Holborne - Pavane and Galliard Essay Example for Free

Holborne Pavane and Galliard Essay Holborne’s Pavane ‘The image of melancholy’ and Galliard ‘Ecce quam bonum’ (Behold, how good a thing is) are two pieces that belong to the genre of ‘consort music’, a form of domestic music that made its appearance in Elizabethan England. A consort may have derived from the French ‘concert’ which implied an ensemble of instruments or voices that perform. In later years, from about 1575, ‘Broken consorts’ were introduced and these included mixed ensembles. The usual instrumentation for a broken consort was lutes, viols (treble and bass) and flute. Consorts of viols began to appear during the time of Henry VIII with the earliest source of the music being a songbook of Henry VIII, found after his death that included copies of Viol consorts. There are three main types of consorts, one being the Pavane and Galliard, which is a dance form. In many of the pieces, the writing was very similar to that of contemporary writing for voices; therefore it was usually polyphonic in texture. When paired together, the Pavane usually takes the more melancholy character, while the Galliard a more cheerful one which is shown in these two movements by Holborne. Although dance forms were used for both movements, the dense counterpoint provides melodic interest for all five players and also listeners, which suggests the music to be more for listening than dancing. Not much is known about Holborne, but he did publish two collections of music with about 120 works altogether.

New rules Essay Example for Free

New rules Essay Seven years ago the first wave of welfare families were about to reach the time limits that had been set for receiving benefits and would soon have their cash handouts cut off. This was happening because of time limits states imposed as welfare reform that was put into place eleven years prior. Republicans created new rules for welfare that hadn’t taken place in over 40 years. In August of 1996 President Bill Clinton signed a law that required the states to push welfare recipients into the workforce. This became known as â€Å"workfare† (Douthat, 2007). This law gave incentives to state welfare offices to shrink their caseloads, and limited families to five years or less of federal money. This incentive included taking the money saved from welfare and converting them into block grants that states could spend as they see fit. Many conservatives thought that this would force poor mothers off of welfare. But many including The Urban Institute said that changes would push more children into poverty (Green, 2007) this did not happen. When the time limits took affect many states scrambled in the fall of 2000 to enact an emergency force that would help families through the transition. The need for this service was not needed. â€Å"After peaking in 1994, when many states began experimenting ahead of the federal law, America’s welfare caseload fell by 60% over the next decade, from 5 million to 2 million families† (Alfred, 2007). Welfare mothers were finding jobs with the largest increase being unmarried mothers. Their unemployment rates jumped from 44% in 1993 to 66% in 2000 and the poverty rate dropped 15.1% to 11. 3%. Reform showed to be working (Derose, 2007). But this was only because of the booming economy during the years between 1993 and 1999. During this period unemployment rates fell and rapid job development created the jobs. Wage subsidies helped with this trend also. When the government increased the earned income tax credit this created a reward for low income families and an incentive for them to work. With this success states changed practices in their welfare offices and in some cases turned many of the caseloads to private firms. Most of the offices would stress work for people that sought help this included job training sessions when they signed up for assistance. Some states required applicants to try job searches before signing up for benefits. The federal grants that were shifted were used for work support. Some of these benefits include childcare, healthcare and transport subsidies (Peters, 2007). But this did not help all incomes because earnings of women that left welfare rose more than their cash assistance fell and this still left families just scraping by. After leaving welfare many women went on to get training and education with government help to find jobs with better pay and benefits. Showing the quality of many of the mother’s lives increasing because of welfare reform. But on the other side things didn’t fare so well. Around 10 to 15 % of America’s former welfare recipient’s are not working or receiving benefits. These individuals are relying on relatives or other forms of charity just to meet their daily needs. Many of the remaining welfare cases are of people with mental or physical disabilities who cannot support their families by working. Welfare reform is not working for them. It makes it difficult for these individuals making them give up or not even try. Welfare reform has helped against the battle of dependency and America is in a better stance to attack poverty head on, but still t here are three important challenges that need to be addressed (Ponnuru, 2007). The first is to find new plan to help the children whose parents are mildly disabled, emotionally disturbed, mentally slow or addicted to drugs or alcohol. These are the individuals that are showing up at the welfare offices for help. These families face a limited ability in raising children which worries many in America. Dealing with these individuals is very complicated you can’t just get them work many are eligible for disability benefits and obtaining them is a long hard process (Mead, 2007). A solution would be training for social workers to identify the needs and solution of these individuals making it more assessable to individuals that are not mobile rather than harder.

