Reservoirs of Infection Essay Example for Free

Reservoirs of Infection Essay Nasal carriage is the principal reservoir, and nasal colonization of the individual patient is the harbinger of subsequent infection. Healthcare workers are propounded to be potential reservoirs. Hand carriage and nasal carriage both are responsible, and they can be transient or persistent. For healthcare workers, the environment of care may function as a reservoir of colonization and infection. The body sites of the patients in the care units may specifically colonize bacteria. These include respiratory tract, any site on the skin such as surgical sites, burns, pressure sores, tracheotomy sites, sites of other foreign bodies, and normal skin, and the perineum and the rectum. In these settings, nasal swabs are inadequate, and culture of the wounds, tracheostomy sites, and sputum may be useful. Environmental contamination in a hospital has been known reservoirs, and virtually any surface, appliance, and instruments in the care setting may be suspected, but they seem to play insignificant roles in transmission of infection (Graffunder, E.M. and Venezia, R. A. , 2002). Modes of Transmission: The principal mode of transmission within an institution is from one colonized or infected patient to another via the hands of the healthcare workers, even though he or she is transiently colonized. Hospital acquired pneumonia that happens with MRSA is thought to be transmitted through air-borne infection (Graffunder, E. M. and Venezia, R. A. , 2002). Control: Handwashing is a time-honoured principle of routine infection prevention and control and is considered to be effective in eliminating transient hand contamination with MRSA and other pathogens acquired from patients or the environment. A simple 10-second hand wash with soap and water can ascertain absence of the bacteria from the contaminated hands in most of the cases. However, povidone iodine or alcohol is better washing agent (Graffunder, E. M. and Venezia, R. A. , 2002). Prescription: Decreasing broad-spectrum antibiotic therapy can reduce the risk of MRSA. Nursing workloads need to be maintained as reasonable level so as to maintain standard hygiene that reduces chances of infection. Drugs, such as, vancomycin is indicated in uncomplicated cases of MRSA. The other antibiotics that are recommended are tetracyclines or cotrimoxazole. Minocycline is also active against MRSA. Linezolid is recommended in skin and soft tissue infections caused by MRSA. Clindamycin is also an effective antibiotic, and a combination of rifampicin and fusidic acid and daptomycin have been found to be effective in such cases (Gemmell, C. G. et al. , 2006), (French, G. L. , (2006). Conclusion: MRSA is a threat, and this threat has been caused by the genetic make up of the bacteria and iatrogenic reasons. Strict hygienic measures in the healthcare facilities, awareness of this threat by the healthcare professionals, and appropriate management of MRSA infection along with surveillance still can reduce the spread and epidemic nature of these infections. References Brown, D. B. J. et al. , (2005).Guidelines for the laboratory diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus (MRSA) on behalf of the Joint Working Party of the British Society for Antimicrobial Chemotherapy, Hospital Infection Society and Infection Control Nurses Association. J. Antimicrob. Chemother. ; 56: 1000 1018. Enright, M. C. et al. , (2002). The evolutionary history of methicillin-resistant Staphylococcus aureus (MRSA). PNAS,; 99: 7687 7692. French, G. L. , (2006). Bactericidal agents in the treatment of MRSA infections—the potential role of daptomycin. J. Antimicrob. Chemother. ; 58: 1107 1117. Gemmell, C. G. et al. , (2006). Guidelines for the prophylaxis and treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections in the UK on behalf of the Joint Working Party of the British Society for Antimicrobial Chemotherapy, Hospital Infection Society and Infection Control Nurses Association. J. Antimicrob. Chemother. ; 57: 589 608. Graffunder, E. M. and Venezia, R. A. , (2002). Risk factors associated with nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection including previous use of antimicrobials. J. Antimicrob. Chemother. ; 49: 999 1005. Huang, H. et al. , (2006). Comparisons of Community-Associated Methicillin-Resistant Staphylococcus aureus (MRSA) and Hospital-Associated MSRA Infections in Sacramento, California. J. Clin. Microbiol. ; 44: 2423 2427. Johnson, A. P. , Pearson, A. , and Duckworth, G. , (2005). Surveillance and epidemiology of MRSA bacteraemia in the UK. J. Antimicrob. Chemother. ; 56: 455 462. Millar, B. C. , Prendergast, B. D. , and Moore, J. E. , (2008). Community-associated MRSA (CA-MRSA): an emerging pathogen in infective endocarditis. J. Antimicrob. Chemother. ; 61: 1 7.

