: â€Å"Men shall take full care of women with the bounties which Allah has bestowed more abundantly on the former (men, with several special merits) than on the latter (women) , also because they spend a part of (their wealth) to maintain them†¦.† This command is further strengthened by a number of Hadith as follows: Prophet said the following concerning women,   Ã¢â‚¬  And their rights which are your responsibility is to feed and clothed them in accordance to their needs† Hence, from the above it is the duty and responsibility of a husband to support his wife from the day he married her. This responsibility continues as long as they are married to each other. Upon divorce, a husband has to maintain his wife during the iddah period which is approximately 3 months. After the 3 months is completed, a husband may no longer have to support her. Apart from maintenance a woman is also entitled to mutaah (consolidation payment upon divorce) and matrimonial property (harta sepencarian) In case of Maintenance Srilankan Muslim Marriage and Divorce Act provides that any claim for maintenance by or on behalf of a wife, legitimate child or illegitimate child (where both parents are Muslims) falls within the exclusive jurisdiction of the Quazi. A Muslim woman’s right to maintenance during marriage is derived from the concept of nafaqa, which encompasses the provision of basic needs such as food, clothing and accommodation to the wife. In contrast to the Maintenance Act, the husband has the primary obligation of providing support and a wife’s own financial means are irrelevant in determining her claim for maintenance. Maintenance after divorce is not recognized under Muslim personal law. However, the Muslim Marriage and Divorce Act provide three situations in which a divorced wife may claim maintenance: 1. until registration of the divorce; 2. During iddat (the period of time that a divorced wife must remain unmarried); and 3. If such woman is pregnant at the time of registration of the divorce, until she delivers the child. A wife who leaves her husbands house without valid and sufficient reason is not entitled to claim maintenance from her husband under section 21 of the Muslim Marriage and Divorce Registration Ordinance. In the case of Seyed Mohamed V. Mohamed Ali Lebbe Court held that â€Å"When the woman abandons the conjugal domicile without any valid reason she is not entitled to maintenance. Simple refractoriness, as has been popularly supposed, does not lead to a forfeiture of her right But if she were to leave the house against his will without any valid reason, she would lose her right, but would recover it on her return to the conjugal domicile. What is a valid and sufficient reason for the wife to leave the husbands home is a matter for the discretion of the Judge. As a general principle a wife who leaves her husbands house on account of his or his relations continued ill-treatment of her†¦. continues entitled to her maintenance . Custody of the child Shariah law give priority to women’s in case of custody of child, One of the key relevant hadith is the following:, a woman came to the Prophet and said: Truly my belly served as a container for my son here, and my breast served as a skin-bag for him (to drink out of) and my bosom served as a refuge for him; and now his father has divorced me, and he (also) desires to take him away from me. The Prophet said: You have a better right to have him, as long as you do not marry again. From this hadith we could arrive a clear understanding that in case of child custody the Mother has the priority. However, if the mother marries again she would generally forfeit her right to custody. This concept in custody which favors to mothers has been adopted in several legal systems which include Muslim law as a personal law. For example in India the first and foremost right to have the custody of children belongs to the mother and she cannot be deprived of her right so long as she is not found guilty of misconduct. Mother has the right of custody so long as she is not disqualified. This right is known as right of hizanat (custody) and it can be enforced against the father or any other person. The mother’s right of hizanat was solely recognized in the interest of the children and in no sense it is an absolute right. Srilankan legal system also follows similar phenomena in regarding the custody of Muslim child which ensures the priority of the mother to keep her children under her custody even without the consent of her husband. In re Wappu Marikar case Wood Renton CJ stated that according to Shafii school, the custody of a girl remains with the mother, not merely until puberty, but till she is actually married; and in the case of a boy, till completion of his seventh year at all events, and from thence until puberty he may place himself under either parent whom he chooses. This case is a clear example to quote that srilankan Muslim law provides a wide safeguard to women’s in regarding the custody of child. Rights on matrimonial property Shariah law clearly defines the rights of women on property. The Muslim woman has always had the right to own and manage her own property. Marriage in Islam does not mean that the man takes over the womans property, nor does she automatically have the right to all his property if he dies. Both are still regarded as individual people with responsibilities to other members of their family parents, brothers, sisters etc. The husband has the duty to support and maintain the wife, as stated in the Quran, and this is held to be so even if she is rich in her own right. He has no right to expect her to support herself, let alone support his children or him. If she does contribute to the household income this is regarded as a charitable deed on her part. Because of their greater financial responsibilities, some categories of male relations, according to the inheritance laws in the Quran, inherit twice the share of their female equivalents, but others, whose responsibilities are likely to be less, inherit the same share -mothers and fathers, for instance are each entitled to one sixth of the estate of their children, after bequests (up to one third of the estate) and payment of debts. Women are thus well provided for their husband’s support them, and they inherit from all their relations. They are allowed to engage in business or work at home or outside the house, so long as the family does not suffer, and the money they make is their own, with no calls on it from other people until their death. â€Å"Men shall have their share of that which they have earned, and women a share of that which they have earned†¦Ã¢â‚¬  (Quran4:33) From the above verse from Quran married women’s are treated sole owners of their property husband cannot claim any part of her property while marriage exist of dissolved. Moreover Upon marriage the husband is required to give his wife a mahr (dowry) which then becomes her exclusive property. A woman can work for financial gain, without any obligation on her part to contribute to the household expenses. Islam also gives her inheritance rights, making it a requirement for women to get their determined share. Two significant features regarding Muslim women matrimonial property are Mahr and Kaikuli. Mahr is like dowry in other communities which is demand by bride and provided by groom when marriage is solemnized. Mahr is a sole property of wife and husband did not have any interest on mahr property. Even after the dissolution of marriage husband cannot claim the mahr from wife but if there any balance has to be settled on agreed mahr the wife could claim that balance mahr after the dissolution of marriage. kaikuli means any sum of money paid or other movable property given or any sum of money or any movable property promised to paid or given, to a bridegroom for the use of bride, before or at the time of marriage by a relative of bride or by any other person. Husband has the ownership of kaikuli property but he is liable to pay it over to the wife if she demands it, even during the subsistence of the marriage. The obligation is to return the property to his wife whenever she demands it or, if she dies, to her heirs. Rights on marriage and divorce. Marriage in Islam is viewed as an important and sacred union between a man and woman that fulfills half of one’s religious obligations. A well-known passage in the Quran discusses marriage as follows: â€Å"Among His signs is that He created for you spouses from yourselves so that you might find repose with them. And He has placed between you affection and mercy. In that there are certainly signs for people who reflect.