Practice Nurses Role in Treating Chlamydia

Practice Nurses Role in Treating Chlamydia The practice nurses role in treating chlamydia and improving the sexual health of the nation Introduction Chlamydia treatment has been the focus of considerable research interest in the past few years. A huge proportion of what used to be called NSU, or was even undiagnosed non-specific pathology, is now recognised as being due to the chlamydia pathogen. It has now achieved the unenviable status of being considered responsible (numerically) for the greatest amount of sexually transmitted disease in the UK today (Duncan 1998) Given the fact that it is now therefore recognised as being a major contributing factor in the overall picture of sexual health, we must examine ways in which the NHS is set up to tackle the problem. (HPA 2003) As with many health related issues such as this there are a number of subsidiary issues that must be considered in relation to the main theme. These include the role of the screening process in trying to contain the prevalence of chlamydial infection, the practice nurse’s role in that screening process, the current thoughts on the treatment of chlamydia and the practice nurse’s role in not only the treatment, but also the partner tracing activity that is vital to try to stop the spread of the disease. (Fenton et al 2001) The practice nurse is generally ideally placed within the primary healthcare team to act as a central liaison point for many of these activities If we start by considering the whole issue of screening. On one level, one could be forgiven for thinking that the issues relating to screening are actually rather simple. We know that many cases of chlamydia are actually asymptomatic (see on). Given the fact that it can cause considerable damage and is eminently treatable, why not screen for it and get rid of it? Sadly, it is not as simple as that. (Simms et al 1996) The National Institute for Clinical Excellence (NICE) has set up the National Chlamydia Screening Programme (NCSP). It quotes its rationale for doing so as: Genital Chlamydia trachomatis is the commonest Sexually Transmitted Infection (STI) in England Genital chlamydial infection is an important reproductive health problem ~ 10-30% of infected women develop pelvic inflammatory disease (PID). A significant proportion of cases, particularly amongst women, are asymptomatic and so, are liable to remain undetected, putting women at risk of developing PID. Screening for genital chlamydia infection may reduce PID and ectopic pregnancy. The study itself was exemplary in design with an entry cohort of nearly 8,000 patients. The authors considered the efficacy of several different methods of screening and then compared the results of the programmes against the costs of allowing the disease to continue untreated in the community and these include all the sequelae of infertility, pelvic inflammatory disease and ectopic pregnancy in women together with the complications that can occur in the male partners (infertility again) and prostatitis. (Berry et al 1995) The paper even covered the incidence of both pneumonia and eye infections in their children. The structure of the study was quite comprehensive insofar as it compared the results of four separate groups One group received no screening at all, a second group were screened if they exhibited mucopurulent cervicitis, the third group included all women who were less than 30 yrs. old and the last group was all women irrespective of symptoms. The actual screening tool was the Polymerase chain reaction (PCR) which is a very specific and sensitive antibody based test. It was performed on either urine or direct cervical samples. (Barlow et al 2001) The study protocol then called for all positive testing patients to receive treatment with doxycycline for seven days. The analysis section of the paper is both long and complex. We shall therefore condense our examination of this part of the study into an examination of the results. The overall treatment costs of treating all of the medical complications of chlamydial infection was calculated as $676,000. Each of the positive screening strategies produced a significant reduction in the expected cost of complications that was greater than the cost of the actual screening exercise. A condensation of the tabulated results is shown here: Screening method Screening costs ($) Medical costs ($) Total cost ($) Number of PID cases PID cases prevented No screening 676,000 676,000 152 CDC criteria 55,000 390,000 446,000 88 64 Women 75,000 297,000 372,000 67 85 Universal screening 120,000 270,000 391,000 61 91 The results need little explanation, as it can be clearly seen that both the costings and the number of cases prevented argue strongly for a case for screening. The only point of contention is the decision on the population that the health care system will fund for screening. Overall, the authors state that their regime reduced the incidence and prevalence of pelvic inflammatory disease by 60% when compared to the unscreened group. The other significant factor was that, taking all groups as an average, they noted a total healthcare saving of about $50 per woman screened, and this clearly does not take any account of any associated comorbidity, pain and suffering that is caused by the chlamydia infection A further corollary can be drawn from the results. The authors went on to provide an impressive statistical analysis of the comparative costs of different community groups with different rates of prevalence. Of great importance to our considerations here was the fact that the authors concluded that the cost of screening was cost effective when the incidence of infection in a population of asymptomatic women was above 1.1%. when the incidence rose above 11% then they found that