Syrian Refugee Assistance Project Development

Syrian Refugee Assistance Project Development Development Project: Assistance for Syrian Refugees Abstract Syria is a country that has been ravaged by war. The residents have lost their livelihood and many people have fled due to the unfortunate state of the country. For prosperity or some mere sense of peacefulness to return, significant changes must occur. By establishing a central development plan, USAID and other participants can aid returning citizens in regaining a life surrounded by peaceful conditions. As part of this plan, resettlement and compensation must occur. Equally important, retraining, economic integration, and transportation assistance will be needed. Without these vital steps, an area that has experienced the devastation caused by civil war will continue to be a land that not only creates strife for its residents, but globally.   Keywords:   Syria, Civil War, Central Development Plan Introduction Sun Tzu said, â€Å"The supreme art of war is to subdue the enemy without fighting.† This process is not reflected through civil wars that have ravaged different countries around the world. With interior battles and people fighting their own neighbors, a lot of devastation has occurred. For Syrians, the illustration of war is all too real. The desolation that has occurred has a result of interior battling will require a lot of development and rehabilitation. These processes will only be successful if peaceful treaties can be reached to stop the battles that have led to such tragedy. The changes that must occur are vast and will have to encompass the entire country’s population. Through these changes, a central plan is needed to address resettlement and compensation, as well as retraining, economic integration, and transportation assistance.   Background During the brutal Syrian civil war (2011-present), greater than 300,000 people have been killed and 1.5 million wounded to date, leading to a refugee crisis which has been without parallel, as those who survived that conflict have increasingly sought to flee from that besieged nation and begin their lives elsewhere. This has prompted a refugee crisis which has been unprecedented in world history, and one which has placed considerable stress upon ‘host’ nations, especially in Europe, to take in those displaced by this war. However, in recent months, this seven year-long conflict has received ample international attention of a sort which has stressed the likelihood that the war may be soon coming to an end. As announced by Syrian president Bashar al-Assad, and endorsed Steffan de Mistyra, United Nations ‘Special Envoy’ to Syria, the conflict – which witnessed the inclusion not just of Assad’s forces and the ‘rebels,’ but the Islamic State, U.S., Israel, and Russia, as well – may have been â€Å"won† by Assad, especially following â€Å"critical military gains made by government forces† throughout 2017 (Al-Doumy, 2017, p. 1). In particular, as of September 2017, after the Syrian capital of Aleppo was captured by Assad’s government regime, ad only the â€Å"Idlib province† was still under the control of the opposition, meaning that such control – and a final ‘victory’ for the Syrian state – may be close at hand (Al-Doumy, p. 1). Current ‘facts on the ground,’ though they are dour, represent a critical point of controversy among international aid agencies. In particular, the United Nations has reported that despite â€Å"reduced violence† in Syria throughout 2017, the warring parties in that nation have continued to perpetrate â€Å"unthinkable crimes† against the Syrian civilian population, including – per the UN report – the Syrian government’s use of â€Å"chemical weapons† against civilians (UN, 2017, p. 1). A report by the United Nations Office of the High Commissioner for Refugees (2017), has mounted strident criticism against the Syrian state, particularly for its use of â€Å"sarin [gas]† as part of an aerial bombardment in northern Hama and southern Idlib, in April 2017, which led to the deaths of over eighty civilians (UNHCR, 2017, p. 1). This campaign –notable for the brutal tactics employed by the Assad government – specif ically targeted â€Å"medical facilities† in this ‘rebel’-held area, leading to a â€Å"severe weakening† in these areas’ ability to provide assistance to the victims, a point which the report stressed led to a â€Å"consequent increase† in the number of civilian casualties this unconscionable government attack caused (UNHCR, p. 1). The United Nations report also criticized the Assad regime for using â€Å"weaponized chlorine,† in Hamah and Damascus, which when combined with the use of sarin, represent multiple and flagrant violations of both â€Å"international humanitarian law and the Convention on Chemical Weapons,† which was signed by Syria in 2013 (UNHCR, 2017, p. 1). That said, the Assad government is not the only group to blame in this ongoing disaster. The report also points to â€Å"international coalition airstrikes,† as by the United States and Israel, to repel Islamic State (ISIL) forces from this country, which have led to an â€Å"increasingly alarming number of [civilian] casualties,† and internally displaced hundreds of thousands of Syrians (UNHCR, p. 1). The U.S., in particular, is criticized for its failure to â€Å"take all feasible precautions to protect civilians† in its incursion (p. 1). The prolonged and brutal nature of this conflict, when combined with the recency of such war crimes, have resulted in the United Nations seeking a â€Å"political solution† which would result in an end to â€Å"grave violations of human rights and the laws of war† (p. 1). However, it appears that the international community – especially among the nations of Europe, which have taken in an unprecedented number of Syrian refugees – is now taking reports of the pending ‘end’ of the Syrian conflict at face value. In Germany, which took in more than a half-million Syrian refugees, its interior ministry has begun to discuss (and vote upon) proposals to begin â€Å"forcibly repatriating Syrian refugees once their asylum status lapses,† as early as June 2018 (Traub, 2017, p. 1). Given the relatively â€Å"muted† international response to the scathing UNHCR report (2017), is apparent that international authorities (especially nations which have taken in Syrian refugees), are willing to overlook the crimes and abuses of the Assad regime, and ultimately, to â€Å"accept,† while heinous, â€Å"the devil they know† (Al-Doumy, 2017, p. 1). In Germany and other nations which have been hard-hit by the Syrian Refugee Crisis, especially as has manifest in â€Å"political pressure,† while the UNHCR guidelines which stipulate the changes required for â€Å"safe return† and repatriation may â€Å"not occur for a generation,† these nations are increasingly looking to treat the â€Å"end of hostilities† as sufficient standard upon which to justify mass repatriation (Traub, p. 1). Given the ongoing military presence of the United States in this nation, America’s responsibility to this region may be great. In advance of mass repatriation of Syrian refugees, especially from Europe, it is necessary to craft a development proposal upon which such American assistance to ‘returning’ Syrian civilians may be formed. Such goals, however, must be in ‘alignment’ with the goals of the U.S. State Department, as well as with the current White House, and will be implemented by the United States Agency for International Development (USAID), an relief organization which is typically tasked with disaster relief efforts. In essence, any plan taken by the United States must be sufficient in scope to prevent