Cancer effectiveness of drugs in its treatment Essay

Cancer effectiveness of drugs in its treatment - Essay Example If an association has been drawn between tumour and cancer; then a benign tumour has no relation with cancer but a malignant tumour sooner or later leads to cancer. Scientific research has revealed that genetic predisposition, oestrogen exposure for women, ionising and ultraviolet radiation, exposure to carcinogenic chemicals and foods, smoking tobacco, taking alcohol, unhealthy diet and presence of free radicals are some of the causes that are believed to be spreading this deadly disease among us. Since prevention is always considered as a better option to cure, hence a series of events that might result in lower risk of getting exposed to cancer should also be taken account of. Taking notice of previous cases of cancer in a family does not directly translate into the same for the successors, but they can resort to regular check up to avoid any late detection of cancer. It has been found that probability of cancer among a woman having baby before 35 is less. Reduction of exposure to sun or other rays such as X – rays and using protective cloths while facing them is a helpful mean to reduce the chances of this disease. Absolute no to tobacco and alcohol will certainly result in less number of cancer cases. Taking vitamin C and green vegetables also help to reduce the risk of cancer. Among the different types of cancer treatments six of them have gained popularity and success over the years. The following paragraph provides a brief discussion of these alternatives before moving into a detailed analysis of drug use in combating cancer. Since chemotherapy also uses drugs to combat cancer, hence for this part it is left beyond the realm of the discussion. Radiation is used vividly against cancer. Ionised radiation destroys cancer cells and prevents them from further growing. When surgery is adopted s a possible cure to cancer, the cancerous cells or parts are surgically removed from the body. In recent times laser is often used to perform these surgeries replacing the conventional method that had been followed before. As it has been found that certain hormones are responsible for the growth of cancerous cells in body, hence doctors often resorts to hormone therapy to bring back the balance within the body that will eventually stop the growth of malignant cancerous cells. Recently a more radical way to fight cancer is in discussion and followed at some places as well. This is known as Biological or Immunotherapy where the inherent immune system of the body is reinforced so that it can prevent the cancerous infection o r fight back this deadly disease. Some doctors have even moved a step further to consider medical disciplines like homeopathy and acupuncture as a possible solution to this life taking disease (â€Å"What is Cancer?†). After the brief discussion of various other means to combat cancer let us concentrate of the possibilities of drugs to prevent cancer. The most widely known use of drugs against cancer is chemotherapy. In chemotherapy specific drugs are used that destroys cancer cells by putting an end to their immense growth rate. It is given to the patient either through intravenous injections or through oral medicines. It follows a cyclic pattern and often the patient is given rest for sometime after the administration of a specific course of medicine. Uses of anti cancer drugs have their own limitations. First of all since it

Social and Health Inequalities in New Zealand

Social and Health Inequalities in New Zealand Assess and discuss the impact the following environmental and attitudinal determinants have on health in terms of planning, implementation, and the evaluation of health interventions: A. Demographic distribution of populations Before discussing the effect of Demographic distribution on population, let us first discuss what is population distribution. Population distributionmeans the pattern of where people live. World population distribution is uneven. Places which aresparsely populated contain few people. Places which aredenselypopulated contain many people. Sparsely populated places tend to be difficult places to live. These are usually places with hostile environments. Basically this determinant focuses on the importance of the number of people in a certain location. For example, if the location is dominated by the older age group, the government focuses their funding to the needs of the senior citizens. They focus more on that particular age group because they compose a great portion of the population. But the government should not disregard the other age group that has different needs also. (Population, 2014) B. Social The society that is present in New Zealand is very diverse. Same as the culture that is in this country. The Pacific people and the Maoris has a tendency to have a lower income job compare to the Pakehas. Therefore the Pakehas can afford better healthcare compared to the Maoris and the Pacific people. There are a lot of factors in the society that determines the health of the people. These factors may include strong family ties, pleasant environment, housing, and ways of living. These factors affect the health of the people in different manners. It may be negative or positive. If something goes wrong with these factors, social problems arise. For example, the poor housing may lead to poor hygiene and then it will eventually lead to sickness. In addition, hazardous environment at work or at home may endanger the health of the people. Looking at an individual perception, firm and good family ties and support enhances the health status of an individual. Strong social networks within a distinct geographical neighbourhood help to create healthier conditions in several ways, including: social control of illegal activity and of substance abuse socialisation of the young as participating members of the community providing first employment improving access to formal and informal health care (Wallace 1993). C. Cultural Here in New Zealand, the culture is very diverse since there are a lot of races that are present in this country. We have the Maoris, the Pakehas, the Indians, Asians and other races. Therefore the healthcare delivery system should also address to the needs of these people with different cultural background. Language is also one factor that we can look into. Many people from different parts of the world come here in New Zealand and let’s face it, not all of the foreigners are well versed in the English language. This creates a barrier in healthcare delivery. When explaining a treatment procedure to a patient who is not well versed in English, it is a challenge to make sure that you are explaining properly and giving the correct information to the patient. So, it is important to know and understand the patient’s background to be able to deliver appropriate care to them. It is very difficult for the Ministry Health of New Zealand to adopt to the