the screening of all women and their partners became the most effective strategy. To some extent, this study can be considered the â€Å"gold standard† for most of the studies in this area. It is well conceived, meticulously executed and well and thoughtfully analysed to give meaningful results which are of great practical importance. Despite such comments it should be noted that there are a number of negative points to be considered in this particular study. The universal treatment constant was the seven day doxocycline treatment. We should note (as the authors did) that there is therefore a potential for non-compliance with the whole seven day regime, and this may introduce a potential source of bias in the figures(Haddix et al.1995). We can also point to other studies that have addressed this particular problem with a one dose treatment regime (azithromycin). It is fair to note that despite the potential for bias, extrapolation to these other studies does not appear to show significant differences in the overall results (Lea et al 1997) The issue of screening, although covered reasonably comprehensively in the last paper, certainly as far as matters of cost are concerned, is examined further in the paper by (Duncan et al. 2001). This paper approaches the issues from a different perspective. It includes the issues of male screening And takes an overview of the Public Health issues from a sociological viewpoint, which makes it, (in our examination of the current literature), almost unique. We should note that we have already addressed the issues faced by the NCSP, but the other major public document in this area is the report commissioned by the Chief Medical Officer (CMO 1998). It is instructional to discuss the recommendations of this group as they differ significantly from the screening criteria used in the previous paper. The recommended groups for screening here are the following: Everyone with symptoms of chlamydia infection, All those attending genitourinary medicine clinics, Women seeking termination of pregnancy.1 Opportunistic screening of young sexually active women under 25 years Women over 25 with a new sexual partner or two or more sexual partners in the past year. In the context of our considerations here, we should note that the advisory group identified the optimum sites for screening as the primary healthcare team (family planning clinic) as well as the usual GUM clinics. (Stokes 1997) The Duncan paper is particularly well written and a major point that comes from it is in sharp contrast to that found in the Howell study. One of the criteria that they suggest for screening males in the population is that women may find that being screened has connotations of being dirty and unattractive A positive result is said to be associated with promiscuity. The authors suggest that not screening men not only fosters gender inequalities but it reduces the Public Health impact on the Man’s responsibilities for sexual health. (Pierpoint et al 2000) There is no argument that this is a valid point, but the paper does not produce any evidence to show that male screening has a positive impact on the cost-effectiveness of the screening procedure. (Stephenson et al 2000) The paper does however, contrast these statements with the accepted fact that women are actually easier to target than men, as they are generally heavier health care users than men in the major at risk age range. (Oakeshott et al 1998) The paper points to the need to tackle the issues of sexual inequality, as it could be considered that the screening programmes may have less than the desired effect if they are perceived by women to be little more than surveillance of their particular sexual habits. It draws a clear analogy between a women only screening programme for chlamydia and the well established women only cervical cytology screening clinics. The paper quotes (Holgate et al 1998) in the comment: The potentially adverse consequences of sexual intercourse a private event can be surveyed and treated through screening services a publicly based and funded system . It is women who transcend this private, public dichotomy and find their lives scrutinised in a manner alien to men . The focus is commonly upon women both as transmitters and contractors of relevant viruses as both those whose cervixes are surveyed and whose sexual activity comes under surveillance. The paper then has a long middle section which, as a critical analysis, is little more than a diatribe against women being singled out for screening. It is fair to say that all of the arguments put forward are valid, to a degree, but are presented with a strongly feminist viewpoint, which is both understandable and worthy of merit form a sociological standpoint. The arguments are not however, convincing from a scientific, financial or practical perspective. The conclusions of the paper are entirely justified in calling for a greater understanding of the woman’s point of view when organising and running screening clinics, in order to broaden their appeal to the target groups. (Santer et al 2000) With specific reference to the role of the nurse in the primary healthcare team screening for chlamydia we can now turn and examine an excellent paper by Grun (et al 1997) which looked at two different methods of screening for chlamydia in a nurse run primary healthcare setting. The study set out to try to accurately determine the prevalence of chlamydia in the North London area using the ligase chain reaction (LCR) technique which is similar to the PCR mentioned earlier. (Butt et al 2001) This particular study used the rather labour intensive cervical scrape method for sampling, which had the added benefit that cervical cytology could be assessed at the same time. The paper is quite detailed in its description of its method