† (Quran 30:21). Marriage requirements There are basic requirements for marriage in Islam. First, a couple must mutually consent to the marriage. This requires both a clear proposal and acceptance. A woman also must have a WALI or legal guardian present during the process. If a WALI is not present a woman must be past puberty and competent to make the decision to marry. Brides are also entitled to a dowry that is typically negotiated at the same time as the marriage contract. The dowry is specifically a gift showing love and devotion to the bride. There are two types of dowries a bride is entitled to: the mahr and the MUAKHR, first, the mahr is the dowry given to the bride at the time of marriage before consummation takes place. She is not required to share this dowry and is free to do what she wishes with the gift. The bride is often asked her opinion to make sure she receives a gift she enjoys. MUAKHR is the second type of dowry that is given upon the death of the husband or the couple’s divorce. This is also referred to as the â€Å"deferred† dowry. MUAKHR is meant for both financial support and as a large consequence that the couple should consider when contemplating divorce. In situations of death, this amount is paid out before the estate is divided. If the estate cannot cover the entire amount, the wife is entitled to collect the amount from the husband’s surviving family members who are also heirs to the estate. She can also waive the obligation for any reason, including hardship on her husband’s family. Polygamy The most controversial topic in Islamic law is polygamy some critics say this concept is is a distinct violation of married women rights. However now let’s analyze what Islamic law says about polygamy and polyandry ‘If ye fear that ye shall not be able to deal justly with the orphans, Marry women of your choice, Two or three or four; but if ye fear that ye shall not be able to deal justly (with them), then only one, or (a captive) that your right hands possess, that will be more suitable, to prevent you from doing injustice’. (Quran 4:3) Historically, the practice of polygamy existed before Islam without restrictions. Islam limited the number of wives to four and established clear rules and regulations for the practice to ensure fair treatment of each wife. Polygamy is an option and not a requirement in Islam. As was mentioned earlier, Muslims must follow the laws of the land that they live in as long as it does not contradict the requirements of the faith. Polyandry, or marrying more than one husband, is not permitted to maintain the children’s lineage for purposes of inheritance and protect children’s rights as heirs. Monogamy is the normal practice in the majority of Muslim communities due to the financial and emotional burden it carries. Divorce TALAQ is the word, used in Islamic law for divorce. It is an Arabic word and means â€Å"set free†. It is only in unavoidable circumstances that TALAQ is permitted as a lawful method to bring marriage contract to an end Requirements for divorce in Shariah Law 1. He or she must have reached puberty and be capable of making a decision 2. He or she must be sane, conscious, alert, and free from intoxication or anger 3. He or she must be free from external pressure 4. His or her intention must be clear Divorce must take place after the wife’s menstrual period and no sexual relations have occurred since her period ended. If all the above factors are present, either the husband or wife can pursue a divorce or they can pursue a divorce jointly and amicably. In SriLanka Muslim marriage and divorce act provides clear guide line for the marriage and divorce procedure for Muslims. Most of the provisions in this act accordance with shariah law. In case of consent of the bride did not taken in account for marriage, consent of the bride is deliberate through the WALI (guardian of bride). This provision seems to be a clear violation of women’s right however he movement for Muslim personal law reforms in Sri Lanka from a feminist perspective has been spearheaded by the Muslim Women’s Research and Action Forum (MWRAF), a small group of professional Muslim women continuously emphasis the legislation to bring changes to ensure that the consent of both parties are obtained as an essential condition of a Muslim marriage and to make provision for the bride’s signature, given the fact that there is no space for her signature in the Muslim Marriage and Divorce Registration Form and it is the wali or marriage guardian who conveys her consent on her behalf. However this recommendation has not been taken account by the legislation yet. In case of divorce, second schedule of Muslim marriage and divorce act defines the steps to get a divorce by women which obviously accordance with Muslim Shariah Law. Eventually the authority of implementing the divorce is vest ed with the Quazi. Conclusion Sharia has certain laws which are regarded as divinely ordained, concrete and timeless for all relevant situations. It also has certain laws which are extracted based on principles established by Islamic lawyers and judges. The sharia as interpreted by Islamic lawmakers is believed by Muslims to be merely a human approximation of the true Sharia, which is understood as the divine and eternal correct path. In deriving Sharia law, Islamic lawmakers are not, therefore, actually creating divinely correct or incorrect actions beyond question, but rather attempting to interpret divine principles. Hence Sharia in general is considered divine, but a lawyers or judges extraction or opinion on a given matter is not, though the process and intention to refer to Allahs law is divinely sanctioned Muslim laws developed from the shariah law are not merely reflecting shariah principles. It purely based on circumstances, traditions, communal influences and etc. as I stated earlier most of the critics from western society comments that shariah law lays some savage rules regarding women’s. But actually Islamic laws are the pioneer laws which grant wider rights to women’s. this article could only analyze the matrimonial rights grant to Muslim women’s by shariah law apart from this rights shariah laws has given adequate rights on each social activities for women’s. Islam provides rigid guide lines for pleasant domesticity. In Quran most of command orders the men to safeguard the women and to provide them all necessary rights and to treat hem equally. One of my favorite quotes in Quran is â€Å"The most honored of you [male] in the sight of Allah is he who is most righteous of you†: (49:13). Interpretation given by Islamic scholars for â€Å"righteous† is â€Å"maintaining the wife with equal rights† from this verse we could realize how far the Islamic shariah law ensures matrimonial rights of women. Srilankan Muslim law is Constructed from Muslim social and communal structure which consist Islamic shariah law as a core part of it. SriLanka Muslim law deals with almost all social conduct of Muslims. Most of the matrimonial disputes arises in Muslim families has been amicably solved by Quazi courts which operates under Muslim marriage and divorce act. As we have discussed earlier part of this article srilankan Muslim law tries to ensure the married women right and it bound to operate within the criteria of shariah law. However the core concept of shariah law is to prevent party (husband and wife) from exceeding their limits. I had an interview with a Quazi judge who had come across more than 3000 of matrimonial disputes he stated that â€Å"Muslim Marriage and divorce act bound by shariah law is primarily intended to bring a peaceful settlement regarding family issues. It provide safeguard to the married women for an extend, but we are required to act in moral manner which should give remedies for the weaker party (mostly women’s). Moreover most of the divorce application initiated by women’s and their husband are duty bound to provide adequate financial support to them even after dissolution of marriage this is a very essential safeguard for women’s. As per the Muslim law, matrimonial properties of women are entirely belonging to her. Even though I wish some changes should be brought in Muslim law regarding the consent of bride at the time of marriage and the duties of register when he registers a second marriage† -M.I. Abdul Qader Quazi Judge Akkaraipattu From the above statement we could understand Srilankan Muslim law has given matrimonial rights to a Muslim women for an extend. But it should be amended to meet the needs of modern era therefore government should take essential steps to find put the contemporary life style of Muslim people and Srilankan Muslim Law has Amend according to satisfy the modern need of the people. [ 1 ]. Ibn al Qayyim (One Islamic Scholar, d. 1347) [ 2 ]. Arab Human Development Report 2002, NY: UN, 2002. [ 3 ]. U.S. State Department, Reports on Human Rights Practices for 1999. [ 4 ]. Quran: Surah An?Nisa’:3 [ 5 ]. Riwayat Musli [ 6 ]. sec 34,35,36 and 38(2) of MARRIAGE AND DIVORCE (MUSLIM) act [Cap. 134 [ 7 ]. S. C. 565-Board of Kathis Appeal 488 [ 8 ]. 14 NLR 225 [ 9 ]. (Quran 4:11) [ 10 ]. sec 47 64 of Muslim marriage and divorce act. [ 11 ]. Sowdoona v. Muees 1[(1955) 57 N. L. R. 75; 53 C. L. W. 47.] [ 12 ]. Abu Dawoud, a companion of the Prophet, reported the following: Omair al-Asdee was reported as saying: ‘When I accepted Islam, I was married to eight wives. I discussed this with the Prophet Muhammad who said: â€Å"Keep four only, and divorce the other four.† [ 13 ]. See Hammudah Abd al Ati, Family Structure in Islam 54-56 (American Trust Publications 1977). [ 14 ]. sec29(4) of muslim marriage and divorce act.