different cultures present here but knowing the different cultures will help them understand and identify what measures to be implemented for the different cultures here in New Zealand. It may be a difficult task to do trying to understand each and every culture present here, but it will be beneficial and the Ministry of Health will be able to plan more strategic interventions for the people that compose New Zealand. Cultural diversity increases the challenge to the effectiveness of the healthcare delivery system in New Zealand (Durie, 2001) D. Political Politicians use healthcare to be one of their focus or goals if they are running for the election. Politicians promise to give the people a better healthcare delivery, healthcare benefits, facilities and other needs. This promises may be politically but if we look at it in a broader sense, it will benefit the people and their health if the promises that he politicians give will be carried out. E. Religious Beliefs New Zealand has become increasingly culturally diverse, there is also an increase in religious diversity. People that has a strong religious orientation and who are primarily motivated by religious belief are believed to have a greater health outcome. People have different religious coping style. This religious coping style is like the way people engage their religiosity to help them cope with their everyday life. Generally, religious belief and practices give a positive outcome to mental health. There is a strong link between religious belief and low incidents of depression. It also reduce the number of suicidal risks, anxiety attacks and sometimes psychotic disorders. Religious belief is important in helping people to recover from traumatic events. In addition, religious belief is believed to reduce practices that result to major health problems. These practices are alcohol abuse, drug abuse and cigarette smoking. Overall, religious belief should not be disregarded when it comes to health because it plays a major role in the life and health of the people. Healthcare personnel should respect the religious belief of the patients. F. Values Some people look at their health as a precious aspect in their life. They value it and take care of it very well. In a multicultural country like New Zealand, people here have different perspective of heath. As for the Pacific people and the Maoris they have a lesser value of health compared to the Pakehas. In order to know how to address the needs of the people, the health department should first identify their needs. Like if the Pacific people and the Maoris do not value their health, they should be given continuous health education to make them realize that they need to value their health. They should be also followed up so that there is continuity of care. G. Ethics Ethics are rules and principles that guide right and wrong. Ethic can be related to health if it is about making proper decisions regarding health. There are a lot of ethical dilemma in healthcare and treatments. It is acting well and making decision that is morally good. Let us take abortion for example. If a pregnant woman come in to the hospital and asks for the Doctor to abort the baby that she is carrying, the Doctor should decide if it is ethically correct to abort the baby or not. The healthcare team should know their morals. H. Traditions Traditions play a major role in healthcare. People are used to involving their traditions to their life and to their health. For the Maoris they value their family or whanau so much. Their tradition is that they want their family members or whanau to get involved in their care. Their family members has a say in making decisions regarding the health of the patient. Therefore, whatever decision the family or whanau has, it should be respected and taken into account by the healthcare team. Environmental Determinants The Public concepts of what health is Before discussing concepts of Health, let me first define what Health is. Health is the state of physical, mental and social well-being of one individual. Health is important because if one is in a Good Health condition, he/she can properly function (eg. For work, sports, etc) and it helps people do activities of daily living. Public concepts of health is important because if the public believes that they are healthy, then they can achieve almost anything and it makes them more productive in the community. The Public concepts of what illness is So what is illness? Illness is a disease or some sort of sickness that will or may affect an individual. It is usually a disease that affects the body of a living organism. There are different kinds of illnesses. For example, there are what you call Physical and Mental illnesses. Physical illness is any illness that affects the body which can be viral, bacterial, rash etc. Mental illness on the other hand, is a disorder characterized by dysregulation of mood, thought and/or behavior. The public’s concept of what illness is important because if they perceive that they are ill or are sick, then they cannot function and work well. This affects their performance outside, whether at work, at play or even at home. They also cannot be easily accepted by society if they are believed to be carrying some sort of disease to prevent spreading. The importance the public put on health With regards to health, it is important that the public have an enhanced idea on how and which are healthy and unhealthy for them. Proper information dissemination and education should be done by different private and public sectors to inform the public. The public or the people on the other hand, should have an open-minded attitude towards learning. Compliance with these certain regimens can and will help the public have a healthy and happy lifestyle. Public attitudes towards health and medical professionals The public should be working together hand in hand with medical professionals into making and having a good and healthy life. Whether they be Caregivers, Nurses, GP’s, Physio’s, or anyone working in the medical field, it is critical that they consider what they suggest. As suggested earlier, compliance is a big factor. All this knowledge that would be provided by all these professionals would go to waste If people are not willing to do or try. They must also have a positive attitude towards learning for them to further expand their knowledge, and at the same time be able to share Health teachings. REFERENCES Durie, M. (2001, November 22). CULTURAL COMPETENCE AND MEDICAL PRACTICE IN NEW ZEALAND. Retrieved February 25, 2014, from http://www.massey.ac.nz/: http://www.massey.ac.nz/massey/fms/Te Mata O Te Tau/Publications Mason/M Durie Cultural competence and medical practice in New Zealand.pdf Population. (2014). Retrieved from Internet Geography: http://www.geography.learnontheinternet.co.uk/topics/popn1.html Wallace R. 1993. Social disintegration and the spread of AIDS II: Meltdown of sociogeographic structure in urban minority neighbourhoods. Soc Sci Med 