and appears to be rigorous in its execution. It is worthy of our consideration here because of it’s direct relevance to our prime consideration. The results and conclusions of the paper make for interesting reading One of the more significant conclusions was that, on the basis of their findings, if there was a policy of simply screening all women aged 25 and all women who had had two or more partners in the past year, they would have detected 20 out of a possible 23 positive chlamydia infections in their cohort. The authors make a salient comment that including other screening criteria such as marital status (which has been suggested by other authors [Lossick JG, et al 1996]), would have made no statistically significant impact on their detection rate. They also make the comment, in line with the other authors we have examined, that selective screening appears to be more cost effective than universal screening, although the actual cost implications were not specifically considered in this paper. In contrast to the Howell paper, it suggests that screening become a viable tool when the community prevalence rate approaches 5% The fourth paper to be reviewed is the more recent paper by Adams (et al 2004). This paper takes a more general overview of the whole issue of chlamydia in the UK. This is effectively a meta analysis of nineteen different papers (selected from 357 studies) which report the incidence of chlamydia as tested by the PCT method on urine samples. This is significant as it is the first meta analysis to be carried out on UK data. (Armitage et al 2001) The results are extremely detailed and many are only of marginal relevance to our considerations here. We shall restrict our comments to those aspects that are specifically relevant. Firstly, the authors comment on the current prevalence of 8.1% of the population testing positive in the under 20 age group, progressively diminishing to 1.4% in the over 30 group. The significance of this is that it is very much lower than other studies. For example studies set in GUM clinics put the prevalence in the under 20 age group in the region of 17% and antenatal clinics at about 12%. (Piementa et al 2003) This may therefore have relevance in targeting of specific at risk groups. It should be noted that this study gave no data with regard to the incidence of chlamydia in the male population. (Dixon et al 2002) Our comments made earlier about the asymptomatic nature of the bulk of the infections, is borne out in the fact that only 8% of those tested and found to be positive, actually volunteered that they had any genital symptoms (of any sort). Another important consequence of this study is the fact that it highlights the comparatively high detection rate to be found in attenders at primary healthcare team premises. This shows a gap in the reasoning and recommendations of the National Sexual Health and HIV Strategy for England (D of H 2002) which currently suggests targeting GUM clinics and family planning centres as prime sites for screening centres. Following on from the reasoning expounded in the last paper, we can look at a provocatively entitled article by Kufeji (et al 2003)† Who is being tested for genital chlamydia in primary care?† The paper makes the point that we already have enough evidence to clearly identify the target populations that are the most likely to give a good yield as far as screening is concerned (viz. the most â€Å"at risk† groups). The raison d’à ªtre of this paper was to compare the characteristics of the actual groups screened with the characteristics which we know to be representative of the groups most likely to be at risk. The corollary of this reasoning being that if the two groups do not match then all the calculations made about the cost effectiveness of a selective screening process do not hold water. (Kinn et al 2000) The most striking feature of this paper is the fact that we know (Adams et al 2004) that the maximum age incidence for chlamydia is in the sexually active under 20 age group and the incidence rapidly decreases with age to the over 30 age group. Kufeji and his co-workers found that the majority of the tests done (63%) were done on the over 25 yr. age group where we would expect the results to be positive only in about 1.5% of the population. Adams’ findings were confirmed with a positive rate of 13.3% found in the under 20 yr. olds tested. The paper also point to the fact that the practices studied had a comparatively high healthcare staff to patient ratio. In the practices where the ratio was lower, even less opportunistic testing was done. (Shefras et al 2002) This correlates to the finding that the Townsend score ( of social deprivation) correlated highly with both a reduction in the amount of testing and an increase in the prevalence of chlamydia. In the words of the authors the study points to the fact that screening programmes for chlamydia in primary healthcare settings suffer from â€Å"a selection bias and social desirability bias, and they do not aim to provide complete descriptive information on testing patterns across a population.