further humanitarian disaster in Syria, but is likely to not carry military mandate, nor will it be conducted for a period of longer than two years, given the low ‘appetite’ of the American people to engage in prolonged relief efforts. However, as has been considered, there is an eminent need for the implementation of this program; The United States has played a pivotal role in this conflict, and while it has not perpetrated the same flagrant human rights abuses as the Assad government, it is critical for the U.S. – through USAID – to adhere to two core ‘tenets’ of its international aid mission, in Syria, by (1) Providing â€Å"life-saving humanitarian assistance to save lives and alleviate suffering,† and (2) Accelerating a â€Å"rapid [and] and durable recovery by supporting livelihoods, markets and the provision of basic services† (USAID, 2017, p. 1). To this end, the following section will present a core ‘treatment’ of a future project, to be implemented in Syria, as contingent upon a likely German decision (anticipated for June 2018) to mandate the repatriation of their 600,000 Syrian refugees. The following section will present the core aspects of this development plan. Central Development Plan The central purpose of this development plan is to provide assistance to Syrians who will return to Syria after the crisis, likely as soon as June 2018, when Germany is anticipated to repatriate hundreds of thousands of Syrians to this nation, contingent upon the anticipated end to eight years of hostilities. The core vector for such development will be dedicated rehabilitation centers, which will be established in conjunction with (and under the protection of) the U.S. military base in northern Syria (Davison, 2017. In addition, such aid presence will also be established within (or close to) centers of population, where repatriated refugees will likely return. The following sections will consider the goals which will be sought at these rehabilitation centers, which will primarily focus upon providing post-return assistance to the hundreds of thousands of Syrians who are anticipated to be repatriated. The intended methodology which will be employed at these rehabilitation centers is of a curative nature, by which individuals who have been repatriated to Syria will be better-prepared to reengage in their lives in a safe and productive manner, following their return. Guidelines established by relief agencies UNHCR and USAID will be used to inform this development plan Sub-Purpose 1: Resettlement and Compensation A primary goal which must be achieved is of resettlement. Though resettlement plans are often undertaken in conjunction with refugee assistance (as in a ‘third party’ country which provides asylum), the UNHCR stipulations regarding such resettlement in the context of repatriation are relevant to this consideration. In particular, one UNHCR report (2016) argues that such measures are often established under a ‘banner’ of international solidarity, through which ‘destination’ countries are party to negotiations through which the â€Å"parameters† of resettlement programs are established, as through â€Å"multi-year agreements,† the likelihood of which will be improved through establishing long-term aid relationships with such nations (UNHCR, 2016, p. 197). Though these rehabilitation centers will be tasked with the resettlement of repatriated Syrian refugees, it will nonetheless be necessary for the U.S. to establish an aid relationsh ip with Syria, through which such resettlement may be facilitated, both through the establishment of ‘short-term’ housing – as in ‘disaster’ trailers – but negotiations with that government, which will likely wish to improve its international reputation through aid to repatriates, will form the basis for the resettlement of repatriated Syrians throughout this nation. Under the USAID guidelines for resettlement (2017a), further considerations which must inform this policy are addressed. USAID policy in this regard pertains particularly to â€Å"compulsory displacement and resettlement,† a signifier which ably represents the hundreds of thousands of Syrians who have been displaced by that country’s civil war (USAID, 2017a, p. 2). As contextualized to the efforts undertaken in any nation where USAID is present, especially those where there is a severe need for ‘refugee’ housing, this document stipulates that is critical to ensure that resettlement goals will â€Å"avoid, minimize, and mitigate† risks of â€Å"impoverishment of affected legitimate landholders,† (USAID, p. 2). The devastation wrought by the Syrian Civil War, especially in urban areas and former centers of population where most refugees originated, has been vast. As a result, this rehabilitation policy will be undertaken with the assumption that most of those whom it serves have suffered either â€Å"total physical displacement,† as through complete loss of land, shelter, or â€Å"other assets,† or â€Å"partial†¦displacement,† as when ‘landholders’ retain their land and assets, but have been removed from the use of such resources due to circumstances out of their control (USAID, p. 3). Given the extraordinary number of repatriated Syrians likely to move through the rehabilitation center, it will be necessary to employ a policy which emphasizes resettlement, in tandem with those by policy by which rote â€Å"compensation† is provided, and to pair such compensation – as to â€Å"improve livelihoods and living standards† – with robust development assistance in the context of a robust resettlement plan (USAID, 2017a, p. 6). As the majority of repatriated Syrians moving through this facility will require permanent resettlement, it will be necessary to produce a resettlement action plan (RAP), per the USAID guidelines for refugees. Because former centers of Syrian population have witnessed such extraordinary destruction, such a plan will be predicated upon the construction of a dedicated resettlement site, which for purposes of convenience, will be located in rural communities near the rehabilitation center. The RAP to be implemented will serve to ensure the following: (1) All â€Å"affected legitimate landholders† – that is, those Syrians who have been forcibly repatriated, yet whose homes are likely still in ruins – are resettled in a manner which serves to protect the â€Å"social and cultural identity† as well as â€Å"cohesion† of their communities (USAID, 2017a, p. 11). In addition, it will also be necessary to provide (2) Receiving communities, those rural areas (which have emerged relatively ‘unscathed’ from the Civil War) with opportunities for â€Å"informed and meaningful engagement† in order to â€Å"avoid, minimize, or mitigate† potential disputes which may arise† (USAID, 2017a, p. 11). Finally, (3) this RAP must be predicated upon all repatriated Syrians having access to a body of â€Å"affordable, accessible, and independent† grievance procedures, to be employed in the event that resettlement disputes arise (p. 11). In addition, the â€Å"fair calculation† of compensation measures must also be incorporated into an effective RAP (USAID, 2017a, p. 14). These would include compensation provided to those who have been displaced (and in this instance, repatriated), in order to facilitate their livelihood, as a factor of the following measures: Individual compensation would be based upon the value of lost (1) Land, as well as â€Å"naturally-occurring resources associated with the land,† (2) Structures on land, such as houses, (3) Legal or professional costs, as well as (4) Loss of earnings, and (5) Intangible losses, as those which hold a particular â€Å"cultural or spiritual value† (USAID, 2017a, p. 