37: 887-96. Social and Health Inequalities in New Zealand Social and Health Inequalities in New Zealand INTRODUCTION Health care services in New Zealand are being delivered by various health organizations and people for the main goal to achieve optimum level of health among all. This assessment will give more insights about inequalities and disparities in healthcare system and services given to the consumers especially in the Maori context. As a healthcare provider, it is a must to study, understand, and adopt the healthcare system in New Zealand to render good quality nursing services to the consumers. Guided by the principles of the Treaty of Waitangi and Cultural Safety, health care providers have an in-depth realization of oneself and the people in New Zealand. This discussion highlights some inequalities and disparities in healthcare towards Maori and non-Maori population. This also provide some input on how the government is responding to this issues. This only limits to the Maori, non-Maori healthcare concerns within New Zealand. Some of the topics are related to political, social, housing, employment, and education inconsistencies of Maori and non-Maori individuals receiving healthcare in New Zealand. POLITICAL DISPARITIES AND INEQUALITIES According to Malcolm (2004), Maori receives only less than 50% of the governments’ expenditure or the primary healthcare services compared to the Europeans. This is believed to be partly economic issue but also of a cultural interests. But Primary Health Organization has been established to address this problem and this is the Access Funding. This provision is specially regulated for the benefits of the marginalized Maori population. But this policy is limited to the GP’s and Practical Nurse accessibility only, there are no provision for an improved funding of healthcare for Maori people. In this status, we can infer that because of lack of financial support, more Maori prefer not to seek healthcare consultation to specialist physician for proper treatment of health due to the limitation of the provision. Thus, more and more Maori are unhealthy and with high rates of disability and morbidity. Healthcare disparities between Maori and non-Maori marked as a colonial history of New Zealand. This racial problem has mixtures of components to be considered and until now it is still a debate. Loschmann Pearce (2006) said that, health inequalities will not be solve if there are no improvement in healthcare access. As evidenced, continues increased of variation of primary and secondary health care access between Maori and non-Maori. One survey showed that 38% of Maori adults reported problems in obtaining necessary care in their local area, as compared with 16% of non-Maoris. Maoris were almost twice as likely as non-Maoris (34% vs 18%) to have gone without health care in the past year because of the cost of such care. (Loschmann Pearce 2006) As primary health care services are the main place for health consultation and treatment in New Zealand, more Maori are going to seek healthcare to GPs clinic and medical centers. Access is not merely the entry to health care facility but it is also the provision of quality health services rendered. Since, most Maori go to primary health care clinics and centers, specific health concerns for Maori is not addressed because treatment for critical or complex case patient cannot be treated in a primary health care facility, specialize treatment is needed. Thus, unmet proper treatment. (The Health of New Zealand Adults 2011). SOCIAL DISPARITIES AND INEQUALITIES Social inequality issues are linked to ethnicity. Social disparity occur continuously in New Zealand. The impact of colonization to the Maori population marked to the very moment. There are issues in cultural identity as to which is more powerful and have the rights in the land and government. Discrimination and power imbalance still exist at present moment and its relation to healthcare is very significant. Social connectedness is the key determinant in gathering data related to social disparities among the two mentioned parties. According to Pollock, (2012) a healthy community has lower morality rate and higher expectancy rates. The data of life expectancy shows 83 years for non-Maori female and 79 years among non-Maori male, whereas, 75 years Maori women and 70 years in Maori men. Another determinant is the income of a particular person. Considering he/she can afford a high standard of living if he/she has a good and highly paid job. But in Maori context, they are marginalized, as shown in the data that median weekly earnings for Maori is $767  ± 15.43 compared to $863  ± 17.26 for non-Maori. This statistics views inequality among Maori and this has a big effect to their household income, thus their standard of living is low compared to the non-Maori people, based from Marriott Sim (2014). Unhealthy practices also associates with low income which eventually leads to unhealthy behavior. Smoking is high in many depressed areas and mostly Maori are living in this areas. There are studies linked that smoking plays important role in socio-economic and ethnic status of Maori and it is interrelated to lung cancer occurrence. Maoris in living in poor conditions were three times likely to use tobacco than those with high standard of living person. There is a rise in lung cancer usage and deaths in the deprived areas and 30% of Maori died because of lung cancer compared to the 17% of non-Maori death rates, Pollock, (2012). There are also studies that conflicting views regarding Healthcare Model in the work place. Maori still practiced their own context of health and healing and this understandings the viewpoints of conventional health services rendered. There are also medical practices that contradicting to their own cultural approach towards health. Marginalization is seen on staff insensitivity, judgmental, and disrespectful delivery of care, according to Elers (2014). The healthier a person is, the lower the mortality rates. Engaging in a healthy lifestyle activities will make a person fit. More Maori experienced sicknesses at a younger age and it happen often and die young. While non-Maori have higher life expectancy rate even if they lived unhealthy. Mortality and morbidity percentage is significantly higher among Maori population. Male with good work shows low death rate than male working as laborers and cleaners. There are also data shows that, the more deprived communities are, the higher percentage of death and illnesses. (Pollock, 2012) EMPLOYMENT DISPARITIES AND INEQUALITIES Employment status is one determinant in healthcare inequalities in New Zealand. According to Pearson (2012), among other ethnicity in New Zealand, Maori and Pacific population has the highest unemployment rate. It comprises of 17.8% compared to non-Maori which is 14.2% in the year 2006. Most of the jobs Maori landed are occupation in the land and fishing. Some of the Maoris are working as laborers with a rate