† It should be noted that this particular study was not just on a small sample. The authors took as their entry cohort all of the 119 General Practices in Nottingham which collected a total of over 7,000 samples. The authors note that the number of tests done in General Practice is increasing at about 35% per year. It follows that if a significant number of these are inappropriately targeted, this has profound implications for the related costings of the exercise. One other salient point in this study was the fact that only 1 in 40 tests were done on men. (Chernesky et al 1999) The last major paper that we shall review in this section is the paper by Cassell (et al 2003) this deals with the thorny issue of partner notification when screening turns up a positive result. Hitherto contact tracing had largely been in the realms of the GUM contact tracing nurse. With the expansion of the screening role into the realms of General Practice and other clinics, the contact tracing role has also expanded and may well have lost some of it’s efficiency due to both a lack of skill, time and resources. (D of H 2002). Cassell and her colleagues have tried to investigate the extent to which this perceived reduction in contact tracing may be responsible for the relentless increase in the overall incidence of chlamydia. (Radia et al 2001). The study was done by postal questionnaire to all GPs in Nottinghamshire. They got a 56% response rate. Arguably the most significant finding of the study was the fact that 86% of respondents considered that chlamydia testing was part of the remit of the primary healthcare team, while only 40% considered that partner notification was a primary healthcare team role. The rationale for this was, that most of the non-contact tracing respondents felt that it was their role to inform the patient that they should inform their partners. Given the fact that we have evidence from the Duncan paper that women tend to equate a positive test with promiscuity and being â€Å"dirty†, it is perhaps not surprising that a substantial number of partners do not get told. If you add to this number the unknown number of chlamydia infections that may have come from clandestine or extramarital liaisons, then this number may be higher still. This is clearly both hypothesis and conjecture but it would seem to be dictated by common sense. The paper goes into considerable detail about the reasons why different primary healthcare teams have different practices, but rather worryingly a surprising 20% treat chlamydia with a dose of antibiotic which is less than the currently recommended therapeutic level recommended by the Central Audit Group for Genitourinary Medicine, (Stokes et al 1997) The difficulty of a postal questionnaire study is that there is an intrinsic bias in the study design. It is quite conceivable that the 56% of primary healthcare teams who responded were the ones who may have been sufficiently motivated to be positive about matters to do with chlamydia and may therefore have been better informed that those who did not respond. In the words of the authors â€Å"our study probably over-represents primary healthcare teams already testing for chlamydia and may exaggerate the extent of good practice.† The paradox outlined by this study is that while the majority of GPs and their teams are already willing to assume the mantle of diagnosing and managing chlamydial infection, the same majority agree that contact tracing is the main difficulty in managing these patients. The study made enquiries relating to the presence of follow up strategies which were designed to minimise the risk of further infection and found that there was â€Å"very little evidence to be found† other than by putting the onus on the patient to tell their partners. It follows from this observation, and the authors put it quite succinctly: If testing in primary care continues to increase without adequate support for partner notification, much of the resource used in testing women will be wasted. (Griffiths et al 2002) If we accept the premise that an increasing amount of chlamydia screening will be done in General Practice in the future, it is likely that an increasing proportion will fall to the practice nurse or the family planning nurse specialist. (Stokes et al 2000). If this is the case, then it is common sense to maximise the benefit of chlamydia screening by supporting the healthcare professionals with time and resources to perform proper contact tracing to minimise the risk of re-infection. (EHC 1999) Conclusions In this review we have selected six primary papers which each represent a significant contribution to the evidence base in our knowledge of the rationale for screening and treatment of chlamydia infection. (Sackett 1996) From our examinations it is clear that there is a considerable disparity in the figures pertaining to the prevalence of chlamydia infection in the community. The paper by Adams (Adams et al 2004) gives us a partial rationale for this and that is that studies done in different areas of health care practice will yield different results because they have a different clientele. It is not, perhaps, surprising that a study done in a GUM clinic will report different prevalences than a study done in a General Practice setting. The common factor that runs through all of the papers examined is the fact that it is rare to find that men are screened. Generally the figures suggest about 2-5% of men are screened when compared to the number of women. There is no evidence to suggest that they have lower infection rates than women and, according to Duncan (et al 2001), there are a number of very good sociological reasons why men should be screened as frequently as women. The fact of the matter is that women are subject to screening with much greater frequency than men and therefore bear the brunt of both the indignity and the responsibility. There is no doubt however, that the case for screening and treatment and contact tracing is made on both economic and health grounds. It is equally clear that the practice nurse has a central role in the efficient administration of all of these vectors to varying degrees. The advent of nurse prescribing (Legge 1997) will make the practice nurse as valuable in this area as they already are in both the screening and contact tracing roles. The only concern here is that according to Kufeji (et al 2003) we are collectively targeting the wrong population in terms of efficacy and efficiency. References Adams EJ , A Charlett, W