Cost Effectiveness of Dialysis for ESRD Patients

Cost Effectiveness of Dialysis for ESRD Patients From 2002-2009 diabetic nephropathies represented 41% of all end-stage renal (ESRD) patients in St. Lucia, which is significantly higher when compared with global distribution. Renal replacement therapy for ESRD is resource intensive, consuming a significant part of the health budget. Financial pressures on the health system continue to increase in the face of the global financial crisis, yet cost-effectiveness studies of ESRD treatment options are not only scarce but nonexistent in the Eastern Caribbean. A retrospective approach to data collection was used and a Markov model of cost, quality of life and survival will be developed to compare hemodialysis and pharmaceutical management of ESRD among diabetics. Micro-costing was used to assess the cost of hemodialysis for ESRD over the 8 year period. While preliminary findings have not identified whether or not hemodialysis for diabetic nephropathy is cost-effective the economic burden of hemodialysis for diabetic nephropathy was signif icant: EC$6.9 million, in St. Lucia for the 8 year period. Pre-emptive procedures need to be considered for the treatment of diabetes to delay onset or progression of ESRD. From a medical as well as fiscal perspective, prevention is the most cost-effective intervention. The health system in St. Lucia needs to focus attention on effective prevention strategies as the mean age among diabetic ESRD patients is 56 years (2.3SD). This age group is representative of a significant part of the countrys labour force and, if left unchecked, could have serious implications for economic development. Introduction End-stage renal disease (ESRD) and its precursor, chronic kidney disease (CKD), are globally emerging as a significant public health problem, with increasing morbidity and mortality as well as economic implications for healthcare (Szucsa et al., 2004). The World Health Organizations 2002 estimate indicated that globally CKD contributes to over 850,000 deaths and over 15 million disability-adjusted life years, with epidemic rise of ESRD in multiple regions in the world (WHO, 2003). The report also predicted that by 2010 more than 2 million people would require maintenance dialysis worldwide, and global estimates indicate that approximately 30% of patients with ESRD suffer as a consequence of diabetic nephropathy (Zelmer, 2007). The economic pressures of ESRD treatment on the collective health system are well documented. Haller, et al. (2011) identifies it as resource intensive, requiring substantial amounts of finite healthcare funds to treat a small percentage of the population. In 2005 alone, care for ESRD patients in Canada represented 1.2% of all healthcare expenditure, despite a 0.092% incidence of the disease (Zelmer, 2007). In St. Lucia, chronic renal insufficiency as a result of diabetes, hypertension, autosomal dominant polycystic kidney disease, and sickle cell disease are the main reasons for starting dialysis treatment in patients with kidney function failure. This is similar to the findings of Perovià ¡ and Jankovià ¡ (2009). In addition to being a chronic disease with significant morbidity impact, ESRD also involves high-cost treatment options (Zelmer, 2007), which are often limited in developing countries such as St. Lucia. Yet cost-effectiveness studies of the modalities of treatment are few and limited, especially in developing countries (Haller, 2011). Previous research has been conducted to identify the economic impact of the estimated health-care costs for ESRD, as well as the cost-effectiveness of various alternatives for renal replacement therapies; however, similar studies have not been replicated in the Eastern Caribbean. The findings are especially relevant to the health system in St. Lucia, as the incidence of diabetes continues to increase in the Caribbean Region (Henry, 2004). Additionally, the recent decision to expand the dialysis service to two new facilities without understanding the scope and magnitude of the total economic burden of ESRD could prove to be challenging. Cost-effectiveness is the fastest growing field in health research and it embodies a form of full economic evaluation that looks at cost and consequence of health programmes or treatment (Muennig, 2008). Cost-effectiveness analysis (CEA) of intervention programmes as a valuable tool employed by decision-makers can be used to appraise as well as possibly improve how the health system operates. Its application allows policy makers to identify which interventions provide the highest value for money and assist in helping to select interventions and programmes that maximize health for the available resources. Health economists are able to purchase the most health under a fixed budget, prioritizing services within the health sector. CEA therefore requires information to indicate the extent to which current and potential interventions are effective for improving population health, and which resources are required to implement the interventions, i.e., costs (Muennig, 2008). Referring to Palmers 2005 definition that states cost-effectiveness studies compare costs with clinical outcomes measured in natural units, like life expectancy or years of diseases avoided, Glassock (2010) noted that the totality of costs may not necessarily be captured. The inclusion of cost means that the design of the study will incorporate cost-unit analysis as a tool to examine the economic impact of dialysis for ESRD patients with diabetes and cost effectiveness to determine the quality adjusted life year (QALYs) or health related quality of life (HRQoL) for that population. The main outcome measure will focus on costs per quality-adjusted life years ($/QALYs), similar to a study conducted in Austria (Haller et al., 2011). Glassock (2010) notes that community willingness-to-pay is the threshold value used to determine cost effectiveness. He goes on to note that these values vary globally, and are estimated at  £30,000/QALY in the United Kingdom, 40,000/QALY in Europe, Aus $5 0,000/QALY in Australia, and US $90,000/QALY in the United States (Glassock, 2010). In the absence of a national threshold value, one can be established using GDP as an objective economic benchmark, (Eichler, et al., 2004). Cost will be viewed from the perspective of direct spending on health care for dialysis, coupled with the indirect costs of productivity losses due to premature death and short- and long-term disability. The impact of mortality costs as the sum of the discounted present value of current and future productivity losses from premature deaths will be measured from an incident-based human capital approach, drawing from a similar study conducted in Canada in 2000 (Zelmer, 2007). Muennig (2008) posits that because it is often difficult to account for all cost, and the time and resource constraints associated with micro-costing, certain assumptions related to costs are often made during cost-effectiveness analysis. This paper serves to examine the cost-effectiveness of hemodialysis among type 2 diabetics in St. Lucia over an 8 year period (2002-2008). Employing the use of CEA, it aims at comparing the cost and effects or outcomes (cost-effectiveness) of hemodialysis for diabetic nephropathy using the comparator of doing nothing, which in this case is the pharmaceutical management of patients with diabetic nephropathy to delay progression of ESRD. The findings will also help to inform those making policy decisions, and may be useful in establishing a set of priorities for further research, prevention programs, and in the planning of alternative treatments to help alleviate that burden. Perspective of the Study Cost effectiveness of dialysis for ESRD patients with diabetes in St. Lucia will be analyzed from a government perspective. This requires conducting cost analysis that measures the recurring direct and indirect cost of providing the service. In the region, specifically in the country under study, health care organizations rarely know the cost of the service provided and rarely employ the tools needed to assess that cost on a regular basis. In a globally operating economic society, economic trends have made it imperative for both profit and non-profit organizations that provide services, including government agencies, to assess the cost of clinical services provided. Finance for health is not infinite and with substantial budget cuts in the health service industry, there is increasing pressure for health care facilities to become more accountable and efficient with the funds