of 30% compared to 15% of European laborers. While, 18.2% of Western people are managers and 10.6% for Maori society. Labour forces are mainly the occupation of Maori. This is in relation to their low educational attainment as Pearson (2012) said. Healthy status can be achieved in many ways, one good factor that leads to a good personal shape would be their status in life. The ability and capability to support basic needs and necessity like food and shelter. Insufficiency in life’s’ basic needs will eventually make a person unhealthy and easily get sick. As Blakely Simmers (2011) stated that, one of the leading disease of Maori is diabetes and it is mostly encountered in marginalized and low income individual and the predisposing factor would be obesity in the Maori race. How employment status affects the health of every individual is very important to discuss. Employment status is regarded as a main basis of health in a person. It has a direct and indirect effect on health and believed to have an increasing impacts over time. Another pointer to review is the funding of the government towards healthcare. Most Maoris seek health intervention in the primary health centers and GPs while the Europeans can afford to pay for specialist physician, thus, better health are achieved by the Western group. Another thing to consider is the discrimination views of Maori towards healthcare. Maori Health Review (2007), shows data that there are 76.3% Maori women wanted to receive transplant while 79.3% to non-Maori women and 80.7% for Maori men and 85.5% fo r non-Maori men respectively. This data indicates healthcare compliance to treatment and this a strong input for improvement of health. Thus, shows, Maoris have higher mortality rate. In addition to that, a person who are unemployed and have family will not able to sustain daily basic needs and health is our basic need. Thus, Maoris have more health vulnerabilities than compared to non-Maoris. HOUSING Family is the basic unit of society. It is the very foundation of social being in the community and it is also the most critical part in obtaining data regarding health and wellness of every individual more focus on children who are dependent of care from their parents or family members for physical and emotional development (Ministry of Health, 2009). In the middle of the 20th century, there is a significant increase in home ownership by the Maoris compared to the decreased percentage of non-Maori home ownership. This data is basically focus on the household proportion and not on the number of households, (Waldegrave, King, Walker, Fitzgerald, 2006). There are 47.0% of Maoris and Pacific people owned their homes as compared to 72.8% for Europeans. These varies with the quality of housing they had, Maoris lived commonly in two or more family sharing in bedrooms whereas, Europeans have enough space in the house and rarely shared bedrooms, as Pearson (2012) said. This pattern of living manifested a not well-designed standard of housing for Maoris, thus health risk is advantageous. Congestion and substandard housing may lead to poor health condition for Maori and most common are: colds, asthma, and post-natal depression. Pearson (2012) added that, there is a significant increase in obesity, smoking and alcohol drinking. There were 38.0% Maori alcoholic beverages drinkers whereas, 23.0% were reported for Europeans. Research shows that one of the leading cause of death for Maoris and non-Maoris are Ischaemic Heart Disease and the second leading cause is lung cancer for both Maori male and female, according to the Ministry of Health (2014). This is an evidence regarding the high number of Maoris who smoked as previously mentioned. The increased rates of respiratory diseases were due to the overcrowding of family members and contamination of molds in the home because of poor housing condition. These highly contagious diseases can be pass through droplet, personal cont act and airborne transmission. Thus, Maoris are susceptible to many easily spreadable diseases and many lifestyle related health problems, (Ministry of Health, 2014). EDUCATION Education is said to be the key factor to success. This is in connection with many advantages and helpful product like high paid jobs, better income, great occupational chances and have relations to positive health outcome, (Marriott Sim, 2014). Good education enables a person to be economically stable and high productivity in life which resulted in an improved standard of living. This also makes a person self-worthy, secured and a sense of belongingness. But there are some indicators to be considered to assess standard of living of every individual. This relates to the physical situations in which people lived, the availability of goods and services, and the accessibility of resources. These are the two pointers to considered, first is the income they get and second is the accommodation they have according to (Ministry of Social Development, 2010P). Maoris educational qualification has dropped enormously compared to non-Maori settlers. Pearson (2012), stated that there are 2 out 5 Maori have no school qualification compared to 1 out 8 Asians and a quarter of Europeans respectively. There are more Maoris who had no degree in education which is an evidence of many Maoris worked as laborers and cleaners. Data shows that many Maori school leavers who attended only the minimum level of education, NCEA level 2, 60.9 % of them completed level 2 compared to 82.1% for non-Maori in the year 2012, Marriott Sim, (2014) said. There are 18.6% Europeans who had bachelor’s degree, while there are only 9.1% of the Maori population finished bachelor’s degree. There is also a great difference in the aged-standardised tertiary participation rates in 2012 data, it shows 9.9% of Maoris compared to 8.0% in Europeans. Across years of observations, changes in educational attainment enhances improvement in Maoris life as to their way of living. The implication of these findings are relatively connected to the education background of individual to achieve optimum of heal th. All aspects are interrelated to each other. As little knowledge about health would lead to unhealthy way of living thus Maori are more unhealthy people compared to other ethnic groups. There is also a premise that education starts at home and this shows relevant to healthy lifestyle. Smoking at home is prevalence among Maoris, and according to their living conditions, overcrowding is a health treat especially to the young generation. Second-hand smoker comprised a high rates among Maori children. There are 2.6 times exposure to SHS among Maoris compared to non-Maori children and a significant high rates of 7.8 times of Maori children living in remote areas. Studies shows that almost 24% of the smokers were diagnosed with many mental health conditions like depression, bipolar, anxiety disorder, and alcohol and drug related disorder, according to the Ministry of Health, (2014). Conclusion Based from the given facts and data, I can confer that health disparities and inequalities among Maori and non-Maori are ambiguous to discuss. However, history plays a vast implication to healthcare services in New Zealand, it should be of greater good of the citizens not merely the matters behind the past. As a result of my review, majority of Maoris were unhealthy compared to the Europeans. This is based from the sources of information I gathered form many research and studies. Thus, health organizations and health providers must collaborate to promote, protect, and sustain health of New Zealanders. BIBLIOGRAPHY Maori Health Review. 