J Edmunds, and G Hughes 2004 Chlamydia trachomatis in the United Kingdom: a systematic review and analysis of prevalence studies Sex. Transm. Inf., October 1, 2004; 80(5): 354 362. Armitage P, Berry G, Matthews J. 2001 Statistical methods in medical research. Malden, MA, 2001. Barlow RE, Cooke ID, Odukoya O, et al. 2001 The prevalence of Chlamydia trachomatis in fresh tissue specimens from patients with ectopic pregnancy or tubal factor infertility as determined by PCR and in-situ hybridisation. J Med Microbiol 2001;50:902–8 Berry J, Crowley T, Horner P, et al. 1995 Screening for asymptomatic Chlamydia trachomatis infection in male students by examination of first catch urine. Genitourin Med 1995;71:329–30. Butt A, McCartney R, Walker A, et al. 2001 Economic advantages of ligase chain reaction for diagnosis of genital Chlamydia trachomatis infection in GUM clinic attenders. Sex Transm Infect 2001;77:227–8. Cassell JA , M G Brook, R Slack, N James, A Hayward, and A M Johnson 2003 Partner notification in primary care Sex. Transm. Inf., June 1, 2003; 79(3): 264 265. Chernesky M, Lee H, Schachter J. 1999 Diagnosis of a Chlamydia trachomatis uretral infection in symptomatic and asymptomatic men by testing first void urine in a ligase chain reaction assay. J Infect Dis 1999;170:1308-11. CMO 1998 Chief Medical Officer. Main report of the Chief Medical Officers Expert Advisory Group on Chlamydia trachomatis. London: Department of Health , 1998. Dixon L, Pearson S, Clutterbuck DJ. 2002 Chlamydia trachomatis infection and non-gonococcal urethritis in homosexual and heterosexual men in Edinburgh. Int J STD AIDS 2002;13:425–6. D of H 2002 (I) Department of Health. The national strategy for sexual health and HIV: implementation action plan. London: DoH, 2002. D of H 2002 (II) Department of Health. Action plan for the sexual health strategy for England. London: DoH, 2002 Duncan B, Hart G. 1998 Screening for Chlamydia trachomatis: a qualitative study of womens views. Prevenir 1998; (suppl 24): 229. Duncan B, Graham Hart, Anne Scoular, and Alison Bigrigg 2001 Qualitative analysis of psychosocial impact of diagnosis of Chlamydia trachomatis: implications for screening BMJ, Jan 2001; 322: 195 – 199 EHC 1999 Effective Health Care. Getting evidence into practice. York: University of York, 1999. Fenton KA, Korovessis C, Johnson AM, et al. 2001 Sexual behaviour in Britain: reported sexually transmitted infections and prevalent genital Chlamydia trachomatis infection. Lancet 2001;358:1851–4. Griffiths C, Cuddigan A. 2002 Clinical management of chlamydia in general practice: A survey of reported practice. J Fam Plann Reprod Health Care 2002;28:149–52. Grun L Julia Tassano-Smith, Caroline Carder, Anne M Johnson, Angela Robinson, Elizabeth Murray, Judith Stephenson, Andrew Haines, Andrew Copas, and Geoffrey Ridgway 1997 Comparison of two methods of screening for genital chlamydial infection in women attending in general practice: cross sectional survey BMJ, Jul 1997; 315: 226 230 Haddix AC, SD Hillia, WJ Kassler. 1995 The cost effectiveness of azithromycin for Chlamydia trachomatis infections in women. Sexually Transmitted Diseases 1995 22:274-80. Harry T, Saravanamuttu K, Rashid S, et al. 1994 Audit evaluating the value of routine screening of Chlamydia trachomatis urethral infections in men. Int J STD AIDS 1994;5:374–5 Holgate HS, Longman C. 1998 Some peoples psychological experiences of attending a sexual health clinic and having a sexually transmitted infection. J R Soc Health 1998 Howell MR , TC Quinn, CA Gaydos. 1998 Screening for Chlamydia trachomatis in asymptomatic women attending family planning clinics. Annals of Internal Medicine 1998 128:277-84 HPA 2003 Health Protection Agency, SCIEH, ISD, National Public Health Service for Wales, CDSC Northern Ireland, UASSG. Renewing the focus. HIV and other sexually transmitted infections in the United Kingdom in 2002. London: Health Protection Agency, 2003 Kinn S, Macnaughton J, Noone A, et al. 2000 Chlamydia trachomatis in primary care: knowledge and practice in Glasgow. Br J Gen Pract 2000;50:214–15 Kufeji O, R Slack, J A Cassell, S Pugh, and A Hayward 2003 Who is being tested for genital chlamydia in primary care? Sex. Transm. Inf., June 1, 2003; 79(3): 234 236. Lea AP, HM Lamb. Azithromycin. 1997 A pharmacoeconomic review of its use as a single-dose regimen in the treatment of uncomplicated urogenital Chlamydia trachomatis infections in women. Pharmacoeconomics 1997 12:596-611. Legge. A 1997 Nurse prescribing is a success BMJ, Feb 1997; 314: 461. Lossick JG, et al. 1996 Recommendations for the prevention and management of Chlamydia trachomatis infection, 1996. MMWR 1996;42:1-37. Oakeshott P, Kerry S, Hay S, et al. 1998 Opportunistic screening for chlamydial infection at time of cervical smear testing in general practice: prevalence study. BMJ 1998;316:351–2. Pierpoint T, Thomas B, Judd A, et al. 2000 Prevalence of Chlamydia trachomatis in young men in north west London. Sex Transm Infect 2000;76:273–6. Pimenta JM, Catchpole M, Rogers PA, et al. 2003 Opportunistic screening for genital chlamydial infection. II: Prevalence among healthcare attenders, outcome, and evaluation of positive cases, Sex Transm Infect 2003;79:22–7 Radja N, Slatter E, Thin N, et al. 2001 A tale of 2 cities: a comparison of demographic details, source of referral, spectrum of infection and contraceptive practice in patients under 16 years attending genitourinary medicine clinics in London and Swansea. Int J STD AIDS 2001;12:361–4. Sackett, (1996). Doing the Right Thing Right: Is Evidence-Based Medicine the Answer? Ann Intern Med, Jul 1996; 127: 91 94. Santer M, Warner P, Wyke S, et al. 2000 Opportunistic screening for chlamydia infection in general practice: can we reach young women? J Med Screen 2000;7:175–6. Shefras J, Edmondson S, McNulty C. 2002 Countywide survey of the current practice of chlamydia detection in primary care. J Fam Plann Reprod Health Care 2002;28:145–8. Stephenson J, Carder C, Copas A, et al. 2000 Home screening for chlamydial genital infection: is it acceptable to young men and women? Sex Transm Infect 2000;76:25–7. Stokes T. 1997 Chlamydia infection in UK family planning clinics. Br J Fam Plan 1997;23:47–50. Stokes T, Bhaduri S, Schober P, et al. 1997 GPs’ management of genital chlamydia: a survey of reported practice. Fam Pract 1997;14:455–60 Stokes T, Mears J. 2000 Sexual health and the practice nurse: a survey of reported practice and attitudes. Br J Fam Plann 2000;26:89–92 Wilson JS, Honey E, Templeton A, et al. 2002 A systematic review of the prevalence of Chlamydia trachomatis among European women. Human Reproduction Upda