14). Moreover, such compensation would also be provided to Syrians so repatriated in order to offset the cost of â€Å"moving and finding alternative housing,† provided that such new housing is not provided as part of resettlement (p. 14). Sub-Purpose 1: Indicators and Outcomes. The establishment of a robust program of housing and resettlement represents the core of this rehabilitation program. As the majority of repatriated Syrians entering this program are likely to have had their homes destroyed during this prolonged period of Civil War, it will be necessary to mount a major course of economic assistance to each individual, to meet their eminent need for shelter. As a result, this rehabilitation center will establish a robust and comprehensive auditing process, in order to address key indicators among these repatriated Syrians, including their need for shelter, but also reflecting the key losses which these individuals suffered. Though all repatriated individuals will be provided with ‘temporary’ shelter – as in an ‘in-country’ facility with disaster accommodations – they will be resettled into (predominantly rural, and local) communities near the shelter in as expedient a manner as possible. Their losses will be compensated in accordance with demonstrable need, meaning that key outcomes pertain to the ability of all individuals who come through this rehabilitation facility to find resettlement in accordance with the RAP, with respect to their expedient delivery to ‘receiving communities.’ Finally, any legal and economic grievances which arise will be settled by authorities at the rehabilitation facility. Sub-Purpose 2: Retraining and Economic Integration Though resettlement and compensation arrangements provided to this vast population of repatriated Syrians will comprise the majority of the rehabilitative ‘burden’ undertaken by this center, it will also seek to aid this population with their employment and reintegration into the Syrian economy. However, the likelihood of such aid policies being effective is somewhat ‘muddied,’ by the serious economic shock that has been wrought by the Syrian Civil War. As presented by Crisp (1996), regarding the UNHCR’s repatriation operations in Mozambique in the 1990s, many individuals so repatriated will express â€Å"apprehension over socio-economic conditions† in their areas of return, a sentiment which â€Å"underlined the need for [establishing] emergency infrastructures† in places of â€Å"actual returnee settlement† (Crisp, 1996, p. 8). However, this report includes little precise information regarding how such ‘infrastructuresâ₠¬â„¢ were to be established. To this end, it is likely that the establishment of some ‘economic infrastructure’ to benefit the vast number of repatriated Syrians anticipated to use this resettlement service would require outsized assistance to Syria, which might result in considerable political antipathy for this plan, by U.S. citizens likely to view such measures as far greater than ‘aid,’ or as falling under the direct responsibility of the Syrian government. An alternative plan by which the economic ‘integration’ of these individuals may be effectuated is through coordinating efforts with the Syrian government, as modeled after measures implemented in other nations. As presented by Beusse (2009), for the European Commission, effective repatriation programs often include â€Å"loan programs,† through which returnees are aided in their achieving meaningful â€Å"livelihood, self-employment opportunities,† and opportunities for â€Å"entrepreneurial development,† and can often be mounted in conjunction with direct educational support (Beusse, 2009, p. 44). Such education is often also primarily economic in nature, and can include support in â€Å"financial literacy, financial planning and management, savings†¦remittance schemes,† as well as in regard to investment opportunity and business counseling, under a broader â€Å"mentoring† framework (Beusse, p. 44). These same methods are emphas ized under the USAID model, which denotes critical methods of â€Å"knowledge and skills training† to be provided to repatriates, to include (1) Short-term technical training, (2) Long-term academic education (or assistance in obtaining such education), (3) Entrepreneurial training, to include â€Å"peer learning,† and (4) Assistance in accessing to â€Å"distance learning,† from which marketable skills can be gained (USAID, 2010, p. 8). Retraining is often unnecessary for populations who are being repatriated, as many members of this Syrian population may present with marketable skills and job histories, and merely lack for employment. To this end, in conjunction with local Syrian businesses – and with its government – this rehabilitation center will also attempt to â€Å"[assist] with job placement† for qualified job candidates, as well as assist with providing â€Å"seed money† to help repatriated Syrians to start businesses (USAID, 2005, p. 17). Sub-Purpose 2: Indicators and Outcomes. Leading indicators of the success of this program will depend on the qualifications of each applicant. In particular, it will be necessary to conduct interviews and audits of the individuals who enter the rehabilitation center, in order to determine their level of skill, and the degree to which they might appreciate inclusion into the locally-provided educational and training programs. In the event that such individuals have a high level of skill, they will be ‘routed’ to Syrian job placement programs, or will be provided with direct grants to aid in their establishment of an independent business. Key outcomes upon which the success of this program will be predicated include the level of interest by the repatriated individuals in these education programs, especially those which concern issues of skills development. Such interest will be used to inform the establishment of educational programs in the rehabilitation center (as to ensure the efficient use of resources), but if there is a low level of interest, this might be interpreted as a failure of the center to ‘craft’ tenable options for all those engaged with this program, and an audit of policies and training deliverables will be implemented, to ensure that such lack of interest is not based on poor ‘fit.’ Sub-Purpose 3: Transportation Assistance In conjunction with the second sub-purpose, it will also be highly beneficial to the wellbeing of these repatriated individuals to provide them with transportation assistance grants, in order to reach their final ‘resettlement’ destination, or to facilitate their ‘re-entry’ into Syrian society, especially if they have achieved employment but cannot reach their new place of employment. In conjunction with other aid project guidelines, this policy will be provided alongside a range of other ‘grant’ programs, to include the resettlement and economic integration plans, but will be provided in a ‘direct’ manner, as alongside â€Å"food†¦health assistance,† and other key requirements (UNHCR, 2016a, p. 15). Transportation aid will also be provided if any repatriated individual at the rehabilitation center requires access to intensive healthcare of a sort (such as surgical or long-term inpatient medical care) which cannot be pro vided ‘on-site.’ Sub-Purpose 3:Indicators and Outcomes.   