2007. Patient preference and racial differences in access to renal transplantation. http://www.maorihealthreview.co.nz/pdf/NZMaoriHealthRR_005_02.pdf Ministry of Health. 2002. Reducing Inequalities in Health. https://www.health.govt.nz/system/files/documents/publications/reducineqal.pdf Lorna Dyall, Valery Feigin, Paul Brown, Mavis Roberts. 2008. Stroke: A picture of Health Disparities in New Zealand. https://www.msd.govt.nz/about-msd-and-our-work/publications-resources/journals-and-magazines/social-policy-journal/spj33/33-stroke-a-picture-of-health-disparities-in-new-zealand-p178-191.html Phoebe Elers. 2014. Maori Health: Issues Relating to Health Care Services. http://www.tekaharoa.com/index.php/tekaharoa/article/viewFile/170/128 Kerryn Pollock. Public health Social and ethnic inequalities, Te Ara the Encyclopedia of New Zealand, updated 13-Jul-12 URL: http://www.TeAra.govt.nz/en/public-health/page-6 Iann Culpitt. 1994. Bicultural Fragments: A Pakeha Perspective. https://www.msd.govt.nz/about-msd-and-our-work/publications-resources/journals-and-magazines/social-policy-journal/spj02/02-bicultural-fragments.html Laurence Malcolm. 2004. Are we proving fair access to our health services for Maori? www.pha.org.nz/documents/fairaccessforMaoritohealthservices.doc Lis Ellison-Loschmann and Neil Pearce. Improving Access to Health Care Among New Zealand’s Maori Population. American Journal of Public Health: April 2006, Vol. 96, No. 4, pp. 612-617. doi: 10.2105/AJPH.2005.070680 The Health of New Zealand Adults 2011/12: Key findings of the New Zealand Health Survey. Section 7: Barriers to Accessing Health Care. http://www.health.govt.nz/system/files/documents/publications/health-of-new-zealand-adults-2011-12-section7.pdf Ministry of Health. 2014.Tobacco Use 2012/13: New Zealand Health Survey. Wellington: Ministry of Health. David Pearson. Ethnic inequalities Occupation and education, Te Ara the Encyclopedia of New Zealand, updated 13-Jul-12 URL: http://www.TeAra.govt.nz/en/ethnic-inequalities/page-6 Lisa Marriott and Dalice Sim. 2014. Indicators of Inequality for Maori and Pacific People. http://www.victoria.ac.nz/sacl/centres-and-institutes/cpf/publications/pdfs/2015/WP09_2014_Indicators-of-Inequality.pdf Ministry of Health. 2014. Major causes of death (all ages) http://www.health.govt.nz/nz-health-statistics/health-statistics-and-data-sets/maori-health-data-and-stats/tatau-kahukura-maori-health-chart-book/nga-mana-hauora-tutohu-health-status-indicators/major-causes-death-all-ages David Pearson. Ethnic inequalities Occupation and education, Te Ara the Encyclopedia of New Zealand, updated 13-Jul-12 URL: http://www.TeAra.govt.nz/en/ethnic-inequalities/page-6 David Pearson. Ethnic inequalities Housing, health and justice, Te Ara the Encyclopedia of New Zealand, updated 13-Jul-12 URL: http://www.TeAra.govt.nz/en/ethnic-inequalities/page-7 Ministry of Business, innovation Employment. 2009. Maori in the New Zealand Labour Market. http://www.dol.govt.nz/publications/lmr/maori/in-the-labour-market-2009/executive-summary.asp Prepared by Tony Blakely (UOW) and Don Simmers (NZMA), with input from many colleagues. June 2011. FACT AND ACTION SHEETS ON HEALTH INEQUITIES. http://www.pha.org.nz/documents/fact-action-health-inequalities.pdf Citation: Ministry of Health. 2009. A Focus on the Health of MÄ ori and Pacific Children: Key findings of the 2006/07 New Zealand Health Survey. Wellington: Ministry of Health. Ministry of Health. Maori PH workforce development: the Aotearoa context. http://www.publichealthworkforce.org.nz/maori-health-development_66.aspx Charles Waldegrave, Peter King, Tangihaere Wlaker, Eljon Fitzgerald. 2006. Maori Housing Experiences: Emerging Trends and Issues. http://www.chranz.co.nz/pdfs/maori-housing-experiences.pdf

Web-Based Education: A Review of an Upcoming Educational Method :: Essays Papers

Web-Based Education: A Review of an Upcoming Educational Method Over the past 20 years, there has been a drastic change in technology. One example is in education. The development of the internet has affected the way in which we teach and learn. Web based education is a relatively new term. There are many methods and techniques for delivering instruction through the web. Academic courses can be enhanced with web-based links, or the courses can be delivered completely on the web. By definition web-based education refers to material found on the World Wide Web which provides information to enhance a person’s knowledge (Virtual Apex Internet Solutions, 2005). Although it is a very broad term, it has just recently had a major impact on the learning development of children. Web based education includes, but is not limited to; E-learning systems, online Universities, individual classroom websites, and general research conducted with the internet (SDSM&T & Sun Microsystems, 2002). Critics argue both the pros and cons of web-based tec hnology; therefore in this paper we will present several opposing viewpoints. Within the development of web based education it is important to discuss the Web-Based Education Commission, which is very influential in the steady progress of positive web-based education (SDSM&T & Sun Microsystems, 2002). As future teachers we feel this topic is essential to being successful in the classroom. As we previously mentioned, web-based education refers to many things on the internet. One example is E-learning systems. E-learning systems refer to the use of network technologies to create, foster, deliver, and facilitate learning, anytime and anywhere (Iqbal, Jones-Harris, & Gordon, 2004). One example is Blackboard. Blackboard is an online tool for teachers and students to enhance communication and learning. Blackboard provides many tools useful to teachers. These useful tools include; discussion boards, chat rooms, quizzes, digital drop boxes to submit assignments, contact information, and much more. Personally we feel that Blackboard has had a major impact on our involvement in classes. In comparison to Blackboard, there is also WebCT. WebCT is a more elaborate example of an e-learning system. This includes; courses, assessments, communication, and content presentations comparable to Blackboard (McCormack & Jones, 2000). Both Blackboard and WebCT can be used to enha nce a classroom learning environment. E-learning is one of the fastest growing trends within colleges and universities.