allocated to health care (Basch, 1999). Health economics recognises the need for health services to be provided in a manner that is not only efficient but sustainable. Measuring, understanding and documenting the cost of services makes it easier to improve cost-efficiency of these services; it also highlights the funding needs of the sector and by extension, the government. It also provides an opportunity to establish fees for clients that are based on realistic site costs. Previous studies on cost-effectiveness of treatment options for ESRD have compared different modalities of dialysis or transplantation (Haller et al.; Gonzalez-Perez et al., 2005, Yang et al., 2001). Treatment modalities for ESRD patients in St. Lucia are either hemodialysis or pharmaceutical management. The analysis of hemodialysis versus pharmaceutical management to delay ESRD progression hinges on the fact that the current capacity of the Renal Unit in St. Lucia cannot provide dialysis for all ESRD patients. In an interview dated December 14, 2010 with the head of the Nephrology Unit, Victoria Hospital, Saint Lucia, it was indicated that while dialysis is offered, the increasing ESRD population means that patients are placed on a waiting list if they are not able to commence treatment due to unavailability of space (Olivert Dupree, 2010). If a patients prognosis requires immediate dialysis, he is treated at the private facility and the government absorbs that cost. But it is quit e clear that hemodialysis, like pharmaceutical management, is not the optimal treatment option for ESRD; rather, the optimal protocol is transplantation. The health system in St. Lucia is mandated by its objectives to improve the health of the population and consequently needs to ensure that its limited resources are not devoted to expensive interventions with small effects on population health, while at the same time low cost interventions with potentially greater benefits are not fully implemented (Ministry of Health, Human Services, Family Affairs and Gender Relations, 2000). Methods Data Sources The study population comprises of ESRD patients with diabetic nephropathy. Patients were considered depending on whether they received hemodialysis or whether their diabetes was being pharmaceutically managed to delay ESRD progression. Data was collected retrospectively and the study population was selected from the only public Renal Unit which forms part of the general hospital, Victoria Hospital. While there is another Renal Unit in St. Lucia that offers dialysis, it is a part of the private hospital, which did not wish to participate in this study. Of the 111 patients on dialysis, 45 were due to diabetic nephropathy and 19 were actively receiving dialysis at the time the study was being conducted. The nephrologists identified 12 ESRD patients who were not receiving dialysis but were being managed pharmaceutically. All diabetics who are or have been on dialysis with end-stage renal disease for the period 2002-2009 and were receiving dialysis due to diabetic nephropathy were included in the study. Persons were excluded from this study if they were on dialysis prior to being diagnosed with diabetes. The comparator group differed from the hemodialysis group only in the form of treatment that they are receiving, and consisted of all patients with ESRD due to diabetic nephropathy who are not receiving dialysis but whose diabetes is aggressively managed with medication to delay ESRD progression. Other variables were considered in the study and a standard questionnaire was administered to the study population to obtain data on the socio-economic status of individuals. A pool of eight persons from those who were on dialysis for reasons other than diabetic nephropathy served as a pilot test group for the socio-demographic questionnaire. This group was similar to the study population in terms of gender, education, socio-economic status and geographic location (Table 1). Content analysis was used to evaluate the information obtained from the socio-demographic questionnaire. All study participants received a letter concerning anonymity and confidentiality and informed consent was obtained prior to participation. Ethical approval was obtained from the IRB at St. Georges University and the ethics committee of the Ministry of Health in St. Lucia. A literature review conducted relied upon peer-reviewed economic evaluations of dialysis treatment modalities among diabetic patients. Ebscohost and PubMed were searched using the keywords cost-effectiveness, dialysis, end-stage renal disease, and diabetic nephropathy and was limited to articles published in the last 12 years (2000-2011). Some articles, if they were published outside of the selected timeframe, were accepted based on the strength and relevance of their findings. Articles were included if they had the keywords in the subject headings as well as focusing on Renal Replacement Therapy/economics, Renal Dialysis/economics, Hemodialysis Units, or Kidney Failure. If they included the term peritoneal dialysis or hemodialysis they were also selected. Exclusion criteria comprised of non-English articles and those that did not compare treatment options. A total of 379 articles were identified but 31 were selected as being relevant. Models Used Chronic conditions such as ESRD require continuous treatment and as a consequence, the cost-effectiveness of treatment options over a period of time for a cohort of patients employs the use of the Markov model to investigate long term costs and outcomes. The Markov model developed for this study describes the process of care noting that patients began their progression through the model in either of two states, hospital hemodialysis or pharmaceutical management of type 2 diabetes to delay ESRD progression, with death signifying the end of the cycle. Data on health care costs, transition to other health states and quality of life were inputted into the Markov model. Data was obtained from the Renal Unit at the Victoria Hospital, the public health facility. Data on quality of life was obtained using the 15D, a multidimensional, standardised generic instrument to measure quality or health-related quality of life (Sintonen, 2001). The 15D was used since it combines the advantages of a profile and single index score measure that describes the health status by assessing 15 dimensions. The mean score value for each dimension was used to determine the health related quality of life in the study population. The use of the 15D to measure quality of life outcome was reported in terms of QALYs, a measure of the burden of disease that included the quality and quantity of life lived against a monetary value, medical treatment or intervention. The mean score value for each dimension measured by the 15D was used to determine the health-related quality of life of the study population using the scale provided by Sintonen (2001). The findings were standardized against the burden of disease markers identified by the WHO. Costs and Analysis Cost-effectiveness, examined from a governmental perspective, used the clinical records of the Division of Nephrology patient registration and billing systems at the Victoria Hospital coupled with information from published studies on survival and quality of life among diabetic nephropathy patients. The model used included the direct health service costs associated with the treatment options, and an annual cost per patient was calculated for each health state in the model. Direct healthcare costs associated with dialysis use included costing regular dialysis sessions, complications of the dialysis, such as clotting of the fistula or hypotension episodes, laboratory tests and services required as a consequence of dialysis and medication use as a result of treatment. Assumptions were made on the regularity of direct healthcare cost associated with dialysis, such as that involving laboratory testing and blood transfusions. Micro-costing, collecting data on staffing, consumables, capital , and overheads were used to determine the cost of one session of hemodialysis (Table 2). Structured interviews were used to obtain details regarding staff time allocated to dialysis activities, as well as the regularity of other services used as a result of the treatment options. Capital items were identified as the building space allotted to the Unit for treatment, and equipment such as the dialysis machines and air conditioner unit. Costs have been reported in Eastern Caribbean Dollars (EC) presented at the 2008 level and an equivalent annual cost calculated using a 3 percent discount