Data Encryption Essay -- Data Security

Missing Chart Encryption Encryption is a method of programming data for security so that it appears to be random data. Only the people sending and receiving the information have the key to decrypt the message, which will put it back into its original form making it readable. The only people with the key are the people who are intended to read the message. Not many people know what encryption is. I took a survey of twenty students and asked two questions. The first question I asked was do you know what encryption means and the second question I asked was have you ever heard of anybody using encryption. This is a chart of the information I received: Many people wonder exactly how encryption works. People think that encryption is the same thing as coding when in fact it is very different. Computer code is used to create software while encryption is used to disguise a message from the public. Coding such as ASCII and EBCDIC are used to create data that is publicly shared. With encryption, when you first put in a message, its goes in as plaintext. Plaintext is the text in its original form when it has not been encrypted. A message that has been encrypted is known as ciphertext. The process of converting plaintext to ciphertext is known as encryption. The process of changing ciphertext into plaintext is known as decryption (Parsons 328). In order to encrypt a message you need to use a cryptographic algorithm key. A cryptographic key can be a word, phrase or number that has to be known in order to encrypt or decrypt a message. Caesar created his own encryption method known as simple substitution. His encryption was to change the alphabet to start with D and continue with the alphabet from there. When he reached... ...n use your private key to encrypt them. It is basically the safest way to send e-mail. As I mentioned before, most people believe that encryption is a very complex process when in often it is very simple. Weak encryptions such as Caesars simple substation method prove how simple encryption can really be. Strong encryption can be nearly impossible to crack. You need a special computer and it can take a long time to figure out the message. Encryption such as the PGP method, are used to keep privacy through e-mails. Overall, encryption is mainly used for privacy and protection in all types of situations. Works cited Parsons, June Jamrich, Dan Oja. New Perspectives on Computer Concepts 8th Edition. Boston, MA: Course Technology. http://en.wikipedia.org/wiki/Encryption http://www.cesa8.k12.wi.us/media/digital_dictionary.htm

Zarathustras Prologue and Three Species :: essays research papers

Summary of â€Å"Zarathustra’s Prologue and Three Species†   Ã‚  Ã‚  Ã‚  Ã‚  At the beginning of the story a man named Zarathustra who was thirty years of age had left his home to go live in the mountains. He had lived in solitude of the mountains for ten years. The text said, â€Å"He enjoyed his spirit and his solitude, and for ten years he did not become weary of it.† I believe that Zarathustra move to the mountains and lived a solitary life to get more in touch with himself. He probably wanted to get to know himself more spiritually. Until one day he finally decided to leave his life of solitude and begin another journey of his own.   Ã‚  Ã‚  Ã‚  Ã‚  During his journey down the mountain, Zarathustra did not encounter anyone. All of that began to change as Zarathustra was walking through a forest and encountered an old man. The old man began to speak to Zarathustra. It had seemed like the old man had met Zarathustra many years ago; he believed that he had changed after living a life of solitude. I believed the old man caught on to the fact that Zarathustra was leaving the mountains, and assumed that he was going to back to civilization. The old man told Zarathustra, â€Å"You floated in the sea of solitude. Alas, will you go ashore?† When the old man said that, he meant that Zarathustra was finally going to be among other people for the first time in along time.   Ã‚  Ã‚  Ã‚  Ã‚  After journeying through the forest, Zarathustra had finally arrived at a town. He noticed that many people where gathered around a marketplace waiting for a rope dancer to perform.   Ã‚  Ã‚  Ã‚  Ã‚  Zarathustra decided to speak to the people. He wanted to teach the people the way of the superman. He made a lot of deep philosophical points about the superman. It seem like no matter how much he tried to prove his point to the people of that town, he just could not get to them. All they did was laugh and ridicule him. Because of this, it made him sad. Zarathustra mentioned, â€Å"They do not understand me; I am not the mouth for these ears.† He started to think the reason behind this is that he had lived in the mountains for too long. He believed living in mountains had made his soul calm and clear, and that is the reason the people do not understand him.   Ã‚  Ã‚  Ã‚  Ã‚  I will briefly talk about one the three speeches.