Project Management Problems

In replying the below inquiries you are to supply a brief analysis of the place at jurisprudence, backed with commendations of the relevant legal commissariats, case-law and commentary. Address the points tersely in such a mode as to demo that you have understood the rules that come into drama and modulate the state of affairs being described.Undertaking Manager is approached by a client who would wish to contract Project Manager’s services as a undertaking director. Undertaking Manager would wish to restrict his exposure to amendss in position of the fact that he will necessitate to contract the services of assorted professionals to complete the occupation.How can he make that?As stated in the Civil Code 960, ‘A contract is an understanding or an agreement between two or more individuals by which an duty is created, regulated, or dissolved.’ This means that if the Project Manager is contracted by the Client, and in bend the Project Manager contracts 3rd parties, the Project Managerstraightwill reply, in favor of the Client for the amendss that are caused by those 3rd parties that the Project would hold engaged. The primary method of understating exposure to amendss is to choose for an Indemnity insurance. This means that in instance of harm, the insurance would counterbalance the Undertaking Manager ( or the client in inquiry, straight ) . Furthermore, the insurance company on payment of the damages, would be subrogated in the rights of its client/project director, thereby it can turn against the party who is found to be responsible for the amendss. Alternatively, On the other manus, the Project Manager has two possible contractual understandings, each with different legal and practical deductions:A Contract with the client and a sub-contract with the 3rd party professional ( ‘sub-contractors’ ) . With a position to minimise the hazards, the latter contract should reproduce the same hazards and precautions which would hold been included in the chief understanding, i.e. The understanding between the client and undertaking director.A contract with the client for supervising the undertaking, where the client has a distinguishable contract with the 3rd party professionals ( the sub-contractors ) .To restrict exposure to amendss, option 2 is safer, but may non be acceptable from the client’s point of position who himself would desire to restrict his exposure/risks. In this instance, each contract would be one where, ‘the individual set abouting the work shall confer merely his labor or accomplishment, or tha t he shall besides provide the materials.’ ( Civil Code 1663 ) . Furthermore, the Project Manager would in bend be dissolved from any incompetence by the other professionals because as stated in the Civil Code 1037, ‘where a individual for any work or service whatsoever employs another individual who is unqualified, or whom he has non sensible evidences to see competent, he shall be apt for any harm which such other individual may, through incompetency in the public presentation of such work or service, cause to others.’ In such instances, the client is considered to be a contractor, and hence is apt ‘for the Acts of the Apostless of the individuals employed by him.’ ( Civil Code 1642 ) In the latter instance, if a client files for amendss against the Project Manager, said Project Manager may raise the supplication that he is non the 1 to reply for the amendss of the 3rd party sub-contractors ( since he would non hold contracted them ) and may besides name to the suit the said 3rd parties or in bend file for amendss against the sub-contractors, as stated under Article 1038 of the Civil Code ‘Any individual who without the necessary accomplishment undertakes any work or serve shall be apt for any harm which, through his unskilfulness, he may do to others.’ In the former instance ( where the Project Manager contracts straight with the Client ) , if the client files for amendss against the Project Manager, the said Project Manager may non raise the supplication that he is non the 1 to reply for the amendss of the 3rd party sub-contractors ( since he would non hold contracted them ) . Furthermore, he may arguably NOT sell to the suit the said 3rd parties, but if found responsible ( for the Acts of the Apostless or skips of the said 3rd parties, which the client would hold to turn out anyhow ) so he MAY in bend file for amendss against the sub-contractors, as stated under Article 1038 of the Civil Code ‘Any individual who without the necessary accomplishment undertakes any work or serve shall be apt for any harm which, through his unskilfulness, he may do to others.’ In any given instance, noteworthy in the context being discussed, the rule contemplated under Article 1138 of the Civil which states that ‘Where the understanding provides that the party who fails to transport it out shall pay a certain amount by manner of amendss, it shall non be lawful to present to the other party a greater or lesser sum.’Does it do a difference if the client is a natural individual undertaking the occupation for his/her personal demands or if the client is abargainer [ SM1 ]? Why?In this instance, a differentiation between Natural [ SM2 ] and Legal individual [ SM3 ] has to be given. The natural individual is by and large a physical entity that is responsible in his ain name for any skip [ SM4 ] , unless he proves that he has contracted on behalf of others. On the other manus, a legal individual is one that is non-physical ( like for illustration a company ) . A natural individual and a legal individual have the ability to either contract in their na me or on behalf of others. Both parties enjoy the ability to come in into contracts. When a Undertaking Manager is undertaking with a legal individual, he is undertaking non with persons but with the company itself, which enjoys a separate legal personality from its members/shareholders.Undertaking Manager is an designer and, apart from moving as undertaking director, will be personally responsible for the construction/ change works. He would wish to restrict his exposure for defects as best he could.How can he make this contractually?First and first, one can non take it for granted that the Project Manager is the designer, intending that if the Project Manager did non straight take portion in the programs and building of the undertaking, he/she shall non be found apt on the footing of the fact that he besides happens to be an designer by profession. Furthermore, one has the right to even diminish contractually the 15 twelvemonth clip span in instance of defects. Such timespan is gi ven in the Civil Code ( 1638 ) , ’If a edifice or other considerable rock work erected under a edifice contract shall, in the class of 15 old ages from the twenty-four hours on which the building of the same was completed, perish, entirely or in portion, or be in apparent danger of falling to destroy, owing to a defect in the building, or even owing to some defect in the land, the designer and the contractor shall be responsible therefor.’Does it do a difference if the client is a natural individual moving in his/her personal capacity or a bargainer?As antecedently mentioned, a natural individual is by and large a physical entity that is responsible in his ain name, unless he proves that he has contracted on behalf of others. On the other manus, a legal individual ( bargainer ) [ Di5 ] is one that is non-physical ( like for illustration a company ) . There is a given that whoever contracts does so in his ain name, unless he proves that he has contracted in the name of another individual. The debitor has the duties to do it clear that he is undertaking in the name of a company. The foregoing considerations apply whether the client is a natural individual ( single or bargainer ) or a legal individual ( company ) .Undertaking Manager is engaged and in order for him to carry through his battle he issues petitions for citations to three providers of stuffs. He stipulates a cap. They all reply with a quotation mark within the cap.Has an understanding been formed?No, an understanding has non been formed. Invitations to offer occurred when the Project Manager asked for a quotation mark. If this is non accepted, no contract has been formed. Said offer is capable to acceptance until and unless that offer is accepted, there is no contract.If so, at what phase [ SM6 ]?