rate over the predicted life span. Muennig (2008) argues that a governmental perspective can include some aspects of transportantion costs. Evidence from the Minstry of Communication and Works and the Transport Board implies that there is no nationally agreed-upon policy for transport costs. There are variations across St. Lucia in terms of mileage costing; therefore for the purposes of our analysis, transport costs are excluded. The study reviewed costs over an 8 year period (2002-2009). This time frame was partly determined by the availability of the data two years after the programme was initiated and the assumptions made with reference to the analysis were tabulated (Table 3). Incremental costs per QALY gained will be calculated by using the estimates of costs and QALYs for each of the two modalities obtained from the model, and the findings were presented as incremental costs per QALY ($/QALY). The threshold value used to determine cost effectiveness of the intervention was established based on the recommendations of the Commission on Macroeconomics and Health, and CHOICE, which uses gross domestic product (GDP) as an indicator to determine cost-effectiveness. They established that an intervention was highly cost-effective if cost per QALY was less than GDP per capita, it was cost-effective if it was between 1 and 3 times the GDP per capita but was not cost-effective if it was more than 3 times GDP per c apita (WHO, 2011). A one-way sensitivity analysis will be used to investigate variability in the data, varying the discount rate from 3% to 5%, then age weights and finally, the disability weights. A final sensitivity analysis of mortality rates will be conducted since the assumption was that the mortality rates for hemodialysis were the same as those of pharmaceutical management of ESRD diabetics. Based on that assumption it becomes important to identify whether any one of these factors, discounted rates, age weights, and disability weights independently affected the data. Multiple linear regressions will be used to identify how the variables and assumptions affected dialysis lifetime. Preliminary Findings Demographic Characteristics The socio-demographic characteristics of the study population are presented in Table 4. According to the modalities compared the mean ages were 52 years (SD 10.06) for hemodialysis patients and 42 years (10.34SD) for patients who were being pharmaceutically managed. Briefly 62% of the patients were male (Figure 1), 40% had completed only primary level education and 20% had received no formal education. Married patients made up 46.7% of the study group and 26.7% were currently employed; but of these patients 80% of them received some form of family support or National Insurance Corporation (NIC) compensation. There was little variation between the groups (hemodialysis and pharmaceutically managed) in terms of employment and education. ESRD, as a consequence of diabetic nephropathy, represents 41% of all patients who have received hemodialysis for the period 2002-2009 (Figure 2). The end of that 8 year period mortality rate among that population is 53% with the average age of death at 57 years and average dialysis lifetime of 3 years. Costs A list of the parameters used to determine cost is presented in Table 2 and total yearly cost for the period is presented in Table 3. The total cost of dialysis for diabetic nephropathy was EC$6.9 million. From a governmental perspective, in 2009 the total cost of dialysis for diabetic nephropathy patients with ESRD totalled EC $1,002,597.23, accounting for approximately 2.27% of all healthcare expenditure for 0.01% of the population. Secondary and tertiary care services accounted for 59% of the total health budget for 2001-2002, 60% for 2002 -2003 and 64% for 2003-2004. Primary care services accounted for 22% in 2001-2002, 22% 2002-2003 and 18% for 2003-2004 (Figure 3). Discussion This is the first study of its kind in the region. It is able to serve as a precursor to further research and therefore is poised to help guide policies on how cost-effectiveness studies are done in the region. Additionally, there will be future application to decision-making in healthcare. While the absence of other studies that compared the treatment modalities used in this study serves as a limitation to this paper, it remains the only viable comparator that was available to the researcher, and being the first of its kind allows it to inform the existing research. The preliminary findings of this paper have significant implications for health and the operations of the dialysis unit. The literature from other studies (Haller et al, 2011; Zelmer, 2007) indicates that the average lifetime on dialysis is 7-10 years, with survial rates lower among senior adults, aged older than 65 years. The inverse seems to be suggested by the preliminary findings, with an average lifetime of 3 years in patients less than 57 years. The deviation may be attributable to younger persons being less compliant with regular dialysis sessions and the strict dietary and lifestlye adjustments that dialysis requires. Further research would need to be conducted to validate these findings. The economic burden of ESRD for diabetic nephropathy is significant: EC$6.9 million, in St. Lucia for the 8 year period (Table 2). While the focus of this study is on the cost-effectiveness of dialysis, the data identified that health services accounted for most of the observed costs. The governmental perspective of the research restricts the papers ability to adequately address the diabetic nephropathy related morbidity and premature mortality among the study population and the substantial burden that it places on society. The early indicators suggest a need for the effectiveness of the programme to be examined against its objectives and how its outcomes compare with other units within the region or the privately operated unit in St. Lucia. In 2006 Government health expenditure per person per year was EC$499.50 (Ministry of Health, Human Services, Family Affairs and Gender Relations, St. Lucia). Yet for that corresponding period, government spending for dialysis per person per year was EC$48,597.81 (Figure 5), for 0.0014% of the population. St. Lucias GDP for that period is estimated as $6,037.00 PPP (EC$16,299.90) and total expenditure on health is estimated as 6.3% of GPD (Table 5). While cost-effectiveness has not been conclusively established, using the threshold value of GDP as an economic estimate to determine cost-effectiveness, a cost-effective programme is one that is between 1 and 3 times the GDP per capita (WHO, 2011). The National Strategic Health Plan 2006-2011 (2006) posits that the Ministry of Healths actions have not been consistent with its declaration of a commitment to Primary Health Care (PHC) as part of its strategy for National Health development. Health spending continues to increase in the areas of secondary and tertiary care and less of the health budget is spent on primary care. The expansion of hemodialysis to meet the growing ESRD population, and an increased incidence of diabetic nephropathy in St. Lucia has implications for the findings of this study. It is important that focus is directed at primary and secondary interventions aimed at reducing cost of diabetic care and consequently complications from diabetes, such as diabetic nephropathy. Primary interventions are the most cost-effective and as such health promotions to reduce risk of developing diabetes, a risk factor for ESRD, needs to become part of the mandate of the Ministry of Health. A policy on chronic diseases develop ed within the primary healthcare plan that currently exists would help guide that focus. The study was limited by the accuracy and quality of the data, which Basch (1999) argues is a recurring problem in developing countries. There are limitations and difficulties in any attempt to calculate the mean cost of a dialysis session, especially in public facilities where cost is subsidized, as every facet of care and cost associated with the session must be taken into consideration. Consequently, assumptions were made on cost for direct and indirect services related to treatment options compared in this study. Assumptions are justified as this is a non-funded research with time constraints and a need to reduce cost drivers. The study was also limited in its perspective as it could not present on national costs from a societal perspective such as the patients ability to work or opportunity costs. Costs from the private facility could not be used as they did not wish to participate in this study. The