Such assistance will be provided in the form of ‘block’ grants to be disbursed on a monthly basis, which will be based upon need and ‘tacked’ to both the price of transportation and availability thereof. Following an estimation of key indicators of transportation cost, such payments will be provided to each qualified repatriated individual based on their day-to-day need. PURPOSE SUMMARY There is no question that this development and ‘rehabilitation’-focused project will require a considerable sum of money, both from American authorities, and from Syria itself. However, as this work has considered, Syria now occupies a ‘precarious’ place within the global sphere, as reflective of its government’s reprehensible actions during the Civil War. Though the Assad government was willing to mount terrible attacks against its civilian population, Syria’s ‘re-gaining’ of international reputation – if it is not to include a war crimes tribunal – may well result from their actions, moving forward, with respect to their own people. As Germany and other nations have shown themselves likely to forcibly repatriate their huge populations of Syrian refugees, and the U.S. (and other nations) are likely to remain in Syria in a military capacity for years to come, it follows that the rehabilitation of these repatriates wou ld follow a ‘tandem’ model effectuated by USAID and Syrian government collaboration. Such ‘collaboration’ will primarily be monetary in nature, and include the sharing of the considerable costs of resettlement, job placement, re-training, and grants for aid and transportation provided to this vast ‘returning’ population. However, in the event that this plan leads to the revitalization of Syria, these two nations will have taken a strong step toward reducing the long-term impact of Syria’s past crimes against its people. Even if there is no true ‘reckoning’ for the horrific crimes which the Assad regime perpetrated against its people, it may come ‘together,’ with USAID, to provide returning citizens a better life. ANNEX A: CHART OF RECENT HUMANITARIAN ASSISTANCE (Source: USAID 12.08.17) ANNEX: B REFFERENCE MAP OF SYRIA, TURKEY AND NEIGHBOURING COUNTRIES (SOURCE: USAID MAP OF SYRIA AND NEIGHBOURING COUNTRIES FACTSHEET #5 2017) (SOURCE: USAID MAP OF SYRIA AND NEIGHBOURING COUNTRIES FACTSHEET #5 2017) ANNEX C: REFERENCE MAP OF SYRIAN REFUGEES (2014) (SOURCE: UNHCR 08.29.14 ANNEX D: WORLD DATA BANK SYRIAS GDP (SOURCE: DATA WORLD BANK 12.17.17) ANNEX E: EMPLOYMENT INDICATORS GRAPH (SOURCE: WORLD DATA BANK ASPECTS OF EMPLOYMENT INDICATORS) ANNEX F: LOGICAL FRAMEWORK CHART Works Cited Al-Doumy, S. (2017). Syria’s civil war is over and Assad has won, says the UN. The Week. Retrieved December 13, 2017 from http://www.theweek.co.uk/syrian-civil-war/88268/syria-s-civil-war-is-over-and-assad-has-won-says-the-un Beusse, M. (2009). Repatriation policies and practices. European Commission. Retrieved December 13, 2017 from https://ec.europa.eu/migrant-integration/index.cfm?action=media.download&uuid=299ECC14-A0B0-774C-D3A44B5898CECD11 Crisp, J. (1996). Evaluation of UNHCRs Repatriation Operation to Mozambique. UNHCR. Retrieved December 13, 2017 from http://www.unhcr.org/en-us/research/evalreports/3ae6bcf90/evaluation-unhcrs-repatriation-operation-mozambique.html Davison, J. (2017). Exclusive: U.S. forces to stay in Syria for decades, say militia allies. Reuters. Retrieved December 13, 2017 from https://www.reuters.com/article/us-mideast-crisis-syria-usa-exclusive/exclusive-u-s-forces-to-stay-in-syria-for-decades-say-militia-allies-idUSKCN1AX1RI Global Migration Data Analysis Center (2016). Migration, asylum and refugees in Germany. Retrieved December 13, 2017 from https://www.iom.int/sites/default/files/country/docs/Germany/Germany-Data-Briefing-1Jan2016.pdf Traub, J. (2017). Germany Is Preparing to Send Refugees Back to Syria. Foreign Policy. Retrieved December 13, 2017 from http://foreignpolicy.com/2017/12/06/germany-is-preparing-to-send-refugees-back-to-syria/ United Nations Office of the High Commissioner for Refugees (UNHCR, 2017). UN Commission of Inquiry on Syria. Retrieved December 13, 2017 from http://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=22030&LangID=E (2016). Solutions for Refugees. Retrieved December 13, 2017 from http://www.unhcr.org/50a4c17f9.pdf (2016a). Yemen situation regional refugee and migrant response plan. Retrieved December 13, 2017 from http://www.unhcr.org/561cf4239.pdf UN News Center (2017). Syria: UN probe documents use of chemical weapons and other crimes against civilians. Retrieved December 13, 2017 from http://www.un.org/apps/news/story.asp?NewsID=57468#.WjFquUqnGUk United States Agency for International Development (USAID, 2017). Working in Crises and Conflict. Retrieved December 13, 2017 from https://www.usaid.gov/what-we-do/working-crises-and-conflict (2017a) Guidelines on Compulsory Displacement and Resettlement in USAID Programming. Retrieved December 13, 2017 from http://pdf.usaid.gov/pdf_docs/PBAAE440.pdf (2010). Participant Training for Capacity Development. Retrieved December 13, 2017 from https://trainethelp.usaid.gov/Documents/rawmedia_repository/ads253january2010.pdf (2005). The rehabilitation of victims of trafficking in group residential facilities in foreign countries. Retrieved December 13, 2017 from http://pdf.usaid.gov/pdf_docs/Pnadk471.pdf

Should the Drinking Age be Lowered? Essay -- Law, Sociology

Although exceptions to every generality exist, alcohol is usually present in most gathering where adults are also in attendance. If one really examines the idea, alcohol is usually at every social event even if adults are not. At this point it would probably be important to know who actually is considered to be an adult. From country to country the answer varies but in the United States of America anyone of the age of eighteen is liable and treated just like adults of any age. Consequently, one could say that the previous statement is technically, in the majority of circumstances, incorrect in that when alcohol is around so are adults. When mentioned in such a way, nothing seems to be out of place except that in the United States the legal alcohol consumption age is twenty-one. There are not many sides one may take when contemplating this alcohol consumption law, one is either for it or against it. Many believe that if the drinking age is lowered it should rightfully be lowered to eighteen. These individuals have a number of reasons to support their ideology. John McCardell Jr. is one of those individuals and actually developed a complete organization in 2006 known as Choose Responsibility that promotes his philosophy (Cloud). McCardell Jr. is the head of Middlebury College and believes eighteen to twenty year olds should be eligible to consume alcoholic beverages as long as they are licensed (Cloud). To receive this license one must first complete a course that is around forty-two hours long and consists of the explanations of the chemistry, history, psychology, and sociology of alcohol that may include AA, alcoholics anonymous, meetings (Cloud). McCardell Jr., along with others, also believes that if one is considered an a... ...at can be done to minimize all the problems alcohol provides; I think the first step in assimilating a similar attitude is by education and through example from older adults to young adults. Maybe McCardell’s forty-two hour course of everything one should know to fully understand the results of consuming alcohol would be beneficial for the general public. With that being said the age should still remain twenty-one and adults should not be one-hundred percent intolerable towards teens that might have slipped some alcohol by, after all who has not broken a rule here and there? I believe if a little ignorance is given to the provocation it will disappear. Works Cited Cloud, John. "Should the Drinking Age Be Lowered?" Time.com. Time US, 06 June 2008. Web. 05 Feb. 2012. Scrivo, Karen Lee. "Drinking on Campus." CQ Researcher 20 Mar. 1998: 241-64. Web. 5 Feb. 2012.