[ Di7 ]A contract is ‘an understanding reached between two or more parties which is lawfully enforceable when executed in conformity with specific requirements.’ Note that contract s should be specific to the undertaking in inquiry, every bit good as reflecting the understanding between the parties in inquiry. Contracts are adhering understandings, which is why it is of great importance that all parties understand the footings entailed by said contract, including rights and duties. Every contract consists of the followers:Offer ;Credence ;‘Acceptance ‘ occurs when both parties arrive to an unqualified understanding of all the offered footings. However, a period of dialogue normally occurs. The purpose of the dialogues is to present new footings and conditions and counter offers to the original offer, so as to get to an understanding that satisfies all parties. Communication of credence The credence of the contract offer occurs merely when the credence is communicated to the offerer. This includes methods like:By telephoneWriteIf non, why? And what is required to organize the contract?No credence has been given by the Project Manager to any of the provided quotation marks. For a contract to be formed, an exchange of an offer from, in this instance the providers, and an credence from the Project Manager must happen. Note that both parties must hold the purpose to adhere themselves. Furthermore, both offer and credence must beecht Acts of the Apostless of will that manifest the relevant consent. It is deserving nil that a contract is valid despite being non written, i.e. Credence by word of oral cavity or electronic mail is besides a contract, unless the jurisprudence expressly requires that the understanding should be in composing. These necessities of offer and credence are non mentioned in the Civil Code ( unlike Italian Civil Code ) . They are specifically mentioned in the Commercial Code and Electronic Commerce Act. The civil codification ( under 966 ) merely spells what is required for the cogency of a contract: (a) Capacity of the parties to contract ; (B) The consent of the party who binds himself ; (degree Celsiuss) A certain thing which constitutes the subject-matter of the contract ; (vitamin D) A lawful consideration.The most favorable quotation mark, from A, comes with a clause saying that â€Å"An understanding must be made in authorship and all payments must be made in advance.† Project director writes to A accepting the quotation mark. Is this sufficient?Yes, in this instance, there is sufficient cogent evidence that a contract has been formed. An offer has been given by A, which was so accepted ‘in writing’ by the Project Manager, a phase of personal businesss which is so confirmed by the fact that works would later be undertaken, in pursuit of and in conformity with the same quotation mark.Undertaking director pays the monetary value and A provides the stuffs, but these are found non to be in line with the specifications requested. What is the consequence of this? What are Project Manager’s options at jurisprudence?When a marketer is selling building stuff, he is ‘bound to justify the thing sold against any latent defects w hich render it unfit for the usage for which it is intended, or which diminish its value to such an extent that the purchaser would non hold bought it or would hold tendered a smaller price..’ ( Civil Code Article 1424 ) When such required are non met, the undermentioned occurs:Client dissatisfactionDelaies in undertaking completionThe marketer is ‘answerable for latent defects, even though they were non known to him, unless he has stipulated that he shall non in any such instance be bound to any warranty.’ As a consequence of this, the Project Manager has two options at jurisprudence ;Actio RedhibitoriaTo return the stuff and have the monetary value repaid to him. Compensation for amendss may be besides implemented.Actio AestimatoriaTo retain the stuff and have a portion of the monetary value repaid to him which shall be determined by the tribunal.Civil Code Article 1434, ‘The purchaser, even though at that place be no understanding to that consequence, is bound to pay involvement on the monetary value up to the twenty-four hours of payment at the rate of five per centper annum, randomly in the undermentioned instances: (a) if the thing sold and delivered outputs fruits or other net incomes ; (B) if, even though the thing yields no fruits or other net incomes, he has been called upon by agencies of a judicial hint to pay the monetary value ; (degree Celsiuss) if the bringing of the thing, being movable, has non taken topographic point through the mistake of the purchaser, and the marketer has called upon him, by agencies of a judicial hint, to take bringing of the thing: Provided that in the instances mentioned in paragraphs (B) and (degree Celsiuss) , involvement shall run merely from the twenty-four hours of the service of the said judicial intimatation.Undertaking director has besides engaged the services of an lineman, B. The contract stated that B had to finish the plants within two months harmonizing to a agenda of plants agreed to. Following the first month it is clear that B has non completed 1/3 of the plants he was to finish within the period of one month. It is clear to project director that B will non finish the plants within two months and now it will be possible for Project Manager to maintain to the timelines imposed on him by client merely if he hires a larger administration to make the plants alternatively of B. But these alternate service suppliers will be more expensive.What are the Project Manager’s options?The Project Manager has the right to register for amendss due to non-performance against the Electrician but would hol d to wait that the term of the contract has expired, as follows:Termination of Contract due to non-performance, ’ Civil Code 1640.( 1 ) it shall be lawful for the employer to fade out the contract, even though the work has been commenced. ( 3 ) If the employer has valid ground for the disintegration, he is to pay the contractor merely such amount which shall non transcend the disbursals and work of the contractor, after taking into consideration the utility of such disbursals and work to the employer every bit good as any amendss which he may hold suffered.’In such instances, choosing for Termination of Contract could ensue in farther holds. One of the Project Manager’s chief functions is to understate amendss, and hence the option of expiration may non be feasible and commercially practical. Punishments would hold been set up contractually that the party in inquiry ( in this instance Electrician B ) , should pay a certain sum for every twenty-four hours of hold . Naturally the Undertaking director would be exposed to liability towards the client but at least he would hold safeguarded himself against the Electrician..Who will hold to bear the addition in costs if Project Manager engages these new service suppliers?The addition in costs are to be incurred by the Electrician B. This includes the followers: Article 1135 of the Civil Code, ’†¦damages due to the creditor are, by and large, in regard of the loss which he has sustained, and the net income of which he has been deprived. Article 1136 of the Civil Code, ’the debitor shall merely be apt for such amendss as were or could hold been foreseen at the clip of the agreement.’Will it do a difference if Project Manager is moving as chief or agent?When a Undertaking Manager is moving as chief, he has to reply for the actions holds. If