inability to capture their costs is relevant as they are used by the government to provide dialysis for ESRD patients whose prognosis prevents them from being placed on a waiting list; this cost is incurred by the government. A patient who commenced dialysis at the private facility and transferred to the Renal Unit at the government facility is not distinguished in the patient register. The strength of the research lies in the use of triangulation to gather and analyse data to ascertain their common conclusion, effectiveness based on costs, and QALYs. Decrop (1999) concurs that one of the main ways to avoid the contentious issue of validity and reliability is the use of triangulation. Triangulation involves the use of multiple data sources in the investigation of a research question for justification or clarification, which in this case involved utilizing primary and secondary data, as well as information from the attending physician. Denzin (1978) also claims that triangulation limits personal and methodological bias as well as enhances the studys generalizability. The use of the Markov model is an inherent strength of the study. Gonzalez-Perez, et al. (2005) argue that the models ability to prognosticate relative effectiveness and cost overtime makes it appropriate for modelling chronic treatment options such as Renal Replacement Therapy (RRT). Cost-effectiveness to determine QALYs as well as the use of a standardized instrument to measure QALY also strengthens the findings of the research. The 15D is recognised as generally being a small measurement burden to both respondents and researchers. As an evaluation tool it is highly reliable due to its repeatability of measurements with minimized random error. The results generated are valid because of the degree of confidence that researchers can place in the inferences that are drawn from the scores. Sintonen (2001) posits that as an instrument to measure cost-effectiveness, it is particularly suitable for calculating quality-adjusted life years (QALYs). While the majority of cost-effectiveness analysis of treatment modalities for diabetic nephropathy focuses on the disease at its latent or progressed stage, Glassock (2010) noted that a study by Gearde et al. (2008) identified that early detection of diabetic nephropathy and intensive pharmaceutical interventions are not only cost effective but significantly reduces the risk of ESRD among type 2 diabetics. These findings are replicated in two studies by Keane and Lyle (2003) and Szucs, et al. (2004) who found that Losartan reduced the incidence of ESRD among diabetics. They went on to argue that proteinuria, which is the single most powerful predictor of CKD in type 2 diabetes, is a simple and inexpensive screening test, and early detection can lead to the early administration of drugs that have been proven to reduce ESRD incidence. Mann, et al. (2010) argue caution against population based screening for CKD, and advocate that screening, as a secondary intervention, should focus on at-risk populations. Their study concluded that targeted screening of people with diabetes is associated with an acceptable cost per QALY in publicly funded healthcare systems. Such an approach can be adopted in the health system in St. Lucia. Cost-effectiveness analysis is able to provide valuable insight to prioritizing within healthcare and so the findings of this research will be able to provide evidence to support efficiency in the use of limited resources. Policy-makers would be able to use these findings to review the decision to expand the number of hemodialysis centres in St. Lucia. Further research to identify more cost-effective treatment options would be the first step to improving efficiency of resource allocation. The preliminary findings have not identified whether or not hemodialysis for diabetic nephropathy is cost-effective. The domination of hemodialysis as a treatment modality for ESRD, despite the plethora of studies that have identified it as the least cost-effective of RRTs (Haller, et al., 2011; Just, et al., 2008, Kontodimopoulos Niakas, 2008), provides the health sector with the evidence needed to revise treatment protocols and an opportunity to improve cost-effectiveness of ESRD treatment. This can be achieved by reducing the use of hemodialysis and introducing as an alternative peritoneal dialysis, which has been cited as being the most effective of dialysis options. Just, et al. (2008) caution that the economics of dialysis in the developing world, where labour may be cheaper than the importation of equipment and solutions, may lead to the perception that peritoneal dialysis is more expensive than hemodialysis. They go on to note that this is not conclusive as there is a dearth in economic evaluations in developing countries to substantiate that view. As an alternative, a well developed CKD Care Program is able to significantly reduce the probability of developing ESRD among at risk populations, as well as significantly lower healthcare costs among ESRD patients (Wei et al., 2010). There is a need to expand the services offered by the Renal Unit as well as its coverage to help achieve that end. Conclusion of Preliminary Findings Despite a declared commitment to Primary Health Care (PHC) as a strategy for National Health development, the Ministry of Healths actions have not been consistent with its declaration. Secondary and tertiary care service is posing a great financial burden on the health system, as purported by the preliminary findings of this paper. Evident in the resource allocations for health in St. Lucia, Primary Care Services are allocated a decreasing or stagnant proportion of the health budget, considered against a decreasing allocation of total public expenditure to health. A sustainable health system needs to maximize the use of health resources, creating a more efficient health system that is capable of providing quality health services in a cost-effective manner in order to maximize population coverage. Primary health care needs to become the thrust used to promote efficiency in health as it is recognized as the most cost-effective of interventions. References Basch, P. (1999). Textbook of International Health

Native Son, A Critical Review :: essays research papers

Bigger, Crime, and Society In the heated trial that determines whether Bigger Thomas will live or die, his supportive defense attorney exclaims, â€Å"You cannot kill this man, your Honor, for we have made it plain that we do not recognize that he lives!† Living in the Chicago slums as a poor, uneducated young black man whose only confidence can come from acts of violence, Bigger Thomas of Richard Wright’s novel Native Son is destined to meet a poor fate. Anger and hopelessness are a daily reality for him as he realizes that his life has no real meaning. When he accidentally murders a young, rich, white woman, however, his actions begin to have meaning as he accepts the crime as his own, even while he lies to the authorities. Bigger is, of course, taken down by a society who takes offense at the remarks of his supporters and seeks to justify itself. Bigger himself is doomed, but his emotions, his actions, and his motivations all help to give the reader a window into the mind of a criminal and a r epressed inner city African American. Fear, flight, fate. These are the three simple and meaningful words chosen by Wright to mark Bigger’s sad existence. Growing up angry at the white world, he is forced into working as a chauffeur for a rich white family, the Daltons, to support his struggling family. He is frightened and angered by the attempts of Mary Dalton and her Communist friend Jan to be friendly to him and interprets their actions as condescending. As he tries to stifle a drunken Mary to avoid detection after carrying her upstairs, he accidentally kills her. In a time of panic, he burns the body in the furnace and concocts an elaborate lie imputing the Communist Party. He lies, dodges questions, and even tries to demand ransom, but this can only last for so long before Bigger is named as chief suspect. He brings with him in flight his girlfriend Bessie and later kills her, as she cannot continue with him nor return home. After being caught and brought to trial he is supported by attorney Boris Max who de fends him intensely with his own eloquence and conviction. Bigger discovers that the man, though white, feels genuinely for him, but in the end, as dictated by fate, he is sentenced to death and is granted no clemency by a society refusing to take any responsibility for a member for whom it has failed to care.