The Impact of NAFTA on the U.S. Textile Industry Essay -- Essays Paper

The Impact of NAFTA on the U.S. Textile Industry When the North American Free Trade Agreement went into effect in 1994, many expressed fears that one consequence would be large job losses in the US textile industry as companies moved production from the United States to Mexico. Opponents of NAFTA argued passionately, but unsuccessfully, that the treaty should not be adopted because of the negative impact it would have on employment in the United States, particularly in industries such as textiles. A glance at the data four years after the passage of NAFTA suggests the critics had a point. Between 1994 and mid-1997, about 149,000 US apparel workers lost their jobs, over 15 percent of all employment in the industry. Much of this job loss has occurred because producers have moved production to Mexico. Between 1994 and 1997, Mexico's apparel exports to the United States trebled to $3.3 billion. In 1993, the US jeans maker, Guess?, sourced 95 percent of its product domestically. Now it gets about 60 percent of its clothing from o utside the United States, with Mexico as one of the biggest suppliers. Similarly, in 1995, Fruit of the Loom Inc., the largest manufacturer of underwear in the United States, said it would close six of its domestic plants and cut back operations at two others, laying off about 3,200 workers, or 12 percent of its US work force. The company announced the closures were part of its drive to move its operations to cheaper plants abroad, particu...

The Oppression of Women Exposed in The Yellow Wallpaper -- The Yellow W

The Oppression of Women Exposed in The Yellow Wallpaper    Charlotte Perkins Gilman is remembered today principally for her feminist work "The Yellow Wallpaper."   It dramatizes her life and her experience with Dr. S. Weir Mitchell's now infamous "rest cure."   Commonly prescribed for women suffering from "hysteria," the rest cure altogether forbade company, art, writing, or any other form of intellectual stimulation.   When Mitchell prescribed this for Gilman, he told her to "'live a domestic life as far as possible,' to 'have but two hours' intellectual life a day,' and 'never to touch pen, brush or pencil again' as long as I lived" ("Why I Wrote . . . n.p.). It nearly drove her insane.   She began to recover only when she returned to her art and writing, and subsequently wrote "The Yellow Wallpaper" to alert others to the perils of the rest cure and its attempt to stifle creativity.   It raises the question, stated by Conrad Shumaker, "What happens to the imagination when it's defined as feminine   (and thus weak) and has to face a society that values the useful and the practical and rejects anything else as nonsense?" (590).   The answer provided by Gilman is that it becomes uncontrollable and has the potential to destroy a person's sanity. In "The Yellow Wallpaper," the narrator suffers from postpartum depression, diagnosed by her husband John as "hysteria."   He recommends the rest cure for her and arranges for them to spend the summer in a country mansion.   Although his wife wants to take a downstairs room which opens out into the garden, John forces her to live upstairs in a nursery with barred windows and hideous yellow wallpaper.   She is not permitted to write, except for a journal which she keeps surreptitiously, an... ...William Day, and Sandra Waller.   New York:   Addison Wesley Longman, 1997.   299-312. "Why I Wrote 'The Yellow Wallpaper.'" The Forerunner October 1913:   n.p. Golden, Catherine.   "The Writing of 'The Yellow Wallpaper':   A Double Palimpsest."   Studies in American Fiction 17 (1989):   198-201. Johnson, Greg.   "Gilman's Gothic Allegory:   Rage and Redemption in 'The Yellow Wallpaper.'"   Studies in Short Fiction 26 (1989): 521-30. Kasmer, Lisa "Charlotte Perkins Gilman's   'The Yellow Wallpaper':   A Symptomatic Reading."   Literature and Psychology 36.3 (1990):   1-15. MacPike, Loralee.   "Environment as Psychopathological Symbolism in 'The Yellow Wallpaper.'"   American Literary Realism 8 (1975):   286-88. Shumaker, Conrad.   "Too Terribly Good to be Printed:   Charlotte Perkins Gilman's 'The Yellow Wallpaper.'"   American Literature 57 (1985):   588-99. The Oppression of Women Exposed in The Yellow Wallpaper -- The Yellow W The Oppression of Women Exposed in The Yellow Wallpaper    Charlotte Perkins Gilman is remembered today principally for her feminist work "The Yellow Wallpaper."   It dramatizes her life and her experience with Dr. S. Weir Mitchell's now infamous "rest cure."   Commonly prescribed for women suffering from "hysteria," the rest cure altogether forbade company, art, writing, or any other form of intellectual stimulation.   When Mitchell prescribed this for Gilman, he told her to "'live a domestic life as far as possible,' to 'have but two hours' intellectual life a day,' and 'never to touch pen, brush or pencil again' as long as I lived" ("Why I Wrote . . . n.p.). It nearly drove her insane.   She began to recover only when she returned to her art and writing, and subsequently wrote "The Yellow Wallpaper" to alert others to the perils of the rest cure and its attempt to stifle creativity.   It raises the question, stated by Conrad Shumaker, "What happens to the imagination when it's defined as feminine   (and thus weak) and has to face a society that values the useful and the practical and rejects anything else as nonsense?" (590).   The answer provided by Gilman is that it becomes uncontrollable and has the potential to destroy a person's sanity. In "The Yellow Wallpaper," the narrator suffers from postpartum depression, diagnosed by her husband John as "hysteria."   He recommends the rest cure for her and arranges for them to spend the summer in a country mansion.   Although his wife wants to take a downstairs room which opens out into the garden, John forces her to live upstairs in a nursery with barred windows and hideous yellow wallpaper.   She is not permitted to write, except for a journal which she keeps surreptitiously, an... ...William Day, and Sandra Waller.   New York:   Addison Wesley Longman, 1997.   299-312. "Why I Wrote 'The Yellow Wallpaper.'" The Forerunner October 1913:   n.p. Golden, Catherine.   "The Writing of 'The Yellow Wallpaper':   A Double Palimpsest."   Studies in American Fiction 17 (1989):   198-201. Johnson, Greg.   "Gilman's Gothic Allegory:   Rage and Redemption in 'The Yellow Wallpaper.'"   Studies in Short Fiction 26 (1989): 521-30. Kasmer, Lisa "Charlotte Perkins Gilman's   'The Yellow Wallpaper':   A Symptomatic Reading."   Literature and Psychology 36.3 (1990):   1-15. MacPike, Loralee.   "Environment as Psychopathological Symbolism in 'The Yellow Wallpaper.'"   American Literary Realism 8 (1975):   286-88. Shumaker, Conrad.   "Too Terribly Good to be Printed:   Charlotte Perkins Gilman's 'The Yellow Wallpaper.'"   American Literature 57 (1985):   588-99.