he’s moving as an agent for a 3rd party, he would be replying in the name of the party, provided that it is clear that the undertaking director is moving in the name of that 3rd party.Undertaking Manager requires pigment. He is approached by a individual who states that he is the local agent of an internationally celebrated industry and the said â€Å"agent† offers a really advantageous monetary value. Undertaking Manager orders the pigment, this is supplied and Project Manager pays for it. But before the pigment is used Project Manager sees a Notice in the newspaper stating that the international maker has nil to make with the â€Å"agent† and th at the â€Å"agent† is a fraudster. Undertaking Manager does non desire to utilize the pigment as he will non be covered by the â€Å"international guarantee† that was purportedly provided by the international maker. What are his options at jurisprudence?In the instance of fraud, the Project Manager has the right to register for nothingness of the understanding in inquiry. As stated in Article 981 of the Civil Code, ’Fraud shall be a cause of nothingness of the understanding Fraud. When the ruses practised by one of the parties were such that without them the other party would non hold contracted.’ The debitor, which in this instance is the agent providing the pigment, is to pay ‘the compensation in regard of the loss sustained by the creditor, and of the net income of which he was deprived, shall merely include such amendss as are the immediate and direct effect of the non-performance.’ ( Civil Code Article 1137 ) . When the mandatary ( provider of pigment ) acts beyond the authorization given to him by the authorization, he may be found responsible for those actions in his ain name. Page1of12

Stefan’s Diaries: Origins Chapter 15

As soon as twilight fell, I sneaked down the stairs, opened the back door, and tiptoed out onto the grass, already wet with dew. I was extra cautious, since there were torches surrounding the estate and I knew Father would be displeased that I was venturing out after dark. But the carriage house was only a stone's throw from the house itself–about twenty paces from the porch. I stole across the yard, staying in the shadows, feeling my heart pound against my rib cage. I wasn't concerned about animal attacks or creatures of the night. I was more concerned that I'd be found by Alfred or, worse, Father. But the notion of not being able to see Katherine that night made me feel hysterical. Once again, a heavy fog blanketed the ground and rose to the sky, an odd reversal of nature that most likely was due to the changing of the seasons. I shivered and made sure to look away from the willow tree as I ran to the bridle path and up the porch steps of the carriage house. I paused at the whitewashed door. The curtains on the windowpanes were pulled shut, and I couldn't see any candlelight seeping under the windows. For a second, I feared I had come too late. What if Katherine and Emily had retired to bed? Still, I rapped my knuckles sharply against the wooden door frame. The door creaked open and a hand grabbed my wrist. â€Å"Come in!† I heard a rough whisper as I was swept into the house. Behind me, I heard the click of the lock and realized I was standing face-to- face with Emily. â€Å"Sir,† Emily said, smiling as she curtseyed. She was dressed in a simple navy gown, and her hair fell in dark waves around her shoulders. â€Å"Good evening,† I said, bowing gently. I glanced around the little house, allowing my eyes to adjust to the dim light. A red lantern glowed on the rough-hewn table in the living room, casting shadows against the wooden beams of the ceiling. The carriage house had been in a state of disrepair for years, ever since Mother had died and her relatives had stopped visiting. But now that it was inhabited, there was a warmth to the rooms that was absent in the main house. â€Å"What can I do for you, sir?† Emily asked, her dark eyes unblinking. â€Å"Um †¦ I'm here to see Katherine,† I stammered, suddenly embarrassed. What would Emily think of her mistress? Of course, maids are meant to be discreet, but I knew how servants talked, and I certainly didn't want Katherine's virtue to be compromised if Emily was the type to engage in idle servant gossip. â€Å"Katherine has been expecting you,† Emily said, a glint of mischief in her dark eyes. She took the lantern from the table and led me up the wooden stairs, stopping at the white door at the end of the hallway. I squinted. When Damon and I were little, we'd always been vaguely afraid of the upstairs of the carriage house. Maybe it was because the servants had said it was haunted, maybe because every floorboard had creaked, but something about the space had stopped us from staying very long. Now that Katherine was here, though, there was nowhere else I'd rather be. Emily turned toward me, her knuckles on the door. She rapped three times. Then she swung the door open. I walked cautiously into the room, the floorboards creaking as Emily disappeared down the hallway. The room itself was furnished simply: a cast-iron bed covered by a simple green quilt, an armoire in one corner, a washbasin in another, and a gilt-plated, freestanding mirror in a third corner. Katherine sat on her bed, facing the window, her back to me. Her legs were tucked under her short white nightgown and her long curls were loose over her shoulders. I stood there, watching Katherine, then finally coughed. She turned around, an expression of amusement in her dark, cat-like eyes. â€Å"I'm here,† I said, shifting from one booted foot to the other. â€Å"So I see.† Katherine grinned. â€Å"I watched you walk here. Were you frightened to be out after dark?† â€Å"No!† I said defensively, embarrassed she'd seen me dart from tree to tree like an overcautious squirrel. Katherine arched a dark eyebrow and held her arms out toward me. â€Å"Y need to stop worrying. ou Come here. I'll help you take your mind off things,† she said, raising her eyebrow. I walked toward her as if in a dream, knelt on the bed, and hugged her tightly. As soon as I felt her body in my hands, I relaxed. Just feeling her was a reminder that she was real, that tonight was real, that nothing else mattered–not Father, not Rosalyn, not the spirits the townspeople were convinced roamed outside in the dark. All that mattered was that my arms were around my love. Her hand worked its way down my shoulders, and I imagined us walking into the Founders Ball together. As her hand stopped at my shoulder blade and I felt her fingernails dig through the thin cotton of my shirt, I had a split- second image of us, ten years from now, with plenty of children who'd fill the estate with sounds of laughter. I wanted this life to be mine, now and forever. I moaned with desire and leaned in, allowing my lips to brush hers, first slowly, as we'd do in front of everyone when we announced our love at our wedding, and then harder and more urgently, allowing my lips to travel from her mouth to her neck, inching toward her snow-white bosom. She grabbed my chin and pulled my face to hers and kissed me hard. I reciprocated. It was as if I were a starving man who'd finally found sustenance in her mouth. We kissed, and I closed my eyes and forgot about the future. All of a sudden, I felt a sharp pain on my neck, as if I were being stabbed. I called out, but Katherine was still kissing me. But no, not kissing, biting, sucking the blood from beneath my skin. My eyes flew open, and I saw Katherine's eyes, wild and bloodshot, her face ghostly white in the moonlight. I wrenched my head back, but the pain was unrelenting, and I couldn't scream, couldn't fight, could only see the full moon out the window, and could only feel the blood leaving my body, and desire and heat and anger and terror all welling up inside me. If this was what death felt like, then I wanted it. I wanted it, and that was when I flung my arms around Katherine, giving myself to her. Then everything faded to black.