Great Expectations - The Growth of Pip in Society Essay examples -- Gr

Great Expectations - The Growth of Pip in Society When Joe visits Pip in London, he stays with him at Mr. Jaggers' house. Pip says that "he had little objection to his being seen by Herbert or his father, but he had the sharpest sensitiveness to his being seen by Drummle" (218). This shows that after time had past without Joe, Pip has become self conscious of him and does not want his friends to meet him, afraid that they might think less of him. Since Pip has made such good friends with everyone in his quest to becoming a gentleman, he is afraid of what they might think of him after meeting Joe. After Herbert leaves for the city, Pip gives Joe lessons on good manners and how to act properly around gentlemen so Joe would not embarrass him so much. When Joe left, he mentioned to Pip that he was going to change and that he will never be seen in the clothes that he is wearing: "It isn't that I am proud but I want to be right as you will never see me no more in these clothes" (223). Because of Joe's sudden change in attitude, Pip perceives Joe's solid honesty and moral depth so he regrets his attitude toward him. After Pip realizes that he was wrong about Joe, he goes back to his original views of Joe which stay right through to the end of the novel. Mrs. Joe has a distinctly different impact on Pip which mostly led to Pip's shyness and cowardliness throughout his childhood. Since, Pip's parents and five brothers died, Mrs. Joe felt the need to raise Pip in a strict household. Because of these strict rules implied by his sister, Pip was always afraid when he was late or did something wrong since his sister would yell at him or punish him when he got home: "Consequently, I said as little as I could and I... ...ip is introduced to many new people who all think that Pip is wonderful. They are always flattering him and commenting on his job. Pip quickly becomes popular so he is always wanted for a number of things; such as dinners or sleep overs. All the attention that Pip gets from his new found friends helps to boost his self esteem to a level that he has never experienced before. From the time he arrives in London to the time the novel is finished, Pip is a changed person and his family and peers are proud of him. Throughout Great Expectations, the growth of Pip in a society becomes more significant in each of the three stages. As Pip matures into a gentleman he learns many things about himself as well as how strong he is as a person. Instead of his critics leading the wrong direction, they helped Pip to discover his morals and led him to a successful future. Great Expectations - The Growth of Pip in Society Essay examples -- Gr Great Expectations - The Growth of Pip in Society When Joe visits Pip in London, he stays with him at Mr. Jaggers' house. Pip says that "he had little objection to his being seen by Herbert or his father, but he had the sharpest sensitiveness to his being seen by Drummle" (218). This shows that after time had past without Joe, Pip has become self conscious of him and does not want his friends to meet him, afraid that they might think less of him. Since Pip has made such good friends with everyone in his quest to becoming a gentleman, he is afraid of what they might think of him after meeting Joe. After Herbert leaves for the city, Pip gives Joe lessons on good manners and how to act properly around gentlemen so Joe would not embarrass him so much. When Joe left, he mentioned to Pip that he was going to change and that he will never be seen in the clothes that he is wearing: "It isn't that I am proud but I want to be right as you will never see me no more in these clothes" (223). Because of Joe's sudden change in attitude, Pip perceives Joe's solid honesty and moral depth so he regrets his attitude toward him. After Pip realizes that he was wrong about Joe, he goes back to his original views of Joe which stay right through to the end of the novel. Mrs. Joe has a distinctly different impact on Pip which mostly led to Pip's shyness and cowardliness throughout his childhood. Since, Pip's parents and five brothers died, Mrs. Joe felt the need to raise Pip in a strict household. Because of these strict rules implied by his sister, Pip was always afraid when he was late or did something wrong since his sister would yell at him or punish him when he got home: "Consequently, I said as little as I could and I... ...ip is introduced to many new people who all think that Pip is wonderful. They are always flattering him and commenting on his job. Pip quickly becomes popular so he is always wanted for a number of things; such as dinners or sleep overs. All the attention that Pip gets from his new found friends helps to boost his self esteem to a level that he has never experienced before. From the time he arrives in London to the time the novel is finished, Pip is a changed person and his family and peers are proud of him. Throughout Great Expectations, the growth of Pip in a society becomes more significant in each of the three stages. As Pip matures into a gentleman he learns many things about himself as well as how strong he is as a person. Instead of his critics leading the wrong direction, they helped Pip to discover his morals and led him to a successful future.

Five-Year Career Development Plan Essay -- Career Ambition

The term career plan is the broad-based exploration associated with the career or profession expansion or growth and gives a clear explanation concerning the people who administer his or her careers within the corporations along with what aspects corporations use in formulating his or her career improvement among his or her associates. Expanding or enlarging a career or professional preparation is not an easy task for the reason behind the expansion plan assists in planning the upcoming period; throughout the whole life period people continually alter or change his or her careers frequently. Therefore, totally based upon victorious evolution or changeovers is the arrangement a person has infect made in favor of unexpected changes or alterations. Imagination relating to the career planning seems to be a crucial factor in favor of a person’s present career to the subsequent one, devoid of the connection, one may easily hesitate or unable to find the right target, subsequently if a person has an association or connection a person must be secure and know proper course of action, which a person has to follow (Hansen, n.d, Para. 2). Further mentioned details below give a clear understanding concerning a person’s career or future expansion program based upon five-year duration. Career Goals and Objectives Career targets or aims seem to be the reasonable or rationale upcoming results relating to somewhat a person has thought in his or her mind. Goals or objectives need to be SMART or elegant, where SMART depicts specific or precise, measurable or considerable, attainable or achievable, realistic or down-to-earth and finally it must be within periods (LoveToKnow, 2010). Ahead of gradation the next target is to acquire a ma... ... Career Vision. (2004). What is career management? Retrieved from http://www.careervision.org/About/CareerManagement.htm Hanse, Randall S. (n.d.). Quintessential careers. Developing a strategic vision of your career plan. Retrieved from http://www.quintcareers.com/career_plan.html LoveToKnow. (2006-2010). Business. Examples of SMART goals and objectives. Retrieved from http://business.lovetoknow.com/ wiki/Examples_of_SMART_ Goals_and_Objectives State of the Service Report. (2006-2007). Employee engagement and job satisfaction. Employee survey. Retrieved from http://www.apsc.gov.au/stateoftheservice/0607/partthreesatisfactionattributes.htm The World Bank Group. (2010). Education. Human development network. Retrieved from http://web.worldbank.org/WBSITE/EXTERNAL/TOPICS/ EXTEDUCATION/0,menuPK:282391~pagePK:149018~piPK:149093~theSitePK:2823 86,00.html

The Causes of World War One

‘World War One was the result of a series of unintended and disconnected events. ’ Does this opinion adequately explain the causes of World War One? It is understandable that historians ponder on what exactly caused a war that destroyed Europe’s economy, cost the lives of 37 million men and involved a country from every region of the world (from the Americas to Asia). The opinion this essay will discuss implies that the events that led to this major conflict were unintended and disconnected; and in order to emit a judgement that would agree or disagree with this view it is important to first identify the causes of world war one.Therefore this essay will first discuss the different types of causes (long, mid and short terms), respectively nationalism, imperialism/militarism and the ‘blank cheque’. Hence this essay will evaluate whether these were ‘disconnected and unintended events’ or if there is a connection between the causes. The main sources used in this essay are Coles’ general notes on world history and historian Martin Gilbert’s book entitled ‘First World War’. The long term causes prepared the ground for the war.Nationalism can be categorized into the long term causes because it had influenced Europe prior to 1914, and as French writer Guy de Maupassant argues, ‘it is the eldest cause of any war’. Quite a popular phenomenon in the late 19th century and beginning of the 20th, nationalism produced pride in one’s country’s achievements. The world war one themes paper observed that this ‘led to xenophobia and ideas of racial superiority’; but what it fails to mention is that as much as nationalism could provide feelings of superiority it could also provide feelings of equality.For example, minorities that