Effect of Spina Bifida on Different Age Groups

EFFECTS OF SPINA BIGIDA ON DIFFERENT AGE GROUPS Individuals who are affected with spina bifida are faced with many difficult challenges. The social factors are different in each age group (newborns to infants, toddlers and preschoolers, school aged children, adolescences, teenagers, and adulthood). Nevertheless, finding resources in your community, knowing what to expect, and planning for the future can help increase confidence in managing spina bifida, enhance quality of life, and assist in meeting the needs of all family. Spina bifida affects the entire family.People who are affected by spina bifida get around in many different ways. This may include walking without any aids or assistance; walking with braces, crutches or walkers; and using wheelchairs. Some people with spina bifida have difficulty picking up the verbal and non-verbal cues necessary for social skills. Some of the areas that might be difficulty for them are talking over differences without getting angry, persistence when facing frustration, taking turns while talking, understanding social rules, demanding immediate attention, and waiting when necessary.However, finding resources, knowing what to expect, and planning for the future can help. No two children with spina bifida are exactly alike. Children’s health issues will be different for each child. Some will have issues that are more severe than other children. With the right care, children born with spina bifida will grow up to reach their full potential. NEWBORNS AND INFANTS In many cases, infants and children with spina bifida require early and frequent hospitalization. This can interrupt normal social development.The challenge is to balance medical needs with the need to let a child develop into a confident, self-sufficient and independent adult. Regular and physical activity is important for all babies, especially for those with conditions that affect movement. There are numerous ways for babies with spina bifida to be active. Ne wborns and infants can be active by: * playing with toys, such as activity mats; * enjoy parks and recreation areas; * participating in community programs, such as the Early Intervention Program for Infants and Toddlers with Disabilities, which is a free program n many communities; and * do exercise with physical therapist. TODDLERS AND PRESCHOOLERS Life with a toddler or preschooler is both fun and challenging. These young children experience huge mental, social, and emotional changes. They have a lot of energy and enthusiasm for exploring and learning about their world and becoming independent. Since developing independence can be particularly trying for children with spina bifida, parents should begin helping their child develop independence early in childhood.The achievements can be measured one by one; building blocks are an effective way to think of them. In the early years, moving about and exploring things with the eyes, mouth and hands are the elements of independence for t he toddler. Parents and other caregivers can help them become more active and independent by: * educating the child about his or her body and about spina bifida; * encouraging the child to make choices, for example, have them choose between two items of clothing; * asking the child to assist with daily tasks, such as putting away toys.Children with spina bifida might require extra help at times. It is very critical that children be given the opportunity to fulfill a task before help is given. It is also important that parents give only the help that is needed rather than helping with the entire task. Parents must become skilled at learning the difficult balance between giving the right amount of help to increase their child’s independence and confidence, while simultaneously not giving the child tasks that cannot reasonably be completed? which might decrease their child’s confidence. School agedSchool connects children regularly with the larger world. Friendships becom e important and physical, social, and mental skills develop quickly during this time. Children who feel good about themselves are more able to resist negative peer pressure and make better choices. Many children with spina bifida do well in school but some can experience difficulties at school. There are children with learning disabilities (water on the brain), struggle with paying attention, work slowly, be restless, or lose things. They also might have difficulty making decisions. There are activities that children an do both at home and at school to help with these problems. These children might struggle with activities which lacks opportunity to socialize with peers. Children with spina bifida have fewer friends and spend less time with peers than typical developing children. Many social difficulties tend to be stable into adulthood. Fortunately, with the proper medical care, children with spina bifida can lead active and productive lives. Many children with spina bifida are suc cessful in school and many are actively involved in modified sports activities despite their physical challenges.With recent progress in care for these children, their outlook continues to improve. This is a significant time for children to become more responsible and independent. This is also a good time to start exploring potential lifetime interests such as hobbies, music, or sports. Acquiring independence can be challenging for people affected by spina bifida. It is important to begin working on this process early in childhood. Physical activity again is important for children of all ages, but especially for those with conditions that affect movement.For example, they can: * engage in active play with friends; * roll or walk in the neighborhood; * enjoy parks and recreation areas with playgrounds that are accessible for those with disabilities; * attend summer camps and recreational facilities that are accessible for those with disabilities; and * participate in sports activitie s and teams for people with or those without disabilities. Children with spina bifida often cannot control when they go to the bathroom (incontinence).They also can develop urinary tract infections. It is important to develop a plan for going to the bathroom that works and is as simple as possible. This can lead to increased health, participation, and independence at school and in the home, and avoid embarrassment for children with spina bifida. ADOLESCENTS AND TEENS Many physical, mental, emotional, and social changes are associated with the adolescent and teen years. Teens and adolescents develop their own personalities and interests and want to become more independent.It is important for the parents and caregivers of adolescents and teens with spina bifida to take effective steps toward making them independent starting in childhood, so that by the time they are older they can develop the necessary skills to help them reach their full potential. Physical activity is important for all teens and adolescents. There are several ways for teens and adolescents with spina bifida to be active. For example, they can: * engage in physical activities with friends; * roll or walk in the neighborhood; * lift weights; participate in sports activities and on teams for people with and those without disabilities; and * attend summer camps and recreational facilities that are accessible for those with disabilities. YOUNG ADULT The transition from adolescence to adulthood can be a time of progression and success, as well as difficulty. For people with spina bifida, it is specifically vital to begin planning for transitions in childhood so they are able to lead independent lives as adults. Young adults affected by spina bifida can face challenges, such as: * learning to take care of their own health needs; working or continuing their education; * volunteering; * finding and using transportation; * living outside their parents’ home; and * obtaining healthy relationships. Young adults can provide or manage much of their