Educational Philosophy Essay -- Education Teaching Educating Essays

Educational Philosophy Writing my educational philosophy has required me to do an extensive amount of personal research that has taken me on some wonderful, inward journeys over the past few months. Voyages through my cognitive and behavioral personas from the beginning of my educational endeavor back in 1992 up until the present day. I have been digging diligently through my archives pulling out old papers I composed regarding my initial views toward education. I have reflected on my days in the writing center at George Mason University as a composition tutor. Plus, I evaluate myself in the classroom now as I teach at the local community college as well as in the local junior high and high schools for my student observation requirements at Concord College. Through all this, I’ve come to understand that my view of education, my philosophy towards education, and my professional development plans are all derived from three goals I have formed which identify my belief in why school exists . Just as John Goodlad (1984) identified four reasons for schooling in A Place Called Home, I’ve formed my own list after a considerable amount of self-reflections and observations. First, I feel as though school must continuously strive to increase academic achievement in all students. In order to do this, the classroom must be focused on academic learning time. The students must be allocated time to become highly engaged in the lesson. This means active learning needs to be increased and other actions, such as administrative measures and straight lecturing, need to be decreased. My second goal is that school must foster positive social relationships among the students. The key to this is in creating an e... ...panish as well as in Health Studies. Also, I maintain active membership to the National Council of Teachers of English (NCTE) in order to keep me informed on new and old theoretical and practical instructional methods regarding grammar, composition, and literature. Continuous educational growth and learning is a major component to my personal wealth and satisfaction as an English teacher. I believe cooperative learning is one key to how I might skim the surface of my educational focus on heightened academic learning time, positive social relationships, and heightened emotional needs of all students. Works Cited: Goodlad, John. (1984). A place called home. New York: McGraw-Hill. Slavin, Robert., & Cooper, Robert. (1999). Improving intergroup relations: Lessons learned from cooperative learning programs. Journal of Social Issues, 55 (4), 647-661.

Poem Explication Essay

The first two lines show the king’s envy of other people in his court who unlike him can sleep soundly. Subsequently, he blames his not being able to sleep upon nature and questions why it has not made him sleepy yet. Line five seems particularly important because there King Henry hints that what he really wants is not sleep itself but the forgetfulness that comes with it. This line somewhat shows why the king is not able to sleep. King Henry wants nature to steep his sense of forgetfulness and let him rest but it does not, and so the king further questions nature as to why those that he considers below him are granted what he is not. He contrasts the common sleeping area with that of his grand chambers in lines six to eleven and asks nature why it would choose the former over the latter. In this part of the poem, the king describes the first sleeping place as shabby and poor while describing his own bed chambers as â€Å"perfumed† with sheets that are very expensive. This shows that the king thinks highly of his status as being superior to others as first expressed in the poem’s first two lines. The king further establishes this in the next lines of the poem, comparing himself to a lowly cabin boy who is probably somewhere sleeping while the monstrous winds rocked the ship floor where he slept. The king again contrasts it to his own situation, peacefully lying down without the disturbance of a heavy storm and again questions why he is denied of sleep. The last line supports the inference made in the fifth line. The words â€Å"uneasy lies the head that wears this crown† denotes that the king cannot sleep because there was something that was really bothering him. Reference The Second part of King Henry the Fourth. Retrieved March 27, 2008 from: http://shakespeare.mit.edu/2henryiv/2henryiv.3.1.html