previously were dominated by larger powers were now swept with waves of nationalism. This could be observed in the Balkans in the prelude of th e world war; where small states were experimenting Pan-Slavism, ‘a nationalistic movement for political and cultural solidity of all Slavic people’ thus a threat to the Austrian Empire who dominated the South Slavs.One could argue that this form of nationalism led to Franz Ferdinand’s assassination by an extreme Serb nationalist group, or that it was the Austrian’s nationalism (their pride in their achievement of an empire) that pressured them into keeping all minorities within the empire at all costs; this leading to the Austro-Hungarian ‘impossible’ ultimatum to Serbia on the 23rd of July 1914.Nationalist mood in Europe could also be seen in France; more than 30 years after the French were defeated in the Franco-Prussian war a black cloth still veiled the statue of Strasbourg in the Place de la Concorde and it was a symbol, a constant reminder of the loss of the two eastern provinces, Alsace and Lorraine. The French still remembered the defe at and often spoke of ‘La Revanche’ (the revenge).As historian Gilbert argues, ‘War, if it came, would be an irresistible opportunity to fulfil long harboured desires or to avenge long-nurtured hatreds’. Historian Martin Kelly also argues that ‘it was nationalism, that manifested itself in the pan-Slav feeling of the Russian population, that tied Russia and Serbia together whilst Austria declared war, and thereby triggering what would have been a limited local conflict into world war’.When the Russian tsar signed the order commanding full mobilisation of Russian troops because ‘Russia could not remain indifferent to a declaration of war on Serbia’ and as the ultimate proof of the stimulating effects of Nationalism, editor Alex Bein remembered that ‘the Russian popular sentiment applauded the fullest possible solidarity with the beleaguered fellow Slavs of Serbia’. In this particular case it is difficult to determine wh ether these events occurred under the ‘Nationalism’ potential cause or the ‘Alliances’.Without dropping into philosophical or anthropological arguments, this essay will assume that alliances themselves were generated because of nationalism, as countries really wanted to increase their power by allying themselves with other powers, which in the end is motivated by a nationalist feeling. It is often observed in general history that events sometimes only occur because they are in a specific context. ‘Mid-term’ causes, if it the events that occurred slightly prior to the commencement of the war (between 1970 and 1914) can be labelled so, could be held responsible for creating a context specific to that time.In this case, militarism and imperialism greatly shaped the relations between the powers and consequently the political shape of pre-war Europe. Imperialism was a symbol of power that allowed the European powers to expand their overseas territor ies and therefore ‘gain new markets, raw materials and fields of investment’. The movement of ‘the Scramble for Africa’ left most of the African continent occupied by Europeans, notably colonies of Britain, France, Portugal, Spain and Belgium; Germany did have some overseas territories, but as historian Gilbert remarks ‘The Kaiser did not make ffective use of its colonies, and owned them by name rather than by practice’. This observation shows that the Kaiser attached a symbolic importance to colonies. The ambitious German king wished that his recently united Germany (the German unification had only occurred in 1971, not even half a century before the war) would possess more overseas territories. Unfortunately most of the African continent was already ‘occupied’; leaving the Kaiser with a bitter feeling of rivalry with Britain and France.This led to the dangerous Agadir crisis, in which the Kaiser had ordered a fleet to establish a port at Agadir, on the Atlantic coast of Morocco. The British feared this would give the Germans an undesired strong grip in Northern Africa, and thus threatened them to respond in ‘a hostile manner’ if the German gunboat did not depart immediately. ‘The threat was effective, but the rancour which left it was equally strong’, noted Gilbert. At the Reichstag, a few weeks after the event, a social democrat commented in a worried tone that tensions could lead to a war, to which a parliamentarian responded: ‘After every war things are better! The imperialistic tendencies of Europeans unavoidably led to tensions within Europe itself, generating mutual suspicions and fear. This could explain why the European powers felt the need to invest in the military: in the 1870s, all six major European powers had adopted compulsory military training, which resulted in some 4 ? million men under arms by 1914. Each power’s General army staffs had well-drawn batt le plans in readiness: the French had ‘Plan 17’, the Germans had ‘Schlieffen plan’ and Russians had ‘Plan A’. By the beginning of the conflict a total amount of $2 billion a year was spent on armament (all powers combined).It can only be logically concluded that if the powers were investing so much time and money in military they were intending to use it. Finally, it was the ‘short term’ causes led to critical events that escalated into the war. A general historical view observes that it all began when Franz Ferdinand was assassinated in Sarajevo, on the 28th of June 2014. The Italian foreign minister at the time observed that ‘The telegram indicated that the assassination of the Archduke was the occasion rather than the cause of Austria’s ultimatum to Serbia, and it reveals the reason for Austria’s action [invading Serbia]’.This view can also be supported by the fact that ‘between 1906 and 1914 the Austrian Chief of Staff General Hotzendorf had asked more than 25 times for a ‘surprise’ war on Serbia’. The Austro-Hungarians wanted to reduce Serbia’s power by attacking her. When they were provided with an excuse to do so (Ferdinand’s assassination) ‘They were not fully confident to attack immediately for fear of Russian retaliation,’ argues Gilbert: ‘but the fact that they had unconditional German support if ever the conflict widened gave them confidence’.It is argued that the Germans had given their full support because the Austro-Hungarians were their most precious allies, and they could not afford losing the cooperation of the other central power when they were encircled by the Triple Entente (Russia, Britain and France). Therefore, to some extent, it can be argued that it is this unconditional support that pushed Austria to declare war on Serbia, without considering the Russian factor. The main issue with identifyi ng causes of the world war is that there are several and none that can be granted full prominence because opinions vary.It is also difficult to establish a cause and effect relationship, because there is no precision and again, it is subjective. This considered, a link can still be noticed in the causes enumerated above: Nationalism made European powers want to achieve more for them, leading to prestigious and expensive colonization. Unfortunately these imperialist tendencies created conflicts between the powers, creating mutual suspicions and alliances. The tensions gave the powers a feeling of insecurity, and led way to intense militarisation which meant that the powers could be ready in a matter of weeks in the event of a war.The Germans were so prepared for a war they could afford giving their unconditional support to Austria, who then attacked Serbia, and triggered the alliance system. It is a way to explain how the causes are linked; but it is not necessarily pertinent in the sense that these events could have been simply events; they only became causes because of the war. For example, if we use counterfactual history and assume that Austria would have never attacked Serbia, perhaps the war would have broken out over Britain and Germany fighting for an access to the Suez Canal, which at that time would have been likely.Perhaps the war would have never happened if the Europeans did not see war as an acceptable method to solve conflicts: as the German parliamentarian had pointed out, ‘after a war all things are better! ’ and the view that most historians believe that actually the war ‘had long been in the making’. As the American historical review states, ‘There was no slide to war, no war caused by ‘unintended’ events, but instead a world war caused by a fearful set of elite statesmen and rulers making deliberate choices’.Word count: 1 712Bibliography & Words cited â€Å"A. J. P. Taylor. † Wik ipedia. Wikimedia Foundation, 18 Aug. 2012. Web. 20 Aug. 2012. <http://en. wikipedia. org/wiki/A. _J. _P. _Taylor>. â€Å"Causes of World War 1. † About. com American History. N. p. , n. d. Web. 20 Aug. 2012. <http://americanhistory. about. com/od/worldwari/tp/causes-of-world-war-1. htm>. Clare, John D. â€Å"Causes of WWI – Four Steps to War. † Causes of WWI – Four Steps to War. N. p. , n. d. Web. 20 Aug. 2012. <http://www. johndclare. net/causes_WWI4. htm>. Gilbert, Martin. â€Å"Chapter 1: Prelude to War. † The First World War: A Complete History. New York: H. Holt, 1994. N. pag. Print. Gilbert, Martin. â€Å"Chapter 2: Wild with Joy. † The First World War: A Complete History. New York: H. Holt, 1994. N. pag. Print. â€Å"Nationalism. † Nationalism, Patriotism and Loyalty to Causes. N. p. , n. d. Web. 20 Aug. 2012. <http://www. tentmaker. org/Quotes/nationalism_patriotism_quotes. html>. †Summary of the Causes of WW1† Moodle. isp. N. p. , n. d. Web. 20 Aug. 2012. <http://isparis. moodle. overnetdata. com/file. php/13/Summary_of_the_Causes_of_WW1. pdf>. World History: Notes. Toronto: Coles Pub. , 1979. Print.