own care. Some instances include: * finding new doctors that care for adults affected by spina bifida; * obtaining medical insurance if they are no longer covered under their parents’ health plan; * talking to health care professionals about their condition; * making doctor appointments; * ordering or reordering medications and supplies; * seeking immediate medical help when needed; and managing their own bathroom plan. There are many ways for people with spina bifida to be active. Such as: * roll or walk in the neighborhood; * lift weights; and * participate in sports activities and teams for people with or those without disabilities. Transportation is important, young adults need to be able to find and use transportation safely. Many adults with spina bifida have problems that can affect safe driving. They may need a driver rehabilitation evaluation specialist in order to identify if special changes are needed to a car to ma ke it accessible for driving by someone with spina bifida.Adults also can learn to find and use other transportation safely, such as buses and cabs. Being safely mobile in their homes and communities will help adults become more independent. As adults plan for employment, college, or vocational training, they need to find and use transportation safely. Many young adults are still getting used to their new independence. They may have started working, volunteering, going to college or other training, or living on their own. Nonetheless, continuing to plan for the future is very important.This involves setting goals and how to achieve them. At times, unexpected problems can make life difficult. It is important for them not give up and to keep moving towards their goals, even if their goals sometimes need to be modified, or take longer than planned. Planning now will help adults continue to grow and succeed as they get older. In summary, people with spina bifida will face lifelong medic al challenges associated with this disorder, and the emotional and financial effects that the family will endure are overwhelming.In the United States, children born with spina bifida often live long and productive lives, even though they face many challenges. Though individuals reported having a high quality of life, they also described facing challenges and barriers that affect their ability to fully engage in life experiences. Individuals of all ages from birth through young adulthood reported experiencing common physical challenges such as pain, skin break-down, pressure sores, mobility limitations, latex allergy, and difficulties with endurance and balance.Some individuals between the ages of 6 and 18 years reported having scoliosis and breathing difficulties, during a time of rapid growth. As youth reach the teen years through young adulthood, many also reported difficulties with weight gain and concern about sexuality. Although individuals with spina bifida may experience sec ondary conditions, the role of support has shown to be a large factor that minimizes these challenges. Family support has been reported as a critical component as well as support given to families from outside sources such as friends, relatives, churches and other community groups.These supports have shown to help reduce secondary complications for individuals with spina bifida as well as ensure that they can participate fully in life activities and experiences. While individuals with spina bifida face many challenges growing up -whether they are social, physical, or academic -remember that the person with spina bifida is first and foremost a person with similar desires, likes, talents, frustrations, and concerns as all people. They will experience the same developmental milestones as all individuals -from saying â€Å"NO! in the toddler years, to becoming more independent and social in the teen years, to thinking about relationships and employment in the adult years. We are privil eged to live in a time of positive change and opportunities for people with disabilities. Expectations are changing for the positive to include individuals with disabilities in all facets of community living. Regrettably, change is usually a slow process and many of the physical and attitudinal barriers of society have not kept speed with the new positive expectations.

Ayala Museum

Little did we know, when we were sent on a field trip to the Loyal Museum, what we would see there. All that we were told was that It was an â€Å"educational field trip† and something to do with Flanagan. Net's advocacy of anything and everything Filipino. So, we were really in for a treat when we set foot on the fourth floor of the museum and a short film started to play the moment we stepped inside the sliding doors. â€Å"Gold of Ancestors: Crossroads of Civilization†, it began, and went on to show some gold artifacts that had been found on archaeological digs all over the country.We were mesmerism's from the very first one. Then, Just beyond the small chamber where we were viewing the film, we caught sight of the display cases containing the very artifacts that were now flashing on the screen. After that, we could hardly Walt to go and see them up close We saw golden bangles, rings, and necklaces, earrings, tiaras and studs, belts, bowls, cups and hilts of weapons. I was fascinated when I saw the burial masks, with stylized features engraved In the gold. I thought: forget ancient Egypt, It turns out the Philippines has its own!Aside from the burial masks, there were also â€Å"orifice coverings†, shaped like the eyes, the nose and the mouth. I guess If the dead couldn't afford a whole mask, they could just go for the important parts! Whew! Move over, King -rut! Aside from the burial masks, I was also fascinated with the Kina, a small vessel shaped like a mythical woman-bird, who appeared to be holding some kind of Jug. Her eyes looked serenely out at the people who had come to see her. There was also the bluntly, an anthropomorphic plaque depleting the head of a lady with what seemed like an elaborate hairdo or headdress.I also drooled over a cuff or wrist ornament, as wide as a sleeve and intricately worked, so that the gold mesh was like lace. The information on it said it weighed 204 grams. Heavy! There were also earrings so big and so heavy that we all wondered how the owner could possibly have worn It without getting his or her ears torn. My personal favorite, however, was a beautiful belt (l know someone's snickering while reading TLS! ). Catalog No. 81. 5175, weighing 575. 1 g, measuring 68. Xx CM. Circa 10th 13th century.It was made of fine mesh, with a zigzag design running along its length, and two golden plaques ornamented with granules of gold painstakingly arranged into stylized designs. Oh, I could have stood there and stared at it forever! Then, there was the piece De resistance: the UAPITA or Sacred Thread, weighing almost 4 kilos (yeah- peeve! ), strikingly similar to one depicted In the 16th century Boxer Codex, said to be the earliest description of the people of the Philippines In a Western language. Copy of which can be found in the exhibit. The UAPITA was supposed to be draped around the neck then attached to the wrist. Wow, the person who wore that must've been pretty strong! What was strik ing about these artifacts was that they seemed so Pinto to me. There were at least two necklaces or bracelets that were woven banging- Tyler: take four flat strips of gold and weave a fifth one back and forth across it, the reminded me of the legs of a modern armchair made of into because it had the same basket-weave technique.Some of the other items were decorated simply by poking holes in the gold to create a lacy pattern. The tiaras were created by cutting a sort of fringe in a strip of gold, then bending them back and forth to make a crown-like design. Seeing the exhibit made all of us walk a little taller and prouder. We had always read about the treasures of other lands, like Egypt and Troy; now we know that we have our own! Mayhap nag Philippians!